It’s common for people to take psychedelics with a trusted person or under the supervision of a professional. Psychedelic journeys can be turbulent and unpredictable. The person chosen for this role may be called a guide, therapist, or trip sitter. If they are leading a ceremonial experience in the context of a spiritual or Indigenous lineage, they are sometimes referred to as shamans. In some situations, a guide can be a spiritual counselor or a wise friend with experience using psychedelics.
For our purposes here, we will refer to all these people as “guides,” with the understanding that they might not always be there to “guide” you, but will sometimes simply hold space as a supportive presence for a person having a psychedelic experience. One of the principles of harm reduction is that a person on a psychedelic journey should not have another person’s belief system imposed on them, but rather encounter the experience on their own terms.
The role of a guide may be simply to hold a safe space and engage in active listening in a peer support environment. This can take place in a dedicated space at events, on a telephone hotline, or informally with a trip sitter. Other guides intentionally help shape the experience in some way. Supervision or companionship of some form is recommended for people who have limited experience with psychedelics. Even veteran psychonauts can sometimes reap benefits from psychedelic-assisted therapy or a guided ceremony.
Choosing a Psychedelic Guide
Things to Know
- There are various types of psychedelic guides in underground, traditional and clinical contexts
- It can be difficult to ascertain the qualifications of shamans or underground therapists due to the often unregulated nature of their services
- It’s important to do your due diligence and ask specific questions to make sure you can trust the guide when in a vulnerable state of consciousness
- Vetting a guide is an important part of psychedelic harm reduction
- A psychedelic guide might be a spiritual facilitator or therapist who directs the experience, or a trained peer support volunteer or trip sitter who sits back and lets a person’s psychedelic journey unfold while simply holding space
Choosing a Psychedelic Guide
It’s crucial to carefully vet whomever is overseeing or serving as a companion for a psychedelic experience, especially if they are operating outside a regulated, clinical context. There are increasing numbers of people who call themselves “shamans” or “guides,” but actually have limited experience. Their self-proclaimed abilities may stem from a grandiose or inflated sense of their own wisdom as a result of their personal psychedelic experiences. Before working with a specific person, get referrals and find out what type of training that person has received or what spiritual lineage they may be part of. Be especially alert to how the guide uses physical touch and how they respect the boundaries of the person under their care.
There are many paths to pursue in choosing a psychedelic guide, from an underground healer to a clinical setting.
Clinical Settings
In clinical settings, the psychedelic guide is a licensed practitioner therapeutically guiding a patient’s experience. Aside from ketamine-assisted therapy, all other psychedelics are still illegal to use in conjunction with psychotherapy unless they are part of a clinical trial. A guide may also be a licensed therapist whom an individual can work with in advance of the psychedelic session, and who they can turn to again for psychedelic integration therapy after the experience.
Currently, the only substance one can have a legal guided experience with in the U.S., outside of clinical trials, is ketamine. There are ketamine clinics around the country providing ketamine-assisted psychotherapy. Some clinics also provide infusions or prescribe ketamine lozenges to be self-administered at home without talk therapy.
In 2023, Oregon began to roll out service centers that will facilitate psilocybin mushroom use for adults under the supervision of a licensed practitioner who is not required to have medical or mental health training. In 2022, Colorado passed a similar initiative, and will begin to accept applicants for facilitator programs in September 2024.
Ceremonial Settings
Indigenous communities in South America, North America, Africa and Europe have plant medicine traditions that go back thousands of years involving the ceremonial use of psychoactive substances. Today, people from all over the world travel to participate in rituals led by shamans trained in their lineage’s tradition.
Until fairly recently, shamans only trained members of their own communities to use these sacred plant medicines. In recent decades, some of these ceremonial leaders have provided this training and initiation to outsiders. Retreat centers have opened up around the world to offer ceremonies that reflect ancient practices with plant medicines that sometimes include shamans. A shaman and often their assistants will typically hold the space and direct the experience through chanting, singing or playing music, and performing rituals that reflect their specific lineage and culture.
Always thoroughly research any retreat or healing centers and the facilitators involved before participating in their ceremonies and ingesting plant medicines that may be offered.
Underground Therapy
In underground contexts, a licensed therapist or unlicensed trip sitter may hold space for individuals undergoing psychedelic experiences with substances of any kind. Due to the unregulated nature of underground facilitation, it’s important that individuals properly vet the people offering to guide them. Vetting includes asking questions about the person’s training and ethical guidelines, how many times they have served in this role, whether they provide integration or aftercare, and how they provide substances if the individual is not supplying their own.
Party Settings
Some party and festival organizers provide peer support services that offer trained volunteers who assist those who have taken psychedelics. If you are expecting to attend such an event, look for these services and information about how the people providing this care are trained and who they are accountable to.