So... You want your ego to die?

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**** this is a work in progress- and is an adaptation to the introduction of my dissertation research- check back for updates and edits!

This essay explores the complex and often overlooked risks associated with psychedelic use, particularly focusing on ego death and its intersection with psychosis. Drawing from personal experience, clinical research, and Jungian psychology, it highlights how psychedelics can catalyze profound psychological transformation — or, conversely, destabilization — depending on individual preparation and a variety of factors.

Key concepts such as ego, persona, and Self are explained through a Jungian lens, emphasizing the necessity of a strong ego structure for safely navigating psychedelic experiences. The essay underscores that while ego death can lead to individuation and deep healing, it also shares neurobiological and phenomenological similarities with psychotic states, particularly when experienced without adequate support or in individuals with unresolved trauma or developmental immaturity.

The narrative critiques Western approaches to psychedelics that overlook indigenous ethics and misuse powerful substances without proper frameworks. Harm reduction strategies are detailed, cautioning against unsupervised use, especially for young adults and trauma survivors. The author calls for better clinical understanding and classification of psychedelic-induced crises, aiming to distinguish between pathological psychosis and spiritual emergencies, advocating for their recognition in psychiatric diagnostic manuals.

In essence, the essay serves as both a cautionary tale and a guide, advocating for intentional, informed, and ethical psychedelic practices rooted in psychological resilience, integration, and respect for traditional knowledge.

Table of Contents

1. Introduction

2. Right Relationship and Psychedelic Ethics

3. Psychedelics and Alchemical Transformation

4. Jungian Individuation and Psychedelic Work

5. Ego, Persona, and Self in Jungian Psychology

6. The Process and Risks of Ego Death

7. Spiritual Emergencies vs. Psychosis

8. The Neurobiology of Ego Death and Psychosis

9. Harm Reduction Guidelines

10. Conclusion- The Evolution of an Embodied Dissertation

11. Managing a Bad Trip (during and after)

1. Introduction

With psychedelics entering the mainstream once again, those of us on the research and treatment end of this spectrum are seeing some surprising and concerning trends online. Spend any amount of time on subreddits dedicated to psychedelics or other message boards such as Erowid, and you may start having flashbacks of the '70s acid casualty days. Nearly every day as I scan Reddit, I find at least one post that goes something like this: "Took 4 grams last night, will never be the same again, my life is over," or "My young friend took acid last month and now he's taken his life," or any number of similar variations.

Sharing even these few sentences, I feel a sense of grief and almost as if I am sharing something deeply personal that doesn't belong to me. However, these are real experiences that people are sharing publicly- everywhere. As someone who's been studying and involved in the psychedelic world for many years, I must make it clear, I am a huge supporter of this movement. I believe these substances have immense healing potential, however, appropriate harm reduction is severely lacking and that is in part what this post, and my dissertation is about. If we want this field to move forward and to not be shut down like it was nearly 50 years ago, we've got some serious public educating and harm reduction work to do.

My name is (almost) Dr. Holly Flammer, and I am writing my dissertation on psychedelic-induced psychosis and other types of prolonged difficulties following psychedelic experiences. Years before I started my doctoral journey at Pacifica Graduate Institute in California, my life was touched personally by someone suffering from these types of, sometimes intractable, difficulties following psychedelic use. A good friend's long-term partner, who had used psychedelics safely for over ten years, started experiencing mania and psychosis after a week-long trip to Mexico—his homeland—where they participated in shamanic ceremonies involving ayahuasca, San Pedro, and finished off with 5-MeO-DMT, commonly known as "bufo."

I was still working on my master's degree at Sofia University when I met him, completely unaware of how to help or what to do. Without going too much into his story, over the course of several years following this week-long psychedelic frenzy, he went from being relatively "normal" to caught in a loop of delusion, violence, mania, and beyond. His partner—my friend—believes he was already suffering from some sort of mental disorder on the sociopathic spectrum. As many of us already know, psychedelics are amplifiers—"non-specific amplifiers," according to the famed Stan Grof—and whatever your usual sober operating state (especially your deep personal unconsious) will merely be amplified under the influence and in the weeks, months, or even years following psychedelic work.

We'll call my partner's friend "G," and, well, long story short, G went on to intractable long-term psychosis. Last any of us heard, he was homeless in our smaller city. There were a lot of interventions to get him help, including forced antipsychotic shots ordered by the courts at one point. By the time he started receiving the shots, however, the psychosis and thought patterns were deeply entrenched, and although they did "calm" him down and keep him relatively grounded, like most people suffering from some sort of severe mental illness, once the court order was lifted, he refused to stay on them.

