Meet the Psychedelic Boom’s First Responders

Everything was insane and fine. The walls had begun to bend, the grain in the floorboards was starting to run. Jeff Greenberg’s body had blown apart into particles, pleasantly so. When he closed his eyes, chrysanthemums blossomed.

A tech executive of 54, Greenberg had eaten 5 grams of psychedelic mushrooms that afternoon. He, like your cousin and your coworker and maybe you yourself, had discovered in recent years the world-­expanding powers of psilocybin. But world expansion can be dicey. At some point that afternoon, Greenberg’s thoughts took a dark turn, and soon dark melted into horrifying.

The psychiatrist Stanislav Grof called psychedelics “nonspecific amplifiers” of the psyche. Any thoughts, feelings, or memories on hand are subject to unplanned wild magnification. Frequently that results in a thrillingly revelatory experience. Occasionally it toggles over into indescribable ­terror, which in turn comes in many flavors: Paranoia. Ghastly hallucinations. Intense grief. Fear of insanity, fear of death.

Greenberg thought of his puppy. He and his ex-wife shared it from when they’d been married, and now a memory came tumbling out of some corner of his mind: One day, in the aftermath of the divorce, he’d dropped off the dog with his former father-in-law. The two had always enjoyed a friendly relationship, but once the handoff was complete, the older man had slammed the door in his face.

And now it wouldn’t stop slamming. How had he done something so awful that a fellow human would slam a door on him after being handed a puppy? A dam burst. The difficult elements of Greenberg’s life—family, career, parenting—began exploding in dark techni­color. What had happened? Who was he? He felt the mushrooms clamping his head in front of a massive screen showing the movie of his life. According to his Fitbit, his heart rate spiked from 90-something to 150.

Greenberg was looping. Passing thoughts became black holes clawing him to untold depths, playing and replaying in a mad, warping whirlpool. Tricks that would have typically changed the channel—classical music, a splash of water to the face, waiting it out, crying it out—had no effect. Worst of all, he had no help. This wasn’t a guided journey, after all, just a man alone in his house, losing his mind. Who do you call in such a state? Who could possibly understand this other­worldly misery with its indescribable new dimensions, its billowing revelations, its slithering dream logic?

Of course, Indigenous communities spent thousands of years mastering that very stuff: the understanding, the preparation, the support structures that help make a brain­-exploding experience positive. But Western culture, having gotten its hands on these substances, showed little interest in that wisdom—at least until recently.

By chance, Greenberg found himself in one of those rare moments when the cultural plates begin to shift. In response to the growth of psychedelics, a new figure has emerged on the psychic landscape. Call them psychedelic first responders, versed in the science of existential first aid and operating, at times, apart from the traditional sphere of psychiatrists and therapists. Where once you might take a free CPR class on a Saturday, you now can learn to escort the addled through the thickets of their own heads.

So it was that, in a fleeting instant of lucidity, Greenberg remembered to reach into his pocket.

I’m not here to herald the current psychedelic boom; it’s been heralded. What interests me is something that gets discussed far less often: the horrific and sometimes life-­altering experiences many of those people will have. What do we do with that?

I don’t mean to sound alarmist. Skiers sometimes smack into trees, and I still consider theirs a worthwhile activity. But mountains have ski patrols. The help available to someone spinning out on psychedelics has historically been limited. Moreover, despite the popularity of using these substances with a professional guide, a shaman, or on an organized retreat, most won’t. The majority of journeys are unsupervised and unsupported—at a concert, at a party, at home reeling from a puppy-based memory.

One summer night 20-plus years ago, a friend and I ate a goodly amount of mushrooms. The idea had been to peel back a few layers, behold unfamiliar vistas, and generally become unstuck in our perceptions. It worked! In Frontiers in Pharmacology terms, the reduction of my serotonergic control, ascendance of my dopaminergic system, and expansion of functional connectivity in my primary visual cortex was “producing a more unified brain, with connections between disparate regions that normally lack communication with each other.” For the first hour I created the universe anew. Vast processions scrolled through my mind, as ornate and elaborate as Chartres.

Then, and with apologies for being 22 at the time, I slipped into what I can only call a post-structuralist crisis. The world, suddenly, was a hollow facade of itself. I suppose some residue of college was working itself out: For four years I’d poked recklessly at ideas and traditions and constructs with no regard for consequences; now, staggering around Lower Manhattan, I saw the flimsy Potemkin reality I’d been so eager to expose, entire ecosystems of meaning drained of substance.

At some point my friend and I made it back to the apartment I shared with my girlfriend. For the next God-knows-how-long, the poor woman assured me the stories in my head were chemical­-induced delusions—nightmares, essentially. I lay on my rooftop a long time, willing my sanity to return. But it never did.

Kidding! I’m fine! By dawn I had fully returned to consensus reality. I was unspeakably grateful. Only later, in the months and years that followed, did I realize I had feelings besides relief. A kind of irresolution began to haunt me. Why were those ideas so scary? What unresolved concerns were trying to surface in my cretin mind? Terrifying as the ordeal had been, it had undeniably contained information—the kind you don’t get access to every day. Instead of willing the nightmare to end, what if I’d somehow pushed through?

