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The Experimental Use of

Psychedelic (LSD) Psychotherapy

Walter N. Pahnke, MD, PhD; Albert A. Kurland, MD;
Sanford Unger, PhD; Charles Savage, MD; and Stanislav Grof, MD

history of research with has been rapidly growing interest What makes psychedelic drugs

psychedelic drugs has pro- concerning these drugs by laymen unique as a class are the psycho
duced a variety of methods for pleasure, excitement, mental ex logical phenomena which they facil
for their use and conflicting claims ploration, and religious experience. itate. Five major kinds of potential
about results. First came the wave The use of psychedelic drugs for all psychedelic drug experiences have
of excitement among experimental- these purposes has produced con been described in detail with ex
ists in the 1950s when it was claimed flicting claims both in the scientific amples elsewhere7 8 and will only
that lysergic acid diethylamide and popular literature, intense pub briefly be summarized here.
(LSD) could produce a model psy- lic attention stimulated by the mass First is the psychotic psychedelic
chosis which might be useful in media, and legislative attempts at experience characterized by the in
understanding schizophrenia. While control of both research and the tense, negative experience of fear to
this promise was fading, enthusi- black market. the point of panic, paranoid de
astic reports about the possibility of lusions of suspicion or grandeur,
LSD as an aid to psychotherapy in Effects in Man Facilitated toxic confusion, impairment of ab
the treatment of alcoholism and by stract reasoning, remorse, depres
other psychiatric disorders ap- Psychedelic Drugs sion, and isolation or somatic dis
peared. All these approaches were Before we turn to the use of psy comfort or both; all of these can be
represented in 1959 at the first in- chedelic drugs as a therapeutic tool, of very powerful magnitude.
ternational conference devoted en- let us review briefly some basic Second is the cognitive psyche
tirely to LSD.1 Since then, there facts. At the outset, it is important delic experience, characterized by
have been at least five more pub- to remember that psychedelic drugs astonishingly lucid thought. Prob
lished proceedings of such confer- are a special class of psychophar- lems can be seen from a novel per
ences on various aspects of psyche- macological agents, not to be con spective, and the inner relationships
delic drugs.2-6 The most recent fused with sedatives like barbitu of many levels or dimensions can be
conference on various means of pro- rates or alcohol, stimulants like seen all at once. The creative ex
ducing states of consciousness was amphetamines or methylphenidate perience may have something in
sponsored by the Menninger Foun- hydrochloride (Ritalin), tranquil- common with this kind of psyche
dation and the American Associa- izers like chlordiazepoxide hydro- delic experience, but such a possi
tion of Humanistic Psychology on chloride (Librium) or meprobamate bility must await the results of
April 7 to 11, 1969, in Council (Miltown), antipsychotic agents future investigation.
Grove, Kan, and was called "Vol like the phenothiazines, or narcotic Third is the aesthetic psychedelic
untary Control Of Internal States." drugs like the opiates (whether syn experience, characterized by a
In the 1960s we have seen re thetic or natural). Psychedelic drugs change and intensification of all sen
search attempts to test scientifically in contrast to true narcotics are not sory modalities. Fascinating changes
the efficacy and safety of psyche physically addicting and produce in sensations and perception can
delic drugs for the treatment of var quite different psychological experi occur: synesthesia in which sounds
ious forms of mental illness, chiefly ences from all these other groups can be "seen," apparent pulsations
alcoholism. At the same time, there of drugs. or lifelike movements in objects
such as flowers or stones, the ap
From the Maryland State Psychiatric York, July 17, 1969. Based partially on a pearance of great beauty in ordi
Research Center, the Johns Hopkins Uni- presentation by Albert Kurland, MD, at nary things, release of powerful
versity School of Medicine (Drs. Pahnke, the American College of Neuropsycho- emotions through music, and eyes-
Unger, Savage, and Grof), and the Depart- pharmacology, San Juan, Puerto Rico, closed visions of beautiful scenes,
ment of Mental Hygiene, State of Mary- Dec 20, 1968.
land (Dr. Kurland), Baltimore. intricate geometric patterns, archi
Read before the Symposium on Psyche- Reprint requests to Maryland Psychi-
delic Drugs at the 118th annual convention atric Research Center, Box 3235, Baltimore tectural forms, historical events,
of the American Medical Association, New 21228 (Dr. Pahnke). and almost anything imaginable.

