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HYPOTHESIS AND THEORY article
Front. Psychol.
Sec. Theoretical and Philosophical Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1528253
Psychedelic Iatrogenic Structural Dissociation (PISD): An Exploratory Hypothesis on Dissociative Risks in Psychedelic Use
Provisionally accepted- 1 OmTerra, Oregon, United States
- 2 University of Exeter, Exeter, United Kingdom
This paper introduces the hypothesis of Psychedelic Iatrogenic Structural Dissociation (PISD), proposing that psychedelics may amplify access to dissociated traumatic material, increasing the risk of psychological destabilization in trauma-exposed individuals. Grounded in structural dissociation theory, the PISD framework suggests that psychedelics may disrupt the dynamic between the "Apparently Normal Personality" (ANP) and the "Emotional Personality" (EP), reactivating unintegrated traumatic memories. Analysis of recent studies highlights enduring adverse effects associated with psychedelic use, including emotional dysregulation, identity fragmentation, derealization, and perceptual disturbances, particularly among individuals with early trauma histories. Integration practices, body-focused therapies such as Psychedelic Somatic Interactional Psychotherapy (PSIP), and structured social support systems are proposed as essential strategies for mitigating risks and facilitating trauma processing. Neurophysiological models, including Canalization, TEMP, and REBUS, elucidate how psychedelics may enhance neural plasticity to recalibrate entrenched dissociative patterns, while also underscoring the dual-edged potential of these substances. These findings emphasize the importance of trauma-informed screening, preparation, and integration protocols to enhance the safety and efficacy of psychedelic therapies, particularly for vulnerable populations.
Keywords: Psychedelic therapy, Trauma, dissociation, Structural dissociation, dissociative symptoms, adverse effects, Trauma-informed care, Psychedelic Iatrogenic Structural Dissociation
Received: 14 Nov 2024; Accepted: 11 Feb 2025.
Copyright: © 2025 Elfrink and Bergin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Steven Elfrink, OmTerra, Oregon, United States
Leigh Bergin, University of Exeter, Exeter, United Kingdom
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