Which brings me back to Greenberg. The day before his trip, he’d downloaded an app he’d seen mentioned somewhere. Called Fireside Project, it billed itself as a “psychedelic peer support line,” reachable by phone or text. Now, fishing out his phone, he managed to hit the call button.

What happened next was life­-changing, Greenberg told me. A volunteer named Jasmine picked up the phone. Immediately she emitted a gentle, knowledgeable, and grounded vibe. She didn’t try to distract him from his anguish or minimize it. On the contrary, she validated what he was feeling and gave him permission to explore his pain further. “Very quickly she turned it into something I felt that I could go through,” he said.

Greenberg spoke with Jasmine for nearly an hour and a half, then called again later, as the crisis softened into something more like curiosity. With her help, his angst metabolized into a searing peek under the hood. Where before he’d felt abject terror, he now saw an invitation to make real changes in his life.

I set out to learn about the Jasmines of the world, and the burgeoning movement they belong to. But as I looked into the Fireside Project and similar operations, I watched a slightly different story come into focus. In the emergence of this new citizen tripsitter is a broader story about how we’ve historically conceived of wellness, how we conceive of suffering—and how we respond to our own minds when they venture off course.

It’s not like everyone’s out there having experiences like Greenberg’s; the planet’s drug of choice will probably always be alcohol. But what these substances lack in booze-level numbers they make up for in the sheer depth of their impact. Insofar as the decade-of-therapy­-in-a-day adage holds true for the millions of people using psychedelics every year, that strikes me as a remarkable disruption of our psychological status quo.

Historically, the options available to someone in rough shape ranged from indifference to county lockup. To the extent that anyone attempted to alleviate such psychic distress, efforts centered around obliteration. Such was the mindset on a rainy Friday in 1969, when a soggy battalion of medical workers began fanning out across Max Yasgur’s upstate New York farm. Acid had already become a feature of festivals. (At San Francisco’s Human Be-In two years earlier, Owsley “Bear” Stanley famously distributed some 300,000 tabs of white lightning to the crowd.) But Woodstock promised all new levels. So the medical workers came armed with Thorazine, a powerful antipsychotic that resolves a frightening drug experience much as a ballistic missile resolves a ground skirmish.

Enter Wavy Gravy and the Hog Farmers, swooping in from their New Mexico commune to provide security for the event. Over the next three days, at trip tents and in the wet grass, the Hog Farmers practiced a radical new approach. Rather than arrest or medicate people having difficult drug experiences, they simply talked to them—distracted them, soothed them, gently reeled them back to earth. To the Thorazine crowd, it must’ve seemed like chatting someone out of cancer.

According to the Journal of Emergency Medical Services, some 797 trippers were treated that weekend. Woodstock became a template for psychedelic harm reduction. In the years that followed, at concerts and gatherings and in 4 million Dead parking lots, “talking someone down” became standard operating procedure. Compared to previous approaches, it was so humane that nobody gave much thought to where it fell short.

Start peeling back the evolution of tripsitting and pretty soon you’re looking at larger shifts. Where once the benefits of these substances were relegated to some questionably spiritual plane, emerging research has shown measurable—and often remarkable—therapeutic benefits. As the value of a psychedelic journey came to be reassessed, so too was the impulse to curtail an unpleasant one.

Forty-three years after Woodstock, at Burning Man, a cardboard yurt appeared on the sun-baked Playa. Inside the structure—shady, fabric-draped, benches here and there—psychedelic harm-reduction history was lurching forward again, with the first official iteration of Zendo Project.

To the untrained eye, the volunteers sitting with distraught Burners were delivering a familiar form of harm reduction—a safe, nonjudgmental alternative to whatever the cops or medical tent would offer. But Zendo, an initiative of the Multi­disciplinary Association for Psychedelic Studies (MAPS), a research and advocacy nonprofit, didn’t want to talk these trippers down. Central to its mission was a respect for the journey, however challenging. To quote one of Zendo’s guiding pillars, “Difficult is not necessarily bad.”

At this point, maybe you’ve noticed my labored avoidance of the phrase “bad trip.” Those words have fallen out of favor in psychedelic circles, as research shows that even the most challenging journeys can lead to positive outcomes. Minor semantic shift, fairly radical idea.

Kelley O’Donnell is the director of clinical training at the NYU Langone Center for Psychedelic Medicine. As she characterized the new thinking to me: Achieving those positive outcomes means leaning into the experience, pleasant or otherwise.

Otherwise can come in many forms, per the Zendo training manual, from reliving traumas to identifying with the victimization of others throughout history. Some merge with nature and experience pollution or the death of a species acutely. Many just think they’ve lost their minds. Through active listening and a gentle reassurance that the experience will pass, the idea is to calm the trippers enough that they might be able to explore those nightmares. Rather than talk them down, talk them through.

Like the guy who just wanted to run.