Nonetheless, G's story has always stuck with me—a cautionary tale and something that has left me with more questions than answers. Until about five years ago, I myself used psychedelics quite extensively, but around 2020, I started having what most would term "bad trips." All of the awe, wonder, euphoria, and so on essentially disappeared, and my trauma became amplified. Nights of sobbing and screaming into the ethers uncontrollably, journeys into the deep underworld—"death" had come for me, at least for my trauma—and there was no putting it back in the box. It's been five years now, and trauma that I thought had been addressed and put to rest has reared its ugly head, psychedelics pulling these repressed parts up and out of me, bringing with it crippling depression, an inability to sleep, not recognizing myself, massive shifts in identity, and so much heartache and grief. Technically, when it comes to psychedelics and healing, _this is what they are supposed to do._ But is the average person prepared for that? Does the average layperson know what to do, and what "integration" work actually means? Many of us do not, and many are not prepared to confront, essentially, their deepest wounding and unconscious bodies. My own journey through this territory, G's story, and my own process of recovery have deeply informed the work I do with others and my dissertation.

2. Right Relationship and Psychedelic Ethics

When I first started my dissertation journey at Pacifica, I was initially writing on the indigenous concept of "right relationship," a term central to psychedelic philosophy within the cultures and groups who have used them ceremonially for thousands of years. I feel as if the Western fascination with psychedelics and healing has gotten a LOT WRONG, and that we've taken a very powerful tool of consciousness and spirit and turned it into something to be capitalized and profited on. I won't go into depth about these topics, but it is something I remain very passionate about. Thankfully, there are a lot of Indigenous peoples out there taking hold of this and helping to educate the masses about psychedelic harm reduction from an Indigenous perspective. This was not my load to carry. I continued working with the mushroom Spirit, and after another harrowing trip nearly two years ago, I realized that the Western world needed a framework that was completely our own. You CANNOT heal while harming others, and appropriating Indigenous medicines, their ceremonies, their songs—this is theft, and it damages the groups of people that these technologies come from. So what are Westerners supposed to do then? How are we to use psychedelics ethically and safely, with an appropriate energy exchange? Well, we must first know that stealing Indigenous technologies harms others and _us_, and we must develop our relationship to these substances without harming others.

3. Psychedelics and Alchemical Transformation

This last mushroom experience I had—we'll call it the "Drowned King" trip—pointed me in my next direction. Psychedelic work is deeply alchemical. In alchemy, the "Drowned King" archetype represents the deflated, wet, drowning ego. To further explain:

In alchemy, the "Drowned King" is a central image in the alchemical process of _solutio_, symbolizing dissolution and the surrender of the ego to a transformative, watery realm. This archetypal figure represents the conscious ego being overwhelmed and immersed in the unconscious, leading to renewal and transformation. According to Henderson (and the Archive for Research in Archetypal Symbolism), "The Drowned King is an image of the conscious ego undergoing dissolution in the waters of the unconscious" (Henderson, n.d.). This dissolution is not an end but a necessary step in the alchemical process, allowing for the emergence of a new, unified self. The _solutio_ phase invites us to embrace the symbolic waters as a medium for transformation, where rigid structures dissolve, and the potential for new insight arises. Henderson explains further: "The image of drowning captures the ego’s confrontation with the vast and overwhelming depths of the unconscious, a process that can be simultaneously terrifying and liberating" (Henderson, n.d.). In many years of intentional psychedelic work, including many so-called "bad trips," I had never felt so incredibly overwhelmed by my own psychic contents—drowning in my pain, my shame—as I did that night. It was after this experience that I was not-so-gently nudged by the mushroom Spirit to better understand psychedelics through an alchemical lens.

And so I continued on through my dissertation process. For any creative who has ever written a dissertation, you understand: a dissertation is a living, breathing, conscious entity. You don’t work on it—it works on you. And so it was that I developed a new framework for psychedelic use—one grounded in alchemy. Psychedelic work is deeply and inherently alchemical and, if done correctly, should bring one through an individuation process.

4. Jungian Individuation and Psychedelic Work

For those unfamiliar with the term “individuation,” let me explain:

Individuation, a central concept in Jungian psychology, refers to the process of integrating unconscious material into conscious awareness, leading to the development of a more complete and authentic Self. Jung described individuation as “the integration of the archaic unconscious with consciousness,” a process particularly relevant in modern psychedelic research (p. 121). Psychedelics, often referred to as “psycho-integrators,” facilitate this integration by bridging ancient subcortical brain systems with the more recently evolved cortical systems associated with ego consciousness (p. 107).

Individuation is not merely a personal journey but also has cultural and collective dimensions. It aligns with the concept of spiritual emergence, suggesting that the transformation of human consciousness can occur not only at an individual level but also at a societal one, inaugurating a process of collective individuation (p. 162). This transformation can be seen as a Dionysian rebirth into a more integrated, embodied Self, where primary process cognition is re-engaged (p. 151).

Jung believed the archetype of the Self is rooted in deep emotional and unconscious layers of the brain (p. 107). Experiences such as ayahuasca visions—which Jung identified as encounters with the Self—illustrate this profound connection (p. 159). If you haven't read Jeremy Narby's "The Cosmic Serpent", the time is now!

Thus, individuation involves a profound journey of self-discovery and integration, bridging the unconscious and conscious parts of the psyche.

