A HANDBOOK FOR THE THERAPEUTIC USE OF LSD-25







Chapter 1. PSYCHIATRIC RATIONALE

The patient must realize that his present methods of behaving are inadequate and unsatisfying to him personally. He must develop sufficiently strong motivation to carry him through the difficult and painful process of coming to understand and accept himself. On the basis of this self-understanding, he must learn how to alter his Behavior to satisfy the new pattern of motivation which has developed out of self-understanding.

2

2

2

2





II



Chapter 14. STAGES IN THE EXPERIENCEII ONSET OF SYMPTOMS





III



Chapter 15. STAGES IN THE EXPERIENCEIII SELF-EXAMINATION





IV



Chapter 16. STAGES IN THE EXPERIENCEIV THE EMPATHIC BOND





V DISCUSSION Chapter 17. STAGES IN THE EXPERIENCE





1. Who are you?

2. How much does your identity determine your behavior?

3. Where are you in space and time?

4. Where do your thoughts come from?

5. How are you different from other people?

6. How are you the same as others?

7. What is the basis of your system of values?

1. If all people are the same in essence, what keeps them separate?

2. What is love?

3. What is wisdom?

4. What is trust?

5. If you could have any single wish come true, what would you wish for?

6. Why are some people more pleasant than others?







VI Chapter 18. STAGES IN THE EXPERIENCEVI DIMINISHMENT OF SYMPTOMS









VII Chapter 19. STAGES IN THE EXPERIENCEVII THE MEAL





VIII Chapter 20. STAGES IN THE EXPERIENCEVIII TERMINATION OF THE SESSION





Very Much Moderately Little None 1. Did you feel that he drug had any effect? V M L N 2. Did you feel that anything unusual happened in the experience? V M L N 3. Did you ever before have a similar experience? V M L N 4. Did you feel physically different in any way? V M L N 5. Did you notice a feeling of weightlessness? V M L N 6. Did you notice a feeling of lack of balance? V M L N 7. Did you find yourself especially talkative? V M L N 8. Did you feel particularly tense during most of the experience? V M L N 9. Did it annoy you more than usual to have others interrupt your thinking an speaking? V M L N 10. Did you feel that you wanted to fight off what was happening to you? V M L N 11. Did you feel yourself more impatient than usual with other people? V M L N 12. Did you concentrate much of the time on just a few ideas? V M L N 13. Did you find the effects of the drug very unpleasant physically? V M L N 14. Did you have any outstanding symptom such As nausea, palpitations, headache or other physical pain? V M L N 15. Did you find yourself too weak to move about much of the time? V M L N 16. Did physical discomfort distract you from everything else? V M L N 17. Did you fear that you might die during the experience? V M L N 18. Did you find yourself confused much of the time? V M L N 19. Was the experience frightening in terms of the images you saw? V M L N 20. Did your thoughts keep shifting too rapidly from one idea to another? V M L N 21. Did the experience seem too complicated to understand? V M L N 22. Do you feel that you remember much of the experience clearly? V M L N 23. Did you feel it difficult to organize yourself to do things? V M L N 24. Did you feel disinterested in usually interesting topics? V M L N 25. Did you feel that you were insane at any time? V M L N 26. Did you feel that you might become insane? V M L N 27. Did you feel suspicious of other people? V M L N 28. Did you feel neglected by other people? V M L N 29. Did you feel easily hurt by others? V M L N 30. Did you feel that other people seemed hostile toward you? V M L N 31. Did you wish that other people would leave you to your own thoughts and not bother you by talking to you? V M L N 32. Did you feel that you could see yourself objectively, as others see you? V M L N 33. Did you feel that other people might find out more about you than you wanted them to know? V M L N 34. Did you feel that other people were influencing your thoughts against your will? V M L N 35. Did you feel at times that you were more than one person? V M L N 36. Did you feel that you were thinking in terms of opposites or alternatives? V M L N 37. Did you feel that the experience was very real? V M L N 38. Did you feel emotionally very close to others in the experience? V M L N 39. Did you feel that you could share other peoples' feelings? V M L N 40. Did you feel that you could share other peoples' thoughts? V M L N 41. Did you feel that you could communicate with others in the experience without words or gestures? V M L N 42. Did you feel a high level of trust and affection for others in the experience? V M L N 43. Did you feel that you were able to give yourself up completely to the experience, (i.e. to relinquish rational control?) V M L N 44. Did you feel that you became more self-accepting? V M L N 45. Did you feel that you were aware of new dimensions of thought? V M L N 46. Did you feel an awareness of several levels of awareness? V M L N 47. Did you feel that you were able to think on different levels? V M L N 48. Did you feel that you were aware of the long ago? V M L N 49. Did you notice much change in your judgment of distance? V M L N 50. Did you feel that you were separate from your body? V M L N 51. Did you notice any changes in the way you felt the passage of time? V M L N 52. Did you notice any change in the significance of things or events? V M L N 53. Did you notice any added brightness of colors? V M L N 54. Did you notice any difference in the effect of listening to music? V M L N 55. Did you notice any mingling of color, sound or feeling or blending of other senses? V M L N 56. Did you notice any images when you closed your eyes? V M L N 57. Did you notice any images when your eyes were open? V M L N 58. Did you feel that you were being moved about in space or time by the music? V M L N 59. Did you feel in the experience like laughing at many of the ideas you help prior to it? V M L N 60. Did you feel that the experience was an enrichment of things which you already knew? V M L N 61. Did you feel a close spiritual bond or unity with others? V M L N 62. Did you feel that there was a unity of all things? V M L N 63. Did you feel yourself a part of a larger unity? V M L N 64. Did you feel a close spiritual bond or unity with God? V M L N 65. Did you find that you gained a more complete acceptance of others? V M L N 66. Did you feel that your understanding was enhanced? V M L N

Very Much Moderately Little None 1. Have you felt that what happened in the experience made any important change in you? V M L N 2. If any such change occurred do you feel it was a change for the better? V M L N 3. Have you felt more satisfied with yourself as a person since the experience? V M L N 4. Have you felt that the experience has helped you to solve your personal problems? V M L N 5. Have you felt that the experience has brought you better understanding of yourself? V M L N 6. Have you found yourself less likely to get angry since the experience? V M L N 7. Have you felt that since the experience you are more forgiving and less inclined to hold grudges? V M L N 8. Have you felt yourself more inclined to have religious beliefs since the experience? V M L N 9. Have you felt that your values or attitudes were altered by the experience? V M L N 10. Have you felt that the experience has made you less anxious than you were previously? V M L N 11. Have you felt that you are m ore relaxed since the experience? V M L N 12. Have you felt that you have become more prone to depression since the experience? V M L N 13. Have you felt that the experience has led to more peace of mind? V M L N 14. Have you felt that the experience has made you a happier person? V M L N 15. Have you felt that since the experience you have been better able to be yourself? V M L N 16. Have you felt that since the experience you have become more considerate of other people? V M L N 17. Have you felt that the experience has made you an easier person to get along with? V M L N 18. Have you felt more satisfied with life in general since the experience? V M L N 19. Have you felt that since the experience your relations with people in general have improved? V M L N 20. Have you felt that since the experience you have found it easier meeting people and making friends? V M L N 21. Have you felt that since the experience your emotional ties with your family and friends have become clear and warmer? V M L N 22. Have you felt that the experience has made you an improved, more productive worker in your day to day employment? V M L N 23. Have you felt since the experience that your work has been more interesting and enjoyable? V M L N 24. Do you feel that since the experience you are more inclined to seek excuses for your mistakes? V M L N 25. Do you feel that since the experience you are less inclined to prolonged feelings of remorse over acts which you deem undesirable? V M L N 26. Do you feel that since the experience you have been more inclined to learn from and correct your misdeed? V M L N 27. Since the experience have you felt that many of your personal difficulties are brought on by the uncooperativeness of other people? V M L N 28. Have you felt that the experience has increased your willingness to consider new ideas and to see the other fellow's point of view? V M L N 29. Have you felt that since the experience you see beauty where you didn't before? V M L N 30. Do you feel that since the experience you have changed so the following sayings of St. Francis applies to you:

"Let me not seek so much to be consoled as to console."? V M L N 31. " - to be understood as to understand"? V M L N 32." - loved as to love."? V M L N 33. Would you recommend that your friends have the experience? V M L N

Question 43. Did you feel that you were able to give yourself up completely to the experience?



Question 59. Did you feel in the experience like laughing at many of the ideas you held prior to it?



Question 48. Did you feel that you were aware of the long ago?



Question 2. Did you feel that anything unusual happened in the experience?



Question 52. Did you notice any change in the significance of things or events?



Question 66. Did you feel that your understanding was enhanced?



Question 44. Did you feel that you became more self-accepting?



Question 42. Did you feel a high level of trust and affection for others in the experience?



Question 65. Did you feel that you gained a more complete acceptance of others?



Question 38. Did you feel emotionally very close to others in the experience?



Question 63. Did you feel yourself a part of a larger unity?



Question 37. Did you feel that the experience was very real?



Question 22. Do you feel that you remember much of the experience clearly?





