http://www.gaiamedia.org/content/english/allgemein/main_e_06_medien.html?/content/english/templates_06_medien/artikel_e_psy-research.html

Thirty Years of Psychedelic Research
The Spring Grove Experiment and its Sequels
by Richard Yensen, Ph.D. and Donna Dryer, M.D., M.P.H.

Introduction

In the late 1960's a multi-million dollar interdisciplinary research center opened in the
State of Maryland. This center for psychiatric research was a consequence of
research in psychedelic psychotherapy performed by Albert Kurland and his
associates at the Spring Grove State Hospital. Though the studies at Spring Grove
State Hospital and those that followed at the Maryland Psychiatric Research Center
(MPRC) ended in 1976, they remain the largest, most sustained and systematic study
of psychedelic drugs and psychotherapy yet attempted.

This article emerged from a dialogue between the authors. We were doing a
retrospective analysis of the Spring Grove research before designing our own study,
one that we hope will advance this tradition (Yensen, Dryer & Kurland, 1991). We
reviewed the studies done at the Spring Grove State Hospital and the Maryland
Psychiatric Research Center asking the following questions: 1) Why did some studies
have such good results and others such equivocal ones? 2) What mistakes occurred
that future researchers in this area might avoid? 3) The research team used statistical
assessment and double-blind controlled studies. This approach is the accepted
standard method for studying psychoactive compounds. Is this methodology
appropriate and sufficient to study psychedelic medicines?

Our analysis of the above questions is separated into five themes: 1) A discussion of
the evolution of the therapeutic paradigms used in the studies. 2) An analysis of the
political and interpersonal contexts affecting the research. 3) A description of the
major studies conducted at Spring Grove State Hospital and the MPRC highlighting
the methodological issues. 4) A survey of the non-drug therapies that evolved from
the psychedelic research. 5) The current status of research and possible future
directions for psychedelic research.

Spring Grove State Hospital
Early observations

Our group's research with psychedelic drugs began with LSD in the early 1950's. The
first study at Spring Grove State Hospital was an attempt to characterize the effects
of LSD upon hospitalized, chronic schizophrenics. Four patients received one hundred
micrograms (100 µgrams) administered daily in a single intramuscular injection for
fourteen (14) days. The initially marked changes in behavior diminished rapidly with
little or no response noted after the second dose.

In order to study the unusually rapid tolerance the experimenters varied the drug
free interval and observed that after five drug free days a strong reaction would
occur. At four days some patients showed a mild reaction, but not the equal of the
first day. After six drug free days a reaction as strong as that on the first day was
observed.

In an attempt to overcome the tolerance exhibited by these four patients, dosage
was increased by 100 µg daily. Every patient would receive 100 µg on day one, 200
µg on day two and 300µg on day three, up to 500 µg. This regimen yielded a
response on the first day, a slight response on the second day, no response on days
three and four, and a very questionable response on the fifth day. Five hundred
micrograms (500 µg) was the maximum dose used.

Cross-tolerance with various LSD derivatives was tested. Cross tolerance was noted
with LAE and brom-lysergic acid. On the theory that what appeared to be
physiological cross tolerance might be psychological in nature (that the patients were
just becoming adjusted to the psychological effects of LSD) the experimenters
alternated LSD and mescaline HCl 1. There was no cross tolerance between LSD and
mescaline HCl 2.

This initial descriptive and naturalistic study came to include twenty (20)
schizophrenics in the various regimens of LSD administration. Important conclusionsq
from this study included the realization that it is impossible to administer LSD in a
double blind fashion. Although LSD was administered in double blind fashion at first,
both experimenters and hospital staff were aware which patients received LSD within
an hour of drug administration.. The authors suggested that the hallucinations
induced by LSD might have value for helping therapists understand the underlying
dynamics of a patient's psychopathology. One can also observe in retrospect the
powerful effect of the then new and now almost universally accepted paradigm of
the psychoactive drug. This way of thinking about pharmacological substances and
their effects on humans was defined by early major neuroleptic drugs like Thorazine
and Reserpine. The basic assumptions that indirectly guided this research included
the conjecture that LSD could be given on a daily basis to patients in order to
produce a chemotherapeutic effect as with other psychiatric drugs. It was assumed
that the effects of LSD could be adequately observed and understood by trained
clinicians not directly involved with the patient's treatment, who had no prior
relationship with the patient. In summary the expectations were for LSD to be a drug
like any of the other known psychoactive drugs. The results were startling,
inexplicable and unexpected:

One catatonic patient who had been mute for some years suddenly burst out into
loud wailing sobs which were shortly followed by overwhelming bursts of laughter
starting 35 minutes after the drug was given. This patient seemed most distressed
and shaken. Intermittently she would open her mouth as if she were trying
desperately to talk or at least to exercise the muscles of her mouth. She also
expressed a state of acute anguish with her body movements. When asked why she
was crying, she said, "You should never leave the farm." A half hour after the crying
started, the wails seemed to end in a giggle. Soon the tears diminished, and she had
almost continuous waves of laughing for another hour or so. The patient then began
to walk about the ward studying the walls and windows as though she were seeing
them for the first time. She seemed to respond to hallucinations, for she began to
talk to non present individuals. Every few moments for the next few hours she would
shake with laughter, and then she might talk a little. Her speech was never
particularly coherent, and she soon became preoccupied with the fact that something
or somebody was tickling her. She often said she enjoyed things very much and that
this was a nice ward, etc.
Three hours after the drug was given, the patient was prancing about the ward and
still bursting into gales of laughter. She could hardly eat since she said she had no
appetite. That afternoon she played basketball for the first time since she was
admitted to the hospital although the opportunity had been offered to her many
times. She seemed interested in the effort and was pleased at her attempts. She
walked about briskly, smiling broadly, and occasionally laughing. That evening she
went to a dance and danced with another patient for the first time. She continued
talking until bedtime. the next morning when she awoke, she was her old catatonic
self, unable to speak, unable to show interest in anything about her, and quite
withdrawn.
On this day the patient received another injection. She laughed a little at first, spoke
few words, but a few hours later lapsed into her previous mute and withdrawn
behavior. Thus on the second day we had slight evidence of change from her
previous behavior, however much less than the change observed on the first day the
drug was given.
When the patient received the same dosage the third morning, she showed no
response at all (Cholden et al., 1955, pp. 213 & 217).

Observations like these helped the team to realize that this drug was unlike other
psychoactive medications because of its unique combination of dramatic alterations in
consciousness, profound psychodynamic action as well as the rapid building of
tolerance. They realized that this combination of effects required a trained clinician
with a well established relationship to the patient in order to understand, correctly
describe and appreciate the dynamics of this complex situation (Cholden, Savage &
Kurland, 1955).

After this rudimentary work there was a chronological gap in the research at Spring
Grove State Hospital. Dr. Kurland involved himself in the study of other psychoactive
medications. Charles Savage trained as a psychoanalyst and pursued his career as a
psychedelic researcher in California at the Institute for Advanced Study.

Spring Grove State Hospital—Cottage 13
A humble beginning

During the late 1950's and early 1960's a young psychologist, Sanford Unger, began
collaborating with Albert Kurland and suggested the renewed pursuit of psychedelic
research. Unger had contact with the team at Hollywood Hospital in Vancouver,
British Columbia, where work was in progress using a psychedelic approach in the
therapy of alcoholism. The therapy involved administration of a single overwhelming
high dose of LSD (400-800 µgrams) within a specially structured environment of
expectations and stimuli designed to foster a mystical experience (Stace, 1960;
Pahnke, 1963). By then the researchers were aware that the experiential roots of this
approach were shamanistic, it seemed to offer a convenient, short, and intense
therapy—a pragmatic vehicle for studying scientifically the effects of psychedelic
substances as adjuncts to psychotherapy.

The project at Spring Grove began in 1963. A modest cottage on the hospital
grounds housed the small research team. It is important to note here that the
facilities were unpretentious and unobtrusively integrated into the overall facility of
Spring Grove State Hospital. This hospital is one of the oldest mental hospitals in the
United States. At the time Spring Grove was well-known for its progressive treatment.
Cottage thirteen was a white clapboard two story cottage with four rooms and a bath
on each floor. Two rooms were outfitted with sound systems and designated as
treatment rooms for the psychedelic drug sessions.

