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Handbook for the Therapeutic Use of LSD-25

HANDBOOK FOR THE THERAPEUTIC USE OF LYSERGIC ACID DIETHYLAMIDE-25
INDIVIDUAL AND GROUP PROCEDURES

1959 - D.B. BLEWETT, Ph.D. & N. CHWELOS, M.D.

OCR by MAPS, Edits by Erowid

In the 1950s and 1960s, mimeograph copies of the following Handbook were shared among pioneering therapists exploring the therapeutic utility of LSD. To this day, it remains one of the most relevant documented explorations of the guided psychedelic session.
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TABLE OF CONTENTS

* Acknowledgements
* Preface

1. Psychiatric Rationale
2. The Nature of the Drug Reaction
3. The Development of Treatment Methods
4. Individual and Group Methods
5. Research Implications
6. The Setting
7. Equipment
8. Indications and Contra Indications
9. The Preparation of the Subject
10. General Considerations Regarding Procedure
11. Dosage
12. Administration
13. Stages in the Experience:
I. Pre-Onset
14. II. Onset of Symptoms
15. III. Self Examination
16. IV. The Empathic Bond
17. V. Discussion
18. Diminishment of Symptoms
19. The Meal
20. Termination of Session
21. After Contact with the Subject
22. Assessment of the Experience

* Appendix A : Assessment Scales I and II
* Appendix B : Results to Date
* Appendix C : Proposals for Psychedelic Research

Review of this Handbook, by Myron Stolaroff
References
PDF Scan of the document (400KB)

ACKNOWLEDGEMENTS
It will be obvious to the careful reader but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer. Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Cambell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. McLean, Dr. T. Weckowicz, Mr. F.E.A. Ewald, Mr. G. Marsh, Mr.R. Thelander and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy..

PREFACE
It will be evident to the reader that the authors have not attempted to deal with the material presented within a theoretical system.

The experience described and utilized in therapy represents so remarkable an extension of common experience that an eclectic approach has seemed mandatory.

The clinician may feel that the depersonalization and rapport which develop in the experience are of prime significance. The experimentalist may see the induction of marked inconstancy of perception or the inconstancy of the sense of time in particular as the important aspect of the experience. In any case, clinician and experimentalist alike will find much of value and of interest in studying the drug effect.

It will be obvious to the careful reader, but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer.

Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Campbell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy.

CHAPTER 1 - PSYCHIATRIC RATIONALE
THE FRAME OF REFERENCE

In the broadest terms there are, at present, two main philosophies of psychotherapy. One of these, based upon the concept of "adjustment" sees as the goal of treatment a happy and comfortable acceptance by the patient of the norms of his society. The other concept sees as the goal of therapy the maximal realization of the individual potential, the flowering as it were, of the personality.

In considering the therapeutic merits of LSD-25, one can scarcely fail to pose such problems as how the drug can contribute to the therapeutic process, how its use affects the therapeutic process, how its use affects the therapist-client relationship, or how its effects seem to relate to various aspects of psychological and psychiatric theory.

Under present day conditions the therapist, though desiring to lead the patient toward full self-realization, almost invariably finds that pressures of time and convention force him to work toward the goal of adjustment more or less to the exclusion of any but the most cursory consideration of those particular facets of the psyche which render each of his patients unique.

When therapy begins, the patient already possesses a complex of motives and mechanisms which have proven more or less inadequate and while the forms and techniques employed in treatment may vary widely, depending upon the theoretical outlook of the therapist, there is nevertheless an underlying process which is common to all psychotherapeutic progress. It might be summarized in the following steps:

1. The patient must realize that his present methods of behaving are inadequate and unsatisfying to him personally.
2. He must develop sufficiently strong motivation to carry him through the difficult and painful process of coming to understand and accept himself.
3. On the basis of this self-understanding, he must learn how to alter his

Behavior to satisfy the new pattern of motivation which has developed out of self-understanding.

The therapist cannot learn these things for the patient, just as the teacher cannot learn for the pupil. It is the role of the therapist, as it is of the teacher, so to structure the situation as to maximize the opportunities for learning. The expertise of the therapist lies essentially in his knowing how to structure the situation so as to fit best the personality of the patient and of himself and the environmental variables which seem of greatest relevance.

Many of the treatment methods in psychiatry have been derived and are currently utilized with a pragmatic disregard for theoretical considerations. This is true of the physical and chemical therapies generally. To the extent that they are regarded as adjuncts to psychotherapeutic treatment but because of their relatively rapid effect and the tremendous economy in terms of treatment time they are frequently used with minimal psychotherapeutic accompaniment.

These treatment methods might be classified in terms of the aim of the therapist. One group including electrotherapy, insulin therapy, psycho-surgery and narcotherapy, is utilized to make the patient more accessible to the therapist, that is to say to alter the patient so that he is better able to utilize the help which the therapist can offer through appropriate structuring of the therapeutic situation. The other group would include such methods as hypnosis, amytal and pentothal, and CO2. Here the aim is to help the patient overcome his reluctance to face himself as he really is-to hasten the learning process and east the pain involved in gaining greater self-understanding.

In these methods the main effect appears to be cathartic. Troubling material is brought up, resistances are reduced and the therapist, having become aware of the nature of the patient's highly emotionally charged experiences, can better structure the therapeutic situation to help the patient understand himself.

To a greater or lesser extent each of these methods permits the expression of emotions which were ordinarily suppressed, and the release of the dammed -up tide of emotional energy relieves the pressure under which the patient has been living. The release of repressed or suppressed, however, is likely to offer but temporary relief. Unless the pattern of values and motives which originally prevented the acceptance of those aspects of self which engendered the emotional potential are altered, the dam to emotional expression will remain and the pressure will again begin to increase.

The great value of LSD-25 lies in the fact that when the therapeutic situation is properly structured the patient can, and often does, within a period of hours, develop a level of self-understanding and self-acceptance which may surpass that of the average normal person. On the basis of this self-knowledge he can, with the therapist's help, clearly see the inadequacies in the value system which has underlain his previous behavior and can learn how to alter this in accordance with his altered understanding.

So sweeping a claim must, upon first reading, seem like nonsense but a growing number of people have come to accept it as undeniable fact. These are the people who have tried the drug on themselves and on their patients. They are convinced that within the next two or three decades LSD-25, will be by far the most common adjunct to psychotherapy. They feel too that since the psychedelic experience can lead to a very high level of self-understanding, and since self-understanding is the key without which the doors to interpersonal, intergroup or international understanding can not be opened, its use as a catalyst in the development of better human relations will become almost universal. To reject the views of this group as being too extreme without investigating the matter seems a remarkably unscientific attitude. The fact that those who have tried it feel that it offers astonishing possibilities would, in itself, seem to be sufficient reason for a thorough testing of the claims made.

While a certain amount is known about the drug at the present time, investigators have barely begun to explore its potential. Although our knowledge is as yet remarkably incomplete, the following is an attempt to outline the more important aspects of the drug reaction and to outline what appear, at present, to be the most rewarding methods of using it in therapy.

The data from which these methods are derived are by no means extensive but the drug has repeatedly offered help where other methods had failed. It has been used in the most refractory cases, the most unpromising situations, and frequently has been employed only once in the case of an individual patient, yet it has proven surprisingly successful as such reports as those of Smith (45), Chwelos et al (13), Eisner and Cohen (16), and Abrahamson (1), (3) indicate.

CHAPTER 2 - NATURE OF THE DRUG REACTION

FEATURES OF THE EXPERIENCE

There are two reasons why the LSD experience does not lend itself readily to verbalization. Firstly, the sensory aspect of the experience is outside the bounds of the usual experience from which language has developed and for the description of which it is intended. Secondly, the experience is mainly in the sphere of emotions or feelings which are difficult to objectify or verbalize at the best of times.

Before attempting to draw any conclusions about the suggested value of LSD one would want to know something of the nature of the experience which the drug induces. Also, it is inevitable that effective methods of using the drug must be dictated by the nature of the experience.

Because of the difficulty in describing the experience in any but subjective terms, our knowledge of it has been built up bit by bit from personal LSD experience and through observations and reports of other individual and group experiences.

In reading accounts of the experience, one cannot fail to be struck by the fact that although there is tremendous variety in these reports there is a relatively consistent communality in certain areas of the experience. In an earlier report (13) we enumerated these commonly reported areas and illustrated them briefly with transcriptions from actual experiences as follows:

1. A feeling of being at one with the universe.
"I had finally understood by experience. The feeling of union with the cosmos."
2. Experience of being able to see oneself objectively or a feeling that one has two identities.
"If we had the gift to see ourselves as others see us, well, I did this morning. There seemed to be two of me and there seemed to be a conflict between these two."
3. Change in usual concept of self with concomitant change in perceived body.
"I had the feeling of leaving my body and drifting off into space. I had no worldly connections and felt as if I was only a spirit.
4. Change in perception of space and time
"I was looking deeply in the picture until the objects in the picture were beside me."
5. Enhancement in the sensory fields.
"The flower was a thing of inestimable beauty as was its scent. It quite transfixed me in essential contemplation, ecstasy and timelessness."
6. Changes in thinking an understanding so that the subject feels he develops a profound understanding in the field of philosophy or religion. Associations of ideas are much more rapid and clear and one tends to see many alternate solutions to each problem. There is a great tendency to think anologically.
"I found I was outside our bounds to space and time and had an understanding of infinity."
7. A wider range of emotions with rapid fluctuation.
"During this period I was swept by every conceivable variety of pleasant emotion from my own feeling of well-being through feelings of sublimity and grandeur to a sensation of ecstasy."
8. Increased sensitivity to the feelings of others.
"I was conscious of an extremely acute sense of awareness of perception of another's mood, almost thoughts. I likened it to the recognition of emotional atmosphere that the child or animal seems to have."
9. Psychotic changes. These include illusions and hallucinations, paranoid delusions of reference, influence, persecution and grandeur, thought disorder, perceptual distortion, severe anxiety an others which have been described in many reports on the psychotomimetic aspects of these drugs."

CHARACTERISTIC TYPES OF REACTION

These aspects of the experience tend to form various combinations and constellations which give rise to certain characteristic type of experience. It is important to attempt to identify and catalogue these since some such classification must form the basis for any scientific description or understanding of reaction patterns. The types of experience listed here have been found to be by far the most commonly occurring. They appear to be ranged along a continuum. Though the exact nature of this underlying variable is not clear, it does appear to be related to the individual's level of self-acceptance, which in turn, is closely related to the degree to which he is able to surrender his usual self-concept. To the extent that the postulated continuum does exist, these six types of responses might be regarded as various levels of such surrender.

Paradoxically the ability to abandon the established self-concept increases with self-acceptance and decreases with diminished self-regard. The person who does not accept himself fears the exposure of the unacceptable elements and struggles to maintain control in the face of the drug's effects.

Several of these levels are likely to occur within a single experience and a person may frequently move from one to another. However, the tendency is to move from the first two levels (in which the subject tries to deny that the drug has any psychological effect) though the 3rd and 4th levels (in which the attempt to explain and thus control the psychological effects leads to psychotic reactions) to the 5th and 6th levels (in which, having realized his inability to prevent, control, or explain the psychological effects within his usual frame of reference, the subject surrenders his habituated self-concept with its limitations, and accepts the psychedelic or mind-manifesting aspects of the reaction as real and useful).

ESCAPE REACTIONS

In the first two types of experience, the reaction is one of attempting to resist and escape from the effects of the drug.

1. The first type of experience might be called a flight into ideas or activity. The drug begins to disturb the individual's perceptions. He reacts against the effects of the drug by concentrating either upon concepts or things outside the self or upon some activity which can absorb his full attention. Any concept, such as, for example, abstract art, religious dogma, racial prejudice or unemployment may be seized upon and the person may devote his full attention to an elaboration to a variety of aspects of this concept while continuing to deny that the drug is having any effect upon him. In other cases, the individual may plunge into some particular activity-usually his own area of work, in which the familiarity of the activity lends reassurance and stability. He seeks to minimize the effect of the drug by this diversion and narrowing of interest.

He attempts, in this fashion, to control the emotional component of the experience and to minimize his awareness of any physiological or psychological change. He will report that nothing is happening. To an observer, it is evident that the individual is expending an amount of energy in his pursuit of the ideas he is considering; that he is excessively talkative and serious; that he grows progressively more irritable and intolerant of interruptions or questions and that, in many cases, he seems to be suffering from severe tension.

If, after the experience, the individual is asked to describe what happened, he is likely to state that little if anything occurred.

2. The second type of experience might be termed a flight into symptoms. This type of reaction seems to be correlated with an inability or unwillingness to direct one's attention to things outside oneself. When the drug begins to affect the individual, he tends to concentrate upon the physiological sensations. The strangeness of these becomes alarming to him and his alarm increases the physiological disturbances, altering his perception to a still greater awareness of bodily discomfort and malfunction. The individual may develop physiological symptoms of various kinds such as violent nausea; palpitations; feeling of constriction in the throat and chest; pain at the base of the skull; numbness of the limbs or violent headache. Sometimes he may express a fear of dying.

In this variety of experience, the individual will voice very frequent complaints about feeling unwell.

To an observer, he will seem to be extremely ill at ease and his nausea may lead to vomiting, although this is unusual.

Afterwards, when asked to describe his experience, the individual is likely to state that the drug's only effect is to make a person terribly sick.

In the first two types of experience, the self-concept is maintained despite the action of the drug. The individual is able to minimize the psychological effects of the drug by developing an idée fixe and by clinging desperately to it in a battle against the drug's effects.

The employment of small doses of the drug tends to contribute to the production of these types of experience. Little or no therapeutic benefit is derived from them, since the individual, by successfully fighting the drug's effects, succeeds in denying himself any possibility of therapeutic change.

Frequently such reactions develop early in an LSD experience as a result of pre-treatment apprehension. It is of particular importance that the therapist be aware of the possibility of the subject concentrating on the physical effects of the drug, for unless the subject's attention be diverted before the symptoms become oppressive, they can rapidly become so marked as to prevent the subject from being able to shift his attention.

PSYCHOTOMIMETIC REACTIONS

The next two varieties or levels of experience which are frequently observed are those which have given rise to the use of the terms hallucinogen and psychotomimetic agent in connection with LSD.

These states, offering as they do an opportunity to study the interior of certain psychotic conditions, have remarkable possibilities as staff training experiences. ON the other hand it is most unfortunate that so much stress has been placed upon these particular aspects of the LSD experience. Not only are they of limited therapeutic value, but, when regarded as the only levels attendant upon taking the drug, they cause the therapist who would otherwise be interested in its therapeutic possibilities to hesitate in including it among his treatment methods.

3. The third type of experience might be termed a confusional state. It is characterized by confused thinking and perceptual distortion. The individual attempts to rationalize what is happening to him but visual imagery and ideas flood into his awareness at so high a speed that he cannot keep up with them. He is like a person trying to listen to a foreign language with which he is only vaguely familiar. He rapidly falls behind and loses the context.

In this state the alterations in the various areas of perception become so overwhelming that they cannot be interpreted; the intellectual or rationalizing processes are swamped and the attempts to establish order fail. The subject is acutely aware of the confusion of visual and sometimes auditory perceptions which become a vast jumble, often frightening and unpleasant. This results in a state which would appear to be very much like an intensification of the schizophrenic breakdown, particularly as it occurs in catatonic and hebephrenic states.

4. The fourth type of experience is characterized mainly by paranoid thinking. It appears that in this type of response the individual reacts to the impact of the drug by rationalizing all of the aspects of the experience as being a function of the drug alone. All aspects of his perception appear to be enhanced or altered-music is felt physically; is heard with greater clarity and intensity and with new meaning; colors are brightened and seem more intense; patterns take on new significance; and an enhanced awareness of feelings of other is noticed. To a greater or lesser extent all of the senses may appear sharpened in their awareness. Smell, taste, texture, pain, temperature, and balance may also be sensed in a novel way.

The individual's thinking stresses the fact that his perceptions area altered by the drug. He mistrusts his own sense data and begins to question the validity and reality of everything he does and perceives. Thus, he interprets the state as delusional, implying that he is incapacitated and helpless. Further, we have previously mentioned that in the experience the subject seems to develop an acute sense of awareness of the feelings of other people. This is so unusual that the subject begins to misinterpret feeling as thought and believes that other people are becoming aware not only of his feelings, but of his thoughts as well. This feeling of empathic proximity seems to the subject to lay hare the unacceptable aspects of himself. He tries to hide his incapacities and imperfections from those around him. He feels that he is completely at their mercy and is uncertain as to whether or not he can trust them.

Ordinarily, small areas or phases of mistrust are not particularly important in interpersonal relations. In the experience, however, overwhelming feelings of inadequacy and inter-dependency tend to develop and the level of trust becomes an extremely important variable. In order to fully stabilize the experience at the psychedelic level, trust must be absolute. Huxley (26) has described this as "the willingness to be completely implicated". Osmond (41) in a personal communication points out " a minimal amount of trust is essential, how much we don't know but absolute trust is desirable and essential for using the psychedelic experience fully."

Inability on the part of the subject to accept others forces him to try to conceal both his present incapacity and those aspects of himself which he feels he cannot trust others to accept. Despite these efforts, he feels that those about him are aware of his weaknesses and his imperfections. When they act as though they were unaware of these things he feels that they are either toying with him or are too embarrassed to mention his difficulties. This feeling causes suspicion, referential thinking and a marked reduction of insight.

Occasionally, the subject reacts with aggression and hostility rather than withdrawal. In such cases there develops a grandiose contempt for the views or wishes of other people and a disregard for convention. This reaction may be characterized by such paranoid delusions as the feeling of being a God. The person may verbalize the idea that nothing matters any more. In some instances excitement may develop into manic-like behavior. We have found that such grandiose reactions are very rare, occurring not more than once in 50 cases. Their mention here is justified in part as a reassurance to the therapist, for although when they do occur, they tend to give way in a few hours to more amenable states, they can pose management problems. When this condition persists, beyond an hour the therapist should consider the administration of a booster dose of the drug. Although it would seem that increasing the drug dosage would simply add to the subjects discomfort, it does not do so. Rather, it helps him to extricate himself from the dilemma in which he finds himself.

These states tend to occur when the subject comes to a point in the experience at which he is aware of the short comings of his accustomed value system but finds the alternative values, growing out of the experience, unsatisfactory to him. In this situation he attempts to deny all value and may declare that nothing matters. Agitation and excitement may build up to a point at which some restraint is necessary. An additional dose of the drug permits him to assess old and new value systems much more objectively and he finds it much easier to accept what he finds in the process. As the subject begins to recover after an experience of this nature he may go through a phase of schizophrenic-like activity in which there may be markedly stereotyped behavior and the subject may seem to be completely unaware of the therapist. In cases we have observed, this phase lasts about an hour, after which the subject becomes completely rational and very calm and relaxed.

