. . . our normal waking consciousness . . . is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different.... No account of the universe in its totality can be final which leaves these . . . disregarded. How to regard them is the question—for they are so discontinuous with ordinary consciousness.—William James. (1)
In recent years, how to regard the "forms of
consciousness entirely different" induced by mescaline,
LSD-25, and psilocybin has posed a seemingly perplexing issue.
For articulate self-experimenters from Mitchell to Huxley,
mescaline has provided many-splendored visual experiences, or a
life-enlarging sojourn in "the Antipodes of the mind"
(2). For Stockings, it may be recalled, mescaline produced
controlled schizophrenia (3)—a thesis which earned the
Bronze Medal of the Royal Medico-Psychological Association and
apparently inaugurated, in conjunction with the advent of LSD-25,
a period of concerted chemical activity in the exploration and
experimental induction of "model psychoses" (4). In
counterpoint, this same so-called "psychotomimetic" LSD
has increasingly found use as a purposeful intervention or
"adjuvant" in psychotherapy (5). The recently arrived
"magic mushroom," psilocybin, has been similarly
equivocal—"psychotogenic" for some,
"mysticomimetic" for others (6). The present paper will
review the literature on drug experience—paying particular
attention to the effects of extradrug variables, for the
realization of the extent of their potential influence has only
recently crystallized, and promises to reduce some of the
abundant disorder in this area.
The phenomenon of drug-associated rapid personality
or behavior change will be discussed in some detail. For example,
a number of different alcoholic treatment facilities, especially
in Canada, have reported, for many of their patients, complete
abstinence after a single LSD session (7). More generally,
neurotic ailments over the full range have been described as
practically evaporating (8). Given this picture, and the present
state and practice of the therapeutic art, it is not surprising
to find at least one psychiatrist envisioning ". . . mass
therapy: institutions in which every patient with a neurosis
could get LSD treatment and work out his problems largely by
himself" (9). James would have been much attracted by the
"spectacular and almost unbelievable results" (10)
reported on the modern drug scene; and, in fact, their
resemblance to the "instantaneous transformations"
attendant on "mystical" religious conversions
—which he discussed so eloquently—may well be more than
superficial and seems worthy of attention.
Since the evidence and testimony accumulated
over the years on the separate drugs will be treated
interchangeably, this raises a preliminary point of some
importance. Although the conclusion was delayed by both
dissimilarities in their chemical structure and differing modes
of introduction to the scientific community, it is now rather
commonly adjudged that the subjective effects of mescaline,
LSD-25, and psilocybin are similar, equivalent, or
indistinguishable. Both Isbell and Abramson have administered LSD
and psilocybin in the same study; Wolbach and his co-workers have
administered all three. All have found that their subjects were
unable to distinguish between the drugs (11).
The reported equivalence in subjective reactions
seems quite consistent—or at least not
inconsistent—with present pharmacodynamic knowledge. Studies
of radioactively tagged mescaline and LSD indicate that the
compounds largely disappear from the brain in relatively short
order—in fact, at about the same time that the first
"mental phenomena" make their appearance (12). Hence,
it has been tentatively suggested that the characteristic
effects, which persist for a relatively long period, are to be
attributed not to the action of the drug itself but to some as
yet unidentified aspect of the chain of events triggered
by drug administration. Isbell, observing the "remarkably
similar" reactions to LSD and psilocybin, hypothesized
"some common biochemical or physiological mechanism" to
be responsible for the effects—that is, that the various
compounds share a final common path (13). The most direct support
for this inference of biological identity in ultimate mechanism
of action has come from cross-tolerance studies wherein subjects
rendered tolerant to one drug—that is, nonreactive after
repeated administrations —have then been challenged by a
different drug. Present indications are that cross-tolerance
among the drugs does in fact develop (14).
This is not intended to suggest that a drug
experience is invariable among subjects—quite the contrary
has been the case. In fact, experiences even for the same subject
differ from one session to the next (15). But when relevant
extradrug variables are controlled, the within-drug variance is
apparently coextensive with between-drug variance, and is
attributable to ubiquitous personality differences; in other
words, while a range of reactions is reported to all of
the drugs, there is no reaction distinctively associated with any
particular drug. Extradrug variables, which have been
uncontrolled and largely unrecognized until recently, are
apparently responsible for much of the variance erroneously
attributed to specific drug action.
By common consent, the drug experience is
paranormal—that is, beyond or outside the range of the
normal, the everyday. Exclamations of "indescribable"
recurrently appear in the literature. However, whenever
descriptions are essayed, there is relative unanimity about
certain features. These, it may be said, are attributable to the
drug administration, per se, independent of the personality of
the subject, the setting, or the experimenter's or subject's
expectations. A sampling from the literature of subjective
reports and testimony may communicate, or at least transmit the
flavor of, these invariant reactions.
First, and perhaps most easily conveyed, is the
characteristic of the drug experience called by Ellis a
"saturnalia" or "orgy" of vision (16).
