Psychedelic experiences can be immensely powerful. They can be both beautiful and majestic, and in other instances, quite harrowing. Being prepared is key to attaining the right kind of “set” for such a potent experience (set refers to the “mindset” of the psychedelic traveler).
Whether you’re using psychedelics recreationally, or as a part of therapy, preparation is an essential component in cultivating the optimal conditions for the psychedelic journey. This article will focus on preparation in the context of psychedelic-assisted therapy and describe some of the basics used by therapists at the Institute for Integrative Therapies,a psychedelic therapy and advocacy clinic in Minnesota. We will also have future blog posts that expand on each of the elements below. The following is just a high-level overview.
What is preparation like in psychedelic therapy at the Institute for Integrative Therapies?
Preparation is the second phase of treatment at the Institute for Integrative Therapies (IIT), following the assessment phase (which includes a mental health evaluation with an IIT therapist and medical exam with our physician). At IIT, we put a lot of intention into the preparation phase of the psychedelic therapy process (see our other blog post HERE for a review of the basics of psychedelic therapy at IIT). The number of sessions really depends on what someone needs in order to feel ready, and the average person lands somewhere around 3-6; we’ve done as little as 1 and as many as 10+.
During the preparation phase, we collaboratively build a framework for navigating the psychedelic experience- utilizing various tools, ideas and concepts drawn from various therapeutic modalities (theories), as well as what we’ve learned from traditional and historic practices involving the use of psychedelic medicines for healing purposes. Preparation is really building the foundation for the psychedelic experience, and for the ongoing “life work” of post-psychedelic integration.
Most importantly, we work with the individual person to support them in articulating their own approach for navigating their experience (based on their beliefs, values and worldview). It’s important that we not impose any one specific way of doing this, but rather use our knowledge and experience to help support you in creating a process that best fits you.
A key component to feeling safe during a psychedelic experience is the relationship you have with the people who accompany you. At the heart of preparation is the cultivation of a trusting connection with your therapist and physician. We spend as much time as we need to, in order to ensure that you feel like you’re in the presence of people you’re able to be vulnerable with. We do our best to show up as authentically as possible, andto learn from you how we can best support. As part of this, we discuss what it means for you to ask for and receive help from others, and together we identify a plan for how we will show-up and respond in your treatment session, should anything distressing arise. Once you can trust, you’re able to let go, and fully immerse yourself in the psychedelic experience.
Throughout the preparation phase, you may also desire to connect with our medical director, Dr. Doss. He is always open to talking with you to address any questions you may have, and to make sure you feel safe with him as your treating physician and co-facilitator.
It’s paramount that we have an ongoing conversation around consent and boundaries- what feels safe, what doesn’t and how we can demonstrate respect for your boundaries throughout the process. In psychedelic-assisted therapy, we sometimes use mindful physical touch such as hand holding or a hand on the shoulder (if and only if someone requests this as part of their experience) and review informed consent on an ongoing basis. For some people, hand holding during moments of intensity can be grounding and a reminder of the therapist’s presence.
Expectations & Fears
A lot of people reach out seeking to experience transformational, life-changing and revelatory experiences with psychedelics. For people who’ve never had a psychedelic experience, reading such powerful stories of others’ journeys can be inspiring, and they can also place undo expectations on one’s-self and the psychedelic experience in general (“If I don’t have a transformational experience, I must’ve done something wrong… or it won’t help me.”)
While powerful, transpersonal experiences can and do happen with psychedelics, they definitely don’t have to, in order to have an impactful and course changing experience, AND having them doesn’t guarantee long-term change. What really counts, regardless of the content of your psychedelic experience, is the work and intention put into the preparation and integration. It’s not the insights that most matter, it’s what we do with them that counts.
In the preparation phase, we talk through expectations, and help to orient you to how can approach and value the psychedelic experience, and most importantly we explore what it looks like for you to live a meaningful life. In this discussion, we explore the existing barriers to your engagement with core values and sources of meaning and see how the powerful disruption, a psychedelic experience can offer, fits into your broader movement towards healing.
Additionally, we talk a lot about fears, worries and anxieties, and together identify how we can approach these should they arise during the treatment experience. This includes an exploration of trauma and other life experiences that may be distressing, and cultivate an “attitude” for how we can “move through” such material when it comes up.
Identifying sources of suffering
People seek out therapy to heal wounds, and it’s essential for us as guides to understand the sources of such pain, and what it means for the person experiencing it. How do you make sense of your suffering? What’s the story around such pain?
