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  LSD — The Problem-Solving Psychedelic

    P.G. Stafford and B.H. Golightly

        Chapter VIII.   Guidelines to the Use of LSD*

* The "guideline" hints given here, it should be understood, are offered mainly for future reference—in the event that the present restrictions against use of LSD are loosened. The authors to not intend them as encouragement to illegal experimentation.

Since LSD is at present so easily available, despite the measures taken against it, many other people are likely to use it from a similar lack-of-knowledge starting point. I should say here that although I came through the experience unharmed, I now think my casual approach to the drug was extremely dangerous. I've taken many other drugs, including heroin and cocaine, and never experienced anything as powerful and overwhelming as the LSD experience.
— Tom McGrath, Peace News        

    EARLY IN 1966, Lawrence Schiller, a journalist-photographer for Life magazine, traveled around the country making a survey of LSD use and distribution. When he learned from a UCLA psychiatrist that 10 to 15 per cent of the University's students had taken LSD, he found it hard to believe. Even harder to believe was the fact—soon verified by Schiller—that the story was neither local nor restricted to the campus:
An eighteen-year-old girl in Los Angeles gave me the name of the president of a major corporation listed on the New York Stock Exchange. A seller gave me the phone number of an established sculptor. One boy introduced me to a major supplier and I confirmed that even the editor of one of the most respected magazines in this country admitted taking LSD.

    Because Life's facilities for collecting and checking data are fairly exhaustive, Schiller's report has to be taken seriously. Bearing in mind that this investigation preceded the recent "psychedelic explosion," which has led to more experimental drug-taking rather than less, the implications of Schiller's findings are sensational: "I believe approximately four million Americans took LSD last year, judging from conversations with suppliers ... one out of eight take it at least every month."
    While conservative estimates of LSD users still hover around the one million mark, it would seem that Schiller's figure is the more accurate because other sources of information indicate that metropolitan centers are inundated with LSD. (The Los Angeles Narcotics Bureau states that in the Southern California area alone more than a million doses are distributed per month.)
    Of these millions of Americans purportedly taking LSD, how many know how to use it properly? How many understand the necessity for a sound pre-knowledge of the drug's action? Only a minute percentage, if one is to judge by the availability and sale of "guide manuals." Leary, Metzner and Alpert had sold fewer than twenty thousand copies of their book, The Psychedelic Experience, at the time Schiller made his survey—yet this is the only detailed guidebook, with do's and don't's for psychedelic sessions. In light of the importance of knowing what to expect of the drug, it is unnerving to realize that so many users were unaware of the manual, or did not think specific guidance necessary, or just did not want to spend five dollars to buy the book. The situation is somewhat analogous to home-doctoring with modern "miracle drugs" or such highly dangerous drugs as penicillin.
    Now that the number of LSD users has mounted even higher, there are still no more than half a dozen articles or sets of guidelines available and none is very satisfactory. The Psychedelic Experience is biased and unacceptable to the reader who cannot or will not accommodate himself to Eastern thought and mysticism. Houston and Masters devote a chapter of their book to the training of a guide, but it is generalized and offers little to the non-professional or the uninitiated. A fairly good short set of directions is available from Dwight Bulkley of Newport Beach, California, a layman who describes himself as a "reasonably responsible senior citizen, knowledgeable in these materials and in the technical sciences." And an article by Gary Fisher in The Psychedelic Reader supplements the foregoing, as it goes into the matter of dosage levels in some detail.

 

Set and Setting:

    "Set and setting," a phrase coined by Dr. Leary, has become a permanent part of the psychedelic idiom because in very simple terms it gives the components which determine what happens in an LSD session. "Set" refers to the user's state of mind, his personality, his expectations and any memory material which may surface when he is under the drug. "Setting" is a term used to designate the environmental factors that might influence the occasion—other people present, selection of music, comfort, locale (indoors or out-of-doors), aesthetic background, amount of privacy, etc. By properly understanding the concept of "set and setting," it is possible to "program" a session for particular goals.
    In the beginning of clinical research with LSD, reports from the experimental centers were perplexing because of their unevenness. This was especially apparent when representatives of several psychiatric disciplines got together at the Josiah Macy Conference and began comparing notes on their work with LSD. Some stated that not one of their volunteers ever wanted to take LSD again, whether the "setting" had been the office or the hospital. This came as a shock to those who maintained the exact opposite about their groups—all of their people had thought the experience rewarding. In time, because of this divergence of responses, it was realized that the drug itself played a minor role in determining the effect of the experience and that the salient point was to have a warm, supportive atmosphere.
    Observers who have audited many LSD sessions and have seen the range of reactions that arise from various sets and settings claim that professional accreditation of the guide is no assurance of a productive experience; conversely, strictly regulated circumstances need not rule out a pleasurable "trip." Seasoned witnesses, however, do stress that the "warm, supportive atmosphere" contains the essence of the outcome and unless something close to "implicit trust" is felt by the experient for the guide, there is not sufficient "warmth" in the setting.
    The session can be programmed by choosing a setting complimentary to the "set." As the mind under the drug works by an associative principle, cues from the guide and the environment are fed into the participant's stream of activated consciousness and can color it entirely. Thus, if the session has been planned with art appreciation in mind, the selection of appropriate "props" must be made with careful forethought. (If a decorator feels it important to understand "Action Painting," that is to say, it will not be appropriate to surround him with reproductions of Academic paintings simply because they fall under the heading of "art.") All sessions, of course, are "programmed," whether advertently or not, since they are shaped by set and setting. A consciously programmed session, however, is superior to an unplanned session for it eliminates the "channel-shifting" aspect and possible "static" that brings about confusion. Also, unplanned sessions may not readily move beyond "visual" material.

 

The Guide:

    The function of the guide is multifold: head nurse tutor, baby-sitter, Mother Earth, sympathetic ear, scullery maid, priest, trouble-shooter, tourist guide, doctor, navigator, soulmate, and blank screen
    The competent guide knows that it is the subject's session, not his. This is why he must void all of his own emotional involvements to the best of his ability, become as nearly "blank" as he can, and in the twelve-or-so hours of the session, superimpose as needed the various other guide roles upon himself. He must be prepared to make a quick change from soulmate to scullery maid; or priest to trouble-shooter.
    Probably the guide has had many sessions, at least one of which was devoted to concentrating on the clues to becoming a good guide. Without personal, first-hand experience with the psychedelics, it would be virtually impossible for him to appreciate what there is to be guided and to know how vital this trusteeship is. An involved non-involvement is the desideratum
    This didactic point of view, shared by the majority of serious LSD advocates, is contested by some conservative clinicians.[1] They argue that a guide who has had the drug has no objectivity and cannot properly maneuver the subject or evaluate the outcome. Masters and Houston are emphatic in their rebuttal of this and similar charges:
    The argument that the person who has taken the psychedelic drugs thereby disqualifies himself as a person able to objectively view and evaluate the experience, must strike most seasoned researchers as simply ludicrous... Work done by those who refused to take the drugs does not demonstrate greater objectivity than that of persons who have had the drug experience; and doubtless refusal to experience the psychedelic state is a product, in some cases, of anxiety about the person's ability to cope with that state...
    It is agreed by most persons who have worked with the psychedelic substances that the guide, to be effective, must himself have taken at least one of the drugs, preferably on several occasions. We see neither the need for nor possibility of a satisfactory alternative to this, and would add that the psychedelic experience of the guide-to-be should include at least two guided sessions in which he is a subject.
    In the early days of clinical use of the psychedelics, it was taken for granted that the "medicine" need not be tried by the therapist, but that it was like other medicines and could be prescribed automatically for specific purposes. Because of this, the few rather than the many actually took LSD themselves, and when they did, it was usually out of curiosity. The patient was given his "dosage" and left in a room by himself while the drug took effect, with only a bell or signaling device to summon help if he needed it. Gradually therapeutic practice recognized that more than a signaling device or a "watcher" was required. Now those specialists who have used the psychedelics for eight or ten years know that a guide is absolutely necessary and that he must be highly trained to cope with crises and to interpret and direct the session. Dr. Van Rhijn, who at the Macy Conference expressed the opinion that patients could get along on their own, had by the time of the Amityville meeting (six years later) recognized new variables which require more subtle and complicated techniques, and therefore demanded the presence of an expert guide. Specifically he suggested the following qualifications:
I think the method could be learned by a qualified psychiatrist in about half a year, through studying and observing methodology while assisting a colleague (who should have, I think, at least three years' experience in psycholytic therapy), in combination with at least five of his own experiences, with dosages ranging from 50 to 500 mcg.

