Crown Heights Therapist Offers His Take on Using Psychedelics

By Rabbi Daniel Schonbuch, LMFT

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

Around seven years ago before the psychedelic craze began, I was dealing with two different clients, one a 50 year-old w who had suffered depression most of her life and was in a terrible marriage. She did not respond to most of the medication she had tried, including drugs like Lexapro, Abilify, and even Risperdal. These drugs range from “light,” to what I would consider quite “heavy” which are usually reserved for more serious cases.

Unfortunately for her, nothing seemed to work. I consulted a physician who I worked with who suggested that she try a drug called Ketamine. At first, I was suspicious, but I recommended it based on my colleague’s suggestion. The suggestion also came in the backdrop of the FDA allowing Ketamine to be used via a nasal spray as a treatment for depression. 

The client could only find one place in New York that would give her the Ketamine. This clinic was run by an anesthesiologist who found a new niche in his practice.  She went in for around six treatments, and that was it. During the treatments, she went into a semi-conscious state as the anesthesiologist delivered it to her intravenously. 

Around the same time, I was seeing another client of mine who was 40 years old and suffering from what I would deem as long-term resistant depression, had trouble getting married, and also had debilitating social anxiety. I recommended to him to try Ketamine as well. At first he was resistant, but in the end he tried it for four or five treatments that were recommended by the anesthesiologist.

After about one month I was amazed to see that both of these clients started to feel much better, and for the first time, their long-term conditions seemed to improve. Not only that, but both their relationships improved and my male client got engaged. From my perspective, these were therapeutic breakthroughs. 

I had been trained that the only real medical treatments for conditions like depression, or PTSD, were SSRIs, or what are commonly known as antidepressants. So, my client’s reported gains truly dispelled my misperception of these types of drugs and over time, I became more willing to recommend drugs like Ketamine to my clients.

Here is the big “however.”

When I speak about the legitimate use of drugs like Ketamine, I’m referring to treating more severe forms of depression or to the levels of trauma that we are seeing in the war in Israel, or someone who experienced significant physical, emotional or sexual abuse. However, what I have seen over the last five or so years is that drugs like Ketamine, mushrooms, LSD, and Ayahuasca have become trendy. They are no longer being suggested just for individuals who truly need, but for those who struggle with problems of less intensity. This would include individuals who struggle with 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 would not know this, is that over the last few years, there has been a tremendous push for therapists like myself to assist people in administering Ketamine therapy. One such company whose training I attended and certified with was willing to give ketamine lozenges to just about anyone who I felt needed them. 

My suspicions arose when I received an email from this company asking me if I would like to try Ketamine! That would be like a cardiologist being asked to just “try” a heart medication that they give to their clients. I don’t think anyone trained in cardiology would ever try drugs they prescribe unless they would need them. 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 potential for massive profits from psychedelics. 

I’m also concerned that there are many people who may suffer from much less severe forms of depression anxiety that could be helped if they would see the right psychiatrist who knew how to prescribe medication tailored to specific to their needs or a well-trained therapist who could help. There are many powerful treatments that I use that can help conditions like depression, anxiety, or PTSD such as Somatic Experiencing, IFS, or the Logotherapy of Viktor Frankl. I also believe that there are certain spiritual therapies where a person could experience different levels of elation without using any drugs whatsoever. 

Finally, readers need to know that there can be serious effects related to the use of psychedelics including:

• Bad trips – Psychedelic drugs can cause users to have terrifying experiences. These bad trips can lead to anxiety, paranoia, and even suicide.
• Flashbacks – Some people who take psychedelic drugs can have flashbacks. This effect means that they will suddenly and unexpectedly experience the effects of the drug again, even if they are not taking 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 any psychedelics, I highly recommend first trying a few rounds of therapy to see if your therapist is your “shliach” for healing. If that is not successful, I would then progress to trying more serious medications such as antidepressants, antipsychotics, or psychedelics.

 

– Rabbi Daniel Schonbuch, LMFT, is a licensed therapist and the owner and director of MyTalkPlace.com , which offers 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, which is available on amazon.com.