TABLE I

Comparison of Responses, NORMALS and ALCOHOLICS

to Questions Dealing with the Therapeutic Aspects of LSD Experience Percentage of Subjects Question Normals (No.-32) Alcoholics (No.-20) Very much Little None No answer Very much Little None No answer 43 60 25 6 3 50 35 15 0 48 50 12 37 0 45 30 35 0 59 34 23 37 0 35 30 35 0 22 78 22 0 0 65 25 10 0 2 90 6 3 0 80 10 10 0 52 72 9 16 3 50 30 15 5 37 94 0 3 3 85 10 5 0 66 62 25 12 0 60 40 0 0 63 62 19 19 0 50 35 15 0 44 44 31 25 0 50 40 10 0 65 47 31 22 0 70 30 0 0 38 72 22 6 0 45 30 25 0 42 75 16 6 3 60 25 15 0 Average 65 19 15 1 57 23 14 0

TABLE II Comparison of Responses, NORMALS and ALCOHOLICS to

Questions Dealing with Non-Therapeutic Aspects of LSD Experience Percentage of Subjects Question Normals (No.-32) Alcoholics (No.-20) Very much Little None No answer Very much Little None No answer 16 6 16 78 0 15 25 60 0 19 6 19 75 0 10 30 60 0 8 6 50 44 1 10 75 15 0 18 12 34 53 0 20 55 25 9 21 22 44 31 3 15 25 60 0 25 22 44 31 3 15 25 60 0 27 6 56 37 0 15 40 45 0 34 3 22 75 0 10 35 55 0 33 12 22 66 0 15 25 60 0 Average 9 33 58 0 13 36 51 0

TABLE III Comparison of Responses After One LSD Experience

With

Those After More Than One Experience Percentage Of Subjects First experience (No.-60) Second Experience (No. -20) Question Very much Little None No answer Very much Little None No answer 41 49 34 13 4 80 15 5 0 59 40 28 32 0 60 30 10 0 2 83 11 6 0 90 10 0 0 48 40 25 36 0 60 35 5 0 22 66 30 2 0 80 10 10 0 52 59 23 13 6 80 10 10 0 37 87 6 8 0 90 10 0 0 66 53 36 9 2 85 5 10 0 63 51 30 19 0 85 15 0 0 44 43 37 19 2 85 10 5 0 65 49 36 15 0 90 5 5 0 38 60 28 11 0 95 5 0 0 42 64 26 8 2 85 15 0 0 Average 57 27 15 1 82 13 5 0

TABLE IV COMPARISON OF NEGATIVE RESPONSES

After one LSD Experience

with

Those After More Than One Experience First experience (No.-60) More than One Experience (No. 20) Question Very much Little None No answer Very much Little None No answer 16 10 23 65 2 0 10 90 0 19 8 27 65 0 0 5 55 0 8 13 57 30 0 0 40 60 0 18 22 42 37 0 0 35 65 0 21 23 33 42 2 5 45 50 0 25 7 27 67 0 0 15 85 0 27 15 47 38 0 0 30 70 0 34 5 28 67 0 0 20 80 0 33 17 23 60 0 0 20 80 0 Average 13 34 52 0 1 24 75 0

Although these data are based on only 80 cases, they offer definite evidence in the following areas:



When the method outlined above is employed LSD shows marked therapeutic potential.



When LSD is used in a therapeutic setting as described there is a minimum of the disturbing side effects which have given this drug a reputation for producing psychotic symptoms.



There is a marked enhancement of the positive therapeutic aspects and a marked decrease of the negative therapeutic elements in second experiences.







COMMUNALITY OF TYPES OF REACTION



As has been pointed out the LSD experience is vast in scope, involving all of the sensory modalities, establishing a remarkably intensified and expanded awareness of the environment, altering the body image and the sense of self and altering the usual reference data of the rational processes. Time, space, color, sound and sensation become fluid and the subject develops a state of unhabitual perception.



To try to establish a taxonomy of reactions to LSD is a necessary first step in any scientific investigation of the phenomena involved. We have proposed a classification based upon the fact that, in general, subjects either try to avoid the unhabitual aspects of their perceptions or to explain them in such familiar terms as to make them fit into the accustomed system of analogical thought. With training, however, subjects learn to accept and eventually to organize the unhabitual into new and expanded frames of reference.



These methods of coping with the drug give rise to six types of reaction, of which two are attempts at escape, two are attempts at using insufficient habitual analogies to delineate the unhabitual and two are the results of accepting the reality of the unhabitual.



Scale 1. was drawn up to investigate the extent to which each of these types of experience occurred in each subject's experience. While such information provides a rather crude description of the experience of any given individual, it does permit a comparison of groups and allows for an investigation of the degree of communality of various areas of the LSD experience.



Prior to item analysis and a revision of the Scale, scoring remains inexact. However, the results can be expected to reflect any outstanding differences in the types of experience of the groups involved. The results of this analysis are summarized in Table V.





TABLE V Percentages of Cases in Each of the Groups

Reporting the Types of Reaction Experienced Percentage of Cases First Experience More than one experience Normals (No. -32) Alcoholics (No. -20) (all cases-20) Escape 1. Flight into ideas 55 55 15 " 2. Flight into illness 25 30 10 Psychotomimetic 3. Confusion 65 80 20 " 4. Paranoidal 40 40 15 Psychedelic 5. Dual-reality 95 95 95 6. Synthesized 75 90 95



In the alcoholic group, when psychotomimetic features develop, they are usually of a confusional quality. In the psychedelic area of experience the alcoholics seem better able to organize the unhabitual aspects of the experience, which could probably be a reflection of their A. A. training.



OBJECTIVE RESULTS



In the case of the alcoholics we have a recent objective assessment of their condition since treatment. The total number of alcoholics who have been treated will be assessed here except for those who are not available for follow-up for reasons of having become deceased or whereabouts unknown.



In all, 59 alcoholics have received LSD in this province, of these follow-up is presently available in 47. The results of this group of 47 are reported in Table VI. The first group consists of those treated by Smith and Hoffer and the second group was treated by Blewett and Chwelos. The method used underwent considerable modification between these series, Blewett and Chwelos using the method laid out in this Handbook.



The criteria for assessment is based on objective observation of the patient's behavior, drinking, social and work habits, and were obtained largely from the Bureau of Alcoholism and to a lesser degree from A.A. members, the family of the Alcoholic and the therapists own follow-up of the patients progress when available. The classification includes:



MUCH IMPROVED



This category includes those considered to be recovered, i.e. one year's sobriety. Because in a large percentage of the group there has not been a year's follow-up, included in this group are those who appear to be on the road to recovery, i.e. have not drunk alcohol but follow-up less than a year, drinking markedly reduced to rate of one to two years and in which patient is obviously gaining marked control over his desire to drink. As well as the criteria of not drinking, there is marked improvement in work and social history as reported by objective observers.



MODERATELY IMPROVED



Included marked reduction in alcohol intake and improvement in work and social history but still relapsing sufficiently frequently that they do not appear close to complete recovery.



SLIGHTLY IMPROVED



This category includes mainly patients who appear to be attempting a pattern towards recovery, but their overall pattern is not too markedly changed from that before treatment.



UNCHANGED



No notable change in drinking, work or social habits as reported by objective observers.





TABLE VI Objective Assessment of LSD Treatment of Alcoholism Reported by No. Cases Much improved Moderately improved Slighly improved Unchanged Smith and Hoffer 24 9 1 2 12 Blewett and Chwelos 23 10 5 3 5



The subjects in this table had an average period of uncontrolled drinking of approximately eleven years. Most had more than one complication of drinking such as tremors, D.T.'s, blackouts, peripheral neuritis, arrests for drunkenness, cirrhosis of the liver, and addiction to sedative drugs. Most cases suffered marital disharmony, poor work history and a large number had been separated or divorced while drinking. In the opinion of the Bureau of Alcoholism this group represents a worse than average cross-section of alcoholics and the cases they considered most difficult are mainly in the much improved category. Eighty percent of the cases had tried A.A. and failed in the program.



Another small group not belonging to the previous category have also been treated. This is a total group of nine patients including neurotics, psychopaths and character disorder and there is insufficient number in any category for an assessment. To date, however, all nine cases habe been reported as showing definite signs of improvement from the treatment so that there appears to be definite therapeutic possibilities with LSD in this group which certainly warrants more intensive study.



A considerable number of staff members have received the treatment and although no attempt has been made to assess and categorize the effects, the vast majority have reported psychological improvement and an enhanced understanding of themselves and others.



To date then, the drug appears to offer very substantial therapeutic potential to all patients but the psychotic group. However, other workers in this field, particularly Sandison (43), have used the drug with appreciable results in psychoses. This is of course another are where the drug's effects should be explored.







APPENDIX C . PROPOSALS FOR PSYCHEDELIC RESEARCH







The outline is offered in the hope that it may, more clearly than other methods, point up the value of research into an area of experience which can throw light upon many basic problems in psychological theory.



Much discussion in the Handbook has dealt with the degree of self-understanding and understanding of others which grows out of the drug experience. As a consequence the reader may feel some concern that the research suggested in this appendix deals extensively with the investigation of various areas of perception and thought process but appears relatively restricted in the area of self-understanding and acceptance. Though these latter areas may well be of remarkably greater importance than much of the work below, it would seem that heir investigation must lag until new and appropriate techniques of measurement and appraisal are forthcoming, for objective accuracy of assessment has, to date, been limited to the measurement of observable behavior. However, as new techniques develop - and the psychedelic experience promises to be remarkably useful in this regard - we may begin to learn how to open to direct scientific inquiry and to shareable objective measurement, the areas of motivation, belief and value and the inhesive subjective complex of the self.



1. PERCEPTUAL STUDIES



Observations

there appears to be a marked sensory enhancement - color, sound, smell, taste, touch.

There appears to be an extension of the time sense.

There appears to be a disruption of distance perception.

There appears to be a disruption of perception of body image.

There appears to be a tendency toward an instability of perception of gestalts.

There appears to be a disruption of balance.

There appears to be a disruption of temperature sensing.

There appears to be a decrease in sensitivity to pain.

There appears to be an overlapping of sensory modalities.

These observations would lead one to hypothesize enhanced performance in certain areas.



Hypothesis

as a result of sensory enhancement

There will be an increased capacity for fine discrimination between colors and an enhanced ability to match colors.

There will be a finer discrimination between differing smells.

There will be a finer discrimination between tones and sound.

There will be a finer discrimination between degrees of loudness of sounds and an enhanced ability to match sounds of equal loudness.

There will be a finer discrimination between differing tastes.

There will be an enhancement of touch discrimination (e.g. determining what is written on one's hand, two touch discrimination or the identification of objects by touch.



