Crossing the Unknown Threshold: The Role of Psychedelic Type, Setting, and Psychological Mechanisms in Outcomes of Intense Challenging Experiences.
Abstract
Psychedelics refer to a heterogenous group of psychoactive compounds that alter perception, cognition, and emotion. In 1956 British Psychiatrist Humphry Osmond wrote, “To fathom Hell or go angelic, just take a pinch of psychedelic”, capturing their paradoxical capacity of the ‘trip’ to be both terrifying and profoundly transcendent (Bisbee et al., 2018; p. 379). Although research has emphasised mystical-type states (intense ineffable experiences that transcend time and space) occasioned by psychedelic use, challenging experiences (acute distressing experiences commonly termed ‘bad trips’) have received less attention (Yaden et al., 2022). Yet, growing evidence suggests that these distressing states may catalyse psychological growth, a process only understood retrospectively (Paul, 2014). Still, the factors that shape challenging experiences and their effects are less understood. Because challenging experiences can result in lasting distress, clarifying the factors that optimise outcomes is essential to support psychedelic users and inform harm reduction strategies across clinical and real-world contexts. Drawing on data from the 2023 Global Psychedelic Survey (GPS), this research examines the unique influence of psychedelic type, setting factors, and experiential factors on outcomes of an individual’s most intense challenging psychedelic experience (worst ‘bad trip’); and which psychological mechanisms of change are linked to persisting well-being effects when the experience was retrospectively endorsed as mostly ‘good’.
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