Subsequent authors have been only slightly more restrained:
The predominance of visual experiences in the picture is striking— not only on account of the persistent hallucinations and illusions, but by the impressiveness of seen real objects, their shape and color.... (17)
There is a great intensification of light; this intensification is experienced both when the eyes are closed and when they are open.... With this intensification of light there goes a tremendous intensification of color, and this holds good of the outer world as well as of the inner world (18).
When I closed my eyes . . . I experienced fantastic images of an extraordinary plasticity. These were associated with an intense kaleidoscopic play of colors (19).
Changes in the perception of visual form occur in virtually everyone.... Consistently reported [are] the plasticity which the forms of the visual world assume . . . the emphasis upon play of light and color, as though light were alive (20).
A second invariant set of drug reactions, more
difficult to characterize or communicate, has been called,
variously, depersonalization, dissociation, levitation,
derealization, abnormal detachment, body image distortion or
alteration, and the like:
There is an awareness of an abnormal distance between the self and what happens in its consciousness; on the other hand, the experience of an abnormal fusion of subject and object (21).
My ideas of space were strange beyond description. I could see myself from head to foot as well as the sofa on which I was lying. About me was nothingness, absolutely empty space. I was floating on a solitary island in the ether. No part of my body was subject to the laws of gravitation (22).
What happens in the LSD experience? . . . the universe is overtly structured in terms of an identification between the perceiver and the thing perceived. You hear the music way off down in a cavern, and suddenly it is you who is way down in the cavern. Are you now the music, or is the music now at the mouth of the cavern? Did you change places with it? And so on? (23)
Some degree of depersonalization probably occurs during every LSD experience . . . the detachment of the conscious self, a sort of detached ego. This self is in touch with reality and is in touch with the self experiencing the psychic phenomena (24).
Regardless of whatever else a drug experience may
be reported to include, alterations in visual experience and in
experience of self, as detailed above, may be predicted with
considerable confidence (25).
In connection with the so-called dissociation
phenomenon— and in view of the connotations of the
"psychotomimetic" and "intoxicant"
labels—it may be well to emphasize that drug experiences, at
least for most nonpsychotic subjects, do not seem to approximate
delirium:
The mescal drinker remains calm and collected amid the sensory turmoil around him; his judgment is as clear as in the normal state.... (26)
It is difficult to classify the state of consciousness during the intoxication which allows such self-observation and, at times, seems to foster detachment and self-scrutiny (27).
. . . in a state of clear consciousness [the subject] . . . is able to describe in detail the manifold mental changes daring drug intoxication (28).
The nondelirious condition of normal volunteers, at
least with low to moderate drug dosage, has been objectively
attested by their ability to perform psychological tests. The
most exhaustive series of investigations along this line has been
carried out for LSD by Abramson and his associates (29).
Generally, although not consistently, subjects show slight
decrements in performance—at least some of which may well be
attributable to an altered state of attention-motivation-affect.
However, the test setting itself seems to contaminate the drug
experience; Savage, among others, has noted "a less profound
effect when subjects are kept busy doing psychological
tests...." (30)
Another and final set of seemingly invariant
reactions concerns the retrospective impressiveness of the drug
experience. The succession of testimonials to this effect is a
striking and salient feature of the history of research with
these compounds:
In some individuals, the "ivresse divine" is rather an "ivresse diabolique." But in either case . . . one looks "beyond the horizon" of the normal world and this "beyond" is often so impressive or even shocking that its after-effects linger for years in one's memory (31).
The experience of the intoxication, as Beringer also observed, makes a particularly deep impression.... The personality is touched to its core and is led into provinces of psychic life otherwise unexplored; light is shed on boundaries otherwise dark and unrevealed and in this some aid may be given to Existenzerhellung (illumination of existence) (32).
. . . most subjects find the experience valuable, some find it frightening, and many say that it is uniquely lovely.... For myself, my experiences with these substances have been the most strange, most awesome, and among the most beautiful things in a varied and fortunate life (33).
To be shaken out of the ruts of ordinary perception . . . this is an experience of inestimable value to everyone and especially to the intellectual . . . the man who comes back through the Door in the Wall will never be quite the same as the man who went out (34).
. . . the whole experience is (and is as) a profound piece of knowledge. It is an indelible experience; it is forever known. I have known myself in a way I doubt would have ever occurred except as it did (35).
After the above renditions, a querulous reader
may be concerned about the appellation "psychotomimetic
drugs." So are many contemporary researchers and therapists,
too numerous to mention. Holliday has provided a trenchant
analysis of "how the semantics in the field of
psychopharmacology became so confused and generally
misleading" (36); here, only a few points will be noted.
Early mescaline investigators clearly tempered
their comparisons between the mescal-induced state and the
hallucinations and dissociations of endogenous psychosis. As far
back as 1930, it was found that when chronic schizophrenics
suffering from persistent hallucinations were given mescal, they
distinguished the mescal phenomena, remarked on their appearance,
and usually blamed them on the same persecutors who had molested
them before (37). Kluver, though he foresaw and extensively
discussed the "model" values of mescal, persisted in
calling it "the divine plant" (38). It was apparently
difficult to consider a sacramental substance—"the
comfort, healer, and guide of us poor Indians . . . the great
teacher" (39)—as unequivocally psychotomimetic.