There will be an extension of limens in the perception of light on the basis of intensity.

There will be an extension of limens in the perception of color into the areas of infrared and ultraviolet.

There will be an extension of limens in the perception of color.

There will be an extension of limens in the range of perception of pitch.

There will be an extension of limens on the basis of intensity of sound.

As a result of extended time sense

There will be higher speed of recognition of tachisticopically presented material.

There will be finer discrimination between very short periods of time.

There will be increased speed of autokimetic movement.

There will be a shorter period of after effect (e.g. Archimedes Spiral).

There will be a higher frequence required to produce flicker fusion.

As a result of disruption of distance perception

There will be less sensitivity to size illusions.

As a result of the disruption of body image

There will be better mirror drawing performance.

There will be an increased ability to perform dissociative physical tasks such as circling one hand while moving the other up and down.

As a result of the instability of perceptual gestalts

There will be an increased ability to find hidden or imbedded pictures.

There will be an increased ability to break down gestalts in such tasks as letter finding.

There will be an enhanced ability of gestalt completion tests.

There will be an enhanced performance of tasks calling for the restructuring of presented gestalts (e.g. anagrams, scrambled or reversed words or sentences).

There will be a swifter shift to alternate concept in concept bridging series.

As a disruption of the sense of balance

There will be less proneness to dizziness.

There will be less directional disorientation as a result of spinning while blindfolded.

There will be less proneness to motion sickness.

There will be an enhancement of body sway and static ataxia.

As a result of disruption of sense of temperature

There will be greater tolerance of heat and cold.

As a result of decreased sensitivity to pain

There will be a greater tolerance of painful stimuli.

As a result of overlapping of sensory modalities

The observations would lead one to hypothesize a decrement in performance in the following areas:



Hypothesis

There will be a decreased ability to discriminate between longer periods of time (i.e. intervals in excess of five seconds.

There will be decreased performance on size - distance tests.

There will be a decreased ability to estimate distance.

There will be a decreased ability to make fine discrete motor responses.

There will be a decreased ability to discriminate between fine differences in weight.

There will be a decreased ability to discriminate between fine differences in temperature.

There will be a decreased ability in tasks calling for a sense of balance.

There will be a decrement in performance on tests of persistence.







II. STUDIES OF THOUGHT PROCESSES



Observations

Associations appear to be made a higher speed.

Associations appear to cover a wider range.

There appears to be an enhanced ability to see alternatives.

There appears to be an enhanced ability to relate ideas across usual boundaries in thinking (frames of reference).

There appears to be an enhanced ability to reason by analogy.

Time appears to be more readily transcended in thinking.

There appears to be an enhancement in deductive ability.

There appears to be an enhanced ability to draw inferences from given date.

There appears to be a tendency to think more abstractly.

There appears to be a decreased ability to limit associations.

There appears to be a decreased span of attention.

There appears to be a decreased ability to attend selectively.

There appears to be a decreased ability to select from among a series of possible alternatives.

In some areas one would hypothesize enhanced performance.



Hypotheses

As a result of higher speed of association

Greater fluency of timed tasks of association.

Increased ability to suggest criteria for classification.

Increased ability to determine the basis upon which presented classifications have been made.

Increased capacity for symbolic communication. (e.g. in such tasks as identifying caricatures, playing Botticelli, charades, etc.)

As a result of a wider range of association

More inclusive concepts will be used on classification or sorting tests.

There will be an enhanced capacity to see "missing links" in a series of concepts.

As a result of increased capacity to see alternatives

Given data for which alternative solutions are possible there will be a more rapid identification of these.

Given a series of alternatives the basic data will be more rapidly determined.

There will be an increase in the speed of reversal of ambiguous perception.

There will be an enhanced ability to determine missing steps in a series.

As a result of enhanced ability to relate ideas across accustomed frames of reference.

Enhanced capacity on tasks calling for a shift of context (e.g. Zen koans).

Enhanced ability to solve riddles or to predict the endings for jokes which rely upon a sudden change of frame of reference.

Faster learning of paired nonsense syllables or unrelated concepts.

As a result of an enhanced ability to reason by analogy

Increased performance on tests based on analogical thinking.

As a result of an enhanced ability to transcend time

There will be an enhanced ability to see similarities in historically discreet events.

There will be an enhanced pre-cognitive capacity.

There will be an increased tendency to think in terms of process rather than in terms of discreet events

There will be an enhanced capacity for the recall of specific instances in one's past.

As a result of entrancement of deductive ability

Increased performance on tests based on analogical thinking.

As a result of enhanced ability to draw inferences from given data

As a result of the tendency to think more abstractly

More abstract answers will be given in such tests as proverbs, similarities, etc.



In some areas one would hypothesize a decrement in performance.



Hypotheses

There will be a decreased capacity for the selection of "sight" answers from a series of possible related alternatives.

There will be a decreased capacity to limit associations in accordance with various restrictive instructions or frames of reference.

There will be a decrement in performance in tasks calling for trial-and-error learning.

There will be a decrement in performance in tasks calling for prolonged selective attention.

There will be a decrease in zarganic effect.







III. STUDIES IN EMPATHY



Observations

There appears to be an enhancement of emotional sensitivity to the moods and feelings of others.

In group experiences there appears to be a direct non-verbal communication of feeling.

In group experiences there may be non-verbal communication of ideas.



Hypotheses

As a result of enhancement of emotional sensitivity

There will be an increased ability to identify emotion from photographs.

There will be an increased ability to determine when another person is lying and when h is telling the truth.

As a result of enhanced communication of feeling in group experiences.

There will be an increased capacity in determining how others have responded, are responding or will respond, to various stimuli, (e.g. Dymond type empathy tests).

Capacities for such activities as psychodrama and role playing or for such activities as charades will be very much enhanced.

Agreement should be found between ratings by group members, (e.g. adjective check tests scored to indicate how each group member in turn responds to stimuli such as music, paintings, etc.).

As a result of non-verbal communication of ideas

Using a group in which one subject knows the answer to a series of problems, the performance of the other group m embers should be enhanced.

- This situation should be studied under several conditions.

when the subjects are face to face.

When the subjects are in the same room but cannot see each other.

When the subjects are at a distance.

- It should also be studied in various qualities of settings ranging from the friendly and accepting to the cold and hostile.

- This situation should also be studied using various types of content for communication ranging from such abstract material as Zeno cards to highly effective material.

- The situation should also be studied using various doses.







IV. STUDIES IN THE AREA OF AESTHETICS, VALUES BELIEFS.



Observations

There appears to be a tendency toward an enhancement of appreciation and enjoyment of various art forms, particularly music.

This appreciation appears to be colored and qualified by each participant in a group experience.

There appears to be a tendency for belief to shift toward:

greater self-acceptance and self-understanding

greater acceptance, appreciation and respect for other people.

There appears to be a tendency for belief to shift toward the acceptance of prime cause.



Hypotheses

As a result of enhanced enjoyment and appreciation of music and other art forms.

As a result of qualification of appreciation by other group members

As a result of the tendency for values to shift toward greater self-acceptance and self-understanding

The subject will report the above on self rating scales.

The behavior of the subject will become less defensive.

As a result of the tendency for values to shift toward greater acceptance of others.

Persons who know the subject will indicate that such a change has taken place.

The behavior of the subject will become less hostile.

Scores obtained on attitude, adjustment, personality or interest inventories will reflect better adjustment.

Lowered scores on scales of Authoritarianism and on such scales as Eysenek's scale of Tough-mindedness.







V. STUDIES IN GROUP PROCESSES



Observations

In group experiences, within group communication is improved.



Hypotheses

Group decisions will be arrived at more rapidly.

Limitations imposed on communication will have less effect.

There will be less expression of annoyance and hostility.



Studies should be conducted to try to determine the effects of varying group size in terms of:

Group efficiency

Levels of empathic relation between members.

Group solidarity or unity.







VI. STUDIES RELATING TO DOSAGE



Using double blind techniques and subjects familiar with the general drug reaction, objective and subjective data should be gathered on the effects of doses ranging from 50-1000 gamma.



Relevant variables accounting for differences in the psychological effect of varying dosage, should be sought out.



Scales should then be developed to obtain some objective measure of change on these variables.



Studies could then be carried out, again using double blind techniques to determine the effect upon members of a four group in which dosage in three cases is constant and that in the fourth member varies.







REFERENCES



Abramson, H.A.: Lysergic Acid Diethylamide (LSD-25). XIX - As an adjunct brief psychotherapy with special reference to ego enhancement; J. Psychology, 41, p. 199, 1955.



Abramson, H.A.: Lysergic Acid Diethylamide (LSD-25). III - As an adjunct to psychotherapy with elimination of fear of homosexuality; J. of Psychology, 39, p. 127, 1955.



Abramson, H.A.: Lysergic Acid Dethylamide (LSD-25). XXII - Effect on transference, J. of Psychology, 42, p. 51, 1956.



Abramson, H.A., Jarvik, M.E., Hirsch, M.V. and Ewald, A.T.: Lysergic Acid Diethylamide (LSD-25). V - Effect on spatial relations abilities, J. of Psychology, 39, p. 435, 1955.



Abramson, H.A., Waxenberg, S.E., Levine, A., Kaufman, M.R. and Kornetsky, C.: Lysergic Acid Diethylamide (LSD-25). XIII - Effect on Bender-Gestalt test performance. J. of Psychology, 40, p.341, 1955.



Abramson, H.A., Jarvik, M.E. and Hirsch, M. A.: Lysergic Acid Diethylamide (LSD-25). VII - Effect on two measures of motor performance. J. of Psychology, 39, p. 455, 1955.



Anderson, E.V. and Rawnsley, K. : Clinical Studies of Lysergic Acid Diethylamide. Monatsschr. Psychiat. Neurol. 128, p. 38, 1954.



Becker, A.M.: On the Psychopathology of the Effect of Lysergic Acid Diethylamide. Wein Ztschr. Nervenh. 2, p. 402, 1949.



