Psychedelic therapy is getting some serious attention from the media, the public, academic institutions, investors, and the psychedelic community at large —and for good reason! Many studies being released, and that already exist, continue to point towards the power and potential of these experiences to facilitate important healing experiences for clients.

There are a few specific conditions, such as treatment-resistant depression (TRD), anxiety, and PTSD, that psychedelic therapy is currently an FDA-approved treatment for. However, these are not the only conditions that psychedelic therapy may be able to provide help with, these are just the only conditions that are currently FDA-approved for treatment using psychedelics.

What other conditions can psychedelic therapy help to address? There are many, and this article will explore some potential future treatments that psychedelic therapy may have a part to play in.

Current Conditions Treated by Psychedelic Therapy

Let’s start at the beginning —what conditions is psychedelic therapy already approved for and already treating people for?

To clarify, this is for treatments that are available to the public in the United States, or to specifically designated groups of individuals (such as army veterans or cancer patients). There are many more treatments for specific conditions being studied and that have great promise, but have not yet been approved by regulators and health authorities.

Depression

Ketamine treatment can currently be prescribed to individuals off-label to help address depressive disorders like major depression disorder (MDD) and bipolar depression and depression’s associated symptoms.

An individual can now ask for a recommendation to a ketamine clinic from their healthcare practitioner, or reach out directly to a clinic or ketamine provider to check their eligibility for treatment and begin the program.

Anxiety

Similarly, ketamine treatment is available for off-label use in individuals with anxiety disorders or acute anxiety and its symptoms. You can begin a conversation with your care team, or reach out directly to a clinician or clinic to begin the process of enrolling in a ketamine treatment program.

Treatment-Resistant Depression

This is listed separately from depression as it’s a notable case in and of itself. We’ve written about psychedelic therapy’s potential to help with treatment-resistant depression before.

What’s notable here is that by definition, treatment-resistant means that other therapeutic interventions haven’t been successful. Psychedelic therapy presents an option to those who currently do not have any, and this is worth recognizing.

Currently, there is an FDA-approved medication for TRD, Spravato, which is an esketamine intranasal spray, and is the ONLY FDA approved psychedelic therapy for mental health at this time. Additionally it is approved for major depressive disorder (MDD) WITH suicidal ideation.

PTSD

There are currently significant studies underway for MDMA therapy to treat PTSD and complex-PTSD sponsored by MAPS (Multidisciplinary Association for Psychedelic Studies).

The results have been promising, and it has received Breakthrough Therapy designation from the FDA. While this treatment isn’t available to military veterans through the U.S. Department of Veterans Affairs (VA), some MAPS studies are focusing on veterans specifically.

Currently moving through Stage 3 trials, as long as outcomes data and safety profile remain consistent, it is likely that MDMA-assisted therapy will become an approved treatment in the next few years.

At the time of this writing, ketamine for major depression, treatment-resistant depression, and anxiety are the only available treatments for the public given a clinical intake process, diagnosis, and approval.

However, there are a number of additional studies and reviews, at various stages of the approval process, currently underway, with promising results. With continued study and investment in the regulatory process, far more psychedelic therapy treatments may be available in the coming years.

Actively Studied Conditions for Potentially Psychedelic Therapy Treatment

There are 3 major FDA-approval phases, appropriately titled Phase 1, Phase 2, and Phase 3, that a new treatment and compound must move through before being approved and scheduled as an available medical treatment.

There are a number of conditions and use-cases that psychedelic medicine and psychedelic therapy protocols are currently being studied for. Some have a history of scientific research done dating back several decades, while others are emerging or are demonstrating potential as a treatment option.

Suicidal Ideation

The psychedelic experience often brings an individual to confront topics such as meaning, engagement in life, purpose, and passion. These explorations, paired with neurobiological effects that assist with treating and managing depression, making psychedelic therapy a promising candidate for addressing suicidality and suicidal ideation.

Although active suicidal ideation or a history of attempts is a contraindication for many studies or existing psychedelic therapy programs, with refined protocols, appropriate dosing, and ongoing support, psychedelic therapy may prove to be an asset in helping individuals to deal with suicidal ideation.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is another field that psychedelic therapy is currently being studied. OCD patterns are often driven by rigid behavioral patterns and high levels of control, something psychedelic therapy helps individuals to confront directly.

There have been some studies in this area, and it is a field that certainly warrants future study and research within. OCD can be quite challenging or debilitating for individuals, and treating OCD and its symptoms through traditional psychotherapeutic or pharmacological methods can be hit or miss. Psychedelic therapy may present a new option for the treatment of OCD.

End-of-Life Anxiety / Depression

End-of-life anxiety or depression in terminally ill patients has been one of the longest studied potential use-cases for psychedelic therapy, particularly with psilocybin as the active compound used.

There are many studies with promising results available to support this thesis. However, this is not yet a fully approved management treatment option for these individuals in the United States. However, Canada is making strides in studies and treatment using this modality, approving psilocybin use for four end-of-life patients in 2020.

Given the results of previous trials, and the great service that this experience can serve for these individuals, moving psychedelic therapy for end-of-life anxiety along the approval and regulatory process seems like a wise decision.

Smoking Cessation

There are fewer studies around the role of psychedelic therapy in smoking cessation, however the initial results have been extremely promising.

Given that the best currently available solution has a success rate of around 17%, and the early trials with psychedelic therapy provided nearly 80% success, the initial results are significant enough to warrant much further study and research. The results will need to be replicated and tested further, but psychedelic therapy may prove to be a powerful asset for those trying to quit smoking or nicotine addictions.

Alcohol/Substance Dependence

Building on the above, psychedelic therapy seems to be uniquely suited to assist with addictive patterns and substance dependence overall.

Initial studies and results seem to show great potential for helping individuals manage addictive patterns of behavior, navigate or mitigate the tapering or withdrawal period, and stay abstinent afterwards. Substance and alcohol addiction affects many members of society quite drastically, and psychedelic therapy is uniquely suited to help manage this.

All of these potential treatment areas have had at least some research and study put into them, but have not completed the approval and regulatory process required to make them fully available treatments to the public.

Given the initial promise of these early studies, and the benefit and healing they could bring to the affected populations of individuals, it seems like further study is warranted and it would be powerful to start moving these treatments through the regulatory process.

Potential/Speculative Conditions for Psychedelic Therapy Treatment

In previous resources, we have covered the neurobiological and phenomenological benefits and effects of psychedelic therapy treatments. Given their ability to act on the physical, mental, emotional, and at times spiritual levels, psychedelic therapy and psychedelic medicines hold an immense potential to bring healing and wholeness to modern culture.

There are a number of fields where these effects and experiences may be extremely beneficial, in many kinds of individuals. Early study and research into these areas must be done to confirm these hypotheses, but there are several areas where it seems that safe and effective psychedelic therapy programs would be highly effective and greatly healing.

Trauma Healing

Nearly everyone has experienced trauma in their lifetime, and each person responds to these traumas differently.

Psychedelic therapy presents a powerful option to assist in the psychotherapeutic healing of trauma. It helps to reconcile the past, help you manage and understand your emotions, and help create a bold vision of a positive future for yourself.

The field of psychedelic-assisted psychotherapy, where traditional therapeutic techniques are used in conjunction with psychedelic medicines, has great potential to create a whole and healed society. Exploring the use of medicines like ketamine, MDMA, psilocybin, and perhaps other compounds may bring great benefits to future generations.

Personality & Mood Disorders

Personality or mood disorders, such as bipolar disorder, dissociative identity disorder (multiple personality disorder), borderline personality disorder, and others are often a contraindication for many existing programs.

However, it is possible that a psychedelic therapy protocol can be developed that would be uniquely suited to assist this population. With the right Set and Setting, preparation and integration, ongoing support, and effective medicine and dosing protocols, psychedelic medicines may be helpful in the treatment and management of personality disorders.

Personal Growth

One of the most exciting potential areas of future application for psychedelic medicines isn’t in the healing space, but in the personal growth and development field.

Most traditional medicines move through this availability arc:

  1. Available to highly specific populations and situations via controlled clinical trials
  2. As a publicly available, FDA-approved medicine with a specific application
  3. General medical availability (like off-label prescription)

Psychedelic therapy has immense potential for healing, but also for personal growth. It can help individuals become more themselves, helps them love more, clears up challenging experiences and emotions, and helps them rise to new levels of satisfaction and engagement with their lives.

This may be down the line, but the study of psychedelic therapy in the “neurotypical” population may hold great promise.

Couples Therapy

Psychedelic therapy, particularly MDMA-assisted psychotherapy, also has immense potential in the field of couples therapy, family therapy, and relationship-specific counseling, and was actually used in couples therapy prior to the FDA making it a Schedule I substances.

Psychedelic medicines can radically increase empathy, sympathetic joy, open-mindedness, and assist in reconciling the past and previous emotions Because of this, there is immense potential for psychedelic therapy to assist in interpersonal relationships. It can bring families closer together, facilitate a deeper love with each other in couples, and create a more compassionate society, which can have major ripple effects for the quality of life of everyone in that culture. It warrants at least initial research and study, to kick things off.

There are many more areas that may hold great potential when combined with psychedelic therapy programs and protocols. While we are still at the stage of making these treatments available for those in need of deep healing, it is always beautiful to look towards what the future may hold as general awareness and medical acceptance of psychedelic therapy continues to grow.

Conclusion

Psychedelic therapy is still in its nascent stages, where the medical and clinical worlds are working to align themselves with the emerging scientific data around the safety and efficacy of these programs.

Across many areas, from end-of-life anxiety, to substance use disorders, to treatment-resistant depression, psychedelic medicines are demonstrating their power and potential as safe and effective treatments for a variety of mental health conditions.

Moving through the approval and regulatory process is an expensive and time-consuming process, but when the potential for healing and wholeness on the other side is this great, it’s worth the investment. It’s an investment in people’s lives, in their quality of life, and in the stewardship of a healthy society.

As more scientific data arises, as the awareness and acceptance continues to grow, it is likely we will see many more use-cases and treatment options available and approved. Then we can continue to look into the far future, at the role psychedelic therapy can play in moving everyone towards the healing and wholeness that is their human right.

You’ve made the decision to move forward with a ketamine therapy treatment. You may have explored the importance of set and setting, and have a sense that you’d like to have your experiences in an environment that is conducive and welcoming, with trained practitioners and clinicians present. The job now is to find a ketamine clinic that is safe, accessible, and can provide the style and quality of treatment that you want.

Where do you begin? How do you identify the clinics and the practitioners that are best suited to help you on your journey? It’s not always straightforward, and finding the solutions that fit best for you is an important part of this process.

This article will explore the process of vetting ketamine clinics and ketamine practitioners, to help ensure your personal safety, program efficacy, and strength of the experiences.

Deciding on IV/IM Clinic or At-Home Ketamine Treatment Methods

The first step is to ensure and confirm that you have selected the correct style of treatment for you. Sometimes decisions are made simply because you don’t know that other options are available. It’s important to have a complete sense of the landscape and all of the available options before choosing something to move forward with.

We have covered the types of ketamine treatments currently available in great detail, including IV (intravenous) infusions, IM (intramuscular) injections, tablets, and nasal sprays. We suggest reviewing that resource to ensure that you are selecting the option that best fits your lifestyle, available price range, and has the level of support, care, and integration guidance that you require or expect to have.

