Facilitation Of The Psychotherapeutic Process By Lsd Administration

During the years of therapeutic experimentation, there have been several systematic attempts to use small doses of LSD to enhance the dynamics of individual or group psychotherapy. In general, the disadvantages of this approach seem to outweigh its potential benefits. The use of small dosages does not save much time, since it does not shorten the duration of the drug action so much as decrease its depth and intensity. Similarly, the risks involved in the use of low doses in psychiatric patients are not necessarily lower than those related to high-dose ses-■ sions. It is of greater advantage to interpolate occasional LSD sessions using ; medium or high dosages in the course of systematic long-term psychotherapy at ! times when there is little therapeutic progress. In the following text we will briefly describe each of the above approaches.

Use of Small Doses of LSD in Intensive Psychotherapy

In this treatment modality the patients participate in a systematic course of long-term psychotherapy, and in all the sessions they are under the influence of small doses of LSD in the range of 25 to 50 micrograms. The emphasis is clearly on psychotherapy and LSD is used to intensify and deepen the usual psychodynamic processes involved. Under these circumstances, the defense mechanisms are weakened, the psychological resistances tend to decrease, and the recall of repressed memories is greatly enhanced. LSD also typically intensifies the transference relationship in all its aspects and makes it easy for the therapist as well as the patient to understand clearly the nature of the processes involved. Under the influence of the drug, patients are usually more ready to face repressed material and accept the existence of deep instinctual tendencies and conflicts within themselves. All the situations in these LSD sessions are approached with appropriate modifications of techniques of dynamic psychotherapy. The content of the drug experience itself is interpreted and used in much the same way as the manifest content of dreams in regular non-drug psychotherapy. In the past this approach has been mostly used in combination with psychoanalytically oriented psychotherapy, although it is theoretically and practically compatible with many other techniques, such as Jungian analysis, bioenergetics and other neo-Reichian therapies, and Gestalt practice.

Use of Small Doses of LSD in Group Psychotherapy

In this treatment modality all the participants in a session of group psychotherapy, with the exception of the leaders, are under the influence of small doses of LSD. The basic idea is that the activation of individual dynamic processes will result in a deeper and more effective group dynamic. The results of this approach have not been very encouraging. Coordinated and integrated group work is usually possible only with small dosages of LSD which do not have a very profound psychological impact on the group members. If the dosages are increased, the group dynamic tends to disintegrate and it becomes increasingly difficult to get the group to do organizeaand coordinated work. Each participant experiences the session in his or her unique way, and most of them find it difficult to sacrifice their individual process to the demands of group cohesion.

An alternative approach to the psychedelic group experiences which may be very productive is its ritual use, as practiced by certain aboriginal groups: the peyote sessions of the Native American Church or Huichol Indians, yage ceremonies of the Amahuaca or Jivaro Indians in South America, ingestion of sacred mushrooms (Psilocybe mexicana) by the Mazatecs for healing and sacramental purposes, or the ibogain rites of some tribes in Gabon and adjacent parts of the Congo. Here verbal interaction and the cognitive level are typically transcended and group cohesion is achieved by non-verbal means, such as collective rattling, drumming, chanting, or dancing.

After a few initial attempts to conduct traditional group psychotherapy with all the members intoxicated by LSD, this technique was abandoned. However, exposure to a group or contact with co-patients during the termination period of an individual LSD session can be a very useful and productive experience. The assistance of an organized group of drug-free peers can be particularly helpful in working through some residual problems from the drug session. A combination of the new experiential techniques developed for use in encounter groups can also be of great value in this context. Another useful technique is the combination of individually experienced LSD sessions with subsequent analysis and discussion of the material in drug-free group sessions involving all the subjects participating in the LSD program.

Occasional Use of LSD Sessions in Intensive Psychotherapy

This approach involves regular, systematic, long-term psychotherapy, with occasional interpolation of an LSD session. The dosages administered in this context are in the medium or high range, usually between 100 and 300 micrograms. The aim of these psychedelic sessions is to overcome dead points in psychotherapy, intensify and accelerate the therapeutic process, reduce the resistances, and obtain new material for later analysis. A single LSD session interpolated at a critical time can contribute considerably to a deeper understanding of the client's symptoms, the dynamics of his or her personality, and the nature of the transference problems. The revealing confrontation with one's unconscious mind, recall and reliv ing of repressed biographical events, manifestation of important symbolic material, and intensification of the therapeutic relationship that results from a single LSD session can frequently provide powerful incentives for further psychotherapy.

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