Navigating the Dissociative Risks of Psychedelic Use: A Trauma-Informed Perspective

Psychedelic therapy is making waves in mental health treatment, showing promise for conditions like PTSD, depression, and addiction. However, recent research raises an important consideration: the potential for psychedelics to activate dissociative states, especially in individuals with unresolved trauma. The concept of?Psychedelic Iatrogenic Structural Dissociation (PISD)?explores how psychedelics might disrupt psychological stability, bringing unprocessed trauma to the surface in ways that could either promote healing or lead to distress and fragmentation. In a recent study by Steven Elfrink and Leigh Bergin on Frontiersin.com the authors explore this concept. Click here for full study What follows is a general summary of their findings.

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Understanding Structural Dissociation

The theory of?structural dissociation?suggests that trauma divides the psyche into two core aspects:

• Apparently Normal Personality (ANP)?– manages daily life but avoids traumatic memories.
• Emotional Personality (EP)?– stores trauma-related responses and emotions.

For individuals with a history of trauma, these divisions can become rigid, making it difficult to integrate distressing experiences. Psychedelics, known for their ability to dissolve ego boundaries and increase neuroplasticity, can temporarily destabilize these structures. This can lead to profound breakthroughs—but also psychological distress if not handled with care.

The Risks: When Psychedelics Uncover Trauma

Studies indicate that some users experience?long-lasting emotional distress, identity confusion, and dissociation?after a psychedelic experience. Reports include:

• Emotional dysregulation?– Anxiety, depression, and intrusive negative thoughts post-experience.
• Existential distress?– A crisis of self-perception, leading to derealization and depersonalization.
• Persistent perceptual changes?– Hallucinogen Persisting Perception Disorder (HPPD) in some cases.
• Flashbacks?– Unwanted reliving of psychedelic-induced experiences, sometimes linked to past trauma.

Trauma-Informed Approaches to Psychedelic Use

To minimize these risks and maximize the benefits of psychedelic therapy, trauma-informed strategies are essential:

1.?Rigorous Screening

Before engaging in psychedelic experiences, individuals should be assessed for?dissociative tendencies and trauma history. Tools like the Dissociative Experiences Scale (DES) can help identify at-risk individuals.

2.?Preparation and Safe Set & Setting

Intentional?preparation and integration practices?create a container for the experience. Having a trained guide or therapist, setting clear intentions, and ensuring a supportive physical and emotional environment can mitigate risks.

3.?Body-Centered Integration

Modalities such as?breathwork, somatic therapy, yoga, and trauma release exercises?can help process difficult emotions and reconnect with the body after a psychedelic journey.

4.?Structured Social Support

Psychedelic experiences can be isolating if difficult emotions arise afterward. A?supportive community, integration circles, or therapy?can provide a safe space to process what emerges.

Moving Forward: Psychedelics as a Tool, Not a Cure

Psychedelics have immense potential to aid in trauma healing, but they are?not a one-size-fits-all solution. When used responsibly with trauma-aware guidance, they can foster profound personal transformation. However, without proper support, they may trigger or intensify dissociative responses.

As the psychedelic field grows, ensuring?trauma-informed protocols and ethical considerations?will be key to making these substances a safe and effective tool for mental health.

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