Why Psychedelics Work Differently for Different People

A Framework for Practitioners

There’s a way the media sells psychedelics as an effortless answer to mental health challenges. If you read a lot of psychedelic books, they’re sold that way too. Add psychedelics to this modality or that modality, people go really deep, it’s transformative.

But what about when it doesn’t work? When you open the package, sprinkle in the “just add psychedelics,” and it doesn’t go as planned. When not much happens. Or when it goes badly.

Is there anything we can say about that beyond “trust the medicine” and keep going? I think there is.

Over the years, I’ve noticed some patterns around this. I’ve developed a framework synthesized out of a couple of different lineages that helps me think through what’s actually going on and what to do about it.

What I’m about to lay out is intentionally simple. The nuance comes in how you apply it.

I have found that there are three different avenues for how I tend to approach people. Getting clear about which direction we’re heading lets me then engage the full nuance of who they actually are.

All of what I’m going to lay out here assumes ongoing work. If people are committed and really want to do the work, we’re looking at a longer time frame. A couple of months minimum to do a light pass or work on one particular thing. But if someone wants to do a comprehensive process, we’re often talking years.

This approach is not about how to maximize a single journey. A single journey is almost inconsequential. It’s a data point. One experience. You would never ask someone what they had mastered of meditation having done one retreat. Why are we having anything close to that expectation in how we talk about this other way of engaging consciousness?

The central question I come back to is, “Does this person need more structure in their sense of self, or more opening?”

To understand what I mean by structure and opening, it helps to know where this comes from.

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Theoretical Grounding

Heinz Kohut was a mid-century psychoanalyst whose major contribution was self psychology. He saw that people weren’t primarily working through drives and conflicts, as traditional psychoanalysis had assumed. Instead, they were working around deficiencies and gaps in their development. The good things that didn’t happen. Kohut was probably the first to describe well what it looks like when someone doesn’t get what they need developmentally, and what they’re left with. In his language, what we’re assessing is someone’s capacity to feel “well put together, of a piece, holding a sameness over time, containing and balancing varied emotional states.” He described healthy development as launching from an energizing platform of ambition toward goals infused with personal meaning. The capacity to feel one’s life as energized, creative, and personally meaningful. That’s what a solid sense of self makes possible.

Wilhelm Reich was the one who first made the case that character lives in the body. The defenses we develop don’t just show up in how we think. They also show up in how we hold ourselves. Posture. Breath. Chronic tension. He called this character armor. Most somatic modalities are basically bastard stepchildren of his in one way or another. Stanley Keleman’s Emotional Anatomy and Stephen Kessler’s The Five Personality Patterns offer accessible maps of how these structures express.

So what does it actually look like when these two come together? That’s the vessel.

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The Vessel

A vessel has two basic qualities. Structural integrity, which is the capacity to hold what’s poured in. And openness, which is the capacity to receive. Both are required, and they need to be balanced.

What gets poured in this case is psychedelic experience. Numinous experience. Life force. The medicine brings something in. You might call it energy. Or shakti. Or expanded consciousness. The question is whether the vessel can hold it.

When the vessel is ready to receive, it’s transformed by being the container. It can actually grow in size and volume. We can hold more over time. A small vessel can become very large. This is what it looks like when psychedelic work is going well.

But not everyone’s vessel is ready. If the container leaks, what gets poured in spills out in all directions. If it’s sealed shut, nothing gets in at all. And if the container is braced and brittle, what gets poured in can shatter it.

This is why the foundational work matters. We’re not just fixing problems. We’re preparing someone to receive something.

What I’ve found is that people tend to need work in one of three directions.

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The Leaky Vessel

If a vessel doesn’t have enough structural integrity, it leaks. Anything poured into it pours out in places not intended for pouring out.

In a person, what this looks like is a capacity to say yes but not enough capacity to say no. Sometimes the yes isn’t even a real yes. It’s just the absence of no. Stuff gets in that shouldn’t. An opinion from someone who has no business offering it. Other people’s feelings or needs that aren’t theirs to carry. Requests that should have been declined. Without a clear boundary, it all comes in and takes up residence. We have to be able to trust our no in order to trust our yes.

One expression of this is doubt. Not being able to trust your own read on a situation. Doubt of one’s own experience, one’s worthiness, one’s judgment. There’s often a lack of a central axis of being. When so much from the outside has gotten in, it becomes hard to locate what’s actually yours.

