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Toward a Psychedelic Medicine1
Richard Yensen, Ph.D.
Yearbook for Ethnomedicine and the Study of Consciousness,
Issue 1, 1992, pp51-69. ©VWB - Verlag für Wissenschaft und Bildung, 1995.
Introduction and Goals
This paper seeks to delineate the need for a fusion of many existing
areas of study into a new discipline that focuses on practice,
research and study of the use of psychedelic substances as medicine.
For the duration of this paper I will call the new discipline
psychedelic medicine. This may not be the most appropriate
name for the new discipline and you are invited to suggest better
ones.
Four major areas will be discussed in this paper: 1) Psychedelic
medicine will be defined and placed in historical context. 2)
An analysis of the shortcomings of our current research methods
will be made. Specifically I will discuss how experimenter errors
are made because of the accepted dichotomy between subject and
object, experimenter and experiment. We will see how these errors
point to the need for an approach that acknowledges the basic
oneness of the psychedelic states of consciousness. I will also
discuss how research which views psychedelics as pharmacologic
agents obscures significant factors that determine human response
to these substances. 3) I will then present the process of treating
a terminal cancer patient as demonstration of a new model for
disclosing fully the experiences of all participants in a psychedelic
session. 4) I will then propose future directions for our collaboration
and suggestions for How to train the practitioners of psychedelic
medicine.
Definition and Historical Context
Psychedelic medicine does not seek to replace contemporary allopathic
medicine. Psychedelic medicine is deeply complimentary to most
of contemporary medical practice. Since it deals with the deepest
levels of human experience and motivation through human relationship,
psychedelic medicine reaches the patient in important ways that
allopathic medicine does not. Psychedelic medicine helps individuals
to find meaning in their existence which produces an emotional
healing that is complimentary to the physical healing offered
by allopathic medicine. Since psychedelic medicine addresses the
whole life history of the patient as a meaningful context for
healing to begin, it is basically holistic in theory and practice.
Psychedelic medicine seeks to produce the deepest harmony possible
between mind, body and spirit. Psychedelic medicine is often most
helpful at times when the remedies of allopathic medicine have
been exhausted or the prognosis is terminal.
Psychedelic medicine is not actually new but is the resurrection
of an ancient discipline. A contemporary Native American healer
using psychedelic plants speaks of their effects on the mind and
what he knows of their history:
"By means of the magical plants and the chants and the search
for the roots of the problem, the subconscious of the individual
is opened up like a flower, and it releases these blockages. All
by itself it tells things. A very practical manner... which was
known to the ancient's" (SHARON, 1978 P. 46).
Since the dawn of time psychedelic substances in the hands of
priests, physicians and metaphysicians have been used in culturally
significant rites of passage, death and rebirth, mystical quest
for meaning, membership and healing. The study of how the appropriate
use of psychedelic substances can be of continuing benefit to
humanity is the focus of psychedelic medicine. Although variations
of psychedelic medicine have been practiced throughout history
and are still practiced in certain groups, knowledge of psychedelic
medicine has been lost in other cultures and at this time is being
intentionally buried in our society.
Why call this area of research and study Psychedelic medicine?
First let us examine the origin and meaning of the word psychedelic.
In 1957 HUMPHREY OSMOND, an early researcher in this area,
introduces the name psychedelic to provide a label for experiences
of great and lasting benefit. Investigators of compounds which
had been given a variety of non-descriptive, pejorative or cumbersome
labels, wanted a name that implied positive potential. OSMOND
had observed profoundly positive personality changes in some of
his subjects. These great spurts in personal growth seemed to
follow transcendental, mystical or, as OSMOND proposed, psychedelic
experiences with the compounds he renamed. He proposed psychedelic
as a new name for these substances and their effects in the hope
of liberating scientific investigation from the enduring influence
of more narrow and negative labels that suggested limited fields
of application and ignored the enduring positive value of these
substances. OSMOND found that LSD, mescaline and psilocybin can
be useful, not only in studying psychopathology, but also that
they shed new light on the greatest philosophical enigma of human
existence, the purpose and meaning of life:
"Our subjects, include many who have drunk deep of life,
authors, artists, a junior cabinet minister, scientists, a hero,
philosophers, and businessmen... Most find the experience valuable,
some find it frightening, many say that it is uniquely lovely.
If mimicking mental illness were the main characteristic of these
agents, psychotomimetics would indeed be a suitable generic term.
It is true that they may do so, but they do so much more... I
have tried to find a more appropriate name" (OSMOND, 1957).
OSMOND'S neologism was brought forth from the Greek roots psyche
and delos meaning mind and manifesting. In the years
that have followed OSMOND'S proposal the name psychedelic has
come to be associated with a counter-cultural lifestyle, wild
innovations in music and art, but most if all with the dangerous,
unsupervised and hedonistic use of these compounds. Certainly
these connotations were not part of lamentable failure of our
society to integrate, use, and understand psychedelics and their
motive potential. Nonetheless the name psychedelic is appropriate
for a wide variety of substances that can facilitate a broad range
of human experiences many of which can be of enduring value to
the individual and the culture. I call this a field of medicine
to acknowledge medicine in a sense mostly lost to this culture,
the aspects of medicine concerned with spiritual growth for its
practitioners and healing of mind, body and spirit for its patients.
This is a form of medicine more akin to that practiced by the
American Indians and Ancient Greeks than our modern technological
allopathic medicine. It is a medicine more concerned with healing
the soul than the body.
How is it that psychedelic medicine could be an ancient discipline?
There is evidence that as long ago as 100,000 years humans were
using medicinal herbs. The use of plants to induce altered states
of consciousness has been documented circa 8,000 B.C. (FURST,
1976). So if we take into account the plant kingdom it becomes
clear that the use of psychedelic substances by humans is not
a recent development. Psychedelics are not associated with counter-cultural
forces in the rituals of cultures that use them. In fact, many
traditional societies use these substances as powerful tools for
renewing and passing on their basic belief system.
