What to Know Before Booking a Psychedelic Retreat

Sometimes a beach vacation just isn’t enough. To really disconnect from the grind of my everyday life, I often need to go very far away—far enough to escape the perturbations of my mind and the self-imposed prison of productivity that I often lock myself into. In the past, I’ve used 10-day silent meditation retreats to accomplish this (I recommend them highly), so when the opportunity to attend a plush private psilocybin mushroom retreat in Jamaica arose, I leapt.

Having worked closely with the leaders of this retreat—who also ran a ketamine healing center in New York City at the time—I trusted their expertise as space holders. Most literature suggests spending several hours before a retreat honing your intentions to articulate your aims. The Cardea method—a playful and relational approach to transformation—went far beyond that simple protocol. Before leaving New York, the 10 other celebrants (singles, couples, and a family!) and I filled out in-depth medical screenings and joined three “dialogic” sessions, which functioned as a sort of talk/somatic therapy to prime our minds for the three magic mushroom journeys that awaited us in Treasure Beach, Jamaica.

The setting was spectacular. The whitewashed villa where we were housed sat on a palm-dotted cove on Jamaica’s tranquil southern shore. Meals were delicious, organic, and complete with the requisite vegan and gluten-free options. Massages were available daily. Upon arrival, I found a note written by the retreat leader in response to our preparatory dialogues. “It is a joy to be hidden and a disaster to not be found” was the opening line. I knew I was in exquisite care.

Over dinner, we learned more about the itinerary. Ceremonies were to be held every other day in a peaceful room overlooking the sea; music was played and sung live by the two space holders. Days between ceremonies would be spent making art, sharing experiences in integration circles, meeting privately with the leaders, journaling, swimming, or staying quiet.

We were invited to choose our doses depending on our appetite for reality-shifting experiences. Having journeyed with serious amounts of psilocybe cubensis over a dozen times, I knew that psychedelics are predictably unpredictable—but because I was in such a safe container, I decided to test my limits. For my first journey, I took a very manageable 3 grams; I scaled to a powerful 5 grams in the second experience; and, after consulting with the facilitators, opted for a heroic 7 grams for the finale.

That last ceremony began like the others: eyes shaded, lying on my mat, awaiting takeoff, which began with the typical stomach-roiling nausea, followed by a kaleidoscope of thoughts and sensations. All was proceeding apace until I heard what I can only describe as a loud internal clang. The blood whooshed out of my face, and the floor dropped away like an airplane falling a thousand feet in the sky. I was clammy. When I opened my eyes, the room was spinning wildly. Something was wrong. Very wrong. I shut my eyes to wait it out.

The next two hours went on for an eternity.

When the ceremony officially ended, the group drifted upstairs to gaze at the night sky, but I was frozen on my mat, unable to move without the room spinning out of control. John, the primary guide, stayed close by, checking in, playing soothing tunes, and offering his calm, steady presence.

Eventually, he lifted me to my feet, braced my wobbly body against his, and walked me to bed, where I lay, eyes sealed. Opening them was perilous.

The retreat leaders suggested calling a doctor, but I declined, hoping that sleep would restore my balance. No such luck. In the morning, the room was still gyrating, so much so that I had to crawl to the bathroom. On that humiliating crawl, I wondered if, despite everything I had read about the safety of psilocybin (never one recorded death), I would be the first human left with a permanently scrambled brain.

Eventually, I managed to voice dial my partner, a physical therapist, who recognized my symptoms as vertigo, which, until then, meant nothing more than the title of my favorite Hitchcock film. (I have since learned that vertigo occurs when the tiny crystals in the inner ear that align one’s head and eye movements dislodge). He sent a video demonstrating the Epley Maneuver, a sequence of head movements that jostle the crystals back into position. One of the guides, also a nurse practitioner, manipulated my head several times, which slowly brought some relief, but not enough to get me walking in a straight line. Without my asking, the organizers went above and beyond by arranging an extra night’s stay and then accompanying me to the airport to ensure I left safely.

Over several weeks, the vertigo resolved itself, but today, two years later, dizziness still strikes, at times without warning. Trust me: driving 60 mph over a bridge with no shoulder and seeing the highway levitate while battling oncoming headlights is nowhere you want to be.

I’ve had an MRI and seen a neurologist and vestibular therapist, and I’ll never know what ​​​​sparked this episode. The megadose of mushrooms? Swimming in the sea? Or did the warranty on my vestibular system simply expire? But here’s what I want you to know, dear readers, especially if you are contemplating an offshore psychedelic retreat: Even in first class, things can go wrong.

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'The medicine may not give you what you want, but it gives you what you need.' To that well-worn cliché, my response is Bullshit!

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Don’t mistake me. I know retreats can be beautiful, healing, and mind-opening, but I share this story as a reminder that they are not vacations. Despite the gorgeous photos of glowing participants set against lush tropical backdrops and the promise of personal transformation, there are risks that often go unmentioned.