With LSD, a laboratory-born drug having no history
to contend with, the situation changed. The adventurous Hofmann,
on that fateful day in 1943, started his self-experiment with 250
micrograms of LSD, thinking, as he put it, that such a small
amount would probably be harmless. His response to this quite
large dose—in terms of present-day experimental
standards— was as follows:
I noted with dismay that my environment was undergoing progressive change. Everything seemed strange and I had the greatest difficulty in expressing myself. My visual fields wavered and everything appeared deformed as in a faulty mirror. I was overcome by a fear that I was going crazy, the worst part of it being that I was clearly aware of my condition. The mind and power of observation were apparently unimpaired (40).
Hofmann went on to list, as his most marked
symptoms, visual disturbances, motor restlessness alternating
with paralysis, and a suffocating sensation, and added:
"Occasionally I felt as if I were outside my body. My 'ego'
seemed suspended in space. .. ." (41)
Stoll, who in 1947 reported experimental
confirmation of Hofmann's experience, is widely reputed to have
warned informally of a case of suicide as the aftermath of an
experimental trial. The most common accounts thereafter had a
psychotic female subject committing suicide two weeks after the
administration; or, in another version, a subject committing
suicide after the drug had been administered without her
knowledge. At any rate, this story, though itself never appearing
in print, is referred to in one form or another in nearly all of
the early work with LSD; it apparently influenced experimenter
attitudes for a number of years.
For many and varied reasons, too involved to trace
here, the initial formulation of the "model psychosis"
properties of LSD engendered enormous investigative enthusiasm.
In this climate, latent reservations on the score of
psychotomimesis tended to go unvoiced. In the more recent,
postenthusiasm era, however, reservations have been more or less
vigorously expressed—for example:
There are considerable differences between LSD-induced and schizophrenic symptoms. The characteristic autism and dissociation of schizophrenia are absent with LSD. Perceptual disturbances due to LSD differ from those due to schizophrenia and, as a rule, are not true hallucinations. Finally, disturbances of consciousness following LSD do not resemble those occurring in schizophrenia (42).
Many alternatives to the
"psychotomimetic" characterization of
"hallucinogenic" agents have recently been proposed. In
1957, Osmond offered, among others, "psychelytic"
(mind-releasing) and "psychedelic" (mind-manifesting)
(43). Other investigators have proposed consciousness-expanding,
transcendental, emotionalgenic, mysticomimetic, and so forth. It
becomes ever more apparent, though, that old labels never die
(44).
It may probably be stated as a pharmacopoeias
commonplace that the effects of a drug administration of any kind
are likely to be compounded by factors other than specific
pharmacologic action. Often this is attributed to
"personality," to individual differences (45). However,
though there have been as yet very few controlled investigations
in the case of the drugs considered here, it has become
abundantly clear from the systematic variability reported
in subject and patient reactions—in both the affective and
ideational dimensions of drug experience—that factors other
than "personality" are also at issue.
Affective reactions attendant on a drug
administration have varied, according to reports, all the way
from hyperphoric ecstasy to unutterable terror—though not
with all investigators. The opinion leader Hoch, through a decade
of observations, consistently maintained:
LSD and mescaline disorganize the psychic integration of the individual.... (46)
. . . mescaline and LSD are essentially anxiety-producing drugs. . . . (47)
The following interchange was recorded at the 1959
conference on the use of LSD in psychotherapy held under the
auspices of the Josiah Macy, Jr. Foundation:
Hoch: Actually, in my experience, no patient asks for it [LSD] again.
Katzenelbogen: I can say the same.
Denber: I have used mescaline in the office . . . and the experience was such that patients said, "Once is enough." The same thing happened in the hospital. I asked the patients there if, voluntarily, they would like to take this again. Over 200 times the answer has been "No" (48).
Subsequently, Malitz also stated:
None of our normal volunteers wanted to take it [LSD] again (49).
In contrast, DeShon and his co-workers reported the
results of the first LSD study done with normal subjects in this
country as follows:
... anxiety was infrequent, transient, and never marked.... All subjects were willing to repeat the test (50).
The experience of other investigators has been
similar:
During the past four years we have administered the drug [LSD] hundreds of times to nonpsychotics in doses up to 225 micrograms. . . . Those who have participated in these groups are nearly always definitely benefited by their experiences. Almost invariably they wish to return and to participate in new experiments (51).
. . . few patients discontinue treatment, in fact, enthusiasm and eagerness to continue are among the features of LSD patients (52) .
The rapidly expanding use of LSD in
psychotherapeutic contexts has provided highly revealing clues to
the patterning of extradrug variability. Busch and Johnson were
the first to report administering LSD to neurotic patients whose
therapy had "stalled" and whose prognosis was
"dim." The result was "a reliving of repressed
traumatic episodes of childhood," with "profound"
influence on the course of therapy (53). Sandison and his
colleagues also found that LSD "produces an upsurge of
unconscious material into consciousness" (54), and that
"repressed memories are relived with remarkable
clarity" (55)—with therapeutically beneficial
consequences.
