Below is a harm-reduction guide for preparing for and undergoing therapeutic psychedelic experiences with psilocybin (magic mushrooms), LSD, ayahuasca, and MDMA.
I offer psychedelic integration counselling to help you prepare for the experience, make sense of what may emerge, and apply any insights afterward.
One of the most determinant factors in having a ‘good trip’ is ‘set and setting.’ Set and setting describe the physical, mental, social, and environmental context an individual brings into a psychedelic experience. The set is a person’s mental state related to the experience, like thoughts, mood, and expectations. The setting being the physical and social environment.
“Turn off your mind, relax and float downstream
It is not dying.”
Tomorrow Never Knows – The Beatles
Why Preparation Matters
Psychedelic substances amplify whatever is already present. If you go into an experience anxious and scattered, those states will likely intensify. If you go in grounded, rested, and clear about your intentions, you give yourself the best chance of a productive experience. This is not about controlling the outcome. It is about creating conditions that support whatever needs to happen.
Research consistently shows that preparation is one of the strongest predictors of positive outcomes in psychedelic-assisted therapy. In clinical trials at Johns Hopkins and Imperial College London, participants go through multiple preparation sessions with therapists before a single dose is administered. You may not have access to a clinical trial, but you can apply the same principle: the more carefully you prepare, the more useful the experience is likely to be.
This guide covers the practical side. For deeper psychological preparation, working with a therapist who understands psychedelic experiences is recommended. If you are in Montreal, I offer preparation and integration sessions for this purpose.
The Days Before
- Start thinking about and setting your intentions for your experience.
- Create a mind-map of ideas/concepts to explore.
- Meditate.
- Light exercise.
- Sleep.
- Ensure that you’re well hydrated. Water, coconut water, non-caffeinated teas.
- Ensure that you have a few snacks for your journey — fruit, nuts, (good) chocolate.
- Prepare a music playlist. Classical, ‘world music,’ music without lyrics is best.
The Night Before
- Tidy the room you will be in for your experience. Get your mind-map, journal, pillow, blanket, eye-mask, music and headphones ready.
- Prepare the bathroom. Ensure you have enough toilet paper, a face cloth, a towel for a shower.
- Prepare snacks for during your journey and a light dinner for afterwards.
- Prepare cups/mugs/bottles for drinks you may want during your experience.
- Lay a yoga mat down for during your experience. You may feel like stretching your body.
- Try to get a good night’s sleep.
- DO NOT WATCH TELEVISION OR USE SOCIAL MEDIA.
The Day of – Before
- Meditate.
- Eat a light breakfast at least 3 hours before beginning your journey.
- Ensure that you’re hydrated.
- Wear comfortable, layer-able clothing.
- Go over your intentions.
- DO NOT WATCH TELEVISION OR USE SOCIAL MEDIA. Try to limit external stimuli. The idea is that you turn inward.
The Day of – During
- Don’t push/pull yourself in any direction. Should you feel like you want to go over the mind-map, do it. If you wish to put your eye-mask and headphones on, do it.
- If you feel like it, talk to your sitter.
- If you’re able, try meditation. Sit with ANY feelings that may come up. As best you can, try not to get in your own way. Let the experience flow.
- If you feel like it, journal.
- Stay hydrated.
- DO NOT WATCH TELEVISION OR USE SOCIAL MEDIA.
The Day of – After
- Eat something. You may not feel like it, but it will be a good idea to get nutrients into you. Soup, toast, fruit, nothing too heavy. No caffeine.
- If you’re up for it, go for a walk outside.
- DO NOT WATCH TELEVISION OR USE SOCIAL MEDIA.
The Day After
- Meditate.
- Journal.
- Go outside, walk.
- Let the experience sink in. Try not to force anything.
- DO NOT WATCH TELEVISION OR USE SOCIAL MEDIA.
