AdolescentsAnxiety DisordersEquity and Ethics

Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences

This qualitative study (n=26) explored existential distress following psychedelic experiences, finding persistent preoccupation with sense-making and confusion about existence and purpose. Participants reported cognitive, emotional, social, bodily, and functional impacts. They managed distress through embodiment practices and social/cognitive normalization.

Authors

  • David Luke
  • Ashleigh Murphy-Beiner
  • John Evans

Published

SSRN
individual Study

Abstract

Psychedelic induced mystical experiences have been largely assumed to drive the therapeutic effects of these substances, which may in part be mediated by changes in metaphysical beliefs. However, there is growing evidence that psychedelic experiences can also trigger long lasting distress and studies of persisting difficulties suggest a high prevalence of ontological challenges (related to the way people understand reality and existence). We conducted semi-structured interviews with 26 people who reported experiencing existential distress following psychedelic experiences. We explored the phenomenology of participants’ difficulties and the ways they navigated them, including what they found helpful and unhelpful in their process. Thematic analysis revealed the kinds of distress that accompanied worldview and identity shifts: persistent preoccupation with making sense of the experience and confusion about their existence and purpose. Along with cognitive difficulties stemming from the ungrounding of their prior frameworks for understanding, participants’ ontologically challenging experiences also had significant emotional, social, bodily, and other functional impact. Participants primarily alleviated their distress through ‘grounding’ practices of embodiment, and the social and cognitive normalization of their experiences. Findings are discussed in the context of the growing field of psychedelic-related difficulties and the challenges of integration.

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Research Summary of 'Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences'

Introduction

Psychedelic experiences can produce profound shifts in metaphysical beliefs and identity, and while many studies emphasise therapeutic benefits such as reduced death anxiety and increased meaning, there is growing evidence that a substantial minority of users experience long-lasting difficulties. Earlier research and large surveys have identified persistent ontological challenges—disturbances in how people understand reality and existence—after single or repeated psychedelic episodes, and qualitative analyses commonly report existential confusion, struggles to make sense of experiences, and functional impairment lasting months or longer. The unpredictability of such transformations raises ethical questions about informed consent, and the literature on integration—the process of making sense of and incorporating psychedelic experiences—remains sparse, with little guidance about how to address specific types of prolonged difficulties like ontological shock. Argyri and colleagues set out to explore, in depth, the phenomenology of existential and ontological distress that persists after psychedelic experiences and to identify what participants found helpful or unhelpful when managing these difficulties. Using a retrospective qualitative design nested within a larger mixed-methods project, the study asked three research questions: what are the features of extended existential struggle after psychedelic use, which supports and practices participants found useful or harmful, and how people described integrating the experience and the learnings they carried forward. The authors aimed to fill a gap in understanding how extended ontological disruption is lived and navigated, and to inform integration and support approaches for such difficulties.

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Study Details

  • Study Type
    individual
  • Journal
  • Topics
  • Authors
  • APA Citation

    Argyri, E. K., Evans, J., Luke, D., Michael, P., Michelle, K., Rohani-Shukla, C., Suseelan, S., Prideaux, E., McAlpine, R., Murphy-Beiner, A., & Robinson, O. C. (2024). Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4817368

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