We want to uncover someone’s internal narratives, and how their suffering fits into a life story and worldview. We may identify ways in which such internal stories are not serving someone well and explore what life would look like if these stories had less control or dominance in someone’s life. During the psychedelic experience, we often open up the possibility of gaining distance from unhelpful narratives, and of finding new ways of conceptualizing our struggles- who we are, and our place in the world.
When we explore psychological and emotional injuries, we tend to uncover what someone values most dearly in the process. As Steven Hayes simply puts it, “where we hurt is where we care”.
Inner healing intelligence
At the heart of psychedelic therapy is the concept of inner-healing wisdom or intelligence. The idea is that within ever individual, there is a deep aspect of the psyche that’s innately driven towards healing, wholeness and integration. During the psychedelic experience, defenses and barriers are lifted and the inner-healing intelligence “takes the wheel”. During preparation, we explore how to develop trusting relationship with one’s own healing intelligence.
I can’t recall where I heard this, but someone likened this to a tree’s seed- within it is an innate drive towards becoming a tree, and all it needs are the right conditions in order to blossom in the way it’s destined to.
Having an intention helps to organize your thoughts and your process around what’s most important to you, and to your experience. Intentions are not the same as goals, but instead more general “aims” to which we can set our sights; often times these are connected to our core values, and generally what we want our lives to be about. We start by asking the question, why are you doing this? And what would you like to get out of this experience? What does healing look like for you? What do you want clarity around? To let go of?
Intentions are component of the process that we continually refer back to and involve a deeper conversation between you and your therapist to identify how these will be infused into your process. Beyond “symptom reduction”, our goal is to help reconnect people to sources of meaning in their lives, and often times intentions help to “thread the needle”, involving an exploration of what life would look like if we were living in accordance with our ultimate values.
During my certification training I heard the phrase, “it’s good to have an intention, but not an agenda”, and this is quite fitting. Ultimately, we should hold our intentions loosely, and allow for whatever happens to happen. Whatever comes up is exactly what is needed for healing and growth.
Connected to intention-setting, is the optional exploration of “meaningful objects”, that can be brought into the treatment session and process. These might be photos of a loved one, a sentimental gift or object, or anything else that is tied to one’s intentions and values. Often times, travelers will bring both a meaningful object, and a piece of writing (poem, or favorite quote), that’s incorporated into the beginning of the treatment session. Some people choose not to do this, and others develop a “ritual” based on such items.
We can never predict how the psychedelic journey will unfold, and so much of preparation involves us developing a willingness, and openness to whatever experience arises. However, we can predict exactly how the “procedure” will go, in terms of what you can expect from us and the sequence of events. During preparation, we review the process of your session multiple times, and answer any questions you have about it. By process, we mean things like- what happens when you get to the office, how we will review your intentions, how we will check in during the experience, how we will provide support should you need it, how the music and headphones work, etc.
Other than the basic protocol, this structure will largely be directed by you, and we will agree to stick to the plan so that there aren’t any surprises.
If the psychedelic experience is like water, music is the vessel. We curate personalized music experiences for each person we serve. We explore your preferences, musical interests and relationship to sound during the preparation phase. To learn more about our approach to curating music playlists, check out this blog post HERE.
Building a framework
Throughout the process, we are exploring your beliefs, worldview and values, and supporting you in cultivating a structure and “philosophy” to approaching your healing process that fits for you. We adapt our language, concepts and knowledge in a way that’s most likely to resonate. We can’t emphasize enough the significance of doing this in a way that’s most meaningful to you. Humans tell stories, and we constantly seek to make sense out ofour experiences- how you interpret, perceive and believe is key to building a philosophy most likely to sustain change and to guide your ongoing journey on the path towards healing and wholeness.
The Institute for Integrative Therapies is a psychedelic therapy clinic in Minnesota, currently providing psychedelic therapy using Ketamine.The Institute for Integrative Therapies will be providing MDMA assisted therapy and psilocybin assisted therapy in Minnesota, as soon as these medicines are available for clinic use. Kyle Keller is a certified psychedelic assisted therapist through the California Institute for Integral Studies and has completed his MAPS MDMA assisted therapy certificate for Parts A-D. He is currently providing Ketamine assisted therapy at IIT’s Saint Paul psychedelic therapy clinic.
To learn more about IIT, our mission and philosophy, check out our FAQ page (and stay tuned to future blog posts, where we will further articulate our vision, thoughts and ideas.