The next choice is whether you’d prefer to receive treatment in a clinic or in the comfort of your own home. Platforms like Mindbloom offer the ability to receive treatment anywhere virtually, provided you’re in a qualifying U.S. state. You can determine if you’re a Mindbloom candidate by taking our free assessment.

Regardless of your decision to receive treatment at home, or head into an in-person clinic, the next step in this process is identifying quality practitioners and quality clinics to provide this treatment.

Identifying Quality Ketamine Practitioners

Throughout your experience you will be working directly with a licensed, trained, and experienced practitioner/clinician. If you’re unsure of the qualifications of your care team, we recommend confirming this before taking any further treatment steps.

How do you understand these qualifications, areas of specialization, and the scope at which the care team is available for assistance before, during, and after your individual dosing sessions?

There are a few factors that go into determining the quality and appropriateness of the practitioner for you.

Education or training

First, you want to ensure that they have an adequate level of education and training in ketamine treatment or therapy to be helpful.

You will want to look at education and depth of study, such as with Psychiatric Nurse Practitioners (PNP’s) or Certified Physician Assistant (PA-C), that are currently licensed and able to provide therapeutic ketamine administration.

Experience with medicine

Second, you want to ensure that they have experience with ketamine treatment. They should have experience providing ketamine treatment for others in order to adequately hold space and provide support in times of need.

Given the nature of the ketamine experience, knowing that your provider has gone through this experience is essential to build trust and rapport in the client-clinician relationship.

Compatible frameworks

It’s highly beneficial that you both share compatible mental frameworks and understandings of how this treatment works, what is important about it, or how the healing process works.

It can be challenging and confronting and erode trust and safety if you find out that you differ greatly on ideology and principles half way through treatment. Asking to learn more about why they do this work and how they approach their work is not something to overlook in this exploratory research process.

Available support level

You must personally determine or decide on the level of available support that you would like from your clinician throughout the treatment process. Does the clinician work with a team that will help you integrate and process your experiences?

Do you expect the opportunity for integration conversations, ability to contact them after dosing sessions for conversation, or otherwise? While this type of support is available with Mindbloom, this is not a service that always comes included in ketamine treatment at in-person clinics. You should know what you expect/want from your clinician during your treatment program, and ensure that they have the capacity and willingness to be able to provide this for you.

The client-clinician relationship is the bedrock of ketamine treatment, and ensuring that you have found a clinician that you are happy with, have trust and rapport with, is an essential component of this process.

Identifying Quality Ketamine Clinics or Online Treatment Platforms

While at-home treatment options like Mindbloom give you control over your own mindset and physical setting (Set & Setting), if you’ve chosen to visit an in-person ketamine clinic, it’s helpful to investigate the clinic they work at and the space that you will be having your sessions in.

Different in-person clinics may have different standards. They may have different resources available to and for you, and so exploring this in further detail will help cement the trust you have going into this process. With Mindbloom, your Guide can help answer any questions about available resources or the process, and lend extra support if needed.

Some factors to look for in ketamine treatment via telemedicine or in-person ketamine clinics:

Following Regulations

First things first, always ensure that they follow regulations. This includes patient-doctor confidentiality agreements, payment protocols, or if you’re seeking in-person treatment, cleanliness and sanitation. These may seem minor, but friction or confusion or distrust leading up to your dosing sessions can have a significant impact on your experience and quality of care. Attention to detail matters.

Welcoming Space

If you’re considering an in-person ketamine clinic, is the space welcoming for you? Does it have the atmosphere and the resources that you would prefer? Knowing where you will have your sessions, what the space is like, and what is included are all important factors that go into establishing your Set & Setting for the dosing sessions.

If you’re choosing at-home treatment with Mindbloom, your Guide can make recommendations on how to make your space and ambiance as comfortable as possible.

Integration Areas

After your in-person treatment concludes, is there a space that you can stay within after your dosing sessions for rest and recovery? Being asked to leave quickly after the sessions while partially under the influence of the medicine can be disorienting, unappealing, and even dangerous. Ensure that there is space and breathing room for you after the dosing session to allow yourself to acclimatize to your environment.

Dosing Methodologies

What are the specific dosing methodologies that the telemedicine platform or clinic uses and follows? How do they determine your dose amounts? Do they refer to your previous historical treatment and medical data to determine this? Where do they receive their medicine from? These questions are part of good due diligence, helping you feel confident in your decision.

These two critical components — quality clinicians working within quality clinical settings — are absolutely fundamental to the safety, quality, and efficacy of the ketamine treatment you will receive. If you can be confident and feel secure with these decisions, you are in good hands for powerful healing experiences

What to Ask

If you’d like to go through this vetting process before starting your own ketamine treatment program or protocol, there are some questions that you can and should be asking before starting:

  • Where did you receive your training and education?
  • How many treatments have you administered and facilitated before?
  • How do you determine dosages?
  • What does the treatment protocol look like?
  • Is there preparation or integration support included with this?
  • Why do you do this work? How do you approach the healing process?
  • Can this treatment work with my existing medical insurance policy?
  • What are the costs associated with this treatment?
  • Do you personally have any concerns with my medical history or any aspect of working directly with me?
  • How could I best assist this process to ensure safe, effective, and powerful experiences?

These questions are good starting points to conversations that you will have with your telemedicine platforms or clinics, and their clinicians, while starting the client intake process. These should help you cover the significant bases covered in the earlier sections.

A reminder: If there is anything in particular that is confusing or concerning to you, raise this as soon as possible. The more information that all parties have, the better. This allows you and your care team to make the best possible decisions for your treatment plans and program protocols.

How to Get Started

Armed with this information and the appropriate questions, you can begin finding telemedicine solutions or ketamine clinics near you, or clinics/clinicians that you would like to work with.

There are several resources to find these options, and many of the questions above are usually addressed directly on the website or with an introductory phone call.

If you are looking for an at-home ketamine treatment solution or ketamine clinic near you, consider these steps:

  • Direct Referrals: A great place to start is a referral from somebody you know and trust who has gone through treatment at that location. This helps you ensure a level of care and quality directly, from a trusted source.
  • Local Online Searches: If you don’t choose an at-home ketamine treatment experience, searching for ‘ketamine clinics in X’ —where X is your particular region, will surface a list of nearby clinics. As always, just because a clinic is close does not guarantee that it will be the best fit for you. This is where your screening questions and due diligence steps will be important.
  • Online Directories: Ketamine treatment is an established practice, fortunately there are many available telemedicine options and clinics providing this treatment, and a number of online directories exist to help create single sources of trusted resources for you. Some of the directories include: Ketamine Clinics Directory, Ketamine Directory, ASKP, Ketamine Academy, and Ketamine Therapy USA.
  • Personal Clinicians: Another opportunity you have is to speak directly with your personal clinician. Let them know that ketamine treatment is something you are interested in pursuing, and ask them if they have any recommendations or resources they can share with you.

The challenge and opportunity of working with ketamine platforms or providers isn’t the lack of available options, it’s simply finding the one that will work best for you and your specific circumstances. Using the information and questions above, paired with the online directories or resources from trusted parties gives you both the resources and the skills needed to find and vet the best option for you.

Conclusion

The decision to move forward with ketamine treatment is a beautiful step and act of self-love. Because ketamine treatment can be so powerful, it deserves a level of respect and due diligence on the part of the client.

Doing your homework, determining your needs and wants, and working alongside the clinics and clinicians to arrange this will help ensure your personal safety, your program efficacy, and help to facilitate powerful healing experiences for you. Enjoy the process, and here’s to your healing.

Psychedelic therapy is an investment. It’s an investment of time, attention, energy, finances, resources, and more. Ultimately, It’s an investment in yourself. And as with any serious investment, you’d like to receive positive outcomes from the work that you’ve put in.

But in the context of psychedelic therapy, individual healing, and personal growth what is a “successful outcome?” How do you define them, how do you measure them, and most importantly, how do you know if you’re moving in the right direction?

Everyone’s experience is unique, and your personal experience throughout this healing journey will be no different. This makes it hard to make direct comparisons, and in fact directly comparing your experience to others can be counterproductive. The act of trying to fit your journey onto someone else’s path can lead to demotivation, distraction, and unnecessary suffering.

This piece will explore some helpful frameworks and metrics that you can use when defining what your own version of progress and success looks like in the context of your healing journey.

Defining Successful Outcomes

If you’ve found yourself moving through a psychedelic therapy program, there’s likely a level of personal healing or a sense of wholeness that you don’t currently feel. Something is missing. This is a helpful place to start when creating the “North Star,” your primary aim, for your healing journey.

As psychedelic therapy has become synonymous with treating mental health conditions such as anxiety or depression, your healing journey aim may be to alleviate or eliminate those symptoms. It may also be tied to your intentions around self-improvement, self-satisfaction, or a more growth-related aim.

If anything, your psychedelic therapy programs and protocols should help you become more of yourself, help you accept and embrace all of yourself, and move closer and closer towards a sense of wholeness and completeness within yourself.

Now the experiences, the specific healings, and the resolutions that are required to help you move in this direction will be unique to you — but if we are to define any level of successful outcome to aim at, an increasing level of health and wholeness within yourself is a good place to start.

Subjective/Objective Progress Markers

Immediately after aiming at this end goal of increased wholeness, you are tasked with determining how to measure this. How do you know that you’re making progress towards this aim?

Therapeutic experiences and psychedelic therapy in particular largely deal with your lived experience —the subjective experience of what it’s like to be you. Given the beauty and complexity of being human, this is inherently difficult to put into simple metrics or measurements. You can assist this process by looking through an objective measurement sense, and a subjective experiential sense.

Objective progress markers

When you begin working with a new therapist, psychologist, or with a psychedelic therapy clinician, you will often be asked to complete a series of mental health surveys or questionnaires. These surveys are scored on a point-based system, measuring the levels of anxiety, depression, PTSD, OCD, etc. that you experience on a daily basis.

This is one way to measure progress or outcomes along your journey. By actively reducing the overall scores for anxiety or depression through these programs, you can mark your own progress in healing from these conditions, moving closer and closer towards wholeness and deep acceptance of yourself and your unique life circumstances.

This is one of the ways that your care team will work alongside you to help measure your progress: through regular check-ins against these scorecards. If you want to help yourself and your care team in this process, it’s very important to complete these surveys as they arise throughout your psychedelic therapy programs.

There are also secondary (downstream) physiological markers that you can measure against.

These are not always directly related, but can help to ground your journey in some quantifiable metrics. Measurements such as resting heart rate or blood pressure can be useful in this process.

For example, many highly anxious people can have higher blood pressure or resting heart rates, and in resolving some of the latent anxiety, you can start to see lower HR/BP readings. Of course, this is a secondary marker, and you may see lowered readings without an associated reduction in anxiety symptoms. However, in attempting to translate the highly subjective in the objective, these physiological markers can be another tool you use alongside your care team to track progress.

Subjective progress markers

There are also a number of subjective progress markers or check-ins that you can use throughout your program to track and measure progress.

During your integration periods, you can help track this yourself by taking the time to reflect or journal on questions such as:

  • Am I as reactive as I used to be?
  • Am I more or less present in the moment?
  • Do I automatically assume the worst in new situations?
  • Am I still experiencing physical pain/discomfort like headaches, pain intensity, tension, or similar?
  • Do I feel as anxious/depressed as I normally do?
  • Is there more space between my thoughts and my actions?
  • Do I feel like I have more control over my emotional state?
  • What is my average mood now?

