The psychedelic-assisted therapy experience: What to expect
Results may vary.
If you have never tried them, every person’s psychedelic journey is unique, based on your intentions, your mindset, your location and setting, and the people you’re with.
The journey of psychedelic assisted therapy is not meant to be a simple recreational experience. PAT can involve intense moments of introspection, self doubt, discomfort, and self-questioning. The entire journey is a lot of work. At Sachi, we we encourage psychedelic exploration under the support of a qualified and trained clinician.
While everyone has a different experience, transformative journeys often have several common components.
Set and setting
Popularized by Michael Pollan in his book “How to Change Your Mind,” set and setting refer to your mindset and physical location for your psychedelic experience. Both are important parts of the psychedelic journey.
Set: What mindset are you bringing with you?
- Do you have any unanswered questions or concerns before your session?
- What intention did you set for the experience?
- Are you open to any thoughts that may come up during the session?
- What is your overall state of mind and mood before the dosing session?
- Do you have a family history of mental disorders?
Setting: Where and who are you with?
- Where are you?
- Do you feel comfortable and safe?
- Do you trust the people around you?
SACHI’S TAKE
Set and setting are critical for anyone considering psychedelics, especially those facing a life-changing disease like cancer. Having the right mindset does not mean you must be in a good mood for their journey. In fact, optimism could limit the experience, preventing deeper feelings or ideas that might come up. At Sachi, most of our best experiences started with a relaxed, open attitude, and a firm intention that was set before the session.
The intention for a psychedelic journey is very personal. For some, it is to come to terms with a problem. For others, it is to explore a nagging question. There is no “right” way to set an intention—but rather, think of it as a mental “north star” to guide you through the journey.
Many people ask about the “optimal” setting. Once again, this is a personal choice. Some people favor the silence of the outdoors, while others feel more comfortable in a room with music. And, equally as important, the people around you can determine your experience: your guide, support staff, or other participants (in group therapy sessions).
In choosing your provider and path for PAT, there are so many variables to consider. We do not provide strict recommendations because every person is unique. However, we refer to the protocols from the clinical trials for cancer because they have produced consistent experiences and are clinically reviewed and approved.
Understanding the experience of psychedelic-assisted therapy
Knowing what to expect, and preparing for the 3 stages of PAT can decrease anxiety and increase the opportunity for a mind-changing experience.
1) PREPARATION
Preparation is entirely about building comfort, rapport, and trust with your guide and support team.
2) THE GUIDED DOSING SESSION
While this may be the shortest part of the overall PAT journey, the dosing session usually draws the most attention and uncertainty. The comfort of your physical setting is very important—whether you are outside or indoors, you should be comfortable. The therapist may not “guide” you, but rather, may simply support you if you need anything throughout the experience.
Music may be a part of the experience. A great summary of research on interactions of music and the experience of psychedelic assisted therapy sessions from the 
Beckley Foundation and Imperial College London. Read about the music playlist designed by Johns Hopkins for their psilocybin research. You can find the playlists used in some of the major critical trials on Spotify and other applications: Johns Hopkins playlist; Therapsil playlist
3) INTEGRATION
The integration phase involves making sense of the experience, applying its insights to everyday life, and fostering personal growth and healing. After the session, you should expect several sessions of traditional talk therapy. You may be encouraged to journal after the session, or use other forms of reflection like a mind map. Your guide will also discuss how to take these thoughts into the “real world” going forward, either through continued therapy, meditative practices, or other forms of introspection.
SACHI’S TAKE ON PREPARATION
Here are some practical questions to discuss with a guide. Through your discussion, you can get a good sense of feelings about your guide and the experience:
- What should I do to prepare in the days leading up to the session?
- What should I wear or bring to the session?
- Is it okay to eat or drink before the session, and are there any dietary restrictions?
- Would you recommend a blindfold during the session?
- Will music be played, and can I choose the playlist?
- Can I take bathroom breaks during the session, and how does that work?
- Can I bring personal items or tokens that provide comfort or significance to me?
SACHI’S TAKE ON THE GUIDED DOSING SESSION
Once you have established trust with your guide and understand the process, it’s time for the actual psychedelic dose! Consider all of our advice as guidelines more than actual rules. Our most important advice: prepare to embrace the process fully, knowing that you are in a safe environment with a trusted guide.
Letting go of your need to control and manage your thoughts is also key: recent research has shown that thinking and processing tasks might actually diminish the effects of the psychedelic (see the 
recent publication that discusses that effect).