PSYCHEDELIC REACTIONS

The next two varieties or levels of experience are those referred to by the term psychedelic. A work of explanation seems necessary here to clarify our differentiation between psychotomimetic and psychedelic experience. We have used Osmond's (40) terms in this regard. He pointed out that the LSD experience can be broken into two categories-the psychedelic (mind manifesting) aspect during which the person learns only of the inside world of madness. He related the perceptual changes in the LSD experience to what William James has termed "unhabitual perception". James felt that the essence of genius lay in the ability to perceive the world in an unusual manner, i.e. with the absence of one's usual rigidity and Osmond (40) suggests that the ability to perceive the world in a new and unaccustomed manner permits the reorganization of one's system of values.

When a state of unhabitual perception comes upon one through disease process as in schizophrenia or when it is induced by LSD it can be a frightening and distressing experience. As long as the unhabitual perceptions are not organized into an understandable pattern, the person in whom they occur remains confused, uncertain of his reality. Unless they are aided in this process by people familiar with the drug experience they can spend many hours in very uncomfortable circumstances. Because of this fact, LSD has most frequently been described as a psychotomimetic or hallucinogenic drug.

It undoubtly does have this potential. However, when an individual who takes the drug is offered support and guidance in the experience by people who have already established order and organization to the unhabitual perceptions, he is usually able to do so himself in a short time. Such organized unhabitual perception makes up the so called psychedelic experience which offers marked therapeutic possibilities.

In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area of reality worthy of exploration. They might be termed stabilized experiences in that the distressing effects of the drug tend to be minimized and the individual is enabled to gain remarkably in terms of increased insight and self-understanding.

There are the levels at which the therapeutic possibilities of the drug are most fully realized. These types of experience are closely related and while the difference between them may not actually seem great enough to merit their separate considerations, the levels of stabilization which they represent differ so markedly that they have both been outlined.

5. The fifth type of reaction is one in which the effects experienced are accepted as comprising a separate but equally real and valid reality to which the drug gains one entry. The person accepts as genuine his apparently enhanced intellectual capacity and his ability to empathize with and to appreciate, accept and understand others. His thinking may be somewhat disrupted by a frequent involvement in what Levey (23) has termed the dilemma of alternates. This is a sort of parallel awareness of opposites which impeded the usual flow of thought. The subject may also find himself increasingly aware that he is thinking analogically; that there is a tendency to extend logical classification beyond the usual bounds and that his perception increasingly tends toward the breakdown or subdivision of usual gestalts.

In this state the person is keenly aware of the possibility of slipping into a psychotic state for madness appears an ever-present possibility and he feels that he is walking a razor's edge, gaining slowly in confidence as he goes.

6. In the sixth type of reaction the experience is accepted as offering a new and richer interpretation of all aspects of reality. The person feels strongly that there is a unifying principle underlying all things, an essence with which he feels in complete accord. He may feel that he is a part of all things and all things are a part of him. His self-concept is in no way limited by the usual restraints of body image. These feelings or beliefs are accompanied by feelings of reality so intense that conviction is inevitable. William James in writing of such intense feelings of reality states, "they are as convincing to those who have them as any direct sensible experience can be, and they are, as a rule, much more convincing than results established by mere logic ever are".

At this level of experience no doubts remain as to the reality and usefulness of the experience and the individual, freed from this concern feels no possibility of unpleasant or psychotic features developing. Once this level is attained it is doubtful if any manipulation of the environment could induce a psychotic state in the experience.

Some may feel that the individual has already, by accepting the experience as reality, fallen into a delusional or psychotic state and, indeed, there is no ready criterion to determine whether or not this is actually the case. The only method of accessing this possibility seems to be that of "By their fruits ye shall know them".

These brief notes upon the nature of the experience are in no way complete. No individual reaction will fit neatly into the categories outlined. There will be frequent overlapping of levels and in some cases little or none of the experience may accord with the reactions outlined above. The classification is intended only as rough chart of a largely unknown area rather than as a detailed guide.

More exact mapping of the area will attend the observations of many therapists over a number of treatment sessions. However, we believe the present classification to be useful, chiefly as an indication that although the LSD-25 or mescaline induced experience is vast and rapidly shifting, communalities in the experience may be catalogued in a way that will eventually offer a sounder scientific understanding of this area of experience.

INDIVIDUAL REACTIONS

There is much individual variation in regard to the levels of experience attained. Most people pass though a phase in which they struggle against the effects if the drug and a period in which they try to explain the effects themselves. Only individuals seem to attain the psychedelic level rapidly in the first experience and, if they lapse at all into denial, confusion or paranoid thinking, do so but briefly and infrequently. Still other individuals may spend as much as a half a dozen sessions being frightened or ill or paranoid or otherwise distressed before they attain the psychedelic experience. The methods utilized by the therapist play a critical part in determining both the level which subject can attain and the disease with which it is accomplished.

CHAPTER 3 - THE DEVELOPMENT OF TREATMENT METHODS
LSD-25 was first isolated by Hoffman and Stoll in 1938. It is a synthetic derivative of lysergic acid of the ergonovine group. This group of drugs is derived from the ergot fungus which grows on rye and several members of the group have been used in medicine for several years. In the 1940's the effect of LSD-25 on smooth muscle contraction was being studied an assessed against the effect of other ergonovine derivatives. The psychological effects attendant upon its ingestion were discovered by accident when Hoffman happened to swallow a minute quantity from a pipette.

Hoffman and Stoll (48) first reported some of the psychological properties of the drug in 1949 and pointed out that it could reproduce most of the major symptoms of schizophrenia when taken in extremely minute quantities. They did not, however, discuss the extreme variability of the reaction which seems to alter as a function of the surroundings.

Following their report the drug came to be regarded as something of a pharmaceutical curios but a great deal of work was begun and many reports were published on its ability to induce, for a period of hours, major symptoms of psychosis. It should be stressed at this point that the drug does not necessarily produce a psychotic reaction and when it is given in a therapeutic setting rarely is there much psychotic manifestation.

It was not however until 1950 that the drug was reported on as a therapeutic agent in a study by Busch and Johnson (10). They cited the usefulness of the drug in permitting extensive recall and abreaction and in producing an enhancement of insight.

In 1953 Katzenelbogen and Fang (30) published a report dealing with the use of small doses of LSD as an aid in interviewing. They reported that the drug induced a greater ventilation of emotion in schizophrenics than was produced with amytal or with methedrine.

In 1954 Sandison (43) published an account of his work in which he employed varying dosages with chronic neurotic mental hospital patients.

In 1955 Frederking (18) outlined a method in which he used mescaline and LSD-25 as adjuncts to psychoanalytic therapy.

Abramson's group subsequent to 1955 have published a number of papers dealing with the LSD reaction (1), (2), (3). Therapeutically they employ the drug in a modified psychoanalytic approach utilizing small doses in a series of interviews.

The literature on the use of the drug in various areas of study has mushroomed remarkably. Several hundred articles are now available on the drug and bibliographies have been prepared by Certelli (12), by the Sandoz Company (44) and by Caldwell (11).

In the main, reports dealing with LSD as a therapeutic instrument, cover such aspects as the effect of LSD on memory, as a catalyst to ventilation and a s an aid in the development of transference, particularly through the reduction of various areas of resistance.

Therapeutically, however, we believe that the great potential of a psychedelic drug lies in its capacity to permit the subject to achieve a remarkable degree of insight and self-understanding. While the drug does permit a review of those repressed or suppressed areas which are the wellsprings of unacceptable behavior, these effects are but the seeds of its full growing. Vastly more important is the new level of identity at which the individual can arrive. He learns that he can be truly himself, perhaps for the first time in his life, and sham and pretense become unnecessary to him. He finds that he can control his own feelings independent of his circumstances or surroundings, a knowledge that frees him from fear and uncertainty of himself or of others. He learns that to him, the world is what he feels it to be. Abraham Lincoln made this point when he said: "A man is just as happy as he makes up his mind to be".

For this reason, the method outlined in detail in this manual is one aimed at the realization of this level of self-understanding. This method grew out of the early work of Hubbard (24). Since 1954 Hubbard has been studying the therapeutic use of the drug and has dealt with a very large number of subjects.

The LSD experience is so vast, so shifting and so unusual that without some specific techniques, it is virtually impossible to contain and control it is as a therapeutic procedure. In the course of his work Hubbard evolved techniques which give structure to the experience. Among these were the introduction of the idea of using music, paintings and various other stimuli to initiate and illustrate various trains of thought which frequently occur in the experience. His work, which demonstrated the usefulness of the psychedelic aspects of the experience, showed that it was not necessary for the subject toe develop a psychotomimetic reaction even when large doses of the drug were used.

Therapists found that the ingestion of dosages of 75 gamma or more created perceptual changes and other alterations which provoked extreme anxiety in the subject. Hubbard (24) indicated how to avoid this disruptive feature by training his subjects to be able to relax in the face of the loss of control of physiology and awareness precipitated by breathing CO2. This capacity to remain relaxed and unconcerned by the early symptoms of LSD, permits the use of large doses without the arousal of intense anxiety.

Hubbard went beyond this, structuring the situation such that the subject was provided with a new framework into which the experience fitted. His method employed a religious setting involving religious themes in pictures and music and a general stressing of the spiritual aspects of the experience. In these terms the experience was understandable to the subjects for, with the exception of the psychotic changes, each of the features, outlined by Chwelos (13) and quoted earlier in this report, can be fitted into this pattern.

One of the unfortunate procedures which has been widely used to prevent the arousal of anxiety in the LSD session is the system of beginning with a small dose and gradually increasing the amount given over a succession of experiences. This procedure is used to reduce anxiety. It is reasoned that as the drug effect is being sampled a bit at a time, it will at no time become so overwhelming as to induce distress. Unfortunately, such a procedure is unlikely to be rewarding. Small dosages, when they produce any reaction, are unlikely to induce confusion and psychotomimetic features. When they provoke little or not reaction, the procedure drastically reduced the therapeutic effect of the drug. Psychotomimetic features tend to appear at that point in the experience at which the individual's accustomed concept of himself and the world about him-the frame of reference which constitutes hi ties with reality-is becoming no longer tenable in the face of the habitual perceptions induced by the drug. When the drug effect is sufficiently pronounced, the accustomed frame of reference is overwhelmed. In the process of having his accustomed attitudes and sets demolished and of finding a stability in experience outside this psychological framework, the individual finds he has acquired a new outlook. In instances in which the drug effect is insufficient, the individual is left in a state in which he has a very tenuous hold on the reality ties represented by his accustomed concepts and yet is unable to structure or accept the unhabitual perceptions and concepts which the experience has engendered. This confusing, painful and often frightening state constitutes a psychotomimetic experience.

When small dose techniques are employed, the individual, by learning through gradually increased effort, as the dosage is increased from experience to experience, may well develop methods of controlling the effects of the drug according to his accustomed pattern of thinking. He may never come to the point of accepting and utilizing the alterations which the drug may make in the mould of feeling and thinking which initially induced his difficulties.

While this objection may be felt to be simply a play with words, it is a very serious one. True, the individual eventually learns, in a stabilized experience, to control and use the drug effects. However, this is a control based upon a new level of self-understanding and self-acceptance which alone can permit the acceptance of others. Unless this level of experience can be attained the therapeutic potential of the drug is not realized. If the person learns gradually to fit the drug effects into his accustomed self-concept, he is simply learning how to pigeon-hole the experience within an unaltered frame of reference. It is, in fact, the acquisition of the ability to remain unchanged. Not only is such a procedure unlikely to have any therapeutic effect but it tends to immunize against his ever being able to gain self-understanding through the psychedelic experience.

As Osmond (40) has stated "our work started with the idea that a single overwhelming experience might be beneficial in alcoholics, the idea springing from James (27) and Tiebout (48)". We have discovered no reason to alter this view as regards the usefulness of the overwhelming experience. However, subsequent work has shown that is often of great value to repeat the experience and has suggested that the method is applicable to the treatment of the neuroses and psychopathy as well as alcoholism.

We feel that it is extremely important that the therapist have a clear understanding of the effects of the drug. This can only be gained by taking the drug one's self. Osmond's (40) golden rule in work with model psychoses "you start with yourself" is even more applicable in work utilizing the psychedelic experience as therapeutic. By gaining this first hand experience the therapist will become much more effective in dealing with subjects during the experience and in aiding them in fitting the insights gained during the experience into their daily lives. Indeed, it is well to have as many as possible of the staff members who will come in contact with the patient similarly trained.

CHAPTER 4 - INDIVIDUAL AND GROUP METHODS
We have utilized both individual and group techniques of administration, and have been able to make fairly extensive investigation of their relative therapeutic efficacy as well as their relative usefulness in other areas of investigation.

In the individual method the subject is given the drug and the therapist, often with one or more staff, stays with him throughout the experience. In the group method one or two therapists and possibly other subjects also take the drug. In such group sessions it is unwise to have more than one person in the group who is taking LSD for the first time and the others should ideally be quite experienced.

In the individual session the subject is more on his own. The therapist should have a good knowledge of what to expect from the LSD experience for this will add an empathic sensitivity on the part of the therapist which is invaluable in this procedure. Being "alone" in the experience, the subject is less distracted from self-analysis and may therefore arrive at a more complete self-understanding. When one takes the drug alone it is more difficult to communicate with other people partly because one's awareness is increased beyond the level of the staff. When one becomes so aware of what is going on in other people, he tends to think that the increased awareness and empathic communication is shared by the staff and feels little need for communication by the usual channels of verbalization. Because of this difference of awareness, there is a relative increase in psychological distance between subject and staff. This problem is not at all insoluable in that empathic sensitivity on the part of the therapist and occasional reminds to the subject that his awareness is expanded beyond that of the others tends to bridge the gap considerably. Indeed the problem is a relative one in that the intensified feelings of the subject make it much easier than usual to empathize with him.

Because the subject begins to feel somewhat unique due to his expanded awareness, there is some danger that grandiosity may develop. It is worthwhile to remind the subject that everyone has the same potential which is brought out by the drug.

One of the main disadvantages then of the individual procedure is the difficulty in following the subject closely enough through his experience. Provided the therapist has an accepting but not sympathetic attitude there is little if any danger of the subject getting into any serious difficulty because of this difficulty in communication. The individual session has the advantage that less staff time is used. Individual sessions tend to last a shorter period and the subject can be sent back to the ward after 7-8 hours, whereas, in the case of group sessions, 12-14 hours may be occupied. In individual sessions, the staff involved are not in any way incapacitated from doing other things during or immediately after the session if the need arises, though they should try as much as possible to avoid distractions.

The subject, in an individual session, feels less encroached upon and is more likely to investigate painful areas than he is in a group session where he is aware that the staff can follow his feeling tone to a very high degree.

Indeed, one major disadvantage of using the group method for the subjects first experience is the alarm frequently precipitated in the patient when he realizes the degree to which the therapists are able to identify and communicate with him non-verbally. This relationship is so close that the patient begins to misinterpret feelings as thought and comes to believe that the therapists can read all his thoughts. Because of this, feelings of inadequacy and guilt frequently lead him rapidly to withdrawal and paranoid thinking. Also the subject is to some extent frightened away from the investigation of problem areas out of the fear of exposing hidden areas to others. This difficulty poses much less of a problem, however, to a subject who has had an individual session and has worked through his main problem areas or to the person whose problems are not marked.

Another difficulty in the extensive use of group sessions is the frequency with which the therapist must use the drug. Further when two therapists are involved, staff time becomes a major consideration. It has been stated that tolerance for LSD builds up quite rapidly but even when we have run group sessions as frequent as three times a week this has not appeared to be a problem and the therapists have been able to work in close empathy with the subject on doses as low as 25 gamma on the third day of such series.

Much more extensive work must be done on the investigation of tolerance in terms of the psychological effects of the drug. There is much to suggest that these effects are much altered in group settings by the impact of the drug on other individuals in the group. These effects cannot simply be brushed aside as suggestion or as a placebo reaction where tolerance has been established. Their effect upon the level of empathy, their duration within a session, their intensity and their persistence from occasion to occasion and their absence when the drug is not ingested, indicate that they are not likely to be the products of suggestion.

Frequently, the question of addiction is brought up in connection with therapists who repeatedly use the drug. We have seen no evidence either in the literature or in our own work to suggest any addictive potential. Further, we find that people using the drug frequently find that tolerance is opposite to that found in addiction. With experience, the subject can reach the same level with smaller and smaller doses as he learns to break down his resistance psychologically. Also the effects of the drug are not pleasant in themselves. Subjects have pleasant experiences only if they work through their problem areas and are able to stabilize the experience by reaching a fairly high level of self-understanding and self-acceptance.

Further, whereas in addiction the subject is striving to reach some form of escape from, or oblivion toward his personality difficulties, in the case of LSD these are brought into sharp focus and are exaggerated to painful proportions until the subject works them through.

Some critics who have never tried the experience have called it an escape into transcendental experience. If this could be termed an escape then all forms of yielding to the desire to learn could equally well be classified as escapes. This would appear to be taking the concept of escape to ridiculous extremes.

In view of the difficulties cited, it may appear that group sessions are difficult and unnecessary. However, the group method does have many remarkable advantages. It offers the subject and opportunity to understand himself in terms of how he relates to others. It permits him, when more than one therapist is involved to see objectively from extremely close range, in terms of understanding, how other people relate to each other. It shows the subjects how his views of the world accords with, and differs from, the views of others. It lets him understand that each person's frame of reference, although peculiarly the person's own (and therefore different from any other view) is nevertheless as valid as his own. Further, the group method fosters a ready transfer of training and knowledge from the LSD experience into day to day living.

Most important, however, would seem to be the great value of the group experience in staff training and particularly in research. The research aspects of working with the psychedelic drugs deserves particular mention and is spelled out more fully in the following chapter.

Therapeutic trials with groups of various sizes have been carried out at various centres in Saskatchewan. This work has suggested that the number in the group is a variable of marked importance.

In therapy a group of three, perhaps because of its particular instability, seems most useful. In a group of two, there is a continuous pressure to relate to the same person. It is impossible to withdraw from this relationship and the intimacy of the empathic bond may be disturbing. Any note of suspicion or hostility is excessively disruptive and its effect tends to be prolonged.

