A thematic analysis of twenty-two first-person accounts of psychedelic use (for ketamine, MDMA, LSD, and psilocybin) identified six factors that shape positive or adverse experiences: three external predictors (nature, music, and preparation) and three internal predictors (understanding, mind-set, and motivation). Each factor contained two sub-themes. Nature and music may help de-escalate adverse reactions. Substance-specific perceptual and sensorial effects also emerged. The findings highlight the importance and interrelationship of preparation, mind-set, understanding, and motivation as common themes. The work represents an early step toward a more nuanced understanding of factors influencing psychedelic experience, with implications for clinical progress and harm reduction.
People who discuss psychedelic experiences on online forums describe them in a sequential structure: what happens before, during, and after ingestion. Before the experience, they mention their existing knowledge and perceptions of psychedelics, their intentions and mental preparation, and aids they use to support the experience. During the experience, they report sensory and cognitive distortions, their mindset and emotional state, and the stability and support of their environment. Afterward, they describe how the experience changed their behavior and outlook. The analysis suggests that set and setting should be studied across all three stages, not just the acute phase.