A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics

This paper is an integrative, theoretical review rather than a report of a single empirical trial; the extracted text does not provide a systematic search strategy or explicit inclusion/exclusion criteria. Instead, the researchers articulate a methodological framework (Box 1) for combining rigorous first-person phenomenological methods with second- and third-person neurophysiological measurements when studying NSCs. Central to the NP approach is training or assisting participants to become reflectively aware of the dynamic, processual features of their experience, enabling the derivation of experiential categories that can be used to guide analysis of neural data. Box 1 (as summarised in the text) stresses iterative, disciplined first-person elicitation—often via skilled interviewers or participants with contemplative training—to reveal tacit, preverbal, and prereflective aspects of experience. These experiential clusters are then mapped onto neural or psychophysiological dynamics to reduce inter- and intra-subject ‘noise’. The authors also describe practical strategies to increase report reliability, including using participants trained in attention/awareness (for example, meditators) and standardised interview protocols. Box 2 in the text provides working definitions of the three practice domains discussed. Hypnosis is described as a procedure of verbal suggestion that typically involves focused attention and increased responsiveness to suggestion; meditation is presented as a broad family of practices that cultivate meta-awareness, attention stability, and cognitive defusion, with multiple subtypes (mindfulness, compassion, analytical) having different mechanisms and outcomes; psychedelics are defined pharmacologically (primarily 5-HT2A agonists) and phenomenologically (visions, altered meaning, mystical-type experiences), and are noted for renewed clinical and mechanistic interest. Across the review, the authors draw on examples from neuroimaging (fMRI, MEG, EEG), neurofeedback, phenomenological interview studies, and clinical trials to illustrate the NP approach and its potential benefits for linking experience to brain dynamics.

Applying the NP perspective to the literature yields repeated observations about how different NSCs perturb experiential structure and content and how these perturbations map to neural signatures. The review organises empirical findings around three exemplar structural features: sense of agency, physical pain, and the sense of self. Sense of agency: Hypnotic suggestion can induce experiences of involuntariness and automaticity in highly suggestible individuals, with associated changes in parietal regions (for example, reduced activity in the supramarginal gyrus and increased activity in the parietal operculum) and correlations between posterior cingulate cortex (PCC) activity and hypnotisability. Suggested loss of agency is also linked to reduced supplementary motor area activation. Meditation exerts variable effects depending on style: some studies (e.g., using Libet-style paradigms) report heightened awareness of action impulses in meditators, whereas practices emphasising ‘letting-go’ can attenuate agency and ownership. Psychedelics acutely diminish agency and promote ‘letting-go’; extreme reductions in agency (for example, possession experiences) are described in ritual contexts. Physical pain: Mindfulness meditation is reported to decouple sensory-discriminative aspects of pain (intensity) from affective unpleasantness, a process linked to increased insula and dorsal anterior cingulate cortex (aMCC) activity and decreased lateral prefrontal activation during pain anticipation and processing. Open monitoring reduces unpleasantness but not intensity, and reduced pain catastrophising correlates with these neural patterns. Hypnosis can modulate both sensory and affective pain components, showing decreases in classical ‘pain matrix’ regions and altered anterior cingulate cortex connectivity with nociceptive circuits. Historical reports and small studies suggest psychedelics may reduce chronic pain (e.g., phantom limb, cluster headaches), with hypothesised psychological (acceptance, imagery) and neural (reorganisation, 5-HT2A-mediated) mechanisms, but the authors note that mechanisms are not yet well elucidated. Sense of self: Psychedelics reliably perturb both narrative and minimal aspects of selfhood, producing ego-dissolution, unity, and disembodiment. Neuroimaging links these effects to altered Default Mode Network (DMN) function—reduced metabolism, oscillatory power, and connectivity among medial prefrontal cortex (mPFC), PCC, and medial temporal areas—as well as changes in multisensory, interoceptive, and somatomotor systems (insula, cerebellum, TPJ). Hypnotic induction can modulate self-related awareness (internal vs external focus) and, with targeted suggestions, induce out-of-body experiences with TPJ deactivations. Mindfulness practices attenuate narrative self-referencing with concomitant DMN decreases. Neurophenomenological (NP) studies: Empirical NP work—combining in-depth first-person reports with neuroimaging—has demonstrated added explanatory power. Examples include real-time fMRI neurofeedback during focused-attention meditation showing PCC deactivation during effortless awareness but PCC activation with ‘efforting’ or distraction, a dissociation that emerged only when subjective reports were considered. MEG and EEG NP studies have linked experiential categories to spectral signatures: reductions in alpha power and increases in delta/theta power accompany intense visual imagery in both psychedelic and hypnotic NP studies; central/parietal beta-band reductions correlate with reduced bodily awareness (minimal self); visual imagery intensity inversely correlates with alpha and positively with delta/theta in a DMT NP study. A MEG study of meditators used phenomenologically guided grouping (timelessness/spacelessness/OBE) to dissociate neural patterns (e.g., right TPJ and insula theta power differences, cerebellar activity, PCC theta reductions) across experiential subtypes. Cross-domain overlaps and state-to-trait effects: Evidence suggests convergent impacts on the DMN across hypnosis, meditation, and psychedelics, though patterns vary by practice and timescale. Psychedelics and meditation can induce both acute DMN decreases and longer-term alterations in connectivity that correlate with improved psychological outcomes; a study combining psilocybin with meditation reported decreased mPFC–PCC coupling during open awareness two days post-retreat, and these neural changes predicted psychosocial improvements at 4 months. Personality and clinical outcomes reported in the literature include increased openness and agreeableness and decreased neuroticism after psychedelics, reduced pain catastrophising and prosocial changes with meditation expertise, and the potential to increase hypnotic suggestibility via training. Clinically, preliminary trials indicate psychedelics plus psychological support can reduce depression and anxiety symptoms (including comparisons reporting psilocybin comparable to escitalopram in one report), and reduce substance use (drinking, smoking); however, these findings are characterised as preliminary. The authors note context (‘set and setting’) and practitioner know‑how substantially modulate acute experiences and downstream outcomes; for example, baseline traits such as absorption, openness, and readiness to surrender, and features like music choice, predict psychedelic session phenomenology and longer-term effects. Adverse and ethical considerations: The review recognises that NSCs can produce adverse psychological reactions (anxiety, challenging experiences) and that whether an NSC is experienced as therapeutic or harmful depends heavily on context, appraisal, and integration procedures. Hypnotic responsiveness varies in the population (about 10-15% highly suggestible), and contextual factors such as rapport, expectations, and framing influence outcomes across domains.

