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What makes a psychedelic setting safe enough to open up and speak up?
Safe psychedelic settings are where a participant’s “no” is as welcome as their “yes,” and where consent is ongoing, embodied and actively protected by the practitioner, not left to the participant to defend.
Key points
- Opening up to a psychedelic experience should leave room to say no, change your mind and hold your own beliefs.
- Speaking up can be difficult, even with a practitioner you trust. Practitioners need to actively make room for requirements, needs and boundaries.
- Consent is ongoing. Bodily signals can prompt a check-in, but do not replace explicit permission.
- Safer settings require attention to different backgrounds and needs, alongside training, supervision and clear complaints procedures.
“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? 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?
And 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.
1. 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).
In another example, a woman who had attended a session with me told me about an earlier MDMA experience in an underground setting. According to her, the practitioner had sexual contact with other participants and also propositioned her. She declined and told me that nothing further had happened. Still, the story stayed with me.
In the first story, serious boundary violations were documented. In the second, according to the woman, there was no sexual contact, although the conduct was still beyond the professional remit. Both stories show why the power relationship between practitioner and participant deserves attention.
2. When speaking up becomes difficult
During a psychedelic experience, perception, emotions and your sense of time can change considerably. You may feel open and connected, or confused and overwhelmed. You may need more time to take in what is happening, to feel or identify your needs, and to put them into words. It is extremely important that those supporting you through the experience understand this change in cognitive processing. You may need longer to notice how a touch, question or suggestion feels, and that delay in response needs to be understood and respected. Perhaps only later do you realise you want something different. Things you can usually say with ease don’t always come naturally during a psychedelic experience.
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.
Previous experiences and personal history play an important part here. Women, for example, experience sexual violence significantly more often than men. Globally, the World Health Organization estimates that 1 in 3 women experience physical or sexual violence in their lifetime. For queer people and people of colour, personal and systemic experiences of rejection, discrimination or exclusion can influence trust in the support they receive. How that affects someone, and what that individual needs to feel safe, differs greatly from person to person.
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.
3. Room for your own view of the world
Speaking freely also means expressing your personal ideas and beliefs. A practitioner has their own views on healing, spirituality and life. Naturally, these can show up in the atmosphere of a ceremony, the words used and the responses to the questions you ask.
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.
When choosing a practitioner, also look at their values and views on life. Do you feel welcome? During an introductory conversation, you can ask how those ideas influence their practice and whether there is room for your own beliefs and experiences.
4. 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.
Many Dutch practitioners offer written agreements about truffle sessions beforehand. What can you expect? What are the risks? What support do they offer, and what are its limits? That gives you something to refer back to. However, you also need a conversation beforehand to ask questions, discuss doubts and identify any needs that are specific to you.
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.
As a participant, you can reflect on which kinds of touch you might welcome or prefer to avoid. Equally, if you are unsure what your boundaries actually are, you can say so. A skilled practitioner will make space for this conversation and help you explore what feels right for you.
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.
5. 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.
Perhaps you recognise this situation outside ceremonies too. You say yes to a hug when you would rather have some space. You do not want to make a fuss, and the other person means well. Before you know it, you have overlooked your own needs.
6. 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.
Beforehand, a touch may seem pleasant, but only during the contact do you notice how it actually feels. Perhaps you feel your body relaxing, or instead notice tension building and would prefer a little more space.
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.
7. Trauma-sensitive practice
Trauma-sensitive support means recognising that past experiences, cultural background and experiences of exclusion, abuse or misconduct can deeply shape what someone needs to feel safe in a vulnerable, altered state. Discuss this during preparation, without expecting someone to share their whole history. What helps them feel safe enough? Are there situations where they feel unsafe? Do they have any personal triggers?
Make your actions as a practitioner predictable. For example, say that you are coming to sit closer and ask whether that feels pleasant. Ask for permission before taking someone’s hand and wait for their answer. Keep checking in, including with touch agreed on beforehand.
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.
8. There needs to be room afterwards too
Sometimes only after an experience can you describe something that felt uncomfortable. During the experience, so much can be happening, or you may not be clear on how you felt.
As a practitioner, also ask during integration how someone experienced your support. “What felt pleasant? Was there anything you would have liked to be different?” This gives the participant space to speak openly.
Take time to listen and explore what your role as a practitioner has been. As a participant, you can also return to this yourself if your practitioner does not ask. Sharing a less pleasant moment deserves attention too, even though that can feel daunting. Discussing it together can create room for acknowledgement, rebuilding trust and processing what has happened. That matters for both of you.
9. 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.
Practitioners need clear agreements and professional support to fall back on. In the Netherlands, Guild of Guides has existed since 2019. Member practitioners follow a code of conduct with professional and ethical guidelines (Guild of Guides NL, n.d.-a). Participants with complaints about a member practitioner can contact a reporting service (Guild of Guides NL, n.d.-b). PsyStandard is also developing a standard for practitioner competence, ethical conduct and professional boundaries (PsyStandard, n.d.).
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.
A safer psychedelic field also needs room for different people and experiences. In my practice, I offer individual truffle ceremonies for women, with attention to women’s bodies and what they need to feel safe and at ease. There are also queer retreats and practitioners with specific knowledge of neurodivergence. Such spaces can offer a sense of recognition and make it easier to discuss wishes and needs with skilled practitioners.
We also need more practitioners of colour and, more generally, more diversity in the psychedelic field. In a small American study of 32 psychedelic therapists, 88% were white (Aday et al., 2023). That does not describe the whole field, but it shows why greater representation deserves attention.
10. Opening up and staying true to yourself
Perhaps surrender begins with listening to yourself. Surrendering to your own yes and no. To what you want, where your boundaries lie and how you see life. Even if you are not quite sure yet, or change your mind along the way.
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?”
References
- Aday, J. S., Skiles, Z., Eaton, N., Fredenburg, L., Pleet, M., Mantia, J., Bradley, E. R., Fernandes-Osterhold, G., & Woolley, J. D. (2023). Personal psychedelic use is common among a sample of psychedelic therapists: Implications for research and practice. Psychedelic Medicine, 1(1), 27–37. https://doi.org/10.1089/psymed.2022.0004
- Busby, M. (2022, June 20). MDMA trials under review in Canada over alleged abuse of study participants. The Guardian. https://www.theguardian.com/world/2022/jun/20/mdma-trials-canada-review-alleged-abuse
- Guild of Guides NL. (n.d.-a). Our code. https://www.guildofguides.org/our-code
- Guild of Guides NL. (n.d.-b). Report concerning conduct. https://www.guildofguides.org/report-concerning-conduct
- Lee, A., Rosenbaum, D., & Buchman, D. Z. (2024). Informed consent to psychedelic-assisted psychotherapy: Ethical considerations. The Canadian Journal of Psychiatry, 69(5), 309–313. https://doi.org/10.1177/07067437231225937
- PsyStandard. (n.d.). A shared standard for psychedelic practice. Retrieved October 8, 2026, from https://psystandard.com/
- World Health Organisation. Violence against women. https://www.who.int/health-topics/violence-against-women