By comparison, in the three groups one can, to some extent, withdraw from the others from time to time, leaving them to relate to each other. The possibility of shifting from relationship to relationship makes it easier to learn gradually to accept the group members completely. Temporary feelings of hostility, anger or suspicion are much less destructive of the empathic bond in this situation and are much more quickly overcome.

The four group is much more complex than the three group and the establishment of the empathic bond is much more difficult since the addition of the fourth participant has doubled the number of relationships involved. This group size appears to lead to a high level of intellectual stimulation and to excellent and rewarding discussion. However, the participants do not readily develop the same high level of empathy as is found in the three group. Frequently the empathic bond is established more completely within pairs than between pairs. It commonly happens too that one individual is not able to accept the others readily and a group of three is formed from which the fourth feels excluded. pmThis makes it still more difficult for him to integrate.

Our knowledge of group relationships in drug sessions involving more than four persons is extremely limited. What we do know is drawn from a few five and six group experiences and from the peyote experiences of the Native American Church. Research in this area of group psychedelic experience will be so interesting and rewarding that it will no doubt gain momentum rapidly.

In considering the staff time involved in group therapeutic sessions it should be recognized that aside from pre-treatment interviewing the treatment is completed in one day. If the subject is to have two sessions they are usually several months apart. Even where two group session are used, such a treatment program could be likely to consume something less than 30 hours of staff working time per patient. If the treatment were not more effective than any other this would correspond to something less than 25 ordinary treatment interviews, allowing time for recording the sessions. Considering the difficult nature of the cases handled, this in no way seems excessive. Also it must be taken into account that nursing time and secretarial work are reduced to an absolute minimum and hospitalization, in the case of in-patients, is remarkably shortened.

There is little doubt that both individual and group experience have much to offer and the therapist could consider giving both experience to each subject. There has been much discussion but no research upon the order in which these experiences should be undergone. Priority must therefore be assigned on the basis of clinical judgment. It is the authors point of view that, in general, it is advisable to have the individual experience first. The subject is less likely to become alarmed and withdrawn and he is more likely to persevere at investigating painful and unacceptable areas for the therapist, to inadvertently "help" too much and help the subject stabilize the experience without working though his difficulties.

The individual session is so called because the subject alone takes the drug. However, this technique may involve a group. Hubbard (24) uses a method in which a group is selected to sit in on the session. The group lends support to the therapist as a well and permits him greater freedom and more relaxation. When this technique is used the subject should have met each group member previously and should know which people will be present at the session. Such group members should have had experience with the drug. The numbers in such a group should probably not exceed four including the therapist. When the group becomes large the subject tends to feel like the lead player in a public execution.

The method which has been outlined below may be adapted to either individual or group procedures. Although the empathic bond is less obvious in the individual session, the role of the therapist remains very much the same.

CHAPTER 5 - RESEARCH IMPLICATIONS
The experiences induced by LSD and mescalin are opening vast new areas to the research and while such considerations may be felt to have only indirect bearing upon therapy, they should not be passed over.

It is the view of the authors that the psychedelic drugs present the most potent tools for psychological research which have yet been discovered. Research possibilities range from simple perceptual experiments to highly complex empathic studies. The research value of the psychedelics stems from two major aspects of the experience which they induce.

Firstly, when the experimenter takes the drug, he becomes aware of his own awareness. He becomes a witness to his own emotions, his own intellectual processes, and his own activity. He can examine the articulation of each of these upon the others and observe their relationship to his perception. Indeed, he can observe concept formation and learning going on from the inside.

Secondly, when a group of investigators take the drug at the same time, they develop a closeness of relationship in terms of feeling which verges upon the telepathic. Thus scientists can develop shared introspection and can begin to evolve research techniques which will permit the comparison of emotional states-the measurement of emotion.

Experimentation and study in these areas offer the hope that eventually they may permit a signal advance in psychological understanding. Early introspectionists were unable to provide shareable information as a basis for scientific inquiry. Only through limiting investigation to the behavior of organisms have we been able to arrive at some level of objectivity and shareability of results. Such an approach, however, confines psychology to the observation of activity and to a concept of man as the sum of his activity.

Psychedelic research promises eventually to permit the investigator to get beyond the behavioral manifestations and into the area of the underlying motivation.

One source of error in framing research in this area should be pointed out. The investigator should not try to study the drug effect in subjects until they have taken the drug a half dozen times before he is used as a research subject. There is a basic confusion of purposes when one attempts to determine the drug effect upon various tasks during the first session. The administration of tests completely alters the experience in early sessions. What is assessed is the degree of confusion in a subject whose reality ties are loosened by the drug and further altered by the testing. The test administration and indeed the research set up in which he is a guinea-pig may alter the entire nature of perceptions. Almost universally, results obtained from testing under such circumstances will show decreased efficiency of one kind or another and there is no method of sorting extraneous situational effects from drug effects as such.

However, once the subject has learned and practiced how to stabilize the experience, testing could be expected to reveal the extent of such phenomena as perceptual enhancement and empathic sensitization. It becomes a challenge to the researcher to seek out and classify the variables involved and to devise tests which will yield valid and, if possible, quantifiable measure of them.

An outline of various areas in which research seem indicated is presented in Appendix C.

CHAPTER 6 - THE SETTING
The setting in which the treatment session is to be conducted must be comfortable and quiet. Frequently the subject may feel like lying down. It is best to provide enough chesterfields, cots or beds so that each person who has had the drug has a place to stretch out comfortable.

The place should be quiet, not only as far as the general noise level is concerned but particularly in terms of interruptions of intrusions of the outside world upon the experience. Worries about getting home for supper or getting certain work done are disruptive and all such interference should be reduced as much as possible. People coming into the room can cause the subject to become upset, particularly from the second to the eighth hour after he has taken the drug. If a group is to be used, all members should be present when the experience begins. Other intrusions should be present when the experience begins. Other intrusions should be kept to a minimum. This is more difficult than it at first appears because LSD therapy usually catches the imagination and provokes the curiosity of nearly all the staff members of the unit involved. Many people will find excellent reasons to be in and out of the treatment room unless the policy of no visitors is established.

The telephone too can be exceptionally disturbing. It is often the greatest nuisance in a session. If the telephone is in the treatment room, the noise of its ringing is a bother but no matter where it is, it is troublesome for the person called, whether or not he has taken the drug, to completely alter his frame of reference such that he can conduct a normal telephone conversation. As much as possible, telephone calls should be held up.

At times, particularly in individual sessions, the subject may become extremely restless or violent. At the height of this disturbed state he is apt to knock or throw things about. For this reason it is wise to use fairly durable furnishings.

Washroom facilities should be relatively near by. It is often a severe strain on the subject to have to walk through a ward or indeed to walk any distance under the effect of the drug. Also, in subjects who become paranoid, the trip to the washroom offers opportunity for them to attempt to get away from the session.

CHAPTER 7 - EQUIPMENT
A record player and a dozen or so recordings of classical selections covering a variety of moods are so useful as to virtually essential. Music is an important feature in permitting the person to get outside his usual self-concept.

Other useful equipment includes paintings, photographs of the subject's relatives, collections of photographs such as the Family of Man series, flowers and gems. A mirror is particularly useful. The subject often can use his reflection in the mirror more objectively than himself and can frequently clarity many aspects of his own self-concept by studying his reflection though it is unwise to present the subject with the mirror until he has worked through the more frightening stages of self-appraisal and has gained at least some degree of self-acceptance. For this reason the mirror should not be mounted on the wall.

Frequently one of the side effects of the drug is a sensation of dryness in the mouth and throat. The people in the experience may feel more than usually thirsty and it is well to have a quantity of fruit juices on hand. The participants may at times feel quite fatigued and may find chocolate or other candy a ready source of additional energy. Fresh fruit provides a light food which is easy to eat and keeps one from becoming excessively hungry during the day.

Niacin is useful in bringing a person out of the experience although this should only be done in case of some emergency which necessitates the subject's leaving the experience. A dose of 400-600 mgms. intravenously should be adequate to terminate the experience. Unpleasant phases of the experience should not lead to its termination as they most frequently indicate that the person is working through some troublesome problem-often a necessary and beneficial process leading to emotional growth.

After the session the subject may find difficulty in going to sleep although he feels quite tired. For this reason it may be considered wise to give him a sedative which he can use if he so desires.

CHAPTER 8 - INDICATIONS AND CONTRA-INDICATIONS
Because of the limited number of studies yet reported, there are many blank areas in current knowledge as to the relative usefulness of LSD in various psychiatric disorders. Much of the work which has been done to date has employed as subjects normal volunteers and staff members who were seeking training. The majority of studies have involved experiments upon the subject. Those yield very little information about therapeutic effectiveness.

Most of the work done with the drug has involved subjects of superior intelligence. It is not known whether the drug can be usefully employed with people in the dull-normal, border-line or defective ranges.

The drug has been used in the main with people ranging in age from the early twenties to the sixties and very little is known about its effect upon younger age groups or upon older people. Hubbard has used the drug with people as young as 14 years of age with successful results. However, this work was restricted to very few cases and a great deal remains to be found out about the drug effect in people in their teens.

Our experience indicates that it is difficult to predict, for any individual, what his response to the drug will be. In general, the greater the degree of insecurity the more difficult it is for the subject to relinquish his defenses and his intellectual control. Failure to do so will lead to tension, illness or paranoid reactions. However, this is not always an easy matter to judge. For this reason only very rough rules of thumb can be suggested as regards indications or contra-indic

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Handbook for the Therapeutic Use of LSD-25

HANDBOOK FOR THE THERAPEUTIC USE OF LYSERGIC ACID DIETHYLAMIDE-25
INDIVIDUAL AND GROUP PROCEDURES

1959 - D.B. BLEWETT, Ph.D. & N. CHWELOS, M.D.

OCR by MAPS, Edits by Erowid

In the 1950s and 1960s, mimeograph copies of the following Handbook were shared among pioneering therapists exploring the therapeutic utility of LSD. To this day, it remains one of the most relevant documented explorations of the guided psychedelic session.
CLICK TO VIEW A PDF VERSION
TABLE OF CONTENTS

* Acknowledgements
* Preface

1. Psychiatric Rationale
2. The Nature of the Drug Reaction
3. The Development of Treatment Methods
4. Individual and Group Methods
5. Research Implications
6. The Setting
7. Equipment
8. Indications and Contra Indications
9. The Preparation of the Subject
10. General Considerations Regarding Procedure
11. Dosage
12. Administration
13. Stages in the Experience:
I. Pre-Onset
14. II. Onset of Symptoms
15. III. Self Examination
16. IV. The Empathic Bond
17. V. Discussion
18. Diminishment of Symptoms
19. The Meal
20. Termination of Session
21. After Contact with the Subject
22. Assessment of the Experience

* Appendix A : Assessment Scales I and II
* Appendix B : Results to Date
* Appendix C : Proposals for Psychedelic Research

Review of this Handbook, by Myron Stolaroff
References
PDF Scan of the document (400KB)

ACKNOWLEDGEMENTS
It will be obvious to the careful reader but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer. Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Cambell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. McLean, Dr. T. Weckowicz, Mr. F.E.A. Ewald, Mr. G. Marsh, Mr.R. Thelander and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy..

PREFACE
It will be evident to the reader that the authors have not attempted to deal with the material presented within a theoretical system.

The experience described and utilized in therapy represents so remarkable an extension of common experience that an eclectic approach has seemed mandatory.

The clinician may feel that the depersonalization and rapport which develop in the experience are of prime significance. The experimentalist may see the induction of marked inconstancy of perception or the inconstancy of the sense of time in particular as the important aspect of the experience. In any case, clinician and experimentalist alike will find much of value and of interest in studying the drug effect.

It will be obvious to the careful reader, but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer.

Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Campbell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy.

CHAPTER 1 - PSYCHIATRIC RATIONALE
THE FRAME OF REFERENCE

In the broadest terms there are, at present, two main philosophies of psychotherapy. One of these, based upon the concept of "adjustment" sees as the goal of treatment a happy and comfortable acceptance by the patient of the norms of his society. The other concept sees as the goal of therapy the maximal realization of the individual potential, the flowering as it were, of the personality.

In considering the therapeutic merits of LSD-25, one can scarcely fail to pose such problems as how the drug can contribute to the therapeutic process, how its use affects the therapeutic process, how its use affects the therapist-client relationship, or how its effects seem to relate to various aspects of psychological and psychiatric theory.

Under present day conditions the therapist, though desiring to lead the patient toward full self-realization, almost invariably finds that pressures of time and convention force him to work toward the goal of adjustment more or less to the exclusion of any but the most cursory consideration of those particular facets of the psyche which render each of his patients unique.

When therapy begins, the patient already possesses a complex of motives and mechanisms which have proven more or less inadequate and while the forms and techniques employed in treatment may vary widely, depending upon the theoretical outlook of the therapist, there is nevertheless an underlying process which is common to all psychotherapeutic progress. It might be summarized in the following steps:

1. The patient must realize that his present methods of behaving are inadequate and unsatisfying to him personally.
2. He must develop sufficiently strong motivation to carry him through the difficult and painful process of coming to understand and accept himself.
3. On the basis of this self-understanding, he must learn how to alter his

Behavior to satisfy the new pattern of motivation which has developed out of self-understanding.

The therapist cannot learn these things for the patient, just as the teacher cannot learn for the pupil. It is the role of the therapist, as it is of the teacher, so to structure the situation as to maximize the opportunities for learning. The expertise of the therapist lies essentially in his knowing how to structure the situation so as to fit best the personality of the patient and of himself and the environmental variables which seem of greatest relevance.

Many of the treatment methods in psychiatry have been derived and are currently utilized with a pragmatic disregard for theoretical considerations. This is true of the physical and chemical therapies generally. To the extent that they are regarded as adjuncts to psychotherapeutic treatment but because of their relatively rapid effect and the tremendous economy in terms of treatment time they are frequently used with minimal psychotherapeutic accompaniment.

These treatment methods might be classified in terms of the aim of the therapist. One group including electrotherapy, insulin therapy, psycho-surgery and narcotherapy, is utilized to make the patient more accessible to the therapist, that is to say to alter the patient so that he is better able to utilize the help which the therapist can offer through appropriate structuring of the therapeutic situation. The other group would include such methods as hypnosis, amytal and pentothal, and CO2. Here the aim is to help the patient overcome his reluctance to face himself as he really is-to hasten the learning process and east the pain involved in gaining greater self-understanding.

In these methods the main effect appears to be cathartic. Troubling material is brought up, resistances are reduced and the therapist, having become aware of the nature of the patient's highly emotionally charged experiences, can better structure the therapeutic situation to help the patient understand himself.

To a greater or lesser extent each of these methods permits the expression of emotions which were ordinarily suppressed, and the release of the dammed -up tide of emotional energy relieves the pressure under which the patient has been living. The release of repressed or suppressed, however, is likely to offer but temporary relief. Unless the pattern of values and motives which originally prevented the acceptance of those aspects of self which engendered the emotional potential are altered, the dam to emotional expression will remain and the pressure will again begin to increase.

The great value of LSD-25 lies in the fact that when the therapeutic situation is properly structured the patient can, and often does, within a period of hours, develop a level of self-understanding and self-acceptance which may surpass that of the average normal person. On the basis of this self-knowledge he can, with the therapist's help, clearly see the inadequacies in the value system which has underlain his previous behavior and can learn how to alter this in accordance with his altered understanding.

So sweeping a claim must, upon first reading, seem like nonsense but a growing number of people have come to accept it as undeniable fact. These are the people who have tried the drug on themselves and on their patients. They are convinced that within the next two or three decades LSD-25, will be by far the most common adjunct to psychotherapy. They feel too that since the psychedelic experience can lead to a very high level of self-understanding, and since self-understanding is the key without which the doors to interpersonal, intergroup or international understanding can not be opened, its use as a catalyst in the development of better human relations will become almost universal. To reject the views of this group as being too extreme without investigating the matter seems a remarkably unscientific attitude. The fact that those who have tried it feel that it offers astonishing possibilities would, in itself, seem to be sufficient reason for a thorough testing of the claims made.

While a certain amount is known about the drug at the present time, investigators have barely begun to explore its potential. Although our knowledge is as yet remarkably incomplete, the following is an attempt to outline the more important aspects of the drug reaction and to outline what appear, at present, to be the most rewarding methods of using it in therapy.

The data from which these methods are derived are by no means extensive but the drug has repeatedly offered help where other methods had failed. It has been used in the most refractory cases, the most unpromising situations, and frequently has been employed only once in the case of an individual patient, yet it has proven surprisingly successful as such reports as those of Smith (45), Chwelos et al (13), Eisner and Cohen (16), and Abrahamson (1), (3) indicate.

CHAPTER 2 - NATURE OF THE DRUG REACTION

FEATURES OF THE EXPERIENCE

There are two reasons why the LSD experience does not lend itself readily to verbalization. Firstly, the sensory aspect of the experience is outside the bounds of the usual experience from which language has developed and for the description of which it is intended. Secondly, the experience is mainly in the sphere of emotions or feelings which are difficult to objectify or verbalize at the best of times.

Before attempting to draw any conclusions about the suggested value of LSD one would want to know something of the nature of the experience which the drug induces. Also, it is inevitable that effective methods of using the drug must be dictated by the nature of the experience.

Because of the difficulty in describing the experience in any but subjective terms, our knowledge of it has been built up bit by bit from personal LSD experience and through observations and reports of other individual and group experiences.

In reading accounts of the experience, one cannot fail to be struck by the fact that although there is tremendous variety in these reports there is a relatively consistent communality in certain areas of the experience. In an earlier report (13) we enumerated these commonly reported areas and illustrated them briefly with transcriptions from actual experiences as follows:

1. A feeling of being at one with the universe.
"I had finally understood by experience. The feeling of union with the cosmos."
2. Experience of being able to see oneself objectively or a feeling that one has two identities.
"If we had the gift to see ourselves as others see us, well, I did this morning. There seemed to be two of me and there seemed to be a conflict between these two."
3. Change in usual concept of self with concomitant change in perceived body.
"I had the feeling of leaving my body and drifting off into space. I had no worldly connections and felt as if I was only a spirit.
4. Change in perception of space and time
"I was looking deeply in the picture until the objects in the picture were beside me."
5. Enhancement in the sensory fields.
"The flower was a thing of inestimable beauty as was its scent. It quite transfixed me in essential contemplation, ecstasy and timelessness."
6. Changes in thinking an understanding so that the subject feels he develops a profound understanding in the field of philosophy or religion. Associations of ideas are much more rapid and clear and one tends to see many alternate solutions to each problem. There is a great tendency to think anologically.
"I found I was outside our bounds to space and time and had an understanding of infinity."
7. A wider range of emotions with rapid fluctuation.
"During this period I was swept by every conceivable variety of pleasant emotion from my own feeling of well-being through feelings of sublimity and grandeur to a sensation of ecstasy."
8. Increased sensitivity to the feelings of others.
"I was conscious of an extremely acute sense of awareness of perception of another's mood, almost thoughts. I likened it to the recognition of emotional atmosphere that the child or animal seems to have."
9. Psychotic changes. These include illusions and hallucinations, paranoid delusions of reference, influence, persecution and grandeur, thought disorder, perceptual distortion, severe anxiety an others which have been described in many reports on the psychotomimetic aspects of these drugs."

