A bad trip (also known as challenging experiences, acute intoxication from hallucinogens, psychedelic crisis, or emergence phenomenon) is an acute adverse psychological reaction to classic
hallucinogen
Hallucinogens are a large, diverse class of psychoactive drugs that can produce altered states of consciousness characterized by major alterations in thought, mood, and perception as well as other changes. Most hallucinogens can be categorize ...
s. With proper screening, preparation, and support in a regulated setting these are usually benign. A bad trip on psilocybin, for instance, often features intense anxiety, confusion, and agitation, or even
psychotic
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior t ...
episodes.
As of 2011, exact data on the frequency of bad trips are not available.
Bad trips can be exacerbated by the inexperience or irresponsibility of the user or the lack of
proper preparation and environment for the trip, and are often reflective of unresolved psychological tensions triggered during the course of the experience.
Stanislav Grof
Stanislav "Stan" Grof is a Czech-born psychiatrist who has been living in the United States since the 1960s. Grof is one of the principal developers of transpersonal psychology and research into the use of non-ordinary states of consciousness ...
, ''LSD Psychotherapy'' In clinical research settings, precautions including the screening and preparation of participants, the training of the session monitors who will be present during the experience, and the selection of appropriate physical setting can minimize the likelihood of psychological distress.
Researchers have suggested that the presence of professional "
trip sitters" (i.e., session monitors) may significantly reduce the negative experiences associated with a bad trip.
In most cases in which anxiety arises during a supervised psychedelic experience, reassurance from the session monitor is adequate to resolve it; however, if distress becomes intense it can be treated pharmacologically, for example with the
benzodiazepine
Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
diazepam
Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, ...
.
The psychiatrist
Stanislav Grof
Stanislav "Stan" Grof is a Czech-born psychiatrist who has been living in the United States since the 1960s. Grof is one of the principal developers of transpersonal psychology and research into the use of non-ordinary states of consciousness ...
wrote that unpleasant psychedelic experiences are not necessarily unhealthy or undesirable, arguing that they may have the potential for psychological healing and lead to breakthrough and resolution of unresolved psychic issues.
Drawing on
narrative theory
A narrative, story, or tale is any account of a series of related events or experiences, whether nonfictional ( memoir, biography, news report, documentary, travelogue, etc.) or fictional (fairy tale, fable, legend, thriller, novel, etc.). Nar ...
, the authors of a 2021 study of 50 users of psychedelics found that many described bad trips as having been sources of insight or even turning points in life.
Intervention
Medical treatment consists of supportive therapy and minimization of external stimuli. In some cases,
sedation
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, ...
is used when necessary to control self-destructive behavior, or when
hyperthermia
Hyperthermia, also known simply as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extrem ...
occurs.
Diazepam
Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, ...
is the most frequently used sedative for such treatment, but other
benzodiazepines
Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
such as
lorazepam
Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. It is used to treat anxiety disorders, trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and che ...
are also effective. Such sedatives will only decrease fear and anxiety, but will not subdue hallucinations. In severe cases, antipsychotics such as
haloperidol
Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychosi ...
can reduce or stop hallucinations. Haloperidol is effective against acute intoxication caused by LSD and other
tryptamine
Tryptamine is an indolamine metabolite of the essential amino acid, tryptophan. The chemical structure is defined by an indole ─ a fused benzene and pyrrole ring, and a 2-aminoethyl group at the second carbon (third aromatic atom, with the f ...
s,
amphetamine
Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
s,
ketamine
Ketamine is a dissociative anesthetic used medically for induction and maintenance of anesthesia. It is also used as a recreational drug. It is one of the safest anesthetics, as, in contrast with opiates, ether, and propofol, it suppress ...
, and
phencyclidine
Phencyclidine or phenylcyclohexyl piperidine (PCP), also known as angel dust among other names, is a dissociative anesthetic mainly used recreationally for its significant mind-altering effects. PCP may cause hallucinations, distorted percept ...
.
Effects
Bad trips may cause
hallucinogen persisting perception disorder
Hallucinogen persisting perception disorder (HPPD) is a non-psychotic disorder in which a person experiences apparent lasting or persistent visual hallucinations or perceptual distortions after a previous use of drugs, including but not limited t ...
(HPPD).
