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Above. The explosive energies and overwhelming emotions involved in the final stages of the perinatal unfolding (13PM III). Right. The connection between this process and the opening of the heart cliakra.

political movements. In the extreme, the death-rebirth experience can seem to have transcended all boundaries and become a drama involving all of mankind.

The number of psychedelic sessions necessary for the completion of the perinatal process varies considerably from person to person and also depends critically on external factors such as dosage, therapist, set and setting. For this reason, any absolutely valid numerical estimate is impossible. In my experience, some individuals were able to work through and integrate the perinatal material in less than ten Fully-internalized high-dose LSD sessions. Others needed several scores of psychedelic experiences in the same framework before they were able to move fully into the transpersonal phase. I have also met a number of people who had taken LSD on their own, in an unsupervised externalized way and in a social context, and had not really even begun this process in spite of hundreds of exposures to the drug.

If high dosages of pure LSD are used and the sessions are approached as in-depth self-exploration, most individuals sooner or later complete the process of ego death and rebirth. Beyond this point, all their sessions are transpersonal in nature and represent a continuing philosophical and spiritual search. Whether the process was originally approached as therapy or for another reason, it becomes at this stage a cosmic adventure in consciousness aimed at solving the riddles of personal identity, human existence, and the universal scheme.

In the program of psycholytic therapy in Prague a typical psychiatric patient with neurotic or psychosomatic problems moved successively from work on psychodvnamic issues through the process of death and rebirth to the philosophical and spiritual exploration of the transpersonal phase. If we want to relate this development to existing schools of psychotherapy, we can refer to the first phase as Freudian, because much of the LSD process on the psychodvnamic level can be understood in psychoanalytic terms. Since an important aspect of the perinatal process is the reliving of the birth trauma, we can refer to it as Rankian. One of the essential characteristics of this phase is enormous release of pent-up energies through orgasrn-like discharges and the dissolving of the character armor; it thus also has an important licichian dimension. The only psychiatrist who systematically explored and described many of the transpersonal phenomena was Carl Gust a v Jung. Although his conceptual framework docs not covcr the entire range of transpersonal experiences, it is appropriate to call the third stage Jungian. Much of the experiential cartography of the perinatal and transpersonal areas has also been covered by various religious and mystical systems and traditions.3

The progression through the above stages and the corresponding changes of content can be illustrated in the series of LSD sessions of Erwin. a twenty-two-vear-old patient with an extremely severe obsessive-compulsive neurosis. Although from the point of view of therapeutic outcome he was one of the few absolute treatment failures, bis sessions were an interesting example of the change of symbolic content. They showed how the snake, a classical Freudian phallic symbol, took on different meanings depending 011 the level of the psychedelic process. During his LSI) therapy, Erwin successively experienced various psychodvnamic. perinatal, and transpersonal phenomena, but all ol a negative nature, lie was never able to experience the ecstatic unitive states that, according to our observ ations, have the greatest therapeutic potential

Erwin was accepted into the LSD treatment program after four years of unsuccessful psychiatric therapy with various conventional methods. His most tormenting clinical problem was a strong compulsion to conceive in his mind a geometrical system with two coordinate axes, and find within this system the proper location for different persons, situations and problems in his life. When lie resisted this urge, he became overwhelmed by intolerable fear and other highly unpleasant emotions. This activity absorbed so much of his time and energy that it interfered with his everyday functioning and frequently totally paralyzed him. Sometimes he spent hours attempting to find the appropriate coordinates for a certain aspect of his life, but was never able to complete the task to his satisfaction. Shortly before his admission, he developed an alarming feeling that the center of his imaginary system was shifting to the left. This was accompanied by a sense of urgency, tension, depression, and general insecurity. At that time he had also developed various psychosomatic symptoms and tended to interpret them in a hypochondriacal way. He was referred to LSD therapy after several psychiatric hospitalizations and unsuccessful treatment with tranquillizers, antidepressants, and drug-free psychotherapy.

