This Is Not What I Expected At All—How Psilocybin Therapy Differs from Recreational Mushroom Trips

Last month, during a psilocybin session, my client looked up, made eye contact and exclaimed,

“Arlo, this is not what I expected at all. I know you tried to tell me; I thought I knew, but I had no idea.”

Keep in mind, he wasn’t angry or disappointed. Rather, he was feeling some visceral catharsis after navigating unresolved trauma, and the realization was punctuated by baritone fits of laughter. And before you swan dive to conclusions, let me say this; he was not psychedelically naive; he had done mushrooms and LSD several times.

So, indeed, he knew what a psilocybin experience feels like, but after drinking a cup of mushroom tea (5 grams of Golden Teacher), donning an eye mask with a whole month’s worth of sacred intentions just simmering beneath the surface, his journey took on a whole new trajectory.  I’ve talked about this in spurts in different articles, but here I’m gonna put all the hay right here where the goat can get at it—here’s why psilocybin-assisted therapy is entirely different from your grandfather’s cough medicine mushroom trip :).

The Disparity of Set and Setting in Psilocybin Therapy

Let’s begin with the basics, and keep in mind, I’m generalizing here (I know some of you out there in the 90s raided your sock drawer, gobbled up a few caps while cruising the mall food court and gorging on Sbarro). But in general, for those of us who stumbled upon mushrooms or LSD in a recreational setting, our experience was more than likely a semi-intentional, outward one. We ate mushrooms because we were surrounded by good friends in a nourishing environment (say at a music festival or on a camping trip) and we wanted to expand our minds and find deeper meaning in the universe. Seemingly minor moments like shared unspoken eye contact, dancing to transcendent music or getting lost in the constellations of a ragged tapestry would shimmer with profundity and joy.

Actual psilocybin-assisted therapy (PAT) couldn’t be more different. Rather than sitting within the world, we visit the universe of the self and rummage through our own stories for the inspiration we need to persist and thrive. My clients and I spend about a month crafting intentions while looking inward and bubbling up deep-seated pain points to the surface. For the ten days leading up to a journey, I ask my clients to deliberately carve out space for themselves and practice dropping into the medicine. Indeed, preparation—beyond a simple vibe check of set and setting—is a major part of this therapy too. By looking unapologetically inward, we often find ourselves reckoning with frustrations and memories that we don’t always make time for. In some cases, preparation asks more of us than the actual medicine session. 

Throughout preparation, we are building a trusting container too. Generally, by the time we enter the journey room, my clients are feeling confident, comfortable and grateful to have me in the room. I’ve witnessed their preparation, advised their approach and promised to keep them safe while they drop into the light. In a recreational context, though we may be surrounded with good friends, it’s rare that they know the darker parts of our stories, and it’s way more organic to look outward for solace and inspiration. 

Two Types of Mushroom Journeys

When it comes to PAT, your trip is meticulously planned a few months in advance. Because of this rigid approach, the actual trip just looks and feels different. While set and setting is still paramount inside Oregon psilocybin centers, it’s not exactly a cushy pillow fort on the fringes of Pickathon. You’ll enter the center, sign a final form or two, pay for your mushrooms and then accompany your facilitator to the journey room. These rooms are intentional and welcoming with a whole forest of indoor plants, hand-crafted furniture, and compelling artwork on the walls. 

Once we’re centered, a service representative will deliver the mushrooms, which we’ll generally grind and mix into tea. You’ll drink the concoction and wait for the mushrooms to whisk you away into an extraordinary state of consciousness. However, this time, you won't be dancing in a room full of strangers, or giggling with friends around a bonfire—you’ll get yourself comfortable, don an eyemask and follow the medicine wherever it leads.

Under the eyemask, communal and sensory details hit differently. Music is not a tangible bridge to humanity, but a peripheral amplifier in the background. Though I’m radiating good vibes and actively holding space, we aren’t a psychedelic Voltron— I’m sober and tethering you to your intentions and your ordinary state of consciousness. Additionally, PAT doesn’t really invite whimsy and distraction. We can’t leave the service center and just wander down the road a spell—instead, we are forced to mine our own stories for inspiration and revel in the small details—spider plants, the smell of cedar incense or a sketchpad and some crayons. 

So when my client exclaimed that the session was not at all like he expected it was primarily because he had only experienced the more superficial outward version of a psychedelic experience. Previously, he leveraged the mushrooms to see the universe in a new light, embrace creativity and stumble upon impromptu magical moments. While he knew we would be confined to the psilocybin service center for the duration of his journey, he figured he’d be drawing feverishly or cataloging the knotty pine figures in the ceiling. What unfolded instead was a visceral jaunt through unresolved trauma, served with a heaving tablespoon of catharsis.

The Overlooked Step in Psilocybin Therapy

And finally, there’s the aftermath. From a recreational perspective, the afterparty might include smoking weed during the come down and swapping stories about our psychedelic adventures. We support each other as we reintegrate into the ordinary world and wander into the future with an extra lilt in our steps. It’s a lovely sentiment awash in wisdom, but it doesn’t resemble the integration work I do on a daily basis.

After you’ve rested and recovered from your medicine session, together we begin the rigorous work of integration. In context with your intentions, we begin to connect the dots of your experience and draft up a blueprint for the days and months ahead. This is a robust investigation that juxtaposes the self and the universe. How can you—based on the insight you received during your trip—modify your daily routine to honor those learnings and exile the negative emotions and habits that prevent you from falling in love with your life?

While recreational journeys don’t necessarily preclude introspection and progress, it’s pretty easy to shake off the psychedelic stardust and backpeddle into the same prohibitive version of reality that may have inspired our journeys in the first place. Likewise, we may feel more isolated or even embarrassed to leverage a compelling experience.

So, I suppose I’ll stop writing now as I could go on forever. I just wanted to say out loud that tripping within the therapeutic model is a whole different, chimeric beast. Recreational experience can alleviate apprehension and give us confidence to drop in, but it won’t give us a sneak preview of the movie in our minds.