The atmosphere was earnestly optimistic. The clinical staff of the State Hospital
collaborated in the selection and support of patients undergoing the new therapy.
The natural expectation was that in time they would be trained to use this exciting
and dramatically effective new treatment. The sense of enthusiasm, confidence and
hope was contagious. A devoted team from the State Hospital Alcoholic Rehabilitation
Unit affirmed the work with LSD totally. Although in the early work a no treatment
group was proposed as a control group, these plans had to be abandoned. Both the
patients and the staff of the State Hospital saw the psychedelic treatment as so
valuable and effective that they adamantly objected to withholding the treatment
from any patient who qualified for it on ethical and humanitarian grounds. The
research team acceded to these demands in a decision that preserved morale and
working alliance while sacrificing scientific precision (Unger, 1969; Kurland et al.,
1966 & 1967).

The research with alcoholics grew from a pilot phase of open clinical trials to double-
blind trials. The response of these patients to the psychedelic treatment was
promising. The research grew to include hospitalized neurotics who would today be
diagnosed as personality disorders, primarily borderline. In 1965, the research at
cottage thirteen came to national attention. The CBS television network produced a
one hour television documentary, LSD: The Spring Grove Experiment. This film
followed the LSD treatment of one male inpatient alcoholic and one female inpatient
neurotic. The excellent quality of this documentary drew much positive attention
toward the research. The film gave a balanced and responsible yet compelling
presentation of the promising new treatment.

Work with LSD Expands

In 1966 tragedy struck this enthusiastic group. A professional member of the Spring
Grove research department, a woman in her forties, discovered she had metastatic
cancer. Well aware of her terminal prognosis, she became significantly depressed.
She knew of the effectiveness LSD psychotherapy had demonstrated with alcoholics
and neurotics, so she sought the treatment for herself. In considering her request a
literature search revealed work done by a Chicago anesthesiologist, Eric Kast. His
study assessed only chemotherapeutic analgesic effects of LSD, but it showed the
drug was safe for cancer patients and suggested that LSD might furnish some pain
relief. There also was an article in Harpers Magazine on LSD and the anguish of
dying by Sidney Cohen (Cohen, 1965). With this support from the literature they
forged ahead. The staff member was granted an LSD session. In her own words:

Mainly I remember two experiences. I was alone in a timeless world with no
boundaries. There was no atmosphere; there was no color, no imagery, but there
may have been light. Suddenly I recognized that I was a moment in time, created by
those before me and in turn the creator of others. This was my moment, and my
major function had been completed. By being born, I had given meaning to my
parents' existence.
Again in the void, alone without the time-space boundaries. Life reduced itself over
and over again to the least common denominator. I cannot remember the logic of
the experience, but I became poignantly aware that the core of life is love. At this
moment I felt that I was reaching out to the world—to all people—but especially to
those closest to me. I wept long for the wasted years, the search for identity in false
places, the neglected opportunities, the emotional energy lost in basically
meaningless pursuits.
Many times, after respites. I went back, but always to variations on the same themes.
The music carried and sustained me.
Occasionally, during rests, I was aware of the smell of peaches. The rose was nothing
to the fruit. The fruit was nectar and ambrosia (life), the rose was a beautiful flower
only. When I finally was given a nectarine it was the epitome of subtle, succulent
flavor.
As I began to emerge. I was taken to a fresh windswept world. Members of the
department welcomed me and I felt not only joy for myself, but for having been able
to use the experience these people who cared for wanted me to have. I felt very
close to a large group of people.
Later, as members of my family came, there was a closeness that seemed new. That
night, at home, my parents came, too. All noticed a change in me. I was radiant, and
I seemed at peace, they said. I felt that way too. What has changed for me? I am
living now, and being. I can take it as it comes. Some of my physical symptoms are
gone. The excessive fatigue, some of the pains. I still get irritated occasionally and
yell. I am still me, but more at peace. My family senses this and we are closer. All
who know me well say that this has been a good experience. (Pahnke et al., I970)

The dramatic success of this first attempt launched a major new research focus, the
study of psychedelic psychotherapy in the treatment of terminal cancer patients. The
work evolved over the next two decades to include some patients that were
diagnosed with cancer but not conclusively terminal. In 1967 the results of the first 6
cancer patients were presented by Dr. Walter Pahnke at the American Psychiatric
Association meeting.

In 1972 the last LSD study in this series was published. Thirty-one (31) terminally ill
cancer patients suffering from anxiety, depression and uncontrollable pain received
200 to 500µg of LSD, usually administered intramuscularly. Multiple sessions were
allowed in the study design, but only three patients received more than one session.
The early Canadian technique was already being modified to include more
psychotherapy and these patients received intensive preparation (6 to 12 hours over
2 to 3 weeks) and follow-up care. Before and after LSD sessions the physical and
emotional status of these patients were rated by: physicians, nurses, family members,
the LSD therapist and an independent rater. Measurements of narcotic use were also
included. On a global measure of improvement that blended the ratings of the
observers already mentioned, 9 patients (29%) improved dramatically, 13 patients
(42%) were moderately improved and 9 patients (29%) were essentially unchanged.
Relief from pain was startling and persisted for a period of weeks or months following
the session. This result was statistically significant (p<.001). The amount of narcotic
medication decreased but this trend was not statistically significant. There were many
complicating factors because other psychoactive medications were involved
(phenothiazines, hypnotics and tranquilizers) and not systematically recorded in this
study. Also some patients reported that pain that was unbearable before the session
became bearable after the session on the same level of narcotic medication (Richards
et al., 1972).

Extra-Pharmacological Factors: Set & Setting

The preliminary results of pilot studies with alcoholics, inpatient neurotics, and cancer
patients were a reflection of the compelling LSD-psychotherapy treatment within this
optimistic and coherent environment of expectations. This dynamic set and setting
was a consequence of both conscious and unconscious factors among the research
team. The interpersonal environment was designed purposely so that all factors of
enthusiasm by the staff might contribute to the patient's preparation for a profound
mystical breakthrough and fundamental life change. The research team's morale was
excellent since they were spending all their time doing this new and exciting
treatment. In a powerful way they saw that they even had something to offer the
hopeless!

The startling level of improvement using the experimental treatment in alcoholics
could best be demonstrated when the results were compared with statistics gathered
on patients' improvement in routine hospital treatment. In study that began in 1963,
69 patients improved significantly on all the scales of the MMPI, except the
Hypomania scale. The conclusions were that no patients were harmed and some
patients demonstrated substantial improvement. In this very challenging patient
population 23 patients (or 33.3% of the sample) were abstinent at the six month
follow-up. The result of the conventional approach to treatment at the Alcoholic Unit
was only 12% rehabilitation in a prior study of routine Spring Grove Hospital
treatment (Kurland et al., 1971 p. 92 and Kurland et al., 1967).

The research team realized that the next logical step was more rigorous study with a
control group. Considering Kurland's earlier research which showed a true double-
blind procedure was impossible to maintain, they designed a study with low dose LSD
as the control condition. A low dose would produce the physiological effects, mood
alterations, and perceptual changes unique to LSD without facilitating a full-blown
psychedelic reaction. The mystical or peak experience was regarded as the
motivational and transformational catalyst. The use of a 50 µgram dose of LSD as a
control would also permit an assessment of the power of a large dose and mystical
breakthrough to be contrasted with the emotional catharsis and psychodynamic
resolution realizable with a smaller dose. The same highly motivated team would treat
both groups. The hypothesis was that only the high dose group would achieve
mystical experiences and hence improve the most.

This study involved 135 patients who were randomly assigned to either high dose
(450µg) or low dose (50µg) LSD treatment. A battery of psychological tests was
administered prior to acceptance in the program and one week after the drug
session. The patient's progress was monitored at 6, 12 and 18 months after
completing the therapy program.

One week after the session both treatment groups demonstrated statistically
significant improvement in their test scores. The follow-up ratings were made by an
independent team of social workers. They indicated that 44 percent of the high dose
group were "essentially rehabilitated" at six months. Only 25 percent of the low dose
group met this criterion at the same point. Abstinence was 53 percent for the high
dose group and 33 percent for the low dose group at six months. This finding was
significant statistically (p<.05). At one year post therapy there was no significant
difference between the two groups. Yet at one and a half years after treatment,
psychedelic psychotherapy had been successful with over half of the alcoholics
treated in this program (high and low dose patients combined). Alcoholics receiving
conventional therapy had a 12% improvement rate.

