The Emperor's New Diagnoses: Psychedelics, Psychosis, and the Limits of Psychiatric Distinctions
June 6, 2026 Maja Willard preprint
Psychedelic and psychotic experiences are often treated as separate, but they share phenomenological and cultural features. Visual hallucinations dominate in psychedelic states, while auditory hallucinations are more common in psychosis. Insight and context influence both experiences, and clinical responses differ. The causal question of whether psychedelics can induce psychosis remains unresolved, as different studies address different aspects. The author argues that psychosis research could benefit from psychedelic science's focus on subjective experience, meaning-making, set and setting, and impartial care. The comparison highlights what current evidence does and does not support, with implications for how psychiatry studies and responds to altered states.