These guiding questions can help you check-in with yourself along the way, and highlight some areas that are going very well, and others that may need some additional time or attention to keep working on. This is also helpful because if you identify any areas that aren’t making much progress, these can become your intentions for the subsequent dosing sessions.

Overall, the best results will be when you combine the objective and subjective progress markers together. And remember, healing is not a linear path, there are some times where you may make exceptional progress very quickly, and other times when the process takes longer to complete and you may have periods where you feel stagnant or stuck. This is okay, use these as opportunities for care and compassion, and recommit to the process, setting up your space, setting your intentions clearly, using the resources and support you have available to you.

Outcomes vs. Intentions

The journey towards healing and wholeness is an ongoing, perpetual progress. Each time you heal and take more ownership of yourself and your experience, new depths are revealed which bring up new material for future sessions. As a result, it’s hard to draw a firm line in the sand somewhere that says, “Now I am healed!”

Indeed, one of the things that you may need to address on this journey is the very state of mind that seeks for such clear-cut simple answers to highly complex and evolving situations and scenarios.

Similarly, just because your mood has increased throughout treatment does not guarantee that it will stay there forever. This is where integration work and ongoing self-care practices become incredibly important. It’s important to stay with your practice and your intentions to maintain the benefits that you do realize throughout your healing journey.

This presents you with another way to view your healing journey: focused on your commitment to your intentions, rather than an ambiguous “final outcome” for your program. To demonstrate this point: if you are focused solely on the final outcome of your program, you may get to that point where you still feel like there is some work to be done, and immediately overlook the incredible progress that you did make throughout the program —still marking it as a failure.

Instead, it can be helpful to frame this as: “One of my intentions was to connect more deeply with my family, and I’ve noticed progress in this area and I’ve done the work to help that —this is a success.”

There may still be other things you wish to work on, and those will be addressed in time. But part of a successful outcome is recognizing the progress you have made, the commitment you have shown, and the desire you have to continue this process.

Refocusing on your intentions and choosing to put your attention on the progress you do make are powerful ways to build positive momentum throughout your therapeutic programs and protocols.

Engaging With the External World

If you want to see the changes unfolding within yourself, the greatest playground to do that is engaging with the external world. It’s difficult to see internal changes when you are only focused on the internal.

Put yourself into the world. Dive back into your work projects, deepen your relationships and have more conversations, push your growth edges and see what happens. Are you as reactive or scared as you were before? Do you have more confidence than before? Are you better able to handle difficult or challenging events now?

One of the easiest ways to measure and see your own progress is to find yourself in similar situations as before, and notice if you react or feel any different.

As always, it’s important to remember that although this is a journey you are taking for yourself, it is not one that must be taken alone. You have resources and support around you: your Guides, Clinicians, friends & family are all able to help you on this path.

It is hard to be objective about yourself and your growth. One of the greatest ways to view your progress and get feedback is to ask those around you!

Ask questions such as:

  • Have you noticed any changes in my mood or personality recently?
  • I’ve been doing this program, is there anything that you’ve seen come from this?
  • What do you think about my energy/mood/attention these days?

This feedback from others who care about you can be invaluable. They may highlight major progress that you have overlooked, present new information that you can work with, or highlight new ideas that you can use in your other dosing sessions to go even deeper into this healing process.

Moving On to More Sessions?

As mentioned at the beginning, everyone’s healing journey is unique. This includes the timing, the level of medicine work required, and the particular feelings or insights that arise throughout the process.

Some individuals may have highly intellectual experience, filled with insights about their past or present circumstances. Others may have highly embodied experiences of strong emotions or trauma release. All of this is okay, and whatever experience you have is also okay. This also means that some of the things you want to work on may simply take more time and energy to work through!

There is always the possibility of continuing your sessions —in coordination with your care team— to give yourself the time and space and experiences to help you work through whatever you need, and continue your journey towards healing and wholeness. If this is something that might feel like it is appropriate for you, you can surface this with your Guides and Clinicians and begin that conversation.

Conclusion

Healing is not a linear part, and it’s not always clear cut. It’s complex, evolving, and at times challenging, while at other times extremely beautiful.

It’s important to welcome all of yourself and this is how you can measure success in your outcomes and your experiences:

  1. Monitoring objective/subjective progress markers
  2. Attach success to your intentions, not final outcomes
  3. Engage with the world and notice any differences
  4. Work with care team to customize treatment plans

In doing these steps, you will begin to create the exact circumstances and experiences that are needed for your healing, and continue walking your path towards increasing health, wellness, and wholeness. And that is true success: showing up for yourself and the world, doing the beautiful challenge of healing, and enjoying the process along the way.

What comes after a powerful psychedelic therapy session? How do you begin to process the experiences, insights, and emotions that may have surfaced? And what does it look like to turn a powerful session into a long-lasting, positive personal transformation?

The answer to these questions is the domain of psychedelic integration, an important and essential component of the psychedelic therapy process. It is not commonly discussed as often as the psychedelic therapy sessions themselves, but it is just as important to help deliver lasting change and solidifying and validating the experiences. Rooting the lessons deep in normal life.

This piece will explore the definition, utility, history, future, scope, and specifics of psychedelic integration — and how you can use this in your own life to provide powerful experiences and make long-lasting personal change.

What is Psychedelic Integration?

The definition of integration is to bring disparate parts together to become a whole.

This is why integration is the term used when processing and working with the lessons and insights provided in a psychedelic therapy session. You are taking disparate insights —or parts of yourself that you may or may not have been aware of — and intentionally bringing them into yourself, into your way of Being, to become whole and facilitate personal healing.

The specifics of integration can take many shapes. Here are some examples:

  • Taking physical action on outstanding tasks
  • Healing, addressing, or letting go of past trauma or personal blocks
  • Cultivating new hobbies and making time for your relationships and playfulness
  • Taking better care of your health

The specifics of integration will depend on the experiences that you have in your sessions and throughout the course of the program overall.

As each person comes into psychedelic therapy with different intentions, life circumstances, and aims or aspirations,  it naturally follows that the integration process and the specific activities will look differently. As is a recurring theme with this work, the journey of healing towards wholeness is very personal and intimate, and will look different for each individual.

The Power of Psychedelic Integration

Psychedelic integration is a term still coming into its full fruition within the psychedelic therapy space. It’s solidifying its place as a central pillar in the full experiential arc of a psychedelic therapy program.

The driving force behind these developments is the deep and essential utility of psychedelic integration. It makes the experiences, and the subsequent change, real. It is the driving force that takes the intangible potential presented in the sessions and grounds them deeply in reality, into your day-to-day existence, and makes them a lasting and enduring part of your life.

Without integration, much of the psychedelic experience itself lives as potential. Part of the beauty and power of the psychedelic experience and psychedelic therapy are the experiences and insights that it provides.

Someone may have a visceral experience of an emotion that they had not felt in a long time —joy, peace, opportunity, excitement, for a few examples. Or perhaps it facilitates novel insights, such as how past traumatic experiences have influenced the way they perceive reality now, and that it needs to be addressed and healed. These experiences are absolutely essential, they are life-affirming and freeing. There is no doubt to this.

However, they demonstrate the potential life the individual can have. They shine a light on a destination or state of being that the person can inhabit in the future. It demonstrates potential. Emotions that can be experienced, the life that can be lived, the peak of the mountain waiting to be ascended.

But the crux of integration is action.

Integration is about taking the lessons, insights, feelings, experiences and translating them into actions, habits, behaviors, and beliefs that carry through the rest of your life. Without acting on these experiences, they remain as potential. Something possible, waiting for action, waiting for movement.

This action —the embodied example of the lessons that arise in session— is the domain of psychedelic integration.

Some integration actions can be small and quick, such as cleaning up your living space. Others take more dedicated time and energy, like making healthier diet choices, or preparing and making career transitions.

Others still don’t have a defined end date, and are an ongoing process throughout life. Examples like speaking the truth, practicing kindness and compassion to others. All of these ideas and experience can arise within the sessions, and thus are all the domain of integrative work.

If you make integration a habit, and see it as a vital and necessary part of psychedelic therapy and the psychedelic experience, a dramatic possibility opens up. By combining thorough and sincere integration work with clear intentions and the sessions involved in the particular protocol or program, individuals have the possibility of making rapid and long-lasting progress.

As new experiences arise, an integration plan for them is made and enacted, helping create new baselines, new normals for the individual’s experience. From this place, new intentions are set, new experiences are had, and the cycle begins again.

This upward spiral, or path of personal progress, can help tackle everything from major mental health concerns, to radical life changes, to deepening relationships, and everything in between.

Progress can take time, and sometimes integration work is challenging. For example, having tough conversations, or getting out of toxic patterns or living situations. These areas arise in awareness and the experiences for a reason: to help you move towards integrated health and wholeness.

History of Psychedelic Integration

The earliest known use of the psychedelic experience as a tool for insight and healing is based in shamanic and indigenous cultures, dating at least 1000 years back, but it’s entirely possible traditions have endured longer than this.

Psychedelics were used for general healing in the community, convening with spirits for guidance and assistance, and as coming-of-age tools in the community. Because the use and practice of these experiences was so fundamentally ingrained in, supported by, and accepted in the cultures that used them, there was not a great need for a formal integration process afterwards. Indeed, the concept of integrating psychedelic experiences did not exist in some psychedelic-medicinal cultures.

However, in today’s modern age, re-entry into society after a significant psychedelic experience or program is not always as smooth as it was for those in ancient cultures. The road back into life and society after these experiences can be challenging or turbulent. This “re-integration” birthed the need for effective and support-based psychedelic integration.

Through this need, modern psychedelic therapy integration techniques have emerged and continue to develop. Individuals undergoing psychedelic therapy programs may face difficulty when sharing these experiences with others, who may not understand or be as supportive. Individuals may also face internal friction when returning back to “normal” life, working to understand what the experiences meant or the potential they have for their future.

The integration world is still maturing, coming into full understanding of best practices, techniques, frameworks, and supportive ideas to assist individuals who have chosen to work with these healing experiences.

Across cognitive, physiological, emotional, and sometimes spiritual levels, the techniques and practitioners who utilize them are emerging, filling the present need for the support and guidance of communities and the wisdom they contain.

Psychedelic integration is also developing and emerging alongside the resurgence of research and study being done into the science and practice of psychedelic therapy. It’s constantly refining itself, orienting around how to best serve individuals, offer support, and help unearth gems of insight and experience that arise during the experiences. This helps them ground clients in everyday reality, action, and growth.

Planes of Integration (PEMS & ACE)

There are a number of ways to approach psychedelic integration, and a number of techniques, models, framings, and practices that you can use alongside your practitioner to deeply solidify and enact the lessons that arose during sessions. There will be links to additional resources/outlets at the end of this article.

There are two common approaches to breaking down the psychedelic therapy experience and understanding what it is asking of you: the ACE model and the PEMS Energy System.

The byproduct from some sessions can be intense. Perhaps it was a particularly emotional experience, or there was a lot of content that surfaced. Beginning to take the first steps of sizing it down and listing out integration activities can be difficult. It’s helpful to have frameworks that help you manage and compartmentalize these experiences.

PEMS ENERGY SYSTEM

The PEMS energy system stands for: Physical, Emotional, Mental, Spiritual.

