On Wednesday my friend sent me a link to a Guardian article about OCD. I wrote her an essay in response, which I published here. I then left her a voicenote about the ‘drugs as therapy’ section of the article and said I’d transcribe it if anyone would be interested in reading it, and someone was (thanks Bunmi!) So here you go.
I will preface this by saying a couple of things:
(a) Psychedelics is its own whole area of therapy and there are people who specialise in this subfield. I am very much not one of those people, so my view on this is far less well-informed than the views I shared in the previous article.
(b) I am writing this from the standpoint of a white Western therapist. There are a lot of psychedelic practices used in Indigenous medicines, alongside or in lieu of therapy, and I appreciate that those are traditions with long, complex histories. That’s not what I’m talking about. In this voicenote I’m talking about the phenomenon of a (usually white) person who doesn’t come from such a tradition deciding to take (e.g.) mushrooms or LSD and finding it psychologically useful in some way. I would not presume to be able to comment on Indigenous medicinal practices because that is something I know basically nothing about.
All that having been said: let’s dive in.
Transcript
Yeah, so I think that's exactly it. Like, people aren’t into nuance when they're writing in publications for the public, which I think is very annoying.
And there is this thing about online publishing where you're expected to take a view and hold it strongly. And I think that's part of the whole polarisation thing, which happens in basically every debate, and a lot of them — not the Israel/Palestine situation! — but a lot of the debates genuinely are complicated. And you do need the context, you know…
[cat meows]
Hello!
I don't think it's helpful to just be like…
[cat meows some more. OK, OK, I’ll show them all how beautiful you are.]
[There. Happy now?]
“…mushrooms helped me so they'll help everyone.”
I can't believe I forgot to address the drugs point, which was one of the things that made me really angry about it.
Because it's so dangerous, oh my god. Like, for some people, it works really well. I've had a few clients for whom it's worked really well. And that's great. And, you know, if it works, do it. Wonderful. But, like, be careful. And if you want to try that, know yourself first.
I have other clients — and I am of this ilk as well — who just wouldn't touch it, because already, like, my brain is just about in control in general, I'm not going to add in substances! And I would rather do pharmaceutical drugs than illegal ones, not because of the legality, because I frankly don't give a shit. But just because they're a little bit better known in terms of side effects, like there's more that you can do with them, blah blah blah. They tend to start off on a lower dose, whatever.
Like, if you're going to do that, I think you need to do it really carefully. And you also need to have a very honest conversation with yourself about what your historic relationship with that sort of thing is like. Because, you know, people can very easily have psychotic breaks.
And I believe, because I'm not an anti-psychiatrist, that a psychotic break is a real thing and a dangerous thing, and, you know, should be managed carefully.
But I believe that about everything. I mean, drugs is an obvious one, but like a lot of people go down the like, “Oh, just do mindfulness and meditation” route. And that can be really… that can be similarly dangerous, that can also lead to psychosis. It can also retraumatise people. Basically, almost anything…
anything that can help can also harm
…which is something that people don't take into consideration. And that really pisses me off.
And also, if a person's… whatever their presenting problem is, like, let's take OCD because we're talking about that. So like, if a person's OCD is linked to something much deeper, regardless of whether or not that thing is the cause… If it's linked to childhood trauma, or if it's linked to, like, literally a hole in their brain, or something… you can't tell what other things it's going to cause if you suddenly do a treatment on them.
Which is why, in my opinion, if you're going to come… like, if people come for therapy with me, I tell them it's for a minimum of a year. And it's usually three or four. And, I mean, at least! Because you can't — in my opinion — change a lifelong pattern in… I mean, six weeks is a fucking ridiculous timeframe. You can't do it in six months, I don't think, either.
Because you've got to… you've got to go really, really slowly. You've got to be really careful of traumatising the patient regardless of whether they've had trauma before. All of the people I work with have, because that's what I specialise in. And you just can't do that in a short timeframe.
But for me, that would be true regardless of whether you're doing talking therapy, or whether you're doing [currently illegal] drugs, or whether you're doing pharmaceutical drugs, or whether you're doing meditation… like, it doesn't matter. Just go really fucking slowly. Because a tiny thing can make a massive difference. And that can be really good or it can be really disastrous.
I could rant for ages, but I'm not gonna. Because I don't want to leave you a podcast as well as a blog post! [laughs]
[End of transcript]
What do you think? Are you a therapist who specialises in the use of psychedelics? I’d love to hear from someone who’s more informed on the topic!
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