Since these early reports, whenever
psychoanalytically oriented therapists have employed LSD,
practically without exception the patient relives childhood
memories. The interesting point is that this phenomenon has
practically never been noted in the experimental
literature!
Jungian therapists, on the other hand, have
repeatedly found that their patients have
"transcendental" experiences—a state beyond
conflict—often with rapid and dramatic therapeutic results.
As a matter of fact, in an amusing and somewhat bemused account,
Hartman has described his LSD-using group comprised of two
Freudians and two Jungians, in which the patients of the former
report childhood memories, while those of the latter have
"transcendental" experiences. In addition, for Jungian
patients, the transcendental state is associated with
"spectacular" therapeutic results, while for Freudians,
should such a state "accidentally" occur, no such
spectacular consequence is observed (56).
While not from a therapeutic setting, the reports
which have emanated from Harvard are noteworthy on the score of
ideational content. Under psilocybin, Harvard subjects do not
relive their childhood experiences, but grapple with age-old
paradoxes:
. . . the problem of the one and the many, unity and variety, determinism and freedom; mechanism and vitalism; good and evil; time and eternity; the plenum and the void; moral absolutism and moral relativism; monotheism and polytheism and atheism. These are the basic problems of human existence.... We need not wonder that the Indians called the mushroom sacred and gave it a name which means "the flesh of the god" (57).
Without multiplying or belaboring divergences
further, it should be apparent that affective reactions and
ideational content may be systematically variable
dimensions of drug experience; in addition, the possible
therapeutic uses or consequences, however these are conceived,
seem clearly variable. Once these "facts" are arrayed,
in Baconian fashion, they nearly speak for themselves. At the
Josiah Macy conference, the emerging consensus was perhaps best
expressed by Savage:
This meeting is most valuable because it allows us to see all at once results ranging from the nihilistic conclusions of some to the evangelical ones of others. Because the results are so much influenced by the personality, aims, and expectations of the therapist, and by the setting, only such a meeting as this could provide us with such a variety of personalities and settings. It seems clear, first of all, that where there is no therapeutic intent, there is no therapeutic result. . . . I think we can also say that where the atmosphere is fear-ridden and skeptical, the results are generally not good.... This is all of tremendous significance, for few drugs are so dependent on the milieu and require such careful attention to it as LSD does (58).
The same conclusion has come from experimental
quarters as well—for example:
[The effect] of hallucinogens is not limited to any single agent since, in addition to psilocybin, we have seen it with LSD-25 and mescaline. The environmental setting in which the drug is administered . . . affects the emerging behavior pattern. This factor may account for variations in results with different investigators. Our hospital setting, with the subject, a paid volunteer, receiving an unknown agent, in an experimental framework surrounded by unfamiliar doctors and nurses, differs markedly from the mystical setting which Wasson observed.... Only one of our subjects reported what might be described as a transcendental experience.... The differences in expectation and setting between these two grossly divergent groups may account in part for the disparity in their responses (59).
More specifically, anxiety in the therapist or
experimenter about administering the drug, about "inducing
psychosis," seems likely to render the experience
anxiety-ridden for the subject. Abramson has flatly declared:
"The response of the subject . . . will depend markedly upon
the attitude of the therapist.... In particular, if the therapist
is not anxious about the use of the drug, anxiety in the patient
will be much decreased" (60). Hyde has reported that
"impersonal, hostile, and investigative attitudes"
arouse hostile and paranoid responses (61). Sandison has observed
that the occurrence of anxiety seems largely to depend on
"what the patient is told beforehand [as well as] rumors and
myths current among patients and staff, or even in the press,
about hallucinogenic drugs" (62). Huxley had intimated this
before it became clarified in the psychiatric literature:
. . . the reasonably healthy person knows in advance that, so far as he is concerned, mescaline is completely innocuous.... Fortified by this knowledge, he embarks upon the experience without fear—it: other words, without any disposition to convert an unprecedented strange and other than human experience into something appalling, something actually diabolical (63).
That the positive or negative character of the
experience can be systematically directed, overriding even
personality factors, seems now to have been fairly conclusively
demonstrated. With "adequate" preparation—that is,
with the specific intent of rendering drug experiences
"positive"—approximately 90 percent of the
subjects or patients, in each of the two most recent studies,
reported at least a "pleasant" or "rewarding"
session, and nearly as many called it "an experience of
great beauty" or something equally superlative (64).
In content, as in affect, subjects apparently
respond to the implicit or explicit suggestion or expectation of
the therapist or experimenter. The Harvard subjects were prepared
for their metaphysical binges, it may be noted, with such
assigned readings as the "Idols of the Cave" parable in
Plato's Republic and passages from The Tibetan Book of
the Dead. The preparation of psychotherapy patients hardly
needs specification.
