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Psychotherapy and Psychedelic Drugs

  LSD and the New Beginning


        from: LSD, The Consciousness-Expanding Drug,  ©1964 David Solomon

    The experience of LSD and the new beginning is similar to what the existentialist Ellenberger (10) has called the Encounter: "Encounter is, in general, not so much the fortuitous meeting and first acquaintance of two individuals, but rather the decisive inner experience resulting from it for one (sometimes for both) of the two individuals. Something totally new is revealed, new horizons open, one's Weltanschauung is revised and sometimes the whole personality is restructured. Such encounters are manifold, perhaps with a philosopher who reveals a new way of thinking, or with a man of great life experience, of practical understanding of human nature, of heroic achievements or independent personality. An encounter can bring a sudden liberation from ignorance or illusion, enlarge the spiritual horizon and give new meaning to life."
    To the writer nothing better exemplifies how LSD can be useful to us. It can provide us with an encounter, a new experience which will enlarge our horizon and give new meaning to life. These experiences are a part not just of therapy, but of life itself.
    While in analytic training, I took a three-day vacation during which I tried a new role—that of a salesman. I happened to meet another salesman and played the role quite enjoyably for the whole weekend. For my analyst this was an acting out of the transference, but I think this view expresses only one side of the coin. Not being a doctor, not being a psychiatrist even for a few days forced me to develop different sets of behavioral tactics and with them a different aspect of me that was enriching. Chancing to meet another person with whom I was compatible reinforced the behavioral change. I feel that there is an analogy in this experience to what can happen with LSD. The new experience under LSD can be reinforced by social experiences and further experience with the therapist. Without this reinforcement the LSD experience gradually pales and dies away; it becomes a memory, not a personality change.
    Not everyone is grateful for a new experience. Galileo's contemporaries refused to look at the moons of Jupiter through his new telescope. And some of our contemporaries refuse to contemplate the intricacies of the LSD experience, or having contemplated them are unable to process the new data. For them the experience is unpleasant as is the inability to handle new data. For many this experience cannot be handled, and leads to grandiosity and rationalizations.
    Some of our professional subjects and patients, learned philosophers, psychologists and psychiatrists, are unable to relax and enjoy the revelations of LSD. Instead of marveling: "My God, I've never been in this land before," they explain, interpret and deny all in terms of their conventional framework. Instead of enjoying the beautiful simplicity of planetary motion, they pile epicycle on epicycle. They cling desperately to the old familiar terminology; they maintain a death grip on their "cathexes" and "repressions"; and clinging to the old, they cannot let go and be intrigued with the new. Acute discomfort is their lot, if they cannot hammer their data onto the cross (chi-square) of their old methodology.16
    The early references to the LSD experience as a schizophrenic-like psychosis were, in my opinion, the natural outgrowth of casting the new in the old mold. If the therapist views the experience as a psychosis he unwittingly helps the patient develop a psychosis not through suggestion alone but also because he cannot offer the patient a framework to handle the new experience. The therapist must furnish adequate help in processing the new data, or a paranoid reaction, ranging from transitory suspicion or accusation to paranoia of several months, may set in.
    In early work with LSD, when the therapist failed to provide the Encounter, psychotic reactions were inevitable. This led to overgeneralization of the effects of psychotomimetic drugs. (More accurately, perhaps, we should speak of psycholytic drugs given by psychosogenic therapists.) The therapist provided the paranoid reaction by withholding vital information; just as with mental illness sui genesis, society and the therapist foster the paranoid reaction by withholding vital data. And often the patient fosters this by refusing to extract the data or, having extracted them, refusing to look at them.
    Bavelas (3) has devised ingenious experiments to demonstrate the effect of withholding data. He has given insolvable problems to a highly motivated, highly intelligent group of engineers; they were encouraged to solve the problem, and inevitably came up with an erroneous answer. The confrontation that they had the erroneous solution and that they could not have solved the problem, far from providing enlightenment, only led them to hold to their false solution with delusional and dogmatic intensity, increasingly buttressed by false rationalizations.
    Having suffered once from the withholding of data, they now refused to process the new data. Could they then have been tested with LSD would they then have had sudden enlightenment, or would they have developed fixed paranoic ideas of being played with? Almost surely it would have depended on the Encounter with the therapist.