Understanding Jung’s individuation process is key to navigating psychedelics in a healing, transformative context. Without these foundational concepts, psychedelic healing often falls short. And when the general public lacks a framework—when psychedelic healing is pushed without a guiding narrative—people inevitably get into trouble. Especially when that narrative is deeply steeped in "love and light" and ignores the shadowy elements psychedelics so often bring out of people.

In the fall of 2024, the mushroom Spirit—and yes, I believe I have been working with a conscious mushroom Spirit throughout this process—led me into a deep dive into alchemy and individuation. I wrote a concept paper on the topic. And then, as is the nature of living, conscious dissertations, the next level and layer revealed itself.

I began working with a 24/M who was suffering from what I call “psychosis lite” after using mushrooms and DMT quite heavily since his late teens. He was lucid and lost at the same time. Like myself—and like many people I have worked with who fall into these psychedelic spirals—his sense of identity had begun to fragment through his use of psychedelics. His barely developed sense of self was crumbling. And as it usually goes, the psychedelics had begun to turn on him, whispering terrible things in the midst of his trips: “You’re going to die,” “I am a demon,” “Stop using psychedelics unless you want to die,” and so on.

One important thing to remember—and something I remind all individuals who have traversed this territory—is that these are not literal messages. They are warnings, messages from the psyche—or perhaps the substances acting as messengers—telling individuals, “You are not prepared,” “You are going too far.”

Almost everyone I have seen who starts having these kinds of experiences shares two very important things in common: unresolved trauma and a lack of an integrated, healthy relationship between ego and Self.

5. Ego, Persona, and Self in Jungian Psychology

To understand what this means, we must first ground ourselves in some key Jungian concepts.

In Jungian psychology, the **ego** is the conscious aspect of the personality, serving as the center of personal identity and awareness. It differentiates an individual from others and provides continuity across time. According to Kelley et al. (2002), “Self-referential processing is unique in terms of its functional representation in the human brain” (p. 790). From a Jungian perspective, the ego manages conscious thoughts, memories, and perceptions, providing the necessary stability for identity continuity. Westerink (2009) emphasizes that the ego is constructed through relationships and social identifications: “The ego is largely built upon identifications with others. These identifications are a further extension of the first narcissistic identification with one’s own image” (p. 175).

The **persona** is the social mask or facade one presents to the external world, shaped by societal expectations, cultural norms, and personal experiences. Jung conceptualized it as necessary for social functioning but warned against over-identifying with it. Jackson (2023) highlights that the persona can sometimes overshadow genuine self-awareness, noting, “The experience of temporary breaks in our personal narratives may enable us to tell more inclusive stories” (p. 23).

The **Self (capital S)**, in Jungian psychology, represents the totality of the psyche, encompassing both the conscious and unconscious aspects. It symbolizes wholeness and integration, guiding the individuation process toward maturity and completeness. Jackson (2023) explains, “Jung preferred to use the term ‘Self’… to refer to the ‘transpersonal center and totality of the psyche’” (p. 24). Jung believed the Self serves as the organizing principle, harmonizing and balancing conflicting internal forces.

Contrasted with the capital S Self, the **self (lowercase s)** broadly refers to a person’s subjective experience of identity. It includes personal history, beliefs, attitudes, and memories, continually reshaped throughout life as individuals confront new experiences and challenges. Lilgendahl, Helson, and John (2013) note, “Adults are engaged in an ongoing process of narrating an identity-defining life story, a dynamic process that ebbs and flows in response to new experiences that require integration into the self” (p. 408).

Individuation involves harmonizing these elements into a cohesive whole. The ego acts as the mediator between consciousness and the unconscious, ideally maintaining a balance without becoming rigid or overly dominant. Kelley et al. (2002) underscore this integrative role, finding that “a region of the MPFC is selectively engaged during self-referential judgments” (p. 789), suggesting a neurological underpinning for the ego’s mediating function.

Over-identification with the persona risks suppressing true individuality, stifling the individuation process. Westerink (2009) warns that the loss or breakdown of persona identifications can precipitate psychological crises, stating, “In melancholia a lost person is ‘set up again inside the ego’ and strongly condemned by the ego ideal” (p. 186). Effective individuation demands moving beyond persona identifications toward deeper authenticity.

The Self, according to Jung, is the guiding archetype driving individuation. Through symbolic dreams, active imagination, and meaningful life experiences, the Self communicates and orchestrates psychic growth. Jackson (2023) highlights the transformative nature of encounters with the Self: “Ego dissolution occurs when the rigid structures of the ego relax, allowing for greater connection with the unconscious and transpersonal realms” (p. 27).

Individuation unfolds through a progression of psychological stages, integrating conscious and unconscious elements. Lilgendahl et al. (2013) demonstrate empirically that individuation is significantly enhanced by “accommodative processing”—the psychological work of making sense of difficult life events: “Among those who were challenged by a difficult life event between age 43 and age 52, high levels of accommodative processing were associated with a relative increase in ego level” (p. 411).

Effective individuation requires acknowledging and integrating shadow elements—those aspects of the self typically denied or suppressed due to their perceived negativity. This integration fosters the emergence of a more complex and authentic self-narrative. Jackson (2023) states, “Temporary breaks in personal narrative identity (ego death) allow for reconstruction of more inclusive, transpersonal narratives” (p. 23).

