What ketamine therapy taught me about my Jewish intergenerational trauma
Artist interpretation of Lyssa Mandel’s experience on therapeutic ketamine. Graphic by Jake Wasserman
In July of 2021, I found myself in a Manhattan clinic wearing an eye mask and headphones, about to receive my fifth of six injections of therapeutic ketamine.
“What’s your intention for this session?” asked my therapist, poised with a notebook to record the answer.
“I’d like to encounter my ancestors or my guides,” I said.
Let me back up.
My great-grandparents immigrated to the United States from Ukraine and Poland in the early 20th century to escape pogroms. Even though I never even met them, their fears were passed to me. It manifested as an underlying rumble of sadness and dread that I couldn’t fully explain with any part of my own childhood. I just thought it was normal. There’s a reason for the stereotypes about Jews and the neuroses we carry: it’s the natural result of millenniums of running for our lives.
Intergenerational or ancestral trauma occurs when traumatic events impact not just the person who experiences them firsthand, but that person’s descendants as well. Research shows, for instance, that the offspring of Holocaust survivors carry the trauma in their bodies. Our DNA encodes this pain and transmits decades of collective and individual toxic stress to the subsequent generations.
My awareness of and ability to speak clearly about my depression from a young age was like a badge of honor in my family. When I described my feelings to my dad, he’d say, “The apple doesn’t fall far” with such tenderness that depression became another loving link that connected us. At Seders and Thanksgiving dinners, my cousins and I bonded over which medications we were on, what type of therapists we were seeing and what was ailing us in body and mind. I believed that dread was my birthright.
I’d ridden manageable waves of depression since I was little. But the bottom dropped out on Dec. 12, 2020, when I moved back to New York from Los Angeles and experienced a nervous breakdown.
I was like a tuning fork that had been struck by lightning. I couldn’t sleep, eat or stop shaking. Waking life was excruciating. I found a new psychiatrist and tried returning to the antidepressant of 17 years off which I’d so painstakingly weaned myself: it didn’t work this time. I took a pill to help me sleep and another to soften the panic, but they barely scratched the surface.
I switched to a new antidepressant. I jumped down Google rabbit holes in an obsessive flurry of hyper-focus to try and self-diagnose. I researched adrenal failure. I tested my blood and my hair for vitamin deficiencies and bought a SAD light therapy lamp. I worked with multiple therapists and pursued healing modalities with the intensity of a Talmud scholar, but nothing brought relief. It was as if all the fear of a dozen generations of Mandels and Potashnicks had caught up to me, and my body had no way of processing it.
At this point, several months into suicidal ideation, I queried my doctor about therapeutic ketamine. I’d read about psychedelics being used as an experimental treatment for depression for years, fascinated by the scientific breakthroughs arising from out-of-the-box treatments. I read up on the history behind entheogens— a psychoactive substance used in religious or shamanic ceremonies — not because I was planning to pursue them myself, but because I was intrigued by any treatment that had the potential to alleviate the symptoms of mental illness.
Ketamine may be best known for its illicit, risky use as a club drug “K,” but its use has been approved by the FDA for decades as an anesthetic and painkiller. Using ketamine to treat mental health is still relatively novel, but thus far, several studies have found it to be highly effective at treating depression. When I asked my doctor about it, I was nervous but desperate for relief. I told her I wanted to take the lead on finding the right clinic for me, since I’d done so much independent reading already. She agreed, knowing I knew myself and my body best, as long as I kept her in the loop.
I found my clinic on Instagram, of all places. It had the vibe of a day spa, with several comfortable rooms decked out with wall murals of nature scenes and Himalayan salt lamps.
I underwent a long screening by phone and two more virtually: one with a nurse practitioner, the other with my assigned therapist, who was trained specifically to guide and integrate ketamine therapy sessions. Ketamine therapy is not yet covered by insurance, and I was lucky that my family could help pay for the treatment.
At my first appointment, I was given a journal, a pen and art supplies, and was encouraged to use them to integrate what I learned in my explorations.