    We speak of a new experience with LSD. What does a new experience mean and how can it be beneficial in specific terms? Let me give an example of a patient, a professor, a man of brilliant promise yet suffused with hopelessness because of an abiding fear of insanity. He had once the misfortune to consult a world-famous analyst about a marital problem, and had been told that he was a pseudoneurotic schizophrenic and unanalyzable. This had been a somewhat less than happy encounter. Given a hopeless prognosis and refused treatment, he was left for years to alternate between lethargy and desperation. In desperation he consulted me and in desperation we tried LSD after a long period of counseling and preparation. His first session (100 micrograms) was uneventful, devoted mainly to a preliminary survey of the unknown and the establishment of trust in the situation. In the next session (150 micrograms) he plunged boldly into the psychotic state, became wildly agitated and was forcibly restrained. Together we came face to face with the insanity he had feared and together we mastered it. He was able to take the wraps off and let himself go because he knew that he and I could see it through together. Instead of finding nothing but the monster of pseudoneurotic schizophrenia thinly veiled in professorial robes, he found a phantom which he could discard, and he also found his real self, a living human being. A far more fortunate encounter than his first.
    Sometimes this may be followed by depression. It has happened where families have not been able to support the new experience and the new changes, where for them the new beginning is fraught with danger.17 Now when we give LSD we insist that the marital partner be involved in the situation lest divorce or depression supervene. Another patient had a remarkable —and unfortunate—experience. He was verbally attacked so roundly by his depressed wife that within a month's time she had brought him lower than when he started. Two years of family therapy were required to restore what had been lost in a single day.18
    The Encounter may be illustrated by the following brief case history.
    The patient was a 35-year-old accountant who had been in intensive psychotherapy for five years because of chronic depression and crippling obsessive traits. He had had a brief psychotic reaction and had made an abortive attempt at self-castration. His oldest sister was a semi-invalid; he was placed in a position of great responsibility for her; yet he had always to be deferential and to accept continuous criticism. He had no pleasant experiences of adolescence, and no dating. At the beginning of therapy he complained of intense loneliness. Both patient and therapist were frustrated by his meager progress. His solid intellectual defenses were refractory to interpretation. Occasionally he made efforts to improve his isolated social position; each time he neatly sabotaged the effort. He improved slightly, worked a little better, and became a little less depressed; but if anything his isolation and loneliness were intensified.
    Because of the complete affect block we decided that he should have LSD (despite the history of a previous psychotic break). He agreed and was given 100 micrograms of LSD. He seemed more relaxed and a bit more happy. Yet, though we focused on his relations to his father, there was little affect, little recall and no fantasy.
    The writer thought that surely there must be some fantasy available in this constricted personality. What kind of a fantasy might such a boy, with such a father, have had? Surely he would have been pleased to have buried his father in a shallow grave, supine; and if Father died like Balzac's M. Beaucoq with his lance erect (because he was hanged) so much the better; and if he reverentially mowed the grass over his father's grave, and if each passage of the blades over his father's grave cut a little deeper, there might be a gradual diminution, or shearing off of the parental authority, a trimming of the father imago. I shared this fantasy with the patient and suggested that he might well have had such a one. The effect was electric. He exploded with laughter. The feelings and fantasies about father came pouring out, as though Moses had smote the rock. For the balance of the afternoon we reveled in an exchange of fantasies about his father.
    From that day he was a changed man. Previously he had been a Milquetoast at work, whom everyone pushed around. Now he became self-assertive and positive. He no longer let advantage be taken of him. He was poised and comfortable. It occurred to him he might do better working by himself. During the next LSD session (150 micrograms) he was able to continue the work of the preceding session. With the dread father laid to rest, he could relive his adolescent days with the therapist, not as they had been, but as they might have been. He expressed for the first time the desire for a girl. In the month following, astounding changes developed. He developed a sense of humor; he became efficient; he began to date; he made plans to leave his job and set up his own business, and this he actually accomplished. He enjoyed dating and experienced intense sexual feelings. In therapy he expressed the desire for marriage and children. He struck up a friendship with another man, with whom he discussed topics formerly tabu: sex and women.
    Following LSD he began to have intense dreams, sometimes pleasurable, often in color, which he had not had before.
    In seventeen (now nineteen) years of practicing psychotherapy I have never seen as much change in an individual with a rigid obsessional character. The change has been permanent. While it has leveled off, there has been no backsliding since our first Encounter using LSD.19



