A 1967 LSD Booklet Gets a Modern Stress Test
Experienced users largely endorsed Lisa Bieberman's six-decade-old safety tips, but researchers caution that agreement does not prove the advice prevents harm.
A new survey in the journal Psychedelics tested whether people with psychedelic experience still endorse practical safety guidance from Lisa Bieberman's 1967 booklet, Session Games People Play. Daniel J. Kruger, a research scientist and research associate professor at the University at Buffalo, State University of New York, led the study with Paul Gillis-Smith, Jacob S. Aday, Julie Barron, Moss Herberholz and Kevin F. Boehnke. The team converted 19 recommendations into questionnaire items and did not tell respondents where the advice originated. Among 496 adults who reported full-dose use, average ratings favored agreement on 18 of the 19 items. The authors read that pattern as substantial overlap between grassroots advice from decades ago and current harm-reduction and clinical safety thinking. [1]
The broader survey reached 581 respondents between September and October 2023. Recruitment used phone-scannable links at Entheofest, an annual psychedelic advocacy event in Ann Arbor, Michigan, plus newsletters, email lists and social media. Answers were anonymous and uncompensated. The analysis excluded people who had only taken microdoses, leaving 496 full-dose users. Their average age was 43, women and men were roughly balanced, and most identified as White. Psilocybin mushrooms or truffles had been used by 95.8 percent; LSD and MDMA each by close to half; nearly 90 percent had used a psychedelic in the prior year. Just under 60 percent, 58.5 percent, reported at least one specialized role, including sitter, guide, therapist, educator, clinician, researcher or Indigenous or shamanic facilitator. [1]
The questionnaire randomized ten preparation items and nine in-session items on a five-point scale from strongly disagree to strongly agree. The top preparation score, 4.66 out of 5, went to the idea that everyone present should know, like and trust one another. At 4.59 came the reminder that a guide does not remove the need to do most of the inner work; the gap between those two was not statistically significant. The weakest preparation items were capping a group at five people, 3.82, and planning hour-by-hour intensity in advance, 3.78. For the active trip, respondents gave the highest averages to remembering the experience will end, 4.76, and to recognizing anxiety does not signal something is wrong, 4.74. A private, undisturbed setting followed at 4.56. Five other in-session rules drew moderate support, led by putting phones away, which the authors compare with Bieberman's instruction to disconnect landline phones. The sole item without consensus was avoiding a mirror, at 2.96, nearly the neutral midpoint. [1]
Across the ratings, the strongest agreement clustered around interpersonal trust, reassurance and control of the setting. Respondents were less unified about logistical rules such as group size or hour-by-hour planning, and they were neutral on mirrors. The authors say this pattern is notable because advice from two generations ago might be expected to produce a wider spread of agreement, disagreement and indifference. Kruger said that apart from the mirror item, the consistency was unusual for guidance that old. The authors also describe the broad endorsement as close alignment between Bieberman's precautions and modern clinical safety protocols and community norms centered on mindset, setting and interpersonal trust. [1]
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Popular accounts of 1960s psychedelia often focus on Timothy Leary and Richard Alpert, former Harvard psychologists whose mystical writings and countercultural celebrity attracted headlines before federal prohibition. Lisa Bieberman has drawn far less attention. A 1963 Radcliffe College graduate, she worked for Leary and Alpert's organization before setting up a Cambridge, Massachusetts, information center in 1965. Through a national bulletin and mail-order pamphlets, she tried to replace rumor with measured safety information for ordinary people experimenting on their own. [1]
Bieberman self-published her dollar booklet in February 1967, long before harm reduction became a familiar public-health phrase. Guides of that period often leaned on Eastern mysticism and esoteric language; hers was secular and practical, addressing what could go wrong and how a beginner might prepare. She borrowed the title idea from Eric Berne's popular book on human relationships. Under LSD, she warned, people might abandon their companions, start a trip without ample unscheduled time, or feel certain that cosmic truths had to be broadcast at once. [1]
A 2025 paper by five of the same authors used the same survey sample to gather open-ended tips for newcomers. Experienced respondents often said newcomers should remain with people they trust and have an experienced sitter, reserve recovery time and stash phones. The new study adds a quantitative check: with the 1967 source hidden, most recommendations still drew average agreement. The authors view that as alignment between Bieberman's precautions and current protocols and community norms centered on mindset, setting and trust. [1]
