I Had a Bad Trip. Now What?

Psychedelic experiences can be awe-inspiring, healing, and expansive. But they can also be overwhelming—especially when they stir up painful memories, frightening visions, or intense emotions that seem to have no off switch.

If you’ve had a difficult psychedelic experience, you’re not alone. Maybe the trip happened recently and you’re still feeling raw. Or maybe days or even weeks later, something about it keeps lingering—flashes of fear, emotional confusion, a sense of disconnection from yourself or the world around you. You might be wondering:
What happened to me? Why did this affect me so deeply? Will I ever feel normal again?

This post is here to help you understand what a “bad trip” actually is, why it can happen, and how psychedelic integration therapy or support can help you find meaning and grounding after a difficult experience.

What Is a Bad Trip, Really?

The term “bad trip” is used casually, but what it really describes is a psychedelic experience that felt emotionally, psychologically, or physically overwhelming—either in the moment or afterward. A “bad” trip might involve:

• Panic, fear, or terror

• Feeling like you’re losing control

• Unwanted or painful memories surfacing

• Intense feelings of guilt, shame, or worthlessness

• A sense of being stuck in time or disconnected from reality

• Feeling as though you “saw something” you weren’t ready for

Sometimes the content of the trip is confusing or disorienting. Other times, it’s crystal clear—but painfully so. What makes a trip difficult isn’t always what happened during the experience, but how it landed in your body and mind.

Why Do Bad Trips Happen?

There’s no single cause—but some common themes include:

• An unsafe or uncontrolled setting: Taking psychedelics in a chaotic environment, with people you don’t fully trust, or without proper support, can make you feel emotionally or physically unsafe. Even well-intentioned recreational use at a party can trigger a loss of internal grounding.

• Emotional content you weren’t prepared for: Psychedelics can bring long-buried memories, traumas, or emotions to the surface. If that happens without support, the experience can feel destabilizing or even re-traumatizing.

• You were scared by what was coming up and understandably tried to fight or resist it: When you resist the unfolding experience—especially if it’s intense or unfamiliar—it can create internal friction, leading to fear, panic, or a sense of fragmentation.

• You had unspoken expectations: Maybe you hoped for healing, insight, or connection—and instead felt confused, detached, or flat. The mismatch between what you hoped for and what occurred can deepen the distress.

What Psychedelic Integration Can Offer

The good news is that a difficult trip doesn’t mean something is wrong with you—and you don’t have to stay stuck in the aftershocks. Psychedelic integration is the process of making sense of the experience, emotionally digesting it, and using it as an opportunity for growth, insight, and healing.

In therapy, integration often looks like:

• Understanding your nervous system’s response: Exploring how your body reacted during or after the experience—fight, flight, freeze, dissociation—and how that might relate to past patterns of survival.

• Making meaning of what surfaced: Looking at the images, emotions, or messages that came up—not to “decode” them like a puzzle, but to reflect on what they might be pointing toward in your life.

• Supporting self-compassion: So many people blame themselves after a difficult trip—“I should’ve known better,” “I failed,” “I’m broken.” Integration creates space to meet those parts of you with curiosity instead of judgment.

• Grounding back into the present: Using body-based practices, mindfulness, and creative expression to reconnect with the here-and-now, especially if you're feeling disconnected or altered.

What Integration Can Look Like

Jordan (not his real name) took LSD in a social setting and became overwhelmed by the sense that everyone around him was silently judging him. In the days that followed, he couldn’t stop replaying the night—cringing at what he said, convinced he had embarrassed himself. Through integration work, Jordan began to recognize that the experience tapped into a deeper sensitivity to social rejection—shaped not only by family dynamics, but by earlier peer experiences as well. Learning to notice and soothe that part of himself helped quiet the inner critic and rebuild a sense of connection.