Bradley, P. B., Elkes, C. and Elkes, J.: J. of Psychology, 121, p. 50, 1953.



Busch, A.K. and Johnson, W.C.: LSD-25 as an Aid in Psychotherapy (preliminary Report of New Drug), Dis. Nerv. System, 11, p. 241, 1950.



Caldwell, A.E.: Psychopharmaca, A Bibliography of Psychopharmacology. U.S. Public Health Services, U.S. Govt. Printing Office, Washington, 1958.



Cerletti, A.: Lysergic Acid Diethylamide (LSD) and Related Compounds, Neuropharmacology. Trans. Second Conference, Josiah Macy, Jr. Foundation, N.Y.1956. (Appendix)



Chwelos, N.., Blewett, D.B., Smith, C. and Hoffer, A.: Use of LSD-25 in the Treatment of Chronic Alcoholism. Quart. J. of Studies on Alcoholism, 20, p.577, 1959.



Davies, M.E.B. and Davies, T.S.: Lysergic Acid in Mental Deficiency. Lancet, 269, p. 1090, 1955.



DeShon, H.J., Rinkel, K. and Solomon, H.C.: Mental Changes Experimentally Produced by LSD; Psychiat. Quart., 26, p. 33, 1952.



Eisner, B.G. and Cohen, S.: Psychotherapy with Lysergic Acid Diethylamide In Press.



Evarts, E.V.: A Review of the Neurophysiological Effects of Lysergic Acid Diethylamide (LSD) and other Psychotomimetic Agents. Ann. New York Acad. Sc., 66, p. 479, 1957.



Frederking, W.: Intoxicant Drugs (LSD-25 and Mescaline) in Psychotherapy. J. Mer. And Ment. Dis., 121, p. 263-266, 1955.



Guttman, E.: Artificial Psychoses Produced by Mescaline, J. of Ment. Sc., 82, p. 203, 1936.



Gibran, K. : The Prophet, New York, N.Y., Knopff, 1956.



Green, R.F. and Nowlis, V. : A factor Analytic Study of the Domain of Mood with Independent Experimental Validation of the Factors. Paper given at the 65th Annual Convention of the American Psychological Association, New York, Spet. 1957.



Hoffer, A. & Agnew, N. Nicotinic acid modified LSD-25 psychosis. J. of Mental Sci., 101, p. 12-27, 1955.



Omitted in manuscript.



Hubbard, A.L.: Personal communication, 1958.



Huxley, A. : Letter to H. Osmond, 1957.



Huxley, F. : Personal communication, 1958.



James, W. : Varieties of Religious Experience. (Twelfth Impression). Longman's, Green, London, England, 1906.



Jarvik, M.E., Abramson, H.A. and Hirsch, M.W. : Lysergic Acid Diethylamide (LSD-25). VI.- Effect upon Recall and Recognition of Various Stimuli. J. of Psychology, 39, p. 443-454, 1955.



Jarvik, M.E., Abramson, H.A., Hirsch, M.W. and Ewald, A.T. : Lysergic Acid Diethylamide (LSD-25) : VIII, Effect on Arithmetic Test Performance. J. of Psychology, 39, p. 465-473, 1955.



Katzenelbogen, S. and Fang, A.D. : Narcosynthesis Effects of Sodium Amytal, Methedrine and LSD-25. Dis. Nerv. System, 14, p. 85-88, 1953.



Kluver, H. : Mescal - The Divine Plant. Keegan Paul, London, England, 1928.



Lennar, H., Jarvik, M.E. and Abramson, H.A. : Lysergic Acid Diethylamide (LSD-25). XIII - A Preliminary Statement of the Effects upon Interpersonal Communication. J. of Psychology, 41, p. 185-198, 1956.



Levey, A.: Personal communication, 1958.



Levine, A., Abramson, H.A., Kaufman, M.R. and Markham, S. : Lysergic Acid Diethylamide (LSD-25). XVI - Effect on Intellectual Functioning as Measured by the Wechler-Bellevue Intelligence Scale, J. of Psychology, 40, p. 385-389, 1955.



Levine, A., Abramson, H.A., Kaufman, M.R., Markham, S. and Kornetsky, C.: Lysergic Acid Diethylamide (LSD-25). XIV - Effect on Personality as Observed in Psychological Tests. J. of Psychology, 40, p. 351-366, 1955.



Lewis, D.J. and Sloane, R.B. : Therapy with Lysergic Acid Diethylamide, J. Clin. And Exper. Psychopath and Quart. Rev. Psychiat. and Neurol., 19, p. 19, 1958.



Nowlis, H.H., Nowlis, V., Riesen, A.H. and Wenst, G.R. : Chemical Influences on Behavior. II- The Effects of Dramamine and Scopolamine on Emotional and Social Behavior with Comparison Data on the Effects of Other Drugs. Technical Report, Project O.N.R., p. 144-160, Univ. Of Rochester, Rochester, N.Y., 1953.



Nowlis, V. and Nowlis, H.H. : Description and Analysis of Mood. Ann. N.Y. Acad. of Sci., 65, p. 345, 1956.



Nowlis, V. : The Use of Drugs in the Analysis of Complex Human Behavior, with Emphasis on the Study of Mood. Univ. Pittsburg Current Trends Conference. Univ. Pittsburg Press, Pittsburg, Pa., 1956.



Osmond, H. : A Review of the Clinical Effects of Psychotomimetic Agents. Ann. N.Y. Acad. Sci., 66, p. 418, 1957.



Osmond, H. : A Personal Communication, 1958.



Rinkel, N., Hyde, R.W. and Solomon, H.C. : Experimental Psychiatry, IV - Hallucinogens; Tools in Experimental Psychiatry, Dis. Nerv. System, 16, p. 1, 1955.



Sandison, R.A. : Psychological Aspects of the LSD Treatment of Neuroses, J. Ment. Sci., 100, p. 503, 1954.



Sandoz Chemical Works Inc. : Sandoz Pharmaceuticals Annotated Bibliography, LSD-25 - Delysid, p. 56, Hanover, N.J., 1956.



Smith, C. : A New Adjunct to the Treatment of Alcoholism, - The Hallucinogenic Drugs, Quart. J. Stad. Alcohol., 10, p. 408, 1958.



Smith, C. : Reflections on the Possible Therapeutic Use of Hallucinogenic Drugs. 1958 in press.



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Von Felsinger, J.W., Lesagua, L. and Beecher, H.K. : The Response of Normal Men to Lyserigic Acid Derivatives (di- and mono- ethyl Amides), J. Clin. And Exper. Psychopath. 17, p. 414, 1956.



Von Felsinger, J.M., Lasagua, L. and Beecher, H.K. : Drug Induced Mood Changes. II - Personality and Reactions to Drugs, J.A.W.A., 157, p. 1113, 1955.



Wendt, G.H. and Cameron, Jean S. : Word Check List, unpublished.



Werthan, F. and Bleuler, M. : Inconstancy of the Formal Structure of the Personality. Experimental Study of the Influence of Mescaline on the Rorschach Test. Arch. Neurol. Psychiat., 28, p. 52, 1932.



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Notes # These empty parentheses appear in the original, which does not spedify any groups. The original manuscript has these empty brackets, and does not specify which of the Abramson references are supposed to be referenced here. Revision History # v1.0 - Aug 10, 2002 - Multiple Authors - Archived on Erowid.

v1.1 - Jun 13, 2009 - Erowid - Corrected minor transcription errors and typos pointed out by Ivar V. Added Revision History.

v1.2 - May 16, 2010 - Erowid - JG - Removed duplicate acknowledgements from preface. Fixed a mistaken line break in "On the basies of this self-understanding".