Interest in psychedelic-assisted therapy trials has risen alongside general-population use, and most use still occurs outside supervised medical care. Classic psychedelics carry comparatively low risks of organ toxicity or addiction compared with many legal and pharmaceutical drugs, but unsupervised sessions can trigger acute panic, paranoia, confusion and, more rarely, heart-related stress or serious psychiatric crises. Adverse reactions may persist once the substance's effects fade. A prior study of individuals with extended difficulties found lasting worry and fear topped the list of post-trip problems, cited by 67 percent of respondents; using a substance without a guide was linked to a broader set of long-term issues. [1]
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Kruger told PsyPost that psychedelic use is now more widespread than at any earlier point, proportionally exceeding even the 1960s. He pointed to regulated, legal therapy pathways in Oregon and Colorado and, soon, New Mexico. Thousands of people have taken psychedelics in those supervised settings, he said, but the increase outside regulated environments in the same states is much larger. He described a mixed picture: many people report dramatic improvements in treatment-resistant depression, PTSD and other conditions, while many others have difficult experiences and some have negative effects that last long after a trip. That gap frames the team's research on reducing risks outside regulated settings. [1]
The authors stress that endorsement is not proof of effectiveness. A survey of experienced users and facilitators can show which historical tips retain community backing, but it does not prove that adopting any single tip wards off difficult experiences or enduring distress. Measuring long-term psychological, social or spiritual effects of particular safeguards would need controlled studies, and the authors say those trials would have to be ethically designed so no participant is denied essential safety information. [1]
The sample also has boundaries. It was a convenience group drawn mostly from North American psychedelic networks, and close to 60 percent held expert or practitioner roles. Their views represent an engaged, English-speaking psychedelic subculture, not casual beginners. Bieberman's 1967 manual reflected mid-century North American norms rather than traditions with much longer histories of psychedelic use. Her booklet also gave little guidance on integration, the modern practice of processing insights in the days and weeks after a session, beyond keeping the next day free. These caveats matter because the survey measures support for selected advice, not the manual's completeness or universal fit. [1]
The mirror item shows how safety advice can involve trade-offs. Bieberman warned that enlarged pupils and noticeable pores could lead users to dislike their reflection. Timothy Leary and co-authors took the opposite view in a 1964 manual, encouraging mirror-gazing as a way to ground confused users in everyday reality. To explain modern division, the researchers cite a 2023 analysis of online psilocybin reports that examined Reddit posts about mirror use during trips. That analysis found wide person-to-person variation, and positive responses outnumbered negative ones. The authors also cite one account of enduring trauma after mirror use, along with contemporary commentary that the practice can prompt useful insights even when frightening. They suggest Bieberman and Leary may both have seen the trade-off, with their opposite advice reflecting different weights on preventing harm versus seeking possible benefits. [1]
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Several questions remain unanswered. The study does not establish which specific precautions reduce harm over time, how advice should be tailored across cultures and user goals, or whether neglected illicit-era guides contain useful safety lessons. The authors propose that future work might study Bieberman's other essays on ethics after a session, adapt safety surveys to diverse cultures and goals, and assess other overlooked manuals. Those are research directions, not findings. [1]
The team has already begun another round of data collection. Kruger said the Psychedelic Community Survey is recruiting people 18 and older, whether or not they have used psychedelics. He said the survey collects no identifying information about participants or their data. This year's version has separate sections by role and experience, including psychedelic therapy facilitators, perceptions of clinical trials, harm-reduction volunteers or staff, first experiences, memories and psychedelic use, and women's health issues. [1]
Kruger also noted practices unavailable in Bieberman's time, such as testing a substance for purity and hazardous contaminants. He said the team continues to study how best to lower risks for people using psychedelics outside regulated settings. Avoiding a risky act is often safest, he said, but people accept many kinds of risk, and he cited an estimate that 14 million U.S. adults used psychedelics in 2025. For those who proceed, he said, the goal is to make the experience as safe as possible. [1]
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Prepared with AI assistance from the cited sources.
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