Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Sean O'Carroll: Bad Trip Integration
266 Plays3 months ago
In this episode I talk with Sean O'Carroll about the very important topic of bad trips. We get into some detail about what this actually means, we talk about Sean's journey into the psychedelic space and what defines a trip as bad versus challenging. We discuss the importance of seeking support for psychedelic experiences that have been traumatic, and explore the barriers to doing that. We discuss what therapists might do if someone comes to them for support after a bad trip and outline the importance of integration support.
Sean O'Carroll is head of psychotherapy at one of Australia's first purpose-built psychedelic-assisted psychotherapy clinics. He is a lead trainer and therapist at the Monash University Psychedelic Lab in Melbourne, Australia. He does consulting work, including training and supervision for a number of other psychedelic assisted psychotherapy trials. Sean has been studying and exploring human consciousness for over 25 years. His BA honours in philosophy explored the relationship between science, subjectivity and the sacred. He trained as a gestalt Psychotherapist back in 2014 and has worked as a Psychotherapist and an academic lecturing in Transpersonal Psychotherapy, Psychotherapy, Eco-Psychotherapy and other but modalities for the last 10 years.
He is the founder and director of the Wild Mind Institute, which delivers training in psychotherapy, eco psychotherapy, bad trip integration and psychedelic assisted psychotherapy. He's also writing a book about bad trips. Once that's available, we'll put a link in the show notes.
keep in touch with me at Insta: dresmedark
Linkedin: www.linkedin.com/in/dr-esme-dark-627156a0/
website: https://www.esmedarkpsychology.com.au/
Find Monash Clinical Psychedelic Lab at www.monash.edu/psychedelics
Find Sean at - www.wild-mind.com
link to Bad Trip work: https://www.wild-mind.com/stibti
Link to Bad Trip Integration Training: https://www.wild-mind.com/bad-trip-integration
Disclaimer: This podcast if for general information only and does not constitute an endorsement or recommendation for psychedelic- assisted psychotherapy.
Recommended
Transcript
Introduction to Beyond the Trip Podcast
00:00:04
Speaker
Hello and welcome to Beyond the Trip, a psychedelic therapy podcast with me, Dr. Esme Ta. During this podcast, I'll be bringing you conversations with thought leaders and other inspiring humans, exploring a wide variety of themes relating to the use of psychedelic-assisted psychotherapy in the healing of human distress.
00:00:26
Speaker
Whether you're an aspiring therapist, already a therapist, or just simply interested in the emerging field of psychedelic therapy, then this podcast is for you. Join me for a journey into the psychedelic world.
Acknowledgment of Traditional Custodians
00:00:39
Speaker
Before we get started, I want to take a moment to acknowledge the traditional custodians of the unceded land on which this podcast is recorded. The Wadda Wurrung people. I pay my respects to elders past, present and emerging.
00:00:54
Speaker
and I extend that respect to any Aboriginal or Torres Strait Islander peoples listening today.
Featuring Sean O'Carroll: Bad Trips & Integration Support
00:01:03
Speaker
Hey everybody, and welcome to this episode of Beyond the Trip. In this episode, I talk with Sean O'Carroll, and we talk about the very important topic of bad trips. We get into some detail about what this actually means. We talk a lot about Sean's journey in the psychedelic space, what defines a trip as bad versus challenging. We talk about the importance of seeking support for psychedelic experiences that may have been traumatic. And we also talk about the barriers to doing that.
00:01:33
Speaker
We discuss what therapists might do if someone comes to them to do some work after a bad trip and the really vital importance of integration support. Sean O'Carroll is Head of Psychotherapy and one of Australia's first purpose-built psychedelic-assisted psychotherapy clinics.
00:01:51
Speaker
He is a lead trainer and therapist at the Monash University Psychedelic Lab in Melbourne, Australia. He does consulting work including training and supervision for a number of other psychedelic assisted psychotherapy trials. He's been studying and exploring human consciousness for over 25 years.
00:02:09
Speaker
His BA honours in Philosophy explore the relationship between science, subjectivity and the sacred. He trained as a Distolved Psychotherapist back in 2014 and has trained and in a number of other psychedelic therapeutic modalities since 2011. Sean has worked as a Psychotherapist and an academic lecturing in Transpersonal Psychotherapy, Psychotherapy, Eco-Psychotherapy and other method methodologies for the last 10 years.
00:02:37
Speaker
He is the founder and director of the Wild Mind Institute, which delivers training in psychotherapy, eco psychotherapy, bad trip integration and psychedelic assisted psychotherapy. He's also writing a book about bad trips. Once that's available, we'll put a link in the show notes. This is a fascinating conversation and a really important area that I think gets neglected in the psychedelic field. So I'm really looking forward to diving into this topic with you all.
00:03:06
Speaker
Hi Sean, welcome to Beyond the Trip. Thank you. Yeah, so lovely to have you here. Good to be here. Yeah. Yeah, really. really grateful for you for coming onto the podcast and giving some time to this project really and I was reflecting on this episode just before that we started recording and thinking this is a topic that I'm just really excited to talk to you about you know today we're going to be speaking a bit about bad trips as well as a bit about your journey and you and your journey into this work and we've obviously known each other now for quite a few years but we haven't had
00:03:41
Speaker
that much space to go into this particular topic together. It's just really nice to have the time to dive into that and also to be recording it as well. Totally. Yes, I feel like we've had about seven little moments in hallways and staff rooms having little snippets of conversations, which never feels like enough. I anticipate that an hour won't feel like enough, but it's definitely better than 10 seconds. Exactly. Exactly.
Sean's Journey into Psychedelic Therapy
00:04:08
Speaker
Well, maybe we can start the beginning for you really, like, I mean, maybe you could like start by telling us how you got into this work, because you've actually been working in the psychedelic space for a long time. And so obviously, you know, I met at the clinical psychedelic lab at Monash, when we were working together, but before that, you've actually been working in this field for many years. So start wherever you like about your journey.
