Healthy living has benefits hugely greater than anything medicine can deliver. - Bandolier 136, Oxford evidence-based medicine website
Trip-sitting for a dear friend: before
"Who will prefer the jingle of jade pendants if he once has heard stone growing in a cliff?" Lao Tzu
I'm just off to the Netherlands with a dear friend. They're planning to take psychedelic truffles and have asked me to 'trip-sit' for them. Thinking about the different things I can do to support them, I came up with the somewhat 'clunky' acronym IDSPM. It stands for Information, Discussion, Safety, Practicalities & Measurement.
So, first Information - I've written before that I neither recommend nor discourage people from taking psychedelics. For anyone who is considering it, I would however strongly encourage a cautious & thoughtful weighing of the pros & cons. These are potentially powerful substances. I think they're much safer than the media & governments have portrayed, but anyone thinking of taking them is likely to be stupid if they haven't looked carefully before they leap - see, for example, both many of the posts on this website and too the UK Psychedelic Society's section on "Responsible use". There is so much information available now, the problem may not be so much finding information, as choosing from what's already accessible and increasing all the time. Michael Pollan's book "How to change your mind: the new science of psychedelics" still seems a good place to start, and James Fadiman's "The psychedelic explorer's guide" takes one into more practicalities. There is so much more one can go on to explore. Here's the "Psychedelic resources" page on Michael Pollan's website and here's an extensive "Psychedelic booklist" from the UK Psychedelic Society (see too their more general "Knowledge" menu). The "John Hopkins" and "Imperial College" sites are, of course, central hubs for current developments in psychedelic use. The various posts listed to the left on this page also contain much knowledge, as too do the quarterly newsletter put out by our Scottish psychedelic health professionals network (PHP Scotland).
Becoming a bit more familiar with some of these Information sources may lead some people to consider the possibility of trying psychedelics for themselves. This is where Discussion may well be helpful. In my work as a psychotherapist, I routinely ask new clients something like "If we worked together for a while and this helped you achieve all you hope for, what is it you would most like to see change or improve ? Or what would you most want to explore or understand better? Or simply, what would you most want to see emerge from our work together?" I think questions like these can also be helpful when considering taking psychedelics. They are not magic bullets, but I might ask "If taking a trip was really helpful for you, what would you most want to see emerge from the experience?" The answer may be that the urge to take psychedelics is simply driven by general curiosity, and that can be fine. If however there are more specific personal reasons than this ... either spiritual questing or wellbeing & relationship enhancement or easing different forms of psychological distress ... then it makes very good sense to get more details and discuss how things ideally would be different.
The third letter in my IDSPM acronym is 'S' for Safety. I've written a good deal about this area in the post "Recent psychedelic research: what are the risks?" See too the UK Psychedelic Society's section on "Responsible use". And in PHP Scotland's retreats information leaflet, there's the comment "Although psychedelic truffles are comparatively safe, it is important that they are used thoughtfully and for some people they won't be appropriate. Typically researchers screen out people who have a personal or family history of bipolar or psychotic disordder and too some other psychological difficulties. Curreht use of antidepressants is also usually a contraindication. Because psilocybin produces a tansient increase in blood pressure, studies typically screen out as well those with a history of coronary artery disease, cerebrovascular disease, poorly controlled hypertension and other unstable medical conditions."
Next we have 'P' for Practicalities. This area overlaps with Safety. What psychedelic is going to be used and at what dose? Are there reasons to be confident that one is taking what one thinks one is taking? Are there checks for substance purity and dose? And what about location? We need somewhere safe, private, comfortable ... and enough time. Psychedelics are 'slow food', they shouldn't be rushed ... at least not if one is serious about exploring their potential benefits. One wants time as well to integrate one's experience after the trip. Plenty to think about and arrange. In the case of my friend, we're taking a quiet Airbnb in the Netherlands and will use legal smart shop psilocybin truffles. Because they are understandably cautious and don't have previous experience of psychedelics, we're going to start with 11gm of High Hawaiian truffles and take up to a further 11gm an hour or so into the trip depending on response. My friend is quite light, so - making the quite major assumption that there is about 1mg of psilocybin in 1gm of truffles - at 22gm of truffles they would be taking the equivalent of about 26mg/70kg body weight. This is slap bang in the middle of the John Hopkins 'high range' doses (they have typically used 20-30mg/70kg of psilocybin in their research). Having said this, I would mention a couple of further points - one is that there is actually very little evidence that making dose adjustments for body weight is a particularly helpful practice, and secondly many higher dose trips currently being taken here in Netherlands typically use 30 to 44gm of truffles. I took eight psilocybin truffle trips last year using a range of doses from 5gm right up to about 60gm. Dose is important, but it's only one of the factors governing the depth/strength of a psychedelic trip.
Lastly we have 'M' for measurement. What is the person coming to psychedelics hoping for? Do they sometimes struggle with anxiety or depression? Are there substance use problems or other difficulties? Here on this website there are many free downloadable measures of the severity of different psychological problems. If reducing distress is a significant focus of the trip, then it makes sense to ask the person to fill in the AAQ-II and possibly too the PANAS pre-trip ... and maybe too specific measures of the areas they would like to see improve.
Measurement helps us pan for gold.
More to follow ...
For the second post in this three-part series, see "Trip-sitting for a dear friend: during".