This system is a way to bucket or segment the experience and its integration activities. Some experiences may have lessons or insights or experiences that fit into each category, while other experiences may be heavily focused on only one or two.

Breaking things down this way helps you notice themes, and more easily identify next steps for integration, getting specific about what activities/actions/habits will help you integrate the experience.

Physical

Physical energy has to do with your body, your health, your level of energy or physical stress, etc. You might have an experience that focuses most on returning to your body, on getting out in nature more often, in reducing stress levels.

This is predominantly physical — and integration activities surrounding this category may include making changes to your diet, dealing with your sleep hygiene, making more time for movement and exercise, and/or cleaning up your living space.

Emotional

Emotional integration is a process of ensuring that the emotions were fully expressed, had a chance to complete the release process, and adequate time has been spent with them.

The novel states of consciousness provide a safe space for deeply rooted or suppressed emotions to arise and express themselves for release. There may be cathartic moments of grieving, ecstatic moments of appreciation, or novel states and mystical experiences.

For example, if you had an experience of grieving a loved one, or a past relationship, integration can look like dedicating time to intentionally reflect on this. This includes journaling about how you feel, or making space to continue the emotional expression if it is required.

Another example of emotional integration may be expressing something that you have been holding in, whether that be frustration, appreciation, fear, love, or any other emotion. Make dedicated time to give your emotions their full expression and release.

Mental

Mental, or cognitive integration, involves making sense of the experience, or taking action on the more literal and physical aspects of your life.

Activities like journaling or talk therapy can help to make sense of ideas, emotions, and experiences that remain unclear. Cognitive integration can also involve taking action on still unresolved areas of your life, like sorting out personal finances, creating conducive environments at home, or seeking out additional support in life where required. Cognitive integration helps to fit the experience inside the narrative arc of your life, to more effectively see where insights lie, what next steps may look like, and how to orient yourself as you move into your future.

Spiritual

It would be disingenuous not to discuss the potentially spiritual or transcendent realms of the psychedelic experience that may arise through these therapeutic programs. Feelings of oneness, of connection with self, others, and world — can be a moving and profound experience for many. Sometimes after these experiences, individuals may be moved to integrate these lessons by starting, developing, or further exploring the spiritual avenues of their life. Perhaps reading scripture, further exploring their native religion or world religions, cultivating a personal practice to help embody these realizations, or investigating for perhaps the first time these transcendent areas of their lives.

ACE Integration Model

The ACE integration model is another useful framework. It’s a starting point to begin relating to a recent experience from your sessions, and seeing what is surfacing. This helps define the integration process, and any insights or emotions that arose during the session.

Accept

The first step in this approach is accepting the experience that you had as real and valid. Some of it may be useful and warrant further exploration. Some of the experience may be less useful. All the same, the experience happened. It was real for you, and it came up in the way it did for a reason.

Your psyche, in combination with your inner healing intelligence, was trying to convey something. Accepting your experiences as real and valid is an important first step, it is the first step of the integration process. Accepting that this experience happened, and beginning to further explore it.

Connect

The second step of the ACE model is to connect. Once you have accepted that the experience happened, was real, and is valid, the next step is to connect to it.

This helps to explore the experience further, inviting the lessons in so that you can see what the experience meant. You can begin to explore what it is asking of you to integrate, and the messages that were conveyed. It is only when we connect in good-faith to the experience, that you can begin to discern the meaning, wisdom, and next steps that are nested within it.

Embody

Through the connection with your experience, next steps and integration activities start to be gleaned. The next approach here is to embody them.

This is what is meant by being integrated: to bring the lessons fully into your being, embodying them so that they become a new normal for you. Embodiment can look like any of the systems from the PEMS approach, embodying new ways of being across the physical, emotional, mental, or spiritual domains of your life.

With continued investment in embodying these lessons and insights, you begin to integrate them fully into your life, the core process of creating long-lasting change through psychedelic therapy.

How Long Does Psychedelic Integration Take?

A common question that arises after psychedelic therapy sessions, once the discussion of integration begins, is “how long does integration take?” Or similarly, “how will I know once I’m done integrating?” Let’s address each of these separately.

As you should be familiar with by now, the immediate response here is that it’s entirely dependent on the individual. The psychedelic therapy process is unique, highly focused on the individual. It’s also highly dependent on their current context, and available time and energy.

This is the most dramatic factor that will influence the length of time that integration takes. There are some other factors, including: dedication, complexity of the activity, and time/resources available.

Dedication to the integration

As with any personal change, habit development, or transformational work, your level of dedication has a large influence on the amount of time it takes, and the depth that it settles in at.

Someone who shows up to work each day will likely make more progress than the individual who shows up once a week. This applies directly to psychedelic integration work: the more you commit to the process, the more you show up, and the more deep the transformation will be. Dedication will increase the speed at which you will begin to recognize the shifts that are taking place.

Complexity of the integration activities

Some integration activities are much more simple than others, and naturally will take less time and/or energy to complete. Cleaning your living space will normally take less time than executing a career change, or developing a new creative hobby.

All of these examples can easily arise in the experience and be on the list for integration. Naturally, the more complex an activity, the larger it is in overall scope. It will take longer to integrate fully and become a part of your life.

Available Resources

The amount of time, energy, and resources you have available to you will also influence the time it takes to fully integrate some lessons.

If you would like to make a career change, but it requires taking an online course, someone who has all day to dedicate to the course can likely take action and integrate this fully faster than someone who can only dedicate 2 hours every Sunday morning due to other commitments.

Time —and your dedication levels mentioned above— is a big factor. Also, aspects like financial resources are involved if you are planning to move to a new home, or live alone. Having the resources available can simplify or accelerate the integration process — though given enough time, it is possible to integrate nearly any experience or insight that arises for you.

Integration Action Timelines

As for timelines in particular, it’s most useful to break this down by immediate, short-term, and long-term/ongoing actions.

Some integration activities are short with defined timelines, others are much larger undertakings requiring many months or years, and others simply do not have ending dates as they are part of an ongoing process or pursuit. Let’s look at each of these a bit closer.

Immediate Integration Actions

Immediate integration actions are quick, well-defined actions that could be completed in a shorter manner of time, from a few minutes to an hour or so.

This could include activities or actions like: cleaning up your space, signing up for that new hobby, calling a friend or family member, or having the discussion you’ve been putting off. These are easily defined, and often don’t take too long.

This is not to say that the tasks are easy. Though having an important conversation doesn’t take a long time, it’s easy to put this off to avoid conflict or expressing your truth. Never underestimate the power of these small, immediate activities.

Sometimes the first domino is all that needs to fall, setting off a chain reaction of positive developments and momentum that can carry you far on your journey towards healing and wholeness. If after your experience(s) you find yourself with a good deal of energy and motivation, these activities are often the easiest place to start. Integration and growth is a long game, and building momentum at the beginning is extremely helpful.

Short-Term Integration Actions

Short-term integration actions are undertakings that cannot be done in a day. They may take a few days, a few weeks, or a few months to fully settle in and reach a stage of completion that you’re happy with.

Forming new habits, extended practice of new hobbies, or moving locations are all examples of integration activities that may fall into the short-term category. Solidifying new habits often takes a few weeks to a month for the habit to become fully ingrained, a part of your new way of being, to integrate fully into your life.

These activities are often the cornerstones of integration work — as many of the insights or experiences in sessions often find their roots in these short-term, but long-lasting developments. A new habit of yoga is something that can be with you for decades to come. A new living situation can bring with it a whole host of new opportunities and experiences.

You’ll also begin to notice an overlapping set of interrelations between these timelines, as these short-term tasks (developing a yoga practice) often can be broken down into the immediate activities mentioned above (do 30 mins of yoga each day). In this way, you begin to develop a holistic orientation towards your integration work — holding long-term visions and plans, while having a set of immediate, well-defined activities, steps along the path, that will move you in that direction.

Long-Term / Ongoing Actions

The final integration timeline is long-term, or ongoing — having no defined end date. These are much larger, more conceptual aims and visions that may arise for you during your sessions.

Long-term activities can include: making a change of careers, building a business or a family, or cultivating deeper relationships. These activities can take months or years to fully develop, bear fruit, and become a new natural way of being for you.

As a specific example, making the move from your current job to a new domain may take some time to train the new skills, build a network of connections in the space, and finally land a new position (or make one yourself!).

These long-term activities will also have accompanying short-term and immediate integration activities as a part of them. When making a career change (long-term), you may need to develop a new skill (short-term), and sign up for the programs/classes that will teach them (immediate). The beauty of these overlaps is that it helps clarify the path forward, as you then have a list of activities that you can do each day, making you more confident that you’re moving in the direction that you want to go.

The final, and most amorphous integration timeline is the “ongoing” category. Think of this as things that don’t have an ending date. They are just new ways of being in the world, that will always be a part of your day to day existence.

Some of the lessons or experiences that you may have in psychedelic therapy can surface themes such as: expressing love more often, speaking your truth, being a supportive partner, or being of service to the world. These are high-level visions that don’t have an end date — you can be integrating and enacting this in your 20’s, all the way through to your final years of life.

These are the north stars, the guiding principles of life, and integrating them isn’t so much about completing the tasks, as it is continually renewing your commitment to uphold and enact these values.

A Note on Integration

An important note on psychedelic integration — it doesn’t have to be a chore, nor should it be perceived this way. These activities need not live as an endless series of overbearing or overwhelming tasks on your to-do list.

Integration is an opportunity.

It’s an opportunity to realize and actualize the profound potential inside of you, which psychedelic therapy is uniquely adept at revealing to you. It’s an opportunity to become the person you want, to have the life you envision for yourself. It is a labor of self-love, of self-compassion, and of showing up with your full being to the spectacle of life.

“After ecstasy, the laundry.” — Jack Kornfield

This quote, from renowned American Buddhist meditation teacher Jack Kornfield is particularly apt when discussing psychedelic integration, or when integrating any form of highly transformative experience.

Psychedelic therapy and the psychedelic experience can launch you into beautiful realms of possibility. They can connect you deeply to your heart, your worth, your compassion, and your potential. Returning to the “normal” world after such experiences can be challenging or disorienting. It can be difficult to see how to make sense of the messages that surfaced in the sessions, or to have a sense of where to go next.

By slowly and diligently grounding the revelations and experiences that psychedelic therapy provides in earnest integration work, you rise up to meet those transcendent realms of possibility that live within the psychedelic experience.

Integration is a process. But it is a process of evolution, and of blooming into the fullness of your being. None of this means that the work is easy. The best rewards rarely have an easy path to receive them.

Integration is life-long, life-level work. Approach it with compassion, and expect that there will be setbacks, mistakes, and some backward progress at times. If you show up with renewed vigor, compassion for yourself, and gratitude for the sublime opportunity that you have to become what you have always wanted to be,  psychedelic integration will be a profound tool of self-actualization and personal development and healing.

The Future of Psychedelic Integration

Just as continued research in psychedelic science will continue to push forward the potential and best practices of psychedelic medicine and therapy, there is just as much potential for this work to impact, improve, and further the expertise and available opportunities in psychedelic integration.

Psychedelic integration is still an emerging field, both an art and a science, based in grounding the lessons of psychedelic therapy. There is certainly room for further development. This includes: establishment of qualifications, techniques, processes, and understanding around what works, what is most helpful, and how to best personalize the integration process for each individual and for each experience.