00:04:37
Speaker
into this one. Yeah. Okay. Yes, it's often hard to come up with a short version of this. And I also often think about how there's kind of a personal and a professional arm in my hands to this question. I'll probably mostly give you the professional one, but just to kind of mention, I guess in passing, you know, for me, I feel like this work and the landscape that we kind of move in feels very much like home to me from my earliest memories. I feel like I've always been really interested in consciousness and, you know, interiority and silence and these things. And just to kind of share one little vignette, you know, when I was about 10, I became an altar boy at my local Catholic church and would kind of, you know, carry the wine and manage the music. And and even then I was just really taken with biblical stories and
00:05:31
Speaker
And also like this thing that would happen, which is all of these adults would would fall into silence together and go inside themselves and pray. And it it was just intriguing to me. And looking back, I go, oh, yeah, OK, I've been interested in this kind of thing for a long time. But yeah, my first kind of academic.
00:05:51
Speaker
foray into this work. It's probably about 25 years ago now when I did my undergraduate in philosophy, which was really in philosophy of mind, philosophy of Buddhism, philosophy of religion. And I ended up doing an honors degree in in philosophy in the field of phenomenology. And my my thesis topic was science, subjectivity, and the sacred.
00:06:13
Speaker
And I feel like those themes, I've really traveled with them ever since. So that was 20 years ago in one way or another. That's been the kind of field that I've been working in. About 15 years ago, I found my way to something called transpersonal psychotherapy. and I've been a therapist ever since. And so I guess on the back of my philosophy learning and and and things, I ended up teaching transpersonal psychology and working at a small college here in Melbourne. And for those, maybe there'll be some listeners who don't actually know what transpersonal psychology is. So really briefly, it's a field of psychology that grew out of humanistic psychology in the sixties,
Transpersonal Psychology & Non-Ordinary States
00:06:59
Speaker
really on the back of the first wave of psychedelic medicine.
00:07:03
Speaker
for people like Stanislav Groff, Abraham Maslow and things like that. And they and the the short version of it is that it's a field of psychology that is really interested in non-ordinary states of consciousness. You know, both what they are, how to think about them and how they relate to human flourishing and wellbeing. And so I was very drawn to that and was teaching in that field and At about that time, you know one of the main ah guess branches of transpersonal psychology is psychedelics, because more than anything else, they they can predictably bring about a non-ordinary state of consciousness for almost anyone. yeah you know Whereas other things like meditation and dance, well, you know you got to do a lot of work in the sense to to to bring about a non-ordinary state of consciousness. So I was teaching in this college, and I was exploring these things myself.
00:07:58
Speaker
And some of my students had started going off to ayahuasca ceremonies. And I was like, an exotic word. And they'd come back and they'd share, you know, profound experiences. They would describe how their life had been changed and things like that. And then I myself had some experiences with ayahuasca. But something else started to happen, which was I was working as a therapist, and some of these students would report really positive life-changing experiences, but you know being a lecturer, I would see them over the course of months and would notice that it wasn't necessarily having a wonderful impact on their capacity to study or work or form relationships. so and they said There was this interesting divergence between the self-reported experience and the impact.
00:08:48
Speaker
And so that led me to be really interested in where psychedelics and therapy overlap and where they definitetly diverge. But I'll try and keep this ah try to wrap this up. so So that led me to working with clients who had had psychedelic experiences.
00:09:06
Speaker
Yeah, but hadn't necessarily had a great time. And and so I guess it was my work as ah as a therapist, my work as a lecturer, my interest in in plant medicine that meant people just started coming to me for what I now call bad trip integration.
00:09:23
Speaker
And so I kind of fell into it by accident. Long story short, did that for about 10 years and then in 2020 was invited to pull together a training for one of the first research trials that got up in Australia, which was originally at St. Vincent's Hospital and then moved to Swinburne Uni.
00:09:42
Speaker
in And really since 2020 have been pretty heavily involved in psychedelic medicine in Australia, mostly as a trainer. So training therapists for that work, but also obviously working as a therapist on a few trials. Yeah, maybe I'll stop there. Quite a long answer.
00:10:01
Speaker
Yeah, no, thank you. And it's really great to hear about kind of all the different threads of it. And like you said, I'm sure there's the personal thread as well. And you can bring as much of that in as you would like, but I think and you know, you're one of our trainers, obviously, at the at the clinical psychedelic lab at Monash. And I know you've also run many other trainings as well. So and it sounds like you've really been involved in this space for a very long time, in many different ways. So it feels really good to have those kind of inputs coming in from that kind of history of all of that work. Yes.
00:10:35
Speaker
And you also have been involved in, and you spoke about kind of music and altered states through dance as well. I don't know if that's something that might be useful to say because you were responsible for doing a lot of the playlists for, for our trial, which is such an important part of psychostat-assisted therapy as well.
00:10:52
Speaker
Yeah. Okay. Yeah. I'll speak to that briefly. So I guess the thing to say is that for me, psychedelics very much exist, you know, as a part of this non-ordinary state landscape. Yeah. I feel like for me, it's very much the case that, you know, non-ordinary states interest me. There are
Music, Movement, and Therapy in Psychedelics
00:11:08
Speaker
lots of technologies that we can employ that help us access those states. One of the most potent is psychedelics, but it's definitely not the only one. And so, yes, you know, along with my psychotherapy study,
00:11:22
Speaker
other things that I've explored are like conscious dance or sometimes called like moving meditation. So I trained as a dancing freedom facilitator, which is something a little like five rhythms, but with a much more shamanic bent and a lot of work out in nature. So nature connection and eco psychotherapy and things like that. And yes, so to your point, the music that, and as we know, plays a big role in this work for me. Yeah, I guess my role in developing the playlist was in part informed by my experience of running dance and music ceremonies for years here in Melbourne.
00:11:59
Speaker
Yeah, absolutely. Yeah. And I think it's true, isn't it? I think about when I was reflecting on my journey into this space, and I i guess I have also like a personal and professional kind of version of this, but one of the, I guess, for me, my first experience of non ordinary states was in meditation. And I've spent lots of time kind of have an on-off relationship. I'm certainly not an everyday meditator, although I have been at points in my life. But, you know, I remember going into a very deep place when I was overseas in India doing some yoga and meditation training and kind of having this quite expansive
00:12:39
Speaker
state of consciousness that felt very much like in that kind of non-ordinary space. Yeah. And I think that was probably one of the first times that I had an experience like that, you know? Yeah. And it was really amazing and beautiful. And I think being there and using movement to help integrate it was a really important part of that process. And that's why the yoga kind of side of it came in for me. Okay. So yeah, that was many years ago, but well before I knew you.
