PsyCare UK

Introduction to Psychedelic Support - Helping Others

Psychedelic support in the context of festivals and events refers to providing support for those who have used psychedelic and empathogenic drugs. The classic psychedelics include LSD, psilocybin (magic mushrooms) and mescaline. MDMA (ecstasy) is the most well known empathogen. The rise of NPS has massively increased the number of substances that fall within these categories, this has increased the risk of things going wrong.

Psychedelic support includes harm reduction activities such as providing information, advice and the testing of substances, however, the focus of this document will be on crisis intervention.

Crisis Intervention is emergency psychological care aimed at assisting individuals in a crisis situation to restore equilibrium to their biopsychosocial functioning and to minimize the potential for psychological trauma. Crisis can be defined as one’s perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms. 

This kind of support shares the approach of person centred counselling in that it is non-directive and non-confrontational, and relies on the values of empathy and unconditional positive regard. It is also informed by psychotherapy and psychedelic therapy.

Research shows that psychedelics and empathogens can be powerful tools for accessing repressed memories and re-experiencing events from the past. This means that those who use these substances at festival and events may unintentionally encounter emotions, memories or experiences which are difficult for them to deal with.

The following information is a condensed and combined version of the following documents with some of our own notes and additions. If you find this information useful please read the source documents:

https://maps.org/resources/responding_to_difficult_psychedelic_experiences/101-how-to-work-with-difficult-psychedelic-experiences

Erowid Psychedelic Crisis FAQ | Helping someone through a bad trip, psychic crisis, or spiritual crisis

What is a difficult trip?

Symptoms include:

  • General discomfort
  • Difficulty communicating
  • Severe time distortion
  • Thought loops
  • Anxiety and panic attacks
  • Fear and paranoia
  • Aggression
  • Overwhelming feelings and emotions
  • Grandiose thoughts

Common experiences include:

  • Threat to sanity – the feeling/experience that one is going crazy, losing one’s mind, or that this will never end
  • Major shifts in ego/personality structure, regarding one’s belief and understanding of oneself, the world, and god.
  • Remembering and/or reliving of old traumas
  • Different, sometimes never experienced, sensory, energy and body sensations – synesthesia, extreme heightened senses, etc.
  • Energetic releases – powerful physical release such as shaking, twising, and vibrating; intensive sexual or emotional release
  • Verbal expression – This might be: a different or dead language, prayers from the different spiritual traditions, far-out stories and memories, jibberish, animal sounds, songs, looping sentences, lamenting, cries, or screams.
  • Being caught in a certain experience
  • Merging with people, reading their minds, feeling their emotions – Merging with rocks, animals, plants and experiencing the pollution and death of the planet and different species

In a psychedelic experience and crisis the person may react to the sitter and project their own feelings and experiences onto them. This could be a sexual, demonic, godlike or fearful transference. When this takes place it is important just to be with, not to defend the transference. In this circumstance it can be useful, if possible, to experiment using a different sitter (gender can be particularly important).

Assessing the situation

  1. Assess risk – does the person need medical attention? Are there risks to yourself, the individual or other people. Is there the threat of violence? Is there a chance that they might: hurt themselves intentionally? Attempt suicide? Get in a car and drive? If the answer is yes to any of the above, do what you can to safeguard yourself, others and the individual. If you don’t know the person or the situation is more than you think you can realistically manage contact emergency services for assistance.
  2. Decide how best to interact with the person, the approach will depend upon the environment, how the individual presents and who else is around. Take a tentative approach, paying attention to what works and what doesn’t. Introduce yourself, say your name and how you come to be there. Use plenty of eye contact unless they seem anxious/fearful of you. “Gently ask them if they would like someone to sit with them. If it seems disturbing to them to have someone sitting with them, have someone nearby keep an eye on them unobtrusively.”
  3. Gather information – what have they taken, when, how much, medication, mental health, recent mind-set, emotional/behavioural issues, when they last slept, ate, hydrated. Do they have friends nearby? Where do they live?
  4. Ensure basic needs are met and that they are as comfortable as possible – hydration, temperature, consider change of environment. “The most comforting thing some people have reported helped them during acute experiences is a blanket wrapped around them.” 

