“Psychedelic mushrooms, Dr. Freedman. You know what I’m talking about"

I first met Ahrele when he was 17. He was angry and suspicious, ready to lash out at anything in his path. And with good reason, too: This was a kid who’d suffered ongoing abuse by a family member who was no longer in the country, and lost trust in the people who were supposed to protect him from harm. More recently, he’d been kicked out of one yeshivah after another, mostly because he’d essentially lost interest in Yiddishkeit – and anything else, for that matter.

I had already met with his father, Reb Leibush, to discuss his son’s decline. His parents, who never really confronted the ordeal, wondered if the lack of success in school was ADHD or some other behavioral issue, but to me at least, a diagnosis of complex trauma with all of its behavioral manifestations was pretty clear. This was a kid who was simply lost.

Ahrele sat in my office in a quiet fury and wasn’t particularly interested in speaking with yet another authority figure who had nothing to offer him. I tried my best tricks, but Ahrele wasn’t going to engage with me and the interview was over.

I discussed the case with his parents, who were still stuck on the “Why isn’t he interested in being frum?” types of questions and essentially brushed the trauma issues under the table. “How long can a thing like that last?” questioned his father, with no small amount of frustration – laced, I sensed, with a slice of guilt.

The answer was potentially a lifetime, but they didn’t want to hear it. I’d given them both the information for an organization that specializes in helping victims of abuse within frum families, but I doubted that they kept the number.

It was two years later when a totally different version of Ahrele walked into my office. He had a pony tail, a tattoo of a lion on his neck, and wasn’t accompanied by any parents this time around. But perhaps even more noticeable was how muscular he’d become — this was a young man who was obviously obsessed with weight training.

Apparently, Ahrele had left his community for good and had found himself on the streets for a year and a half. As he was out of yeshivah, he’d been drafted by the Israeli Army — but his emotional challenges and discipline issues soon landed him an evaluation with the IDF psychiatrist and a formal discharge.

I cried deep inside for this poor neshamah who was so profoundly lost. These days, he told me, he spent most of his time in the gym lifting weights with a new friend named Tamir. But it didn’t take more than a few minutes to see what kind of friend this Tamir fellow really was.

“Psychedelic mushrooms, Dr. Freedman. You know what I’m talking about, psilocybin, the mushrooms that people eat that make them hallucinate. Either that or ayahuasca, DMT, that stuff that people take for trauma.”

I’d heard these requests before, but I admit I was blindsided by Ahrele, who had replaced his peyos with earrings and tzitzis with tattoos. Before I could answer him, he was already showing me pictures of psychedelic compounds on his iPhone and reading off quotes by individuals who’d “found complete healing” with these potentially dangerous and illegal substances.

“I’m glad that you’re interested in getting help and addressing your challenges with the help of a professional,” I told his honestly. “But Ahrele, I’m not sure that psychedelic drugs are the treatment of choice for you.”

“Well, all these people think it’s fantastic,” he said as he scrolled down more articles. “Look, there are even scientific studies suggesting it’s a good treatment for past or buried trauma, and here it says there are more studies opening up. Maybe you can get me into one of those trials?”

“Ahrele, have you ever googled ‘Jews’ to see what you’ll find? Just because it’s on the internet doesn’t mean it’s factually correct. And real scientific studies are done in a very well-controlled environment with specifically regulated doses of these compounds, not just with a plastic baggie filled with mushrooms.”

“Dr. Freedman, if you won’t recommend me for a study, then I’ll just have Tamir get them for me. I’m sure it will be cheaper than some overpriced psychiatry appointment.”

I dodged his jab and tried to steer him into a practical place. “Look, Ahrele, I do know a medical director of one of these studies out in San Francisco and we’ve discussed how having a family member with serious mental illness often disqualifies a patient from the study. If I remember from the family history intake, your Bubby suffered from schizophrenia and therefore they’d be wary of you participating in such a study, as there’s an increased risk of these drugs triggering long-lasting psychotic symptoms.”

Ahrele thought for a moment and then answered, “well, you know that psychiatric medications have side effects too. I saw what they did to my Bubby. Anyway, some of this stuff is gonna be legal soon -- they’re already voting to decriminalize them in a lot of places.”

Ahrele gave it his best shot, but these substances would be dangerous for him, especially if he was going to buy them from some guy named Tamir who could provide him with just about anything at any dose regardless of whether it was unsafe, illegal, or asur. Still, this kid was in my office finally ready to seek help and I didn’t want to lose him.

“Listen, Tzaddik, you’re right that many States are voting to decriminalize them, but just because something is legal doesn’t mean it’s a great idea. Many of these same states have legalized physician-assisted suicide but you don’t see me flying my patients over there to take lethal injections. Plus, who said anything about me prescribing you any medications? I still need to be brought up to speed about what went down over the past two years.”

Ahrele looked frustrated as he saw that he was unlikely to leave my office with a prescription for psychedelic drugs. Not that I could have written one even if he wanted me to -- their use is thankfully regulated to very specific clinical research studies.

“Ahrele, there’s a reason that this stuff is still illegal in most of the civilized world: Plant-derived psychedelic drugs like psilocybin and ayahuasca may grow ‘naturally,’ but they induce serious hallucinations and not everyone who takes them comes back the same.”

“Right. That’s what I’m looking for,” he replied edgily. “Listen Dr. Freedman, all I do now is lift weights to kill my pain, but even though I might get stronger every time I put the bar over my head, it doesn’t exactly make the pain go away. I need something that will take this pain away for good.”

I certainly hoped Ahrele wouldn’t turn out like those college kids who wound up on my rounds in the emergency room back in America with drug-induced psychosis, and ended up in the locked psychiatric ward.

But his mind was made up. He didn’t want to hear about any treatments or therapies for complex trauma, and I wasn’t the address.

We agreed that he would call me if he ever needed my help and I bentched him to be safe as I wished him hatzlachah.

Less than three weeks later, I got the phone call. Ahrele had had a bad drug experience with his friend Tamir, and he was now in the locked ward at a local psychiatric hospital. His father Reb Leibush wanted me to come and visit his son.

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.

Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in the Old City or hiking the hills outside of Jerusalem. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com

(Originally featured in Mishpacha, Issue 824)