The Beginner's Guide to Psychedelic Medicine
If you’re considering using psychedelics as medicine, and aren’t sure where or how to start–this is the guide for you.
It will help you answer two questions:
- Is psychedelic medicine right for you?
- If so, what’s the best way to start?
Who am I to talk about psychedelic medicine?
I’m not an expert on everything about psychedelics. For a deep dive into the broader aspects of psychedelics, I link out to my favorite experts at the end.
What I am is an expert at being a beginner at using psychedelics as medicine.
I’ve spent the last 4 years using psychedelic medicine to help me heal my trauma. Though I’m a beginner, I’ve sought out and learned from some of the very best experts and guides in the world, and I’ve listened to them.
All this being said, I’m not just some random. Psychedelic Invest named me the #8 most influential person in psychedelics, and they did it mainly because of pieces I’ve written about my psychedelic experiences (like the piece I wrote about my first two MDMA experiences, or how to get started in psychedelics), or the many podcasts I’ve been on talking about my experiences.
I’m in the unique position of having 4 years of deep and intense experience with psychedelic medicine, led by some of these top experts in the space–but I still remember what it’s like to be a complete beginner who knows nothing and is totally confused.
This world was incredibly complex and hard to comprehend for me when I started, and I hope to make it easier for you.
I’m writing this guide to fill that glaring gap in the psychedelic space: to simply and clearly explain psychedelic medicine to the true beginner who is considering using it.
I will do my best to speak to you on your level, as plainly and simply as possible, with no other agenda than to help you make the best decisions for yourself.
Is Psychedelic Medicine Right For You?
IMPORTANT: This guide is NOT advice or advocacy.
Psychedelic medicine is right for many people, but NOT right for everyone.
In fact, many of you reading this will probably decide not to use psychedelic medicine–at least not right now, and that’s fine.
I approach this topic from a neutral perspective because I’m not selling you anything and I have nothing to gain from your decision, one way or the other.
This medicine has been so meaningful to me, I really do want to share what I know and have learned about it to help people. All I want is the personal satisfaction that comes from sharing my experiences and helping people make the right decision for their own lives–which in many cases is NOT to do it.
I will NOT tell you “should” do.
What I will offer you is INFORMATION about my experiences + what I learned from the many experts I’ve both read and personally interacted with.
In short: I’ll tell you what I’ve done, and what I’ve learned.
Ultimately, YOU MUST MAKE UP YOUR OWN MIND about what’s right for you personally.
Why Do Psychedelic Medicine?
The first question to ask: Why would someone take psychedelics at all?
There are two main uses for psychedelics:
- Healing trauma (therapy)
- Mind expansion (enlightenment)
In essence, you go looking for enlightenment or therapy.
Psychedelics are most well known in popular culture for their ability to expand the mind, and this piece is not about that. There are much better experts to consult if you are primarily interested in that (I link them at the end).
These days, most people who use psychedelics (at least as medicine) do so because of their incredible potential to help them heal their trauma.
If you’ve never heard of using psychedelics to heal trauma, and your only experience with them is the hippie culture of the 60’s, this might seem very weird. That was where I was about 5 years ago as well.
The easiest way to dive into the history of psychedelics as a medicine is to read Michael Pollan’s book, How To Change Your Mind.
The first half of the book goes deep into the history of psychedelics, how they used to be regarded as medicine up until the 50s, all the amazing research that was done then and how thousands of therapists used them for therapy, and how they got banned (fucking Richard Nixon playing politics), and how they came back into the mainstream. It’s a long read, and you don’t need to read it at all, but if you’re interested it will catch you up to the current day.
As of now, using psychedelics as medicine is a cutting edge idea, and not a passing fad, or some fringe notion. Some of the most prestigious research institutions in the world have set up dedicated centers to study this. Johns Hopkins, Imperial College, UT Austin, and UC Berkeley just to name a very few (literally new ones open up every month).
In case you’ve missed it, the past few years the news has been full of stories about this. It’s been covered in places as varied as Vox, Axios, Bloomberg, Wall Street Journal. You can google your favorite news outlet and “psychedelics” and get multiple articles to come up, as it has been covered quite a bit in almost every news outlet imaginable. Here are three different pieces in the New York Times just from the past year.
It’s so mainstream the VA of all places is using it. Even the incredibly conservative ex-governor of Texas, Rick Perry, is on board with this after seeing the results from vets he knows who used this treatment.
But you don’t need to rely on the corporate media to filter reality for you. I prefer to assess primary sources myself, and in this space, you can read the research directly–there’s already been a ton of it published. There are so many studies to read that show how psychedelics can help resolve PTSD, depression, anxiety, fear of death, smoking–the list goes on and on, it’s hard to keep track.
To follow along with the most cutting edge scientific research on psychedelics, MAPS is the organization you want to follow. They have a page that curates most of the research being done on psychedelics as a modality to heal trauma. You can access it here.
If you don’t want to read that, you can get the gist of all this research just reading this one paragraph summarizing (from here) some of the early results of MDMA research:
“In MAPS’ completed Phase 2 trials with 107 participants, 61% no longer qualified for PTSD after three sessions of MDMA-assisted therapy two months following treatment. At the 12-month follow-up, 68% no longer had PTSD. All participants had chronic, treatment-resistant PTSD, and had suffered from PTSD for an average of 17.8 years.”
If you don’t understand what that means, then Dr. Dan Engle, a board certified psychiatrist and psychedelic researcher, said (this is from amazing book about MDMA therapy, A Dose of Hope):
“When it comes to treating chronic severe PTSD, the current standard of care model (psychotherapy and medication management) has a roughly 35% improvement rate.
