Pivotal physical states: The somatic equivalent to pivotal mental states

Background: The Pivotal Mental States (PiMS) construct posits that psychedelics and other stress-inducing practices, such as fasting and hypoxia, can evoke transformative mental states through increased serotonin receptor activation in the brain. These states are associated with enhanced cognitive flexibility, accelerated associative learning, and psychological insights that may catalyze meaningful behavior change. While PiMS primarily conceptualizes transformation within the domains of brain and mind, emerging evidence from psychedelic research suggests that psychedelics also exert profound effects on the body, pointing to the possibility that transformation occurs in psychological and bodily dimensions. Aims: This paper introduces the novel construct Pivotal Physical States (PiPS), conceptualized as the somatic counterpart to PiMS. We propose that, like the mind, the body can enter a 'pivotal state' in response to acute stressors, including but not limited to psychedelic substances. Methods: We synthesize interdisciplinary literature to build a theoretical foundation for PiPS, focusing on the peripheral serotonin system as well as other somatic trigger points and their downstream physiological effects. Discussion: Psychedelics and other stressors may set the stage for pivotal states that span the mind-body continuum. This dual action may have the potential to facilitate profound psychological and physiological recalibration in either a positive or negative direction, depending on several moderators. Together, PiMS-PiPS may guide a more integrated view of transformation that invites new interdisciplinary research and innovative therapeutic applications. Future work should prioritize empirical validation of the PiPS construct.