As with any emerging field, the future looks bright, but there is much work to be done. As with each initiative, with each client and practitioner, the body of knowledge continues to grow, expand, and refine itself.

In the future we would expect to see new and improved containers and support systems to help individuals process their experiences, define an integration plan, and offer continued guidance and resources throughout the individuals integration journey.

There will likely be the further proliferation and expansion of tools and techniques that are uniquely effective at integration. This would include supplementation routines, movement and embodiment exercises, and multimedia experiences to help return individuals to the expansive states of psychedelic therapy.

There is already an emerging market of trained therapists and practitioners who are uniquely skilled at helping make sense of the experiences and support the integration process. Establishment of unified qualifications, and improved awareness and access will also come with continued investment in this space.

The more integration is seen as a necessity to psychedelic therapy and healing, instead of an ancillary option or supplement, the faster the progress will be.

You can help this process, by encouraging responsible psychedelic experiences, and underscoring the importance of grounding the experiences back in the lived experiences.

Everyone who works in, or embarks on a journey of psychedelic therapy has a unique signal to contribute to psychedelic integration. The growth of good-faith conversations and sharing will only help the entire field mature and refine itself further, ultimately helping all who come to this work in the future.

Psychedelic Integration Resources

The list below can be considered a jumping-off point. These resources help if you are in need of additional support with your integration process, want to contribute to the growth of psychedelic integration as a field and practice, or if you would simply like to see what is currently available to the public and in what form.

As with anything in this line of work, this list is not exhaustive, as new initiatives are currently in development.

Psychedelic Integration Handbook – The Integration Handbook from Ryan Westrum is a comprehensive guidebook to embarking on and integrating a psychedelic experience or program. Combining both theory and practice, it is an asset to anyone wishing to explore the realm of psychedelic integration further.

Psychedelic.Support – Psychedelic.Support is a fantastic outlet to help individuals find a mind/body practitioner uniquely skilled and focused at helping individuals process their experiences and work through the things that come up throughout the integration process. Though integration is a personal journey, that does not mean it needs to be done alone.

MAPS Integration List – MAPS is a pioneering and influential organization in the psychedelic therapy space, they have put together their own resources list to help individuals find support and other practitioners to assist with the integration process.

Fireside Project – A 24/7 hotline that can help individuals in need during and just after an experience. Powerful psychedelic experiences can be intense, and having the support available on hand, or having someone with the knowledge to help point you in the direction of next steps can be an asset.

Hakomi Method – The Hakomi method is another technique and therapeutic approach that is useful to help unpack and understand experiences, feelings, or insights that arise throughout psychedelic therapy programs. They have a list of practitioners available that can be of service to anyone moving through the integration process.

Traditional Psychotherapy – Traditional therapeutic techniques and experiences are helpful when it is difficult to make sense of the experiences or insights that arise in psychedelic therapy, or throughout the integration process. It is not always immediately clear what the next step or best course of action is. Working with skilled therapists and clinicians help accentuate and accelerate this process, and unearth new insights and drive new connections that may not have arisen if it was done alone.

Somatic Bodywork – Making sense of the experiences in an embodied fashion, not merely on the cognitive level, can be just as important or useful along these journeys. Somatic experiencing and somatic bodywork is a useful outlet when navigating trauma healing or approaching integration work from a body-based perspective.

Mind/Body Practices – Ensuring that you are supporting yourself with a mix of mind/body practices on your own provides important scaffolding and support to continue diving deep into the integration process. Techniques like meditation, journaling, yoga/movement, or breathwork can all be helpful to make the re-entry and integration into life at home smoother.

Disclaimer: This article explores a highly sensitive topic involving the tapering off of or weaning down certain mental health medications with the assistance of ketamine treatment and psychedelic therapy. Never make decisions like this without first consulting your clinical team that manages your mental health medications like: a primary care provider, psychiatric clinician, and psychedelic/ketamine therapy care team.

At Mindbloom, there are many clients who throughout their healing process in ketamine therapy state that they are feeling very good —sometimes better than ever before— and are curious about the possibility of tapering down, or discontinuing, the existing prescribed psychiatric medications they’re actively taking alongside the treatment.

With increased and adequate support, through the responsible use of psychiatric best practices and supportive techniques, it is possible to taper off of medications. This can result in either lowered dosages of existing medications, or the complete cessation of certain prescriptions. Though this is in the realm of possibility, it is a highly individual process and may not be appropriate for everyone.

This resource explores when tapering or cessation may be appropriate, and what the specifics of this process may look like. As always, if this seems resonant with your own interests, the first step is always consulting your current care team and bringing this topic into your healing discussion.

Tapering vs. Discontinuing Medications

It is seldom appropriate to immediately stop using any or all of your existing psychiatric medications —known as going “cold turkey”, particularly if you are feeling calm, strong, and happy. If a change needs to be made, the process of slowly tapering down or off of existing medications, guided by your care team, is the more appropriate route.

The process of tapering down medications can be challenging. Anti-depression or anxiety medications like selective serotonin reuptake inhibitors (SSRI’s) have a significant impact on your neurochemistry. Altering the specific balance of these neurotransmitters can instigate or bring back many of the symptoms you’ve been working to address, such as depressive tendencies, feelings of anxiety, mental fog, and potentially more serious symptoms such as suicidal ideation.

That said, some medications can also bring along side-effects such as drowsiness, lethargy, mental fog, depression, lack of appetite, or other effects that are generally undesirable —yet tolerated— because the net benefit of taking the medications outweighs the accompanying side effects. However, if an individual experiences deep healing and is feeling significantly better, it is understandable that the desire to taper off of some medications and find relief from the side effects that may arise.

Due to the complex nature of tapering off of psychiatric medications, this is a long process, and it is not always linear in nature. There can be significant periods of time staying and adjusting to a lowered dose before then continuing to taper the dose down. This should be known and expected when entering into this process.

Fortunately, when working alongside a care team, if you do notice the resurgence of any adverse effects, you can also address this by slowly returning to a suitable dose that addresses these issues. There are steps you can take to reverse any effects, which can help build trust and confidence in the process, knowing that you can simply return to where you started if anything comes up.

Utility & Durability of Ketamine Experience While Evaluating Medications

There are many reasons why ketamine treatment in particular is useful in the process of tapering or discontinuing psychiatric medications. It has to do with the phenomenological and neurobiological effects of ketamine treatment and the durability of the experience even after the dosing session has passed.

Neurobiological effects

There are many resources that explore the beneficial neurobiological (physical) effects of ketamine in more detail, but the primary area of focus is that ketamine can have positive effects on the brain itself: increasing the overall health, growth, and resiliency of the brain.

Ketamine can facilitate this process through a few mechanisms:

  • Upregulating Neuronal Production: Ketamine increases the production of new neurons, supplying the brain with healthy and vital neurons, the basis for more effective and harmonious connections in the brain.
  • Upregulating Release of BDNF (brain-derived neurotrophic factor): BNDF, colloquially referred to as ‘fertilizer for the brain’ helps promote neuron growth, overall health, and ongoing maintenance. Providing both short and long-term benefits.
  • Stimulating mTOR: mTOR regulates many processes involved in cell growth and healing worn out synaptic connections, and also stimulates activity/growth in the prefrontal cortex and hippocampus, essential areas for emotional regulation.

This means that over time, ketamine can help increase the overall health and resiliency of the individual brain — helping an individual regulate their emotions, create new behavioral patterns, and maintain this new baseline health in the long-term.

Phenomenological effects

Alongside the neurobiological benefits, ketamine also presents immediate and long-term phenomenological effects, or mental / emotional effects.

Some of the phenomenological benefits include:

  • Novel Insights: With dissociation comes a sense of being separate from yourself. With this perspective individuals can spot certain behavioral patterns, environmental triggers, or see how they act in a new way. These insights can catalyze short-term respite or long-term positive behavior/mood change.
  • Embodied Feelings: The ketamine experience can induce a number of embodied emotions/feelings. For those with depression, having an embodied experience of calm, joy, contentment, or elation can be a powerful reminder or positive reinforcement that these states are possible for them. This can change long term outlooks and actions.
  • Cognitive Distancing: Both during and for a brief window after a ketamine session, it’s possible that individuals may notice more ‘space’ between an external stimulus and their internal reaction to it. This space can provide the room to change behavior, remove automatic self-sabotaging habits, all of which are valuable in managing depression.

This combination of neurobiological benefits and significant phenomenological experiences creates a favorable context for individuals to feel better and move closer towards healing and wholeness. This experience in clients often creates the circumstances that lead them to begin questioning whether or not its possible to taper off of or discontinue their psychiatric medications.

This is paired with what is called the “durability” of the ketamine experience, in which these benefits are not only experienced within the dosing session, but can last for upwards of 7-10 days after a single dosing session.

If a comprehensive tapering schedule is paired with a ketamine therapy protocol, the positive benefits of ketamine treatment can help equip an individual to better handle the direct and side effects of tapering off of psychiatric medications.

Building Self-Support Skills and Resiliency

One of the important points in this process is that all of this work must be paired with the intentional act of building the skills and personal resiliency that can carry on and support the individual beyond any use of medication.

One of the most important components to a successful tapering program will be in actively building the skills and resiliency to support individuals in times of challenge, unexpected events, or when setbacks occur.

Some of the skills that can be helpful to cultivate are:

  • Contemplative/reflective habits and rituals for continued growth and insight
  • Emotional regulation techniques
  • Somatic, body-based techniques for stress reduction
  • Cultivating deeper relationships and communities of support
  • Creating a welcoming and warm living environment
  • Working to overcome any addictions or self-sabotaging behavior
  • Asking for support when challenged
  • Understanding the integration process for psychedelic therapy
  • Moving towards meaningful work, authentic connection, and rediscovering joy and play in their day-to-day life

If the individual can build these skill sets, alongside the positive effects of ketamine treatment (like reduction in anxiety and depression symptoms), they are in good shape to begin the process of tapering. The ketamine treatment can give the support needed to help the process, while the increased confidence and skills ensure that the individual has what they need to better handle what life throws at them in the future.

This is where ketamine treatment and effective integration of the psychedelic experience from the dosing sessions become a very powerful asset for the individual. They are creating an adaptable, healthy brain, putting themselves in a neuroplastic state to adopt new patterns of behavior, and building skill sets for resiliency and growth for the long-term future.

Sensitivity & Working With Care Team

It is easy to read this and make the assumption that this is a straightforward and simple process. In some individuals that may be the case, but it’s not an assumption that can be granted as a natural part of the process. This is highly sensitive work, and must be done while working alongside a seasoned, well-trained, and compassionate care team.

Investigating resources for mood regulation, stress management, and psychedelic integration are assets to the process. Also, working with a licensed therapist to help process the experiences that are happening is also helpful for individuals making this change.

Despite the sensitive nature of this work, it feels important to say that although challenging, it is possible for some individuals to successfully taper down their psychiatric medications, or discontinue some of them entirely. It is always a unique process, and no result is guaranteed, but it is possible.

If individuals are prescribed psychiatric medications to help them cope with symptoms of anxiety or depression, and the individual is able to reduce these symptoms, and build the skill sets to help them manage their health moving forward, it stands to reason that they are then in a position where the psychiatric medications may no longer be necessary. They have served their purpose as a critical support in a sensitive and challenging time, and the individual can now embark on the process of slowly and intentionally weaning off of these medications.

