Psychedelic Substances: A New Frontier in Psychiatric Treatment

Insights from the Annual Conference of the Israeli Association of Biological Psychiatry

The annual conference of the Israeli Association of Biological Psychiatry, held last week in Ra'anana, was titled "Psychedelic Substances: A New and Renewed Front in Psychiatric Treatment" and focused entirely on psychedelia. Dr. Raz Gross from the Sheba Medical Center (Tel Hashomer), the driving force behind the conference and a close friend, invited me to lead the panel concluding this fascinating and emotional day. It was a moving experience—I can't recall the last time I cried at a scientific conference, and I wasn't the only one.

The conference began with Dr. Eran Harel from the Be'er Ya'akov Mental Health Center. In his lecture "Is There Magic in a Mushroom? Psilocybin for the Treatment of Resistant Depression," Harel reviewed impressive literature supporting the notion that, in the right therapeutic context, psilocybin (the psychoactive substance in mushrooms) has advantages over current psychiatric treatments for resistant depression, with low toxicity and mild side effects (excluding reactions from your sister-in-law). Dr. Harel emphasized the importance of "set and setting," meaning the patient's intentions, goals, and the external context of the place and attendant, a theme echoed by other speakers at the conference.

Throughout the day, I attended captivating lectures. Dr. Yoav Domani from the Sheba Healing Center presented a study demonstrating ketamine's impressive effectiveness in treating acute suicidality in the emergency room, significantly reducing suicidal thoughts for a limited period. Ketamine, a synthetic anesthetic, works differently from other antidepressants, resulting in rapid changes in suicidal patients, providing a critical time window for doctors to tailor the best treatment.

Prof. and Colonel Erik Vermetten of Leiden University in the Netherlands, a strategic mental health advisor to the Dutch military and a leading voice in MDMA and PTSD research, passionately explained why MDMA-assisted psychotherapy is the future for treating this severe disorder affecting millions worldwide. MDMA, a psychedelic drug that increases serotonin levels and induces euphoria, is not treated as a medicine but as an aid to therapy. It helps reduce the anxiety associated with recalling traumatic experiences, making negative memories more accessible for processing without overwhelming the patient emotionally.

Participants in the conference. From right to left: Dr. Yoav Domani, Dr. Zvi Fishel, Dr. Keren Zarfati, Dr. Nadav Shalit, Dr. Amalia Rosenblum, Dr. Bela Ben Gershon, and Dr. Raz Gross Photo: Racheli Hazan-Zalek, for the Israeli Association for Biological Psychiatry

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Other noteworthy lectures included Dr. Ido Hartogson's discussion on psychedelic drugs at the crossroads of science and society, followed by Dr. Nadav Shalit from the Lev Hasharon Mental Health Medical Center, who explained how psychedelic molecules produce certain experiences with potential therapeutic effects. Dr. Bela Ben Gershon from the Ministry of Health expressed her enthusiasm for the therapeutic potential of psychedelia in alleviating severe and life-threatening suffering.

The highlight of the day for me was Dr. Lior Roseman's lecture from the Center for Psychedelic Research at Imperial College London. Roseman presented a qualitative study involving Israelis and Palestinians, examining the potential of Ayahuasca ceremonies to contribute to conflict resolution and reconciliation processes. Participants in these ceremonies drink a potion made from a specific vine and other plants, creating a psychedelic experience lasting hours.

A quote that moved me to tears came from a young Israeli who described experiencing a vision during the ceremony. He relived a mild event from his military service in the territories, but the memory unexpectedly developed as he saw it from the perspective of the Palestinian family whose home he had entered during a routine arrest.

Roseman's talk made me reflect on the unique balm psychedelia offers, different from regular psychotherapy or common psychiatric medications. Anxiety, depression, and meaninglessness can stem from existential conditions, creating an unbridgeable gap between ourselves and others, a disturbance from the lack of external meaning, and fear of being forgotten. Psychedelics provide a sense of belonging, not based on excluding others but on universal or supratemporal connections or connections to nature.

In social psychology, many studies show the connection between the recognition of mortality and nationalist sentiments. The sense of belonging often comes at the cost of rejecting others, as national and group identities are defined comparatively: "us" versus "them." Many people cope with anxiety, depression, and insignificance by belonging to exclusive, antagonistic, and often extreme identity groups.

Regular psychotherapy offers temporary connections within meaningful relationships, but this solution is not always accessible for those with persistent emotional distress due to trauma or difficulty integrating treatment into daily life. Psychedelic therapy, on the other hand, fosters a sense of belonging from a different category, not based on long-term relationships or a commitment to therapy but on a universal connection.

From existing documentation, psychedelic therapy reduces anxiety, depression, and meaninglessness while significantly decreasing tendencies toward nationalistic or exclusive identifications. My experience working with patients who choose alternative paths (not guided by me, as I lack the training) shows that while psychiatric drugs can alleviate suffering, psychedelic processes can provide a sense of meaning.

The panel I guided, attended by conference chairman Raz Gross, Israeli Association for Biological Psychiatry chairman Prof. Yoav Cohen, Israel Psychiatry Association chairman Dr. Zvi Fishel, and MAPS representative Dr. Keren Zarfati, discussed making psychedelic-assisted psychotherapy available worldwide. This sparked a heated debate between cautious and enthusiastic voices.

As an emotionally focused therapist, the conference filled me with optimism. Studies show that treatments focusing on the most painful emotions are more effective. Psychedelics allow patients and therapists to address these wounds within structured contexts. Traumas are registered non-verbally, and traditional psychotherapy may not be the best approach. Psychedelics offer different processing suited to these issues.

At the end of this unforgettable day, in contrast to some participants' visions, I left into the warm Israeli night, feeling that someday we will look at psychiatry without psychedelics as we do at dentistry before anesthetics.