Maya (not her real name) took MDMA hoping to process unresolved grief but felt emotionally numb throughout the experience. Afterwards, she questioned whether something was wrong with her—why hadn’t she felt anything? Integration helped Maya understand that the emotional flatness was a protective response, shaped by earlier experiences where vulnerability wasn’t safe. Naming this as protection—not failure—opened the door to relating to her emotions with more understanding and self-compassion.

Integration in Practice

You don’t have to dive straight into therapy to begin integrating. Here are a few ways to support yourself now:

Immediate Grounding

• Stay connected to basic routines: Sleep, meals, movement, hydration. Even if your inner world feels chaotic, consistent daily rhythms help signal safety to your nervous system.

• Talk to someone who won’t judge: Whether it’s a therapist, a trusted friend, or an integration circle, simply being heard and believed can help settle the nervous system.

• Avoid over-analyzing right away: The mind often scrambles to “figure it out.” Let things settle before trying to extract meaning.

Deeper Exploration (When you're ready)

• Somatic awareness: Begin to notice patterns of tension in the body—clenched jaw, tight chest, restlessness—and gently ask what they might be holding.

• Reconnect with values (ACT-inspired): Make a list of your core values. What really matters to you? Ask yourself if your experience pointed toward any unmet needs, unexpressed fears, or forgotten hopes.

• Creative expression: Journaling, drawing, movement, music—sometimes the unconscious communicates best through nonverbal channels.

You Don’t Have to Integrate Alone

If you find yourself feeling stuck, anxious, or haunted by the experience well after the fact, it may be time to seek support. Psychedelic integration therapy is not about pathologizing the experience—it’s about honoring its impact and creating space to relate to it in a different way.

There’s no one-size-fits-all path—but don't worry, while there are many options for integration, it is not your job to figure it all out on your own. With the right support, a skilled therapist can help you make sense of what you’re carrying and find the approaches that fit you.

And if therapy feels out of reach, there are free or low-cost integration circles available. For example, In the DC area, PATH: Psychedelic-Assisted Therapy & Healing offers donation-based integration groups open to the public.

Moving Forward

A “bad trip” doesn’t mean you’re damaged. It may simply mean that something was touched that deserves care, attention, and support.

With the right integration, even a painful experience can become a turning point—not because you force it to mean something, but because you learn to relate to yourself with greater honesty, compassion, and clarity.

Part 2: Can KAP Help With Trauma?

In Part 1, we discussed how ketamine-assisted psychotherapy (KAP) can help individuals with depression. We explored how ketamine, initially developed as an anesthetic, has shown promise as an innovative approach for various mental health conditions, including depression.

Trauma is a common experience that can lead to conditions such as post-traumatic stress disorder (PTSD), anxiety, chronic pain, depression, and substance use disorders. Trauma can result from a single event or a series of events, affecting people in different ways. Fortunately, several treatment options are available, including ketamine-assisted psychotherapy (KAP).

A Few Reminders About Trauma

It Does Not Define You

Trauma can feel overwhelming, often becoming an integral part of one's perceived identity. However, working with a skilled professional can help you see trauma as an external challenge that can be addressed. KAP, along with other therapeutic approaches, can provide you with the skills and tools needed for recovery. Embracing self-awareness and self-compassion is crucial, and your KAP therapist will guide you on this journey.

Acceptance is Not Surrender

Accepting what happened to you can be difficult and may initially evoke feelings of guilt. However, understanding that it is okay to not be okay is a significant step. Recognizing that the traumatic event was not your fault allows you to let go of anger, resentment, and shame. From this place of acceptance, you can fully engage with KAP and its potential benefits.

How KAP Can Benefit Someone Struggling With Trauma

Ketamine-assisted psychotherapy offers several potential benefits for individuals dealing with trauma:

• Rapid Reduction of Symptoms: Many experience a quick decrease in symptoms such as flashbacks and nightmares.

• Sustainable Symptom Relief: KAP can provide long-lasting relief from trauma-related symptoms.

