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  3. Ontologically Challenging Psychedelic Experiences: Considerations For Managing Associated Distress.
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  3. Ontologically Challenging Psychedelic Experiences: Considerations For Managing Associated Distress.

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Ontologically Challenging Psychedelic Experiences: Considerations for Managing Associated Distress.

Eirini K Argyri1, Jules Evans2

  • 1Department of Psychology, University of Exeter, Exeter, UK. E.K.Argyri@exeter.ac.uk.

Current Topics in Behavioral Neurosciences
|December 2, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Ontologically challenging psychedelic experiences (OCPEs) can profoundly disrupt self and reality, impacting mental health treatment. While challenging, OCPEs can be therapeutically beneficial when individuals are supported through integration strategies.

Keywords:
Existential distressOntological shockPsychedelic harm reductionPsychedelic integration

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Area of Science:

  • Psychiatry and Psychology
  • Neuroscience
  • Philosophy of Mind

Background:

  • Psychedelic substances show promise for mental health conditions.
  • Psychedelic use can lead to ontologically challenging psychedelic experiences (OCPEs), disrupting sense of self, reality, and existence.
  • OCPEs are viewed as a phenomenological and harm reduction concept, not a diagnostic category.

Purpose of the Study:

  • To examine the phenomenology of OCPEs and their aftermath.
  • To explore strategies for recovery and integration of OCPEs.
  • To outline ethical and practical implications for clinical and harm reduction practices.

Main Methods:

  • Qualitative studies on OCPEs.
  • Review of psychological research on psychedelic experiences.
  • Examination of existing harm reduction and therapeutic integration strategies.

    • Main Results:

    • OCPEs can cause ontological instability and existential distress, persisting post-experience.
    • When individuals are adequately resourced, OCPEs can be a valuable part of the therapeutic mechanism for personal growth.
    • Grounding techniques, cognitive reframing, and supportive structures show potential for facilitating recovery and integration.

    Conclusions:

    • Ethical and practical considerations for psychedelic therapy require attention to ontological disruptions.
    • Informed consent in psychedelic therapy has limitations; preparation and post-experience support are crucial.
    • Further research is needed to refine best practices for managing OCPEs and maximizing psychedelic therapy benefits while minimizing harm.