00:13:04
Speaker
Yeah. Well, I mean, just on that as me, you know, I know we're here in part to talk about the bad trip integration work. And I will say in passing that I have found myself working with people who haven't only had a bad trip on the back of a psychedelic experience, but increasingly people who they may have had that kind of experience at a Vipassana retreat or on a vision quest or other things like
Trauma from Non-Ordinary States
00:13:29
Speaker
this. So there's a lot of overlap in the terrain. Yeah. that people experience and the and the trouble they can get in. Yes, absolutely. Yeah, I've also worked with people. like Luckily for me, my experience was very positive and beautiful. But I've also worked with people who have had those kind of challenging experiences after a meditation retreat, or sometimes kind of yoga, like really deep yoga practice as well, that's kind of cracked them open in a way that's been quite scary for them.
00:13:56
Speaker
Sure. Yeah. So maybe we should, it feels like we've kind of navigate into the next kind of section, really. Like, so I'd love to hear people talk about kind of bad trips and there's this kind of, it gets used a lot, right? And in in the field to mean slightly different things. And so, and and there's also, of course, trips that that can be challenging and then have ah a kind of a resolution. So for you, like, how do you define a bad trip in the work that you do? Because I know it's quite a significant part of your practice, and you also teach about it. What does that mean to you? And how does that differ from something that say is just a hard trip or difficult or challenging experience?
00:14:35
Speaker
Yeah, thanks. It's a good question. So I guess the way I think about it is, you know, if you start with, you might think of it in terms of like concentric circles. So, you know, there's the set of all possible psychedelic trips yeah that someone could have. And then within that, there's a subset of trips we might call challenging trips. So this is trips with periods of difficulty, or hardship, or struggle, or ordeal, you know, and they're mixed in with other experiences like positive experiences. And maybe at the end, there's a sense of resolution and the person looks back and goes, whoosh, geez, that some of that was really tricky. But I'm glad I did it. And you know, that was ah overall a positive experience. It's important to start there. Because you know, what we know from this work is so often experiences of challenge are integral to the healing journey of a positive psychedelic. Exactly.
00:15:23
Speaker
So we've got all psychedelic trips and then within that challenging trips. Now there are some there's another subset of challenging trips, which I'd call bad trips. So this is trips that ah in a sense primarily challenge and struggle and ordeal.
00:15:39
Speaker
And importantly, often don't have a sense of resolution at the end. So someone goes through, it might be confusing, it might be confronting, it might be discombobulating, it might be terrifying, and it's all kind of difficult and unpleasant. It doesn't seem to make a whole lot of sense, and they come out the end and it didn't kind of come good.
00:16:00
Speaker
In the end, not necessarily makes sense of of what's happened and feel a bit kind of, ah yeah, discombobulated is a good word for that. And so that that I'd say is like, again, psychedelic experiences, challenging experiences within that, bad trips as a subset of challenging experiences. And then the final category,
00:16:21
Speaker
that I use is psychedelic casualties. So not all challenging trips are bad trips. Not all bad trips result in psychedelic casualties. So the way I define a psychedelic casualty is someone who has had a bad trip and has ended up in a place where they are worse off than they were when they went in and they feel they are in need of help. Yeah.
00:16:47
Speaker
And so those are the people that might often come through, say your therapy practice or other people who are out in the world doing this work, they might come to us. And and so, ah yeah, I was i was reading ah um an article actually from someone who around this topic in preparation for today and she was talking someone who'd had a bad trip and i'm with ayahuasca. And she talked about it as being kind of like, for her, it felt like it was a trauma that registered in her nervous system, the actual psychedelic experience, not that it was, you know, because you're right, right? Like a lot of the in our work and in the trials that we've worked on, a lot of people have a challenging time at some point. And that can be
00:17:27
Speaker
that hero's journey that they go on is then something that's really important for healing. But this woman talked about this kind of idea, this was actually something that stayed within her that felt traumatic, and that she found it quite hard to get support for because she wasn't sure why she could look for that and she didn't know who to ask for. And so, you know, I think that's, says it does that it sound like the kind of people that you might work with that they felt that the experience is traumatic or some of the people? Yeah, well, yeah, I think So now you're getting in into the detail a little bit more. One of the ways I describe what's happened for many psychedelic casualties is something like a non-ordinary state trauma. Yeah. So there is a lot that we understand about trauma and how to work with it that is applicable to working with psychedelic casualties. However, it's even trickier.
00:18:19
Speaker
in many instances because it's a non-ordinary state trauma. So this person has had a traumatic experience, not from their ordinary waking consciousness, like I was going along and the car crashed, for example. yeah But I was in a radically altered state and then I had a traumatic experience. And so, you know, there are all kinds of ways in which that makes the work more complicated.
00:18:41
Speaker
in that when we're trying to do the the healing or the recovery, there's this sort of disconnect between who I am now and who it was that experienced the trauma. yeah But some of the language you used in in sharing from that article is very familiar to me, like the sense that a trauma has sort of registered in the body.
00:19:01
Speaker
and still in there in some way. yeah But and we may get into this, but you know if you just deploy your normal therapeutic skills and try and go and work with that trauma, you'll find it's a very slippery beast. And that relates to the non-ordinary state nature of what's happened.
00:19:20
Speaker
Yes. Well, let's get into that in a moment. But I'd like to just because I think that's important for, you know, the people listening who are therapists to think about. But let's go back a tiny bit. I actually just wanted to ask. So if you think about those circles, I really like that way of kind of explaining it. You've got people who have kind of a challenging trip.
00:19:39
Speaker
and then the people who have how you what you call a bad trip and then the casualties in the middle. So not everyone who has a bad trip will need support and become a casualty. Do you want to say something about that? Because I think yeah if people are listening, that feels important as well. Yeah. Yeah. So I think, you know, many people will have an experience of a bad trip, but over the days and weeks and months that follow, we'll find ways to kind of locate it or integrate it or process it or maybe make sense of it or at least get on with life.
00:20:09
Speaker
And they'll look back and go, whoa, that was intense. But they can still go back to work, and their relationship's fine, and and so on and so forth. And you know I think, although statistics in this field are very missing, my hunch is that the majority of bad trips resolve in that way, as in, it's intense, but people survive it, and they get on with their lives.