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Fourth is the psychodynamic psy In
psycholytic therapy, which is self-understanding during the pre
chedelic experience, characterized practiced mainly in Europe, the paratory psychotherapy. This prep
by a dramatic emergence into con aim is usually the uncovering of un aration, which averages about 20
sciousness of material that was pre conscious material which can be hours per patient, enables the ther
viously unconscious or preconscious. psychodynamically analyzed both apist to establish close rapport with
Abreaction and catharis are elements at the time and in subsequent psy the patient and to gain intimate
of what may subjectively be experi chotherapy sessions. There is con knowledge of the patient's develop
enced as an actual reliving of inci siderable time spent on psycho mental history, dynamics, defenses,
dents from the past or a symbolic therapy before, during, and after and difficulties. In specific prepara
portrayal of important conflicts. the actual drug sessions. This type tion for the session itself the patient
The fifth and last type of psyche of therapy is relatively long-term is encouraged to trust the therapist,
delic experience has been called by with multiple sessions over time and himself, and the situation, to let
various names: psychedelic peak, usually with small doses of the drug go voluntarily of his usual ego con
cosmic, transcendental, or mystical, (25Mgtol50iag). trols and be carried by the experi
and canbe summarized under the In psychedelic-chemotherapy, the ence, and to be completely open to
following six major psychological major emphasis is on administra whatever experiences he encounters.
characteristics (described in more tion of the drug itself, during which The experimental drug sessions
detail elsewhere7): (1) sense of limited psychotherapy may or may themselves are carried out in a
unity or oneness (positive ego trans not be carried out. There is minimal special treatment suite furnished
cendence, loss of usual sense of self preparation and follow-up therapy. like a comfortable living room, with
without loss of consciousness), (2) A single session with a relatively sofa, easy chairs, rugs, drapes, pic
transcendence of time and space, high dose of the drug (200 xg or tures, flowers, and high-fidelity
(3) deeply felt positive mood (joy, more) has been the usual practice, music equipment. The patient's
peace, and love), (4) sense of awe- although there have been experi therapist and a psychiatric nurse
someness, reverence, and wonder, ments which consisted of weekly are in constant attendance through
(5) meaningfulness of psychologi sessions with little or no attempt at out the period of drug action (10 to
cal or philosophical insight or both; help with interpretation or integra 12 hours). For most of the session,
and (6) ineffability (sense of diffi tion. This method is called hypno- the patient reclines on the sofa with
culty in communicating the experi delic when hypnotic induction is eyeshades and stereophonic ear
ence by verbal description). employed during the preparation phones, alternately listening to care
for the session or before the onset fully selected classical music or in
The Varieties of Psychedelic of drug effects or both with the aim teracting with his therapist. The
Drug Therapies of providing better control. The function of the music is to help the
In the course of experimental major differences between psyche patient let go more easily, to enter
therapeutic work with psychedelic delic-chemotherapy and psycholytic more fully into his unfolding inner
drugs (especially LSD), three major therapy are the number of drug world of experience, and to facili
approaches have evolved: (1) psy- sessions, amount of therapy outside tate the release of intense emotion
cholytic therapy, (2) psychedelic- the drug sessions, and drug dosage. ality.
chemotherapy, and (3) psychedelic- In psychedelic-peak therapy, one Although the LSD session itself
peak therapy. Each of these methods of the distinctive characteristics and is only one part of psychedelic-peak
has been described and discussed in immediate goals in the drug session therapy, it plays a unique and
detail at the international confer itself is the achievement of a peak necessary role without which the
ence on LSD therapy held in 1965.3 or transcendental experience, but total therapeutic impact would not
In any evaluation of therapeutic just as important is the intensive be the same. In a dosage of 200 xg
effects, it is essential to keep in psychotherapy which occurs in the or more, LSD produces a 10- to 12-
mind the differences in procedure weeks prior to the psychedelic drug hour period of striking, varied, and
among the various methods, not session and the follow-up therapy anomalous mental functioning; the
only because different kinds of ex in the weeks after to help with the range of possible effects or episodes
periences are facilitated, but because work of integration. The LSD ses of reaction or both is multiform.
conflicting results can be correlated sion can add meaningful emotional Certain dimensions of possible re
with the method used. Reactions to insight and dramatic validation of activity are therapeutically irrele
LSD invariably involve a complex an individual's basic self-worth, but vant (eg, sensory changes) others
interaction between drug dosage, set, usually only after the achievement have distinctly antitherapeutic con
and setting. of psychodynamic resolution and sequences (eg, panic, terror, or

