Crown Heights Therapist Offers His Take on Using Psychedelics

By the rabbi Daniel SchönbuchLMFT

Are psychedelics a good idea? This is a question that many of my clients aged 30 and under often ask me in my office. I understand why. This is a very hot topic that we cannot avoid listening to on countless podcasts and from social media influencers. Psychedelic drugs are also an attractive topic since many of these substances are illegal but are now being touted as “cures” for mental illness. The answer to my clients, and the one I’ll share with you, is a bit complicated, so give me a few paragraphs to explain my position.

About seven years ago, before the psychedelic craze started, I was dealing with two different clients, including a 50-year-old woman who had suffered from depression most of her life and was living in a marriage terrible. She didn’t respond to most of the medications she tried, including drugs like Lexapro, Abilify, and even Risperdal. These medications range from “mild” to what I would consider quite “heavy” and are generally reserved for more severe cases.

Unfortunately for her, nothing seemed to work. I consulted a doctor I worked with who suggested he try a drug called ketamine. At first I was wary, but recommended it based on my colleague’s suggestion. The suggestion also came against the backdrop of the FDA allowing the use of ketamine via a nasal spray as a treatment for depression.

The client was only able to find one place in New York that would give her ketamine. This clinic was run by an anesthesiologist who found a new niche in his practice. She’s had about six treatments, and that’s it. During the treatments, she entered a semi-conscious state as the anesthesiologist administered the medication intravenously.

Around the same time, I was seeing another client of mine who was 40 years old and suffering from what I would consider long-term resistant depression, was having trouble getting married, and also suffered from debilitating social anxiety. I recommended he also try ketamine. At first he was resistant, but eventually he tried four or five treatments recommended by the anesthesiologist.

After about a month, I was amazed to find that both of these clients began to feel much better and, for the first time, their long-term condition seemed to be improving. Not only that, but their relationships improved and my male client became engaged. From my point of view, these were therapeutic breakthroughs.

I had learned that the only real medical treatments for conditions like depression or PTSD were SSRIs, or what are commonly called antidepressants. So the gains my client reported truly dispelled my misperception about these types of medications, and over time I became more willing to recommend medications like ketamine to my clients.

Here’s the big “however”.

When I talk about the legitimate use of drugs like ketamine, I am referring to the treatment of more severe forms of depression or the levels of trauma we see in the war in Israel, or to someone who has suffered significant physical, emotional or sexual abuse. . However, what I have noticed over the last five years is that drugs like ketamine, mushrooms, LSD and Ayahuasca have become fashionable. They are no longer offered only to people who really need them, but to those who are struggling with lower intensity problems. This includes people suffering from minor anxiety, ADHD, boredom, or what Viktor Frankl would call an existential crisis (not knowing who they are).

What I find most interesting, and the public doesn’t know this, is that over the last few years there has been a huge push for therapists like me to help people administer ketamine therapy . One such company that I trained and got certified with was willing to give ketamine lozenges to almost anyone I thought needed them.

My suspicions arose when I received an email from this company asking if I would like to try ketamine! It would be like asking a cardiologist to simply “try” a heart medication he is giving to his clients. I don’t think anyone trained in cardiology would try the medications they prescribe unless they need to. From my perspective, traditional pharmaceutical companies that are criticized for caring about their profit margin have just been replaced by new pharmaceutical companies and organizations that see the massive profit potential of psychedelics.

I also worry that many people suffer from much less severe forms of depression and anxiety that could be relieved if they saw the right psychiatrist who knew how to prescribe medications tailored to their specific needs or a well-trained therapist. who could help. There are many powerful treatments that I use that can help with conditions such as depression, anxiety or PTSD, such as Somatic Experiencing, IFS or Viktor Frankl Logotherapy. I also believe that there are certain spiritual therapies in which a person can experience different levels of elation without using drugs.

Finally, readers should be aware that there can be serious effects from using psychedelics, including:

• Bad trips – Psychedelic drugs can give users terrifying experiences. These bad trips can lead to anxiety, paranoia and even suicide.
• Flashbacks – Some people who take psychedelic drugs may have flashbacks. This effect means that they will suddenly and unexpectedly feel the effects of the medicine again, even if they do not take it.
• Psychotic Episodes – Long-term use of psychedelic drugs can cause psychotic episodes. Psychotic episodes cause users to experience delusions, hallucinations, and paranoia.

Before trying psychedelics, I highly recommend trying a few rounds of therapy first to see if your therapist is your “shliach” for healing. If that doesn’t work, then I would try more serious medications such as antidepressants, antipsychotics, or psychedelics.

– Rabbi Daniel Schonbuch, LMFT, is a licensed therapist and owner and director of MyTalkPlace.com, which provides therapy with frum therapists for the Jewish community. He is the author of several books on therapy, including Think Good and It Will Be Good: Spiritually-Based Therapy Inspired by Viktor Frankl and Jewish Wisdom, available on amazon.com.