00:20:34
Speaker
Yeah. And perhaps, you know, for people listening, maybe you have had that kind of experience in the more recent past and they're kind of not sure how to help, how to integrate it. Like, what are some ways that might be helpful just thinking about the audience for a moment? Like, if they've had a difficult time, I think, you know, I can think of some things, but from your perspective, what would you suggest?
00:20:57
Speaker
Well, I guess it depends. I mean, one of the things about psychedelic casualty work is I only get to see these people you know if they decide themselves that they are in need of of help. So there's a question there for for anybody listening, like the bad trip you had, does it feel resolved to your satisfaction?
00:21:16
Speaker
Or is it lingering in some way? And you would be amazed as me that, you know, people come to me with trips they had 10 years ago or 15 years ago or 20 years ago and they come literally 20 years.
Encouragement to Seek Help for Bad Trips
00:21:31
Speaker
So they come upon my website or whatever and they decide, now you know what, this is still hanging around.
00:21:37
Speaker
and And so what I would say is if you feel like you have had a bad trip and you feel like it's hanging around in some way, and you can get help for that. And I'd encourage and encourage people to to seek that help sooner rather than later. It can often be quite difficult if someone feels like they've spent 10 years of their life impacted by something like this.
00:22:04
Speaker
I could have, should have, might have got help for this far sooner. There's certainly no shame in having bad trips. I think, you know, yeah, I think therapists can help and then therapists with a specialty in this area can help possibly even more. Yeah. yeah Yeah, absolutely. Thank you. I think that's really important. I also have had clients who and sometimes it takes them a while to even tell me that they might be coming to see me for something else. Yes. And then and then in the assessment phase, you know, say they've come for like just anxiety in general, which is a generic term. But yeah,
00:22:38
Speaker
And then in the assessment phase, it turns out that it's not the whole story, but like 15 years ago, they had this terrifying experience and they've never quite integrated it. And and and and doesn't it still sits with them. and can i um That's a really good point, Esme. Can I kind of speak to that for a moment? Because I think it might be useful. Yes. you know i think people listening One thing I've found in doing this work and training others in this work is I think people in general underestimate the size of the problem. As in, I think we are, you know for everyone that seeks help for an intense bad trip, or for every psychedelic casualty that seeks help, I suspect there are five or 10 who don't. yeah and you know there and And they certainly don't often go back to the people that were involved in that trip. So to give you some examples,
00:23:29
Speaker
Very often when people seek out a psychedelic experience, let's say an ayahuasca ceremony, they've heard of other people having really good experiences, people having healing experiences. And so they go along and then if they have a terrifying or discombobulating or harmful experience,
00:23:48
Speaker
One of the first sort of things that happens is they blame themselves. It goes something like, well, everyone else had a great time. you know That person met God, that person healed their trauma. I went in this hellish landscape. There must be something wrong with me.
00:24:05
Speaker
Yeah. And that is one thing that can deter people from seeking help. Another really important factor there is, is sort of fear, you know, so often these, there's sort of few branches to this, but just to give you two examples, people are aware, are aware often that the symptoms they're experiencing in the aftermath are really unusual.
00:24:28
Speaker
And they worried that if they go to a psychologist or a GP and say, oh, I'm hearing a voice or oh, I feel like I'm mad that the one of the responses they might get is, you know,
00:24:43
Speaker
pathologizing that experience, medicating that experience, diagnosing them with X, Y or Z. and And so it's a very common story when I meet with someone to share with me that they were really worried to take this experience to a professional, to a mentor professional because of the stigma and because of you know some of the likely pathways that may lead them down.
00:25:06
Speaker
yeah but then The other fear piece is that often these experiences, yeah because they're not societally condoned or in many cases even legal,
00:25:17
Speaker
There's often this culture of but of, it's a secretive culture. Well, this facilitator is taking a risk doing this, so shh, don't tell any anyone and da da da. So for someone who's had a terrible experience, it takes a lot of guts and courage to say, contact that facilitator and say, Hey, I came along. I found myself in a really awful place. so and Can you help? Most people just disappear off the radar. Yeah. And there there are a number of other factors, if you know, and in a training, I'll go into all of them. But there are lots of factors that mean we don't hear from psychedelic casualties. Yes. Yeah.
00:25:57
Speaker
Yeah, I think that's really important to say and I think you know, I guess one track that I was wondering about going down with this is also like a question of are there a kind of particular because a lot of your work has been with people who've kind of gone in that mostly underground settings and have had these experiences is that But it's definitely also now we're having more and more people go through trials and more and more people going. Do you think it's less likely to happen in a clinical setting or are we still kind of trying to learn about that really? So yeah, just to be clear, I think I get quite a few people who've taken a psychedelic in a recreational setting. Yeah.
00:26:36
Speaker
So it could be like a rave or it could be like camping trip, it could be out hiking on their own, or it could be something more intentional, like an ayahuasca circle or an underground therapy session. So all of those things can show up as psychedelic casualties. I do believe it's far, far less likely that someone will end up as a psychedelic casualty if they've come through a clinical trial setting.
00:27:02
Speaker
It can happen. Certainly bad trips can happen. We know that. And challenging trips are the norm, you might say. But psychedelic casualties are very infrequent. And that is the short version is because there is a lot of attention generally given to support.
00:27:17
Speaker
Yeah, they're less likely to drop off the radar because we know, right, you know, like, if I think about our work, of course, there was many people that had challenging times. And that's actually part of their healing. But we're much more likely to catch it, aren't we? Because we're following up with them. That's after the session, we're seeing them for multiple psychotherapy sessions, there's a team involved, yeah and which is very different to if someone is out kind of on their own in the bush or a ceremony, and then You know, and some underground ceremonies have really good structures around support and set up, but and others others don't. And that's the trouble is that it's all very unregulated in that space.
00:27:53
Speaker
I think that's right. I think ah a lot of people, you know again, just to zoom out for a second, you some of the factors that are at play here are that on the one hand you have a lot of positive stories about psychedelic medicine and the outcomes. So the classic one being Fred has been depressed for 20 years. Fred did psilocybin assisted therapy. Fred is no longer depressed. and you know When that is heard by someone else who has been suffering with depression for decades, naturally they're like, wow, I need to try this. How can I do this? And so you have this you know surge of hope, but then when they go looking, what do they encounter? There's clinical trials and the chance of getting on one of them is about as good as getting struck by lightning or something like that. like it's very, very hard it's you know or or a clinic. But then the cost of the clinic at the moment is probably somewhere between 20 and $50,000. And so it's this cruel situation where it's like, hey, this is a wonderful treatment and could probably really help you. And guess what? You can't have it. you know And so there's a supply and demand issue. And so naturally, these people understandably go, OK, well, I can't do it in any of those sanctioned contexts.
