Psychedelics & Psychiatry

ASYLUM A Magazine for Democratic Psychiatry, Summer 1999, Volume 11 Number 3

Contacts:

Prof. F A Jenner, Manor Farm, Brightholmlee Lane, Wharncliffe Side, Sheffield, S35 0DB, UK.
Phone: 0114 286 2546
Fax: 0114 286 4591
e-mail: F.A.Jenner@sheffield.ac.uk

Phil Virden, 19 Edgware Road, York, YO1 4DG, UK.

This edition of ASYLUM edited by: Jon Atkinson, 13 Victoria Place, Bristol, BS3 3BP, UK.
Phone: 0117 963 9813 e-mail: atkinsonjon@yahoo.co.uk or atkinsonjon@hotmail.com

Editorial

ASYLUM felt uncertain about an issue on psychedelics. Whatever the true nature
of, for example, schizophrenia, we recognise how difficult it can be to distinguish
between drug-induced and other mental states presented to psychiatrists. The
enthusiastic and responsible writers who here draw attention to the mind-
widening potential of various substances do so while emphasising the dangers
and warning that their use should be properly supervised and in a supportive
environment.

With those thoughts in mind it was felt we should have the courage to look
openly and honestly at the issues raised. We are therefore indebted to Jon
Atkinson, the enthusiast who got his colleagues to put this edition together. The
layout is by Phil Virden, an original member of the collective which has persisted
for 12 years now. Phil has frequently played a central role.

ASYLUM is however still going through a difficult period and hoping a new group
will take over, as has been mentioned in previous editions. So far little has
happened, and there might be a flier saying more. Our next number will however
involve the old methods, and we have been able to engage three volunteers to
put it together - Peter Good, who produced the Age & Ageing edition, Peter
Speedwell and Colin Brady. It will be a general issue with no special theme.

ALEC JENNER

Notes on Contributors

Contents

Where To With Psychedelic Research ? Rick J. Strassman

Supporting Research with Psychedelics in the 90s Sylvia Thyssen

Can Drugs Be Used to Enhance the Psychotherapeutic Process? Lester Grinspoon &
James Bakalar

Ipomoea violacea Dale Pendell

Ketamine and Quantum Psychiatry Dr. Karl Jansen

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Beyond Psychotic Experience Stan Grof

Psychedelic Plants and Peoples Jon Atkinson

Hasheesh Psychosis Louise Theodosiou

Requesting Greater Empathy and Compassion Kevin Brunelle

Utopian Soup Dave Cunliffe

Tales of the Medicine Circle Anna Eleusis

Where to with psychedelic research ?

Rick J. Strassman, M.D.

Port Townsend, Washington, 98368 USA
e-mail: rstrassm@olypen.com

Psychedelic, or hallucinogenic, drugs are a unique family of chemicals. They

modify perception, thinking, emotions, and body sensation in various
combinations and to different degrees. The particular syndrome they produce is
unlike that caused by any other drugs. Psychedelics are found in nature: many
plants and fungi, and occasional animals, contain large enough quantities to
produce noticeable effects. Others are laboratory modifications of naturally found
compounds. Humans produce very small amounts of DMT and closely related
psychedelics. Duration of effects can range from minutes, for DMT, to nearly a
day, for ibogaine. Psilocybin, LSD, and mescaline last for 6-12 hours.

Psychedelics produce their effects by altering brain chemistry, primarily of

serotonin, an important neurotransmitter. The gap between brain chemistry and
subjective experience, however, remains enormous for psychedelics--this also is
true for all mind-altering drugs, including medications like Prozac.
Psychedelics have been used by non-literate societies from prehistoric times until
now. The extraordinary states of mind brought on by these drugs reserve them a
singular social role in personal and cultural maintenance and development.

In the 1940's and 1950's psychedelics were important in the development of

"biological psychiatry" or "psychopharmacology." This allowed psychiatry to
return to the fold of medicine, a victory for psychiatrists disillusioned with the
monopoly exerted by Freudian psychoanalysis.

Psychiatric researchers have used psychedelics to study mind-brain mechanisms,

as well as mimic certain features of naturally-occurring psychoses. They also used
psychedelics to improve psychotherapy for difficult-to-treat conditions--ranging
from neurosis to terminal illness. In treating death-related issues, psychiatry
ventured into pastoral realms.

Outside of psychiatric research, contemporary Western use is mostly recreational.

Few take psychedelics in a psychotherapeutic or religious setting. Relatively new
Latin American churches consume a beverage, ayahuasca, containing psychedelic
doses of DMT.

One of the main reasons I trained as a psychiatrist, in fact, even went to medical
school, was to learn more about psychedelic drugs. I hoped I might learn enough
to be able to give them in human research.

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I was exposed to both science fiction, and science, by my father, an electrical
engineer by training. He was hard-working and modest, but also drank
excessively and was prone to depression and violent outbursts. The altered state
caused by alcohol held a strong hold on him.

My own drug use in college, primarily marijuana and psychedelics, sealed my

interest in drug-induced alterations of consciousness. I felt, thought, and saw
things, and in ways, I never imagined possible. I learned to meditate, and worked
in a tissue culture laboratory, publishing on the developing central nervous
system. I took classes on dreams and hypnosis, physiological psychology, and
early Buddhism. Somehow the pineal gland seemed involved in the production of
naturally occurring psychedelic states--perhaps in produced DMT during non-drug
induced altered states of consciousness.

I became involved with a Buddhist organization for support and guidance. Many
of the monks' first sense of a religious dimension to their lives came while
undergoing a psychedelic experience. This was an important shared context for
my association with this community.

I found out about DMT in the late 1980's. This short-acting, naturally occurring
psychedelic seemed ideal for resuming human research with psychedelics. I
proposed to give various doses of DMT, to carefully characterize biological and
psychological effects. This is called a dose-response study. I suggested we enroll
normal volunteers, who had previous psychedelic drug experience.

I wanted to give DMT for several reasons. Some were quite conscious, some were
less conscious, and others took years later to see more clearly. However, the
thread that ran through the entire tapestry of this research was the following
question: Are psychedelics, in and of themselves, beneficial?

Was Tim Leary right, when he promoted widespread unsupervised use, in which
the inherent nature of the drug steers the experience toward a positive outcome?
Or was Aldous Huxley more correct, suggesting that a carefully selected, even
elite, group of individuals take psychedelics only rarely, and then only in carefully
supervised settings?

Resuming human psychedelic research after a nearly 20 year lapse in the field
was a huge challenge. My professional friends and colleagues in the psychedelic
field were not optimistic. At this time, MDMA, or Ecstasy, was just getting to be
known. Psychotherapists were using it in their practices. When looking for a way
to give MDMA with government approval, the current drug laws looked
impenetrable. Requests to the US Food and Drug Administration for permission to
administer MDMA to humans were delayed indefinitely while scientists tried to
understand its neurotoxic potential. My request to administer DMT might end in
the same interminable review process.

While gaining permission to give DMT at the University of New Mexico took nearly
two years, I actually found local, state, and federal agencies consistently helpful.
Lack of protocol was more the problem than were political or moral objections to
my proposal.
We obtained federal and private foundation financial support for this first and
subsequent studies. From 1990 to 1995, we gave 60 volunteers over 400 doses
of DMT. We also performed preliminary studies with psilocybin. We had
permission and drug to begin an LSD study, but did not start by the time I left
the University.

Pure DMT is usually smoked, but this was impractical on a hospital research unit.

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Injection into the shoulder muscle was not as fast as the smoked route, so we
chose to give DMT intravenously (IV). Onset of effects was usually within 2-3
heartbeats after the injection ended. The peak of the experience occurred within
90-120 seconds after that. Volunteers felt essentially normal by 20-30 minutes.
Studies occurred in the hospital, which turned out to be a significant source of
support for volunteers, especially those who believed they were dead or dying as
the rush of DMT effects swept over them.

Our style of supervising sessions was supportive, but not therapeutic. We did not
talk very much, and rarely offered interpretations of people's experiences,
preferring instead to let the volunteer work on things with only our prompting.
We provided an accepting, loving, concerned, but rather ascetic atmosphere. It
was almost a hybrid of my understanding of Buddhist and psychoanalytic
principles and practices.

DMT was physically safe, even in doses that produced temporary

unconsciousness. People varied in their sensitivity to DMT. The majority had
never been as affected by a psychedelic drug, including those with previous DMT
experience, as they were by their high dose DMT sessions. A smaller number
thought it was similarly or a little less intense than previous high dose psychedelic
experiences. A handful, maybe 2-3, had minimal psychological and physical
responses.

Many volunteers were deeply moved by high doses of DMT. It was difficult not to
be anxious while drug effects started, but if a volunteer was able to "let go"
during the first five or ten seconds, the session would be extraordinarily
enjoyable. Beautiful abstract geometric patterns might metamorphose into well-
defined images and visions. This eyes closed visual display included animals,
people, landscapes, and non-human but somehow "conscious entities."

Many volunteers likened a high dose of IV DMT to what they imagined death must
be like. The loss of bodily awareness, the separation of consciousness from the
body, seemed like the movement of the soul, spirit, or mind into non-material,
and perhaps spiritual, worlds. Those with this sort of experience often remarked
that they now were much less, if at all, afraid of death.

While our volunteers were not suffering from major mental illnesses, they, like all
of us, had personal problems. Most volunteers did at least some, and sometimes
a great deal of, psychological "work" on themselves. A high dose of DMT seems to
me to be essentially "traumatic;" that is, marked by an unexpected, sudden
onset, and overwhelming loss of control and integrity of self-identity. This may be
why those who had unresolved feelings about their own past traumatic
experiences were able to process those memories, if they were so inclined, in new
and deeper ways.

A surprisingly large number of people had contact with "entities." Not infrequently
there was a sense of communication between them and the volunteer.
Sometimes there would be references to the time and space the entities
inhabited. Themes of experimentation, such as "implants" and "adjustments," by
the beings on our volunteers reminded me of alien abduction stories. Their
"nearness" started me thinking about dark matter, which comprises about 95% of
the universe's mass.

A number of volunteers had what I believe were mystical, or religious,

experiences. They felt, saw, and understood the basic underlying nature of
reality. They found indescribable support and love within that experience. There
was a certainty that there is an unborn, undying, unchanging, and uncreated

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wellspring of existence. Occasional visits to, and correspondence with senior
clergy from, the Buddhist center helped focus my goals and thinking about these
phenomena.

What we were seeing at this stage was all I had hoped for, and more. People
were reaching the most altered states of consciousness they ever had
experienced. Even more gratifying was what seemed to be positive outcomes to
those altered states in the vast majority of cases. People were happier, more
relaxed, had gained insights into troubling circumstances, and accepted their lives
in new ways.

Further into the project, some difficulties developed, clinically and conceptually.
All but two of the original group of 13 volunteers were people I had known for a
number of years in different circles. Additional studies recruited people I did not
know. The implicit trust and familiarity that existed in the first, dose-response,
study was missing for subsequent ones. This made it more difficult for volunteers
to let go as readily into the DMT experience, and made me less certain about
their and my ability to manage their highly regressed condition.

In addition, I began to feel the constraints of the biomedical model that we used
to place our initial project. I believe this model was the only one that could have
succeeded in obtaining approval and funding. The initial project asked, "What
does DMT do?", and involved giving only DMT to volunteers.
To continue within that model, however, we needed to ask, "How does DMT
work?" To answer this, other drugs were combined with DMT so as to increase,
reduce, or otherwise modify its effects. In addition, more intrusive scanning and
imaging protocols were developed. It was difficult to recruit people for these
studies: they were not especially interested in having a modified DMT experience,
nor being so intruded upon by high technology. I also didn't like feeling as if I
needed to "sell" these projects to less than fully willing and interested potential
volunteers.

I was concerned that treating people like large laboratory rats might lead to them
feeling like ones. I drew the line at a study that would have injected volunteers
with radioactivity. The gap between ethics and science was too great.

IV DMT is best given in the hospital. Its effects on heart rate and blood pressure
are so great that I needed the reassurance provided by instantly available
resuscitation teams. However, our preliminary psilocybin work convinced me that
for the full experience to occur with this longer-acting drug, a non-hospital setting
was necessary. The local hospital ethics committee was concerned about safety.
The case of a volunteer who signed out of the hospital against medical advice,
just as psilocybin effects were beginning, made it even less likely we could give
this drug outside of the hospital. This also sharply reduced the number of
potential volunteers.

