The psychedelic-assisted therapy experience: What to expect

For those who have tried them before, you understand when we say results may vary. If you have never tried them, every person’s psychedelic journey is unique, based on: What intentions/mindset have you brought with you? Where are you? Who else is with you? Who is your integration team?
It cannot be understated that 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. Sachi does not endorse, nor advocate psychedelic use without the support of a qualified and trained clinician. While everyone has a different experience, transformative journeys often have several common components. While the “trip” effect is brought about by a psychedelic molecule, the overall experience depends on an individual’s “set and setting,” and their understanding of the journey.

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?

Medium

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 on their headphones. The ideal setting brings feelings of safety and comfort for you both in location and with the people in the room: 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 believe strongly in the clinically-proven, vetted protocols from clinical trials for cancer. We use these guidelines for all of our recommendations, so that we can be sure that the experience is: well controlled and proven; under the supervision of a trained and qualified guide; and done in a safe setting.

LEARN MORE

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.PreparationPreparation is entirely about building comfort, rapport, and trust with your guide and support team.THE GUIDED DOSING SESSIONWhile 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, simply support you in whatever journey you 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 playlistINTEGRATIONThe 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, especially as a cancer patient, survivor, or supporter. Consider all of this advice as a set of 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, all of us have experienced 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

How do I get access to PAT?

RECOMMENDED REsources

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 Trial

WebMD video about a physician’s experience in one of the trials

The information on this site is for educational purposes only and is not intended as medical advice. Psychedelics may or may not be legal in your jurisdiction. Consult a lawyer if you have questions about the law, and consult your care team before making any decisions about your health. Legal notice.

Note: There are several psychedelics under investigation for treatment of the mental and emotional symptoms of cancer. While we focus almost exclusively on psilocybin, we will include breaking information from trusted sources about others (MDMA, Ketamine, etc.).