    A question frequently discussed is whether or not the guide should have at least a minimal dosage of LSD during a session. There are good arguments on both sides, but most cautious investigators agree that anything above 25 mcg. for the guide would necessitate the presence of a third person.
    It is believed that a small amount of the drug helps to establish a quicker and more fluid rapport between guide and subject and also lessens the possibility of boredom on the part of the guide. It is far from easy to sit from eight to twelve hours with a person who may be silent and motionless much of the time. Furthermore, the guide's responsibilities are so much greater and more complex than that of an ordinary nurse that inattention may be disastrous. A small quantity of LSD is in most cases considered adequate to keep the guide alert and interested, while leaving him capable of fulfilling his function. Having a bit of the drug himself also frees his imagination, and his interpretations of the subject's material are more trenchant.
    A good rule of thumb is never to accept as guide a therapist or anyone who is antagonistic personally, for vulnerability and naturalness will be inhibited to some extent at least, regardless of good intentions.
    A well-trained LSD therapist will never try to manipulate the subject, i.e., probe obviously, ask loaded questions, etc. If detected, these will be taken as hostile manifestations. Because of the sensitivity aroused in the LSD subject, hints of underlying ambivalence, either positive or negative, will be telegraphed and will distort the session.
    The following is an example of "discoloration" of the LSD session through such material:
One group of five patients was tested while under LSD. Each was accompanied by a selected nursing assistant throughout the test experience. Only one patient had a psychedelic experience, and he did so "because I found it too painful to come back into consciousness to answer the questions. I just gave up and paid no attention to the questioners." The other four patients had psychotomimetic reactions, mostly at the paranoid level, and were most vociferous in telling us so after the tests were over. Because of our understanding the basis for the disruptive impact of psychological testing, we gave them another opportunity to have LSD, but in the informal, completely supportive environment. We will not test patients anymore while they are undergoing an LSD experience....

    This observation was made by Dr. Kenneth Godfrey, Assistant Chief, West Psychiatric Service, at Topeka Veterans Administration Hospital. He continued giving the drug to the group of four, using 500 mcg. dosages, and all had psychedelic experiences. By doing away with the testing program and providing a congenial setting, Dr. Godfrey and his colleagues found that "almost 100 percent of the patients began to reach a high level of psychedelic experience within one and one-half to three hours.... Experiences of ecstasy became somewhat commonplace."
    A final word on guiding—if full self-confidence is lacking, more harm than good can result. As Drs. Leary, Metzner and Alpert say:
From our own research studies and our investigations into sessions run by others—serious professionals or adventurous bohemians—we have been led to the conclusion that almost every negative LSD reaction has been caused by fear on the part of the guide which has augmented the transient fear of the subject.

 

The Candidate:

    There is continuing argument among professionals as to who is a good candidate for LSD and who is not The matter is simplified if it is understood that the guide can be no more than an expert navigator, and that the subject is both the captain and the ship. No reliable captain would take his ship out without a navigator worth his salt, but no navigator can save a ship from peril if the captain refuses to act on his advice. This is why splendid results have sometimes occurred in the most unpromising cases. Among the proscribed have been middle-aged spinsters, neurotics and social isolates. Yet if motivation and guide-trust are high, these are among the very people who stand to gain the most from psychedelic drugs. With poor motivation and an indifferent guide, almost anybody, on the other hand, can run aground.
    The success of a psychedelic "voyage" seems to depend less on the psychological label of the candidate and his personal history than it does on his willingness to surrender to the possibility of great chaos. "Swingers," those who enjoy wild, uninhibited activity, or those who can cope with a good deal of tumult, usually do well in their sessions. On the other hand, if flexibility is all pose, LSD can shred such protective facades, and at some point it probably will. Being unprepared and defenseless under a flood of confusion may give rise to shock and anxiety.
    There are also those orderly, cautious personalities who require an explanation for everything, who are most comfortable in a static set of circumstances, and who are compelled to maintain a favorable self-image—those in this group tend to find the LSD experience terribly upsetting, if not devastating. This need not always be the case, however, if the pre-session briefing has been intelligent and thorough, and if the guide is astute and gifted.
    The cardinal qualification for the LSD odyssey is ultimately one of honesty. In time of personal catastrophe, the most appropriate reaction is an honest one, in which the individual functions with a minimum of hysteria. So, too, when LSD swirls the voyager into unknown regions. He must be prepared to confront, without panic, unsightly scenes (his own image included), threats and tragedy. Some who have had LSD experiences that they called "delightful cruises," without "bad weather," may yet run into heavy seas. Somewhere along the line there usually does comes a reckoning from which there is no escape, especially if the subject has been dissembling. Without a well-trained guide, the psychedelic experience is best avoided by those individuals who must maintain defenses that keep self-exposure at second remove.
    Except for those who have been involved in drug usage for therapeutic reasons, it would appear that the prerequisite of granite-bound honesty deters many who might otherwise benefit from a well-guided LSD session and restricts it to those already possessing the positive attitudes the drug tends to elicit. This dilemma, however, is resolvable. Those who desire such atrophied qualities rejuvenated can overcome their hesitancy and face up to the fact that the ultimate destination is worth the trip. To borrow the clinician's term, the "highly motivated" are promising subjects.
    Of course this, too, amounts to problem-solving. The awakening or revitalization of such human qualities may be one of the greatest benefits of the psychedelic experience. If the drug should be taken with a definite problem-solving goal in mind, the shoals encountered in the LSD trip will be far easier to navigate.

 

Dangers and Precautions:

    The dangers of LSD use have popularly been presented in bogey-man fashion—i.e., exaggerated and not fully explained. In almost every incident of failure, the subject has been left ignorant of basic facts. The guide has been careless in his duty and neglected to remind his ward that he must never forget that whatever is happening to him is simply the effect of a drug, and that the experience will terminate in a matter of hours. The subject must understand in advance that although he may feel capable of "flying" while under the drug, he must not let himself be deluded in this regard. Properly prepared, his residual judgment will remain intact and keep him away from windows and other danger areas. Similarly, he must be reassured that the guide will not attempt to "freak" him by misrepresenting realities. If the subject thinks he is in eternity and that the whole universe is in similar condition, he must be assured that on another level the old reality still exists and that he will be able to return to it when he wants to. Therefore, one of the main obligations of the guide is to provide the subject with a firm perspective, whenever necessary; if this is met, the dangers inherent to the drug are minimal.
    Over-guiding, in contrast, can actually cause dangers where none exist.[2] Too much forewarning in a negative fashion implants anxiety—if not fear—which may become overwhelming in session, especially if the guide is not especially capable. This was particularly true when the drug was first known. Psychiatrists would say to their volunteers, "You know you may go mad, don't you?"—a suggestion more appropriate to brain-washing techniques than keeping the patient out of harm's way.
    Most LSD experients spend part of their session bewildered by their surroundings, dazzled and in doubt of their external world. When Albert Hofmann first tried psilocybin, for instance, he saw his hospital ward change to Mexican scenery (earlier he had been thinking about the source of the "magic mushroom") and his German doctor transformed to an Aztec priest, hovering over him with an obsidian knife. Try as he would, for several minutes he could not return the situation to normal. In most cases such alterations in externals are fascinating to the subject rather than disturbing, especially if it is known that these visions will pass and give way to other things. But to some of the inexperienced who have received poor preparation and mediocre guidance, "traveling via the mind to other lands" may not be at all pleasant, especially if the sensation of being "lost" comes as a surprise. The novice wanders into a side room or down a hall and suddenly no longer knows where he is. His disorientation—like other LSD mishaps—is then amplified and reverberates. "How did I get here?" "Will I ever get back?"
    "Getting lost" is probably the most disagreeable portion of a misguided trip as well as the most obvious step-off into psychotic trauma. Yet it is possible to avoid, since it stems from surprise and general ignorance of the drug-induced state of mind. Advance preparation for the possibility of temporary dislocation is usually enough to sustain the bewildered experient until he can regain his bearings.
    The next danger zone, not uncommon to the casual LSD session, is sexual paranoia. The subject may feel victimized and spied upon and fear that at any moment he will be helplessly swept up into an obscene orgy with unwanted sexual partners. This suspicion usually occurs to the subject when he has sent out distress signals and his guide is trying to comfort him by physical reassurance. If the subject and guide are of the same sex and if the subject's libido is insecure, well-meant gestures may be interpreted as an accusation of homosexuality and the subject may have a deep psychotic reaction. This possibility will be obviated if there is prior understanding of the guide's function.
    It is not unusual to find cautionary advice in the psychedelic literature, although the details are often scanty and tend to be forgotten as soon as they are read. Without a frame of reference, it is difficult to keep their importance in mind. It is all too easy to gloss over such warnings and assume they are only for the "other guy." Likewise, many assume that a first-hand knowledge of marijuana or any other psychedelic drug is more than enough preparation for LSD. This is simply not the case. To avoid the obvious craters, and the small ruts as well, thorough and concentrated briefing must take place, preferably including both reading and discussion.