Compare this to chronic severe PTSD treated with MDMA-assisted psychotherapy. It has roughly a 70% cure rate.
At face value that sounds pretty good, as it appears to double the benefit rate. Except it’s better than that. MDMA-assisted psychotherapy is orders of magnitude better.
Conventional standard of care has a 35% improvement rate. A mild to moderate improvement is better than nothing to be sure, but it still means the symptoms are present and they are negatively impacting the person’s life in a significant way.
MDMA-assisted psychotherapy on the other hand, has a 70% cure rate. A cure in this context means a person no longer has symptoms meeting the criteria for even having PTSD at all.
This is not a small change. This is as big as it gets in the field of mental health.
No other tool known to the world today has as much potency and potential to help people heal trauma, and instigate change in their lives, than MDMA-assisted psychotherapy.”
The evidence is pretty clear that psychedelics work to heal trauma (among other things). But even if you believe the evidence shows this is clearly, that still leaves the question:
How do you know it’s for you?
Well, I hate to say this, but there’s no way to know for sure.
The best thing to do is learn as much as you need to about what the medicine does, talk to others who have used the medicine (or read the experiences others have with it), and then determine if you feel it’s right for you. That’s the only way you can know if it’s for you.
I don’t believe anyone else can tell you if it’s right or wrong for you. You must make up your own mind based on what you think and feel.
I can tell you what led me to using psychedelics as medicine:
I’d done 4 years of intense talk therapy and years of other therapeutic modalities like meditation, and though many of them helped, none really got to the core.
I was often angry or sad or depressed or anxious, and could not understand why, nor really solve the problem.
I felt stuck, and wanted to get unstuck. I wanted to get to the root of my problems, and stop dealing with symptoms. I wanted to live a life I knew I could live, but just couldn’t seem to reach.
Then a friend of mine did MDMA therapy, I saw the profound change in him, and I knew I wanted the same thing.
I already knew about some of the research and how people were using it, but it wasn’t until I saw the results on someone that I knew, that I realized for myself I was ready to do it.
And once I did it, I knew–this was the tool I was looking for. I describe my first two experiences here.
Again, I am NOT saying you should do it. I don’t know if it’s the right choice for you.
But in my experience, people tend to know–almost intuitively–if they want to do it or not. The ones who do want to do it feel as if they are “being called” to the medicine.
If you feel that way, it might be for you.
If You’re Interested, Where Do You Start?
Step 1: Set Expectations
There are several expectations to set for yourself, these are the ones I find most helpful:
Expectation #1: Psychedelic medicine is not a magic pill, and in fact, things can get harder before they get easier.
Many people who ask me about this medicine do so because they are looking for a quick fix, or a magic pill type solution. Something that will take their pain away, without much effort on their part.
If that is your desire–and I am not judging you, I was the same way at one point–then I would avoid psychedelic medicine.
This is something that often shocks people: psychedelic medicine can often make your life harder before it gets easier.
Why is this?
Because most of what psychedelic medicine does that helps facilitate healing is to create a space to bring up old, painful, traumatic memories and experiences.
The things you have run from and pushed away your whole life will come up. That shame you felt as a child that you have hidden away deep in your psyche? Well, letting it come up and feeling it will be very challenging. Yes, it will help you in the long run, but in the short run, it can be extremely hard to face.
By doing psychedelic medicine, it’s very common for things to get much harder for you, at least in the short term.
There are many people who kind of think they just take some MDMA and then everything will be better.
It doesn’t work that way. In fact, when taking this medicine, life can often get harder before it gets easier.
To be even more clear: psychedelic medicine does NOT directly cure you or heal you.
Psychedelic medicine opens a space for you to awaken your inner healer, so that you may do the work to heal yourself. This can make the healing journey easier, yes, but they do not do the work for you.
If you are looking for a magic pill or a quick fix, psychedelic medicine is not the approach to take.
Expectation #2: Healing trauma through psychedelic medicine is often a long process.
I went into this assuming it would be at least a 5 year process for me to heal my trauma, and that’s looking to be a pretty good expectation. I am 4 years in, have had substantial healing and improvement, but still have more work to do to work through the bulk of my trauma.
Don’t get me wrong, after even a few sessions I saw incredible changes and massive improvement. I could’ve stopped after only a few sessions, but I wanted to keep going and keep healing.
Even though I saw incredible results pretty quickly–as do most people–but the deepest healing often takes time (though not always).
And to be clear: time and psychedelics are, by themselves, not enough. Which leads to the most important expectation:
Expectation #3: Building a full therapeutic practice is an absolute MUST (and should come first).
The absolute KEY expectation to carry into psychedelic medicine is that it’s only ONE tool to be used in your whole therapeutic practice, and should NOT be the only tool.
In psychedelic medicine, everything you do to help you heal and process is often referred to as an “integration practice.”
So what is a good therapeutic/integration practice?
There is not ONE correct answer to this. There are many ways to build an effective integration practice.
I will say that almost all good integration practices involve some form of serious and sustained talk therapy. Being able to talk about your emotions and experiences with people who can be non-judgmental and on your side is an absolutely key aspect of this process.
My integration practice:
- Talk therapy
- Daily journaling
- Daily nature walks (I live on a ranch, this is easy for me)
- Acupuncture
- Body work (I really like cranial-sacral massage, and somatic release massage)
- Eight hours sleep every night
- No refined grains, sugars or seed oils, I instead eat a lot of meat, organ meats and other natural sources of crucial vitamins and minerals.