Adding to these issues, I was getting the answer to my question about the
intrinsically beneficial effects of psychedelics, and it was "No." As I followed our
volunteers over time, it was clear that there were not many profound or lasting
effects of the high dose DMT experience, in the absence of ongoing psychological
or spiritual work in their everyday lives. Of the triad: drug, set, and setting, I was
concluding that the most dispensable of the three in one's personal growth was
drug.

Personally, I began this research with great anticipation and enthusiasm.

However, as high dose DMT session after high dose DMT session followed one
after another over the months and years, I noticed a certain psychological,

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emotional, and spiritual exhaustion setting in. The reasons for this are complex,
but a major factor was the lack of a richer and more supportive context within
which this work could be conceptualized. I was giving drugs; neither more, nor
less.

If the drugs themselves, in our neutral clinical environment, had little long-term
benefit on our volunteers, what about the risks? I thought I was exceptionally
well-trained and prepared to do this sort of work. Despite this, we had many
short-term difficult situations with DMT. And hospital-based psilocybin sessions
seemed a set-up for problems, especially paranoid reactions.

How to modify the research setting so as return to the roots of my original

interest in them? That is, to minimize adverse effects, and maximize potential
benefits. I saw a conflict between the best setting, and the requirements for
research. This conflict is over the need for data. We wanted something from our
volunteers while they were in a psychedelic state.

I also saw longer-range implications of resuming psychiatric research with

psychedelics. What if there were to be a wave of similar biomedical psychiatric
research with them? These studies would refer to mine as precedent, and would
likely be performed by scientists less familiar with, and supportive of, the
complex and unusual states brought on by these drugs. I felt as if I had opened a
Pandora's box, and I wondered if I could close it.
The issues raised by this research contributed to an over twenty-year relationship
with my Buddhist community straining and rupturing. An article I wrote on DMT
and "enlightenment," DMT's role in death and dying, and a suggestion to combine
meditation and psychedelics in religious training, spurred a hasty withdrawal of
support. Senior priests who now had positions of authority within the religious
order could no longer acknowledge their indebtedness to the psychedelic
experience. Holiness superseded the truth.

The pressures showed themselves in yet another form. My wife fell ill and
required emergency surgery.

Things seemed to be dangerously accelerating. The momentum of the work was

too great to modify it mid-stream. I decided to stop.

Over three years have passed since I gave anyone DMT or psilocybin. The drugs
are stored in a secure site in North Carolina. I send in annual reports to the
government, requesting that the files for the drugs be kept on hold, but not
closed.

I do not plan to return to this work any time soon. I think the psychiatric research
setting is not an especially safe nor effective way to give these drugs. I do not
know the best setting.

I am impressed with the little I know about culturally sanctioned and constrained
ritual using long-acting psychedelic plants. However, there are no contemporary
Western models for this kind of use.

I think the dominant Western religions should take a very serious interest in
developing such rituals. I also believe that any institutionalized religion runs the
risk of dogmatizing experience and abusing power. I think clinical psychiatry can
join forces with an established religious tradition in this endeavor. The
partnership could provide a more egalitarian and "peer-reviewed" view of reality
and relationships. And perhaps the best of both disciplines could be brought to

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bear on the pressing issue of how to best utilize these powerful and potentially
beneficial drugs.

Supporting Research with Psychedelics in the 90s:

A look at the Multidisciplinary Association for Psychedelic
Studies

Sylvia Thyssen
MAPS Director of Communications

Recently I came across something I wrote for the MAPS Newsletter in 1994:

Though honestly what I first found compelling about MAPS was its 19-syllable
name, what has kept me committed is its multidisciplinary imperative... Ignore
the interplay of culture, medicine and politics, and you're missing the point. This
is why I am here ! I look forward to working with you.

Surprisingly, I could have written that today in 1999. And now I could be more
specific and point to the incredible potential of MDMA-assisted therapy. So many
people whom we come across refer to their MDMA experiences as a touchstone
for their personal growth and deep healing. In fact, MAPS was founded in
response to the scheduling of MDMA. Whatever projects we support and promote,
the foundation of our work is the prospect of making this drug available in
sanctioned contexts.

What advantages do we see between socially sanctioned use of MDMA,

(and other drugs,) and use as it happens now at raves and in private
homes?

In a world where MDMA is illegal, only people who have access to the illegal
market, and who can accept doing something that's against the law, have access
to it. This prevents a huge number of other people who would greatly benefit
from it from using it, or even knowing about it. If you are a person today in the
late 90s who understands how MDMA can allow getting in touch with difficult
emotions and beginning to accept them, how it can facilitate the expression of
feelings, how it can make you feel really good, then you can easily see how it
would be great for people in a variety of life situations, especially people who are
facing death from an illness. Think about the older man who is dying of cancer
and who has never been able to really talk with his family. What if he and his wife
and children could do MDMA together? Or the adult woman who is a survivor of
rape and who is struggling with feelings of anger and guilt? If MDMA were legal
for therapy then she maybe begin to work through some of those issues, where
before she was just blocked.

It is such a shame that some of the people who would most profoundly benefit
from the therapeutic aspects of MDMA are the ones who have the least inclination
to do it, simply because it's illegal. We often are contacted by people who have a
family member who is elderly and dying and they want to be able to give that
person MDMA. Many personal accounts indicate that MDMA can help a person
accept their illness and be less afraid. This often diminishes or eliminates the
psychological component of the pain they are feeling. If they have cancer and are
in a lot of pain, some of the physical pain comes from an organic cause, (such as
a tumor putting pressure on nerves,) and some of it comes from the mind
expressing fear somatically. MDMA therapy may not even add one day to a
person's life, but if their remaining days can be spent in peace, with a sense of

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acceptance, the dying process is greatly improved for both that person and their
family. It is tragic that something that can be so useful for improving the quality
of the last remaining days of a person's life is totally illegal. And the rate at which
we can do research progresses so slowly that it will be a long while still until the
situation changes. Fortunately, there are many people who support this goal and
want research to proceed, if not for their own generation's benefit, then for that
of their children.

Another advantage of a socially sanctioned MDMA is the potential for

homogeneity of product. Right now, the illegality makes it a seller's market. This
results in a huge number of Ecstasy pills that contain little or no MDMA. Precise
information about dosage, combined with widely available harm reduction
information, would cut down on potential emergency room visits. And if a person
did have an adverse reaction to MDMA anyway, then there would not be the fear
of risking legal problems for seeking prompt medical attention. To sum up, it
would be even safer to do MDMA if there were socially sanctioned uses.

If MAPS achieved its goal of making MDMA into a drug available by prescription,
then there would be more research, and we would learn more things more quickly
about these unique substances. Programs could be set up to train therapists in
facilitating MDMA therapy sessions, and people doing it in this way would get
even more out of the experience.

On the flip side, if MDMA becomes available by prescription, it will be regulated,

and unless the system for regulating it and training therapists is carefully thought
out, it could become yet another bureaucratic morass. Rick Doblin, the founder of
MAPS, is writing his doctoral dissertation on just this topic. To envision today a
working system for MDMA's eventual availability allows us to anticipate difficulties
and develop an efficient process.

The use of MDMA at raves reflects other aspects of drugs that deserve a fair
chance: the celebratory and spiritual. The religious underpinnings of Western
society vaguely frowns upon ecstatic celebration and definitely frowns on certain
classes of intoxicants. Yet were we allowed to follow the development of rave
culture rather than pathologizing it, we may learn a few things. In his writing
about spiritual uses of MDMA in traditional religion, Nicholas Saunders describes
taking a Rinzai Zen monk to a rave, where he took some MDMA. Previously he
had only taken it while meditating. When it took effect, he glowed and
announced, "This is meditation!" What if we understood this more? Surely this
effect of MDMA in combination of ecstatic dance is not less valid that MDMA in the
context of therapy -- it's just a use that does not fit as readily into our society's
current categories of human activity.

And who is to say that an altered state of consciousness can't in itself have a
therapeutic effect? It comes down to challenging current ways in which drug use
is described and categorized within our culture. It might be politically expedient
to break things down into "good" and "bad" drugs or "good" and "bad" uses, but
it is far more honest (and difficult!) to redefine things. The "therapeutic use" of
MDMA and psychedelics may be understand more readily within our current
medical model, yet their use outside of "therapy" cannot be dismissed. Consider
Alcoholics Anonymous, a conservative institution and model for many treatment
programs. Its own founder, Bill Wilson, had positive things to say about LSD.
After trying it, he recognized that LSD could bring an alcoholic to an awareness of
the higher power to which AA holds that one must surrender one's will.

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We get into messy waters here, where "God in a pill" flies in the face of currently
accepted ideas about medicines. The preparation and integration of the
psychedelic experience are as important as the effect of the drug, that doesn't fit
very well, either. Yet it's exciting, too, because as much as they may try,
governmental agencies cannot just dismiss the vast amounts of clinical research
that was done in the 50s and 60s. It's just a question of resuscitating that
research.

What ways are there of increasing it's therapeutic potential?

First of all, having a therapist present who is knowledgeable about how to

maximize an MDMA session is really a great way to do it. If a person were to do
MDMA with therapeutic intent without the presence of a therapist, they could do it
somewhere without interruptions, with one or several trusted friends, and with a
pill known to be 125 mg with the possibility of boosting after an hour and a half,
to lengthen the time of the peak. A really great primer for this is the book The
Secret Chief. The books of the Shulgins and Nicholas Saunders are also
invaluable.

Because it's so difficult to do research, we can only look back to the period before
MDMA was scheduled, to find other ways to increase MDMA's therapeutic
potential. For instance, people have done MDMA in conjunction with LSD or
another psychedelic, for the synergistic effect. We can only speculate on the
potential combinations of MDMA and other drugs or non-drug methods (body
work, guided imagery, EMDR, hypnosis, yoga, etc.).

What kinds of use of MDMA are unacceptable or dangerous?

First of all, one of the golden rules of psychoactive drugs, first proposed by Leary,
is not to dose someone without their knowledge or against their wishes. That is
unethical. Otherwise, the regular contraindications, or ways that it is not
advisable to do MDMA, are in Nicholas Saunders' books, and on the Internet.
They include if you have heart problems or high blood pressure, if you have a
seizure disorder, or if you are drinking alcohol or taking amphetamine, or if you
are operating a motor vehicle. It is also not recommended to take MDMA where
you don't feel emotionally or physically safe. Other common sense precautions
related to intoxicants are just as relevant for MDMA, such as, ‘you have a
problem if your use is hurting you or other people.’

Are there any social developments related to psychedelics we hope to

see happening beyond research?

In an ideal world where MDMA and psychedelics have become available in the
context of therapy, research with them shouldn't stop, it should be increased!
Today the status of these drugs is such that we can only do studies with them if
we are looking at potential risks, or if we are looking for their utility in the
treatment of a specific disorder or symptom. The ultimate use for psychedelics,
the vision which it seems most people have for them today, is how can they
make healthy people even healthier, how can they help us learn more about our
minds, and how can they further illuminate the "big mystery" of life. So, today we
research MDMA and psychedelics in cancer patients and alcoholics; tomorrow we
research their potential for stimulating creativity, understanding the mind and
helping us achieve more happiness. This is an idealistic goal. We really may never
reach it in our lifetimes. But it is a dream kept alive over many decades in the
Western world by people who have discovered MDMA, LSD, psilocybin and other
drugs.

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Another social development which we are keen on and attempting to stimulate, is
the development of saner and more effective drug abuse education programs for
school-age children and teens. This largely involves redefining "drug use" and
developing curricula about risk-taking behavior that is based on fact and not on
fear. In the MAPS Bulletin, we publish personal accounts of families who value
psychedelics. We have had these articles in past issues: What Do We Tell The
Kids?, Stumbling on his stash (how a mother and father handle their child's wish
to experiment with marijuana), The Rite of Passage: A family's perspective on the
use of MDMA, and Youths and Entheogen Use - A Modern Rite of Passage? Just
recently, we funded a pilot study called The Second Generation Project. This
study focuses on the experiences of children -- mainly teenagers and young
adults -- whose parents value psychedelics. In general the children have grown
up in an open and honest environment concerning their parents' drug use. A
number of the parents ceremonially initiated their children into their first
psychedelic journey. We can learn from the experiences of these families in order
to teach future generations to have less fear, and more communication, when
faced with questions about drugs. If there is more communication then the
subject becomes less taboo, and it is easier to deal with potential difficulties as
they come up.