Psychedelics in the form of sacred plants appear to have played
an influential role in the formation of religions and the early
development of Western philosophy. R. GORDON WA550N is foremost
among a new genre of scholars who call themselves ethnopharmacologists
and who specialize in examining the role of pharmacologically
active plants in history. His book Soma, the Divine Mushroom
of Immortality meticulously relates the legendary Soma
as described in the Hindu oral tradition of the Rig Veda
to Amanita muscaria, a psychedelic mushroom. Mr. WA550N'S
scholarly efforts, not to be confused with the fanciful proposals
of others regarding mushrooms and religious practice (e.g. ALLEGRO,
1970), amount to a profound interdisciplinary analysis of how
Amanita muscaria mushrooms fit the Rig Veda's poetic
imagery from the perspective of botany, chemistry, pharmacology,
anthropology and psychology. WA5SON presents convincing evidence
for his hypothesis that at the dawn of human history the effect
of a sacred plant were cornerstone in the foundation of one of
the great religions of the world. Not content to allow this scholarly
tour de force to stand alone, WASSON has since joined with others
to present strong evidence that the "wine" consumed
as part of the mysteries at Eleusis in ancient Greece was made
from ergot infested grain and hence possessed mystical, sacred
and psychedelic properties due to the effects of Iysergic acid
amides. These renowned mysteries were said to profoundly affect
the participants which included Plato and Socrates in Greece and
Pythagoras in Egypt (WASSON et al., 1978).
Clearly sacred plants and psychedelic medicine have played a more
significant role in human history than common knowledge would
suggest. The use of these plants has been in the context of deeply
meaningful ritual setting that invoked transpersonal experiences
of a mystical and spiritual nature. Cultures of oral tradition
have revealed to us their awe of the vast frontiers revealed by
these substances through the names they chose for these sacred
plants: semen of the sun, vines of the serpent, the tracks of
the deer, plant of the tomb, vine of the soul, mainstay of the
heavens, herb of divination and flesh of the gods (SCHULTES &
HOFMANN, 1979).
Analysis of Current Research Methods
Psychedelics are a unique new frontier in our exploration of the
universe. People from all walks of life, who have sufficient experience
with the psychedelics in a supportive setting, discover that there
is a profound and basic unity to the universe that is more real
and true than the superficially apparent diversity and separateness
of our ordinary experience. Instead of realizing the revolutionary
implications of this insight our society attempted to study these
substances of if they fit neatly into our pre-existing ways of
understanding of the world. The scientific methods applied to
studying these substances in our culture ignored this crucial
insight about the nature of the universe.
In our culture the use and study of these compounds fell to the
disciplines of psychiatry and psychology. Both of these disciplines
had adopted methods for conducting research based on the assumption
that subject and object are separate and that the experimenter
is separate from the experiment. Although insights exist from
20th century physics that under certain circumstances subject-object
experimenter-experiment dichotomies break down, these insights
were not incorporated into the design of scientific research in
either psychiatry or psychology. Psychologists and psychiatrists
tried to understand the actions of these substances by integrating
them into pre-existing conceptual frameworks for understanding
the actions of drugs.[2] The
range and depth of understanding achieved through these methods
is very limited. If our healers couldn't understand the use of
psychedelics, how could they be used by the culture in a safe
and meaningful way?
Psychedelic medicine accepts the basic unity implied by psychedelics
and psychedelic experience. This insight forces a return to naturalistic
reporting of our experiences along this new frontier. We must
begin the work of gathering information from all participants
in psychedelic sessions as a way of acknowledging the basic unity
of the phenomenon under study. This information will assist us
in making new maps of our consciousness and its inseparable union
with the universe. I believe that this important unitive insight
can be a fulcrum to lever our thinking about psychedelics out
of the l9th century and into contemporary thought about the nature
of the universe.
Our complex technological society has abandoned ways of thinking
about the world that would allow us to accept these substance
as sacred or divine. Yet we must take into account that all cultures
throughout history that used these substances successfully, accorded
them a sacred role. This perception of psychedelics is actually
quite reasonable. A substance that can facilitate personal insight
into the most meaningful dimension of existence where the unity
of all creation is perceived surely meets the requirements for
sacred status.
"[There is a] curious symmetry between people who abuse drugs
and people who study them. The person who is convinced that highs
come in drugs, if he is negatively oriented toward society, becomes
a drug abuser; if he is positively oriented toward society, he
becomes a drug researcher. But the two are essentially the same,
because both arc laboring under the identical materialistic illusion.
Only their mutual antagonism keeps them from realizing they are
two poles of the same way of thinking" (WEIL, 1972, P. 70,
72).
The world view prevalent in our culture has made it possible to
accept these substances only as drugs, pharmacologically active
agents. Since drugs are considered man made tools they are anything
but divine within this culture. To think of these substances as
drugs is an unfortunate error. Though it may be impossible for
us to think of them as divine. there are advantages to such thinking.
Clearly God is everywhere at once and so the experience attained
through such a sacramental substance is not contained within this
substance. This way of thinking about psychedelics provides a
conceptual schema superior to pharmacology for understanding that
the non-drug or ceremonial factors are what determine the actions
and effects of psychedelics on human beings. Thinking in this
way also gives the implicit instruction that all experience engendered
by these substances is to be accepted even though it may be difficult
or painful.
