The history of psychiatry is often a story of our own impatience. When we look back at the era of the ice-pick lobotomy, we tend to view it as a distant, primitive horror. But if we look closer, the impulse behind it remains very much alive. It was the dream of the “quick fix,” the belief that if we could just physically alter the brain, we could bypass the messy, painful work of being human.
Today, that dream has been rebranded as the “neural reset.” As psychedelics move from the fringes of counterculture into the mainstream of clinical psychiatry, the rhetoric is becoming uncomfortably familiar. We talk about “rebooting” the brain as if it were a glitchy laptop. But when we treat the mind as a computer, we risk losing the person who is actually living inside it.
As a clinician who has seen the pendulum swing for decades, I am struck by how little has changed. Despite our immense strides in neurobiology, the reality is that the vast majority of patients, perhaps 95 percent of those walking into our clinics, are not suffering from a clear physical lesion or a simple chemical imbalance. They are carrying the weight of trauma, the ache of grief, and the profound existential confusion that comes with modern life.
When we tell a young person that their despair is just a circuitry problem that can be cleared with a microdose, we are doing more than just offering a treatment. We are offering a dissociation from their own story. The “Silicon Valley” approach to the soul, where one can simply order a laboratory kit to manage the “pain of life,” feels less like medicine and more like a form of modern alchemy. It is an attempt to achieve “ripening” without the time or the struggle that growth requires.
There is, of course, a place for extreme interventions. When a life is in immediate peril and all other paths have been exhausted, we must reach for whatever relief is available. But these should be the rare exceptions, guarded by the oversight of a committee that values philosophy and ethics as much as pharmacology.
If we continue to promote these interventions as a mainstream shortcut, we are essentially performing a digital lobotomy, quieting the symptoms while ignoring the soul. True healing isn’t a “reset.” It is an integration. We must have the courage to meet our patients in their depth, honoring the person who was there already, rather than trying to overwrite them with a chemical “edit.” Our job is to help them bear their reality, not to help them escape it.
Farid Sabet-Sharghi is a psychiatrist.