Timmermann and colleagues interpret their synthesis as arguing that a neurophenomenological approach can address several persistent limitations in consciousness research by making the dynamics of experience experimentally accessible and better linked to neurobiology. They propose that disciplined first-person methods—especially when paired with participants skilled in introspective practices or guided by skilled interviewers—allow researchers to unpack content versus structural changes in experience and to explain inter- and intra-subject variance that is otherwise treated as noise. The authors position NP as complementary to existing neuroscientific approaches: rather than seeking brain-bound correlates in isolation, NP emphasises the embeddedness of experience across brain, body, and socio-cultural context. They argue that NSCs are useful perturbations for interrogating process-based features of consciousness (for example, agency, selfhood, pain), and that integrating experiential know-how and contextual scaffolding is essential both for rigorous research and for safe, effective therapeutic application. Key limitations and uncertainties acknowledged include the relative paucity of integrative empirical NP studies, the lack of standardised, precise measures across NSC research, and incomplete understanding of mechanisms by which acute NSC-induced changes translate to sustained trait-level outcomes. The authors call for longer-term neuroimaging work, improved methods for integrating first-, second-, and third-person data, and efforts to determine whether common computational accounts (for example, predictive processing or free energy principles) can unify disparate NSC phenomena. Ethical considerations are explicitly discussed: NSCs can both alleviate suffering and precipitate harm, and their valence depends on context, appraisal, and practitioner competence; consequently, the authors stress the importance of experience-based know-how, culturally informed practices, and safeguards when translating NSC methods into clinical settings. For future research and application, the authors highlight several implications: need for standardised experiential measures, methodological work to combine qualitative phenomenology with quantitative neural and behavioural data, investigation of contextual variables (rituals, music, facilitation) that shape outcomes, and exploration of whether coupling techniques (for example, combining suggestion or meditation with psychedelic therapy) augments efficacy. They present these as a research agenda rather than definitive claims about therapeutic mechanisms.

In their concluding remarks the authors reiterate that integrative research into NSCs remains limited and that many questions about experiential and neural overlaps, theoretical placement within consciousness science, state-to-trait mechanisms, and contextual interdependence persist. They conclude that adopting the neurophenomenological approach could make relationships between subjective experience and neurobiology more accessible, falsifiable, and potentially reproducible, thereby advancing consciousness research and informing clinical applications, while acknowledging substantial empirical work still required to realise this potential.