Bad trips do sound horrific.

People who smoke DMT have reported seeing entities with grinning faces jeering at them mercilessly. Others say they lost all sense of self and melted into their surroundings. One report I came across, was that of a man who felt himself lose his footing. But instead of a brief fall to the ground, he fell towards a crack in the ground. The crack widened as he fell, only to reveal more cracks, which again widened and complicated like a fractal, and so on to infinity.

Most doctors take accounts such as these as a frightening and stark confirmation that psychedelics are to be avoided and cannot in any way promote health. After all, the idea that a temporary psychosis is beneficial in some way sounds absurd.

And yet… people used to believe the same of mold.

What good could possibly come of mold? Mold! Ewww. Yet in 1928, penicillin was discovered. Suddenly, doctors took a radically different view of the stuff.

Interestingly, mold contains ergot alkaloids, the compounds from which LSD was developed in 1938. Ergot fungus (a rye mold) is the cause of ergotism, a malady that included hallucinations. Ergotism was not an uncommon problem in medieval France, and ergotism was, and is— essentially—  a very bad trip.  Around the time when LSD was discovered by Albert Hofmann in 1938, numerous other ergot-derived drugs were developed, almost all of which are still in use today. So, as history shows, simple moralism, or a moral attitude that is simple, reflexive and incurious, is antithetical to medicine and to science. The sort of knee-jerk moralism we see in standard medical opinion on psychedelics, and on bad trips especially, is truly the opposite of scientific inquiry.

The line between toxin and medicine is a fine line. And it is a child-like curiosity into toxins which is the very backbone of science and medicine. In medicine the relationship of ‘good’ to ‘bad’ may be a quantity rather than a quality.

We knew this as children. Most of us as kids enjoyed twisting ourselves up on a swing-set, spinning around to make ourselves dizzy.  Humans seem to be born with a natural curiosity for altered mental states in general. Toddlers bend down and peer at you through their legs, from upside down. It is as if they do this by instinct, from some wish to not only see the world, but see it again, as if for the first time.

Just as we all have brains, the altering of our brains and our mental state is to be simultaneously interested in both ourselves and in the world. The two interests seem to be linked.

The pharmacologist researcher at UCLA, Ron Siegel, described in his 1989 book, Intoxication: The Universal Drive for Mind-Altering Substances, how a large number of species have been observed to pursue intoxication states. Hawaiian mongoose have been observed, for instance, to eat morning glory seeds and to hallucinate after being widowed. When they lose their pair bonded partner, they seem to eat the seeds to resolve their grief.  Reindeer, jaguar, cattle, and a variety of other animals are known to actively pursue psychosis in various circumstances. Ron Siegel called intoxication a ‘fourth drive’, writing “Like sex, hunger, and thirst, the fourth drive to pursue intoxication, can never be repressed. It is biologically inevitable.”

Given all of this, the only really curious thing, is why most doctors today aren’t more curious about intoxication states.

And about psychedelic trips in general.

Doctors in the early 1900s seemed much more interested. Heinrich Kluver wrote an influential treatise on mescaline hallucinations. He gave monkeys mescaline, and some of his experiments on mescalinized monkeys were very influential in psychiatry. The Kluver-Bucy syndrome was named after those experiments, and influenced how we understand the limbic part of the brain. Around the same time, Sigmund Freud and his ilk were intensely interested in dreams, which are not unlike a psychosis. To Freud, a doctor uninterested in dreams is like an astronomer uninterested in telescopes. It’s unthinkable not to want to look. That is why Freud called dreams “the royal road to the unconscious.” 

But psychedelics are like that, too. Most doctors today aren’t interested in how a bad trip could help them understand people. Here we have a window into the deepest reaches of the psyche, and most doctors consider it meaningless noise.

Perhaps we can trace the attitudinal change in doctors to the advent of pharmaceuticals.

Prior to the 1990s, many psychoanalysts would forbid a patient being on an antidepressant if there were to do talk therapy. The idea was that a medication which reduced all anxiety was antithetical to the goal of therapy, which was to understand anxiety. Unless a patient is anxious, how can they understand themselves?

Talk therapy itself is a stressor. It can bring up very uncomfortable feelings. “I hate my father…”  “Ok. But perhaps you miss him, too? Perhaps you hate him because he let you down?” These sorts of questions can make people very uncomfortable. An older view of psychotherapy was that it can— just like a psychedelic— be a stressor which allows buried feelings to bubble up. But it seems the popularization of antidepressants has changed the landscape. No longer is it a common psychiatric view that fear or discomfort is likely to be beneficial.

