by STANISLAV GROF
This summary was made with Ollama eBook Summary.
LSD Psychotherapy is a complete account of a remarkable chapter in the ever-continuing inquiry into our transpersonal nature and origins.
The sensationalism surrounding the widespread use of LSD in the late 1960s and the subsequent legislative overkill virtually ended psychotherapeutic LSD research. Much of what had been learned over thirty years of scientific medical study was so distorted or suppressed that no objective overview was available to the general reader except for this book.
The controlled studies described in this book reveal exciting and challenging data about the nature of human consciousness, perception, and reality itself. Drawing on this work, Stanislav Grof outlines a new cartography of the human mind, one which accounts for experiences such as shamanic trances, near-death experiences and altered states of consciousness. This vision is also the foundation for Dr. Grof's revolutionary Holotropic Breathwork techniques.
This book is also a visual feast, with numerous color drawings and paintings created by research participants (see featured artist Sherana Harriette Frances’ book, Drawing It Out: Befriending the Unconscious). Many of these depict archetypal images from the collective human consciousness, forming a powerful addition to the text.
LSD Psychotherapy is a valuable source of information for those who are involved with LSD in any way, whether as parents, teachers, researchers, legislators, or students of the human psyche. The approach to healing described in this book is inspired by the eternal desire of humankind for wholeness and an enduring grasp of reality. - LSD Psychotherapy
- PREFACE
- 1. HISTORY OF LSD THERAPY
- 2. CRITICAL VARIABLES IN LSD THERAPY
- 3. PSYCHOLYTIC AND PSYCHEDELIC THERAPIES WITH LSD: TOWARDS AN INTEGRATION OF APPROACHES
- 4. PRINCIPLES OF LSD PSYCHOTHERAPY
- 5. COMPLICATIONS OF LSD PSYCHOTHERAPY: OCCURRENCE, PREVENTION, AND THERAPEUTIC MEASURES
- 6. THE COURSE OF LSD PSYCHOTHERAPY
- 7. INDICATIONS FOR LSD PSYCHOTHERAPY, THERAPEUTIC POTENTIAL, AND CLINICAL RESULTS
- 8. NON-THERAPEUTIC USES FOR LSD
- 9. EFFECTIVE THERAPEUTIC MECHANISMS OF LSD THERAPY
- EPILOGUE: THE FUTURE OF LSD PSYCHOTHERAPY
- APPENDIX: Crisis Intervention in Situations Related to Unsupervised Use of Psychedelics
- APPENDIX: The Effects of LSD on Chromosomes, Genetic Mutation , Fetal Development and Malignancy
Psychedelic Therapy: LSD and the Search for New Understandings
Background:
- Book on LSD psychotherapy published during psychedelic research ban
- Introducing material with practical and theoretical reasons for its relevance
- Personal experimentation continues despite legislation
- Misinformation prevalent in literature
- Importance of accurate information for self-experimenters, relatives, friends, professionals
- Discussion of unsupervised LSD use in an appendix
- Relevance to parents, teachers, lawyers, mental health professionals
- Regret that psychology and psychiatry have lost a valuable research tool and therapeutic agent
Controversies and Confusions:
- Urgent need for clear understanding of effects and transformation processes of LSD
- Possibility of future research enriched by past lessons
- Theoretical relevance independent of the future of LSD therapy
- Expanded model of psyche, therapeutic change, personality transformation, psychotherapy strategies, spirituality in human life
New Discoveries and Insights:
- Relevance to experiential psychotherapies (gestalt practice, bioenergetics, primal therapy)
- Blocked development due to old conceptual frameworks
- New cartography of mind integrating elements from various spiritual traditions
- Bridging the gap between religious systems and psychology
- Theoretical relevance extending beyond psychiatry and psychology into other disciplines (anthropology, sociology, politics, general medicine, obstetrics, thanatology, religion, philosophy, mythology)
- Challenging observations from LSD sessions compatible with quantum-relativistic physics
- Contributes significantly to understanding the nature of reality.
History of LSD Therapy
Discovery of LSD and its Psychedelic Effects
- LSD (diethylamide of d-lysergic acid) synthesized in 1938 by Albert Hofmann at Sandoz chemical-pharmaceutical laboratories, Basle, Switzerland
- Discovered as a semisynthetic compound derived from lysergic acid, a natural component used for therapeutic purposes like inducing uterine contractions and stopping gynecological bleeding
- LSD showed marked uterotonic action but excitation in animals; initial interest was not great due to limited understanding of its potential effects
- Albert Hofmann's accidental intoxication in 1943 led him to explore LSD further as a central nervous system stimulant
- Described experiencing vivid and plastic images, intense kaleidoscope-like play of colors, restlessness, dizziness, and unmotivated desire to laugh
- Took a minute dose (250 micrograms) without proper preparation or knowledge about psychedelic states
- Hofmann's experience led him to suspect LSD was responsible for his unusual symptoms; three days later he intentionally ingested a known quantity of LSD for scientific testing
Lab Accident and Self-Experimentation
- On April 16, 1943, Hofmann experienced an accidental intoxication while synthesizing LSD in the lab
- Described experiencing vertigo, visual disturbances, motoric unrest, paralysis, heavy feeling in body, throat constriction, and feelings of being out of his body
- Doctor's examination revealed a weak pulse but otherwise normal circulation
- Six hours after ingestion, Hofmann's condition improved but visual disturbances persisted with distorted colors and hallucinations
- Acoustic perceptions transformed into optical effects, creating changing colored hallucinations like kaleidoscope images.
Early Laboratory and Clinical LSD Research
- More scientists became interested in LSD's psychoactive properties after Hofmann's self-experimentation
- Studies focused on understanding its therapeutic potential and minimal side effects
- Early pharmacological tests showed LSD had a marked uterotonic action, caused excitation in animals, but did not consider these effects significant for further exploration.
Therapeutic Experimentation with LSD
- Psychedelic substances like LSD gained popularity in the 1950s and 60s as potential therapeutic agents
- Used to treat various mental health conditions, including anxiety disorders, depression, and addiction
- Therapy involved careful preparation, administration of the drug under controlled conditions, and guidance from experienced therapists.
Early LSD Research
Discovery of LSD's Effects:
- Discovered by Hofmann in 1938, first planned experiment conducted in 1943
- Proved the hypothesis about the mind-altering effects of LSD
- Subsequent experiments with volunteers from Sandoz Research Laboratories confirmed the extraordinary influence on the human mind
Walter Stoll's Study:
- First scientific study of LSD in normal volunteers and psychiatric patients
- Published report became a sensation in the scientific world, stimulating more research
Model Psychosis Hypothesis:
- LSD could simulate schizophrenic symptoms in normal volunteers
- Suggested that endogenous psychoses like schizophrenia were caused by a pathological shift in body chemistry
- Goal: to understand the etiology of schizophrenia and potentially discover new treatments
Descriptive Studies:
- Phenomenological description of the LSD experience
- Comparison between psychedelic states and schizophrenia, using clinical measurements, psychological tests, electrophysiological data, and biochemical findings
LSD Effects on Biological Systems:
- Research explored LSD's effects on various physiological and bio-chemical functions
- Experiments on the antagonism between LSD and other substances
Biochemical Hypotheses of Schizophrenia:
- Serotonin hypothesis: LSD interferes with the neurotransmitter serotonin, which was postulated to be the primary cause of schizophrenia
- Repeatedly criticized by psychoanalytically and phenomenologically oriented clinicians and biochemical investigators
Training for Mental Health Professionals:
- LSD sessions recommended as a tool for understanding psychotic patients, approaching them with sensitivity, and treating them effectively
- Unique learning experience for all clinicians studying abnormal mental states
Influence on Art and Religion:
- Psychedelic experience could lead to profound religious and mystical experiences resembling those described in sacred texts and writings of mystics
- Controversy about the authenticity and value of "chemical" versus "spontaneous" mysticism
Negative Potential of LSD Research:
- Explored by secret police and armed forces, with techniques like eliciting confessions, gaining access to secrets, brainwashing, disabling foreign diplomats, and non-violent warfare
The Therapeutic Potential of LSD
Discovery of LSD's Therapeutic Potential:
- Suggested by Condrau (21) in 1949, only two years after Stoll published the first scientific study on LSD in Switzerland
- Pioneered by Busch and Johnson (17), Abramson (1,2), Sandison, Spencer and Whitelaw (91), and Frederking (28) in the early 50s
- Attracted considerable attention among psychiatrists, leading to therapeutic experimentation with LSD in various countries
Benefits of LSD-Assisted Psychotherapy:
- Expedited the psychotherapeutic process and shortened treatment time for various emotional disorders
- Enabled successful treatment of patients previously considered poor candidates for psychotherapy (e.g., alcoholics, narcotic-drug addicts, sociopaths, criminal psychopaths, etc.)
Expanding Applications of LSD Therapy:
- Used in the care of dying individuals with cancer and other incurable diseases
- Alleviated emotional suffering and pain associated with chronic illness
- Changed attitudes towards death and dying
Research and Development of LSD Therapy:
- Extensive research spanning three decades
- Hundreds of papers published on various types of LSD therapy
- International conferences organized to exchange experiences, observations, and theoretical concepts
Therapeutic Potential of LSD:
- Euphoria in LSD sessions suggested potential for treating depressive disorders
- Profound effects on psychological and physiological functions, similar to electroshocks or other forms of convulsive therapy
- Unusual ability to facilitate intensive emotional abreactions (e.g., hypnoanalysis, narcoanalysis)
- Potential to mobilize and intensify fixated, chronic conditions, making them more amenable to conventional treatment
- Combination with individual and group psychotherapies of different orientations was most effective
LSD Therapy Approaches Based on Pharmacological Effects
Exploration of Euphoriant and Antidepressant Effects of LSD
- Condrau proposed using LSD for depression due to its euphoric effect
- Small, increasing daily doses given to depressive patients
- Results inconsistent, deeper pre-existing mood rather than consistent euphorization
- Negative or inconclusive clinical experiences reported by other authors
Shock-Inducing Properties of LSD and Its Effect on Personality Structure
- Early researchers suggested profound experience induced by LSD could benefit patients
- Comparable to electroshocks, insulin coma therapy, etc.
- Unexpected clinical improvements reported after single LSD sessions
- Dramatic changes in hierarchy of values, basic attitudes, and life style
- Difficulty replicating transformative experiences due to unpredictable nature
- Development of psychedelic therapy based on these observations
Limitations of Pharmacological Effects Approach
- LSD does not have consistent pharmacological effects on depression that can be therapeutically exploited
- This approach has been largely abandoned in favor of other methods.
LSD Therapy: Abreaction and Activation Effects
Abreactive Effect of LSD:
- Facilitates reliving of emotionally relevant episodes from infancy, childhood or later life
- Preceded by powerful emotional abreaction and catharsis in case of traumatic memories
- Logical to explore as an agent for abreactive therapy due to historical and theoretical roots in Freud and Breuer's theories (29)
Use of LSD in Abreactive Therapy:
- Valuable in treating traumatic emotional neuroses
- Particularly effective during Second World War as a quick remedy for hysterical conversions
- Unique abreactive properties make it different from other methods like ether, short-acting barbiturates or amphetamines (oversimplification to focus on abreaction alone would be misleading)
Activating Effect of LSD:
- Intensifies and mobilizes manifest and latent psychopathological symptoms
- Inspired by clinical observation of relationship between nature of psychotic process and prognosis (41)
- Principle of activation or "provocation" therapy with LSD developed and employed in practice by Austrian researcher Jost
- Accelerates spontaneous development of disease to mobilize autonomous healing forces within the organism
- Combination of chemical (LSD) and electrophysiological (ECT) methods used to shorten schizophrenic episode and deepen remission (42)
- Sandison and Whitelaw applied tranquilizing effect of chlorpromazine but later discarded its role as positive in procedure (92)
Limitations:
- Activational therapy with LSD has not found broader acceptance in clinical practice, remaining limited to attempts described above.
Modern Approaches:
- Intrinsic trajectory of psychotic process and value of acceleration agreed with modern approaches like those of R. D. Laing, John Perry, Julian Silverman, Maurice Rappaport.
- Observations regarding culmination moment and experiences associated with breaking point make new sense when viewed in context of dynamic matrices in unconscious rather than Jost’s mechanical model.
LSD-Assisted Psychotherapy
Background:
- Pharmacological properties of LSD have failed to bring positive results
- Abandoned as a chemotherapeutic agent by serious researchers
- Use of LSD as an activating substance (Jost and Vicari's sense) is valued but requires structure
Therapeutic Outcome:
- Dependent on non-pharmacological factors (extrapharmacological variables)
- Personality structure
- Therapeutic relationship
- Psychological support
- Set and setting of session
- Optimal use involves a complex psycho-therapeutic program
Approaches to LSD Therapy:
- Facilitation of Psychotherapeutic Process by LSD Administration:
- Small doses of LSD used in intensive psychotherapy sessions (25-50 micrograms)
- Emphasis on systematic psychotherapy and weakening defense mechanisms
- Enhance recall of repressed memories and intensify transference relationships
- Interpret content similarly to dreams in non-drug psychotherapy
- Compatible with various techniques, such as psychoanalytic, Jungian analysis, bioenergetics, and Gestalt practice.
- Small doses of LSD used in intensive psychotherapy sessions (25-50 micrograms)
- Emphasis on Specific Aspects of Drug Experience:
- Less focus on systematic psychotherapy
- Use of LSD to prepare subjects for sessions, provide support during experiences, and aid in integration of material.
LSD in Group Psychotherapy
- Small doses of LSD used during group sessions for deeper dynamic processes
- Coordinated group work possible with small dosages, but disintegration occurs with increased dosages
- Participants experience session individually and find it difficult to sacrifice for group cohesion
- Alternative approaches: transcending verbal interaction through non-verbal means in rituals (peyote sessions, yage ceremonies, etc.)
LSD in Intensive Psychotherapy
- Regular psychotherapy with occasional LSD sessions for intensifying and accelerating therapeutic process
- Primary emphasis on drug experience, modified psychotherapeutic techniques used
- Techniques of LSD therapy: greater therapist activity, elements of assistance and attendance, direct approach, physical contact, psychodrama involvement, tolerance for acting-out behavior, abandonment of orthodox analytic situation
- Intensified therapeutic relationship and analysis of transference phenomena essential parts of treatment process.
Psychedelic Therapy with LSD
Background:
- Developed from observations of dramatic clinical improvements and profound personality changes during LSD sessions with a religious or mystical emphasis
- Inspired by similarities between LSD state and delirium tremens experience in alcoholics
- Foundations laid by Hoffer, Osmond, and Hubbard in cooperation with others
Objective:
- Create optimal conditions for subject to experience ego death and transcendence into psychedelic peak experience
- Ecstatic state characterized by loss of boundaries, unity with world, feelings of joy and affirmation of life process
Preparation:
- Period of drug-free preparation to facilitate peak experience
- Exploration of patient's history, symptoms, personality factors that may hinder achieving psychedelic peak experience
- Emphasis on growth potential and encouragement to reach personal resources
- Discouragement from detailed exploration of psychopathology
- Orientation towards life strategy based on observations of successful LSD treatments
Approach:
- Focuses on general directions for existence, life philosophy, hierarchy of values
- Discussions in preparation period revolve around philosophical and spiritual issues due to the nature of psychedelic sessions.
Psychedelic Therapy Preparation:
- Interview before session focuses on technical questions related to drug experience
- Therapist describes nature of drug effect and spectrum of potential experiences
- Emphasis on verbal yielding to drug effect and psychological surrender
- Beautiful environment with emphasis on aesthetically rich settings
- High doses of LSD (300-1500 micrograms) used, typically only one high-dose session or a few sessions
- Encouragement for patients to relax, use eye shades, and stereo headphones during entire drug effect period
- Limited verbal contact and preference for nonverbal communication for support
- Settings often include Eastern and primitive art, spiritual symbols, and univeral symbolism
History of LSD Therapy:
- Less emphasis on psychodynamic issues unless problematic in treatment
- Transference phenomena generally discouraged through limitation of visual contact
- Focus on peak psychedelic experience, often a death-rebirth sequence with resulting feelings of cosmic unity
- Incomplete theoretical system compared to psycholytic therapy which relies on various dynamic psychology schools.
- Not popular in Europe, primarily recognized and practiced in North America by representatives such as Hoffman, Osmond, Hubbard, Smith, Chweles, Metzner, Ditman, Hayman, Whittlesey, Sarafian, Laughlin, Leary, Alpert, and Metzner.
- Research program systematically exploring potential of psychedelic therapy for various psychiatric problems, mental health professional training, and care of dying cancer patients conducted in Maryland by Albert A. Kulpin since 1969 with contributors including Cimonetti, Bonny, Lehman, DiLeo, Lobell, McCabe, Pahnke, Richards, Rush, Savage, Schiffman, Soskin, Wolf, Yensen, and Grof.
Anaclitic Therapy with LSD (LSD Analysis)
Background:
- Developed by Joyce Martin and Pauline McCririck, London psychoanalysts
- Based on observations of deep age regression during LSD sessions for patients with psychoses, psychiatric disorders, neuroses, and character issues
- Patients relive episodes of early infantile frustration and emotional deprivation
- Agonizing cravings for love, physical contact, and instinctual needs on a primitive level
Approach:
- Based on psychoanalytic understanding and interpretation of situations in drug sessions
- Active mothering role with an emphasis on direct satisfaction of anaclitic needs
- Holding patients, feeding them milk, caressing, reassuring touches, hugging, rocking
- "Fusion technique" involves full body contact and comforting movements
- Patient lies on couch covered with blanket; therapist lies beside in close embrace
- Authentic feelings of symbiotic union and mystical rapture
- Contact with the Great Mother or Mother Nature
- Reports of deepest form involving feelings of oneness with cosmos and divine source
Controversy:
- Criticism from psychoanalytically oriented therapists regarding violation of touching taboo and potential consequences for transference
- Martin and McCririck responded that lack of fulfillment in conventional therapeutic relationship perpetuates transference, which is resolved through deep regression and satisfaction of anaclitic needs
- Fusion technique should only be used during periods of deep regression and kept strictly on pregenital level to avoid adult sexual patterns confusion.
Hypnodelic Therapy:
- Developed by Levine and Ludwig to combine LSD's uncovering effect with hypnotic suggestion
- Hypnosis used for trance induction, guiding patient through drug experiences
- Patient trained as a hypnotic subject before LSD administration
- Transition from hypnotic trance to LSD state is relatively smooth due to similarities between experiences
- Therapists help patients work through problems during LSD session, encourage overcoming resistances and defenses
- Post-hypnotic suggestions given for remembering details of the session and continuing problem reflection
- Combination of LSD administration and hypnosis more effective than either separately according to original report
Aggregate LSD Psychotherapy:
- Patients experience drug sessions with other co-patients in the same psychedelic treatment program
- No effort at coordinated group work during drug action
- Goal is to save time for therapeutic team, but lack of individualized support may make treatment less effective
- Advantage: ability to treat multiple patients simultaneously from economic perspective
- Disadvantage: potential for psychological contagion and negative influences among patients.
Roquet's Psychosynthesis:
- Combination of psychoanalytic training, knowledge of indigenous healing practices, and use of various psychedelic substances in therapy sessions
- Patients meet for leaderless group discussions before drug administration to build connections and discuss fears, hopes, expectations
- Variety of psychedelic substances used including LSD, peyote, psilocybin mushrooms, morning glory seeds, Datura ceratocaulum, and ketamine
- Sensory overload show with slides, movies, stereo effects, and colored floodlights during drug sessions
- Reflective phase after drug session for integrating insights from the experience into everyday life.
The Need for a Comprehensive Theory of LSD Therapy
Problems with Current LSD Research:
- Therapeutic experimentation with LSD has been negatively influenced by:
- Existence of the black market
- Unsupervised self-experimentation
- Sensational journalism
- Irrational legislative measures
- Literature on LSD effects and therapeutic potential is controversial and inconclusive
- Independent teams in different countries need to interact and cooperate to collect experimental data and exchange information
- Number of places studying LSD has been cut down and continues to decrease
Future Prospects for Psychedelic Research:
- Indications that systematic exploration will be resumed after general confusion is clarified and rationality reintroduced
- Controlled studies on a large scale are needed to assess the efficacy of LSD as an adjunct to psychotherapy with scientific accuracy
- Clarification of present controversies and disagreements would be of great practical importance
Limitations in Previous Psychedelic Therapy Research:
- Individual authors and research teams used LSD starting from very different premises:
- Different therapeutic objectives
- Adhered to different theoretical systems
- Employed differing technical approaches
- Administered the drug in disparate frameworks and settings
- Main reason for controversies about LSD therapy: Lack of understanding regarding the nature of the LSD effect
- Need for a plausible and generally acceptable conceptual framework to reduce observed data to common denominators
Important Problems to be Addressed in Theory Framework:
- Understanding the content and course of separate LSD sessions as well as repeated exposures
- Explaining the paramount importance of extrapharmacological factors (subject/guide personalities, mutual relationship, set/setting) in LSD sessions
- Accounting for occasional prolonged reactions, psychotic breakdowns, or "flashbacks"
- Bridging the gap between psycholytic and psychedelic therapy, as well as other therapeutic modifications
- Providing practical directives for optimal conditions for LSD use in psychotherapy (dosages, approaches, auxiliary techniques, set/setting)
- Offering partial working hypotheses that can be tested using scientific methodology
Religious Conversions:
- Atheists becoming true believers or fanatics: observed in ecstatic sects and during sermons of charismatic preachers like John Wesley (1)
- Maya Deren's conversion to Haitian voodoo through studying aboriginal dances (2)
- Victor Hugo’s Jean Valjean's moral conversion in Les Misérables (3)
- Biblical examples: Barabas and Mary Magdalene (no reference)
Childhood Trauma and Psycholytic Therapy:
- Systematic study on the significance of traumatic memories from childhood for psycholytic therapy by Hanscarl Leuner (4)
- Discussion of psychodynamic experiences in Realms of the Human Unconscious (5)
Psychedelic Peak Experiences:
- Characteristics: feelings of unity, transcendence of time and space, strong positive affect, sense of reality, sacredness, ineffability, paradoxicality, transiency, subsequent changes in attitudes and behavior (6)
- Psychedelic Experience Questionnaire (PEQ) by Walter Pahnke for assessing and quantifying psychedelic peak experiences during LSD sessions.
Other:
- Hic sunt leones: old geographical expression meaning "Here are lions," used to denote insufficiently explored territories or potential dangers. (7)
Critical Variables in LSD Therapy
Pharmacological Effects of LSD:
- Personality of the Subject:
- Importance of non-drug factors as determinants of psychedelic experiences
- Critical role they play in the therapeutic process
- Set and Setting of the Sessions:
- Full awareness required to understand the nature and course of LSD therapy
- Abandonment of simplistic models, such as "model schizophrenia" or "toxic psychosis"
Personality of the Subject:
- Utmost importance in determining psychedelic experiences
- Emotional condition and current life situation critical factors
Personality of the Therapist or Guide:
- Deep understanding required for all serious researchers
- Critical role in the therapeutic process
Set and Setting of the Sessions:
- Complex of additional factors including:
- Set: Subject's attitude, expectations, and mood
- Setting: Environment where therapy is conducted
LSD State: Complexity and Variability
- LSD state is multiform, interindividual and intraindividual
- No standard or invariant pharmacological effects of LSD
- Visual changes not mandatory in all sessions
- Physical manifestations vary greatly from session to session
- Sympathetic and parasympathetic symptoms
- No dose-effect relationship
- Sensitive to psychological factors
- Relevant interpretations, arrival of specific person, use of physical contact, bioenergetic exercises
- Mydriasis (pupil dilation) not invariant manifestation
- Intensity and response to LSD depend on complex psychological factors.