    The LSD experience is considered a complex transaction of the amount of material given, the psychological and physical environment, the set or expectancy and the personality of both the patient and therapist. According to the structuring of the situation, a psychotic-like (psychotomimetic), a psychotherapeutic (in the sense of facilitating psychotherapy), or a transcendental reaction may evolve. The psychotic-like reaction may emerge where the intent is to produce and study psychoses, where excess stress and insufficient security is provided, and where the therapist fails to help the patient process new and unfamiliar data. The psychotherapeutic reaction is an intensification of the conventional therapeutic process and leads to an intensification of the traditional psychotherapeutic values of recall, reliving, insight and emotional release. These may be experienced where they had not been before the administration of LSD. The transcendental reaction is a temporary loss of differentiation of the self and the outer world. It may lead to a lessening of alienation, to a rediscovery of the self, to a new set of values, to the finding of new potential for growth and development and to a new beginning. This may be followed by a change in behavioral patterns, as in the cessation of drinking. If the environment (including therapist) supports these changes, they may become a part of the patient's habitual reaction patterns. Otherwise, the social matrix will remold the patient and the LSD experience will become a memory rather than an integral part of the personality.
    An historical paradigm of the therapeutic use of LSD-25 is found in the use of peyote by the Plains Indians, in the treatment of alcoholism.



    16. The logical conclusion of Jackson's remarks would be to jettison all previous models. However, in the discussion he implied that a model borrowed from psychoanalysis and existentialism might be constructed. Vikter Tausk (25), in his essay on the origin of the influencing machine, describes the human need for causal explanations and the fantastic distortions of familiar explanations to process unfamiliar data. (back)
    17. This is a danger common to many therapies, including psychoanalysis (13). (back)
    18. See footnote 7 (first patient) and Savage's illustrative case history, above. (back)
    19 Dr. Jackson's fantasy may have been suggested by one of our patients who had the hallucinatory experience of roasting his father over a slow fire in Hell, experiencing the most intense glee as he basted him. Despite its effectiveness one is hard put to explain its success. But it seems to have combined an accurate representation of the patient's feelings with complete nonsense. Thus it derives much of its force from its absurdity, much as the Zen masters drive a point home by a seeming absurdity. The combination of the LSD and the complete nonsense allowed the patient to see the complete absurdity of his continued subservience to his father, to get beyond it and to achieve the new beginning. A sensible interpretation would probably have remobilized intellectual defenses and demolished the whole LSD experience. (We have learned [1962] that this former patient is now president of his men's service club.) (back)



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    3. Bavelas, A. "Group size, interaction, and structural environment." In Shaffner, B., ed ., Group Processes: Transactions of the Fourth Conference. New York: Josiah Macy, Jr. Foundation, 1959, pp. 133-179.
    4. Beringer, K. Der Meskalinrausch. Springer-Verlag, Berlin, 1927.
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    6. Cantril, H. The "Why" of Man's Experience. New York: Macmillan 1950.
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    9. Chwelos, N., Blewett, D. B., Smith, C. M., and Hoffer, A. "Use of d-lysergic acid diethylamide in the treatment of alcoholism." Quart. J. Stud. Alcohol, 20:577590, 1959.
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    12. Fromm, E. Psychoanalysis and Religion. New Haven: Yale University Press, 1950,
    13. Jackson, D. D. "Family interaction, family homeostasis, and some implications for conjoint Emily psychotherapy." In Masserman, J. H., ed., Science and Psychoanalysis, Vol. 2: Individual and Familial Dynamics. New York and London: Grune & Stratton, 1959, pp. 122141,
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    17. MacLean, J. R., MacDonald, D. C., Byrne, U. P., and Hubbard, A. M. "The use of LSD-25 in the treatment of alcoholism and other psychiatric problems." Quart. J. Stud. Alcohol, 22:34-45, 1961.
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    22. Savage, C. "The LSD psychosis as a transaction of the psychiatrist and patient." In Cholden, L., ed., LSD and Mescaline in Experimental Psychiatry. New York: Grune & Stratton, 1956, pp. 3543.
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    25. Tausk, V. "On the origin of the influencing machine in schizophrenia." Psychoanal. Quart. 2:519-556, 1933.
    26. Tsa Toke, M. The Peyote Ritual. San Francisco: Grabhorn Press, 1957.

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