- Daily exercise (I do ranch work and BJJ/MMA 3x weekly)
I will dive deeper into building and maintaining an integration practice later, because it’s the most crucial piece of using psychedelics as medicine.
The important thing to take from this is that psychedelics are a tool that help you heal your trauma, but they don’t don’t do the work for you. They open a space for you to feel your emotions and integrate them–how you do that is what makes the healing take or not.
Expectation #4: There are real risks with psychedelic medicine that must be considered
The major risk is, of course, that psychedelic medicine is still mostly illegal in most places. We will talk about this further later on, but that is a real risk.
The other major risk is that it can make things worse before they get better. As discussed above, for many people, psychedelic medicine facilitates you feeling all the emotions you’ve avoided your whole life. That can be VERY challenging.
This is where a “bad trip” can come up.
A “bad trip” is conventionally defined as something like “a mentally or physically horrifying drug-taking experience, as one accompanied by nightmarish hallucinations or by physical pain.”
That’s not inaccurate, but its also not fully accurate. In my experience, a “bad trip” is when you aren’t ready or expecting for what comes up on psychedelics. But also in my experience, these very challenging experiences can be the most important experiences. If dark and hard things come up, its because they are in you and need to be felt before they can be let go.
To put it simply, the only way out of it, is through it.
This is why I’ve never used psychedelics in a purely recreational way. I can’t imagine taking LSD and going to a concert, for example. I’m not judging that experience, but for me, when I use psychedelics to heal trauma, I am expecting that it might be challenging, and I want to be in a set and setting that is best for me to deal with that.
Step 2: Pick Your Medicine
Your next step is to decide the psychedelic medicine you will use. There are many options for which medicines to use, and this area is where a lot of confusion comes in.
I hear lots of people with opinions about the various medicines, and most of those opinions I hear are based on poor understsanding of psychedelics or at worst, dangerous for people.
I will describe the major medicines, why you might use them, and what to think about when deciding.
MDMA
MDMA is the best starting point for psychedelic medicine for most people. This is for two main reason:
1. MDMA is by far the most effective medicine for healing trauma. MDMA is a nearly perfect medicine for dealing with trauma. The shortest explanation of how it works is that it helps you feel loved and safe, which makes the space for your body to bring up old traumatic emotions, process them, and let them go.
The best description I’ve heard is that it “feels like doing 5 years of therapy in a day.”
2. MDMA is safe and gentle. MDMA is very physically safe, but beyond that, the actual emotional experience of taking it is safe as well.
It is not technically a psychedelic in a chemical sense, and because of that, the experience is very different from what most people think of with psychedelics.
For example, on MDMA, most people know where they are, who they are, what time it is, and are fully in their mind, they simply have a deep and open experience of love and safety.
Contrast this to a true psychedelic like psilocybin or LSD, where once you take the medicine, you are on the “ride.” There is no getting off or modulating it, you just have to come out the other side.
This is not really so with MDMA. You can, to some extent, modulate the effects. If it feels overwhelming, you can take your mask off and distract yourself and reduce the felt impacts.
There is a much higher feeling of “control” with MDMA (though of course, the best possible scenario for healing is to surrender and let go of control), and MDMA is far less intense in most ways than traditional psychedelics.
If you’re interested in MDMA therapy, there is an amazing book about it that walks you through what every step is like, called A Dose of Hope (written by Dan Engle, a psychiatrist and one of the moderbn pioneers in psychedelics, and the book is incredible, I cannot recommend it highly enough).
My experiences with MDMA:
I have done at least a dozen MDMA assisted psychotherapy sessions, and though many of them were incredibly challenging, each one has been transformative and ultimately wonderful for me.
If I had to pick one medicine for trauma, MDMA is the hands down pick, no question.
Psilocybin
This is what most people call “mushrooms” because it comes from actual mushrooms.
Mushrooms are the “multi-tool” of psychedelics. You can use them effectively for almost anything that psychedelics can do: trauma healing, mind expansion, releasing the fear of death, etc. They’re an amazing and beautiful compound and I like them very much.
There are people who’ve used mushrooms to effectively deal with trauma, and for that, they can absolutely work.
Here’s the thing with mushrooms: they can be very dark, especially for people with a lot of trauma or those who are new to using psychedelics to help with trauma.
They can also be very confusing, because they tend to be very psychedelic in nature–meaning that there will often be lots of visuals, confusing symbols and shapes, and many other things going on that can be hard to interpret or understand.
If someone is really interested in dealing with trauma, mushrooms are not usually the optimal place to start. For most people, “graduating” to mushrooms is the best way to go.
One strategy I’ve seen many people utilize effectively is to begin by microdosing mushrooms, and then move to MDMA therapy, and from there move to larger doses of mushrooms. This is what I did, and it has worked great.
[This is an excellent beginners guide to microdosing mushrooms if that is appealing to you.]
My experiences with psilocybin:
I have done several mushroom sessions, ranging from microdosing to 8.5g (which is a large amount, and I of course did with a very qualified guide). In fact, I routinely microdose, using the Stamets Stack, which works great for me. I have found mushrooms to be an important part of my healing and growth (especially microdosing).
For me, mushrooms are most effective when used either as a microdose, or as a “reset” for me. When I feel stuck in my thinking, or spinning in circles on something, mushrooms are a great way to get me out of that cycle and open up space for new ways of thinking.
In my experiences with mushrooms, I usually get far more “mind expansion” than I get “trauma healing,” which is why I use them sparingly, and more as a supplement to my core trauma healing practice.