Subjects Resisting LSD Effects
Factors Affecting High Resistance:
- Need for self-control and relaxation difficulties
- Setting personal tasks or competing with therapist
- Proving psychological "strength"
- Impressing friends
- Insufficient preparation, instruction, reassurance, agreement, cooperation, and basic trust in therapeutic relationship
- Analysis of unconscious motives behind resistance
- Unsupervised self-experimentation in unfamiliar environments
Additional Causes of High Resistance:
- Lack of full dosage response (300-500 micrograms)
- Gradual reduction of psychological resistance through series of sessions
- Saturation point of LSD between 400 and 500 micrograms
- Mental processes and neural processes intensified
- Pre-existing and recent psychogenic symptoms amplified
- Emotional reactivity enhanced
Factors Influencing LSD Effects:
- Perceptual changes in various sensory areas
- Consciousness qualitatively changed with dream-like character
- Facilitated access to unconscious material
- Psychological defenses lowered
- Affective factors play important role as determinants of reaction
Unspecific Effects of LSD:
- Activation and amplification of neurological processes
- Possible reliving of past injuries, operations, and emotional charges
- Diagnostic tool for exteriorizing latent organic damage in the central nervous system (CNS)
- Risk of activating seizures in patients with epilepsy or a latent disposition to it.
LSD as a Catalyst:
- Facilitates emergence of unconscious material from various levels of personality
- Richness and variability influenced by extrapharmacological factors: subject's personality structure, current life situation, guide's personality and relationship, and session set and setting.
Personality Factors Affecting LSD Experience
Pre-Drug Phase:
- Individuals with anxiety and apprehension toward sessions
- Raise questions, doubts about effect and value of treatment
- Share horror stories and fear of losing control or social embarrassment
- Struggle with instinctual energies and emotional outbursts
- Fear of loss of control, inferiority, guilt, self-reproach
- Dislike situations threatening unconscious impulses (fatigue, illnesses)
- Problems in sexual life due to fear of unleashing aggressive impulses or losing control
- Perinatal energy manifestations
- Lack of trust in self, others, human society, world
- Intellectuals seeking unusual experiences and exploring hidden recesses of mind
- Attraction to psychedelic session as learning opportunity
- Full attention and undivided attention from therapist
- Desperate patients with strong motivation for quick relief or termination of conflict
- Unable to tolerate psychological forces, considering suicide
- May activate self-destructive tendencies if sessions do not result in elements of ego death and transcendence.
During a Therapeutic Series:
- Patients realize deep self-exploration potential
- Insight that suspension of defenses is liberating experience instead of loss of control.
Psychedelic Sessions: Obsessive-Compulsive Neuroses vs. Hysterical Personality Structure
Obsessive-Compulsives:
- Tend to be afraid of drug session beforehand
- Resist the effect of LSD, characterized by intense inner struggle
- Limited phenomenology: fight against drug, massive somatization
- May experience physical symptoms like headaches or nausea
- Sessions followed by excessive fatigue
- High resistance to therapeutic benefit
Hysterical Personality:
- Extremely sensitive to LSD effects
- Dramatic reaction after small doses
- Rich perceptual changes, predominance of visual elements and body sensations
- Erotic nature and sexual symbolism dominate experiential world
- High tolerance for suffering during sessions
- Can present challenges in transference and countertransference
Observations from LSD Psychotherapy:
- Confirmation of Freud’s findings: close relationship between homosexuality and paranoid behavior
- Intensification of suicidal ideas or deepening depression in sessions
- Euphoric or ecstatic way, with improvements sometimes leading to complete remission of serious periodic depressions (exogenous origin)
- Useful for making differential diagnoses between exogenous and endogenous depressions: rich biographical material in patients with exogenous depression vs. limited content in those with endogenous depression.
Relationship Between LSD Use and Clinical Diagnosis:
- Patients may experience temporary intensification of symptoms after LSD sessions
- No clear relationship between diagnostic group and nature of LSD experiences, except in extreme cases
- Limited value of LSD as an auxiliary to conventional clinical diagnosis
- Unpredictable changes in personality structure and symptoms with repeated exposure to LSD
Dynamic Diagnosis:
- Useful tool for exploring the forces constituting basic personality and deep dynamic structures underlying clinical symptoms
- Can observe intensification of pre-existing personality characteristics and behavior patterns during sessions, accompanied by accentuation of current clinical symptoms or recurrence of emotional and psychosomatic effects
- Opportunity to study psychogenesis and physiology of newly formed symptoms in the process of origination
Observable Phenomena During LSD Sessions:
- Emotional Reactivity:
- Explore present emotional condition
- Experience affective states, especially ambivalence and conflicting attitudes
- Express anxieties and various specific fears, depression, despair, etc.
- Agonizing feeling of loneliness and isolation with a sense of uselessness
- Self-Image and Self-Esteem:
- Preoccupation with physical appearance, imaginary or insignificant defects
- Comparison of own abilities unfavorably to significant others
- Low moral self-evaluation and conflicts between instinctual impulses and ethical principles
- Feelings of emotional inferiority, incapable of experiencing genuine affection
- Other Phenomena:
- Enhancement of subtle personality elements to the point of caricature during low-dose sessions
- Aggressive tension, irritability, impulsivity, or emotional lability with alternating depressive and euphoric moods.
Common Manifestations Related to Personality Characteristics
- Agonizing guilt feelings, qualms of conscience, and self-accusation
- Unnatural bragging and boasting, condescending and pseudoauthoritative attitudes
- Exaggerated demonstrations of power, indulgence in caustic attacks and hypercritical comments
- Tendency to cynicism and ridicule
- Marked enhancement of sociability with incessant search for human contact, non-stop talking, clowning, joking, and entertaining others
- Enormous need for attention, imagined or actual neglect is experienced as painful
- Attention-getting maneuvers such as noisy and theatrical performances, affectionate behavior, seeking gentle physical contact
- Erotic component may come to the foreground: coquetry, seductiveness, minor sexual aggression, verbalizations full of sexual undertones or overt obscenities
- Marked accentuation of withdrawal mechanisms such as psychological withdrawal and unwillingness to interact with people
- Withdrawal can reflect conflicts and problems related to aggression
- Intensification of social and interpersonal patterns related to dominance and submission: strong tendencies to manipulate, control, criticize, or mentor others; making determined efforts to create situations involving competition and testing of powers, or derogation, humiliation and ridicule of others. Conversely, submissive maneuvers can also be accentuated to the point of caricature.
- Desperate and determined fight for maintenance of full self-control in individuals with various problems with self-control even in everyday life.
- Inability to relate fully to external world or inner experience in subjects with a rich inner world to which they can turn as a protective shelter against traumatizing reality.
Manifestations after Psychological Reversal
- Marked aggressivity with hostile and destructive tendencies in extremely submissive and anxious persons who in everyday life are timid, shy, and overly polite, and meticulously avoid any interpersonal conflict.
- Overriding feeling of abysmal insecurity, low self-esteem, and childlike helplessness surfacing and dominating the experiential field in markedly authoritarian persons who are excessively autocratic in their normal life and ostenatiously demonstrate their personal strength and power.
- Sudden, dramatic changes in individuals with intense feelings of inadequacy and inferiority: they tend to become grandiose and overtly self-confident, manifest various dictatorial and domineering tendencies, and express megalomanic ideas and fantasies. Conversely, in markedly authoritarian persons, the underlying feelings of abysmal insecurity, low self-esteem, and childlike helplessness surface.
- Male patients who in everyday life demonstrate elements of masculine pride and macho behavior with an emphasis on bodybuilding, who accentuate male supremacy and superiority, and treat women with disrespect and irony discover in these sessions that they have serious doubts about their masculinity and harbor intense homosexual fears.
LSD Therapy and Personality Structures
Experiential Expression of Animal Symbolism:
- During characterological self-exploration, LSD subjects may identify with animals that represent certain human personalities, attitudes, or behaviors.
- Examples: tiger (aggression), monkey (polymorphous perversions), station/bull (strong sexual drive).
Perception of Others:
- Subjects can project intrapsychic events onto others during open-eye sessions.
- Therapists, nurses, co-patients, friends or relatives may be perceived as sadists, lechers, perverts, criminals, murderers, or demonic characters.
- Conversely, they can represent embodiments of the critical attitudes of the Superego and be seen as parental figures, judges, members of a jury, policemen, jailers, or executioners.
- Extreme cases: entire human and physical situation may become transformed into scenes like bordello, harem, sexual orgy, medieval dungeon, concentration camp, courtroom, or death row.
Benefits of LSD Therapy:
- Detailed analysis of LSD experiences reveals important emotional problems and relevant situations from past history and present life situation.
- LSD is a unique tool for psychodynamic diagnostics due to its ability to selectively activate unconscious material with the strongest emotional charge.
Repeated LSD Sessions:
- Subjects can trace emotional and psychosomatic symptoms, interpersonal attitudes, and behavior patterns to their deep sources in the unconscious during a therapeutic series.
- Sequential LSD sessions can be seen as a process of progressive activation and unfolding of content in dynamic matrices in the unconscious.
Experiential Realms:
- Distinct content and dynamic systems govern each experiential realm.
- Characteristic significance for mental functioning: holographic, multileveled, multidimensional nature of the unconscious.
Psychodynamic Experiences
Characteristics:
- Associated with biographical material from subject's life
- Derived from emotionally relevant events, situations, and circumstances
- Related to unresolved conflicts since early childhood
- Accessible in normal states of consciousness or repressed unconscious
- Involve reliving past traumas and confronting conflicts
Examples:
- Psychosexual dynamics and basic conflicts described by Freud
- Regression to childhood and early infancy
- Experiences containing symbolic disguises, cryptic defenses, metaphorical allusions
Understanding:
- Based on COEX systems (systems of condensed experience)
- Specific constellation of memories from different life periods
- Memories have similar basic theme or contain similar elements
- Accompanied by strong emotional charge of the same quality
- Defense mechanisms and connected with specific clinical symptoms
Psychoanalytic Framework:
- Manifestation of psychosexual dynamics and basic conflicts described by Freud
- Regression to childhood and early infancy, reliving psychosexual traumas
- Confronting conflicts related to activities in different libidinal zones
- Incomplete understanding without introducing new principle: COEX systems.
Perinatal Experiences and COEX Systems
Influences from External World:
- Uterine contractions disrupt peaceful state of womb
- Transition to BPM IV: Gigantic, threatening figure blocks access to light source
Transition from BPM III to BPM IV:
- Subject faces and embraces unobstructed rising sun
- Physical and emotional agony during opening heart chakra
- Activated COEX systems determine perception and reaction to environment
- External events can activate COEX systems with associated features
- Governing function of activated COEX system may continue post-session
Biographical Experiences:
- Transitional form between psychodynamic area and perinatal level
- Memories of physical traumas, survival threats or body integrity violations
- Examples: serious operations, painful injuries, severe diseases, near drowning, cruel psychological/physical abuse, concentration camp experiences, brainwashing techniques, maltreatment in childhood
- Frequently occur with experience of birth agony
- Important role in emotional disorders like depressions, suicidal behavior, sadomasochism, hypochondriasis and psychosomatic disorders
Perinatal Experiences:
- Focus on biological birth, physical pain and agony, disease, aging, decrepitude, dying and death
- Profound first-hand experience instead of symbolic confrontation
- Characteristic illustrations: eschatological ideation, wars, revolutions, concentration camps, accidents, decaying cadavers, coffins, cemeteries and funeral corteges
- Shattering confrontation with vulnerability and impermanence of humans
- Two consequences: profound emotional and philosophical crisis, opening to religious and spiritual experience.
Perinatal Experiences in LSD Sessions
Experiences and Symptoms:
- Oscillating body temperature
- Profuse sweating
- Nausea with projectile vomiting
- Cardiac distress and irregularities
- Hypersecretion of mucus and saliva
- Fetal postures and movements
- Visions of or identification with fetuses, newborns, infants
- Authentic neonatal feelings, postures, and behavior
- Visons of female genitals and breasts
Perinatal Matrices:
- Four typical clusters or experiential patterns reflecting unconscious content
- Relate to the four consecutive stages of biological birth process and perinatal experiences
- Governing systems similar to COEX systems on the psychodynamic level
Parallels with Biological Birth Process:
- Searching for a simple conceptualization
- Synoptic paradigm showing parallels between stages of biological delivery and pattern of sexual orgasm
Importance of Perinatal Experiences:
- Shift etiological emphasis in psychogenesis from sexual dynamics to perinatal matrices
- Clues to understanding puzzling aspects of LSD experiences
- Far-reaching implications for psychiatric theory
BPM I (Biological Delivery Stages 0-1):
- Schizophrenic psychoses, hysterical hallucinosis, and hypochondriasis
- Libidinal satisfaction in erogenic zones
- Memories from postnatal life: happy moments, fulfilling love, vacations, exposure to art
Perinatal Matrix I (Primal Union With Mother)
- Fetus's original state of intrauterine existence during which maternal organism and child form symbiotic unity
- Ideal conditions: protection, security, continuous satisfaction of needs
- Adverse circumstances can interfere with ideal condition: diseases, emotional states of mother, external factors like toxic substances or loud noises
- Experienced as "good womb" or "bad womb" in LSD sessions: undisturbed intrauterine existence vs. physical and psychological suffering
- Association between the two conditions: "oceanic feelings" (embryonic state) and experience of cosmic unity (spiritual counterpart)
Positive Aspects:
- Protection and security
- Continuous satisfaction of needs
- Symbiotic unity with mother
- Ideal conditions for fetus
Negative Aspects:
- Diseases and emotional states of mother
- External factors: toxic substances, loud noises, mechanical vibrations
- Disturbances in intrauterine existence (bad womb experience)
LSD Sessions:
- "Good womb" experience: undisturbed intrauterine existence or spiritual counterpart
- Cosmic unity: transcendence of subject-object dichotomy, awareness of oneness with others, nature, universe, God.
Mystical Experiences Induced by BPM I and LSD
Positive Aspects of BPM I:
- Experience of cosmic unity
- Perceived as existing outside space-time continuum
- Sense of sacredness, ultimate insight into existence
- Referred to as Paradise, Garden of Eden, Heaven, etc.
- Oceanic ecstasy with closed eyes
- Merging with environment and sense of unity with objects
- Defined by Walter Pahnke's mystical categories and Maslow's peak experience
Relation to Memory Mechanisms:
- Positive aspects linked to COEX systems
- Recording of relaxed, tension-free experiences
- Negative aspects related to certain negative COEX systems
Perinatal Matrix II (Antagonism With Mother):
- Confronted with cosmic engulfment and no exit
- Disturbance of original equilibrium in intrauterine existence
- Relived experience of delivery and its first clinical stage
- Feeling of being swallowed by a monster or descending into underworld
- Symbolic counterpart: experience of hell, unbearable suffering
Negative Aspects:
- Unbearable psychological and physical tortures
- Convinction that no escape from torments
- Agonizing feelings of loneliness, alienation, helplessness, hopelessness, inferiority, guilt.
Experiential Matrix BPM II vs. III
Characteristics of Experiences:
- BPM II (No Exit): Unbearable, inescapable situation where the victim is helpless and there's no way out.
- BPM III (Synergism with Mother): Active involvement in struggle for survival during birth or delivery, involving titanic fight, sadomasochistic orgies, interne sexual sensations, scatological involvement, and purifying fire (pyrocatharsis).
- Differences: No exit situation seems hopeless and the subject is a helpless victim; in contrast, death-rebirth struggle represents borderline between agony and ecstasy. The individual can observe both sides and identify with them.
Associations with Freudian Erotogenic Zones:
- BPM II: Hunger, thirst, nausea, painful stimuli on oral level; retention of feces on anal level; retention of urine or sexual frustration/excessive tension on urethral level.
- BPM III: Struggle for survival during birth or delivery involving all erotogenic zones.
Symbolism:
- Phoenix: symbolizes the purifying fire and spiritual rebirth.
- Hercules cleaning Augeas' stables, Aztec goddess Tlacolteutl (Devourer of Filth): scatological aspect of death-rebirth struggle.
- Religious symbols related to bloody sacrifice or rituals involving sex and wild rhythmic dances: fertility rites, phallic worship, tribal religions.
Associated Memories:
- Intense sensual and sexual experiences, wild adventures, violent rapes, scatological exposures.
Experiential Matrix BPM III:
- Active involvement in struggle for survival during birth or delivery.
- Titanic fight and sadomasochistic orgies.
- Interne sexual sensations, scatological involvement, and purifying fire (pyrocatharsis).
- Fusion of intense agony and ecstasy.
- Subject can observe both aggressor and victim roles.
- Symbolized by the Phoenix's rebirth from ashes.
- Memories related to intense sensual and sexual experiences, wild adventures, violent rapes, scatological exposures.
Perinatal Matrix IV (Separation From Mother)
- Meaningfully related to the final phase of delivery
- Agonizing process culminates in physical separation from mother
- Experiences can represent a realistic reenactment or specific obstetric interventions
Symbolic Counterpart
- Death-rebirth experience
- Termination and resolution of death-rebirth struggle
- Physical and emotional agony followed by relief and relaxation
Ego Death and Rebirth Symbolism
- Destructive deities like Moloch, Shiva, Huitzilopochtli, Kali, Coatlicue
- Union with Great Mother: Isis, Cybele, Virgin Mary
- Radiant sources of light: divine, heavenly blue cosmic spaces, magnificent rainbow spectra
- Non-figurative images of God: Tao, Atman-Brahman, Allah, Cosmic Sun
- Personalized images and traditional representa-tions of God and deities
Memory and Freudian Erotogenic Zones
- Records major personal successes and ends of prolonged serious danger
- Associated with the condition following an activity that reduced tension (swallowing food, relieving vomiting, defecation, urination, sexual orgasm and delivery of a child)
Basic Perinatal Matrices and Psychedelic Sessions
- Result of successive exteriorization, abreaction, and integration of negative perinatal matrices (BPM II and III)
- Connecting with positive ones (BPM I and IV)
- Determines emotional reactions, thought processes, physical manifestations, and perception of physical and interpersonal environment.
Transition from BPM I to BPM II
- Hegemony of BPM I provides a totally positive stencil, seeing the world as radiant and divine
- Transition to BPM II introduces insidious threat, subject tends to fear entrapment and attempt to escape treatment room.
Transpersonal Experiences
Characteristics:
- Subject's consciousness expands beyond ego boundaries
- Transcendence of time and space limitations
- Regression to past experiences (fetal, embryonic, cellular, ancestral)
- Merging with others, identifying with groups or all of humanity/creation
- Consciousness of body parts
- ESP phenomena (out-of-body, telepathy, precognition, clairvoyance, space/time travel)
- Encounters with spirits, deities, archetypes, universal symbols, Kundalini, chakras, Supracosmic and Metacosmic Void
Relationship to Perinatal Experiences:
- Transpersonal experiences can occur during perinatal exploration
- Difficulty in understanding the sources of transpersonal phenomena due to being beyond individual's history or conventional context
Thematic Clusters:
- Embryonal experiences associated with evolutionary memories and archetypal deities
- Influence on perception of self, others, physical environment
Importance:
- Understanding essential for approach to shamanism, religion, mysticism, rites of passage, mythology, parapsychology, schizophrenia
Governing Systems and Matrices:
- Unlike psychodynamic or perinatal experiences, transpersonal experiences do not allow for clear organization and classification due to questioning of principles like time, space, matter, causality.
Personality of Therapist or Guide
- Personalities of therapist, co-therapist, sitters, or any persons present are paramount in structuring the content, course, and outcome of psychedelic sessions
- Feeling of safety and trust on the part of the experient is critically dependent on the presence or absence of the guide, their personal characteristics, and nature of relationship
- Subject must be able to surrender control and abandon defenses for successful session outcome
- Importance of reality testing and practical matters delegated to a trusted sitter
- Transference aspect in therapeutic relationship is more powerful than conventional psychotherapy
- Therapist's actions can have far-reaching influence on the content and course of sessions
- Degree of human and professional interest, clinical experience, personal security, freedom from anxiety, and current physical/mental condition are important factors for successful LSD therapy
- Clarity in therapist's motivation, attitudes, examining own motivations, establishing good working relationship, and clarifying transference-countertransference situation are necessary prerequisites for a successful course of therapy.
Importance of Human Element
- LSD sessions cannot fully overcome certain recurrent impasses without human element providing corrective emotional experience
- Patients may need therapist's presence to resolve issues related to basic trust, especially in early stages of therapeutic work with LSD.
Transference Aspect
- Emotional significance of therapist has two components: patient's actual life situation and transference aspect
- Transference element is more powerful than conventional psychotherapy and tends to increase with number of sessions
- Patients project strong emotional attitudes derived from important figures in their past, especially close family members onto the therapist.
Therapist's Behavior during Sessions
- Actions of therapist can have dramatic effects on content and course of psychedelic sessions
- LSD subjects may show strong reactions to therapists' leaving or entering room, offering/withdrawing physical contact, or seemingly indifferent gestures/comments.
Importance of Preparation and Relationship
- Clarity in relationship between therapist and subject is necessary prerequisite for a successful course of therapy
- Therapist should be aware of own intrapsychic and interpersonal patterns to avoid interference with psychedelic process.
LSD Sessions and Transference Distortion
Factors Affecting Transference Distortion:
- Degree of transference distortion related to:
- Dosage
- Nature of unconscious material emerging in session
Effects of LSD on Perception:
- Subjects can show depth and clarity of perception during drug use, but not dealing with emotional material
- Ability for intuitive and empathic understanding of others sharpened and deepened
- LSD subjects can make accurate readings of sitters when problems faced are similar to their own
Reading Sitters' Feelings:
- Subjects able to tune into sitters' inner feelings with great accuracy
- Can sense therapist's concentration, dedication, and emotional state through facial expressions or other clues
- Some subjects can guess specific content of therapist's thought processes or describe remote events from their life
Projective Distortion:
- In high-dose sessions, most perceptions about sitters reflect subject's inner experiences (emotions, instinctual tendencies, superego functions) rather than reality
- Therapeutic relationship critical for working through "crisis of basic trust" and avoiding projective distortions
- Projective distortions can range from simple fantasies about therapist's facial expressions to complex illusions and symbolic transformations
- Common categories: projections of aggressive or sexual instinctual tendencies, representing the subject's own feelings and experiences
Illusory Transformations of the Therapist
Famous Characters from Horror Movies:
- Frankenstein's monster
- Creature from the Black Lagoon
- Dracula
- King Kong
- Godzilla
Symbolic Transformation into Aggressive Creatures:
- Bloodthirsty predator: eagle, lion, tiger, black panther, jaguar, shark, or Tyrannosaurus Rex
- Traditional adversaries of such animals: gladiator, hunter, or tamers of wild beasts
Archetypal Images Symbolizing Aggression:
- Evil magicians
- Malicious witches and vampires
- Devils, demons, and devouring deities
Transformation into Specific Adversaries:
- Parental figures, teachers, and critical authorities from the subject's life
- Priests, judges, and jury members
- Archetypal personifications of Justice
- Three representations of illusory transformation of the therapist: Arabian merchant dealing with dangerous drugs; wild and primitive African native; Indian sage radiating perennial wisdom.
Representations of Superego:
- Sadistic monster who enjoys inflicting suffering on the patient
- Absolutely perfect human, a person endowed with all virtues
- Unconditional love and undivided attention
Need for Exclusive Possession and Control:
- Difficulty accepting sharing therapist with other patients or having private life
- Feeling treated as experimental guinea pig or professional ploy
- Physical contact viewed as therapeutic technique or professional ploy rather than genuine expression of human affection.