CHARACTERISTIC TYPES OF REACTION

These aspects of the experience tend to form various combinations and constellations which give rise to certain characteristic type of experience. It is important to attempt to identify and catalogue these since some such classification must form the basis for any scientific description or understanding of reaction patterns. The types of experience listed here have been found to be by far the most commonly occurring. They appear to be ranged along a continuum. Though the exact nature of this underlying variable is not clear, it does appear to be related to the individual's level of self-acceptance, which in turn, is closely related to the degree to which he is able to surrender his usual self-concept. To the extent that the postulated continuum does exist, these six types of responses might be regarded as various levels of such surrender.

Paradoxically the ability to abandon the established self-concept increases with self-acceptance and decreases with diminished self-regard. The person who does not accept himself fears the exposure of the unacceptable elements and struggles to maintain control in the face of the drug's effects.

Several of these levels are likely to occur within a single experience and a person may frequently move from one to another. However, the tendency is to move from the first two levels (in which the subject tries to deny that the drug has any psychological effect) though the 3rd and 4th levels (in which the attempt to explain and thus control the psychological effects leads to psychotic reactions) to the 5th and 6th levels (in which, having realized his inability to prevent, control, or explain the psychological effects within his usual frame of reference, the subject surrenders his habituated self-concept with its limitations, and accepts the psychedelic or mind-manifesting aspects of the reaction as real and useful).

ESCAPE REACTIONS

In the first two types of experience, the reaction is one of attempting to resist and escape from the effects of the drug.

1. The first type of experience might be called a flight into ideas or activity. The drug begins to disturb the individual's perceptions. He reacts against the effects of the drug by concentrating either upon concepts or things outside the self or upon some activity which can absorb his full attention. Any concept, such as, for example, abstract art, religious dogma, racial prejudice or unemployment may be seized upon and the person may devote his full attention to an elaboration to a variety of aspects of this concept while continuing to deny that the drug is having any effect upon him. In other cases, the individual may plunge into some particular activity-usually his own area of work, in which the familiarity of the activity lends reassurance and stability. He seeks to minimize the effect of the drug by this diversion and narrowing of interest.

He attempts, in this fashion, to control the emotional component of the experience and to minimize his awareness of any physiological or psychological change. He will report that nothing is happening. To an observer, it is evident that the individual is expending an amount of energy in his pursuit of the ideas he is considering; that he is excessively talkative and serious; that he grows progressively more irritable and intolerant of interruptions or questions and that, in many cases, he seems to be suffering from severe tension.

If, after the experience, the individual is asked to describe what happened, he is likely to state that little if anything occurred.

2. The second type of experience might be termed a flight into symptoms. This type of reaction seems to be correlated with an inability or unwillingness to direct one's attention to things outside oneself. When the drug begins to affect the individual, he tends to concentrate upon the physiological sensations. The strangeness of these becomes alarming to him and his alarm increases the physiological disturbances, altering his perception to a still greater awareness of bodily discomfort and malfunction. The individual may develop physiological symptoms of various kinds such as violent nausea; palpitations; feeling of constriction in the throat and chest; pain at the base of the skull; numbness of the limbs or violent headache. Sometimes he may express a fear of dying.

In this variety of experience, the individual will voice very frequent complaints about feeling unwell.

To an observer, he will seem to be extremely ill at ease and his nausea may lead to vomiting, although this is unusual.

Afterwards, when asked to describe his experience, the individual is likely to state that the drug's only effect is to make a person terribly sick.

In the first two types of experience, the self-concept is maintained despite the action of the drug. The individual is able to minimize the psychological effects of the drug by developing an idée fixe and by clinging desperately to it in a battle against the drug's effects.

The employment of small doses of the drug tends to contribute to the production of these types of experience. Little or no therapeutic benefit is derived from them, since the individual, by successfully fighting the drug's effects, succeeds in denying himself any possibility of therapeutic change.

Frequently such reactions develop early in an LSD experience as a result of pre-treatment apprehension. It is of particular importance that the therapist be aware of the possibility of the subject concentrating on the physical effects of the drug, for unless the subject's attention be diverted before the symptoms become oppressive, they can rapidly become so marked as to prevent the subject from being able to shift his attention.

PSYCHOTOMIMETIC REACTIONS

The next two varieties or levels of experience which are frequently observed are those which have given rise to the use of the terms hallucinogen and psychotomimetic agent in connection with LSD.

These states, offering as they do an opportunity to study the interior of certain psychotic conditions, have remarkable possibilities as staff training experiences. ON the other hand it is most unfortunate that so much stress has been placed upon these particular aspects of the LSD experience. Not only are they of limited therapeutic value, but, when regarded as the only levels attendant upon taking the drug, they cause the therapist who would otherwise be interested in its therapeutic possibilities to hesitate in including it among his treatment methods.

3. The third type of experience might be termed a confusional state. It is characterized by confused thinking and perceptual distortion. The individual attempts to rationalize what is happening to him but visual imagery and ideas flood into his awareness at so high a speed that he cannot keep up with them. He is like a person trying to listen to a foreign language with which he is only vaguely familiar. He rapidly falls behind and loses the context.

In this state the alterations in the various areas of perception become so overwhelming that they cannot be interpreted; the intellectual or rationalizing processes are swamped and the attempts to establish order fail. The subject is acutely aware of the confusion of visual and sometimes auditory perceptions which become a vast jumble, often frightening and unpleasant. This results in a state which would appear to be very much like an intensification of the schizophrenic breakdown, particularly as it occurs in catatonic and hebephrenic states.

4. The fourth type of experience is characterized mainly by paranoid thinking. It appears that in this type of response the individual reacts to the impact of the drug by rationalizing all of the aspects of the experience as being a function of the drug alone. All aspects of his perception appear to be enhanced or altered-music is felt physically; is heard with greater clarity and intensity and with new meaning; colors are brightened and seem more intense; patterns take on new significance; and an enhanced awareness of feelings of other is noticed. To a greater or lesser extent all of the senses may appear sharpened in their awareness. Smell, taste, texture, pain, temperature, and balance may also be sensed in a novel way.

The individual's thinking stresses the fact that his perceptions area altered by the drug. He mistrusts his own sense data and begins to question the validity and reality of everything he does and perceives. Thus, he interprets the state as delusional, implying that he is incapacitated and helpless. Further, we have previously mentioned that in the experience the subject seems to develop an acute sense of awareness of the feelings of other people. This is so unusual that the subject begins to misinterpret feeling as thought and believes that other people are becoming aware not only of his feelings, but of his thoughts as well. This feeling of empathic proximity seems to the subject to lay hare the unacceptable aspects of himself. He tries to hide his incapacities and imperfections from those around him. He feels that he is completely at their mercy and is uncertain as to whether or not he can trust them.

Ordinarily, small areas or phases of mistrust are not particularly important in interpersonal relations. In the experience, however, overwhelming feelings of inadequacy and inter-dependency tend to develop and the level of trust becomes an extremely important variable. In order to fully stabilize the experience at the psychedelic level, trust must be absolute. Huxley (26) has described this as "the willingness to be completely implicated". Osmond (41) in a personal communication points out " a minimal amount of trust is essential, how much we don't know but absolute trust is desirable and essential for using the psychedelic experience fully."

Inability on the part of the subject to accept others forces him to try to conceal both his present incapacity and those aspects of himself which he feels he cannot trust others to accept. Despite these efforts, he feels that those about him are aware of his weaknesses and his imperfections. When they act as though they were unaware of these things he feels that they are either toying with him or are too embarrassed to mention his difficulties. This feeling causes suspicion, referential thinking and a marked reduction of insight.

Occasionally, the subject reacts with aggression and hostility rather than withdrawal. In such cases there develops a grandiose contempt for the views or wishes of other people and a disregard for convention. This reaction may be characterized by such paranoid delusions as the feeling of being a God. The person may verbalize the idea that nothing matters any more. In some instances excitement may develop into manic-like behavior. We have found that such grandiose reactions are very rare, occurring not more than once in 50 cases. Their mention here is justified in part as a reassurance to the therapist, for although when they do occur, they tend to give way in a few hours to more amenable states, they can pose management problems. When this condition persists, beyond an hour the therapist should consider the administration of a booster dose of the drug. Although it would seem that increasing the drug dosage would simply add to the subjects discomfort, it does not do so. Rather, it helps him to extricate himself from the dilemma in which he finds himself.

These states tend to occur when the subject comes to a point in the experience at which he is aware of the short comings of his accustomed value system but finds the alternative values, growing out of the experience, unsatisfactory to him. In this situation he attempts to deny all value and may declare that nothing matters. Agitation and excitement may build up to a point at which some restraint is necessary. An additional dose of the drug permits him to assess old and new value systems much more objectively and he finds it much easier to accept what he finds in the process. As the subject begins to recover after an experience of this nature he may go through a phase of schizophrenic-like activity in which there may be markedly stereotyped behavior and the subject may seem to be completely unaware of the therapist. In cases we have observed, this phase lasts about an hour, after which the subject becomes completely rational and very calm and relaxed.

PSYCHEDELIC REACTIONS

The next two varieties or levels of experience are those referred to by the term psychedelic. A work of explanation seems necessary here to clarify our differentiation between psychotomimetic and psychedelic experience. We have used Osmond's (40) terms in this regard. He pointed out that the LSD experience can be broken into two categories-the psychedelic (mind manifesting) aspect during which the person learns only of the inside world of madness. He related the perceptual changes in the LSD experience to what William James has termed "unhabitual perception". James felt that the essence of genius lay in the ability to perceive the world in an unusual manner, i.e. with the absence of one's usual rigidity and Osmond (40) suggests that the ability to perceive the world in a new and unaccustomed manner permits the reorganization of one's system of values.

When a state of unhabitual perception comes upon one through disease process as in schizophrenia or when it is induced by LSD it can be a frightening and distressing experience. As long as the unhabitual perceptions are not organized into an understandable pattern, the person in whom they occur remains confused, uncertain of his reality. Unless they are aided in this process by people familiar with the drug experience they can spend many hours in very uncomfortable circumstances. Because of this fact, LSD has most frequently been described as a psychotomimetic or hallucinogenic drug.

It undoubtly does have this potential. However, when an individual who takes the drug is offered support and guidance in the experience by people who have already established order and organization to the unhabitual perceptions, he is usually able to do so himself in a short time. Such organized unhabitual perception makes up the so called psychedelic experience which offers marked therapeutic possibilities.

In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area of reality worthy of exploration. They might be termed stabilized experiences in that the distressing effects of the drug tend to be minimized and the individual is enabled to gain remarkably in terms of increased insight and self-understanding.

There are the levels at which the therapeutic possibilities of the drug are most fully realized. These types of experience are closely related and while the difference between them may not actually seem great enough to merit their separate considerations, the levels of stabilization which they represent differ so markedly that they have both been outlined.

5. The fifth type of reaction is one in which the effects experienced are accepted as comprising a separate but equally real and valid reality to which the drug gains one entry. The person accepts as genuine his apparently enhanced intellectual capacity and his ability to empathize with and to appreciate, accept and understand others. His thinking may be somewhat disrupted by a frequent involvement in what Levey (23) has termed the dilemma of alternates. This is a sort of parallel awareness of opposites which impeded the usual flow of thought. The subject may also find himself increasingly aware that he is thinking analogically; that there is a tendency to extend logical classification beyond the usual bounds and that his perception increasingly tends toward the breakdown or subdivision of usual gestalts.

In this state the person is keenly aware of the possibility of slipping into a psychotic state for madness appears an ever-present possibility and he feels that he is walking a razor's edge, gaining slowly in confidence as he goes.

6. In the sixth type of reaction the experience is accepted as offering a new and richer interpretation of all aspects of reality. The person feels strongly that there is a unifying principle underlying all things, an essence with which he feels in complete accord. He may feel that he is a part of all things and all things are a part of him. His self-concept is in no way limited by the usual restraints of body image. These feelings or beliefs are accompanied by feelings of reality so intense that conviction is inevitable. William James in writing of such intense feelings of reality states, "they are as convincing to those who have them as any direct sensible experience can be, and they are, as a rule, much more convincing than results established by mere logic ever are".

At this level of experience no doubts remain as to the reality and usefulness of the experience and the individual, freed from this concern feels no possibility of unpleasant or psychotic features developing. Once this level is attained it is doubtful if any manipulation of the environment could induce a psychotic state in the experience.

Some may feel that the individual has already, by accepting the experience as reality, fallen into a delusional or psychotic state and, indeed, there is no ready criterion to determine whether or not this is actually the case. The only method of accessing this possibility seems to be that of "By their fruits ye shall know them".

These brief notes upon the nature of the experience are in no way complete. No individual reaction will fit neatly into the categories outlined. There will be frequent overlapping of levels and in some cases little or none of the experience may accord with the reactions outlined above. The classification is intended only as rough chart of a largely unknown area rather than as a detailed guide.

More exact mapping of the area will attend the observations of many therapists over a number of treatment sessions. However, we believe the present classification to be useful, chiefly as an indication that although the LSD-25 or mescaline induced experience is vast and rapidly shifting, communalities in the experience may be catalogued in a way that will eventually offer a sounder scientific understanding of this area of experience.

INDIVIDUAL REACTIONS

There is much individual variation in regard to the levels of experience attained. Most people pass though a phase in which they struggle against the effects if the drug and a period in which they try to explain the effects themselves. Only individuals seem to attain the psychedelic level rapidly in the first experience and, if they lapse at all into denial, confusion or paranoid thinking, do so but briefly and infrequently. Still other individuals may spend as much as a half a dozen sessions being frightened or ill or paranoid or otherwise distressed before they attain the psychedelic experience. The methods utilized by the therapist play a critical part in determining both the level which subject can attain and the disease with which it is accomplished.

CHAPTER 3 - THE DEVELOPMENT OF TREATMENT METHODS
LSD-25 was first isolated by Hoffman and Stoll in 1938. It is a synthetic derivative of lysergic acid of the ergonovine group. This group of drugs is derived from the ergot fungus which grows on rye and several members of the group have been used in medicine for several years. In the 1940's the effect of LSD-25 on smooth muscle contraction was being studied an assessed against the effect of other ergonovine derivatives. The psychological effects attendant upon its ingestion were discovered by accident when Hoffman happened to swallow a minute quantity from a pipette.

Hoffman and Stoll (48) first reported some of the psychological properties of the drug in 1949 and pointed out that it could reproduce most of the major symptoms of schizophrenia when taken in extremely minute quantities. They did not, however, discuss the extreme variability of the reaction which seems to alter as a function of the surroundings.

Following their report the drug came to be regarded as something of a pharmaceutical curios but a great deal of work was begun and many reports were published on its ability to induce, for a period of hours, major symptoms of psychosis. It should be stressed at this point that the drug does not necessarily produce a psychotic reaction and when it is given in a therapeutic setting rarely is there much psychotic manifestation.

It was not however until 1950 that the drug was reported on as a therapeutic agent in a study by Busch and Johnson (10). They cited the usefulness of the drug in permitting extensive recall and abreaction and in producing an enhancement of insight.

In 1953 Katzenelbogen and Fang (30) published a report dealing with the use of small doses of LSD as an aid in interviewing. They reported that the drug induced a greater ventilation of emotion in schizophrenics than was produced with amytal or with methedrine.

In 1954 Sandison (43) published an account of his work in which he employed varying dosages with chronic neurotic mental hospital patients.

In 1955 Frederking (18) outlined a method in which he used mescaline and LSD-25 as adjuncts to psychoanalytic therapy.

Abramson's group subsequent to 1955 have published a number of papers dealing with the LSD reaction (1), (2), (3). Therapeutically they employ the drug in a modified psychoanalytic approach utilizing small doses in a series of interviews.

The literature on the use of the drug in various areas of study has mushroomed remarkably. Several hundred articles are now available on the drug and bibliographies have been prepared by Certelli (12), by the Sandoz Company (44) and by Caldwell (11).

In the main, reports dealing with LSD as a therapeutic instrument, cover such aspects as the effect of LSD on memory, as a catalyst to ventilation and a s an aid in the development of transference, particularly through the reduction of various areas of resistance.

Therapeutically, however, we believe that the great potential of a psychedelic drug lies in its capacity to permit the subject to achieve a remarkable degree of insight and self-understanding. While the drug does permit a review of those repressed or suppressed areas which are the wellsprings of unacceptable behavior, these effects are but the seeds of its full growing. Vastly more important is the new level of identity at which the individual can arrive. He learns that he can be truly himself, perhaps for the first time in his life, and sham and pretense become unnecessary to him. He finds that he can control his own feelings independent of his circumstances or surroundings, a knowledge that frees him from fear and uncertainty of himself or of others. He learns that to him, the world is what he feels it to be. Abraham Lincoln made this point when he said: "A man is just as happy as he makes up his mind to be".

For this reason, the method outlined in detail in this manual is one aimed at the realization of this level of self-understanding. This method grew out of the early work of Hubbard (24). Since 1954 Hubbard has been studying the therapeutic use of the drug and has dealt with a very large number of subjects.

The LSD experience is so vast, so shifting and so unusual that without some specific techniques, it is virtually impossible to contain and control it is as a therapeutic procedure. In the course of his work Hubbard evolved techniques which give structure to the experience. Among these were the introduction of the idea of using music, paintings and various other stimuli to initiate and illustrate various trains of thought which frequently occur in the experience. His work, which demonstrated the usefulness of the psychedelic aspects of the experience, showed that it was not necessary for the subject toe develop a psychotomimetic reaction even when large doses of the drug were used.

Therapists found that the ingestion of dosages of 75 gamma or more created perceptual changes and other alterations which provoked extreme anxiety in the subject. Hubbard (24) indicated how to avoid this disruptive feature by training his subjects to be able to relax in the face of the loss of control of physiology and awareness precipitated by breathing CO2. This capacity to remain relaxed and unconcerned by the early symptoms of LSD, permits the use of large doses without the arousal of intense anxiety.