Ketamine
Ketamine is the best known compound for two things: suicidal ideation, and chronic pain. If you are thinking about killing yourself, or have chronic physical pain that won’t go away, nothing beats ketamine.
Studies are also seeing promising results using ketamine to help with depression, anxiety, and other issues as well.
There’s one major problem with ketamine: the effects tend to be very short lasting. The effect of ketamine (usually) only lasts about two weeks, though of course they can and often do last longer.
That being said, ketamine has one major benefit: it is legal and accessible to everyone in America, right now.
There are a few problems with ketamine:
- Ketamine tends to be a very dark and difficult medicine for many people, especially at the beginning of their experiences with psychedelic medicines. It is not technically a psychedelic, but has many psychedelic properties and can be very challenging for the user.
- Though ketamine is legal, and you can find clinics to do treatments, very few ketamine clinics are set up to do it in a way that is reflective of the intensity of the process. They essentially treat it as a basic outpatient treatment, but it is not, it is an INTENSE psychedelic treatment.
My experiences with ketamine:
I’ve never used ketamine in a clinic; all my experiences with ketamine were with licensed practitioners who administered it to me in a private, safe, and supportive setting.
One of the most challenging, but ultimately rewarding, experiences of my life was with ketamine. It took me to a very dark and hard place, and pushed me to access some parts of me I had stored away and forgotten. It was the first time I ever truly achieved ego death, and it was very very hard for me, but I am so glad it happened (now, at least, it was not fun during the process).
If I had done that early in my journey, I believe I would have considered it a “bad trip.” But I was ready for it when I did it, and so I was able to see even though it was very challenging, it was what I needed.
I also combined ketamine with another medicine, that helped me navigate that space.
LSD
I do not believe LSD is appropriate for everyone, and rarely at the beginning of a healing journey.
LSD can be harsh. It is reality breaking and boundary shattering, and this tends to be very disconcerting for beginners. If you are not ready to essentially have everything you believe challenged and broken, then LSD is not the option.
LSD is also impossible to predict. Reactions to it can vary widely based on dosage, biology, and other factors.
My experiences with LSD:
LSD has been my absolute favorite psychedelic medicine–it pulled the veneer off of reality and forced me to see all of those things I was avoiding. It did not “pull its punches” and felt like it was shoving my face into what I didn’t want to see.
This was extremely disconcerting and identity breaking–which what I was looking for at the time.
Had I NOT been looking for this, LSD would have been a very bad choice. I can see why so many people have what they call “bad trips” while on LSD.
As discussed before, a “bad trip” is best thought of as things coming up you are not ready to deal with, and LSD seems to bring them up.
I will say this: even though my intention is primarily to heal (right now), I get quite a bit of mind expansion on LSD. I don’t use it that often because of this: the mind expansion is incredible, but very distracting from healing (at least for me, it keeps me in my head instead of in my feelings).
Ayahuasca
Ayahuasca is a well known medicine, and I’ve used it and love it.
But aya is also one of the last places I would begin my journey, especially if my goal was to heal trauma.
I have known many, many people who began their healing journeys with aya, and it was extremely hard for (almost) all of them.
Two specific people I know are both very experienced with psychedelics have similar stories: they went to the jungles of Peru many years ago to begin their psychedelic journey with aya, and both of them spent weeks (or months) in a horrific agony of vomiting, shitting themselves, and intense psychological pain.
Both of them made it through, and both are–on one hand–very grateful for the experience. But both also cautioned me against starting with aya for this reason, and I’m glad I listened to them.
There are many people who disagree with me on this subject. I know many people who recommend people begin with aya, and you are welcome to seek them out and hear their take as well.
I will say this though: most people who call themselves “ayahuasca shamans” are NOT reliable and should NOT be administering that medicine.
Aya–along with iboga–are somewhat unique in that the skill of the shaman is absolutely crucial to the experience of the medicine.
With MDMA and ketamine and LSD–and to some extent psilocybin–you don’t usually need a skilled shaman, you only need someone who has experience with the medicine, has done their own work and knows how to hold space.
This is because the psychedelic does the work, and the guides job is to hold space.
But with aya, the shaman is very involved in the medicine itself. They sing, they decide how much medicine you get, they work with you actively during the process and guide the medicine itself. I know this might sound a bit out there if you have never done the medicine, and I was quite skeptical of this notion as well–until I did aya. Then it all made sense.
It takes years of apprenticeship and work to get to the point one is able to lead others in aya sessions. The problem is that most people calling themselves “shamans” are not experienced and did not apprentice under real shamans in a true lineage. One of the major risks of aya is in fact that huge demand paired with the lack of experienced and capable shamans.
There are VERY real downside risks when working with inexperienced aya shamans. I would and do not trust my mind and soul to someone who is not very experienced in handling that medicine.
My experiences with Ayahuasca:
I came to aya after 2.5 years of psychedelic medicine therapy, and it was great. I was ready for the intensity and the depth, and it helped me immensely. I would not have been “ready” had it been the first medicine I used, and would have been incredibly challenging for me, and possibly set me back.
A BIG part of why it was so great for me is because I was lucky enough to work with possibly the best shaman in North America. He trained with and lived with one of the primary tribes who use aya as a medicine for decades. I would not personally use this medicine with anyone who did not have that level of experience.
5-Meo-DMT
This is the deep end of the psychedelic ocean. 5-Meo-DMT is (arguably) the most “psychedelic” of all the psychedelic medicines, and is often lauded as the premier psychedelic for mind expansion.
Were I seeking mind-expansion only, this medicine might be my first choice.
But I do not recommend 5-Meo at all for trauma healing (for most people).