In the beginning, Erwin showed extreme resistance toward LSD; at one point, he was able to fight with full success the impact of 1500 micrograms of Sandoz LSD administered intramuscularly.'1 A long series of high-dose sessions was entirely uneventful; the content of most of them consisted in massive somatization and struggle for control. After this, he gradually started to gain access to some recent biographical material, such as certain memories from his military service. Finally, in his thirty-eighth LSD session, he suddenly regressed into childhood in a very convincing and realistic manner. He felt small and helpless and had various strange sensations around his genital area. It seemed to him that his penis had shrunk and was as tiny as that of a child. This was associated with anxious concerns about losing control of his bowels, and embarrassing feelings of having his pants wet and soiled. His usual obsessive urge was intensified to an enormous degree and seemed to be intimately linked to visions of moving reptilian bodies and patterns of snake skin. The shifts of various elements within his imaginary geometrical system seemed to be perfectly synchronized and at times even identical with the movements of the snakes. In these sessions, he was working through problems related to toilet training and to rebellion against parental authority. The excretory functions had a strongly ambivalent meaning for him, being simultaneously or alternately pleasurable and repulsive.

In this context, he relived in a complex way and in full age-regression an event which occurred when he was two and a half years old. His mother had taken him to a circus, and he was watching the show while sitting on her lap in the front row. After a performance that involved a female belly dancer with a large boa constrictor, her male partner carried the snake around the arena, exhibiting it to the audience. When he approached Erwin and his mother, the snake made an unexpected movement. In a sudden state of panic, Erwin wet and soiled his pants while sitting on his mother's lap. She was greatly embarrassed by the incident and left the circus immediately. The authenticity of this memory was later independently verified by Erwin's mother.

It took a long time to work through all the complicated emotions associated with this event. They ranged from disgust, embarrassment, shame, and inferiority feelings to strong libidinal pleasure and a sense of triumph related to breaking through exaggerated parental restrictions regarding cleanliness. On this level, the image of the snake and the neurotic symptoms had clear anal connotations: the serpentine forms represented feces and the obsessive preoccupation with the shift of the coordinate system reflected the movements of the bowels.

Later on, entirely new elements appeared in Erwin's LSD sessions. The visions of the snake skin and of the serpentine loops now became associated with strong erotic excitement and sexual tension. On occasion, Erwin now saw scenes involving naked male and female bodies in sexual intercourse. These sequences finally opened into a complex reliving of a classical Freudian primal scene—observation of sexual activities of his parents to which he gave a sadistic interpretation, fie felt that this event took place at approximately the same time as the circus scene. The two memories seemed to have a deep similarity; both of them involved a male and female figure with himself as an observer. The boa constrictor from the circus scene and the penis from the primal scene appeared to be symbolically equivalent. On this level, the snake was clearly a phallic symbol in full accordance with the Freudian tradition.

When Erwin progressed to the perinatal level, many of the previously described phenomena were meaningfully related to the birth agony. In this_ context, the snake became the symbol of the destructive female element, crushing and smothering the baby during delivery. Erwin recalled books and films showing constrictor snakes strangulating the prey and swallowing it. The similarity between these acts and birth or pregnancy seemed to represent the associative bridge between the phallic connotation of the snake symbol and its relation to the process of death and rebirth. The obsessive symptoms continued to be closely related to the movements of the snake's body, but now they symbolically reflected the conflicting forces during the propulsion through the birth canal. The feelings of uncleanliness extended from the genital and anal areas to the entire body and could be identified as the condition of the newborn during and immediately after the delivery. The problems of losing control of the bowels and bladder were now related to reflex urination and defecation, which occurs as a reaction to the agony of birth.

The serpentine visions persisted even in some later sessions that had elements of a transpersonal nature. Here the snake was perceived in a variety of archetypal and mythological contexts. Erwin described numerous visions of high priestesses attending and worshipping sacred pythons, snakes embodying the primordial forces of nature, gigantic Ouroboroses swallowing their tails, plumed serpents, and other mysterious serpent deities.

The LSD experiences on all the levels described seemed to make perfect sense in regard to Erwin's symptoms. Unfortunately, none of these seemingly relevant connections proved to be therapeutically useful. Although Erwin frequently felt that he was coming close to the solution of his problems, the long series of psychedelic sessions failed to bring the desired results.

Continue reading here: Emotional And Psychosomatic Changes In The Postsession Intervals

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