Perspectives
Stanislav Grof
Psychiatrist
Stanislav Grof
Stanislav "Stan" Grof is a Czech-born psychiatrist who has been living in the United States since the 1960s. Grof is one of the principal developers of transpersonal psychology and research into the use of non-ordinary states of consciousness ...
once said in an interview:
In a 1975 book, Grof suggested that painful and difficult experiences during a trip could be a result of the mind reliving experiences associated with birth, and that experiences of imprisonment,
eschatological
Eschatology (; ) concerns expectations of the end of the present age, human history, or of the world itself. The end of the world or end times is predicted by several world religions (both Abrahamic and non-Abrahamic), which teach that nega ...
terror, or suffering far beyond anything imaginable in a normal state, if seen through to conclusion, often resolve into emotional, intellectual and spiritual breakthroughs. From this perspective, Grof suggests that interrupting a bad trip, while initially seen as beneficial, could potentially trap the tripper in unresolved psychological states. Grof also suggests that many cathartic experiences within psychedelic states, while not necessarily crises, may be the effects of consciousness entering a perinatal space.
Rick Strassman
Professor of psychiatry
Rick Strassman refers to bad trips as ''challenging experiences''.
See also
*
Altered state of consciousness
An altered state of consciousness (ASC), also called altered state of mind or mind alteration, is any condition which is significantly different from a normal waking state. By 1892, the expression was in use in relation to hypnosis, though there ...
*
Set and setting
Set and setting, when referring to a psychedelic drug experience or the use of other psychoactive substances, means one's mindset (shortened to "set") and the physical and social environment (the "setting") in which the user has the experience. ...
*
Ego death
Ego death is a "complete loss of subjective self-identity". The term is used in various intertwined contexts, with related meanings. Jungian psychology uses the synonymous term psychic death, referring to a fundamental transformation of the psych ...
*
Existential crisis
In psychology and psychotherapy, existential crises are inner conflicts characterized by the impression that life lacks meaning. Some authors also emphasize confusion about one's personal identity in their definition. Existential crises are acc ...
*
Hard and soft drugs
Recreational drug use indicates the use of one or more psychoactive drugs to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions and emotions of the user. When a ...
*
Lucid dreaming
*
Out-of-body experience
An out-of-body experience (OBE or sometimes OOBE) is a phenomenon in which a person perceives the world from a location outside their physical body. An OBE is a form of autoscopy (literally "seeing self"), although this term is more commonly us ...
*
Overdose
A drug overdose (overdose or OD) is the ingestion or application of a drug or other substance in quantities much greater than are recommended.
*
Posttraumatic growth
*
Posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threat ...
*
Psychedelic experience
A psychedelic experience (known colloquially as a trip) is a temporary altered state of consciousness induced by the consumption of a psychedelic substance (most commonly LSD, mescaline, psilocybin mushrooms, or DMT). For example, an acid ...
*
Psychedelic therapy
Psychedelic therapy (or psychedelic-assisted therapy) refers to the proposed use of psychedelic drugs, such as psilocybin, MDMA, LSD, and ayahuasca, to treat mental disorders. As of 2021, psychedelic drugs are controlled substances in most countr ...
*
Psychedelics, dissociatives and deliriants
Hallucinogens are a large, diverse class of psychoactive drugs that can produce altered states of consciousness characterized by major alterations in thought, mood, and perception as well as other changes. Most hallucinogens can be categorized ...
*
Psychonautics
Psychonautics (from the Ancient Greek ' 'soul, spirit, mind' and ' 'sailor, navigator') refers both to a methodology for describing and explaining the subjective effects of altered states of consciousness, including those induced by meditati ...
*
Psychosis
Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavi ...
*
Recreational drug use
Recreational drug use indicates the use of one or more psychoactive drugs to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions and emotions of the user. When a ...
*
Responsible drug use
Responsible drug use maximizes the benefits and reduces the risk of negative impact psychoactive drugs cause on the lives of the user. For illegal psychoactive drugs that are not diverted prescription controlled substances, some critics believe tha ...
*
Sensory deprivation
Sensory deprivation or perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses. Simple devices such as blindfolds or hoods and earmuffs can cut off sight and hearing, while more complex devices can ...
*
Spiritual crisis
References
External links
Crisis Intervention in Situations Related to Unsupervised Use of PsychedelicsPsychedelic Crisis FAQ: Helping someone through a bad trip, psychic crisis, or spiritual crisisPsychedelic Harm ReductionPsychedelic Harm Reduction and Policylecture in the Psychedelic Science in the 21st Century conference in 2010.
Psychedelics in the Psychiatric ER - Julie Holland, M.D.lecture in the Psychedelic Science in the 21st Century conference in 2010.
The Psychedelic crisis (bad trip) entry at Drugs-Wiki
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Drug culture
Drug overdose
Psychedelia
Substance intoxication