Transformations Reflecting Irritation and Criticism:
- Sherlock Holmes, Hercule Poirot, Leon Clifton, or caricatured detective with pipe, spectacles, and magnifying glass
- Funny-looking learned owl sitting on cobweb-covered volumes
- Philistine bureaucrat, ambitious and diligent schoolboy, or provincial clerk.
Transformation into Specific Professions:
- Grocers, barbers, or butchers in white coats (instead of the physician)
Symbolic Transformations Reflecting Therapist's Curiosity and Objectivity:
- Caricatured as a detective with large pipe, Sherlock Holmes-like
- Satirical illustration of hatchery symbolizing successful end of treatment and cure of neurosis.
LSD Experiences and Illusive Transformations of Therapist:
Competition Among Patients for Therapist's Attention:
- Patient-eggs competing to expedite hatching process
- Trying to win affection of therapist (represented by electric bulbs)
- Patient herself is a dissatisfied little chicken embryo, wanting real mother hen
Simultaneous Transformations:
- Therapist's transformation can accompany patient and environment changes
- Multi-level and overdetermined structure with opposing tendencies and emotions
Visual Manifestations vs. Projective Distortions:
- Most striking are visual manifestations, but projective distortions involve other senses
Abstract Changes vs. Psychodynamic Levels:
- Abstract changes do not have deeper symbolic significance
- Therapist's face can appear undulating, distorted, or changing colors
- Psychodynamic levels reflect basic themes of COEX systems and specific content
Therapist as Significant Figures:
- Parental figure, sibling, close relative, nanny, neighbor, or surrogate parent
- Doctors/nurses conducting painful medical interventions
- Abusers in childhood experiences
Other Representations of Therapist:
- Favorite animals: family dog, pet rabbit or hen, children's toy
- Other variations on central theme
Example: Renata's Sphinx Moth Transformation:
- Perceived therapist's light reflection as large Sphinx moth
- Free associations to night moth visiting intoxicating flowers, human skull on back
- Intimate connection between sex and death due to childhood experiences
- Links to LSD process: hallucinogenic properties of Belladonna, Witches’ Sabbath, dangerous aspects of sex, loss of autonomy, fear of annihilation
- Transformation reflects complex, overdetermined unconscious material.
Perinatal Matrices and Therapist Transformations on LSD:
Negative Perinatal Matrices:
- Therapist as Representative of Threats: chief, Nazi/Communist leader, religious fanatic, mad scientist, Devil
- Loss of critical insight into symbolic process
- Paranoid reactions possible
- Specific elements: monster threatening to devour, Great Inquisitor, concentration camp commandant, diabolic sadist
- Depends on stage and level of death-rebirth process
- Passive or active role of subject
Positive Perinatal Matrices:
- Therapist as Savior: triumphant military leader, embodiment of cosmic wisdom, teacher of life's secrets
- BPM IV: radiance, sacredness, humor
- Subject experiences loss of boundaries and fundamental oneness with therapist
- Patient-therapist role: delivering mother or magical powerful figure
- Relevance is basic and a matter of life and death
- Trust in world and human beings essential for enjoying dependent role
Transference Relationship:
- Can lose ability to differentiate between therapist and self
- Merged perceptions, emotions, thoughts
- Feel magical influence or control by suggestion
- Experience as delivering mother or obstetrician/midwife
- Trust crisis in critical stages of death-rebirth process
- Ultimate vulnerability and questioning of therapist's character and motives.
Transference Relationship Extremes:
- After trust is reestablished: ultimate source of love, security, and nourishment
- Experience as good breast and womb at the same time
- No individual boundaries: continuous flow of thoughts, emotions, and energy
- Patient experiences therapist as archetypal image of Great Mother or God.
Transpersonal Projections in Therapeutic Relationships
Types of Transpersonal Experiences:
- Powerful archetypal images assumed by therapist: Cosmic Man, Wise Man, Great Hermaphrodite, etc.
- Transformations into religious figures or teachers: Jesus, Buddha, Mohammed, etc.
- Representatives of other cultures and past centuries
- Ancestral or phylogenetic memories: human or animal ancestors
Characteristics of Projective Transformations on Transpersonal Level:
- Feel genuine, authentic, convincing
- Contain valid information beyond patient's education level
- Cannot be deciphered and interpreted as symbolic representations of present existence
Implications for Psychotherapeutic Practice:
- Therapist role presents challenges: emotional pressures, transference/countertransference situations
- Intensification of therapeutic relationship goes beyond conventional psychotherapy limits
- Opportunity to mediate corrective emotional experiences on deep levels
Requirements for Experienced LSD Therapist:
- Personal experiences with the drug for deeper understanding
- Long clinical experience: dealing with unresolved issues and managing various phenomena common in psychedelic therapy
- Equanimity, confidence, tolerance towards the entire spectrum of psychedelic phenomena
- Ability to allow patients to experience emotions emerging in sessions without fear or judgment.
LSD Therapy: Set and Setting of Sessions
- Non-pharmacological parameters referred to as "set and setting"
- Includes expectations, motivations, intentions, goals, preparation, and guidance during sessions
- Critical for understanding LSD reactions and therapeutic use
Importance of Set:
- Amplifier of mental processes with broad range of effects
- Disagreements about LSD often relate to different uses and sets of observations
Sets for LSD Sessions:
- Model psychosis approach: dominated early research, explored biochemical basis of endogenous psychoses or trained mental health professionals
- Creative potential enhancement: popular among artists seeking inspiration
- Religious or mystical experience: explored spiritual phenomena in controlled settings
- Therapeutic potential for psychiatric patients and terminally ill: various methods used, including anti-depressant, abreactive, activating agent, catalyst of mental processes, adjunct to psychotherapy (Freudian psychoanalysis, Jung's analytical psychology, Peris’ Gestalt practice, existential psychotherapy), anaclitic approach, psychedelic therapy, and variations based on specific religious frameworks.
- Non-medical use: self-experimentation with varying settings and unreliable drugs, potential for paranoia or panic reactions but no scientific justification for addiction or physiological dependence.
Psychedelic Experimentation: Motivations and Risks
Different Categories of Individuals Involved
- Imature/irresponsible youngsters
- Pleasure seekers
- Couples working through emotional problems
- People with serious emotional issues seeking therapeutic alternatives
- Intellectuals for philosophical and spiritual search
Motivations for Psychedelic Experimentation
- Cravings for emotional well-being, spiritual fulfillment
- Desire to make meaningful life connections
- Exploring new dimensions of sexual interaction
- Finding therapeutic alternatives when traditional methods fail
- Curiosity and philosophical exploration
Risks and Dangers
- Unsafe situations without trust relationships or experienced sitters
- Destructive sets (psychological liquidation, confessions, brain washing)
- Accidental ingestion of LSD
- Secret administration of LSD to others without consent
Experimental Contexts
- Model psychosis approach research
- Didactic sessions with professional colleagues
- Inspiration and insight for artists, philosophers, scientists
- Adjunct to systematic dynamic psychotherapy
- Transpersonal experiences and death-rebirth process emphasis
- Consulting on non-medical experimentation complications
Set Determinants of LSD Reaction
- Obvious and explicit factors: preparation, session techniques, props
- Subtle factors: presence or absence of verbal communication between subject and sitter.
Impact of Set on Psychedelic Experiences:
- Superficial experiences with excessive talk during sessions are counterproductive for effective self-exploration.
LSD Sessions: Experimental Frameworks and Questioning Approaches
Dialogue vs. No Dialogue:
- Continuous dialogue between subject and sitter is significant
- Nature of verbal exchange impacts choice and formulation of questions
- Can attract attention to specific aspects of LSD experience
- Influences direction, content, and course of the experience
Descriptive Approach:
- Focus on formal, superficial aspects of subject's experience
- Interest in presence or absence of physical symptoms
- Emotional changes, perceptual distortions, psychomotor excitement/inhibition
- Subject experiences as spectator rather than participant
- Questions: "Is vision sharp or blurred?", etc.
Psychopathological Description:
- Strong focus on dynamic material in sessions
- Relevant psychological phenomena associated with schizophrenia
- Patients encouraged for self-exploration and understanding emotions
- Deciphering symbols, tracing psychopathological symptoms to sources
- Questions: "Why do you have this particular experience?", etc.
Aesthetic Experiences:
- LSD subjects focus on changed perception of forms, colors, sounds
- Preoccupation with artistic techniques and expressions
- Questions: "Do your visions resemble famous artist's work?", etc.
Psychotherapeutic Sessions (Psychodynamic):
- Encourage self-exploration, dynamic understanding of emotional problems
- LSD phenomena seen as complex symbolic formations reflecting unconscious processes
- Systematic effort to decipher all manifestations and trace back to sources
- Questions: "Why do you think you see me transformed in this particular way?", etc.
Religious or Mystical Experience:
- Deemphasize descriptive aspects, psychopathological phenomena, traumatic personal material
- Focus on the supraindividual, transpersonal, and transcendental
- Little verbal interaction between therapist and patient during sessions
- Directive statements rather than questions used if they occur.
The Importance of Setting During LSD Experiences
Observations on the Influence of External Stimuli:
- The physical and interpersonal elements of the setting can significantly influence the LSD reaction
- These effects can be understood in terms of the content of underlying dynamic governing systems and their interaction with environmental stimuli
Positive Elements of the Setting Facilitate Pleasant or Ecstatic Experiences:
- Components of positive COEX (cooperative, open-exchange) systems or perinatal matrices tend to facilitate pleasant or ecstatic experiences
- Healing potential and therapeutic value of such experiences should be systematically utilized in psychedelic sessions
Ideal Settings for Psychedelic Facilities:
- Natural environment, such as by mountain lakes, on ocean beaches, on little islands, in deserts, in wooded areas, or in old parks
- Clean water has a powerful impact on LSD subjects; swimming, showering, bathing can dispel negative experiences and facilitate ecstatic reentry
- Good stereophonic music of high aesthetic quality is one of the most significant factors of the setting
Negative Elements of the Setting Precipitate Unpleasant Experiences:
- Extreme example: small, ugly, claustrophobic treatment room with an unpleasant view
- Loud human voices, unpleasant music, noises from machinery and sirens have a disturbing influence on the psychedelic experience
- Settings that remind the subject of hospitals, doctor's offices, laboratories, prisons, concentration camps, or military barracks can facilitate experiences related to these institutions
Interpersonal Elements of the Setting:
- Presence of a few well-known persons whom the subject trusts has a very favorable influence on the session
- Frequent changes in the interpersonal situation with many unknown persons can have negative consequences
- Dramatic reac tions can occur when certain nurses or other people enter the treatment room, due to physical resemblance or similar behavior patterns
LSD Experiences: Significance of Set and Setting
Patients' Reactions:
- Could be explained by personal attitudes towards nurse: sexual partner, dangerous seductress, erotic rival, competitor, maternal woman, understanding person, domineering type, authority figure, or personified superego.
Successful Therapy with LSD:
- Intimate understanding of significance of set and setting required for effective therapy.
- Set and setting become tools instead of unpredictable problems.
Cartography of Psychedelic Experiences:
- Sensory Level: Eidetic images, altered body image, spatial/temporal distortions (same as Masters and Houston's first level).
- Recollective-Analytic Level: Personal problems, conflicts in relationships, life goals (similar to Masters and Houston's second level).
- Symbolic Level: Historical, legendary, mythological, ritualistic, archetypal images (combined with symbolic level from Masters and Houston).
- Transpersonal Experiences: Religious enlightenment, mystical union, illumination, psychological integration.
COEX Systems:
- Significance for LSD sessions: detailed discussion in "Realms of the Human Unconscious" (Grof) and "Die experimentelle Psychose" (Leuner).
Parallels between Psychedelic Therapy and Peak Experiences:
- Abraham Maslow's concept of metavalues and metamotivations derived from spontaneous peak experiences outside the drug context.
Early Therapeutic Philosophy:
- Small treatment cells for patients to work through emotional problems with LSD assistance (Dr. van Rhijn).
Transference Aspects in Therapy:
- Example: Charlotte's LSD session dominated by transference aspects in "Realms of the Human Unconscious" (Grof, p. 224).
Individual Case Studies:
- Renata's case history condensed in "Realms of the Human Unconscious" (Grof), p. 52.
Advantages and Drawbacks of the Psycholytic Approach
- Originally used the Freudian arrangement in LSD psychotherapy sessions
- Intended to intensify and accelerate the psychoanalytic process
- Found the Freudian technique not appropriate for LSD psychotherapy
- Shifted from a detached attitude to direct participation in the process
- Offered support through touch, reassurance, and deep massage
- Eventually moved away from extensive verbal interaction and eye contact
Pros and Cons of Psychedelic Therapy
Advantages:
- Unique experiences and emotional ordeals require a more human approach
- Genuine support and personal involvement can be beneficial
- Can lead to profound therapeutic changes
Drawbacks:
- Challenges the Freudian taboo of touch in psychotherapy
- Observations from psychedelic sessions put common assumptions about the unconscious, memory, consciousness, mental health, illness, and therapy to test
- Requires a comprehensive conceptual framework to account for these phenomena
The Search for an Effective Technique of LSD Psychotherapy:
- Initial attempts used Freudian arrangement and psychoanalytic understanding
- Observations from sessions led to modifications in therapeutic technique
- Shifted from extensive verbal interaction to internalized sessions with minimal exchange of words
- Changes in conceptual framework required revisions on fundamental issues related to psychotherapy
Psychedelic Therapy vs. Psycholytic Therapy
Approaches to LSD Use in Psychotherapy:
- Four viable approaches: psycholytic, psychedelic, anaclitic, hypnodelic (focus on psycholytic and psychedelic for practical purposes)
- Both techniques use the same chemical compound and have the same goal
- Differences lie in emphasis on certain phenomena and discouragement of others
Psycholytic Therapy:
- Rejects transpersonal phenomena as an escape or undesirable "psychotic" experiences
- Tends to focus on biographical material, childhood traumas
- Discounts the therapeutic value of transcendental states
- Lower dosages used, less conducive to perinatal and transpersonal experiences
Psychedelic Therapy:
- One-sided emphasis on transcendence and mystical experiences
- May discourage patients with biographical sessions, seeing it as inferior
- Therapists may feel a sense of "lost opportunity" if no transpersonal states are reached
Author's Background:
- Started in psycholytic therapy
- Recognized the significance of death-rebirth process and transpersonal phenomena
- Participated in anaclitic therapy work
- Practiced psychedelic therapy for years with various patient groups
Advantages and Drawbacks of Psycholytic Approach:
- Heuristic value: rich insights into human mind, emotional disorders, and LSD reaction
- Important for both therapist and intellectually curious individuals.
Psycholytic Therapy vs. Psychedelic Therapy
Psycholytic therapy:
- Takes longer to achieve comparable results as psychedelic therapy
- Gives the patient a better understanding of the mind and how change was achieved
- Preferred for less serious, non-urgent problems with intellectual interest in the process
- Provides an open-ended situation for working through life's issues
- More understandable and acceptable to conventional circles due to its focus on widely accepted psychotherapeutic concepts
- Disadvantages: Time-consuming, can limit discovery of challenging observations from psychedelic research
Psychedelic therapy:
- Can shorten the psychotherapeutic process compared to psycholytic therapy
- Focuses on alcohics, drug addicts, and terminal cancer patients
- Results are more solid and permanent due to underlying material being thoroughly worked through
- Use of high dosages and internalization of the process is more productive therapeutically
- Disadvantages: Lack of systematic comparative studies, potential for longer term physiological effects yet to be determined
Low and medium dose LSD sessions in psycholytic therapy:
- Activate unconscious material effectively but can result in unwillingness to face it fully
- Can lead to feelings of fatigue, incompletion, unpleasant emotional and physical aftereffects, and precarious emotional balance conducive to later recurrences ("flashbacks")
Transference analysis in psycholytic therapy:
- Therapist's focus on transference can cooperate with defense mechanisms rather than acknowledging it and directing attention beyond it
- Experiences like death-rebirth process, past-incarnation memories, archetypal phenomena, cosmic unity have significant therapeutic potential but are often limited by conventional dynamic psychotherapy framework
Advantages of Psychedelic Therapy:
- Dramatic and profound changes achieved in a single session
- Acceleration and deepening of therapeutic process
- Increase in efficacy and safety
- Emphasis on positive experiences and potential
- Positive structuring of the set and setting for sessions
- Critical importance of reentry phase
- Reduced time investment, less intense drug exposure, fewer transferrence problems
Theoretical Advantages:
- Acknowledgement and validation of transpersonal realities
- Greater depth, intensity, spontaneous flow of experience
- Fewer risks for worsened clinical condition with severely emotionally disturbed patients
Disadvantages of Psychedelic Therapy:
- Uncertainty regarding the nature of changes observed (temporary or deep)
- Limited understanding of underlying mechanisms
- Difficulty selecting candidates for productive sessions
- Lack of knowledge about the effects of LSD, cartography of human mind, psychodynamics of mental illness, mechanisms of therapeutic change
Psychedelic Insights:
- Global, intuitive and holographic nature of insights from high-dose sessions
- Transcendental "aha" experience without rational understanding or exploitation
- Instant comprehension into the essence of existence, akin to Upanishads' Knowing That.
Psychedelic Therapy and Mystical Consciousness
Mystical States and Relevance of Questions:
- Accompanied by conviction that some previous questions are irrelevant or not relevant anymore
- Reaching a state where those questions don't exist or need to be asked
- Both finding answers and transcending them represent solutions, on different levels
Challenges for Scientific Research:
- Enormous interindividual variability precludes valid generalizations
- Definite spiritual emphasis may appeal less to skeptical audiences
- Recognition of mystical states and incorporation of religious elements into therapy is necessary but lacks adequate conceptual framework in existing psychological knowledge.
Comparison with Primal Therapy:
- Arthur Janov's approach to spiritual experiences in some patients during primal therapy
- Original emphasis on early childhood material, later incorporating birth trauma
- Dilemma: Uses a tool that elicits experiences for which limited primal theory does not have an adequate conceptual framework.
Transpersonal Psychology and the Mystical Worldview:
- Often referred to as unscientific due to outdated scientific models and worldviews
- Actual compatibility with revolutionary discoveries in modern science, such as relativity theory and quantum physics
- Both modern physics and mysticism violate common sense and challenge pedestrian consciousness.
Principles of LSD Psychotherapy: Preparation Period
- Ideal course of LSD psychotherapy: involves an open-ended situation with no limit on number of sessions
- Consists of three phases: preparation period, drug session, post-session integration
- Preparation period: series of drug-free interactions to prepare subject for drug experience
- Amount of time necessary depends on client's issues and circumstances
- Less time required for emotionally stable clients
- More time required for seriously disturbed patients
- Amount of time necessary depends on client's issues and circumstances
- Therapist's role in preparation:
- Discuss client's life situation, emotional/interpersonal adjustment, professional background, and psychopathological symptoms
- Get acquainted with client's biographical data from childhood to recent past
- Important for understanding patterns and traumatic experiences that may occur during LSD sessions
- Identify recurrent themes, repetitive patterns, vicious cycles, and self-perpetuating elements in client's interpersonal interaction
- Share insights and observations on emerging material to develop a framework for understanding the relationship between past and present issues
- Focus on client's healthy core despite symptoms that may seem overwhelming or crippling
- Adopt a more optimistic view of human nature compared to psychoanalytic approach, emphasizing the positive potential in every individual.
Psychedelic Therapy: Existential Strategy and Values
Importance of Present Moment:
- Emphasis on life in the present moment, here-and-now
- Direct client's awareness from grandiose schemes to simple, everyday life situations
- Deep confrontation with death realizes that self-image, positive feelings, and sense of meaning are not dependent on external conditions
Value System:
- Participation in consciousness and cosmic process is precious
- Ordinary activities can be joyful expressions of life
- Absence of fundamental appreciation leads to vicious cycles and futile pursuits
- Self-exploration and inner transformation necessary for positive feelings
Preparation for Sessions:
- Explicit and implicit communication of value system during preparation
- Discourage excessive dwelling on the past or future plans
- Emphasize present moment, ordinary situations, and spiritual dimension in a non-specific way
- Clarify subject's understanding of religion, spirituality, and relationship between science and religion
Spiritual Experiences:
- Differ from orthodox religious experiences: no personified godhead or formalized divine service
- Focus on the mysteries of nature, meaning of human life, ultimate purpose, etc.
- Compatible with observations from modern research, illustrated by convergence of quantum-relativistic physics and mystical traditions.
Psychedelic Therapy: Preparation for Successful Outcomes
Perinatal and Transpersonal Experiences:
- Can occur during psychedelic sessions in symbolic forms
- Not limited to specific cultures or historical periods
- Deities appear as manifestations of a creative principle beyond form
- Experience congruent with teachings of mystical branches of religions
Transcendental Realities and Trust:
- Subjects may experience elements alien to their own religious tradition
- Accepted forms as appropriate and compatible with personality
- Importance of trust between guide and client for successful outcomes
Preparation Process:
- Development of trust relationship between experient and guides
- Addressing fears and doubts before session
- Discussing technical aspects and handling experience during last meeting before session
Safety and Risks:
- Addressing misconceptions about LSD from professional literature
- Rare occurrence of transitional psychotic states in supervised conditions
- Cardiovascular stress as the only serious risk if proper screening is done.
LSD's Motor Abreactions
- Most dramatic motor abreactions: occur in connection with death-rebirth process
- Tend to diminish or disappear when individual moves beyond perinatal level
- Despite higher total drug ingestion, great variability and lack of dose-effect relationship suggest no organic basis
- Testing failed to detect brain damage using neurological exams, electroencephalography, and psychological tests
Personality Changes Observed in LSD Users
- Loss of ambition, dropping out from school, growing long hair and beard, unusual clothes, lessened concern about hygiene, departure from rational orientation, preoccupation with philosophical and religious issues
- Cannot be attributed exclusively to use of psychedelic substances; involves important sociopolitical factors and elements of juvenile revolt reflecting generation gap
- Profound personality changes can occur without external hippie personality characteristics
Equating Psychedelic Personality Changes with Organic Brain Diseases
- Misunderstands the problems involved
- Negative publicity, sensational newspaper headlines influenced psychiatrists and psychologists
- Strong emotional bias rather than solid scientific evidence
Effect of LSD on Chromosomes, Fetal Development, and Heredity
- No indication pharmaceutically pure LSD has deleterious effect on chromosomes or heredity
- Increased danger of abortion and possible interference with fetal development for pregnant women; best to proceed with caution in individuals with serious cardiovascular problems and epilepsy predisposition
- Dangers are psychological, not inherent in drug itself, determined by extrapharmacological factors
Understanding LSD's Effect and Therapeutic Potential
- Catalyst or amplifier of mental processes, facilitating deep self-exploration
- Mediates journey into hidden recesses of one's own unconscious mind and superconscious realms
- Routinely referred to as "experimental psychoses" in early LSD research; important to avoid negative terminology and metaphors for sessions.
Preparation for Psychedelic Therapy:
Importance of Appropriate Metaphors:
- Clients may interpret anxiety, aggression, etc. as "psycho-tomimetic" effects of the drug instead of opportunities for personal growth
- Allusion to schizophrenia or psychosis can be frightening and unhelpful
- Useful metaphors: intrapsychic movie, vivid fantasy, waking dream
Discussing Possible Experiences:
- Perceptual changes in various sensory areas
- Reliving emotionally relevant childhood experiences
- Sensations related to diseases and operations
- Elements of death-rebirth process
- Transpersonal phenomena
- Encourage focus on experience rather than intellectual analysis
Intensity of Psychedelic States:
- Warn client about intensity beyond usual consciousness
- Discuss potential for dramatic, realistic experiences of dying
- Confrontation with death can be symbolic and subtle, not necessarily physical crisis
Addressing Common Difficulties:
- Acceptance is key to resolving issues
- Fear of permanent insanity or inability to end the experience
- Fighting the fear of psychosis prolongs suffering, acceptance leads to termination
- Homosexual feelings can be a unique opportunity for understanding opposite sex experiences
- Sudden physical attractions may represent transference to parental figures
- Physical symptoms are psychosomatic and associated with important psychological material.