 

Dosage:

    Dosage is regarded as the last serious consideration in an LSD session, being preceded by set and setting, preparation and choice of guide. The drug is, after all, only a key, and as long as it is of sufficient strength, it will open the door to psychedelic realms. Once these provinces are available for exploration, the question really is how far the subject wishes to "travel." Those people who are experienced with the "lock," who know their way with LSD, can travel far and fast on small dosages, and "setting" becomes secondary to "set" for them. But the inexperienced adventurer who is reluctant to go far afield may absorb a massive dose and stubbornly resist its effect. There are even those who rely on heavy dosage to anesthetize fear of "crossing the threshold," yet are unable to attain psychedelic experience and escape instead into the safety of blackout. This would seem to illustrate that initially the subject must take the drug or the drug cannot "take" the subject.
    The easiest way to understand the various strengths of dosage is to think of the drug as a high-powered microscope with a range of optic lenses that can be manipulated to suit the individual eye or the matter being observed. The dosage in this scheme determines the magnification.
    LSD, because it is the most potent drug known to man, is not measured in the usual milligrams, but in the smallest unit in the scale, the microgram (a millionth of a gram). Anything lower than 15 mcg. rarely has an effect on humans and doses higher than 2000 mcg. are extremely rare in clinical literature.
    The range between 25 and 75 mcg. brings the psychedelic microscope into low focus and gives an effect similar to that of marijuana At this level the drug is useful in group therapy. It also causes perceptual alterations and heightens reception of auditory and visual entertainment—the ballet, for example. A dosage between 100 and 250 mcg will change the focal length so that the subject is projected into the realms of the unconscious and will be concerned with psychological and sexual matters. If his session has been programmed for intellectual and artistic reasons, suitable material will be brought into focus. This is the dosage most commonly used. An increase in dosage to 300 to 600 mcg. will produce cosmic and mystical experience, and above 600 mcg. the LSD field shifts into what are often called "cellular" or "molecular" realities. Because the dosage changes the type of experience, the concept of "overdosing" in the narcotic sense is not applicable and is inaccurate. The lethal human dose, if any, is not known as yet
    Each of these dosage levels should be understood as a necessarily rough approximation since the effects depend upon so many variables. With alcoholics and addicts, twice the dosage is needed to achieve characteristic effects. Women require about 75 per cent of the amount required by men—body weight being one of the determining factors. Once above a certain dosage, a session has some aspects of all of the LSD "states"—the goal is more the determinant than the dose. Nonetheless, the dosage defines the intensity even though it does not rigidly restrict the terrain.
    Many scientific researchers feel that the first experience requires a "super dose" in order to get the subject propelled with dispatch. Others, objecting to a rapid escalation, suggest a "boost" if the subject remains on a low plateau. If such a "boost" is necessary, it is generally thought that a duplicate dosage should be given within the first three hours. It is considered important, however, to allow more than the standard 20 to 40 minutes for the drug to take hold, for some people have high thresholds of resistance.
    The other psychedelics, usually measured in milligrams (thousandths of a gram), often have side-effects not ordinarily associated with LSD. The dosage range for psilocybin falls between 10 and 40 mg., and one may expect some initial physical effects; perhaps slight nausea, chill, slight cramp. The emotional impact is gentler than that of LSD and the subject slips into the drug state instead of being thrust into it. The same applies to mescaline (derived from the emetic, peyote), for which the dosage range is 100 mg. to 600 mg. In the gross sense, all the psychedelics lead to the same "beyond within," but to the adept, the approaches are quite different.
    There are some scientists and laymen who feel that a combination of drugs is the best way to put the psychedelics to use. As mentioned earlier, Drs. Ling and Buckman, Dr. Ruth Fox and Dr. Jack Ward, among others, gave LSD with a number of less potent substances such as ritalin, librium, methedrine and other amphetamines and some barbiturates. To prevent nausea, particularly induced by peyote, some doctors recommend using Marezine, Bonamine, Dramamine, etc.
    Should it seem advisable to terminate the session, a strong phenothiazine-type tranquilizer such as Thorazine (chlorpromazine) is used. An injection of 100 to 200 mg., or 80 to 100 mg. taken orally, brings the subject "down" when an average psychedelic drug dosage has been ingested. For heavier doses, one milligram per microgram (of LSD) is the usual terminant. Some doctors, on the other hand, prefer nicotinic acid (200 to 600 mg.)—in the larger doses to end the session, and in smaller doses to reduce confusion and anxiety. Nicotinic and ascorbic acid (vitamins B3 and C) are increasingly used because they are readily obtainable and there is no danger if an excessive amount is taken. If the intent is simply to ameliorate the session and calm the subject without ending the experience, 20 to 100 mgs. of librium are also considered adequate.

