Psilocybin Therapy for Athletes and High Performers: A rant

In all of the rigorous clinical research on psilocybin therapy that has emerged over the past two decades, including the landmark Johns Hopkins trials, the NYU studies, the Imperial College London work, the COMPASS Phase 2 data… almost none of it has been conducted with athletes or high performers as a target population. Not because researchers doubt there's something meaningful there but because clinical trials are designed to measure psilocybin's efficacy against diagnosable conditions like treatment-resistant depression, major depressive disorder, end-of-life anxiety, obsessive-compulsive disorder, and other conditions. The inclusion criteria for these studies almost always require that participants have a formal diagnosis. Athletes who are functioning at a high level, managing stress, chasing excellence, and quietly struggling with the psychological weight of all of that… they tend to get screened out.

In the language of research, they're called a 'healthy population.' And ironically, that label is likely why so few research studies are available at this point in time with this population. Relatedly, it needs to be stated that psilocybin may not be the best option for many people, though, and while we are in the midst of plenty of hype around psychedelics these days, it is important to reinforce that taking a precautionary stance towards psychedelic use is essential. Just because athletes and performers are not the prime target population for psychedelic assisted therapies does not mean there are contraindications, though!

The published clinical literature on psilocybin is genuinely exciting, and it's growing fast. Meta-analyses published in recent years have found large effect sizes for psilocybin in treating depression (for fellow stats nerds, this means a Hedges' g of around 0.89, which is substantial in a field where most pharmacological treatments land well below 0.5).

The neurochemistry is also compelling. Psilocybin acts primarily as a serotonin receptor agonist (particularly at 5-HT2A receptors), but it also produces downstream increases in dopamine, glutamate, and GABA, a “cascade” that researchers believe underlies both its antidepressant properties and its capacity to facilitate neuroplasticity.

But here's what gets less attention in popular coverage of this research: the therapeutic benefits documented in these trials (i.e., reduced anxiety, expanded perspective, increased openness, sustained emotional processing, and what many researchers describe as a reset of hyperactive fear-based neural circuits to name a few) are not unique to people with diagnoses. Study participants tend to describe psychological processes that are deeply relevant to anyone navigating the high-stakes, high-pressure, high-visibility terrain that is customary of elite performance.

A 2024 survey of athletes and sports staff in Canada and the United States, published in a peer-reviewed journal, found that psychedelic use was the third most common substance category among athletes in the prior year. Notably, those who had some knowledge of psilocybin were significantly more likely to express support for psilocybin-assisted therapy, particularly for concussion recovery and mood management. The researchers concluded that people in the sports industry are, broadly speaking, already curious and willing. The infrastructure to serve them well, and to do it safely and ethically, is what's still catching up. That gap is one of the reasons I started The Clearing.

What Aaron Rodgers Said in Denver, and Why It Stayed With Me

In June 2023, NFL quarterback Aaron Rodgers took the stage at the MAPS Psychedelic Science conference right here in Colorado and said something that I don't think got nearly enough attention in the sport and performance psychology community. In a conversation with author Aubrey Marcus, Rodgers described his ayahuasca experience as "radically life-changing." He reflected that it gave him a deeper sense of self-love, and that "it unlocked that whole world of what I'm really here to do: to connect, to connect with those guys, and to make those bonds and to inspire people."

He also offered a comparison that I believe to be pretty captivating to listen to for performance oriented people in the audience that day. In the season prior to his first experience, he reported throwing 26 touchdowns and four interceptions; in the following season, he threw 48 touchdowns, five interceptions, and he won the MVP award that year.

Don’t get me wrong about this… I'm not suggesting that psychedelics make you throw more touchdowns. And, I am particularly allergic to such claims that psychedelics are directly causing enhanced performance on the field of play. Rodgers himself wasn't even making a simple cause-and-effect argument. What he was describing was something more nuanced and, frankly, more interesting, I think… he was talking about a shift in purpose, enhanced connection with his teammates, and apparently a newfound relationship to his inner life that happened to coincide with one of the finest seasons in his career. He was describing what psychedelic researchers would recognize as increased psychological flexibility, and what performance psychologists would recognize as a reduction in the psychological noise that gets in the way of peak performance.

Many pro athletes have reached out to Rodgers since he went public. He is far from alone in this experience, but most are not yet willing to speak about it publicly. But in my professional experience, what Rodgers talked about at the MAPS conference in 2023 has been heard by many, many athletes and performers, and according to some survey results, it appears psychedelics are common in locker rooms and board rooms across the nation.

