u/nofern

Tl;dr: curious about experiences with lowering dose to reduce comedown and how that impacts people, and how/when to transition to psilocybin and/or consider combining both :)

Hi everyone, I am continuing to work on integrating my recent medicine journey. This integration has focused primarily on working with deep grief. I've been doing a lot of journalling about how I speak to myself/my inner child when I am experiencing grief and hurt, and this feels fruitful.

These are my questions/areas where I am hoping for some input:

1. The comedown I experience from these sessions is absolutely brutal - usually I am physically knocked flat with fogginess, exhaustion, and short term memory loss for about a week, then depressed and anhedonic for another 2 weeks or so, and now I am slowly starting to recover from that, though I still don't feel totally myself and am sad and exhausted no matter how much I sleep.

While I do feel like I have the skills to weather this through, I do worry that it's a sign that this is maybe not ideal for my brain, as I don't often hear of people having this rough of a time with the comedown. I do think some of it is related to unmet needs and not having enough human contact and support during integration, but I worry that some of it is that the medicine is just really rough on my brain and body.

I feel like I am doing everything to help myself - good preparation and integration, as much nutrition, sleep, and gentle exercise as I can do, taking a reasonable dose (120 mg with a 40-60 mg booster), spacing out sessions (3-6 month breaks in between, the last time had been a 4 month break, with a 6 month break before that, and I have waited until I really felt like I had done a lot of integration and felt like I really needed to go ahead again), supplements (ALCAR, ALA, ginger, vitamin C, and CoQ10 during the session, 5HTP afterwards, and NAC in between sessions stopping about 1 month prior to the next session), and I am off all other psychiatric medications. I don't drink alcohol or use any other substances at all aside from occasionally microdosing mushrooms. The medicine I use is tested/decent quality.

Is there anything else that might help with this? If I do another session in the future (planning to wait at least 6 months and see how I feel), I am thinking of asking about lowering the dose a little bit, but I am a bit worried that it won't be as effective. Does anyone use lower doses and if so, what does that look like?

I've also considered trying a short term SSRI for just a few weeks after the session, but I don't want to mess with my brain/body more than necessary when things are already out of whack.

2. Increasingly, I have been wondering about trying psilocybin assisted therapy. Part of why I'm interested in it is the idea that it might go deeper or be more helpful with depression and existential dread, but the major reason is that it might not be as hard on my body afterwards, and I've had the idea of either trying it by itself or mixing it with a lower dose of MDMA to see if this is easier on my system afterwards while not losing the power of the sessions. My fear is that it might get too dark or overwhelming for me, or that it might be much more destabilizing in a way that I wouldn't be able to handle (hence the appeal of potentially mixing to cushion it).

I have microdosed very small amounts (25 mg) before and found that it made me feel calm and ruminate much less on the day, but this didn't really last. I've also tried larger microdoses (50-200 mg) and found that the higher microdoses made me more spacey and sometimes more anxious (especially when it wore off I seemed to get a bit of a crash afterwards).

I've done some reading and it seems like there is disagreement about the best way to work with psilocybin for complex trauma. Some people say that you can inch up the dose and experiment with mid range doses (1-2g) as a first step to get to know the medicine and figure out what dose is helpful for you and others say that's a bad idea because there is more anxiety with mid range doses and you should just go straight for a 3-5g dose. Some people say if you're worried about it being too dark/difficult, to combine it with MDMA, other people say that you shouldn't take it with MDMA unless you've experienced it alone.

So I am curious/interested to know if anyone who has primarily worked with MDMA has then gone on to work with mushrooms, and if so, what their approach was to making that transition, how they knew they were ready, and how it went.

This is not something I'd be doing any time soon as I still have a lot of integration work to do from my most recent session, and obviously I'd need to talk to my guide about it, but it's something I'm curious about for the future and wondering about others' experiences with.

Thanks!

Hi everyone, wanted to report back on my recent session. Welcome any thoughts or feedback or suggestions that anybody has about how my work is going.

I had posted a bit before the session looking for ways to have a more somatic focus during the session. Part of my intention was to be really present with my body and also to really focus on not avoiding or moving away from intense emotions and sensations but instead being with them and allowing them to release if possible. The remainder of my intention was to let go of needing to be in control and let go of putting pressure on myself during the session to achieve anything in particular (somewhat paradoxical but it felt important).