Paranoia: “If the person doesn’t want anyone near them, hang back, turn so you aren’t staring at them, but keep an eye on them as discreetly as possible. Think about what it would feel like to be in a paranoid state, having some stranger (whether you are or not) follow you around and watch you.”

Working with psychedelic emergencies

“With support, knowledge, and integrative work there is very little danger in the psychedelic experience itself. Even the most frightening and bizarre behaviour, when explored and worked with, can turn out to be beneficial and enlightening.”

The PsyCare UK approach:

  • Non-judgemental – based on honour and respect – each person is a unique individual (and that is what makes us all the same)
  • Listening is key
  • Empathy
  • Allow the process to unfold
  • Acknowledges the individual’s capacity to heal themselves
  • Makes it safe to go deeper if desired
  • Non directive or confrontational
  • Mutual learning experience
  • Can be an opportunity for deep transformation

The Four Principles of Psychedelic Harm Reduction (Zendo Project)

  • Create a safe space
  • Sitting, not guiding
  • Talk through, not down
  • Difficult is not the same as bad

What to do

The following can be useful:

Reassure them:

  • This will pass, this is a process – Remind the person that they have taken a drug and that the effects will wear off.
  • This is an experience other people have had.
  • That, if they want, you will stay with them until they no longer require your support.
  • That they are not physically in danger and that you will keep them safe.
  • That everything in the outside world is ok.
  • Change the setting – find somewhere quiet, change the music, get away from crowds of people, find a comfortable space to sit or lie down, move inside/outside, 
  • Breathe – breathing deeply can help to relieve tension and ground people. If appropriate get them to breathe with you. As with meditation focusing attention on the breath can be a good way to eliminate unwanted mental noise.
  • Try not to bombard the person with questions, if they are unable to answer basic questions about themselves it may add to their distress. However, if appropriate it can help to ground people and bring them back to reality to talk about their everyday life, work, family, etc. 
  • Negative/difficult experiences are often caused by people resisting the effects of the drug and trying to remain in control – “it is argued that much of the emotional dissonance and mental stress comes from fighting and resisting potentially uncomfortable internal processes.” Try to make the person feel safe and comfortable.  Invite the person to trust, let go and be open. Hopefully you are able to provide an environment in which the person is able to surrender to the experience.

Try to keep your knowledge and experience of what is happening to the person to yourself – just be with, listen, pay attention. Allow the person to express and communicate whatever they want. If the person wants to speak, if sounds come out uncontrolled, support the expression.

Even if we don’t understand what’s happening we serve as an anchor, a resting place, a quiet centre. We know that our presence is helpful. At this moment we don’t have to solve all the problems and answer all the questions that the experience or the person’s life presents.

Pay attention to the body language while you listen to what’s being expressed verbally and emotionally. Follow the expression of the person. If they have a lot of energy, let the energy move, let it express itself in whatever form.

Respond when needed, do not take over, try to (if appropriate) engage in a calm conversation, responding to fear and anxiety.

The most appropriate response to a powerful psychedelic crisis might be to just sit quietly with the person, making them feel safe.

  • Look at beautiful things.
  • Sing (anything, but especially children’s songs).
  • Pet or play with an animal.
  • Go for a walk.
  • Recall good memories (beach, children, etc.).
  • Dance.
  • Hold hands.
  • Draw.
  • Get bare feet on the earth.

 

Pitfalls to Avoid

  • Don’t confuse them by repeatedly asking them questions they can’t answer.
  • Don’t make them feel even more isolated by acting worried and nervous around them.
  • Probably avoid any complex physical activities, like trying to zipper a jacket or fixing the stereo or lighting the pilot light on the stove.
  • Respect their needs and boundaries.
    • Don’t touch them if they don’t want to be touched.
    • Give them space if they seem to want it