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# "There Are No Bad Trips" Is a Lie
- URL: https://fieldnotes.nahuapacific.com/there-are-no-bad-trips-is-a-lie/
- Published: 2026-08-24T14:51:33.000Z
- Updated: 2026-08-24T14:51:33.000Z
- Description: How the gospel of surrender can make real harm harder to see
- Author: Brian Gleason
- Tags: Cultural Coherence & Ethics

Most of what you will read about psychedelics is saturated with sales pitches offering instant cures, tidy worldviews, and promised transformations. But decisions with the power to reshape a life require more than a slick, curated highlight reel. A decision like this merits an honest accounting of the full experience, especially the parts no one wants to market.

Serious, lasting psychiatric complications after psychedelics are rare, particularly in carefully screened clinical settings. Difficult experiences are another matter. Those are common. You can be terrified, convinced you are dying, overwhelmed by grief, or briefly unsure whether you have lost your mind, and still emerge unharmed. You may even feel grateful for it.

The trouble is that these two facts are often forced into competition. The skeptic points to rare harms as proof that the whole enterprise is reckless. The enthusiast points to the rarity of those harms as proof that the warnings are overblown. Neither gets us very far. A hard trip is not necessarily an injury, and a rare injury is still an injury.

Both camps tend to skip what sits between. Some difficulties outlast the drug without ever becoming a psychiatric emergency: sleep that will not come back, a world that stays flat for weeks, a conviction that keeps demanding to be acted on. Large surveys of people who use psychedelics suggest these are considerably more common than psychosis. They are also the ones most likely to be explained away.

## The language became self-sealing

Some of the mythology around psychedelic danger deserved to be dismantled. Decades of drug-war rhetoric left psychedelics carrying reputations that the evidence does not support. Panic is not a safety protocol.

The correction was necessary. Somewhere in the enthusiasm of recent years, though, it began to overshoot. Psychedelic culture developed a vocabulary that could explain almost any outcome without ever having to concede that the experience itself might have caused harm.

If the experience transformed you, the medicine worked. If it frightened or destabilized you, well then, clearly, you resisted. There were no bad trips; there were insufficiently surrendered people. Distress became “resistance.” Prolonged destabilization became a “spiritual emergency.” If you questioned what had happened, that questioning itself could be treated as evidence that your ego was still fighting the lesson.

Some of this language can be useful. A frightening experience should not automatically be mistaken for permanent damage, and people sometimes need reassurance while something difficult settles. The problem begins when the vocabulary has an answer for every possible outcome. *You didn’t surrender. Your ego was fighting. The medicine gives you what you need, not what you want.* Each one can turn a person’s distress back on them as a personal failure, while obscuring the moment when reassurance has stopped being useful and something has actually gone wrong.

The same honesty that lets us reject exaggerated psychedelic risks requires us to name the real ones. That raises the more practical question: what does a real problem actually look like after the drug has cleared?

## Watch the grip, not the strangeness

“How strange was your trip?” is not a terribly useful question. Strangeness tells us remarkably little. Someone may emerge convinced that they encountered God, became the universe, relived their own birth, communicated with a dead parent, or understood for the first time that every tree is conscious. None of those claims, by itself, tells us whether the person is doing well.

What matters more is the relationship they have to what happened afterward. Can they wonder about it? Can they hold more than one explanation? Can someone they trust disagree without suddenly becoming an enemy? Can they sleep on a revelation rather than obey it? Can they continue eating breakfast, answering messages, seeing friends, going to work, taking care of the dog? And over the next day or two, is whatever is happening beginning to settle, or is it gathering force?

That gives us three practical things to watch: **grip, function, trajectory.** (Sleep belongs inside function, but it deserves special attention because it can change the trajectory itself.) A healthy insight can be profound, strange, even life-altering, and still remain something you possess. A dangerous one begins to possess you.

Picture someone who comes home from a psychedelic session certain that they need to repair a long-broken relationship with their father. That may be an important realization. They can think about it, talk about it, reconsider it, sleep on it, and decide when or whether to act.

Now imagine the same realization acquiring urgency. The call must happen tonight. Waiting until morning becomes impossible. Anyone suggesting caution is obstructing something sacred. Hesitation is betrayal. Discussion makes the person angrier rather than more reflective.

The content has not changed. The grip has.