 

Tight Spots:

    A "dry-run" examination of an LSD experience would be incomplete without a consideration of "tight spots" and how to get out of them. Such moments of potential crisis are due to the nature of the experience, for like any voyage, it is not all smooth sailing. The following points out some of the "reefs" upon which LSD users have run aground and suggests a few methods of circumvention:

    1) Under LSD, the user is not simply adrift, a tourist cast off at the mercy of the elements and in the grip of forces that cannot be influenced. He is, instead, the master of his ship and can change directions. Because of the overwhelming nature of what occurs, however, this may not be easy to remember.
    One subject became hopelessly enmeshed in a net of music and could not break the thrall. He was listening to a recording of "Spellbound," and believed that the eerie music somehow was emanating from his nervous system. As each recurring theme built to a climax, he would twitch and wriggle along the floor. He felt "unable to do anything" until a thoughtful assistant walked over to the record player and turned it off. He was released at once.
    Since "real life" continues after the ingestion of LSD, there is always the need during the session to get up, move about to some extent (to go to the bathroom, to cite a practical example). But in the psychedelic state, few people feel capable of doing so—until they try. The subject under LSD can function normally and he can also alter the experience as he wishes. He should fully grasp this fact before taking the drug. Once into his session, he should take time out and practice "reversing" sensations. He can turn water into wine (at least his taste buds will tell him so) just by thinking it; he can make a light object feel heavy; he can turn a tin can into a silver samovar; or he can turn another's glistening tears into a dry-eyed expression of joy. When he is sufficiently skilled, he will be able to "select hallucinations" for himself.

    2) For the initiate, some difficulty may be encountered in "take-off," since the transition is comparable to a jet thrust. Care should therefore be taken to reduce rigidity and awkwardness. The best approach for entering "inner space" gently is made with the aid of a "fluid" selection of music and simple breathing exercises, or a massage, since a tense, tight attitude may grow out of "waiting for something to happen."

    3) During the eight or ten hours of altered reality under LSD, much that is shocking or distasteful may occur within the subject, especially unpleasant fantasies of a physical nature. Cardiac specialists as well as other doctors often direct their heightened psychedelic sensitivity to their bodies and witness in surgical detail the actions of internal organs. They may develop the delusion that they are bleeding to death, suffering an attack, or experiencing the collapse of lungs or other organs. These physical scrutinies also preoccupy the layman of course, and birth experiences—being born or giving birth—are within the ordinary line of LSD events. As mentioned previously, disorientation with regard to time can terrorize the most valiant.
    All of these "hallucinations" are merely subjective experiences with little basis in everyday fact. If the subject wants them to "go away," his best remedy is to dispense with the natural impulse to "fight them." "Going with them" or "giving one's self over" disperses the unwanted vision and the "screen" is cleared for something else.
    Facing terrifying LSD events calls for courage and stamina in the early sessions.