• Enhanced Self-Esteem: Patients often report increased confidence and self-compassion.

• Reduced Reliance on Substances: KAP may help decrease the need for prescription medications or other substances.

• Elevated Mood and Energy: Patients often feel more energetic and have improved moods.

• Improved Relationships: Better social connections and relationships are commonly reported.

• Deeper Spiritual Life: Many find a more meaningful spiritual connection.

• Increased Calm and Gratitude: A greater sense of relaxation, safety, joy, and gratitude is often experienced.

How Does KAP work?

The process begins with a thorough medical assessment to determine if KAP is the right fit for you. Treatment involves alternating sessions, with some focused on the administration of ketamine (typically via lozenge, intramuscular injection, or IV) by a trained physician or nurse. Your therapist can be present with you during dosing sessions for support and non-intrusive guidance.

Between ketamine sessions, you will engage in integration sessions with your KAP therapist. These sessions help you process and harmonize the insights gained during ketamine administration with your everyday life. The therapy is highly personalized, tailored to address your specific experiences and needs.

KAP: A Therapeutic Alternative for Trauma

Ketamine-assisted psychotherapy represents a promising approach to addressing trauma-related issues. Under the guidance of specially trained professionals, KAP employs a combination of techniques to facilitate healing and recovery. While trauma can feel permanent, KAP can help create the necessary shifts to support your journey towards healing.

If you are curious about KAP and how it might help you, please feel free to reach out to me for more information.

Learn more about Trauma Treatment…

Part I: Can KAP Help With Depression?

Some people who struggle with depression find that standard approaches like psychotherapy and antidepressant medications do not garner positive results. In the past, this could present quite a problem. But today, we have ketamine-assisted psychotherapy (KAP). Ketamine was used primarily as an anesthetic until it was found to be effective in treating depression. 

While not a traditional “psychedelic,” medically administered ketamine brings patients into a trance-like state. In such a state, they can safely address and resolve negative memories and emotions. The underlying process involves KAP enhancing your brain’s neuroplasticity by accessing the glutamate neurotransmitter. As a result, KAP tends to work faster than anti-depressants. Let’s take a closer look.

Can Ketamine Help With Depression?

Here are some highlights from recent studies:

• KAP works quickly and is effective when used in repeated treatments 

• It has anti-suicidal effects

• KAP continues to be effective over time

• Positive results are seen in “even the most treatment-resistant patients.”

All of this (and more) is possible because ketamine can help to “reshape” the brain. 

KAP Makes and Remakes Connections 

Depression is a mood disorder, but it’s also a state of mind. Which comes first? It’s hard to say for sure, just as specific causes can be challenging to identify. However, a common hypothesis involves connection issues among the nerve cells that regulate our moods. The longer depression occurs, the fewer synapses between these nerve cells exist, hampering their ability to communicate.

KAP has been found to both reconnect the nerve cells — and increase the number of such nerve cells. This empowers the person to shift away from a depressive episode, which is what’s meant by the word “reshape” above. It’s also interesting to note that once the brain has rebuilt synapses, antidepressant medications may suddenly become effective.

What is KAP Like? 

As you might expect, there is an introductory phase in which the client is assessed and prepared for treatment. Once this has been completed, you’ll undergo two kinds of sessions. The first type is roughly two to three hours (depending on route of administration) and involves the administering of ketamine. Another type of session is called integration. Since ketamine is a unique, psychedelic-like experience, it must be integrated into your everyday life. Here’s a glance at both:

Ketamine Sessions

Before getting a ketamine infusion or lozenge, time will be allocated to making sure you’re comfortable and fully aware of what will happen. This includes discussions of what you’ll need once the ketamine wears off. The amount of time that you’re actually in the trance-like state usually ranges from 40 to 60 minutes.

Most patients report the experience to be pleasant, but most experience some dissociation along with changes in their emotions and thoughts. There may be temporary shifts in your motor skills, too. Think of it as an inward journey. Afterward, dizziness and drowsiness can last for a couple of hours, so it’s necessary to have someone drive you home.

