Elfrink Steven, Bergin Leigh
OmTerra, Oregon, OR, United States.
Department of Psychology, University of Exeter, Exeter, United Kingdom.
Front Psychol. 2025 Mar 4;16:1528253. doi: 10.3389/fpsyg.2025.1528253. eCollection 2025.
This paper introduces the hypothesis of Psychedelic Iatrogenic Structural Dissociation (PISD), proposing that psychedelics may reactivate dissociated traumatic material, increasing the risk of psychological destabilization in trauma-exposed individuals. Grounded in structural dissociation theory, this framework suggests that psychedelics can disrupt the balance between daily functioning (the Apparently Normal Personality, ANP) and trauma-related responses (the Emotional Personality, EP), leading to the resurfacing of unintegrated memories. A review of recent studies highlights persistent adverse effects associated with psychedelic use, including emotional dysregulation, identity fragmentation, derealization, and perceptual disturbances, particularly among individuals with early trauma histories. To mitigate these risks and facilitate trauma processing, integration practices, body-focused therapies, and structured social support systems are proposed as key interventions. Additionally, emerging neurophysiological models suggest that psychedelics may reconfigure dissociative processes through the modulation of entrenched patterns, potentially facilitating trauma integration or increasing vulnerability to destabilization, depending on individual and contextual factors. These findings underscore the necessity of trauma-informed screening, preparation, and integration protocols to enhance the safety and efficacy of psychedelic therapies, particularly for vulnerable populations.
本文介绍了致幻剂医源性结构解离（PISD）假说，提出致幻剂可能会重新激活解离的创伤性材料，增加受过创伤的个体心理不稳定的风险。基于结构解离理论，该框架表明致幻剂会破坏日常功能（表面正常人格，ANP）和创伤相关反应（情感人格，EP）之间的平衡，导致未整合记忆的重新浮现。对近期研究的回顾突出了与使用致幻剂相关的持续不良影响，包括情绪失调、身份认同破碎、现实解体和感知障碍，尤其是在有早期创伤史的个体中。为了减轻这些风险并促进创伤处理，建议将整合实践、身体聚焦疗法和结构化社会支持系统作为关键干预措施。此外，新兴的神经生理学模型表明，致幻剂可能通过调节根深蒂固的模式来重新配置解离过程，这可能会促进创伤整合，也可能会根据个体和情境因素增加不稳定的易感性。这些发现强调了采用创伤知情筛查、准备和整合方案的必要性，以提高致幻剂疗法的安全性和有效性，特别是对于弱势群体。
