What makes a psychedelic setting safe enough to open up and speak up?
“You can completely surrender to the experience.” It sounds reassuring, especially for someone who finds letting go of control daunting. But what are you actually surrendering to: the truffles, whatever comes up, or the practitioner? Surrender can mean saying yes to whatever comes up: letting yourself feel something, or letting go of the need to control the experience. But is there room to say no, too?
In psychedelic practice, we often talk about safety, trust and surrender. How can you open yourself to an experience while staying connected to your own boundaries? What makes a setting where you are invited to open up also a place where you can speak up? What does that ask of you as a participant, and of us as practitioners?
A safe setting matters for everyone. Here, I explore what that looks like. I pay particular attention to women, queer people and people of colour, because they may be more likely to experience certain forms of violence, discrimination or exclusion. Disabled people and neurodivergent participants also need appropriate support to feel safe. Previous experiences can affect trust in a practitioner and how much room someone feels they have to express their wishes and boundaries.
Where things can go wrong
In 2022, The Guardian reported on Meaghan Buisson, who took part in a Canadian study of MDMA-assisted therapy. Recordings showed her therapists lying in bed with her and holding her down while she resisted. Buisson also described sexual abuse by one of the therapists after the treatment sessions, although the therapist maintained that the sexual relationship was consensual (Busby, 2022).
When speaking up becomes difficult
In these vulnerable contexts, the practitioner is someone you lean on and need to feel supported by. Their job is to stay with you, attune to you, notice how you are doing and help when needed. At the same time, there is a difference in position and power: you depend on your practitioner’s support, while they influence what happens during the session.
Imagine a practitioner is holding your hand and, after a while, you realise you would rather they let go. Or maybe you want to sit up and move for a moment, but the practitioner is encouraging you to remain lying down. Yet you say nothing. Perhaps, at that moment, you think the practitioner knows what is best for you. Perhaps you do not want to reject them, disturb the atmosphere or be a “difficult participant”. Especially if you are hoping for relief from symptoms, it can be difficult to turn down a suggestion presented as helpful.
That is why simply saying, “You can always express your boundaries,” is not enough. As a practitioner and space holder, you need to explicitly explore what makes speaking up difficult for that participant, and what you can do to make it easier.
Room for your own view of the world
One practitioner calls truffles a plant medicine; another calls them a psychedelic substance. What you experience may be interpreted as a memory of a past life or a message from the universe. For one person, that fits their beliefs; for another, it does not. Especially when you feel more receptive during the experience, such an explanation can seem convincing. There must also be the space and trust to say, “That is not how I experience it.”
Ideas about femininity, masculinity, gender, relationships and sexuality also call for considerate care. An invitation to “embrace your feminine energy” may resonate with someone, but it may make another person feel uncomfortable, especially when it comes with expectations about how someone should be.
A practitioner does not need to share your background or beliefs to listen well. But there needs to be space for other perspectives and views to be held. A simple question such as “What does this mean to you?” gives participants space to find their own words for their experience, without the practitioner interpreting it first.
Informed consent: knowing your rights
Safe settings undoubtedly begin before a ceremony. Discussing informed consent with a practitioner means understanding what the proposed intervention is, what the possible risks and benefits are, what alternative options are available, and what you are and aren’t giving permission for.
Touch also needs to be an essential part of that conversation. Simply asking, “Is it okay if I touch you?” is far too general. Perhaps holding hands at the right moment is acceptable, but have you discussed touch in other areas, for example the shoulders or chest? Maybe you only want practical help, such as assistance getting up to go to the bathroom. Consent to one form of contact does not mean consent to every other form. Each of these situations, and your personal preferences, need to be carefully discussed.
It is the practitioner’s responsibility to explain what touch they might offer and why. Together, agree on how you can indicate that something needs to stop. If speaking becomes difficult during the experience, a simple word such as “stop” or an agreed gesture may help.
Discuss that you are allowed to change your mind, too. Something may seem perfectly fine beforehand and no longer feel pleasant during the session. In a scientific article on consent in psychedelic therapy, Lee et al. (2024) emphasise that consent is an ongoing process: if someone withdraws consent to touch during the session, that must be respected. An earlier yes does not automatically remain a yes.
When a yes changes
Unfortunately, many people, including myself, have experienced this. During a women-only group ceremony, I felt safe with the practitioners. Beforehand, I had said that I was comfortable with touch.
The practitioners came over occasionally. Holding my hand, a hand on my head, at one point a hand over my heart: it felt pleasant. Until a practitioner came over again later and lovingly held my hand. This time, it did not feel good. I wanted more space. Yet I said nothing.
I did not experience that touch as a boundary violation. I did notice how difficult it could be to express a changed need, even in a setting where I felt safe. The touch itself was similar to before; only my need had changed.
Embodied consent: how does it feel inside?
Embodied consent is about noticing how a choice feels in your body. You can say yes with words while your body is actually signalling a no. Perhaps you hold your breath or notice you want to move away.
As a participant, you can explain beforehand that speaking up is difficult for you. What might help? Perhaps a brief question during the session: “Does this still feel pleasant?” For us as practitioners, this calls for attention to what someone communicates with and without words. If someone freezes, moves away or withdraws, that is a reason to stop the touch and check in again.
Body language helps us communicate non-verbally, but it does not replace explicit consent. That is what embodied consent means: continuing to check in with yourself about how contact feels in the moment.
Trauma-sensitive practice
Small choices can also create space. “Would you like me to stay here or sit a little further away?” “Would you like the music quieter or louder?” “Would you like me to hold your hand, or would you rather I didn’t?” These conversations help, but responsibility must never rest entirely with the participant.
What does this ask of the field?
Who are you actually surrendering to? As a participant, you can look critically at that. What training and experience does your practitioner have? How do they respond to your wishes and boundaries? And where can you turn if something has gone wrong?
This also asks something of the wider field. Participants need a clearer way to recognise responsible practitioners and understand what to look for in a safer setting. Especially in a field that is still developing, training and supervision matter. At PsyStandard, supervision is part of membership (PsyStandard, n.d.). This helps practitioners continue learning and work together towards a shared understanding of what professional, safe and responsible support requires.
In a nutshell
With careful support, a psychedelic experience can be a beautiful opportunity to discover how a yes or no feels in your body, what you want and where your boundaries lie. To receive and ask for space. To open yourself to whatever comes and stay true to yourself at the same time.
As a participant, ask yourself: “What am I saying yes to when I surrender to a psychedelic journey?” As a practitioner, ask yourself: “Is their no as welcome as their yes?”
This is a shortened version of an article I wrote in collaboration with PsyStandard. You can read the full article on the PsyStandard website here.
Lotte Boekhout’s practice
Do you recognise yourself in this? Perhaps you are curious about what psychedelics could mean for you and are looking for an approach that feels right. As an experienced ACT therapist specialising in supporting women, I offer microdosing coaching and individual truffle ceremonies.
Curious? Book your free discovery call.