Again, there are people who disagree with me on this subject, and you can find them and listen to their opinions as well.
My experiences with 5-Meo-DMT:
I have done 5-Meo-DMT one time, and it was brutally challenging for me. Probably the hardest experience I have ever had with psychedelic medicine. It felt to me like I was feeling all the grief and sorrow of the world. I honestly felt like I was going to die from grief during the session (obviously I did not).
I was also way out of sorts for weeks afterwards. It took me awhile to fully re-center and get back to myself. And all of this happened even though I had a very experienced guide.
I will do 5-Meo-DMT again, but not until I feel as though I have faced and processed the vast majority of my life trauma.
Iboga
Iboga is called “grandfather” for a reason: it’s probably the most intense, most challenging psychedelic medicine there is (for most people).
Even though Iboga is very intense and challenging, it IS a place to start for some people. Iboga is considered one of the very best total immersion treatments for drug and alcohol addiction.
This is not a medicine to try lightly. Everyone I know with extensive experience in psychedelic medicines has said it is one of the most challenging medicines they’ve ever taken, and there are some real medical risks associated with it.
Do not do this lightly or with anyone less than an advanced shaman.
My experiences with Iboga:
This is the only medicine on this list I haven’t tried, because even after many years of deep and intense psychedelic medicine and integration and healing, I have not believed I was ready for it.
I expect this to change in 2023, and will update this when it does.
Step 3: Find A Guide
The difficulty of finding a guide varies widely based on the medicine you want to take. Here I examine both paths to finding a guide.
Fully Legal Options
- Ketamine
- Ketamine is currently legal in America. Most states and major cities now have several ketamine clinic options.
- Note that not all ketamine clinics are created equal. MANY are quite poor, in that they simply inject you with ketamine and don’t do any integration support.
- When selecting a clinic, pay attention to how they treat you outside of the administration of the medicine.
- Look for places that have someone with you in the room the whole time, and have some sort of psychological and emotional support.
- Psychedelic Churches
- Psychedelic churches are a legal way to find treatments. These are legal in America.
- There are many around, this is the best list I could find, though it is not comprehensive (or updated recently).
- Study Participants
- MDMA and psilocybin studies are currently on-going and many people looking for treatment are enrolled in these studies.
- Psychedelic Resorts
- Psilocybin is legal in Jamaica, and there are several facilities there that are reputable, though many have struggled with safety issues.
- Ayahuasca is legal in Peru, and there are a few legal clinics in other countries.
- There are also resorts in a few other central and south American countries (Costa Rica especially) that offer services in a quasi legal manner.
- Databases of treatment options
- There are several websites where you can find clinics, guides, integration coaches, and other services. Here are a few I trust:
- 1. Third Wave
- 2. Psychedelic Support
- 3. Healing Maps
- There are several websites where you can find clinics, guides, integration coaches, and other services. Here are a few I trust:
Less than fully legal options
- MDMA
- There is a small but high quality underground network of experienced and capable guides who will facilitate for people.
- If you’re reading this, you can reach out to me and ask for an introduction to a guide. I know two guides who are willing to take “blind” referrals. Email me through the contact form on this site, I will email you their contact information. I get nothing at all from this referral, of course.
- You can often find them through the databases I listed above, you just have to be discreet and read between the lines a little.
- Psilocybin
- This is the same as MDMA, in that there is an underground network of guides.
- LSD
- There are far fewer guides who facilitate with LSD. I only know two, and they only take personally vetted referrals, and usually only for a series of treatments.
- The reason is that LSD has such a long time frame in the body and can also require a skilled psychiatrist, thus it tends to have less experienced guides.
- Ayahuasca
- As I said, there are very few shamans who are truly experienced in Aya facilitation in America. The two I know and trust do not take blind referrals.
- Iboga
- Iboga is very similar to aya, in that an experienced guide is crucial. I only know one truly experienced iboga guide in America, and they do not take blind referrals.
Here is another resource about these options, which covers many of the points I make above.
Do You Need A Guide?
A question I get a lot: Can you do psychedelics without a guide?
Yes, of course it’s possible.
But in almost all cases, I do not recommend it, especially for beginners.
Psychedelic medicine is no joke, and entails a lot of risks and without proper experience, doing it alone magnifies that risk.
Furthermore, doing it alone can be re-traumatizing. If emotions come up that are hard to handle, and you don’t have anyone there to support you or help you work through them, that can lead to even more difficulty.
In my experience, having an experienced guide to hold space for you and be there to help is a crucial part of the process.
But yes–I HAVE done this medicine without a guide. Twice. Once MDMA and once psilocybin. Both times were very challenging and I did not take as much from them as when I do guided sessions.
Even if I don’t talk to the guide at all, having them there changes the experience drastically for me. I have found that all psychedelic medicines do is open the space for healing; the healing work itself is often done relationally, between two people. Talking can help at times yes, but even without talking, I have had profound healing experiences with guides there.
All this being said, there is a strong case to be made for doing MDMA without a guide in some cases. And if you are going to do that, there is a somewhat different approach to take than what I am describing. If you are looking to do that, I highly recommend this guide: MDMA Solo, by the Castalia Foundation.
I actually agree with 90% of their argument for why doing it solo makes sense. I agree that having a therapist in the room trying to intervene is a bad idea. Thats why I recommend a guide who does NOT intervene with the patient unless the patient asks, and not having your therapist be your guide.
Step 4: Assessing Your Guide
However you find your guide, know that they are NOT all the same. There is no formalized training (though there are training programs), and there is no formalized review or accreditation system (yet). It is your responsibility to assess your guide before you work with them.