Another expression is over-responsiveness to others’ needs while being under-responsive to their own. The fawning quality. The doormat. Someone who organizes around what others want while losing track of what they want. They may be exquisitely attuned to everyone else in the room and strangely absent to themselves.

This often shows up in life circumstances. Dysfunctional relationships where their needs don’t get recognized, career troubles, staying in jobs they’re overqualified for. Agency, the capacity to point themselves in a direction and accomplish a goal, is hard to access. Sometimes it’s others who derail them. Sometimes it’s their own lack of trust in themselves. Or it can look like a solid career but really confused close relationships. It doesn’t have to show up in every aspect of life to be a leaky vessel.

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The Capped Vessel

The capped vessel is a different problem. It’s almost more like a barrel than a vessel. There’s plenty of structural integrity. A solid sense of self. But nothing is able to be poured in. Too much no and not enough yes. What’s missing isn’t self. It’s other. Receptivity. Influence. Vulnerability.

This is a continuum. Someone can be a completely sealed barrel or one with a small hole. The less extreme end of the spectrum can do quite well with psycholytic work. The more sealed, less so.

This can show up as surety. People with a lot of willpower. A lot of drive and not a whole lot of compromise. Agency is very much intact. They execute. They achieve. Careers often work well. They can point themselves in a direction and make things happen. They can be good at having fun.

But life can feel flat. They may not tend to feel very deeply. Sometimes they want more. Sometimes their spouses want more. Sometimes these folks approach this work wanting a reset from the medicine. They want to optimize. They may want to feel more.

What suffers is relationships. The spouse’s complaint is usually something about unilaterality. “I’d like you to open up. Be more available. Compromise more. It doesn’t always have to be your way.” Those kinds of challenges. Partners feel unseen. Feedback doesn’t land. There’s not enough responsiveness to what’s happening around them.

Somatically, these folks often fill out space. They can be warm, sociable, gregarious even. Good social skills. They inhabit the room and themselves. There’s presence. The issue isn’t that they’re not there. It’s that they’re not letting much in.

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Compensatory Rigidity

Then there’s what I think of as compensatory rigidity. This is the one that’s dangerous to misread.

From the outside, it might look similar to the capped vessel. Closed. Rigid. But the underlying structure is completely different. I think of it like a leaky vessel with barrel bands strapped really tight around it. That’s what’s holding it together. It’s not that there’s a solid interior. It’s that the system is bracing to not fall apart.

The underlying deficit is the same as the leaky vessel. A lack of solid sense of self, of central axis. But the survival strategy is opposite. The leaky vessel merges to stay safe. Compensatory rigidity creates distance to stay safe, bracing or dissociating to keep the world at arm’s length. Rigidity stands in for structure. It’s not the “I can and nothing will stop me” of the capped vessel. It’s “I’m bracing against life and experience otherwise I could be blown apart.”

This is earlier developmental trauma territory, more on the withdrawn side where the leaky vessel can be more on the fawning side. The earlier the wound, the more the capacity to self-regulate isn’t developed and is replaced by dissociation. To stay structured, the system needs immense tightness. It can’t allow much in because there isn’t much coherent structure inside.

Stan Grof observed this in his LSD research in the 1960s. There were subjects he could give 400 or 500 micrograms and nothing would happen. In one case, a man was given up to 1500 micrograms intramuscularly. Afterward, he wanted to play chess. He found the session uneventful and monotonous. Grof concluded that psychological resistance can’t be broken by increasing dose. Nothing gets in because it’s too dangerous to let anything in.

In life circumstances, people with compensatory rigidity can successfully do jobs, often work that doesn’t require dealing with people in free-form ways. They might do well in contrived scenarios with clear structure. But intimate, close relationships are very hard. Letting people in is hard. They often don’t know what they’re feeling. Turning toward others from that place is even harder.

Somatically, the difference from the capped vessel is visible. Compensatory rigidity can feel very still, but it’s still like a telephone pole, not still like a tree. Rigid, tight, not responsive. There can be a brittleness. The eyes can go a bit wide. While often very polite, there’s a thinness in their presence. Pulled back, almost hiding behind themselves or behind their eyes. They don’t fill space the way a capped vessel does.

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The Danger of Two Categories

Here’s why this matters clinically.

If practitioners only think in two categories, porous or closed, the logic is simple. Too closed? Give them more to help them open.