Integration Sessions

Integration sessions are similar to talk therapy and can be quite free-wheeling. These in-between sessions will be designed to help you harmonize your new perceptions into your daily life. Your therapist may suggest “homework” to help this process move along safely and effectively, e.g., meditation, bodywork, journaling, and breathing exercises.

What Role Does Your KAP Therapist Play? 

Your therapist brings an unusual and important combination of skills to the treatment room. Of course, they are well-trained in the intricacies of a KAP. At the same time, they have plenty of knowledge about depression (or other mental health concerns). A KAP therapist understands that this approach is an evolving modality, so they know when to adapt and adjust to keep you moving toward your goal of healing.

Learn more about Psychedelic Harm Reduction and Integration…

Ketamine vs. Esketamine: What Gives?

The mental health field is currently undergoing a significant evolution with the reintroduction of psychedelics into the psychotherapeutic landscape. Ketamine, while not a traditional psychedelic (working on the glutamate pathway rather than on serotonin), stands out as a notable treatment offering hope to individuals struggling with depression, especially those who haven't found success with conventional methods.

When integrated into a comprehensive treatment plan, ketamine can act as a catalyst for profound change, assisting individuals in breaking free from ingrained patterns. However, navigating the plethora of ketamine treatments, often aggressively marketed through social media, can be challenging. It's crucial for individuals seeking treatment to understand their options and find ethical, informed providers. A common area of confusion is discerning the differences between ketamine and its relative, esketamine. This post aims to clarify these distinctions, providing a clearer understanding of these two treatments.

Ketamine vs. Esketamine: Key Differences

Ketamine and esketamine, while chemically related, differ in their applications and effects:

1. FDA Approval and Use:

   • Esketamine (Spravato) is FDA-approved specifically for treatment-resistant depression (TRD), targeting patients who have not adequately responded to at least two different antidepressant treatments during their current depressive episode. This response is evaluated through a specific approval process before insurance coverage is granted and clinicians can prescribe it.

   • Generic ketamine is used off-label for various depressive conditions and can be administered through IV infusions, intramuscular injections, or lozenges.

2. Effectiveness, Rapid Action, and Neuroplasticity:

   • Both esketamine and generic ketamine are recognized for their rapid action in alleviating depressive symptoms for some and increasing neuroplasticity, which is key in facilitating long-term psychological change.

3. Side Effects and Risks:

   • Common effects include changes in perception, drowsiness, and high blood pressure, with risks such as addiction and tolerance requiring careful medical supervision.

Treatment Options and Considerations:

• Esketamine Nasal Spray: Suited for TRD patients, usually covered by insurance following the approval process, and administered under medical supervision.

• Generic Ketamine Treatments: Offer a range of administration methods for a broader spectrum of depressive conditions, with variable insurance coverage.

Cost Considerations:

• Esketamine: More likely to be covered by insurance due to FDA approval, but can be expensive without insurance.

• Generic Ketamine: May incur high out-of-pocket expenses if not covered by insurance.

Not a Magic Bullet

It's important to recognize that treatment with ketamine or esketamine is not suitable for everyone. While some individuals may find these therapies incredibly helpful in managing their depression, others may not experience the same level of benefit. The effectiveness of these treatments can vary greatly from person to person. This variability underscores the importance of working closely with healthcare providers to determine whether ketamine or esketamine is an appropriate option. Healthcare professionals can assess individual health histories, current mental health status, and overall treatment goals to decide if these treatments can play a beneficial role in one's mental health journey. It's crucial for patients to have open, informed discussions with their providers about the potential risks and benefits, ensuring that any treatment decision is made with a comprehensive understanding of their personal health needs.

