The Importance Of

Since LSD is a non-specific amplifier of mental processes, the LSD phenomena cover an extremely broad range, extending potentially to all aspects of human experience and behavior. For this reason there can be many different sets for the LSD sessions. The fierce controversies surrounding LSD could be dispelled easily if those involved in arguing about the dangers and benefits of LSD would clearly recognize the critical relevance of the non-drug factors. In most instances, discussions that pretend to be about LSD are actually about different uses of the drug, and about the influence of set on the outcome of the LSD experience. Humphrey Osmond, an early pioneer of LSD research, analyzed this situation in a conference on LSD psychotherapy. He emphasized the fact that LSD is a tool, and the way it is employed is of crucial importance. To illustrate his point, he asked the audience to imagine a situation in which a group of people with different backgrounds and different sets of observations try to assess whether a knife is a dangerous object or a useful tool. In this context, a surgeon would present statistics of successful surgical operations, a chief of police would talk about murders and mutilations, a housewife would consider the knife in relation to cutting meat and vegetables, and an artist would think about it in connection with carving wood. In such a situation any attempt to choose one view over the other is clearly absurd and inconceivable; it would be obvious to everybody that the critical factor is the use the knife is put to. Nobody would seriously consider that the dangers and positive potentials of this tool represent its intrinsic properties. Yet this is exactly what has been done in the past in various discussions about LSD.

In the following text, we will briefly review the most important sets in which LSD has been administered, and discuss their specific characteristics. The first major conceptual framework for the administration of LSD was the so-called "model psychosis" approach. It dominated LSD experimentation in the years immediately following the discovery of the drug. The LSD experiences were viewed in a clearly psvchopathological connection and labeled "experimental psychoses" or "chemically induced schizophrenia." In this stage, the drug was administered to volunteers for research purposes, with the aim of exploring the biochemical basis of endogenous psychoses, or to mental health professionals for didactic and training purposes—to send them on a reversible journey into the world of the schizophrenic.

A completely different set for LSD sessions emerged when it became obvious that the drug experiences could enhance creative potential in certain individuals. The drug became popular among artists as a source oj inspiration and many hundreds of painters, sculptors, musicians, architects, and writers volunteered for LSD experiments. Somewhat later, scientists, philosophers and other highly creative individuals bccarne favorite subjects for LSD sessions. This was based on the observation that the unusual states of consciousness induced by LSD can generate important insights, facilitate problem-solving, and lead to valid intuitions or unexpected resyntheses of accumulated data.

Another important set for LSD sessions was developed after experimenters had repeatedly observed that the drug experience could take the form of a profound religious or mystical experience. Some researchers interested in exploring this "instant" or "chemical mysticism" tried to create frameworks and circumstances facilitating the incidence of these spiritual phenomena.

Many different sets have been used in sessions exploring the therapeutic potential of LSD for psychiatric patients and the terminally ill. Various methods of LSD therapy have been described in an earlier chapter and will be only briefly reviewed here. In some of these studies LSD was administered routinely, as any other pharmacological agent, without regard to its specific psychedelic properties. This strictly medical model was applied in approaches using LSD as an anti-depressive, abreactive, or activating agent. In others, LSD was seen as a catalyst of mental processes and an adjunct to psychotherapy; psycholytic, anaclitic, and hypnodelic therapy are examples of this approach. Certain therapeutic orientations such as psychedelic therapy or Salvador Roquet's psychosynthesis have a clearly religious emphasis and stress the "mysticomiinetic" effects of LSD.

The drug can be administered in the context of individual or group psychotherapy and its use may lean in theory and practice on various therapeutic systems —Freudian psychoanalysis, Jung's analytical psychology, Moreno's psychodrama, Perls' Gestalt practice, or existential psychotherapy. The anaclitic approach puts a great emphasis on physical contact and mothering behavior. Psychedelic therapy can use the framework of different religions; its individual variations also stress particular aspects of the set and setting, such as music, elements of nature, the use of universal symbols, or readings of specific passages from sacred books.

Almost infinite variations of set are associated with non-medical use and unsupervised self-experimentation. Some individuals have a sitter for their sessions while others take LSD on their own or participate in group experiences. The settings for these experiences cover a wide range, from private apartments, beautiful natural locations, or rock concerts to streets with busy traffic and cars on the highways. The quality of the street samples of LSD is questionable, and possible impurities include substances such as amphetamines, phencyclidine, STP, and even strychnine. The quantity of the active substance is equally unpredictable. The unreliability of the drugs, absence of a support system, and illegal framework of such self-experiments are conducive to paranoia and panic reactions. For this reason the incidence of serious psychological complications under these circumstances cannot be considered an indication that the use of LSD is intrinsically dangerous.

LSD and some other psyehedelies have been listed as narcotics. This is incorrect and has no scientific justification. No genuine physiological addiction to LSD or related substances has been demonstrated. The reasons for their use and abuse are extremely complex and can have very deep psychological roots. Any legislation that overlooks or ignores this fact is necessarily doomed to fail. The individuals involved in non-medical self-experimentation with psyehedelies belong to different categories and have very different motivations. Some of them are immature and irresponsible youngsters who lack or ignore serious information about the nature of the LSD effect and take the drug for kicks, rebellion, or group orgies. Others are pleasure seekers trying to enhance their sensory experience for aesthetic, recreational and hedonistic reasons. Some couples use joint psychedelic experiences to work through emotional problems within the dyad, improve the quality of their relationship, open new channels of communication, and explore various levels and dimensions of their sexual interaction. A not insignificant group of self-experimenters seem to be people with serious emotional problems for whom traditional psychotherapy is inaccessible, or who are disappointed by its inef-ficacy. They are desperately looking for therapeutic alternatives, and since responsible and professional LSD treatment is not available, they make attempts at self-therapy. There also exists a large group of responsible and sophisticated intellectuals who see repeated psychedelic sessions as a unique opportunity for philosophical and spiritual scarch, comparable to the way offered by traditions such as Tibetan Vajrayana, Zen Buddhism, Taoism, Sufism, or different systems of yoga.

Thus the motivations for psychedelic experimentation can be extremely serious and reflect the most fundamental needs of human beings—cravings for emotional well-being, spiritual fulfillment and a sense of meaning in life. However, there is no doubt that, whatever the motivations and intentions of the subjects may be, the LSD sessions should be conducted in a safe situation and in the context of a trust relationship with an experienced and responsible sitter. If these requirements are not met, the dangers and risks of such an undertaking far outweigh the potential benefits.

The last area of LSD experimentation that will be mentioned in this context is characterized by what can be referred to as destructive sets, Here belong "experiments" which explore the potential of LSD for the psychological liquidation of certain individuals, eliciting of confessions, brain washing, and chemical warfare. We could include here situations in which an individual ingests LSD without knowing it and frequently without any previous knowledge of its effects. The danger of this situation cannot be sufficiently stressed; not only the sanity, but the life of the subject can be at stake under these circumstances. Sometimes this can happen by accident when LSD is mistaken for other pills, or sugar cubes containing LSD for plain sugar. However, secret police, intelligence agencies and military experts have in the past systematically exposed naive and unprepared subjects to the effects of the drug to test its destructive potential. In several instances this even has been done by psychiatric researchers; the objective of these experiments was to test whether in unprepared and surprised subjects the LSD reaction would resemble schizophrenia more closely than when the drug is administered with informed consent.

It has also happened quite frequently in the past that irresponsible indi-

viduaJs added LSD secretly into the food or drink of relatives, friends or strangers, as an "initiation," "psychedelic defloration," entertainment, or just a mischievous and vengeful act. Sometimes this has been combined with other activities that further accentuate the hazards of this situation. I can refer here to an encounter with a group of youngsters several years ago in Washington Square in New York City. When they heard that I had been doing research with LSD, they proudly shared with me their own "experiments," in which strangers were given LSD without knowing it. After ingestion of the drug, these involuntary guinea pigs were taken into a private apartment. Here the "experimenters" performed a wild dance around their victims clad in bizarre aboriginal masks and costumes, swinging daggers and spears. The objective of this "research" was to study the reactions of various subjects to this unusual situation. It is obvious that under these circumstances, LSD can have a profoundly disorganizing effect and precipitate acute, uncontrollable panic and even psychotic decompensation. If LSD is given to another person covertly, without his or her informed consent, I would not hesitate to use the term criminal set for such a situation.

During the last twenty years I have had the opportunity to conduct, observe and personally experience psychedelic sessions in several different sets. I started working with LSD at the time of the "model psychosis" approach, and I also ran didactic sessions with my professional colleagues during this period. Occasionally, artists, philosophers and scientists came to our facility and had LSD sessions for inspiration and insight. Later, I started using LSD as an adjunct to systematic dynamic psychotherapy and conducted an exploratory study of its diagnostic and therapeutic potential within the framework of a specially structured patient community. During this work, I developed a therapeutic technique using repeated administrations of LSD. Although it was originally conceived as drug-assisted psychoanalysis leaning in theory and practice on Freudian concepts, it gradually became a treatment modality sui generis. In addition to working through traumatic material from childhood, as practiced in psychoanalysis and psycholytic therapy, this approach puts great emphasis on the importance of the death-rebirth process and transpersonal experiences.

After many years of clinical experimentation with LSD in Prague, I was able to spend some time in London and to acquire first-hand experience of anaclitic therapy as it was practiced by Joyce Martin and Pauline McCririck. In 1967, I moved to the United States and joined the research team at Spring Grove in Baltimore, where I learnt and practiced the psychedelic treatment technique. During this time I was occasionally called in as a consultant 011 cases of nonmedical experimentation with LSD which involved various complications and I became quite familiar with the counterculture's use of psychedelics. All these experiences have been a rich source of important observations, and they clearly indicate the paramount significance of set as a determinant of the LSD reaction.

Certain aspects of set are quite obvious and explicit. It is not difficult to see that specific programming during the preparation period, certain techniques of conducting the sessions, or props and paraphernalia to which the subject is exposed can influence the LSD experience. However, some other important factors have been overlooked in the past, or were not appreciated sufficiently because they are much more subtle and not easily identifiable. One of thein is the presence or absence of verbal communication between the subject and the sitter. Talk that goes beyond a certain necessary minimum during psychedelic sessions tends to make the experience more superficial and is generally counterproductive in terms of effective self-exploration. However, in those situations where there is a continuing dialogue between the subject and the sitter, the nature of their verbal exchange becomes a factor of considerable importance. This is particularly true in regard to the choicc and formulation of the questions that arc asked. In addressing the subject, the sitter continuously reinforces and redefines the set that has been established in the preparatory period of the session. A specific wording of the questions can attract the subject's attention to certain aspects of the multidimensional and multifaceted content of the LSD experience. In the extreme, it can significantly determine the direction in which the experience moves, modify its content and influence its course.

In the descriptive approach to an LSD session, which tries to capture the phenomenology of the drug reaction, the subject is encouraged to focus on some formal and relatively superficial aspects of his or her experience. The elements that are of interest in this context are the presence or absence of physical symptoms, direction of emotional changes, quality of perceptual distortions, and the degree of psychomotor excitement or inhibition. The experimenter wants to know if the subject's vision is sharp or blurred, if objects are perceived as steady or undulating, if the visions are of a geometrical or figurative nature, if hearing is more or less acute than usual, and if synaesthesias are present. Under these circumstances, the subject usually experiences all the LSD phenomena in a rather impersonal way, as a spectator watching an interesting movie. Whatever is happening in the session is seen as a result of the interaction between the drug and the subject's brain; the experient is used as an observer and reporter of these changes. Even if relatively strong emotions are involved, they are attributed to the chemical effect of the drug rather than seen as a manifestation of the subject's personality; they are simply noticed and recorded. In the sessions focusing on psycho-pathological description, relevant dynamic material is seldom recognized and never pursued any further. Typical questions redefining this experimental framework are sentences such as: "Are you sweating?", "Are your hands trembling?", Do you feel dizzy?", "Are the colors different from the usual?", "Do you have any strange feelings in your body?" The records of early LSD experiments and the questionnaires used in this period abound in questions of this kind.

When LSD was administered in the context of the model psychosis research, the sessions were connected with strongly negative programming. They were explicitly referred to as "experimental psychoses" and psychedelic drugs as "hallucinogens," "psychotomimetics" or "psychodysleptics." The subjects would both expect and selectively focus their attention on phenomena that are usually associated with schizophrenia, such as paranoid feelings, panic anxiety, dissociation between affect and thought, various perceptual distortions and disturbances, delusional interpretation of the environment, or disorganization and fragmentation of the ego. In LSD sessions conducted with mental health professionals for training purposes, the psychopathological focus was particularly strong. These individuals would try to properly identify and diagnose various perceptual disturbances, abnormal thought-processes, and unusual emotional qualities, assigning the appropriate clinical labels to them, and comparing them with those occurring in schizophrenic patients.

The questions characteristic of this approach would be: "Do you have any visual or acoustic hallucinations?", "Are your emotions inappropriate to the content of your thoughts and visions?", "Do you have any strange sensations or bizarre changes of your body image?", "How does your experience compare with schizophrenia?", "Are you getting any insights into the psychotic process?"

In sessions where the emphasis is on aesthetic experiences and artistic inspiration, LSD subjects are primarily interested in changed perception of forms, colors and sounds. They focus their attention on such phenomena as the intricacy of geometrical patterns, dynamics of optical illusions, and richness of synaesthesias. They frequently try to relate their experiences to various modern movements in art or the work of individual artists. Abstractionism, impressionism, cubism, surrealism, superrealism, and concrete music seem to be particularly relevant from this point of view. Another typical feature of these sessions is preoccupation with technical problems and difficulties in expressing these unusual phenomena in artistic forms. The following questions would be characteristic of this type of session: "Do your visions resemble the work of some famous artist?", "What are the predominant colors you see?", "Are your visions geometrical or figurative?", "What material and what technique would be best to express what you see?", "Is this a picture of a vision you had or an automatic drawing?", "How is your coordination?", "Is it difficult to concentrate on painting?", "Does the music you are hallucinating remind you of any piece you know?", "Which instruments would you use in composing this music?", "Do you now have a better understanding of modern art?"

In psychotherapeutic sessions of psycliolytic orientation, the patients are encouraged to use the sessions for self-exploration and dynamic understanding of their emotional problems. The LSD phenomena are seen as complex symbolic formations that reflect important unconscious processes in the patient. There is a systematic effort to decipher all the manifestations of the experience and use them as clues in the process of tracing psychopathological symptoms back to their original sources. The psychodynamic set is continuously redefined by such statements as: "Try to understand why you have this particular experience," "What do you think it means?", "Does this remind you of something in your past?", "Try to attach these feelings of aggression to the original targetl", "Where does your fear come from? Trace it back to its sourcel", "Why do you think you see me transformed in this particular way; could it have some symbolic meaning?", "Do you have any associations or memories connected with this vision?"

In sessions where the main objective is to have a religious or mystical experience, there is a definite tendency to deemphasize or ignore descriptive aspects, psychopathological phenomena, and traumatic personal material. The aesthetic elements are considered important, but the major focus is on the supraindividual, transpersonal, and transcendental. To a great extent, this is also characteristic of psychedelic therapy. In sessions aimed at achieving a psychedelic peak experience, there is usually very little verbal interaction between the therapist and the patient. If it occurs, it tends to take the form of simple directive statements rather than a iquestion. Some typical examples would be the following: "Don't be afraid to die; !this is not really dying. The moment you can accept death, you will experience | rebirth" . . . "It is not really annihilation and disintegration—it is dissolving, dissolving in the universe" . . . "Try to use the music—let the music carry you; be in it and stay with it, try to become the music" . . . "Do not fight it; let it happen, let go, try to surrender completely to the experience" . . . "We can think and talk i later; for now just try to experience whatever is happening, be yourself, simply bel"

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