Tuesday Brunch: Four beliefs that cause bad trips and post-psychedelic difficulties

(and just...suffering in general)

Welcome to Tuesday Brunch. First bit is free, the rest just for paid subscribers.

When I was 18, I had a bad LSD trip that led to me developing PTSD and social anxiety, both of which lasted for a few years. I recovered thanks to a few things, particularly Cognitive Behavioural Therapy and Stoic philosophy (which is the inspiration for CBT). I spoke about how they helped me in this TEDX talk. CBT and Stoicism are based on the idea, also found in Buddhism and other wisdom traditions, that what causes suffering is your own beliefs, and you can change your beliefs, which gives you some control over the dial of suffering / bliss.

In the last few years, in my work researching post-psychedelic difficulties, I’ve noticed several core beliefs or cognitive biases which seem to make bad trips more likely to occur, and post-psychedelic difficulties more likely to continue. Here are four of them:

1. This is catastrophic

Catastrophizing is a cognitive bias which causes a lot of suffering and appears in many emotional disorders like depression and anxiety. It involves the mind jumping to the worst possible conclusion. For example: “If I make one mistake in this report, I’ll get fired and never find another job.” Or “This headache must mean I have a brain tumor.”

On psychedelics catastrophizing gets amplified: ‘I’m in hell! Someone I love is dead! The world is literally ending! I’ve gone psychotic!’ and so on. The catastrophic thinking style can thencontinue in the weeks and months after the bad trip: ‘I’ve broken my brain! I’ve ruined everything!’ and so on.

Antidote to catastrophizing:

Each negative way of thinking is met, in CBT (or Stoicism, or Buddhism, or other wisdom traditions) with alternative ways of thinking and seeing, which in turn alter our emotions. Alternative ways of thinking to catastrophising might be:

‘This is bad, there’s no sugar-coating it. But things could always be worse. I am still alive. I still have the power to heal myself. This is not the end of the world, it’s a severe challenging time in my life. Maybe I will look back on it as the most challenging time of my life. But I can get through it. Many others have been through post-psychedelic crises and come out the other side. I can too. Thinking catastrophically doesn’t help in a crisis. As Churchill said: ‘When you’re in hell, keep going’.

2. This is permanent

In CBT this is known as the ‘fortune teller’s error’: ‘because it’s bad now, that means it will always be this bad for ever and ever’. It’s a very common cognitive bias that causes a lot of suffering. The fortune teller’s error can occur during trips and cause people to freak out: ‘I have gone psychotic and will always be psychotic’. And it also often crops up during post-psychedelic difficulties: ‘I will never get better. I have permanently broken my brain. I will always be this anxious, dysregulated, unhappy and alone’.

Unsurprisingly, thinking this way is like throwing lighter fluid onto a fire. It will really intensify your catastrophising and your emotional suffering, until your mind is a whirlwind of negativity.

Antidote to the fortune teller’s error

‘Nothing is permanent. This is the essential teaching of Buddhism, Stoicism and every great wisdom tradition. Nothing lasts forever. We cause ourselves suffering when we freeze the moment instead of letting it flow. Saying to yourself ‘It will always be like this’ is a form of attachment, it’s holding onto the moment out of fear. Let it go. Each mental or emotional or physical symptom is like a cloud passing, if you really examine it closely. It arrives in your consciousness, it can flare up and intensify, but it always passes. Nothing is permanent.’

3. Others can see how fucked up I am

This is called Mind Reading in CBT. It’s a cognitive bias in which people assume they know what others are thinking. You may assume others are looking at you, talking about you, judging you, criticizing you, laughing at you and so on. It’s a common thought pattern in depression, anxiety and especially social anxiety and paranoia.

This cognitive bias turned up in my bad LSD trip when I was 18. I was sure everyone at a party was judging me for not saying anything. It turned into this mental spiral where I was a terrible person and everyone was judging me and picking me apart. The mind creates a thousand different hells for itself. And this cognitive bias continued afterwards, for years: ‘Others are judging me, they look down on me, they think I’m a bad person, and that’s intolerable, it means I really am a worthless person’.

Antidote to Mind Reading

We often over-estimate the extent to which others are paying attention to us or thinking about us. Most people aren’t thinking about us, they’re involved in their own dramas. We can even check in with people, occasionally, to test our beliefs about what they think of us. If our guesses prove to be wrong, repeatedly, we are probably prey to a strong cognitive bias.

Sometimes you might find evidence that people really do look down on you and think you’re a joke, a loser, a fraud or general scumbag. That doesn’t mean you have to buy into their opinion of you. You can decide if a criticism of your behaviour is accurate and try to change accordingly, or decide to ignore it. Either way, you can say something like this to yourself: ‘I am not perfect, nobody is. I can try to improve my self and my behaviour, while still choosing to accept myself and like myself, warts and all. My self-worth does not depend on the fickle judgements of other people’. I would repeat statements like this to myself, every day, for months, until they became new mental habits that I really believed.

4 Hyper self-monitoring

This is something I’ve noticed in a lot of people struggling with post-psychedelic difficulties - they intensely monitor their own thoughts, emotions and bodily sensations, anxiously checking to see if a certain unwanted symptom is still present, such as feeling dissociated, or visual distortions, or brain fog, or anxiety. And if they find it, they sometimes catastrophize: ‘this proves that I’ve permanently broken my brain and will never recover’.

This leads to them constantly ruminating about their inner state. And guess what, the more you anxiously monitor your inner state, the more likely it is the hated symptom will appear and the larger it will loom in your consciousness, until the whole world and everyone in it becomes dimmed, and all the person can pay attention to is the hated inner symptom that proves they are screwed.

The antitode to anxious self-monitoring

One antidote to this obsessive self-monitoring (in fact, there are a few different possible antidotes but here’s one) is to re-focus your attention outside of yourself - on the world, on a game, on your work, on what the other person is saying in a conversation, on exercise, on anything. Just take your mind off your inner state for a moment.

And if you notice the symptom occurring, just let it occur, let it arise and pass away like a leaf floating down a river. It is not you. It is passing weather. The more we learn to accept it and not catastrophize about it, the less we react to it, the less we notice it, the less we care about it and - maybe - the less it occurs.

There are other core beliefs I could mention which often turn up in bad trips and post-psychedelic difficulties. A big one is shame and self-blame: ‘I am a terrible person, I have messed everything up’. People really beat themselves up and don’t even necessarily realize they are doing it.

So, I hope some of these reframing techniques might work for you, as they did for me. You might think CBT during a post-psychedelic crisis is fiddling while Rome burns. But honestly, like the Stoics and Buddhists say, everything is a view, an opinion, a mental construct, and a post-psychedelic crisis is often sustained by certain deeply-held negative views, and we can change the weather within by letting go of some of these views and training ourselves to hold wiser or more skilful views. It worked for me, anyway, and for many others too - we’re working on an analysis of 50 YouTube videos in which people describe what helped them recover from derealization, and the most consistent reply is cognitive reframing.

OK, now for this week’s round-up of interesting links. This week we have: a church of designer drugs in Austin; hemp products caught in the crossfire of the US government shutdown; a New York Magazine take-down of Internal Family Systems; a new Netflix documentary about veterans and iboga, and my book and movie picks for November. All that, after the paywall.

By the way, he hasn’t paid me (and I have never accepted payment or sponsorship for an article or a link) but my friend Pedram Dara has organized a free online conference called the Psychedelic Lived Experience Summit. It’s happening Nov 21-23, and it includes some people who come to CPEP’s support group talking about post-psychedelic difficulties. You can sign up for free here .