In his books, Saunders quotes a Soto Zen monk and teacher in an analogy that
bears repeating:

'It is like a climber walking in the mountains who is lost in the fog and unable to
see the peak he has set out to climb. All of a sudden the fog clears and he
experiences the reality of the peak, and gains a sense of direction. Even though
the fog moves in again, and it's still a long hard climb, this glimpse is usually an
enormous help and encouragement.'

This is a lovely way to describe MDMA's effect to a person who has never taken it.
If more people grew to understand this type of drug use, so different from the
sheer abuse that non-drug users imagine drug use is about, then maybe we could
begin to communicate more effectively about it.

Ultimately, a society that has legal contexts for psychedelic use could be one that
has more and more people honoring the interconnectedness of all people and all
of nature, developing more and more novel ways of meeting life's challenges, and
finding better ways to face death. Until that day, we can continue to ask
questions and MAPS can continue to work within the system as much as it can.

Here There Be Dragons

Just six hundred years ago, maps of the known world contained the inscription,
“Here there be dragons,” indicating terra incognita about which we knew nothing
and hence feared to tread. Today we find this viewpoint exceedingly quaint. What
changed? Knowledge and information was gathered by souls brave enough to
challenge orthodoxy and venture into those uncharted realms inhabited by
dragons. They returned with first-hand information that refuted “common
knowledge” and led to a revised worldview.

Today, knowledge of our physical environment has expanded beyond belief.

Regarding our inner environment, however, many still fear that ‘here there be
dragons.” Replacing fear with understanding will require the use of every tool
available, including psychedelic substances, to increase our knowledge of the
internal terrain.

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The Multidisciplinary Association for Psychedelic Studies (MAPS) is a membership-
based non-profit research and educational organization. We assist scientists to
design, fund, obtain approval for and report on studies into the healing and
spiritual potentials of psychedelic drugs and marijuana.

If you can even faintly imagine a cultural reintegration of the use of psychedelics
and the states of mind they engender, please join MAPS in supporting the
expansion of scientific knowledge in this area. Progress is possible with the
support of individuals who care enough to take individual and collective action.

Fore more information, please contact

MAPS, 2105 Robinson Avenue, Sarasota, FL 34232 USA
Tel: (00 1) 941 924 6277
Fax: (00 1) 941 924 6265
E-mail: info@maps.org
Web: http://www.maps.org

Can Drugs Be Used to Enhance the Psychotherapeutic

Process?

Lester Grinspoon, MD & James B Bakalar

(First printed in American Journal of Psychotherapy vol.XL, no.3: 393-404, 1986, as part of a longer article
which extends into consideration of ecstasy (MDMA) in particular as a tool for therapy - “Many MDMA
patients have claimed a lasting improvement in their capacity for communication with others”)

The drug revolution that began 30 years ago has transformed psychiatry, but it
has left little imprint on psychotherapeutic procedures themselves. We have used
psychiatric drugs as adjuncts to psychotherapy, and psychotherapy as adjunct to
psychiatric drugs. But efforts to make use of drugs directly to enhance the
process of psychotherapy--diagnosing the problem, enhancing the therapeutic
alliance, facilitating the production of memories, fantasies, and insights--have
been very limited. In preindustrial cultures, however, there is an ancient tradition
in which drugs are used to enhance a process of psychotherapeutic healing; and
from 1950 to the mid-1960s, there were 15 years of experimentation in Europe
and the United States--an episode in the history of psychiatry that is now almost
forgotten. The drugs used in these therapeutic efforts were psychedelic or
hallucinogenic substances, both natural and synthetic.

Ever since experimentation with psychedelic plants began, some users have
maintained that the experience could be useful for self exploration, religious
insight, or relief of neurotic and somatic symptoms. The plants have been used
for thousands of years in a number of cultures for healing and in magical and
religious rites. The rite is often conducted by a shaman or professional healer.
This religious and therapeutic use of psychedelic plants continues in the Amazon
Basin, in southwestern Mexico (where psychedelic mushrooms are used in healing
rites) and in the Native American church services of Indians in the western United
States, which make use of the peyote cactus. The peyote ritual has been
proposed as a possible adjunct to the treatment of alcoholism among American
Indians.

Psychedelics were also used extensively in psychotherapy as experimental drugs

in Europe and the United States for almost two decades. A large number of
clinical papers and several dozen books on psychedelic drug therapy were
published. They were employed for a wide variety of problems including
alcoholism, obsessional neurosis, and sociopathy. They were also used to ease
the process of dying. Complications and dangers were generally reported to be

11
minimal. It soon became clear that with proper screening, preparation, and
supervision, it was possible to minimize the danger of adverse reactions.

Beginning in the early 1960s, as illicit use of LSD and other psychedelic drugs
increased, it became difficult to obtain the drugs for psychiatric research, and
professional interest declined. Those two decades of psychedelic research may
someday have to be written off as a mistake that has only historical interest, but
it might be wiser to see if something cannot be salvaged from them.

One reason for the therapeutic interest in psychedelic drugs was the belief of
some experimental subjects that reduced their feelings of guilt, made them less
depressed and anxious, and more self accepting, tolerant, or sensually alert.
There was also interest in making therapeutic use of the powerful psychedelic
experiences of regression, abreaction, intense transference, and symbolic drama
to improve or speed up psychodynamic psychotherapy. Two basic kinds of
therapy emerged, one aimed at exploring the psychodynamic unconscious and
the other making use of a mystical or conversion experience. The first type,
psycholitic (literally, mind-loosening) therapy, required small doses and several
or even many sessions with LSD, mescaline, or psilocybin. It was used mainly for
neurotic and psychosomatic disorders. Psychedelic therapy, the second type,
involved the use of a large dose (200 micrograms of LSD or more) in a single
session; it was thought to be potentially helpful in reforming alcoholics and
criminals as well as improving the lives of normal people. In practice, many
combinations, variations, and special applications with some features of both
psycholitic and psychedelic therapy were adopted.

In psycholitic therapy patients might be asked to concentrate on interpretation of

drug induce visions, on symbolic psychodrama, on regression with the
psychotherapist as parent surrogate, or in discharge of tension and physical
activity. Eyeshades, photographs, and other props were often used. Music played
an important part in many forms of this therapy. Patients usually remain
intellectually alert and remember the experience vividly. They also become
acutely aware of ego defenses such as projection, denial and displacement as
they catch themselves in the act of using them.
Case histories can always be questioned as anecdotal. Placebo effects,
spontaneous recovery, special and prolonged devotion by the therapist, and the
therapist’s and patient’s biases in judging improvement must be considered. The
most serious deficiencies in psychedelic drug studies were absence of controls
and inadequate follow-up; in addition, psychedelic drug effects are so striking
that it is difficult to design a double blind study. No form of psychotherapy for
neurotics has ever been able to justify itself under stringent controls, and
psychedelic drug therapy is no exception. Furthermore, psychiatrists never
agreed about the details; for example, should the emphasis be on catharsis or on
working through a transference attachment, and how much therapy is necessary
in the intervals between psychedelic drug treatments? Because of the complexity
to these drugs’ effects, there are no simple answers to these questions. Although
the treatments sometimes seem to produce substantial improvement, no reliable
formula for success could be derived from the results. In these respects, it is
true, psychedelic drug therapy seems to be in no worse position than most other
forms of psychotherapy.

Psychedelic therapy for alcoholism was based on the assumption that one
overwhelming experience could change the self-destructive drinking habits of a
lifetime, and the hope that psychedelic drugs could produce such an experience.

The question is whether the powerful effects of psychedelic drugs on alcoholics

can be reliably translated into enduring change. Early studies reported dazzling

12
success--up to 50 percent of severe chronic alcoholics recovered and were sober
a year or two later. But later and better controlled studies were disappointing.
The problem is that many alcoholics improve, at least temporarily, after any
treatment because excessive drinking is often sporadic and periodic relapses are
common. An alcoholic who arrives at a clinic is probably at a low point in the
cycle and has nowhere to go but up. But it would be wrong to suppose that a
psychedelic experience could never be a turning point in the life of an alcoholic.
As William James said, “Religiomania is the best cure for dipsomania.”
Unfortunately these experiences have the same limitations as religious
conversions. Their authentic emotional power is not a guarantee against
backsliding when the old frustrations, limitations, and emotional distress have to
be faced in everyday life. Even when the experience does seem to have lasting
effects, it might have been merely a symptom of readiness to change rather than
a cause of change.

Still, there is no proven treatment for alcoholism, and it may not make sense to
give up entirely on anything that has possibilities. In the religious ceremonies of
the Native American Church, periodic uses of high doses of mescaline in the form
of peyote is regarded as, among other things, part of a treatment for alcoholism.
Both the Indians themselves and outside researchers often contend that those
who participate in the peyote ritual are more likely to abstain from alcohol.
Peyote sustains the ritual and religious principles of the community of believers,
and these sometimes confirm and support an individual commitment to give up
alcohol. Another significant point is that controlled studies of psychedelic drug
treatment of alcoholics indicate some improvement lasting for several weeks to
several months. If some way could be found to take psychotherapeutic advantage
of this improvement, it might be helpful in the treatment of alcoholics.

Psychedelic drugs have also been used to ease the pain, anxiety, and depression
of the dying. Beginning in 1965, the experiment of providing a psychedelic
experience for the dying was pursued at Spring Grove State Hospital in Maryland
and later at the Maryland Psychiatric Research Institute. When patients received
LSD or another psychedelic drug, dipropyltyptamine (DPT), after appropriate
preparation, about one-third improved “dramatically,” one-third improved
“moderately,” and one-third were unchanged by the criteria of reduced tension,
depression, pain, and fear of death. The drug session was designed as a part of a
process of reconciliation; reconciliation with one’s past, one’s family, and one’s
human limitations. These studies employed no control groups, so it is not possible
to separate with certainty the effects of the drugs from those of the therapeutic
arrangements that were part of the treatment. But the case histories reported in
this work are impressive, and it would seem worthwhile to renew the research.

When a new kind of therapy is introduce, especially a new psychoactive drug,

there is often a pattern of spectacular success and enormous enthusiasm followed
by disillusionment. But the rise and decline of psychedelic drug therapy were
somewhat unusual. From the 1960s on, the revolutionary pronouncements and
religious fervor of the nonmedical advocates of psychedelic drugs began to evoke
hostile incredulity rather than simply the natural skeptical response to
extravagant backed mainly by intense subjective experiences. Twenty years after
their introduction, psychedelics became pariah drugs, scorned by most
psychiatrists and banned by the law.

A generation of physicians and scientists has grown up without the opportunity to

pursue human research with these drugs, and the financial and administrative
obstacles remain serious. These drugs should not be regarded as a panacea or as
entirely worthless and extraordinarily dangerous. If the therapeutic results have
been inconsistent, that is partly because of the complexity of psychedelic drug

13
effects. For the same reason we may not yet have had enough time to sort out
the best uses of these drugs. The fundamental aim here is not chemotherapy,
and the drugs are not primarily symptom-relievers but catalysts. Like
psychotherapy, they depend for their usefulness on the sensitivity and the talent
of the therapist who employs them.

Despite the years of neglect, interest persists among some psychologists and
psychiatrists. The following letter was sent to us in 1977 by Hanscarl Leuner of
the University of Gottingen:

Though in several European countries therapists in this field could apply for
licenses to continue using the drugs, the government authorities over the years
started to make things difficult ... I myself was convinced that science does not
depend on ideologies. This seems to be in error. The continuation of psycholitic
therapy during the last years has led us to new techniques and conceptions. The
results in practical therapy are even more convincing than before. We would not
like to stop doing psycholitic therapy. Optimistically, I hope that in time we can
publish these results. For so many patients there is a tremendous need for deep
probing and intensity in psychotherapy which psycholitic and related therapies
could fill.
It is a misunderstanding to consider psychedelic drug therapy a form of
chemotherapy, which must be regarded in the same way as prescribing lithium or
phenothiazines. The claims of psychedelic drug therapy are subject to the same
doubts as those of psychodynamic and other forms of psychotherapy. The
mixture of mystical and transcendental claims with therapeutic ones is another
aspect of psychedelic drug therapy troubling to our culture. Preindustrial cultures
who make use of psychedelic plants were willing to tolerate more ambiguity in
this matter, regarding the psychedelic healing process as both religious and
medical.