Setting Intentions
An intention is not a goal. It is a direction. Goals are rigid (“I want to resolve my childhood trauma”). Intentions are open (“I want to be present with whatever comes up about my family”). The difference matters because psychedelic experiences rarely follow a script. If you go in with a fixed expectation, you are more likely to resist what actually arises, and resistance tends to produce difficult experiences.
Good intentions are honest and specific enough to be meaningful, but broad enough to allow the experience room to move. Some examples: “I want to understand why I feel stuck.” “I want to be open to grief I’ve been avoiding.” “I want to connect with a sense of purpose.” Write your intention down. You do not need to hold it in your mind during the experience. The act of clarifying it beforehand is what matters.
Choosing a Sitter or Guide
A sitter is someone who remains present and sober during your experience. Their role is not to guide you through the journey or interpret what happens. It is to provide a stable, calm presence and to intervene only if necessary for safety.
Choose someone you trust deeply and feel comfortable being vulnerable around. This is not a social event. Your sitter should be someone who can sit quietly for hours, who will not panic if you cry or become distressed, and who understands that their job is to hold space rather than fix anything.
Practical points to discuss with your sitter beforehand: what substances you are taking and the expected duration, your intentions for the experience, what kind of support you want (verbal reassurance, physical contact like a hand on the shoulder, or simply their quiet presence), what to do if you become distressed (usually: speak calmly, remind you where you are, encourage slow breathing), and when to contact emergency services (this is very rarely needed, but discuss it anyway).
If you do not have someone suitable in your life for this role, that is worth taking seriously. Doing a significant psychedelic experience alone, particularly for the first time, increases risk. Consider working with a professional who offers preparation and support.
Substance-Specific Considerations
The general preparation advice in this guide applies across substances, but there are differences worth knowing about.
Psilocybin (magic mushrooms). Effects typically begin within 30 to 60 minutes and last 4 to 6 hours. Nausea during the onset is common. Having ginger tea or ginger chews on hand can help. The come-up can involve anxiety, which usually passes as the effects settle in. Fasting for at least 3 hours before ingestion reduces nausea and may lead to a faster onset.
LSD. Longer duration than psilocybin, typically 8 to 12 hours. This means your playlist, supplies, and sitter availability all need to account for a longer day. The extended timeline can be tiring. Ensure you have nothing scheduled for the following day either. LSD is generally less likely to produce nausea than psilocybin but can produce more stimulation, making it harder to lie still.
Ayahuasca. Usually taken in a ceremonial context with experienced facilitators. The brew contains an MAOI (monoamine oxidase inhibitor), which creates dangerous interactions with many common medications including SSRIs, SNRIs, and certain foods. A strict dietary protocol is required in the days before. If you are considering ayahuasca, do not undertake it without thorough medical screening and experienced guidance. This is not something to do casually or alone.
MDMA. Not a classic psychedelic but widely used in therapeutic contexts, particularly for trauma processing. Effects last 3 to 5 hours. MDMA increases body temperature and heart rate, so staying cool and hydrated is important. Avoid alcohol. Do not redose beyond what you have planned. MDMA depletes serotonin, and the days following can involve low mood. Plan for a gentle recovery period.
What to Do if Things Get Difficult
Difficult moments during a psychedelic experience are not the same as a bad experience. They are often where the most meaningful therapeutic work happens. Fear, sadness, confusion, and even physical discomfort can all be part of a productive journey. The instinct to fight these feelings is strong, but the most helpful response is usually the opposite: to stop resisting and allow the feeling to be present.
Practical strategies if you or the person you are sitting for is struggling: change the music to something gentler or pause it briefly. Move to a different position or location within the space. Focus on slow, deep breathing. Have the sitter offer calm, simple reassurance: “You are safe. This is temporary. You took a substance and it will wear off.” Physical grounding can help: feel the floor under your feet, hold a familiar object, wrap yourself in a blanket.