That logic works for the capped vessel. They have genuine structure. The system can handle opening. A bigger experience can help them learn something about yielding, about surrendering the driver’s seat. The classic example is military vets doing healing work with 5-MeO and iboga. The strongest medicines as a starting place. For a genuinely capped vessel, that can be exactly what’s needed to crack the door.

But that logic is dangerous with compensatory rigidity. The rigidity IS the structure. Push through it and there’s nothing holding things together underneath. The low-end risk is they spent a lot of money and nothing happened. The high-end risk is psychological fragmentation. There’s another risk too. When the vessel can’t hold what’s been poured in, the psyche sometimes compensates with grandiosity. False structure in place of real structure. More on that in future writing.

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The Balanced Vessel

Finally, the balanced vessel. Structural integrity and openness working together.

An expression of this is humility. A capacity to follow one’s sense of things, believe in oneself, and remain open to change. Robert Moore defined humility simply: knowing your limitations and getting the help you need. That’s it. That’s what the grandiose self hates, and that’s what the balanced vessel can do.

We’re not looking for perfect here. This is about good enough. There’s no optimal center point. People have a wide range of dispositions. Even under perfect conditions of psychological health, some will be more permeable, others more dense. What we’re looking for is a capacity to be responsive to life and to use one’s gifts and strengths well. A self that can hold experience without fragmenting, and open to experience without losing itself.

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In Practice

In any descriptions I offer here, I’m painting with exceptionally broad strokes. Starting with Wilhelm Reich, entire books have been filled with different personality structures, physicalities, and constructions. Stanley Keleman’s work maps the variety in how character lives in the body. What I’m giving is a handful of primary expressions within which there is enormous variety. The point isn’t exhaustive typology. It’s directionality. Which direction does this person need to go?

If it’s not clear, this is a functional way of thinking about horizontal work. What we’re doing here is building a vessel that can actually hold something.

The vertical dimension is about what gets poured in, the numinous experience, the life force. A vessel that’s ready to receive it is transformed by being the container for it. It can actually grow in size and volume. We can hold more over time.

And there’s more beyond that. The pouring in and the pouring out. But that’s beyond our scope here.

To be clear, this isn’t a diagnostic model. It’s not assess, diagnose, prescribe, execute. It’s a guidance system for an emergent process.

This is what I’ve come to from 700 sessions. This is the result of the tinkering. The result of doing the dumber, less nuanced thing many, many times, and paying attention to what happened.

When you’re working with someone and you’re a good fit, there’s a sense that you’re going where you need to be going. What they want to work on, what you’ve decided on for medicine and dose, it’s all come together. It might be choppy, it might not be easy territory, but it’s unfolding. There’s a distinct pleasure in that.

This framework is for when that sneaking suspicion starts to grow. The sense that we’re not really getting it. Something’s happening but not much. When doubt starts to creep in. This is a lens to look through and see if there’s something that needs adjusting.

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Why This Matters

This isn’t just about safety. It’s about efficacy.

For people with a leaky vessel, psycholytic work tends to go well. Shoring up ego strengths, therapy-style work, building structure. These are not people I start with big doses of mind-melting psychedelics. These are typically the folks who have nightmare experiences at retreat facilities.

For people with a capped vessel, psycholytic work is often too subtle. They’re so used to driving their own experience, they’re not good at following, at surrendering. In session, they can be quite high and still turn from one thing to the next. A lot of intellectualizing. The journey can even feel important. But afterwards, not much changes. Sometimes starting with a bigger experience helps them learn what yielding actually feels like. Then you can backfill with gentler work. Not that they don’t need it. They very much do. You just can’t always start there.

For compensatory rigidity, move very slow and careful. Help build a sense of self before doing anything that asks that sense of self to dissolve. This is developmental trauma territory. Patience. Time. Relationship. Regulation.

And again, these are extremely broad strokes. This is not meant to be a cut and paste protocol. It’s meant to offer a way of thinking about what serves different dispositions. The actual work will be as varied and complex as every person who sits across from you.

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Final Thoughts

This assessment precedes everything else. Before you choose the medicine. Before you plan the dose. It helps frame intentions.

The intervention that lands for a leaky vessel will miss entirely for a capped one. And the intervention that opens a capped vessel might fragment a compensatory one.

And as always, your own work on structure and openness will affect both the subtlety of your radar and your capacity to help others walk that territory.