I’ve worked with many guides, some of the most experienced and highly recommended in the world, and I still did my due diligence assessing them prior to working with them.
The number one thing I look for when assessing a guide: Do I trust them?
If I‘m going to open up my mind and my soul and ask them to hold the space to protect me as I do my work–and possibly interact with me while I do my work–I have to believe they can do that job effectively.
Though my trust is very much based on feeling, it is also based on other factors. The primary factor I cobnsider is have they done their own work, especially with this medicine?
If I’m going to use a psychedelic medicine to face the dark parts of myself–and that always has the potential to go sideways and be very challenging–I need to know they’ve already been there and done that, so they can understand how to help me should I need it.
To explore their experience and my level of trust, I like to ask them a bunch of questions. An example of some questions I ask of my guides:
- “How many times have you done this medicine, and how often do you still use it?
- “What have your experiences been like with this medicine?”
- “Who trained you in facilitation?”
- “How many people have you facilitated for?”
- “What happens if things get very hard for me?”
- “What’s the worst/hardest/most challenging thing that’s happened to you while facilitating?”
- “Why did you focus on this medicine? How did it help you in your journey?”
There are no “right” answers to these questions. For me, its more about finding patterns and seeing what they say and getting an idea of who they are. The more they tell me about themselves and their own story and their own healing, the better I know them. I like to know they have survived the things I may have to face.
I also like to see what questions they ask me. This is often enlightening.
For example, if I’m doing MDMA, the most important question to ask is about medicinal counter-indications. If you do MDMA while on SSRI antidepressants, that’s quite bad, and in a (very) rare worst case scenario, you can die. If the guide isn’t asking you what medicines you’re on, that’s a major red flag.
There is not a “must ask” list for guides, but the types of questions I look for are:
- Are they asking about what other medicines I’m taking?
- This is important for obvious reasons.
- Are they asking about my therapeutic and integration practices?
- This is important because it shows they understand that the medicine is only a tool, and they want to ensure you are both ready with a support system and capable of handling what comes up.
- Are they asking about my previous psychedelic experience?
- This is important because it shows they are looking for patterns as well, to ensure this is the right medicine for you and that its the right time.
- Are they pushing one medicine on me (red flag), or are they asking questions and trying to help me figure out what is best for me (green flag)?
- If I feel they are pushing a specific medicine, I am out right away. But if I feel they are listening to me and trying to help me find the medicine, then it creates trust for me.
For a great example of what it looks like to question a guide and have a guide question you, read the book A Dose of Hope.
It details a very enlightening exchange between a guide (Dr. Dan) and a new patient (Alex) in the first few chapters, and helps show how that conversation can go when done right.
Step 5: Preparation for The First Session
Once you’ve made the decision to move forward with a guide, it’s now time to begin planning for the session (and post session).
Your guide should have some sort of plan for you, depending on the medicine. For example, with MDMA, there are several supplements you can take and practices to do that make the process much more effective.
With psilocybin and LSD there are not (usually) any supplements to take, but many guides will recommend certain readings or practices to do in the week leading up to the session. For example, my mushroom guide had me avoid pork, sex, and processed foods for a week leading to the session.
Each medicine (and guide) has its own specific best practices, so I cannot give you a “correct” template.
The thing I will help you with is understanding and setting up your integration practice if you don’t already have one.
First, Build An Integration Practice
I’m going to walk you through my personal integration practice, then I’ll tell you about other things people have used effectively.
Building an integration practice is essentially building a self-care routine that is oriented around helping you heal your issues and become the person you want to be.
It’s not specifically “self-improvement” oriented. Think of it more as self-care. Self care, is at its core, keeping promises to yourself.
- Talk Therapy
The only thing I believe is a “must have” for an integration practice is doing some sort of talk therapy with a trusted therapist or qualified coach of some sort.
I define talk therapy as this: talking to a specific person on a regular basis, who is there only for you, and provides space to fully explore your thoughts and feelings in a supportive and non-judgmental space.
There are some many great talk therapists out there, but sadly, there are plenty who aren’t very good.
There is not a “right” way to find a therapist, but here is what I recommend:
- Make a list of at least 5, but ideally 10 to 15 therapists that are either recommended to you by friends, or seem appealing.
- Schedule an appointment with them.
- See how you feel during and after that appointment.
- Pick your therapist based on how well connected you feel to them and how much you feel able to trust them.
It is not a scientific method, but it is very effective. The most important factor to effective talk therapy is not the skill of the therapist–though that is of course a relevant factor–but how much you trust them, how comfortable you are with them, and how open you are willing to be with them.
Here is a long list of talk therapists of many different accreditations that are supportive of psychedelic medicine.
Important Note: It is normal and natural to “outgrow” therapists in time. A person can (almost) never help you deal with something if they have not dealt with something at least very similar. As you heal and raise your level of consciousness, you may outgrow your therapist and need to find another. That’s fine, and it does not mean anything “bad” about your therapist, or anyone else.
We are all walking our own path.
- Eight hours sleep every night
Creating a schedule that allowed me to sleep as much as I needed was one of the most important things I did for myself.
There are so many great resources about sleep, but the big thing I did was make sure my bedroom was totally dark, and cold. Helped me sleep a lot.
- Daily journaling
I’ve been journaling consistently since 2014, and daily since 2019. This practice has been incredibly helpful for me in so many ways that were hard to measure at first, but became very clear once I was consistent. The more I journal, the clearer and simpler my life becomes.
My journal prompts are very simple:
What happened today, and how do I feel about it?