But attitudes may be changing. A growing literature on the ideas and techniques
shared by primitive shamans, Eastern spiritual teachers and modern psychiatrists
is emerging. They remind us that the word “cure” means both treatment for
disease and care of souls, and that all psychotherapy relying on insight in some
ways resembles a conversion; Jung once compared psychoanalysis itself to an
initiation rite.

Our society still has not found a way to be at ease with psychedelic drugs, but the
scientific and medical communities should eventually acknowledge their potential,
devise new and better questions to ask, and give psychedelic research another
chance.

Ipomoea violacea : from PHARMAKO/GNOSIS

Dale Pendell

Common names: Tlitliltzin. Heavenly Blue. Pearly Gates. Morning glory.

Ololiuhqui, sometimes applied to morning glory, is the Nahuatl word for the seeds
of Turbina corymbosa (Rivea corymbosa), a closely related plant.

Part Used:
The seeds

Chemistry:
Lysergic acid amide ("LSA"). By chemical extension, if the two protons clinging to

14
the nitrogen atom are replaced by ethyl groups, we have d-lysergic acid
diethylamide ("LSD"). LSD has not yet been found in a plant.

[structural formulae for LSA and LSD appear here]

Besides ergine (d-lysergic acid amide), ololiuhqui and other psychoactive morning
glories contain isolysergic acid amide and half a dozen other closely related
compounds of various toxicities, including ergometrine (ergonovine), a powerful
uterotonic.

Ergine, or LSA, is about one-twentieth the potency of LSD.

Effects:
Albert Hofmann claimed, after self-experiment, that LSA was a narcotic-sedative
as much as a hallucinogen.

moving and flowing--

dream/waking
blur.
Or are we dreaming
always?

Colors. Plants, ready to talk. Me, just as I am. Act of faith.

The Ally:
Much esteemed by a few aficionados. Most find LSD both more reliable and more
pleasant. The plant freaks smile to themselves and gently shake their heads.

Not the same. Not the same.

The indigenous people of Oaxaca use various species of Ipomoea, as well as

ololiuhqui, for divination and curing, exactly as had the Aztecs five hundred years
before them. Gordon Wasson wrote that ololiuhqui and tlitliltzin are more widely
used today in Mesoamerica than teonanacatl, the sacred mushroom.

Many mesoamerican Indians believe that the tlitliltzin speaks so clearly and
plainly that the services of a shaman are unnecessary. Unlike the mushrooms,
the seeds are usually given to one person at a time.

The Plant:
Ololiuhqui, "the round ones," in Nahuatl. Sometimes coaxihuitl, or coatl-
xoxouhqui:
Snake plant, the green snake plant.

The Ally:
Some claim it to be profound.

Effects:
10:15 pm.
Drank a cold water infusion of Heavenly Blue. Not bad tasting. Herbal and wild,
but not bitter.

The Plant:
Xtabentum: "precious stone cord," Mayan.
Tlitliltzin: "the sacred black ones,"

15
Mazatec: na-so-le-na: "flower-her-mother."
Mayans call morning glory xtontikin, "dry penis."

Effects:
10:40 pm.
Took a shower and a bath. Soaking in the tub felt good. Closed my eyes. A weird
and penetrating sound wormed into my thoughts. Opened my eyes: it was the
faucet, leaking. First alert.

Standing, bending, towelling off brings some slight nausea. Some anxiety.
But I was even more anxious before I started. Mainly I just want to lie down. If I
had a uterus, would I be cramping? Maybe. Tightness in the gut.

Closing eyes, thoughts/mental events are loud, amplified. Try to keep my eyes
slightly open, follow my breathing.

The Plant:
In 1629, Hernando Ruiz de Alarcon described the use of ololiuhqui in his Treatse
on the Heathen Superstitions. Alarcon had been brought to the attention of the
Inquisition because he was torturing and conducting his own autos-da-fé, matters
of Inquisitional jurisdiction. The investigation that followed found that his error
had been made out of ignorance rather than malice, and his zeal was recognized
and rewarded with an eccesiastical judgeship in the Holy Office.

The religious character of the War on Drugs has been obfuscated as much as
possible. Only when the speciousness of the arguments of public health and crime
are refuted by logic, science, and sociological research do the warriors sometimes
reveal their true beliefs and prejudice: i.e. that the use of entheogenic plants is a
threat to civilization itself, by which they mean their religious hegemony. Willfully
exploring self and consciousness with the aid of plants is considered worse than
mere criminality, it is seen as heresy and blasphemy, as an attack on the Holy
values of the true church of Western rationalistic materialism.

And it is punished accordingly. Twenty-year-olds in their tie-dyeds, arrested at

Grateful Dead shows for possessing LSD, are often given longer prison terms than
embezzlers or killers.

Almost all of them [the Indians] hold that the ololiuhqui is a divine
thing . . . And with the same veneration they drink the said seed,
shutting themselves in those places like one who was in the
sanctasanctorum, with many other superstitions. And the veneration with
which these barbarous people revere the seed is so excessive that part
of their devotions include washing and sweeping even those places where
the bushes are found which produce them, which are some heavy vines,
even though they are in the wilderness and thickets.

--Hernando Ruiz de Alarcon, 1629

The War on Drugs was launched by the European invaders shortly after their
arrival in the New World. Possession of the sacred seeds was made a crime, and
Alarcon, like other ecclesiastical authorities, began a campaign of uprooting and
burning the vines wherever he could find them, along with those who loved them.
The Holy Inquisition itself was formally inaugurated in 1571, set up to ferret out
lapsed maranos, sephardic Jews who had feigned conversion to Christianity, in
addition to exterminating heresy among the Indians. The Inquisition specifically
ordered the prosecution of divination by hallucinogenic plants.

16
Since preaching has not sufficed, rigorous punishment is needed,
because, being--as they are--children of terror, it may be that
punishment may accomplish what reason has not been sufficient to,
since the Apostle said, compelle intrare. ["Compel them to
come in." Luke 14:23.]

--Hernando Ruiz de Alarcon

A war of sacraments.

Wine was the blood of Christ, but the Aztecs had their own sacred plants:
teonanacatl, "God's flesh," the sacred mushroom, and teotlacualli, "food of God,"
an unguent prepared with ololiuhqui.

The sorcerers persuade the people with such ease that they find it
unnecessary to use menaces or torture or threaten them with the wheel
of blades of Saint Catherine or the gridiron of Saint Lawrence.

--Fray Diego Duran

Alarcon complained that in spite of severe punishments, the Indians seemed to

be more concerned with maintaining the good will of the ololiuhqui than with
escaping the fury of the Inquisition.

aco nechtlahueliz: let it not be that he become angry.

Effects:
10:50 pm.

Drifting.
Phantoms. Truths. Insights. Connections. Poems.
River of dreaming.

"There aren't any good things in those values."

Values/thoughts. Dharmas. All are ill. Dukkha. The Way of Makyo is the Path of
Ill. Up to your armpits in samsara.

Go further.

11:00.
Ring? Or ring in the mind? Which telephone? Either way it wakes me up.
Thoughts, jokes, all flowing down the river and over the falls.
Who is guest and who is host? We dine together. The guests pay their way
by talking and telling stories. But the banquet is interrupted.

(a pebble striking bamboo . . .)

Who knocks? Serres's parasite. Alcibiades banging at the door.

The gods come to visit.

The Poison:
Don't take It unless you want to know everything simultaneously,
hell & heaven, terror & ecstasy --

17
When I tell you to try it it is afterwards in a room with solid
furniture, remember that.

--Alden Van Buskirk, "Lami in Oakland"

Matters of State and Liberty:

Alarcon's program was the extirpation of heresy, sycretism, and the works of the
Devil. He feared divination, and he feared the resemblances of Mesoamerican
religion to his own. He feared the easy way that the Indians could assimilate
Catholicism without denying the older gods of their own land. He feared the little
carved animals and figures, the "idols." He found them hidden in piles of rocks at
passes and crossroads. He found them hidden in churches where the people
would place their offerings of copal. He even found one that had been built into
the base of a large cross (after the cross had been struck by lightning). And he
found them in the specially woven baskets that hid the ololiuhqui.

The special baskets contained ritual objects along with the seeds: a small carving,
a piece of incense, pieces of embroidery, "little girls' dresses, and things of this
nature." An ololiuhqui basket was passed on to the owner's descendents.
Sometimes the basket was placed inside of a larger, carved wooden box.

Alarcon's advice for catching the heretics:

1. Arrest the delinquent outside of the village, so that he cannot take precautions
or warn others.
2. Place guards at his house and place his nearest relatives under guard.
3. Don't trust the local authorities as "usually there is no one who is faithful."
4. The judge should seize the evidence in person, as the delinquent Indian will
often swallow the idol if
it comes into his reach "even though he is already convicted and knows that if he
swallows it he will
surely die."
5. In searching a house be diligent, examining even old and dirty pots.

. . . while it did not actually show up in the house, she had an old,
dirty pot covered with a potsherd in the courtyard of the house. The
black pot was full up to the brim with ololiuhqui, and in the middle
of it, in the depth of the pot, wrapped in a rag, was the little idol,
which was a little black frog of stone.

--Hernando Ruiz de Alarcon

As Moses said,

I the Lord thy God am a jealous God.

The Ally:
Tlitliltzin is above all a plant of divination. Divination was its principal use by the
Aztecs, as it is in Mesoamerica still today. Alarcon reported, with some
indignation, that some of the Aztec doctors "practice ololiuhqui drinking as a
profession."

Whether it is the doctor or another person in his place . . . he

closes himself up alone in a room, which usually is his oratory, where
no one is to enter throughout all the time that the consultation lasts,
which is for as long as the consultant is out of his mind, for then

18
they believe the ololiuhqui or peyote is revealing to them that which
they want to know.

--Hernando Ruiz de Alarcon

Alarcon distinguishes between the false results of divination, "just a

representation of the imagination caused by the conversation," and the true
results, which are revealed by the Devil.

Despite Mathias having been selected by the eleven as Judas's successor by the
casting of lots, the Church inveighed against divination of any form. Fortuna had
been mostly disassembled by Chance-- but the Devil, the one who could speak
truth, was a far deadlier foe.

The Devil usually mixes something of our holy religion in those

apparitions of his so that he whitewashes his malice and lends a
color of goodness to such a great evil.

--Hernando Ruiz de Alarcon

Effects:
11:15.
I'm fairly comfortable. Don't want to get up. Some belching. Dog sleeping upside
down with all his feet splayed out into the air: from me? Fluidity begins. Formerly
distinct partitions between categories, perceptions, and thoughts blur, visually.

Ripple in a clear lake: grass and sedges rippled beneath.

In the mountains at a lake, wave patterns on the transparent surface of the

water. Sunrise. Birds darting over the lake like bats, feeding. Blue.

Grasses on the bottom of the lake and his mind fell through.

Out across the lake the breeze breaks up the glassy surface into alternating
patches of smooth and rippled water, like pages, the rippled areas like an ancient
script.

Cursive runes. Stelae.

An oasis on the Silk Road. Takla Makan.

The letters and words of an eidetic alphabet. The script of knowledge.

WE WILL SHOW YOU HOW TO READ OUR LANGUAGE. YOU MAY ASK US ANY
QUESTION.

The world as poison. This world. Of all possible and parallel and coexisting
universes, this particular one: the one in which stones are heavy and thoughts
light. "The world is a drug." Not a metaphor but a tautology.

"What are the poisons?"

WE ARE THE POISONS.

All dharmas are poisons. Stone in the mind, goose in a bottle.

19
"What is seeming and what is real?"

WE WHO SHOW YOU THE REAL ARE SEEMING.

The light on the water supported his weight. In the middle of the
lake he thrust his hand into the water.

Curings are performed at night, and quiet is important. Sometimes the doctor
speaks into the patient's ear, reminding him of his questions. To an outside
observer it may appear that the person is talking to himself.

