Some people come out of a psychedelic experience worse than they went in. That is what I study.
Most of that work sits in one place. In 2025 I published the Psychedelic Iatrogenic Structural Dissociation hypothesis in Frontiers in Psychology, co-authored with Leigh Bergin at the University of Exeter. It proposes that psychedelics can reactivate dissociated traumatic material and destabilize people carrying unresolved trauma.
It is not an argument against psychedelics. It is an argument for understanding what happens when the system opens more than it can hold. I think it is one of the most important conversations the field is not having.
The PISD hypothesis
What the four words mean.
Structural dissociation theory describes what trauma does to a self over time. Some experiences are too large to integrate in the moment they happen, so the system walls them off and keeps enough of itself running to get through the day. A psychedelic, in the right setting, can dissolve those walls. For some people that is the point. For others the walls come down faster than the system can rebuild them.
- PsychedelicThe experience that set it off.
- IatrogenicCaused by the thing meant to help. The word describes a cause. It does not assign blame.
- StructuralIt reaches the structure holding a person together, not a passing mood.
- DissociationThe distance the mind puts between a person and what was too much to feel.
Frontiers in Psychology, Volume 16, March 2025. Hypothesis and Theory.
Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use
Open access, CC BY. doi.org/10.3389/fpsyg.2025.1528253
Publications
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Elfrink, S., and Bergin, L. (2025). Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use.
Frontiers in Psychology, 16:1528253. Peer reviewed, open access. 10.3389/fpsyg.2025.1528253
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Razvi, S., and Elfrink, S. (2020). Psychedelic Somatic Interactional Psychotherapy.
Journal of Psychedelic Psychiatry, Vol. 2, Issue 3. ISSN 2690-0912.
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Elfrink, S. Psychobiological capacity and the foundations of mental wellbeing.
Manuscript in preparation.
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Elfrink, S. The dissociative destabilization cascade: a falsifiable model of post-catalyst destabilization.
Manuscript in preparation.
Research frameworks
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Psychedelic Iatrogenic Structural Dissociation (PISD)
A proposed etiological pathway. Psychedelic exposure relaxes dissociative containment faster than the system can stabilize and integrate what comes through. Published, peer reviewed, 2025.
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Dissociative Destabilization Cascade (DDC)
The broader syndrome. PISD is one route in. What disintegration looks like when capacity is exceeded, whether by psychedelics, intensive contemplative practice, illness, sleep loss, or relational rupture. The model carries pre-registered predictions and can be falsified.
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Psychobiological capacity
The body's physiological ability to absorb, regulate, and integrate experience over time. The organizing concept underneath the other two.
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3D Healing
A conceptual map of suffering across three dimensions: dissociation, dysregulation, and disconnection. Not a modality or a treatment protocol. A way of naming where a system has been overrun.
Talks and appearances
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From destabilization to scientific insights: Psychedelic Iatrogenic Structural Dissociation.
Psychedelic Support webinar, 2025. Session recap
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Psychedelics, dissociation, and trauma.
Brainforest Café with Dennis McKenna, McKenna Academy of Natural Philosophy, May 2025. Listen
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Dosing, potency, and safety in Oregon's psilocybin program.
Healing Advocacy Fund panel webinar, hosted by Bob Jesse, October 2023. Watch
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Dreaming, psychedelics, and primary consciousness.
The Dream Journal, KSQD 90.7 FM, February 2024. Listen
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Meet Oregon's first psilocybin therapy facilitators.
Jefferson Public Radio, May 2023. Reported feature. Read
Professional background
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Founder, OmTerra (2021–2026).
Independent research and publishing. Closed August 2026. Institutional affiliation of record on the 2025 Frontiers in Psychology paper.
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Former co-founder, Psychedelic Somatic Institute (2019–2021).
Training and development in psychedelic somatic therapy. No current involvement with the organization.
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Safety Committee member and advisor, Healing Advocacy Fund.
Oregon and Colorado regulated psilocybin program launches.
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Co-founder, Rogue Valley Psychedelic Society.
Southern Oregon.
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Study participant, University of Wisconsin–Madison.
FDA Phase 1 pharmacokinetic study of psilocybin, 2015.
Contact
For research correspondence, speaking, and press.
OmTerra closed in August 2026. The research and writing published under that affiliation still stands.
This page is a professional and academic record. It is not medical or psychological advice, and it does not describe a clinical service.
If you are in crisis, call or text 988 in the United States. Outside the US, contact your local emergency services or a crisis line.