Psychedelics and Somatic Flashbacks

When we hear the word “flashback”, we picture the visual: a soldier, traumatised by war, seeing the battlefield superimposed over the supermarket carpark, a survivor of some traumatic event, witnessing it again – like watching a movie. For many survivors of intense trauma, however, the experience of a flashback is something far less cinematic and far more visceral. While they may not see the past, they feel it intensely. These are “somatic flashbacks”. They are one of the most misunderstood and distressing aspects of trauma recovery.

Resources such as Charlie Health explain somatic flashbacks as:

reexperiencing the physical sensations or bodily responses associated with the original trauma. These bodily experiences…are more than a memory: they center on the physical sensations of past traumas.

Psychedelics are currently being considered as a means to unlock these somatic experiences. Substances like psilocybin and MDMA can turn off the brain's usual filtering mechanisms. This can force these stored physical sensations to the surface. While this offers the potential for genuine, long-lasting healing, it does open up the individual to a lot of associated risk. These risks can be both mental and physical. Allowing a rush of traumatic sensations to the surface without a clear memory of where they are reemerging from can lead to retraumatisation rather than release.

Further to this, the desperation to resolve these debilitating experiences has created somewhat of a wild west of unregulated therapies. New therapeutic frameworks like Psychedelic Somatic Interactional Psychotherapy (PSIP) claim to force the nervous system to open up. However, evidence of the effectiveness of PSIP is based largely on theory and anecdote, as opposed to clear, verified, scientific data. While, as ever with psychedelics, there is huge potential here, we cannot ignore the fact that for some, this may not be a miracle cure. It may even be just as destabilising as the condition itself.

To understand why it is that flashbacks manifest physically rather than visually, we have to distinguish between two forms of memory storage: explicit and implicit memory.

Explicit Memory: This is what you would normally think of as “remembering”. It is autobiographical, narrative, and placed within a specific time. It is stored in an area of the brain known as the hippocampus (responsible for memory and learning).

Implicit Memory: This is timeless, sensory and non-verbal. Rather than the hippocampus, implicit memory primarily involves the amygdala, which processes emotions, and the brainstem, which connects the brain to the spinal cord and is responsible for sending messages to the rest of your body to regulate balance, breathing, heart rate, etc.

When a traumatic event is too powerful or overwhelming to be processed by the hippocampus, it can effectively go offline. In doing so, it fails to timestamp the event as past, and therefore gone. This is why a memory is not stored as an element of a continuing, linear narrative. It stays as a lived reality in the present. As Dr Bessel van der Kolk, author of The Body Keeps the Score, explains, the impact of trauma isn’t experienced only in our minds but is also stored in our bodies. The threat does not dissipate; the body continues to react as if the event is occurring right now.

This physical entrapment in a past moment is often the result of what is known as the freeze fear response. When faced with a threat, the nervous system immediately assesses its options. If it is possible to fight, it fights. If it can flee, it flees. If neither of these options is available, however (for example, an individual trapped in an abusive home), the nervous system can completely shut down. This is an ancient survival mechanism. To survive unbearable situations, the body releases a flood of endogenous (internal) opioids and cannabinoids, numbing both physical and emotional pain. This is “disassociation”, a biological anaesthetic of sorts. It allows the victim to survive the traumatic moment by completely disconnecting from it. The authors of one paper write, “The individual [may feel] as if they are detached from or even floating above their physical body.”

The crucial element here in relation to somatic flashbacks is the fact that the effect of the chemical response to fight or flight does not disappear. The adrenaline and cortisol are not discharged from the system. According to theorists like Saj Razvi, of the Psychedelic Somatic Institute, this creates a highly charged state of physical repression. The trauma is still there, and the body has to expend a large amount of energy to keep the chemical response to the trauma suppressed. This can cause conditions like chronic fatigue syndrome, unexplained pain, and autoimmune issues.

To actually begin to resolve the trauma, the nervous system must leave the state of disassociation. In doing so, it re-enters the original state of terror/pain/fear, which the endogenous chemicals masked. This explains why these somatic flashbacks can feel so life-threatening in the moment. The body is literally metabolising the past fear response in the present. This could be years, even decades, on from the original occurrence.

In his book LSD Psychotherapy, Dr Stanislav Grof described psychedelics as “nonspecific amplifiers” of the psyche. This is reflected in the name given by Humphry Osmond to this group of substances; the Greek word “psychedelic” translates literally as mind-manifesting.

