Psychedelic Therapy and Its Potential to Induce Visual Imagery in Individuals with Aphantasia

Recent research conducted by psychologists at UNSW Sydney and Macquarie University highlights a significant consideration in the field of psychedelic therapy. While psychedelics like psilocybin, LSD, MDMA, and ketamine have shown promising results in treating conditions such as treatment-resistant depression, PTSD, anxiety, and substance use disorders, new findings suggest potential risks for individuals with aphantasia—a condition characterized by an inability to generate mental visual imagery.

Aphantasia, often described as having a "blind mind's eye," involves recalling personal memories with fewer details and lacking the vivid visual components typical in the general population. Interestingly, emerging reports, including case studies and anecdotal accounts, indicate that some individuals with aphantasia have experienced the sudden acquisition of visual mental imagery after a single dose of psychedelics like ayahuasca or psilocybin. These individuals report positive experiences during and even up to a year after the sessions.

The scientific article, "The potential risks of opening the mind's eye with psychedelic therapies," published in Cortex, raises concerns about this phenomenon. It emphasizes that psychedelic-assisted therapy should involve comprehensive informed consent, clearly explaining the possible induction of imagery, especially for people with aphantasia, who may not anticipate developing visual mental imagery. The induction of such imagery can be a source of emotional amplification, which might trigger intrusive thoughts, distress, or exacerbate conditions like PTSD, depression, or hallucinations.

Mechanistically, psychedelics such as psilocybin and LSD activate serotonin 5-HT2A receptors, leading to neuroplasticity and reorganization of neural networks involved in imagery and perception. Studies have demonstrated increased activity in the visual cortex during psychedelic experiences and altered visual network dynamics, which may explain the emergence or intensification of mental imagery. For individuals with aphantasia, who typically show reduced connectivity between relevant brain regions, this sudden activation could pose unforeseen psychological risks.

The authors urge practitioners and patients to consider the potential for imagery-related intrusive thoughts or memories during psychedelic therapy. In particular, the risk that these visual experiences could serve as emotional triggers linked to distress or maladaptive memories underscores the importance of thorough pre-treatment assessments and transparent discussions about possible outcomes.

While some evidence suggests that controlling or blocking visual imagery shortly after trauma can lessen symptoms, the unanticipated onset of imagery in individuals treated with psychedelics could have adverse effects. Furthermore, the connection between imagery, neuroplasticity, and neuropsychiatric conditions highlights the need for cautious, personalized approaches in psychedelic-assisted treatments.

Overall, this research underscores an essential ethical dimension: full disclosure of potential effects, including the development of visual imagery in those with aphantasia, should accompany psychedelic therapy protocols. Further studies are needed to understand the neurobiological mechanisms behind imagery induction and to develop strategies for managing its psychological impacts.

Source: https://medicalxpress.com/news/2025-08-psychedelic-therapy-trigger-visual-imagery.html