In the 1950s and 1960s, mimeograph copies of the following Handbook were shared among pioneering therapists exploring the therapeutic utility of LSD. To this day, it remains one of the most relevant documented explorations of the guided psychedelic session.It will be obvious to the careful reader but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.The work could not have been completed without the continuous assistance of Mr. A.B. Levey, Mr. Francis Huxley, Dr. C.M. Smith and Dr. A. Hoffer. Many colleagues, including in particular Dr. S. Jensen, Mr. J.F.A. Calder, Mr. A.R. Cambell, Dr. T.T. Paterson, Dr. M.G. Martin, Dr. J.R. McLean, Dr. T. Weckowicz, Mr. F.E.A. Ewald, Mr. G. Marsh, Mr.R. Thelander and Mr. M.E. Rubin, have given us freely of their insightful observation and of their time and energy..It will be evident to the reader that the authors have not attempted to deal with the material presented within a theoretical system.The experience described and utilized in therapy represents so remarkable an extension of common experience that an eclectic approach has seemed mandatory.The clinician may feel that the depersonalization and rapport which develop in the experience are of prime significance. The experimentalist may see the induction of marked inconstancy of perception or the inconstancy of the sense of time in particular as the important aspect of the experience. In any case, clinician and experimentalist alike will find much of value and of interest in studying the drug effect.It will be obvious to the careful reader, but it is a pleasure to acknowledge here as well, the debt which the authors owe to the work of Dr. A.M. Hubbard and the help of Dr. H. Osmond.This handbook has been considered important for many years as one of the earliest descriptions of how to use LSD in psychotherapy. It has been mentioned and referenced in many discussions of psychedelic psychotherapy since its original publication in 1959. This version was made available online in March 2002 through work by MAPS and Erowid. MAPS scanned & OCR'ed this document in early 2002 and Erowid edited, HTMLed, and created a printable PDF version. The formatting and look of the document has been kept as close to the original as possible and OCR errors have been removed where found. If you note errors in this document, please send them to corrections@erowid.org.THE FRAME OF REFERENCEIn the broadest terms there are, at present, two main philosophies of psychotherapy. One of these, based upon the concept of "adjustment" sees as the goal of treatment a happy and comfortable acceptance by the patient of the norms of his society. The other concept sees as the goal of therapy the maximal realization of the individual potential, the flowering as it were, of the personality.In considering the therapeutic merits of LSD-25, one can scarcely fail to pose such problems as how the drug can contribute to the therapeutic process, how its use affects the therapeutic process, how its use affects the therapist-client relationship, or how its effects seem to relate to various aspects of psychological and psychiatric theory.Under present day conditions the therapist, though desiring to lead the patient toward full self-realization, almost invariably finds that pressures of time and convention force him to work toward the goal of adjustment more or less to the exclusion of any but the most cursory consideration of those particular facets of the psyche which render each of his patients unique.When therapy begins, the patient already possesses a complex of motives and mechanisms which have proven more or less inadequate and while the forms and techniques employed in treatment may vary widely, depending upon the theoretical outlook of the therapist, there is nevertheless an underlying process which is common to all psychotherapeutic progress. It might be summarized in the following steps:The therapist cannot learn these things for the patient, just as the teacher cannot learn for the pupil. It is the role of the therapist, as it is of the teacher, so to structure the situation as to maximize the opportunities for learning. The expertise of the therapist lies essentially in his knowing how to structure the situation so as to fit best the personality of the patient and of himself and the environmental variables which seem of greatest relevance.Many of the treatment methods in psychiatry have been derived and are currently utilized with a pragmatic disregard for theoretical considerations. This is true of the physical and chemical therapies generally. To the extent that they are regarded as adjuncts to psychotherapeutic treatment but because of their relatively rapid effect and the tremendous economy in terms of treatment time they are frequently used with minimal psychotherapeutic accompaniment.These treatment methods might be classified in terms of the aim of the therapist. One group including electrotherapy, insulin therapy, psycho-surgery and narcotherapy, is utilized to make the patient more accessible to the therapist, that is to say to alter the patient so that he is better able to utilize the help which the therapist can offer through appropriate structuring of the therapeutic situation. The other group would include such methods as hypnosis, amytal and pentothal, and CO. Here the aim is to help the patient overcome his reluctance to face himself as he really is-to hasten the learning process and ease the pain involved in gaining greater self-understanding.In these methods the main effect appears to be cathartic. Troubling material is brought up, resistances are reduced and the therapist, having become aware of the nature of the patient's highly emotionally charged experiences, can better structure the therapeutic situation to help the patient understand himself.To a greater or lesser extent each of these methods permits the expression of emotions which were ordinarily suppressed, and the release of the dammed -up tide of emotional energy relieves the pressure under which the patient has been living. The release of repressed or suppressed, however, is likely to offer but temporary relief. Unless the pattern of values and motives which originally prevented the acceptance of those aspects of self which engendered the emotional potential are altered, the dam to emotional expression will remain and the pressure will again begin to increase.The great value of LSD-25 lies in the fact that when the therapeutic situation is properly structured the patient can, and often does, within a period of hours, develop a level of self-understanding and self-acceptance which may surpass that of the average normal person. On the basis of this self-knowledge he can, with the therapist's help, clearly see the inadequacies in the value system which has underlain his previous behavior and can learn how to alter this in accordance with his altered understanding.So sweeping a claim must, upon first reading, seem like nonsense but a growing number of people have come to accept it as undeniable fact. These are the people who have tried the drug on themselves and on their patients. They are convinced that within the next two or three decades LSD-25, will be by far the most common adjunct to psychotherapy. They feel too that since the psychedelic experience can lead to a very high level of self-understanding, and since self-understanding is the key without which the doors to interpersonal, intergroup or international understanding can not be opened, its use as a catalyst in the development of better human relations will become almost universal. To reject the views of this group as being too extreme without investigating the matter seems a remarkably unscientific attitude. The fact that those who have tried it feel that it offers astonishing possibilities would, in itself, seem to be sufficient reason for a thorough testing of the claims made.While a certain amount is known about the drug at the present time, investigators have barely begun to explore its potential. Although our knowledge is as yet remarkably incomplete, the following is an attempt to outline the more important aspects of the drug reaction and to outline what appear, at present, to be the most rewarding methods of using it in therapy.The data from which these methods are derived are by no means extensive but the drug has repeatedly offered help where other methods had failed. It has been used in the most refractory cases, the most unpromising situations, and frequently has been employed only once in the case of an individual patient, yet it has proven surprisingly successful as such reports as those of Smith (45), Chwelos et al (13), Eisner and Cohen (16), and Abrahamson (1), (3) indicate.FEATURES OF THE EXPERIENCEThere are two reasons why the LSD experience does not lend itself readily to verbalization. Firstly, the sensory aspect of the experience is outside the bounds of the usual experience from which language has developed and for the description of which it is intended. Secondly, the experience is mainly in the sphere of emotions or feelings which are difficult to objectify or verbalize at the best of times.Before attempting to draw any conclusions about the suggested value of LSD one would want to know something of the nature of the experience which the drug induces. Also, it is inevitable that effective methods of using the drug must be dictated by the nature of the experience.Because of the difficulty in describing the experience in any but subjective terms, our knowledge of it has been built up bit by bit from personal LSD experience and through observations and reports of other individual and group experiences.In reading accounts of the experience, one cannot fail to be struck by the fact that although there is tremendous variety in these reports there is a relatively consistent communality in certain areas of the experience. In an earlier report (13) we enumerated these commonly reported areas and illustrated them briefly with transcriptions from actual experiences as follows:1. A feeling of being at one with the universe."I had finally understood by experience. The feeling of union with the cosmos."2. Experience of being able to see oneself objectively or a feeling that one has two identities."If we had the gift to see ourselves as others see us, well, I did this morning. There seemed to be two of me and there seemed to be a conflict between these two."3. Change in usual concept of self with concomitant change in perceived body."I had the feeling of leaving my body and drifting off into space. I had no worldly connections and felt as if I was only a spirit.4. Change in perception of space and time"I was looking deeply in the picture until the objects in the picture were beside me."5. Enhancement in the sensory fields."The flower was a thing of inestimable beauty as was its scent. It quite transfixed me in essential contemplation, ecstasy and timelessness."6. Changes in thinking an understanding so that the subject feels he develops a profound understanding in the field of philosophy or religion. Associations of ideas are much more rapid and clear and one tends to see many alternate solutions to each problem. There is a great tendency to think anologically."I found I was outside our bounds to space and time and had an understanding of infinity."7. A wider range of emotions with rapid fluctuation."During this period 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."8. Increased sensitivity to the feelings of others."I was conscious of an extremely acute sense of awareness of perception of another's mood, almost thoughts. I likened it to the recognition of emotional atmosphere that the child or animal seems to have."9. Psychotic changes. These include illusions and hallucinations, paranoid delusions of reference, influence, persecution and grandeur, thought disorder, perceptual distortion, severe anxiety and others which have been described in many reports on the psychotomimetic aspects of these drugs."CHARACTERISTIC TYPES OF REACTIONThese aspects of the experience tend to form various combinations and constellations which give rise to certain characteristic types of experience. It is important to attempt to identify and catalogue these since some such classification must form the basis for any scientific description or understanding of reaction patterns. The types of experience listed here have been found to be by far the most commonly occurring. They appear to be ranged along a continuum. Though the exact nature of this underlying variable is not clear, it does appear to be related to the individual's level of self-acceptance, which in turn, is closely related to the degree to which he is able to surrender his usual self-concept. To the extent that the postulated continuum does exist, these six types of responses might be regarded as various levels of such surrender.Paradoxically the ability to abandon the established self-concept increases with self-acceptance and decreases with diminished self-regard. The person who does not accept himself fears the exposure of the unacceptable elements and struggles to maintain control in the face of the drug's effects.Several of these levels are likely to occur within a single experience and a person may frequently move from one to another. However, the tendency is to move from the first two levels (in which the subject tries to deny that the drug has any psychological effect) through the 3rd and 4th levels (in which the attempt to explain and thus control the psychological effects leads to psychotic reactions) to the 5th and 6th levels (in which, having realized his inability to prevent, control, or explain the psychological effects within his usual frame of reference, the subject surrenders his habituated self-concept with its limitations, and accepts the psychedelic or mind-manifesting aspects of the reaction as real and useful).ESCAPE REACTIONSIn the first two types of experience, the reaction is one of attempting to resist and escape from the effects of the drug.1. The first type of experience might be called a flight into ideas or activity. The drug begins to disturb the individual's perceptions. He reacts against the effects of the drug by concentrating either upon concepts or things outside the self or upon some activity which can absorb his full attention. Any concept, such as, for example, abstract