The distinction is not merely philosophical. In the first longitudinal study of Oregon’s regulated psilocybin program, researchers found that serious post-session difficulties were not always visible during the session itself. Among four participants who later experienced serious behavioral reactions requiring medical attention, two had no adverse reaction recorded by their facilitator, and another was noted only to have mild stomach contractions. The important question was what happened in the days and weeks afterward, not just what happened in the room. 

![](https://storage.ghost.io/c/80/f9/80f90a89-9974-451f-a6c6-0f8fab381c1c/content/images/2026/08/no-bad-trips-fig1-three-questions_3x.webp)

These questions turn attention away from the theatrical qualities of the experience and toward the things that tell us whether someone is stabilizing: whether the belief can still be questioned, whether ordinary life is holding together, and whether the pattern is receding or accelerating.

## When the world feels unreal

That distinction becomes especially useful with one of the most frightening post-psychedelic experiences: the feeling that reality itself has gone strange.

After an intense session, people sometimes describe the world as dreamlike, flat, artificial, distant, or seen through glass. Others feel as though they are watching themselves from slightly outside their own body. These experiences are called derealization and depersonalization, and they can be profoundly unsettling.

The key clinical feature is preserved reality testing. The world *feels* unreal, but the person understands that something has changed in their perception. They can say, in effect, *something is off with how I am experiencing reality.* That is very different from concluding that reality itself has actually been exposed as fraudulent.

“The world seems unreal” and “I have discovered that the world is unreal” may sound similar in casual conversation. They are worlds apart. The first describes an altered experience. The second may indicate that the person’s ability to question the experience itself is beginning to erode.

Visual effects can also persist after the drug has cleared: trails, halos, visual snow, after-images, or subtle distortion around text. When these linger and cause real distress or interfere with daily life, clinicians call the condition hallucinogen persisting perception disorder, or HPPD. But here again, the same distinction matters: experiencing a perceptual after-effect is not the same thing as developing a disorder.

In that Oregon study, about one in ten participants reported HPPD-type visual changes at one month. One of them found it distressing. By three months, a similar share (about one in ten) still noticed something, and none of them found it distressing.

Lingering visual changes are possible; disabling disorders are rare.

When someone notices mild visual snow weeks after a session, the distress usually comes not from the visual itself, but from the terrifying conclusion they attach to it: the belief that they have broken their own brain.

## Sleep is a lever

Of all the ordinary things that can begin to come apart after a psychedelic experience, sleep deserves disproportionate attention. Prolonged sleep loss can itself produce some of the very phenomena we are trying to understand, which means insomnia can become more than a symptom of instability. It can start feeding the instability.

Studies of otherwise healthy people kept awake for prolonged periods show a striking progression. Perceptual distortions and a sense of unreality can appear first. With longer wakefulness, thinking becomes increasingly disorganized. After severe and sustained sleep deprivation, hallucinations and delusional thinking can emerge even in people with no psychiatric history.

That is why sleep is a lever rather than merely one box on a symptom checklist. A person who has slept badly for one night after an intense psychedelic experience may simply be activated, anxious, or overwhelmed. A person moving into a second or third night with almost no sleep deserves much closer attention, because sleep loss can begin amplifying the very instability that caused the insomnia in the first place.

There is another pattern to be on the lookout for: someone sleeping very little while feeling unusually energized, expansive, driven, euphoric, or invulnerable rather than exhausted. That can be the early shape of hypomania or mania, particularly in someone with a bipolar vulnerability.

Careful screening asks about personal and family psychiatric history partly because these patterns are easier to recognize when you know where vulnerability may lie. Screening reduces risk. It cannot make the risk disappear.

![](https://storage.ghost.io/c/80/f9/80f90a89-9974-451f-a6c6-0f8fab381c1c/content/images/2026/08/no-bad-trips-fig2-sleep-progression_3x.webp)

## Surrender is not a standing order

At this point an obvious tension appears. Psychedelic therapy often asks people to let go: to stop steering the experience, fighting every frightening image, and monitoring every second for evidence that something has gone wrong. Yet here I am telling you to pay attention to warning signs afterward.

Both ideas can be true because they apply to different moments.

People who enter psychedelic experiences prepared and able to relinquish control tend to fare better than people who enter white-knuckling, resisting, and trying to manage every turn. Hypervigilance feeds on itself. The more desperately you monitor an experience for danger, the more salient every strange sensation becomes, and the effort to keep the experience at arm’s length can intensify the very distress it was meant to prevent.

But “let go” cannot become a standing order to distrust your own distress forever. Surrender during the psychedelic experience does not require surrendering judgment afterward. You can allow an experience to unfold without resistance and still notice, two days later, that you have barely slept. You can entertain an extraordinary idea without pledging allegiance to it. You can decide that something meaningful happened without deciding that every interpretation your mind generated during an altered state must therefore be true.

