1 Psychology and human development1.2 Awareness, sleep and consciousness
1.2.4 Altered states of consciousness
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
What they are
An altered state of consciousness changes attention, perception, the sense of self or awareness of the surroundings, compared with ordinary waking experience.
Dissociation breaks the usual joining-up of awareness, memory, identity or perception. It can happen while the person stays fully awake.
Main types
State | What changes | What to establish in assessment |
|---|---|---|
Meditation or absorbed prayer | Attention and the sense of self | Voluntary practice, context and impact |
Trance | Awareness narrows and the sense of control over actions changes | Accepted practice or unwanted impairment |
Psychedelic state | Perception, sense of time and the boundary of the self | Substance, dose, setting and time course |
Dissociative state | Feeling detached from experience, or gaps in it | Amnesia, depersonalisation or derealisation |
Psychedelics
Classic psychedelics act mainly through serotonin 5-HT2A receptor signalling. Their effects differ from the sedation caused by central nervous system depressants.
Assessment
Assess religious and spiritual experiences within the person's culture, beliefs and context. Unfamiliar content alone does not make an experience an illness.
Consider what the experience means to the person alongside distress, impairment, risk, substance exposure, sleep loss and physical illness.