How to Survive a Bad Trip, According to a Psychedelic Therapist

December 14th, 2023

Awake Goy

This article originally appeared on VICE Germany.

A sunny day outdoors, good friends, and an afternoon of funny, mind-expanding experiences—that’s how everyone hopes their psychedelic trip will go. Unfortunately, things don’t always turn out that way. Even if you’re an experienced drug user, chances are you might have a bad trip someday, a negative experience while high on psychedelics like LSD, mushrooms, or ayahuasca.

A “bad trip” is a bit of a catch-all that refers to anything from anxiety to full-blown panic attacks or even psychoses and delusions. From a scientific point of view, we still don’t understand particularly well why bad trips happen or what they are exactly. What we do know is that, surprisingly, people who went through one don’t always regret it. Some say they later understood it as an important moment of growth.

But finding a silver lining after having dreadful hallucinations isn’t easy. That’s why Berlin-based anesthesiologist and physician Andrea Jungaberle decided to specialize in a type of therapy that helps people make sense of what they experienced while on psychedelic drugs, both the good and—most importantly—the bad.

Jungaberle believes psychedelics have great therapeutic potential and is also participating in a study to treat mental health patients with the help of psilocybin, the psychedelic component in shrooms. We spoke to her about what happens during a psychedelic trip and what you can do to avoid some of their more negative repercussions.

Andrea Jungaberle – woman with dark hair in an updo and blue eyes dressed in black smiling at camera

Dr Andrea Jungaberle.

VICE: Hello Dr Jungaberle. Some people say there’s no such thing as a bad trip. Why?
Andrea Jungaberle: Many of the trips people perceive as negative are just very demanding or challenging—living through them means learning something about yourself or the world. However, there are also some truly horrific trips, for instance, when someone thinks they’re in a state of danger or close to death. It can be very hard to draw some positives from these kinds of experiences, at least at first. That’s why we offer help with that in the form of integration therapy.

What does integration mean, actually?
Integration means you work with the psychedelic experience to integrate what you’ve learned during the trip into your life. In the best-case scenario, you’ll see a change in your behavior or perspective.

In general, I’d recommend this integrative mindset to anyone who has had a psychedelic experience. It starts with thinking about what you’re taking, with whom and where you’re taking it beforehand. The better prepared you are for the experience, the more likely you are to do the integration on your own. But obviously, there’s no guarantee.

What do you mean?
You might have 20 years of experience with psychedelics and have a bad trip the hundredth time you do it. It doesn’t even have to be a high dose. Anyone seeking a psychedelic experience puts their psychological integrity at risk. You have to keep that in mind. Psychedelics simply aren’t playthings.

Are some people particularly at risk?
Definitely. Mentally healthy people have an easier time integrating intense psychedelic experiences. Due to recent research on the possible effects of psychedelics on mental illness, more and more people are trying to use psychedelics to treat their depression, anxiety, or trauma by themselves. This is partly because there’s simply no legal way of accessing these treatments at the moment. And integrating your experience without a therapist can be very overwhelming.

What experiences are particularly difficult to integrate?
Those related to fear or shame. For example, feeling your own mind is broken or that you broke the world, that you’ve encountered the ultimate evil, or that you’re dying. It can be anything, really. Those experiences are closely tied to our primal fears. Often, the main issue is that the person on drugs can’t surrender to these negative experiences.

Why should they surrender?
Psychedelic experiences are often about acceptance. People who believe they’ll make it out unscathed usually get through it better than people who fight it tooth and nail. That only makes things worse and worse, and you might come out of it feeling like you can’t cope with what you’ve just been through. The negative effects can also continue beyond the trip in the form of sleep disturbances, for example, or loss of appetite, stress, anxiety. In this case, integration therapy can really help.

So you mostly need therapy for negative experiences?
Not necessarily. People who have gained important insight but don’t know what to do with it also come to us. Sometimes it’s for practical things, like someone understanding why they smoke during a trip and wanting to quit without knowing how.

Why are we suddenly able to realize important things during a psychedelic trip?
There are several theories, but we don’t have a clear answer. The theory that makes the most sense to me on a neurobiological level is that these substances connect areas of the brain that don’t normally communicate.

Think of it like this: Some areas of our brain have formed groups that are used to work with each other. Out of the blue, psychedelics introduce them to new team members, giving you access to new voices and images. You remember things differently or make mental connections that weren’t possible before.

You can see it happen in MRI scans when you’re measuring someone’s metabolic activity and blood flow during a trip. We call these experiences disruptive because they stir things up. That’s where the healing lies. But if you stir things up too much, you can also break something. There’s a difference between intense and too intense, and the line is different for everyone.

Why is the experience so personal?
We all have different hardware and software, if I may use the computer analogy here. The hardware is our brain. We’ve all developed different neural connections over the course of our lives. Someone who’s been depressed for 20 years will have different brain pathways than a healthy person.

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