00:29:11
Speaker
Where can I experience this? And then they won't necessarily have the information they need to be really discerning about where they go. So that's from the client side. From the facilitator side, I mean, I think, yes, broadly, you can say, look, some people do this well, others don't do it well.
00:29:32
Speaker
One of the things I've seen in my work is that the populations seeking psychedelic sisters to therapy have changed. So when I started doing this work back in about 2011, most people seeking this out were like psychonauts. They were like interested and they were kind of, you know, they'd go to Confest or some festival or you know, they do ecstatic dance and then try psychedelics.
00:29:56
Speaker
The population has shifted. So now you have a lot of people seeking out these treatments who are already dealing with severe mental illness issues or at least mental health
Clinical vs. Underground Psychedelic Therapy Settings
00:30:06
Speaker
issues. yeah And as we might get into, those people are far more susceptible to have bad trips and end up with psychedelic casualties. So my broad feeling is that People in the underground in general are not necessarily ready for the influx of this particular cohort of participants. They don't necessarily know what they're dealing with, but even if they are the most well-intentioned facilitator in the world,
00:30:35
Speaker
they don't have the supports around them that say you and I do in a clinical trial to keep track of someone. yeah So even if you're a facilitator and you're like, no, I'm going to take really good care. I'm going to do lots of prep and lots of integration. If that person goes to a place of shame or fear,
00:30:54
Speaker
They might just disappear. You can you can ring them, but they won't answer. yeah I've seen this from the other side. I've had clients who've been there and facilitators tried to reach and they're like, there's no way I was going to talk to that. But ah what would I say? Et cetera, et cetera. And so we're just not well supported, societyeally you know, for this kind of client showing up in an underground setting. So I feel like it's very fraught terrain at the moment.
00:31:19
Speaker
Yeah, that's such an important point, isn't it, that it really has shifted and there's you know there's lots of great things about psychedelic therapy being more widely understood and explain and explored and now available in Australia, but it brings with it these kind of challenges. yeah Because at the moment we're really, and this is probably a whole other podcast, we're really in a space of challenge in terms of the cost and trying to get this out there to the right people yeah because it's so new and because of the way it's been rescheduled. And that's probably all we can, that's ah that's a rabbit hole we can go down another day. But yeah, it would yeah I think it's important to to say that.
00:31:56
Speaker
Yeah, i look, and I won't go off on another tangent, but I will just drop this in that, you know I think even for those of us working in clinical part, it can seem odd that we are learning the ropes with these powerful medicines through the experiences of people who are already really, really struggling.
00:32:17
Speaker
and You could make a good argument at a society level that, okay, if we're going to try and integrate psychedelics into our society or healthcare frameworks, let's start with you know well people who have great support and all the rest of it. and Then as we find our way, then we might expand the circle you know safely to people who are dealing with greater job. But for systemic reasons, we're coming out it the other way. So we're starting with the most in many cases, the people who are struggling the most. yeah And so that that makes the work much more delicate, I think, for us in the field.
00:32:57
Speaker
100%. And then one hand, I can see why that they did it in that way, because I think there was a desperation, right, to try to find something, particularly for treatment resistant depression, because suicide rates are really high, and because they want to kind of do, to to find something new to work in that space. But I totally agree that It's always feels what we've had many conversations about this, but it feels like kind of almost the wrong way around. yeah like Because it's such a different way of healing, comparative to, especially people who've had a lot of mental health treatment. It's really coming at things from quite a different angle as well.
00:33:33
Speaker
which has its own challenges. But maybe we'll kind of shift back into psychedelic casualties now, like kind of honing into that. I'd say one more thing. yeah please and um Yes, please. please. Misbehaving podcast guest. but No, please.
00:33:49
Speaker
Thinking of your listener, just to really underline this point that what you read about in the media in terms of outcomes for clinical PET, what clinical PET is, like clinical psychedelic system therapy, often looks radically different to what you might experience underground, yeah to the degree that it's really, in many instances, a completely different treatment. So to not conflate those two things.
00:34:15
Speaker
Yeah, absolutely. And I think that's a really important point. And I think, you know, in terms of the clinical space that, ah you know, on our trials or in in spaces, there's many prep sessions, you know, at least three with two therapists usually. And then the dosing has two therapists and then two therapists working with you afterwards. And then there's another dosing. And so there's there's many sessions and many touch points and longer term follow up, which is very different.
00:34:43
Speaker
And it's within the, it's within a whole, I think what you spoke to is also really important that we as practitioners have support around us to help us to hold people too. Oh yeah. Yeah. Because if you think about like an underground facilitator, for example, they might be sitting in ceremony with 20 people, you know, and and then they do that regularly. And that's ah so meant, that is a lot of people to keep track of it as well. Yes.
00:35:09
Speaker
Yeah. So maybe we can go now into kind of when you, if someone was to come to you as a psychedelic casualty in your words, when you're kind of working with them, tell us a bit about that work. I don't mind where you take this really, like what feels useful to you, like what that might, what someone, how someone might present.
00:35:29
Speaker
maybe, and and some of the things you might do or be curious about. sure In as much detail as feels okay to go into on here. yeah Keep it general. I mean, so I guess in one way, the definition of a psychedelic casualty comes down to the client themselves. Like they have self-identified as someone who has had a psychedelic experience and that has caused them trouble. And that's why they're showing up.
00:35:55
Speaker
But in terms of of what they might present with, there are a few layers to it. So maybe I'll just give you some examples of the kinds of things that are pretty common. you know So one thing that people often report is a sense of feeling, the sense of discombobulation that they felt in the trip has persisted long after the trip. So they might give me a month later and they'll say something like, I still feel like I'm about to go mad or lose my mind.