Hubbard went beyond this, structuring the situation such that the subject was provided with a new framework into which the experience fitted. His method employed a religious setting involving religious themes in pictures and music and a general stressing of the spiritual aspects of the experience. In these terms the experience was understandable to the subjects for, with the exception of the psychotic changes, each of the features, outlined by Chwelos (13) and quoted earlier in this report, can be fitted into this pattern.

One of the unfortunate procedures which has been widely used to prevent the arousal of anxiety in the LSD session is the system of beginning with a small dose and gradually increasing the amount given over a succession of experiences. This procedure is used to reduce anxiety. It is reasoned that as the drug effect is being sampled a bit at a time, it will at no time become so overwhelming as to induce distress. Unfortunately, such a procedure is unlikely to be rewarding. Small dosages, when they produce any reaction, are unlikely to induce confusion and psychotomimetic features. When they provoke little or not reaction, the procedure drastically reduced the therapeutic effect of the drug. Psychotomimetic features tend to appear at that point in the experience at which the individual's accustomed concept of himself and the world about him-the frame of reference which constitutes hi ties with reality-is becoming no longer tenable in the face of the habitual perceptions induced by the drug. When the drug effect is sufficiently pronounced, the accustomed frame of reference is overwhelmed. In the process of having his accustomed attitudes and sets demolished and of finding a stability in experience outside this psychological framework, the individual finds he has acquired a new outlook. In instances in which the drug effect is insufficient, the individual is left in a state in which he has a very tenuous hold on the reality ties represented by his accustomed concepts and yet is unable to structure or accept the unhabitual perceptions and concepts which the experience has engendered. This confusing, painful and often frightening state constitutes a psychotomimetic experience.

When small dose techniques are employed, the individual, by learning through gradually increased effort, as the dosage is increased from experience to experience, may well develop methods of controlling the effects of the drug according to his accustomed pattern of thinking. He may never come to the point of accepting and utilizing the alterations which the drug may make in the mould of feeling and thinking which initially induced his difficulties.

While this objection may be felt to be simply a play with words, it is a very serious one. True, the individual eventually learns, in a stabilized experience, to control and use the drug effects. However, this is a control based upon a new level of self-understanding and self-acceptance which alone can permit the acceptance of others. Unless this level of experience can be attained the therapeutic potential of the drug is not realized. If the person learns gradually to fit the drug effects into his accustomed self-concept, he is simply learning how to pigeon-hole the experience within an unaltered frame of reference. It is, in fact, the acquisition of the ability to remain unchanged. Not only is such a procedure unlikely to have any therapeutic effect but it tends to immunize against his ever being able to gain self-understanding through the psychedelic experience.

As Osmond (40) has stated "our work started with the idea that a single overwhelming experience might be beneficial in alcoholics, the idea springing from James (27) and Tiebout (48)". We have discovered no reason to alter this view as regards the usefulness of the overwhelming experience. However, subsequent work has shown that is often of great value to repeat the experience and has suggested that the method is applicable to the treatment of the neuroses and psychopathy as well as alcoholism.

We feel that it is extremely important that the therapist have a clear understanding of the effects of the drug. This can only be gained by taking the drug one's self. Osmond's (40) golden rule in work with model psychoses "you start with yourself" is even more applicable in work utilizing the psychedelic experience as therapeutic. By gaining this first hand experience the therapist will become much more effective in dealing with subjects during the experience and in aiding them in fitting the insights gained during the experience into their daily lives. Indeed, it is well to have as many as possible of the staff members who will come in contact with the patient similarly trained.

CHAPTER 4 - INDIVIDUAL AND GROUP METHODS
We have utilized both individual and group techniques of administration, and have been able to make fairly extensive investigation of their relative therapeutic efficacy as well as their relative usefulness in other areas of investigation.

In the individual method the subject is given the drug and the therapist, often with one or more staff, stays with him throughout the experience. In the group method one or two therapists and possibly other subjects also take the drug. In such group sessions it is unwise to have more than one person in the group who is taking LSD for the first time and the others should ideally be quite experienced.

In the individual session the subject is more on his own. The therapist should have a good knowledge of what to expect from the LSD experience for this will add an empathic sensitivity on the part of the therapist which is invaluable in this procedure. Being "alone" in the experience, the subject is less distracted from self-analysis and may therefore arrive at a more complete self-understanding. When one takes the drug alone it is more difficult to communicate with other people partly because one's awareness is increased beyond the level of the staff. When one becomes so aware of what is going on in other people, he tends to think that the increased awareness and empathic communication is shared by the staff and feels little need for communication by the usual channels of verbalization. Because of this difference of awareness, there is a relative increase in psychological distance between subject and staff. This problem is not at all insoluable in that empathic sensitivity on the part of the therapist and occasional reminds to the subject that his awareness is expanded beyond that of the others tends to bridge the gap considerably. Indeed the problem is a relative one in that the intensified feelings of the subject make it much easier than usual to empathize with him.

Because the subject begins to feel somewhat unique due to his expanded awareness, there is some danger that grandiosity may develop. It is worthwhile to remind the subject that everyone has the same potential which is brought out by the drug.

One of the main disadvantages then of the individual procedure is the difficulty in following the subject closely enough through his experience. Provided the therapist has an accepting but not sympathetic attitude there is little if any danger of the subject getting into any serious difficulty because of this difficulty in communication. The individual session has the advantage that less staff time is used. Individual sessions tend to last a shorter period and the subject can be sent back to the ward after 7-8 hours, whereas, in the case of group sessions, 12-14 hours may be occupied. In individual sessions, the staff involved are not in any way incapacitated from doing other things during or immediately after the session if the need arises, though they should try as much as possible to avoid distractions.

The subject, in an individual session, feels less encroached upon and is more likely to investigate painful areas than he is in a group session where he is aware that the staff can follow his feeling tone to a very high degree.

Indeed, one major disadvantage of using the group method for the subjects first experience is the alarm frequently precipitated in the patient when he realizes the degree to which the therapists are able to identify and communicate with him non-verbally. This relationship is so close that the patient begins to misinterpret feelings as thought and comes to believe that the therapists can read all his thoughts. Because of this, feelings of inadequacy and guilt frequently lead him rapidly to withdrawal and paranoid thinking. Also the subject is to some extent frightened away from the investigation of problem areas out of the fear of exposing hidden areas to others. This difficulty poses much less of a problem, however, to a subject who has had an individual session and has worked through his main problem areas or to the person whose problems are not marked.

Another difficulty in the extensive use of group sessions is the frequency with which the therapist must use the drug. Further when two therapists are involved, staff time becomes a major consideration. It has been stated that tolerance for LSD builds up quite rapidly but even when we have run group sessions as frequent as three times a week this has not appeared to be a problem and the therapists have been able to work in close empathy with the subject on doses as low as 25 gamma on the third day of such series.

Much more extensive work must be done on the investigation of tolerance in terms of the psychological effects of the drug. There is much to suggest that these effects are much altered in group settings by the impact of the drug on other individuals in the group. These effects cannot simply be brushed aside as suggestion or as a placebo reaction where tolerance has been established. Their effect upon the level of empathy, their duration within a session, their intensity and their persistence from occasion to occasion and their absence when the drug is not ingested, indicate that they are not likely to be the products of suggestion.

Frequently, the question of addiction is brought up in connection with therapists who repeatedly use the drug. We have seen no evidence either in the literature or in our own work to suggest any addictive potential. Further, we find that people using the drug frequently find that tolerance is opposite to that found in addiction. With experience, the subject can reach the same level with smaller and smaller doses as he learns to break down his resistance psychologically. Also the effects of the drug are not pleasant in themselves. Subjects have pleasant experiences only if they work through their problem areas and are able to stabilize the experience by reaching a fairly high level of self-understanding and self-acceptance.

Further, whereas in addiction the subject is striving to reach some form of escape from, or oblivion toward his personality difficulties, in the case of LSD these are brought into sharp focus and are exaggerated to painful proportions until the subject works them through.

Some critics who have never tried the experience have called it an escape into transcendental experience. If this could be termed an escape then all forms of yielding to the desire to learn could equally well be classified as escapes. This would appear to be taking the concept of escape to ridiculous extremes.

In view of the difficulties cited, it may appear that group sessions are difficult and unnecessary. However, the group method does have many remarkable advantages. It offers the subject and opportunity to understand himself in terms of how he relates to others. It permits him, when more than one therapist is involved to see objectively from extremely close range, in terms of understanding, how other people relate to each other. It shows the subjects how his views of the world accords with, and differs from, the views of others. It lets him understand that each person's frame of reference, although peculiarly the person's own (and therefore different from any other view) is nevertheless as valid as his own. Further, the group method fosters a ready transfer of training and knowledge from the LSD experience into day to day living.

Most important, however, would seem to be the great value of the group experience in staff training and particularly in research. The research aspects of working with the psychedelic drugs deserves particular mention and is spelled out more fully in the following chapter.

Therapeutic trials with groups of various sizes have been carried out at various centres in Saskatchewan. This work has suggested that the number in the group is a variable of marked importance.

In therapy a group of three, perhaps because of its particular instability, seems most useful. In a group of two, there is a continuous pressure to relate to the same person. It is impossible to withdraw from this relationship and the intimacy of the empathic bond may be disturbing. Any note of suspicion or hostility is excessively disruptive and its effect tends to be prolonged.

By comparison, in the three groups one can, to some extent, withdraw from the others from time to time, leaving them to relate to each other. The possibility of shifting from relationship to relationship makes it easier to learn gradually to accept the group members completely. Temporary feelings of hostility, anger or suspicion are much less destructive of the empathic bond in this situation and are much more quickly overcome.

The four group is much more complex than the three group and the establishment of the empathic bond is much more difficult since the addition of the fourth participant has doubled the number of relationships involved. This group size appears to lead to a high level of intellectual stimulation and to excellent and rewarding discussion. However, the participants do not readily develop the same high level of empathy as is found in the three group. Frequently the empathic bond is established more completely within pairs than between pairs. It commonly happens too that one individual is not able to accept the others readily and a group of three is formed from which the fourth feels excluded. pmThis makes it still more difficult for him to integrate.

Our knowledge of group relationships in drug sessions involving more than four persons is extremely limited. What we do know is drawn from a few five and six group experiences and from the peyote experiences of the Native American Church. Research in this area of group psychedelic experience will be so interesting and rewarding that it will no doubt gain momentum rapidly.

In considering the staff time involved in group therapeutic sessions it should be recognized that aside from pre-treatment interviewing the treatment is completed in one day. If the subject is to have two sessions they are usually several months apart. Even where two group session are used, such a treatment program could be likely to consume something less than 30 hours of staff working time per patient. If the treatment were not more effective than any other this would correspond to something less than 25 ordinary treatment interviews, allowing time for recording the sessions. Considering the difficult nature of the cases handled, this in no way seems excessive. Also it must be taken into account that nursing time and secretarial work are reduced to an absolute minimum and hospitalization, in the case of in-patients, is remarkably shortened.

There is little doubt that both individual and group experience have much to offer and the therapist could consider giving both experience to each subject. There has been much discussion but no research upon the order in which these experiences should be undergone. Priority must therefore be assigned on the basis of clinical judgment. It is the authors point of view that, in general, it is advisable to have the individual experience first. The subject is less likely to become alarmed and withdrawn and he is more likely to persevere at investigating painful and unacceptable areas for the therapist, to inadvertently "help" too much and help the subject stabilize the experience without working though his difficulties.

The individual session is so called because the subject alone takes the drug. However, this technique may involve a group. Hubbard (24) uses a method in which a group is selected to sit in on the session. The group lends support to the therapist as a well and permits him greater freedom and more relaxation. When this technique is used the subject should have met each group member previously and should know which people will be present at the session. Such group members should have had experience with the drug. The numbers in such a group should probably not exceed four including the therapist. When the group becomes large the subject tends to feel like the lead player in a public execution.

The method which has been outlined below may be adapted to either individual or group procedures. Although the empathic bond is less obvious in the individual session, the role of the therapist remains very much the same.

CHAPTER 5 - RESEARCH IMPLICATIONS
The experiences induced by LSD and mescalin are opening vast new areas to the research and while such considerations may be felt to have only indirect bearing upon therapy, they should not be passed over.

It is the view of the authors that the psychedelic drugs present the most potent tools for psychological research which have yet been discovered. Research possibilities range from simple perceptual experiments to highly complex empathic studies. The research value of the psychedelics stems from two major aspects of the experience which they induce.

Firstly, when the experimenter takes the drug, he becomes aware of his own awareness. He becomes a witness to his own emotions, his own intellectual processes, and his own activity. He can examine the articulation of each of these upon the others and observe their relationship to his perception. Indeed, he can observe concept formation and learning going on from the inside.

Secondly, when a group of investigators take the drug at the same time, they develop a closeness of relationship in terms of feeling which verges upon the telepathic. Thus scientists can develop shared introspection and can begin to evolve research techniques which will permit the comparison of emotional states-the measurement of emotion.

Experimentation and study in these areas offer the hope that eventually they may permit a signal advance in psychological understanding. Early introspectionists were unable to provide shareable information as a basis for scientific inquiry. Only through limiting investigation to the behavior of organisms have we been able to arrive at some level of objectivity and shareability of results. Such an approach, however, confines psychology to the observation of activity and to a concept of man as the sum of his activity.

Psychedelic research promises eventually to permit the investigator to get beyond the behavioral manifestations and into the area of the underlying motivation.

One source of error in framing research in this area should be pointed out. The investigator should not try to study the drug effect in subjects until they have taken the drug a half dozen times before he is used as a research subject. There is a basic confusion of purposes when one attempts to determine the drug effect upon various tasks during the first session. The administration of tests completely alters the experience in early sessions. What is assessed is the degree of confusion in a subject whose reality ties are loosened by the drug and further altered by the testing. The test administration and indeed the research set up in which he is a guinea-pig may alter the entire nature of perceptions. Almost universally, results obtained from testing under such circumstances will show decreased efficiency of one kind or another and there is no method of sorting extraneous situational effects from drug effects as such.

However, once the subject has learned and practiced how to stabilize the experience, testing could be expected to reveal the extent of such phenomena as perceptual enhancement and empathic sensitization. It becomes a challenge to the researcher to seek out and classify the variables involved and to devise tests which will yield valid and, if possible, quantifiable measure of them.

An outline of various areas in which research seem indicated is presented in Appendix C.

CHAPTER 6 - THE SETTING
The setting in which the treatment session is to be conducted must be comfortable and quiet. Frequently the subject may feel like lying down. It is best to provide enough chesterfields, cots or beds so that each person who has had the drug has a place to stretch out comfortable.

The place should be quiet, not only as far as the general noise level is concerned but particularly in terms of interruptions of intrusions of the outside world upon the experience. Worries about getting home for supper or getting certain work done are disruptive and all such interference should be reduced as much as possible. People coming into the room can cause the subject to become upset, particularly from the second to the eighth hour after he has taken the drug. If a group is to be used, all members should be present when the experience begins. Other intrusions should be present when the experience begins. Other intrusions should be kept to a minimum. This is more difficult than it at first appears because LSD therapy usually catches the imagination and provokes the curiosity of nearly all the staff members of the unit involved. Many people will find excellent reasons to be in and out of the treatment room unless the policy of no visitors is established.

The telephone too can be exceptionally disturbing. It is often the greatest nuisance in a session. If the telephone is in the treatment room, the noise of its ringing is a bother but no matter where it is, it is troublesome for the person called, whether or not he has taken the drug, to completely alter his frame of reference such that he can conduct a normal telephone conversation. As much as possible, telephone calls should be held up.

At times, particularly in individual sessions, the subject may become extremely restless or violent. At the height of this disturbed state he is apt to knock or throw things about. For this reason it is wise to use fairly durable furnishings.

Washroom facilities should be relatively near by. It is often a severe strain on the subject to have to walk through a ward or indeed to walk any distance under the effect of the drug. Also, in subjects who become paranoid, the trip to the washroom offers opportunity for them to attempt to get away from the session.

CHAPTER 7 - EQUIPMENT
A record player and a dozen or so recordings of classical selections covering a variety of moods are so useful as to virtually essential. Music is an important feature in permitting the person to get outside his usual self-concept.

Other useful equipment includes paintings, photographs of the subject's relatives, collections of photographs such as the Family of Man series, flowers and gems. A mirror is particularly useful. The subject often can use his reflection in the mirror more objectively than himself and can frequently clarity many aspects of his own self-concept by studying his reflection though it is unwise to present the subject with the mirror until he has worked through the more frightening stages of self-appraisal and has gained at least some degree of self-acceptance. For this reason the mirror should not be mounted on the wall.

Frequently one of the side effects of the drug is a sensation of dryness in the mouth and throat. The people in the experience may feel more than usually thirsty and it is well to have a quantity of fruit juices on hand. The participants may at times feel quite fatigued and may find chocolate or other candy a ready source of additional energy. Fresh fruit provides a light food which is easy to eat and keeps one from becoming excessively hungry during the day.

Niacin is useful in bringing a person out of the experience although this should only be done in case of some emergency which necessitates the subject's leaving the experience. A dose of 400-600 mgms. intravenously should be adequate to terminate the experience. Unpleasant phases of the experience should not lead to its termination as they most frequently indicate that the person is working through some troublesome problem-often a necessary and beneficial process leading to emotional growth.

After the session the subject may find difficulty in going to sleep although he feels quite tired. For this reason it may be considered wise to give him a sedative which he can use if he so desires.

CHAPTER 8 - INDICATIONS AND CONTRA-INDICATIONS
Because of the limited number of studies yet reported, there are many blank areas in current knowledge as to the relative usefulness of LSD in various psychiatric disorders. Much of the work which has been done to date has employed as subjects normal volunteers and staff members who were seeking training. The majority of studies have involved experiments upon the subject. Those yield very little information about therapeutic effectiveness.

Most of the work done with the drug has involved subjects of superior intelligence. It is not known whether the drug can be usefully employed with people in the dull-normal, border-line or defective ranges.

The drug has been used in the main with people ranging in age from the early twenties to the sixties and very little is known about its effect upon younger age groups or upon older people. Hubbard has used the drug with people as young as 14 years of age with successful results. However, this work was restricted to very few cases and a great deal remains to be found out about the drug effect in people in their teens.

Our experience indicates that it is difficult to predict, for any individual, what his response to the drug will be. In general, the greater the degree of insecurity the more difficult it is for the subject to relinquish his defenses and his intellectual control. Failure to do so will lead to tension, illness or paranoid reactions. However, this is not always an easy matter to judge. For this reason only very rough rules of thumb can be suggested as regards indications or contra-indic

Lue lisää

Vähän aiheen vierestä mutta itselläni psykedeelit (sienet) auttavat masennukseen ja vaativaan persoonallisuuteen todella hyvin. Tripin jälkeen on kuukausia helvetin hyvä olo.

