The Psychotherapeutic Setting
There are many radically different contexts in which psychedelics have been found to be beneficial, but one model for how to facilitate a powerfully transformative experience stands out. This setting combines safety, support and intensity in a way so effective that many people who had taken acid or mushrooms repeatedly before trying it have described it as their first “true” psychedelic experience, completely overshadowing all their previous trips.
The model arose out of the work of many pioneers of psychedelic therapy in many countries, but for the purposes of this article I will rest mainly upon the work of Stanislov Grof, who crystallized the research of many other psychologists into the book, definitive as of the 1980s, LSD Psychotherapy. I also draw upon the work of “secret chief” Leo Zeff, and on my own experience as well as that of those I have interviewed.
The model is essentially this: deep introspection in a supportive environment facilitated by experienced and compassionate guides.
It Goes Something Like This:
This is a best case scenario; practical considerations may necessitate alterations.
You are referred by somebody who trusts you to a psychedelic guide or group. You meet with the people who will be facilitating your trip, and each of you works to establish comfort levels. You discuss expectations, prior knowledge and experience, your views on spirituality, your current life situation, the areas of your psyche that you feel need work, and anything else that seems relevant. They run you through a list of contraindications to make sure everything will be safe (pregnancy, epilepsy and heart defect are of particular concern). If the guides require compensation for their services, that is discussed, negotiated and agreed upon. If you all get along and trust each other, and they feel you are a good candidate, a time is chosen on a separate day for the trip to take place, making sure that you will be able to have both that and the following day completely free of any responsibilities.
On the chosen day you meet at a place where privacy will be guaranteed (your home is fine, provided absolute privacy can be assured). You partake in some form of relatively minimal ceremony, designed to put you on a positive footing without adding unnecessary content. Different guides have different levels of ceremony or ritual they like to employ. Leo Zeff, for example, would have the tripper bring a series of photographs from their childhood and of people important to them, so that these images would be fresh in the mind, and would present the medicine in a cup as a symbol for transformation. In any case, last minute questions are dealt with, the plan and any rules are explained (typical rules include “there will be no sex during the experience” and “you will not go outside without my permission”), and a moderate dose of LSD is consumed, LSD being widely agreed upon as the ideal for a first experience; availability, legal concerns, intention, personal preference and time constraints may lead to something else being substituted.
Then… you lie down and go into it.
Headphones with a long playlist of beautiful, spacious music, eyeshades and a comfortable place to lie down combine to block out external stimuli and encourage maximum introspection. At this point, the role of the guide(s) is to keep you lying down with your eyes closed. Any attempt at psychoanalysis or counseling at this point will be counterproductive.
It’s highly, highly recommended that you continue to introspect for the first several hours of the experience. This, really, is the key to the entire model, and if you can’t find or afford an experienced guide, at least follow this part. Don’t walk around. Don’t talk to people. Don’t play games. Don’t have sex. Just… go inward and face whatever comes. Later, when you’re well past the peak, there will be time to do that other stuff, all of which is great, but all of which can distract from the vitally important work at hand.
What happens when you’re ready to emerge depends entirely on what happened up to that point and so I won’t try to list examples, but your guide(s) will be there to talk to you, to hold you if you want to be held and to keep you comfortable. As you come down, taking a walk somewhere beautiful is highly recommended (water and trees are perennial favourites).
If the arrangement you’d settled upon was a single trip, you should meet with your guide(s) again after sobering up, ideally before a week has passed, to discuss the experience. In Grof’s work, it was common for people to have many subsequent sessions so as to progress through different layers of the psyche, from biographical memories of formative experiences to reliving the birth trauma to archetypal encounters. It was not expected that this all take place in a single session. However, there are also many reports of single sessions so transformative for later work to be unnecessary.
On Suitability of Guides
Guides must: be compassionate, trusting, patient and experienced.
Having more than one guide, ideally with a diversity of skillsets and genders, is a best case scenario. If you have both a male and a female guide, there will be someone onto whom to project either your mother or father complexes, and it will give an alternative person to talk to if the gender or disposition of the individual guide makes it difficult for you to relate whatever it is you’re going through to them; you want to be able to be able to share whatever comes up, no matter how intense or personal, and sometimes that’s just easier with one gender or another, depending on your comfort levels. A historically typical therapeutic dyad, such as the one employed in the Hopkins Psilocybin experiments, consists of one psychologist and one social worker or counsellor, t0 ensure a variety of skills for you to draw upon.