The results demonstrated an interesting failure. The team did not fully appreciate the
positive impact of its own enthusiasm and esprit de corps so intentionally and
carefully cultivated. The inspiration in the team grew, fueled by sharing the mystical
breakthroughs of patients undergoing high dose LSD sessions. This further
stimulated the already exemplary value placed on human life by the researchers
themselves. This motivated group of therapists worked uncommonly well. The 50
µgram control group improved more than expected. A few patients even had full
blown mystical experiences on this threshold dose of LSD. Others did quite significant
work on their inner conflicts under nearly ideal therapeutic circumstances. At the
conclusion of the study, the staff broke the blind and were chagrined at the results,
but felt that they had been true to their values and tried their best with all patients.
The very hypothesis of this carefully designed study, turned out to be the major
problem: Because the "control" was itself LSD, it was a much greater activator of the
therapeutic relationship even at a low dose than was previously recognized. The low
dose had become another experimental condition rather than the control. The impact
of the positive dynamic among the staff was profoundly underestimated. The
combination of these drug and non-drug factors produced equivocal results.

Another possible conclusion was that psychotherapy alone was far more effective with
alcoholics than suggested by any other study in the literature. However, both the
experimental and the "control" groups produced greater improvement than previous
studies of routine hospital treatment. Although the search for an adequate control did
not meet with success in this study, the role of non-drug factors was demonstrated to
be far more powerful than even this research group had anticipated (Kurland et al.,
1971).

The Evolution of Paradigms and Therapeutic Approach
From Psychedelic to Psychodelytic Paradigms

Over the years from 1963 to 1976 the therapeutic techniques employed in this
research matured and changed. The clinical staff completely changed during this
time as well. The beginning psychotherapy research efforts were a direct application
of the Canadian technique of psychedelic psychotherapy. The psychedelic (mind
manifesting) approach. This technique, as practiced at Spring Grove, used a single
large dose of a psychedelic with a specialized environment, eyeshades, headphones
and specially selected music. Conventional interpretive psychotherapy was primarily a
preparation for the LSD session. In this method there is a preparatory period where
the therapist explores the background of the patient with a goal of establishing
rapport and preparing the patient for a single overwhelming high dose psychedelic
session. When LSD is used in this procedure, the dose ranges from 250 µgrams to
800 µgrams and the session lasts from 8 to 12 hours. Throughout the research
endeavor all psychedelic sessions were run by a therapeutic team. The primary
therapist and a co-therapist of the opposite sex were in constant attendance
throughout the day of the drug session. The morning and early afternoon of the
drug session was spent listening to music over stereo headphones with eyeshades to
block out the external environment and allow a contemplative inner focus. Musical
programs were evolved and eventually a music therapist joined the staff full time.
She developed motivational sequences of musical accompaniment for psychedelic
therapy. Western classical orchestral and choral music sequences were played to
support and express the expansiveness, profundity, sense of sacredness & awesome
qualities of the psychedelic experience. The technique aimed to facilitate a
breakthrough to transcendental experience (Bonny & Pahnke, 1972). The therapeutic
team did not usually offer interpretation but instead offered emotional support and
companionship. In the afternoon the patient might sit up and experience visual
stimuli, for example pictures of family members. or beautiful art or scenery. Props
were used to great effect in psychedelic therapy. A single, long stemmed red rose
was part of every session. During the afternoon time was set aside to gaze deeply at
the rose under the effects of LSD. Patients were encouraged to look at themselves in
a mirror so that they might observe the effects of thinking about their past use of
alcohol on their self-image. After the drug session the therapy focus was to
consolidate insights and positive motivations for change from the peak or mystical
experience into everyday life.

Psycholytic Orientation Exerts Influence

In 1968 Stanislav Grof, a Czechoslovakian psychoanalyst, joined the psychedelic
research team. This event marked a time of growth and transition for the therapeutic
staff. Grof had developed a complex theoretical schema for understanding the
phenomenology of the psychedelic experience and had done much careful work
under the Psycholytic approach. The Psycholytic approach involves the use of
repeated low doses of psychedelics in a psychoanalytically oriented psychotherapy or
a psychoanalysis. The doses used with a drug like LSD would fall in the range 75
µgrams to 250 µgrams. The sessions typically continued for six months to two years.
The process involved in-depth analysis of the drug experiences both during and after
the drug sessions. The experiential goal of this type of work is to uncover
psychodynamically relevant material including repressed childhood memories. It is
also useful that psychedelics can enhance the transference and, at the same time,
enhance the patients' insight into their transference toward the therapist.

Grof had already suggested in a paper presented to the European Psycholytic
Association that perhaps an integration of the psychedelic method and the
psycholytic method would be a valuable approach. Psycholytic therapy produced
insight and psychedelic therapy seemed to produce a uniquely powerful motivation
toward change. Grof strongly influenced the last years of work at the Research
Center. He created a more psychoanalytic atmosphere and the trend toward
including more interpretive psychotherapy in psychedelic work blossomed. He
proposed a birth paradigm for understanding psychedelic experience and offered a
system of interpretation where negative emotional experiences were useful and could
be worked through in a systematic way. This supported a therapeutic process that
included deeper experiences of conflict with the knowledge that eventually the
negative experiences led to transformation, mystical union and re-birth.

As the clinical staff examined patients who returned for additional treatment several
years after the original studies, it became apparent that these individuals had
experienced a relatively long-term withdrawal from alcohol (up to five years). It
seemed that the psychedelic peak therapy provided these individuals with a mystical
experience and new insight into the meaning of their lives. The new sense of
meaning in their lives slowly diminished following the treatment. This seemed to
occur when important conflicts were not completely resolved in the preparatory and
post-LSD integrative therapy. Another important factor was that the integration of
insights from the LSD session into everyday life was usually incomplete. Despite these
shortcomings in their therapy and subsequent adaptation, these individuals had
remained sober for significant amounts of time, but when confronted with high-stress
life situations, they succumbed to alcohol. The team felt these cases strongly
suggested that psychedelic psychotherapy could be improved by including more
extensive psychodynamic therapy and additional LSD sessions.

A Melding of Two Approaches:
The Psychodelytic Paradigm

Consequently, the last research conducted with psychedelics at the Maryland
Psychiatric Research Center was guided by the extended psychedelic or psychodelytic
paradigm 3. This approach involved several high-dose sessions with a psychedelic
drug in an environment previously used for psychedelic therapy. The number of
sessions increased and the theoretical framework expanded to include a greater
emphasis on personal dynamics, perinatal dynamics (Grof, 1976), ego
transcendence, and other transpersonal experiences. The thorough exploration of
the personal history of the patient was recognized as an important factor contributing
to the probability that a peak experience would occur. Thus the aim of this
therapeutic approach became to work through the early childhood traumas that
surfaced during individual psychotherapy and the early drug sessions.
Conversely, working through was facilitated by later mystical experiences. These
profound experiences provided the patient with a deeply experiential, philosophical
position from which life had a new meaning: life itself was intrinsically healing.
Difficult memories were often accepted easily from the new vantage point. This
approach combined the positive aspects of the psychedelic and psycholytic
paradigms (Di Leo 1975-76, Grof 1969).
Eventually, the Clinical Sciences Division of the Maryland Psychiatric Research Center
conducted several studies using the psychodelytic or extended psychedelic approach
with neurotic outpatients and inpatient alcoholics by administering compounds with a
shorter duration of action than LSD, such as dipropyltryptamine and psilocybin
(Richards and Berendes 1977; Rhead et al., 1977). The results of these studies and a
pilot study (Yensen et al., 1975) that explored the use of the milder psychedelic drug
MDA (3,4 Methylenedioxyamphetamine) in neurotic outpatients had promising
results.
In this later analysis, the psychedelic paradigm appeared to be most useful in work
with terminal cancer patients (Richards et al., 1977), whereas the newer, more
involved paradigm seemed most promising with neuroses and character disorders
(Richards and Berendes, 1977-78; Yensen, 1976).

From Psychodelytic to Holotropic Therapy

Grof evolved a new orientation out of the psychodelytic approach. The new approach
he calls holotropic, which means moving or growing toward wholeness. The name
and the approach reflect a deeply optimistic view of the intrinsic healing mechanisms
released through altered states of consciousness.

On the one hand, the Holotropic modality does not focus directly on resistances, but
instead relies on the effects of the altered state of consciousness to erode or explode
resistance and defense. This leads at its worst to an attitude that regards the
psychedelics as inherently therapeutic. If a resolution does not occur in one session
then another session is indicated. This is a valuable formulation because it allows the
therapeutic relationship to evolve and develop, but it is weak because it ignores the
possibility of a therapeutic impasse. As a consequence, the need for therapist skill to
interpret material from a psychedelic session is not stressed.