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psychotic reactions). The major ever, that even with optimal pro psychotherapy. While the study de
dimension of drug-altered reactivity gramming, such peak experiences sign made it possible for the pa
with therapeutic relevance is the are neither universally achieved nor tients to have up to three sessions,
affective or emotional sphere; in stabilized, and certainly they do not the vast majority in both experi
tense, labile, personally meaningful automatically occur merely by ad mental and control group (total of
emotionality is uniformly produced, ministration of a psychedelic drug. 117 patients) received only one
v/ith periodic episodes of over In our research setting, profound or treatment with LSD. The 18 pa
whelming feeling. In terms of se- marked psychedelic-peak reactions tients who had more than one LSD
ruence of events, the first several were judged to have occurred in session were not found to be differ
hours of a psychedelic session are 63% (56) of 82 consecutive alco ent from the other 117 in psycho
nonspecific and pervasive; persist holic patients who received a total logical and social measures based
an* preoccupations an^ emotional of 450/j.g of LSD given in two equal on pretreatment testing, but as a
distress patterns are "broken" or doses 45 to 60 minutes apart. group they received more average
fragmented, and subsequent recall Research Projects With
hours of treatment. Therefore, in
for this period is nearly always the interests of uniformity concern
poor. During the third to fifth
Psychedelic-Peak Psychotherapy ing amount of treatment, results
hours, psychedelic reactivity usual Since 1963, at the Spring Grove were analyzed separately for the
ly appears at peak intensity. With State Hospital, Baltimore, and now 117 patients who had only one LSD
skillful handling, the remainder of continuing at the Maryland Psy session (either a high or low dose).
the session may be stabilized in chiatric Research Center, research Out of these 117 pateints, 104 were
an elevated mood state in which has been in progress to investigate personally located for follow-up in
psychotic and other turbulent phe the usefulness of psychedelic-peak terview after six months. It should
nomena are no longer problems. psychotherapy with alcoholic, neu be noted that the 13 patients not
Follow-up therapy begins during the rotic, and narcotic addict patients reached for follow-up were properly
reentry period of the session day and patients who are dying of can proportioned according to the orig
and continues the next day as the cer.9 18 The project which involved inal random assignment in which
patient and therapist review the alcoholic and neurotic patients, both two thirds of the patients were al
events of the session and attempt originally funded by research grants lotted to the high-dose procedure.
to integrate them. The patient is from the National Institute of Comparison of means before treat
encouraged to write a detailed Mental Health (NIMH) were de ment and six months after treat
description of his experience. signed as double-blind, controlled ment for global adjustment and
If a psychedelic-peak experience studies. In each project the experi drinking behavior are shown in
has been achieved and stabilized mental group received a relatively Table 1. Global adjustment included
during the session, a clinical picture high dose of LSD (350/ig to 450/xg) occupational, interpersonal, and res
which we have termed the psyche in contrast to only 50/ig for the con idential factors as well as the pa
delic afterglow can be observed in trol group; both groups received tient's reaction to alcohol. Ratings
the days after the session. Mood is exactly the same therapeutic prep were made on each patient on a
elevated and energetic; there is a aration. In the study of neurotic predetermined 0 to 10 behavior rat
relative freedom from concerns of patients there was an additional ing scale. The end points of the
the past and from guilt and anxiety, control group of randomly assigned scale measuring drinking behavior
and the disposition and capacity to patients who received an equivalent were 0, indicating daily alcohol con
enter into close interpersonal re number of hours of group psycho sumption, and 10 indicating total
lationships is enhanced. These psy therapy without any LSD. Evalua abstinence. Patients were also cate
chedelic feelings generally persist tion of each patient's status was gorized according to whether a pro
for from two weeks to a month and performed by an independent rating found, marked, or minimal psyche
then gradually fade into vivid mem team before treatment and at 6, 12, delic-peak experience was achieved
ories that hopefully will still influ and 18 months following the treat during the LSD session as rated by
ence attitude and behavior. During ment phase. Full and final analysis the patient's therapist immediately
this immediate postdrug period, and evaluation of these data are after the session. In Table 1, com
there is a unique opportunity for still in progress. parison of means before and after
effective psychotherapeutic work on Results are now completed at the treatment between groups receiving
strained family or other interper six-month checkpoint for the study high and low doses and among the
sonal relationships. of a total of 135 alcoholic patients psychedelic reactivity groups may
It should be emphasized, how- who were treated with psychedelic be seen to show statistically signifi-

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cant differences using an analysis Table 1.Comparison of Means of Alcoholic Patients Receiving One LSD Session
of covariance statistical procedure Global Adjustment Drinking Behavior
(one-tailed test). ,_A_ _A_
The percentage of patients func Before 6 mo After Before 6 mo After
_Patient Group_Treatment_Treatment_Treatment_Treatment
tioning in an "essentially rehabili Dosage
tated" fashion is shown for the (N =

various groups in Table 2. A score
of 8 or more on the 0 to 10 scale
(N =

Psychedelic reactivity
was considered a rigorous criterion, (N

indicating for global adjustment (N=31)_3J57_6J6_2J54_6.94

that a patient was making "good Minimal
attainment or adjustment" with re (N 50)_3J>0_5J4_232_5.82