The psychedelic journey, typically spanning 5 to 6 hours, has three distinct phases. Here is what to expect and some gentle guidance:
- The Come-Up (0–60 minutes): onset of relaxation or feelings of anxiety; start of audio/visual alterations, possible blurring of senses; potential for physical or emotional discomfort as your body reacts to the psychedelic; flushing of cheeks, body. Ensure you are comfortable, focus on your breathing, and establish the presence and reassurance of your guide.
- Sustain to Peak (2–3 hours): emotional intensification; changes in time perception; sensory enhancement/distortion; deep introspection and self-reflection may occur. Engage in dialogue or deep introspection. Use your guide if necessary to navigate emotional highs and lows.
- Come Down to Completion (1–2 hours): reflective thoughts continue with a gradual return to normal perception; emerging sense of calm as your system returns to baseline. Debrief with the therapist, hydrate, and rest in a calm environment for the rest of the day, giving your body and mind time to process the experience.
- Post-session—Restore and reflect: post-session reminiscing and processing usually takes several days or even weeks. The day after, and throughout the integration phase, consider journaling or using a voice recorder to capture thoughts and feelings, for discussion with your guide.
SACHI’S TAKE ON INTEGRATION
The integration phase is the longest and most important part of the entire journey with psychedelics. Your guide will provide some tools and frameworks to process the experience and thoughts that came up during the dosing session. Integration could last for months outside of your direct talk therapy sessions.
At Sachi, we have gone through integration and recognized our feelings, emotions, and thoughts changing, sometimes dramatically, and sometimes more subtly: we experienced reversals or changes in our views; we realized that we are less certain or absolute about certain topics; and we started questioning fundamental beliefs about life and the universe. As always, everyone will experience and take different things from their psychedelic journey. We encourage you to find community and support groups to continue the integration process.
Continue Learning from Sachi
Watch a powerful video from NYU trial patients
Watch the interview with JHU Psilocybin Cancer Project Participant
2018 study from NYU focused on the personal experiences from 4 trial participantsWebMD article about Aquilino Cancer TrialWebMD video about a physician’s experience in one of the trialsThe psychedelic-assisted therapy experience: What to expect
Results may vary.
If you have never tried them, every person’s psychedelic journey is unique, based on your intentions, your mindset, your location and setting, and the people you’re with.
The journey of psychedelic assisted therapy is not meant to be a simple recreational experience. PAT can involve intense moments of introspection, self doubt, discomfort, and self-questioning. The entire journey is a lot of work. At Sachi, we we encourage psychedelic exploration under the support of a qualified and trained clinician.
While everyone has a different experience, transformative journeys often have several common components.
Set and setting
Popularized by Michael Pollan in his book “How to Change Your Mind,” set and setting refer to your mindset and physical location for your psychedelic experience. Both are important parts of the psychedelic journey.
Set: What mindset are you bringing with you?
- Do you have any unanswered questions or concerns before your session?
- What intention did you set for the experience?
- Are you open to any thoughts that may arise that may come up during the session?
- What is your overall state of mind and mood before the dosing session?
- Do you have a family history of mental disorders?
Setting: Where and who are you with?
- Where are you?
- Do you feel comfortable and safe?
- Do you trust the people around you?
SACHI’S TAKE
Set and setting are critical for anyone considering psychedelics, especially those facing a life-changing disease like cancer. Having the right mindset does not mean you must be in a good mood for their journey. In fact, optimism could limit the experience, preventing deeper feelings or ideas that might come up. At Sachi, most of our best experiences started with a relaxed, open attitude, and a firm intention that was set before the session.
The intention for a psychedelic journey is very personal. For some, it is to come to terms with a problem. For others, it is to explore a nagging question. There is no “right” way to set an intention—but rather, think of it as a mental “north star” to guide you through the journey.
Many people ask about the “optimal” setting. Once again, this is a personal choice. Some people favor the silence of the outdoors, while others feel more comfortable in a room with music. And, equally as important, the people around you can determine your experience: your guide, support staff, or other participants (in group therapy sessions).
In choosing your provider and path for PAT, there are so many variables to consider. We do not provide strict recommendations because every person is unique. However, we refer to the protocols from the clinical trials for cancer because they have produced consistent experiences and are clinically reviewed and approved.
