Set & Setting: Why Environment Matters in Psychedelic Therapy

It’s safe to say that after years of exploring neuropharmacological effects, humans and psychedelics have had a complex heterogeneous evolutionary relationship. From mystical and recreational use to clinical trials in a controlled therapeutic environment, psychedelic treatments have given rise to the issues of set and setting in psychedelic therapy.

Psychedelics heighten our sensory modalities to both internal and external stimuli, thereby amplifying our experiences of them. However, changes in our mindset or physical environment can alter these experiences. At MINDCURE, we advocate the importance of a regulated therapeutic environment as researchers and users struggle with varying results of a psychedelic experience. As psychedelic therapy enters the mainstream, clinicians set out to explore the fundamentals of set and setting for a successful session.

What Is Set & Setting in Psychedelic Therapy?

Timothy Leary emphasizes the need for addressing set and setting in his 1964 guidebook for taking psychedelics, The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead. He believed that the key to maximizing the benefits of a successful psychedelic experience lies in understanding the impact of internal and external characteristics.

According to Hartogsohn (2015), setting refers to the "physical, social and cultural environment," where the psychedelic experience happens (i.e., the therapeutic environment). He highlights the importance of social and cultural forces that have influenced the psychedelic experience over the years. 

On the other hand, set refers to one’s “personality, expectation, intention, and preparation.” Set is further explored by Leary as “long-range” and “immediate.” The former is a manifestation of the “kind of person you are,” such as your desires, passions, conflicts, and fears, while the latter is your attitude or current mental state going into the experience.

Leary‘s manual encourages researchers and therapists to carefully “prepare” for a psychedelic therapy session by accounting for the “expectations” that a patient has about the experience itself. Hartogsohn believes that psychedelics are “mind-manifesting,” meaning they stimulate modular thoughts and magnify one's current awareness.

As clinicians strive to determine safe therapeutic practices, there is an apparent need for a digitized network of standardized therapeutic protocols and clear frameworks that will help clinicians prepare clients and clinical settings for psychedelic therapy.

Achieving the Ideal “Set” in Psychedelic Therapy

The future of effective psychedelic therapy depends on the clinician's easy access to the client’s ongoing mental status. iSTRYM enables clinicians with essential patient data, thus allowing them to alter or deepen the treatment as necessary for successful breakthroughs. 

To achieve an ideal setting in a therapeutic environment, clinicians must include the following essential principles in their practice. These are based on Leary’s understanding of the Immediate Set, thereby ensuring a positive holistic experience.

1. Ground Your Attention

Grounding is essentially derived from meditative healing. It’s primarily an attention focusing tool to help clients control their inner feelings. The best way to begin is by placing your feet flat on the ground and taking deep, calculated breaths. This motion of rooting oneself helps induce feelings of calm and composure. Grounding is most beneficial when clients find themselves in an anxious or troubled mental state. 

2. Surrender Your Preconceived Notions

Surrender is fundamentally the most important principle of psychedelic therapy. People are preprogrammed with preconceived notions that may hinder their ability to let go and fully immerse themselves in the psychedelic experience. According to Leary, the best way to detach yourself from any expectations is by “turning off your mind, relaxing and floating downstream.”‍

3. Be Curious

Rather than completely disqualifying your preconceived ideologies, become a spectator to your discomforts. Curiosity helps in the healing process by allowing you to take note of every thought, pattern, and feeling before letting it go. This teaching experience becomes a guiding source for understanding the root cause of your inner turmoils.

4. Set Your Intentions

Intentions help establish the therapeutic purpose or goal. They guide your psychedelic experience and also act as an anchor to keep you grounded, especially during anxious episodes. If you find it difficult to set your intentions, start by asking yourself simple questions like what led you to therapy and what are you hoping to achieve? 

Perfect the “Setting” in Psychedelic Therapy

Setting accounts for the physical attributes of a therapeutic environment. Traditionally, psychedelic experiences were most successful when undertaken in a familiar outdoor space or a comfortable indoor area. Today, therapists can build safe therapeutic environments by incorporating comforting elements like a couch, music, and neutral tones in the space.

iSTRYM’s integrative platform provides clinicians with access to individual patient-level data that can help them set up therapeutic spaces for a supportive healing journey. Since music is a key ingredient in achieving an enlightening entheogenic experience, the platform also offers a vast library equipped with aiding the therapeutic experience by reducing anxiety, enhancing memory function, and others.

At MINDCURE, we understand the need for building safe and effective therapeutic environments that foster healing. As a catalyst of meaningful change, we strive to build systems and digital resources for transcendental experiences. Head over to our blog for more information on our research, products, and future aspirations.