​​​​​​​​​​​Psychedelic aka spiritual tourism is officially booming. And like any early stage “industry” in the throes of a growth spurt, it is uneven and unregulated. For every well-run retreat like mine, there are others led by charismatic amateurs or self-styled gurus with little training and no accountability–one company, Inner Mastery, which ran retreats in 40 countries, has been accused by members and retreatants of multiple crimes including sexual abuse and operating as a cult. Only now, as increasing numbers of people head off to the Peruvian Amazon or Costa Rican jungle, are we seeing a fuller picture of what can go wrong.

To avoid being alarmist I want to reiterate that large surveys indicate most people have positive outcomes, but a minority do report serious adverse effects. The Global Ayahuasca Survey, which sampled over 11,000 people, found that 12 percent sought psychological assistance after a difficult trip. What’s more, some psychonaut surveys show that 39 percent of people who’ve had a challenging trip ranked it among the five most difficult experiences of their lives. And it wasn’t one-and-done. Nearly 8 percent of those whose difficult trip occurred a year earlier sought treatment for enduring psychological symptoms; 16 percent of them felt they did not ultimately benefit. Some reported an altered sense of time and boundary dissolution. Others experienced “derealization,” a condition in which walking down a street feels dreamlike or you lose your sense of self. These are not pathologies per se, but they are disturbances that can leave people wildly off center. ​

Then there is the matter of accountability, which in this new market is not assured. Certain retreats have been known to coerce or strongly encourage people to continue doing ceremonies even after they’ve had difficult experiences. This can compound problems—despite what some guides may tell you, distress does not equal progress! And though it’s not common, several well-funded retreats and clinics in resort-like settings have been at the center of scandals, ranging from neglect of participants to wrongful deaths. ​

What to Ask Before You Book

So before you plunk down thousands of dollars, do your homework and ask the hard questions. If the retreat leaders aren’t willing to discuss your questions, consider it a bright red flag. They should also be able to clearly lay out the sequence of activities that comprise the ceremony and the all-important and often undervalued follow-up integration periods, which can soften your landings.

Here are ten questions to ask:

1. What medical screening do you require? If they fail to ask about your health history—including any medications you take, underlying medical conditions, and most importantly, your mental health history and family history—consider booking elsewhere.
2. Is there a licensed medical professional on site or on call? The answer should be ‘Yes.’ Duh. This could be a nurse or MD, but even in areas with limited infrastructure, there should always be an accredited medical professional available for emergencies.
3. Where is the nearest hospital, and what type of transportation is available in an emergency? Too often these questions aren’t asked in advance.
4. What training and credentials do the facilitators have? Ethical retreats should have be able to provide the space holders’ bona fides and assure your safety. Facilitators should be trained guides at a minimum. (“I’ve done 300 ceremonies” is not a credential.)
5. How many participants are in each ceremony and what is the ratio of staff to participants? Groups of 40 to 60 feels like an assembly line to me. Smaller groups mean more individualized care. At no point in a ceremony should you feel unable to get the support you need.
6. Does the retreat website mention risks?Around 90 percent don’t mention risks, according to reporter Jules Evans, and only 4 percent of websites include an ethical code of conduct.
7. What is the plan for aftercare, should you need it? Support should be available beyond the last day of the retreat, but not all facilities have the resources to offer this. If that’s the case, consider staying on a few days after the final ceremony to relax and regroup. Or be sure to arrange integration or therapeutic support beforehand so you can have it at the ready upon return.
8. What substances are being used and in what dosages? In the case of ayahuasca, who prepares the medicine? It’s safer if the medicine servers prepare their own brews. There have been reports from Peru that some servers are adding “fortifiers” such as Brugmansia (also known as toe’, floripondio or angel’s trumpet) or Datura to give Westerners a mind-shattering experience. High doses can cause delirium, amnesia, psychosis, or heart problems. You want to come back refreshed, not refried.
9. What cultural traditions are being drawn from, and how are they honored or compensated? Indigenous people have been using the medicines for centuries. Be sure that your center has a program for giving back to these communities.
10. And finally, be on the lookout for financial exploitation. The lure of easy money attracts opportunists, even in lovely rustic settings. There are reports of retreats upselling celebrants into follow-up “trainings” or “facilitator certifications”—I’ve heard tales of one retreat offering real estate tours after the final sharing circle! It’s easy to succumb to financial coercion when you’re vulnerable. And, no, don’t give your ATM card and PIN to the shaman “just in case you need something” during a ceremony.

I’ve since been asked if I’d go on a retreat again, and to my own surprise, the answer is a cautious yes. I would likely choose a different substance (mushrooms, while rumored to be the “easier” psychedelics, may not be for me anymore). In one way, a psychedelic retreat is somewhat akin to sitting in silent meditation. It’s not an easy experience, but it can bring me somewhere I can’t get to in ordinary life, which is a vacation from my ordinary mind.

​​​Joe Dolce is the author of Modern Psychedelics, The Handbook of Mindful Exploration