The effects of substances like psilocybin, LSD, and DMT are a result of their impact on the Default Mode Network (DMN). The DMN can be explained as the conductor of the brain, maintaining our coherent sense of self and the linear narrative of our experience – the “core of consciousness”. It keeps the raw data of sensory experience in check. Psychedelics lower the effect of the DMN, removing the boundaries between self and other. For a survivor of trauma, this effectively means that the barriers the brain has erected against their pain are suddenly removed.

There is a pervasive cultural myth that psychedelics are inherently therapeutic, in and of themselves. This often presumes that these substances possess a specific intelligence which guides the user towards healing. However, prominent figures in the space, such as Rus Devorah, dispute this, stating that “psychedelics are not inherently therapeutic. They are amplifiers.” Herein lies both their power and potential risk. If a person is carrying a vast reservoir of unresolved trauma, a psychedelic can act as a release valve. In some circumstances, this can be incredibly positive, resulting in a necessary release of pressure and subsequent healing. Devorah explains, “For trauma survivors, amplification can just as easily re-open wounds as it can heal them.”

Without adequate safety measures, psychedelics can be akin to fighting fire with fire. Instead of releasing the trauma, a poorly managed psychedelic experience could potentially reinforce the neural pathways relating to the terror of the experience. This will leave an individual re-traumatised, which is even harder to resolve than the original repression.

The risk profile for this potential occurrence varies significantly depending on the particular substance used. MDMA, for example, is often described as an “empathogen” (promoting emotional, social effects), rather than a traditional psychedelic. MDMA is often preferred in trauma therapy because it reduces activity in the amygdala (where the fear response is located in the brain). This allows trauma survivors to revisit somatic memories with a sense of safety and compassion, which is impossible during the event itself.

Substances like cannabis and ketamine have also been utilised in this context to break the disassociated, freeze response. In doing so, individuals may be able to begin to “thaw” the freeze. However, while this is a possibility, there is also the risk that this chemical removal of the only coping mechanism they possess could be terrifying. Basically, it appears to be a very fine line between therapeutically helpful and dangerous.

While theoretical models provide a framework for understanding somatic flashbacks in relation to psychedelic experiences, recent data have begun to actually quantify the phenomenon. A recent study titled ‘Recalled childhood trauma and post-psychedelic trajectories’, published in Scientific Reports in November 2025, offers the most comprehensive analysis to date.

The researchers surveyed 608 individuals who had experienced extended difficulties following psychedelic use. The findings were stark: 41.8% of these respondents explicitly linked their ongoing difficulties to a traumatic experience from their childhood or youth, which resurfaced during the trip. This suggests that for a significant minority of users, the well-known phenomenon of the “bad trip” may not simply be a period of anxiety, as a direct result of the substance. It may rather be an encounter with a historical wound, facilitated by the effects of the substance.

The demographic profile of this group offers further insight into who is potentially most at risk. The study found that those who linked their difficulties to resurfaced trauma were significantly older and predominantly female (57.7%, compared to 39.2% in the non-trauma group). On top of that, 73.8% of this group had a prior mental health diagnosis, compared to 50.2% of those who did not link trauma to their difficulties.

Perhaps the most unsettling finding, in terms of employing psychedelics therapeutically, however, relates to the context of use. Conventional wisdom holds that adequate “set and setting” mitigates risk. However, those who had a prior mental health diagnosis were significantly more likely to have used psychedelics in a guided or ceremonial setting (36.3% compared to 21.5%). Users with a history of trauma may be actively seeking out guided healing, only to find that the provisions made are still insufficient to hold the magnitude of what emerges.

The study also provided a detailed description of how this trauma manifests, identifying three distinct phenomenological modes:

• The first, reported by 39% of the interview participants, was “direct trauma re-experiencing". These individuals vividly relived specific events, with three explicitly stating that the trauma they re-experienced had not been previously recalled in conscious memory prior to the psychedelic session.
• The second mode, affecting 22% of participants, was “symbolic/somatic re-embodiment". Here, the memory was not visual but physical; participants reported intense shaking, pain, or convulsions that they interpreted as the body shaking off a past threat, like animals are known to do in nature.
• The final and most prevalent mode, reported by 50% of participants, was "fragmentation and confusion". This state was defined by cognitive disintegration, confusion, and a profound inability to make sense of the sensory overload, leaving the user in a state of groundless terror rather than insight.

One of the worst forms of distress identified in the study was what is known as “ontological shock”. This is the anxiety of not knowing whether a resurfaced memory is real. Psychedelics possess what William James famously called a "noetic quality". This can lead “people to feel as though what is intuited or perceived in this state has the quality of feeling real – often somehow “more real” than one's ordinary state of mind.” 