Results of Covariance Analyses

gard to drinking, occupation, inter For Above
High dose
personal relations, etc. A score of 8 low dose_3J6_O05_4_.4J_0.025
on the drinking scale indicated some, Psychedelic reactivity
groups 2.42 0.05 3.09 0.025
but only minimal, departure from
*P values are for one-tailed tests of significance.
total abstinence. Statistical analysis
revealed that there were significant An NIMH-sponsored project to quite as much time is spent ii
differences between the high and investigate the effect of psychedelic- preparation, and the treatment takei
low-dose groups in percentage of peak psychotherapy with narcotic place in a private room of a gen
patients reaching this criterion, both addicts is well underway, but it is eral medical facility (Sinai Hospi
in global adjustment and on the too early for any indication of ther tal, Baltimore). Also, family ther
scale measuring drinking. The apeutic outcome. These patients in apy plays a larger role.
group of patients with the most pro general seem to have a greater de Thus far, we have treated 35 pa
found psychedelic-peak experiences gree of psychopathology than the tients in a pilot project. Our find
had the highest percentage of pa alcoholics with whom we have ings must remain only suggestive a
tients who showed evidence of re worked, but the skilled implementa this point, but they do give somi
habilitation. This trend was statisti tion of psychedelic psychotherapy promising indications of the poten
cally significant among the three seems to be proceeding smoothly. tial of this form of treatment. Mea
psychedelic reactivity groups for An observation of interest is that surements before and after LSI
global adjustment, but not for drink the character of the drug experience on depression, anxiety, emotiona
ing, and thus must be interpreted with LSD has been reported by the tension, psychological isolation, fea
with caution. addicts to be distinctly and qualita of death, and amount of medicatioi
In evaluating these findings in tively different from what they ex required for pain have shown changi
practical terms, we can say that a perienced under heroin (ie, a con in a positive direction in about two
given alcoholic patient receiving a frontation with their problems thirds of the patients. In half o
single high dose of LSD in the con rather than an escape from them). these the improvement was dra
text of psychedelic-peak psycho During the past several years, we matic, and those patients who ha<
therapy and experiencing a profound have also been exploring the poten the most profound peak experience
psychedelic-peak reaction has the tial of psychedelic-peak psychother tended to show the most benefil
best likelihood for improvement six apy with patients with cancer.18'18 Also, patients treated earlier in tb
months later. Within the context of The purpose has been to treat the course of their disease were able h
our method, dosage appears to be a depression, anxiety, psychological use the experience more reward
more certain outcome predictor than isolation, and intractable pain which ingly.
type of experience, although peak so many of these patients face. The While not all patients were helpec
experiences do occur more frequent families, too, must cope with psy dramatically, none, even the mos
ly with high doses of LSD. Also the chological problems which relate to ill, appeared to have been harmed
estimation of psychedelic reactivity their own fears and impending This finding in regard to the safet;
(from the individual judgments of sense of loss. How to relate to the of the procedure has been consisten
different therapists) is probably not patient and what to tell him about with our results in alcoholic am
as reliable as the measurement of his diagnosis further complicates neurotic patients.
therapeutic outcome made by eval- what is already a grim situation. The following case summary wil
uators independent from the treat This use of LSD is similar to that serve to illustrate both the methoi
ment team. already outlined, except that not and possible outcome.

