For much of human history, psychoactive plants, fungi, roots, and bark were consumed to enhance perception and dreams, bring visions of the cosmos to the psyche, create telepathic bonds between hunters, or help family members connect with ancestors and spirits. Many indigenous cultures relied on shamans, curanderos/as, and medicine people to administer the medicines through a variety of spiritual rites and rituals to alter the consciousness of those undergoing the journey.
We, as a species, have always been interested in shifting our perception of who and what we are to heal psychic wounds, have a greater understanding of the mystery of life, and to feel a sense of belonging to the whole. While our exploratory spirit and longing for healing, growth, and belonging remain the same, these transformational medicines have entered modernity and are now used in clinics, universities, and therapy offices.
As psychedelic medicine and its accompanying therapies are becoming more widely known and used, it is important that the public be as educated as possible about the risks and benefits, contraindications, and ethics, as well as the process of engaging in psychedelic therapy. And one of the most important pieces is the integration process.
While the psychedelic journey itself can be life-changing and perspective-shifting, what one does with the information and experiences that arise in session is often more valuable for making long-lasting, sustained positive changes. The most important work happens after the journey is done.
While the psychedelic experience and therapeutic sessions can be helpful, healing, and transformational in themselves, the lessons must be turned into daily practices and behaviors to concretize the changes we are making. The hard part of this process is going home and facing the parts of our lives that were created out of the trauma, resentment, anxiety, and depression we were seeking to work through and heal. Old habits and old feelings continuously surface because these conditions take time to dissolve within the newfound spaciousness and loving awareness that we built during therapy.
In general, most sustained and long-term changes need intentional, attention-setting repetition and reinforcement to become a new worldview or behavior. The integration process is focused on creating and committing to practical and reasonable changes in behavior, perception, and thinking in our daily lives. We are not looking for huge shifts because they are difficult to sustain. We want to focus on small, realistic changes.
During the integration process, we choose which behaviors we want to practice. We determine which to practice by becoming aware of our values and our overall health and wellness goals. When we have clarity around those, it becomes easier to choose new behaviors over habituated behaviors that no longer serve us.
The Hard Side
To be clear, the journey can remain difficult during the integration phase. Contracting back into ourselves, our old ways of being, is quite common. Contracting after expansion is natural, just as some flowers open in the day and close at night. We must learn to be tolerant of and compassionate toward contracting or retracting states of mind and energy after psychedelic experiences. This is why having a good support system in place is essential.
The integration phase lays out a map of support that includes trusted friends and community, a therapist, a mentor, and an integration support group. People often struggle to return to their normal routines, ones that were created out of stress rather than health-oriented thinking. I’ve heard clients complain that their spouses or partners seem distant or stuck in the past, while they are moving into a new future. Sometimes, clients feel more depressed than before. But in most of these cases, it’s just that they are much more aware of their historical emotional baseline. All this can be anticipated and worked with. We can never predict the outcomes of this type of therapy or of psychedelics in general, so it’s wise to seek counsel from those who are trained.
The Art of Curating
A good integration plan starts during the preparation phase with solid education and aftercare planning. It is the therapist’s responsibility to offer this, and the client’s responsibility to ask for it. The better the preparation, the smoother the integration can be.
In my practice, once we get through the therapeutic sessions, the client and I establish our integration plan, which will include specific daily practices such as mindfulness, prayer, exercise, or mindful communication skills. We choose which new behaviors and people the client wants to include in their life. We begin to curate their lifestyle activities and new habits derived from the learning and growth experienced during the psychedelic sessions. The client learns to choose consciously and more carefully who they want to spend time with, which activities to engage in, what to do for a living, and how to talk to their loved ones and those they have conflicts with. Each piece of their life can be chosen with care because their future well-being depends on the choices they make now.
Bad trips are nothing compared to the horror stories about people quitting their jobs or leaving their spouses immediately after a session or two. I totally understand the impulse, but doing so right then is akin to drunk texting, which is never a good idea. Even if an individual was considering these very moves before they began therapy and gained the clarity and confidence needed to move forward with these important decisions during psychedelic therapy, we still recommend taking time in the integration process to mindfully and carefully curate the next phase of life. Unless there is immediate danger, there is usually no need to rush, and being skillful and conscientious will pay off in the long run.
Old ways of being will still arise, and our job is to monitor and respond in a way that aligns with our deepest values. This, in itself, is a practice. We are not going for perfect. We are going for consistent. Think of yourself like a jigsaw puzzle with missing pieces and no edges. You discover some of what’s missing in psychedelic psychotherapy, but no edges, because you learned you are boundless like the cosmos and will forever expand your understanding of yourself. Integration is adding pieces to the ever-expanding beautiful puzzle that is you.
The original article was featured in Psychology Today.
Michael Ryoshin Sapiro, PsyD is an ordained Zen Buddhist monk and poet, clinical psychologist, psychedelic psychotherapist, author, and meditation teacher. His book, Truth Medicine: Healing and Living Authentically through Psychedelic Psychotherapy will be published by Hachette Go in June, 2025. He is a Fellow at the Institute of Noetic Sciences, and is core faculty in the Psychedelic’s Today Vital psychedelic certification program. Dr. Sapiro teaches internationally on the art and science of transformation, expanded human capabilities, psychedelic psychotherapy, and futuremaking. He offers Ketamine Assisted Psychotherapy sessions for first responders, special operations combat veterans, and community members at the Boise Ketamine Clinic. His work is dedicated to personal awakening for the sake of collective and planetary transformation. He can be found at michaelsapiro.com and on Instagram as @dr_mike_boise