An important part of my preparation was meditating 30+ minutes per day in the weeks leading up to the session (vipassana-style with a focus on open noting and investigating somatic experiences of resistance to sitting and to emotion). I also had some sessions with the therapist who was going to be sitting with me, and we talked about strategies she could use during the session to help me be more aware of my body.

I noticed that during this session, I went into the medicine a lot faster. Usually I go through a period of really fighting it for the first hour or so but this time I started feeling the physical effects after about 20 minutes. I think this was related to increased openness and also the meditation I had been doing. I also took NAC at higher dose and more consistently between sessions this time, so that might have contributed too.

The first component of the session focused on really experiencing my own resistance to experience, emotion, and physical sensation. This manifested as going back and forth between feeling a lot of pain and sensation in my chest (sharp stabbing pain, burning, and intense pressure), and then feeling tension and resistance in my shoulders and face, then my therapist would work with me, doing some body work but also just verbally reminding me to release and let go into the resistance, and then as the resistance ebbed, the chest sensation would arise again. I remember having a very strong feeling that my insides were going to fall out of my body through my chest, and I was having my therapist place her hand on my chest and press down, which also felt helpful. I also talked about feeling like my chest was full of these sharp crescent shaped knives with a blade all around the edge and no handle or base.

I was able to stay with these sensations and this somatic cycle for a very long time, and as a result, I feel like I went deeper into the medicine experience than I ever have before. In previous sessions, I have rejected certain parts of it, or gotten hyper-focused on what my therapist might be experiencing or her reactions and then gotten out of my own experience, but this time I was able to really just stay in my own experience even though it was uncomfortable. Interestingly, I didn't even want music this time and turned it off fairly early in the session, even though I pretty much always have wanted music in the past. I felt like I needed to just strip away every distraction from the environment and go into the experience (but still talking incessantly because that I find impossible to not do).

After some time of this oscillation between resistance and painful chest sensations, really deep core belief material started to pour out of me, particularly related to the belief that I am an unbearable person. I've talked in previous sessions about feeling unloveable, but this felt like an even deeper level - feeling unbearable, exiled from the rest of humanity. This related both to my childhood trauma and my experience of being autistic and how those two things have interplayed, and I talked about this in the session.

In some moments, I was able to access a feeling of self compassion, and reassure and comfort the young part of me who was feeling that way. Other moments, my focus was more on just being with the experience.

In the later part of the session I felt very stimulated and talked incessantly about my trauma. This has been a challenge for me because in the later part of the session I tend to get more "sped up" and will talk a lot and not be as present with the emotions/processing, but I am extremely resistant to being interrupted because my brain feels very full and I am having so many connected thoughts that I feel I need to get out, and I also feel very rejected and silenced if my therapist tries to stop me. Very difficult to redirect or slow down.

The other thing I did differently was that I always experience terrible attachment distress at the end of the session, really not wanting it to be over, not wanting to say goodbye to my therapist, feeling completely alone and lost and unable to cope. I'm told this can be normal with the medicine but for me it feels very similar to how I feel a lot of the time even without the medicine. Like just very in touch with this lost, lonely little girl inside.

Usually I feel terrible shame about feeling this way and refuse to talk about it, but this time I was willing to at least name that I was struggling with it, which felt embarrassing but important. After the session I basically passed out on the floor for eight hours because I was so physically wrung out.

The integration period so far has been a lot of exhaustion, grief, and aloneness. I'm someone who struggles a lot to figure out how to get other people to support me, and I have a lot of unmet relational needs in the present as a result. It's been hard to be alone and there's a lot of attachment longing and feelings of abandonment and rejection and separation anxiety.

My focus has largely been on continuing with meditation (despite extremely wanting to avoid sitting with myself), and deliberately working on self-validation and self compassion, trying to work differently with this belief of being "unbearable" as one of the important insights from the session was that whatever other people think of me, it's important that I find a way to not be unbearable to myself or see myself as unbearable.

Overall it was a tough session. Once again, there was not really much if any joy or pleasure. A lot of it centred on how unbearable it feels to be alive and to be myself. At the same time, I feel I was more open to the medicine than ever before, and like I truly went deep into myself in a way that I needed to and have been avoiding even in previous medicine sessions.

Given how deep it was, I feel a lot of pressure and urgency to make the most of it in integration, but I am trying to remember my intention to let go of pressure and focus on resting and allowing things to unfold.