If the experience is becoming harder to question, harder to steady, or harder to live around, asking for help is not evidence that you failed to surrender properly. It means you noticed.

## Be careful who supplies the explanation

Noticing creates an appetite for explanation, and that appetite can arrive at exactly the wrong time.

People emerging from powerful psychedelic experiences are, in the main, quite suggestible. Their ordinary assumptions about themselves and the world may be loosened for a while. That openness is part of what makes psychedelics psychologically interesting, but it also makes the person more vulnerable to somebody else’s certainty.

A person in that state can easily be told that they are undergoing a spiritual awakening, purging trauma, communicating with a dead relative, or selected by entities for a purpose. That their terror was merely ego death, or that their insomnia just means energy is moving through them.

Perhaps later they will choose one of those interpretations. That is their right. But a vulnerable person should not have somebody else’s cosmology installed at the moment they are least able to evaluate or refuse it.

When people do become destabilized after psychedelics, the most useful routes back are often spectacularly unheroic: sleep, food, routine, familiar people, movement, daylight, ordinary conversation, and temporary distance from obsessive interpretation. Psychedelic culture has a strong appetite for grand meaning, which can make these answers feel almost embarrassingly mundane.

Sometimes you need breakfast.

## Rare is not never

Careful screening matters. Preparation, setting, dose, skilled support, all of it matters. None of it makes psychedelic treatment risk-free. A small number of people will develop persistent psychiatric or perceptual problems despite doing everything “right,” and we do not yet know enough to predict every case in advance.

That uncertainty does not justify panic, and it certainly does not preclude discussion. The mature position is less dramatic than either camp prefers: psychedelic experiences can be extraordinarily beneficial; serious lasting harm appears to be uncommon; and when harm does occur, insisting that every difficult outcome must secretly be healing is not compassion. It is abandonment coded as optimism.

The practical task is simpler. Watch whether the person can still question what happened. Watch whether ordinary life is holding together. Watch sleep. Watch direction of travel. Strange and receding is a very different thing from strange and accelerating.

The point is not to make you afraid of strange experiences. It is to make sure that when an experience stops loosening its grip, someone notices.

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### Sources and what they supplied

This essay draws on peer-reviewed research on psychedelic adverse events, challenging experiences, depersonalization and derealization, persistent perceptual effects, mania, sleep deprivation, and the psychological conditions associated with better or worse psychedelic outcomes. The three-question framework is a synthesis for practical use, not a validated diagnostic or screening instrument.

Argyri, Eirini K., Jules Evans, David Luke, et al. 2025\. “[Navigating Groundlessness: An Interview Study on Dealing with Ontological Shock and Existential Distress Following Psychedelic Experiences.](https://doi.org/10.1371/journal.pone.0322501?ref=fieldnotes.nahuapacific.com)” *PLOS One* 20 (5): e0322501.

> Interviews people who experienced ontological shock and existential distress after psychedelic use, including the coping strategies that helped them regain stability.

Barrett, Frederick S., Matthew P. Bradstreet, Jeannie-Marie S. Leoutsakos, Matthew W. Johnson, and Roland R. Griffiths. 2016\. “[The Challenging Experience Questionnaire: Characterization of Challenging Experiences with Psilocybin Mushrooms.](https://doi.org/10.1177/0269881116678781?ref=fieldnotes.nahuapacific.com)” *Journal of Psychopharmacology* 30 (12): 1279–95.

> Establishes that difficult psychedelic experiences can be measured across recurring dimensions such as fear, grief, paranoia, isolation, and perceived insanity.

Carbonaro, Theresa M., Matthew P. Bradstreet, Frederick S. Barrett, et al. 2016\. “[Survey Study of Challenging Experiences after Ingesting Psilocybin Mushrooms: Acute and Enduring Positive and Negative Consequences.](https://doi.org/10.1177/0269881116662634?ref=fieldnotes.nahuapacific.com)” *Journal of Psychopharmacology* 30 (12): 1268–78.

> Useful for the distinction between an acutely frightening experience and a lasting harmful outcome; many respondents described severe difficulty while still reporting later benefit.

Eskinazi, Mickael, Rayan Nasserdine, Romane M. Cusin, et al. 2026\. “[Psychedelic-Induced Hypomania and Mania: A Systematic Review and Meta-Analysis.](https://doi.org/10.1038/s41380-026-03657-6?ref=fieldnotes.nahuapacific.com)” *Molecular Psychiatry*, May 29, 1–15.