However, one concerning trend in the current discourse around ego death is that while many are experiencing ego dissolution, few are completing the necessary circle of reconstruction—the rebuilding of the Self.

At this point, some may ask: What exactly is ego death?

6. The Process and Risks of Ego Death

The term “ego death” describes an experience in which an individual’s sense of personal identity, selfhood, and individuality dissolves profoundly or is entirely lost. It represents a collapse of the psychological boundaries separating the self from the external world, resulting in a merging with the surroundings—often described as an experience of oneness or unity with the universe. Ego death is a complex phenomenon, explored extensively across psychology, philosophy, neuroscience, spirituality, and literature.

Ego death is frequently characterized by a fundamental shift in self-perception, wherein an individual’s subjective identity undergoes radical transformation. According to Hama (2019), “In Jungian Psychology, ego death is known as psychic death. It simply means that the person improves his/her past life and makes radical changes in it as if he was born again; he goes from one stage to another to start life anew” (p. 64). This view positions ego death within a transformative framework, signaling profound psychological renewal.

From a neuroscientific perspective, ego death closely relates to the disruption of brain networks, particularly the Default Mode Network (DMN), which is active during self-referential thinking, autobiographical memory, and mind-wandering. Metzinger (2016) describes this as a state in which the brain-generated self-model collapses, revealing that “Nothing lives in the Ego Tunnel, just as nothing lives in a 3D-movie—even if the audience is completely immersed and fully identifies with the hero” (p. 1). This analogy underscores the transient and constructed nature of our sense of self, highlighting how alterations in brain function can dramatically shift personal experience.

Ego dissolution has been extensively studied through the lens of psychedelic experiences. Nour et al. (2016) define ego dissolution as “a disruption of ego-boundaries which leads to a partial or complete blurring of the distinction between the self and the rest of the environment” (p. 2). These experiences can be both profound and challenging, heavily dependent on the individual’s mental preparedness and the context of the experience.

Phenomenologically, individuals undergoing ego death often report profound alterations in consciousness, including feelings of unity, interconnectedness, and transcendence. Martial et al. (2021) note that near-death experiences, which involve intense ego dissolution, show phenomenological parallels with psychedelic states, asserting that these experiences involve “a partial or complete blurring of the distinction between the self and the rest of the environment and other objects or people combined with a loss of self-identity or ‘narrative self’” (p. 2).

However, not all ego dissolution experiences are positive or transformational. Some individuals experience destabilization, leading to symptoms akin to psychosis. Carhart-Harris et al. (2016) observe that psychedelics can “precipitate psychotic breaks in vulnerable individuals” due to the collapse of hierarchical brain processing, where the DMN loses its regulatory dominance (p. 23). Similarly, Evans et al. (2023) found that “13–16% of participants presented with overtly psychotic symptoms following their experience,” highlighting the potential risks associated with ego dissolution in susceptible individuals.

According to Jung, psychic death is essential for individuation, as it facilitates the integration of unconscious elements into consciousness. Gashi et al. (2023) state, “Psychedelic-induced psychosis may not be a simple emergence of latent pathology, but rather a crisis of integration related to the individuation process and a misalignment with the central Self archetype” (p. 1). Thus, from a Jungian perspective, successful navigation through ego death can lead to profound personal growth and deeper alignment with the Self.

Practically speaking, integrating the ego death experience is critical for positive outcomes. Tagliazucchi et al. (2016) emphasize the importance of post-experience integration, asserting that “the temporary dissolution of self-boundaries could allow for new insights, emotional breakthroughs, and an expanded sense of perspective—a crucial aspect of psychedelic-assisted therapy” (p. 1050). This highlights the immense therapeutic potential of ego dissolution when properly guided and integrated.

In summary, ego death represents a significant alteration of self-perception, spanning transient, profound insights to destabilizing psychological crises. Its interpretation varies across disciplines—neurologically as a disruption of brain networks, phenomenologically as a state of unity or psychosis, and psychologically as a pathway to greater individuation and self-understanding. Recognizing the dual potential for positive transformation or psychological destabilization is essential. Proper preparation, psychological resilience, and guided integration are critical in determining whether ego death experiences become therapeutic or detrimental.

What might someone experience if they’ve had a true ego death? Mileage varies. People describe ego death experiences in many ways. Commonly reported sensations include profound unity, feelings of deep interconnectedness, or a sense that one’s individual identity has merged with the universe. Martial et al. (2021) observed that individuals often describe these experiences as “a complete blurring of the distinction between the self and the rest of the environment combined with a loss of self-identity” (p. 2).

However, not all ego death experiences are positive. Some people feel terrified or profoundly disoriented. Evans et al. (2023) note that a small but significant portion of individuals who experience psychedelic-induced ego death later exhibit psychotic symptoms, demonstrating how sensitive and impactful these experiences can be. Some individuals who later struggle with the aftermath report the trip as being completely blank—essentially a blackout. Some experience convulsions or events resembling seizures.