Taking Control of Your Health

This work can also be an empowering step for many, as it is deeply rewarding to take full control and ownership of your mental health and your engagement with life.

This perception of renewed empowerment and possibility can also be a significant healing force for many individuals going through this process —reconnecting with their own innate power and possibilities in life.

And as responsible care providers, this is what should be desired for clients: making progress towards their own healing and return to wholeness. A return to their happiness, their power, their meaning, and their deep engagement with life.

If medications are required to assist that process, wonderful. It’s amazing that modern science has come to a point where that service can be provided. And if the next step on their journey towards wholeness is now an attempt to move away from the support that they once had, to stand once again on their own two feet, this decision requires and warrants serious care, consideration, and conversation. With the guidance, wisdom, and expertise available of course, but also honoring the individual’s request to take full control of their health once again.

Conclusion

As mentioned, this is highly sensitive work. Never make a decision on these topics without first consulting your medical care teams and practitioners so that you have the support and guidance necessary. It is a reality that this process may not be possible for everyone, and it may not be a positive move towards others.

This is why it must be done with attention, with full awareness of the positive and negative potentials, and with the support and care of experienced practitioners.

With this said, ketamine treatment can present an opportunity for some individuals to attempt to taper off of existing medications, and for many reasons creates a favorable environment to do this sensitive work within. Whatever you choose, may it be for your health, healing, and wholeness.

One can be forgiven for struggling to keep up with the legal status of different drugs and medicinal compounds in the United States. Knowing what drugs fall under what classification these days, depending where you are in the country can be tricky to navigate.

Cannabis, for example, has come a long way since it was subjected to the “Reefer Madness” treatment of the 1930s. Once a vilified and criminalized substance, marijuana is now legal, either medically or recreationally, in a majority of states in the U.S. That monumental shift is currently underway for certain psychedelic drugs, like psilocybin (mushrooms) and MDMA, which are proving to have promising results when treating the effects of certain mental health conditions, along with already legal ketamine.

Mark Haden is an adjunct professor at the University of British Columbia and Director of Clinical Health at Psydin, a psychedelics and clinical trials company. He spoke to Mindbloom about the differences between decriminalization, legalization and regulation when it comes to the statuses of psychedelic medicines across local, state, and federal jurisdictions in the U.S.

Decriminalization

When a substance is decriminalized, it means that the substance is not criminalized and there are no criminal penalties for drug law violations. But Haden explains that there’s degrees of decriminalization, which could apply to the amount of possession before the law kicks in, as well as severity of punishment.

“With decriminalization, there might not be a criminal penalty, but civic ones, like a fine, could still apply,” he says. “Decriminalization is a scale, really, of the amount of civil and legal sanctions that apply to possession or sale of a substance.”

In February, Oregon became the first U.S. state to decriminalize possession of small amounts of “hard” drugs, a decision that was made by ballot measure. That means anyone in the state caught with small amounts of psilocybin, LSD, MDMA, heroin, methamphetamine or other drugs can no longer be arrested by police. They can, however, still face a civil citation, the equivalent to a traffic ticket.

In 2019, Denver, Colorado, became the first city in the U.S. to decriminalize hallucinogenic mushrooms, in an effort to cut back on city spending. The purpose and intent of the Denver Psilocybin Mushroom Initiative was to deprioritize “spending resources on imposing criminal penalties” for the personal use and personal possession of psilocybin mushrooms.

Legalization

Legalization sits within the context of federal or state regulatory structure. In contrast, within the decriminalization structure, access to the substance is generally through illegal markets.

With legalization, the substance becomes a regulated legal product and access comes from legal markets. However, the way legalization works varies widely.

Oregon is the only state where psilocybin mushrooms are both decriminalized and legal, the latter of which is only designated for use in controlled therapeutic settings.

You won’t be able to buy them in a corner store or grow them at home, since it’s the legalization of a service, rather than the legalization of the product. The only legal means of accessing psilocybin mushrooms in the state of Oregon is through a licensed professional. It is currently in a two-year development plan to hammer out the rules and regulations for the first-ever psilocybin therapy program in the country.

And while the legalization and decriminalization of psilocybin is recognized in the state of Oregon, federally, the substance is still considered a Schedule I substance under the Controlled Substances Act.

“There’s a variety of legal portholes that are opened up through the process of legalization so it’s brought within the context of government in terms of how it’s accessed,” explains Haden. “Which government arm makes it available varies based on country and state.”

Regulation

When a drug is legalized, an important part of the process is determining how it will be regulated. Rules and directives are established largely by government agencies that outline how a substance will be legalized, distributed, and/or administered.

For example the U.S.’ Food and Drug Administration (FDA) determines which substances are available for on-label medicinal use — the use it’s specifically approved for. But Haden explains the word “regulation” is broader than that for institutions like Canada’s College of Physicians and Surgeons, and the professions that make it available, such as licensed clinicians.

“In the [Canadian] context of psychedelics, if there’s a regulated body, discipline, or profession that makes these things available, the profession that makes them available, like the psychedelic supervisors, the psychedelic guides, and the psychedelic therapists report to their College for oversight and training, and that’s also regulation,” he says.

Ketamine, for example, is a drug that is currently legal to be prescribed for multiple on and off-label uses. While its initial FDA-approved application being as an anesthetic, it’s also used off-label for pain management and mental health treatment.

Ketamine has been observed to be useful at a lower dosage for depression and other mental health conditions. Its use in those contexts, such as major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and suicidal ideation, has only gone through Phase 1 and 2 clinical trials in the FDA approval process to prove its effectiveness, so it’s currently used off-label.

Only esketamine, a low dose ketamine nasal spray that’s sold under the brand name Spravato, is available in the US as an on-label prescription specifically for treatment resistant depression, as it has passed Phase 3 clinical trials and FDA approval.

Eskatmine is the s-isomer of racemic ketamine. Racemic ketamine has both the r-isomer & s-isomer. Isomers mean they have the same chemical compound and makeup but are arranged differently. While ketamine’s use in all situations hasn’t been approved by the FDA, it’s still able to be used off-label given its legal status.

Another compound that’s currently in the midst of being regulated for legalization in the U.S. is MDMA —also known as “ecstacy” or “molly.” The drug has been found to have a positive effect for those with PTSD, when used along with talk therapy. Phase 3 clinical trials are complete, with recently published data set to be reviewed by the Federal Drug Administration. Its approval for therapeutic use could come as early as 2023.

Ketamine therapy is coming to the forefront of the psychedelic medicine conversation, over other classical psychedelics and compounds.

While it’s increasingly becoming recognized in the mainstream over other options, ketamine therapy has a number of factors that are putting it at center stage in the world of psychedelic medicine. Kristin Arden, psychiatric nurse practitioner and Lead Clinician at Mindbloom, helps explain some of the components that make this treatment option so promising.

It’s Already Being Used in Medical Practices

For decades, ketamine has been used in a clinical setting for anesthesia and to help treat pain. As a result, there’s plenty of science that validates the safety of its use in a medical context.

“In thinking about treating off-label, for things like depression and anxiety, we have a medication that’s scientifically validated as being safe,” Arden says. ”We have a large body of research that has validated its safety for treatment indications that often require higher doses than we typically use in a mental health setting.”

Medications face a lot of barriers before they can be accessed for general use. They go through an extensive review process by the FDA and are scheduled by the DEA. Ketamine is scheduled by the DEA as a Schedule III controlled substance, which is defined as “drugs with a moderate to low potential for physical and psychological dependence.” Some examples of Schedule III substances are anabolic steroids, supplemented testosterone, and pain-relief products containing less than 90mg of codeine.

At this time, other psychedelics such as psilocybin (mushrooms) and MDMA are classified by the DEA as Schedule I, which by definition means drugs with no currently accepted medical use and high potential for abuse. This is despite the fact that those compounds are currently in various phases of FDA trials for their medicinal applications.

“The regulatory barriers for utilizing ketamine in the treatment of mental illness aren’t there as they would be with other substances at this time,” Arden says.

The FDA already has indications for the use of ketamine for treatment of conditions like treatment-resistant depression and depression with suicidality.

Ketamine has a Relatively Short Half-Life, Which Means Quick Recovery

When you are treated with ketamine, the acute, disassociating effects wear off quickly, and the side effects dissipate rapidly as well. When comparing ketamine to other psychedelics available, the more acute phase of the ketamine treatment generally lasts about an hour. Generally, it takes about three hours after someone who has done the treatment to return to their baseline mental status and physical status.

This is significantly shorter compared to treatments with other psychedelic compounds, which can last anywhere from four to eight hours during the acute effects of the medicine, followed by a much longer recovery time.

“When we think of ongoing maintenance treatment, or a course of several treatments for conditions like depression and anxiety, ketamine is really on the up side of that, just based on sheer time commitment or time burden for the individual,” Arden says.

It also doesn’t have lingering effects, so you won’t need to take time off to recover from the treatment process.

It Doesn’t Interfere with Traditional Treatments for Depression / Anxiety

Another promising aspect of ketamine, especially those using it for depression and anxiety, is the way it works neurobiologically.

Unlike SSRIs and SSNIs, which are active in the serotonin pathways, ketamine works through different brain receptor pathways, known as the NMDA (N-Methyl-D-aspartic acid). Other substances like LSD, psilocybin, MDMA/ecstacy have a very high serotonin burden. This means there’s more potential for drug to drug interactions.

For example, if someone on Prozac wanted to try psilocybin to help treat their depression, they would have to taper off their antidepressant treatment, as there would be risk of serotonin syndrome. This is a life threatening condition that can lead to extreme nerve activity and dangerous symptoms like confusion, agitation, and heart arrhythmias. With ketamine, there isn’t that risk, since it works on a different neurotransmitter and pathway of the brain.

“For people who are on antidepressants, they may feel 50 percent better,” says Arden. “Ketamine works really great as an adjunct, to add on, to treat that other 50 percent.”

It has the Potential to be Affordable

While it’s not clear how accessible ketamine will be in the future from a regulatory standpoint, there’s a good chance that it will be a more affordable option than other psychedelic medications. Arden suspects that once synthetic versions of psilocybin hit the market, they will have the potential to be pricey.

However, while there is a relatively expensive ketamine product currently on the market —ketamine-derived nasal spray Spravato for treatment-resistant depression— generic ketamine is already being used in many practices, such as through Mindbloom.

“We have generic ketamine that we can use, and that significantly reduces the price point in that it’s already in that generic group of medications, as far as classifications go,” says Arden.

It has Fewer Barriers to Treatment

There’s a lot of steps to follow when prescribing a drug like Spravato. It’s logged into the drug safety program, Risk Evaluation and Mitigation Strategy (REMS), which the FDA requires for many medications with safety concerns. This is to help make sure the benefits outweigh the risks.

Once it’s prescribed, a doctor has to follow very specific steps to ensure the patient’s safety. With generic ketamine, there are less barriers to allow access.

“Ketamine is in a special place in that we’re using it off-label in its generic form, and it removes step-by-step legislations where you have to go through all these [measures] to prescribe it safely,” says Arden.

Currently, clinical studies involving psilocybin and MDMA have a very high clinical burden. Patients are monitored for eight hours and must have two clinicians with them, which adds up in terms of time and expenses.  With generic ketamine, there are less clinical burdens.

You’ve just come out of a significant experience in your psychedelic therapy program. It’s important to you and you don’t want to lose the effects, or skip over or miss out on some of the healing benefits. You want this to have long-lasting positive effects in your life.