On the other hand, Grof offers a rich map of the territory of the inner psychedelic
journey. This theory links emotion from childhood experiences to global pools of
affect associated with the birth trauma. The intensification of the altered state leads
finally to breakthroughs into the transpersonal unconscious and many varieties of
experience beyond the time & space boundaries of the ego. This is the farthest
reaching and most meticulously detailed map of consciousness produced in western
scientific research into the human psyche. It links the innermost depths of the psyche
with the essential fabric of the universe (Grof, 1988).

The Political Context
New facilities and changing funding patterns

By 1969 the Governor of Maryland, Spiro T. Agnew, inaugurated a large four-story
building with an attached 200 person auditorium. The basement had a sensory
isolation tank, two sound-proof sensory isolation rooms and a psychophysiology
facility with EEG and mini-computer. The third floor was the basic sciences floor with
several laboratories. The second floor of this building was devoted to the Clinical
Sciences Division and housed two completely self-contained treatment suites with
private bathrooms and small kitchens. These rooms were decorated with art, sofa
and overstuffed chairs, in the relaxed manner of a comfortable living room. The staff
of the entire Research Center included over one hundred people. A primary focus
was to be psychedelic research. This included the development of new compounds,
isolation of active ingredients in plant materials and capacity to perform basic toxicity
assessments with animals.

Conflict with the Hospital Staff

At the same time that this pristine, air-conditioned building sprouted on a hill
overlooking the old state hospital buildings, new federal legislation cut funding for
state hospitals.

There was strong political pressure to move institutionalized patients out of state
hospitals and into community settings. The new legislation created community mental
health centers that absorbed much of the funding previously devoted to the state
hospitals. Many members of the state hospital staff grew jealous and angry towards
the well salaried, highly credentialed, predominantly white, staff of the fancy new air-
conditioned Research Center. Meanwhile their own working conditions steadily
deteriorated. Studies of inpatients done during this time, compared "routine hospital
treatment" to experimental procedures. It is important to note the animosity that this
situation engendered between the formerly cooperative and enthusiastic staff of the
state hospital and the suddenly more privileged research staff.

This context also may account for the great difference in results between the studies
done with inpatients and those done with outpatients during this time. Only the
inpatient studies that used the "routine hospital treatment" as the control group were
affected by the jealousy of the hospital staff. Only these studies had problematic
results that failed to demonstrate the efficacy shown in earlier studies. Public concern
about possible chromosome damage was raised in 1967. An in vitro study was
published in the journal Science which reported a higher chromosomal aberration
rate in white blood cell cultures to which LSD had been added (Cohen et al., 1967). A
series of in vivo studies followed, mostly performed on users of illicit LSD. These
studies produced contradictory results due to some major shortcomings of the
experiments. The studies had no adequate controls and no measurement of the
chromosome breakage rate prior to LSD use. Since the furor over these reports had
implications for human research with LSD, our group decided to investigate this area
in collaboration with the National Institute of Health. In 1969, Tjio, Pahnke, and
Kurland reported on a study done at Spring Grove State Hospital: a prospective,
double-blind controlled experiment with 32 hospitalized alcoholic or neurotic patients
who had never taken LSD prior to the study. This study was the largest and the only
one to date that controlled for other drugs taken, concurrent infections, and used
pure LSD of known dosage. The results of the study gave no evidence that LSD
damages the chromosomes of human subjects given pure pharmaceutical quality
LSD. Although early reports were widely publicized, this later careful research was
summarily ignored by the popular press. (Tjio et al., 1969)

Other dramatic changes were also taking place at the Research Center. In 1971,
Walter Pahnke, Director of Clinical Sciences, died in a scuba diving accident. He had
been an energetic, charismatic leader in the research team. His successor as Director
of Clinical Research, although a board certified psychiatrist, had no background in
psychedelic research.

Scientists were quickly recruited to fill the research positions that threatened to
vanish from future budgets if not filled within a few months of their creation. As
many, hastily retained, investigators arrived to the Center, they brought their own
areas of interest. Through this process the focus of divisions other than Clinical
Sciences, strayed from the original vision of a multidisciplinary center to study
psychedelics to include a broad gamut of research in basic sciences as it related to
psychiatry. During this time the popular press continued sensational coverage of the
negative effects of LSD abuse. The State Hospital staff's attitude toward the research
continued its rapid decline.

Hospitalized Neurotic Study

Work with neurotics progressed at Spring Grove alongside the studies with alcoholics.
In 1973 Oliver Lee McCabe reported on a study of 96 patients, 31 received a high
LSD dose (350 µgrams), 31 a low LSD dose (50 µgrams) and 37 control subjects who
received a combination of therapeutic measures as prescribed by the hospital staff.
This control therapy was varied and included psychotropic medication, electro-shock
therapy, individual psychotherapy & group psychotherapy on the hospital ward. The
patients were nominally hospitalized chronic severe neurotics, but most of them met
the now more carefully defined criteria for a more severe borderline diagnosis.

Immediately following the treatment program all three groups improved significantly.
High dose LSD treatment appeared superior to conventional treatment on 19
measures. Low dose LSD seemed superior to conventional treatment on 11 measures.
The improvement was not just a reduction in psychopathology but also reflected and
increase in measures of positive mental health.

At six months following the therapy all groups showed significant improvement in
functioning. There were no statistically significant differences between groups at this
point. At one year there were a few measures that favored the high dose LSD group
over conventional treatment. The samples were considered skewed at this point and
no longer representative of the original group. At 18 months there was no difference
between the groups.

This study was beset by low dose responders and was confounded by the broad
scope of neurotic disorders treated. There were problems randomizing males and
females and different diagnoses. There was a suggestion that the single or double
dose approach was inadequate for this level of pathology. In addition, the women in
this study "tended to develop a protracted transference neurosis which was only
partly resolved in the course of the treatment." (Savage et al., 1973 p. 43). Savage's
comments raise a concern as to how adequately the psychedelic therapists were
trained to manage transference in this difficult population.

Heroin Addict Study

Savage and McCabe published a paper in 1973 describing a controlled study of
thirty-six (36) male heroin addicts in a halfway house. The treatment model included
daily urine monitoring, several weeks of preparatory therapy and one high dose (200
to 500 µg) LSD session. Thirty-seven (37) patients randomly assigned to the control
group received daily urine surveillance and weekly group therapy in an outpatient
abstinence program.

Abstinence data significantly favored the LSD group during the one year follow-up..
Nine (25 % of the 36 subjects in the LSD group) maintained complete abstinence for
one year. Two (5% of the 37 subjects in the control group) remained abstinent over
the same period. Three LSD patients relapsed briefly and then remained abstinent
for the rest of the year. This brings the total abstinent among the LSD group to 12
(33%). Additional research with outpatients was suggested (Savage & McCabe,
1973).

Other Research Projects

In spite of political and journalistic pressures and some equivocal results, the
research expanded and diversified. The Clinical Sciences Division ran studies with
alcoholics, heroin addicts, inpatient neurotics, outpatient neurotics and instituted a
unique program for professionals to have a "training experience" with LSD. The
drugs explored included LSD, DPT (Dipropyltryptamine), MDA (3, 4-
Methylenedioxyamphetamine), DOET (2,5-Dimethoxy-4-Ethyl Amphetamine),
Psilocybin, and, as an active placebo, the stimulant Ritalin (Methylphenidate HCl).

LSD Training Program for Mental Health Related Professionals

Beginning in June of 1969 a program was instituted to provide one to three LSD
training sessions to mental health professionals. This program sought to provide
subjects with a better understanding of: 1) the unconscious or primary process 2) the
problems of young people involved in drug abuse 3) how better studies of
psychedelic drugs might be designed 4) better insight into their own minds and
enhancement of their therapeutic skills including empathy. Two hundred three (203)
professionals received one to three LSD sessions in this program between 1969 and
1976.

In follow-up reports many trainees reported considerable benefits from their LSD
sessions. These positive reports included profound insights into philosophical and
religious systems, relief from emotional and psychosomatic symptoms, enhanced
feelings of well-being and overall improved functioning. Many of these changes were
confirmed by family members and professional colleagues (Harari & Kashof, 1972
give an account of their subjective experiences in this program).

