setting in order to put the “hyper-suggestible properties” of these
medicines to best use. This is precisely where psychedelic therapy seems
to be operating: on a frontier between spirituality and science that is as
provocative as it is uncomfortable.
Yet the new research into psychedelics comes along at a time when
mental health treatment in this country is so “broken”—to use the word of
Tom Insel, who until 2015 was director of the National Institute of
Mental Health—that the field’s willingness to entertain radical new
approaches is perhaps greater than it has been in a generation. The
pharmacological toolbox for treating depression—which afflicts nearly a
tenth of all Americans and, worldwide, is the leading cause of disability—
has little in it today, with antidepressants losing their effectiveness* and
the pipeline for new psychiatric drugs drying up. Pharmaceutical
companies are no longer investing in the development of so-called CNS
drugs—medicines targeted at the central nervous system. The mental
health system reaches only a fraction of the people suffering from mental
disorders, most of whom are discouraged from seeking treatment by its
cost, social stigma, or ineffectiveness. There are almost forty-three
thousand suicides every year in America (more than the number of
deaths from either breast cancer or auto accidents), yet only about half of
the people who take their lives have ever received mental health
treatment. “Broken” does not seem too harsh a characterization of such a
system.
Jeffrey Guss, a Manhattan psychiatrist and a coinvestigator on the
NYU trial, thinks the moment could be ripe for psychotherapy to
entertain a completely new paradigm. Guss points out that for many
years now “we’ve had this conflict between the biologically based
treatments and psychodynamic treatments. They’ve been fighting one
another for legitimacy and resources. Is mental illness a disorder of
chemistry, or is it a loss of meaning in one’s life? Psychedelic therapy is
the wedding of those two approaches.”
In recent years, “psychiatry has gone from being brainless to being
mindless,” as one psychoanalyst has put it. If psychedelic therapy proves
successful, it will be because it succeeds in rejoining the brain and the
mind in the practice of psychotherapy. At least that’s the promise.
For the therapists working with people approaching the end of life,
these questions are of more than academic interest. As I chatted with
frankie
(Frankie)
#1