LSD:tä on hankalampi suomesta saada. LSD:nä myytävät laput ovat suurimmaksi osaks jotain tutkimuskemikaalilappuja esim. bromo-dragonfly joka eroaa LSD:stä kemialliselta rakenteeltaan vaikutus kestää jopa 30h kun LSD vain n.12h.

Siispä suosittelen käyttämään nuppilääkkeenä suomestakin löytyviä psilosybiiniä sisältäviä sieniä. Sienet ovat vaikutuksiltaan erittäin lähellä LSD:tä (samat terapeuttiset ominaisuudet myös), mutta tripin kesto on lyhyempi.
Itsekään en ole oikeaa LSD:tä päässyt kokeilemaan mutta sienillä mennään! tutkimuskemikaalilaput kannattaa jättää melkein kokeilematta.

Kakkulaq kirjoitti:

Ja tässä ohjeet.

http://www.maps.org/ritesofpassage/lsdhandbook.html

Handbook for the Therapeutic Use of LSD-25

HANDBOOK FOR THE THERAPEUTIC USE OF LYSERGIC ACID DIETHYLAMIDE-25
INDIVIDUAL AND GROUP PROCEDURES

1959 - D.B. BLEWETT, Ph.D. & N. CHWELOS, M.D.

OCR by MAPS, Edits by Erowid

In the 1950s and 1960s, mimeograph copies of the following Handbook were shared among pioneering therapists exploring the therapeutic utility of LSD. To this day, it remains one of the most relevant documented explorations of the guided psychedelic session.
CLICK TO VIEW A PDF VERSION
TABLE OF CONTENTS

* Acknowledgements
* Preface

1. Psychiatric Rationale
2. The Nature of the Drug Reaction
3. The Development of Treatment Methods
4. Individual and Group Methods
5. Research Implications
6. The Setting
7. Equipment
8. Indications and Contra Indications
9. The Preparation of the Subject
10. General Considerations Regarding Procedure
11. Dosage
12. Administration
13. Stages in the Experience:
I. Pre-Onset
14. II. Onset of Symptoms
15. III. Self Examination
16. IV. The Empathic Bond
17. V. Discussion
18. Diminishment of Symptoms
19. The Meal
20. Termination of Session
21. After Contact with the Subject
22. Assessment of the Experience

* Appendix A : Assessment Scales I and II
* Appendix B : Results to Date
* Appendix C : Proposals for Psychedelic Research

Review of this Handbook, by Myron Stolaroff
References
PDF Scan of the document (400KB)

ACKNOWLEDGEMENTS
It will be obvious to the careful reader but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer. Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Cambell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. McLean, Dr. T. Weckowicz, Mr. F.E.A. Ewald, Mr. G. Marsh, Mr.R. Thelander and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy..

PREFACE
It will be evident to the reader that the authors have not attempted to deal with the material presented within a theoretical system.

The experience described and utilized in therapy represents so remarkable an extension of common experience that an eclectic approach has seemed mandatory.

The clinician may feel that the depersonalization and rapport which develop in the experience are of prime significance. The experimentalist may see the induction of marked inconstancy of perception or the inconstancy of the sense of time in particular as the important aspect of the experience. In any case, clinician and experimentalist alike will find much of value and of interest in studying the drug effect.

It will be obvious to the careful reader, but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.

The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer.

Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Campbell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy.

CHAPTER 1 - PSYCHIATRIC RATIONALE
THE FRAME OF REFERENCE

In the broadest terms there are, at present, two main philosophies of psychotherapy. One of these, based upon the concept of "adjustment" sees as the goal of treatment a happy and comfortable acceptance by the patient of the norms of his society. The other concept sees as the goal of therapy the maximal realization of the individual potential, the flowering as it were, of the personality.

In considering the therapeutic merits of LSD-25, one can scarcely fail to pose such problems as how the drug can contribute to the therapeutic process, how its use affects the therapeutic process, how its use affects the therapist-client relationship, or how its effects seem to relate to various aspects of psychological and psychiatric theory.

Under present day conditions the therapist, though desiring to lead the patient toward full self-realization, almost invariably finds that pressures of time and convention force him to work toward the goal of adjustment more or less to the exclusion of any but the most cursory consideration of those particular facets of the psyche which render each of his patients unique.

When therapy begins, the patient already possesses a complex of motives and mechanisms which have proven more or less inadequate and while the forms and techniques employed in treatment may vary widely, depending upon the theoretical outlook of the therapist, there is nevertheless an underlying process which is common to all psychotherapeutic progress. It might be summarized in the following steps:

1. The patient must realize that his present methods of behaving are inadequate and unsatisfying to him personally.
2. He must develop sufficiently strong motivation to carry him through the difficult and painful process of coming to understand and accept himself.
3. On the basis of this self-understanding, he must learn how to alter his

Behavior to satisfy the new pattern of motivation which has developed out of self-understanding.

The therapist cannot learn these things for the patient, just as the teacher cannot learn for the pupil. It is the role of the therapist, as it is of the teacher, so to structure the situation as to maximize the opportunities for learning. The expertise of the therapist lies essentially in his knowing how to structure the situation so as to fit best the personality of the patient and of himself and the environmental variables which seem of greatest relevance.

Many of the treatment methods in psychiatry have been derived and are currently utilized with a pragmatic disregard for theoretical considerations. This is true of the physical and chemical therapies generally. To the extent that they are regarded as adjuncts to psychotherapeutic treatment but because of their relatively rapid effect and the tremendous economy in terms of treatment time they are frequently used with minimal psychotherapeutic accompaniment.

These treatment methods might be classified in terms of the aim of the therapist. One group including electrotherapy, insulin therapy, psycho-surgery and narcotherapy, is utilized to make the patient more accessible to the therapist, that is to say to alter the patient so that he is better able to utilize the help which the therapist can offer through appropriate structuring of the therapeutic situation. The other group would include such methods as hypnosis, amytal and pentothal, and CO2. Here the aim is to help the patient overcome his reluctance to face himself as he really is-to hasten the learning process and east the pain involved in gaining greater self-understanding.

In these methods the main effect appears to be cathartic. Troubling material is brought up, resistances are reduced and the therapist, having become aware of the nature of the patient's highly emotionally charged experiences, can better structure the therapeutic situation to help the patient understand himself.

To a greater or lesser extent each of these methods permits the expression of emotions which were ordinarily suppressed, and the release of the dammed -up tide of emotional energy relieves the pressure under which the patient has been living. The release of repressed or suppressed, however, is likely to offer but temporary relief. Unless the pattern of values and motives which originally prevented the acceptance of those aspects of self which engendered the emotional potential are altered, the dam to emotional expression will remain and the pressure will again begin to increase.

The great value of LSD-25 lies in the fact that when the therapeutic situation is properly structured the patient can, and often does, within a period of hours, develop a level of self-understanding and self-acceptance which may surpass that of the average normal person. On the basis of this self-knowledge he can, with the therapist's help, clearly see the inadequacies in the value system which has underlain his previous behavior and can learn how to alter this in accordance with his altered understanding.

So sweeping a claim must, upon first reading, seem like nonsense but a growing number of people have come to accept it as undeniable fact. These are the people who have tried the drug on themselves and on their patients. They are convinced that within the next two or three decades LSD-25, will be by far the most common adjunct to psychotherapy. They feel too that since the psychedelic experience can lead to a very high level of self-understanding, and since self-understanding is the key without which the doors to interpersonal, intergroup or international understanding can not be opened, its use as a catalyst in the development of better human relations will become almost universal. To reject the views of this group as being too extreme without investigating the matter seems a remarkably unscientific attitude. The fact that those who have tried it feel that it offers astonishing possibilities would, in itself, seem to be sufficient reason for a thorough testing of the claims made.

While a certain amount is known about the drug at the present time, investigators have barely begun to explore its potential. Although our knowledge is as yet remarkably incomplete, the following is an attempt to outline the more important aspects of the drug reaction and to outline what appear, at present, to be the most rewarding methods of using it in therapy.

The data from which these methods are derived are by no means extensive but the drug has repeatedly offered help where other methods had failed. It has been used in the most refractory cases, the most unpromising situations, and frequently has been employed only once in the case of an individual patient, yet it has proven surprisingly successful as such reports as those of Smith (45), Chwelos et al (13), Eisner and Cohen (16), and Abrahamson (1), (3) indicate.

CHAPTER 2 - NATURE OF THE DRUG REACTION

FEATURES OF THE EXPERIENCE

There are two reasons why the LSD experience does not lend itself readily to verbalization. Firstly, the sensory aspect of the experience is outside the bounds of the usual experience from which language has developed and for the description of which it is intended. Secondly, the experience is mainly in the sphere of emotions or feelings which are difficult to objectify or verbalize at the best of times.

Before attempting to draw any conclusions about the suggested value of LSD one would want to know something of the nature of the experience which the drug induces. Also, it is inevitable that effective methods of using the drug must be dictated by the nature of the experience.

Because of the difficulty in describing the experience in any but subjective terms, our knowledge of it has been built up bit by bit from personal LSD experience and through observations and reports of other individual and group experiences.

In reading accounts of the experience, one cannot fail to be struck by the fact that although there is tremendous variety in these reports there is a relatively consistent communality in certain areas of the experience. In an earlier report (13) we enumerated these commonly reported areas and illustrated them briefly with transcriptions from actual experiences as follows:

1. A feeling of being at one with the universe.
"I had finally understood by experience. The feeling of union with the cosmos."
2. Experience of being able to see oneself objectively or a feeling that one has two identities.
"If we had the gift to see ourselves as others see us, well, I did this morning. There seemed to be two of me and there seemed to be a conflict between these two."
3. Change in usual concept of self with concomitant change in perceived body.
"I had the feeling of leaving my body and drifting off into space. I had no worldly connections and felt as if I was only a spirit.
4. Change in perception of space and time
"I was looking deeply in the picture until the objects in the picture were beside me."
5. Enhancement in the sensory fields.
"The flower was a thing of inestimable beauty as was its scent. It quite transfixed me in essential contemplation, ecstasy and timelessness."
6. Changes in thinking an understanding so that the subject feels he develops a profound understanding in the field of philosophy or religion. Associations of ideas are much more rapid and clear and one tends to see many alternate solutions to each problem. There is a great tendency to think anologically.
"I found I was outside our bounds to space and time and had an understanding of infinity."
7. A wider range of emotions with rapid fluctuation.
"During this period I was swept by every conceivable variety of pleasant emotion from my own feeling of well-being through feelings of sublimity and grandeur to a sensation of ecstasy."
8. Increased sensitivity to the feelings of others.
"I was conscious of an extremely acute sense of awareness of perception of another's mood, almost thoughts. I likened it to the recognition of emotional atmosphere that the child or animal seems to have."
9. Psychotic changes. These include illusions and hallucinations, paranoid delusions of reference, influence, persecution and grandeur, thought disorder, perceptual distortion, severe anxiety an others which have been described in many reports on the psychotomimetic aspects of these drugs."

CHARACTERISTIC TYPES OF REACTION

These aspects of the experience tend to form various combinations and constellations which give rise to certain characteristic type of experience. It is important to attempt to identify and catalogue these since some such classification must form the basis for any scientific description or understanding of reaction patterns. The types of experience listed here have been found to be by far the most commonly occurring. They appear to be ranged along a continuum. Though the exact nature of this underlying variable is not clear, it does appear to be related to the individual's level of self-acceptance, which in turn, is closely related to the degree to which he is able to surrender his usual self-concept. To the extent that the postulated continuum does exist, these six types of responses might be regarded as various levels of such surrender.

Paradoxically the ability to abandon the established self-concept increases with self-acceptance and decreases with diminished self-regard. The person who does not accept himself fears the exposure of the unacceptable elements and struggles to maintain control in the face of the drug's effects.

Several of these levels are likely to occur within a single experience and a person may frequently move from one to another. However, the tendency is to move from the first two levels (in which the subject tries to deny that the drug has any psychological effect) though the 3rd and 4th levels (in which the attempt to explain and thus control the psychological effects leads to psychotic reactions) to the 5th and 6th levels (in which, having realized his inability to prevent, control, or explain the psychological effects within his usual frame of reference, the subject surrenders his habituated self-concept with its limitations, and accepts the psychedelic or mind-manifesting aspects of the reaction as real and useful).

ESCAPE REACTIONS

In the first two types of experience, the reaction is one of attempting to resist and escape from the effects of the drug.

1. The first type of experience might be called a flight into ideas or activity. The drug begins to disturb the individual's perceptions. He reacts against the effects of the drug by concentrating either upon concepts or things outside the self or upon some activity which can absorb his full attention. Any concept, such as, for example, abstract art, religious dogma, racial prejudice or unemployment may be seized upon and the person may devote his full attention to an elaboration to a variety of aspects of this concept while continuing to deny that the drug is having any effect upon him. In other cases, the individual may plunge into some particular activity-usually his own area of work, in which the familiarity of the activity lends reassurance and stability. He seeks to minimize the effect of the drug by this diversion and narrowing of interest.

He attempts, in this fashion, to control the emotional component of the experience and to minimize his awareness of any physiological or psychological change. He will report that nothing is happening. To an observer, it is evident that the individual is expending an amount of energy in his pursuit of the ideas he is considering; that he is excessively talkative and serious; that he grows progressively more irritable and intolerant of interruptions or questions and that, in many cases, he seems to be suffering from severe tension.

If, after the experience, the individual is asked to describe what happened, he is likely to state that little if anything occurred.

2. The second type of experience might be termed a flight into symptoms. This type of reaction seems to be correlated with an inability or unwillingness to direct one's attention to things outside oneself. When the drug begins to affect the individual, he tends to concentrate upon the physiological sensations. The strangeness of these becomes alarming to him and his alarm increases the physiological disturbances, altering his perception to a still greater awareness of bodily discomfort and malfunction. The individual may develop physiological symptoms of various kinds such as violent nausea; palpitations; feeling of constriction in the throat and chest; pain at the base of the skull; numbness of the limbs or violent headache. Sometimes he may express a fear of dying.

In this variety of experience, the individual will voice very frequent complaints about feeling unwell.

To an observer, he will seem to be extremely ill at ease and his nausea may lead to vomiting, although this is unusual.

Afterwards, when asked to describe his experience, the individual is likely to state that the drug's only effect is to make a person terribly sick.

In the first two types of experience, the self-concept is maintained despite the action of the drug. The individual is able to minimize the psychological effects of the drug by developing an idée fixe and by clinging desperately to it in a battle against the drug's effects.

The employment of small doses of the drug tends to contribute to the production of these types of experience. Little or no therapeutic benefit is derived from them, since the individual, by successfully fighting the drug's effects, succeeds in denying himself any possibility of therapeutic change.

Frequently such reactions develop early in an LSD experience as a result of pre-treatment apprehension. It is of particular importance that the therapist be aware of the possibility of the subject concentrating on the physical effects of the drug, for unless the subject's attention be diverted before the symptoms become oppressive, they can rapidly become so marked as to prevent the subject from being able to shift his attention.

PSYCHOTOMIMETIC REACTIONS

The next two varieties or levels of experience which are frequently observed are those which have given rise to the use of the terms hallucinogen and psychotomimetic agent in connection with LSD.

These states, offering as they do an opportunity to study the interior of certain psychotic conditions, have remarkable possibilities as staff training experiences. ON the other hand it is most unfortunate that so much stress has been placed upon these particular aspects of the LSD experience. Not only are they of limited therapeutic value, but, when regarded as the only levels attendant upon taking the drug, they cause the therapist who would otherwise be interested in its therapeutic possibilities to hesitate in including it among his treatment methods.

3. The third type of experience might be termed a confusional state. It is characterized by confused thinking and perceptual distortion. The individual attempts to rationalize what is happening to him but visual imagery and ideas flood into his awareness at so high a speed that he cannot keep up with them. He is like a person trying to listen to a foreign language with which he is only vaguely familiar. He rapidly falls behind and loses the context.

In this state the alterations in the various areas of perception become so overwhelming that they cannot be interpreted; the intellectual or rationalizing processes are swamped and the attempts to establish order fail. The subject is acutely aware of the confusion of visual and sometimes auditory perceptions which become a vast jumble, often frightening and unpleasant. This results in a state which would appear to be very much like an intensification of the schizophrenic breakdown, particularly as it occurs in catatonic and hebephrenic states.

4. The fourth type of experience is characterized mainly by paranoid thinking. It appears that in this type of response the individual reacts to the impact of the drug by rationalizing all of the aspects of the experience as being a function of the drug alone. All aspects of his perception appear to be enhanced or altered-music is felt physically; is heard with greater clarity and intensity and with new meaning; colors are brightened and seem more intense; patterns take on new significance; and an enhanced awareness of feelings of other is noticed. To a greater or lesser extent all of the senses may appear sharpened in their awareness. Smell, taste, texture, pain, temperature, and balance may also be sensed in a novel way.

The individual's thinking stresses the fact that his perceptions area altered by the drug. He mistrusts his own sense data and begins to question the validity and reality of everything he does and perceives. Thus, he interprets the state as delusional, implying that he is incapacitated and helpless. Further, we have previously mentioned that in the experience the subject seems to develop an acute sense of awareness of the feelings of other people. This is so unusual that the subject begins to misinterpret feeling as thought and believes that other people are becoming aware not only of his feelings, but of his thoughts as well. This feeling of empathic proximity seems to the subject to lay hare the unacceptable aspects of himself. He tries to hide his incapacities and imperfections from those around him. He feels that he is completely at their mercy and is uncertain as to whether or not he can trust them.

Ordinarily, small areas or phases of mistrust are not particularly important in interpersonal relations. In the experience, however, overwhelming feelings of inadequacy and inter-dependency tend to develop and the level of trust becomes an extremely important variable. In order to fully stabilize the experience at the psychedelic level, trust must be absolute. Huxley (26) has described this as "the willingness to be completely implicated". Osmond (41) in a personal communication points out " a minimal amount of trust is essential, how much we don't know but absolute trust is desirable and essential for using the psychedelic experience fully."

Inability on the part of the subject to accept others forces him to try to conceal both his present incapacity and those aspects of himself which he feels he cannot trust others to accept. Despite these efforts, he feels that those about him are aware of his weaknesses and his imperfections. When they act as though they were unaware of these things he feels that they are either toying with him or are too embarrassed to mention his difficulties. This feeling causes suspicion, referential thinking and a marked reduction of insight.