00:36:24
Speaker
I have this persistent sense that I'm about to die. I, you know, what else might they say there? And you know, often when they're reporting that the trip content they will share will often center around what I come to hear about as the void, the abyss, a black hole, this kinds of thing. So this sort of encounter with darkness, blackness, that has this residual experience of of sort of yeah near death or madness and this kind of thing. And so for a person, that's just a very like a sense of being quite untethered often, ungrounded and things like that. More specifically, people will have experiences of of
00:37:07
Speaker
of things like what I call the possession. So this is where someone on the back of a psychedelic journey has the sense that something in the in their trip went inside them and is still inside them some weeks or months or years later. And they don't want it inside them or it causes them trouble, et cetera. And it might show up quite explicitly as a voice, but it might also just show up as as somatic sensations and other things. Another version of that, which I think of as like the haunting Similarly, someone encounters something in a trip and again weeks or months later, they still have this sense that this thing, which could literally be like something that feels like an entity or it could be like a mood or or something like that, is still kind of hanging around, like haunting them, floating around in their awareness in a really... Yeah.
00:38:00
Speaker
upsetting or unsettling kind of way. It might be useful. I mean, in in my trainings and in my work, I broadly identify two categories of bad trip content. yeah I call them existential themes and personal or sometimes relational themes. So the existential themes, and typically someone who's a psychedelic character will have had this kind of experience. And so when I say existential, it's a big word, but all I really mean is that What they're experiencing is sort of total or global in its scope. So it's like, I am going mad. I am going to die. I am not real. I am fundamentally isolated. So it's like, and it is this is a whole picture. It's about everything in my life. Or it's about the world itself. So the world is not real. Is it?
00:38:50
Speaker
Right? So like but the whole world is a big, cruel, common one. Whole world is like some big, cruel, fake joke, but no one else is in on the joke except me. They're examples of existential bad trips. And again, they often relate to that sort of ego dissolution experience, encountering like the abyss, the black hole, the void, but not always. And then there's this other class of bad trips, which I call but personal or relational. And I call, I use the word relational because they usually involve encountering something else. So I still sort of feel mostly like me, but I'm encountering a demon. I'm encountering a traumatic memory.
00:39:30
Speaker
I'm encountering, you know, a dark blob. I'm encountering an abusive person from my past. I'm encountering an answer, whatever it might be. So it's an encounter, an encounter experience. And through that relationship, the person has been left in a really difficult place. In most instances, you get both and they interrelate in really tricky ways.
Challenges in Psychedelic Casualty Work
00:39:53
Speaker
Yeah. And so but one of the this is why I've come to think of this field as a specialty because if you, again, if you just go in and try and deploy in normal therapeutic models, it's like, what is going on here? Everything keeps like slipp slipping and changing. Yeah. ah Sometimes I'll use the analogy of like,
00:40:12
Speaker
It's like being a carpenter and week after week, you adjust the door frame and the window frame, but then the foundations shift again and you're back the next week and everything is gone. All right, everything's skewed then. You do it again and everything's shifted. Yes, I don't know if that's helpful, but they're the two categories I tend to work with, existential and relational in terms of encounters. And within those categories, there are many different versions that can show up, but not an infinite number. So I think one of the really useful things in in my trainings and how I think about this is you can actually come up with a map that can capture most psychedelic bad trip experiences in terms of like categorizing, oh, yep, that was one of them and that was one of them.
00:40:58
Speaker
and we know now how to work with this kind of thing and we know how to work with this kind of thing. Yeah, I guess that can be really helpful for therapists who are kind of perhaps encountering this stuff for the first time, or or maybe not for the first time, but kind of starting to think about it in a different way. Yeah. Which I think is probably becoming more common than us as we move clinical path out into the world. I think more therapists are understanding it more, people are more likely to be coming to them. So I think it's really useful to think about that and the different types.
00:41:30
Speaker
As we can, I throw in one more piece, yeah which is which is slightly different, which is like, in a sense, symptoms related to those symptoms. yeah so ah Someone may have had any of the things I just described to you and in the training, we'll go through about 14 specific types of bad trip, but they will also have, you know, we were familiar from this from like working with anxiety.
00:41:52
Speaker
They will also have a new set of worries related to their symptoms. So for example, have I broken my brain? Very common for people to feel like, have I done something irreversible? Like I really damaged myself in a way and there's a lot of fear, a lot of regrets, a lot of grief, a lot of worry about like, I just wish I could go back and undo this, you know, was I thinking. And so, you know, one of the things I'm imparting early on is, hey, I've seen this before, you're not alone.
00:42:21
Speaker
ah We can help with this. You haven't broken your brain. I can ah feel very confident that they haven't broken their brain yeah and so on and so forth. So that's an example of like a symptom related to their idyllic symptom. Yeah. Yeah. Yeah. Thank you. and i i think I feel like that's so such an important thing. I was thinking about the messaging in the field around this is kind of, you know, there's a lot of really, really positive people to expect dialogue that, you know, psychedelics healed my depression, like you was talking about before, or lots of other things where I met God or, and then bad trips, I feel like if I think about when I first knew about bad trips before I did this work before I met you, it was more in the in line with the kind of almost the
00:43:07
Speaker
the banning of psychedelics, the kind of that dialogue is very extreme, like they're going to break your brain, like that was actually used, right? but I think the reason some people think that is because that was kind of used as a tool in the war against drugs, right? So I think it's almost like reclaiming this as yes, you can have a bad trip and it's it's not going to break your brain and we can help you is such an important message.
00:43:32
Speaker
I agree. is me I mean, it gets complicated because what I find is that that if people don't get the right kind of help, they can actually end up in a far worse place, oh which is a bit of a scary thing to say, a bit of a sad thing to say, but it is the reality. So, you know, and that's because our medical slash mental health system hasn't got a common language or a common understanding around, first of all, psychedelics, but certainly bad trips. And so these symptoms, if you look at them through a DSM framework or something like that, they resemble psychosis.
00:44:10
Speaker
Delusional beliefs, hallucinations, hearing voices, seeing things that aren't there. I mean, a ah mental health practitioner who's just applying the book will quite accurately go, yep, these are symptoms of psychosis. And so what that can mean is ah You know, I always feel relieved if someone comes to me a week or a month after their trip, not a year and a half or three, because if they and will still do the work, but if they come a year and a half or three, more often than not, they'll be on a couple of antipsychotic meds, they'll be on an array of other psychotropic meds, and they will have lived a year or two with all of their fears and worries and symptoms. And as we know, you know, they get more entrenched and they're more difficult to work with.