Alcoholism and a New Psychedelic

A low dose DPT pilot study with inpatient alcoholics was reported in 1973. This was
the last study conducted where a positive relationship existed between the research
center staff and the Alcohol Rehabilitation Unit staff at Spring Grove. There was an
initial double-blind assessment of low doses of DPT on measures of interview depth
and quality (Soskin et al., 1973), and then 51 patients were treated in a non-double-
blind format. The results were "dramatic improvement" from pre to post-treatment
on a variety of psychological test variables many of which reached high levels of
statistical significance. At six months follow-up five variables were measured: 1)
occupational adjustment improved (p<.01), 2) residential adjustment improved
(p<.02), interpersonal adjustment improved (p<.001), abstinence (p<.001), global
adjustment improved (p<.001) (Grof et al., 1973).

Federal funds were secured to follow-up on these extremely promising results. The
outcome of this final alcoholic study (conducted during the time described above
when staff relationships were in extreme distress) was published in 1977. The study
assigned 175 patients randomly to three treatment groups: DPT therapy,
conventional therapy and routine hospital treatment. This regimen was completed by
103 of the original 175 patients. The research center staff conducted both the
conventional therapy and the DPT therapy. The hospital staff conducted the routine
hospital treatment. There was a differential dropout rate between the DPT group and
the other groups. Many patients assigned to the DPT group dropped out of
treatment. Earlier discussion of the dynamics with the Alcohol rehabilitation unit
describe the atmosphere of competition and fear promulgated at this time.

This study is an example of the effects of non-drug factors on outcome. These
equivocal results were obtained when the state hospital staff felt their treatment was
pitted against the Research Center staff. This created a hostile environment for the
patients undergoing the psychedelic treatment. There were no significant differences
between the three groups. The composition of the follow-up groups was confounded
because of difficulty in locating patients (Rhead et al., 1977).

With so many confounding variables this study defied straightforward analysis. One
conclusion is that DPT is not effective as a treatment for alcoholism. This contradicts
earlier findings from this team but confirms one other study (Another conclusion
might be that the quality of therapy was not the same as that in the encouraging
pilot work, since there was only a partial overlap of clinical staff between the two
studies. The concurrent studies with outpatients indicate that the staff performance
was at high levels with that population. This suggests that the dynamics with the
state hospital staff may be significant.

Outpatient Studies

In contrast to these inpatient DPT studies, Richards published a paper in 1976 with
terminal cancer patients. The results were overwhelmingly positive and reflected the
research staff's continued high level of motivation and enthusiasm (Richards et al.,
1976).

In another outpatient study Yensen published a report on ten outpatient neurotics
using MDA as an adjunct to psychotherapy. The therapy process lasted two to six
months with a maximum of 75 hours. Two to four MDA sessions were given with
doses ranging from 75 mg to 200 mg. There were standardized assessments before
and after treatment and a six month follow-up. Statistically significant psychological
improvement (reduction of obsessive-compulsive traits, depression and anxiety) was
demonstrated after therapy and remained stable over six months follow-up. Measures
of self actualization and sense of well-being also increased significantly. Mean global
improvement was significant at the p<0.01 level at follow-up (Yensen, 1976).

There were two studies begun at the research center that have not been mentioned
in the literature to date because they were never completed. One was a large (150
subjects) and ambitious study designed by Yensen, Richards, Rhead, Williams and Di
Leo. This study involved outpatient psychotherapy with a neurotic population. DPT
was the psychedelic drug used and both sterile water and Ritalin (Methylphenidate)
served as inactive and active placebos. There is evidence in the literature that Ritalin
has use as an adjunct to psychotherapy in addition to its effects as a stimulant. The
study involved six groups and both psycholytic style therapy and extended
psychedelic style therapy; two of these groups were double-blind controls for DPT in
a psycholytic format. Low dose DPT, Ritalin or sterile water were administered in
double blind fashion up to 25 times. High dose DPT and marathon music sessions
completed the active treatment groups and a waiting list control was the sixth group.
This quite involved study attempted to control for expectations and various types of
drug action. A grant was submitted to NIMH and a site visit was made but the project
received approval with no funding. Nonetheless the staff treated a few patients with
this protocol.

The second incomplete and unpublished project involved the referral of outpatients
already engaged in psychotherapy with professionals in the surrounding
communities. These treating therapists could refer patients they felt were at an
impasse in their therapy for consultation with the research center clinical staff and
evaluation for possible psychedelic sessions with LSD, DPT or MDA. The referring
therapist was free to assist in the psychedelic session. Less than ten patients received
sessions in this fashion. (Berendes, 1979)

The Demise of the Research Center

In 1975 there was a great controversy over the dismissal of three scientists from the
Basic Sciences division of the research center. The controversy flourished amidst
news reports of a suicide due to the CIA's irresponsible practices with LSD. The
estranged scientists accused the research center director of mismanaging public
money, and alleged that the research center engaged in no real treatment and thus
rendered no service to the people of the state of Maryland.

This political contention led to the eventual transfer of the facility from the
Department of Health and Mental Hygiene to the University of Maryland. News stories
broke about research with LSD at Edgewood Arsenal (an Army weapons research
facility) in Maryland where recruits were given LSD without informed consent. This
research was linked to the University of Maryland and created unbearable political
pressure to discontinue all psychedelic research at the University of Maryland. As a
consequence all psychedelic research at the center was stopped, most of the staff
was dismissed or resigned and a new director was appointed. By 1978 there were
only five of the original staff employed at the research center and the basic research
direction was shifted to schizophrenia research.

Studies after 1976: Psychedelic Research After MPRC

By the end of 1976 over 700 patients had been treated by this team of investigators.
The results of these studies include a preponderance of positive results and some
perhaps just as interesting equivocal outcomes.

Yet the tide was shifting already. A news report came out about a government agent
who the CIA slipped LSD a few days before he jumped out a window in the 1950's.
This report came to the attention of the Maryland legislature which provided the
funding for the Research Center. They decided to close down this controversial
research and turn the big white building toward research with more conservative
psychiatric treatments.

In 1976 the Research Center was completely restructured and virtually the entire
professional staff was replaced. The director was relieved of his responsibilities and
the psychedelic work was completely eliminated. The success of this research empire
went bust in 1976. Why, what happened and what can we learn that is of value to us
in our efforts to continue the exploration, to meet the scientific challenge and
therapeutic promise of psychedelic drugs?

In 1979 a small group of investigators from the previously disbanded Research Center
team began meeting again to plan a way to continue the interrupted research
projects. This team met with some success in dealing with the FDA and secured a
new Investigational New Drug Permit for LSD as well as reactivating the previous IND
for work with terminal cancer patients. Approximately 10 cancer patients were
treated through a collaboration with the University of Maryland and North Charles
General Hospital. These results have not yet been published (Di Leo, 1993).

Non-Drug Assisted Therapies Evolved from Psychedelic Research

As with the outer space exploration program sponsored through NASA 4, there have
been some new techniques developed out of psychedelic research that do not
depend on drug adjuvants and have diffused into the culture of psychotherapy.

Holotropic Breathwork (Grof Breathing)

In the middle 1980's Stanislav & Christina Grof developed an approach to therapy
that involves the use of intense breathing and specially selected stereophonic music.
This approach is taught internationally and has spread to many countries. The
breathwork session produces phenomena which Grof has described as equivalent to
the profound experiential sequences he described for patients undergoing psycholytic
and psychedelic therapy (Grof, 1985)

Guided Imagery and Music (GIM)

This technique was developed at the Research Center by Helen Bonny, the staff
music therapist. It emerged from a blending of Guided Affective Imagery techniques
developed by Hanscarl Leuner in Germany and music therapy approaches she
developed for psychedelic work. In this method the patient reclines and enters a
deeply relaxed trance while listening to carefully prepared classical music sequences
designed to elicit and support death rebirth mystical sequences of experience (Bonny
& Savary 1973).

Perceptual Affective Therapy (PAT)

Perceptual Affective Therapy developed as a technique to emulate the effects of
psychedelic drugs through the selection and management of audio-visual stimuli to
enhance and amplify the inner feeling state of the patient. During a Perceptual
Affective Therapy session the patient may alternate between visual deprivation and
sensory overload through the alternation of eye shades and intense visual stimuli
from slide & motion picture projectors. The patient is induced to enter an altered
state by encouraging them to let the stimuli become their feelings and visa versa and
to breathe in the stimuli (Yensen, 1981). More recently deep tissue bodywork and
breathwork have been integrated with the Perceptual Affective Approach.

