[Enginerrrd]

Honestly a fair number of studies have been done and the problem with all that stuff is there's always been a relatively high rate of complications and adverse outcomes. Responses/experiences are hard to predict.

I get that in some people it can be a wonderful thing, nearly a miracle cure. I've done plenty of psychedelics myself, but I always find the insistence by proponents that any harm done is the fault of the user ("poor preparation", "not the right setting", "inexperienced guide", etc, etc) to be really disingenuous and unscientific. Like, there are legit some people that really won't respond well to this as therapy.

Now, conventional pharmaceuticals and therapy have the same issues, but the reality is psychedelic therapies have never been a clear favorite.

[gavinray]

This is something that needs to be heard more.

I'd taken psychedelics perhaps 50-60 times before I had one out-of-nowhere bad experience that caused more harm than all the good I'd gotten out of them in my life.

I'm not against psychedelics after this either, huge supporter, but people like to pretend traumatic experiences don't have a chance of occuring.

[zadler]

What was the cause of the bad experience?

[gavinray]

This is such a difficult question -- I honestly wish I knew the answer outright and could give it to you.

I don't think I can do that much, but what I can do is offer some theories and context.

(Note: I wrote at length about this experience, and my general experiences with both psychedelics + MDMA here: https://news.ycombinator.com/item?id=22991744)

I'll write the following under the assumption that you/the reader don't have experience with psychedelics. There are some things you can put into words for those unfamiliar, and a great many other things you cannot.

---

Psychedelics are a fundamentally neutral substance. What I mean by that is, that they and the experience, are neither good nor bad. As hippy as it sounds, "they are what you make of them".

This quality, if you ask me, boils down to one property: Psychedelics are enhancers. If you feel beautiful and happy and lively, you feel REALLY beautiful, happy, and lively.

If you start to become frightened/anxious of something, or are in a frightening situation, you become REALLY frightened.

And this becomes further amplified by a second property of psychedelics:

Rather than the usual business of "Some external occurrence or sensation happened, and here is my one thought/reaction to it." IE "Wow, that statement was rude, what a jerk." Or "Man, that dark alleyway looks kind of scary, I think I'll not go that way."

Your subconscious and free-association become stronger respective of dose, to the point where they can become runaway.

No longer is the equation "1 external action = 1 internal processing response", but some small experience can set off a chain reaction of internal association tumbling down a bunch of different paths.

Dark alleyway -> Oh that's scary -> That's the sort of place monsters would be -> Monsters, oh those are terrifying -> Murder is terrifying -> I don't want to be murdered -> There's probably a monster in that dark alleyway -> Dark alleyway, that's so terrifying -> You know what's probably in there, a monster? -> A monster would murder me -> I don't want to die -> Die.. death...

It becomes a looping, inescapable schizophrenic sort of experience where you've also lost enough short-term memory to forget you've been going in loops like this for what feels like years.

And because things are so ENHANCED, the amount of screaming terror, dread, etc you can feel is beyond any thing you can comprehend. Time is slowed to a crawl, this can continue for eternity.

Now, if that all sounds awful -- just imagine this whole scenario, but filled with the most intense happiness and love you can imagine. That's what MOST experiences are like, generally.

---

What happened that night is I started getting anxious and fell into a dark place in my mind and got stuck there for an eternity instead of a happy place, to put it shortly.

I also won't pretend I probably didn't have a lot of subconscious trauma from a really messed up childhood and likely other mental issues/insecurities.

[yomly]

Agree. I have passed up opportunities to take LSD on several occasions as I knew my emotional state baseline positive enough. The time I did do it was at one of the happiest times of my life and it was a fun experience.

The time element of a deep LSD trip can make it very challenging. Being stuck in your thoughts for 18 hours is not for the light hearted

[pmoriarty]

"Psychedelics are a fundamentally neutral substance. What I mean by that is, that they and the experience, are neither good nor bad."

There are a significant number of people who view the psychedelic substances they use as teachers, as sacred, as emissaries of gods or other supernatural beings, or as those beings themselves.

Though such views are often dismissed as superstition or magical thinking by many who consider themselves part of "advanced", "civilized" societies, and who view these substances more as neutral tools, such societies' confrontation with these substances is relatively young, and I suspect that as they gain more experience with them their views will change.