> Reviews the evidence for manic and hypomanic episodes associated with psychedelics and supports special attention to reduced need for sleep and bipolar vulnerability.

Espiard, Marie-Laure, Laurent Lecardeur, Pascale Abadie, et al. 2005\. “[Hallucinogen Persisting Perception Disorder after Psilocybin Consumption: A Case Study.](https://doi.org/10.1016/j.eurpsy.2005.04.008?ref=fieldnotes.nahuapacific.com)” *European Psychiatry* 20 (5–6): 458–60.

> Documents a case of hallucinogen persisting perception disorder (HPPD) following psilocybin use, illustrating that persistent perceptual disturbances can occur even though severe, disabling cases appear uncommon.

Evans, Jules, Oliver C. Robinson, Eirini Ketzitzidou Argyri, et al. 2023\. “[Extended Difficulties Following the Use of Psychedelic Drugs: A Mixed Methods Study.](https://doi.org/10.1371/journal.pone.0293349?ref=fieldnotes.nahuapacific.com)” *PLOS ONE* 18 (10): e0293349.

> Documents the range of persistent problems reported by people who experienced difficulties lasting beyond the acute drug effects. It is useful for describing what persistent problems can look like, not for estimating how frequently they occur among all psychedelic users.

Ford, Hannah, Clare L. Fraser, Emma Solly, et al. 2022\. “[Hallucinogenic Persisting Perception Disorder: A Case Series and Review of the Literature.](https://doi.org/10.3389/fneur.2022.878609?ref=fieldnotes.nahuapacific.com)” *Frontiers in Neurology* 13 (May): 878609.

> Reviews hallucinogen persisting perception disorder and the range of persistent visual disturbances associated with it.

Haijen, Eline C. H. M., Mendel Kaelen, Leor Roseman, et al. 2018\. “[Predicting Responses to Psychedelics: A Prospective Study.](https://doi.org/10.3389/fphar.2018.00897?ref=fieldnotes.nahuapacific.com)” *Frontiers in Pharmacology* 9 (November): 897.

> Finds that psychological state before a psychedelic experience—including readiness to surrender rather than resist—is associated with subsequent experience and outcome.

Hunter, Elaine C. M., Jane Charlton, and Anthony S. David. 2017\. “[Depersonalisation and Derealisation: Assessment and Management.](https://doi.org/10.1136/bmj.j745?ref=fieldnotes.nahuapacific.com)” *BMJ*, March 23, j745.

> Provides the clinical distinction between distressing experiences of unreality and loss of reality testing.

Hunter, Elaine C. M., Mauricio Sierra, and Anthony S. David. 2004\. “[The Epidemiology of Depersonalisation and Derealisation: A Systematic Review.](https://doi.org/10.1007/s00127-004-0701-4?ref=fieldnotes.nahuapacific.com)” *Social Psychiatry and Psychiatric Epidemiology* 39 (1): 9–18.

> Provides background on these phenomena outside the psychedelic context and reinforces that experiences of unreality are not synonymous with psychosis.

Johnson, Matthew W., William A. Richards, and Roland R. Griffiths. 2008\. “[Human Hallucinogen Research: Guidelines for Safety.](https://doi.org/10.1177/0269881108093587?ref=fieldnotes.nahuapacific.com)” *Journal of Psychopharmacology* 22 (6): 603–20.

> A foundational account of screening, preparation, monitoring, and other safeguards used in modern psychedelic research.

Korthuis, P. Todd, Ryan R. Cook, Devin Gregoire, et al. 2026\. “[Safety and Mental Health Outcomes of Oregon State-Regulated Psilocybin Services.](https://doi.org/10.1001/jamanetworkopen.2026.30608?ref=fieldnotes.nahuapacific.com)” *JAMA Network Open* 9 (8): e2630608.

> Reports outcomes from 346 participants receiving services through Oregon’s regulated psilocybin program, providing early longitudinal data on benefits, adverse reactions, persistent symptoms, and the limitations of acute-session monitoring. Particularly relevant for the distinction between difficult experiences and delayed post-session difficulties.

Müller, Felix, Elias Kraus, Friederike Holze, et al. 2022\. “[Flashback Phenomena after Administration of LSD and Psilocybin in Controlled Studies with Healthy Participants.](https://doi.org/10.1007/s00213-022-06066-z?ref=fieldnotes.nahuapacific.com)” *Psychopharmacology* 239 (6): 1933–43.