art, religious dogma, racial prejudice or unemployment may be seized upon and the person may devote his full attention to an elaboration to a variety of aspects of this concept while continuing to deny that the drug is having any effect upon him. In other cases, the individual may plunge into some particular activity-usually his own area of work, in which the familiarity of the activity lends reassurance and stability. He seeks to minimize the effect of the drug by this diversion and narrowing of interest.He attempts, in this fashion, to control the emotional component of the experience and to minimize his awareness of any physiological or psychological change. He will report that nothing is happening. To an observer, it is evident that the individual is expending an amount of energy in his pursuit of the ideas he is considering; that he is excessively talkative and serious; that he grows progressively more irritable and intolerant of interruptions or questions and that, in many cases, he seems to be suffering from severe tension.If, after the experience, the individual is asked to describe what happened, he is likely to state that little if anything occurred.2. The second type of experience might be termed a flight into symptoms. This type of reaction seems to be correlated with an inability or unwillingness to direct one's attention to things outside oneself. When the drug begins to affect the individual, he tends to concentrate upon the physiological sensations. The strangeness of these becomes alarming to him and his alarm increases the physiological disturbances, altering his perception to a still greater awareness of bodily discomfort and malfunction. The individual may develop physiological symptoms of various kinds such as violent nausea; palpitations; feeling of constriction in the throat and chest; pain at the base of the skull; numbness of the limbs or violent headache. Sometimes he may express a fear of dying.In this variety of experience, the individual will voice very frequent complaints about feeling unwell.To an observer, he will seem to be extremely ill at ease and his nausea may lead to vomiting, although this is unusual.Afterwards, when asked to describe his experience, the individual is likely to state that the drug's only effect is to make a person terribly sick.In the first two types of experience, the self-concept is maintained despite the action of the drug. The individual is able to minimize the psychological effects of the drug by developing an idée fixe and by clinging desperately to it in a battle against the drug's effects.The employment of small doses of the drug tends to contribute to the production of these types of experience. Little or no therapeutic benefit is derived from them, since the individual, by successfully fighting the drug's effects, succeeds in denying himself any possibility of therapeutic change.Frequently such reactions develop early in an LSD experience as a result of pre-treatment apprehension. It is of particular importance that the therapist be aware of the possibility of the subject concentrating on the physical effects of the drug, for unless the subject's attention be diverted before the symptoms become oppressive, they can rapidly become so marked as to prevent the subject from being able to shift his attention.PSYCHOTOMIMETIC REACTIONSThe next two varieties or levels of experience which are frequently observed are those which have given rise to the use of the terms hallucinogen and psychotomimetic agent in connection with LSD.These states, offering as they do an opportunity to study the interior of certain psychotic conditions, have remarkable possibilities as staff training experiences. On the other hand it is most unfortunate that so much stress has been placed upon these particular aspects of the LSD experience. Not only are they of limited therapeutic value, but, when regarded as the only levels attendant upon taking the drug, they cause the therapist who would otherwise be interested in its therapeutic possibilities to hesitate in including it among his treatment methods.3. The third type of experience might be termed a confusional state. It is characterized by confused thinking and perceptual distortion. The individual attempts to rationalize what is happening to him but visual imagery and ideas flood into his awareness at so high a speed that he cannot keep up with them. He is like a person trying to listen to a foreign language with which he is only vaguely familiar. He rapidly falls behind and loses the context.In this state the alterations in the various areas of perception become so overwhelming that they cannot be interpreted; the intellectual or rationalizing processes are swamped and the attempts to establish order fail. The subject is acutely aware of the confusion of visual and sometimes auditory perceptions which become a vast jumble, often frightening and unpleasant. This results in a state which would appear to be very much like an intensification of the schizophrenic breakdown, particularly as it occurs in catatonic and hebephrenic states.4. The fourth type of experience is characterized mainly by paranoid thinking. It appears that in this type of response the individual reacts to the impact of the drug by rationalizing all of the aspects of the experience as being a function of the drug alone. All aspects of his perception appear to be enhanced or altered-music is felt physically; is heard with greater clarity and intensity and with new meaning; colors are brightened and seem more intense; patterns take on new significance; and an enhanced awareness of feelings of others is noticed. To a greater or lesser extent all of the senses may appear sharpened in their awareness. Smell, taste, texture, pain, temperature, and balance may also be sensed in a novel way.The individual's thinking stresses the fact that his perceptions are altered by the drug. He mistrusts his own sense data and begins to question the validity and reality of everything he does and perceives. Thus, he interprets the state as delusional, implying that he is incapacitated and helpless. Further, we have previously mentioned that in the experience the subject seems to develop an acute sense of awareness of the feelings of other people. This is so unusual that the subject begins to misinterpret feeling as thought and believes that other people are becoming aware not only of his feelings, but of his thoughts as well. This feeling of empathic proximity seems to the subject to lay bare the unacceptable aspects of himself. He tries to hide his incapacities and imperfections from those around him. He feels that he is completely at their mercy and is uncertain as to whether or not he can trust them.Ordinarily, small areas or phases of mistrust are not particularly important in interpersonal relations. In the experience, however, overwhelming feelings of inadequacy and inter-dependency tend to develop and the level of trust becomes an extremely important variable. In order to fully stabilize the experience at the psychedelic level, trust must be absolute. Huxley (26) has described this as "the willingness to be completely implicated". Osmond (41) in a personal communication points out " a minimal amount of trust is essential, how much we don't know but absolute trust is desirable and essential for using the psychedelic experience fully."Inability on the part of the subject to accept others forces him to try to conceal both his present incapacity and those aspects of himself which he feels he cannot trust others to accept. Despite these efforts, he feels that those about him are aware of his weaknesses and his imperfections. When they act as though they were unaware of these things he feels that they are either toying with him or are too embarrassed to mention his difficulties. This feeling causes suspicion, referential thinking and a marked reduction of insight.Occasionally, the subject reacts with aggression and hostility rather than withdrawal. In such cases there develops a grandiose contempt for the views or wishes of other people and a disregard for convention. This reaction may be characterized by such paranoid delusions as the feeling of being a God. The person may verbalize the idea that nothing matters any more. In some instances excitement may develop into manic-like behavior. We have found that such grandiose reactions are very rare, occurring not more than once in 50 cases. Their mention here is justified in part as a reassurance to the therapist, for although when they do occur, they tend to give way in a few hours to more amenable states, they can pose management problems. When this condition persists, beyond an hour the therapist should consider the administration of a booster dose of the drug. Although it would seem that increasing the drug dosage would simply add to the subjects discomfort, it does not do so. Rather, it helps him to extricate himself from the dilemma in which he finds himself.These states tend to occur when the subject comes to a point in the experience at which he is aware of the shortcomings of his accustomed value system but finds the alternative values, growing out of the experience, unsatisfactory to him. In this situation he attempts to deny all value and may declare that nothing matters. Agitation and excitement may build up to a point at which some restraint is necessary. An additional dose of the drug permits him to assess old and new value systems much more objectively and he finds it much easier to accept what he finds in the process. As the subject begins to recover after an experience of this nature he may go through a phase of schizophrenic-like activity in which there may be markedly stereotyped behavior and the subject may seem to be completely unaware of the therapist. In cases we have observed, this phase lasts about an hour, after which the subject becomes completely rational and very calm and relaxed.PSYCHEDELIC REACTIONSThe next two varieties or levels of experience are those referred to by the term psychedelic. A word of explanation seems necessary here to clarify our differentiation between psychotomimetic and psychedelic experience. We have used Osmond's (40) terms in this regard. He pointed out that the LSD experience can be broken into two categories-the psychedelic (mind manifesting) aspect during which the person learns only of the inside world of madness. He related the perceptual changes in the LSD experience to what William James has termed "unhabitual perception". James felt that the essence of genius lay in the ability to perceive the world in an unusual manner, i.e. with the absence of one's usual rigidity and Osmond (40) suggests that the ability to perceive the world in a new and unaccustomed manner permits the reorganization of one's system of values.When a state of unhabitual perception comes upon one through disease process as in schizophrenia or when it is induced by LSD it can be a frightening and distressing experience. As long as the unhabitual perceptions are not organized into an understandable pattern, the person in whom they occur remains confused, uncertain of his reality. Unless they are aided in this process by people familiar with the drug experience they can spend many hours in very uncomfortable circumstances. Because of this fact, LSD has most frequently been described as a psychotomimetic or hallucinogenic drug.It undoubtedly does have this potential. However, when an individual who takes the drug is offered support and guidance in the experience by people who have already established order and organization to the unhabitual perceptions, he is usually able to do so himself in a short time. Such organized unhabitual perception makes up the so called psychedelic experience which offers marked therapeutic possibilities.In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area of reality worthy of exploration. They might be termed stabilized experiences in that the distressing effects of the drug tend to be minimized and the individual is enabled to gain remarkably in terms of increased insight and self-understanding.There are the levels at which the therapeutic possibilities of the drug are most fully realized. These types of experience are closely related and while the difference between them may not actually seem great enough to merit their separate considerations, the levels of stabilization which they represent differ so markedly that they have both been outlined.5. The fifth type of reaction is one in which the effects experienced are accepted as comprising a separate but equally real and valid reality to which the drug gains one entry. The person accepts as genuine his apparently enhanced intellectual capacity and his ability to empathize with and to appreciate, accept and understand others. His thinking may be somewhat disrupted by a frequent involvement in what Levey (23) has termed the dilemma of alternates. This is a sort of parallel awareness of opposites which impeded the usual flow of thought. The subject may also find himself increasingly aware that he is thinking analogically; that there is a tendency to extend logical classification beyond the usual bounds and that his perception increasingly tends toward the breakdown or subdivision of usual gestalts.In this state the person is keenly aware of the possibility of slipping into a psychotic state for madness appears an ever-present possibility and he feels that he is walking a razor's edge, gaining slowly in confidence as he goes.6. In the sixth type of reaction the experience is accepted as offering a new and richer interpretation of all aspects of reality. The person feels strongly that there is a unifying principle underlying all things, an essence with which he feels in complete accord. He may feel that he is a part of all things and all things are a part of him. His self-concept is in no way limited by the usual restraints of body image. These feelings or beliefs are accompanied by feelings of reality so intense that conviction is inevitable. William James in writing of such intense feelings of reality states, "they are as convincing to those who have them as any direct sensible experience can be, and they are, as a rule, much more convincing than results established by mere logic ever are".At this level of experience no doubts remain as to the reality