The Eight Worldly Winds and the Hidden Cost of High Performance

There is an ancient Buddhist teaching I find myself returning to often in my work, both in sport and performance psychology as well as in psilocybin facilitation. It describes eight conditions that the human mind is perpetually blown about by, like a leaf in the wind:

Gain and loss. Pleasure and pain. Praise and blame. Fame and disrepute.

I originally learned about this teaching as being colloquially called the “Eight Worldly Winds” or aṭṭha loka dhamma. It describes the fundamental conditions that tend to disturb the equanimity of the mind. For the general person navigating ordinary life, these eight winds can be destabilizing. For the high performer? They are the daily weather.

Think about what it means to build a life around outcomes. Gain or loss with every game, every race, every evaluation cycle. Pleasure or pain tied to performance results that are, in many domains, brutally public. Praise and blame from coaches, managers, media, fans, shareholders. Fame and shame or embarassment, sometimes within the same news cycle. Athletes and executives who perform at the highest levels are not just exposed to these eight winds occasionally, but I have heard many people say for close to two decades of doing this work that they live inside them.

The psychological cost of this is real, and it is under-discussed. It flies in the face, so to speak, to those who promote mental toughness at all costs, or those who prop up hustle culture as the cause for performance success. But toughness is not the same as immunity. The accumulated weight of operating under perpetual evaluation, of tying self-worth to outcomes, of managing the gap between your public identity and your private experience, of never quite being able to put the game down… all of these things extract a toll. And for many high performers, there is simply no sanctioned space to examine that toll honestly. In my work facilitating for athletes and performers, these difficult-to-wrestle-with mental concepts are where psilocybin therapy can be genuinely extraordinary.

Psychedelics as Nonspecific Amplifiers and Why That Matters for Performers

There's a phrase in psychedelic therapy practice and research that I think deserves far more attention in performance contexts: psychedelics are nonspecific amplifiers. The phrase is often attributed to Stanislav Grof, one of the earliest and most rigorous researchers in this field. What it means, essentially, is that psilocybin doesn't impose a particular experience on you. It amplifies and brings into higher relief what is already there.

If you have never seen a gremlin before, chances are you wouldn’t see a gremlin come up in a psilocybin journey. While eating psilocybin mushrooms can often lead to hallucinatory experiences, they don’t always give you a visual that you don’t already have a pre-existing relationship with. (Would you believe, though, that if you have a long history of watching Disney movies, you may have Disney-character related visuals during psychedelic states? Interesting study by the Canadian researchers hyperlinked here).

Think of psychedelics, especially psilocybin-containing mushrooms, as having the capability of turning up the volume on your emotional material, your relational patterns, your beliefs about yourself, your relationship to uncertainty and control... the thing is, no one really knows which parts of you will be turned up during your journey. This is why we spend ample time in preparation sessions together. More on that later, though.

Here is what I find striking about that framing when applied to athletes and high performers: a person who trains daily to perform under uncertainty is already doing a version of this work. The competitor who practices visualization, manages performance anxiety, prepares for adversity, and learns to regulate themselves in high-stakes moments has developed a psychological toolkit that translates remarkably well to the psilocybin experience.

Put differently: the traits that make someone excellent at their craft, such as the enhanced capacity to tolerate discomfort, to stay present, to trust a process even when the outcome is uncertain, to enter flow states, and to truly examines their ‘edges’ are the same traits that support a meaningful and generative psilocybin journey. The performer who has learned to welcome uncertainty is, in many ways, already well-trained for this.

That said, there are a few patterns I see come up specifically in high-performing clients that are worth naming directly.

What It's Actually Like to Do This Work as a High Performer

The day is fully about you. This is highly disorienting for many people.

Many of our high-performing clients are people who have organized their daily lives around others. This usually shows up as athletes whose lives are structured around team needs, or executives whose attention seems to be inherently glued to people, problems, and organizational needs; and many of our clients have been advanced providers in medical and mental health spaces, who are used to being “the person” for their clients, patients, and their communities.

The experience of spending an entire day with nothing to accomplish, nowhere to be, no one to lead or perform for… a day to truly attend to your own interior landscape… this often is genuinely unsettling at first. There's often a kind of grief in it, actually - it feels like a recognition of how rarely they've given themselves that kind of permission.

I try to address this explicitly in our preparation sessions. We talk about what it might feel like to be the recipient of care rather than the provider of it, and we work with whatever resistance or discomfort shows up around that. We come back around to this concept as part of our “flight instructions” during the ceremony on the day of the journey, too.