What one thing am I especially grateful for today?
That’s (basically) it. But here’s the thing: it’s not prompts that create great journaling. It’s how I use it.
I use my journal as a place to be totally honest with myself and really allow myself to explore anything I want, in any way I want to.
I highly, HIGHLY encourage journaling for people who use psychedelic medicine. Commit to doing it for 30 days, and by the end you will understand what I mean.
- Daily nature time
I live on a ranch, so nature time is basically my life whether I want it or not. I am out in nature and with animals every single day, and it is incredibly refreshing. Just that change–moving from the city to a ranch in the country–improved my life at least 25%. Everything is so quiet and soothing, I was automatically calmer.
That’s not possible for everyone, but just about everyone can find some nature and be in it for a period each day. For me, it has become crucial to my daily routine.
- Body work
This basically just means massage or some other sort of physical work. To me, it’s a crucial part of integration. Great body work centers me and helps me really connect to myself and my emotions in another way.
I like acupuncture and I really like cranial-sacral massage as well. I also do energy work with a Andean trained shaman named Christina Allen, the head of the Austin Shamanic Center. I used to be a deep energy work skeptic, and then I tried it, and well…its pretty amazing for me.
There are many other forms of body work as well. Many people use somatic massage or things like lomi massage to actually access emotion.
- Serious nutrition focus
I got pretty serious about nutrition long before I was serious about mental and emotional health. I cut out all refined grains, sugars and seed oils at least 15 years ago, and it made my life much better. For the most part, I eat clean and healthy meat and vegetables, with some fruit and fermented dairy.
An important part of this for me is paying attention to blood work, and vitamin and mineral levels in my body. When I did my first micronutrient test a decade ago, I realized I was B-12 and magnesium deficient. Correcting those deficiencies alone leveled me up.
I do not take many supplements. Instead, I get all my nutrients by eating a lot of organ meats, like liver, heart and kidney. Yeah, that is too intense for many people, but its amazing for me. The only supplements I take are whole food ones, like liver pills.
- Consistent exercise
I’ve been consistently exercising for most of my life, so this is nothing new. But when I don’t exercise for a while, shit goes sideways.
My daily movement is doing ranch chores, but I also have a home gym, and do some sort of high intensity weight training at least twice a week. I also do BJJ/MMA 3x weekly.
- Conscious time with my family
This encompasses a lot of what is above, but one of the most important parts of integration for me is spending a lot of time with my family. I don’t just love my family–I really like them, so I have structured my life to spend as much time with them as possible.
This might seem obvious to you, but it wasn’t until the Covid lockdowns hit that I really saw how little time I was spending with them. Being forced to be with them all day was actually awesome, and I realized that was what I wanted my life to be like. So I made it that way.
- Daily Sauna & Reflective Thinking
I built a sauna in my backyard specifically so I could have a nice sweat every day and take time to really stop and reflect on my thoughts. Sort of like meditation, but more active.
The sauna has some amazing health benefits and intense sweating has a long history of association with shamanic practices, and I like that, but I mainly use it as a way to feel better each day and focus on my thoughts without distraction.
Other Forms of Integration
These are not things that are a regular part of my integration experience, but other people do them and really find them effective.
Meditation
I have never been a big fan of formal meditation, for many reasons. That said, many of the most experienced guides and psychedelic practitioners I know are avid meditators. I absolutely see the benefit in being still and connecting with your thoughts and feelings, but I feel like I do this in other ways than classic meditation.
One of the few true meditation masters I met told me that both BJJ and carpentry are forms of meditation, so I’ve got both of those going for me, which I guess means that I mediate in some form.
Yoga
To me, yoga has never made sense. It feels like a combination of bad exercise and mediocre meditation.
That being said, there are plenty of people who find it incredibly rewarding, and of course yoga has a long and deep history in the healing arts. The people I know who love yoga tell me it helps them connect to their body in ways nothing else does.
Float tanks
I have never felt comfortable in these, but I know many people who love them and swear by them.
Group Therapy
There are a lot of people who resist one-on-one talk therapy, but thrive in a group setting. With a skilled practitioner, that can absolutely work as well. Even informal groups can work, as long as there are people in there who have done their work and keep the group on track.
Red Light Therapy
This is one of those things that the science bros argue endlessly about. Some people love it. Others think its snake oil. I don’t know. I just go out in the sun on my ranch.
Second, Re-affirm Expectations and Set Intentions
This is simply making sure you really understand that this can get harder before it gets easier, and then understanding what your intentions are.
Setting intentions is a place that people tend to take it too far and spend too much time. I never spend much time on this, and I try to avoid getting too detailed.
For example, I will say something like:
“I intend to surrender to whatever comes up, let it have its say without judging or fighting it, and allow it move through me and back to where it came from.”
This is opposed to a more specific intention, the type I try to avoid:
“I intend to heal from all the pain of my childhood.”
I am NOT saying this is the “right” approach. But I have found it to be very effective–and I tried both.
Why do I take this approach?
Setting a specific intention is about control, which is not a useful frame for psychedelic medicine. I’ve found it far more useful to surrender to the experience as much as possible.
Third, Set Expectations with Those In Your Life
One of the big questions I get is “Do I have to tell people in my life I’m doing this?”
No. You don’t have to do anything.
That being said, it might make sense to tell people who are very close to you, especially those who live with you or you may rely on, on a day to day basis.
If you do feel comfortable telling them, then I tend to recommend being honest and upfront, discussing what you will be doing and what you will need from them afterwards.
Your guide should help you navigate this conversation and give you advice here as well.
