Psychotherapy with lysergic acid diethylamide
By Eisner B.G and Cohen S
Journal of Nervous and Mental Disease 1958
Reviewed by Alex Pearlstein
22 patients (5 inpatients and 17 outpatients) with conditions ranging from depressive states to borderline schizophrenia were given an average of 4 to 5 weekly sessions with LSD. Dosage was started at 25 mcg orally and built up in 25 mcg increments to 125 mcg. In a few instances 250 mcg were given. During the sessions one therapist was in constant attendance. During stressful periods the presence of a male and female therapist speeded the therapeutic process.. Music an other aids (photographs and a mirror) were found to facilitate the action of the drug. Follow-up studies lasted 6 to 7 months. The main criteria of improvement was continuing succession in behavioral adaption as assessed by 3 persons (2 therapists and 1 person in close contact with the patient). Improvement was noted in 16 of the 22 cases and was not restricted to any one diagnostic category. However, patients with anxiety, compulsiveness, depressive states and anxiety with alcoholism made a good response. Inadequate schizoid personalities made a poor response. The potential dangers of LSD (suicide, suicidal preoccupation and depression) are pointed out. Caution in the selection of patients is therefor indicated.
It was hypothesized that LSD-25 might be useful in a therapeutic setting, as an aid in the uncovering and acceptance of unconscious material and might shorten total treatment time. This was based on the wealth of research findings from previous experimentation with LSD-25 and psychotherapy.
The therapeutic sessions were conducted in comfortable atmospheres with the patient usually on a couch. Music was played when there were periods with no verbal exchanges. Usually the patient made selections or semi-classical selections were used during early phases; certain piano concertos were used during the height of the experience.
In addition to music being used as an aid, a mirror was found to be helpful when a patient faced difficult problems of self-identification. It was common for the patient to project his unconscious concept of himself onto the reflection in the mirror. Photographs were found a valuable tool to help externalize associated conflicts, and to re-experience repressed events with such vividness and force that they were repeatedly referred to as "relived". This is beneficial as well for as a childhood incident was being relived with appropriate emotional discharge, simultaneously it was also perceived by the patient from an adult perspective. Towards the end of a session, patients were brought to the clinics art center to draw or paint. This was found to be a helpful experience and provided an opportunity to objectify subjective experiences.
The results of these clinical sessions were found to be quite helpful for several patients. Occasionally, the patient could clearly understand the problems and the defenses he had established even when these appeared in symbolic form. More frequently it was necessary to interpret these unconscious materials deeply and directly as they arose. Such interpretations, which in conventional psychotherapy might have had devastating effects, seemed to be accepted without difficulty.
For this type of therapy it was actually suggested that the therapist, himself should undergo a few personal LSD-25 experience of increasing dosages, before conducting such sessions. This would help the therapist to identify with the process and to aid in the translation and interpretations of the patients experience. Without first hand knowledge of the LSD-25 experience some of the patients reactions or statements would be misinterpreted or considered unintelligible.
A key factor to the success rate of this type of psychotherapy is the patient selection. All patients were screened for specific characteristics to identify them as good candidates for LSD therapy. First and foremost the patient had to have a desire to get well. After motivation, ego strength and intelligence are important. It was also found that the more troubled a patient, the better the prognosis since the desire for change would be greater.
Improvement from LSD-25 therapy was found to work well with a spectrum of diagnostic categories. Patients suffering from a range of issue such as anxiety, compulsive behavior, alcoholism, predominantly traumatic neurosis and depression showed favorable results from therapeutic sessions. A great note in this paper is that people in emotional distress, unhappy and floundering individuals who had lost their ability in anything greater than themselves, were found to be extremely responsive.
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