The need for control is real, and it's worth examining together.

High performance almost universally requires a significant degree of control orientation. Controlling your diet, your training load, your sleep, your mental state, your preparation routines. This is appropriate and adaptive in the performance environment, and with the psilocybin experience, that same orientation can become something to work with consciously. The medicine will often surface exactly the places where holding tightly is costing something.

This doesn't mean that high performers have a harder time with psilocybin. Often the opposite is true! Not to generalize, but many of the athletes and performers who have journeyed here seem to have a built-in capacity to work with discomfort, to stay curious in difficult moments, and to trust a longer process that actually serves them well.

Especially during preparation, I find it important to name control dynamics explicitly, to bring it into awareness before journey day, so it becomes something they can observe rather than something that drives the experience from behind the scenes.

The public self and the private self often live very far apart.

This is perhaps the most consistent theme I see in working with high performers. The public version of themselves (e.g., the competitor, the leader, the champion, the executive, etc.) is often extraordinarily well-developed. It's capable, confident, and well-rehearsed. The private self, though, the ‘one’ who has doubts and fears and needs and grief and wonder, that part often hasn't received nearly as much attention.

Psilocybin has a way of closing that gap. Not violently, but thoroughly. I've watched people encounter parts of themselves that they haven't visited in decades. The medicine has a particular gift, it seems, for finding the places we've stopped looking.

The inner critic is often the true opponent.

Aaron Rodgers named something at the MAPS 2023 conference that I think is one of the most underappreciated insights in high performance: psychedelics helped him confront his true opponent. We are not talking about “the defense” or the competitor across the field. He talked about confronting his inner critic, and the relationship with the voice inside that evaluates, judges, questions, second-guesses and at times, attacks.

Sport and performance psychology, as a group of social scientists and applied practitioners, has ‘known’ for a long time that the inner critic is often the most limiting factor in a talented performer's development. The research on self-compassion in athletes, particularly the work coming out of places like Stanford and the University of Texas, consistently shows that athletes who relate to themselves more kindly after failure actually perform better over time, not worse. Psilocybin therapy has a remarkable capacity to interrupt long-standing self-critical patterns, to create a kind of perspective that makes it genuinely hard to maintain the same level of contempt for yourself that you may have carried for years.

The Neurochemistry of Performance and Where Psilocybin Fits

Here is another frame I find useful when thinking about how psilocybin can support athletes, specifically. The performance arc, from preparation, to competition, to recovery, involves significant neurochemical and hormonal fluctuations. Dopaminergic activation in the lead-up to competition is anticipatory in nature. Dopamine is what is felt when you are looking forward to something, when you are starting to zone in on an upcoming event, when you become ‘dialed’ or ‘locked in.’ Adrenaline is often what accompanies activation (along with epinephrine & cortisol) during the competitive event itself. It can feel like a high-octane boost from within, like having your own brain barista serving up some triple espresso shots to the system. And then, in the aftermath of competition, a serotonergic come-down that is often accompanied by a kind of emotional flatness, or what some athletes describe as a post-competition void. Turns out there is a biological arc that parallels the psychological arc many performers feel.

This cycle, repeated over a career, tends to create what I'd describe as a kind of emotional ratcheting. The highs become the baseline expectation. The lows, which are neurobiologically normal and appropriate, start to feel pathological. And over time, many high performers find that the range of experiences they can comfortably tolerate has narrowed considerably.

What we know about psilocybin's effect on serotonin and related systems suggests that it may be particularly well-suited to address exactly this dynamic. Psilocybin's interaction with 5-HT2A receptors, and the downstream effects on dopamine and glutamate pathways, tends to create what researchers may be describing as increased psychological flexibility and openness. Essentially, an expanded range of emotional experience. In the context of the high performer's often-constrained emotional range, that expansion can be genuinely liberating.

The Post-Competitive Blues

Research on post-Olympic mental health is more extensive than most people realize. Studies have found that somewhere between 24 and 41 percent of elite and Olympic-level athletes experience clinically significant depression, anxiety, or eating disorders, including athletes who performed well. Two-time Olympic rower and gold medalist Christine Roper, in one widely circulated interview, noted that she had a harder time emotionally after her better performance than her worse one. She mentioned a common stereotype that depression only follows poor results, yet her experience was the opposite, and it points to something important.

This is the thing about the post-Olympic blues, and post-retirement depression more broadly, that I don't think gets talked about honestly enough. The denouement of a performers’ mental health is not primarily about results, it's about identity. It's about the sudden absence of the structure that has organized your entire self-concept for years, sometimes decades. It's the Eight Worldly Winds without the container that had always held them before.