Preparing for Crisis of Trust:
- Discuss possibility of basic trust crisis despite good therapeutic relationship
- Suggest looking within for sources of mistrust before focusing on external circumstances.
LSD Psychotherapy: Keeping Sessions Internalized
Importance of Internalized Sessions:
- Reasonable to assume perception changed by powerful psychoactive drug rather than unexpected situation or personalities
- Discussing crisis of trust beforehand helps mitigate it when it occurs
- Basic rule in LSD psychotherapy: keep sessions internalized
Deep Self-Exploration:
- Psychedelic experience is a journey into one's own mind
- Introspective orientation is most productive approach
- Encourage subjects to stay in comfortable reclining position with eyes closed
- Use soft eyeshades for best technical solution
Counterproductive External Stimuli:
- Exposure to complex stimuli and moving around interferes with self-exploration
- Expressive dancing can be useful if subject keeps eyes closed and maintains introspective connection
- Aesthetic, emotional, spiritual participation in environment valuable on occasion
- Important to stay in lower dosage range for externalized experiences (below 100 micrograms)
Unproductive Externalized Sessions:
- Higher dosages activate unconscious material that can distort perception of environment
- Difficult emotional or psychosomatic problems, precarious mental balance possible after sessions
- Balance between lowering defenses and effective working through of emerging material essential for good outcome
- Awareness of inner process and full expression important for productive integration
Preparation Period:
- Explain importance of maintaining reclining position during session, keeping eyeshades on, facing and expressing emerging material
- Prevent counterproductive situations by addressing potential external projections in preparation period
Temporary Worsening after Sessions:
- Symptoms may alleviate or disappear after some sessions, while others may intensify or new forms emerge
- Prolonged reactions, temporary psychotic decompensations possible for borderline patients
- Patients should be prepared to tolerate difficult post-session intervals and approach them constructively.
LSD Therapy: Stages of Improvement and Challenges
Clinical Improvement:
- Patients with poor prognoses may experience striking improvement
- Continued therapy aimed at stabilizing results opens new areas of problems
- General trend toward more positive LSD experiences and better functioning in life
Phases of Psychedelic Therapy:
- Freudian Phase: Biographical material dominates early sessions
- Rankian Phase: Middle part of therapy is dominated by death-rebirth process
- Jungian Phase: Advanced sessions focus on metaphysical and philosophical topics
Factors Affecting Outcome:
- Importance of good, free intervals following significant resolutions
- Ideal goal: tension-free, pleasant or ecstatic experiences during termination periods
Facilitating Positive Experiences:
- Natural Scenes and Artistic Creations: Beautiful lakes, calm oceans, tropical islands, etc.
- Spiritual and Mystical Emphasis: Enchantment with nature and creative forces
- Ideal Relationships: Experiences of good womb, breast, maternal care, love, friendship
- Therapist Tools: Walks in nature, objects reflecting creativity, beautiful art, spiritual texts
- Physical Contact
Theoretical Justification: Deep unconscious association between oceanic ecstasy and experiences of natural beauty, inspired artistic creations, spiritual feelings, and highly satisfactory human relationships. 6. Integration into Comprehensive LSD Therapy Program: Facilitates positive experiences during psychedelic sessions and in termination periods, increasing therapeutic potential.
Ideal LSD Therapy Session Setting
- Situated on ground floor, isolated from rest of facility with separate entrance
- Small kitchenette and easily accessible lavatory for therapists to stay with patient during session
- Patient able to reach bathroom quickly without social interaction
- Adequate provisions made for animated episodes involving loud noises (e.g., screaming, growling, banging)
- Homelike, comfortably furnished treatment room with soft padding and cushions
- Fresh flowers, fruit and nuts, art books, natural objects of beauty
- High fidelity stereo record player and tape deck with headphones and extensive collection of tapes/records
- Beautiful natural setting (optional) for session termination period and sensory perception enhancement
- Swimming pool or bathtub, or good shower available if water significant to patient
- Morning sessions preferred; optimal dosage between 200-400 micrograms depending on psychological problems, personality structure, age, health
- Fasting before session has advantages but not mandatory with light dinner and liquids for breakfast
- Patient wears light, casual clothes and removes restrictive or dangerous items beforehand.
Additional Considerations:
- LSD fully effective orally; intramuscular administration of little value due to inconvenience and medical model introduction
- Fastidious patients may prefer injection for concerns about resorption in certain cases (e.g., cancer patients, gastrointestinal issues)
- Discuss physical and emotional conditions before session, brief focus on "here-and-now" instead of fantasies about experience.
Psychedelic Therapy Session:
Preparation:
- Latency period: 20-40 minutes after LSD administration
- Meditation, music, relaxation or discussions during this time
- Encouraged to lie down with eyeshades and headphones once effect begins
- Sitters provide support, protection, facilitate experience unfolding
- Minimize verbal exchange during intense drug effect
Session Process:
- Latency Period:
- Spend time in meditation or relaxation activities
- Listen to quiet music or have discussions
- Onset of Effect:
- Encourage patient to lie down, put on eyeshades and headphones
- Reclining position for next 4-5 hours
- Experience Unfolding:
- Sitters provide non-verbal support (hand holding, touches)
- Music selected based on psychological state of subject
- Sensitive Response:
- Offer blanket if cold, wipe sweat or mucus from face
- Uncomplicated Session:
- Client maintains reclining position and internalizes experience adequately
- Sitters listen to music, meditate and empathize with client's experience
- Resistance:
- Minor resistance: evasive maneuvers or trivial chatting
- Major resistance: projection onto sitters, intellectual arguments, fear of insanity or homosexual panic
- Complications:
- Subject cannot maintain recommended position or interprets situation incorrectly
- Acting-out behavior
- Intervention:
- Sitters move from passive to active intervention when necessary
- Termination Period:
- Discussions and analyses can be postponed until a later time
- Checking-in:
- Therapist checks in with client every half hour for reassurance and clues about process.
Psychedelic Session Preparation:
- Atmosphere: Security, privacy, full commitment necessary for successful session
- Distractions: Avoid answering phone calls or leaving treatment room during sessions
- Sitters: Two therapists (male-female dyad), who know each other and work well together
- Reasons for both sexes: Division of tasks, facilitation of certain experiences, handling projective distortions related to Oedipal triangle or transpersonal experiences.
- Music: Evokes emotions, creates structure, helps patients overcome difficulties, provides continuity and connection; avoid vocal pieces with specific themes or intellectual associations.
Music in Psychedelic Therapy:
- Functions: Facilitates deeper involvement, creates emotional flow, provides a carrier wave, helps patients let go of defenses, structures reentry period.
- Selection Principles: Respond sensitively to experience's phase and content, high artistic quality but little concrete content, avoid specific themes or intellectual associations.
- Alternatives for structuring: White noise or monotonous sounds from electric appliances or ocean tide recordings.
Psychedelic Music Therapy
Overview:
- Effective atmosphere during medium range of session
- Subjects personalize experience with own unconscious gestalt
- External input does not reduce therapeutic significance
Preparation:
- Discuss music preferences beforehand
- Sitters make selections based on process understanding
Latency Period:
- Quiet, flowing and calming music
Drug Effect Onset:
- Music with opening and building quality
- Classical composers like Beethoven, Rachmaninoff used
Culmination of Session:
- Powerful, overwhelming music with transcendental quality
- Sacred music from Mozart to Poulenc suggested
Termination Period:
- Quiet, relaxing and flowing music
- Contemporary composers like Deuter, Horn also useful
- Oriental selections include Ravi Shankar, Zen meditation music
General Guidelines:
- Sensitive response to subject's experiences
- Change records with sensitivity to process
- Facilitate resolution through verbal exchange and active intervention during critical period.
Technique for Addressing Emotional Distress and Incomplete Psychological Gestalts
- Hyperventilation: sitters ask experient to breathe faster and deeper, following the air with eyes, activates emotional material
- Physical Symptoms: sitters mimic symptoms reported by subject (e.g., pressure on head, chest constriction) to intensify experience
- Merging Conscious and Unconscious Content: facilitate convergence of conscious experience and unconscious gestalt through sensations
- Positive Closure: aim for optimal resolution, even if not always achievable
- Experiential Workshops: use various techniques from different approaches (gestalt practice, bioenergetic exercises, rolfing, guided affective imagery, Hatha yoga, primal scream)
- Therapeutic Community: facilitate integration through group members during termination period
- Positive Inputs for Integration: physical contact, nature experiences, positive emotions and states
- Reunion with Friends or Relatives: respect the experient's needs and space
- Post-Session Care: subject should stay in special treatment suite, have a companion for the night, avoid heavy interpersonal problems.
Integration of Drug Experiences
The Day After the Session:
- The client should be able to sleep as long as necessary
- The general suggestion is to rest, relax, and stay in a meditative state
- Recommended activities: quiet walks in nature, basking in the sun, swimming, listening to music (especially the pieces played during LSD experience)
Long Interview with the Client:
- Scheduled for later that day
- Opportunity to share experiences of the preceding day in detail and discuss any puzzling aspects
- Facilitates integration of material and its application to everyday life
- Special attention to transference phenomena and their analysis
Other Techniques for Integration:
- Subjects can watch a videotape of their LSD session, providing an objective point of view
- Clients encouraged to write detailed account of their psychedelic experience
- Intense emotions can emerge during this work, providing opportunity to complete unfinished gestalts
- Clients given ample opportunity to express experiences through various artistic forms
Integration Over Time:
- Integration may take days or weeks
- Encouraged to keep emotional channels open and continue the uncovering process
- Completion of unconscious gestalt more likely in intermediate states between waking consciousness and sleep
- Dreams can mediate completion and final integration of material activated by the drug
Prolonged Hyperventilation Technique:
- Based on Indian breath practice, pranayama
- Intense breathing collects tensions in the body and eventually releases them
- Associated with activation of unconscious material from various levels
- Encourages vocalization and conventional abreaction is generally discouraged
Continued Psychedelic Therapy:
- If a session results in an intensification of clinical symptoms or prolonged reaction, continuation of therapy may be indicated
- The idea is that these issues represent unfinished unconscious gestalts that should be completed
Group Psychotherapy as Part of Comprehensive LSD Treatment:
- In the context of a therapeutic community, LSD patients spend late hours with co-patients
- This can lead to valuable observations and insights for both the subject and other group members
- The use of material from psychedelic experiences in group meetings can deepen and intensify the group process
Psychedelic Therapy with LSD: Unique Opportunities for Group Work
Experiences Discussed in Meetings:
- Powerful unconscious material that rarely appears in group work
- Ranges from:
- Sexual perversions, murderous aggression, sadomasochistic drives, incestuous tendencies, and indulging in biological material
- States of ecstatic rapture, feelings of cosmic unity, past-incarnation memories
Therapist's Role:
- Therapist's matter-of-fact approach to potentially objectionable unconscious material helps group members accept and experience such situations
- Unconscious material that is usually anxiety-, guilt-, and conflict-laden can be treated with lightness and humor
Advantages of Group Work:
- Saves time for the LSD therapist
- Allows therapist to communicate general principles, experiential strategies, and interpretive possibilities to the entire group
Detailed Therapeutic Strategy:
- Depends on many factors and must be creatively developed by therapists based on clinical experience and firsthand exploration in LSD training sessions
- Psychedelic therapy is based as much on intuition as it is on knowledge of therapeutic principles, combining elements of art and science.
Additional Information:
- Prefrontal lobotomy: a psychosurgical procedure developed by Edgar Moniz for chronic psychoses, impulsive behavior, and severe obsessive-compulsive states (1)
- Music in Psychedelic Sessions: article by Helen Bonny and Walter Pahnke, "The Use of Music in Psychedelic (LSD) Therapy" (14), and book "Music and Your Mind" by Helen Bonny and Louis Savary (15)
- Breathing Techniques: the "hyperventilation syndrome" is a mandatory physiological reaction to intense breathing, but observations from psychotherapeutic work indicate this is not true (3)
Notes:
- (1) Prefrontal lobotomy is a surgical procedure where connections between the frontal lobes and rest of the brain are severed. It was used for chronic psychoses, impulsive behavior, and severe obsessive-compulsive states, awarded a Nobel Prize in 1949 to Edgar Moniz.
- (2) The use of music in psychedelic sessions and non-drug experiential work is discussed in a special article by Helen Bonny and Walter Pahnke, "The Use of Music in Psychedelic (LSD) Therapy" (14), and in the book "Music and Your Mind" by Helen Bonny and Louis Savary (15).
- (3) In medical handbooks, this is referred to as the "hyperventilation syndrome," but observations from psychotherapeutic work utilizing breathing techniques indicate that this is not true. If the subject is encouraged to continue hyperventilating after these spasms have developed, it will paradoxically release the tensions. After several initial sessions employing this method, the organism stops responding to intense breathing with the "hyperventilation syndrome."
Complications of LSD Psychotherapy: Occurrence, Prevention, and Therapeutic Measures
Physical and Emotional Contraindications:
- Critical situations in LSD sessions
- Adverse aftereffects of LSD psychotherapy
- Prevention and management of complications in LSD psychotherapy
Dangers of LSD Psychotherapy:
- Intrinsic risks of the drug and psychedelic process
- Extrapharmacological factors dependent on set, setting, and session technique
Physical Contraindications:
- Absolute: pregnancy
- Relative: cardiovascular problems, epilepsy, severe liver damage
Emotional Contraindications:
- Individuals with considerable emotional issues or unconscious material
- Highly emotional individuals may experience strong reactions to small doses of LSD
Screening for Complications:
- Physical examination, including ECG
- Pregnancy is an absolute contraindication
- Caution with high-risk individuals and mild cardiovascular problems
Misrepresented Street Acid:
- Impurities and admixtures in street samples can be more dangerous than LSD itself
- Chemical analysis identified amphetamines, strychnine, STP, phencyclidine (PCP), and other substances in some street samples of LSD.
Emotional Risks:
- Intense emotions during high-dose sessions beyond everyday experiences
- Extreme emotional stress can be dangerous or fatal for individuals with cardiovascular problems, epilepsy, severe liver damage, or pregnancy history
- Individuals with emotional instability or significant unconscious material may experience strong reactions to small doses of LSD.
Risks of LSD Use for Psychotherapy
Factors Increasing Adverse Aftereffects:
- Serious emotional problems
- Severe interpersonal maladjustment
- Psychiatric hospitalization history
Working with Psychiatric Patients:
- Careful preparation and internalization of experience necessary
- Active psychotherapeutic work reduces but does not eliminate hazards completely
- Unresolved unconscious material may result in:
- Intensification of pre-existing complaints
- New set of symptoms
- Prolonged reactions
- Later recurrence of unusual states of consciousness (flashbacks)
Calculated Risks:
- Triggering serious emotional reactions a calculated risk for borderline schizophrenic symptoms or past psychotic episodes patients
- Under optimal circumstances, LSD psychotherapy can be conducted with any psychiatric patient whose condition is not organic but requires open-ended situation and experienced therapeutic team
Cautions:
- Experienced therapists, trained nurses, and supportive atmosphere of a therapeutic community necessary for working with severely disturbed individuals
- Under unfavorable conditions (limited sessions, no bed facilities), careful screening out of patients with borderline psychotic problems and psychotic disposition is essential.
Psychedelic Sessions: Critical Situations and Handling Them
Preparation:
- Inform clients of potential difficult experiences during sessions
- Discuss resistance mechanisms
Types of Resistance:
- Intellectualizing/talking constantly
- Focusing on external environment
- Sudden sobering up
- Refusing to continue without explanation
- Attempting to leave the treatment situation
- Disrupting relationship with therapists
Handling Resistance:
- Negotiate with clients
- Refer back to original contract and preparation period discussions
- Maintain calm, centered attitude towards emergencies
General Principles:
- Emotional reaction is crucial in crisis handling
- Therapist's emotional response can affect the patient's perception of safety
- Sitters are a client's only reality check during sessions
- Adequate handling of critical situations essential for trust and security.
Important Factors:
- Emotional maturity and experience of sitters
- Unresolved emotional issues in therapists can lead to destructive interactions with clients.
Emergency Situations:
- Manifestations of unconscious material: anxiety, aggression, self-destructiveness, paranoia, extreme pain
- Handling these situations calmly and supportively is crucial for effective therapy.
LSD Therapy: Adequate Training for Therapists
- Adequate experience and training are crucial for therapists conducting LSD sessions
- Personal LSD sessions under experienced therapist's guidance (minimum of 5) and thirty therapeutic sessions with psychiatric patients conducted under supervision required for training
- Useful for psychiatric nurses functioning as female co-therapists or coming into contact with patients under the influence of LSD
Tranquillizers in Psychedelic Sessions
- Experienced therapeutic dyad can handle most situations without tranquillizers
- Three negative experiences terminated by tranquillizers early in author's research career due to limited experience with drugs
- Tranquillizers do not neutralize LSD effects; they have a general inhibiting effect that masks psychedelic action and may cause unpleasant combination of both drug effects
- Using tranquillizers during a negative psychedelic state can prevent resolution, contribute to prolonged reactions, negative aftereffects, and "flashbacks"
Death Experience in Psychedelic Sessions
- Encounter with death is authentic and convincing, often mistaken for a real emergency by both subject and external observers
- Resistance against psychedelic process can be powerful due to deep-seated anxiety and activation of survival programs
- Critical situation for the smooth course of session and positive outcome; subjects must stay with eyeshades and headphones, keep experience internalized
- Sitters should connect client's intellectual knowledge of process with actual experience through metacommunication and non-verbal approach
- Repeated LSD sessions focusing on perinatal level lead to deeper and more complete experiences of dying.
Technical Challenges in Ego Death
- Ego Death: Destruction of self, possessions, attachments, and systems of reference
- Characteristics: Total annihilation, loss of all relationships, destruction of objective world
- Approached from different levels and directions, requires psychological sacrifice
- Final stages: Facing unacceptable or unimaginable experiences and circumstances
- Examples of final obstacles: High degree of suffocation, agonizing physical pain, blacking out, violent seizures, vomiting, losing control of bladder/bowels, sexually unacceptable behavior, confusion and disorientation, making inhuman sounds, humiliation or loss of prestige
- Expectation of catastrophic explosion with destruction of self and world
- No Exit: Extreme distress, unable to see any way out, feeling of eternal doom, circular thought patterns
- Strategy: Emphasize distinction between psychological time and clock time, accept full content of experience
- Difficult situations related: Repetitive verbal or motor behavior (verbigeration and perseveration)
- Encourage giving up control to release suppressed material
Fear of Insanity
- Fear of losing control, even in everyday life
- Strategy: Encourage giving up control to work through repressed material
- Association with loss of sphincter function will be discussed later.
LSD-Assisted Therapy: Paranoid Reactions and Acting Out Behavior
Symbolic Journey through Phases of LSD Experience:
- Sequence resembling shamanic initiation (11-17)
- Facing reduction to a skeleton and annihilation
- Renewal, ascent, and return to life
- Symbolic crucifixion and reminiscence of surgical intervention
- Rebirth with vision of peacock
- Experience of birth opening way to unitive state (16)
- Sense of rejuvenation and revitalization
Paranoid Reactions:
- Unique therapeutic opportunities rather than problems
- Technical difficulties affecting therapeutic cooperation
- Wide range from minor mistrust to full-blown delusions
- Rooted in childhood abuse, emotional deprivation, or no-exit situation (BPM II and III)
- Psychotic reactions with paranoid perception can be traced back to early embryonal crises, past incarnation experiences, negative archetypal structures, etc.
- Approach less serious forms by reminding clients about earlier discussions on basic trust and encouraging self-exploration
- More severe cases handled internally; sitters may discover after experience is over (18)
Acting Out Behavior:
- Occurs in many varieties and levels of the unconscious
- Sexual acting out can provide powerful corrective experiences for some clients
- Genital or anal masturbation: allowed if sitters are open-minded
- Adult sexual activities directed toward sitters: discouraged, reference to agreed rules before session (19)
- Difficult situations involve fear of dependency and helplessness, potential negative consequences for client and relationship with sitter.
Sexual Acting Out:
- Manifestation of deep unresolved issues
- Involves adult sexual activities: genitals, breasts, or mouth discouraged due to serious reasons beyond moralistic considerations (20)
- Fear of contamination of everyday relationships with deep transference problems and sexual confusion.
Psychedelic Therapy: Sexual Boundaries and Hostility/Aggression
Sexual Boundaries:
- No limits to client's experience on the fantasy level
- Sitters should be clear about their own attitudes and motives, approach subject with integrity and sensitivity
- No justification for adult sexual activities in psychedelic therapy
- Only between partners who have emotional and sexual commitment in everyday life
- Can add interesting dimensions, but dangerous and pitfalls even for mature partners
Physical Intimacy:
- Deep age-regression may involve intense anaclitic feelings and tendencies
- Regressive behavior can be difficult to distinguish from authentic regression or inadvertent occurrences
- Sexual overtures on adult level can present technical problems, especially in later stages of sessions
- Therapist's approach can represent a corrective emotional experience or perpetuate pathological patterns
- Boundaries can be negotiated subtly through verbal and nonverbal communication
Aggression:
- In good working relationship, real technical problems with aggression are rare
- Skillful combination of verbal communication and metacommunication can keep situation in experiential ambiguity
- Maintaining trusting relationship is primary consideration
- Actual acting out of destructive tendencies is extremely rare in supervised sessions
- Encouraging external expression in cooperative framework can be effective
- Relating to deeper level of anxiety, hurt, and helplessness can have magical influence
Session with Julia and Henry
Julia:
- Young colleague recently joined the team
- Had sat in on LSD sessions before, but this was her first independent one
- Frightened and shaking when running the session
Henry:
- Experienced regression to childhood and need for closeness/affection
- Put head in Julia's lap, which triggered painful memory of being caught masturbating by his mother
- Mother's reaction led Henry to block access to channels of dependency and sexual feelings
- Combination of sexuality, punitive feedback, and anxiety made the perinatal level of unconscious experience available
- Led Henry to "choose" the path of aggressive behavior
Julia's Development:
- Recovered from the difficult experience as a learning opportunity
- Increased tolerance for unconventional manifestations in LSD sessions
- Became a better and more effective therapist
Physical Manifestations in LSD Sessions:
- Common physical manifestations: Generalized muscular tension, complex postures/twisting movements, tremors, jerks, twitches, seizure-like episodes
- Subject should be encouraged to let these happen, as they represent valuable channels for energy discharge
- Breathing difficulties: Can occur in asthmatic attacks or as subjective experiences; sitters should provide honest and objective feedback
- Pain: An integral part of the psychedelic process, representing physical traumas or symbolic connotations; can be increased through pressure/massage to help experience fully
- Nausea and vomiting: Common in individuals with a history of these issues; sitters should encourage vomiting when appropriate, as it has a powerful purging effect
Psychedelic Experiences and Urethral/Anal Issues
Projectile vomiting:
- Can be associated with expelling alien energy forms or exorcism
- Difficulties with urination and defecation are common in psychedelic sessions
Urination Problems:
- Frequent micturition (pollakisuria) or urethral personality traits: intense ambition, concerns about prestige, shame, fear of blunder
- History of enuresis (wetting the pants/bed)
- Psychodynamic level: associated with specific traumatic biographical material
- Deeper roots in perinatal matrices: BPM II (painful urge to void), BPM III (conflicts about voiding), BPM IV (loss of bladder control)
- Resistance tactics: delaying confrontation, unnecessary bathroom visits, using surgical rubber pants or pads
Defecation Problems:
- Common in obsessive-compulsive patients, males with latent/manifest homosexual tendencies, and anal personalities
- Psychodynamic level: conflicts around toilet training, gastrointestinal disorders in childhood, history of enemas
- Deeper perinatal roots: BPM II (urge to defecate and conflicts), BPM III (explosive bowel release or loss of anal control), ego death and moment of birth
Anal Letting-Go:
- Often connected with reliving traumatic incidents from childhood involving ridicule for urethral accidents
- Releases libidinal pleasure related to unrestricted urination, removes psychological blockages, facilitates letting go
- Can connect patient with moment of birth and fundamental relief after hours of agony.