Final Thoughts:

As we navigate the evolving landscape of mental health treatment, it's clear that ketamine and esketamine hold significant potential in transforming lives. However, their use is not a one-size-fits-all solution. The decision to incorporate ketamine or esketamine into one's treatment plan should be made with a deep understanding of personal health needs and in alignment with the broader goals of therapy. Above all, these treatments underscore an important message: while the path to healing is varied, hope and help are available.

Note: This information is for educational purposes and should not replace professional medical advice. Consult a healthcare professional for personalized advice and to evaluate what treatments are appropriate for your specific mental health needs.

Learn more about Psychedelic Harm Reduction and Integration Therapy.

What is Ketamine-Assisted Psychotherapy & Is it Right for You?

Psychotherapy never stops evolving. As time passes, more and more treatment options are available to people in need. Ketamine-Assisted Psychotherapy (KAP) is a relatively new concept that is rapidly gaining acceptance and popularity. Ketamine is a psychedelic drug that can induce a hypnotic state during which healing happens.

Ketamine began as an animal anesthetic but was used for humans during the Vietnam War. Such use expanded to emergency responders, and that’s how its psychotherapeutic potential was discovered. When ketamine was given to a person who had attempted suicide, it had an unexpected, positive side effect—suicide ideation was drastically reduced.

Ketamine-Assisted Psychotherapy FAQ

How does KAP work?

Ketamine is believed to impact a particular neurotransmitter that increases your brain’s ability to adapt and adjust. Through a process called neuroplasticity, your nerve cells become better equipped to reduce the risk of mental distress. For example, KAP has been found to short-circuit the factors that can create treatment-resistant depression. 

What other conditions are commonly treated with KAP? 

The list is long, varied, and growing. Some problems addressed via KAP include Post-Traumatic Stress Disorder (PTSD), anxiety, depression, substance abuse, disordered eating, Obsessive-Compulsive Disorder, chronic pain, and Bipolar Disorder. 

How is ketamine administered?

Lozenges are the most common method. But it can also be delivered via injections, nasal sprays, and intravenous infusions. The positive impact is felt within minutes. 

What are KAP sessions like?

Your therapist is with you all the way as the ketamine eases you into a trance-like state for about 40 to 60 minutes. Think of it as a healthy and productive form of dissociation. But there’s even more to it than the actual ketamine sessions.

In between, you meet with your therapist to work on integration, during which:

• You talk about your ketamine experiences 

• Integrate these experiences into your everyday life

• Homework is given as a way to carry over the healing outside the therapy setting 

Are there any side effects or other cautions to know about?

Let’s start with the side effects. Generally speaking, they are rare. If present, they usually present as minor episodes of:

• Drowsiness

• Headache 

• Nausea 

• Headache

• Increased blood pressure and/or heart rate

• Disorientation

You will need someone to bring you home from the sessions in which ketamine is administered. Other factors to bear in mind:

• In cases when ketamine is injected, needles are involved 

• Anyone deemed susceptible to addiction must address this reality in pre-treatment conversations

• Make sure your insurance will cover KAP

• Be diligent about making sure your KAP clinic is regulated 

What can KAP offer me?

KAP can provide symptom relief that often occurs in a matter of hours. In addition, most patients experience long-lasting symptom relief and become more sustainable with ensuing sessions. KAP is still relatively new, so there’s not a very long-term record yet. What we do know is promising—especially for folks who have not found relief through other treatment approaches.

General Benefits of Ketamine-Assisted Psychotherapy

• Calm mind

• Mood enhancer

• New brain cell growth 

• A reduction of pain and, thus, less of a need for traditional painkillers

• A general sense of being an active participant in your everyday life 

How Can You Know if KAP is Right for You?

I will safely assume that the above summary of KAP has provided some answers and provoked more questions. As is typically the case, the next step is to speak with a mental health professional with experience in Ketamine-Assisted Psychotherapy. Therefore, I invite you to reach out at your earliest convenience to learn more. Let’s talk about your situation and decide together if KAP is the right path to take you to a place of healing and recovery.