This year the field of psychiatry has seen psychedelic assisted psychotherapy research explode. I am personally a bit concerned about it. My greatest concern is that patients will be once again looking for a quick fix. This will also do nothing more but excite the insurance companies. They would like us to quickly fix our patients. Will this give them one more reason? This also begs the question as to whether or not we actually “fix our patients?”
Trauma, not the Reader’s Digest version
Trauma happens mostly over a long period of time. It’s not usually the one time awful thing that happens to someone. It’s usually cumulative in nature. That is why it is so hard to rid oneself of trauma. Dealing with trauma takes a long time. It is not something we can rush through. Rushing through trauma can have deleterious effects and cause issues such as regression and increased depression and anxiety. It is my job to be patient. As I have said before, treatment takes as long as it takes.
Will this become the New SSRI?
Recently on a listserv I frequent, with other Psychiatrists, there was a lively discussion about psychedelic assisted psychotherapy. The actual drug being discussed was Ketamine. There were Psychiatrists with strong opinions on both sides of the issue. One Psychiatrist who has been a round a long time mentioned this was tried before with LSD. He was right, and it caused “psychosis” and other undesirable outcomes. A concern is this will become the new norm. Similarly , when the SSRI’s hit the market. , they quickly became one of the most prescribed drug classes. Another concern is the cost to patients. The therapy is not currently covered by insurance and even if some of it is, the reimbursement is a fraction of what the actual cost will be.
Staying the course
I am not sure if this will ultimately get FDA approval, but I know it is not something I will be doing in my practice. Currently a very low prescriber of medication in general., I still believe in psychotherapy. Medication is certainly of value in some instances, but I will stay the course for what I believe works best over time.