Rare Uncontrolled Defecation:
- Extremely rare in over 5000 LSD sessions studied
- May be an artifact of cultural programming and therapeutic technique rather than clinical reality
- Our taboo against feces is much stronger than that against urine, and unwillingness of experiencer and sitters to deal with aftermath of anal letting-go is a factor.
LSD Psychotherapy: Adverse Aftereffects
Activation of Deep Unconscious Material
- Involves exteriorization and conscious integration
- Continuous uncovering process during treatment series
- Dynamic unfolding of unconscious processes continues after sessions
- Dreams reflect content of psychedelic sessions
- Pre-session dreams anticipate, post-session dreams complete unfinished gestalts
- Integration of material not guaranteed before pharmacological effect ends
Risks of Incomplete Integration
- Intensification or emergence of preexisting emotional problems
- New forms of psychopathology
- Prolonged reactions, psychotic breaks, flashbacks
- Adverse aftereffects reflect deep unconscious dynamics
Mechanisms of Complications
- Unresolved unconscious gestalts can persist indefinitely or recur
Emotional Symptoms
- Depression, sense of inferiority, suicidal feelings
- Affective lability, anxiety, guilt, paranoia, aggression, mania
Psychosomatic Symptoms
- Nausea and vomiting, breathing difficulties
- Psychogenic coughing and gagging, cardiovascular distress
- Constipation or diarrhea, headaches, pain in various body parts
- Chills, hot flashes, increased sweating, "hangover" feelings, flu symptoms
- Hypersalivation, skin rashes, psychomotor manifestations
Thought Processes and Values
- Changes in thinking about sex, relationships, philosophy, existence
- Intensified opinions, judgments, systems of values in various areas
Perceptual Alterations
- Anomalies in color perception, blurred vision, after-images
- Spontaneous imagery, alterations in body image, hearing changes
- Physical feelings and new clinical syndromes
Psychogenetic Connections to Functional Systems
- Emotional, psychosomatic, ideational, perceptual symptoms persist for days, weeks, or unlimited periods
- Can accentuate or intensify original emotional problems
- Repetition of childhood, adolescent, or later period symptoms
- Interpersonal patterns and clinical symptoms recur from symptom onset.
Understanding Irrational Emotions and COEX Systems:
Mechanisms of Unpleasant Emotions
- Acceptable to experience emotions as reactions to actual circumstances
- Incomprehensible and absurd feelings may lead to maneuvers provoking hostility
- Seeking support or understanding can rationalize irrational fears
- Behavior in dangerous situations may result from anxiety or guilt feelings
Activation of COEX Systems:
- Changes not dramatic unless activated layer is early childhood or has excessive emotional charge
- Intensification of clinical symptoms and distorted perception after session
- Tendency to exteriorize theme or characteristics in treatment situation and everyday life
- Peculiar idiosyncrasies, overreactions to certain circumstances
- Behavior can involve complex psychological maneuvers provoking specific reciprocal attitudes
LSD Therapy Complications:
- Incomplete resolution of COEX system may result in adverse aftereffects
- Emotional and interpersonal problems reflect general theme and individual layer content
- Experienced therapist can anticipate elements based on specific characteristics
Clinical Example: Tom's Case
- Severe impulsive neurosis with antisocial behavior (poriomania, dipsomania, toxicomania)
- Anxiety and agitation during LSD sessions, associated with visions of pale female face or water elements
- Anger towards women and intolerance of their presence
- Behavior provoking hostility from co-patients and nurses due to idiosyncrasies, recklessness, aggression, and motor phenomena.
Tom's Experience with LSD Therapy
Tom's Reactions:
- Dissatisfied with therapy sessions, found them confusing
- Experiences described as "crazy pell-mell," "mish-mash," or "chaos"
Uncovering Traumatic Memories:
- Tom relived traumatic memories from early childhood
- Emotionally disturbed nurse maltreated him and frightened him during bathing
- His stepmother later fired the nanny after discovering the abuse
Development of Symptoms:
- After fully reliving these memories, many elements disappeared
- Tom's anxiety and muscular jerks persisted, despite being associated with the traumatic memory involving the nanny
- Anxiety became more primitive and elemental, associated with unpleasant tastes and oral sensations
- Reliving early childhood experiences involving disinfectant solutions applied to his mouth
- Muscular jerks particularly emphasized around his head and neck, identified as escape reactions
Tom's Negative Attitude Towards Hospitals and Medicine:
- Strong negative attitude towards medical aspects of treatment procedures
- Criticized and ridiculed these aspects
Addition of Other Symptoms:
- Intense hunger and thirst, feelings of cold and emotional starvation
- Craved the presence of women, asked for female therapist and nurses
- Desire to find ideal woman, depression accentuated, urge to consume alcohol and drugs
Perinatal Trauma:
- Tom recognized his panic anxiety, aggression, guilt, and driving tension as derivatives of the birth trauma
- Saw his massive muscular jerks and twitches as belated discharges of pent-up energies related to the "hydraulic" aspects of the delivery
Transference Relationship:
- Impulsive, ruthless, and erratic behavior around birth sessions
- Expressing strange ambivalent tendencies and conflicts between dependence and independence
- Behavior could be labelled as psychotic by conventional standards
Completion of Birth Process and Deep Transcendental Experience:
- Tom seemed to have completed the birth process in his 65th session
- Had a dramatic but not lasting improvement
Recovery and Stability:
- Took six more sessions and several months to reach a new equilibrium
- In the years following, did not need hospitalization or psychiatric help
- Married and was able to maintain a job and care for his children
Somatic Problems as Part of Traumatic Memories:
- Renata's eczema appeared during reliving a sexual abuse memory
- Intense pain in "injured" parts of her body after reliving a childhood injury
- Dana experienced symptoms of bronchitis during reliving a traumatic episode with severe bronchitis
Perinatal Matrices and Post-Session Intervals
Bronchitis-like Symptoms:
- Sudden onset at time of traumatic memory emergence
- Abrupt termination when psychological gestalt is completed
Post-Session Intervals and Perinatal Matrices:
- Influence of activated basic perinatal matrices can be dramatic
- Can lead to mitigated form of influence for days, weeks, or months
- Deep level of a negative matrix can result in psychotic proportions
- Consequences are distinct and characteristic for each perinatal matrix
BPM II - Depression:
- Post-session interval characterized by deep depression
- Individuals experience various unpleasant feelings, thoughts, and physical sensations
- Access only to unpleasant memories, cannot see any positive elements in life history
- Guilt, inferiority, and shame dominate thinking about the past
- Present life appears unbearable with no solutions; have no perspective on anything
- World is perceived as threatening, ominous, oppressive, without color
- Suicidal ideation common, in form of wishing to fall asleep or be unconscious
- Typical physical symptoms include headaches, breathing difficulties, chest pain, etc.
BPM III - Aggression and Tension:
- Post-session interval characterized by intense aggressive tension
- Frequently associated with strong but vague apprehension and anticipation of catastrophe
- Individuals liken themselves to "time bombs" ready to explode at any minute
- Oscillate between destructive and self-destructive impulses, afraid of hurting others or themselves
- World perceived as dangerous and unpredictable, constantly on guard for survival
- Painful awareness of real or imagined limitations combined with exaggerated ambitions
- Suicidal thoughts, fantasies, and tendencies quite frequent, different from BPM II
- Physical symptoms include intense muscular tension, nausea, diarrhea, excessive libidinal drive, etc.
BPM IV - Alleviation of Symptoms:
- Post-session interval characterized by dramatic alleviation or disappearance of previous psychopathological symptoms
- Individuals feel they have left the past behind and can start a new chapter in life
- Exhilarating feelings of freedom from anxiety, depression, and guilt
- Deep physical relaxation and sense of perfect physiological functioning
- World appears simple and exciting, with unusual sensory richness and joy
BPM I - Metaphysical Interpretations:
- If subject remains under negative aspects of BPM I or transpersonal matrices, can experience emotional and physical distress
- Difficulties interpreted in spiritual, occult, mystical, or religious terms
- Attributed to adverse forces of destiny, "bad karma," malefic influences, or evil spiritual entities
- Can reach psychotic proportions but individual eventually integrates experience and assumes more tentative approach.
LSD Sessions and Unresolved Unconscious Material
Weakening of Defense System:
- LSD sessions can activate underlying unconscious material more strongly than before
- Incomplete resolution of unconscious material leads to exponential availability
- Weakening of resistance is most apparent in situations where symptoms from the original LSD session are activated and intensified
Prolonged Reactions:
- Defense system collapses, but the material behind it is not worked through
- Unleashed unconscious material becomes energetically charged and difficult to repress
- Subject tries to prevent the unconscious theme from emerging fully
- Can result in temporary psychotic decomposition after an LSD session
Recurrences of LSD-like States:
- Psychodynamics similar to prolonged reactions and psychotic breaks following sessions
- Defense mechanisms are strong enough to cover up activated and unresolved material initially
- Resulting dynamic balance is precarious, and can be disturbed by various circumstances
- Unconscious theme may continue to emerge, often seen as an attack of the drug rather than a manifestation of unconscious
Factors Facilitating "Flashbacks":
- Weakening defenses during hypnagogic/hypnopompic states, physical fatigue, or sleep deprivation
- Use of drugs such as alcohol, marijuana, psychostimulants, or virus diseases
- Later psychotherapeutic sessions, especially those using hyperventilation
- Meditation and other spiritual practices or group exercises at growth centers
- Triggers: situations involving elements similar to the unresolved unconscious matrix, such as "no exit" situations or violence
Prevention and Management of Complications in LSD Psychotherapy
Occasional Activation of Unconscious Material:
- Intensification of emotional or psychosomatic symptoms can occur during various forms of experiential psychotherapies, including LSD therapy
- This indicates the patient has approached important unconscious problems
Basic Dynamics of Complications in LSD Psychotherapy:
- Preparation for First Session: Therapist explains that intensification of symptoms is normal and a meaningful part of the process
- Patients should understand that consistent internalization of sessions can reduce complications
- Patients must be willing to work hard on unfinished material during termination period
Importance of Active Work During Termination Period:
- Explaining the rationale and rules for cooperation increases chances for good integration
- Reduces incidence of prolonged reactions or "flashbacks"
Conducting LSD Sessions:
- Patients who remove eyeshades may have difficulty with reentry
- Unwillingness to work on unfinished material can lead to prolonged integration process
Potential for After-Effects:
- Psychedelic experiences represent powerful interventions in unconscious dynamics
- Integration takes time, even after a well-resolved session
- Additional unconscious material may surface later, requiring ongoing therapeutic work
Approach to Difficult Emotions and Physical Symptoms:
- Short period of hyperventilation can help activate underlying problem for resolution
- Patients should arrange for safe expression of emerging material if not available in everyday life
- Therapy team can assist with uncovering work using various techniques, including bioenergetic exercises, Gestalt technique, psychodrama, guided affective imagery, and deep massage
Value of Therapeutic Community Approach:
- Group engagement can be useful for dealing with unresolved gestalts
- Patients can volunteer or be chosen for specific roles in psychodramatic reenactments
Impact of Therapeutic Events on Helpers and Patients:
- Intense experiences can trigger valuable emotional reactions in helpers
- Material from such sessions can be used for group discussions
- Role of helper contributes to self-esteem, mastery, and closeness with patients
- In rare cases, patients may need continuous assistance due to intense aftereffects or potential danger to self or others
Administration of LSD:
- Shortening free interval between sessions can decrease intensity and therapeutic efficacy
- Other pharmacological substances can be used if necessary
- Major/minor tranquilizers inhibit process and prevent resolution
- Inhalation of Meduna's mixture or Ritaline can facilitate integration of material from previous LSD session
- Psychedelic drugs like THC or MDMA hold promise but require further exploration
- Ketamine, a dissociative anesthetic, shows great potential in psychedelic therapy due to its powerful effects on consciousness and ability to catalyze breakthroughs.
Understanding Hell:
- Crossculturally defined as experiences involving unbearable tortures without end or hope for release
- Difference between purgatory and hell: presence vs lack of hope
- Confusion between psychological time and clock time in spiritual systems
Sexual Disturbances:
- Most cases not based on lack of libidinal drive but excess volcanic instinctual energies related to BPM III
- Unconscious fear of unleashing these forces and need to control them interferes with sexual act
- When excess energies are discharged in non-sexual context, individuals can handle them better sexually.
The Course of LSD Psychotherapy
Background:
- Study conducted at Psychiatric Research Institute in Prague between 1960 and 1967
- Explored LSD's potential for personality diagnosis and as an adjunct to psychotherapy
- Oriented toward psycholytic approach, but assimilated principles of psychedelic approach
- Emphasized increased dosage, internalization, use of music, and appreciation of perinatal/transpersonal experiences
- Final method described in this book
- Subjects included psychiatric patients, professionals, and others for training/insight/inspiration
- Criteria: represent major psychiatric diagnoses; have severe chronic disorders unresponsive to conventional therapy; above-average intellectual functioning and introspection ability
Study Details:
- Collected records from serial LSD sessions of 54 patients (15-103 sessions)
- Treated various conditions: depression, psychoneuroses, psychosomatic diseases, sexual dysfunctions, addictions, character disorders, borderline psychosis, schizophrenia, and cancer patients
- Detailed records essential for research purposes and clinical practice
Importance of Record Keeping:
- Useful in research to draw general conclusions and provide theoretical insights
- Helpful in clinical practice: therapists forget details; patients may not remember all sequences
- Can be more evident when reviewing drawings/paintings from sessions
- Revealed connections, recurrent themes, important trends, typical stages, and characteristic turning points
- Expanded the model of the human unconscious
Changes in Psychedelic Sessions:
- Four major categories: abstract, psychodynamic, perinatal, transpersonal
- Precedence for first few sessions: abstract experiences (geometric designs, colorful visions)
- Higher dosages lead to other phenomena: emotional exploration, psychosomatic changes, perinatal and transpersonal experiences.
LSD Experiences: Abstract and Geometric Visions
- Can take complex forms of temples, cathedrals, mosques, or decorations
- Environment appears in flux or rhythmic undulating movement
- Colors bright and explosive, contrasts stronger than usual
- World can appear geometrized, ornamentalized, or transformed into fantasy
- Synaesthesias may occur: seeing music, hearing pain, tasting colors
- Experiences have little relevance for therapy, self-exploration, personal growth
- Physiological explanation: chemical stimulation of sensory organs
- Can be produced by anoxia, hyperventilation, carbon dioxide inhalation or physical means
- Distinguish advanced geometrical images from abstract and aesthetic experiences
- Advanced geometrical visions related to specific forms of micro- and macrocosm or spiritual geometry
- Colors, shapes may reflect underlying emotional quality and biographical material
- Transitions from abstract to psychodynamic level in LSD sessions
- Understanding content facilitated by COEX systems and governing dynamic systems.
Psychedelic Sessions Research Findings
- Content of Psychodynamic Sessions: Reliving traumatic memories of psychological nature to serious diseases, operations, accidents
- Transition to reliving biologically threatening events or severe psychological traumas in early infancy
- Overlap between biographical level and perinatal level of the unconscious
- Gradual transition, experienced LSD patients recognize connection between birth trauma and childhood memories
Perinatal Trauma Recognition: Experienced LSD therapist can identify emerging perinatal elements behind excessive emotional reactions and psychosomatic manifestations related to childhood memories.
Movement into Perinatal Area: Every LSD subject eventually transcends biographical stage and moves fully into perinatal area
- Number of sessions necessary varies, more sessions for psychiatric patients with severe problems
- Patients avoiding perinatal material due to fear, supported by initial Freudian orientation of therapists
- Shortening time needed if subjects are familiar with perinatal dimensions
Perinatal Sequential Patterns: No universal patterns or regularities in order confronted
- Exceptional subjects access BPM I and transpersonal phenomena before negative matrices
- Access to BPM IV and I increases as subjects deal with difficult aspects of BPM II and III
- Factors determining sequences: biological birth process, individual history, external factors like therapist personality and setting.
Experiential Sequences in Perinatal Unfolding: Emphasis on emotional quality or psychosomatic manifestations in negative matrices
- Central focus can be on depression, anxiety, guilt, anger, aggression, or revulsion
- Physical pains, discharge of tension, nausea and vomiting, cardiac difficulties
- Each stage of perinatal process experienced on different levels: symbolic allusions to primal elemental nature.
Therapeutic Potential and Insights: Rich experiential content from various fields contributes to understanding the death-rebirth process.
Perinatal Process in LSD Therapy
Importance of Perinatal Process Completion:
- Takes many sessions to finish and disappear from content
- Agrees with anthropological observations of rites of passage in non-Western cultures
- Episodes become less dramatic and lack perinatal elements in second half of life
Perinatal Process Stages:
- Initial stages: Large periods spent as suffering victim, helpless and hopeless
- More advanced stages: Increasing access to aggressive feelings, active role in sequences
- Ending stage: Experiential predominance of the element of fire (pyrocatharsis)
Experiential Transition from Death to Rebirth:
- Can be unbearable without sitter's support and encouragement
- Concomitants include:
- Catastrophic global explosion expectation
- Excessive degrees of suffocation, loss of consciousness ("black-out")
- Bodily disintegration, collapse of reference points
Perinatal Experiences:
- Intermediate between individual and collective unconscious
- Progression indicators:
- Biographical emphasis in early phases
- Transpersonal realms increasingly represented later on
- Examples of transpersonal phenomena:
- Archetypal images of deities/demons, past-incarnation memories, identification with persons and groups.
Perinatal Process
- Number of sessions varies from person to person
- Depends on external factors like dosage, therapist, set and setting
- Some individuals complete process in less than ten high-dose LSD sessions
- Others need several scores of psychedelic experiences
- Can be approached as therapy or for another reason
- Progresses through psychodynamic, perinatal, and transpersonal phases
Psychodynamic Phase (Freudian)
- Reliving birth trauma
- Release of pent-up energies
- Dissolving character armor
Perinatal Phase (Rankian & Reichian)
- Enormous release of emotions
- Interferes with everyday functioning
- Can be illustrated by Erwin's experience:
- Severe obsessive-compulsive neurosis
- Compulsion to create geometrical system
- Intense struggle for control
- Regression to childhood during LSD therapy, reliving toilet training issues and rebellion against parental authority.
Transpersonal Phase (Jungian)
- Continuing philosophical and spiritual exploration
- Cosmic adventure in consciousness
- Beyond ego death and rebirth
Erwin's Experience
- Twenty-two year old patient with severe obsessive-compulsive neurosis
- Compulsion to create geometrical system for organizing life
- Intense struggle for control, interfered with everyday functioning
- Regression during LSD therapy: reliving toilet training issues and rebellion against parental authority.
Erwin's LSD Sessions: The Snake Symbolism
Snake and Neurotic Symptoms:
- Serpentine forms represented feces
- Obsessive preoccupation with coordinate system shift reflected bowel movements
New Elements in Erwin's Sessions:
- Visions of snake skin and serpentine loops became associated with strong erotic excitement, sexual tension
- Saw scenes involving naked male and female bodies in intercourse
- Reliving of a classical Freudian primal scene: observation of parents' sexual activities, gave it a sadistic interpretation
Symbolism of the Snake:
- Phallic symbol, according to Freudian tradition
- At perinatal level, snake represented the destructive female element, crushing and smothering the baby during delivery
- Serpentine visions reflected the conflicting forces during birth agony
- Uncleanliness extended from genital and anal areas to entire body, condition of newborn after delivery
Later Sessions: Transpersonal Contexts:
- Saw images of high priestesses attending sacred pythons
- Snakes embodying primordial forces of nature
- Gigantic Ouroboroses swallowing their tails
- Plumed serpents and other mysterious serpent deities
Outcome of Sessions:
- Relevant connections but not therapeutically useful
- Erwin felt close to solving problems, but long series of psychedelic sessions failed to bring desired results.
Emotional and Psychosomatic Changes During Post-Session Intervals
General Patterns of Change:
- Emotional enhancement or vitality increase following sessions in "normal" individuals
- Occasional negative aftereffects, but minimal in emotional stability
- Dramatic oscillations in clinical condition for psychiatric patients with severe neurotic and psychosomatic disorders
- Some sessions result in dramatic improvement
- Other sessions unexpectedly worsen symptoms or create new ones
- Small changes in some cases, negligible
Less Structured Circumstances:
- Observations provide understanding of dynamics involved
- Important for future LSD therapists to actively intervene during reentry period
- Negative aftereffects minimal in emotionally stable individuals
Post-Session Intervals and Therapeutic Approach:
- Discussion of course of LSD process before introducing strict internalization and positive resolution principles
- Minimal negative sequelae when therapeutic help offered during termination period
Clinical Example: Richard's Case
- Twenty-six-year-old student suffering from severe depression, unrelenting anxiety, headaches, cardiac pain, insomnia, and sexual dysfunction
- Depression and suicide attempts due to sexual problems
- Homosexual activities with self-hatred and guilt feelings
- LSD session: Completed reliving and integration of negative COEX system related to BPM II.5
- Followed by ecstatic experience and sense of being cured
- Reentry period: Experienced different memory constellation, hysterical paralysis instead of old symptoms
- Classical hysterical conversion reaction with "belle indifference" attitude towards symptom
- Continued psychedelic treatment led to lifting of paralysis in subsequent sessions
- Emergence and resolution of father-son relationship aggression and conflicts about patricide.
Themes Underlying Richard's Paralysis:
- Freudian id vs superego: His hand oscillated between his face and hip joint, reflecting conflict between the overwheeling desire to masturbate and guilt/fears.
- Masturbation conflicts: Strong desire to masturbate was followed by guilt and fears, causing his hand to reach and pull back. He had experiences involving sex, punishment, and a traumatic memory of being caught by his father.
- Perinatal area and relationship with mother: Both themes traced back to the perinatal period and Richard's relationship with his mother.
- Death-rebirth struggle: Sequences of this struggle were intertwined with biographical material related to his father.
- Improvement and continuation of therapy: After working through these two areas, Richard regained control over his hand and arm but new symptoms did not emerge. However, emotional and psychosomatic suffering continued during sessions, leading the therapist to continue LSD psychotherapy beyond this point due to a limited theoretical model and expectation that only "residual problems" would remain.
- Perinatal realms: As the patient dealt with various aspects of death-rebirth process, emotional qualities and sensations expanded beyond imagination. Patients experienced agonies, ecstasies of cosmic proportions, and temporary psychotic symptoms or clinical deterioration.
- Psychedelic afterglow: Deep ecstatic states followed by considerable reduction of symptoms and an actively joyful approach to existence with a spiritual undertone.
- Complications during critical phase: Depressions, aggressive tension, self-destructive tendencies, mania, and temporary rehospitalization were common as the patient moved into the perinatal area. A special treatment facility with trained personnel should be available during this critical phase to manage complications.
