Emotional Distress And Physical Pain Of Dying Individuals

Probably the most interesting and promising indication for LSD psychotherapy is its use in seriously ill people who are facing death. Although this approach has been most systematically explored in cancer patients, it is applicable to persons with other life-threatening diseases. The use of psychedelic therapy in this indication has been discussed in detail in a previous volume4 and will only be briefly described here.

The original suggestion that psychedelic therapy could be useful for persons with terminal diseases came independently from the American pediatrician of Russian origin, Valentina Pavlovna Wasson, and the writer and philosopher Aldous Huxley. Wasson came to this conclusion on the basis of her experience with the Mexican sacred mushrooms, and Huxley as a result of his psychedelic sessions with mescaline and LSD. The pioneering clinical work with cancer patients was conducted in the early sixties at the Chicago Medical School by Eric Kast who was primarily interested in the possibility of using LSD as an analgesic. A systematic complex study of the effects of psychedelic therapy on cancer patients in relation to their emotional condition, physical pain, concept of death, and attitude toward dying was carried out by the team of the Maryland Psychiatric Research Center. The initiator and original head of this research project was Walter Pahnke; after his death 1 assumed mcdical responsibility and completed it in cooperation with William Richards. In this program, over one hundred cancer patients were treated over the years with psychedelic therapy using LSD and a similar short-acting substance, DPT (dipropyltryptamine). Positive changes were observed quite consistently in several different areas. Many patients showed a definite alleviation of various emotional symptoms, such as depression, general tension, sleep disturbances, and psychological withdrawal. LSD therapy also had a striking, although not predictable, effect on severe physical pain. In some patients who had not responded to analgesics or narcotics, pain was alleviated or even completely eliminated for periods of weeks or months after a single LSD session. The most remarkable changes were observed in the patients' concepts of death and attitudes toward dying. Those patients who had perinatal or transpersonal experiences tended to show a marked decrease in fear of death. Their understanding of the process of dying tended to shift in the direction of ancient or non-Western belief systems according to which consciousness or some form of existence continues beyond the time of biological annihilation.

I mentioned earlier that the psychedelic transformation observed after LSD sessions with a transcendental emphasis involves drastic changes in the hierarchy of values. Having experienced death and rebirth and/or feelings of cosmic unity, LSD subjects tend to put less emotional emphasis on the past and future and show an increased appreciation of the present. Preoccupation with the dismal prospects for the future is replaced by concern about the best possible utilization of each day. The ability to draw satisfaction from simple and ordinary things in life is accompanied by acute awareness of the ultimate futility of anxious pursuit of status, power and possessions. It is not difficult to understand that the above changes in values and life strategy can make the situation of the terminally ill more tolerable. Psychological work with the patients and their families also seemed to have a positive influence on the survivors. It not only eased their reaction to dying and to the death of their relative, but helped thein to cope with their grief and integrate the loss in a constructive way.

According to the clinical ratings, approximately thirty percent of the cancer patients showed dramatic improvement in the above areas after a single LSD session and an additional forty percent showed a moderate degree of positive change. In the remaining thirty percent there were no manifest differences, positive or negative, from pre- to post-session measurements. The results of DPT-psychotherapy were similar, although less striking and consistent.

Of all the indications for LSD psychotherapy, its use for work with the dying seems to be the most interesting and least controversial or problematic. The possibility of alleviating in a relatively short time the emotional and physical distress of persons facing the ultimate crisis of human life should be of great interest to all of us. Most of the objections raised against the use of LSD are of little relevance here, certainly those concerning heredity and chromosomes. In addition, recent research showing the possible role played by psychological factors in cancer, as well as some of our own observations on the subject, seem to suggest that at least for some cancer patients, LSD psychotherapy could become a factor contributing to healing, and not only a preparation for death.

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