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The pharmaceutical and the therapy industries have done it again. First there was the introduction of antidepressant medication which, although somewhat helpful to patients,  is clearly not the answer leaving at least some 40% of people fundamentally untreated or only partially treated. Then they backed atypical anti psychotics which although only a poor improvement over the older agents, have as their big plus that they, the drug companies, can’t be sued for tardive dyskinesia. Of late, big pharma has been pushing things like ketamine for rapid improvement from major depression and even offering it as a first line treatment for suicidal ideation.

The homegrown “therapy health movement” has been just as busy with its own revolution. From marijuana and LSD coupled with being around “loving people,”  it has now advanced, in light of poor outcome to recommend use of psychoactive and hallucinogenic agents like ayahuasca or magic mushrooms. These experiences are designed to intentionally disassociate the patient and free him or her from their conflicts. Often there is a “mentor” who guides the hallucinating patient through the experience and by putting together clues from the patient’s statements can come up with superficially clever explanations for the respective disorder. It must be acknowledged that these experiences are indeed very powerful and create the impression that the patient that has entered a new world, a sort of promised land.

The difficulty with both of these new approaches, which of course shine with the glitter of “the latest thing”, is that they both circumvent the essential need for someone else who matters to the patient to work with that patient to discover an alternate path. The plus is that it fosters the ongoing comforting albeit mistaken belief that emotional relief is in the patient’s control and that he or she, with only a little work and understanding, requires nothing more to be in charge of his or her life.

Such an idea simply is not so. Usually, only weeks or perhaps a month or two after the hallucinatory experience, the patient is right back at square one again. However, the intervening period, while the patient has convinced himself that he or she has all the tools required for their recovery,  can be damaging to any real dyadic treatment in which they have been engaged. These experiences can falsely convince the patient that the need to depend upon someone else is simply unnecessary.

Let’s be clear it is difficult for anyone to rely upon an analyst or a therapist over a period of time, to relinquish the ways in which we try to maintain control over a life that is actually out of control; Nobody likes that. Such a dependent relationship raises all kinds of anxieties about being manipulated, seduced or being hurt or attacked; fundamentally all the deep anxieties that have blocked real intimacy for the whole of one’s life.

My word to the reader is just be careful. The hucksters are everywhere and delighted to offer you what you yourself at some level would love to have be the case. Think of all the time and money you might save on cutting back therapy: buy a new vacation, a new car or new outfit. If only such an approach would work and all you had to do was pay for one life-changing hallucinogenic experience. But all I can say is: good luck with that!

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