Psychiatric Patients' Convergence during LSD Therapy
Observations:
- Patients with diverse clinical problems (claustrophobia, alcoholism, inhibited depression) exhibit similar symptomatology in LSD sessions and free intervals
- Symptoms characteristic of BPM II, III, IV appear, often reducing specific biographical differences to typical BPM phenomenology
- Observations suggest new model for mental illness and psychotherapy
Implications:
- Subjects transcend biographical and perinatal levels, but negative transpersonal matrices can still influence everyday life
- Working through negative transpersonal matrices has therapeutic effects on emotional, psychosomatic, interpersonal processes
- Understanding one's identity, dimensions of being, human life, and existence is expanded through psychedelic process
Dream Life:
- Continuity between nature and content of drug-induced experiences and mental activity during sleep and hypnagogic period
- Dreams before LSD session anticipate content; post-session dreams elaborate on themes from preceding sessions
- Unresolved gestalts and unconscious material become experientially available
Dream Content:
- Biographical issues: Freudian approach to interpretation is adequate
- Perinatal dreams (BPM II): passive experiences of tortures, claustrophobic experiences, meaningless situations
- Perinatal dreams (BPM III): titanic warfare, murders, accidents, pornographic scenes, decay and unimaginable dirt
- Transition from BPM III to IV: dreams about individual and mass death, destruction of world
- Dreams related to first perinatal matrix involve elements of divine revelations, triumphant victories, escape, loving reunion, joyful celebration.
The Dream: A Symbolic Representation of Birth and Ego Death
- The dream involved a house falling into the Pacific Ocean
- The author and family were about to die
- Elements of acceptance of death, end of world, elemental forces, and spinning head were present in both the dream and LSD sessions
- Recognition of these elements as representing aspects of ego death was essential for interpretation
Transpersonal Stage of LSD Process
- Dreams during this stage cannot be adequately interpreted using Freudian terms
- Content may represent transpersonal phenomena such as past-incarnation memories, ancestral experiences, encounters with archetypal entities, extra sensory perception, or out-of-body travels
- Recognition of these dreams' specific nature is crucial for their understanding and interpretation
Symbolic Dream Representation During Analytical Training
- Author in a horrible dungeon, chained to a slab and exposed to tortures
- Magic cup outside the prison providing nourishment when certain conditions were met
- Free associations included Spanish Inquisition, instinctual life of apes, oral themes, and childhood incidents
- Analyst's interpretation was superficial and unsatisfactory
- Elements of the dream reappeared in a high dose LSD session and made sense in the context of birth trauma
- Dungeon: delivering uterus; tortures end with nursing stage
- Magic cup: nourishment provided during birth process
- Identification with monkeys: unleashing instinctual impulses during perinatal process
LSD Psychotherapy for Neurotic and Psychosomatic Symptoms
- Individuals with serious emotional problems followed a general course of progression from abstract to perinatal experiences
- Difficult experiences limited to the drug's effect culmination, but most reentries were pleasant or ecstatic
- Negative carry-overs to free intervals were rare, and no prolonged reactions or psychotic breakdowns observed in non-psychotic patients
LSD Psychotherapy for Schizophrenic Patients
- Fluctuations in clinical condition before entering the perinatal realm
- Improvement just before perinatal process, with alleviation or disappearance of psychotic symptoms and critical insight into previous difficulties
- Post-perinatal process: recurrence of original psychotic symptoms but focused on the therapist (transference psychosis)
LSD Therapy vs. Psychoanalytic Approach:
- LSD therapy sessions continue despite deteriorating clinical condition and transference psychosis, leading to higher levels of integration and mental functioning
- A specially structured treatment unit is necessary for therapeutic experimentation with LSD
- Use of high dosages, eyeshades, and stereophonic music deepens the experience
- Psychedelic phenomena can be encountered in a single session instead of gradual unfolding as in psychoanalytic approach
- Beginning of session: abstract period with colors and dynamic geometrical patterns (BPM 0)
- Focus shifts to psychodynamic realm, brief touch with biographical elements related to COEX system (BPM I)
- Confrontation of deep levels of memory dealing with survival and bodily integrity or perinatal matrices (BPM II)
- Memories of near-drowning, injuries, operations, dangerous diseases, profound encounters with death beyond concrete biographical events (BPM III)
- Transpersonal realm: mythological sequences, ancestral and phylogenetic memories, elements of the collective unconscious, past-incarnation phenomena (BPM IV)
- Reentry: repetition of psychodynamic episodes and application of insights to life situations. However, death-rebirth process may not be completed with a single high-dose LSD session
- Fewer difficulties and complications in intervals between sessions when applying principles of psychedelic therapy and intensive experiential work during termination period is involved. Overall time required for process completion much shorter than psycholytic therapy.
Long-Term Changes in Personality Structure, Worldview, and Basic Values+
Psychedelic Experience's Lasting Influence:
- Can have profound and lasting consequences on personality structure
- May catalyze a sudden transformation if the subject has intrinsic potential for change
- Can drastically alter worldview, life philosophy, and way of being
- Profound spiritual opening in atheists, skeptics, materialists, scientists
- Facilitates emotional liberation
- Causes radical changes in value systems and lifestyle
Risks:
- Serious emotional disturbances lasting months or years for individuals with emotional problems or psychosis susceptibility
- Important to screen out individuals with serious issues before LSD therapy
Freudian Stage of LSD Psychotherapy:
- Subjects discover inauthentic aspects of their lives, such as perceptions, emotional reactions, and behavior patterns
- Confronting past traumatic material can lead to freedom from idiosyncrasies and psychological fixations
- Can result in alleviation or elimination of certain psychopathological symptoms
Perinatal Experiences:
- Have a fundamental impact on LSD subjects
- Insights into the birth process can drastically change perception of self and world
- Realization that entire concept of existence may be contaminated by fear of death
- Individuals under the influence of perinatal energies are psychologically involved in the life-and-death struggle in the birth canal
Outcomes:
- Enhanced ability to relax physically and emotionally
- Shift from pursuit of external schemes to appreciation of simple aspects of existence
- Deep satisfaction derived from everyday experiences
- Pull participation in the process of life becomes more important than specific goals
- Feeling of belonging and synergistic behavior patterns replace selfishness and competition
- Rejection of Western life philosophy that confuses conspicuous consumption with richness of life
- Increased ecological awareness and need to live in harmony with the environment.
Psychedelic Transformation and Consciousness Exploration
Positive Perinatal Matrices:
- Holistic and synergistic approach to human/natural environment related to positive perinatal matrices
- Based on memory of mutually satisfying, nourishing exchange with maternal organism
Psychedelic Transformation and Spiritual Quest:
- Development of intense interest in consciousness, self-exploration, spiritual quest
- Spontaneous inclination toward mysticism, ancient/oriental spiritual practices, yoga/meditation, fascination with mythology/religious art
- Emergence of new transcendental ethic, similar to Maslow's metavalues and metamotivations
- Sense of compassion, tolerance, basic justice, aesthetic appreciation (transpersonal or cosmic quality)
- Successful completion leads to more joyful, interesting, satisfying way of being in the world with a sense of belonging, meaning, natural spirituality, synergistic participation
Transcendence of Newtonian-Cartesian Worldview:
- Enormous expansion of experiential world challenges acceptance of objective reality, material essence, 3D space, linear time, and causality
- Possibility of transcending limitations of matter, time, space, and causality experienced and integrated into new worldview
- Universe ceases to be assembly of material objects; becomes infinite system of adventures in consciousness
- Holonomic features with transcendence of part/whole, experiencer/experienced, determinism/free will, form/emptiness, existence/non-existence
Implications for Emotional Disorders and Psychotherapy:
- LSD process can be therapy in traditional sense (self-exploration limited to biographical areas)
- Once reaches perinatal level, better described as rite of passage or spiritual transformation
- Client works on emotional, psychosomatic, interpersonal problems, but emphasis shifts toward philosophical and spiritual quest
- Problems latent during LSD process must be addressed for complete integration of each session in the series
- Ultimate reconciliation comes from insight into totality of existence as unified field or network available to each individual
Problems in Evaluating LSD Psychotherapy
Disagreement about Potential and Efficacy:
- Enthusiastic reports from LSD therapists of quick results in emotional disorder therapy
- Negative clinical results reported in some studies, denying positive reports
- Reports on deleterious aftereffects of self-experimentation
Evaluating Therapeutic Potential:
- Difficulties with accurate and reliable measuring instruments for assessing change
- Lack of agreement on basic indicators of therapeutic progress
- Differences in perspectives between symptomatic approaches vs. dynamic orientation
- Use of various criteria, such as changes in psychophysiological or biochemical parameters, and societal values like income and professional achievement
Specific Problems with LSD Psychotherapy:
- Treatment involves more than just drug administration
- Importance of non-drug variables, including therapist personality and approach, set and setting factors
- Critical role of therapist's ability to tolerate and appreciate unusual experiences
- Complications from profound changes in life strategy, worldview, and values following treatment
Evaluation Challenges:
- Therapist's assessment of efficacy is critical, but difficult due to their role in the process
- Specialized training for therapists, including personal psychedelic experiences, is important
- Difficulty in evaluating changes that may challenge the current value system
LSD Psychotherapy: Personal View
- Limitations and dangers of Occidental value system more obvious than before
- Criticism of unlimited industrial growth and competitive politics/technocracy
- Rapidly changing criteria of sanity, with mystical experiences considered healthy by humanistic and transpersonal psychologists
- Attraction to Eastern systems of thought and spiritual practices
- Increasing acceptance of transpersonal psychology and psychiatry
- Theoretical physicists' compatibility of mystical worldview with modern science
- Personal view on potential of LSD psychotherapy based on personal philosophy
Indications for Psychedelic Therapy:
- Psychological rather than organic basis
- Result of learning in its most general sense
- Loose definition leaves space for individual therapeutic experimentation
- Importance of psychogenic factors in certain disorders, such as anxiety, conversion hysteria, obsessive-compulsive neurosis, character disorders, alcoholism, drug addiction, sexual dysfunctions and deviations, bronchial asthma, peptic ulcers, psoriasis, ulcerous colitis
- Uncertainty regarding the ratio of psychogenic and somatogenic factors in other conditions; exploration with LSD sessions can clarify this
- Emotional and physical symptoms tend to be accentuated during LSD sessions and provide relevant insights into the root causes
- Therapist feeling about the possibility of influencing disorder through psychotherapeutic work
- Detection and bringing to consciousness dynamic structures with intense emotional charge for introspective analysis and working through
- Highly demanding, specialized procedure requiring rigorous training of therapist
- Course may not be equal in smoothness or safety, nor outcome always predictable and successful
- Some patients require a large number of sessions with slow progress; limited therapeutic gain for a small percentage despite investment
- Certain intervals between sessions can be difficult or potentially dangerous
- Successful clinical conditions: depressions, neuroses, psychosomatic symptoms; alcoholism, drug addiction, character disorders, sexual deviations; borderline states and endogenous psychoses; emotional distress and physical pain of the dying, particularly cancer patients.
Psychedelic Therapy for Mental Health Issues
Best Candidates:
- Subjects with good intellect and adequate interpersonal/professional adjustment
- Lack zest for life and a sense of meaning
- Symptoms: Noogenic depression, lack emotional connection to achievements
Effects of LSD Therapy:
- Dramatically changes situation (depression, etc.) within hours
- Enhances mood, self-esteem, capacity for relationships, appreciation of beauty
- Insights can be applied creatively in professional life
Depression and Psychedelic Therapy:
- Depression is most changeable psychiatric symptom
- Single LSD session can dispel clinical depression, but relapse possible
- Periodic depressions can be terminated by LSD administration
- Systematic work required to change underlying dynamic structure
Neurotic Disorders and Psychedelic Therapy:
- Prognosis best in cases where anxiety and depression are prominent
- Successful with anxiety disorders, conversion hysteria (transference/countertransference issues)
- Monosymptomatic neuroses require long-term systematic LSD therapy
- Obsessive-compulsive neurosis has dimmest prognosis
- Improved understanding and technique may lead to better outcomes
Emotional Neuroses and Psychedelic Therapy:
- Traumatic emotional neuroses respond well to LSD as abreactive agent
- Single high-dose LSD session can alleviate/remove symptoms in these cases
- Prolonged, chronic trauma may require more extensive treatment
Sexual Experiences and Behavior:
- Intense, deep orgasms related to letting go of psychological defenses
- Sexual neuroses (frigidity, vaginal spasms, genital pain, impotence) respond well to LSD therapy
- Effective treatment requires serial administrations and confrontation of perinatal roots
LSD Psychotherapy for Various Physical Problems
Physical problems influenced by LSD psychotherapy:
- Organ neurotic manifestations
- Symptoms with hysterical or pregenital conversions structure
- Psychosomatic diseases
Improvements in Painful Conditions:
- Headaches (ordinary, migraine)
- Severe menstrual cramps
- Gastric/intestinal spasms
- Pains in neck muscles or lumbar area
- Arthritic pains without organic basis
Neurotic Disorders of Organs:
- Cardiac dysfunction
- Gastric distress
- Breathing difficulties
- Excessive sweating
- Muscular tremors
- Constipation or diarrhea
- Menstrual irregularities
Unexpected Improvements in Myopia:
- Resolution of psychogenic muscular tension
Resistance to LSD Therapy for Pregenital Conversions:
- Obsessive-compulsive personality structure
- Successful treatment reported for some patients
Interesting Indications for LSD Psychotherapy:
- Psoriasis: dramatic improvements in severe cases
- Clearing of various skin disorders, especially eczemas
Possible Mechanism:
- Resolution and integration of psychological gestalt
- Improved blood flow to affected area
- Increased immunobiological resources in the afflicted region
- Decreased vitality of organ or tissue as a factor
- Psychological factors play an essential role
- Possible mechanism: psychogenic constriction of afferent vessels, limiting blood supply and defense against bacterial invasion.
- LSD subjects report a block being removed and free flow established in the affected area during the session preceding improvement.
Psychedelic Therapy for Alcoholism and Other Disorders
Limitations of Traditional Indications:
- Emotional and psychosomatic disorders within the range of traditional psycho therapy indications
- Use of LSD as an adjunct can intensify, deepen, and accelerate therapeutic process
Success in Chronic Alcoholics:
- Dramatic results reported for alcoholism treatment with LSD
- However, evaluations were based on clinical impressions, not rigorous research methodology
- Controlled study by Spring Grove team:
- High-dose (450 micrograms) vs. low-dose (50 micrograms) LSD
- After 6 months, high-dose group had 53% rehabilitated vs. 33% in low-dose
- After 18 months, differences narrowed but overall results were impressive
- Unexpected improvement in some patients in the control (low-dose) group
Contrast with Mendola Study:
- Extensive controlled study by Ludwig et al. at Mendola State Hospital
- Randomly assigned patients to psychedelic therapy, hypnotic treatment, LSD alone, or milieu therapy
- After 6 months, 70-80% of all groups were drinking again, and after a year this number ranged between 80-90%
- Even Antabuse introduction had no effect on the poor results
- Critique by Savage:
- Serious deficiencies in methodology, e.g., inexperienced therapists, limited preparation, and lack of human support
- Study reflected a bias against psychedelic therapy that emerged when LSD fell out of favor
Key Elements for Psychedelic Therapy:
- Therapist must be experienced and committed to the work
- Proper preparation is essential, including measuring suggestibility and providing adequate support during the session
- Mystical experiences are considered important and occurred in 78% of Spring Grove study
- Violation of these elements can result in therapeutic failure, as seen in Mendola study
LSD Psychotherapy for Addicts and Difficult Patients
Study Overview:
- Conducted at Maryland Psychiatric Research Center
- Involved male heroin addicts serving sentences, recommended by research staff
- Participants randomly assigned to: LSD group or control group (non-drug therapy)
- All granted parole and accepted into study program
Results:
- LSD Group: 11 of 34 patients did not return to narcotics during 6-month follow-up, vs. 1 in control group
- At 1-year follow-up: 8 LSD patients were still abstaining, vs. none in control group
- Short-term follow-up of conventional treatments showed 94-97% of addicts relapsed within weeks
Psychedelic Therapy with Alcoholics and Addicts:
- Striking improvements observed after a single high-dose LSD session in some alcoholics and heroin addicts
- Possibly related to ease in achieving transcendental states of mind
- More sessions may yield better clinical results
Psychedelic Therapy with Sociopaths:
- Can be effective for individuals with asocial, antisocial, or criminal tendencies
- Strong emotional ties form between patient and therapist, even if positive/negative/ambivalent
- LSD provides channels to discharge and integrate destructive feelings
- Experiences of transcendental states can reframe criminal behavior as violation of cosmic order
Other Successful Cases:
- Favorable results reported for patients with sadistic/masochistic tendencies, fetishism, exhibitionism, coprophilia
- Difficult to generalize about male and female homosexuality due to heterogeneity
- Prognosis dependent on individual's problem, attitude, motivation for therapy
Character Disorders:
- Can be considered for LSD therapy if well-equipped facility and trained personnel available
- Temporary manifestations of neurotic/psychosomatic symptoms may occur during sessions
Borderline Psychotic States and Endogenous Psychoses
- Psychiatric patients with borderline and manifest psychotic conditions can be included in psychedelic therapy
- Prognosis better than severely defended neurotics, particularly obsessive-compulsive patients
- Treatment of schizophrenic and other psychotic states with LSD is limited
- Psychedelic process: intensified psychotic symptoms between sessions; "transference psychosis" in critical stages
- Requires special preparation and training, not for the unprepared
- Deepest roots of schizophrenic symptomatology: perinatal matrices and negative transpersonal experiences
- Therapist must remain grounded and centered during the process
Case Study: Milada
- 38-year-old psychologist with neurotic disorder (obsessive-compulsive, organ-neurotic, hysterical conversion symptoms)
- Developed acute psychotic symptoms, including erotomanic delusional system and hallucinations of imaginary lover
- Received unsuccessful treatment with tranquilizers, antidepressants, and psychotherapy
- Selected for LSD therapy after 4 months of hospitalization
- After 12 LSD sessions, psychotic symptoms disappeared, developed full insight
- Subsequent sessions worked on neurotic and psychosomatic problems
- Experienced "perinatal realm" and relived traumatic memories from childhood
- Milada developed a transference psychosis, believed the therapist was her lover/husband
- Therapist encouraged this to help Milada work through her early symbiotic relationship with her mother.
Experience of a Schizophrenic Patient Undergoing LSD Therapy
- The patient became a member of an ancient culture she couldn't identify
- She could draw and paint in its artistic style, but couldn't name the culture
- Early intrauterine experience with placentary circulation and complex communication with maternal organism
- Consciousness of rapidly growing tissues within the embryo
- Chemical energy of metabolic processes seen as explosions of golden light
- Conscious experience of individual cells constituting the embryonal tissues
- Insight that consciousness pervades all manifestations of life, not limited to human brain
- Archetypal demonic entities envisioned during transpersonal sessions
- Stylized dragon representing metaphysical evil
- Winged demonic creature screening source of divine light and preventing unity
- Experiences of cosmic unity; others had deep depression, nausea, and metaphysical anxiety
- Relating to intrauterine competition with twin brother for resources
Treatment Process
- Regular weekly administrations of LSD despite persisting psychotic symptoms
- Sessions consisted mostly of negative transpersonal experiences
- Reliving unpleasant intrauterine memories
- Emphasis on emotional stresses and illnesses of mother during pregnancy
- Embryonic crises and mechanical discomfort as twin
- Negative karmic sequences and archetypal demonic experiences
- Unusual phenomenon: LSD had paradoxical effect in final phase
- Gained insight, critical judgment, and perspective
- Experienced profound ecstatic feelings with cosmic unity
- Emerged without psychotic symptoms or neurotic behaviors
- Successful treatment of other schizophrenic patients using LSD therapy (less involved and dramatic)
Considerations for Treating Paranoid Patients with LSD Psychotherapy
- Difficult to achieve good therapeutic relationship and basic trust
- Best circumstances: informed consent, active interest, cooperation
- Tend to experience sessions in total psychological isolation, blaming therapist for distress
- Extraordinary experiences can reinforce paranoid beliefs and magnify therapist's image into a malefic figure
- Other psychotic conditions (manic-depressive) can be treated with LSD psychotherapy but special problems may arise
- Single session can cause complete remission of episode or change phase
- Effects not a cure, possibility of recurrence due to underlying mechanisms and triggers
- Systematic intrapsychic work in serial sessions may influence psychological roots
- Risks: triggering deep depressions with suicidal tendencies after some sessions
- Inpatient or suitable hospitalization necessary for manic-depressive disorders treatment.
LSD Psychotherapy for Dying Individuals: Emotional Distress and Physical Pain
Pioneering Work on LSD Therapy for Terminally Ill Patients:
- Systematically explored use of LSD in cancer patients
- Originally suggested by Valentina Pavlovna Wasson (pediatrician) and Aldous Huxley (writer/philosopher)
- Pioneering clinical work conducted by Eric Kast at Chicago Medical School in the early 1960s
- Research program led by Walter Pahnke and William Richards at Maryland Psychiatric Research Center
Observed Changes in Patients:
- Emotional Symptoms: alleviation of depression, tension, sleep disturbances, psychological withdrawal
- Physical Pain: significant reduction or elimination for some patients, especially those not responding to analgesics/narcotics
- Concepts of Death and Attitudes Toward Dying:
- Patients with perinatal or transpersonal experiences showed decreased fear of death
- Understanding of dying shifted toward ancient or non-Western belief systems
- Values and Life Strategy: less emphasis on past/future, increased appreciation for the present
Psychedelic Transformation:
- Drastic changes in value hierarchy after LSD sessions with a transcendental emphasis
- Patients putting less emotional emphasis on past and future, showing increased awareness of the present
- Ability to draw satisfaction from simple things in life accompanied by acute awareness of the ultimate futility of pursuing status/power/possessions
Interesting and Least Controversial Indication:
- Use of LSD therapy for terminally ill patients is the most interesting and least controversial of all indications
- Possibility of alleviating emotional and physical distress in a relatively short time should be of great interest to everyone
Non-Therapeutic Uses for LSD
Training Sessions of Mental Health Professionals:
- Unique opportunity for professionals to experience the "alien worlds" encountered with psychiatric patients
- Recommended as a "reversible journey into the experiential world of psychotics" to gain insights
- Experiences include perceptual distortions, thought processes, and emotional states
- Can lead to more humane attitudes towards patients
Drug-Induced Religious and Mystical Experiences:
- LSD can induce religious or mystical experiences
- These experiences have educational value for mental health professionals
Role of LSD in Personal Growth and Self-Actualization:
- LSD has been used to aid in personal growth and self-actualization
Use of LSD in the Development of Paranormal Abilities:
- LSD has been used to develop paranormal abilities, such as psychic phenomena
Trauma Sessions for Mental Health Professionals:
- Psychedelic experiences can be used for training sessions to gain insights into mental disorders
- Participating in the sessions of other subjects offers an opportunity to observe abnormal phenomena and extreme emotional states
LSD Training for Psychotherapists:
- Sitting in LSD sessions has been recommended as a training for future psychotherapists
- Provides an opportunity to observe transference phenomena and learn to cope with them
Research on LSD Training for Mental Health Professionals:
- A study was conducted at the Maryland Psychiatric Research Center, offering up to three high-dose LSD sessions to mental health professionals for training purposes
- Over 100 participants agreed to psychological testing and follow-up questionnaires
- Data from this study has not yet been systematically processed and evaluated
Importance of LSD Training Sessions:
- Necessary qualification for an LSD therapist to fully understand the psychedelic state
- Essential for developing the ability to assist others in deep self-exploration
- Recommended for nurses and other staff members in psychedelic treatment units
Psychedelics and Creativity: LSD and its Impact on Artistic Expression
LSD Research and Controversy
- Inconclusive evidence on relationship between psychedelic state and creative process (Robert Mogar's review)
- Impairment during drug experience in some studies, enhancement in others
- Conflicting results for various functions related to creativity: color perception, recall, recognition, concentration, symbolic thinking, perceptual accuracy
- Lack of motivation and cooperation from subjects in formal psychological testing
- Contrast between negative outcome of studies and everyday experience of LSD therapists
Artistic Influence of LSD
- Deeply influenced by psychedelic experiences: painters, musicians, writers, poets
- Enhancement and unleashing of fantasy, extraordinary vitality, originality, freedom of artistic expression
- Quality improvement in creations according to own judgment and professional colleagues
- Dramatic quantum jump in content and style for some artists
- Unusual nature and power of material from the unconscious mind
- Technical aspects of drawings or paintings sometimes superior
- Exceptional cases: emergence of genuine artistic talent
- Enhancement of appreciation and understanding of art in individuals previously unresponsive or indifferent
- Sudden development of interest in non-conventional art forms
- Visionary experiences influenced famous painters' work: Hieronymus Bosch, Vincent van Gogh, Salvador Dali, etc.