Use of these substances have already been the wellspring from which multiple religions have come, and the potential for them to spawn more major religious movements, and with them a much more deferential attitude towards and view of these substances, will only grow as their use increases.

[krageon]

> I suspect that as they gain more experience with them their views will change.

Kind of like how more experience with nature moved those same societies to not want to destroy it? While it's reasonable to question underlying prejudice and (frankly) very little actual knowledge I do not think that's going to be solved with more experience. We just don't see that reflected in reality. Most of Western society is fossilised, hostile and fundamentally exploitative. Having those attitudes change would involve a complete overhaul of the underlying cultures, which just isn't likely.

[pmoriarty]

Take a look at what happened in the 1960's -- a period massively influenced by psychedelics. Our current society is still benefiting from that influence today, including the birth of the environmental movement, the massive influence of psychedelics on music and the arts, etc. Psychedelics also influenced politics in that day, which we all know was very turbulent and radical then.

So the entire culture doesn't have to be overhauled to have a massive influence. During and after the 60's there was a backlash against the counterculture -- a backlash that was ultimately very effective in some ways, and one which continues today, but I do believe a lot of people will start to once again see that another way is possible once psychedelic use becomes more widespread and mainstream. That potential is one of the few things that gives me a sliver of hope about humanity's future.

[evo_9]

I don't disagree with this; I do wonder however if this is more related to the black-market nature of this drug. Aka, inconsistent 'manufacturing' processes, etc. Meaning if it were legal and had a process in place to assure the correct chemical composition, if that would still happen.

Thinking about this further - have bad trips been observed in clinical studies where the the LSD was created in a controlled, ideal lab setting?

Would be interesting to know if this was or wasn't the case; could indicate a bad trip is an unavoidable potential side-effect, or if it is a specific reaction to poorly created LSD.

[saiya-jin]

I've seen really bad trips from literally just weed, the same I smoked and was as A-OK as possible. I mean really bad stuff, like blood flowing down the walls around us, they are coming for us panick etc.

Its not the substance purity, but some people are a mess, and sometimes they don't realize/admit it. Some become mess with frequent use. Those definitely shouldn't play with stronger stuff, whatever that is for them.

[Enginerrrd]

>Meaning if it were legal and had a process in place to assure the correct chemical composition, if that would still happen.

It will. I'll stake my life-savings on it too.

>Thinking about this further - have bad trips been observed in clinical studies where the the LSD was created in a controlled, ideal lab setting?

Yes, actually, the results here are the ones usually criticized by psychonauts for causing bad trips due to "bad settings" or "poor preparation". There's a bit of truth to that, but the bad trips are always going to happen.

[bb88]

I do absolutely agree on that.

What would be nice is that you get the benefits of the drug without any of the "bad trip" experiences, in a controlled way.

[pmoriarty]

If you look at every trip as a learning experience, even a bad trip doesn't have to be all bad.

Now, I wouldn't wish my own bad trips on anyone, but I've found I learned far, far more from them than I did my good trips, so in that sense they were actually beneficial.

Also, the term "bad trip" may be a misnomer. They might be more fittingly called "difficult trips" or "challenging trips". It is possible to draw meaning and even wisdom from such trips.

[Enginerrrd]

>If you look at every trip as a learning experience, even a bad trip doesn't have to be all bad.

For some, maybe even most, but it would be irresponsible to assume that it would be the case for everyone, and this is exactly the sort of blaming the victim of the bad trip for "doing it wrong" that I was talking about. Somehow it's their fault for having a bad trip, or for looking at it wrong and failing to "correctly" integrate it into their worldview.

Humans are a diverse group. That line of thinking just doesn't work from a clinical perspective.

[pmoriarty]

Blame was the last thing on my mind when I wrote my comment. I was merely trying to provide some suggestions that would maximize the odds of having a productive experience and good integration afterwards.

Yes, things could go wrong even if one takes every reasonable precaution, is in the best frame of mind, etc. That's why having helped from experienced people you can trust is a good idea, but even that offers no guarantees.

There are no guarantees in life for anything. You could break your neck climbing a ladder to change a lightbulb. People can and do suffer severe accidents (including severe brain damage) skiing, driving, or crossing the street.

Yes, you should be aware of the risks and look both ways when crossing the street, but you could still suffer some accident even then. For some the risky activity is worth it, for others not. For those who think it is, it's helpful to educate oneself and take reasonable precautions. No blame necessary or intended.