and usefulness of the experience and the individual, freed from this concern feels no possibility of unpleasant or psychotic features developing. Once this level is attained it is doubtful if any manipulation of the environment could induce a psychotic state in the experience.Some may feel that the individual has already, by accepting the experience as reality, fallen into a delusional or psychotic state and, indeed, there is no ready criterion to determine whether or not this is actually the case. The only method of accessing this possibility seems to be that of "By their fruits ye shall know them".These brief notes upon the nature of the experience are in no way complete. No individual reaction will fit neatly into the categories outlined. There will be frequent overlapping of levels and in some cases little or none of the experience may accord with the reactions outlined above. The classification is intended only as a rough chart of a largely unknown area rather than as a detailed guide.More exact mapping of the area will attend the observations of many therapists over a number of treatment sessions. However, we believe the present classification to be useful, chiefly as an indication that although the LSD-25 or mescaline induced experience is vast and rapidly shifting, communalities in the experience may be catalogued in a way that will eventually offer a sounder scientific understanding of this area of experience.INDIVIDUAL REACTIONSThere is much individual variation in regard to the levels of experience attained. Most people pass through a phase in which they struggle against the effects if the drug and a period in which they try to explain the effects themselves. Only individuals seem to attain the psychedelic level rapidly in the first experience and, if they lapse at all into denial, confusion or paranoid thinking, do so but briefly and infrequently. Still other individuals may spend as much as a half a dozen sessions being frightened or ill or paranoid or otherwise distressed before they attain the psychedelic experience. The methods utilized by the therapist play a critical part in determining both the level which [the] subject can attain and the ease with which it is accomplished.LSD-25 was first isolated by Hofmann and Stoll in 1938. It is a synthetic derivative of lysergic acid of the ergonovine group. This group of drugs is derived from the ergot fungus which grows on rye and several members of the group have been used in medicine for several years. In the 1940's the effect of LSD-25 on smooth muscle contraction was being studied and assessed against the effect of other ergonovine derivatives. The psychological effects attendant upon its ingestion were discovered by accident when Hofmann happened to swallow a minute quantity from a pipette.Hofmann and Stoll (48) first reported some of the psychological properties of the drug in 1949 and pointed out that it could reproduce most of the major symptoms of schizophrenia when taken in extremely minute quantities. They did not, however, discuss the extreme variability of the reaction which seems to alter as a function of the surroundings.Following their report the drug came to be regarded as something of a pharmaceutical curios but a great deal of work was begun and many reports were published on its ability to induce, for a period of hours, major symptoms of psychosis. It should be stressed at this point that the drug does not necessarily produce a psychotic reaction and when it is given in a therapeutic setting rarely is there much psychotic manifestation.It was not however until 1950 that the drug was reported on as a therapeutic agent in a study by Busch and Johnson (10). They cited the usefulness of the drug in permitting extensive recall and abreaction and in producing an enhancement of insight.In 1953 Katzenelbogen and Fang (30) published a report dealing with the use of small doses of LSD as an aid in interviewing. They reported that the drug induced a greater ventilation of emotion in schizophrenics than was produced with amytal or with methedrine.In 1954 Sandison (43) published an account of his work in which he employed varying dosages with chronic neurotic mental hospital patients.In 1955 Frederking (18) outlined a method in which he used mescaline and LSD-25 as adjuncts to psychoanalytic therapy.Abramson's group subsequent to 1955 have published a number of papers dealing with the LSD reaction (1), (2), (3). Therapeutically they employ the drug in a modified psychoanalytic approach utilizing small doses in a series of interviews.The literature on the use of the drug in various areas of study has mushroomed remarkably. Several hundred articles are now available on the drug and bibliographies have been prepared by Certelli (12), by the Sandoz Company (44) and by Caldwell (11).In the main, reports dealing with LSD as a therapeutic instrument, cover such aspects as the effect of LSD on memory, as a catalyst to ventilation and as an aid in the development of transference, particularly through the reduction of various areas of resistance.Therapeutically, however, we believe that the great potential of a psychedelic drug lies in its capacity to permit the subject to achieve a remarkable degree of insight and self-understanding. While the drug does permit a review of those repressed or suppressed areas which are the wellsprings of unacceptable behavior, these effects are but the seeds of its full growing. Vastly more important is the new level of identity at which the individual can arrive. He learns that he can be truly himself, perhaps for the first time in his life, and sham and pretense become unnecessary to him. He finds that he can control his own feelings independent of his circumstances or surroundings, a knowledge that frees him from fear and uncertainty of himself or of others. He learns that to him, the world is what he feels it to be. Abraham Lincoln made this point when he said: "A man is just as happy as he makes up his mind to be".For this reason, the method outlined in detail in this manual is one aimed at the realization of this level of self-understanding. This method grew out of the early work of Hubbard (24). Since 1954 Hubbard has been studying the therapeutic use of the drug and has dealt with a very large number of subjects.The LSD experience is so vast, so shifting and so unusual that without some specific techniques, it is virtually impossible to contain and control it is as a therapeutic procedure. In the course of his work Hubbard evolved techniques which give structure to the experience. Among these were the introduction of the idea of using music, paintings and various other stimuli to initiate and illustrate various trains of thought which frequently occur in the experience. His work, which demonstrated the usefulness of the psychedelic aspects of the experience, showed that it was not necessary for the subject to develop a psychotomimetic reaction even when large doses of the drug were used.Therapists found that the ingestion of dosages of 75 gamma or more created perceptual changes and other alterations which provoked extreme anxiety in the subject. Hubbard (24) indicated how to avoid this disruptive feature by training his subjects to be able to relax in the face of the loss of control of physiology and awareness precipitated by breathing CO. This capacity to remain relaxed and unconcerned by the early symptoms of LSD, permits the use of large doses without the arousal of intense anxiety.Hubbard went beyond this, structuring the situation such that the subject was provided with a new framework into which the experience fitted. His method employed a religious setting involving religious themes in pictures and music and a general stressing of the spiritual aspects of the experience. In these terms the experience was understandable to the subjects for, with the exception of the psychotic changes, each of the features, outlined by Chwelos (13) and quoted earlier in this report, can be fitted into this pattern.One of the unfortunate procedures which has been widely used to prevent the arousal of anxiety in the LSD session is the system of beginning with a small dose and gradually increasing the amount given over a succession of experiences. This procedure is used to reduce anxiety. It is reasoned that as the drug effect is being sampled a bit at a time, it will at no time become so overwhelming as to induce distress. Unfortunately, such a procedure is unlikely to be rewarding. Small dosages, when they produce any reaction, are unlikely to induce confusion and psychotomimetic features. When they provoke little or no reaction, the procedure drastically reduced the therapeutic effect of the drug. Psychotomimetic features tend to appear at that point in the experience at which the individual's accustomed concept of himself and the world about him-the frame of reference which constitutes his ties with reality-is becoming no longer tenable in the face of the habitual perceptions induced by the drug. When the drug effect is sufficiently pronounced, the accustomed frame of reference is overwhelmed. In the process of having his accustomed attitudes and sets demolished and of finding a stability in experience outside this psychological framework, the individual finds he has acquired a new outlook. In instances in which the drug effect is insufficient, the individual is left in a state in which he has a very tenuous hold on the reality ties represented by his accustomed concepts and yet is unable to structure or accept the unhabitual perceptions and concepts which the experience has engendered. This confusing, painful and often frightening state constitutes a psychotomimetic experience.When small dose techniques are employed, the individual, by learning through gradually increased effort, as the dosage is increased from experience to experience, may well develop methods of controlling the effects of the drug according to his accustomed pattern of thinking. He may never come to the point of accepting and utilizing the alterations which the drug may make in the mould of feeling and thinking which initially induced his difficulties.While this objection may be felt to be simply a play with words, it is a very serious one. True, the individual eventually learns, in a stabilized experience, to control and use the drug effects. However, this is a control based upon a new level of self-understanding and self-acceptance which alone can permit the acceptance of others. Unless this level of experience can be attained the therapeutic potential of the drug is not realized. If the person learns gradually to fit the drug effects into his accustomed self-concept, he is simply learning how to pigeon-hole the experience within an unaltered frame of reference. It is, in fact, the acquisition of the ability to remain unchanged. Not only is such a procedure unlikely to have any therapeutic effect but it tends to immunize against his ever being able to gain self-understanding through the psychedelic experience.As Osmond (40) has stated "our work started with the idea that a single overwhelming experience might be beneficial in alcoholics, the idea springing from James (27) and Tiebout (48)". We have discovered no reason to alter this view as regards the usefulness of the overwhelming experience. However, subsequent work has shown that is often of great value to repeat the experience and has suggested that the method is applicable to the treatment of the neuroses and psychopathy as well as alcoholism.We feel that it is extremely important that the therapist have a clear understanding of the effects of the drug. This can only be gained by taking the drug one's self. Osmond's (40) golden rule in work with model psychoses "you start with yourself" is even more applicable in work utilizing the psychedelic experience as therapeutic. By gaining this first hand experience the therapist will become much more effective in dealing with subjects during the experience and in aiding them in fitting the insights gained during the experience into their daily lives. Indeed, it is well to have as many as possible of the staff members who will come in contact with the patient similarly trained.We have utilized both individual and group techniques of administration, and have been able to make fairly extensive investigation of their relative therapeutic efficacy as well as their relative usefulness in other areas of investigation.In the individual method the subject is given the drug and the therapist, often with one or more staff, stays with him throughout the experience. In the group method one or two therapists and possibly other subjects also take the drug. In such group sessions it is unwise to have more than one person in the group who is taking LSD for the first time and the others should ideally be quite experienced.In the individual session the subject is more on his own. The therapist should have a good knowledge of what to expect from the LSD experience for this will add an empathic sensitivity on the part of the therapist which is invaluable in this procedure. Being "alone" in the experience, the subject is less distracted from self-analysis and may therefore arrive at a more complete self-understanding. When one takes the drug alone it is more difficult to communicate with other people partly because one's awareness is increased beyond the level of the staff. When one becomes so aware of what is going on in other people, he tends to think that the increased awareness and empathic communication is shared by the staff and feels little need for communication by the usual channels of verbalization. Because of this difference of awareness, there is a relative increase in psychological distance between subject and staff. This problem is not at all insoluble in that empathic sensitivity on the part of the therapist and occasional reminds to the subject that his awareness is expanded beyond that of the others tends to bridge the gap considerably. Indeed the problem is a relative one in that the intensified feelings of the subject make it much easier than usual to empathize with him.Because the subject begins to feel somewhat unique due to his expanded awareness, there is some danger that grandiosity may develop. It is worthwhile to remind the subject that everyone has the same potential which is brought out