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Navigating groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences

Summary

People who use psychedelic substances like psilocybin or LSD sometimes experience profound changes in how they understand reality that can be distressing and last for months or years. This study interviewed 26 people who went through such difficult experiences and found that what helped them most was practicing grounding techniques (like yoga, spending time in nature, and creative activities), talking about their experiences with others, and learning to accept their new perspectives. The research shows that while these experiences can be challenging, people can recover and grow from them with the right support and practices.

Background

Psychedelic experiences can trigger profound shifts in metaphysical beliefs and worldviews, which have been associated with therapeutic benefits in some contexts. However, growing evidence suggests that psychedelic experiences can also trigger long-lasting existential and ontological distress, with approximately 50% of individuals reporting extended difficulties experiencing protracted ontological challenges related to how they understand reality and existence.

Objective

To conduct an in-depth exploration of self-reported experiences of existential distress following psychedelic use through semi-structured interviews with individuals who reported experiencing existential distress after psychedelic experiences. The study aimed to identify common themes, understand the phenomenology of difficulties, and explore what participants found helpful and unhelpful in managing their challenges.

Results

All participants experienced ontological shock and existential confusion following their psychedelic experiences. Ten experienced existential crisis and despair, eight experienced emptiness and meaninglessness, fifteen experienced derealization and reality questioning, and twelve experienced obsessive preoccupation with meaning-making. Participants found relief primarily through ‘grounding’ practices including embodiment practices (yoga, trauma release exercises, time in nature), creative expression, and social/cognitive normalization of their experiences.

Conclusion

Psychedelic experiences act as pivotal mental states that can facilitate transformative learning but may also challenge individuals’ foundational understanding of reality. Effective integration of ontologically challenging experiences involves grounding practices, embodiment, social support, and cognitive normalization. The research contributes to understanding psychedelic integration by identifying specific strategies that help individuals reestablish coherence and achieve psychological growth following ontologically challenging experiences.
  • Published in:PLoS One,
  • Study Type:Qualitative Interview Study,
  • Source: 40323979, 10.1371/journal.pone.0322501
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