Sometimes the ally speaks in visions rather than in voices. If the visions are
hellish, it is said to be because a taboo has been broken. The remedy is to eat
chilies and salt and to go to sleep.

Effects:
11:30.
(hey, he still hasn't moved up off of the bed)
(yeah, what's he doing down there?)

The words are sinking. The clock is running down.

(Yes. That means you are dying.
The time alloted to works is not infinite.)
Words sinking.
(some may rise up, have their own life,
live for awhile in the free air like butterflies . . .

live for a season.)

I have arrived at square minus one.

From here we could go anywhere.

A voice would lead me.
(a voice whispering into my ear...)

The Poison:
turn out lights, lie alone in dark room &
start imagining anything, start with any image & let it send out
another. Don't drink or take any depressants. Luck.
--Alden Van Buskirk, "Lami in Oakland"

Effects:
all a dream we dreamed
one afternoon long ago
--Robert Hunter, Phil Lesh

Karma is the link from one thought to the next. Ahhh, endlessly arising.
Dharmas and phantoms, Mara and Buddha. The uninvited guest is the ring.
The knock. Door bursting open. Alarm clock. The medicine.

The Poison:
I am ready to come back to you. I've lived my life a
million times over in a few hours, seen everything, known too
much, & now I'm burnt out, want only love & peaceful madness

20
of America seen & shared with your eyes.
--Alden Van Buskirk, "Lami in Oakland"

Matters of State and Liberty:

It is worth noting that Aztec religion and society were both hierarchical. That the
Aztec nobility evidently had no trouble integrating the use of entheogenic plants
into that hierarchy should give pause to those who believe that if only more
people today would use hallucinogenic drugs, our society would perforce become
kinder, gentler, and more egalitarian.

The Plant:
Considering the easy availability of psychoactive morning glory seed, the ease of
growing them, and their tolerance of many climate zones, it is remarkable that
more plant people do not make use of this ancient and time-tested plant. It says
something about the availability of LSA's better known diethyl cousin.

The Plant:
I. violacea: quiebraplato, "plate breaker."
Mixe: piH pu'ucte.sh, "broken plate flower."
Ma-sung-pahk: Mixe, morning glory, "bones of the children."
La'aja shnash: Zapotec, "seeds of the virgin."

Gordon Wasson and Jonathan Ott note that the contemporary Mexican term for
morning glory seeds, semillas de la virgen, probably does not refer to the Virgin
Mary, but to the virgin who ground the seeds.

Effects:
1:00 AM: Music. Grateful Dead in a long jam with Branford Marsalis. All the
instruments distinct and separated.

2:00 AM: Gut still hard. Tired. Mind still very active, but I will sleep and let the
dream be dreaming.

The dreams of the children.

The little ones who come to tell you.
The plant children, our children,
who grind the medicine.

Ketamine (K) and Quantum Psychiatry

Dr. Karl L.R. Jansen

K@BTInternet.com

‘X-Rays are a fraud’

Lord Kelvin, c. 1900

Ketamine (K) has been used in human anaesthesia for the last 30 years, and has
a relatively good safety record in this medical context. The drug also has
psychedelic properties. A psychedelic drug is one which may tell us something
about how the mind constructs reality, personality and a sense of meaning.
‘Psychedelic’ K doses are rarely more than 30% of surgical anesthetic doses,
given by the same route for the same person. At these levels, K behaves more
like a stimulant than a sedative and does not usually suppress the breathing or
heart rate, although exceptions do occur. When K is taken outside a medical

21
setting, the main dangers arise from the physical incapacity it produces, and the
risk of addiction to the psychological effects.

Near-Death Experiences (NDE) and Near-Birth Experiences (NBE)

K can induce an NDE in some people, in a conducive set (personality, history,

mood, motivations, intelligence, imagination, attitudes, current life events and
expectations of the person) and setting (the physical, social and emotional
environment). Empathy with the person giving the drug is a very important
factor, even with an anaesthetic. K-trips can include odd sounds at the beginning,
travel through a tunnel into light at high speed, the conviction that one is dead,
communion with God, out-of-body trips and entering other realities. Memories
can emerge to the point of being re-experienced, sometimes leading to a life
review. K-trips can also involve clarity of thought, distinct phases (including a
border between different realms), hearing words said by spectators and hovering
above the scene. ‘Lessons in love’ (e.g. ‘love is at the core of being’) are
common. An NDE does not imply that the person is physically near death. This is
usually not the case. K does not stop the heart and produce a ‘flat-liner’ effect.
The heart rate rises.

K-trips may involve a re-experiencing of parts of the birth process in symbolic

form - another occasion on which we emerged from a tunnel into the Light. Thus
some NDE’s are really a near-birth experience (NBE). K-trips show that birth and
death are seen as the same process at the unconscious level. The birth trauma is
a core imprint deep in the psyche. Grof’s ‘amniotic universe’ with its lack of
boundaries can be re-experienced as the galaxy, ocean or Heaven, leading to
cosmic unity. The feeling of ‘coming home’ relates to this level, a return from
exile. The next stage is when the uterus contracts but the cervix is closed. There
is no way out. Contractions restrict the blood supply, producing the same
conditions in the brain which can trigger an NDE in later life. The symbolism is of
no exit or Hell: entrapment in a claustrophobic, endless nightmare from which
escape is impossible. The child is born from the darkness (or at least dim
redness, like ‘Hell’) into light. In adults, this transition can involve annihilation of
previous reference points, ‘death’, followed by rebirth: visions of white or golden
light, a sense of salvation, death and resurrection including religious images, God,
and the self reuniting with the Universal Energy. These stages may not be worked
through sequentially. Any stage may be repeated many times. The belief that
memories of birth cannot be formed because of the immaturity of the higher
brain is outdated. New data shows that the foetus can hear and remember
sounds heard at 20 weeks.

An NDE can be therapeutic, with after-effects such an increased concern for

others, reduced levels of depression, anxiety, neurosis and addictions, improved
health and a resolution of various symptoms. Positive changes can also
sometimes follow K-trips which occur within a therapeutic alliance, in an
appropriate set and setting. Other conditions can lead to very negative K-trips
and potentially harmful consequences.

Where do these experiences originate? Advances in quantum physics suggest that

K, and the conditions which produce NDE's, may 'retune' the brain to provide
access to certain fields and 'broadcasts' which are usually inaccessible. In this
model, the brain acts as a transceiver, converting energy fields beyond the brain
into features of the mind, as a TV converts waves in the air into visible, audible
programs.

22
K can be seen as a mental modem which can potentially connect the mind to
'everything else', allowing a peek behind the curtain at the inner workings of
‘reality’. In the old Newtonian universe, the mechanical view declared that all
possible forms of energy and fields had already been discovered; that the
ordinary, everyday perception of space, time, matter and energy was the only
scientifically (and medically) correct reality; and that all people were separate
from each other and the rest of the universe. However, physicists have found that
a subatomic particle can be in many different places at once. It has been shown
that photons are either a particle or a wave depending on the observer. When a
photon changes in one place and time, it’s ‘linked photon’ changes
simultaneously, even if it on the other side of the universe, or in a different time.
So some physical boundaries are arbitrary. One explanation is Bell’s theorem
which involves a hyper-space where all realities exist at a single point. If entry
can be gained to the quantum sea, a person’s awareness - the ‘disembodied eye’
- might travel through different ‘realities’ without the body itself going anywhere.
Timeless, spaceless zones where alternative universes roll of the assembly line is
also the language of K-trips. Scientists looking into the basic nature of matter and
energy may arrive in the same place as those said to ‘retune their brains to
quantum frequencies’ with K: the finding that everything really is connected to
everything else.

It was next observed that there are similarities between quantum processes and
human thought processes. Leading physicists suggested that consciousness may
involve quantum events, with profound implications for understanding certain
altered states of being. It is hard to dismiss these authors as a lunatic fringe, and
we should be wary of dismissing the new theories out of hand. Einstein himself
opposed quantum physics, declaring that God did not play at dice. Einstein
described this physics as 'absurd, bizarre, mind-boggling, incredible, beyond
belief...' and 'the system of delusions of an exceedingly intelligent paranoiac,
concocted of incoherent elements of thought'. However, Einstein was wrong. The
'system of delusions' worked very well, and its 'psychotic' advocates won many
Nobel prizes. Subatomic particles could indeed behave as if time and space were
non-existent, and quantum truths now lie at the core of such practical matters as
the laser, the atom bomb, and the semiconductor. From the ‘quantum
perspective’, God (+) does appear to play at dice with the Devil (-) , giving rise to
the +/- pagoda of being. The key issue is the extent to which subatomic events
are involved in consciousness. Although a person is not a photon, and it is a real
quantum leap to go from the subatomic world to human events, ‘quantum’ based
explanations may advance our understanding of certain mental states. Some of
the K and NDE reports of eternity, infinity, multiple universes, and linkage with
other beings demand a more sophisticated explanation than a brief dismissal as
‘hallucinations.’. Hallucination is only another descriptive term - it doesn't really
explain anything.

Professor Stephen Hawking, who sits in Newton's chair at Cambridge, believes

that the universe has no boundaries in space or time, and is made up of super-
strings which vibrate in 'extra dimensions', balancing vibrations in the usual
dimensions: positive and negative energies balancing each other to produce our
universe, based on a 'new' kind of symmetry called 'super symmetry' (which is
really very old: the Yin-Yang). The division between some physicists and
psychedelic mystics sometimes appears to be one of whether instruments (called
‘science’) or the direct experience of the mind itself (called ‘spirituality’) are used
to make remarkably similar observations about ‘the ground of being’. The
language of LSD trips can resemble the language of the older quantum physics,
involving white light and dancing particles, but more recent reports in physics
journals use terms which are much closer to 'the language of K'. Super-string
theory is being supplanted by the discovery of whole groups of extended objects

23
called p-branes . These may be viewed as types of membranes, some of which
have many dimensions. Becoming an across-the-universe membrane is a typical
K effect. John Lilly MD wrote:

The point of consciousness becomes a

surface or a solid which extends
throughout the whole known universe…
your centre of consciousness has ceased
to be a travelling point and has become
a surface or solid of consciousness ... It
was in this state that I experienced
'myself' as melded and intertwined with
hundreds of billions of other beings in a
thin sheet of consciousness that was
distributed around the galaxy. A
'membrain'.
(J. Lilly and E.Gold, (1995) Tanks for the Memories:
Flotation Tank Talks. Gateways/IDHHB, Ca.)

Ketamine and Psychiatry

Over the past 15 years, K has been given to over 1,000 alcoholic patients as an
aid to psychotherapy, in Russia. There are clinical control groups and long-term
follow-up of patients, which has been encouraging. No patient has had
complications such as prolonged psychosis, flashbacks or non-prescribed use of
K. The team leader is psychiatrist Dr. Evgeny Krupitsky, who recently pursued his
K research at Yale, sponsored by the conservative National Institute of Drug
Abuse. The sessions are supervised by two physicians, a psychotherapist and an
anaesthetist. In addition to very good rates of recovery at 1 and 2 year follow-up
compared to controls, personality tests show significant improvements on many
scales: increased concern for others, reduced levels of anxiety, depression,
neurosis, and addiction; positive changes in self-concept, attitudes, spiritual
development, life values and a sense of life’s purpose. Non-verbal (unrealised)
emotional attitudes were brought to the surface and made known, resulting in
less conflict between verbal /conscious and non-verbal/unconscious attitudes.
Reducing this discord via a unifying journey through the unconscious favours
health. The ego reconnects with denied parts of the self. It can also lead to a
perception of reconnection with ‘wider fields’ such as the family, community,
planet and universe in general. I have called this ‘quantum therapy’, due to the
emphasis on universal inter-connectivity (not the same as Deepak Chopra’s
‘quantum healing’, which involves non-causal cures for physical illness). It must
be stressed that these K-trips took place within a strong therapeutic alliance. The
patients had been in hospital for 3 months, had already done important work with
their therapists, and both the set and setting were highly controlled. All of the 12-
step programs, such as Alcoholics Anonymous, stress connectivity with others.

An NDE can be a pivotal turning point, encouraging positive life changes. People
who attempt suicide have a subsequent risk of further attempts which is at least
50-100 times greater than the norm. In contrast, suicide attempts which result in
NDE's are often followed by a reduced risk of further attempts, suggesting that
artificial induction of NDE's by relatively safe means, within a consensual, legal,
ethically and medically approved therapeutic alliance, in an appropriate set and
setting, might have benefits in some people. The ‘re-birthing’ aspects of a K-trip
could also be helpful in certain cases, aiding resolution of problems which arose

24
out of the negative aspects of being born and later events, including a sense of
being inadequate, an unrealistic need to be prepared for hidden dangers, and a
compulsion to be in control. Difficulties with resolution of the various stages in
the birth process may result in compulsions to repeat the process in an attempt
to achieve resolution. A report in the British Medical Journal (1998) linked violent
suicide by males to a traumatic birth. The authors said that the birth trauma had
scripted a violent death in the adult. This may explain why the re-attempt rate is
dramatically lower in persons who had an NDE while attempting suicide: they
may have been able to ‘re-do’ aspects of birth resulting in healing. It may also
explain some mysterious deaths in K addicts: frequent return to the death-rebirth
process may be harmful if it strengthens a destructive pattern. Revisiting this
realm is not necessarily beneficial.

The Back Pages

Altered states of being have long played a part in healing. The roles of priest and
doctor came together in one person (e.g. shaman, 'witch-doctor' , tohunga etc.)
who entered 'mental realms', perhaps aided by psychoactive plants, to speak with
the spirits. Sometimes, they attempted to take the ill person into these realms
with them. The belief that inducing such states for therapeutic purposes was a
mis-guided idea of the 1960's, now abandoned due to lack of efficacy and
unacceptable risks, is debatable. This was not a minor curiosity of the lunatic
fringe, and many of those involved were neither radical nor liberal in outlook.
New treatments have sometimes been greeted with inappropriate use and
extravagant claims, before finding their proper place in the medical cupboard. In
some cases, this can be affected by political, social and ideological factors. In the
normal course of events, treatment involving psychedelic drugs would also have
found its proper place, with the usual list of possible adverse effects, indications
and contra-indications, cautions and precautions, advocates and opponents -as
exist for all forms of treatment. Psychedelic drugs, however, became caught up in
an intense ideological battle. The result was that not only did all therapeutic use
come to an abrupt halt, but all research projects were also suppressed. This did
not happen because a serious new side-effect emerged, or because there was
absolutely no evidence of efficacy. The complete ban appears to have arisen from
issues which are largely ideological. K provides an example of the processes
involved. It has been given to millions of patients worldwide in the past 30 years,
and many reviews affirm its safety in a controlled medical context. Nevertheless,
if a research proposal is made involving 10% of the normal anaesthetic dose, to
be given to healthy informed volunteers, and the word 'psychedelic' appears
anywhere in the proposal, there is immediate and grave concern amongst some
ethical committees where anaesthetic trials may proceed with relative ease. It is
difficult to explain this anomaly using scientific and health concerns alone.
Nevertheless, mental health research with K is proceeding and may eventually
lead to the development of a quantum psychiatry, just as Freudian psychiatry ,
which saw psychic energy as a head of steam in the mind, took its cue from
Newton's mechanical outlook. Physics is the well-spring for theories in other
disciplines. The ideas of Marx, Darwin and Freud are traceable to Newton, and we
may yet develop a quantum psychiatry traceable to Planck, Bohr, Heisenberg and
Feynman.

Beyond Psychotic Experience

Stan Grof interviewed by Jon Atkinson

Could you talk about how see the relationship between what is termed
psychotic experience, and the long term pathological problems that can

25
be associated with it.

I would say that among the people who are treated as psychotic there is a
substantial subgroup of people who are really involved in a transformative
process. And if it’s differently understood, and differently supported, it can
actually manifest itself in a form of healing that can be transformative. If it’s
misunderstood, and they get labels and tranquilizers, they can get started on a
lifetime of pathology.

The term psychosis was developed in the context of the medical model. It implies
some form of disease. Where as what we are trying to say is that certain intense
states, of dramatic emotions, of visionary or psychosomatic manifestations and so
on, they don’t have to be necessarily disease states. That having those in itself
doesn’t justify a pathological diagnosis. And the outcome can depend very much
on the set and setting, the surroundings and how the condition is treated.

What kind of positive effects can a supposedly psychotic experience have

if it is treated in the most desirable way?

Well the idea is that if people have say dramatic states which involve a lot of
painful emotions, and other kinds of experiences, that the organism is actually
trying to get rid something. It’s trying to purge something, and so ideally it can
result in emotional and psychosomatic healing. It can result in radical personality
transformation where people can feel better about themselves and about the
world, they can function better, they enjoy life more.
We work with a much larger model. The kinds of conceptual frameworks in
psychology that see the psyche as something that can be explained from
postnatal events, and from the Freudian individual unconscious, they don’t have
any way of accounting, in a believable way, for some of the extreme states, or
powerful states of violence, of fear of death, or fear of destruction of the whole
world. Where as if you have a larger model which includes not just post natal
biography but something like biological birth, which is for many people a very
dramatic event, then if the organism is trying to clear such a fundamental trauma
you can explain very dramatic emotions and very unusual states and sensations.
And if you add to this the Jungian concept of the collective unconscious,
archetypes and so on, then you can quite believably explain some states that
would otherwise be considered to be very exotic, like for example mythological
reality, deities and so on.

So much of this depends on having a large enough model of the psyche if you’re
trying to explain some of the extreme states of some of the so called psychosis. If
you’re trying to explain it in a narrow theoretical framework you will not be able
to do it, and everything that doesn’t fit, that goes beyond that framework gets
labeled as pathology and you’d suspect some kind of exotic brain pathology.

With that standard reaction of assuming brain dysfunction, the approach of

orthodox psychiatry is to administer major tranquilizers. What effect do you see
this as having on the person who is going through these non-ordinary
experiences?

Well basically if you have a situation where the unconscious opens on a very deep
level and these contents start surfacing, and it becomes uncomfortable and you
apply tranquilizers at this point, it tends to sort of freeze the process mainly, and
effectively prevent a kind of a resolution of this. This is the same in psychedelic
states. The worst thing that you can do to people having a bad trip is to give
them tranquilizers because many of the so called bad trips, if they are properly
handled, are supported while it’s happening, you know so they cannot do

26
anything to themselves or to others while this is happening, then in most
instances they end with radical breakthroughs.

The state itself is very unpleasant for the person who is clearing a very difficult
aspect of themselves, so if it’s allowed to run it can be completed and integrated,
it will be a major healing event. And if you apply tranquilizers you might reach a
situation where it’s too late, it’s too close to the surface and too much is
happening, you will not be able to really push it back deep enough into the
unconscious. And so you might have to keep people on maintenance doses, and
every time you start reducing the dosage that stuff will be coming back. So you
kind of freeze it. You prevent effective resolution. And of course people are on
tranquilizers for many years and you’re running the risk of side effects,
irreversible neurological damage, actual addiction to some tranquilizers.

Then again I would not like to talk against tranquilizers in general. There are
certainly states where they are quite indicated, and people can be in states that
don’t really respond very well to the kind of alternative strategy that we are
suggesting. For example people who are heavily paranoid, they don’t usually
cooperate, they will not accept this kind of help. Lots of people are in this state
where they’re projecting, and they would be dangerous to themselves or to
others, then tranquilizers would be very useful and appropriate for approaching it.
So we just like to present our strategy as an alternative, as an option.

Are there any techniques for gaining someone’s trust in the possibility
that with support the experience may be beneficial to them?

I think if you are personally familiar with the states that people are in, which can
happen if you did some powerful inner work, or you have some episodes of
spontaneous non-ordinary states, then you know intimately the territories, so
you’ll be able to talk with those people in a language that they understand. You
will not invalidate their experiences and you will ask intelligent questions.
Otherwise if you’re going to be approaching in a traditional framework, where
there’s no real understanding of non-ordinary states, then you are asking
questions from a totally different world and you can’t expect that there will be
very deep contact.

It’s like say a pre-adolescent trying to understand what it is to have a sexual

orgasm. You would have a situation where a pre-adolescent would be
interviewing somebody who’s already having sexual experiences, interviewing
them about sex, and would want to be perceived as an expert in that area. We
have this kind of idea in psychiatry that it’s enough to go to medical school and
read the right books and then that makes you an expert. To have done some
work with psychedelics or with these states can help. They always say that unless
you’ve had the experience there is just no way that you can have an idea. So
what I’m saying, by having had personal experiences and letting people know
that you have an idea of where they are, well that itself will cultivate trust
because you are asking them questions that make sense.

What about a situation where someone begins with trust, enters into a
non-ordinary state, and then that trust is suddenly lost? Are there
precautions that can be taken with this?

Well the first and most important thing is that you understand that you are
exploring your inner world, and that if you do any serious exploration of this kind,
that you do it in an internalized way. Because what’s happening here is that the
ordinary relationship that we have between the consciousness and the
unconscious will shift very radically, and while you will have now powerful access

27
to the unconscious you will be also handicapped in term of conscious functioning.

And in addition there is a tremendous danger of confusing the inner world with
the outer world, so you’ll be dealing with your inner realities but at the same time
you are not even aware of what’s happening, You perceive a sort of distortion of
the world out there. So you can end up in a situation where you’re weakening the
resistances, your conscious is becoming more aware, but you’re not really in
touch with it properly, you’re not really fully experiencing what’s there, not seeing
it for what it is. You get kind of deluded and caught into this.

So that’s the first and most important thing is to create the right circumstances, a
protective environment. And do it in an internalized way. Don’t interact with the
external world until you know that you’re back to your ordinary reality testing.

That’s the right set and setting, but even then there’s no guarantee that that’s
not going to happen. You have to understand that if something is happening to
you, say with LSD, that it’s very unlikely that because you took LSD your current
environment has changed, and what is changing is your relationship with your
unconscious. So the major problem in any kind of work of this kind really is
projection, where people cannot recognize this. A lot of it can be prevented with
the right set and setting. And with the right person being there with you.

Could you say something about the relation between a particular psychotic state,
and the emotional atmosphere and symptoms which prevail in the period
immediately after that state, in the everyday world of consensus reality.

Anything that before was in the deep unconscious, now in the psychedelic state
it’s going to start surfacing. And if you don’t complete that internally then you can
end up in a situation where that condition is now close to the surface, you’re
really under its influence for an indefinite period after the session. It’s not
something that’s related to the LSD, to the psychedelic, it has to do with the shift
of the relationship between your unconscious and your consciousness. It’s like a
dream, with a dream something that was part of you, but in a deep unconscious,
takes over and you’re going to be experiencing as if it were happening now. After
a psychedelic session you can get back in this state in everyday life.

Could you clarify the ideas you have about the internalization of symbolic
experience, and the externalization of emotionally expressing
experience. You talk about control and the abandon of control.

Well what we do in the holotropic breathwork, [a form of therapy which aims to

approximate the effects of psychedelics,] we create a situation where you can let
go of control where there is support and understanding. And there, on your own
terms, you can confront your unconscious. And doing this kind of work in a
protected situation can take the charge away from everyday situations. You don’t
want to loose control in San Francisco airport. But if there is support to let go to
the inner process, that gives you the possibility of coming to terms with it,
express what you couldn’t express, and integrate it.

The expression is important but it has to be done in a special kind of situation.

Working with emotions is extremely useful, but you hold back to some extent as
long as you know that the emotions are inappropriate, you hold back your
reactions or actions in everyday life. You can create working situations, whether
they are psychedelic sessions, or holotropic sessions, or meditation, when you
can really process whatever’s coming from within. It’s also a situation where you
can differentiate, you can discriminate what’s yours and what’s really out there.
To confuse those two is very unproductive, very detrimental.

28
After intense psychotic experience, if it does move in a beneficial
manner, what do you mean by integrating the experience?

It means completing it emotionally and physically with the gestalt completed.

That means there are no more disturbing emotions coming up, no more
uncomfortable symptoms.

And then part of the integration would be to handle successfully the interface with
the cultural environment. You can get into a lot of trouble by having had unusual
experiences and talking about these. So part of the integration is being aware of
where other people are, what they can understand and can’t understand, with
whom you can talk about certain things, and with whom you don’t talk, the kind
of metaphors you chose. We had, in one of the Spiritual Emergency newsletters,
a cartoon showing a naked yogi hanging on a tree with his foot and a guy in a
straight jacket saying “Why do they call you a mystic and me a psychotic?” and
the yogi says, “The mystic knows whom not to talk to.”