The individuals I work with who go on to experience ongoing difficulties usually report one of two things: a complete blackout or horrific messages and imagery, often revolving around themes of death, anxiety, crippling shame, self-hate, and similar dark material. Phenomenologically, ego death experiences marked by unity, oceanic boundlessness, or merging with the universe tend to yield better outcomes in the weeks and months following the event. Those marked by negative emotions or complete blackouts tend to be followed by existential dread, anxiety, suicidal ideation, and, in some cases, psychosis.

It is important to note that even those who have negative experiences rarely trigger a latent mental illness. Those who develop long-term symptoms are typically the “predisposed” individuals discussed often in psychedelic literature. By long-term, I do not mean one month, six months, or even a year—I mean if someone is still hearing voices or holding delusional beliefs after two years, then a deeper examination may be warranted.

Until that point, I would caution against labeling someone as having triggered a latent mental illness. This is not to say that individuals with ongoing symptoms should not seek medical care or a formal diagnosis if appropriate. Rather, it suggests that immediate labeling or pathologizing after a difficult psychedelic experience should be avoided. If appropriate support integration, and spiritual emergency work have all been attempted and symptoms persist, then a deeper examination into potential mental illness should be considered.

Within this, it is imperative to note that a full recovery from adverse psychedelic experiences is dependent on the individual receiving care *immediately* by someone that understands the nature of spiritual emergence, individuation, psychedelic integration and will not jump to conclusions and thus label the person as "mentally ill". Going back to G's story briefly, it is possible that G may have recovered had he received appropriate integration therapy and support when his symptoms started. We will never know....

So what exactly is a spiritual emergency?

7. Spiritual Emergencies vs. Psychosis

A **spiritual emergency** refers to an intense psychological crisis arising during a profound transformation involving spiritual awakening. These experiences can include visions, extreme emotions, physical symptoms, and altered perceptions of reality—often resembling psychotic states. According to Moreira-Almeida and Cardeña (2011), spiritual emergencies differ fundamentally from pathological psychoses because they often lead to personal growth and greater psychological integration rather than dysfunction. Although these experiences might initially seem distressing, they are typically followed by meaningful and positive personal transformation when properly supported and understood within cultural and personal contexts (Moreira-Almeida & Cardeña, 2011, pp. S31–S33).

Spiritual emergencies are characterized by specific criteria: a lack of long-term suffering, cultural compatibility, and eventual control over the experiences. Importantly, these experiences generally do not cause lasting social impairment or significant psychiatric issues (Moreira-Almeida & Cardeña, 2011, pp. S31–S33). The ability to successfully integrate these profound experiences is closely tied to a strong and adaptive ego, allowing for effective navigation through such transformative crises. Structured support systems and community recognition play significant roles in determining whether individuals successfully integrate or fragment under the impact of the experience (Moreira-Almeida & Cardeña, 2011, p. S33).

The majority of individuals with prolonged symptoms, even lasting years, have likely not triggered a latent mental illness. Nearly twelve years ago, I experienced kundalini psychosis—a phenomenon neuro-scientifically and phenomenologically similar to psychedelic or meditation-induced psychosis—and I still have minor relapses during periods of significant stress. The acute phase of my spiritual emergency lasted around six months and included delusions, speaking with angels, hearing voices from the radio, communicating with my deceased grandmother, and an intense “psychic opening.” Had I sought clinical mental health support during that time, I would have likely been diagnosed with a psychotic spectrum disorder. However, with proper integration work and therapeutic support, I largely recovered and was able to later consume psychedelics extensively without further issues.

One of my central goals through my dissertation research is to establish a formal category for “psychedelic-induced crisis” in the DSM. Researchers like David Lukoff and Stan Grof have made significant strides over the past 15 years in getting spiritual emergency-type crises acknowledged in the DSM, but making clear distinctions and educating clinicians and researchers about these phenomena remains an uphill battle.

Naturally, a broader conversation about **psychosis** is necessary here, as no discussion of spiritual emergency or ego death would be complete without it.

8. The Neurobiology of Ego Death and Psychosis

Psychosis** is commonly defined as a mental condition characterized by significant impairments in reality testing and alterations in perception, cognition, and emotional functioning. The American Psychiatric Association (APA) describes psychosis primarily as a state where individuals experience disruptions that profoundly affect their ability to distinguish reality from unreality. Core symptoms include hallucinations, delusions, disorganized thinking, and impaired insight (Gergel & Iacoponi, 2016, pp. 534–535).

At its core, psychosis involves a marked disruption in the coherence of an individual’s sense of self and reality. Gergel and Iacoponi (2016) note that psychotic disorders “often cause major, sometimes irreversible, changes in identity, challenging the notion of a continuous self” (p. 534). Psychosis thus affects not only cognition and perception but also the fundamental experience of personal identity and continuity.

Clinically, psychosis is categorized into **affective** and **non-affective** psychoses. Affective psychoses include conditions like bipolar disorder with psychotic features, while non-affective psychoses are exemplified by schizophrenia. This diagnostic distinction reflects differing neurochemical and clinical trajectories (Yildirim et al., 2024, pp. 4043–4044).