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Table 2.Alcoholic Patients Improved Six Months After One LSD Session and some realistic expectations for the
future were the major issues explored.
No. of Patients With Ten months after her first session
No. of Patients With Drinking Behavior
Global Adjustment Scores Scores of 8, 9, the patient was readmitted to the hos
Patient Group of 8, 9, or 10 (%) or 10 (%)
pital for her second LSD treatment.
Josage Her initial reaction to the session was
(N =
64) 44 (28/64) 53 (34/64) one of anxiety, and then the issue of
Low her disease was encountered. She faced
(N 40) = 25 (10/40) 33 (13/40) the fact that throughout her illness she
'sychedelic reactivity
Profound had tended to deny that she was really
(N =
23)_ 61 (14/23) 61 (15/23) sick. She remembered patients she had
(N=31) 39 (12/31) 48 (48/31)
known with cancer, and her fear of
Minimal decaying flesh was symbolized by vi
(N =
50) 24 (12/50) 36 (18/50) sions of vultures feeding on rotten
|ra Results For Above Data meat. After confronting rather than re
Global Adjustment Drinking Behavior treating from these unpleasant feelings
X3_P* X2_P* and experiences, the patient had the
Ugh vs
low dose 2.97 0.05 3.44 0.05 experience of passing through a series
'sychedelic Not of blue curtains or veils. On the other
reactivity groups 7.74 0.025 3.07 significant
side she felt as if she were a bird in the
"P values for one-tailed tests of significance.
sky soaring through the air. Then she
was on a high mountain top in a small
Report of a Case that her life could still go on even if cabin alone with the snow falling. She
she were confined to bed, a condition experienced wonderful feelings of peace
The patient, a 58-year-old Jewish which she had previously greatly and harmony and visions of beautiful
narried woman, had suffered from feared. However, the patient spontane colors like the rainbow. After this, she
;ancer of the breast for 12 years. In ously expressed her determination to stabilized the experiences and had en
pite of numerous surgical and medical try her best in physiotherapy, in spite joyable reliving of happy memories
rocedures which included hysterec- of the odds against her. She was sup from her past, the best of which was
omy, oophorectomy, and adrenalec- ported in her resolve to try. but also her wedding day, which she relived
omy, the disease had spread widely discussed was acceptance of her condi in great detail including a reexperience
n her spine. At the time she was re- tion, if it could not be improved. Dur of the way her mother sighed as she
erred for LSD treatment, pressure on ing the evening after the patient had came down the aisle. These happy
erves in her spine had caused numb- emerged from the effects of the drug, memories were in contrast to the early
ess and a paralysis of the lower half the patient's family visited. This was part of her experience when she had
if her body. When first interviewed, a time of intense closeness and inter relived some unpleasant events such as
he patient was anxious and depressed. personal sharing. The family remarked the prejudice she felt against her as a
After six hours of preparatory psy- on the change in her mental condition child because she was Jewish and her
hotherapy with the patient and her from that of anxiety and depression to failure to take advantage of the cul
amily over the period of a week, dur- one of peace and joy. tural opportunities her father had pro
ng which the nature and purpose of In the days after the session the pa vided. In the latter part of the experi
he treatment was explained, the pa tient's mood was cheerful and hopeful. ence the patient thought deeply about
ient was given 300 /ig of LSD. The Upon discharge from the hospital six her family while looking at their pic
irst few hours of her psychedelic ses days after her LSD treatment, the pa tures. She was able to resolve some of
in went well and were pleasant, but tient returned home and began inten the ambivalence she had about her
complete psychedelic-peak experi- sive work with a physiotherapist. She younger daughter who was to be mar
not obtained. There were a
nce was made remarkable, quite unexpected ried in three months. She felt sorry for
ew moments of intense positive psy- progress and within four months was some of the strife they had had and
hedelic reactivity; for example, at one able touse a walker. Six months after came out of the experience with a re
loint the patient exclaimed, "This is treatment the patient was doing some solve to make a more constructive at
ne of the happiest days of my life. I limited walking with a cane. tempt to relate to this girl in the fu
/ill always remember it." There were In spite of her impressive accom ture. When the patient's family arrived
lso transient episodes of apprehen- plishments, the patient again became after supper, she had a serene smile on
ion, confusion, and paranoia which depressed and difficult to manage at her face, but was reluctant to talk
rere easily handled by reassurance home because of her feelings that she about her experience too much. She
nd support. would always be an invalid. She was said, "You wouldn't believe me if I did
During the latter part of the session, especially distressed because the back- tell you."
he patient raised the question of brace which she had to wear out of bed Subsequently, the patient left the
fhether or not she would walk again, (four to six hours a day) was cumber hospital in good spirits and was able to
^his issue was handled by a realistic some and she needed assistance by an participate actively in her daughter's
eview of the patient's condition, and other person in order to put it on. Be wedding. She fulfilled her desire to
he therapist finally stated in a direct cause of her increasing depression, walk down the aisle without the aid of
nswer to her question that it was very both the patient and her family re even a cane, and during the wedding
inlikely that she would be able to quested another LSD treatment. She reception she amazed all the guests by
ralk again. The patient then expressed was seen regularly for preparation. In dancing with her husband. Her sister
er reluctant acceptance of the idea terpersonal relations, her self-concept, said she had been the life of the party.

