How to Prepare for Psychedelic Therapy
So you’ve made the decision to embark on a psychedelic therapy program… what now?
How do you adequately prepare yourself and your environment to be as conducive and helpful as possible to the process?
There are many terms that may be new or unfamiliar as you embark on this adventure of healing and wholeness: intentions, Set and Setting, dosages, subjective effects, and more. This list is long, and getting into the right relationship with the preparation process is an important undertaking worthy of your consideration.
This article makes the assumption that you have already selected a medicine and program to work with, have begun the program, and have been paired with a practitioner or clinician. The focus of this resource is to discuss the space between your initial registration for the program/experience and the first session of the program.
Update Your Clinician on Health Changes
An important start to the preparatory process is notifying your clinician/practitioner of any major changes to your physical and mental health throughout this process.
As there are certain contraindications —reasons to withhold treatment— for each medicine and experience. Changes outside of healthy ranges for factors like blood pressure or heart rate, or any changes to your physical or mental health should be relayed to your clinician as soon as you have this information. It is important that they have complete information so that you remain safe, and that the experiences are healing and help you realize the outcomes that you agree on.
Examples of some changes to report can be:
- Major increases in anxiety or depression levels
- Suicidal ideation or suicidal attempts
- Newly discovered family health history information (ie: history of bi-polar)
- New clinical diagnoses of physical or mental health conditions
- Major shifts in resting heart rate or blood pressure levels
- Newly prescribed medications (including changes in dosages)
- Newly pregnant or possibility of pregnancy
Your health and safety are the number one priority in any psychedelic therapy program. Your clinician/practitioner will make key decisions such as your eligibility for the treatment entirely, the medication dosage, level of additional support required, and other factors.
For these reasons, it is essential and imperative that they have a complete picture to begin the program, and remain informed of any changes as they unfold before, during, and after the experiences and throughout the entire therapeutic program.
Ask “Why Am I Choosing This Path?”
Before diving in, getting clear on your “why” is also important.
Why are you doing this? What is going on in your life and your inner world that has called you to embark on this healing journey?
Sometimes you are brought to things that your inner healing intelligence knows are the next step, without full conscious clarity as to why.
Being clear on why you are doing this, what the aims and aspirations are, in clear conscious communication, is an important first step. Set aside some time with yourself, perhaps talking to a loved one, writing in a journal, or just speaking out loud “Why am I doing this?
The helpful step is going through the earnest attempt to put it into linear language. Intentions, motivations, and internal drives that live swirling around in your head as impulses, images, disparate words, or memories can be vague and unclear.
Take the time, and make the initial investment in this entire process, to unpack and put into language your “why” is an important first step. If you feel like you can use some assistance with this process, this is also something that your clinician or practitioner can help with early on in your intake process.
Consider Your Set and Setting
“Set and Setting” emerged as a cornerstone concept in early clinical trials in psychedelic science throughout the 1950’s and 60’s. This concept has had a profound influence on the power and experiential journey in psychedelic experiences to date.
Set refers to your individual mindset going into the experience. It is helpful to approach your first session in a calm, trusting, and open mindset. As an example, a less than conducive mindset may include things like feeling hectic from a busy day beforehand, extreme doubt or fear of the experience, or being angry or upset about other areas of life.
Taking the time to prepare your mindset in the days and hours leading up to an experience helps create the most favorable conditions for powerful experiences and positive outcomes.
Mindset preparation steps include:
- Getting restful sleep the night before
- Taking time to journal and feel relaxed and composed
- Resolving any questions beforehand to feel informed and trusting
- Meditating or walking beforehand to feel calm yet alert throughout the experience
Setting on the other hand, refers to the physical environment that you will have the experience in. This may be the office of a clinician/practitioner, or in the comfort of your own home. Having a welcome, safe, quiet, and uninterrupted environment will once again help to create the most conducive conditions for a safe and powerful experience.
Setting preparation steps include:
- Dimming the lights to turn your focus inward
- Cleaning up the room, putting things in their place, and ensuring there is a clear, unobstructed path to the washroom
- Asking any roommates to kindly refrain from entering the room before, during, and just after the experience (unless they are required to do as a Peer Monitor, in which case just asking them to remain quiet when doing so)
- Keeping any pets or children out of the room during the experience
- Wearing comfortable, loose-fitting clothing
- Adding your own comforting touches, such as an eye mask, calming scents, any sentimental or important items that help create a calm, open environment
It is very easy to underestimate the importance of Set and Setting and the influence they have on the safety, efficacy, and outcomes you experience during psychedelic therapy. Just a few minutes of preparing your mindset and physical setting contribute greatly to the overall experience you have.