Since just before the turn of the century Western scholars have
attempted to study psychedelics without being able to grasp the
full scope of the potential embodied in the knowledgeable use
of psychedelics. During this period of time, the psychedelics
were examined for their possible role as facilitators in psychological
healing, providers of insight into the mysteries of human existence
and stimulators of creativity. Of several factors limiting the
development of knowledge in this area a central one has been an
unwillingness of the scientists involved to look at the influence
they have exerted on their own research. Scientists have labored
under the commonly accepted misconception that they are unbiased
or can design clever studies to eliminate the influence any bias
might exert on the experiment. The dichotomized view of reality
where subject and object are separate entities with exactly definable
influences on each other was the state of our scientific view
of the universe at the turn of the century. The application of
this world view to the design and interpretation of studies with
psychedelics has obscured and confounded research efforts. Dogged
adherence to methods that demand a clear separation between experimenter
and experimental subject to produce meaningful results are continually
suggested as the most scientifically appropriate and in fact the
only way to scientifically study this area. Advances in our understanding
have also been limited by the materialistic illusion that pharmacologic
activity must be a prime determinant of any effects that these
substances might have on human beings including both the nature
of the experiences reported by people taking psychedelic substances
and their ultimate expression in human behaviour. Research with
psychedelic drugs, even after a significant amount of time and
study with thousands of published reports, is still at a frontier
stage. This does not signify, as some would have it that the psychedelics
are neither promising nor fruitful as area of study. Drug researchers
have floundered by applying prematurely rigid and conceptually
inappropriate, methodologies. They have refused to report on their
own important biases and emotional responses. This has helped
to maintain the fiction of the unbiased investigator. They have
thus conducted research that asks hopelessly incorrect questions
and may produce the results expected by mechanisms overlooked
in the original research design and conduct. So rather than advancing
understanding of a complex field of study, early attempts obscured
the important variables in this research while laying undeserved
claim to scientific status. There is no published study where
the experimenter describes their biases vis-à-vis psychedelics
or their own feelings during a psychedelic session with subjects.
This situation is rather like a chemist reporting that he mixed
two reagents together and they blew up but refusing to disclose
what the reagents were! From a scientific perspective these researchers
failed to report on significant independent variables.
The inadequacy of contemporary models for research in this area
has combined with social concern over the threat of uncontrolled
use of these substances to lead the governments of the world to
impose restrictions on psychedelics which impede scientific research.
The need to control use of these substances by the general public
and the difficult nature of this goal has lead regulatory agencies
to over-regulate legitimate researchers.
For instance in the United States the Food and Drug Administration
insists that qualified investigators adhere in the design of their
studies to accepted views of how to investigate other psychoactive
substances where the direct chemotherapeutic activity of a drug
is being evaluated. Psychedelic research involves a unique and
complex interaction of psychotherapeutic, pharmacologic and environmental
factors. This completely ignores the fact that psychedelics are
unlike pharmacologic agents and require a serious reconsideration
of our methods and techniques for conducting research. This control
over the scientific community is accomplished by appointing "peer
review" panels of researchers with little or no background
in psychedelic research. Thus progress in this area is effectively
stopped by blocking any innovative study that does not adhere
to the methods and techniques deemed appropriate by committees
of researchers with no specific expertise in the precise area
they are offering expert opinions about.
"It is an inherent property of intelligence that it can jump
out of the task which it is performing, and survey what it has
done; it is always looking for, and often finding, patterns. Now
I said that intelligence can jump out of its task, but does not
mean that it always will" (HOFSTADTER, 1979, P 37).
For these reasons it is my opinion that a new interdisciplinary
field of study called psychedelic medicine must be inaugurated.
This new field should strive to adopt appropriate methodologies
for studying the states of consciousness that are facilitated
through the growing family of compounds that are best described
as mind-manifesting.
A Case History in Psychedelic Medicine
As a model for studying psychedelic medicine, I would like to
share with you the poignancy of an actual clinical experience
with psychedelic substances. I do this to foster the reader's
appreciation and understanding of the value of inherent in this
way of producing psychological healing, T would like to do this
by giving a case presentation of the psychedelic treatment of
a terminal cancer patient. I will describe this experience with
the most candid and complete disclosure of my experiences and
those of others involved in the process as possible. This is my
attempt to fully disclose of all the relevant variables in the
situation in the manner I suggest is appropriate for psychedelic
medicine. I introduce this material also because the moral, philosophical
and religious elements that are characterized by reverence for
life and appreciation of the infinite value of the individual
human being are illustrated in this account and they must be the
central tenets of psychedelic medical ethics. We cannot study
the transcendent realities of psychedelic consciousness without
accepting the unity that these experiences convey and fully reporting
our own experiences as participant-observers. For these reasons
I choose to look back 13 years to openly share my own first experience
with administering a psychedelic to a terminal cancer patient.
I hope the events that follow will highlight the complex interweaving
of meaning for me as a researcher, psychotherapist and human being
and do justice to the importance this treatment had for my patient.
Such an account has not to my knowledge found its way into the
literature before now. Most important, the study that provided
the context for this experience was not reported in a manner that
did justice to the remarkable nature of this and many other beautiful
human experiences that are the essence of psychedelic medicine.[3]
I came to know this man in the process of
therapy as a remarkable and unique person experiencing the exquisite
crafting of the final facets to the jewel of his lifetime. This
experience had special meaning for both of us because for each
of us in our own way it was both a first as well as a last experience.
For Joe it was his first and last experience with the drug DPT
and our research therapy team. For me it was my first experience
with a terminal cancer patient, a joyous loss of significant aspects
of my virginity as a psychedelic therapist. The whole team involved,
myself, the co-therapist and Joe emerged from this event with
significant personal growth. Although every psychedelic session
is a first and has the value of newness this experience has stayed
with me over the years as a special one that demands further analysis
and understanding to appreciate fully.
