Science | Mescaline: A Neglected Tool for Psychotherapy
Sam Woolfe looks at the unique characteristics and therapeutic potential of mescaline.
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One of the most common pieces of advice you’ll hear when it comes to tripping is not to take psychedelics if you’re in a negative frame of mind. This is encompassed by the concept of ‘set and setting’, with the first half – ‘set’ – referring to the fact that one’s mindset can influence the quality of a psychedelic experience. Setting, meanwhile, refers to how one’s environment and social context can affect the journey.
Since psychedelics can intensify whatever mindset you’re in, it makes sense to avoid tripping if you’re experiencing low mood, as the fear is that this could lead to a dark or frightening experience. But at the same time, studies from institutions like Imperial College London  and Johns Hopkins , as well as plenty of anecdotal reports, continue to reveal that psychedelics can lift people out of ruts and the states of chronic low mood that characterise depression. So here we encounter what I call the paradox of ‘set’: tripping can both worsen and improve bad moods.
Given this paradox, how can a would-be tripper decide whether it is sensible to trip or not? My aim is to explore in more depth this paradox, why psychedelics can at times massively worsen moods and at other times ameliorate them, and the particular circumstances in which tripping in a negative emotional state is perhaps too risky.
It is completely normal and understandable to be unsure about whether now is an ideal time to be taking psychedelics, even if you have a desire to take them and want to benefit from the experience. This uncertainty, for some people, comes from the recognition that one is not in a good mood. And since you want to have as positive an experience as possible, it might make sense to wait until your mood improves.
However, many people’s desire to use psychedelics is born out of struggling with negative feelings like low mood, disconnection, emptiness, and joylessness.
According to the concept of set, one’s current mood, personality, beliefs, and attitudes can help determine the direction of a psychedelic experience. This fits in with psychiatrist Stan Grof’s definition of psychedelics as “nonspecific amplifiers”  of the human psyche. Thus formulated, these substances amplify whatever contents exist in your mind, be they conscious or unconscious. So if your prior mindset is gloomy and cranky, you should expect these states to be intensified, making for a challenging experience.
On the other hand, we continue to see new research suggesting that one or two powerful psychedelic experiences (combined with therapy and integration, it should be stressed) can lead to significant improvements in both severe and treatment-resistant depression. While earlier clinical trials on using psilocybin therapy for depression have found that depression typically returns for participants after six months  (and sometimes earlier than this), a new study  from Johns Hopkins shows that this treatment can relieve depression for at least a year for some patients.
But if psychedelics really are nonspecific amplifiers, then why do people find themselves in these clinical trials experiencing joyful states of mind and an unburdening of depression, rather than a worsening of it?
Well, firstly, it should be emphasised that some patients in these trials do have difficult moments during their experiences. Rosalind Watts, a clinical psychologist and former Clinical Lead at the Imperial College London psilocybin for depression trial, has pointed this out . Whatever events and psychological material are at the root of depression can surface – in an intense way – during these altered states.
Secondly, the fact that depression improves may still support the notion of psychedelics as nonspecific amplifiers in the sense that they amplify positive aspects of oneself that have been overshadowed by the negative. If you struggle with rumination and feelings of low self-worth, psychedelics could help by catalysing and enlarging pre-existing capacities like self-acceptance and self-compassion. (Some might argue this implies a specific kind of amplification, but I will leave the discussion on the merits and criticisms of thinking of psychedelics as nonspecific amplifiers for another post.)
Based on such promising research, people struggling with low mood (related to depression or not) might want to experience the curative effects of psychedelics themselves. But it should be underlined that most people who take – or want to take – psychedelics do not do so under the conditions present in these clinical trials, where preparation, support, and integration are provided by trained therapists.
One way to try to resolve the paradox of set is to pay attention to the context in which one is taking psychedelics. Taking psychedelics while experiencing negative emotions is not necessarily reckless. But this does increase the chances of having to face intensified negative states. For this reason, it would be wise to have psychological support at hand – before, during, and after the experience.
We can also deal with the thorniness of this problem by looking at some instances in which a bad mood is intense enough to warrant delaying a trip.
There are many circumstances that can make us feel stressed, angry, sad, irritable, or fatigued. When these unwelcome events – and the negative feelings they lead to – are fresh in our mind, the risks of tripping can outweigh the potential rewards. Dr. Rick Barnett, a psychologist and founder of the Psychedelic Society of Vermont, wrote an excellent article  on some of these situations. They include:
I would also add to this list recent major losses like losing a job or breaking up with a partner. Again, you need to spend some time processing these events. Psychedelics can often worsen how you feel in these instances, rather than speed up the healing process.
Struggling with bad moods is not, in itself, a reason to avoid using psychedelics. If this were the case, many people would miss out on making significant improvements in how they think and feel, and in their general levels of life satisfaction.
Nonetheless, tripping when in a bad mood, clinically or not, carries a set of risks, such as a predominantly negative experience, with little to take from it. Based on the above discussion, there seem to be cases of acute bad mood where the risks of taking psychedelics are much higher than they otherwise would be, and so it would be prudent to postpone the experience.
Risks increase, of course, if you’re taking psychedelics without support. Most of us cannot access the ideal conditions of preparation, support, and integration provided by therapists in clinical trials. Nevertheless, it is still important to have emotional support available from someone you trust – be that a friend or a guide – when embarking on a potentially powerful journey.
While it is difficult to know if you should trip now or wait until your mood improves, there are some signs you can look for that can aid in your decision-making. For instance, if your gut instinct keeps telling you not to take psychedelics, it’s worth listening to your intuition. Don’t commit to a psychedelic experience just because it’s been planned for a specific date or because others around you want to trip at that particular time.
You have to trust your judgement when it comes to distinguishing between resistance and ‘feeling off’. In the latter case, you can do yourself a favour by pausing, taking time to look after yourself physically and mentally, thinking about your intentions for tripping, and then preparing for the experience. Preparation should involve readying yourself to be open to whatever occurs and having some tools ready in case disturbing thoughts, feelings, and perceptions do arise: practices like mindfulness, acceptance, and self-compassion.
Whether you’ve booked a psychedelic retreat (or want to book one) or you’ve planned to trip by yourself (or with others), remain mindful of your inner state. Delaying the experience does not mean you’ve ‘wimped out’; it might instead just mean you’re self-aware enough to prioritise your well-being.
Sam Woolfe | Community Blogger at Chemical Collective
Sam is one of our community bloggers here at Chemical Collective. If you’re interested in joining our blogging team and getting paid to write about subjects you’re passionate about, please reach out to Matt via email at firstname.lastname@example.org
Sam Woolfe looks at the unique characteristics and therapeutic potential of mescaline.
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