You will likely receive some Set and Setting recommendations from your clinician/practitioner. If you don’t, it is worthwhile to inquire about this beforehand. If none are provided, the recommendations above will help this preparation process.
Set Your Intentions
Intentions are a cornerstone of the psychedelic experience, and an essential component of the process of preparing for your sessions.
An intention is a simple statement that articulates the way you would like to show up for the session, the themes in your life you would like to address, or states of being you wish to embody.
An important point is that an intention is fundamentally different from an expectation. An expectation can be perceived as a requirement, and you may spend the session time waiting for your expectation to arise and come to pass. The experiences will unfold naturally, in conjunction with your internal states and your inner healing intelligence. Though we cannot dictate the experience, we can meet it halfway, in open dialogue. This is the role of an intention. Learn more about setting intentions and read examples in this resource.
Intentions are highly personal, and they vary also from session to session. Your intention for one session may be entirely different for the next one. Each experience is unique, and so each intention should be as well.
It is helpful to spend some time working on your intention in private, but you can, and should, work to clarify and refine with your clinician/practitioner before embarking on your experience.
Learn to "Clear House"
If you are prone to rumination or distracting thoughts, it can be helpful to take some time to “clear house” before embarking on your psychedelic therapy program/experience.
This means taking a bit of time to tackle any outstanding tasks that have been slipping. It can literally be taking the time to clean up your living space. It might be addressing a few dusty tasks on the to-do list, like giving friends or family a call or check-in. The sooner you can address things that might catch your attention during the experience, the more you arrive in full presence for the experience you are about to have.
If you don’t have the available time, energy, or resources to take care of everything, or if some tasks are much larger undertakings, there is no need to stress about this. This is just a caring suggestion in case you are looking for additional ways to prepare for your experience.
For example, if you have recently had a disagreement or argument with somebody, or if there is something left unsaid that continues to arise in your awareness, taking some steps to resolve this beforehand can be very helpful. You’ll notice that taking care of these minor “clearing house” tasks go towards preparing a more conducive Set and Setting.
Trust, Let Go, and Be Open
“Trust, Let Go, and Be Open” (or TLO) is a time-tested mantra developed through ongoing work in psychedelic science, and the early clinical research done during the advent of psychedelic medicine.
Early clients faced the same concerns, fears of the unknown, and anticipatory excitement that arises in the weeks and days before embarking on a psychedelic therapy program. Through continued refinement and establishment of best practices, TLO came about as a useful framing to help prepare yourself for your experiences.
Trust comes first. Trust that the experience(s) you will have will contribute to your healing and surface any relevant emotions or insights to help you on your way. Trust that you are safe, working with appropriate dosages, and that you’ve enlisted the help of skilled and experienced practitioners. Trust in your inner healing intelligence to be serving you and active during your process. Trust in yourself as being ready and able to move forward in your journey of healing and wholeness.
Letting go helps us fully arrive and be present with the experience as it unfolds for us. Holding on to preconceived notions of what the experience will be like, or gripping tightly to expectations of what we require, can hinder progress or make certain experiences more difficult than they need to be. If you are already trusting, you can let go of ideas, concerns, and expectations, and receive the experience exactly as it wants to appear for you.
Once you have let go of the particular requirements or ideas you may have, you are able to fully be open to the experience. Be open to the possibility that you can realize your intentions for this program. Be open to the idea that you can heal and move towards wholeness. Be open to the understanding that the experiences and emotions are arising for a reason, and that through the integration process you will be able to recognize important insights and bring these into a new way of being for yourself.
With your “why” clearly defined, Set and Setting ready, intentions set, and TLO at the front of your mind, you are more than ready to embark on your healing experience in psychedelic therapy. These preparatory steps will serve you well, and though the experience may not go as you plan, it will always deliver what you need. Experiences can be intense, they can also be mild. They can be clear and direct, they can also be vague and nebulous.
Preparing for psychedelic therapy will help provide the best possible conditions for your experience, but the experience will always emerge as wants. Doing your due diligence to prepare is a helpful part of the process, and most importantly, it is the one aspect that is in your control. An important first step of showing up fully for psychedelic therapy is to show up fully for the preparatory process.
Enjoy the Process!
A final note is to enjoy this process. It is a great honor, privilege, and opportunity to be able to do this work for yourself. To have the means, energy, and resources available to continue your journey of healing and wholeness with psychedelic therapy.
Though the healing process can feel like hard work at times, and there will most certainly be challenging moments, it’s important to enjoy this process. To take pride in showing up for yourself in this way, and to express gratitude for this level of self-love and self-acceptance that you are showing yourself. It is a beautiful gift to give yourself, so enjoy the process and recognize yourself for choosing this journey.
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety