Pharmacological Effects Of

Since administration of LSD is the conditio sine qua non, or the absolutely necessary condition for the LSD reaction, it would seem only logical to consider the drug itself as the factor of fundamental importance. Careful analysis of clinical observations from LSD psychotherapy, however, shows this issue to be much more complicated. The phenomena that can occur in the cburse of LSD sessions cover a very wide range; there are hardly any perceptual, emotional, or psychosomatic manifestations that have not been observed and described as part of the LSD spectrum. If different subjects take the same dosage of the drug under relatively standard circumstances, each will have a distinctly different experience. The extreme multiformity and interindividual variability of the LSD state is complemented by its equally striking intraindividual variability. If the same person takes LSD repeatedly, each consecutive session is usually quite different from the others as to its general character, specific content, and course. This variability cfer-tainly is a serious objection to the concept that the LSD reaction has simple biochemical and physiological determinants.

The question whether there exist invariant, repeatable and standard effects of LSD that are purely pharmacological in nature is very interesting and important from both the theoretical and practical point of view. Such effects would have to be unrelated to the personality structure and independent of external circumstances; they would have to occur without exception in every subject who took a sufficient dose of LSD. Conversely, the questions of the extent to which various extrapharmacological factors participate in the LSD experience, and the nature and mechanism of their effect, are equally interesting and theoretically as well as practically relevant. The/search for typical and mandatory pharmacological effects of LSD was an important aspect of my analytical work on the LSD data. The result of this quest was rather surprising: after analyzing almost five thousand records from LSD sessions, I did not find a single symptom that was an absolutely constant component in all of them and could thus be considered truly invariant.

Changes in optical perception are usually described as typical manifestations of the LSD state and are thus serious candidates for being pharmacological invariants. Although reports of various abnormal visual phenomena occurred frequently in my records, I have observed a number of high-dose sessions where there were no alterations in optical perception. Some of these LSD reactions where visual changes were absent had the form of intense sexual experiences; others were characterized by massive somatization with feelings of general malaise and physical illness, or experiences of excruciating pain in various parts of the body. Special examples of sessions without optical perceptual changes were observed in advanced stages of psycholvtic treatment and in some psychedelic sessions. They involved either a brutal and primitive experiential complex described by various subjects as reliving of their own birth, or transcendental experiences of cosmic unity and the Supracosmic Void which had the paradoxical quality of being "con-tentless yet all-containing."

Physical manifestations of the LSD state deserve special notice in this context since, in the early reports, they were seen as simple pharmacological effects of the drug and attributed to direct chemical stimulation of the vegetative centers in the brain. Careful observation of a large number of sessions and analysis of the records does not support this explanation. The physical concomitants of the LSD reaction vary considerably from session to session. The spectrum of so-called "vegetative symptoms" is very broad and cxcceds that of any other drug known, with the exception of some other psychedelics. Strangely enough, these symptoms include both sympathetic and parasympathetic phenomena, and they appear in clusters involving various combinations thereof. They occur with the same frequency and intensity in low- and high-dose sessions and there is no demonstrable dose-effect relationship. In many high-dose LSD sessions, physical manifestations

Lsd Effects Physical Picture
An experience of nausea, one of the most frequent physical symptoms in LSD sessions.

are entirely absent, or they occur intermittently in close connection with difficult and strongly defended unconscious material. Conversely, some low-dose sessions are characterized by massive vegetative symptoms during the entire course of the drug reaction. It is not uncommon that after administration of an additional dose of LSD a subject suffering from severe physical symptoms surrenders to the experience, works through the underlying problem, and gets rid of the somatic distress: Another aspcct of these symptoms that is particularly relevant to our discussion is their unusual sensitivity to various psychological factors; they can often be modified or even terminated by specific external influences and psychotherapeutic interventions. The factors that can dramatically affect "vegetative" and other physical manifestations in LSD sessions range from relevant interpretations or arrival of a specific person to the use of physical contact and various bioenergetic exercises.

One of the physical manifestations of the LSD reaction that deserves special mention is the dilation of the pupils (mydriasis). It is so common that its presence has been used by many experimenters and therapists as a relatively reliable indication that a person is still under the influence of the drug. For a long time, mydriasis seemed to be a serious candidate in my investigations for being the invariant manifestation of the LSD effect. Later, I witnessed several LSD sessions, some of them very dramatic, in which the pupils of the subjects appeared constricted or in which they oscillated rapidly between extreme dilation and constriction.

A similar situation exists in the area of gross physical manifestations such as psychomotor excitement or inhibition, muscular tension, tremors, twitches, seizure-like activities, and various twisting movements. None of these symptoms is standard and predictable enough to be considered a specific pharmacological effect of LSD. This does not mean that LSD does not have any specific physiological effects per se; these can be clearly demonstrated in animal experiments using incomparably higher dosages. However, my experience indicates that within the dosage range commonly used in human experiments or in psychotherapeutic practice, physical manifestations do not result from direct pharmacological stimulation of the nervous system. They seem to reflect chemical activation of dynamic matrices in the unconscious and have a structure similar to hysterical conversions, organ-neurotic phenomena, or symptoms of psychosomatic disorders.

As unpredictable as the content of the LSD reaction is its intensity, and individual responses to the same dosage level vary considerably. The degree of sensitivity or resistance to LSD seems to depend on complicated psychological factors rather than on variables of a constitutional, biological, or metabolic nature. Subjects who in everyday life manifest a strong need to maintain full self-control, and have difficulties in relaxing and "letting go," can sometimes resist relatively high dosages of LSD (300-500 micrograms) and show no detectable change. Occasionally, individuals can resist considerable doses of LSD if they have set this as a personal task for themselves. They may do it to defy the therapist and compete with him or her, to prove or demonstrate their psychological "strength," to endure more than their fellow patients, to impress their friends, or for many other reasons. However, it is obvious that deeper and more relevant unconscious motives should be looked for behind such superficial rationalizations. Additional causes of high resistance to the effect of the drug may be insufficient preparation, instruction and reassurance of the subjects, lack of their full agreement and cooperation, or absence of basic trust in the therapeutic relationship. In this case, the LSD reaction sometimes does not take its full course until the motives for resistance are analyzed and understood. Similar factors seem to be responsible for the inability of many persons to surrender to the effect of the drug under the circumstances of unsupervised self-experimentation in the prcscncc of strangers and in unfamiliar environments. Such sessions are conducive to incomplete resolution and integration, adverse after-effects, arid later recurrences ("flashbacks"). Instant sobering, which can occur at any period of the session and on any dosage level, typically indicates a sudden mobilization of defenses against the impending emergence of unpleasant traumatic material.

Among psychiatric patients, severe obsessive-compulsive neurotics are particularly resistant to the effect of LSD. It has been a common observation in my research that such patients can frequently resist dosages of more than 500 micrograms of LSD and show only slight signs of physical or psychological distress. In extreme cases it can take several dozen high-dose LSD sessions before the psychological resistances of these individuals are reduced to a level where they start having episodes of regression to childhood and become aware of the unconscious material that has to be worked through. After observing several situations in which even a drastic increase of dosage—in one instance to 15000 micrograms given intramuscularly—did not result in a fully developed LSD experience, it became obvious that high psychological resistance to LSD cannot he overcome just by an increase in,dosage; it has to be gradually reduced in a series of sessions. There seems to be a saturation point of LSD somewhere between 400 and 500 micrograms; if the subject does not respond adequately to this dosage, additional LSD will not change anything in the situation.

There is some evidence, of an anecdotal rather than experimental nature, suggesting that a lowered response to LSD can occur in spiritually highly-developed individuals who have extensive experience of unusual states of mind or live in such a state most of the time. The most famous example of this is Ram Dass' account, according to which his Indian guru did not respond on two occasions to extremely high dosages of LSD (900 and 1200 micrograms respectively). (83) This would indicate the possibility that lack of reaction to the drug can be associated paradoxically with two opposite conditions, namely excessive rigidity and a strong psychological defense system or extreme openness and a lack of separating barriers.

Having reviewed various kinds of evidence suggesting the absence of any clear, specific and invariant pharmacological effects of LSD at the dosage level commonly used in experimental and clinical work with human subjects, we can try to outline what the effects of LSD actually are. According to my experience, they are very unspecific and can be described only in the most general terms. In a great majority of sessions there is an overall tendency toward perceptual changes in various sensory areas. Consciousness is usually qualitatively changed and has a dream-like character. The access to unconscious material is typically facilitated and psychological defenses are lowered. Emotional reactivity is almost always greatly enhanced and affective factors play an important role as determinants of the LSD reaction. A rather striking aspect of the LSD effect is a marked intensification of mental processes and neural processes in general; this involves phenomena of differing nature and origin.

Pre-existing and recent psychogenic symptoms, as well as those the individual had suffered from in childhood or at some later period of life, may be amplified and exteriorized. While experiencing them in an exaggerated form the individual frequently develops insights into the network of unconscious processes that underlies them, discovering their specific psychodynamic, perinatal and trans-personal roots. Traumatic or positive memories connected with a strong emotional charge are activated, brought forth from the unconscious, and relived, and the content of various dynamic matrices from different levels of the individual and collective unconscious may emerge into consciousness and be experienced in a complex way. Occasionally, phenomena of a neurological nature can be amplified and manifested in the sessions; this is true for pains associated with arthritis, dislocation of vertebral discs, inflammatory processes, or post-operative and posttraumatic changes. Reliving sensations related to past injuries and operations is particularly common. What is interesting from a theoretical point of view is that LSD subjects even seem to be able to relive pains and other sensations related to past operations conducted under deep general anesthesia. The propensity of LSD and other psychedelics to activate and amplify various neurological processes is so striking that it has been used by several Czech neurologists as a diagnostic tool for the exteriorization of latent paralyses and other subtle organic damage of the central nervous system. (24) The negative side of this interesting property of LSD is the fact that it can activate seizures in patients suffering from manifest epilepsy, or those who have a latent disposition to this disease. A rapid sequence of epileptic seizures that might be difficult to control, the so-called status epileptictis, represents one of the few serious physical risks of LSD therapy.

By and large, I have not been able to discover during my analyses of the data any distinct pharmacological effects that are constant and invariant and can therefore be considered drug-specific. At present, I see LSD as a powerful unspecific amplifier or catalyst of the biochemical and neurophysiological processes in the brain. It seems to create a situation of general undifferentiated activation that facilitates the emergence of unconscious material from various levels of the personality. The richness, as well as the unusual inter- and intra-individual variability, can be explained by the participation and determining influence of ex-trapharmacological factors.

In the following sections we will discuss in detail all the major non-drug variables that seem to have a decisive influence on the process of LSD psychotherapy. They include the personality structure and current life situation of the subject, the personality of the guide, the nature of their mutual relationship, and the set and setting of the sessions.

Continue reading here: Personality Of The Subject

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  • Gundobad
    What is the pharmacological effect of lsd?
    3 years ago