I wanted to treat the ketamine process with the same respect and reverence I’d bring to synagogue or studying Kabbalah. Spirituality had helped pull me out of depression before: In the existential slog of my late 20s, studying Jewish mysticism brought confirmation of a beautiful cosmic order to the world and my place in it. It felt like evidence that there was a greater reason for my suffering, even if I couldn’t always comprehend it. Perhaps ketamine didn’t have to only be a clinical procedure; it could also be a renewal ceremony of sorts in the temple of my body.
My course of ketamine therapy included six sessions over three weeks, each one lasting 40-60 minutes. At the beginning of each session, a nurse took my vitals and gave me an anti-nausea pill before giving me an intramuscular injection of ketamine. My therapist wrote down the day’s dosage, my intentions and the time of injection, then sat with me for the duration.
As I’d “blast off” into the darkness, my fingers and toes would tingle and grow numb and my mouth would go dry. I felt confused, a tightening and the sensation of my consciousness wandering around inside me like an ant in a dark theater.
Within hours of the first session, though it had been terrifying and exhausting, I felt the faintest clearing in my brain. I took my sheets to the laundromat and answered long-abandoned emails, tasks I’d been unable to do for weeks. The ancestral dread was still there, but its grip was slightly looser.
Yet it was my fifth session, when I set the intention to encounter my ancestors, that was the most empowering and profound. In the darkness, at first I felt heat: it was the deep, dry, primordial heat of prehistory. Behind my eyes, neon green pixels became billions of grains of sand. I felt myself writhing to the rhythm of the music in my headphones, rhythmic, percussive and haunting. I was a snake, slithering up to the surface of the sand in the desert night.
If by this point you’re thinking “this all sounds a little out there …” I know. I was deeply skeptical for a long time, too. Yet I was determined to be open to this experience. What was the burning bush if not an inspired vision?
In the darkness, I couldn’t see people, but I felt them around me -— dancing in a wide circle around a bonfire, with the shadows of flame licking up the dusty cliff faces all around. There was a pulse connecting us and a communal bond I recognized from a place so deep and old inside me, I hadn’t known it was there. I was ecstatic, and the energy radiated. I knew, somehow, that I was one of these people. It was as if I were present at the dawn of the Israelites in their native home and in their joy before the trauma of exile. What a revelation: there was a way of being Jewish, and being me, without the backdrop of fear and despair.
Suddenly my intense connection to the Negev, a desert I’ve only visited once and briefly, made sense: I’d felt home there, even though I’d been raised in colonial New England. The soft smell of dust felt like a safe embrace, and hadn’t I seen these craggy mountains in a dream? This desert — this was the origin of my tribe. I’d always imagined my ancestors would appear to me like ghostly figures. Instead, they’d brought me to them — not to see, but to feel.
As I floated back down to earth, sensation returning to my hands and face, I was flooded with insight. All this time, I’d sought external mentors and guides, convinced that I was defective and healing could only come from outside of myself. Now I knew that I was the composite of all those ancestors, my DNA was actually made of them. I had access to not just their trauma, but also their wisdom — I brought them with me everywhere.
Over the course of treatment, I felt my brain regaining its balance, and my cortisol and adrenaline soften back to normal. My appetite returned, and so did my sleep. Ketamine didn’t solve all my problems; there is no “quick fix” for clinical depression. But it did help synthesize a cerebral understanding of my ancestral story into more experiential knowledge. My pain is not just me, broken: it was in me before I was born.
My brain does feel restored, like ketamine cleaned the slate chemically so I’m on more solid ground from which to chip away, do the work and keep healing, day after day. It’s a marathon, not a sprint.
If my ancestors could wander the desert for 40 years for their own survival, and I am made up of them, then this journey through the desolate wasteland of my subconscious for my survival doesn’t feel like a fluke in my path: it feels like my birthright. And I’m so much wiser for it.
To contact the author, email editorial@forward.com.
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