The precise background and training of the guide(s) can vary widely and still be excellent, but in order to qualify as guides for a psychedelic session, it is absolutely crucial that they have been through intense psychedelic experiences themselves (dramatic experiences with transcendental meditation, for example, can substitute for drug use; however, familiarity with the specific substance being used is a big plus). In depth understanding of mind, open-mindedness, compassion and trust-worthiness are also key. Remember that this is the best case scenario: you may not be able to find (or afford) two guides for an extended session. One will usually be good enough, provided the trust is there. Sometimes, bizarre or terrifying things can emerge during the process, so it’s essential that a guide be able to accept intense, even shocking material, without judgment. Because of that, an inexperienced friend or lover may not be appropriate, regardless of how good their intentions may be. At the same time, a trained psychologist who has never had a psychedelic experience will also be inappropriate, because their training will not be adequate preparation for what can happen during a psychedelic trip. Choose your guide(s) carefully.
To Summarise:
Have at least one, ideally two, trustworthy and experienced guide(s) who you’ve met at least once before. Do your preparations, take your medicine, lie down, close your eyes and listen to music until your head explodes. After a few hours, talk about what just happened. Then go for a walk somewhere pretty. Meet up a couple days later and talk more.
In conclusion:
The psychotherapeutic setting for psychedelic experience is not the only setting which may produce benefit, but it is the most reliable, and one of the most powerful. I therefore highly recommend it as a starting point for anyone who wishes to explore psychedelics. Group, natural and ceremonial settings can also be great… but you should never, ever take a psychedelic for the first time in a public place, around people who don’t understand what a psychedelic trip is all about, or who you don’t trust completely. You simply do not know how you will react. You might miss out on most of the benefit you could have received, and you could even put yourself in physical or psychological danger. Save public settings for after you’ve established familiarity and comfort with the substance, and never take a psychedelic if you aren’t sure that it’s the right time and place to do so.
Michael Vipperman 
Best method of consoling someone who is freaking out?
Depends entirely on the situation. Why are they freaking out? What’s their history? Where is this happening?
Most freakouts are because the person wasn’t expecting the experience to go where it did or be so intense, and wasn’t prepared to handle it. Following the model explained in this article will preclude that. If you’re at a big party and somebody is freaking out, the best method will probably be to get them out of the party to somewhere safe, comfortable and (ideally) beautiful. A change of scene, some privacy and/or someone compassionate to talk to is usually all they need.
If you’re following the psychotherapeutic model properly, freakouts are going to be very rare because the person will already feel safe, will be in comfortable and private surroundings, and will have had it explained to them that the experience can be overwhelming at times but that it will pass, and that parts of their psyche they may not have been aware of and which can seem very disturbing might come to the surface. If you’re in those circumstances and they freak out anyway… then if at all possible you want them to lie down, close their eyes and go back into it. Running from a scary experience will not help, and will just lead to flashbacks. Physically holding them, or applying pressure to parts of the body which are embodying discomfort, may help a lot. Changing the music can also be a good idea.
If that isn’t working, they’re still freaking out and you can’t get them to go back into it, then you have to try some other things… but that’s going to be pretty rare. As I said, most freakouts are because either they aren’t comfortable, or didn’t realise that they could end up reliving the birth process and experiencing the total immolation of their body (or whatever).
Do people practice this therapy in the US? Are there any countries where it’s done legally?
The majority of it is done underground… hard to know the extent, but Dr. Leo Zeff alone spread it to quite a number of psychologists before his death, many of whom are no doubt still practicing in the US.
As for it being done “legally,” it depends what you mean by “it.” There are plenty of research chemicals which work as effective substitutes in places where LSD or mushrooms cannot be reliably accessed, and which are not controlled anywhere, so it wouldn’t be difficult for a psychologist to start using it in therapy. However, they’re still likely to keep quiet about it, for fear of attracting the wrong kind of attention. There may well be some people openly offering this kind of service, but I’m not personally aware of any.