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Psychotherapy and Psychedelic Drugs


  LSD, Alcoholism and Transcendence

    CHARLES SAVAGE, M.D.

        from: LSD, the Consciousness-Expanding Drug  ©1964 David Solomon



    "Visit either you like: they're both mad."
    "But I don't want to go among mad people," Alice remarked.
    "Oh, you can't help that," said the Cat.
    "We're all mad here. I'm mad. You're mad."
    "How do you know I'm mad?" said Alice.
    "You must be," said the Cat, "or you wouldn't have come here."
   

The Cat recognized what was not apparent to his Victorian contemporaries. We are all part of a sick society, troubled members of a troubled world. Inevitably many people look to drink for salvation. For some it is an imperfect salvation, leading to the couch, the hospital or the grave.
    Our plight is not unlike that of the nineteenth-century American Indian. His land was stolen, his livelihood lost, his life forfeit, his language, customs and beliefs were all deliberately undermined by the white man in the name of Christ, Culture and Civilization. Confronted with physical and spiritual annihilation, the "red man" faced the future with grim foreboding. Many Indians turned to drink; but others turned to peyote, the Aztec counterpart of LSD. Seemingly they turned to peyote for inner strength. "Peyote gave them faith in a new power and a new road that they might follow from the path that was still in their hearts and mind to a feared and little understood future. The meeting of compelling forces, conscious and unconscious, of racial memories, the loss of tribal security and religious beliefs, added to the drive of the creative urge to make live in form and color the spirit of the Indian" (26).8
    Slotkin (24) has reported that peyote has remarkable physiological and psychological characteristics so that when taken under proper conditions, the worshiper experiences a revelation. In most cases this takes the form of a vision. In some cases, it is a mystical state, the unification of all immediate experience with "God."
    The connection of peyote and LSD is not only in their psychophysiological properties; it happens also that both have been and are used in the treatment of alcoholism. As early as 1907 anthropologists (24) had reported that peyote was a cure for alcoholism; and in 1909 it was reported of the Winnebagos that of the degenerate drunks of thirty years ago (1879), those who had turned to peyote had now become the most successful, healthy and outstanding members of the Winnebago community.9
    Today (1960) recovery rates as high as 70 percent are being reported with the LSD therapy of alcoholics.10 Rather than attempt a critical evaluation of these claims, I propose to deal here with the question: How may LSD be of help to the alcoholic?
    Long ago William James (14) made the comment: "The cure for dipsomania is religomania."
    James quoted the following example from a drunkard, S. H. Hadley: "One Tuesday evening, I sat in a saloon in Harlem, a homeless, friendless dying drunkard. I had pawned and sold everything that would bring a drink. I could not sleep unless I was dead drunk. I had not eaten for days, and for four nights preceding I had suffered with delirium tremens or the horrors from midnight until morning. I often said, 'I will never be a tramp. I will find a home in the bottom of the river.' But the Lord so ordered it that when the time did come, I was not able to walk one quarter of the way to the river. As I sat there thinking, I seemed to feel some great and mighty presence. I did not know then what it was. I did learn afterwards that it was Jesus, the sinners' friend. I walked up to the bar and pounded it with my fist 'til I made the glasses rattle. Those who stood by drinking looked on with scornful curiosity. I said I would never take another drink if I died in the street." And so complete was Hadley's conversion that he never did take another drink. As an example of a conversion reaction with LSD followed by abstinence: An alcoholic woman was given 150 micrograms of LSD; during her session she fell silent. She closed her eyes and seemed to fall into a trance. She woke with a start, and said: "I thought I had been killed. I thought I was tried, dragged in chains before God, condemned and taken out to be executed." She awoke feeling that she had been reprieved, that she had been saved.11
    Another patient had had doses of 100 to 200 micrograms of LSD without noticeable benefit. She laughed and danced and listened to jazz records. She once described that she had talked with the devil and had thrown in her lot with him. So she went the devil's way, increasing her drinking and taking "dope." Her final session was with 500 micrograms. She talked to the devil and told him: "Look, I tried it your way and what has it got me?" She then had the feeling that "God" reached out his hand to her, and she was debating whether or not to grasp it. Following this experience, the patient seemed to be in a psychotic or depersonalized state, became very depressed and planned suicide. She wrote a suicide note in the midst of which she fell asleep, awoke in the morning and found she was still alive. The last word she had written in her suicide note was "church" and she thought perhaps a miracle had occurred.
    This patient's experience also illustrates the need for careful aftercare in order to prevent suicide and psychosis.12
    James' explanation of such experiences is compelling: "The difference between a sudden and a gradual convert is not necessarily the presence of a divine miracle in the case of one and of something less divine in that of the other, but rather a simple psychological peculiarity, the fact that in the recipient of the more instantaneous grace we have one of those subjects who are in possession of a large region in which mental work can go on subliminally and from which invasive experiences abruptly upsetting the equilibrium of the primary consciousness may come."
    Some of these patients (treated with LSD) equate forgiveness of sins with healing. The relentless conscience has relented and now the patient is freed of guilt: Thus the old cycle of drink to still guilt, and drink giving rise to guilt, is broken. With the slate wiped clean, the patient is free to deal with the guilt of the moment rather than the guilt of the accumulated years. Borrowing from analytic metapsychology we might say the unconscious superego has become conscious, though it is still projected onto God rather than recognized as part of the self. Made conscious, it has lost some of its minatory quality.13
    The conversion reaction is only one type of spiritual experience which might lead to recovery from alcoholism; but there is still another and more basic one: the mystic experience. James has suggested that one of the motivations for drinking is to achieve an actual mystic experience:
    "The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties of human nature, usually crushed to earth by the cold facts and dry criticisms of the sober hour. Sobriety diminishes, discriminates and says No. Drunkenness expands, unites, and says Yes. It is in fact the great exciter of the Yes function in man. It brings its votary from the chill periphery of things to the radiant core. It makes him for the moment one with truth. Not through perversity do men run after it. To the poor and unlettered it stands in the place of symphony concerts and of literature; it is part of the deeper mystery and tragedy of life that whiffs and gleams of something that we immediately recognize as excellent should be vouchsafed to so many of us only in the fleeting earlier phases of what in its totality is so degrading a poison. The drunken consciousness is one bit of the mystic consciousness and our total opinion of it must find its place in our opinion of that larger whole." A long-shoreman put it more simply: "If it weren't for whiskey, a poor man would never know how a rich man feels."
    What, then, is the need for this mystic experience or the transcendental experience? I believe that Fromm has given us the answer. The alcoholic suffers from alienation, from the "sickness of the soul." All that has been worthwhile in him has been projected onto the outer world, whether it be God or manna. All that is base is retained within himself. "What is his problem? Is it his drinking or is his drinking only a symptom of his real problem, his failure to live a meaningful life? Can man live with this degree of alienation from himself with so much hate and so little love without feeling inferior and disturbed?" (12).
    An illustration of this appeared in Life sometime ago (1959) under the ironic title "The Good Life." The people therein portrayed are so discontented with themselves that they are continually racing after power saws, power motors, power boats. They cannot stand being with themselves for a moment. They are alienated from themselves, alienated from their universe. Their transcendental or creative function is entirely blocked. Compare them with Wordsworth:


    Nuns fret not at their convent's narrow room;
    And hermits are contented with their cells;
    And students with their pensive citadels:
    Maids at the wheel, the weaver at his loom,
    Sit blithe and happy; bees that soar for bloom,
    High as the highest Peak of Furness Fells,
    Will murmur by the hour in foxglove bells:
    In truth, the prison, unto which we doom
    Ourselves, no prison is:
   

Unlike Wordsworth's ideal, modern man is so completely imprisoned and alienated that for him the happy idle hours become a rat race, and the time waster spans his weekend with drink. Many drinkers drink because their lives have lost purpose and meaning. The old drunk might drown his sorrows; the modern drunk fills the emptiness of his existence.
    The alcoholic attempts to find himself, to fulfill himself with drink; but the attempt fails and now the guilt over drink and the wasted opportunity has him trapped. How then may LSD help with this situation? It may provide a genuine transcendental or mystic experience instead of the spurious one "bit of mystic consciousness" which the alcoholic has been seeking. The artificial distinction between subject and object, self and world, conscious and unconscious, ego, id and superego are all abolished. The person is at one with the universe. In his mystic selflessness he awakens with a feeling of rebirth, often physically felt, and he is provided with a new beginning, a new sense of values. He becomes aware of the richness of the unconscious at his disposal; the energies bound up in and by repression become available to him.
    One patient during LSD was drawn into a mystic experience by the sound of a floor buffer turning round and round in the passageway. She was drawn into a mystic participation with the writer and with God. Yet she struggled for her individuality, even as Jacob wrestled with the Angel. Afterwards she said: "I recognized after this that I was strong, that I didn't need to be afraid, that I didn't need to drink." She and her husband had been refractory members of Alcoholics Anonymous for years. Now that she has stopped drinking the husband has started again.14
    What happens when we seek transcendence with LSD? Once we open Pandora's box, we cannot always control what flies out. The LSD experience may strip the patient of his capacity for lies and rationalization; he may see himself in all his psychological nakedness. To expose him so violently and suddenly to his shortcomings may only increase his guilt to an intolerable degree and leave him very depressed. He should, one would think, have at least some "glimpse of heaven" if he is to be "saved." Some inner strength, some hope, some creativity and some positive feelings must be revealed to him.
    This brings us forcibly to the dangers of LSD treatment. The transcendental experience may open up avenues of creativity but it is not creativity itself; the experience of revelation while present may lead the person to confuse fantasy with actual achievement. Unless the constructive aspects of the experience are sufficiently stressed, the individual may not have the strength to face himself stripped of all his rationalizations and projections, a "herring lying in the gutter" (2). Therefore, unless he has some awareness of "God's" mercy, unless he can come to terms with himself as through the mystic experience, and unless he develops new and free energy from the unconscious to alter his life situation, he may develop not only a depression but a frankly paranoid reaction. The intervention of the therapist makes the difference between a helpful and a damaging experience. The therapist need arrogate no religious attributes to himself; indeed he must resist the temptation to believe in the omnipotent role in which he has been placed. For if he does not, he will then reinforce, rather than alleviate the pathological alienation which he is striving to overcome.
    There is another danger which is shared with the peyotists. For years government experts and anthropologists have been warring as to whether peyote is or is not harmful. In point of fact the writer has been able to find authentic evidence of only one peyote psychosis, this on a brief personal visit to the Navajo reservation. But the circumstances are instructive. This was a young man who had branched out on his own. He had his own private stock of peyote which he was nipping on the side, instead of taking it during the highly formalized peyote ritual. 15 In the same manner self-experimentation with LSD is clearly dangerous. LSD strips off the protective barriers of the ego and all sensitivity and perceptivity is heightened. The effect of any input is heightened, so that the drug has great potential for good and evil. It is possible to induce or reinforce unusual beliefs which may alienate the individual from his society at a time when he desperately needs it.
    Finally, LSD causes an inflation of the ego which may be an effective antidote for low self-esteem. Low self-esteem, of course, has many roots. All Good is projected onto God; all Bad is retained in the form of original sin within oneself. There are other problems that derive from the Protestant ethic. There is the stress on the outward evidence of grace as seen by visible evidence of prosperity, the stress on social mobility, the existential guilt arising from the fact that few reach their actual potential: all this adds up to a sort of mass, low self-esteem, a cosmic sense of inferiority, which is actually increased by material achievement and accession of material goods. Ordinary psychotherapy brings out a person's shortcomings and not his assets. But LSD allows a person to face his shortcomings with honesty, and at the same time experience some of the wealth and reservoirs which lie within him. We can perhaps promise that the Mute Inglorious Milton experience the raptures felt by Milton, even if he cannot write his poetry.
    We should also recall that Vergil guided Dante into the Inferno and returned him safely, chastened and enlightened. Those who would use LSD should do as well for their patients.
    Case History of Excessive Drinking with Improvement Following LSD
    This was a 30-year-old radiologist who consulted the writer in 1959. He complained that for the past year he had nightly drunk himself to sleep, and then awoke with nightmares in the middle of the night. His wife would become enraged at being awakened and he would spend the rest of the night crying. He was depressed, unable to work. However, his chief complaint, of years duration, was an inability to feel or experience. "It was as if I was inside a glass shell. I mean I could see out and people could see in, but I couldn't talk or feel."
    The patient was an only child, whose mother had died when he was an infant. He was raised by foster parents until the age of four and then repossessed by father and stepmother. His relations with them were distant. His father reportedly insisted on high standards of intellectual performance, always blamed, never rewarded or praised. Raised as a strict Catholic, the patient married out of the Church and was cut off by his family. He abandoned the Church but it made little difference: as he expressed it: "When I was on a religious kick, it was 'I'm a sinner'; and essentially now it's 'I'm a neurotic.'" His purgatory was in effect merely moved from the future into the present. Alienated from God, nature, man, church, mother and family, he tried for reconciliation by conquering. His friends he subdued with words, his patients with his X-rays, and the universe with his theories. Only once in his life had he overcome his alienation. During sexual relations with his secretary, out in the moonlight, he felt "At that instant I had contacted the universe." He hoped for a repetition of this with his wife, and had the unwisdom to tell her about it on their honeymoon. But he felt nothing for her, could not love her. To add to their misery she became pregnant and he had a psychotic breakdown. She aborted but never forgave, never forgot nor allowed him to forget. He wanted a reconciliation but his efforts to force it only estranged them further. The patient said that he had taken to drink to recapture the experience, but it failed.
    Psychotherapy seemed futile; words were used as hostile ammunition and playthings; he fielded each interpretation perfectly and returned the appropriate riposte, for he had read and was well versed in Freud, Jung and Watts. Yet when he left the hour, he had forgotten everything. It was the patient's suggestion that LSD be tried, which was done after fourteen preliminary psychotherapeutic interviews.
    He began the session by using the drug as a platform to preach his private philosophy. "So anyway this sort of thing, Goedel's proof, the Heisenberg principle of indeterminacy, the insolubility of any mechanical problem that contains more than two bodies by a method of other than successive approximation.... There's me sub one and me sub two and me sub one gets in the way of me sub two."
    In order to turn off this stream and direct him inward we tried some abstract paintings and then Bruckner. "Anyway I'd like to hear a little Bruckner now. Oceanic feelings. Da dum da da dum. That is what Bach did for a living, Bach did for kicks."
    Bruckner's music was an effective stimulus: the patient became ill and then suddenly experienced the nightmare of which he had complained. He shook with fear, trembled and sobbed: "I'm afraid, I'm afraid. I keep looking; there is nothing there; what am I afraid of?" I replied: "Perhaps that's what you are afraid of: nothing." With this the nightmare disappeared, and years later the patient reported that it had never returned. At that moment he reported a mystic enlightenment, a kind of satori. He experienced feeling, closeness with the therapist, with himself and the universe (and, after the session, with his wife). In the evening he telephoned to tell me how grateful he was. He had experienced completely successful sexual relations for the first time. He began to pour his energy into his work, and nightly drinking sessions were no longer required.
    To the therapist he seemed profoundly changed, and for the better. His wife, on the contrary, became much upset, bitter, angry and depressed. She reminded the patient continuously: "You're no different; besides it won't last; you'll see." A self-fulfilling prophecy. We thought to rectify the situation by repeating the LSD experience with the patient, by giving the wife an LSD experience, and then arranging a joint LSD session. The first two were accomplished, but not the third. She refused, saying it was a terrible experience. (During the LSD the observer would have thought she was having a delightful experience.) Eighteen months of intensive conjoint family therapy were required before she could accept the possibility of his being well.
    Three years after the first consultation we learned that he was a professor of radiology at a leading university; and the couple was happily expecting a baby.


Footnotes


    8. Monroe Tsa Toke, from whom this quotation is taken, has done paintings which are unquestionably the best illustration of the Peyote ritually and the peyote visions. (back)
    9. A controversy still rages about peyote and its value for alcoholism. Slotkin quotes Hensley [1908] with approval: Jilt [peyote] cures us of our temporal ills as well as those of a spiritual nature. It takes away the desire for strong drink I myself have been cured of a loathsome disease too horrible to mention. so have hundreds of others. Hundreds of drunkards have been dragged from their downward way. La Barrel however, is cynical about the antagonism of alcohol and peyote. "One can eat lobsters one day and ice cream the next, but one ought not eat them the same day (15)." Radinss Crashing Thunder (19) gives an eloquent account of his cure of chronic alcoholism with delirium tremens by the use of peyote. Radin himself remained skeptical.
    "So completely did all those who joined the peyote cult give up drinking that many Indians and whites were at first inclined to believe that this was a direct effect of the peyote. However, this is an error. The correct explanation is that John Rave, the leader of the cult, gave up drinking when he became a convert and included this renunciation of all liquors in the cult which he so largely moulded and dominated. If any additional proof were needed it can be found in the fact that as Rave's personal influence decreased and as the membership increased the number of people who drank liquor and ate peyote at the same time increased." But Radin overlooks the fact that John Rave gave up drinking because of peyote! (back)
    10. The figure of 70 percent is taken from Hoffer (2) and covers a five-year period, The data on which the present paper is based, however, derive from a series of 20 hospitalized alcoholics (in addition to the M.R.I. patients). They were treated in the same manner described by Terrill except the dosage ranged from 150 to 500 micrograms. Fifty percent had stopped drinking at the time of this symposium. Unfortunately follow-ups could not be obtained. (back)
    11. Following this experience she stopped drinking, became interested in psychotherapy and I referred both her and her husband to a psychiatrist. He was an ex-alcoholic who had a spontaneous religious conversion and he insisted hers was synthetic and not genuine, Three years later he finally proved his point. My sympathies are somewhat with her. After listening to him on the phone for long periods in the late evening I have often found a drink very soothing. (back)
    12. After a period of accelerated drinking, dope taking and dalliance, this patient straightened out, returned to the church, and according to last report (1961) had made a good adjustment for two years. (back)
    13. The mere evocation of the superego into conscious form is not in itself curative. It occurs in terrifying fashion in delirium tremens, and can occur in terrifying fashion with LSD. In the writer's opinion it is the support of the therapist and his ability to maintain contact with the patient that makes the difference in the outcome. (back)
    14. She has since found it prudent to bolster her new found strength with antabuse, to counteract her husband's importuning her to drink. (back)
    15. The writer has found that warnings against self-experimentation (22) are ineffective: it is like telling children not to put beans up their noses. (back)


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