“He would run, and then drop to the ground and not move. Then he’d leap up and exclaim, ‘I’m alive.’ Again and again he did this,” says Chelsea Rose Pires, Zendo’s executive director. “Finally we were able to explore what was going on, and he was able to talk about his childhood and his fear of dying.”

The training manual states:

Rule #1, under any condition, is that we honor and respect the person having the crisis. Even if we don’t understand what’s happening (the person having the crisis might be much more developed than we are, lost in worlds unknown to us, or reliving a drama we can’t comprehend), we serve as an anchor, a resting place, and a quiet center …

We have to remember that tens of millions of people have used psychedelics, in many different, sometimes not very supportive, environments, and returned home safely. With support, knowledge, and integrative work there is very little danger in the psychedelic experience itself. Even the most frightening and bizarre behavior, when explored and worked with, will turn out to be beneficial and enlightening.

Since 2012, zendo has been a mainstay at Burning Man and festivals around the world, assisting some 6,000 trippers and training 4,000 sitters in this new protocol. Meanwhile, the harm-reduction movement has grown internationally too. ­Kosmicare delivers similar services, having started at Portugal’s Boom Festival many years ago. Within the club scene across Europe, several groups have expanded their harm-reduction efforts to include trip assistance. Stuck at home? Tripsit.me offers real-time, 24/7 peer support for those in need. For its part, the Organization of Psychedelic and Entheogenic Nurses brings nursing expertise into the realm of psychedelic care. And then there’s Joshua White.

A longtime lawyer in the San Francisco City Attorney’s Office, as well as a volunteer at a local parenting support hotline, White had an eye for undernoticed communities not getting the help they need. He knew that more people were using psychedelics, he understood the outsize power these drugs wielded—and he knew that good support was not only hard to find but often inaccessible. (This is particularly true for those left out of the psychedelic movement in decades past. To that end, the organization committed to offering “identity-based integration support,” connecting any caller who is BIPOC, trans­gender, or a military veteran with a volunteer who shares that identity.) In April 2021, Fireside Project started answering phone calls—lots of them. Hanifa Nayo Washington, an equity and training adviser at Fireside, describes a general sense of alienation behind the boom. “People are really suffering from disconnection, from being alone and not having a community to talk with,” she told me.

That first year, Fireside trained more than 100 volunteers and conducted some 2,550 conversations with callers—including Greenberg. Within months of reaching Jasmine, he had walked away from his job (and psychedelically high salary) to focus on work “that adds value to the universe.” Eventually he got on the phone with Fireside again—this time not to ask for help but to offer it. By the time we spoke, he’d donated $100,000 and was poised to start as the organization’s CTO, working for free.

There’s a fairly obvious point I should make, maybe one that sometimes gets lost: While exceedingly rare, psychedelics can cause serious harm. A family history of mental illness can propel someone into a psychotic episode. And the symptoms of a trip can potentially obscure a simultaneous medical crisis. A 2022 lawsuit found MAPS partially responsible for the death of Baylee Gatlin, who received care from Zendo volunteers at a music festival in 2017 and later died from organ failure and heat stroke.

“What this movement is doing is absolutely helpful for many people,” says Charles Nemeroff, codirector of the Center for Psychedelic Research & Therapy at Dell Medical School at the University of Texas at Austin. But while the “vast number of case reports would suggest that these substances are relatively safe,” he adds, we’re still in the data-gathering phase.

For her part, O’Donnell calls the harm-reduction approach “incredibly valuable.” She also cautions that a single session with even a well-trained trip­sitter won’t necessarily be enough for someone whose past trauma is suddenly surfacing, or who is other­wise having a deeply disturbing experience.

The stakes, Nemeroff notes, are even higher than any one individual’s well-being. “What none of us want to have happen is that the unregulated use of psychedelics lead to tragedies, which then will result in a backlash,” he says. “It’s been so long since we’ve been able to actually study psychedelics.”

For now, there seems little danger of reversing our interest in psychedelics. Sara Gael, a harm reduction officer at MAPS, describes a societal inflection point behind the current psychedelic renaissance. As waves of dysfunction—economic despair, climate change, white supremacy—have surfaced in recent years, people have increasingly looked to these substances to turn the prism on their worlds.

All of this makes me wonder about the real essence of the psychedelic peer support movement. It is, of course, a movement specific to these substances, rooted in a specific context: a time when drug policy remains insistently retrograde and official support systems have crumbled. But maybe it’s also more than that.

Jail, Thorazine, Wavy Gravy, Zendo: As nodes on an arc, these represent a decades-long, mostly underground evolution in how we understand a very particular species of psychic distress, but also in how we help one another at a more general level.

Pires told me that the principles behind contemporary psychedelic peer support apply to regular life too—she uses some of those same skills with her kids. Slow down. Offer calm. Let feelings arise. Maybe good tripsitting isn’t all that different from being a good partner, a good friend, a good relative. And maybe one day we’ll look back and be struck by this era—not so much by our growing interest in these substances, but our shifting understanding of ourselves in their midst.

This article appears in the Jul/Aug 2023 issue. Subscribe now.

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