by the drug.One of the main disadvantages then of the individual procedure is the difficulty in following the subject closely enough through his experience. Provided the therapist has an accepting but not sympathetic attitude there is little if any danger of the subject getting into any serious difficulty because of this difficulty in communication. The individual session has the advantage that less staff time is used. Individual sessions tend to last a shorter period and the subject can be sent back to the ward after 7-8 hours, whereas, in the case of group sessions, 12-14 hours may be occupied. In individual sessions, the staff involved are not in any way incapacitated from doing other things during or immediately after the session if the need arises, though they should try as much as possible to avoid distractions.The subject, in an individual session, feels less encroached upon and is more likely to investigate painful areas than he is in a group session where he is aware that the staff can follow his feeling tone to a very high degree.Indeed, one major disadvantage of using the group method for the subjects first experience is the alarm frequently precipitated in the patient when he realizes the degree to which the therapists are able to identify and communicate with him non-verbally. This relationship is so close that the patient begins to misinterpret feelings as thought and comes to believe that the therapists can read all his thoughts. Because of this, feelings of inadequacy and guilt frequently lead him rapidly to withdrawal and paranoid thinking. Also the subject is to some extent frightened away from the investigation of problem areas out of the fear of exposing hidden areas to others. This difficulty poses much less of a problem, however, to a subject who has had an individual session and has worked through his main problem areas or to the person whose problems are not marked.Another difficulty in the extensive use of group sessions is the frequency with which the therapist must use the drug. Further when two therapists are involved, staff time becomes a major consideration. It has been stated that tolerance for LSD builds up quite rapidly but even when we have run group sessions as frequent as three times a week this has not appeared to be a problem and the therapists have been able to work in close empathy with the subject on doses as low as 25 gamma on the third day of such series.Much more extensive work must be done on the investigation of tolerance in terms of the psychological effects of the drug. There is much to suggest that these effects are much altered in group settings by the impact of the drug on other individuals in the group. These effects cannot simply be brushed aside as suggestion or as a placebo reaction where tolerance has been established. Their effect upon the level of empathy, their duration within a session, their intensity and their persistence from occasion to occasion and their absence when the drug is not ingested, indicate that they are not likely to be the products of suggestion.Frequently, the question of addiction is brought up in connection with therapists who repeatedly use the drug. We have seen no evidence either in the literature or in our own work to suggest any addictive potential. Further, we find that people using the drug frequently find that tolerance is opposite to that found in addiction. With experience, the subject can reach the same level with smaller and smaller doses as he learns to break down his resistance psychologically. Also the effects of the drug are not pleasant in themselves. Subjects have pleasant experiences only if they work through their problem areas and are able to stabilize the experience by reaching a fairly high level of self-understanding and self-acceptance.Further, whereas in addiction the subject is striving to reach some form of escape from, or oblivion toward his personality difficulties, in the case of LSD these are brought into sharp focus and are exaggerated to painful proportions until the subject works them through.Some critics who have never tried the experience have called it an escape into transcendental experience. If this could be termed an escape then all forms of yielding to the desire to learn could equally well be classified as escapes. This would appear to be taking the concept of escape to ridiculous extremes.In view of the difficulties cited, it may appear that group sessions are difficult and unnecessary. However, the group method does have many remarkable advantages. It offers the subject an opportunity to understand himself in terms of how he relates to others. It permits him, when more than one therapist is involved to see objectively from extremely close range, in terms of understanding, how other people relate to each other. It shows the subjects how his views of the world accords with, and differs from, the views of others. It lets him understand that each person's frame of reference, although peculiarly the person's own (and therefore different from any other view) is nevertheless as valid as his own. Further, the group method fosters a ready transfer of training and knowledge from the LSD experience into day to day living.Most important, however, would seem to be the great value of the group experience in staff training and particularly in research. The research aspects of working with the psychedelic drugs deserves particular mention and is spelled out more fully in the following chapter.Therapeutic trials with groups of various sizes have been carried out at various centres in Saskatchewan. This work has suggested that the number in the group is a variable of marked importance.In therapy a group of three, perhaps because of its particular instability, seems most useful. In a group of two, there is a continuous pressure to relate to the same person. It is impossible to withdraw from this relationship and the intimacy of the empathic bond may be disturbing. Any note of suspicion or hostility is excessively disruptive and its effect tends to be prolonged.By comparison, in the three groups one can, to some extent, withdraw from the others from time to time, leaving them to relate to each other. The possibility of shifting from relationship to relationship makes it easier to learn gradually to accept the group members completely. Temporary feelings of hostility, anger or suspicion are much less destructive of the empathic bond in this situation and are much more quickly overcome.The four group is much more complex than the three group and the establishment of the empathic bond is much more difficult since the addition of the fourth participant has doubled the number of relationships involved. This group size appears to lead to a high level of intellectual stimulation and to excellent and rewarding discussion. However, the participants do not readily develop the same high level of empathy as is found in the three group. Frequently the empathic bond is established more completely within pairs than between pairs. It commonly happens too that one individual is not able to accept the others readily and a group of three is formed from which the fourth feels excluded. This makes it still more difficult for him to integrate.Our knowledge of group relationships in drug sessions involving more than four persons is extremely limited. What we do know is drawn from a few five and six group experiences and from the peyote experiences of the Native American Church. Research in this area of group psychedelic experience will be so interesting and rewarding that it will no doubt gain momentum rapidly.In considering the staff time involved in group therapeutic sessions it should be recognized that aside from pre-treatment interviewing the treatment is completed in one day. If the subject is to have two sessions they are usually several months apart. Even where two group session are used, such a treatment program could be likely to consume something less than 30 hours of staff working time per patient. If the treatment were not more effective than any other this would correspond to something less than 25 ordinary treatment interviews, allowing time for recording the sessions. Considering the difficult nature of the cases handled, this in no way seems excessive. Also it must be taken into account that nursing time and secretarial work are reduced to an absolute minimum and hospitalization, in the case of in-patients, is remarkably shortened.There is little doubt that both individual and group experience have much to offer and the therapist could consider giving both experience to each subject. There has been much discussion but no research upon the order in which these experiences should be undergone. Priority must therefore be assigned on the basis of clinical judgment. It is the authors' point of view that, in general, it is advisable to have the individual experience first. The subject is less likely to become alarmed and withdrawn and he is more likely to persevere at investigating painful and unacceptable areas for the therapist, to inadvertently "help" too much and help the subject stabilize the experience without working though his difficulties.The individual session is so called because the subject alone takes the drug. However, this technique may involve a group. Hubbard (24) uses a method in which a group is selected to sit in on the session. The group lends support to the therapist as well and permits him greater freedom and more relaxation. When this technique is used the subject should have met each group member previously and should know which people will be present at the session. Such group members should have had experience with the drug. The numbers in such a group should probably not exceed four including the therapist. When the group becomes large the subject tends to feel like the lead player in a public execution.The method which has been outlined below may be adapted to either individual or group procedures. Although the empathic bond is less obvious in the individual session, the role of the therapist remains very much the same.The experiences induced by LSD and mescalin are opening vast new areas to the researcher and while such considerations may be felt to have only indirect bearing upon therapy, they should not be passed over.It is the view of the authors that the psychedelic drugs present the most potent tools for psychological research which have yet been discovered. Research possibilities range from simple perceptual experiments to highly complex empathic studies. The research value of the psychedelics stems from two major aspects of the experience which they induce.Firstly, when the experimenter takes the drug, he becomes aware of his own awareness. He becomes a witness to his own emotions, his own intellectual processes, and his own activity. He can examine the articulation of each of these upon the others and observe their relationship to his perception. Indeed, he can observe concept formation and learning going on from the inside.Secondly, when a group of investigators take the drug at the same time, they develop a closeness of relationship in terms of feeling which verges upon the telepathic. Thus scientists can develop shared introspection and can begin to evolve research techniques which will permit the comparison of emotional states-the measurement of emotion.Experimentation and study in these areas offer the hope that eventually they may permit a signal advance in psychological understanding. Early introspectionists were unable to provide shareable information as a basis for scientific inquiry. Only through limiting investigation to the behavior of organisms have we been able to arrive at some level of objectivity and shareability of results. Such an approach, however, confines psychology to the observation of activity and to a concept of man as the sum of his activity.Psychedelic research promises eventually to permit the investigator to get beyond the behavioral manifestations and into the area of the underlying motivation.One source of error in framing research in this area should be pointed out. The investigator should not try to study the drug effect in subjects until they have the experience fully stabilized. Ideally, an individual should have taken the drug a half a dozen times before he is used as a research subject. There is a basic confusion of purposes when one attempts to determine the drug effect upon various tasks during the first session. The administration of tests completely alters the experience in early sessions. What is assessed is the degree of confusion in a subject whose reality ties are loosened by the drug and further altered by the testing. The test administration and indeed the research set up in which he is a guinea-pig may alter the entire nature of perceptions. Almost universally, results obtained from testing under such circumstances will show decreased efficiency of one kind or another and there is no method of sorting extraneous situational effects from drug effects as such.However, once the subject has learned and practiced how to stabilize the experience, testing could be expected to reveal the extent of such phenomena as perceptual enhancement and empathic sensitization. It becomes a challenge to the researcher to seek out and classify the variables involved and to devise tests which will yield valid and, if possible, quantifiable measure of them.An outline of various areas in which research seems indicated is presented in Appendix C The setting in which the treatment session is to be conducted must be comfortable and quiet. Frequently the subject may feel like lying down. It is best to provide enough chesterfields, cots or beds so that each person who has had the drug has a place to stretch out comfortably.The place should be quiet, not only as far as the general noise level is concerned but particularly in terms of interruptions or intrusions of the outside world upon the experience. Worries about getting home for supper or getting certain work done are disruptive and all such interference should be reduced as much as possible. People coming into the room can cause the subject to become upset, particularly from the second to the eighth hour after he has taken the drug. If a group is to be used, all members should be present when the experience begins. Other intrusions should be ke