He was 70 years old and his cancer began in the eye then it spread
to his prostate and ultimately insinuated its way into the other
abdominal organs. His surgeon noted that the patient had signs
of depression and a markedly increased need for pain medication,
this led the doctor to recommend our experimental treatment with
psychedelic drugs. He had seen the treatment help other patients
dramatically so Joe would improve too. For me this was a very
special event, Joe was the first cancer patient I had the opportunity
to treat as a research psychotherapist. The staff person at the
Maryland Psychiatric Research Center who was in charge of the
project laughed as he told me that I should have fun treating
this man because he had lived with his mother for his whole life.
This was still the case even though Joe was 70 years old!
As I walked up to the Cancer Unit I prepared myself for what I
anticipated would be a significant experience in my career as
a therapist. I remembered that for me it seemed a very important
part of my role as a healer to assist people in experiencing the
fears and joys that are hallmarks of confrontation with the boundaries
of human existence. I was quite proud of my accomplishments because
against all odds I had been able to join the clinical stall of
the only psychedelic research project in the country working with
human subjects and psychotherapy. For me this was a dream realized.
I had disdain for the fact that medicine seemed to emotionally
abandon people near death and was resolved to learn everything
I could from this experience.
Joe was in a room with several other patients and when I asked
the nurse who showed me in where we might go for some privacy
she acted surprised. After walking us out to the hall she quickly
darted in and out several doors and then apologetically offered
us the janitor's room. There were brooms and pails strewn around
the small office and she moved a couple of chairs into the closet
sized room. She then said she hoped we wouldn't be disturbed by
janitors looking in for their tools. My pride was a bit tarnished
by the idea of meeting in a broom closet, but there seemed no
other alternative.
He was quite jovial when I asked him about his stay in the hospital.
He chatted off-handedly about the excellent treatment he was receiving
and told me loudly of his implicit trust in the doctors. Then
he informed me that the doctors might have to remove his eye because
of the cancer. He told me this with such a matter-of-fact and
emotionless tone that he could have been describing the cosmetic
removal of a wart rather than a vital organ of sight. When I asked
him how he felt about possibly losing his eye, Joe replied without
a moment's hesitation that whatever the doctors decided he would
accept. Then he quickly went on to say that there were many more
important things for us to discuss. I prepared myself for him
to say something about his impending demise, but to my astonishment
he said that he needed to understand labor unions. I decided that
although that wasn't my agenda for our meetings I would have to
allow Joe to express whatever was on his mind. What sometimes
sounded like a lecture on how to organize a labor union slowly
changed into a recollection of the important events in Joe's life.
I began to feel the power and beauty of the life Joe had led and
to appreciate the privilege of hearing his story.
I learned that Joe was an electrician and had worked with his
hands all of his life. Five years earlier he had been retired
from a position in local industry. Joe spoke at length about his
life as a working man and activities in organizing a labor union.
When Joe was six his father had been blackballed from working
as a riveter in the United States because he was involved in early
attempts at organizing a union. Because of his union efforts Joe's
father had to, with a group of friends, gather together enough
money to get over the border to Canada. They could only gather
enough funds for one of their group to cross the border at a time.
In order restrict the immigration of vagrants into Canada, you
needed to post a $ 50.00 bond before crossing the border. Once
a man was able to secure a job in Canada the he would send his
first paycheck back to fund the transfer of another friend into
Canada. Joe was outraged that this had been the plight of early
union organizers who were trying to improve working conditions.
Joe, his brother and one sister, were raised in a northern state
where they struggled to survive on the meager income from his
father's Canadian job. When Joe was 11 his father was able to
secure permission for him to work as a water boy on the riveting
gang. This took Joe out of school, but he was glad for the opportunity
to help support the family. Joe described his father as a hard
working, hard drinking man who was very kind to his children.
He remembered playing ball with his father on weekends and listening
to his fascinating stories about working and organizing.
Joe described for me the working conditions riveters faced in
that area. The men worked in cruelly confining spaces on hot days
made hotter by the blazing coal fires used to heat the rivets.
When the supervisors were away, Joe's father had allowed him to
work as a "holder on". This job involved using all of
his youthful strength to hold a red hot rivet in place while another
worker peened the end of it. Joe was especially proud of the way
he had cleaned up the crew's water bucket which had been rusty
and dirty when he arrived. He had first asked that the company
purchase a new water bucket, but when they refused he was able
to clean up the old one so the men could drink clean water.
Joe's mother was the backbone of the family. She was still living
though his father passed away many years before. Joe said her
faculties were undiminished even though she was 90 years old.
Joe lived with her and his only sister, Jean. He said his mother
was a warm, comforting and emotionally available person throughout
his childhood. However the family had very little material means.
Joe told me that he never married; he had a girlfriend when he
was in his twenties and though he proposed marriage to her, she
didn't accept because of her family's counsel against marrying
a man who drank as much as Joe did. I asked if he really drank
that much and Joe said, "I must admit I could really put
it away." Quickly adding that his fellow workers did the
same. As a way of explanation this Joe told me that throughout
his childhood the men all worked in gangs and the foreman of each
gang received the weekly pay in gold. So on payday the entire
gang of men would adjourn to a tavern immediately after work.
At the bar, in the process of dividing up the money, they inevitably
drank a fair measure of their income. Joe spoke of alcohol fondly
almost as though he were talking about a person, a working man's
friend and entertainer, who gave a few moment's respite from the
grueling daily labor that made up the lives of the men. He said
he had to give up drinking in 1955 because he suffered heart damage
from an accidental electrical shock at work. Though he was sad
to lose the companionship he apparently had no great difficulties
in giving it up.
Joe said he moved to an Eastern Seaboard city and where he began
his efforts to create a union. He said it all started with a few
men meeting in bars after work dreaming of how things could be.