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Table 3.Means of Chromosomal Aberration Rates* Before and She was pessimistic about the fu
After LSD Among Various Experimental Groups ture, in spite of the new knowledg
about the diagnosis of metastatic car
Group_Before LSD_After LSD_Difference_P_ cer of the spine. She was able to to]
32 patients_4^8_FjJU_
5 users_2J1_3.57
+1.63_NoVsignificantt erate the pain in the back with the ai
8 experimental
_+0.76_Not significant!: of narcotic drugs, but did not hav
subjects_^_2.79_._lj^_^_ complete relief from pain.
2 normal While still in the hospital, an h>
subjects 2.65 ... ... ...
pophysectomy was attempted as a pos
Aberration rate percentage of aberrant cells/total metaphases analyzed (at least 200
per sible means to stop further spread c
culture). her metastatic process. Because c
tWilcoxon matched-pairs, signed-ranks, two-tailed test,
j Fisher exact probability test. hemorrhage the operation could not b
completed, and the patient died a fei
Within six months the patient re pain, the patient again became some days later.
quested a third LSD treatment. At this what depressed. Both the patient and
time she had increasing pain and was her family requested another LSD This patient experienced consic
discouraged because she had not treatment. The patient was seen week rable relief from pain, depressior
worked in over two years although she ly for about a month as an outpatient, and anxiety over the period of a'
had kept the hope alive that she would and then readmitted for a treatment
with LSD, almost six months after her most two years during which sh
eventually return to her old job. The
session began smoothly but the patient third treatment. received four LSD treatments. He
became frightened when she saw a The evening before her session, dur first session was not judged to hav
huge wall of flames. After support and ing the final preparation, the patient had much psychedelic content, bv
encouragement by the therapist, the suddenly asked a direct question about the second, third, and fourth ses
patient was able to go through the her diagnosis for the first time in the
sions did. The third session was th
middle of the flames, and at this point almost two years she had been in the
experienced positive ego transcend LSD-treatment program. Although she most complete psychedelic-peak e>
ence. She felt that she had left her knew that her breast had been removed perience and seemed to provide th
body, was in another world, and was in for a tumor, she had believed there most benefit. This patient's gratify
the presence of God which seemed was no further growth, but the increas
symbolized by a huge diamond-shaped ing pain in her back had made her ing physical improvement can b
iridescent Presence. She did not see wonder. Her questions were answered attributed only indirectly to th
Him as a Person but knew He was gently, but without evasion, and the LSD treatment in that her own ur
there. The feeling was one of awe and meaning and emotional impact were derlying resolution to pursue phys
reverence, and she was filled with a discussed with her. The family mem
sense of peace and freedom. Because bers were informed of this conversa iotherapy emerged when her depres
she was free from her body, she felt tion immediately thereafter, and they sion and anxiety were relieved. B
no pain at all. She was quiet during reacted by becoming quite upset and a fortunate coincidence, her cond:
most of the day and emerged from the angry. That very evening, in a general tion responded well to these effort
session with a deep feeling of peace family discussion with the patient and on her part, contrary to the mos
and joy. When her family had arrived, therapist, however, most of them were
she radiated a psychedelic afterglow of able to resolve their feelings. Some felt informed medical prognosis. All ou
peace and beauty which all remarked embarrassed because of their previous patients are told that LSD is fo
upon. During the course of the evening pretense; most felt relieved when they treatment of psychological distres
the patient had a serious talk with her saw how well the patient had dealt and not a cure for their physicE
daughters about her condition and with the situation. The patient stated disease. In this case, as happens nc
what might lie ahead. Shortly there that she was glad to know the truth
after the patient was discharged from and was obviously not psychologically infrequently, sometime during th
the hospital in good spirits. One effect shattered or further depressed as some course of LSD treatment the issu
of the treatment was that when the of the family members had feared. of diagnosis was brought up by th
patient was troubled with pain, she The fourth session the next day went patient and had to be worked ou
could push the pain out of her mind smoothly, except for some nausea with the patient and the family.
by remembering her out-of-the-body which was experienced shortly before
LSD experience. admission when she had eaten some
The patient did very well for about spoiled food. Much psychodynamic ma
The Question of Safety
one month, until she slipped on the terial emerged concerning her feelings When psychedelic drugs are ac
stairs one day and injured her back, about various members of her family, ministered under controlled media
which began causing her considerable especially her two daughters. In the
pain again. She also became sick with evening the patient felt very close to conditions (as has been the case i
influenza and was confined to bed. Prior her family and spent some time in several large-scale research projecl
to this she had been considering going talking to each of them alone in a very in recent years), permanent advers
back to work at her old job, part-time, personal way. She was reluctant to effects have been rare. Since 196."
but with the worsening of her physical have them leave at the end of the eve
condition these plans had to be post at the Spring Grove State Hospiti
ning, even though she was very tired. and now at the Maryland Psych
poned. With these physical setbacks In the days after the session the pa
and especially the recurrence of her tient felt relaxed and in good spirits. atric Research Center, Baltimon