Finally, what may be said about therapeutic
implications?— given the fact that the compounds under
discussion may induce a powerful paranormal experience whose
affective and ideational content can be guided. Only perhaps that
the extent to which the experience can serve as a useful adjunct
to traditional interview therapies, or vice versa, or even as a
"compleat therapie" would seem to depend on the
particular practitioner of the art—his conceptions of
therapeutic gains and consequences, his philosophy and
enthusiasm, and his orientation toward "placebo" or
"faith" cures (65). Schmiege has summarized the current
state of affairs as follows:
Those using LSD in multiple doses as an adjunct to psychotherapy feel that it is so useful because of its ability to do the following: (I) It helps the patient to remember and abreact both recent and childhood traumatic experiences. (2) It increases the transference reaction while enabling the patient to discuss it more easily. (3) It activates the patient's unconscious so as to bring forth fantasies and emotional phenomena which may be handled by the therapist as dreams. (4) It intensifies the patient's affectivity so that excessive intellectualization is less likely to occur. (5) It allows the patient to better see his customary defenses and sometimes allows him to alter them. Because of these effects, therapists feel that psychotherapy progresses at a faster rate. Of course this poses the age old problem of what is the essence of psychotherapy.
There are many reports of patients receiving
meaningful insight about themselves in an LSD experience without
the intervention, participation or even presence of a
therapist.... Those who administer lysergic acid in a single dose
have as their goal, in the words of Sherwood, et al., an
overwhelming reaction "in which an individual comes to
experience himself in a totally new way and finds that the age
old question 'Who am I?' does have a significant answer."
Frequently, this is accompanied by a transcendental feeling of
being united with the world.... Some spectacular, and almost
unbelievable, results have been achieved by using one dose of the
drug (66) .
An increasing number of subjects, patients, experimenters, and psychiatrists—spontaneously or with priming—have declared their drug experiences to be transcendental, mystical, cosmic, visionary, revelatory, and the like. There seems to be difficulty in finding the right name for the experience, even among the professional so-called "mystics":
There is no really satisfactory name for this type of experience. To call it mystical is to confuse it with visions of another world, or of god and angels. To call it spiritual or metaphysical is to suggest that it is not also extremely concrete and physical, while the term "cosmic consciousness" itself has the unpoetic flavor of occultist jargon. But from all historical times and cultures we have reports of this same unmistakable sensation emerging, as a rule, quite suddenly and unexpectedly and from no clearly understood cause (67).
Whatever this type of experience is called,
however, a growing body of "expert" testimony
apparently confirms the possibility of its induction by drugs.
Watts, the dean of current Western Zen scholars, has recently
described "cosmic consciousness," courtesy of LSD, in
exquisite detail (68). Seminary students and professors in the
Boston area are said to have definitely concluded that their
contact with psilocybin was "mystico-religious" (as to
whether or not it was "Christian," however, they are
still in doubt) (69). Huxley has been most outspoken about the
capacity of the drugs to induce "traditional"
mystical-visionary states:
For an aspiring mystic to revert, in the present state of knowledge, to prolonged fasting and violent self-flagellation would be as senseless as it would be for an aspiring cook to behave like Charles Lamb's Chinaman, who burned down the house in order to roast a pig. Knowing as he does (or at least as he can know, if he so desires) what are the chemical conditions of transcendental experience, the aspiring mystic should turn for technical help to the specialists.... (70)
Nearly invariably, whenever dramatic personality
change has been noted following the use of these drugs, it has
been associated with this kind of experience—that is, one
called transcendental or visionary—with the particular name
the experience is given seemingly most dependent upon whether the
investigator focuses on affect or content. These experiments in
drug-induced behavior change will shortly be reviewed in detail.
Since accounts of behavior transformations attendant on paranormal experience are not without precedent, it may be helpful to set the stage for present developments by citing some examples not connected with drugs. James reported on the phenomenon in its most familiar and perhaps prototypic context:
In this lecture we have to finish the subject of conversion, considering it first through striking instantaneous instances of which St. Paul's is the most eminent, and in which, often amid tremendous emotional excitement or perturbation of the senses, a complete division is established in the twinkling of an eye between the old life and the new.
After adducing numerous examples, James continued:
I might multiply cases almost indefinitely, but these will suffice to show you how real, definite, and memorable an event a sudden conversion may be to him who has the experience. Throughout the height of it he undoubtedly seems to himself a passive spectator or undergoer of an astounding process performed upon him from above. There is too much evidence of this for any doubt of it to be possible. Theology, combining this fact with the doctrine of election and grace, has concluded that the spirit of God is with us at these dramatic moments in a peculiarly miraculous way, unlike what happens at any other juncture of our lives. At that moment, it believes, an absolutely new nature is breathed into us, and we become partakers of the very substance of the Deity (71).
One may also recall to mind the
"vision-seeking" American Indians whom Ruth Benedict
immortalized. Adapting Nietzsche's designation
"Dionysian" to characterize their cultural pattern, she
portrayed its fundamental contrast with the
"Apollonian" Zuni-Pueblo way of life. The Dionysian
"seeks to attain in his most valued moments escape from the
boundaries imposed on him by his five senses, to break through
into another order of experience." He values "all means
by which human beings may break through the usual sensory
routine" (72).
