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The Consumers Union Report on Licit and Illicit Drugsby Edward M. Brecher and the Editors of Consumer Reports Magazine, 1972 Chapter 47. LSD and psychotherapyFor a time after 1943, LSD was a drug in search of a use. The United States Army tested its usefulness for brainwashing, and for inducing prisoners to talk more freely. Later, LSD was stockpiled in very large amounts by the American armed forces for possible use in disabling an enemy force. * 2 Military interest in LSD waned, however, when psychoactive chemicals such as BZ, capable of producing even more bizarre effects, were developed. **
Psychiatrists were naturally interested from the beginning in LSD effects. Many of them took the drug themselves, and gave it to staff members of mental hospitals, in the belief that its effects approximate a psychotic state and might thus lead to better understanding of their patients. Some of those who tried LSD reported that it did enable them to achieve greater empathy with their psychotic patients. It was as an adjunct to psychotherapy, however, that LSD came into widespread use. Drs. Anthony K. Busch and Warren C. Johnson secured a supply of LSD from Sandoz in 1949, and published the first report on its psychotherapeutic use in twenty-one hospitalized psychotic patients in 1950. They concluded that "LSD-25 may offer a means for more readily gaining access to the chronically withdrawn patients. It may also serve as a new tool for shortening psychotherapy. We hope further investigation justifies our present impression." 5 Other reports soon followed. In 1950, Rostafinski in Poland told of giving LSD to eight patients with epilepsy. 6 In 1952 Dr. Charles Savage, who had first received LSD for use in a United States Navy project, reported lack of success in fifteen patients suffering from depression. 7 In 1953, Liddell and Weil-Malherbe in England reported favorable effects in patients suffering from a number of mental disorders. 8 By 1954 LSD was being used therapeutically in Baghdad. 9 Also in 1954, Federking in Germany reported the comparative effects of 60 LSD trips and 40 mescaline trips among neurotic patients refractory to psychotherapy; he thought LSD more effective than mescaline. 10 By 1965, it was estimated that between 30,000 and 40,000 psychiatric patients around the world had received LSD therapeutically; and additional thousands of normal volunteers had received it experimentally. 11 Countless experiments had been run on animal species ranging from the spider and the snail to the chimpanzee. It was estimated in 1965 that some 2,000 papers on LSD effects had been published. 12 Few drugs known to man have been so thoroughly studied so promptly. At a 1965 LSD conference Dr. Sidney Cohen, an American authority on LSD, summed up the claims made for LSD and LSD-like drugs by psychiatrists:
"It is curious," Dr. Cohen added,
Dr. Cohen did not conclude, however, that this curious LSD phenomenon invalidates LSD results. Instead, he called attention to an explanation first offered by a California psychoanalyst, Dr. Judd Marmor, who pointed out that while the technical terms used by different therapists may vary,
Dr. Daniel X. Freedman, chairman of the department of psychiatry at the University of Chicago-Pritzker School of Medicine, has pointed out yet another feature of the LSD experience, one which he calls "portentousness": 16 the sense that something even a trivial platitude is fraught with a cosmic significance too profound to be adequately communicated. * Whether or not LSD does in fact enable users on occasion to grasp significant new insights into themselves or the world about them a much debated issue the drug certainly gives many users a feeling that they have achieved profound new insights.
LSD was tried for the treatment of alcoholism at several research centers after 1952. The early reports suggested that a single large dose of LSD, given under appropriate circumstances, might profoundly affect drinking patterns and even produce total abstinence reports curiously paralleling nineteenth-century and recent accounts of abstinence from alcohol among Indians entering the peyote cult. One LSD report of this kind from the Mendocino State Hospital in Talmadge, California, in 1967 concerned the effects of large doses (400 to 800 micrograms) of LSD on 71 women alcoholics with an average of 7.8 years of uncontrolled drinking:
Bad trips occasionally occurred when LSD was used in psychotherapy but these, too, were sometimes therapeutic. At a Wesleyan University LSD conference in 1967, Dr. Albert A. Kurland of the Maryland Psychiatric Research Center cited a remarkable example from among the 177 patients whom he and his associates Drs. Charles Savage, John W. Schaffer, and Sanford Unger had treated up to that time. This patient was a forty-year-old male alcoholic, black, brought to the hospital from jail after ten days of uncontrolled drinking. He had dropped out of the fourth grade at the age of twelve and had an I.Q. of 70. "He had been draining whiskey barrels at his place of work, a distillery. He gave a history of excessive alcohol consumption over the past four years.... The only limit on his drinking was his low income and the need to support five children. During these years his marriage had deteriorated." 19 Given a week of preparation and a single large dose of LSD, this patient felt (among other things) that be was being chased, struck with a sword, run over by a horse, and frightened by a hippopotamus a quite typical "bad trip." His own verbatim report of his trip then continued:
This patient was given psychological tests both before and after his LSD experience. His score on the Eysenck neuroticism scale before LSD had been in the eighty-eighth percentile highly neurotic. One week after LSD his score had swung to the normal portion of the scale. His pre-LSD depression, as measured by the Minnesota Multiphasic Personality Inventory (MMPI), had lifted and his score was greatly improved. Tested a third time, six months after LSD, his depression score on the NIMPI was still within normal limits. More important "He had been totally abstinent, and his wife reported that there was a peace and harmony in the home that had never existed before and that he had never been better." 21 A full year after the single LSD treatment, "the family picture remains the same. He is still sober, although there has been one brief break in abstinence following the loss of his job." 22 The credit for this and similar one-shot successes with alcoholics, Dr. Kurland believes, is traceable only in part to the LSD experience itself. "This particular patient was fortunate in having a family that reinforced his newfound feeling of love and affection for them. A patient who goes back to a rejecting family is very likely to return to drink." 23 Observations such as this have led some therapists to offer the LSD experience to the spouses of patients as well as to the patients themselves. "What seems striking about this particular case," Dr. Kurland concluded, "is not only that an alcoholic's drinking has been arrested, but that an illiterate, culturally deprived man of low intelligence could apparently be reached through a psychotherapeutic procedure.... " 24 Another field in which LSD has been used at a number of medical Centers is the palliation of terminal cancer. Beginning in 1964, a Chicago anesthesiologist, Dr. Eric C. Kast of Cook County Hospital, published a series of reports on LSD given to 128 terminal cancer patients in great pain. 25 LSD proved about as effective as the usual opiates in relieving this pain and the effect was much longer-lasting. Indeed, the pain relief continued even after the LSD-trip terminated. More remarkable still, many patients retained their equanimity for several weeks after the pain returned; they no longer considered the pain important. Dr. Kast's findings were confirmed by Dr. Sidney Cohen in his work with terminal cancer patients, 26 and by Dr. Kurland and his associates in Maryland. The Maryland research was launched under dramatic circumstances. "A professional member of our own research department, a woman in her early forties, developed a progressive neoplastic disease [cancer]," Dr. Kurland explained at the 1967 Wesleyan University conference. "She had undergone radical mastectomy [breast removal], and subsequent surgery had revealed inoperable metastases to the liver. Although still ambulatory, she was in considerable physical distress unable even to breathe deeply without severe pain. She was fully aware of the gravity of her condition, and her depressed and distraught psychological state was steadily worsening." In these desperate straits, the patient requested LSD therapy. "After discussion with her husband and her surgeon, and with the approval of all concerned, a course of psychedelic therapy was initiated." 27 A week was devoted to preparation. Then LSD was administered. Two days later the patient went on a two-week vacation with her husband and children. Upon her return she wrote the following report:
Psychological tests were administered to this patient both before and after LSD therapy. "The retesting indicated a significant reduction on the depression scale and a general lessening of pathological signs." The patient "returned to work and appeared in relatively good spirits" for five weeks. Then she was hospitalized for accumulation of fluid caused by the cancer, and died three days later. "Investigation of the utility of psychedelic therapy with terminal patients is continuing," Dr. Kurland concluded his 1967 report, "with the collaboration of staff at the Sinai Hospital in Baltimore...." 29 Through the years of LSD psychotherapy from 1949 to the mid-1960s, psychiatrists and others relearned the lesson American Indian users of LSD-like drugs had learned long before: that the setting in which the drug is given, the expectations aroused in the patient prior to the experience, the people and objects present during the experience, the reassurance given the patient as the trip progresses, and countless similar ancillary factors are as significant in molding the experience as the drug itself and are essential safeguards against adverse effects. Ultimate pharmacological proof of the effectiveness of LSD in psychotherapy has not been established. Ideally, candidates for therapy should be divided at random into two groups, one of which is given the medication while the other is treated in exactly the same way except that it is given a placebo instead. To guard against bias, moreover, the procedure must be "double-blind"; neither doctor nor patient must know whether the patient is receiving the active drug or a placebo. The effects of LSD are so obvious, however, that the "double-blind" requirement is utterly impractical; any physician will recognize within a very short time whether a patient has in fact received LSD. Despite lack of a control group, both patient and psychiatrist may conclude that the patient's life pattern has improved under treatment. The patient is in this respect his own control: a comparison of his condition before and after therapy takes the place of a comparison between treated and untreated patients. So it was with the use of LSD in psychotherapy. It survived and spread in the United States from 1949 into the mid-1960s, and continues in use in other countries, because psychiatrists and patients alike have been impressed by the changes experienced. As Dr. Sidney Cohen points out, "No method of using LSD therapeutically has as yet met rigid scientific requirements, which include long-term follow-up and comparison of patients receiving LSD with a control group who receive identical treatment except for the LSD. But, in truth, no other type of psychotherapy has been fully tested by these exacting methods." 30
Footnotes
1. J. H. Rothschild, Tomorrow's Weapons (New York: McGraw-Hill, 1964), quoted in Seymour M. Hersh, Chemical and Biological Warfare: America's Hidden Arsenal (New York: Doubleday Anchor, 1969), p. 50.
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