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>ver300 patients have been treated No difference was found in the agent or with a minimum of psycho
with LSD without a single case of rate of chromosomal aberrations be therapy have not shown any greater
ong-term psychological or physical fore and after administration of efficacy regarding therapeutic out
larm directly attributable to the LSD when the data from these 37 come, especially with alcoholics,
reatment, although there have been separate individuals were statisti than control groups.28'31 The evi
wo cases in which disturbances per- cally analyzed. Also, chromosomal dence from the psycholytic use of
isted in the days following the analysis after LSD administration LSD by European researchers and
ictual LSD session. Both patients was done on eight normal subjects psychedelic-peak therapy as prac
ubsequently responded to conven- who had received LSD in research ticed at the Maryland Psychiatric
ional psychiatric treatment. experiments in the past, and no in Research Center indicates that LSD
Throughout the years of research crease over normal chromosomal can be an enhancer of skilled psy
vith LSD many possible harmful breakage rate was found. A sum chotherapy when integrated with
)hysical effects have been suggested, mary of these results is presented an intensive psychotherapeutic pro
ut careful subsequent investiga- in Table 3. The mean rates before gram of sufficient duration (30 to
ion has failed to furnish much LSD in the 32 patients (4.28%) 50 hours).
nclusive scientific evidence. Most and the five LSD users (2.81%) The scientific evidence concern
ecently, the question of chromo- are comparable to each other and ing possible genetic hazards of LSD
omal damage has been raised fol- to the values obtained from sam is conflicting and inconclusive. The
owing the positive in vitro findings ples from two normal control sub difference in results between our
n white blood cells by Cohen.19 jects for eight to ten consecutive carefully controlled study before
tetrospective studies on persons days (2.65%). The differences be and after administration of LSD in
laving taken LSD (most from the tween the rates before and after patients and the research on LSD
lack market and only a few under receiving LSD for both the 32 pa abusers may be explained by the
ledical supervision) have produced tients ( + 1.63%) and the five LSD many uncontrolled variables such
onflicting reports. Some research- users (+0.76%) are not statistical as viral infections and the effects of
rg2o 22 founf] increased chromosom- ly significant. The mean chromo other drugs. Certainly much more
1 breakage over normal rates, and somal aberration rates for the 32 research needs to be done in this
ithers no increase.23'25 patients and five LSD users (in complex area before valid conclu
Because we were in a position to cluding those both before and after sions can be drawn.
tudy the effect of pure LSD of administration of LSD), eight ex Research with psychedelic drugs
iiown amount on patients who perimental LSD subjects (after LSD needs to be continued to learn more
rere to be treated with psychedelic administration), and two normal about their effective use. Questions
sychotherapy, we entered into col- controls (no LSD) only vary from need to be answered, such as what
iboration with the cytogenetics lab- 2.65% to 5.91%. Detailed reports kinds of patients will benefit most
ratory of Joe-Hin Tjio, PhD, at of this research have been presented and under what circumstances. As
he National Institute of Arthritis and published.2027 our research progresses and we gain
nd Metabolic Diseases to carry more experience we expect to mod
ut a rigorously controlled study.
ify our implementation of psyche
$lood samples from 32 patients be- Part of the conflicting evidence delic-peak psychotherapy. Newer
rig treated at the Spring Grove about the efficacy of psychedelic psychedelic drugs may have certain
itate Hospital were drawn and cul- drugs as a therapeutic tool for the advantages over more well-known
ured both before and after LSD treatment of mental illness comes ones. For example, we have been
dministration. The white blood cell from the differences in the methods testing dipropyltryptamine (DPT)
WBC) chromosomes were then employed by various groups of developed by Szara32 at the NIH,
tudied without prior identification researchers. Unfortunately, rather which has a duration of action of
f the slides, and at least 200 meta- than replicating each other's meth from two to four hours depending
hases were analyzed per culture, ods, each research team seems to on dosage. If this drug proves to
n addition, the WBC chromosomes have developed its own procedure. be as effective and safely manage
f five chronic LSD users were In spite of such diversity of ap able as the much longer-acting LSD,
tudied before, during, and after the proach, several points seem to be it could result in a psychedelic pro
dministration of known doses of clear by now. Use of LSD is not a cedure that could be more flexibly
D in research on sensory, cog- substitute for skilled psychotherapy. and easily implemented than that
itive, and perceptual functions at Experiments where LSD was used with LSD.
le National Institutes of Health. primarily as a chemotherapeutic In spite of the potential uses