Shamanic Paradigm in a Contemporary Frame

In an attempt to integrate experience from Western psychedelic research, contact
with contemporary shamanic healers in Mexico and group process, Richard Yensen
and Donna Dryer developed a ritual context for psychospiritual healing. This involves
the use of breathwork and sensory overload within an anamnestic group journey.
While held within the compelling energy of group process in a shared vessel for
healing participants undergo an all night healing journey that blends all these
elements. Great emphasis is placed on affective, biographical, intellectual and
spiritual integration of this experience. The all night ceremony or velada 5 is the
experiential centerpiece of a 5 to 6 day residential retreat.

Current Status of Psychedelic Research in the United States

Within the United States we are aware of at least four psychedelic projects. Rick
Strassman at the University of New Mexico is pursuing systematic human
psychopharmacology of DMT (N,N-Dimethyltryptamine) and Psilocybin (Strassman,
1993). Charles Grob and his associates at Harbor Hospital (UCLA) are involved in
safety studies of MDMA (3,4-Methylenedioxymethamphetamine) with mental health
professionals and will soon proceed with clinical efficacy studies of terminal cancer
patients (Grob, 1993). Juan Sanchez-Ramos and Deborah Mash are proceeding with
dose-response studies and safety trials of Ibogaine at the University of Miami (Doblin,
1994). Kurland, Yensen and Dryer have FDA approval for a study involving 60
outpatients with a substance abuse disorder who will receive various doses of LSD in
a psychodelytic approach (Kurland et al., 1991).

Future Directions for Research and Training

Fifty years of LSD research has failed to demonstrate that double blind placebo
controlled studies are appropriate to study the effects on humans. The adequacy of
this method, for instance, whether a double-blind is actually possible, needs to be
tested in a study specifically focused on validity of assessment. We are in the process
of designing such a study. It will attempt to systematically map, cross-check and
control extraneous variables and subjective distortions. The publication of such a
study in a peer reviewed journal will open the scientific dialogue necessary if the
findings question this accepted method of study. If they do not then we can go
forward with a solidly confirmed scientific foundation. If double-blind is not feasible
we must develop other rigorous approaches.

Clearly there are many wonderful new tools to assess the physiology and brain
metabolic actions of psychedelics. Psychotherapy research with these compounds
strongly indicates that physiological response often mirrors subjective experience. For
this reason a report of the subjective experience is an important element in data
gathering that must not be overlooked in any physiological study. Rick Strassman's
studies are exemplary in this regard. We encourage researchers who use sensitive
new techniques such as the PET scanner to correlate the physiology with the
psychology of the psychedelic experience. This subjective scope should in not
compromise the rigor of such work. Instead it should reflect the intimate connection
between mind and body established by psychoneuroimmunology.

In reviewing this work it seems clear that the experimental treatment in psychedelic
therapy involves a mystical experience. The presence or absence of this experience is
the true experimental condition, not the presence, absence or dose of a psychedelic.
This insight suggests another method for analyzing even studies that have already
been done. This also substantiates the need for human experimentation as laboratory
animals cannot communicate subjective experience with adequate resolution.

The ability to predict which patients are likely to have a peak experience would allow
effective selection of the best candidates for treatment. Mechanisms for adequate
reporting of non-pharmacological factors in all human research must be discerned.
These factors are so uniquely important to the study of psychedelic drugs in human
subjects that if they are not systematically reported and studied they merely
confound results. Thus set & setting, attitude of all present in a session, institutional
politics and psychodynamic interplay are essential reagents in the psychedelic
reaction. They must be assessed and reported for replication to be possible.

The assessment of subjective experience is a frontier that directly intersects with
psychedelic research. Our tools in this area are by and large primitive, but
measurement is imperative. At the research center the Psychedelic Experience
Questionnaire was routinely used to quantify the depth of peak experiences.
McClelland's work in psychoneuroimmunology indicates that peak experiences have a
profound effect on the immune system. Perhaps new tools will involve direct
measurement of immune function as an indicator of peak experience intensity
(McClelland, 1988).

Regulatory & Training Issues

Psychedelics pose a challenge to the existing regulatory mechanisms because they
are unique in their ability to amplify the effects of extra-pharmacological factors. The
regulatory apparatus was established to deal with substances whose effects are
consistent and independent of extrapharmacological factors. It would be irresponsible
to release psychedelic compounds as prescription drugs. Any physician, psychiatrist,
psychologist, or scientist wishing to use psychedelic compounds in human studies
must be carefully and extensively trained in their use. That training must reflect our
knowledge of their long history of use in other cultures. Models for training come
from other subjective disciplines such as psycho¬analysis. Psychoanalysis requires
extensive first hand experience in a training analysis. A prospective psychedelic
researcher must work with these substances under the careful supervision of more
experienced researchers. Most assuredly it is inappropriate for these drugs to be
administered by those who refuse to thoroughly explore their own psyche with them
as a necessary precondition for responsibly and sensitively dealing with another
human being's response to the same compounds.

Interdisciplinary approaches are imperative The disciplines of psychology,
anthropology, philosophy and theology must not be excluded merely because we
conceive of these compounds as drugs and of drugs as the exclusive province of
physicians. The

Consciousness Laboratory

The use of computers, virtual reality, and physiological measurement could be
integrated into a nearly ideal laboratory for psychedelic research. Such an
environment would allow free access to a tremendous variety of audio-visual stimuli
to enhance and manage response to the compounds while still permitting
un¬obtrusive measurement of physiological states and their subsequent correlation
with the experiences facilitated by psychedelics in this setting. The advantage of this
setting is that it would thoroughly document the stimuli used, the drug, dosage and
psychological response all in real-time with possibilities for feedback into the on-going
drug session (Yensen, 1982).

Summary

The role of usually ignored and unreported extra-pharmacological factors in
psychedelic research has been explored with the Spring Grove and MPRC studies as
examples. The relationships among the entire research team have quite significant
impact on the milieu for psychedelic research. These factors of set & setting play a
major role by increasing or decreasing the probability of a peak experience. We
found the peak experience to be the actual treatment condition not the presence or
absence of a psychedelic. The psychedelic is another contributing factor, one that
enhances the likelihood of a peak experience, but does not guarantee it.

Consistently errors were made in underestimating the impact of non-drug factors on
psychedelic sessions and their outcome. Training sessions that provide study
designers with enough first hand experiences to understand the phenomenological
shifts that occur with psychedelics would be helpful.

As we explore the evolution of more effective therapy with psychedelics there is need
for more systematic and complete reporting of all non-drug variables. If these
important reagents in the psychedelic reaction are not reported the work cannot be
replicated.

The appropriateness of double-blind methodology and indeed the possibility of a true
double blind has been called into question. This is a testable research hypothesis that
we propose to investigate.

In the process of conducting the research at Spring Grove and the Maryland
Psychiatric Research Center over 750 patients received psychedelic sessions. The
majority benefited in some way, a minority were unchanged. We are not aware of
any long-term complications among the subjects. This establishes a solid basis for
future investigations in terms of risk to benefit ratio.

We need a rigorous and systematic approach to investigating the therapeutic
potential of psychedelic compounds as enhancers of the healing process. We must
use the insights available from past efforts in this culture and others to develop this
investigational capacity.

Summary Listing of Major Studies

Cholden, Kurland & Savage, 1955
20 inpatients with chronic schizophrenia
LSD 100-500µg Intramuscular Injection
up to 14 administrations given daily
Conclusions
1) LSD can be given I.M. over protracted period without untoward effects
2) Tolerance is seen on the 2nd day and after 4-6 days is gone
3) Gross behavior is useful indicator of tolerance
4) There is no cross tolerance between LSD and mescaline
5) Clinical responses of schizophrenics were categorized
6) The reactions may in part be determined by the milieu

Kurland, Unger, Shaffer, Savage, 1967
69 chronic alcoholic inpatients
LSD 200-900 µg orally
1 administration
18 month follow-up study
Conclusions
1) Safe treatment modality as shown by pre- and post- EEG's on 20 patients
2) Specialized training is necessary for safe an effective treatment
3) One-third maintained abstinence up to 6 months
4) Reversal of pattern of pathological functioning as seen on MMPI's

Pahnke, Kurland, Goodman, Richards, 1969
22 metastatic cancer inpatients
LSD 200-500µg
Conclusions
Pilot study and case histories: 6 showed dramatic improvement, 8 showed good
improvement, 8 remained unchanged of 22 Improvement: decreased depression, anxiety, fear of death; increased relaxation, greater ease in medical management, closer interpersonal family relationships with more openness and honesty on a 13 point scale

Tjio, Pahnke, Kurland, 1969
32 psychiatric inpatients, 5 drug abusers & 8 normals
LSD 21 high dose=250-400 µg; 11 low dose=50 µg
Conclusions
Mean pre-LSD rate of chromosomal aberrations in the 32 patients (4.28%) and the 5 LSD users (2.81%) are comparable to each other and to the values obtained from 2 normal control subjects sampled for 8 to 10 consecutive days (2.65%). Pre- to post-LSD differences for both the 32 patients (+1.63%) and the 5 LSD users (+0.76%) are not statistically significant. Mean chromosomal aberration rates for the 32 patients and 5 LSD users (including both pre-and post-means), 8 experimental normal LSD subjects (post-LSD), and 2 normal controls (no LSD) only vary from 2.65% to 5.91%.