It may simply be the case that we have seen a cultural shift after decades of overprescribing. And we’re at a place where doctors see all fear and anxiety as needing to be suppressed. In this milieu, it’s no surprise a bad psychedelic trip would be judged as meaningless noise.

By contrast, consider the 1950s:

Bad trips became a significant part of medical history, when LSD was given to alcoholics to test the theory that a traumatic drug experience could scare them sober.  Dr. Humphrey Osmond, working at a psychiatric hospital in Saskatchewan, believed a difficult trip experience, by resembling the delirium tremens of alcohol withdrawal, could engender sobriety. Real delirium tremens is of course life-threatening, but it sometimes cures alcoholism. A great many ex-alcoholics do credit the nightmarish experience with turning them around.

Another theory, that of Al Hubbard, was that a bad LSD experience may induce in an alcoholics the fear of a Higher Power. And that a feckless alcoholic will achieve sobriety when he surrenders his will to that Power.  Bill Wilson, the co-founder of Alcoholics Anonymous, believed the exact same thing after taking LSD himself. Wilson’s opinion not surprisingly caused a stir in the AA community.

The idea that sobriety could be promoted by an intoxication state, surely at least ran counter to common sense. It is like speaking of insanity as the path to sanity, confusion a source of clarity, or recklessness a means of selfcontrol. Such ideas run totally counter to most moral paradigms.

They run counter to most medical paradigms too.

When is an overwhelming, fearful, or uncomfortable experience the goal of a medical treatment?

Not often, perhaps? I will attempt to make a list of exceptions.

• Hiccups are believed to be stopped by fright. This may be just rumor, or folk medicine.
• Exposure therapy extinguishes fears by flooding the senses. E.g. to treat clown phobia, place the sufferer into a confined space with clowns.
• Brief intensive psychotherapy, developed by Dr. Habib Davanloo in the 1970s, intended to break through a patient’s defenses through very confrontational interactions.
• Exercise is uncomfortable, yet, while doctors are supposed to recommend it, most doctors do avoid the topic, almost as much as they avoid the topic of overeating.
• Natural childbirth isn’t a medical treatment, but how doctors discuss it is of great interest here. With its endorphins, afterglow effects, the oxytocin release and the immediate infant bonding, natural childbirth is medically preferable to a cesarean. And yet, when a woman requests an elective cesarean most obstetricians today do not push back. Why not?

Are medical attitudes today at odds with “no pain, no gain?”

• Capsaicin (pepper extract) was known to relieve pain for thousands of years by overwhelming the nerves to the point they become desensitized. Although widely available in creams, most doctors know little about it. Perhaps it doesn’t fit the paradigm.
• Fever is uncomfortable, so doctors suppress it. But we know it’s a sign of a healthy immune response. Why then, do doctors so often suppress fever? Surely this is strange?

As we can see from the above, with perhaps the exception of exposure therapy, the mainstream medical attitude prides itself on an avoidance of discomfort.

In cases where a difficult experience is healthy, such as natural childbirth and fever, doctors are either conflicted, or have little to say.

After all, doctors sell comfort, and they sell normalcy. Consider pharmaceutical advertisements. The people in them are exceedingly vapid and normal. Their counterparts in the daytime television soaps are always getting betrayed or getting cancer. But in Pharma ads, people are always flying kites with grandkids, strolling a pier, or licking an ice cream cone.

But life isn’t like that. Difficult experiences are often the most life changing.

The last example— fever—  is the most interesting. Fever isn’t something anybody wants. But it always benefits them. Fever is infrequent, but necessary. The body is processing or purging something.

These characteristics are, interestingly, also true of bad trips on psychedelics.

In fact, the comparison does not stop there. Like a bad trip, a high fever can produce fearful hallucinations known as fever dreams. That may be unrelated to why they help, but it may also be. Schizophrenics have a higher basal temperature than do other people, so body temperature and psychosis are at least slightly correlated.  

Fever also appears to temporarily reduce autism. And psychedelics also appear to help autism, by making autistic individuals more outward and more social. If we think of autism as a kind of self-absorption and a deficiency in outwardness, and if we think of psychosis as an excess of outwardness, it makes sense that a psychedelic which can cause a temporary psychosis, could benefit autism. And if fever also benefits autism, perhaps there is a connection here.

(No one really knows why fever reduces autism, but it may be due to T-cell activity. There is evidence that those with autism have antibodies to their own brain, suggesting an auto-immune problem, or an overactive B cell (antibody) system. If fever— which is caused by T cells—  simulates healthy T cell function, perhaps it corrects for an auto-immune issue.)

