From Destabilization to Scientific Insights: Psychedelic Iatrogenic Structural Dissociation

PISD Elfrink

Psychedelic therapy is often celebrated for its capacity to catalyze profound healing, but what happens when it unearths more than the system is ready to hold? In this compelling session, Steve Elfrink traces the origins of the PISD hypothesis back to his own destabilizing ayahuasca experience—one that triggered a cascade of emotional flooding, depersonalization, and the emergence of early developmental trauma. Rather than pathologizing the experience or dismissing it as a “bad trip,” Steve turned to trauma science to make sense of what had occurred, drawing particularly from the theory of structural dissociation.

Join us for a powerful and clinically informed webinar with Steven Elfrink, founder of OmTerra and co-author of the newly published hypothesis on Psychedelic Iatrogenic Structural Dissociation (PISD), recently featured in Frontiers in Psychology.

Through the lens of personal story, clinical research, and somatic psychology, this webinar will explore how psychedelics may dissolve dissociative defenses too quickly in trauma-exposed individuals, leading to overwhelming internal experiences and what Steve calls psychedelic iatrogenesis. Attendees will learn about the roles of the Apparently Normal Personality (ANP) and Emotional Personality (EP), how these parts can become destabilized in expanded states of consciousness, and why trauma-informed pacing and containment are critical for safe, effective psychedelic work. Steve will also reflect on his decades of experience in the field, including his co-founding role in the development of the PSIP (Psychedelic Somatic Interactional Psychotherapy) protocol and his current work as a licensed psilocybin facilitator in Oregon.

Grounded in frameworks like Internal Family Systems and structural dissociation, this conversation offers a timely re-evaluation of what “healing” truly requires in psychedelic contexts. Don’t miss this opportunity to explore how psychedelic journeys can both heal and harm—and how we can meet this paradox with care, clarity, and embodied presence.

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