00:44:56
Speaker
And so it's kind of ironic, but for me, the the closest thing I've seen to a broken brain, which is a horrible phrase, but it's one client to use, is not related to the bad trip, but often to the effort to get help in the aftermath of that bad trip, leading someone to be in a really, really difficult place. And then sadly, in that category of like you know clients for whom you know There is a lot of stigma, things like schizophrenia, things like serious mental health conditions like that. And so for me, the tragedy is if you can catch this early, although it looks like psychosis, you can work with it quite quickly and quite efficiently and quite thoroughly and a need not go down that path.
00:45:43
Speaker
Yes. Yeah. So it's almost like we need another word for psychotic symptoms that are not actually yeah you know brought about in the way that other psychosis might emerge. Yes. Oh my goodness. This is a topic that I'm so interested in. I could go down so many tracks, but I completely agree with you.
00:46:03
Speaker
So for people who are kind of working in this space and they might be supporting clients who are coming to them for this and they want to kind of learn more, like could you you run a lot of training in this area. Is this a good time to speak a little bit about that and anything that you have coming up or how people might find out more? Because it does sound like something that's quite specialized and it would be but useful for people to learn more about.
00:46:30
Speaker
Yeah. Yeah. So I think, you know, I think it's fair to say there's not a lot of research in this field. And in a sense, it's hard to do because people, as we've said, do disappear off the radar and they're not taking psychedelics in any kind of controlled setting or anything like that.
00:46:47
Speaker
Yeah. Yeah. I mean, I can speak to the training that I do. I mean, what would I say about that? I guess, is that useful for me to sort of describe what that is and what that involves at this point? Yeah. Okay. So we we kind of start with a broad view, talking about some of the things you and I have talked about, like background factors and context. I break my training into sort of three parts, symptoms, causes, and treatment.
00:47:14
Speaker
And symptoms really includes all of this background content context, rather, you know in terms of where we're at as a society, the West's relationship with psychedelics, what people go into an experience like this, what their expectations and understandings are, but also just underlining the fact that as a culture and a society, we don't have an agreed upon way of thinking about psychedelic experience yet. Yeah. And that and that is in part what makes it so difficult for people to get the help they need, because every practitioner is thinking about it differently and working differently and so on. What you and I haven't talked about today is when I, in the training, go into the next bit, which is causes.
00:47:55
Speaker
So the reason it's useful to look at what causes a bad trip and and what causes particular types of bad trip is that that's an essential part of a client's recovery. So and one of the things I find in this work that I do far more than I do in my normal psychotherapy work is psychoeducation.
00:48:19
Speaker
And that is because it's really, really helpful to be able to offer a client an explanation or some way of understanding what they've been through that is different to the one that's just sort of popped into their head on the back of the trip, which might be I'm possessed, or it might be I'm broken, or it might be whatever it is. and so My sense is we need to be able to offer someone a narrative, an explanation of like, okay, so hiss here's what was happening when you went in, here's what happened when you're in there, and here's where you found yourself now. And that gives us a map for finding our way back.
00:48:57
Speaker
And so in part, when I'm talking about causes with practitioners in the training, well, in part, it's just it's very useful to understand what has happened when someone's had a bad trip. But I'm also kind of handing over a whole lot of psychoeducation materials that they can then hand over in a sense to their clients to help their clients make sense of what's happened. And just broadly, you know, really quickly, what I'd share is that Fear or a sense of unsafety is really integral to most bad trip experiences and thus most psychedelic casualty experiences. And the things that give rise to fear or a sense of unsafety, I really broadly break into internal and external.
00:49:40
Speaker
yeah There's all the things going on around me that might lead me to feel unsafe, contextual things. Where am I? Who's here? All of that kind of thing. And then there are the things that are happening inside me. So really the psychic material that I encounter from old memories, parts of myself to the ground of being or whatever else is down there. And we don't need to get into the metaphysics of that.
00:50:03
Speaker
And so really looking at the external and the internal factors separately yeah and and working through them. And so and my experience of working with clients and sharing these things is just waves of relief. ah e And so, you know, it it creates the possibility of putting down a lot of the fear and terror and confusion and mystifying elements of what's happened to them.
00:50:30
Speaker
And then the final part of the training, once we've gone through like looking at all of that psychoeducation and causes, is treatment. And so that's where I'm sort of sharing more detailed case studies of of treatment with someone who's come to me. We look at some video of of of work with clients, and then I go through sort of you know a nine-step process. and And like most processes in psychotherapy, it almost never goes one, two, three, four, five. close It's good to have the, you know, all of these steps or keys show up in some way. And so I really then walked through. And here are the things I've found are really integral to this treatment. And I think it's just really useful to have that map.
00:51:15
Speaker
to help people sort of not miss a step. Because as I said, this work can feel very slippery. You know, I found no way I think through trial and error. And in the training, you know, I guess what I'm trying to do there is spare other people 10 years of trial and error. You know, they're all you'll probably make here all the things you'll miss, misunderstand or misconstrue.
00:51:40
Speaker
Yeah, it sounds like really interesting training and also important. And I think, you know, our clients are our greatest teachers, aren't they? And it sounds like that's, this is kind of part of how you learned how to do this work. Yeah. understand Like it's, you know, it's only through people sharing the experience after experience after experience that I'm then looking at, you know, hundreds of bad trips and have all that kind of empirical data, if you like, and can then start recognizing patterns and giving things names and categorizing. And so, yeah, all of that rich data has come from clients who
00:52:19
Speaker
Yeah, have had the courage to kind of seek out help. I think one thing I would say to people, to to practitioners listening is this, you know, about this kind of work. I think just as there's a supply and demand issue for clients wanting psychedelic experiences, there's actually a supply and demand issue for therapists wanting to be involved in clinical work.
Psychedelic Integration: Ethics and Applications
00:52:42
Speaker
Like there's so many people want to do this work. There are so few opportunities.