Various theoretical models attempt to explain psychosis, drawing from biological, psychological, and socio-environmental factors. Neuroscientific research often highlights abnormalities in brain networks, particularly the Default Mode Network (DMN). Kong et al. (2023) provide substantial evidence that “hyperactivity within the DMN plays a role in cognitive dysfunction and psychotic symptoms of patients with schizophrenia” (p. 3). Given that the DMN is involved in self-referential thinking and autobiographical memory, disruptions in this network are central to understanding the fragmented self-experiences common in psychosis.

Nair et al. (2020) also emphasize the role of DMN connectivity disruptions in psychosis, stating that “disrupted DMN functional connectivity has been implicated in several psychiatric conditions with associated social difficulties, including ASD and schizophrenia” (p. 5). These disruptions in neural connectivity patterns are thought to underlie the fragmented self-experiences observed in psychotic states.

Psychological and philosophical perspectives further enrich our understanding. Gergel and Iacoponi (2016) critique traditional theories of psychological continuity and narrative identity, suggesting they fail to account for the disruptions experienced during psychosis. Instead, they propose a model embracing discontinuity, arguing that “a model of selfhood over time which can accommodate psychosis must incorporate fundamental discontinuity and incoherence” (p. 16).

So, how are ego death and psychosis so deeply intertwined? While ego death is often described in mystical or transcendent terms, it shares significant phenomenological overlap with psychotic experiences.

Shim et al. (2010) offer important insights, linking alterations in DMN connectivity to profound disturbances of self, suggesting “the hyperconnectivity of the DMN and the reduced anti-correlation between the DMN and task-related networks may be involved in the impaired neurocognitive function” seen in individuals at high risk for psychosis (p. 6). This neurobiological model underscores the shared neural substrates between psychosis and ego death.

Interestingly, Luhrmann et al. (2019) explore how **auditory hallucinations**, a hallmark of psychosis, may manifest differently depending on cultural context and social framing, noting that “voice-hearing embedded in an agreeable social world may become more manageable” (p. S28). Their work highlights the fine line between pathological and potentially transformative states, emphasizing the importance of context and interpretation in determining whether experiences akin to ego death lead to integration or breakdown.

Given the delicate balance between ego dissolution as a transformative experience and its potential to trigger or exacerbate psychotic states, careful clinical consideration is essential. Morris (2024) warns that “psychedelic use, specifically heavy psilocybin consumption, can precipitate a psychotic episode characterized by catatonia and suicidality in predisposed individuals” (p. 684). This underscores the need for cautious, controlled therapeutic approaches when employing psychedelics, emphasizing both pre-existing vulnerabilities and the imperative role of proper context.

Moreover, Conneely et al. (2024) discuss how antipsychotic medications, while stabilizing acute symptoms, might paradoxically impede deeper psychological transformation. They point out that antipsychotics can cause “an involuntary ego death rather than facilitating a mystical or transformative experience” (p. 4), highlighting the ongoing tension within psychiatric treatment between symptom management and supporting deeper individuation processes.

Kong et al. (2023) argue compellingly for differentiating pathological psychosis from spiritual emergence, a transformative psychological process involving ego dissolution. They suggest that “if DMN disruption underlies both psychosis and ego death, it suggests that whether one experiences a pathological breakdown or a transcendent awakening depends on context, integration, and guidance” (p. 11). This perspective aligns closely with Jungian psychology, where ego dissolution—if properly supported—can serve as a gateway to individuation, the process of integrating unconscious elements into consciousness.

Jung’s framework offers a profound lens for viewing psychosis not merely as pathology but also as a potential radical psychic attempt at individuation. However, Jung also cautioned about the risks, warning that encounters with the unconscious, including those precipitated by psychedelics, could “unleash overwhelming guilt and persecutory inner voices rather than newfound freedom” if the individual lacked sufficient psychological preparedness (Jung, as cited in Yildirim et al., 2024, p. 4037).

9. Harm Reduction Guidelines

Harm Reduction Guidelines to NOT Ignore

This discussion would be incomplete without addressing harm reduction guidelines, especially for individuals at the highest risk of adverse outcomes from psychedelics. The mainstream advice—psychedelics are NOT for individuals with personal or family histories of mental illness—while important, only scratches the surface.

Youth and Brain Development

Young individuals, particularly adolescents and young adults, should approach psychedelics and ego death experiences with significant caution. During adolescence and early adulthood, the brain and psyche are still developing. Critical areas such as the prefrontal cortex—key to self-regulation, emotional management, and impulse control—do not reach full maturity until approximately the mid-twenties. Kelley et al. (2002) note that “a region of the MPFC is selectively engaged during self-referential judgments,” underscoring the neurological foundations necessary for a coherent, stable sense of self (p. 789).