To return to the connection of fever with psychedelics: fever is a state in which the body is processing or purging something.

Likewise with ayahuasca.

A challenging or difficult trip with ayahuasca is very common, and are taken as a sign someone is in catharsis: processing something emotionally. Although a ‘cathartic’ usually refers to a laxative, the word was originally used to mean emotions. Aristotle long ago spoke of Greek tragedy as cathartic in that it purifies an audience by arousing pity and fear.

So, psychedelics are purgative… but so are fevers. But besides this obvious connection, there is yet another more subtle connection fever has with psychedelics:   If you look at the first antipsychotic drug ever developed—- reserpine— it came from Indian Snakeroot. This was a natural drug traditionally used to treat both fever, and psychosis.

The second antipsychotic drug— chlorpromazine— was promoted for use by a French surgeon named Henri Laborit, who sought a way to suppress the stress response of surgery. From the shock of surgery, the body ordinarily produces adrenaline, even with anesthesia. Surgery is a very distressing experience to the body, and Laborit found that by giving an antipsychotic, he could block the response. It is almost as if the body reacts to surgery with a bodily expression of intense fear… as if from a bad psychedelic trip…  Henri Laborit was a genius, and experimented with cooling surgical patients to a very low temperature, preventing the stress or shock response, which again, can also be treated by an antipsychotic. Dr. Laborit’s cooling idea, and his giving antipsychotics to those getting surgery, are interesting when you consider that schizophrenics are known to have a slight heat intolerance and a higher base temperature.

I hope you find these subtle connections as interesting as I do. Dr. Laborit needed a cure for the body’s almost psychotic stress response to surgery.

And the reason he needed a cure was because he was also causing the problem. In other words he was intentionally putting the body in a fearful stress response. Here is another medical instance where causing intense fear is medically warranted. If having your abdomen cut open, your naked body scrutinized, and your inner parts seen isn’t akin to psychosis, I don’t know what is. And yet it’s medically warranted.

Like surgery, psychedelics are invasive and uncomfortable. People lose all sense of privacy, including mental privacy. Many psychedelics function like a truth-serum which reveals all secrets, opens up all channels of emotion, and unhides what is hidden.

And that is central both to why they are frightening to some, and to their usefulness for promoting mental health. “Secrets make you sick”, as Freud once said, and so psychedelics can be thought of as a sort of surgery of the mind, an access point for the hidden parts of the psyche.

Many people report immense psychological benefits after bad trips.  As if they had undergone a kind of psychosurgery.

One patient of mine reported that during ayahuasca he felt he was spiraling down a drain, as if to die and go back to God. I saw him in the ensuing months of 2021, and I can attest this young man rapidly dropped many of his narcissistic traits. His near-death experience with ayahuasca released him from some deep seated fears, likely of early neglect by his mother. There was significant change to his personality, changes that impressed me profoundly. Strong narcissistic traits are deep-seated, and like alcoholism, do not usually respond to treatment.

Such near-death experiences in which people experience ‘ego-death’ are common with ayahuasca, and sometimes with ketamine, which is used as an anesthetic in surgeries.

Again, just like a fever, childbirth, or surgery, the stress of a bad trip may be both necessary and beneficial.

Yet, with all these connections, most doctors today will balk, and say they see no reason at all for a temporary psychosis. Some of these psychiatrists, keep in mind, may recommend shock treatment, with its seizures and its risk of permanent amnesia. Yet, they will balk at the possibility of the benefits of a bad trip. Again, these same doctors will prescribe drugs which can cause psychosis, e.g. steroids, or (in the case of Parkinson’s) L-DOPA, a  drug known to cause hallucinations.

Perhaps some of the attitude of physicians stems from the fear of a permanent psychosis.

In my opinion, the risks of this are overblown in comparison to the psychological benefits.

Brian Wilson of the Beach Boys (RIP), did lose his mind after abusing LSD in the 1960s. However he reported taking it daily. This again was a widespread fear in the 1970s, and there do appear to be instances of it with LSD, but with the other psychedelics, particularly ketamine and psilocybin, I just haven’t seen it.

And so, again, in conclusion, the fear or judgment of psychedelics due to the occurrence of bad trips is an attitudinal problem among doctors, which is at odds with many things: with the benefits observed in animals, with the history of surgery provoking the development of antipsychotic drugs, and with the usefulness of fever and its connection to psychosis.

In this article, I’ve taken a broad, medical view of bad trips.

But in another article titled ‘The Benefits of a Bad Trip’, I delve specifically into the psychological benefits of bad trips, and I elucidate why a temporary psychosis is a cure for introjection— the cause of depression.