Occasionally, the subject reacts with aggression and hostility rather than withdrawal. In such cases there develops a grandiose contempt for the views or wishes of other people and a disregard for convention. This reaction may be characterized by such paranoid delusions as the feeling of being a God. The person may verbalize the idea that nothing matters any more. In some instances excitement may develop into manic-like behavior. We have found that such grandiose reactions are very rare, occurring not more than once in 50 cases. Their mention here is justified in part as a reassurance to the therapist, for although when they do occur, they tend to give way in a few hours to more amenable states, they can pose management problems. When this condition persists, beyond an hour the therapist should consider the administration of a booster dose of the drug. Although it would seem that increasing the drug dosage would simply add to the subjects discomfort, it does not do so. Rather, it helps him to extricate himself from the dilemma in which he finds himself.

These states tend to occur when the subject comes to a point in the experience at which he is aware of the short comings of his accustomed value system but finds the alternative values, growing out of the experience, unsatisfactory to him. In this situation he attempts to deny all value and may declare that nothing matters. Agitation and excitement may build up to a point at which some restraint is necessary. An additional dose of the drug permits him to assess old and new value systems much more objectively and he finds it much easier to accept what he finds in the process. As the subject begins to recover after an experience of this nature he may go through a phase of schizophrenic-like activity in which there may be markedly stereotyped behavior and the subject may seem to be completely unaware of the therapist. In cases we have observed, this phase lasts about an hour, after which the subject becomes completely rational and very calm and relaxed.

PSYCHEDELIC REACTIONS

The next two varieties or levels of experience are those referred to by the term psychedelic. A work of explanation seems necessary here to clarify our differentiation between psychotomimetic and psychedelic experience. We have used Osmond's (40) terms in this regard. He pointed out that the LSD experience can be broken into two categories-the psychedelic (mind manifesting) aspect during which the person learns only of the inside world of madness. He related the perceptual changes in the LSD experience to what William James has termed "unhabitual perception". James felt that the essence of genius lay in the ability to perceive the world in an unusual manner, i.e. with the absence of one's usual rigidity and Osmond (40) suggests that the ability to perceive the world in a new and unaccustomed manner permits the reorganization of one's system of values.

When a state of unhabitual perception comes upon one through disease process as in schizophrenia or when it is induced by LSD it can be a frightening and distressing experience. As long as the unhabitual perceptions are not organized into an understandable pattern, the person in whom they occur remains confused, uncertain of his reality. Unless they are aided in this process by people familiar with the drug experience they can spend many hours in very uncomfortable circumstances. Because of this fact, LSD has most frequently been described as a psychotomimetic or hallucinogenic drug.

It undoubtly does have this potential. However, when an individual who takes the drug is offered support and guidance in the experience by people who have already established order and organization to the unhabitual perceptions, he is usually able to do so himself in a short time. Such organized unhabitual perception makes up the so called psychedelic experience which offers marked therapeutic possibilities.

In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area of reality worthy of exploration. They might be termed stabilized experiences in that the distressing effects of the drug tend to be minimized and the individual is enabled to gain remarkably in terms of increased insight and self-understanding.

There are the levels at which the therapeutic possibilities of the drug are most fully realized. These types of experience are closely related and while the difference between them may not actually seem great enough to merit their separate considerations, the levels of stabilization which they represent differ so markedly that they have both been outlined.

5. The fifth type of reaction is one in which the effects experienced are accepted as comprising a separate but equally real and valid reality to which the drug gains one entry. The person accepts as genuine his apparently enhanced intellectual capacity and his ability to empathize with and to appreciate, accept and understand others. His thinking may be somewhat disrupted by a frequent involvement in what Levey (23) has termed the dilemma of alternates. This is a sort of parallel awareness of opposites which impeded the usual flow of thought. The subject may also find himself increasingly aware that he is thinking analogically; that there is a tendency to extend logical classification beyond the usual bounds and that his perception increasingly tends toward the breakdown or subdivision of usual gestalts.

In this state the person is keenly aware of the possibility of slipping into a psychotic state for madness appears an ever-present possibility and he feels that he is walking a razor's edge, gaining slowly in confidence as he goes.

6. In the sixth type of reaction the experience is accepted as offering a new and richer interpretation of all aspects of reality. The person feels strongly that there is a unifying principle underlying all things, an essence with which he feels in complete accord. He may feel that he is a part of all things and all things are a part of him. His self-concept is in no way limited by the usual restraints of body image. These feelings or beliefs are accompanied by feelings of reality so intense that conviction is inevitable. William James in writing of such intense feelings of reality states, "they are as convincing to those who have them as any direct sensible experience can be, and they are, as a rule, much more convincing than results established by mere logic ever are".

At this level of experience no doubts remain as to the reality and usefulness of the experience and the individual, freed from this concern feels no possibility of unpleasant or psychotic features developing. Once this level is attained it is doubtful if any manipulation of the environment could induce a psychotic state in the experience.

Some may feel that the individual has already, by accepting the experience as reality, fallen into a delusional or psychotic state and, indeed, there is no ready criterion to determine whether or not this is actually the case. The only method of accessing this possibility seems to be that of "By their fruits ye shall know them".

These brief notes upon the nature of the experience are in no way complete. No individual reaction will fit neatly into the categories outlined. There will be frequent overlapping of levels and in some cases little or none of the experience may accord with the reactions outlined above. The classification is intended only as rough chart of a largely unknown area rather than as a detailed guide.

More exact mapping of the area will attend the observations of many therapists over a number of treatment sessions. However, we believe the present classification to be useful, chiefly as an indication that although the LSD-25 or mescaline induced experience is vast and rapidly shifting, communalities in the experience may be catalogued in a way that will eventually offer a sounder scientific understanding of this area of experience.

INDIVIDUAL REACTIONS

There is much individual variation in regard to the levels of experience attained. Most people pass though a phase in which they struggle against the effects if the drug and a period in which they try to explain the effects themselves. Only individuals seem to attain the psychedelic level rapidly in the first experience and, if they lapse at all into denial, confusion or paranoid thinking, do so but briefly and infrequently. Still other individuals may spend as much as a half a dozen sessions being frightened or ill or paranoid or otherwise distressed before they attain the psychedelic experience. The methods utilized by the therapist play a critical part in determining both the level which subject can attain and the disease with which it is accomplished.

CHAPTER 3 - THE DEVELOPMENT OF TREATMENT METHODS
LSD-25 was first isolated by Hoffman and Stoll in 1938. It is a synthetic derivative of lysergic acid of the ergonovine group. This group of drugs is derived from the ergot fungus which grows on rye and several members of the group have been used in medicine for several years. In the 1940's the effect of LSD-25 on smooth muscle contraction was being studied an assessed against the effect of other ergonovine derivatives. The psychological effects attendant upon its ingestion were discovered by accident when Hoffman happened to swallow a minute quantity from a pipette.

Hoffman and Stoll (48) first reported some of the psychological properties of the drug in 1949 and pointed out that it could reproduce most of the major symptoms of schizophrenia when taken in extremely minute quantities. They did not, however, discuss the extreme variability of the reaction which seems to alter as a function of the surroundings.

Following their report the drug came to be regarded as something of a pharmaceutical curios but a great deal of work was begun and many reports were published on its ability to induce, for a period of hours, major symptoms of psychosis. It should be stressed at this point that the drug does not necessarily produce a psychotic reaction and when it is given in a therapeutic setting rarely is there much psychotic manifestation.

It was not however until 1950 that the drug was reported on as a therapeutic agent in a study by Busch and Johnson (10). They cited the usefulness of the drug in permitting extensive recall and abreaction and in producing an enhancement of insight.

In 1953 Katzenelbogen and Fang (30) published a report dealing with the use of small doses of LSD as an aid in interviewing. They reported that the drug induced a greater ventilation of emotion in schizophrenics than was produced with amytal or with methedrine.

In 1954 Sandison (43) published an account of his work in which he employed varying dosages with chronic neurotic mental hospital patients.

In 1955 Frederking (18) outlined a method in which he used mescaline and LSD-25 as adjuncts to psychoanalytic therapy.

Abramson's group subsequent to 1955 have published a number of papers dealing with the LSD reaction (1), (2), (3). Therapeutically they employ the drug in a modified psychoanalytic approach utilizing small doses in a series of interviews.

The literature on the use of the drug in various areas of study has mushroomed remarkably. Several hundred articles are now available on the drug and bibliographies have been prepared by Certelli (12), by the Sandoz Company (44) and by Caldwell (11).

In the main, reports dealing with LSD as a therapeutic instrument, cover such aspects as the effect of LSD on memory, as a catalyst to ventilation and a s an aid in the development of transference, particularly through the reduction of various areas of resistance.

Therapeutically, however, we believe that the great potential of a psychedelic drug lies in its capacity to permit the subject to achieve a remarkable degree of insight and self-understanding. While the drug does permit a review of those repressed or suppressed areas which are the wellsprings of unacceptable behavior, these effects are but the seeds of its full growing. Vastly more important is the new level of identity at which the individual can arrive. He learns that he can be truly himself, perhaps for the first time in his life, and sham and pretense become unnecessary to him. He finds that he can control his own feelings independent of his circumstances or surroundings, a knowledge that frees him from fear and uncertainty of himself or of others. He learns that to him, the world is what he feels it to be. Abraham Lincoln made this point when he said: "A man is just as happy as he makes up his mind to be".

For this reason, the method outlined in detail in this manual is one aimed at the realization of this level of self-understanding. This method grew out of the early work of Hubbard (24). Since 1954 Hubbard has been studying the therapeutic use of the drug and has dealt with a very large number of subjects.

The LSD experience is so vast, so shifting and so unusual that without some specific techniques, it is virtually impossible to contain and control it is as a therapeutic procedure. In the course of his work Hubbard evolved techniques which give structure to the experience. Among these were the introduction of the idea of using music, paintings and various other stimuli to initiate and illustrate various trains of thought which frequently occur in the experience. His work, which demonstrated the usefulness of the psychedelic aspects of the experience, showed that it was not necessary for the subject toe develop a psychotomimetic reaction even when large doses of the drug were used.

Therapists found that the ingestion of dosages of 75 gamma or more created perceptual changes and other alterations which provoked extreme anxiety in the subject. Hubbard (24) indicated how to avoid this disruptive feature by training his subjects to be able to relax in the face of the loss of control of physiology and awareness precipitated by breathing CO2. This capacity to remain relaxed and unconcerned by the early symptoms of LSD, permits the use of large doses without the arousal of intense anxiety.

Hubbard went beyond this, structuring the situation such that the subject was provided with a new framework into which the experience fitted. His method employed a religious setting involving religious themes in pictures and music and a general stressing of the spiritual aspects of the experience. In these terms the experience was understandable to the subjects for, with the exception of the psychotic changes, each of the features, outlined by Chwelos (13) and quoted earlier in this report, can be fitted into this pattern.

One of the unfortunate procedures which has been widely used to prevent the arousal of anxiety in the LSD session is the system of beginning with a small dose and gradually increasing the amount given over a succession of experiences. This procedure is used to reduce anxiety. It is reasoned that as the drug effect is being sampled a bit at a time, it will at no time become so overwhelming as to induce distress. Unfortunately, such a procedure is unlikely to be rewarding. Small dosages, when they produce any reaction, are unlikely to induce confusion and psychotomimetic features. When they provoke little or not reaction, the procedure drastically reduced the therapeutic effect of the drug. Psychotomimetic features tend to appear at that point in the experience at which the individual's accustomed concept of himself and the world about him-the frame of reference which constitutes hi ties with reality-is becoming no longer tenable in the face of the habitual perceptions induced by the drug. When the drug effect is sufficiently pronounced, the accustomed frame of reference is overwhelmed. In the process of having his accustomed attitudes and sets demolished and of finding a stability in experience outside this psychological framework, the individual finds he has acquired a new outlook. In instances in which the drug effect is insufficient, the individual is left in a state in which he has a very tenuous hold on the reality ties represented by his accustomed concepts and yet is unable to structure or accept the unhabitual perceptions and concepts which the experience has engendered. This confusing, painful and often frightening state constitutes a psychotomimetic experience.

When small dose techniques are employed, the individual, by learning through gradually increased effort, as the dosage is increased from experience to experience, may well develop methods of controlling the effects of the drug according to his accustomed pattern of thinking. He may never come to the point of accepting and utilizing the alterations which the drug may make in the mould of feeling and thinking which initially induced his difficulties.

While this objection may be felt to be simply a play with words, it is a very serious one. True, the individual eventually learns, in a stabilized experience, to control and use the drug effects. However, this is a control based upon a new level of self-understanding and self-acceptance which alone can permit the acceptance of others. Unless this level of experience can be attained the therapeutic potential of the drug is not realized. If the person learns gradually to fit the drug effects into his accustomed self-concept, he is simply learning how to pigeon-hole the experience within an unaltered frame of reference. It is, in fact, the acquisition of the ability to remain unchanged. Not only is such a procedure unlikely to have any therapeutic effect but it tends to immunize against his ever being able to gain self-understanding through the psychedelic experience.

As Osmond (40) has stated "our work started with the idea that a single overwhelming experience might be beneficial in alcoholics, the idea springing from James (27) and Tiebout (48)". We have discovered no reason to alter this view as regards the usefulness of the overwhelming experience. However, subsequent work has shown that is often of great value to repeat the experience and has suggested that the method is applicable to the treatment of the neuroses and psychopathy as well as alcoholism.

We feel that it is extremely important that the therapist have a clear understanding of the effects of the drug. This can only be gained by taking the drug one's self. Osmond's (40) golden rule in work with model psychoses "you start with yourself" is even more applicable in work utilizing the psychedelic experience as therapeutic. By gaining this first hand experience the therapist will become much more effective in dealing with subjects during the experience and in aiding them in fitting the insights gained during the experience into their daily lives. Indeed, it is well to have as many as possible of the staff members who will come in contact with the patient similarly trained.

CHAPTER 4 - INDIVIDUAL AND GROUP METHODS
We have utilized both individual and group techniques of administration, and have been able to make fairly extensive investigation of their relative therapeutic efficacy as well as their relative usefulness in other areas of investigation.

In the individual method the subject is given the drug and the therapist, often with one or more staff, stays with him throughout the experience. In the group method one or two therapists and possibly other subjects also take the drug. In such group sessions it is unwise to have more than one person in the group who is taking LSD for the first time and the others should ideally be quite experienced.

In the individual session the subject is more on his own. The therapist should have a good knowledge of what to expect from the LSD experience for this will add an empathic sensitivity on the part of the therapist which is invaluable in this procedure. Being "alone" in the experience, the subject is less distracted from self-analysis and may therefore arrive at a more complete self-understanding. When one takes the drug alone it is more difficult to communicate with other people partly because one's awareness is increased beyond the level of the staff. When one becomes so aware of what is going on in other people, he tends to think that the increased awareness and empathic communication is shared by the staff and feels little need for communication by the usual channels of verbalization. Because of this difference of awareness, there is a relative increase in psychological distance between subject and staff. This problem is not at all insoluable in that empathic sensitivity on the part of the therapist and occasional reminds to the subject that his awareness is expanded beyond that of the others tends to bridge the gap considerably. Indeed the problem is a relative one in that the intensified feelings of the subject make it much easier than usual to empathize with him.

Because the subject begins to feel somewhat unique due to his expanded awareness, there is some danger that grandiosity may develop. It is worthwhile to remind the subject that everyone has the same potential which is brought out by the drug.

One of the main disadvantages then of the individual procedure is the difficulty in following the subject closely enough through his experience. Provided the therapist has an accepting but not sympathetic attitude there is little if any danger of the subject getting into any serious difficulty because of this difficulty in communication. The individual session has the advantage that less staff time is used. Individual sessions tend to last a shorter period and the subject can be sent back to the ward after 7-8 hours, whereas, in the case of group sessions, 12-14 hours may be occupied. In individual sessions, the staff involved are not in any way incapacitated from doing other things during or immediately after the session if the need arises, though they should try as much as possible to avoid distractions.

The subject, in an individual session, feels less encroached upon and is more likely to investigate painful areas than he is in a group session where he is aware that the staff can follow his feeling tone to a very high degree.

Indeed, one major disadvantage of using the group method for the subjects first experience is the alarm frequently precipitated in the patient when he realizes the degree to which the therapists are able to identify and communicate with him non-verbally. This relationship is so close that the patient begins to misinterpret feelings as thought and comes to believe that the therapists can read all his thoughts. Because of this, feelings of inadequacy and guilt frequently lead him rapidly to withdrawal and paranoid thinking. Also the subject is to some extent frightened away from the investigation of problem areas out of the fear of exposing hidden areas to others. This difficulty poses much less of a problem, however, to a subject who has had an individual session and has worked through his main problem areas or to the person whose problems are not marked.

Another difficulty in the extensive use of group sessions is the frequency with which the therapist must use the drug. Further when two therapists are involved, staff time becomes a major consideration. It has been stated that tolerance for LSD builds up quite rapidly but even when we have run group sessions as frequent as three times a week this has not appeared to be a problem and the therapists have been able to work in close empathy with the subject on doses as low as 25 gamma on the third day of such series.

Much more extensive work must be done on the investigation of tolerance in terms of the psychological effects of the drug. There is much to suggest that these effects are much altered in group settings by the impact of the drug on other individuals in the group. These effects cannot simply be brushed aside as suggestion or as a placebo reaction where tolerance has been established. Their effect upon the level of empathy, their duration within a session, their intensity and their persistence from occasion to occasion and their absence when the drug is not ingested, indicate that they are not likely to be the products of suggestion.

Frequently, the question of addiction is brought up in connection with therapists who repeatedly use the drug. We have seen no evidence either in the literature or in our own work to suggest any addictive potential. Further, we find that people using the drug frequently find that tolerance is opposite to that found in addiction. With experience, the subject can reach the same level with smaller and smaller doses as he learns to break down his resistance psychologically. Also the effects of the drug are not pleasant in themselves. Subjects have pleasant experiences only if they work through their problem areas and are able to stabilize the experience by reaching a fairly high level of self-understanding and self-acceptance.

Further, whereas in addiction the subject is striving to reach some form of escape from, or oblivion toward his personality difficulties, in the case of LSD these are brought into sharp focus and are exaggerated to painful proportions until the subject works them through.

Some critics who have never tried the experience have called it an escape into transcendental experience. If this could be termed an escape then all forms of yielding to the desire to learn could equally well be classified as escapes. This would appear to be taking the concept of escape to ridiculous extremes.