If distress is severe and sustained, moving to a different room or going outside (with your sitter) can reset the experience. Changing the environment is one of the most effective de-escalation strategies available.
Integration: The Days and Weeks After
The experience itself is only part of the process. What you do with it afterward is what determines whether it produces lasting change. Integration is the practice of making sense of what happened and applying any insights to your daily life.
In the first few days, keep things simple. Journal what you remember, even fragments. Do not try to interpret everything immediately. Walk. Sleep. Eat well. Avoid alcohol and cannabis for at least a few days, as they can blur the clarity that often follows a psychedelic experience.
Within the first week, review your journal entries. Look for patterns, images, or emotions that recur. Talk to someone you trust about what came up, whether that is a friend, a partner, or a therapist. The act of putting the experience into words helps consolidate it.
Over the following weeks, notice changes in your behaviour, mood, or perspective. Some shifts are immediate and obvious. Others are subtle and only become clear over time. Be patient with the process. If you feel confused or unsettled, or if the experience brought up material you are struggling to process on your own, professional integration support can help. That is a significant part of what I do in my integration counselling work.
Medication Interactions and Contraindications
This is not optional reading. Certain medications interact dangerously with psychedelic substances. The most critical interactions to be aware of:
SSRIs and SNRIs (e.g. sertraline, escitalopram, venlafaxine) can reduce the effects of psilocybin and LSD. When combined with MDMA or ayahuasca, they carry a risk of serotonin syndrome, which is a potentially life-threatening condition. Do not stop or taper psychiatric medication without guidance from your prescribing physician.
Lithium combined with psychedelics has been associated with seizures. This is considered an absolute contraindication.
MAOIs interact dangerously with MDMA and many common foods and medications. If you are taking an MAOI, avoid psychedelics entirely unless under direct medical supervision.
If you are on any psychiatric medication, discuss it with both your prescribing doctor and your integration therapist before proceeding. This is a safety issue, not a formality.
Frequently Asked Questions
How do I know if I’m ready for a psychedelic experience?
There is no universal checklist. But certain indicators suggest you are not ready: you are in acute psychological crisis, you are using the experience to escape from something rather than work through it, you feel pressured by someone else to do it, or you are on medications that interact dangerously with the substance. Readiness looks like genuine curiosity, a willingness to face uncomfortable material, stable mental health (not the same as perfect mental health), and a clear intention.
Can I do this alone?
It is strongly advised against, particularly for a first experience or at higher doses. Having a sober, trusted person present significantly reduces psychological risk. If something difficult arises, having someone calm and grounded nearby can make the difference between a challenging-but-productive experience and one that feels traumatic.
What should I do if I feel nothing?
Wait. Effects can take 30 to 90 minutes to appear depending on the substance, dose, and what you have eaten. Redosing because you are impatient is a common mistake that leads to taking more than intended. If after two hours you have felt genuinely nothing, the dose may have been too low or the material may have been inactive. Discuss with your sitter and do not add more.
How long should I take off work?
At minimum, have nothing scheduled for the day of the experience and the full day after. If possible, take two days after. You may feel perfectly fine the next day, or you may feel emotionally tender, tired, or reflective. Giving yourself space to process without the pressure of obligations is worthwhile.
Why the repeated advice to avoid television and social media?
Psychedelic experiences increase sensitivity to external stimuli, and that heightened sensitivity can persist for a day or two afterward. Television, news, and social media deliver a high volume of content designed to provoke emotional reactions. In a state of increased openness, this material can be overwhelming or destabilising. Silence, nature, and low-stimulation environments support integration. Screens do the opposite.
Do I need a therapist for integration?
Not always. Many people integrate meaningful experiences through journaling, conversation with trusted people, meditation, and time. But if the experience brought up difficult or confusing material, if you are struggling to make sense of what happened, or if you notice increased anxiety or low mood in the weeks following, working with a therapist who understands psychedelic experiences can be very helpful.
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