He told me of the fantastic battle with the management, of the
dirty tactics the company used in trying to scare the men out
of strike, and of his persistence and dedication to the men in
the yard. As our meetings became more intimate he recalled some
of his disappointments, at one point he discovered other men stealing
from the union funds and he was especially hurt when one of them
turned out to be a trusted friend. Joe said he always tried to
handle these incidents with care and secrecy, encouraging the
man to pay back his debt and resign the elected office he held.
Joe's attitude during the early interviews was heavily pedantic.
Our meetings had the tone of a class on labor relations. He strongly
denied any fears of losing his sight and spoke optimistically
about the future. Joe's surgeon assured me that he had discussed
the diagnosis and prognosis with him though Joe was discharged
from the hospital at this point. He was complaining of constant
abdominal pain and was receiving substantial doses of narcotic
medication without great effect.
Our meetings were continues at the Maryland Psychiatric Research
Center where we were able to meet in one of the comfortable drug
meeting suites which was furnished like a living room. Our meetings
began to have a more relaxed, less cramped, janitorial and medical
atmosphere. During our second interview at the center I suggested
to Joe that he try listening to some music over stereo headphones
while wearing eyeshades so that he could see perhaps a small glimpse
of what the psychedelic drug treatment session would be like.
I talked to him about how important this experience might be if
he could use the drug effects to go within himself and see where
the feelings about his illness and pain were coming from. Joe,
exuding confidence and bravado, allowed me to place the earphones
and eyeshades on him. As soon as the music was played, his tone
became complaining and angry. At first the music was too loud
and then he found it reminiscent of riveting. When I asked Joe
what riveting reminded him of he became panic stricken and removed
the eyeshades and earphones. He paled visibly and in a frightened
voice told me that he was unable to continue and would I please
turn off the music. I complied and Joe then told me that he was
suddenly experienced fear of losing his sight. He said that up
to this point he had not realized how frightening this might be.
Joe's attitude toward me changed drastically, when he became frightened
the authoritarian manner dissolved revealing a man genuinely scared
of what the future might bring. Over the next few interviews Joe
and I discussed his claimed ignorance of the possible outcome
of his illness. When I would suggest to him that he discuss the
prognosis with the physicians, Joe took refuge in the belief that
they would tell him as soon as the test results were in.
One day Joe complained of pain during the beginning of an interview,
I asked him if he wished to know what the medical findings were
in his case. He said yes, and I informed him of how the cancer
had spread throughout his body and that the doctors found in cases
where this happened that the most likely thing, though no one
could predict the future with certainty, was death. Joe didn't
act surprised or shaken instead he said he'd secretly suspected
for some time that he was dying. He had taken special precautions
to shield his mother from any knowledge that he was ill. He said
that it was clear to him now this attitude of protection was also
his attempt at shielding himself. "If I pretend my cancer
doesn't exist for my mother's benefit then I don't have to look
at it myself".
As part of preparation for Joe's session I interviewed his sister
Jean, who lived in Joe's mother's house with him. Jean was quite
upset about Joe's illness and ultimate demise which she considered
fait accompli. During a short interview I attempted to
communicate to her that it was possible for Joe's last days to
be a beautiful time of enhanced closeness and interpersonal warmth
for the whole family. Jean seemed somewhat reassured by our talk,
but she still seemed more focused on her own grief and feelings
of abandonment than on relating to her brother as the alive human
being that I was coming to appreciate more and more in my interviews.
I offered Jean the opportunity for additional therapy sessions;
however, it became clear that she did not wish to consider herself
as needing help. I made it clear to her that often in times of
severe stress such as this, talking with someone about the difficulties
could help and that I would be available to her throughout Joe's
illness. In watching Joe and Jean together, it seemed that the
attitude of fear and denial on both of their parts was responsible
for diminished human contact at a time when warmth and love were
the best treatment available. I asked myself what I could possibly
do to change this state of affairs. There was no ready answer
to my question.
Joe and I discussed his upcoming drug session as a special opportunity
for him to review and express the feelings he had inside himself.
Joe was confused as to what I meant by his "insides".
He had never imagined that there was a possibility of inner experience
until our meetings and hadn't felt that he could change anything
about the way he felt about himself or his life situation.
With some trepidation, I scheduled Joe's drug session. It was
my feeling that we had established good rapport; however, it was
still extremely difficult for Joe to introspect and share his
emotions. Joe continued to use denial as a way of fending off
his fear of death. Although we had been able to break through
his barrier sometimes, Joe in his daily life still constantly
spoke of the future as though his complete recovery were certain.
I experienced great hesitation in telling him that death was almost
inevitable. It was my fear that this news might be taken as a
verdict or a death certificate indicating that there was no hope.
I tried to convey clearly the fact that medical understanding
of cancer is incomplete and that recovery could take place though
it wasn't likely. We talked about death as something facing all
men and I told Joe that coming to terms with our fear of death
can lead to enhanced enjoyment of what life remains.
I introduced Joe to my co-therapist for the drug session, Mrs.
Nancy Jewell. Nancy was in her early 60's, a psychiatric aide
who had been working with the director of the Research Center
for years. I liked Nancy very much and sometimes would thing of
her privately as my "West Virginia Mamma" when I heard
the words of a then popular song by John Denver. When I brought
them together there was such an immediate rapport that I was amazed
and a bit jealous that Joe and Nancy took to each other so suddenly
and completely. I had been building my relationship of trust with
Joe gradually and tentatively for several weeks now.
On the day of the drug session Joe arrived in considerable pain.
According to my instructions, he had discontinued his pain medication
on the day prior to the session. Nancy and I made him as comfortable
as we could on the couch in the treatment suite. At 9 A.M. Nancy
administered 90 mg of dipropyltryptamine intramuscularly, a dosage
capable of producing profound experiences in a willing individual.
