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Psychotherapy and Psychedelic Drugs


  The Future of LSD Psychotherapy

    Stanislav Grof, M.D.

        The Epilogue from LSD Psychotherapy, ©1980, 1994 by Stanislav Grof
        Hunter House Publishers, Alameda, California. ISBN 0-89793-158-0



    In the preceding sections of this book I have tried to express and illustrate my belief that LSD is a unique and powerful tool for the exploration of the human mind and human nature. Psychedelic experiences mediate access to deep realms of the psyche that have not yet been discovered and acknowledged by mainstream psychology and psychiatry. They also reveal new possibilities and mechanisms of therapeutic change and personality transformation. The fact that the spectrum of the LSD experience appears puzzling to most professionals and cannot be accounted for by the existing theoretical frameworks does not mean that the effects of LSD are totally unpredictable. The safe and effective use of this drug requires a fundamental revision of the existing theory and practice of psychotherapy. However, it is possible to formulate basic principles for LSD-assisted psychotherapy which maximize its therapeutic benefits and minimize the risks.
    It is very difficult at this point to predict the future of LSD psychotherapy. The fact that it can be used safely and effectively does not automatically mean that it will be assimilated by mainstream psychiatry. This issue is complicated by many factors of an emotional, administrative, political and legal nature. However, we should clearly differentiate between the future of LSD psychotherapy and its contribution to the theory and practice of psychiatry. I mentioned earlier in this volume that LSD is a catalyst or amplifier of mental processes. If properly used it could become something like the microscope or the telescope of psychiatry. Whether LSD research continues in the future or not, the insights that have been achieved in LSD experimentation are of lasting value and relevance.
    The theoretical formulations and practical principles that LSD psychotherapy has discovered or validated include a new, expanded cartography of the human mind, new and effective therapeutic mechanisms, a new strategy of psychotherapy, and a synthesis of spirituality and science in the context of the transpersonal approach. In addition, the recent rapid convergence between mysticism, modern consciousness research and quantum-relativistic physics suggests that psychedelic research could contribute in the future to our understanding of the nature of reality.
    It is true that psychedelic experimentation has its dangers and pitfalls. But ventures into unexplored areas are never without risk. Wilhelm Conrad Roentgen, the discoverer of x-rays, lost his fingers as a result of his experiments with the new form of radiation. The mortality-rate of the early pilots who paved the way for today's safe jet travel was allegedly 75 percent. The degree of risk is directly proportional to the significance of the discovery, and its potential; thus the invention of gun powder involved a different level of risk from the development of nuclear energy. LSD is a tool of extraordinary power; after more than twenty years of clinical research I feel great awe in regard to both its positive and negative potential. Whatever the future of LSD psychotherapy, it is important to realize that by banning psychedelic research we have not only given up the study of an interesting drug or group of substances, but also abandoned one of the most promising approaches to the understanding of the human mind and consciousness.
    The present prospects for systematic LSD research and its extensive use in psychotherapy look rather grim. It is difficult at this point to say whether or not the situation will change, though there are indications that the general climate might become more favorable in the years to come.
    One of the major problems in LSD psychotherapy was the unusual nature and content of the psychedelic experience. The intensity of the emotional and physical expression characteristic of LSD sessions was in sharp contrast to the conventional image of psychotherapy, with its face-to-face discussions or disciplined free-associating on the couch. The themes of birth, death, insanity, ESP, cosmic unity, archetypal entities, or past-incarnation memories occurring in psychedelic states were far beyond the conventional topics of psychotherapy which emphasized biographical data. An average professional at that time felt reluctance toward or even fear of the experiential realms of this kind because of their association with psychosis. At present, intense emotional outbursts, dramatic physical manifestations, and various perinatal and transpersonal experiences are much more acceptable to and less frightening for many therapists because they can be encountered quite routinely in the context of the new experiential therapies, such as Gestalt practice, encounter groups, marathon and nude marathon sessions, primal therapy, and various neo-Reichian approaches. Many modern therapists value and encourage various dramatic experiences which in the framework of classical analysis would be seen as dangerous acting-out and considered a reason for discontinuation of treatment or even psychiatric hospitalization. Some modern approaches to schizophrenia actually encourage deep experiential immersion into the process instead of its chemical inhibition. For new therapists of the above orientation, psychedelics would naturally be the next step to help accelerate and deepen the process.
    LSD entered the scene at the time of the psychopharmacological revolution, when new tranquilizers and antidepressants had their early triumphs and generated excessive hope for easy chemical solutions to most of the problems in psychiatry. At present much of the original enthusiasm in this area has tapered off. While appreciating the humanization of the mental hospitals and pacification of psychiatric wards which has brought their atmosphere close to that of general hospitals, it is becoming increasingly obvious that tranquilizers and antidepressants are, by and large, only symptomatic remedies. They do not solve the problems and in more serious cases lead to a life-long dependence on maintenance medication. In addition, there is an increasing number of professional papers that emphasize the dangers of massive use of these drugs—irreversible neurological symptoms of tardive dyskinesia, degenerative changes in the retina, or actual physiological addiction with a withdrawal syndrome.
    We should also mention important social forces that might play a role in the future changes of policy toward psychedelic research. Many of the young persons who are in or will be moving into various positions of social relevance—as lawyers, teachers, administrators, or mental health professionals—had intense exposure to psychedelics during their student years. Those individuals who had experiences themselves, or had the opportunity to observe the process in close friends and relatives, will have formed an independent image and will not be dependent on second-hand sources for information. Elements of sanity in the new marijuana laws in many states may be the first fruits of this development. The fact that ritualized and responsible use of psychedelics received social sanction in some ancient societies and pre-industrial countries and was meaningfully woven into the social fabric represents a somewhat hopeful precedent.


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