In view of the difficulties cited, it may appear that group sessions are difficult and unnecessary. However, the group method does have many remarkable advantages. It offers the subject and opportunity to understand himself in terms of how he relates to others. It permits him, when more than one therapist is involved to see objectively from extremely close range, in terms of understanding, how other people relate to each other. It shows the subjects how his views of the world accords with, and differs from, the views of others. It lets him understand that each person's frame of reference, although peculiarly the person's own (and therefore different from any other view) is nevertheless as valid as his own. Further, the group method fosters a ready transfer of training and knowledge from the LSD experience into day to day living.

Most important, however, would seem to be the great value of the group experience in staff training and particularly in research. The research aspects of working with the psychedelic drugs deserves particular mention and is spelled out more fully in the following chapter.

Therapeutic trials with groups of various sizes have been carried out at various centres in Saskatchewan. This work has suggested that the number in the group is a variable of marked importance.

In therapy a group of three, perhaps because of its particular instability, seems most useful. In a group of two, there is a continuous pressure to relate to the same person. It is impossible to withdraw from this relationship and the intimacy of the empathic bond may be disturbing. Any note of suspicion or hostility is excessively disruptive and its effect tends to be prolonged.

By comparison, in the three groups one can, to some extent, withdraw from the others from time to time, leaving them to relate to each other. The possibility of shifting from relationship to relationship makes it easier to learn gradually to accept the group members completely. Temporary feelings of hostility, anger or suspicion are much less destructive of the empathic bond in this situation and are much more quickly overcome.

The four group is much more complex than the three group and the establishment of the empathic bond is much more difficult since the addition of the fourth participant has doubled the number of relationships involved. This group size appears to lead to a high level of intellectual stimulation and to excellent and rewarding discussion. However, the participants do not readily develop the same high level of empathy as is found in the three group. Frequently the empathic bond is established more completely within pairs than between pairs. It commonly happens too that one individual is not able to accept the others readily and a group of three is formed from which the fourth feels excluded. pmThis makes it still more difficult for him to integrate.

Our knowledge of group relationships in drug sessions involving more than four persons is extremely limited. What we do know is drawn from a few five and six group experiences and from the peyote experiences of the Native American Church. Research in this area of group psychedelic experience will be so interesting and rewarding that it will no doubt gain momentum rapidly.

In considering the staff time involved in group therapeutic sessions it should be recognized that aside from pre-treatment interviewing the treatment is completed in one day. If the subject is to have two sessions they are usually several months apart. Even where two group session are used, such a treatment program could be likely to consume something less than 30 hours of staff working time per patient. If the treatment were not more effective than any other this would correspond to something less than 25 ordinary treatment interviews, allowing time for recording the sessions. Considering the difficult nature of the cases handled, this in no way seems excessive. Also it must be taken into account that nursing time and secretarial work are reduced to an absolute minimum and hospitalization, in the case of in-patients, is remarkably shortened.

There is little doubt that both individual and group experience have much to offer and the therapist could consider giving both experience to each subject. There has been much discussion but no research upon the order in which these experiences should be undergone. Priority must therefore be assigned on the basis of clinical judgment. It is the authors point of view that, in general, it is advisable to have the individual experience first. The subject is less likely to become alarmed and withdrawn and he is more likely to persevere at investigating painful and unacceptable areas for the therapist, to inadvertently "help" too much and help the subject stabilize the experience without working though his difficulties.

The individual session is so called because the subject alone takes the drug. However, this technique may involve a group. Hubbard (24) uses a method in which a group is selected to sit in on the session. The group lends support to the therapist as a well and permits him greater freedom and more relaxation. When this technique is used the subject should have met each group member previously and should know which people will be present at the session. Such group members should have had experience with the drug. The numbers in such a group should probably not exceed four including the therapist. When the group becomes large the subject tends to feel like the lead player in a public execution.

The method which has been outlined below may be adapted to either individual or group procedures. Although the empathic bond is less obvious in the individual session, the role of the therapist remains very much the same.

CHAPTER 5 - RESEARCH IMPLICATIONS
The experiences induced by LSD and mescalin are opening vast new areas to the research and while such considerations may be felt to have only indirect bearing upon therapy, they should not be passed over.

It is the view of the authors that the psychedelic drugs present the most potent tools for psychological research which have yet been discovered. Research possibilities range from simple perceptual experiments to highly complex empathic studies. The research value of the psychedelics stems from two major aspects of the experience which they induce.

Firstly, when the experimenter takes the drug, he becomes aware of his own awareness. He becomes a witness to his own emotions, his own intellectual processes, and his own activity. He can examine the articulation of each of these upon the others and observe their relationship to his perception. Indeed, he can observe concept formation and learning going on from the inside.

Secondly, when a group of investigators take the drug at the same time, they develop a closeness of relationship in terms of feeling which verges upon the telepathic. Thus scientists can develop shared introspection and can begin to evolve research techniques which will permit the comparison of emotional states-the measurement of emotion.

Experimentation and study in these areas offer the hope that eventually they may permit a signal advance in psychological understanding. Early introspectionists were unable to provide shareable information as a basis for scientific inquiry. Only through limiting investigation to the behavior of organisms have we been able to arrive at some level of objectivity and shareability of results. Such an approach, however, confines psychology to the observation of activity and to a concept of man as the sum of his activity.

Psychedelic research promises eventually to permit the investigator to get beyond the behavioral manifestations and into the area of the underlying motivation.

One source of error in framing research in this area should be pointed out. The investigator should not try to study the drug effect in subjects until they have taken the drug a half dozen times before he is used as a research subject. There is a basic confusion of purposes when one attempts to determine the drug effect upon various tasks during the first session. The administration of tests completely alters the experience in early sessions. What is assessed is the degree of confusion in a subject whose reality ties are loosened by the drug and further altered by the testing. The test administration and indeed the research set up in which he is a guinea-pig may alter the entire nature of perceptions. Almost universally, results obtained from testing under such circumstances will show decreased efficiency of one kind or another and there is no method of sorting extraneous situational effects from drug effects as such.

However, once the subject has learned and practiced how to stabilize the experience, testing could be expected to reveal the extent of such phenomena as perceptual enhancement and empathic sensitization. It becomes a challenge to the researcher to seek out and classify the variables involved and to devise tests which will yield valid and, if possible, quantifiable measure of them.

An outline of various areas in which research seem indicated is presented in Appendix C.

CHAPTER 6 - THE SETTING
The setting in which the treatment session is to be conducted must be comfortable and quiet. Frequently the subject may feel like lying down. It is best to provide enough chesterfields, cots or beds so that each person who has had the drug has a place to stretch out comfortable.

The place should be quiet, not only as far as the general noise level is concerned but particularly in terms of interruptions of intrusions of the outside world upon the experience. Worries about getting home for supper or getting certain work done are disruptive and all such interference should be reduced as much as possible. People coming into the room can cause the subject to become upset, particularly from the second to the eighth hour after he has taken the drug. If a group is to be used, all members should be present when the experience begins. Other intrusions should be present when the experience begins. Other intrusions should be kept to a minimum. This is more difficult than it at first appears because LSD therapy usually catches the imagination and provokes the curiosity of nearly all the staff members of the unit involved. Many people will find excellent reasons to be in and out of the treatment room unless the policy of no visitors is established.

The telephone too can be exceptionally disturbing. It is often the greatest nuisance in a session. If the telephone is in the treatment room, the noise of its ringing is a bother but no matter where it is, it is troublesome for the person called, whether or not he has taken the drug, to completely alter his frame of reference such that he can conduct a normal telephone conversation. As much as possible, telephone calls should be held up.

At times, particularly in individual sessions, the subject may become extremely restless or violent. At the height of this disturbed state he is apt to knock or throw things about. For this reason it is wise to use fairly durable furnishings.

Washroom facilities should be relatively near by. It is often a severe strain on the subject to have to walk through a ward or indeed to walk any distance under the effect of the drug. Also, in subjects who become paranoid, the trip to the washroom offers opportunity for them to attempt to get away from the session.

CHAPTER 7 - EQUIPMENT
A record player and a dozen or so recordings of classical selections covering a variety of moods are so useful as to virtually essential. Music is an important feature in permitting the person to get outside his usual self-concept.

Other useful equipment includes paintings, photographs of the subject's relatives, collections of photographs such as the Family of Man series, flowers and gems. A mirror is particularly useful. The subject often can use his reflection in the mirror more objectively than himself and can frequently clarity many aspects of his own self-concept by studying his reflection though it is unwise to present the subject with the mirror until he has worked through the more frightening stages of self-appraisal and has gained at least some degree of self-acceptance. For this reason the mirror should not be mounted on the wall.

Frequently one of the side effects of the drug is a sensation of dryness in the mouth and throat. The people in the experience may feel more than usually thirsty and it is well to have a quantity of fruit juices on hand. The participants may at times feel quite fatigued and may find chocolate or other candy a ready source of additional energy. Fresh fruit provides a light food which is easy to eat and keeps one from becoming excessively hungry during the day.

Niacin is useful in bringing a person out of the experience although this should only be done in case of some emergency which necessitates the subject's leaving the experience. A dose of 400-600 mgms. intravenously should be adequate to terminate the experience. Unpleasant phases of the experience should not lead to its termination as they most frequently indicate that the person is working through some troublesome problem-often a necessary and beneficial process leading to emotional growth.

After the session the subject may find difficulty in going to sleep although he feels quite tired. For this reason it may be considered wise to give him a sedative which he can use if he so desires.

CHAPTER 8 - INDICATIONS AND CONTRA-INDICATIONS
Because of the limited number of studies yet reported, there are many blank areas in current knowledge as to the relative usefulness of LSD in various psychiatric disorders. Much of the work which has been done to date has employed as subjects normal volunteers and staff members who were seeking training. The majority of studies have involved experiments upon the subject. Those yield very little information about therapeutic effectiveness.

Most of the work done with the drug has involved subjects of superior intelligence. It is not known whether the drug can be usefully employed with people in the dull-normal, border-line or defective ranges.

The drug has been used in the main with people ranging in age from the early twenties to the sixties and very little is known about its effect upon younger age groups or upon older people. Hubbard has used the drug with people as young as 14 years of age with successful results. However, this work was restricted to very few cases and a great deal remains to be found out about the drug effect in people in their teens.

Our experience indicates that it is difficult to predict, for any individual, what his response to the drug will be. In general, the greater the degree of insecurity the more difficult it is for the subject to relinquish his defenses and his intellectual control. Failure to do so will lead to tension, illness or paranoid reactions. However, this is not always an easy matter to judge. For this reason only very rough rules of thumb can be suggested as regards indications or contra-indic

Lue lisää

joistain vanhoista tutkimuksista ja käyttänyt LSD:tä itsekin. Mukavaa toisin kuin alkoholin tai kannabiksen käyttö: en halua itselleni väsyneisyyttä, sekavuutta, aistien turtumista jne. Mielestäni kyseistä ainetta ei kannata käyttää useammin kuin muutaman kerran vuodessa, koska yhdessä tripissä tulee vastaan niin paljon asioita, että niitä pitää mietiskellä pitkään ja hartaasti jälkeenpäin. Happoa ei ole helppoa löytää, pitäisi olla joku kaveri ulkomailla.

Ainakaan minä en ole pystynyt jättämään mitään lääkityksiä (on krooninen unihäiriö tms.) pois LSD:n käytön perusteella. Meinasitko saada persoonallisuutesi muutettua pysyvästi vai? En suosittele uskonnollisia hurahtamisia kenellekään.

sienimies kirjoitti:

Vähän aiheen vierestä mutta itselläni psykedeelit (sienet) auttavat masennukseen ja vaativaan persoonallisuuteen todella hyvin. Tripin jälkeen on kuukausia helvetin hyvä olo.

LSD:tä on hankalampi suomesta saada. LSD:nä myytävät laput ovat suurimmaksi osaks jotain tutkimuskemikaalilappuja esim. bromo-dragonfly joka eroaa LSD:stä kemialliselta rakenteeltaan vaikutus kestää jopa 30h kun LSD vain n.12h.

Siispä suosittelen käyttämään nuppilääkkeenä suomestakin löytyviä psilosybiiniä sisältäviä sieniä. Sienet ovat vaikutuksiltaan erittäin lähellä LSD:tä (samat terapeuttiset ominaisuudet myös), mutta tripin kesto on lyhyempi.
Itsekään en ole oikeaa LSD:tä päässyt kokeilemaan mutta sienillä mennään! tutkimuskemikaalilaput kannattaa jättää melkein kokeilematta.

Lue lisää

Mihin lähteä ensi vuonna sienestämään ja voiko tuota lakkia sekoittaa vahingossa mihinkään muuhun sienilajiin?

................. kirjoitti:

Mihin lähteä ensi vuonna sienestämään ja voiko tuota lakkia sekoittaa vahingossa mihinkään muuhun sienilajiin?

Mitä väliä sillä, sekottaako sitä muihin sieniin? Sekasihan sitä sieniä nauttimalla halutaan muutenkin mennä :). Jos henki lähtee, sehän se vasta trippi onkin =).

................. kirjoitti:

Mihin lähteä ensi vuonna sienestämään ja voiko tuota lakkia sekoittaa vahingossa mihinkään muuhun sienilajiin?

Kasvattaa itsekin, eikä se ole edes vaikeaa. Nettiä kun vähän tutkiskelet niin löytyy suomeksikin infoa tästä. Suippomadonlakin tunnistamiseen vaaditaan kokemusta. Olen törmännyt hyvin samankaltaisiin sieniin jotka saattavat olla ties kuinka myrkyllisiä. Tunnistamisestakin löytyy kyllä netistä...

lääkitys on riittämätön (eli mikään tutkituista lääkkeistä ei toimi) ja vaihtoehtona ovat laittomat piristeet tai itsemurha? Valitsen ensimmäisen, kiitos.

Jos saataisi lekuri järjestämään tutkimus sanotaan 2 vuotta ja trippi joka 6 kk ja verrattaan apteekkilääkkeitä käyttäviin, plaseboa ja LSD:stä ei voi vissiin käyttää tutkimuksessa, luulisi ryhmän kaksi huomaavan jotain kun ei huomaa mitään pillerin nieltyään.

Joo tutkimus käyntiin minä osallistun heti.
Saettaisi saada muuten aika puhdasta LSD:tä eli hyviä kokemuksia?

Kakkulaq kirjoitti:

Jos saataisi lekuri järjestämään tutkimus sanotaan 2 vuotta ja trippi joka 6 kk ja verrattaan apteekkilääkkeitä käyttäviin, plaseboa ja LSD:stä ei voi vissiin käyttää tutkimuksessa, luulisi ryhmän kaksi huomaavan jotain kun ei huomaa mitään pillerin nieltyään.

Joo tutkimus käyntiin minä osallistun heti.
Saettaisi saada muuten aika puhdasta LSD:tä eli hyviä kokemuksia?

Lue lisää

Miksi tulette jauhamaan jotain paskaa asiasta mistä ette mitään tiedä?
Miksi kaikkia jotka käyttävät luonnon omia lääkkeitä apuna pidetään jonain vitun narkkareina?
Ei kyse ole todellakaan siintä pään sekaisin saamisesta. pellet. Kaikki popsimanne lääkkethän ne vasta onkin terveellisiä? ja niitähän nyt käytetään huumeena ja päänsekoittamistarkoituksessa paljon enemmän. Vedätte kaiken maailman kemikaalipaskaa naamaa ja dissaatte sieniä ja happoa vain siksi että ne laajentaa tajuntaa? eih....

Mutjoo, asiaan. En tiedä voivatko sienet auttaa pois persoonallisuushäiriöstä ku en ole vielä ehtinyt hankkia tarpeeksi empiiristä tietoa asiasta. Elämänlaatuni kuitenkin parani HUOMATTAVASTI tripin jälkeen. Pitäs tossa joskus muutaman kuukauden sisään saada tatteja tripin verran niin ehkäpä sen jälkeen tiedän enemmän psykedeelien terveysvaikutuksista :P

sienimies kirjoitti:

Miksi tulette jauhamaan jotain paskaa asiasta mistä ette mitään tiedä?
Miksi kaikkia jotka käyttävät luonnon omia lääkkeitä apuna pidetään jonain vitun narkkareina?
Ei kyse ole todellakaan siintä pään sekaisin saamisesta. pellet. Kaikki popsimanne lääkkethän ne vasta onkin terveellisiä? ja niitähän nyt käytetään huumeena ja päänsekoittamistarkoituksessa paljon enemmän. Vedätte kaiken maailman kemikaalipaskaa naamaa ja dissaatte sieniä ja happoa vain siksi että ne laajentaa tajuntaa? eih....

Mutjoo, asiaan. En tiedä voivatko sienet auttaa pois persoonallisuushäiriöstä ku en ole vielä ehtinyt hankkia tarpeeksi empiiristä tietoa asiasta. Elämänlaatuni kuitenkin parani HUOMATTAVASTI tripin jälkeen. Pitäs tossa joskus muutaman kuukauden sisään saada tatteja tripin verran niin ehkäpä sen jälkeen tiedän enemmän psykedeelien terveysvaikutuksista :P

Lue lisää

toisaalta vois toimii jos tulee hyvä trippi ja saa pidettyy ajatukset ilosina mutta en suosittele itse sain promo dragonflyista saatanan pahan paniikkihäiriön ja ahdistuksen ja vähän samantapanen kävi lsd n kanssa mutta huomattavasti kevyempi mutta ei mennyt kauaakaan kun se iloinen meininki jatku

Sain LSD:llä pitkäksi aikaa tosi hyvän olon. Olo oli viikkoja kirkas ja elämänhaluinen. Jossain vaiheessa olin jo hypomaaninen ja otin silloin lappuja lisää. Tästä seurasi kunnon Mania ja Psykoosi.

Itsekkin olen lukenut että joillekkin ollut apua psykedeeleistä kaksisuuntaisessa. Jo muutama trippi saattaa auttaa. Olen myös lukenut että monilla LSD laukaisee manian. Jälkimmäinen yleisempää.

Tohon parantumiseen saattaa vaikuttaa tripin vaikutuksesta positiivisemmaksi muuttunut ajatusmaailma ja/tai LSD:n sekä Psilosybiinin aivojen neuroplastisuutta lisäävät vaikutukset. Eli ihan fyysisiä muutoksia.

Kuitenkin melkoista arpapeliä. Mania vahingoittaa aivoja.

Tutkimusten ja käyttäjä-raporttien mukaan psykedeelit ovat mm. masennuksen ja alkoholismin hoitoon lupaava lääke. Tripin vaikutus saattaa olla huomattavan pitkä. 6kk - loppu elämä. Googlella löytyy tutkimusDadaa.

http://www.hs.fi/tiede/a1305708116054