Pahnke, Kurland, Unger, Savage, Wolf, Goodman, 1970
6 metastatic cancer patients
LSD 200µg to 300 µg orally or intramuscular
Conclusions
case histories; showed decrease in need for pain medication and improvement in global change for all 6 patients

Pahnke, Kurland, Unger, Savage, Grof, 1970 JAMA
Experimental Use of Psychedelic Psychotherapy
overview

Kurland, Savage, Pahnke, Grof & Olsson 1971
135 chronic alcoholics
LSD 50µg or 450µg orally
one session
6, 12, and 18 mo follow-up
Conclusions
6 month follow-up 53% rehabilitated high dose group vs. 33% in low dose group p=.05. This initial gain was attenuated at end of 18 months although overall levels of improvement was considerably better for both groups than usual improvement for other alcoholics in the same setting without LSD-assisted psychotherapy.

Richards, Grof, Goodman, Kurland, 1972
31 cancer patients
LSD 200-500 µg orally or intramuscular
one session
Conclusions
25% had peak experiences and less fear of death afterwards 29% dramatically improved, 41.9% moderately improved, 29% unchanged McCabe, Savage, Kurland, Unger, 1972 96 inpatient neurotics LSD 31 high dose (350µg), 32 low dose (50µg), 33 group therapy alone Conclusions High dose psychedelic therapy was superior to conventional therapy on specific "symptom" areas as defined by the MMPI, e.g.. depression, obsessive-compulsive syndrome, social introversion, manifest anxiety, ego strength, neurotic overcontrol. On the POI "Spontaneity" and "Self-regard" consistently show greater increments after both forms of psychedelic therapy and "self-actualized values" are more frequently increased after high-dose LSD administration.

Savage, McCabe ,Kurland, Hanlon, 1973
same 96 inpatient neurotics as above
more complete data analysis
Conclusions
High dose>Conventional treatment
p<.05 for MMPI items Depression, Social Introversion, Ego Strength, Benaric Items
p<.01 for Validity, Correction, Factor, Social Desirability. for POI items p<.05 for Self-actualizing value, and Self-Acceptance and p<.01 for Spontaneity and Self-regard for PEP items p<.05 Distress, Distrust, Social Desirability, Future p<.01 for Insight
Low Dose better than Conventional Treatment p<.01 only for PEP Distrust and Distress and POI Self-Regard and p<.05 for MMPI scales Correction, Factor, Social Desirability, PEP scales Future and Insight and POI Spontaneity.

Soskin, Grof, Richards, 1973 18
inpatient alcoholics
15-30 mg of DPT intramuscular
Conclusions
Therapist Rating Scale DPT > placebo p<.01 for items: Recall of Memories and Experiences, Emotional Expressiveness, depth of Self-Exploration and p<.05 for Psychodynamic Resolution.

Grof, Soskin, Richards, and Kurland, 1973
51 inpatient alcoholics
15-150 mg DPT intramuscular
one to six two-hour sessions
72 DPT and 64 placebo therapy interviews on a double-blind basis
Conclusions
Percentage rehabilitated at 6 month follow-up: global adjustment=46.8% and abstinence=53.2% at p<0.001 and significant improvement (compared to pre-treatment) on occupational adjustment (p<.01), residential adjustment (p<.02), interpersonal adjustment (p<.001).

Savage and McCabe, 1973 37
narcotic addicts in a halfway house
200-500 µg LSD orally
one session
Conclusions
25% remained abstinent vs. 5% abstinent at 12 month follow up with p<.05

Turek, Soskin, Kurland, 1974
10 mental health professionals
MDA 40-150mg orally
one session Pilot Study
Conclusions
Analyzed blood pressure, digit symbol subtest, digit span subtest, handwriting, Psychedelic Experience Questionnaire, Modified Linton-Langs Questionnaire and the Subjective Drug Effects Questionnaire. MDA invites inner exploration vs. LSD which demands it. Might be helpful in treatment of obsessive and depressive traits.

Yensen, Di Leo, Rhead, Richards, Soskin, Turek, Kurland, 1976
10 neurotic outpatients
MDA 75-200 mg orally
2-4 sessions
Conclusions
Significant improvements on POI, MMPI, BPRS, WPRS, and Social History Questionnaire at pre- to post and 6 months post therapy

Rhead, Soskin, Turek, Richards, Yensen, Kurland, Ota, 1977
33 inpatient alcoholics received DPT, compared to 46 Conventional Treatment (CT), 24 Routine Hospital Treatment (RHT)
DPT 15-150mg intramuscular injection
1-6 sessions
Conclusions
Not much difference due to drop-out rates and other complexities discussed in this paper.

Richards,, Rhead, Di Leo, Yensen, Kurland, 1977
34 cancer patients
75-127.5 mg DPT intramuscular injection
one session
Conclusions
Predictors of peak experiences analyzed (peakers=14, non-peakers=17)

Richards, Rhead, Grof, Goodman, Di Leo, Rush, 1979
30 cancer patients
75-127.5 mg DPT intramuscular injection
one session
Conclusions
ECRS scales of Depression and Anxiety were p<.05 pre- vs. post- Mini-Mult showed decreased distress, e.g. D p<.006, Hy p<.006, Pt p<.004, Pa p<.01, Sc p<.001, Ma p<.02; POI: Time competency p<.03, Inner Directedness p<.01, Self-Regard p<.02, Self-Acceptance p<.005, Capacity for Intimate contact p<.02.

Berendes, 1979
12 neurotic outpatients
20-30 mg psilocybin or 200-300µg LSD or 70-120 mg DPT
one session in the context of ongoing psychoanalytic psychotherapy
Conclusions
Analytic description of shifts in therapy and transference leading up to, during, and after the session.

Footnotes

1. Mescaline HCl was used rather than mescaline sulfate because it was more soluble and easier to prepare for intramuscular injection.

2. This finding is contradicted by later studies with mescaline sulfate in animals and humans. Yet mescaline does not affect 5HT2 receptors while LSD does.

3. This name was suggested by Stanislav Grof in an address to the European Psycholytic Association (Grof, 1969).

4. National Aeronautics & Space Administration.

5. The velada is a Mazatec ritual in which psychedelic mushrooms are used to enter a deep altered state of consciousness for healing. In this modern shamanic approach multimedia portrayals of death re-birth sequences, breathwork and deep tissue bodywork are used to produce the altered state rather than psychedelics.

References

Berendes, M. Formation of Typical Dynamic Stages in Psychotherapy Before and After Psychedelic Drug Intervention. Journal of Altered States of Consciousness, 1979, 5, 4, 325-338.

Bonny, H. & Pahnke, W.N. The Use of Music in Psychedelic (LSD) Therapy. Journal of Music Therapy, 1972, 9, 64-87.

Bonny, H. & Savary, L. Music and Your Mind. New York: Harper, 1973.

Cholden, L.S., Kurland, A. A. & Savage, C. Clinical Reactions and Tolerance to LSD in Chronic Schizophrenia. The Journal of Nervous and Mental Disease, 1955, 122, 3, 211-221.

Cohen, M., Marinello, M., & Bach, N. Chromosomal Damage in Human Leukocytes Induced by Lysergic Acid Diethylamide. Science, 1967, 155, 1417-1419.

Cohen, S. LSD and the Anguish of Dying, Harpers Magazine. 1965, 231, pp. 69-88.

Di Leo, F. The Use of Psychedelics in Psychotherapy. Journal of Altered States of Consciousness, 1975, 2, 4, 325-337

Di Leo, F.B. Personal Communication, 1993.