At these developmental stages, many individuals have not yet formed a robust, cohesive identity. Exposing them prematurely to experiences involving ego dissolution can destabilize their psychological foundations. Lilgendahl et al. (2013) show that ego development advances significantly when individuals process life events through mature “accommodative processing,” a skill often underdeveloped in younger individuals (p. 411). Consequently, the risks of psychosis or severe anxiety are considerably higher for adolescents and young adults engaging in ego death practices.

Trauma History

Individuals with unresolved trauma histories should be exceptionally cautious when pursuing strong psychedelic experiences (beyond microdosing). Trauma can fragment psychological coherence, leaving emotional experiences unprocessed, compartmentalized, or dissociated. Carhart-Harris et al. (2016) warn that psychedelics can “precipitate psychotic breaks in vulnerable individuals” by overwhelming them with suppressed traumatic memories and emotions (p. 23).

Trauma impacts the Default Mode Network (DMN), the brain network involved in sustaining identity and autobiographical memory. Individuals with trauma histories often display alterations or dysregulation in DMN connectivity, making them particularly vulnerable to the overwhelming experiences characteristic of ego dissolution. Kong et al. (2023) explain that disruptions in DMN connectivity are central to cognitive dysfunction and psychotic symptoms, further complicating outcomes for traumatized individuals (p. 3).

Unresolved trauma may surface unpredictably during profound psychological experiences. The protective boundaries of the ego, often essential for maintaining stability, can collapse under such strain, exposing raw, unintegrated material and leading to re-traumatization or severe psychological distress. Morris (2024) also notes that heavy psychedelic use in vulnerable individuals can precipitate severe psychotic episodes (p. 684).

There is a dangerous misconception on online forums that psychedelics are a “cure” for trauma. Some individuals prepare for “big trips” hoping to heal themselves in one session—an idea aggressively promoted in mainstream narratives around “psychedelic healing.” However, evidence suggests that individuals with unresolved trauma, rather than latent mental illnesses, are most at risk for ongoing, prolonged difficulties. Even those who have engaged in therapy and emotional processing are not immune.

TRAUMA is the number one risk factor for undesirable, prolonged psychedelic symptoms. If you are considering using psychedelics for trauma work, it must be done in a **clinical setting** with a trained and credentialed facilitator. Without proper support, the risks of exacerbating your condition are significant—even if you believe you have “nothing left to lose.”

Instability of the Sense of Self

Finally, individuals lacking a stable, integrated sense of self represent another high-risk group. According to Jungian psychology, a strong ego structure is critical for safely navigating encounters with deep unconscious content. Jung stressed that individuation—the process of becoming whole—requires a sufficiently developed ego to integrate unconscious material without being overwhelmed.

As mentioned, Jung also warned that premature ego dissolution can “unleash overwhelming guilt and persecutory inner voices rather than newfound freedom” if the ego is underdeveloped (Yildirim et al., 2024, p. 4037). Thus, individuals with already fragile senses of self—as seen in disorders like borderline personality disorder, dissociative identity disorder, autism spectrum disorders, or severe anxiety disorders—should generally avoid ego dissolution and strong psychedelic experiences. The ego acts as a container; without it, unfiltered unconscious material can be profoundly destabilizing.

Blanke and Metzinger (2009) similarly note that practices aiming to induce ego dissolution—such as meditation or psychedelic therapies—require strong psychological foundations. Without these, “such reduction [in DMN activity] can lead to pathological self-disturbance,” including severe derealization, anxiety, and psychosis-like symptoms (p. 12).

Psychological and Clinical Screening

Given these risks, thorough psychological and clinical screening is crucial before engaging in any ego death work. Healthcare providers, therapists, and guides should rigorously assess an individual’s psychological history, current mental health status, and readiness for such profound experiences. Tagliazucchi et al. (2016) emphasize that successful psychedelic-assisted therapy requires robust preparation and integration phases, underlining the necessity for a solid psychological framework (p. 1050).

Pre-experience screening should evaluate the stability of the individual’s self-concept, ego strength, and integration of past psychological experiences. Special attention should be given to psychiatric history, family history of psychosis, and trauma history. Individuals with significant personality instability, chronic dissociation, or ongoing severe mental health symptoms should be advised against pursuing ego dissolution.

Potential Consequences of Ignoring These Precautions

Ignoring these precautions can lead to devastating psychological consequences. Gergel and Iacoponi (2016) caution that psychosis can cause irreversible identity changes, significantly impairing an individual’s ability to maintain psychological coherence (p. 534). Such outcomes can necessitate long-term clinical intervention and have profound impacts on quality of life.

Individuals with such vulnerabilities discussed who undergo ego death without sufficient preparation risk acute psychotic episodes and prolonged disturbances such as persistent anxiety, derealization, depersonalization, chronic dissociation, or even enduring psychotic disorders. Evans et al. (2023) report that a substantial portion of individuals undertaking ego dissolution without adequate readiness develop lasting psychological symptoms and dysfunction (p. 23).

Recommendations for Individuals Considering Ego Death or Psychedelic Use

For those still determined to explore ego death, careful, deliberate preparation is essential. This includes psychological support, therapeutic guidance, and a well-structured integration process. Ongoing psychotherapeutic support—through Jungian analysis or trauma-focused therapy—can significantly improve one’s ability to navigate and integrate challenging psychological material.