People get into trouble either by acting in the external world while they are still in
the non-ordinary state, when they confuse realities, and sometimes they do it
after the experience when they don’t discriminate, they don’t differentiate, they
talk about it indiscriminately. They walk around trying to convince people that
“you’re God, you should just experience it”, or that there’s consciousness after
death. People get into trouble about it, by trying to convince everybody they have
a message and become messianic.

Psychedelic plants and peoples :

Towards getting to know each other better ...

Jon Atkinson
1F3, 41 Royal Park Terrace, Edinburgh, EH8 8JA
atkinsonjon@hotmail.com

Psychedelic drugs can be used safely if they are taken under the right kinds of
conditions. There is ample evidence for this in decades of scientific research, and
from thousands of years of traditional use. When used with the appropriate
respect they do not increase the incidence of psychological problems, and the
vast majority of them are not addictive. Our cultural approach to psychedelics
could mature through more of a consideration of how they are used in other
societies. There is potential for a wide range of benefits if we can openly engage
in similar kinds of use ourselves.

Psychedelic plants have an ancient role in medicine, religion and celebration

Throughout the world they are still traditionally used for these purposes. In
comparison with numerous non-literate and other peoples we are just beginning
to explore these uses. To many these plants are sacred and magical, they are
viewed as fundamental to their culture, not in a problematic way, but as an
aspect of reality that enriches their lives. They are delighted, terrified, awestruck,
and much else by them.

The belief in a medicinal value to psychedelics should not be casually dismissed

as superstition. Mental health work has been practiced through this green alliance
for much of human life. Only cultural arrogance could discount the possibility that
we may have something to learn.

For a culture with a dominant mythology of having been cast our of Eden, it

29
seems reasonable to look at societies which still live more directly within nature,
at the least to see if there is anything we are missing out on. Contemporary
culture tends to overlook that there are other forms of development elsewhere.
The concern to help “underdeveloped” peoples could be better balanced by more
openness to reciprocal learning about things of practical value in their cultural
legacies.

RD Laing was considerably influenced by a Brazilian shaman who he and Francis

Huxley played host to in London. Having taken psychedelics many times, Laing
asserted that they should be used in the presence of a sitter. He viewed drug use
as a means of enabling a perfectly natural experience, and as with many others,
it played a formative role in the development of his ideas. He talked of LSD as
remarkable in all sorts of ways which have been described by all sorts of people,
and his experience of MDMA as a fleeting moment of sanity.

Today psychedelics are used in a lot of different ways. They are used at parties,
at raves and at festivals. They’re used in established relationships between
friends and partners for a variety of different reasons. They’re taken on an
individual basis in a range of contexts from family interactions to days in the
country. Amongst other purposes they are used for inspiration in creativity, for
exploring problems, out of sheer curiosity and simply to more fully experience
being alive.

All of the above is very often free from any serious complications. It’s felt to be a
wholesome and valued part of people’s lives. But there are also situations where
problems are encountered, and these may not always be dealt with in the most
desirable way. Often they are left unresolved, relegated to the quiet corners of
people’s identities, not much discussed and frequently whitewashed over. On rare
occasions they may result in the intervention of authorities like the police or the
psychiatric services, who usually don’t know the best ways to respond to the
situation. The availability of a diverse range of groups to help deal with such
difficulties would be a valuable public service.

The kind of use that is not yet being found in our culture for psychedelics, at least
not in an open way, is that kind which countless other societies have
constructively integrated into their social fabrics and which is interwoven into
their world views. From our current perspective this is difficult even to conceive
of.

As a form of medicine the plants are not applied as simple chemotherapy.

Extensive cultural skills enable psychedelics to work differently from one society
to the next. Much depends on the view or conception that is held of the drugs’
effects. Individuals within the same culture also react differently according to
their personalities and expectations. However, the context and intention of use
strongly influence the kinds of outcome which prevail. One of the most significant
factors is the social environment in which the plant is taken. The drug may be
used in a group context, or it may be administered by someone who may do little
more than simply sit by to watch over things. Whatever the case, the kind of
people who are involved strongly affect the course of events.

What a drug does depends very much upon the way it is viewed, what is thought
and felt about it, why it’s taken and the way it’s used. Feelings towards it are
shaped by socially constructed knowledge. Beyond their intrinsic capacities, and
with psychedelics these are very non-specific, drugs are what we make of them.
Their effects and consequences change as our ways of thinking about them
change according to the models that we use. The use of psychedelics can become
less dangerous and more beneficial by a change in the way the effects are

30
generally considered.

The value of non-pathological models of non-ordinary states is clearly illustrated

in Marius Romme’s work on hearing voices. Andrew Weil uses the term active
placebo in explaining the action of psychedelics. More generally he talks about
changing things in the external world by changing our perspective of them. This
alters the qualities they absorb from our projections upon them. It is analogous
to our shaping of other people's behaviour by the view that we hold of them. The
same interactive process shapes the psychological nature of a plant or a
molecule.

For this reason there is significant clinical relevance to the conceptual frameworks
through which an understanding of psychedelic states is constructed. It would be
of value to study the various approaches towards managing difficult psychedelic
experiences in different social worlds. There are striking differences between
various contemporary user contexts, those of traditional cultures, and the
contexts of psychiatric or other professional intervention. There would be much to
gain from looking at the relationships between ideological background, social
context and the outcome of experiences. This would provide a better
understanding of the consequences of different ways of responding to adverse
reactions. The number of people using the drugs means that this kind of
information has extensive practical relevance, including its application to public
harm reduction messages and in helping to provide a more adequate general
education for health professionals.

When psychedelics were administered by psychiatrists before the current laws

were passed, this was not always done with the appropriate integrity. There is a
legal case currently underway against the NHS regarding this, and there were
some serious abuses of professional power. One example was psychiatric patients
being chained to beds and left alone on 800 mcg of LSD. Clearly there is a need
to set down some basic mandatory requirements for institutionalized use, and for
this to be carefully supervised. Professionals must be supportive rather than
clinically removed, and be aware of the serious responsibility involved.

The minimum safety requirements for the use of high doses of psychedelics
seems to involve: substantial preparation and follow up, to have another person
who is not affected by the drug present during the session itself, there to be
mutual trust and good rapport between the people involved, and commitment to
seeing difficult situations through the duration of the drug’s effects, and there to
be minimal interaction by the subject with the outside world during the most
intense phase of the experience.

The need for both parties to feel comfortable and to trust each other suggests the
importance of the people knowing each other well, ideally in social networks that
maintain an active connection with society as a whole. Rick Strassman writes of
feeling the need for a richer context in which to conduct research. In Britain there
is little organized communication between people interested in psychedelics. It
may be useful if there were some meetings. Though they would probably need to
develop slowly over time, there seems no reason why small groups should not
form who might use one of the legal plants such as salvia divinorum, fly agaric or
ibogaine in a way similar to their use in other cultures.

A promising area for future development is with the combinations of people who
might want to explore psychedelics together in a structured way. An example
could be a group involving psychiatrists, users and survivors of the psychiatric
system engaging in non-interactive sessions, and hearing each other’s stories the
next day. It would almost certainly lead to new levels of mutual understanding.

31
There could be applications for many different sections of society who may
benefit from a fuller knowledge of the feelings and internal worlds of significant
others. This could be among people with conflicting interests, such as ecologists
and industrialists, or among people with shared purpose, such as members of
various teams. Of course mainstream culture is not currently open to these
possibilities and I risk credibility in suggesting them. None the less similar social
organization serves productive functions elsewhere and it could work in new ways
in a contemporary context if it was undertaken with adequate care.

Approaches to group exploration such as described in The Secret Chief, (see book
review,) can bring about communication in a different mode than usual. It is not
initially interactive in the way of discussion, but entails more of a shared
disclosure of internal experience. There is a high potential for people to listen to
each other in empathic ways. And expression may also venture into otherwise
hidden areas. An atmosphere of respect surrounds the participants of a shared
ordeal or extreme experience, and psychedelic states can create this kind of
bonding. It may not be easy work to engage in, but there could be a lot to gain
from it. Development in communication is a widely desirable human value.

Traditional use of psychedelics takes place within institutionalized forms which are
often associated with highly valued outcomes, including lower incidences of
alcohol and other drug consumption, and higher levels of concentration and social
functioning. Conceptual frameworks and social context support beneficial effects
and guard against the dangers of irresponsible or uninformed use. It seems
extremely likely that similar forms of practice within contemporary culture will
have similar consequences for public health. These social forms are already
developing now. I would be glad to hear from anyone interested in this general
area.

Hasheesh Psychosis

Louise Theodosiou

One of the striking aspects of a publication such as Asylum is the fact that it
allows individuals to express their personal views. Similarly, although Psychiatry
is a discipline with a clear set of ideas and rules, and a historical way of behaving,
it is nevertheless interpreted and enacted upon differently by the diverse range of
doctors who represent it.

Consequently, my article is only my individual interpretation of the relationship

between cannabis and psychosis and my desire to convey the ideas and situations
that I have encountered in my brief time as a very junior psychiatrist.

It is possible that other contributors in this publication have written in to describe

their individual relationships with cannabis. It may be that they celebrate and
support the use of this intriguing substance. Hopefully my article with show that
for some people in some circumstances, the experience of cannabis is not
something to celebrate, and may actually be damaging. I must emphasis that I
do not hold some moralistic view that cannabis should be bad for people. I do not
rejoice in this potential sting in its aromatic tail.

The idea that cannabis may trigger psychosis is not a new one. It can be traced
back through literature and history and seen in texts such as The Indian Hemp
Drugs Commission in 1894. Additionally there is evidence that the Ancient
Egyptians made reference to this as well. Having been asked to describe such an

32
unpopular aspect of such a popular drug, the idea of writing in Hieroglyphs in the
peace of a pyramid is indeed appealing. It would be interesting to know if the
matter was controversial in these times as well.

The uneasy relationship between cannabis and the law tends to distort any
objective assessment of the risk of cannabis use as a trigger for psychosis;
people are less likely to admit to distressing experiences, and more likely to
suffer in silence. At a time when the analgesic properties of cannabis are being
championed, the issue of its role in psychosis is unlikely to be happily
entertained.

Before exploring this connection further, it seems appropriate to define the word
'psychosis'. The Comprehensive Textbook of Psychiatry/V1, volume 2 tells us that
psychosis can be described as 'psychiatric disorders characterised by the
occurrence of delusions, hallucinations, incoherence, catatonic behaviour, or
inappropriate affect that causes impaired social or work functioning. Insomnia,
excessive sleepiness, or shifted sleep schedules are a common feature of the
psychosis.'.

It may be tempting to imagine that the experience of psychosis would be as

erudite and liberating as that described by Aldous Huxley in his adventures with
mescaline. However, the confusion and paranoia, which can sometimes erupt into
abject terror, is by no means an experience that the sufferers would recommend.
Auditory hallucinations, and alteration of ones cognitive processes can cause the
most stable and rational of people to behave in ways that are dangerous both to
themselves and to other people.

Psychiatry describes clearly that people suffering from schizophrenia can be

acutely psychotic. Additionally a syndrome has been described known as 'drug
induced psychosis'. In this condition, psychosis can be seen to stem from drug
use and resolves when this drug is no longer used. Drug induced psychosis does
not tend to last longer than about two weeks. A range of drugs including cocaine,
cannabis and amphetamines are believed to trigger it. It is disturbing when
healthy young people who have previously had no reason to come into contact
with psychiatric services end up being admitted onto psychiatric wards.

It is interesting to note that many people are unaware of this potential risk of
cannabis. People who smoke cigarettes are inundated with messages informing
them of the danger to their health. Some of the people admitted onto the ward
where I work appear genuinely surprised when I discuss the idea of cannabis
causing psychosis. It may be naïve to imagine that my advice changes the habits
of any of the people that I meet, but I believe strongly that people should make
decisions about the way they behave based on as much information as possible.
Additionally when people suffer the distressing experience of a psychotic episode,
it can be very comforting to know that they can avoid the experience again by
changing their habits.