Psilocybin therapy, done well, is precisely the kind of deep identity work that can support someone navigating this transition. The capacity for psilocybin to facilitate what researchers call increased meaning-making, to interrupt rigid self-narratives, to reconnect people with a felt sense of purpose beyond their role or their results, these are central to what makes this medicine so compelling for this population.

Spiritual Exploration as a Competitive Advantage

I recognize this whole idea of working alongside psilocybin with performance-oriented people is unconventional in the performance space, and working with psychedelic medicines can be frought with misuse, so this is territory on which we need to tread lightly. My hope in writing this is to convey my belief that spiritual exploration is not the opposite of competitive excellence. For many of the highest performers I've encountered in my career, their curiosity of who they are behind the logos they represent seem to be the foundation of sustainable high performance.

When Aaron Rodgers talked about psychedelics helping him understand what he was really here to do, which again was to connect, to inspire, and to make bonds through sport, I believe he was describing a clarity of purpose that is, from a sport & performance psychology perspective, exactly the kind of intrinsic motivation that predicts durable, sustainable high performance.

Extrinsic motivation, like performing for outcomes, praise, social standing, and recognition could be powerful in the short term yet brittle over time. Comparatively, intrinsic motivation, rooted in genuine meaning and connection, is what sustains people across the inevitable winters of a long career.

Psilocybin therapy has a remarkable capacity to help people access and articulate that deeper layer of motivation. To sit with the question of why they do what they do at a level that goes beneath a trophy case. And for many performers, that encounter with their own depth is not just personally meaningful but the exploration of one’s self indirectly yet powerfully changes how they compete.

The preparation work we do together attends specifically to the patterns that show up in high performance contexts. We talk about the control orientation, the public-private self split, the inner critic, the relationship to outcomes and identity, all sorts of things! We build a container that honors both the clinical rigor of the process and the particular interior landscape of someone who has spent their life in pursuit of excellence. And then, on journey day, we trust the medicine. Because what I've observed, again and again, is that psilocybin has a particular intelligence about what a person most needs to encounter. It is not always comfortable, and it is very rarely “ordinary.” And, it has a way of finding, with something close to precision, the edges where growth is actually possible.

Adam O'Neil, PhD, is a licensed clinical psychologist and licensed Clinical Facilitator of Natural Medicine (NMCF 0000018) in Boulder, Colorado. He is the founder of The Clearing, a licensed psilocybin healing center, and Atlas Psychology. He has served as a sport and performance psychologist for three Team USA Paralympic teams and has spent 17 years working with Olympic-level athletes, executives, and high performers. This post is for informational purposes only and does not constitute medical or clinical advice. Please refer to The Clearing's medical disclaimer for full guidance.

Sources & Citations Shoutout

Rodgers, A. (2023, June 21). Remarks at Psychedelic Science 2023. Multidisciplinary Association for Psychedelic Studies (MAPS) conference, Denver, CO. As reported by NBC News, CBS Colorado, and AP News.

Dames, S., Grewal, H., Garcia-Barrera, M. A., & Garcia-Romeu, A. (2024). Exploring psychedelic use in athletes and their attitudes toward psilocybin-assisted therapy in concussion recovery. Journal of Psychedelic Studies.

Pang, J., et al. (2024). Efficacy and acceptability of psilocybin for primary or secondary depression: A systematic review and meta-analysis. Frontiers in Psychiatry, 15, 1359088.

Madden, K., et al. (2024). Psilocybin for clinical indications: A scoping review. Journal of Psychopharmacology.

Howells, K., & Lucassen, M. (2018). Post-Olympic blues — the diminution of celebrity in Olympic athletes. Psychology of Sport and Exercise, 37, 67–78.

Samuel, R. D., Tenenbaum, G., & Bar-Mecher, H. (2016). The post-Olympic transition: An exploratory examination of Israeli Olympic athletes. Journal of Clinical Sport Psychology.

Hu, C. (2024, February 2026). For Olympic athletes, first come the Games, then come the post-Olympics blues. Scientific American.

Roper, C. (as cited in Hu, C., Scientific American, 2026). Post-Olympic depression interview.

Frontiers in Systems Neuroscience (2025). Neurobiology of psilocybin: a comprehensive overview. doi:10.3389/fnsys.2025.1585367

Grof, S. (1980). LSD psychotherapy. Hunter House. (Origin of the 'nonspecific amplifier' framing.)