    4) If resistance remains high, the experience may become repetitious, leading up to a crucial point but without a breakthrough. The subject vacillates—hot and cold, back and forth, endlessly affixed to the same treadmill. He cannot make decisions. He has been through this all many times before.
    In such instances, "boosting" may be called for. An additional dosage is usually enough to "break the set" and move the subject off his plateau. Dr. Duncan Blewett gives the rationale:

One of the things we discovered is that if you don't give a large enough dose of the drug, a person gets into a sort of interim position. He has one foot in the camp of the usual frame of reference and the other in the camp of unhabitual perception. He finds it impossible to make a break between these two... But if a large enough dose of the drug is used, so that the person is propelled rapidly out of the old context and cannot maintain the self-context as he has known it, he then—rather than becoming more uncomfortable as you would think—becomes much more comfortable and able to accept as valid this new and novel way of seeing the world.

    One of the reasons for the occasional vortex-like recurrence of the same material seems to lie in the fact that the drug effects come in waves, and if the subject is allowed to persist in one particular area too long, he may be caught in an undertow. The favored method for breaking through this "hangup" is to change the subject matter completely—with the intention of returning to it later if it seems worthwhile. If the recurrent material is deliberately brought up again after some time has passed, the subconscious will have had a chance to devise other approaches and the insight level will probably be more acute. A good technique in such instances, borrowed from hypnosis, is to suggest to the subject that in a specified length of time he will return to his problem and then be able to resolve it

    5) The development of physical symptoms (such as coldness, nausea, pressure on the spine, restlessness, tingling, tremors or "a pain in the kidneys") is often the body's way of evading psychedelic effects. With peyote, and to a lesser extent with magic mushrooms or morning-glory seeds, these effects may be attributed to the drug, but with LSD and other synthetics, such symptoms are a sign of the subject's resistance. The guide should in such cases recognize these symptoms as an indication that the drug is about to take effect, and he should reassure the subject that these physical symptoms will soon pass, with "the psychedelic experience" taking their place.

    6) Another evasion of the full psychedelic experience may involve over-intellectualizing what happens and talking on and on throughout the session. Because language depends upon familiar ways of thinking, reliance on words keeps much that is non-verbal from developing and restricts the LSD experience. To carry on a lengthy conversation confines "psychedelia" even further, since the subject when questioned or spoken to is somewhere "out in orbit" and must then come back and touch down before replying. For the average person, a period of verbalization may not develop into a problem, but a rigidly defensive person, on the other hand, may use words to avoid the experience, and as time passes he may become increasingly desperate. This may make him aggressive, causing him to react with hostility toward the guide. He may impute a variety of menacing motivations to him. In such a situation the guide should refuse the various "ploys," gently reminding the subject what he is there for.

    7) If terror grips the subject continuously during the session, physical comforting may lend the needed reassurance. But as pointed out previously, this is a delicate matter unless the guide is certain that the subject will not misinterpret the gesture. Because attendant LSD distortions may seem too vile or alien to be shared, the subject who has lodged himself in a crevasse can most successfully be brought out, if other means have not been satisfactory, by the guide's taking him into his arms and soothing him.

    8) If "reversing" the disturbing hallucinatory material has not dispelled anxiety, counter-diversion should be attempted. The subject should be encouraged to try some appropriate physical activity such as dancing, keeping time to music, playing the piano or even typing. Taking deep breaths and paying attention to the lungs as they expand and contract is quite effective. Such diversionary efforts will in all probability become the new focus of attention.