Understanding the experience of psychedelic-assisted therapy
Knowing what to expect, and preparing for the 3 stages of PAT can decrease anxiety and increase the opportunity for a mind-changing experience.
1) PREPARATION
Preparation is entirely about building comfort, rapport, and trust with your guide and support team.
2) THE GUIDED DOSING SESSION
While this may be the shortest part of the overall PAT journey, the dosing session usually draws the most attention and uncertainty. The comfort of your physical setting is very important—whether you are outside or indoors, you should be comfortable. The therapist may not “guide” you, but rather, may simply support you if you need anything throughout the experience.
Music may be a part of the experience. A great summary of research on interactions of music and the experience of psychedelic assisted therapy sessions from the Beckley Foundation and Imperial College London. Read about the music playlist designed by Johns Hopkins for their psilocybin research. You can find the playlists used in some of the major critical trials on Spotify and other applications: Johns Hopkins playlist; Therapsil playlist
3) INTEGRATION
The integration phase involves making sense of the experience, applying its insights to everyday life, and fostering personal growth and healing. After the session, you should expect several sessions of traditional talk therapy. You may be encouraged to journal after the session, or use other forms of reflection like a mind map. Your guide will also discuss how to take these thoughts into the “real world” going forward, either through continued therapy, meditative practices, or other forms of introspection.
SACHI’S TAKE ON PREPARATION
Here are some practical questions to discuss with a guide. Through your discussion, you can get a good sense of feelings about your guide and the experience:
- What should I do to prepare in the days leading up to the session?
- What should I wear or bring to the session?
- Is it okay to eat or drink before the session, and are there any dietary restrictions?
- Would you recommend a blindfold during the session?
- Will music be played, and can I choose the playlist?
- Can I take bathroom breaks during the session, and how does that work?
- Can I bring personal items or tokens that provide comfort or significance to me?
SACHI’S TAKE ON THE GUIDED DOSING SESSION
Once you have established trust with your guide and understand the process ahead, it’s time for the actual psychedelic dose! But, everyone’s experience will be different. Consider all of this advice as guidelines more than actual rules. Our most important advice: prepare to embrace the process fully, knowing that you are in a safe environment with a trusted guide.
Letting go of your need to control and manage your thoughts is also key: recent research has shown that thinking and processing tasks might actually diminish the effects of the psychedelic (see the recent publication that discusses that effect).
The psychedelic journey, typically spanning 5 to 6 hours, has three distinct phases. Here is what to expect and some gentle guidance:
- The Come-Up (0–60 minutes): onset of relaxation or feelings of anxiety; start of audio/visual alterations, possible blurring of senses; potential for physical or emotional discomfort as your body reacts to the psychedelic molecule; flushing of cheeks, body. Ensure you are comfortable, focus on your breathing, and establish the presence and reassurance of your guide.
- Sustain to Peak (2–3 hours): emotional intensification; changes in time perception; sensory enhancement/distortion; deep introspection and self-reflection may occur. Engage in dialogue or deep introspection. Use your guide if necessary to navigate emotional highs and lows.
- Come Down to Completion (1–2 hours): reflective thoughts continue with a gradual return to normal perception; emerging sense of calm as your system returns to baseline. Debrief with the therapist, hydrate, and rest in a calm environment for the rest of the day, giving your body and mind time to process the experience.
- Post-session—Restore and reflect: post-session reminiscing and processing usually takes several days or even weeks. The day after, and throughout the integration phase, consider journaling or using a voice recorder to capture thoughts and feelings, for discussion with your guide.
SACHI’S TAKE ON THE INTEGRATION PHASE
The integration phase is the longest and most important part of the entire journey with psychedelics. Your guide will provide some tools and frameworks to process the experience and thoughts that came up during the dosing session. Integration could last for months outside of your direct talk therapy sessions.
At Sachi, we have gone through integration and recognized our feelings, emotions, and thoughts changing, sometimes dramatically, and sometimes more subtly: we experienced reversals or changes in our views; we realized that we are less certain or absolute about certain topics; and we started questioning fundamental beliefs about life and the universe. As always, everyone will experience and take different things from their psychedelic journey. We encourage you to find community and support groups to continue the integration process.
Continue Learning from Sachi
Watch a powerful video from NYU trial patients Watch the interview with JHU Psilocybin Cancer Project Participant 2018 study from NYU focused on the personal experiences from 4 trial participants WebMD article about Aquilino Cancer TrialWebMD video about a physician’s experience in one of the trials