Two Years Later: Is What I Told the Wall Street Journal About Psychedelics Still True?
In June 2023 The Wall Street Journal published, “Magic Mushrooms. LSD. Ketamine. The Drugs That Power Silicon Valley.” A paywall-free version is available from Kanebridge News. The article profiled tech executives including Elon Musk, micro‑dosing psychedelics for creativity and mood. The examples ranged from executives who found greater clarity and creativity, to cautionary tales involving escalating use, erratic behavior, resignation, and for some—death.
When reporter Kirsten Grind asked for my clinical opinion on the risks of self-administered psychedelic use, particularly in a cultural environment that is only hyping up the benefits, I said, “There’s no guarantee you’re going to be the one who gets that positive outcome on your own. You can get very comfortable with, ‘Well it has positive values, so I’m not going to pay attention to my use.’ It’s kind of blinding.”
Two years later, after watching the rise of the latest psychedelic renaissance give way to what seems to be a more level headed conversation, I’m reflecting on the state of the psychedelic nation.
To be clear, I’m not opposed at all to the use of psychedelics for therapeutic purposes. I’m as hopeful as anyone to have alternatives to the harsh and often ineffective use of pharmaceuticals in the treatment of trauma, PTSD, and related mental health issues. But the culture of Silicon Valley psychedelia is almost antithetical to my understanding of the psychedelic call to break out of our programming and come home to ourselves.
Using Ketamine, LSD, Psilocybin, and Ayahuasca for the purpose of becoming an overlord of efficiency and venture capital domination is a bizarre twist for my mind, and represents something deeply skewed in the American psyche. The drive to “fix” and “optimize” ourselves versus accept, be with, and heal ourselves shows me why it’s so easy to peddle simple solutions to some of the most complex problems, and why over-reliance on a magic drug, or mushroom, so often backfires.
It’s not the medicine I’m skeptical of, it’s the culture, the hype, and the intentions. Can psychedelics hold their power after capitalism extracts their value?
So What’s Happened Since Then?
Over the last 24 months, headlines have oscillated between “psychedelics are a cure-all” and “slow down, the data is early.” Some notable developments include:
Psychiatric News
“How Do We Get Ketamine Safety Right? Three Questions From a Clinical Service,” provides expert commentary from the Journal of Clinical Psychiatry on how ketamine can worsen or induce traumatic experiences in vulnerable patients. Brody et al. report on a new clinical phenomenon observed in a subset of ketamine patients dubbed, “dysphoric dissociation,” a terrifying experience in stark contrast to the usual pleasant dissociative effects of ketamine. The authors also note that a small percentage of their patients have become acutely suicidal after ketamine administration.
A major concern is that what started as a treatment for refractory depression has quickly expanded to a wide range of clinical applications (PTSD, anxiety, OCD, eating disorders) without enough time to assess the potential risks.
Recommendations include ensuring pre- and posttreatment psychotherapy, monitoring during administration, and the development of screening and assessment tools that predict adverse reactions more accurately than are presently available. This poses the question of how well mail order ketamine services can truly mitigate the risks.
Guidance for Journalists
The Journalist’s Resource published, “Reporting on psychedelics research or legislation? Proceed with caution.” This article reads like a literature review and does a thorough job of bringing the reader up to date on the state of the science. In summary, although there is research being done on ketamine, MDMA, and psilocybin, the cultural push for legislative change is riding on limited research plagued by a lack of controls, difficulty with blinding, small samples, and lack of follow-up.
In short, the revolution is ahead of the data, and political momentum is being used to fill in the gaps. Reporters are cautioned to not get swept up in the push to fast-track the movement’s success.
I’m not in favor of seeing anyone go to jail for having a bag of mushrooms. The archaic laws from the Nixon era war on drugs are relics of a failed past. But the push to create sensible drug policy and open the doors for research to happen should not be confused with conclusive research proving broad and repeatable effectiveness for mental health issues.
Trauma-Focused Implications
Bergin and Elfrink have created quite an interesting discussion on LinkedIn with their Frontiers in Psychology article, “Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use.” Here we are introduced to the concept of Psychedelic Iatrogenic Structural Dissociation (PISD), a proposed phenomenon where psychedelics may inadvertently reactivate dissociated traumatic material, especially in individuals with unresolved childhood trauma.
Drawing on Structural Dissociation Theory, the authors suggest that psychedelics can disrupt the delicate balance between the Apparently Normal Personality (ANP), which handles daily life, and the Emotional Personality (EP), which holds trauma. This disruption can cause unintegrated memories and emotions to resurface abruptly, leading to destabilization rather than healing.
The paper reviews emerging reports of persistent adverse effects following psychedelic use in trauma-exposed individuals. These include emotional dysregulation, derealization, identity fragmentation, and perceptual distortions, symptoms that mirror or intensify pre-existing dissociative tendencies. In such cases, psychedelics may magnify internal fragmentation instead of promoting coherence.