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for psychedelic drugs suggested by 2. Crockett R, Sandison RA, Welk A 17. Pahnke WN, The psychedelic mysti-
our work, the future of such re (eds): Hallucinogenic Drugs and Their cal experience in the human encounter
Psychotherapeutic Use. London, HK with death. Harvard Theological Review
search, unfortunately, seems uncer Lewis & Co Ltd, 1963. 62:1-32, 1969.
tain. Contributing factors for this 3. Abramson HA (ed): The Use of LSD 18. Pahnke W, Kurland AA, Goodman
dim prognosis are sensationalism of in Psychotherapy and Alcoholism. New LE, et al: LSD-assisted psychotherapy
York, Bobbs-Merrill & Co, 1967. with terminal cancer patients, in Hicks RE,
the effects of LSD along with a con 4. Leaf R, Debold R (eds): LSD, Man Fink PF (eds): Psychedelic Drugs. New
tinuing spread of illicit use, public and Society. Middletown, Conn, Wesleyan York, Grune & Stratton Inc, 1969 pp 33-42.
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fear stimulated especially by reports 5. Cavanna R, Ulmann M (eds): Pro- Chromosomal damage in human leucocytes
of irreversible genetic and psycho ceedings of an International Conference on induced by lysergic acid diethylamide.
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had first-hand clinical or research 1969. 1043-1049, 1967.
7. Pahnke W, Richards W: Implications 21. Egozcue J, Irwin S, Maruffo CA:
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culty of obtaining such training. ligion Health 5:175-208, 1966. JAMA 204:214-218, 1968.
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formed research including special al: Psychedelic therapy utilizing LSD in posed to lysergic acid diethylamide: Lack
ized training and experience for the treatment of the alcoholic patient: A of chromosomal damage. Science 158:508\x=req-\
those interested in this area. Our preliminary report. Amer J Psychiat 123: 510, 1967.
1202-1209, 1967. 24. Bender L, Sankar DVS: Chromoso-
past and present research continues 10. Kurland AA, Unger S, Shaffer JW, mal damage not found in leucocytes of
to intrigue us with the promise of et al: Psychedelic psychotherapy (LSD) children treated with LSD-25. Science 159:
in the treatment of alcoholism: An ap- 749, 1968.
psychedelic drugs, but they are ob proach to a controlled study, in Abramson 25. Sparkes RS, Melnyk J, Bozzetti LP:
viously powerful tools that need to HA (ed): The Use of LSD in Psycho- Chromosomal effect in vivo of exposure to
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These investigations were supported in
et al: LSD-type drugs and psychedelic 27. Tjio JH, Pahnke WN, Kurland AA:
part by Public Health Service research therapy, in Shlien J, Hunt H, Mataruzzo J, LSD and chromosomes: A controlled
support grants MH-13747 (Psychedelic et al (eds): Research in Psychotherapy. study. JAMA 210:849-856, 1969.
Therapy Research Program), MH-15555
Washington, DC, American Psychological 28. Smart RG, Storn T, Baker EF, et al:
(Program for Treatment of the Narcotic Assoc Inc, 1968, vol 3, pp 521-535. Lysergic Acid Diethylamide (LSD) in the
Addict), MH-08474 (Controlled Study of Treatment of Alcoholism, publication 6.
LSD Therapy with Alcoholics), MH-11001 13. Unger S: The psychedelic use of
(A Controlled LSD: Reflections and observations, in Bookside monograph of the Addiction Re-
Study of LSD Therapy with search Foundation, Toronto, University of
Neurotics), and FR-05546 (General Re Hicks RE, Fink PJ (eds): Psychedelic
search Support Program). These grants Drugs. New York, Grune & Stratton Inc, Toronto Press, 1967.
were administered by Friends of Psychi 1969, pp 199-209. 29. Johnson FG: LSD in the treatment
atric Research, Inc, Baltimore. 14. Savage C: Psychedelic therapy, in of alcoholism. Amer J Psychiat 126:481\x=req-\
The lysergic acid diethylamide used in Shlien J, Hunt H, Mataruzzo J, et al 487, 1969.
this research was manufactured by the (eds): Research in Psychotherapy. Wash- 30. Ludwig A, Levine J, Spark L, et al:
Sandoz Pharmaceutical Co., Basel, Switzer ington, DC, American Psychological Assoc The clinical study of LSD treatment in
land, and distributed by the FDA-NIMH Inc, 1968 vol 3, pp 512-520. alcoholism. Amer J Psychiat 126:59-69,
Committee for psychomimetic drug re 15. Savage C, McCabe OL, Olsson JE, 1969.
search. et al: Research with psychedelic drugs, in 31. Hollister LE, Shelton J, Krieger G:
Lee McCabe, PhD, Sidney Wolf, MA, Hicks RE, Fink PJ (eds): Psychedelic A controlled comparison of lysergic acid
William Richards, STM, and Thomas Ci- drugs. New York, Grune & Stratton Inc, diethylamide (LSD) and dextroampheta-
monetti, MD, collaborated in these studies. 1969, pp 15-22. mine in alcoholics. Amer J Psychiat 125:
James Olsson, PhD, performed the statisti
cal analyses. Harry Shock, LLB, headed 16. Kurland AA, Pahnke WN, Unger S, 58-63, 1969.
the independent evaluation follow-up team. et al: Psychedelic psychotherapy (LSD) 32. Szara S, Faillace LA, Speck LB:
Louis Goodman, MD, Sinai Hospital, Balti in the treatment of a patient with a ma- Metabolic and physiological correlates of
more, Md, arranged the clinical facilities
lignancy, in Cerletti A, Dove FL (eds): the psychological reaction to three short-
for the study of patients with cancer. The Present Status of Psychotropic Drugs: acting tryptamine derivatives, in Brill H,
Proceedings of the Sixth International Con- Cole J, Deniker P, et al (eds): Proceed-
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