I placed the eyeshades and earphones on Joe and suggested that
he allow the music to carry him through the experience. I also
advised Joe to confront whatever experience should present itself.
Joe began to complain of pain and I advised him to enter the pain
as fully as possible. Joe began to scream "God damn it!"
"This is terrible, I can't stand this any longer!" he
asked me repeatedly if he could remove the eyeshades and earphones.
I asked him to trust Nancy, myself, and himself by facing the
feelings no matter how terrible they might seem. I encouraged
him to yell, scream, and express the powerful emotions in any
way he could. Nancy reassured him when he expressed concern that
his cussing might offend her.
Over the next 45 minutes Joe trashed, struggled and experienced
difficulties in breathing. We monitored his respiration rate as
slightly elevated. The struggle culminated when Joe said, "I
guess in the end you just have to give in." This statement
was followed by a deep sigh and a profound relaxation of his musculature.
He listened to the music peacefully with a contented smile on
his face for about thirty minutes.
Joe then called Nancy and me over to the couch. He held our hands.
He spoke of being a child, of the difficulties he experienced
being poor, of the joys of his profound identification with his
father and the struggle that was his father's. Joe said he was
experiencing that his father's struggle was also his own and at
the same time it was the struggle of all men. The struggle to
overcome life's difficulties; the pain, the disillusionment, and
the horror of being alive. Joe said, "I feel like I am becoming
the blood that flows through my veins, It's Irish blood. There
is strength here, I feel the strength of the Irish people. The
noble strength of working men. I can feel the meaning of the struggle,
of my Irish ancestors. They are stubborn and strong." Joe
said he experienced the ideals and dreams that brought people
and others to this country as immigrants. "They wanted to
overcome pain, injustice and suffering with their strength, not
just for themselves but for all of us. I share this struggle.
It has been my struggle to carry forward these ideals through
my work with the union."
Joe's face softened and looked young. He spoke about his early
jobs. He had dropped out of school and worked as a child so that
his brothers and sister could have shoes and could attend school.
He remembered working while a teenager for the railroad in their
roundhouse as an apprentice mechanic. He smiled and told us of
his foolish pride and overblown confidence in his abilities as
a boxer. He illustrated the ephemeral quality of physical strength
for us by describing an encounter he had with a fireman. He told
this fireman where to go because a guy left a locomotive in a
mess for Joe to clean up. As they fought Joe realized that he'd
met his match in boxing, but Joe's pride would not allow him to
admit defeat even though he was clearly losing the fight. The
fireman finally knocked him unconscious. Joe said this was valuable
lesson for him, he learned to have humility about his virtues.
"No matter how big you are, you act too big or too proud."
Joe recalled the girl wanted to marry with definite sorrow. I
encouraged him to use the session as his chance to express all
his feelings. I asked him not to hold anything back to share all
of himself with us. Joe said in his family he had learned that
a man can do many things but one thing he should never do is let
another man see him cry. I told Joe that crying is part of being
human and a person's strength can grow through letting tears express
what word cannot. Joe described his feeling of longing for his
fiancee. He told us how much he loved this girl and wanted to
marry her. I watched as his psychological conflict over crying
expressed itself in a physical struggle. Joe was holding his breath
and tensing his muscles as though trying to hold back a heavy
burden of his feelings. Finally he surrendered and deep sobs racked
his now frail looking body.
After crying Joe went on to describe his role in organizing the
labor union in the shipboard, the long hard struggle with management,
the difficult working conditions and how he was moved to action
when he saw men suffer. What was most striking was the complete
way in which he shared and relived all of this intense life experience
emotionally. He was able to cry now with less of a struggle and
he expressed in beautiful openly flowing tears his compassion
for fellow worker's suffering. He fumed and spit his hatred for
those managers and foremen more interested in production quotas
than in human welfare. The drama and grand sweep of this man's
life and his efforts seemed all the more poignant as he shared
the depth of his humanity so openly.
There was a broad satisfied smile on Joe's face as he shared his
exultation over the inauguration of a new four million dollar
union hall. He had helped inaugurate the new building a few years
before his retirement. As he beheld the costly new building he
contrasted this victory with the experience he had close to 40
years before when a local merchant was not willing to accept a
check written on the union's first checking account. Joe's expression
changed suddenly and he was able to admit for the first time the
pain that his mandatory retirement had caused him. He told us
how much it meant to be called "Mr. Union" by his friends
and even by his enemies at work. Joe described the sinking of
feeling he felt when he was told that because he was now retired
he could no longer prepare union cases for arbitration, the emptiness
he felt at being excluded from participation purely on the basis
of age. He said that if he knew he were going to live long enough
he would take on the struggle for the rights of older people.
At this point Joe's sister and niece arrived to pick him up. Joe
was able to sit up comfortably in a chair. I asked him if he was
still in pain. In a cheerful manner and with a smile he admitted
that he, "hurt something of fierce." Joe was relaxed
and joyous reminiscing with his family about happy events in their
childhood. His positive mood was infectious and soon all present
were enjoying the pronounced psychedelic afterglow. I allowed
Joe to leave the center at about 3.30 P.M. after making an appointment
for the following day.
The next morning Joe arrived for his appointment promptly an announced
that he was uncertain as to exactly what had take place the day
before. He claimed that his mind was completely blank. I asked
whether he felt any relief from his pain. He said that he hadn't.
At this point when Joe failed to remember his session even after
I mentioned some highlights to him. I became openly disappointed
with him. I told him that I could not believe that he had no recall
for the moving and profound experience that he had narrated so
eloquently the day before. Nancy was also present during this
interview and I experienced her presence as very important in
that it allowed me to confront Joe more powerful than I would
have dared to were I alone with him. I openly challenged his denial
repeating for him his own description of the content of his experience.