- Dramatic change of attitude toward music; discovery of new dimensions and ways of listening to it
- Impact on contemporary music composition, interpretation, and audiences
Other Creative Branches Affected by Psychedelics
- Aldous Huxley: Brave New World, Island, Heaven and Hell, The Doors of Perception influenced by psychedelic experiences
- Allen Ginsberg's powerful poems inspired by self-experimentation with psychedelic substances
- French art of the fin de siècle and hashish usage
- Kiyo Izumi: designed modern psychiatric facilities using LSD experiences
Reason for Psychedelics' Impact on Creativity
- Access to vast repositories of concrete and valid information in collective unconscious
- Mediation of access to deep unconscious, primary process.
Observations on Revealed Knowledge from LSD Experience
Diverse Areas of Insights:
- Reveled knowledge can be specific, accurate, and detailed
- Relevant insights occurred in various fields: cosmogenesis, space/time, subatomic physics, ethology, animal psychology, history, anthropology, sociology, politics, comparative religion, philosophy, genetics, obstetrics, psychosomatic medicine, psychology, psychopathology, and thanatology
Facilitation of New Syntheses and Unconventional Problem-Solving:
- Many important ideas and solutions came from unusual states of mind (dreams, sleep/awakening, fatigue, illness)
- Examples: Kekulé's benzene formula, Tesla's electric generator, Loewi's chemical transmission discovery, Einstein's special theory of relativity
- Psychedelic drugs seem to facilitate unconventional problem-solving and new paradigms
Harman-Fadiman Study on Creativity with Mescaline:
- 27 male subjects: engineers, mathematicians, architects, psychologist, designers, managers
- Objective: Test for increased creativity and production of valid solutions under mescaline
- Results: Many solutions were accepted, others could be developed or opened new avenues
- Mescaline facilitated changes that aided the creative process: lowering inhibitions, enhancing fluency/flexibility, increasing visual imagery, concentration, empathy, access to subconscious data, motivation, and visualization of completed solutions
- Potential for LSD to enhance creativity is proportional to intellectual capacity and sophistication of the experiencer
The Use of Psychedelic Substances in Religious Traditions
Traditional Use:
- Traced back to ancient shamanic traditions
- Ancient Vedic religion used soma, a preparation from a lost plant
- Hemp Cannabis indica and sativa used in Asia and Africa for religious ceremonies and folk medicine
- Important role in Brahmanism, Sufi practices, Rastafarians
- Prevalent in Pre-Columbian cultures (Aztecs, Mayans, Olmecs)
- Peyote, sacred mushroom Psilocybe mexicana, morning glory seeds used
- Ritual use of peyote and sacred mushrooms still survives among Mexican tribes
African Hallucinogenic Plants:
- Tabernanthe iboga (eboga) a key ingredient in Middle Ages potions and ointments
- Bufotenine found in toad skin has psychedelic properties
Modern Research on Psychedelics and Spiritual Experiences:
- Discovery of LSD sparked debate among scientists, philosophers, theologians about the nature of these phenomena
- Extreme Views:
- Some saw it as an opportunity to scientifically explain religious experiences
- Others considered LSD-induced experiences genuine and authentic spiritual experiences
- Quasi-religious perspective: experiences simulate, but do not compare to true spirituality through discipline and devotion
- Difficulty in distinguishing between spontaneous mystical experiences and chemically induced ones due to lack of specific pharmacological effects and physiological changes during mystical experiences
- Decision on authenticity lies with theologians and spiritual masters, but opinions are varied and sometimes biased.
Psychedelic Experiences and Spiritual Insights:
Importance of LSD sessions for Theologians and Ministers:
- Opportunity to gain profound insights into nature of religion
- Validation of spirituality as relevant force in human life
- Resolution of conflicts and liberation from hypocrisy
Impact on Skeptics or Atheists:
- Realization of the importance and relevance of spirituality
- Liberation from burden of conflict and hypocrisy
- Increased power and natural authority in sermons
LSD Training Sessions:
- Unique perspective for those studying comparative religion
- Crossing boundaries between different creeds
- Draws on symbolism of collective unconscious.
Role of LSD in Personal Growth and Self-Actualization
Background:
- Intensive research on LSD focused mainly on psychology, therapy, or specific uses (artistic expression, religious experience)
- In mid-60s, issue of personal development for normal individuals emerged during wave of self-experimentation
- Controversy: pros and cons discussed passionately with inconsistent views
- Psychedelic self-exploration as panacea vs. grave danger to mental health
- Emotional charge subsided, time for sober reflection on issues involved
Benefits of LSD for Normal Individuals:
- Enhance quality of life
- Move towards self-realization or self-actualization
- Comparable to peak experiences described by Maslow
- Motivations: emotional dilemmas, philosophical and spiritual answers
- Craving for contact with transcendental realities stronger than sexual urge
Perspective on Drug Use:
- Few serious researchers believe in genetic hazards of LSD under proper circumstances
- Psychological dangers are only serious risk
- Creation of facilities for supervised psychedelic sessions
- Reduce psychological risks to a minimum
- Opportunity to accumulate valuable information about psychedelics through systematic research
- Existing situation: almost no professional research conducted in area where millions experiment on their own.
Psychedelic Substances and Paranormal Abilities
Historical Context:
- Psychedelic substances have facilitated extrasensory perception since ancient times
- Used for spiritual healing, magical purposes like diagnosing diseases and locating objects or persons
- Plants used: hemp (Cannabis), fly-agaric mushrooms, tabernanthe iboga, cohoba and epená snuffs, peyote cactus, teonanacatl sacred mushrooms, ololiuqui seeds, yagé brew
- South American Indians used yagé for telepathic experiences and accurate predictions of events
Anecdotal Evidence:
- Housewife saw daughter in LSD session, later confirmed by husband
- LSD subject saw ship named "France" trapped in ice near Greenland before it happened
- Stanley Krippner visualized JFK's assassination during psilocybin session a year beforehand
Paranormal Experiences:
- Out-of-body experiences common in drug-induced states
- Subjects detached from physical bodies, observing themselves or others
- Losing awareness of physical setting and identifying with archetypal entities
- Controlled traveling to specific places and reporting detailed descriptions
- Difficulties in objective testing due to loose interpretations, memory distortions, and potential contamination
Laboratory Research:
- Unimpressive results using standard parapsychological techniques
- Decrease of variance in Whittlesey's study, subjects guessed closer to mean chance expectation than predicted mathematically
- Walter Pahnke's unpublished findings suggest statistical approach may be misleading. He used electronic keyboard panels for a more complex test design.
LSD Experiments on Parapsychological Phenomena
LSD Study:
- Subjects guessed key lit on a panel in adjacent room manually or by computer
- Results for entire group were not statistically significant, but some individuals achieved high scores
- Some researchers objected to uninteresting approach, sought more appealing tasks
Emotionally Loaded Materials:
- Cavanna and Servadio used emotionally-loaded materials instead of cards
- One subject did well, overall results were nonsignificant
Mediums Experiment:
- Karlis Osis administered LSD to mediums asked to describe owners of objects
- Some became interested in aesthetic/philosophical aspects or personal problems, had difficulty maintaining concentration on task
Most Interesting Data: Pilot Study by Masters and Houston (65)
- Used emotionally charged images with 62 LSD subjects during termination periods
- 48 individuals approximated target image at least two times out of ten, 5 made successful guesses seven or more times
- Examples: "tossed seas" for Viking ship, "lush vegetation" for rain forests, etc.
Paranormal Phenomena in Psychedelic Sessions:
- Many technical problems: getting subject interested/keeping attention, rapid flow of eidetic imagery interfering with response selection
- Some extraordinary observations indicate psychedelics can induce extrasensory perception during pharmacological effect
- Future research should assess if abilities can be harnessed and cultivated
LSD and Creativity:
- Comprehensive discussion in Masters' and Houston’s Psychedelic Art (66)
- Influence on professional painters, uniquely documented in Experimental Psychoses by J. Roubiček
- Examples of relevant insights described in Realms of the Human Unconscious (32)
- Additional examples found in Arthur Koestler’s The Act of Creation (48)
- Research on creativity and psychedelic drugs, summarized in Stanley Krippner's paper (51)
- Interesting study: Walter Pahnke's Good Friday experiment in 1964 (75)
Notes:
- LSD therapy experience with sufficient clinical experience collects challenging observations on paranormal phenomena
- Occurrence of parapsychological phenomena not a standard or constant aspect of LSD effect, but can be facilitated by the drug
- Future research needed to assess if abilities can be harnessed and systematically cultivated.
LSD Therapy Mechanisms
Introduction:
- LSD therapy mechanisms are complex and multifaceted
- Some can be explained through conventional therapeutic methods
- Others involve undiscovered or unacknowledged processes
- Similarities found in spiritual healing, shamanic practices, and rites of passage
Intensification of Conventional Therapeutic Mechanisms:
- Defense systems weakened, psychological resistance decreases
- Emotional responses enhanced, leading to abreaction and catharsis
- Repressed unconscious material becomes accessible, including early childhood memories
- Unconscious material appears as symbolic phenomena similar to dreams
- Conscious integration of content made possible by the patient's dual role
- Age regression to past traumatic periods
- Maintaining adult perspective for analysis and reevaluation
Transpersonal Level Therapeutic Mechanisms:
- Unique to LSD therapy, not found in traditional psychotherapeutic schools
- Involve deep release of pent-up energies and emotional abreaction
- Opportunities for corrective emotional experiences through therapeutic relationship
- Intensified transference analysis facilitated by the patient's vivid perception of the therapist
- Therapist must remain understanding, unperturbed, and consistently supportive.
Conclusion:
- LSD therapy offers numerous opportunities for deep dynamic shifts and transformations
- The therapeutic process involves a complex interplay of various mechanisms on different levels
- Effective use requires a skilled therapist who can navigate the patient's experiences with sensitivity and understanding.
Changes in Dynamics of Governing Systems
Negative Governing Systems:
- Negative COEX systems
- BPM II and III
- Negative aspects of BPM I
- Negative transpersonal matrices
Positive Governing Systems:
- Positive COEX systems
- Positive aspects of BPM I
- BPM IV
- Positive transpersonal matrices
Strategies of LSD Therapy:
- Reduction of emotional charge attached to negative systems
- Facilitation of experiential access to positive ones
Specific Tactical Rule:
- Structure termination period to facilitate completion and integration
Manifest Clinical Condition:
- Not a global reflection of unconscious material
- Dependent on specific selective focus and tuning
Individuals Tuned into Negative Governing Systems:
- Perceive themselves and world in pessimistic way
- Experience emotional or psychosomatic distress
Individuals Under Influence of Positive Governing Systems:
- In state of emotional well-being
- Optimal psychosomatic functioning
Changes in Governing Influence of Dynamic Matrices:
- Can occur due to biochemical, physiological processes or external influences
- LSD sessions represent deep intervention in governing systems and their interplay
Transmodulation:
- Sudden clinical improvement during therapy can be explained as shift from negative to positive governing system
- Can occur on several levels: COEX, BPM, transpersonal
- Not necessarily mean all unconscious material underlying pathological state has been worked through
Importance of Focusing on Both Negative and Positive Experiences:
- Working through traumatic material and experiencing ecstatic states are both important and integral parts of the healing process
- Mutually interrelated in a dialectic fashion: reduction of negative systems opens way to deep positive episodes, and positive experiences enhance overall optimism and attitude towards therapy.
The Death-Rebirth Process in Psychotherapy
Therapeutic Potential:
- Experiences on the psychodynamic level have relatively minor therapeutic significance compared to those from perinatal sequences
- LSD psychotherapy reveals the powerful healing potential of the death-rebirth process
Perinatal Matrices and Psychopathological Symptoms:
- Negative perinatal matrices are a repository for intense emotions and physical sensations
- These symptoms, such as anxiety, aggression, depression, fear of death, guilt, inferiority, helplessness, emotional tension, can be traced to the birth trauma
- Other symptoms like headaches, neurotic feelings, lack of oxygen/suffocation, cardiac distress, nausea and vomiting, dyskinesias, pains, and tremors can also be linked to the death-rebirth process
Limitations of Psychodynamic Level:
- Patients who have moved beyond the psychodynamic level in their process continue to have clinical problems
- These symptoms are rooted in the perinatal level and cannot be fully resolved without addressing that underlying material
Death-Rebirth Struggle and Emotional Issues:
- Claustrophobia and inhibited depression require confronting the "no-exit" matrix experientially for a lasting resolution
- Agitated depression is rooted in the death-rebirth struggle, with suicidal urges often disappearing after working through perinatal material
- Suicidal tendencies are consumed in the death-rebirth process and individuals consider human existence in a broader spiritual framework
Alcoholism and Heroin Addiction:
- Can be seen as suicidal behavior extended over a long period of time
- Patients who experienced cosmic unity on LSD realized their craving was for transcendence, not drug intoxication
- Alcohol/heroin intoxication produces a caricature of the unitive state, leading to addiction and damage
Destructive Tendencies and the Birth Trauma:
- The destructive potential is an important aspect of the death-rebirth struggle
- Scenes of aggression and sadomasochistic tendencies are standard components of the perinatal unfolding
- The experience of rebirth is associated with a sense of love, compassion, and reverence for life
Perinatal Elements in Anxiety States, Phobias, and Sexual Disorders:
- Perinatal elements play an important role in various anxiety states, phobias, hysterical conversion symptoms, obsessive-compulsive neuroses, and sexual disorders.
The Perinatal Unconscious and Psychopathology
- The perinatal unconscious represents a universal matrix for various psychopathological and psychosomatic symptoms
- Pathology develops depending on the quality of an individual's post-natal life
- Experiences of death and rebirth can lead to dramatic improvements in diverse clinical conditions
Perinatal Matrices and Psychopathology
- BPM II: Impotence, frigidity, menstrual cramps, dyspareunia, coprophilia, urolagnia, clinical sadomasochism, fetishism, homosexuality
- BPM III: Episodes of diabolic tortures, extreme suffering, a sense of the absurdity of existence, visions of a monstrous world
- BPM IV: Messianic delusions, identification with Christ, experiences of rebirth or recreation of the world
Therapeutic Mechanisms on the Perinatal Level
- Release and discharge of pent-up emotions and physical sensations
- Healing potential of unitive ecstatic states experienced in BPM IV and I
Cosmic Unity and Good Womb/Breast Experiences
- Oceanic ecstasy related to undifferentiated state during intrauterine existence and nursing
- Satisfies fundamental psychological and biological needs
- Facilitates emotional and psychosomatic healing
Transcendental Experience and Its Significance
- New image of identity and cosmic status
- Replacement of materialistic universe with mystical alternative
- Far-reaching consequences for every aspect of life
Historical Context
- Long history of these experiences in various spiritual frameworks
- Healing potential significant enough to suggest new orientation in psychiatric therapy
The Role of Perinatal Matrices in Psychotherapy
- Careful study of characteristics and facilitation methods for inducing these states.
Transpersonal Experiences in LSD Psychotherapy
Observations from LSD Psychotherapy:
- Transpersonal experiences are more than just curious phenomena of theoretical interest
- Specific clinical symptoms can be anchored in dynamic structures of a transpersonal nature and cannot be resolved on the level of psychodynamic or perinatal experiences
- In order to eliminate a specific emotional, psycho-somatic, or interpersonal problem, the patient sometimes has to experience dramatic sequences of a clearly transpersonal nature
Unusual Observations:
- Patients' seemingly bizarre and unexplainable experiences can have a dramatic impact on their clinical symptoms
- Therapeutic process may lead into unexplored and uncharted territories, requiring open-mindedness and an adventurous spirit in both the client and the therapist
Therapist Approach:
- A therapist adhering to conventional paradigms and being unaware of or closed to unfamiliar levels of consciousness will generally be less effective with patients whose problems have a strong transpersonal emphasis
- This approach fails to meet the spiritual needs of these patients and provide sensitive guidance
Transpersonal Experiences in Therapy:
- Difficult emotional symptoms that had not been resolved on the psychodynamic or perinatal level disappeared or were mitigated in connection with embryonic experiences (e.g., attempted abortions, maternal diseases)
- Particularly dramatic therapeutic change has been observed in past-incarnation experiences, often accompanied by synchronistic changes in the lives and attitudes of people involved
Case Example: Tanya's Past-Incarnation Experience
- Tanya, a 34-year-old teacher, was undergoing LSD psychotherapy for depression, anxiety, and fatigue
- She had been suffering from chronic sinusitis for 12 years, which did not respond to conventional medical treatment
- In an LSD session, Tanya relived a past-incarnation memory of being accused of witchcraft in New England and drowned by her father and husband
- This experience cleared Tanya's chronic sinus condition, despite the lack of evidence for its historical validity or causal link to reincarnation
Similar Observations with Non-Drug Techniques:
- Similar mechanisms have been observed in therapy using hypnosis, gestalt practice, or primal therapy
- Clients undergoing these therapies may relive past-incarnation memories and resolve their symptoms in this context
Patient Case Study: Flora's Complex Psychological Conditions and LSD Experiences
Background:
- 28-year-old single woman, hospitalized for over eight months due to various psychological issues
- Previous therapies including tranquillizers, antidepressants, psychotherapy, and occupational therapy had failed
- Criminal history: member of a gang that committed an armed robbery and killed a night watchman at age sixteen; served four years in prison and placed on parole for the rest of her sentence
- Drug addiction: alcoholic, heroin addict, frequent use of psychostimulants and barbiturates
- Severe depressions with violent suicidal tendencies
- Hysterical vomiting upon emotional excitement
- Painful facial cramp, "tic doloreux" suggested brain surgery by neurosurgeon
- Lesbian with severe conflicts and guilt about her sexuality
Psychedelic Experiences:
- LSD sessions focused on problems of embryonic development and birth due to being a twin
- Visions and experiences of complex geometrical organization in animal forms, emotionally involved but incomprehensible
- Recognized many recognized forms from Haeckel's "Art Forms in Nature" book during convalescence after heart attack
- Insights into the nature of embryological development and asymmetrical organs like the heart led to understanding life-long interest in mathematics, symmetry, and geometrical forms.
Archetypal Structures:
- Some LSD patients recognize symptoms, attitudes, behavior as manifestations of underlying archetypal structures
- Full experiential identification can lead to resolution of problems
- Energy forms involved may have alien qualities, resulting in therapeutic procedures similar to exorcism or spirit possession expulsion.
Flora's Symptoms:
- Criminal history and addiction issues
- Severe depressions with suicidal tendencies
- Hysterical vomiting
- Painful facial cramp, "tic doloreux"
- Lesbian with conflicts about her sexuality
Recognition of Past Experiences:
- Insights into embryological development and asymmetrical organs led to understanding her life-long interest in mathematics, symmetry, and geometrical forms.
Unusual Behavior During LSD Sessions:
- Patients may experience spirit possession or exorcism-like therapeutic procedures during LSD sessions due to the energy forms involved having an alien quality.
Flora's LSD Therapy Session
Background:
- Flora had a criminal record and severe suicidal tendencies
- Had access to weapons
- Considerable risk to give her an LSD session due to national hysteria around the drug
First Two Sessions:
- Similar experiences as previous sessions
- Minimal therapeutic gains
Third Session:
- Suddenly, Flora's facial spasms became unbearable
- Face contorted into a "mask of evil"
- Spoke in a deep male voice, identified as the "devil"
- Blackmailed the therapist and made threats
- Difficult to control emotions and fear
- Visualized a capsule of light to remain calm and centered
- After two hours, Flora's face returned to normal and she remembered nothing of the possessing state
Outcomes:
- Lost suicidal tendencies
- Gave up drugs and alcohol
- Improved sexual adjustment, but marriage ended
- Experienced occasional recurrences of pain, but negligible intensity
- Accepted as a taxi driver, continued to have ups and downs but did not require hospitalization
Therapeutic Value of Transpersonal Experiences:
- Observations from LSD research suggest they can be therapeutically valuable
- Therapists should be aware of their potential and support clients in self-exploration
- None of the existing psychological schools covers the entire spectrum of processes involved
- Freudian psychoanalysis, Rankian framework, Reichian and neo-Reichian approaches, and Jungian psychology offer useful formulas but do not cover all aspects.
Embracing Flexibility in LSD Psychotherapy: The "Bootstrap" Philosophy and Spectrum Psychology Approach
Psychedelic Process and Theoretical Frameworks
Limitations of Existing Systems:
- Each partially applicable to psychedelic process
- Rigid adherence antitherapeutic
Lesson from Modern Physics:
- Universe as intricate web of interrelated events (bootstrap philosophy)
- Reality arbitrary, theories are approximations
Approach to Self Exploration:
- Spectrum psychology: various levels or bands of consciousness
- Approach process from spirit of "bootstrap" philosophy
Theoretical Models:
- Approximate and useful organizations of data
- Tentative and flexible
- Not essential for therapeutic progress
Emotional and Psychosomatic Symptoms:
- Indicate blockage of energy
- Attempts to emerge, representing potential experiences
Role of Therapist:
- Help mobilize energy and facilitate experiential flow
- Encourage following the process content regardless of specific form
- After process completed: intellectual processing an academic exercise
Intellectual Processing:
- Discussion reserved for next volume
- Meaningfully related to new model of universe, human nature.
Additional Notes:
- Socio-political implications of observation (perinatal roots of wars, totalitarianism and revolutions) discussed in author's paper "Perinatal Roots of Wars, Totalitarianism and Revolutions."
- Ernst Haeckel's biogenetic law: organism repeats phylogeny during ontogeny.
