“Diversity makes the richness of humanity”: The emergence and persistence of mental imagery after self-reported psilocybin truffles intake in an autistic woman with “blind imagination” (aphantasia): A 33-month retrospective case report

Abstract This 33-month retrospective case report explores the impact of psilocybin truffle intake on the emergence (and persistence) of mental imagery in an autistic woman with aphantasia. Aphantasia refers to the inability to generate visual mental images, which can significantly affect individuals' experiences and cognitive processes. The case study focuses on a 34-year-old autistic woman who had been living with aphantasia since childhood. After consuming psilocybin truffles, she reported experiencing vivid mental imagery for the first time, with the ability to manipulate and explore images in her mind. The effects persisted even after the psychedelic effects of psilocybin subsided. To document this change, she completed the Vividness of Visual Imagery Questionnaire at several timepoints. Retrospectively, she reported a baseline score of 16 (pre-intake) and a post-intake score of 80. A contemporaneous follow-up conducted 12 months later revealed a score of 59, and a subsequent assessment at 33 months showed a further increase to 68, slightly above the population average. The findings align with previous research on the effects of psilocybin on brain connectivity, neuroplasticity, and visual processing. The case report highlights the potential of psilocybin to modulate mental imagery in individuals with (putatively congenital) aphantasia and suggests avenues for further research. Moreover, it raises questions about the classification and pathologization of aphantasia, encouraging a shift toward recognizing cognitive diversity rather than pathologizing neurocognitive differences.