I bluntly told him that if this was an example of how he expected
to deal with death that I was sure he would find his death hard,
but that if he could recall his experience of the day before where
he looked death right in the eyes and continues to do that, death
should be kind and gentle.
Joe looked somewhat sheepish and asked that I got a little easy
on him. He acknowledged that he could remember what had transpired
the day before and said that it was so new and different an experience
to him that he found it difficult to understand and accept. Nancy
and I reassured him that the experience was genuine and worked
with him by discussing the different aspects of the session. When
Joe returned for his next interview he described to me that he
dad been having a great time going through his tools. He said
that for him one of the deepest pleasures of being alive was the
ability to give pleasures to the others. He had gathered together
all of his tools and made up three tool boxes. One of these went
to his brother, one to his nephew and the third to the workshop
of the blind. Joe said that it was plain to him through his physical
deterioration that death was near he told me that this was no
longer frightening and said he planned to spend as much time as
he could with his family.
This was the last meeting I had with Joe. I tried unsuccessfully
to reach him by telephone several times, but was informed that
the telephone would not reach his bed. Joe's niece relayed messages
from him sending his regards and she told me that Joe spoke so
warmly of me she wished she could arrange another meeting for
us. I told her that I would be glad to come out to the house and
visit Joe. She said that Joe's sister was still trying to keep
Joe's mother from knowing how sick he was. the mother had recently
broke a hip and was bedridden in another part of the house. They
therefore preferred that I not visit the household.
Joe died peacefully about two months after his drug session. One
of the secretary's at the Research Center saved the obituary for
me and I felt my body tingle and could feel tears welling up in
my eyes as I read the headline: "MR. UNION DIES". I
knew that Joe would have really been pleased by his obituary!
The experience with Joe was an especially meaningful one in my
training. I gained insight into my own feelings and how they affected
my conduct as a therapist. I marvel still at the amazing confluence
of coincidences that allowed this event to happen. In looking
at the session and the events that surround it I am struck by
the blending of the meaning in each of our lives into a harmonious
whole. I had my own, at times proud and arrogant, at times humble,
goals for helping Joe to confront his fears and emotions through
facing death, an experience that is one of the mysteries of human
existence. How could a 22 year old young man such as I was feel
that he could have anything to offer his elder facing such an
enigma? My own training experiences with psychedelics had provided
me the utterly convincing feeling of confronting death on many
occasions. This gave me the conviction that although I hadn't
physically died I knew something of the human emotions that surround
such an event, how they might manifest themselves in a person,
respond to the effects of a psychedelic and how I might manage
them helpfully.
I needed for my own growth and development as a healer to confront
death in many aspects, both in my own psychedelic experiences
and in work with patients like Joe. A different experience at
this juncture could easily have changed my area of interest. In
order for this experience to be valuable it needed to be preceded
by the series of sessions in which I confronted many aspects of
my own fears and feelings about death. These sessions also involved
confronting the fact that I grew up with the notable absence of
a fathering figure. These factors added to the emotional import
of this first experience with a dying person. I felt that in accompanying
Joe through his treatment process I experienced him as offering
me something a great value, a deep sharing of his wisdom as an
older man reflecting on the meaning of his life. Certainly this
is one of the more meaningful levels of the nurturing between
father and son. It fascinated me that the process was mutually
rewarding and beneficial, that somehow my need to listen, understand,
and help joined with his need to tell the story of his life to
produce an experience of deep meaning and healing for us both.
Most striking of all is the basic unity of the shared experiences
around the psychedelic session. The way in which the inter-related
factors of my own personal history and training combined with
my prior relationship with Nancy Jewll, my developing relationship
to each of us added together to create a complex set and setting
for Joe's experience. It is not really Joe's experience or my
experience or Nancy's experience but rather the amazing confluence
of meaning in this session that proved moving and significant
for each of us.
I think that such accounts such as this one must be a definite
part of the reporting process in psychedelic medicine. The history
and personality of all parties involved in a psychedelic session
are relevant background to the experience that ostensibly unfolds
only in the person taking the drug. In fact Joe's experience was
not only psychedelic for Joe, but also for me and for Nancy even
though we were not under the pharmacological influence of any
drug at the time. We cannot reduce an experience such as Joe's
to a set of before and after measurements and hope to justly report
useful information. We do not yet know or fully understand all
the elements that influence the process and outcome of experiences
with psychedelics so we must try to bare our psyches and those
of our subjects for there is no clear subject in these experiments
and we must not prematurely dissect into components such exquisite
experiences. We must first gather together enough of this naturalistic
data that we allow a new and more comprehensive view of this process
to emerge.
The need for sweeping revision of the paradigms that organize
our approach to the clinical investigation of psychedelic drugs
as significant elements in a complex process of human healing
and transformation can be clarified by turning to mathematics.
KURT GODEL brought a famous paradox from philosophy into mathematics
and it seems to have relevance for research with psychedelics
as well. GODEL'S theorem holds that the logical consistency and
completeness of a system may not be assessed from within that
system, in fact in order to assess such properties one must build
another system from which to observe and assess the first. With
this situation we may then make an assessment of the logical consistency
and completeness of the first system but may not be sure of the
consistency or completeness of the system that we are observing
from. If one applies this to psychedelic research it becomes apparent
that when researchers sought to apply previously existing conceptual
frameworks to the startling new phenomenon of psychedelic drugs
they influenced the results through mechanisms outside of their
awareness at the time. The logical systems they sought to apply
to psychedelics were incomplete, but they nonetheless served the
limiting and organizing function described for scientific paradigms
(KUHN, 1970).