To address these risks, the authors emphasize the importance of integration practices, including body-based therapies and strong social support systems. They also note that psychedelics might have a dual effect: reconfiguring dissociative patterns in a healing direction, or deepening psychological vulnerability, depending on a person’s trauma history, nervous system, and the therapeutic container.
Ultimately, this research reinforces a key point: trauma-informed screening, preparation, and aftercare are non-negotiable in psychedelic-assisted therapy, especially for clients with complex trauma or dissociative symptoms.
My Clinical Observations
As a trauma therapist in Austin, TX, I routinely encounter clients who’ve tried it all, and are hoping EMDR and longer term therapy will prevail over quick fixes. Living with the effects of PTSD, complex trauma, and dissociative symptoms can be debilitating, and I hold no judgment for those seeking relief, whether that’s trying the latest supplement on Instagram or ordering ketamine through the mail. I’m rooting for everyone to find relief and freedom.
But I’ve seen what I would categorize as Psychedelic Iatrogenic Structural Dissociation first hand, often in those with childhood trauma who tried ketamine with no preparation or follow-up therapy. A common report is not being able to remember much of what happened in the session(s), emerging in a state of hyperarousal (fight or flight), and feeling as though their nervous system is stuck on high alert for “no apparent reason” for weeks to months afterward. The journey back to regulation to even consider working with trauma memories can be a long one.
In other cases, people tell me a mushroom trip in Colorado was just what the doctor ordered and helped them integrate a lot of the previous work they did in therapy. The reports are as mixed and unique as the people I meet and work with, even among clients who share the same diagnosis.
This hits on a major problem with research in the field in general and especially for trauma and stressor related disorders. Diagnosis is often not specific enough to capture a clinical profile or accurately predict the risks involved with novel treatments. Only a thorough assessment from a provider up to date on trauma-based and dissociative presentations could have a hope of spotting the red flags. A basic check-list or cross-cutting screener won’t cut it.
Moving Forward: A Balanced Lens
So what do you think? Was I right to tell the Wall Street Journal the hype could be misleading? I don’t want to dismiss or demonize psychedelics. I know people who found relief from chronic suicidality through ketamine, a relief they never found with anti-depressants.
I’ve always had a revolutionary bent toward progress, innovation, and adventure. In the early 2020’s I was also swept up in psychedelic fever, hoping the mental health field would get a much needed shake-up. But I also understand the unique factors involved with trauma and dissociation, and the risks of harmful use for people with addiction histories.
To be fair, EMDR is well known to cause iatrogenic structural dissociation when used inappropriately in people with dissociative symptoms. But this is why I spent years training and receiving supervision on how to properly prepare clients and mitigate these risks.
My sense is that we’re settling into a more nuanced era, dare I say “neuro nuanced?” An era where the research can proceed, the protocols can be refined, and the real promise of these sacred medicines can be harnessed. Maybe we had to get all fired up just to move the needle, and now we can roll up our sleeves and do the hard work of making good on the promise.
EMDR Therapist | Founder of Neuro Nuance Therapy and EMDR, PLLC | Austin, TX
🔗 About Neuro Nuance Therapy and EMDR, PLLC:
Neuro Nuance Therapy and EMDR, PLLC is a trauma-focused psychotherapy practice based in Austin, TX, specializing in EMDR therapy for PTSD, childhood trauma, dissociation, and healing at the core level. Learn more at neuronuancetherapyandemdr.com
References
Brody, B. D., Popeo, D. M., Smetana, R. W., et al. (2025). How do we get ketamine safety right? Three questions from a clinical service. The Journal of Clinical Psychiatry, 86(3), 25com15946. https://doi.org/10.4088/JCP.25com15946
Elfrink, S., & Bergin, L. (2025). Psychedelic iatrogenic structural dissociation: An exploratory hypothesis on dissociative risks in psychedelic use. Frontiers in Psychology, 16, 1528253. https://doi.org/10.3389/fpsyg.2025.1528253
Grind, K., & Bindley, K. (2023, June 28). Magic mushrooms. LSD. Ketamine. The drugs that power Silicon Valley. Kanebridge News. https://kanebridgenews.com/magic-mushrooms-lsd-ketamine-the-drugs-that-power-silicon-valley/
Grind, K., & Bindley, K. (2023, June 27). Magic mushrooms. LSD. Ketamine. The drugs that power Silicon Valley. The Wall Street Journal. https://www.wsj.com/tech/silicon-valley-microdosing-ketamine-lsd-magic-mushrooms-d381e214
Mikhail, A. (2023, June 27). Silicon Valley elites are reportedly taking ketamine and attending psychedelic parties to bolster their focus and creativity. Yahoo Finance. https://finance.yahoo.com/news/silicon-valley-elites-reportedly-taking-190231808.html?guccounter=1
Miller, N. S. (2024, February 27). Reporting on psychedelics research or legislation? Proceed with caution. Journalist’s Resource. https://journalistsresource.org/home/psychedelics-research-roundup/