00:52:46
Speaker
There are more and more. It's much better than it was three years ago when there was like one trial in the country. but and so That can give rise to dilemma for therapists. Like, what do I do? you know This is powerful work. I could help clients, but I can't work in the in the clinics or research trials, you know, should I go underground or geez, that, you know, that that's a bit dodgy, that's a bit fraught. Should I offer prep and integration work? Maybe I feel like it's quite a fraught space. It's quite a fraught time to be a practitioner who's drawn to this work. I think there are a lot of ethical considerations that people need to take into account. However, saying all of that, I think bad trip integration work or working with psychedelic casualties
00:53:32
Speaker
is really simply and clearly very ethical, very necessary. So this is someone who's already gone and had this psychedelic experience. You weren't involved in that and you couldn't don't condone it. And they've just turned up on your doorstep saying, I'm in trouble. And and so I feel like that simplifies things greatly. They want help, you know, can you help? And the other thing I'd say is that it it's a great way to get exposure to psychedelic experience. yeah know like Even as you and I say, working on clinical trials, like whatever training we might do, you're really learning so much on the job.
00:54:11
Speaker
all the time. Yeah. yeah And when you look back and you go, well, I know so little and yet I know so much more than I knew 10 dosing sessions ago. And I think this bad trip work is a way of just sort of getting exposure to what psychedelic experiences can look like for people, the kinds of places they can go, the kind of terrain encountered, the kind of challenges navigated.
00:54:38
Speaker
And so if you are a therapist interested in this work, maybe not yet able to work in trials or clinics, you know, putting yourself out there as someone who can work with people who've had bad trips or psychedelic casualties. I just think it's a great way. I mean, for me, I guess I'm telling my own story here, right? So this is how, you know, this is how I became, I feel very familiar with the psychedelic terrain without working on trials and clinics.
00:55:08
Speaker
10 years. Because when you just hear story after story after story, you can't help but go, okay, get a bit of a where people go and what happens. Yeah, absolutely. And I think, you know, as I've been listening to you, I guess I've been thinking about my own practice and and the people that I was speaking about earlier kind of landed with me through my, not through my work, it was prior to me being involved in psychedelic work, but more through, I guess, me taking an interest in of states of consciousness through meditation, but also having done my clinical doctorate research in psychosis and first episode psychosis. and So that's kind of how
00:55:46
Speaker
how that all happened. yeah And so there's actually people who maybe are not even working in the psychedelic space as therapists that still might find some of these concepts really important to hold. Because if I if i think about, it's definitely come up when people have come to see me for other things, be that anxiety, OCD, something that looks a bit like psychosis, but actually probably resolved in a different way for that person as well. So it's really useful to have some tools to have these conversations and find out a bit about what people have experienced, I think. Yeah, that's right. Yeah, absolutely. Yeah. All right.
00:56:24
Speaker
You don't need to be involved in clinical PAT to be involved in this, and you don't need to be involved in clinical PAT to be really good at this. Yeah, absolutely. All right. Well, is there anything that we haven't talked about in mindful work almost at time? So is there anything that you feel like it would be really important to share before we wrap up?
00:56:44
Speaker
Who is my audience? Talking to and to therapists. Therapists. I think both. I think both. So my final question that I had down here for you is what advice do you have for anyone starting out in the field and wanting to learn more
Future Developments in Psychedelic Therapy
00:57:00
Speaker
about this work? But I feel like we've kind of answered that maybe. I don't know if you want to go there. Well, by field, did you mean clinical psychedelics at therapy or did you mean bad trip integration?
00:57:10
Speaker
clinical psychodelic path. I think clinical psychodelic work. Yeah. I mean, I guess briefly on that, I think what I'd say is, although we use the phrase like psychedelic assisted therapy, the reality is that 10 or 20 or 50 years down the track, you're going to have an array of psychedelic assisted therapies yeah in the same way that you have an array of standard therapies. And so I think it's used for us for us to start moving in that direction already. So when you think about getting interested in this work, the follow-up question is, well, what what version of psychedelic assistant therapy speaks to you? you know yeah And there's a lot more I could say there. i think I think we're at the beginning of a very long collective learning journey.
00:57:59
Speaker
And so I feel like any sense of urgency people feel to get involved could probably be usefully put to one side. I don't think the field's going anywhere. In a way, there's a lot of like there's a lot of stuff in the clinical pet field that I hope will get ironed out over the coming years. And so in a way,
00:58:18
Speaker
It might be a more comfortable ride if you sort of get on the train in a couple of years down the track. It's been quite bumpy for me personally and for others involved. Yeah. So I think patients, and I think just recognizing that this is a form of therapy. So, you know, in some ways the best ongoing training for psychedelic assisted therapists is for them to keep pursuing their therapy learning and practice. Yeah.
00:58:45
Speaker
Yeah, absolutely. And you know, you and I have had several conversations about this, but and I've talked about it with other people on this podcast is that you know, this work, it's actually like assisted therapy is many things, and I would hate for it to become standardized to the point where it's just one type of therapeutic approach, because that's not actually how humans work, we need to different all of us. And so we need to be able to draw on a range of different psychotherapy approaches to suit the clients that we're working with. And also the kind of person and kind of therapist that we are already because it is like they're like assisted psychotherapy, right? So I think that's really important. And I think, yeah, I think the importance of doing continuing the training in their own therapy is really important. And in doing the work on themselves, having their own psychotherapy or or psychological therapy, so they really know themselves, I think is also something that's really important, stepping into this work.
00:59:45
Speaker
Yeah. I mean, on that one, you know, I think psychedelics are very potent. Yeah. And one of the risks is that we, we misconstrue that or misunderstand that as us being very powerful or potent as therapists. Yeah. And so that, that phrase, oh, I am not the medicine, I think is really important to keep front and center. But while, while the in a sense, the power is announced, the responsibility is. Yeah. And so you step into this frame where woof you know you're utilizing a very powerful tool and that places a great deal of responsibility on your shoulders. And so I think, yeah.
01:00:24
Speaker
trading with humility and not not caution necessarily, but awareness is a great but way to think about it. Yeah. Thank you, Sean. That feels like a really great way to to end, I think. So thank you so much for coming on to the podcast and talking about this really important, and I think not spoken about enough topic. So thanks. Yeah. Wonderful. It's me. I've enjoyed it. Thank you. Thank you.
01:00:50
Speaker
Thanks for listening. If you're interested in following along on the journey with me, check out my Instagram or website details listed in the show notes. And if you enjoyed this episode, please leave a review and share this podcast to help get this important conversation out to more listeners.