Since these investigators had no vantage point outside the logical
systems they sought to apply they were blind to the manner in
which their own theoretical and scientific orientations were influencing
the psychedelic experiences of their patients and subjects. When
one looks from the vantage point offered by history it becomes
apparent that this is how at least three differing and at times
mutually exclusive views of nature, effects and possible usefulness
of psychedelics came into being. Each system had ways for dealing
with its competitors and each system had its own blind spots and
inadequacies. What has been missing from our Western scientific
approach to psychedelics has been the original awe and humbleness
necessary when approaching an entirely new dimension, a new frontier
in the study of the human mind and consciousness. Awe, wonder
and open minded, open hearted description of the human experiences
of all parties involved in psychedelic journeys with the quality
of a beginners mind is what must be used to begin a new science
of consciousness. Surely as we grasp the new view of consciousness
and the universe that will emerge from these early naturalistic
studies and their careful analysis our mind will distinguish new
pictures, new paradigms, new views of human nature. These insights
will lead us in turn to the development of appropriate analytic
instrumentation and new research methods to reflect and enhance
the detail of the emerging picture of humanity and its relation
to the cosmos. In order to make the necessary conceptual leaps
we will have to abandon our precious status as unbiased and knowledgeable
scientists. We will lose little in doing this for psychology and
psychiatry, the disciplines most involved in psychedelic research
to date, currently tend to make poor use of research methods and
techniques derived from l9th century physics. This subject object
dichotomized view is simply not applicable to substance since
it denies the basic unity at the core of any psychedelic experience
and relies for validity on the presence of boundaries that are
clearly transcended by the states of awareness possible when humans
take psychedelic substances.
"Many great physicists over the years have become deeply
absorbed in the role of the mind in constructing reality. Schrodinger,
for instance, remarked that exploring the relationship between
brain and mind is the only important task of science. He
once quoted the Persian mystic Aziz Nasafi: 'The Spiritual world
is one single spirit who stands unto a light behind the bodily
world and who, when any single creature comes into being, shines
through it as through a window. According to the size and kind
of the window, less or more light enters the world.' Western thinking
is trying to objectify everything, Schrodinger said, 'It is in
need of blood transfusion from Eastern thought.' A Hindu sutra
proclaims, 'There is nothing in the moving world but mind itself,'
a view echoed by physicist John Wheeler: 'May the universe in
some strange sense be brought into being by the vital act of participation?"'
(FERGUSON, 1980, PP. 172-173).
The scope of substance is clearly interdisciplinary because of
the many different disciplines can bring useful techniques and
partial understandings to this new area of study. Disciplines
that can both enrich the study of psychedelics and be themselves
enhanced by psychedelic medicine include: anthropology, philosophy,
religion, physics, psychiatry, ethnobotany, history, pharmacognosy,
pharmacology, psychoanalysis, psychiatry, psychology, sociology.
Psychedelic medicine may also be called transdisciplinary in that
it can offer scholars and scientists more as a unique whole than
does a simple collection of the separate insights from the individual
disciplines that combine to form this new field.
The possession of a degree in allopathic medicine or any other
existing discipline should not be taken as a qualification to
practice psychedelic medicine, neither should such degrees disqualify
an individual. Training in psychedelic medicine involves a series
of explorations employing the technique of full disclosure reporting
by all participants in the training sessions. Through the series
of training sessions the trainee is exposed to progressively deeper
layers of consciousness ultimately including profound experiences
of a mystical-unitive nature. During this process the trainee
will inevitably suggest modifications to the naturalistic method
on the basis of their training and background in other scientific
disciplines. Creativity enhancement has been documented to occur
in properly planned and conducted psychedelic sessions. It is
therefore reasonable to expect that trainees will gain creative
insight into their own disciplines and psychedelic medicine in
addition to experiencing personal and transpersonal insights into
human condition. This training is conducted by a core training
group of psychedelic therapists and the trainee is qualified for
practise by a consensus of the training group.
The field of psychedelic medicine will eventually develop its
own methodology out of the initial purely descriptive naturalistic
phase that we must begin now. The basic paradigm of psychedelic
medicine is that the psychedelic phenomenon can only be studied
by methods which accept the basic unity of the process under study.
Furthermore the study of human experience with psychedelic substances
must always take into account the infinite value of the individual
and must always seek to do justice to the human qualities of the
psychedelic experience. This means that our techniques of study
must not lump together different varieties of human beings and
their experiences in such a manner as to efface the meaning and
significance of individual experience. Much use of statistics
in research studies with human subjects involves such lumping
together of these scores across individuals without regard to
differences. Though this may be necessary at a certain point it
is not apparently useful at the beginning stages of investigation
and in fact often obscures the meaningfulness of individual experiences
and their relationship to psychological change and growth.
The profound challenge of conducting significant research with
psychedelic and empathogenic compounds can only be met by creating
a new discipline: psychedelic medicine. This new outlook
allows us to overcome the existing paradigms which limit and confound
scientific research with these substances. We are called to incorporate
a quantum leap in honesty and completeness of scientific reopening
in this research. Work in this area also requires that respect
and empathy play a central role in the design and conduct of studies
with human beings. And foremost, ways must be found to overcome
the fear and misunderstanding so prevalent in our society's reaction
to this new frontier.
Notes
1) This paper was originally presented to
the second annual conference of the Association for the Responsible
Use of Psychoactive Agents, Esalen Institute, Big Sur California,
June 16th—22nd, 1985. (back)
2) The development of three competing paradigms
for understanding psychedelics is discussed in detail and at some
length in a prior paper: From Mysteries to paradigms: Humanity's
journey from sacred plants to psychedelic drug (Yensen 1989).
(back)
3) This shortcoming in the scientific literature
is not merely some lack on the part of the psychedelic researchers
involved, but the fact that in order to have reports of psychedelic
research published researchers are forced to fit the presentation
of results into the dominant paradigms held by editors and reviewers
of scientific journals. (back)
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