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The above discussion focused on the course of LSD psychotherapy for subjects with neurotic and psychosomatic symptoms that were serious enough for them to require psychiatric hospitalization. A few words should also be said about the individuals who were at the two extreme ends of the psychopathological spectrum—"normal" persons and schizophrenic patients. Those subjects who did not have serious emotional problems and participated in the LSD program for training purposes or because of intellectual curiosity, basically followed the same general course as neurotic patients. However, this group was characterized by a rapid progression from abstract to perinatal experiences. These individuals did not spend much time on biographical issues and entered very quickly the realm of the death-rebirth process. In the perinatal sessions, the difficult experiences were usually limited to the time at which the drug-effect culminated, and most of the reentries were pleasant or even ecstatic without any active assistance from the sitters. Negative carry-overs from the contents of the LSD sessions to the free intervals were rare and only minimal, and no prolonged reactions or psychotic breakdowns were observed in persons who had not had serious emotional problems prior to the administration of the drug.

The number of psychotic patients we treated was too small to allow any safe generalization. However, the LSD process in these patients had certain interesting characteristics which deserve to be mentioned. Those persons whom we began treating with LSD at a time when they had manifest schizophrenic symptomatology showed considerable oscillation in their clinical conditions after the initial sessions. Although these fluctuations were deeper and more dramatic, the over-all process resembled that described for the neurotic group. Just before these patients entered the perinatal realm, their clinical condition appeared to be greatly improved. Their psychotic symptoms were alleviated or had altogether disappeared, and they showed surprising critical insight into and psychological distance from their previous difficulties. They typically displayed a variety of neurotic and psychosomatic complaints. Their LSD sessions and clinical symptoms in the intervals between them seemed to be similar to those of the neurotic group, and their perinatal process was equally stormy.

The major difference occurred after the completion of the death-rebirth process. At this point these patients suddenly developed various degrees of what can best be described as "transference psychosis." This condition is characterized by recurrence of the original psychotic symptoms, but with the therapist as the main focus and target of all the patient's thoughts, emotions, and behavior. I will return to this process in more detail in a later section and illustrate it with a typical clinical example, (see p. 244) When the LSD sessions were continued despite the deteriorating clinical condition and the persisting transference psychosis, the patients were eventually able to reach an entirely new level of integration and mental functioning. A specially structured treatment unit is absolutely necessary for therapeutic experimentation of this kind and the therapist has to be prepared to work for several weeks under the difficult and demanding conditions of transference psychosis.

The course of LSD therapy is considerably different from the one described above if the therapist uses the approach outlined in this book. The use of high dosages, eveshades, and stereophonic music deepens the experience considerably.

Under these circumstances, one does not see the gradual unfolding of various levels of the unconscious from one session to another as described for the psycho-lytic approach. Instead, all the categories of psychedelic phenomena can be sequentially encountered in a single LSD experience. At the beginning of a session the subject usually experiences a short period of an abstract nature when he or she sees colors and dynamic geometrical patterns. Then the focus shifts to the psycho-dynamic realm, and the individual might briefly come in touch with some biographical elements related to a particular COEX system. As the LSD session culminates, he or she usually confronts deep levels of memory constellations dealing with survival and bodily integrity, or the material of the basic perinatal matrices. Memories of near-drowning, injuries, operations, and dangerous diseases, as well as profound encounters with death that go beyond concrete biographical events are quite common. After several sequences of death and rebirth, the session can stabilize on the level of BPM I, or the subject can enter the transpersonal realm and experience various mythological sequences, ancestral and phylogenetic memories, elements of the collective unconscious, or past-incarnation phenomena.

During reentry, when the effect of the drug is diminishing, episodes of a psyehodynamic nature might be repeated. At this time, the insights acquired earlier in the session are frequently applied to the concrete conditions and circumstances of one's life. However, the fact that the subject has had experiential access to the transpersonal level does not mean that he or she has completed the death-rebirth process. It will still take a series of internalized high-dose LSD sessions of a kind similar to the one described above to work through and integrate all the perinatal material and the associated psyehodynamic elements. However, if the principles of psychedelic therapy are applied, the overall time required to complete this process is much shorter than in psycholytic therapy. In addition, there are fewer difficulties and complications in the intervals between the sessions, especially when the therapeutic approach involves intense experiential work in the termination period and the sitters make an active effort at positive structuring of the reentries.

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