    9) The skilled guide always has extra resources up his sleeve or is capable of fast, imaginative thinking. One example, which can serve as a pattern for the latter, occurred when the subject decided she was made of metal and was unable to move. "Oh, you're the friendly robot in that TV serial," the guide remarked genially, and as the subject was familiar with the program referred to, she immediately "recognized herself" and began moving about gaily in a deliberate parody of an automaton's gyrations.
    Dr. Leary had an amusing and instructive episode to recount along these lines. An electronics engineer had taken psilocybin and was reacting with great anxiety:

... his traveling companion was unable to calm him down. The psychologist in charge happened to be in the bathroom. He called to his wife, who was drying dishes in the kitchen: "Straighten him out, will you?" She dried her hands and went into the living room. The distressed engineer cried out: "I want my wife!" and she put her arms around him, murmuring: "Your wife is a river, a river, a river!" "Ah!" he said more quietly. "I want my mother!" "Your mother is a river, a river, a river" "Ah, yes," sighed the engineer, and gave up his fight, and drifted off happily, and the psychologist's wife went back to her dishes.
    10) Pinpointing the source of the unpleasant hallucination can eliminate it rapidly. One subject, for instance, convinced that the house was on fire said he could actually see his "charred limbs" in the ruins. He was set straight when he was shown a burned-out candle in an ashtray, still smoking because the wax had been set afire by cigarette butts. Another person was able to deal with distasteful hallucinatory material when told that he was "merely a visitor passing through a slum" and that "a better neighborhood would soon emerge."

    11) Crises do sometimes arise even in well-planned sessions. If the subject is unable to cope with them in a sober manner, the guide may suggest "game-playing." The subject should be instructed to think of himself as a versatile actor who must portray a character in a serious role, stand aside and let the play begin.

    12) If the subject has insisted upon taking a stroll through heavy traffic, wants to drive a car or undertakes some other ill-advised pursuit, and if the guide has been outwitted or has lost contact, the subject should remind himself that what is happening is due to the drug he has taken and that its effects will, in time, wear off. He should realize that finding his way home is not an impossible feat. He should try to recall, step by step, how he did it the day before. Since evaluating distance may be difficult, he should force himself to obey all traffic signals rigorously in crossing streets, taking his cue from the surge of the crowd. He must curb his inclinations toward bizarre behavior and bear in mind that his mission is simply to get home.
    If the subject has been driving a car, upon realization of his situation he should park as soon as he can and take a cab, a bus or proceed on foot. Although he may not believe it, most people will have no idea of his condition, either through their own preoccupation or the simple fact that it is not always easy to detect psychedelic drug behavior.

    These final precautions have been deliberately emphasized because they deal with the rare mishaps which the popular press has presented as run-of-the-mill, without suggesting any means for avoiding or coping with them. In point of fact, "runaway" and out-of-control sessions are extremely unusual. Rather, those who fear the ballooned Mr. Hyde (promised by the press to lurk just beneath Dr. Jekyll's thin, suave veneer) and who reject the drug, sight unseen because of this, usually find if they eventually take LSD that the "Mr. Hyde" who lives in their unconscious is not such a bad fellow after all.
    The carry-over of the psychedelic experience, once the session is completed, depends upon where the stepping stones have been placed, or if the desired bridge has been reached. A single resolve, clung to throughout the whole of the session, strengthens the effects. So does the delay, or avoidance, of return to established routine. Ideally, time should be allowed for relaxation in "normal reality" to let the subconscious integrate its new insights. This is the time to put the "psychic house" in order; to speculate about what has been resolved and what remains to be resolved.

 

Footnotes

    1. It has been recently disclosed that grants to study the effects of LSD are not available to applicants who have used the drug, whether they have done so professionally or not. Since the National Institute of Mental Health is the sole legal distributor, this decision limits research even further. (back)
    2. Another danger situation is over-preparation, or too much eagerness for the experience, especially if long awaited. Jane Dunlap, in her LSD memoirs, Exploring Inner Space, unwittingly records well over fifteen episodes during her five experiences which any objective reader would find gruesome, disgusting or terrifying. Miss Dunlap, however, seemed to take them all in good stride because she was so grateful for the other aspects of her LSD experience. The point, though, is that all of her negative sensations were intensified as a result of inadequate guiding. When she felt utterly helpless in the early part of her first session, for instance there apparently was no one who knew what to do. "This blood-freezing emotion, I knew, could be relieved if Dr. Snow, seated near us, would pray for me. Although I asked him to pray and he is a deeply religious man, he was now wholly a psychiatrist and remained silent." (back)

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