A new study published in Psychology of Religion and Spirituality explores how psychedelic experiences relate to people’s spiritual struggles. Some participants associated their experiences with a sense of spiritual growth, while others described feelings of disconnection or confusion. The findings suggest that psychedelics may be associated with both the intensification and resolution of spiritual conflict, depending on individual differences and the nature of the experience.
The research team launched this project to better understand how psychedelic use intersects with spiritual life, especially in relation to spiritual struggles. These struggles, which involve tension or conflict related to beliefs about what is sacred, have been linked to both psychological distress and long-term spiritual transformation. While previous studies have focused on the therapeutic potential of psychedelics and their association with mystical experiences, little attention had been given to their potential to provoke or alleviate spiritual turmoil.
“Psychedelics have become increasingly popular both from a research and clinical perspective,” said study author William Schutt, a PhD student in Case Western Reserve University’s Clinical Psychology program.
“I’ve always been interested in spirituality, and I was surprised when I wasn’t able to find much reliable information on psychedelics and spiritual struggles, despite clear relationships between psychedelics and religion/spirituality. Because these substances are becoming more widely used in clinical settings, I wanted to understand the full scope of their spiritual implications, both to help people who are struggling spiritually and to mitigate risks for those who aren’t.”
To address this gap, the researchers conducted three connected surveys. The first study included 574 U.S. adults who had previously used psychedelics and were asked whether these experiences had influenced any spiritual struggles. Those who said psychedelics had either caused or resolved such struggles were invited to complete one or both of two follow-up studies: one focusing on struggle resolution (260 participants) and the other on struggle causation (248 participants). Across these surveys, the researchers examined both the quantitative characteristics of the psychedelic experiences and open-ended descriptions of how these experiences impacted participants’ spiritual lives.
In the initial survey, participants completed measures assessing six types of spiritual struggles: divine (conflict with God), demonic (perceived attack by evil forces), doubt, moral conflict, interpersonal tension related to religion, and struggles with ultimate meaning. The researchers also gathered information on demographics, psychedelic use history, attitudes about psychedelics, substance use, and religiosity.
One of the main findings from this first survey was that psychedelic experiences were just as likely to be linked with the resolution of spiritual struggles as they were with the onset or worsening of those struggles. Contrary to predictions, participants reported similar levels of struggle resolution and causation overall. Among the types of struggles, ultimate meaning and doubt were the most frequently reported, whether psychedelics had helped or harmed the participant spiritually.
“I was surprised that past psychedelic use alleviated/helped and caused/worsened spiritual struggles a little bit, on average, with no significant difference in the extent to which psychedelics resolved/helped and caused/worsened spiritual struggles,” Schutt told PsyPost. “There’s a large body of research suggesting that psychedelics lead to spiritual growth, so it was unexpected that there weren’t significant differences here.”
The researchers also identified individual characteristics that made certain people more likely to report either struggle resolution or causation. Participants who were younger and more religious reported stronger effects of psychedelics on both struggle resolution and causation. Those who identified as spiritual but not religious and who held positive views about psychedelics were more likely to report struggle resolution. In contrast, participants who were Christian, had concerns about substance use or addiction, or viewed psychedelics as potentially demonic were more likely to report struggle causation.
The second and third studies provided a more detailed look at specific psychedelic experiences that participants associated with struggle resolution or causation. These follow-up surveys included in-depth questions about the features of the psychedelic trip, including the presence of mystical or challenging elements, and participants’ perceptions of spiritual growth and decline afterward.
Participants who described experiences of struggle resolution reported more mystical features—such as feelings of unity, transcendence, and connection—as well as more spiritual growth and fewer challenging experiences. They also described long-term benefits such as greater clarity, a deeper sense of purpose, and improved relationships with death, loss, or the sacred. Participants often attributed these benefits to psychological factors like gaining new perspectives, reducing stress, or letting go of control. Others described overtly spiritual interpretations, such as encountering a divine presence or receiving guidance from otherworldly realms.
By contrast, participants who reported that psychedelics caused or worsened their spiritual struggles described more distressing features. These included overwhelming hallucinations, terrifying entity encounters, and deepened confusion or doubt about spiritual matters. The most common reason given for struggle causation was that the psychedelic experience challenged existing religious or spiritual beliefs, leading to increased uncertainty. Other explanations included heightened emotional distress, a sense of disconnection, or being forced to confront unwanted thoughts or unresolved trauma.
Interestingly, many participants in both groups described mixed experiences. Some said that the same psychedelic trip both deepened their spiritual confusion and ultimately helped them grow. The researchers found that mystical and challenging elements of the experience were largely independent, meaning a trip could be spiritually transformative and distressing at the same time. Similarly, spiritual growth and decline were not opposite ends of a single continuum but could occur in parallel.
These results highlight the complexity of psychedelic experiences. The same substance can produce widely different outcomes depending on the user’s beliefs, expectations, psychological state, and context. The researchers suggest that psychedelics might offer new perspectives or spiritual insights for some individuals, while triggering spiritual crises in others. Experiences that feel profound and healing to one person might be disturbing or disorienting to another.
“The relationship between psychedelic experiences and spirituality is complicated and can differ depending on the type of spiritual struggle experienced,” Schutt explained. “For anybody considering using these substances for clinical or recreational reasons, know that psychedelics have the potential to alleviate, help, cause, or worsen spiritual struggles, leading to spiritual growth, spiritual decline, or even both! For a lot of folks, it’s not always clear how broad the spiritual implications of using these substances can be.”
The study has some limitations. The sample was drawn from online survey participants and was not representative of the broader population. Most respondents were White, cisgender men with relatively high levels of education, and the majority used psychedelics recreationally rather than in clinical or ceremonial contexts. The findings also relied on retrospective self-reports, which can be shaped by memory biases and personal interpretations.
“This study was preliminary, cross-sectional, and retrospective,” Schutt said. “Think of this as an early conceptual study to be built upon by future research.”
Despite these limitations, the research offers important insights into the spiritual risks and benefits of psychedelic use. As interest in psychedelic-assisted therapy continues to grow, the findings underscore the need for clinicians to assess clients’ spiritual history, struggles, and beliefs when planning treatment.
“I would really like this line of research to assist the development of psychedelic-assisted psychotherapy protocols, perhaps by integrating tools like the Religious and Spiritual Struggles Scale (RSS-6),” Schutt explained. “I hope that identifying common qualitative themes related to spiritual struggles and psychedelics will inform the development of more nuanced therapeutic interventions targeted at specific types of spiritual struggles.”
“Tailoring psychedelic-assisted psychotherapy to individual needs would help clinicians maximize potential benefits while minimizing the spiritual risks associated with psychedelic use. For example, by considering the specific nature of a client’s spiritual struggles and how factors such as religiosity, age, and psychedelic attitudes relate to psychedelic effects, clinicians can better prepare clients who are interested in psychedelic-assisted psychotherapy.”
The study, “How Psychedelic Experiences Can Cause, Worsen, or Resolve Spiritual Struggles: A Mixed-Methods Study of Psychedelic Users,” was authored by William A. Schutt, Julie J. Exline, and Kathleen C. Pait.