Skip to content

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

Eirini K. Argyri, Jules Evans, David Luke, Pascal Michael, Katrina Michelle, Cyrus Rohani-Shukla, Shayam Suseelan, Ed Prideaux, Rosalind McAlpine, Ashleigh Murphy-Beiner, Oliver Robinson

PLoS One 2025 DOI: 10.1371/journal.pone.0322501 (opens in new tab)

The journal has published a correction to this paper. Read the correction (opens in new tab)

Read Full Text
Relevant Not relevant

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study Peer reviewed
Sample size 26
Population People who reported experiencing existential distress following psychedelic experiences
Topics End-of-life distress
Keywords Psychedelics Existential-crisis Psychological-integration Transformative-experiences Mental-health
Citations 27
Key findings Participants experienced persistent existential struggle and confusion, alleviated primarily through grounding practices of embodiment and social and cognitive normalization.

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. 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 that participants experienced persistent existential struggle, marked by confusion about their existence and purpose and preoccupation with meaning-making. 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 managed to alleviate their distress primarily through 'grounding': practices of embodiment and the social and cognitive normalisation of their experience. Our findings suggest that psychedelic experiences act as pivotal mental states that can facilitate transformative learning processes, challenging and expanding the ways individuals make meaning. This research contributes to the growing field of psychedelic integration by exploring the complex pathways through which people reestablish coherence and grow following ontologically challenging psychedelic experiences.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • State of the evidence: End-of-life distress Opposes

    Participants reported persistent existential struggle and confusion after psychedelic experiences, alleviated mainly through grounding practices of embodiment and social and cognitive normalization.

    Synthesized

Comparable studies

Other qualitative studies on end-of-life distress, most cited first.

Study Year Design Participants
Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program Interdisciplinary palliative care team staff 2017 Observational mixed-method pilot evaluation n = 28
Exploring the Use of Psilocybin Therapy for Existential Distress: A Qualitative Study of Palliative Care Provider Perceptions Interdisciplinary palliative care providers from a hospital-based team 2021 Qualitative descriptive study n = 5
What do health professionals think about implementing psilocybin-assisted therapy in palliative care for existential distress? A World Café qualitative study. Palliative care professionals 2024 Qualitative study n = 16
The Lived Experiences of Palliative Care Professionals in Cultivating Mindfulness: A Phenomenological Study Palliative care professionals (three physicians, four nurses, three psychologists, and... 2024 Qualitative study using a phenomenological approach n = 11
Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression. Patients with cancer and depression 2025 Qualitative study n = 28

Citations in the library

Cited by 29

and 24 more in the library

Cites 71

and 66 more in the library

Related reading

Explore topics

End-of-life distress Mystical experience Mysticism Philosophy of mind