Individuals who lack sufficient preparation, have unresolved trauma, or are still forming a stable identity should first engage in substantial therapeutic work. They should focus on strengthening ego functions, addressing trauma through evidence-based therapies like EMDR or trauma-focused CBT, and developing a stable, integrated sense of self before considering strong psychedelic work (i.e., more than 1.5g of mushrooms or half a hit of LSD).

If pursuing psychedelic healing, **start small**: 0.5g of psilocybin or a quarter-hit of LSD. Avoid powerful substances like ayahuasca, DMT, bufo, or peyote at the outset. Progress slowly over years—not months.

While ego death holds profound transformative potential, it is not universally safe or appropriate. Individuals who are developmentally immature, have unresolved trauma, or possess poorly integrated senses of self should proceed with extreme caution—or avoid such experiences entirely. Comprehensive psychological assessment, careful preparation, and structured integration support are critical to ensuring that these powerful psychological states yield growth rather than harm.

10. Conclusion- The Evolution of an Embodied Dissertation

As I have mentioned throughout this work, this dissertation has been a living, conscious entity—an alchemical vessel undergoing its own cycles of transformation and psychic death. It has demanded of me what true individuation demands of any seeker: a willingness to dissolve, reconstitute, and emerge anew, again and again.

The most pivotal turning point that shaped the trajectory of my research came when I began working with the young man, the lucid yet lost figure—caught in the liminal space between dissolution and reformation. Through our work together, I witnessed firsthand the profound alchemical processes that had, until then, largely been theoretical. He and I embarked on an intricate journey through the stages of the opus: beginning with nigredo, the blackening, where his psyche confronted its own death drive, the annihilation of a once-cohesive but now outdated ego structure. Nigredo is the phase of descent, the death of what no longer serves, and it was here that the work truly began.

From the darkness of nigredo, we moved through solutio, the phase of dissolution. His fragile ego dissolved into the watery depths of the unconscious, the barriers between conscious and unconscious minds melting away. It was an ego death in the truest sense: a loosening of the rigid boundaries that had both defined and confined him. In this melting, there was a dangerous surrender, but also a necessary one. The weak and fragmented ego was deconstructed, symbolically returning to prima materia—the raw psychic substance needed for true transformation.

From there, we entered the albedo and, eventually, the coagulatio phase—the coagulation. Slowly, painstakingly, a new form began to emerge: a more cohesive, authentic sense of identity. His Self, long obscured by dissociation and fragmentation, began to take shape. This delicate, painstaking work mirrored the individuation process Jung described: the integration of unconscious material into conscious awareness, not to destroy the ego, but to reform and strengthen it around a more authentic center.

Ego death, whether it unfolds slowly over years or strikes suddenly like a lightning bolt, is not an endpoint. It is the threshold. In surviving dissolution, something new emerges—a truer Self, an individuated Self, no longer defended by the brittle structures that trauma or immaturity once necessitated. This rebirth, this magnum opus, is the true aim and highest ideal of psychedelic work, at least from a Jungian and alchemical perspective.

I have sat with the death drive myself, known the Drowned King, and labored slowly to rebuild my own psyche from its ruins. Stripped of all that was not truly mine, it was an excruciating and humbling process—one guided, I believe, by the mushroom Spirit that has accompanied me through this long journey. It is a path fraught with peril and pain, and it called to me not because I was exceptional, but because I was willing to be broken down and remade.

In the end, this work is not about mastery or conquest. It is about humility. True psychedelic and ego death work does not inflate the ego; it humbles it to the point where one is no longer even certain of one’s competence, or at times existence. And in that profound not-knowing, a truer form of wisdom begins to take root.

It is my hope that this dissertation—and the work it represents—serves as a guide for those daring enough to traverse this dark and luminous terrain. The alchemical path is not for the faint-hearted, but for those willing to die and be reborn in pursuit of a more whole and conscious life.

11. Managing a Bad Trip (during and after)

And lastly, I recently wrote another article about what to do in the midst of, or after a "bad trip" that you can find here: https://www.drhollyflammer.com/post/when-the-mind-cracks-open. Destablising psychedelic experiences do not have to turn into psychosis or long term difficulties, and as a responsible user of these powerful substances, we should all know what to do when a trip turns bad, either for yourself or someone you love. If you're needing support in this realm, please feel to reach out through my contact button to book a free 15 minute consultation. Stay safe out there folks.

Legal Notices:

Services provided include spiritual consulting, coaching, integration support, and wellness education. Dr. Holly Flammer is not a licensed psychologist or medical provider and does not diagnose, treat, or prevent any medical or mental health condition.This work is protected by the First and Fourteenth Amendments of the U.S. Constitution and is not subject to public regulatory authority. Nothing on this website is intended as a substitute for licensed psychological or medical care.

This blog and all writing are original peices written by Holly Flammer, MA, PhD(c), QMHA, however I do utilize AI editing tools to polish and edit my writing (ie., grammar, citations, etc.).