Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use.
Front Psychol March 4, 2025 Steven Elfrink, Leigh Bergin 11 citations
Psychedelics may reactivate dissociated traumatic material, increasing the risk of psychological destabilization in trauma-exposed individuals. The hypothesis of Psychedelic Iatrogenic Structural Dissociation (PISD) proposes that these substances can disrupt the balance between daily functioning and trauma-related responses, leading to unintegrated memories resurfacing. A review of studies highlights persistent adverse effects such as emotional dysregulation, identity fragmentation, derealization, and perceptual disturbances, especially among those with early trauma histories. To mitigate these risks, integration practices, body-focused therapies, and structured social support are proposed. The work underscores the need for trauma-informed screening, preparation, and integration protocols to enhance safety and efficacy.