THE THERAPEUTIC USE OF
LYSERGIC ACID DIETHYLAMIDE - 25
INDIVIDUAL AND GROUP THERAPY
D. B. Blewett, Ph.D. and N. Chwelos, M.D.
Approximate date of Printing 1958
Reviewed by Myron Stolaroff
Psychedelic drugs are currently very much misunderstood by our government and the public at large. A great deal of the misunderstanding derives from attempting to evaluate these substances in scientific terms which leave out the very essential factors required to understand and appropriately employ these substances. Probably the most essential factor not generally recognized is the transpersonal nature of human beings -- the fact that we are in our essence spiritual beings, a concept which the majority of scientists reject. Without this recognition of our true nature, the most important contributions of psychedelic chemicals can be overlooked or misinterpreted.
It is most fortunate that in the 1950's, one of the research teams studying the therapeutic potential of LSD had through their own experiences discovered the true nature of LSD, its action, and appropriate methods of employing it. Their work resulted in this handbook, which to this day remains one of the most informed documents on LSD therapy. This manual is a thorough investigation of the factors to be considered in successfully employing LSD in a therapeutic setting. It is an outstanding collection of information that should be of great value to those wishing to understand the nature of the LSD experience and how this remarkable drug can best be employed. In this review, I have chosen examples of important issues which I hope can convey the flavor of this document. For those pursuing these interests, I highly recommend a thorough reading of this manual, which can be read on the MAPS website by clicking here.
In their preface, the authors state the psychological effects of the new psychedelic or mind-manifesting drugs "are so profound as to lie beyond the customary comprehension or, often the imagination of people who have not experienced them. Their vast scope and tremendous psychological impact lend them a remarkable therapeutic potential. However, in large part this potential can be realized only to the extent that the therapist is aware of the nature and scope of the reaction he is dealing with and to the extent that he can use the various features and stages of the experience to the benefit of his patient.
"With this in mind, the authors have attempted to sort out the features and stages of L.S.D. experience in general, and indicate, insofar as possible, the extent and areas of individual variation. They have outlined in detail the techniques which they have found useful and appropriate at each stage and have indicated these areas in which they have encountered difficulty and the techniques evolved to avoid or overcome such problems (Preface page 1)."
The authors' recommendations are based on extensive and intensive studies conducted over several hundred sessions included normal, psychotic, neurotic, psychopathic and alcoholic individuals. Each author has taken L.S.D. over 100 times in a variety of settings and each has participated in more than 50 group sessions in groups of 2 to 6 with colleagues and patients.
"The psychedelic reactions induce an extension of awareness, an enhancement of perceptions and an increase in emphatic potential which open vast and important areas of functioning and experience to scientific investigation (Preface, page 2)."
Chapter 1 covers the rationale for using LSD. "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 (Chapter 1, page 2)."
The Nature of the Drug Reaction is covered in Chapter 2. Despite the tremendous variety in individual reports, the authors point out nine factors that consistently appear. The list includes such things as "1. A feeling of being at one with the universe. . .4. Change in perception and time. . .6. . .the subject feels he develops profound understanding in the field of philosophy and religion. . .8. Increased sensitivity to the feelings of others." Each factor is supported by a transcribed statement of a subject (Chapter 2, page 4-5).
Characteristic types of reaction are described, which reduce to six general levels. These levels are primarily related to the subject's degree of self-acceptance, and represent the degree of surrender achieved.
The first two levels are reactions to resist and escape from the effects of the drug. The first is called a flight into ideals or activity. The second is a flight into symptoms, which seem correlated with the inability to direct attention outside oneself. The subject becomes preoccupied with body feelings and sensations which can become quite alarming and uncomfortable. The inability to free oneself produces even greater alarm, and can go as far as nausea, numbness of limbs, or violent headaches.
The next two levels are states that have given rise to the labels hallucinogen and psychotomimetic. "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 (Chapter 2, page 7)." The fourth level is characterized mainly by paranoid thinking.
The final two levels are characterized as psychedelic. "In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area 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 understanding. These are levels at which the therapeutic possibilities of the drug are most fully realized. (page 9-10)." In the sixth level, "the experience is accepted as offering a new and richer interpretation of all aspects of reality (page 10)."
All of the above levels are discussed with great detail and cover many variations. In summary, "some 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 many 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 the subject can attain and the ease with which it is accomplished (page 11)."
In Chapter 3, the authors review the first synthesis of LSD-25 in 1938 and the progression of research by a number of investigators as the potential for therapeutic application was discovered. By the late 1950's, the literature on LSD-25 had mushroomed remarkably with three bibliographies sited. While numerous promising applications were uncovered, the authors are convinced that the greatest potential application is in realizing the remarkable degree of insight and self-understanding that is available. "While the drug does permit a review of those repressed or suppressed areas which are the well-springs 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 (page 14)."
The focus of the manual is to aid subjects in achieving this important level. This method grew out of the early work of Hubbard, who had developed his technique of the overwhelming dose experience through working with large numbers of subjects. Hubbard developed techniques of focusing the experience, such as using music, paintings, and other stimuli. In addition to discussing Hubbard's contributions, the authors make a strong case for using large doses of LSD, in lieu of starting with small doses and working up, which can permit the subject to maintain control and reinforce his false belief systems. The authors also stress the importance of therapists having first hand experience with LSD-25 before administering to subjects. In fact, all staff members who come in contact with subjects can be much more supporting and understanding if they have first experienced LSD-25.
Chapter 4 reviews work done with both individuals and groups, describing important elements and outcomes from these different procedures. Chapter 5 discusses how the work resulting from individual and group sessions can contribute to the furthering of scientific research in this field. In Chapter 6 the requirements for a good setting in conducting this work are described. Set and setting have now been widely recognized by informed investigators as very important factors affecting the outcome of the psychedelic experience. Useful tools, equipment and supplies are described in Chapter 7. Chapter 8 reviews Indications and Contra-indications in selecting subjects; a great deal more needs to be known to extend the range of coverage. It is clear that LSD works best with persons of higher intelligence, while those who are rigid, compulsive, suspicious, or withdrawn are like unlikely to respond well. In developing the prescribed methods, work was done mainly with alcoholics and psychopaths and some neurotics. "It is important that the experience should be explained as fully as possible to the subject and...he should be willing to accept the treatment voluntarily (page 23)" without coercion.
Chapter 9 reviews the preparation of the subject. A partial list of some important factors: It is especially important that rapport be established in advance between the therapist and the subject. The subject is requested to write a biography prior to treatment, as well as prepare a list of questions dealing with problems for which he is seeking answers. It is very helpful for the subject to write a report of the experience following treatment. This chapter reviews other suggestions that will aid the subject in being prepared, at ease, and having some idea of what to expect under various circumstances.
Important things to remember:
"During the experience accept the novel feelings as real and true. You can question them and apply the usual forms of logic to them at your leisure in the days that follow b