4 warning signs of a bad psychedelic trip, according to an expert

• Mike Dow, a therapist and ketamine facilitator at Field Trip Health in Los Angeles, gives patients the drug so they have healing psychedelic trips.
• Dow told Insider that prepping the patient with a therapy-like session and setting intentions can prevent a bad trip.

A mounting body of research suggests psychedelics like psilocybin, LSD, and MDMA have therapeutic potential for mental health conditions like anxiety, depression, and post-traumatic stress disorder.

As more states decriminalize psychedelics, people are curious about having positive psychedelic journeys of their own.

But for anyone who has experienced a bad psychedelic trip, they know the experience could offset the potential benefits.

There are ways to prepare a patient for a trip that can prevent a bad one and get the most out of the experience, Mike Dow, a psychotherapist at psychedelic therapy clinic Field Trip Health's Los Angeles location, told Insider.

He said it's important for patients to look out for warning signs, like feeling unsafe in the setting before the session, and share any concerns with their clinical psychedelics practitioner to stop a bad journey before it starts.

Physical safety is important

The setting, or environment in which a person trips on a psychedelic substance, can influence the experience they have, said Dow.

Dow oversees patients who take ketamine in Field Trip's Los Angeles clinic as a treatment for anxiety, depression, and PTSD. Though not a traditional psychedelic, ketamine can allow a person to experience ego death-like experiences just like psilocybin can, according to Dow.

That means setting up a calm, quiet, and distraction-free area that allows patients to focus, he said.

He gives patients ketamine while they wear eye shades and listen to calming music while sitting in a room with natural elements like greenery and fractals.

A negative mindset before the trip can lead to a bad one

Similarly, if a patient feels anxious, scared, or are in a generally negative headspace ahead of their psychedelic experience, it could signal a bad trip, according to Dow.

"What we tend to find is, when people go in with a negative head space, they're really unprepared. There are these parts of you that are picking up on everything around you," which can feel overwhelming, Dow told Insider.

He said it's important people prone to anxiety center themselves before a psychedelic experience so they're able to focus on healing, instead of feeling frozen by stimuli. To help patients pull their focus inwards, Dow uses music during sessions and journaling beforehand.

Patients should set intentions for the trip

Preparing a patient for a trip with a therapy-like session is essential, according to Dow.

This typically entails discussing the patient's childhood, previous significant relationships, mental health, and their ultimate goal for the session. Then, he has each patient write a two-sentence intention before giving them ketamine.

Dow said that people who don't address recent trauma or grief, whether a breakup, death, or sudden life change, could be taken by surprise once they're tripping.

Any drug that elicits a psychedelic feeling is an "amplifier of the subconscious," said Dow, adding that, in his experience, people who have been to therapy tend to report better trips than those who have not.

Giving up alcohol or weed before the trip can enhance the experience

Though not essential, Dow said eliminating alcohol and cannabis two weeks before a trip can help patients be more intentional about the experience so they get the results they want.