Di Leo, F.B. The Activation and Experiential Integration of In-Depth Psychic Introjects in Psychedelic-Activated Psychotherapy. International Journal of Eclectic Psychotherapy, 1982, 1, 1, 33-55.

Doblin, R. FDA Approves Human Studies with Ibogaine. Multidisciplinary Association for Psychedelic Studies, Winter 1994, 4, 3, p. 4.

Grob, C. Personal Communication, 1993.

Grof, S. Psycholytic and psychedelic therapy with LSD: Toward an integration of approaches. Address to the Conference of the European Association for Psycholytic Therapy, Frankfurt, West Germany, October 1969.

Grof, S. Realms of the Human Unconscious: Observations from LSD Research. New York: Viking Press, 1975.

Grof, S. The Adventure of Self-Discovery. New York: SUNY Press, 1988. Grof, S., Goodman, L.E., Richards, W.A. & Kurland, A.A. LSD-Assisted Psychotherapy in Patients with Terminal Cancer. International Phamacopsychiatry, 1973, 8, 129-144.

Grof, S., Soskin, R.A., Richards, W.A. & Kurland, A.A. DPT as an Adjunct in Psychotherapy of Alcoholics. International Pharmacopsychiatry, 1973, 8, 104-115.

Harari, C. & Kashoff, S. A Guided Psychedelic Experience: Subjective Report. Voices: The Art and Science of Psychotherapy, 1972, 8, 4, 45-59.

Kurland, A.A., Savage, C., Pahnke, W.N., Grof, S. & Olsson, J.E. LSD in the Treatment of Alcoholics. Pharmakopsychiatrie Neuro-Psychopharmakologie, 1971, 4, 2, 84-94.

Kurland, A.A., Shaffer, J.W. & Unger, S. Psychedelic Psychotherapy in the Treatment of Alcoholism (An Approach to a Controlled Study). Excerpta Medica International Congress Series No. 129, 1966.

Kurland, A.A., Shaffer, J.W., Savage, C., Wolf, S., Leihy, R., McCabe, O.L. & Shock, H. LSD-Type Drugs and Psychedelic Therapy. Research in Psychotherapy, 1968, 3, 521-534.

Kurland, A.A., Unger, S., Shaffer, J.W. & Savage, C. Psychedelic Therapy Utilizing LSD in the Treatment of the Alcoholic Patient: A Preliminary Report. American Journal of Psychiatry, 1967, 123, 10, 1202-1209.

McCabe, O.L. & Hanlon, T.E. The Use of LSD-Type Drugs in Psychotherapy: Progress and Promise. In McCable, O.L. (Ed) Changing Human Behavior: Current Therapies and Future Directions. Grunne & Stratton, 1977.

McCabe, O.L., Savage, C., Kurland, A.A. & Unger, S. Psychedelic (LSD) Therapy of Neurotic Disorders: Short Term Effects. Journal of Psychedelic Drugs, 1972, 5, 1, 18-28.

McClelland, D.C. & Kirshnit, C. The Effect of Motivational Arousal Through Films on Salivary Immunoglobulin A. Psychology and Health, 1988, 2, 31-52.

Pahnke, W.N., Drugs and Mysticism: An Analysis of the Relationship Between Psychedelic Drugs and Mystical Consciousness. (Doctoral Dissertation, Harvard University) 1963.

Pahnke, W.N., Kurland, A.A., Goodman, L.E. & Richards, W.A. LSD-Assisted Psychotherapy with Terminal Cancer Patients. In Hicks, R.E. & Fink, P.J. (Eds) Psychedelic Drugs. New York: Grunne & Stratton, 1969, 33-42.

Pahnke, W.N., Kurland, A.A., Unger, S., Savage, C. & Grof, S. The Experimental Use of Psychedelic (LSD) Psychotherapy. Journal of the American Medical Association, 1970, 212, 11, 1856-1863.

Pahnke, W.N., Kurland, A.A., Unger, S., Savage, C., Wolf, S. & Goodman, L.E. Psychedelic Therapy (Utilizing LSD) with Cancer Patients. Journal of Psychedelic Drugs, 1970, 3, 1, 63-75.

Rhead, J.C., Soskin, R.A., Turek, I., Richards, W.A., Yensen, R., Kurland, A.A. & Ota, K. Y. Psychedelic Drug (DPT)-Assisted Psychotherapy with Alcoholics: A Controlled Study. Journal of Psychedelic Drugs, 1977, 9, 4, 287-300.

Richards, W., Grof, S., Goodman, L. & Kurland, A. LSD-Assisted Psychotherapy and the Human Encounter with Death. Journal of Transpersonal Psychology, 1972, 4, 2, 121-149.

Richards, W.A. & Berendes, M. LSD-Assisted Psychotherapy and Dynamics of Creativity: A Case Report. Journal of Altered States of Consciousness, 1977, 3, 2, 131-146.

Richards, W.A., Rhead, J.C., DiLeo, F.B., Yensen, R. & Kurland, A.A. The Peak Experience Variable in DPT-Assisted Psychotherapy with Cancer Patients. Journal of Psychedelic Drugs, 1977, 9, 1, 1-10.

Richards, W.A., Rhead, J.C., Grof, S., Goodman, L.E., Di Leo, F.B. & Rush, L. DPT as an Adjunct in Brief Psychotherapy with Cancer Patients. Omega, 1979, 10, 1, 9-26.

Savage, C. & McCabe, O.L. Residential Psychedelic (LSD) Therapy for the Narcotic Addict: A Controlled Study. Archives of General Psychiatry, 1973, 28, 808-814.

Savage, C. Psychedelic Therapy. Research in Psychotherapy, 1968, 3, 512-520.

Savage, C., Hughes, M.A. & Mogar, R. The Effectiveness of Psychedelic (LSD) Therapy: A Preliminary Report. The British Journal of Social Psychiatry, 1967, 2, 1, 59-66.

Savage, C., McCabe, O.L., Kurland, A.A. & Hanlon, T. LSD-Assisted Psychotherapy in the Treatment of Severe Chronic Neurosis. Journal of Altered States of Consciousness, 1973, 1, 1, 31-47.

Soskin, R.A., Grof, S. & Richards, W.A. Low Doses of Dipropyltryptamine in Psychotherapy. Archives of General Psychiatry, 1973, 28, 817-821.

Stace, W.T. Mysticism and Philosophy. New York: Lippincott, 1960.

Strassman, R. Personal Communication, 1993.

Tjio, J., Pahnke, W.N. & Kurland, A.A. LSD and Chromosomes A Controlled Experiment. Journal of the American Medical Association, 1969, 210, 5, 849-856.

Turek, I.S., Soskin, R.A. & Kurland, A.A. Methylenedioxyamphetamine (MDA) Subjective Effects. Journal of Psychedelic Drugs, 1974, 6, 1, 7-13.

Unger, S. The Psychedelic Use of LSD: Reflections and Observations. In Psychedelic Drugs. New York: Grunne & Stratton, 1969.

Yensen R. From Mysteries to Paradigms: Humanity's Journey from Sacred Plants to Psychedelic Drugs. In: Rätsch C, ed. Gateway to Inner Space: Sacred Plants, Mysticism and Psychotherapy. Dorset: Press, 1989: 11-53

Yensen, R. The Thousand Petalled Lotus and the Computer: A Tale of a Powerful Tool for the New Age. Paper presented at the Seventh International Transpersonal Conference in Bombay, India, 1982.

Yensen, R., DiLeo, F.B., Rhead, J.C., Richards, W.A., Soskin, R.A., Turek, B. & Kurland, A.A. MDA-Assisted Psychotherapy with Neurotic Outpatients: A Pilot Study. Journal of Nervous and Mental Disease, 1976, 163, 4, 233-245.

Yensen, R., Kurland, A.A. & Dryer, D. The Relationship Between Peak Experience And Outcome In LSD Assisted Psychotherapy With Substance Abusers, A Double-Blind Controlled Study. Protocol submitted to Food & Drug Administration, 1991.


This article is based on an address to the European College of Consciousness (ECBS) International Congress, Worlds of Consciousness in Göttingen, Germany 24 27 September 1992.

Richard Yensen, Ph.D., Director, Orenda Institute, 4324 West 15th Avenue, Vancouver, British Columbia V6R 3A8, ryensen(at)orenda.org

Donna Dryer, M.D., M.P.H., Medical Director, Orenda Institute

_______________________________________________
THS mailing list