We have spoken about the importance and significance of effective psychedelic integration work to compliment and solidify the lessons and insights you experience within sessions. With a foundational understanding of what psychedelic integration is, why it’s important, ways to frame and approach the integration process and period, it’s time to get down to the specifics.

The following techniques, tactics, tools, framings, and understandings will help you unlock the most from your experiences, and help these lessons settle deep down into new ways of being and relating in your day-to-day life.

This process is broken down into 2 steps: understanding the nature of your experience, and taking the appropriate actions based on that.

Understanding Your Experience to Help Integrate It

The first step is to understand the nature of your experience. Another way to say this is:

“What was the dominant theme or core message that the medicine was trying to tell you with this session?”

It may be related to the intention that you set, or it may be directly pointing to something outside of your intention.

You can draw 3 broad categories for the theme:

  • Self (Physical, Mental, Emotional)
  • Others (Relationships)
  • World (Meaning, Life)

You can, and often will, have experiences that blend across different categories. That is why the first step of your integration process is to continue reflecting on the nature of your experience and see if you can find the “center of gravity” that your experience had —whether it was rooted in yourself, in others, or in the world.

To be clear, no one type of experience is better than the other, these come up for us for a reason, at the right time. All you’re doing is assisting the process by helping identify the nature of your experience so you can take complimentary integration steps.

Self: The physical, mental, or emotional

There are a few signals you can use to determine if your experience was centered mostly in yourself. The Self typically surfaces through physical sensations, mental thoughts, or emotional experiences.

Some specific characteristics can manifest as:

  • Overall numbness
  • Crying or cathartic/emotional release
  • Increase in physical/mental energy
  • Insights into personality or life history
  • Connections with emotions or with Self
  • Revisiting childhood memories/stories
  • Visions of yourself, your future, etc.

If the main thread of your experience was relating to your sense of Self, your physical sensations, your emotions, or your thoughts/beliefs/ideas, it’s safe to say that the nature of this experience was Self-focused.

Other: Relationships and connection to humanity

Similarly, there are some classic signs that you can look for when reflecting on your experience to see if it was rooted in connection to others, to humanity, or to the relationships in your life.

Some signs that your session was largely focused on your relationships are:

  • Looking back on your own isolation or feelings of loneliness
  • Healing or addressing specific relationships in your life
  • Feeling deep connection to others, to humanity, to existence
  • Coming alive to being part of a collective/community

If it seems like your experience was focused outside of yourself, on how you fit into bigger networks of relationships —family, friends, colleagues, your community, country, or the entire web of humanity at large— it’s likely that the dominant nature of your experience was rooted in others/relationships.

World: Meaning, being, and transcendence

Finally, another major aspect of the experience can be focused and rooted within the world, or life itself. This goes beyond your individual Self or the relationships that you have within the world.

There are a number of hallmarks that can point in this direction:

  • Loss of meaning of life
  • Connection to greater source, to web of life
  • Having a highly spiritual or transcendent experience/feeling
  • Feelings of unity, of interconnectedness to all things
  • Loss/dissolution of Ego
  • Out of body experiences

Experiences that are focused on the level of meaning and being are harder to put language to. However, they have a sense of being beyond the scope of yourself or the relationships you have in your life. At times it’s beyond the scope of humanity itself, looking at something larger, more removed, or more fundamental than human life.

As always, if you ever have any questions or would like to explore these experiences further, reach out to your support network, continue journaling on the experience and how you relate to it, and check in with your care team for ongoing discussion and support. Integration is not a process that has to be done alone.

Taking the Appropriate Actions

With a bit of reflection and perhaps some conversations with those around you, you’ve identified the nature or theme of your recent session.

The next step along your path of integration is to match the integration actions you take to the nature of the experience that you had. This helps the lessons deepen themselves, settle down into your life and take firm rooting. This helps you grow into the person you are becoming and assists you on your journey to healing and wholeness.

Of course, you should always try to find the activities that work best for you. Doing the things that come naturally to you, and give you the strongest results, will always be the most helpful steps to take. The suggestions below are merely starting points to get you on your way. It’s up to you to pick the ones that work the best and resonate most for you.

Actions for the Self

If you identify that the nature of your experience was largely focused on yourself, it can be helpful from this point to continue exploring the nature of the experience and the lessons/sensations that arose within it to see if you can point to whether it was largely physical, mental, or emotional in nature.

With this identification in place, you can try some of the following activities below to begin and assist the integration process.

Physical

If the experience was largely physical, you can assist the process by matching this energy and taking care and giving love to your physical body:

  • Clean up your diet, stay hydrated
  • Get adequate sleep
  • Continue or begin a movement/exercise practice
  • Get outside for fresh air, sunlight, and time in nature
  • Take time to rest, meditate, find stillness
  • Get a massage, cold showers, sauna sessions

Mental

If the experience was highly mental (cognitive) or insight/lesson-based, you can augment this by cultivating passions, interests, and areas of study:

  • Cultivate a meditation practice
  • Dive into learning some new idea or skill
  • Read books (any kind)
  • Make time for creative, artistic expression
  • Continue journalling, writing, storytelling
  • Make your physical environments beautiful/comfortable to live in

Emotional

If your experience was emotionally dominant, you can be an ally here by ensuring the process is resolved, and honoring the sensitivity of your work:

  • Start a daily gratitude practice
  • Journal about your experience and allow for any further release
  • Express yourself and your feelings, privately or in relationship
  • Write a letter to yourself or to others
  • Practice compassion-based meditations
  • Do something nice for yourself or for loved ones
  • Return to the soundtracks or music you listened to

Actions for the Other

If your experience was largely relationship-focused, there are a number of practices that you can do both privately and with others to assist in this process.

It is helpful to note that it is wise to take some time to let things settle after an experience. “Sleeping on it” for a day or two before taking action is a good rule of thumb here.

If your experience was relationship-based, consider trying the following:

  • Schedule time for deeper check-ins with friends and family
  • Reach out to old connections you haven’t heard from in a while
  • Send gratitude letters to friends, family, colleagues, etc.
  • Go out (or online) and spark new connections and new friendships
  • Find communities that share your interests/passions and join them
  • Clean up your existing relationship, close any open loops and address anything that is still unresolved

Actions for the World

There is a class of experience that is rooted beyond yourself, your relationships, and your connection to humanity. It can point to much larger topics, such as the nature of being, the meaning of life, or provide glimpses of transcendent experiences beyond your individual sense of self.

While there are common suggestions and starting points to kick this off in your integration process, this is an area that is largely up to you. This is about your connection to life, and is a very different process for each person.

With that said, some starting points along this path include:

  • Continue to study/explore any visions/lessons/teachings you received in your sessions
  • Begin to cultivate (or deepen) a personal spiritual practice
  • Study or review existing sacred texts and teachings
  • Listen to or watch spiritual material/media
  • Begin journaling your views on topics such as the nature of life, meaning of life, your role in the world/existence, etc.
  • Find a teacher/mentor/guide who can help in this process
  • Join communities of other individuals also moving along this path

Integration Timelines

As you begin to enter your integration period and continue your process of bringing these experiences and insights deeply into your life, it’s again helpful to have a reminder that there is no deadline to this work.

There is no final exam to pass at the end of this. No penalty for late submissions. This is about your own personal process, and your connection to your own healing and journey to wholeness.

Some of the experiences and insights you have throughout your sessions may be quick and easy to set up —scheduling a monthly family Zoom call, for example. Others are more nuanced and less obvious, like cultivating a personal spiritual practice for the first time. What matters most is honoring where you are in the process, what you feel called to focus on, and showing up as best you can for each step along the way.

Taking integration actions that match the nature of your experience can augment and assist the process, and as mentioned earlier, these suggestions are merely starting points. With time and experience you will land on the activities that are most beneficial to you and provide the greatest results. Whatever that ends up looking like is okay, and it’s important to trust yourself and your inner guidance throughout this journey.

Continue On and Enjoy Your Journey

The opportunity to continue your journey towards healing, growth, and wholeness is a beautiful gift and opportunity. Thank yourself for making this decision, for demonstrating this great act of self-love and compassion by embarking on this journey.

The path is not always straightforward for this work, and that’s okay. Remember that you have support in community, relationships, and your care team should you need it. You are not alone on this path, and this is the journey of a lifetime. Enjoy this work while you do it, and walk boldly towards your future.

Throughout the course of your psychedelic therapy protocols, you may hear about or experience yourself a session that feels underwhelming, as if “nothing” happened in your conscious experience.

If this occurs, it’s easy to quickly jump to conclusions, such as: “this isn’t for me,” “it didn’t do anything,” or “I did something wrong”. Though this isn’t the case, and there’s often a lot more going on under the surface than you may anticipate.

This piece explores the mechanics of milder experiences, potential meanings as to why they happen, the biological mechanics, and how to integrate/work with these experiences throughout the rest of your healing journey.

Defining “Nothing Happened” Experiences

By “nothing happened” experiences, individuals tend to mean that there didn’t appear to be any active effect/change in their physical bodily sensations and/or their conscious waking state.

In other words, they were “lucid” or “normal” the entire time during the session. And as mentioned, at this point it’s easy to make the jump to assuming that it didn’t work, that nothing happened, or that the individual made some form of mistake before or during the session. Though none of these are true, and “nothing happened” experiences can and likely will happen to anybody throughout a psychedelic therapy program with multiple sessions.

Given the amount of stories you may hear from others and their journeys, and given the classic hallmarks of a psychedelic experience — it is common to have some assumptions, or hard as you may try not to, have expectations about the nature of the experience. This includes what your session will be like, and more importantly, what you think you need to experience in any given session.

For the purposes of this resource, “nothing happened” experiences will be defined as no detectable change in the physical sensations or the conscious landscape during the dosing session, or while under the influence of the medicine.

Biological Mechanisms/Healing

Let’s return for a moment to a topic we have explored before in a number of pieces — which is that there are often two apparent sides to the psychedelic experience: the biological and the phenomenological.

These are differentiated by what happens to the brain and body, and what happens in your subjective experience and your conscious awareness.

It’s important to remember that when going through psychedelic therapy with any psychedelic compound, you will have ingested a compound that has a neurobiological effect. These effects are dose-dependent and will happen regardless of whether or not there are any associated phenomenological sensations/experiences that accompany them.

Psychedelic therapy compounds such as ketamine, psilocybin, MDMA, and others have powerful neurobiological effects. They help to repair, maintain, or promote healthy neural connections and pathways in the brain. These healing effects are always present whenever you ingest the compound.

No matter what the experience is like for you, rest assured in knowing that you are receiving a dose of medicine tailored to your needs, that is working on your mind and body regardless of the experience.

Just like a plant, if you give your brain and body the right conditions it needs to thrive, healthy growth is a natural byproduct. The positive neurobiological effects of psychedelics medicines help create and maintain the environment for your mind and body to heal, grow, and move towards health and wholeness.

What Does The “Nothing Happened” Experience Mean?

With the neurobiological benefits covered, there are many ways that you can interpret the “nothing happened” experience to help you continue on your healing journey.

A few framings and potential drivers of nothing experiences may include:

It may be unconscious priming

Some individuals are working through very challenging circumstances, and seek psychedelic therapy to resolve intense emotional pain or challenges. Always remember that the medicine and the experience is on your side, it is helping to heal and avoid further harm.