> Examines persistent or recurring perceptual phenomena following controlled psychedelic administration and helps place diagnosable HPPD in context.

Palitsky, Roman, Deanna M. Kaplan, John Perna, et al. 2024\. “[A Framework for Assessment of Adverse Events Occurring in Psychedelic-Assisted Therapies.](https://doi.org/10.1177/02698811241265756?ref=fieldnotes.nahuapacific.com)” *Journal of Psychopharmacology* 38 (8): 690–700.

> Important for treating functional impairment, trajectory, and practitioner-imposed religious or ideological interpretations as legitimate dimensions of harm.

Robinson, Oliver C., Jules Evans, David Luke, et al. 2024\. “[Coming Back Together: A Qualitative Survey Study of Coping and Support Strategies Used by People to Cope with Extended Difficulties after the Use of Psychedelic Drugs.](https://doi.org/10.3389/fpsyg.2024.1369715?ref=fieldnotes.nahuapacific.com)” *Frontiers in Psychology* 15 (May): 1369715.

> Examines strategies used by people coping with persistent difficulties after psychedelics, including grounding, social reconnection, and reducing engagement with destabilizing interpretations.

Robinson, Oliver C., David Luke, Jules Evans, et al. 2026\. “[Extended Difficulties after Psychedelic Experiences: Prevalence and Associations in a Global, Multilingual Sample.](https://doi.org/10.21203/rs.3.rs-9304959/v1?ref=fieldnotes.nahuapacific.com)” **Preprint, In Review**, April 8.

> Surveys 6,476 psychedelic users from a globally diverse, 19-language sample and supplies the denominator that difficulty-recruited studies cannot: roughly half reported a difficulty lasting more than a day, and about one in ten reported one lasting more than a year. The sample is self-selected and largely recruited through psychedelic-community networks and online outreach, so the rates describe people who use psychedelics and volunteer to discuss them. **Under review.** The abstract and the conclusion give different figures, eight percent and roughly six percent, for the clinically disruptive subset.

Russ, Suzanne L., Robin L. Carhart-Harris, Geoffrey Maruyama, and Marc S. Elliott. 2019\. “[Replication and Extension of a Model Predicting Response to Psilocybin.](https://doi.org/10.1007/s00213-019-05279-z?ref=fieldnotes.nahuapacific.com)” *Psychopharmacology* 236 (11): 3221–30.

> Further supports the association between pre-session surrender, acceptance, and psychedelic outcomes.

Sabé, Michel, Adi Sulstarova, Alban Glangetas, et al. 2025\. “[Reconsidering Evidence for Psychedelic-Induced Psychosis: An Overview of Reviews, a Systematic Review, and Meta-Analysis of Human Studies.](https://doi.org/10.1038/s41380-024-02800-5?ref=fieldnotes.nahuapacific.com)” *Molecular Psychiatry* 30 (3): 1223–55.

> The broadest recent synthesis of psychosis risk and the basis for describing serious psychedelic-induced psychosis as uncommon but real.

Schlag, Anne K., Jacob Aday, Iram Salam, Jo C. Neill, and David J. Nutt. 2022\. “[Adverse Effects of Psychedelics: From Anecdotes and Misinformation to Systematic Science.](https://doi.org/10.1177/02698811211069100?ref=fieldnotes.nahuapacific.com)” *Journal of Psychopharmacology* 36 (3): 258–72.

> Useful corrective to both historical exaggeration of psychedelic risk and contemporary tendencies to understate adverse effects.

Waters, Flavie, Vivian Chiu, Amanda Atkinson, and Jan Dirk Blom. 2018\. “[Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake.](https://doi.org/10.3389/fpsyt.2018.00303?ref=fieldnotes.nahuapacific.com)” *Frontiers in Psychiatry* 9 (July): 303.

> Reviews the progression from perceptual disturbance through disordered thinking and delusion with increasing time awake, supporting the argument that sleep loss can actively worsen instability.

Wolff, Max, Ricarda Evens, Lea J. Mertens, et al. 2020\. “[Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance.](https://doi.org/10.3389/fpsyt.2020.00005?ref=fieldnotes.nahuapacific.com)” *Frontiers in Psychiatry* 11: 5.

> Provides a cognitive-behavioral account of why reduced resistance and increased acceptance may contribute to beneficial psychedelic experiences.

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Essays on treatment resistance, altered states, and the conditions under which change becomes possible. 

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