A lot of people do get serious resistance from other people in their lives. That is a complicated area to talk about in general, let me just say this:
If people or factors in your life are not supportive of your truth and values, it may be time to leave them behind and continue on with the path you have chosen in life.
That has been a hard lesson for me to learn. But also a crucial one.
I also recommend you take as much time as possible after your session to recover. I like to take at least 3-4 days with little to nothing on my calendar to rest and recuperate and integrate everything that came up. The first few days after the session can be very impactful if you make enough space for them.
Step 6: During the First Session
Your guide should give you a pretty good rundown of what to expect from them during the first session. Anything they tell you should take precedence over what I’m about to write, but I want to at least give you a very basic and high level understanding of what a session is “normally” like.
The basic set-up is that you will go to the guides space that they have set-up. It will be a warm, comforting place, soft lighting, candles, sage, stuff like that is most common.
You’ll take the medicine, and usually lie on a sofa or small bed, with an eyeshade on.
Why an eyeshade?
Well, the visual system of your brain when active takes up a huge percentage of your brains resources. Turn that off, and you can’t distract yourself with what you are looking at externally, so you have to look internally.
If that sounds weird to you…it did to me too at first. But damn if it’s not accurate.
From there, generally speaking, you let the medicine do its work.
I’m NOT going to describe in detail what you will feel, simply because that’s impossible to explain this in words. If that sentence doesn’t make sense now, it will after your first session.
What I can do is give you some idea of the basic important themes.
Set & setting
The most important aspect of any session is what is referred to as “set and setting.” In short, set is the mindset you bring to the work, and setting is the total environment that the work goes on in.
Generally speaking, this is the domain of the guide. A good guide will help you get the right mindset, and then totally be in charge of the setting, so you can relax as much as possible and do your session safely.
Whole books can be written on set and setting, the key thing to remember is if you feel safe. If you do, you’re good to go. If not, pause and re-consider whether its the right place, person or time.
Intense Emotion
I’ll be upfront: you can expect to feel a lot of intense emotions.
Beyond that, it’s impossible to say what will happen. One thing people expect is that they’ll only feel “negative” emotions. No. They may not all be challenging. You may feel joy, appreciation, connection, etc. There is now way to know ahead of time.
The thing with emotions is that they tend to go away in about 60 seconds, maybe 90 seconds max. If you let them come and have their say, you can let them go.
This does not mean ALL emotions go away. The first time I did LSD, I was in grief for 9+ hours. It was what seemed like an endless cycle of feeling intense and horrific grief, surrendering to it as it reached its peak and cascaded over me in waves of sorrow and wracking full body sobs, and then it would recede, and I would recover for awhile and wait until the next wave. Almost like surfing, except I never got on the board, I just had a wave crash on me and pull me under, over and over.
But the important part is that I always came up for air. There were times I thought I was going to die from grief, but I never did. I just kept surrendering to it, and I eventually came through it.
The Basic Instructions: Trust, Surrender, Receive
The basic instructions I subscribe to for a session are this: Trust, surrender, receive.
Trust the medicine.
Surrender to the process.
Receive what comes up.
I know it seems basic, which is why it works. Whenever I get off kilter, I can always come back to trusting the medicine, surrendering to it, and receiving whatever comes up.
This is another one of these things that I did not get until I started doing this work. It seems easy and obvious, but once I was in the medicine, it wasn’t so easy.
Step 7: After The First Session
What to do after the first session?
Keep going with integration. THIS is where the work really happens. During the session, you might get 10% to maybe 30% during the session. The majority is after the session, and it comes from how you integrate what you felt.
This might be hard to understand until you’ve been through it.
One of the things I like to do is not talk about it with others for awhile. I find that talking about things is a way to “make meaning,” and can often just put me back in the same old patterns that were not serving me. Whereas the best part of integration is to let the meaning find me out of the space I leave–which means not talking about it.
Again, I know that probably sounds weird, but you will probably get it after you do a session or two.
IMPORTANT: It’s OK To Not Do It
If you decide that psychedelic medicine is not for you, that’s totally fine.
In fact, if you have any doubt, then it’s probably not the right thing for you, at least right now. For many people, it’s not right at all, and for others, its not right now, but will be right later.
I know for me personally, I had access to this treatment at least 5 years before I did it. Even though it’s the most important thing I’ve ever done for myself, I’m glad I waited as long as I did, because I was not ready 5 years before I did it.
I was ready when I did it.
Resources
Here is a list of resources I recommend to people who need more information:
If your goal is to use psychedelics to help you heal trauma and pain, there are three books I recommend:
- The single best book on MDMA is A Dose of Hope. If you are going to read one book, that is the book to read.
- The single best book on developing an integration practice: How To Do The Work. Its not at all about psychedelics, but the author nails the integration process very well.
- The single best book on trauma and why psychedelic medicine is so necessary: The Body Keeps The Score. This explains the science behind trauma really well, and is not necessary to read, but was really eye-opening for me.
You can read a lot more books if you want, but you don’t need to.
If you want to use psychedelics primarily for mind expansion, then there are several options. Here are the books I’ve found really useful:
- The best place to start to learn about general use of psychedelics for mind expansion is The Psychedelic Explorer’s Guide, by James Fadiman. This book is easy to read and a great resource on psychedelics by a true pioneer in the field.
- If you liked that and want to go REALLY deep, try Food of the Gods by Terence McKenna. I’m just going to warn you: that book will totally change how you see everything and melt your mind. At least it did for me.
Need More Help?
If you still have questions, reach out and ask. I will try to answer them.