The experience may be working to prime or prepare a foundation of safety and healing, even before beginning to present the material being healed in your conscious awareness. Surfacing highly traumatic material before the individual has the resources, safety, strength, and trust in the experience to handle it can lead to re-traumatization, and does more harm than good. For this reason, the medicine may keep the healing and processing at an unconscious level to set the stage for further experiences.

It may be related to intentions

Though it is possible, the psychedelic experience does not always address intentions through the format of linear, languaged responses. You may ask a question in your intention, but the answer doesn’t always come in the form of a single-sentence response to you.

The medicine may present visions or images, re-surface childhood memories, generate physical sensations in the body, or many other forms of “communicating” the lesson and insight to be learned. It is not always straightforward or immediate to understand. This is also why continued integration and unpacking is essential in psychedelic therapy.

One of the ways the experience can address your intentions is in stating “you don’t need anything else/new,” or “the work you need to do is here in the world”. Instead of saying that in language, it answers you by not responding.

By keeping your awareness in the here-and-now of conscious experience, in the world. If you experience “nothing,” consider how a non-response or a suggestion of “there’s nothing you need to see right now in the psychedelic space” might be the answer or insight you need.

You may need rest

The healing process itself is a long-game. It’s a marathon, not a sprint. It’s possible to exhaust yourself with healing, to feel like you’re not doing enough, not moving quickly enough, haven’t “gotten there” just yet. Notice how these are the same feelings/patterns many people often seek to heal! With these attitudes, it’s easy to push yourself too far, too hard, too fast.

As always, your inner healing intelligence and the psychedelic experience recognize this, and will accommodate and match the experience to your energy levels, both physical and psycho-spiritual energy.

If you are tired, have a habit of overworking yourself or of pushing too far too fast, the medicine may bring you a restful experience. No grand insights, no visuals, no physical discomfort, just a period of time to relax, to be in relationship with yourself, and to directly see what self-care and self-love look and feel like. It’s not glamorous or fancy, and that’s the point. It’s taking intentional time to rest and recover.

Other Reasons

Now of course, these are merely potential reasons as to why the experience unfolded as it did. They are different lenses that you can view your experience through, to see if anything clicks, if that feels correct, or to glean any insights from.

Though it’s important to also take the time to continue connecting with this experience, and to journal and reflect upon it.

Ask yourself: What did this mean to me? How did I react to this experience? What is this giving me the opportunity to learn?

It’s About the Healing Process

First and foremost, individuals come to psychedelic therapy for healing. To become more whole, to cultivate a deeper relationship with themselves and with life. The healing is paramount.

How the medicine and the experience chooses to facilitate that healing should come later. This is where the timeless mantra of Trust, Let Go, and Be Open comes back up.

Trust that the medicine and the experience is working for your benefit and for your healing. Let go of the preconceived notions you have of what the experience will be like and what it needs to do for you, when. And finally, Be open to the possibility that this is all working exactly as it needs to, when it needs to, how it needs to.

Sometimes these “nothing happened” experiences can be delivering you exactly what you need. This may be an opportunity to work with your disappointment, and an understanding of how to accept reality as it is. Maybe there aren’t any visions or visuals, strange sensations or distortions of time, but it helps to get the job done regardless. It helps facilitate your healing process, and that’s what matters most.

Integration and the Space Between

If you are moving through a psychedelic therapy protocol, it’s likely that you still have some additional sessions as part of the program. It is helpful to return to viewing these experiences as part of a much larger story, where the success of the program is not determined by the “success”’ of one individual session. This is a long game, and there are many steps involved.

In a way, having these ’nothing’ experiences can be extremely valuable. They help you address the balance of wanting a fancy experience vs. true healing. They help you come into direct contact with reality and accept things as they are. And they help you take the integration process more seriously and focus on the time outside of sessions, an often neglected area in psychedelic therapy protocols.

If you would like to be an ally on your own healing journey and continue the integration process after an experience like this, you might try:

  • Continued Reflection: Dedicate time in the following days to continue reflecting on the experience —and in particular your reaction/emotions related to it— and see if you can dig deeper into why this experience happened as it did.
  • Assist the Neurobiological Benefits: You will always have the neurobiological healing benefits, and the neuroplastic integration window, after any dosing session. Help this process by dealing in your physical health and wellness practices and routines.
  • Continue Integrating: Whether it’s outstanding integration activities from previous sessions, or establishing new behaviors, honor your integration window by continuing the best integration practices you have available to you.

Conclusion

“Nothing happened” experiences can be challenging and highly confronting. It’s easy to get swept up in an emotional response to them afterwards, either blaming yourself or believing that this just isn’t the fit for you.

As you’ve seen, there are a number of ways that “nothing happened” experiences can be just as significant as any other session you may have throughout your psychedelic therapy program.

By taking advantage of the neurobiological healing benefits, and in working to continue processing and reframe the meaning of the subjective experience, you have a valuable opportunity to continue exploring who you are. This includes how you think or act, and where you want to go next.

If you ever have any questions about this, reach out to your Guide, to your Care Team, or others who have done this work for additional support and guidance. With that, enjoy the rest of the journey towards healing and wholeness!

A crucial part of the psychedelic therapy experience is trusting the professional(s) you’re working with. If the trust isn’t there, it will prove to be a major obstacle when doing the work.

While each professional may come to their practice with a different training background or approach, they all ultimately have the same intention: to help the client on the right path to self discovery and healing.

Just as there are a number of ways to experience psychedelic therapy, there are a range of professionals to help you through your journey. Some of these include clinicians, licensed therapists who leverage psychedelics, guides, and shamans.

A Guide’s Experience is Paramount

Set and setting —your mind-frame, and held space or location— are important factors to consider when engaging with psychedelic therapy, and in all cases, guidance is equally paramount. Journeying into this type of therapy requires the direction of someone with experience, otherwise there’s high potential for things to go sideways, fast.

Dr. Leonard Vando is a New York-based board certified psychiatrist, addiction psychiatrist, and Medical Director at Mindbloom.

He says that an experienced guide can help determine the direction in which the medication is going to evolve and unfold within the patient.

“When a person with experience in this area has more tools, they’ll help you develop your intentions,” he says. “That’s super useful because like everything else, where the intention is and how you come into this experience will make all the difference in what you get out of it.”

At Mindbloom, experienced guides are able to give a client the support and direction needed throughout their ketamine therapy experience, should challenging emotions or insights come out of their sessions, which sometimes happens.

“If you run into some emotional difficulty, an experienced guide who has helped people in a situation like this before will make a difference between a healing session and a terrible session,” Dr. Vando says.

Retreating and Treating

Outside of Mindbloom’s at-home treatment, there are many options to experience guided psychedelic therapy at alternative medicine retreats. They’re found all over the world, but are particularly abundant in countries like Mexico, Peru, and Costa Rica.

The facilities can vary when it comes to environments and resources. Some are resort-like settings that offer all-inclusive amenities while others are rustic, no-frills facilities with only the bare minimum provisions on hand. What these resorts have in common is access to a variety of spiritual healing practices, like “magic” mushrooms, ayahuasca and ibogaine.  

Depending where you go, the person leading these sessions can be referred to by different monikers. Some common ones are curandero, healer, shaman or guide.

Guided ayahuasca retreats

With ayahuasca, the therapeutic work takes place during a formal ceremony —usually amongst a group— where guests ingest the medicine and wait for the effects to kick in. This is where an experienced guide is crucial, as they will help the guest navigate the effects of the medicine. The experience often brings various psychological and emotional insights and challenges to the surface.

The experience is intense and long lasting: Ayahuasca can last up to six hours. A skilled guide will know how to help anyone having a distressing experience steer through unearthed fears so that they can take away meaningful connections and revelations.

Guided ibogaine retreats

Ibogaine is a psychoactive alkaloid found in the root bark of the Iboga shrub, which is native to central Africa. It’s been used in rituals by native populations and passed on through the Bwiti tradition for centuries.

Ibogaine retreats can be found across North America, Central America and Europe. Some position themselves as detox centers, while others offer more of a getaway experience.

Ibogaine ceremonies are often focused on helping the patient with addiction issues. Mental and physical health conditions, medications they’re on, and use of recreational drugs may factor into whether a patient is qualified to take part in this treatment.

As ibogaine is considered a spiritual plant medicine, facilitators who are guiding the ceremony should be experienced and properly trained in the Bwiti tradition.

Doing the Work

Justin Townsend is the CEO and head facilitator of MycoMeditations, a psilocybin mushrooms retreat based in Treasure Bay, Jamaica. His retreat staffs licensed therapist facilitators, clinical psychologists, a nurse, and a social worker. He says having trained professionals on hand during treatment is essential.

“In the same way a commercial pilot needs hours of experience under their belt before they can fly people around in the plane, the same can be said for anyone working as a facilitator, guide, and therapist in the dosing space,” he says.

The people who come to the facilities typically are there to treat issues like depression, childhood trauma, PTSD and/or anxiety. Over the course of a week, and three formal group dosing sessions, they work with the professionals at the center.

He admits that someone who isn’t properly trained to navigate the unknown and chaos that’s unearthed after dosing can end up intimidated, fearful, and even judgmental if they don’t trust the process or understand the experience.

“If they bring that to the equation, it can send the whole experience for the guests sideways,” he says. “As facilitators and therapists, we can often end up being a lightning rod for people’s repressed anger, so another key facility for the professionals is to not take things personally.

The professionals who work at the retreat also dose regularly, as an opportunity to ‘clear out’ their own basement.”

“We’re constantly working on ourselves so we can be very present for our guests as well,” Townsend says.

The Future of Facilitated Dosing

Psychedelic therapy involving psilocybin may not be exclusive to foreign retreats for much longer.

As more American states decriminalize magic mushrooms, it clears the way for psychotherapy-based practices involving the drug. In 2020, Oregon became the first state to legalize magic mushrooms for therapeutic use in licensed facilities, so it’s only a matter of time before this becomes an option for clients who want to explore psychedelics as an integrative treatment.

In Canada, a non-profit coalition helps offer psilocybin-assisted psychotherapy for patients with terminal illnesses. Dr. Bruce Tobin, a registered clinical counselor with Victoria B.C.-based TheraPsil, explains in one of the facility’s YouTube videos the importance of trust between a guide and a patient.

“You can’t open up inside very much further than you can trust the person who’s next to you,” he says.

He goes on to explain that there’s opportunity for this trust to be built in preparation sessions prior to dosing. First the patient is encouraged to examine what they want from the sessions and what areas they want to explore in their life. Then, there is the medicine session, when the patient doses and is monitored by a registered professional. That session is followed by at least three integration sessions, where the patient is helped to understand the nature of their experience with psilocybin and how it relates to their personal challenges. It’s meant to help the patient reflect on the therapeutic content of their psychedelic therapy experience and weave it into the context of everyday life.

Finding the Right Source

Finding the right treatment, facility and facilitator may take some time.

Go about it as you would when you’re looking for other medical services – through recommendations and reviews. Be wary of services, retreats, or guides who offer suspect pricing, as it’s often the sign of a cash grab. When doing the research, look for platforms or facilities with positive reviews and ones that have come from recommendations.

Venturing into psychedelics for therapeutic use is an intense process that shouldn’t be done alone. Just like any kind of therapy, it takes guidance and trust to start to feel an impact on your life.