Widespread among the western Indians (except in the
Pueblos) was what Benedict called the "Dionysian dogma and
practice" of the vision-quest—sought by fasting, by
torture, and by drugs. The point of interest, of course, is that
when the vision came, it could apparently trigger large-scale
behavior alterations which had the stamp and reinforcement of
social approval.
. . . on the western plains men sought these visions with hideous tortures. They cut strips from the skin of their arms; they struck off fingers; they swung themselves from tall poles by straps inserted under the muscles of their shoulders. They went without food and water for extreme periods. They sought in every way to achieve an order of experience set apart from daily living.
On the western plains they believed that when the vision came, it determined their life and the success they might expect. If no vision came, they were doomed to failure.... If the experience was of curing, one had curing powers; if of warfare, one had warrior's powers. If one encountered Double Woman, one was a transvestite, and took woman's occupations and habits. If one was blessed by the mythical Water-Serpent, one had supernatural power for evil, and sacrificed the lives of one's wife and children in payment for becoming a sorcerer (73).
The final example which will be noted here of rapid
personality change not induced by drugs has emerged quite
recently from Maslow's studies of "self-actualization."
Maslow reports that the occurrence of a dramatic "peak
experience"— defined or alternatively described as a
"cognition of being," or as "mystic" or
"oceanic"—is a major event in the life histories
of his "self-actualizing" subjects. Maslow avers
"unanimous agreement" among his subjects as to the
"therapeutic" after-effects of such peak
experiences—for example, that they were so profound as to
remove neurotic symptoms forever; or were followed by greater
creativity, spontaneity, or expressiveness; or produced a more or
less permanently changed, more healthy world-view or view of
self, and so on (74).
It is an intriguing historical accident that, on
the one hand, anthropological studies of the Native American
Church (Peyotism) consistently record the peyote-associated
reformation of alcoholic and generally reprobate characters (75),
and, on the other hand, LSD has been increasingly utilized in the
treatment of the white man's "fire-water" ills. LSD was
first systematically administered to non-Indian alcoholics in
order to explore a putative similarity between the so-called
model psychosis and delirium tremens. Two independent
undertakings along this line, one in the U.S. and one in Canada,
resulted in highly unexpected and sudden "cures" (76).
Investigators in Saskatchewan pursued this
serendipitous result aggressively. The outcome, with
lately-evolved refinements in technique, has been an explicitly
formulated "new concept" in psychotherapy (77). The
following narrative, pieced together from Hoffer's statements at
the Macy LSD conference, describes the conditions under which the
rapid change phenomenon seems first to have occurred in sizeable
numbers:
. . . we have what we call the "businessman's special," for very busy people, the weekend treatment.... They come in because the police or Alcoholics Anonymous or others bring them in. They come in on day one. They know they are going to take a treatment, but they know nothing about what it is. We take a psychiatric history to establish a diagnosis. That is on day one. On day two, they have the LSD. On day three, they are discharged.
Our objective [in using 200-400 gamma doses] is to give each patient a particular LSD experience.
The results are that 50 per cent of these people are changed [that is, they stop drinking or are much improved].... As a general rule . . . those who have not had the transcendental experience are not changed; they continue to drink. However, the large proportion of those who have had it are changed (78).
The only other investigators to report a
"weekend treatment" are Ball and Armstrong (79). They
describe a small series of "sex perverts," at least two
of whom had had, over a number of years, "a variety of forms
of psychotherapy, including psychoanalysis . . . [resulting in]
no improvement whatever." The large-dose LSD experience,
however, is said to have had "remarkable, long-lasting
remedial effects" (80).
MacLean and his co-workers in British Columbia,
Canada have reported on a series which included 61 alcoholics and
33 neurotics (personality trait disturbance and anxiety reaction
neurosis) (81). Each patient was carefully and intensively
prepared for the 400-1500 gamma, "psychedelic
LSD-day"—which was jointly conducted by a psychiatrist,
a psychologist, a psychiatric nurse, and a music therapist. Their
follow-up data (median follow-up was for 9 months) were
interpreted to yield a "much improved" or
"improved" rating for over 90 percent of the neurotics
and 60 percent of the alcoholics, with just under 50 percent of
the alcoholics found at follow-up to have remained "totally
dry" (82). The results of this single LSD session with the
alcoholic cases seem most impressive, in view of the picture
provided:
These were considered to be difficult cases; 59 had experienced typical delirium tremens; 36 had tried Alcoholics Anonymous and were considered to have failed in that program. The average period of uncontrolled drinking was 14.36 years. The average number of admissions to hospital for alcoholism during the preceding 3 years was 8.07 (83).
Since Hoffer's account, procedures in Saskatchewan
have apparently been modified to incorporate considerable
"psychotherapy"—as an adjunct to, and preparation
for, the LSD experience. In a recent report, Jensen has described
a greatly expanded treatment method and its results:
The treatment program includes three weekly A.A. meetings. The patients are strongly encouraged, but not forced, to attend. There are also 2 hours of group psychotherapy, in the course of which those who are not already familiar with the A.A. program are indoctrinated mainly by the other patients' discussion.... Because of the fairly short time available, the group therapy is superficial in nature and primarily educational.
Toward the end of hospitalization (which averaged 2 months), the patients were given an LSD experience. They routinely received 200 gamma of the drug.... (84)
Of 58 patients who experienced the full program, including LSD, and were followed up for 6 to 18 months, 34 had remained totally abstinent since discharge or had been abstinent following a short experimental bout immediately after discharge; 7 were considered improved, i.e., were drinking definitely less than before; 13 were unimproved; and 4 broke contact.
Of 35 patients who received group therapy without LSD, 4 were abstinent, 4 were improved, 9 were unimproved and 18 were lost to follow-up.
Of 45 controls, consisting of patients admitted to the hospital during the same period who received individual treatment by other psychiatrists, 7 were abstinent, 3 improved, 12 unimproved, and 23 lost to follow-up (85).
Among the reservations that might be expressed
about Jensen's study, two are outstanding. First, there is some
ambiguity about the assignment of patients to the different
treatment conditions—it does not seem to have been entirely
random. Second, Jensen's assumption that patients who broke or
refused follow-up contact with the hospital staff are safely
categorized, for statistical purposes, as "treatment
failures" would seem somewhat overweening. At any rate, on
his count, the difference in percentages of patients
"abstinent or improved" between the "full
program-LSD" group (41 out of 58, or 71 percent) and the
"individual psychotherapy" group (10 out of 45, or 22
percent) was highly statistically significant.
The present "official policy" of the
Saskatchewan Department of Public Health may be of interest. A
recently issued document, which reviews the results of four such
follow-up studies as Jensen's, concludes with the directive that
the single, large-dose LSD treatment of alcoholism is to be
considered "no longer as experimental," but rather,
"to be used where indicated" (86).
There seem to have been only two efforts in the
U.S. to explicitly and systematically follow the Canadian model.
In quite different contexts, both are reported as at least
"doing well." Leary and his co-workers at Harvard, over
the last two years, have conducted a research and treatment
program at Massachusetts Correctional Institution, Concord,
"designed to test the effects of consciousness-expanding
drugs on prisoner rehabilitation" (87). This undertaking,
which emphasizes the crucial importance of drug-induced
"far-reaching insight experiences" —prepared for,
supported, and reinforced by group therapy sessions—has
resulted in a recidivism rate considerably reduced from actuarial
expectation. The number of post-treatment cases on which this
evaluation is based, however, is only 26. The program is ongoing
(88).
In a much more familiar setting, a group of workers
on the West Coast has been treating the full range of
garden-variety neuroses. The patients are intensively prepared
over a two- to three-week period for a large-dosage,
"transcendental" drug session. The stated intent is to
induce a "single overwhelming experience . . . so profound
and impressive that . . . the months and years that follow become
a continuing growth process" (89). Thus far, in over 100
treated cases, at least "marked improvement" in the
condition for which treatment was sought has been reported in
about 80 percent—after one so-called overwhelming experience
(90).
It is a commonplace that new psychiatric treatments
seem to effect remarkable cures—at least for a short time
and in the hands of their originators. In raising the spectre of
the powerful placebo effect (91), it need hardly be pointed out
that the results reviewed above should be regarded with healthy
skepticism. On the other hand, they are more than merely
trifling.
In addressing a recent international assemblage at Copenhagen, Leary asserted:
The visionary experience is the key to behavior change. [In its wake] change in behavior can occur with dramatic spontaneity . . . (92).
Van Dusen, who bids fair to become the
psychologist-philosopher of the "new concept" movement,
puts the issue as follows:
There is a central human experience which alters all other experiences . . . not just an experience among others, but . . . rather the very heart of human experience. It is the center that gives understanding to the whole.... It has been called satori in Japanese Zen, moksha in Hinduism, religious enlightenment or cosmic consciousness in the West.... Once found life is altered because the very root of human identity has been deepened . . . the still experimental drug d-lysergic acid diethylamide (LSD) appears to facilitate the discovery of this apparently ancient and universal experience (93).
Although reminded on all sides of the
incommunicableness of "the transport," as James called
it, of its ineffability, one may, before following him in the
descent toward "medico-materialistic" explanation,
inquire further of its nature. James proffered the traditional
demurrer ". . . it is probably difficult to realize [its]
intensity unless one has been through the experience one's self .
. ." (94). He then proceeded, with seeming aplomb, to
describe it:
The central [characteristic] is the loss of all worry, the sense that all is ultimately well with one, the peace, the harmony, the willingness to be....
The second feature is the sense of perceiving truths not known before . . . insight into depths of truth unplumbed by the discursive intellect.... The mysteries of life become lucid ... illuminations, revelations, full of significance and importance, all inarticulate though they remain....
A third peculiarity . . . is the objective change which the world often appears to undergo. "An appearance of newness beautifies every object" . . . clean and beautiful newness within and without . . . (95).