When this feeling of absolute truth attaches itself to a vague somatic sensation, such as pressure on the chest or a feeling of suffocation, the mind may rush to construct a narrative to explain it. A feeling of tightness becomes a memory of restraint, a sensation of nausea becomes a memory of poisoning. This can effectively create false memories.

This ambiguity presents a severe ethical challenge for clinicians. If a client "remembers" abuse by a family member during a session based solely on a feeling, treating it as legal fact can destroy families and relationships. However, dismissing it risks gaslighting the survivor.

Integration therapists such as Dee Dee Goldpaugh advocate for a nuanced approach that prioritises "biological truth" over "historical truth". Goldpaugh suggests telling clients, "We may never know for sure what exactly happened to you, but I will do my best to help your body to heal from the trauma it is holding." This approach validates the reality of the nervous system's distress, which is undeniable, without committing to a potentially inaccurate reconstruction of the past. By focusing on the somatic release rather than the narrative details, therapy can proceed safely. The important thing is acknowledging that the body is expressing a valid, real pain, regardless of how the mind is explaining it.

Traditional talk therapy has done little to solve the issue of somatic flashbacks. This has promoted new experimental treatments, as people seek out a means of healing their unresolvable trauma. Foremost among these is Psychedelic Somatic Interactional Psychotherapy (PSIP). This was developed by the Psychedelic Somatic Institute. It represents a pretty radical departure from the methods of traditional psychedelic-assisted therapy (incidentally, a field which itself is still in its complete infancy).

Usually, a patient/client lies passively, wearing eyeshades while a therapist holds space. In PSIP, however, the process is extremely active. It uses cannabis or ketamine to break the dissociation from the trauma. It aims to forcibly strip away the biological anaesthetic and encourage the nervous system to process the frozen trauma response.

Proponents such as Saj Razvi, founder of the institute, argue that this is the only way to reach the root of complex PTSD. Dramatic video footage of clients shaking and convulsing is often cited as evidence of successful release.

However, the legitimacy of PSIP remains controversial. It exists in the unregulated realm of psychedelic wellness. Unlike MDMA-assisted therapy, which is undergoing rigorous Phase 3 clinical trials, PSIP has zero large-scale studies to validate its effectiveness. Its evidence is largely anecdotal and theoretical, relying solely on the clinical observations of its founders. This is murky. In medicine, the burden of proof lies with the claimant. In the psychedelics space, charismatic proponents of therapeutic frameworks can gain traction through podcasts and social media. With a single Google search, we can quickly see that Saj Razvi, while completely lacking in clinical data, is a regular on the podcast circuit.

Critics argue that PSIP very much operates on “guru” logic, rather than medical science. A cursory review of various practitioner websites reveals a blend of high-pressure marketing, expensive (unaccredited) training certifications, and sweeping claims. This obvious commercialisation, combined with an apparent lack of oversight, raises serious ethical red flags. The training appears brief and expensive, creating a pipeline of what amounts to pretty much unqualified practitioners. They lack the clinical experience and expertise required to tackle trauma of any kind, let alone the severity of somatic flashbacks. The fact that they will be responsible for a patient/client with severe trauma, in a chemically altered, extremely vulnerable state, carries a frankly massive risk of making the condition much, much worse.

If an unskilled therapist projects their ill-educated agenda onto a client who has been chemically stripped of their defences, the potential for psychological harm is immense. I will say once more to make this perfectly clear:

Removing the only coping mechanism which severely traumatised people have without a hospital-grade, clinically sound safety net is either an act of extreme hubris, deception, or lack of understanding.

Psychedelics are not merely mind-manifesting, they are body-manifesting. They act as a kind of high-powered light that reveals what is hidden inside the nervous system. Somatic flashbacks are a testament to the body's capacity to record history, holding onto threats long after they have passed. While the resurfacing of this material offers a profound opportunity to release chronic tension and resolve lifelong patterns, it is a double-edged sword. As the data indicates, a significant minority of users walk away from psychedelics not with relief, but with fresh wounds.

The field is currently a minefield of unproven frameworks and "guru" therapists operating in an unregulated landscape. While frameworks like PSIP offer intriguing theoretical promise, their lack of clinical validation and the high risks involved in aggressive somatic interventions demand extreme caution.

Trauma recovery requires more than just a chemical catalyst; it requires a framework of safety, somatic literacy, and a robust support system. Without these, the body's attempt to speak can easily become an out-of-control scream. True integration is not just about remembering the past, but about building a present safe enough to hold it.

David is one of our community bloggers here at Chemical Collective. If you’re interested in joining our blogging team and getting paid to write about subjects you’re passionate about, please reach out to Sam via email at [email protected]