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  ETC.: A Review of General Semantics

    S. I. Hayakawa, editor

        December 1965, "Special Issue on the Psychedelic Experience"


COMMENTS

HUMPHRY OSMOND

(Commentary on a paper by Richard P. Marsh, "Meaning and the Mind Drugs.")


    THIS IS a lively and intelligent paper and I am glad to see that Dr. Marsh has taken issue boldly and directly with the matter of psychedelic and psychotomimetic experiences.
    I do not think, however, that even he has emphasized sufficiently how valuable LSD-25 and mescaline, for instance, have been as psychotomimetics. Our greater understanding of the experience of schizophrenic patients, derived from studying the madness-mimicking effect of these substances, has enabled us to do things which might have been otherwise impossible. Since many discussions of psychedelics and psychotomimetics deal largely with their potentials, it may be as well to familiarize ourselves with some of their actualities.
    1. We have been able to devise much better hospitals for mentally ill people. Working closely with my friend, Kyo Izumi, a Canadian architect from Saskatchewan, we developed a new formulation for mental hospitals in terms of what we have called socio-architecture. Parts of at least five mental hospitals have now been built using these ideas. Of the Saskatchewan Hospital, Yorkton, Saskatchewan, designed by Izumi himself and his partners, the Joint Information Service of the American Psychiatric Association wrote:


    Kyoshi Izumi, a pioneer in psychiatric architecture, designed the physical structure, and designed, or in some cases specified, all the furnishings. The result must certainly rank among the most attractive and architecturally advanced buildings ever constructed for psychiatric services .... as for the physical plant, it was a pleasure to view a facility that was more than merely new. Creativity and imagination were evident in scores of details. We felt the wards and day rooms combined efficiency with comfort and cheerfulness to a very exceptional degree.1


    TO MY KNOWLEDGE, Mr. Izumi himself took LSD-25 on several occasions so that he could experience and explore the effect of perceptual anomalies upon his experience of space, time, color, and texture. While doing this, he took particular notice of certain kinds of architectural configurations. These experiences of his, along with my own—combined with perceptual studies by our colleagues, Drs. Weckowitz and Sommer, and an extensive reading of the writings of mentally ill people—formed the basis of our original formulations and so of his splendid designs. Psychotomimetic experiences have thus been used for the benefit of the mentally ill and also of the well people who work in hospitals. In addition to this, some of the principles which we have discovered are also being used to develop a better kind of living accommodation, particularly when large numbers of people have to live in a communal building. It may be argued that Kyo Izumi, an unusually gifted person, would have done this just as well without the use of LSD-25. I do not know how this could be proved or disproved, but I do know that both he and I believe that it played a crucial part in deepening our understanding of the problem and so enlarging the communication between us. The fruits of this collaboration are there to be judged by any who care to go and look at them. It is not frivolous to say that here, indeed, are some of those concrete results of the psychotomimetic experience which critics have been so keen to discover.
    2. Because we came to believe that psychotic people were cut off by their changes in perception, which they could not readily describe, and did not necessarily understand, we began to pay close attention to their umwelts, or experiential worlds. It became evident that due to a professional preoccupation with the "meaning" of their experiences, the experiences themselves were often almost completely neglected. Patients who, for instance, described that the world looked different were usually supposed to be saying that it was feeling different. In other words, their perceptual anomalies were ascribed to some change of mood or affect. For many years little interest had been paid to the actual experiences of the ill and the social consequences which might derive from them. To explore these experiences more thoroughly we developed the HOD (Hoffer-Osmond Diagnostic Text),2 which is an exceedingly crude but unexpectedly effective instrument for exploring the umwelts of schizophrenic and other patients. This is already showing considerable usefulness. An ex-schizophrenic patient once remarked, "I wish you had had this test when I was ill. I would have known you knew something about my illness."
    The HOD combined with our interest in psychotomimetics has led to new and very exciting developments in the use of hypnosis by Fogel and Hoffer3 (in Canada) and Aaronson4 (here in Princeton). Because we ourselves had experienced marked changes in perception and had listened to our patients reporting these same happenings, it was easy to suppose that however they were produced they might have many interesting effects. A great advantage of hypnosis and post hypnotic suggestion is that it can be used to study in a very detailed way the effects of clear-cut and circumscribed perceptual anomalies. Much work of this kind is now in progress, and while it is time consuming and demanding, it seems that this will be a very potent tool for exploring the psyche. Aaronson noted with some surprise that he had been unable to predict what the psychological effects of a particular set of perceptual changes would be and suggested that substantial revisions of our theories of personality may become necessary. In the course of this work, Hoffer and Fogel have found that in some subjects the LSD experience can be evoked without LSD and—even more surprising—that the effects of the drug can be almost totally repressed, by post hypnotic suggestion.
    4. Mescaline, LSD-25, etc., have great possibilities for training psychiatrists, psychologists, and others, who are then less likely to produce standardized answers for their patients' distresses. Many psychiatrists suppose that because they have devised or accepted from others an explanation for their patients' behavior which makes sense to them, they understand what has been happening to their patients. This, however, is often not so and the psychiatrist's too ready assumption of omniscience, although it may be reassuring to him, simply prevents him from listening to the patient's halting, but often quite accurate, explanation. Miss Norma McDonald, herself a sufferer from schizophrenia, wrote:

    One of the most encouraging things which has happened to me in recent years was the discovery that I could talk to normal people who had had the experience of taking mescaline or lysergic acid, and they would accept the things I told them about my adventures in mind without asking stupid questions or withdrawing into a safe smug world of disbelief. Schizophrenia is a lonely illness and friends are of great importance. I have needed true friends to help me to believe in myself when I doubted my own mind, to encourage me with their praise, jolt me out of unrealistic ideas with their honesty, and teach me by their example how to work and play. The discovery of LSD-25 by those who work in the field of psychiatry has widened my circle of friends.5

    Schizophrenics are lonely because they cannot let their fellows know what is happening to them and so lose the social support, help and encouragement which they need so much yet so rarely evoke. LSD-25, used as a psychotomimetic, allows us to study these problems of communication from the inside and learn how to devise better means of helping the sick. This combined with the HOD and the hypnosis work allow us to reduce the alienation of these very ill people. We are no longer forced to suppose that the experience of the schizophrenic person must always be harmful; indeed, there is growing evidence that the psychosocial variability which they endure, although dearly bought by the individual, may be valuable and even necessary to society, especially in times of change.
    5. Our early work on alcoholism6 was based on the idea that it might be helpful to produce a condition resembling delirium tremens and so allow the patient to "hit bottom" earlier than he might otherwise do. Later, after we had become aware of the possibilities of the psychedelic experience and had exchanged ideas with Dr. A. M. Hubbard of Vancouver, one of the pioneers of psychedelic therapy on this continent, we changed directions: Nevertheless, the original impetus came from our interest in the psychosis-mimicking experience.



    THESE FEW illustrations show that these remarkable substances have already impinged on psychiatry in a positive way, quite apart from their extensive and very interesting use in psychotherapy. While I would be the last to discourage investigators from exploring that huge panorama which sweeps from the creative to the transcendental experiences, I would urge that we continue to study carefully and intensively some of the rather mundane matters which I have noted here. While there may be marked similarities in the ultimate experiences of birth and death, and while it is valuable to recognize that we have much in common, the fact is that our day-to-day experience of the world, our umwelts, can be surprisingly dissimilar. It is often these dissimilarities, unrecognized and—until we develop better means of acquainting ourselves with them—unrecognizable, that lead to the greatest and often most tragic failures in communication. Life, like art, is, in William Blake's words, "a matter of minute particulars." We must accept, however difficult it may be to do so, that the "minute particulars" experienced by one person may be very different from those experienced by other people, even though they may be very close to him. By patience, determination, and skill, we can perhaps develop "universal particulars" in which many more can share and can know that they are sharing. To do this we must start with very simple matters and discover the various ways in which each one of us builds a world comfortable for him, but more or less incomprehensible and sometimes even grotesquely strange for others.

 

References

    1. R. M. Glasscote, et al., the Joint Information Service of the American Psychiatric Association and the National Association for Mental Health, Washington, D.C., September 1964.
    2. A. Hoffer and H. Osmond, "A Card Sorting Test Helpful in Making Psychiatric Diagnosis," J. Neuropsychiat., 2:306, 1961.
    3. S. Fogel, and A. Hoffer, "Changes in Personality by Altering Perception in Post Hypnotic States," J. Clin. Exper. Psychopath., 1962.
    4. B. S. Aaronson, Hypnosis, Depth Perception, and Schizophrenia." Presented at E.P.A. Meetings, 1964.
    5. B. Kaplan, ed., The Inner World of Mental Illness (New York: Harper, 1964).
    6. H. Osmond, "A Review of the Clinical Effects of Psychotomimetic Agents," Ann. N.Y. Acad. Sci., 1957, 66:418-434.


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