PART VII THERAPEUTIC APPLICATIONS

From the very start of the modern rediscovery of psychedelics, these drugs have been involved with mental health. In the beginning, when they were regarded as psychotomimetics or hallucinogens, their value was seen in research, in building models of madness, which would enable the basic etiologies of schizophrenia and similar disorders to be reconstructed in the laboratory so that, when their patterns were known, cures could be devised. Later on, it was felt that if those who had to deal with the mentally ill took these substances themselves, they would be better able to know what the experiences of their patients were, and by this sensitization become better and more empathic therapists.

When it was observed that small doses of these drugs increased the capacity for visualization, moved thinking to more-basic and primitive levels, and left the patient more open to his own feelings and needs, therapists began supplementing their therapies with such small doses, and psycholytic therapy began. When it was also observed that some subjects went into mystical and ecstatic states from which they returned fundamentally changed, psychotherapists began administering psychedelics in sufficiently large doses to produce these states, and psychedelic therapy began. Although investigation into therapy with these drugs has now come to an almost total halt because of government restriction of their use, the best picture of the current state of the art is given in the collection of papers edited by Harold Abramson (1967). More recently, Caldwell (1968) has published an exceptionally good account of psychedelic and psycholytic therapy and related it to the historical events around the use of these compounds as well.

The opposition to the use of psychedelics in therapy seems to arise primarily from fear of the transforming power and intensity of the responses these drugs evoke. It has been far easier to view this power with alarm than to try to find ways of controlling it. Especially since the term "ecstasy" has been raised in connection with some of the responses to these compounds, the gloomy tradition that pleasure is offensive to God has been revived. Those experiments that seem to indicate, however vaguely, that something is amiss with a psychedelic are publicized without regard to their validity, and contrary evidence is ignored. Psychedelics are not a panacea, but declaring them anathema will not make them go away, and will even make the situation worse by polarizing their proponents and opponents in opposite positions of irrationality. A balanced approach that would permit proper evaluation and use of these agents has been absent, and a scientific scandal of the first rank has been created.

In this section, a collection of papers on the use of psychedelics in therapy is presented. Except for the program at Spring Grove (Kurland, 1967), no active major research pro' gram in psychedelic therapy is currently in existence. In the first paper, Masters and Houston discuss the use of psychedelics in individual therapy. They note that psychedelics create new and unique opportunities to achieve the solution of problems and promote personality integration, and argue for new approaches based on the characteristics of psychedelic experience itself.

Blewett deals with the use of psychedelics in groups. The approaches required for group use differ from those of conventional psychotherapy, but seek fundamentally the same aims. He feels that group experiences with psychedelics fulfill important needs that individual experience cannot provide, and that the two should be blended.

Hoffer deals with the use of psychedelics in the treatment of alcoholism, an area in which psychedelic therapy has been notably successful. He discusses the history of the use of psychedelics in this area and the indications and contraindications for such use.

Kast discusses a study on the use of LSD with dying patients and presents some psychodynamic formulations about the experience of dying. This is an area generally ignored, perhaps because of our feelings about the inevitability of death. It is also an example of a new area for treatment, in which the use of LSD might be of great service.

The paper by Izumi is reminiscent of the era in which therapists took the new psychedelics in order to better understand their patients. In this case, the drug was taken to facilitate the design of a mental hospital that would provide a properly therapeutic environment for patients. The hospitals that have been built as a result of these experiences have been the first major innovations in mental-hospital construction in many years, and herald an era in which buildings will be people-oriented, in contrast to the present, when people are required to be building-adapted.