The Future of LSD Psychotherapy
Exploration of the Human Mind and Nature:
- Psychedelic experiences reveal new possibilities and mechanisms for therapeutic change and personality transformation
- The spectrum of the LSD experience is puzzling to professionals, but not unpredictable
Revision of Existing Therapeutic Frameworks:
- The safe and effective use of LSD requires a revision of existing psychotherapy theory and practice
- Basic principles can be formulated for LSD-assisted psychotherapy to maximize benefits and minimize risks
Theoretical Formulations from LSD Psychotherapy:
- New, expanded cartography of the human mind
- New effective therapeutic mechanisms
- New strategy of psychotherapy
- Synthesis of spirituality and science in the transpersonal approach
- Possible contributions to understanding the nature of reality through convergence with myisticism, consciousness research, and quantum-relativistic physics
Risks and Dangers of Psychedelic Experimentation:
- Psychedelics have dangers and pitfalls, but risks are proportional to the significance of the discovery
- Early inventions involved high levels of risk, such as gunpowder and nuclear energy
Challenges for LSD Psychotherapy in Mainstream Psychiatry:
- The present prospects for systematic LSD research and use in psychotherapy look grim
- Reasons include the unusual nature and content of psychedelic experiences, contrasting with conventional psychotherapy
Acceptance of Experiential Therapies:
- Modern experiential therapies like Gestalt practice, encounter groups, and primal therapy now accept and encourage dramatic experiences
- New approaches to schizophrenia encourage deep experiential immersion
Shifting Enthusiasm in Psychoactive Drugs:
- The original enthusiasm for chemical solutions has tapered off
- Tranquillizers and antidepressants are symptomatic remedies, not solutions
- Dangers of massive use include irreversible neurological symptoms and physiological addiction
Social Forces Shaping the Future of Psychedelic Research:
- Young professionals who had exposure to psychedelics may challenge existing attitudes
- The social sanction of ritualized and responsible psychedelic use in ancient societies and pre-industrial countries is a hopeful precedent
Psychedelic Use Crisis Intervention: Understanding Psychedelic Experiences for Effective Crisis Intervention
Background:
- Shift in professionals' role from researchers to rescuers due to unsupervised psychedelic use since the mid-sixties
- Limited scientific research on psychedelics due to restrictive legislation
- Paradoxical situation: expected to provide expert help without research capabilities
Nature and Dynamics of Psychedelic Experiences:
- Catalyst of Mental Processes: LSD amplifies unconscious material, revealing hidden recesses in the mind
- Influence of External Factors: sensitivity to external stimuli is intensified; "set" and "setting" play a role
- Difficult Experiences: reflect pathogenic constellations or traumatic circumstances
- Importance of Proper Handling: proper handling leads to positive outcomes, while insensitive approaches can cause damage
- Defense System Weakening: defense system weakened by drug but unintegrated released material may result in imbalances or prolonged reactions
- Tranquilizers Use during Sessions: prevents natural resolution and can be harmful
- Complications during Unsupervised Psychedelic Experimentation:
- Lack of pharmaceutically pure LSD and accurate quality gauging in black market samples
- Differences between clinical research and unsupervised use situations
Crisis Intervention:
- Understanding the Nature and Dynamics of Psychedelic Experiences: essential for effective crisis intervention
- Proper Handling of Difficult Experiences: keep it internalized, work through and integrate released material without interfering
- Providing Basic Protection: support and facilitate the process; do not prevent natural resolution
- Continuing Uncovering Work: complete unfinished gestalts to avoid prolonged reactions or flashbacks.
Psychedelic Crisis Intervention and Self-Help Approaches
Poor Quality of Street Samples:
- Researchers have detected amphetamines, STP, PCP, strychnine, benactyzine, and traces of urine in some street samples
- Alleged LSD samples contained substances other than LSD
- Poor quality and uncertainty about dosage can lead to adverse reactions during self-experimentation
Circumstances Surrounding Psychedelic Use:
- Some people are given the drug without prior information or adequate preparation
- General understanding of LSD effects is poor, even among experienced users
- Unsupervised experimentation often takes place in complex and confusing settings
- Personal support and trusting relationships are rarely available during these sessions
Problems with Professional Crisis Intervention:
- Interventions based on the medical model often create more problems than they solve
- Tranquilizers administered to stabilize the patient can prevent effective resolution of underlying conflicts
- Transferring the individual to a psychiatric facility and hospitalization can contribute to long-term complications and stigmatization
- Current psychiatric care may involve continued medication with tranquilizers instead of uncovering therapy
Example Case:
- Two employees at a pharmaceutical lab suffered accidental LSD intoxication
- The man experienced symptoms of deep depression, anxiety, meaninglessness, and doubts about his sanity
- The woman had bizarre sensations in her scalp and believed she was losing her hair
- The crisis intervention by the psychiatrist with no personal or professional experience of LSD was typical of conventional medical and psychiatric approaches
Impact of Misinformation on Psychiatric Staff
- Pharmaceutical workers' fear heightened by apocalyptic description of LSD from psychiatrist
- Belief in need for Thorazine, hospitalization, and isolation reinforced
- Experiences with LSD and Thorazine combination:
- Department chief witnessed traumatic events, contributing to desperate state
- Research assistant suppressed deep psychological regression, preventing traumatic memory from surfacing
- Negative feelings towards LSD perpetuated
Optimistic Perspective on Psychedelic Crises
- Approach to psychedelic crises: understanding dynamics is crucial for intervention
- Emergencies depend on subject's feelings, people present, and professional judgment
- Drastic measures often reflect helpers' own fears and unconscious material
- Exposure to deep emotional material can shatter defenses and activate corresponding areas in the unconscious of assisting/witnessing persons unless confronted and worked through themselves
- Lack of understanding leads to suppression of experiences, potentially harmful aftereffects.
Psychedelic Experiences: LSD Sessions and Crisis Management
Positive Effects of LSD:
- Facilitates resolution of long-term problems
- Induces fewer complications compared to other psychiatric therapies in early years (1960)
- Incidence of attempted suicides: less than one in a thousand cases
- Prolonged reactions: 0.8 per thousand
Comparing LSD Experimentation:
- Supervised sessions vs unsupervised scenes
- Protected environments and responsible individuals vs public locations or parties
Handling Psychedelic Crises:
- Create a safe and supportive environment:
- Quiet, secluded place
- Remove individual from traumatic situation
- Establish good contact with the subject:
- Trust is essential for positive outcome
- Factors influencing crises:
- Internal factors: more important than external in most cases
- Crisis handling techniques:
- Create a safe environment and establish good contact
- Remove individual from traumatic situation or change it
- Professional intervention during an emergency:
- Establish trust and cooperation quickly
- Convey a sense of safety and security
- Offering a positive framework:
- Present LSD experience as opportunity to face unconscious issues rather than tragedy.
Comparison between Controlled Settings vs Unsupervised Scenes:
- Protected environments with responsible individuals lead to fewer complications (early LSD experiments)
- Unsupervised scenes result in high incidence of adverse reactions and complications (psychedelic scene in the late sixties)
- Important skills for handling a crisis:
- Freedom from anxiety
- Ability to remain centered
- Deep empathy
- Intimate knowledge of psychedelic states
- Communication during a crisis:
- Convey sense of safety and security
- Emphasize self-limiting nature of LSD experience (five to eight hours resolution)
- Restraining techniques:
- Effectively restrain individual without using physical force or open conflict
- Encouraging the subject during a crisis:
- Internalize their experience
- Face critical issues involved.
Psychedelic Crisis Intervention Techniques:
Establishing Rapport and Communication:
- Repeatedly communicate that surrendering to emotional/physical pain is the quickest way out of a difficult state
- Music can facilitate this process if a good stereo system is available and the subject is open to it
- Offer active assistance using comforting physical contact, playful struggle, and pressure on blocked energy areas
- Avoid physical contact if trust bond is precarious or the subject is paranoid
Handling Crisis Situations:
- Use any means necessary to keep the LSD subject from hurting themselves or others, including material damage prevention
- Establish rapport and gain cooperation when possible
- Facilitate integration of unfinished gestalt after drug effects subside
Post-Crisis Approach:
- Ensure a safe and nourishing atmosphere for at least 24 hours after LSD ingestion
- Reevaluate condition, choose future strategy based on client's condition
- Discuss the LSD experience in detail to facilitate integration into everyday life
- Offer various techniques like meditation, Gestalt practice, neo-Reichian approaches, guided imagery with music, controlled breathing, polarity massage or rolfing for unresolved emotional/psychosomatic complaints
- Consider hospitalization if all above approaches fail and condition remains precarious
Psychedelic Sessions as Follow-Up Treatment:
- Administer psychedelics under appropriate preparation to facilitate completion of unfinished gestalt
- Use LSD alternatives like psilocybin, methylene-dioxy-amphetamine (MDA), tetrahydrocannabinol (THC), and dipropyltryptamine (DPT) if available
- Consider using Ritaline or Ketalar as feasible alternatives if psychedelics are unavailable
Dramatic Psychedelic Crisis Intervention Example:
- Young couple, Peter and Laura, experienced an acute psychotic state in Peter after taking LSD
- Peter became paranoid and violent, smashing car windows and throwing objects
- Laura sought help from Esalen Institute security guard and psychologist Rick Tarnas
- Guard called the therapist who arrived with Rick to calm Peter down and facilitate expression of emotions
- Team talked to Peter, reassured him, and encouraged full emotional expression through working on blocked body parts
- By 7 AM, all negative elements of LSD experience had disappeared, leaving Peter feeling cleansed and reborn
Effects of LSD on Chromosomes, Genetic Mutation, Fetal Development, and Malignancy
Chromosome Changes:
- LSD may cause structural changes in chromosomes
- Studies have been conducted to investigate this effect:
- In vitro studies: adding LSD to cultures of human, animal, or plant cells in a test tube
- In vivo studies: studying the effects on living organisms after ingestion or injection
Genetic Controversy:
- Interest in the potential genetic consequences of LSD increased due to its widespread use and the possibility of inducing chromosome abnormalities
- Debate over whether LSD should be classified as a substance capable of causing such effects
In Vitro Studies:
- LSD added to cultured human leucocytes (white blood cells) from healthy individuals
- Concentrations ranged from 0.001 to 10 micrograms per cubic centimeter (cc), for 4, 24, or 48 hours
- Incidence of chromosome breaks was at least twice that of control cells, except at the lowest concentration and time
- No simple linear relationship between frequency of aberrations and LSD dosage or exposure duration
In Vivo Studies:
- Blood samples taken from subjects exposed to either "street acid" or pharmaceutically pure LSD
- Chromosomes examined after exposure (retrospective approach) in most cases
- A minority of studies used a prospective approach, checking before and after drug administration
- Technical procedure similar to in vitro studies
Special In Vivo Studies:
- Reports on the influence of LSD on the chromosomes of germinal cells (meiotic chromosomes)
Experiments on LSD and Chromosomal Breakage
Findings of In Vitro Experiments:
- Significant inhibition of mitosis (cell division) with LSD addition
- Proportional suppression of mitosis to duration of exposure
- Lowest frequency of chromosomal breakage in control: 3.9%
- Highest frequency in treated cultures: over four times the control value (17.5%)
- Jarvik et al.'s study found a higher incidence of chromosome breaks with LSD (10.2% vs. 5.2%) compared to controls
- Similar breakage rate with aspirin and ergonovine (10.0% and 9.6%, respectively)
- Concentration of LSD in blood approximates level reached 1-4 hours after injection
- Aspirin concentration was below therapeutic level, streptonygrine induced 35% chromosome breakage
Limitations and Interpretations:
- Findings not completely consistent across studies
- Concentrations of LSD and durations used in experiments were often greater than in vivo
- Cohen et al. found no increase at lowest concentration (0.001 μg/cc for 4 hours)
- Effective concentration in vivo may be less due to metabolic degradation
- Caution required extrapolating in vitro findings to living organism
- Limitations of techniques used in studies, especially with lymphocytes
Other Factors Inducing Chromosomal Breakage:
- Radiation, temperature changes, oxygen pressure, water impurities, and viruses
- Commonly used drugs: aspirin, artificial sweeteners, DDT, morphine, caffeine, theobromine, theophylline, tranquilizers, vitamins, hormones, antibiotics (e.g., aureomycin, chloromycetin, terramycin, streptomycin, penicillin)
In Vivo Studies on Chromosomal Damage from LSD Exposure
Findings:
- Initial studies found increased chromosome breakage in illicit LSD users compared to controls: 23.4% vs. 11.0% (Irwin and Egozcue), 18.76% vs. 9.03% (Egozcue, Irwin, and Maruffo)
- Some studies found no increased chromosome breakage in LSD users
Limitations:
- Methodological issues: high control breakage rates, potential contamination or interference with media and chromosome evaluation techniques
- Unreliable self-reporting of drug use, dosages, and frequency of exposure by subjects
- Questionable content and quality of illicit LSD samples
Discrepancies:
- Explained partly by technical issues: high control breakage rates, viral contamination, insufficient media, and cell culturing techniques
- Uneven distribution of aberrations between groups suggests other factors at play
Important Clue:
- Characteristics of "LSD users": unreliable self-reporting, questionable drug content and quality in illicit samples.
Chromosomal Damage from LSD Use
Background:
- Samples analyzed in past contained various drugs besides LSD: amphetamines, mescaline, DOM (4-methyl-2, 5-dimethoxyamphetamine), phencyclidine (PCP), benactyzine, strychnine, Ritaline, phenothiazines, alcohol, opiates, marijuana, hashish, psilocybin, mescaline, STP, MDA, DMT.
- Uncertainty regarding purity and potency of illicit drugs; subjects often malnourished or had high rates of STDs and other viral infections.
Chromosomal Damage from Pure LSD:
Retrospective Studies:
- Two groups reported increased chromosome breakage: Cohen et al., Nielsen et al. (with revisions).
- Five teams failed to confirm positive findings: Tjio et al., Sparkes et al., Bender and Siva Sankar, Rozsa et al., Corey et al.
- Reasons for discrepancies: insufficient number of cells analyzed, long time since last LSD exposure, data analysis criticized.
Prospective Studies:
- Tjio et al.: mean aberration rate 2.8%, not significantly higher than control group; effects may have been rectified over time.
- Dishotsky et al.: fifty-eight out of seventy subjects (82.9%) had no chromosome damage, with an estimated 17.1% to 4.9% having elevated breakage rates.
Conclusion:
- Results from pure LSD studies are more reliable than those of illicit drug users due to better control over variables like dosage and administration route. However, research suggests that chromosomal damage may not be a significant long-term effect of LSD use.
Prospective Studies of Chromosomal Changes in Pure LSD Users
First Report:
- Published in 1968 by Hungerford et al.
- Examined chromosomes of three psychiatric patients before and after repeated therapeutic administrations of LSD
- Blood samples taken before, one hour before, and fourteen hours after each dose; follow-up samples taken at intervals of one to six months
- Increase in chromosome aberrations observed after each LSD injection
- Increase was small in two patients, but dicentric and multiradial figures appeared only after treatment, and acentric fragments appeared more frequently
- Return to earlier levels observed in all three patients in follow-up study
- Results indicated that pure LSD may produce transitory increases of chromosome abnormalities, but they are no longer evident one month after administration
- Complicated by chlorpromazine (Thorazine) administration, which can also cause chromosomal aberrations
Study by Tjio, Pahnke and Kurland:
- Examined 32 hospitalized alcoholic or neurotic patients treated with LSD in a double-blind controlled study
- Dosage ranged from 50 micrograms to 450 micrograms
- Observed 22,500 cells, more than twice the total in other studies
- Amount of breakage not directly proportional to dosage; those on low doses showed greater increases
- Statistical analysis revealed no significant difference in chromosomal aberrations before and after LSD
Study by Corey et al.:
- Examined 10 persons before and after administration of 200-600 micrograms of pure LSD
- Found no significant difference in rate of chromosome breakage between pre- and post-samples
- Confirmed negative findings of previous study
Studies on Rhesus Monkeys:
- Egozcue and Irwin: 2 out of 4 animals showed increased chromosomal breaks, while others stayed within normal range
- Kato et al.: Transitory changes in chromosomes after multiple subcutaneous injections of LSD in high doses
- Dishotsky et al. found the results statistically non-significant
Conclusion:
- Prospective studies showed that only 10.7% (6 out of 56) of patients studied before and after pure LSD had elevated breakage rates; three received LSD intravenously and one had a viral infection
- In the remaining five, breakage returned to normal levels
- Of the total subjects studied, 89.3% did not have chromosome damage
Effects of LSD on Meiotic Chromosomes
Findings:
- Some studies suggest high doses of LSD may influence meiotic chromosomes in mice, but results are inconclusive due to small number of abnormalities and potential technical errors.
- Changes found could impact fertility, litter size, and congenital malformations.
- Later study: High frequency of abnormalities detected in mice injected with 1,000 micrograms per kg twice a week for five weeks.
- Spermatozoa from LSD-treated mice also showed morphological differences.
- Practical significance reduced due to dosages used exceeding clinical practice limits.
Other Studies:
- Negative results reported in studies on mice and Rhesus monkeys using various dosages of LSD daily or every ten days.
- Acute and chronic experiments on both male and female mice also showed no significant differences in meiotic cells.
- Two studies on the banana fly, Drosophila melanogaster, reported negative findings regarding mutagenic effects of LSD on genetic mutation.
Caution:
- Extrapolating animal study results to humans requires caution due to interspecies variability.
- Only one report exists about the effect of LSD on human germ cells which showed no increase in structural chromosome aberrations.
Mutagenic Effects of LSD:
- Inconclusive evidence regarding mutagenic effects of LSD based on existing studies.
- Some studies suggest high doses may induce mutations in Drosophila melanogaster but results are inconsistent and often require excessive dosages.
Experimental Studies on LSD's Effects on Genetic Systems
- Drosophila flies: Significant increase in recessive lethal mutations observed after exposure to high doses of LSD; effects dropped with dilution
- Fungus Ophistoma multiannulatum: No difference between treated and control cells when exposed to 20-50-micrograms/cc LSD solution
- Studies suggest that LSD is a weak mutagen, effective only in high concentrations
Interaction of LSD with Deoxyribonucleic Acid (DNA) and Ribonucleic Acid (RNA)
- Evidence of binding between LSD, its isomer, and analogue to helical DNA; specific for helical DNA and unlikely to cause chromosomal breakage
- LSD may lead to dissociation of histones, making DNA susceptible to enzymatic attack
Teratogenic Effects of LSD on Embryonic Development
- Contradictory findings in rodent studies: some report high rates of malformations, others report no effects
- Auerbach and Rugowski's study showed brain defects, while Hanaway found only lens abnormalities; both used relatively low doses early in pregnancy
- DiPaolo et al. failed to demonstrate teratogenic effects for mice and Syrian hamsters using larger dosages
- Alexander et al. reported increased stillbirths and stunting in rats given 5 micrograms per kg of LSD early in pregnancy
- Geber's study on hamsters showed various central nervous system malformations with a wide dose range, but no correlation between dose and percentage of congenital malformation
- Roux et al. reported no teratogenic or embryonic growth-depressing factors for mice, rats, and hamsters after administering large doses of LSD
Studies on Teratogenic Effects of LSD on Rats
- Warkany and Takacz (113): no abnormalities despite large doses of LSD, reduction in size in one young
- Nosal (83): no external malformations or macroscopic lesions at 5, 25, 50 micrograms per kg on the fourth and seventh days of gestation
- Negative results also obtained from studies by Uyeno (109, 110)
- Fabro and Sieber (35): thalidomide had marked embryotoxic effect but LSD produced only decrease in mean fetal weight at twenty-eight days with dosages up to 100 micrograms per kg
Primate Study on LSD's Effects on Fetal Development
- Kato et al. (66): one normal infant, two stillborn with facial deformities, one died at one month after multiple subcutaneous injections of LSD to pregnant Rhesus monkeys; dosage more than 100 times usual human experimental dose
- Overall view: wide range of individual, strain, and species susceptibility; effect occurs early in gestation
Clinical Observations on Human Infants Exposed to LSD During Pregnancy
- Six reported cases of malformed infants born to women who ingested illicit LSD before or during pregnancy
- Abbo et al. (2): congenital limb anomaly, both parents took unknown amount and purity from unidentified source; mother took four times during first three months
- Zellweger et al. (117): fibular aplastic syndrome, parents took illicit LSD; seventh week of gestation is period of most active differentiation
- Hecht et al. (49): malformation of arm, mother took unknown amounts before and during early pregnancy
- Carakushansky et al. (16): thoracic part of skeleton defects (spondylothoracic dysplasia), mother believed exposed to LSD and cannabis during pregnancy
- Hsu et al. (53): multiple malformations associated with chromosomal aberrations, parents were both LSD users prior to conception and used other drugs during pregnancy
- Berlin and Jacobson (12): 62 live births, six of these infants had congenital abnormalities; high risk obstetric population, multiple drug use, infectious diseases, malnutrition, extensive radiological investigations.
Eller and Morton's Study on LSD and Congenital Malformations
Blaine's Criticism:
- No scientific evidence of a causal relation between illicit substance ingestion and embryonal malformation in the individual case histories presented
- Findings could represent pure coincidences, related to various situational factors contributing to congenital abnormalities
- Differences in type and severity may be due to genetic factors
Clinical Evidence Contradicting or Limiting the Findings:
- Studies reporting elevated chromosome breakage rates in children exposed to illicit LSD, but no birth defects were observed
- Chromosomal findings were normal for most reported cases of actual congenital malformations attributed to LSD
- No physical abnormalities observed in children with chromosomal damage
Zellweger et al. Case and Sato/Pergament's Discussion:
- Newborn whose mother took LSD before and during early pregnancy had no fetal deformities, despite critical stage for production of limb deformities
- Women exposed to LSD in utero without any teratogenic effects or chromosomal damage reported by Sato and Pergament
Healy and Van Houten's Calculation:
- Low probability (1:1024) that the entire series of ten pregnancies resulting in children of the same sex is a random event, suggesting LSD may influence sex ratio
McGlothlin et al. Study:
- No evidence of increased rate of abortions, premature births or birth defects related to LSD use by men prior to conception
- Possible higher incidence of spontaneous abortions among women exposed to LSD, causal connection unclear
Arendsen-Hein's Data on LSD Patients' Offspring:
- Out of 170 infants born to former LSD patients, only two showed pathology that could not be attributed to LSD for any sound reason
Summary of Teratogenic Effects Evidence:
- Increased incidence of congenital malformations reported in mice, rats, and hamsters; evidence contradicting these findings exists
- Preliminary evidence from lower primate studies suggests a possible teratogenic effect, deserving further investigation
- Lack of scientific evidence to establish causal relation between illicit LSD use and birth defects or fetal wastage in humans
- No evidence of pure LSD causing birth defects or spontaneous abortions in humans
- Pregnancy considered a contraindication for LSD administration due to practical clinical purposes.
Caution Required with LSD Use During Pregnancy
- Balance between maternal organism and developing fetus is precarious
- Disturbances can be caused by various external influences, including LSD
Carcinogenic Effects of LSD
- Speculation that LSD might have carcinogenic potential
- First mentioned in paper by Cohen et al. (22)
- Increased frequency of chromosomal breakage and quadriradial chromosome exchange
- Linked to inherited disorders: Bloom's syndrome, Fanconi's anemia, ataxia telangiectatica
- High incidence of leukemia and other neoplasms in these disorders
- Similar chromosomal aberrations found in cells of neoplastic origin
- Some carcinogens produce similar chromosome lesions as LSD
Objections to Carcinogenic Hypothesis
- Problematic evidence for pure LSD causing chromosomal aberrations
- Uncertain relation between chromosomal lesions and neoplastic development
- Chromosomal lesions found in normal individuals and not all cell types affected in leukemia
- Dishotsky et al. (28): Long-term chromosomal damage from LSD reported only in retrospective studies, not prospective ones
- Phi-like chromosomes found only in two studies, and not relevant to chronic granulocytic leukemia as they are observed in myeloid and erythroid cells, not lymphocytes
- Only two cases of leukemia reported in individuals treated with pure LSD; association with familial predisposition to malignant disease in one case
- Carcinogenic hypothesis poorly supported by experimental and clinical data
- No definite evidence that LSD is a carcinogenic agent.
LSD and Teratogenesis:
- Original reports of teratogenic effects in rodents not confirmed by later studies
- Wide range of individual strain and species susceptibility to LSD's effect
- Questionable extrapolation of results from animal studies to humans
Congenital Malformations and LSD Use:
- Six reported cases of malformed children born to illicit LSD users
- One study showed increased frequency of congenital malformations in offspring of illicit LSD users, but other variables may have contributed
- High frequency of unexplained "spontaneous" birth defects and widespread abuse of LSD make observations coincidental
- No clear evidence that pure LSD is teratogenic in humans
LSD and Carcinogenesis:
- Early studies suggested carcinogenic properties, but no increase in incidence of tumors among LSD users has been detected
- Case reports of leukemia and malignant tumors may have been coincidental
- No convincing evidence that pure LSD produces genetic mutations or malignant growths
Complexities with Illicit LSD:
- Uncertainties about dosages and contamination of black-market samples
- Psychological hazards associated with unsupervised self-experimentation
- Importance of responsible experimental and therapeutic use by experienced professionals.