In James' view, "melting emotions and
tumultuous affections" were the constant handmaiden of
"crises of change" (96). Also Benedict, in the context
of the vision-quest, remarked on ". . . very strong affect,
either ultimate despair or release from all inadequacy and
insecurity" (97). Chwelos and his co-workers, describing the
transcendental drug experience as "mainly in the sphere of
emotions or feeling" (98), exemplify this by quoting an
alcoholic patient:
I was swept by every conceivable variety of pleasant emotion from my own feeling of well-being through feelings of sublimity and grandeur to a sensation of ecstasy (99).
Finally now, turning from the poetry of phenomenal
experience to medico-materialism, how did James approach the
matter of explanation?
If you open the chapter on Association, of any treatise on psychology, you will find that a man's ideas, aims, and objects form diverse internal groups and systems, relatively independent of one another.... When one group is present and engrosses the interest, all the ideas connected with other groups may be excluded from the mental field.... Our ordinary alterations of character as we pass from one of our aims to another, are not commonly called transformations . . . but whenever one aim grows so stable as to expel definitively its previous rivals from the individual's life we tend to speak of the phenomenon and perhaps to wonder at it, as a "transformation."
Whether such language be rigorously exact is for the present of no importance. It is exact enough, to recognize from your own experience the fact which I seek to designate by it.
Now if you ask of psychology just how the excitement shifts in a man's mental system, and why aims that were peripheral become at a certain moment central, psychology has to reply that although she can give a general description of what happens, she is unable in a given case to account accurately for all the single forces at work.
In the end we fall back on the hackneyed symbolism of mechanical equilibrium. A mind is a system of ideas, each with the excitement it arouses, and with tendencies impulsive and inhibitive, which mutually check or reinforce one another.... A new perception, a sudden emotional shock . . . will make the whole fabric fall together, and then the center of gravity sinks into an attitude more stable, for the new ideas that reach the center in the rearrangement seem now to be locked there, and the new structure remains permanent (100).
More modern discussions of rapid personality change
seem, in large part, to be variations on the theme of
"melting emotions and tumultuous affections." There
have been two relatively recent efforts to deal with rapid change
associated primarily with conversion. Wallace, who attempted an
heroic amalgam of Selye's "stress" theory and cultural
anthropology, summed this up as follows:
. . . the physiologic events of the general adaptation syndrome [in situations of massive emotion] establish a physicochemical milieu in which certain brains can perform a function of which they are normally incapable: a wholesale resynthesis that transforms intellectual insight into appropriate motivation, reduces conflict by partial or total abandonment of certain values and acceptance of others, and displaces old values to new, more suitable objects (101).
Sargant has linked along an axis of abnormal
"anger, fear, or exaltation" such "abrupt total
reorientations" in personality as attend religious and
political conversion experiences—as well as violent
abreactions in therapy, spontaneous or narcosynthetic. His
explanatory scheme derives directly from Pavlov—in the final
analysis, sudden alterations in behavior are attributed to
"paradoxical" and "ultraparadoxical" brain
processes, and the like, induced by extreme emotion (102).
To return to LSD-related developments, Ditman and
his coworkers have reviewed a whole range of considerations and
theories which might "rationalize" the sudden change
phenomenon—including a highly libidinized psychoanalytic
formulation (103).
It remains to raise just one final query. Rapid
personality change, translated into language more congenial to
behavioral psychology, could be taken to describe a situation in
which formerly dominant or high-probability responses, overt or
mediational, were suddenly greatly reduced in frequency of
occurrence; and, vice versa, uncommon responses, or those
formerly low in a hierarchy, appear with greatly elevated
frequency. The only experimental results which even approximate
this order of events seem to be those which have arisen with the
aid of direct intracranial electrical stimulation. With
response-contingent reinforcement of this kind—that is, with
electrical "trains" delivered to the hypothalamic,
so-called pleasure or reward centers—the repertoires of many
rats and monkeys have been dramatically altered in a very few
moments: Utterly new behaviors have been shaped, old responses
eliminated (104). The degree to which such "artificially
induced" learning has been sustained has been a function, as
with all behavior, of the ebb and flow of environmental
contingencies. Thus, to point the issue: Do transcendental
experiences at the human level, however they are interpreted,
tread in this area of superreinforcement—with a
potential for radically altering the probability of occurrence of
"heuristic" mediating processes (for example, positive
rather than negative self-concepts) which might channel behavior,
at least temporarily, in new directions, toward a "new
beginning"?
With Ruth Benedict's "Apollonian" Zuni,
the tendency of the modern West is to regard paranormal
experiences, indiscriminately and often with little idea of their
nature, as "pathological"—to be distrusted,
feared, avoided. The Zuni Indian, said Benedict, "finds
means to outlaw them from his conscious life. . . . He keeps the
middle of the road, stays within the known map, does not meddle
with disruptive psychological states" (105). It would seem
unfortunate were this Zeitgeist to unduly prejudice the
exploration of therapeutic potential in the drugs here discussed.
In conclusion, let it be noted that the public
health implications of drug-associated rapid personality change,
should this phenomenon prove not to be a will-of-the-wisp, are
apparently great. Intensive investigation would seem a reasonable
order of the day. The procedures and time involved are manifestly
economical—in truth, there seems little to be lost.