As I mentioned earlier, one of the reasons why the relationship between cannabis
and psychosis is not fully explored is because of the illegal nature of cannabis
use. Additionally the fact that it is sold on the street means that its quality and
composition vary. It would be interesting to know if this has an impact on its
psychogenic qualities as well. It may be that some of the impurities in certain
batches of cannabis are more likely to trigger psychosis. Bearing this information
in mind, it is interesting to note that the mind altering properties of cannabis
range from auditory and visual hallucinations through to what is known as an
'acute confusional state', in which the user becomes disorientated in time and

33
place and sometimes person. Additionally, since people can sometimes be using a
range of street drugs as well, it is sometimes difficult to tease out whether
cannabis is the likely trigger factor, or another substance such as cocaine or
amphetamines.

The fact that chocolate is dangerous for people with diabetes is an indisputable
fact. The rest of the population enjoy chocolate, and the unfortunate sensitive
sub-group do not. If cannabis does trigger psychosis is a similarly sensitive
group, then surely it would make more sense to identify these people and warn
them of the risks that they are running.

In my brief time as a psychiatrist I have certainly seen some people who seem
less able to cope with cannabis. While anecdotal evidence does not have the
clarity of statistics, it does leave an impression on the people who experience it. I
will never forget the sight of a terrified psychotic 21 year old woman, or her
equally distressed boyfriend!

There are three different situations in which cannabis is believed to play a part.
Firstly there is the induction of Drug Induced Psychosis, a condition I mentioned
earlier, in which previously healthy people become briefly psychotic and
subsequently recover. Further episodes of psychosis are always triggered by
further drug use, and they are free of psychosis in between times. Secondly there
is the precipitation of a first attack of Schizophrenia, an illness which does not
resolve without the help of medication, and usually requires the sufferer to take a
life maintenance dose. Thirdly, there is the induction of an acute episode of
psychosis in someone who already has a diagnosis of schizophrenia. There are
separate debates raging as the role of cannabis in the precipitation of all three
situations.

Looking on the internet one can find a web site advertising the 'Inaugural
International Cannabis and Psychosis Conference 1999' which is to be held in
Australia. To me this shows what an emotive subject this is, and also how keen
people are to resolve the debate! Admittedly reading through the available
scientific literature conclusions are tentative. Some longitudinal studies tend to
indicate that cannabis is highly likely to be a cause of psychosis, however for the
reasons I mentioned earlier, it is difficult to tease out the effect of drug use, and
even which drugs have been used.

Reading through my work I feel that at times it is as insubstantial as exhaled

smoke. However I can only hope that it can be perceived as an individual
experience of cannabis, as subjective and as relevant as the other experiences
described.

On a practical note, I would stress that psychiatry and casualty departments are
always tremendously sympathetic to people who find themselves in the grip of a
drug experience that they are finding frightening. Admission to a psychiatric ward
can be a very transient experience, and people do not have to stay in hospital for
any longer than is needed. Sometimes professional help is the only way out of a
situation, and I hope that my article indicates that this is generally open minded
help.

[In contrast the beliefs of the editor of this issue of Asylum include that
schizophrenia sometimes does resolve without the help of medication, and can do
so in about a third of cases, and that further drug use following a drug induced
psychosis does not always trigger further episodes of psychosis.]

34
Requesting Greater Empathy and Compassion -
And a Side-Order of Democracy, Please

Kevin Brunelle
brunelle@rpa.net

I detest the fact that in order for me to be honest about my life, I will have to be
depressing and dark. But that is simply where I am. In describing what has led
me into the world of clinical psychology, I might not make a hell of a lot of sense.
I do not like that fact one bit. It reflects that I have been in a very trying, often
torturous place. It is crippling. On every level.

It feels like it is a matter of me being detached from myself, to the point that I
feel like I am not experiencing myself as a person. Rather, I am trying to latch
onto something, onto a self, from what feels like the inside of a black box. It is a
perpetual state of oblivion. It feels like something has shut off inside me --
something essential that is supposed to just happen naturally. The only times I
have felt close to "right" (for lack of a more appropriate word) have involved the
use of a psychedelic compound. For some reason, they have conceded me the
energies which have never, of their own accord, been freed.

At this point it certainly feels, and to most people probably sounds, pathetic. It
often feels impossible, to the point that I have felt, especially recently, that the
only way beyond this is to take my own life. I have to be honest. I am in some
sort of state: something that has not responded to psychoanalysis and talk
therapy, hypnotherapy, group therapy, cognitive therapy, spiritual counseling,
past-life regression, antidepressants, antianxiety drugs, antipsychotics, prolonged
fasting, sleep deprivation, prayer, meditation, strenuous exercise, yoga,
transmedium work, Chi Kung, and that special New Age advice to just "let it go!"

I firmly believe I have been a candidate for the kind of psychotherapeutic

application of LSD-25 and/or MDMA, for example, that characterized much of
their use while they were legal. At some points over the past couple years, I have
been surprised that anybody interested in the application of these drugs in this
type of fashion, can find a wealth of positive evidence in literature. That nothing
else has helped and these psychoactives truly can, should be reason enough to
implement one of these time-honored agents in situations like mine. If wisdom,
compassion and maturity characterized the legal scene concerning these
substances -- at least in psychotherapeutic circles -- I am quite certain I would be
in a very different place now. I might actually have my life instead of this.

I know these compounds have been used to facilitate people's moving beyond
"mental illness," most notably when every other imaginable approach has failed.
The languishing ability of modern psychiatric medicine to facilitate meaningful
change in people's lives, imparts that something that could be taking place, is
not. We have a vast pharmacopeia of agents through which we can immediately
and actively encounter the subconscious mind. And hereby we can advance out of
stagnation, bypass certain unhealthy, even crippling, mental blocks.

Speaking from personal experience, especially, I feel strongly that psychedelics,

appropriately applied, can save years of a person's life. I do not feel I have had
the opportunity to appropriately apply them. This owes itself to my feeling that
lacking an experienced, compassionate, sensitive, wise and able therapist or
guide, could be dangerous.

35
The most viable opportunity for me eventually appeared in the form of a
workshop in Peru which included the use of ayahuasca in its traditional context.
What had initially sparked my interest in preparing for a trip like this were my
experiences with Salvia divinorum.

I figure that when everything you do, say, and act on fails to produce what you
intuit you need, accessing the other-than-conscious could prove more than just
mildly useful. I have never been fortunate enough to take MDMA but I have read
a good deal about it...I have to mention that during my time as a day-patient in
the local hospital's psych-wing, I could not help intuiting, and saying to myself, "I
swear that MDMA would be a truly positive thing to happen to a good deal of us
here. Hell, if they only tried a minuscule dosage, what the hell would be the
problem? Half of us are dangerously doped-up on some sort of chemical salad,
the risk of which clearly exceeds what has been substantiated about MDMA..." I
certainly am not the only one banging my head here.

I am dealing with a severe mental block on life. I have almost bypassed this with
psychedelics: with ayahuasca. All that really happened with my Salvia divinorum
sessions was that it gave a sense of hope. Hope that somewhere, somehow,
there must be a resolution for this; with a pervasive impression that it would be
"shamanic" in nature.

I just knew that I wanted to reconcile what I was going through with the novel,
fresh energy -- which felt like "health" -- which the sublingually-administered
Salvia leaves presented. The Salvia state also pointed an internal compass in the
direction of the Amazon Basin. It seemed to hint that a healing experience for
which I was looking was there. I already knew vaguely of ayahuasca and its
native region. For the year and a half following my initial Salvia divinorum
experiences, the money I was earning went toward the Yagé Fund. There was to
be a workshop put on by a group openly advertising their belief in and application
of ayahuasca as a healing agent and valuable exploratory tool.

There were moments during what became a four-month stay in Peru, where I felt
"healed." Most of these moments were immediately following an intense session
of vomiting after taking the sacramental tea. All the stuff I'd been trying
exhaustively to move through -- especially with hypnosis and meditation -- this
barrier, this block on life, softened and life started to come through. "I'm alive!" I
felt. "Thank God." This is the thing, at least a bit of it, that I have been telling
various professionals for years "is supposed to happen naturally but is not."

I look back on my jungle experiences as objectively as I can and see that I did go
far with the ayahuasca -- it seemed at times to be bringing me back to myself. I
worked very hard. The churning and purging, which is certainly not merely
physical, is uncomfortable at some times, almost torture at others. I got
substantial relief for a while. It seems the ayahuasca can break even the most
treatment-resistant depressions: the actual physical purge, which is accompanied
by some measure of psychological reconfiguration, exemplifies that this is not an
easy, airy-fairy "trip." One works! One works, but she gets rewarded for it.
Noticeable effects from a well-concocted ayahuasca tea can last several weeks. It
never went further than about five for me; after that, things really started to
deteriorate. Back in the U.S.A. at that point, it then was as if I had nothing on
which to walk.

So the results, which were singularly positive, were obviously not far enough.
Understand that I never took the "heroic dose" previously recommended to me by
a certain researcher in the field (as I was feeling it strongly, thank-you!) and I did

36
not work with the kind of guide necessary to help me integrate back into the real
world. I did just fine in the rainforest, and the jungle-river city of Iquitos. For
various reasons this environment simply provided. And I had felt so horrible for
so long I just liked the idea of feeling good. Now I realize I had not resolved the
core, so to speak, although at the time my feelings seemed to indicate I had done
so.

I am doing probably just what anybody in these shoes would. I still think it is a
load of horse-shit and just an abstract monster that nobody, including myself,
understands. I want to begin my life. I have every reason to believe the cure
involves the use of a psychedelic -- but it must also involve a situation which I
have not been able to find, or was not sharp enough to procure on my own (in
Peru, for example). I am uncomfortable about taking a full-on hit of LSD-25
without a wise, compassionate, experienced and able guide or trained therapist.

I'd like to be perfectly upfront, even though that may not be judicious. This bit of
writing is a sincere, heavy-hearted and wholehearted cry out for social change
that I am aware many life stories and circumstances demonstrate is long
overdue. "Come on, psychiatry," you're better than this: you and I both are
castrated here. Westerners are a naive culture, not equipped as are the
rainforest-dwellers for these abstruse and shamanic types of matters. (If we
cannot talk it away or reuptake-inhibit it away, we'll impotently and pallidly
imitate an archaic shamanic practice.) Perhaps people like me being pigeonholed
is not the fault of the medical establishment, or the APA...okay, part of the blame
must go here...but it does not help when doctors who should know better dismiss
a mass -- a hurricane -- of personal stories, relegating poignant and significant
life experiences to the next-to-nothing label "anecdotal."

Of course that is all this little "story" of mine is -- a single "anecdote" -- and mine
might not even be worth that much, because I'm still hurting, struggling and
pleading -- and I have taken some psychedelics. I will leave it up to each of the
readers to opine her own individual answer to "What's wrong with this picture?"

I am not a bad guy. But I am standing on the periphery praying to get back in --
putting all my energy into getting back in -- on several levels. And I swear...that
it doesn't seem correct that I am the only one who needs help in maturing.

Assuming psychiatric medicine is invested in helping people transform into what

they wish to be -- and wouldn't that be a good assumption to make(!) -- it is
rendered far less valid and far less capable if it is withheld from using the most
effective means of which we know to work within the human mind. With the
psychedelic, psychotherapy demands work. And the work (the inner process of
healing) is of a greater amplitude, depth and essential nature than without the
psychedelic. Psychiatric justice is certainly one of our least-addressed social
concerns...sure, we can appreciate plenty of reasons for this...but I have to
reiterate that not only do I feel handicapped because of what I've been going
through personally, but also because of the widespread denial of my most basic
of human rights and civil liberties. Finally -- LSD, MDMA, and Ayahuasca are not
the enemy: but ignorant -- at best misinformed -- spiritually desolate, politically-
motivated, fear-begotten decisions to whitewash a very sophisticated and
complex issue are NOT our friend. I cannot bear experiencing life this way much
longer: I must somehow do something differently. And I question whether our
global village can afford to limit its resources much longer; however double-
edged is the psycho-delic sword, mustn't we do some things differently?

37
Utopian Soup

Dave Cunliffe

During that unique hyperactive ferment of creativity, in late fifties London Beat
bohemia, I enjoyed my first psychedelic experience. By 1960 I’d become an
active evangelist for drug experimentation and universal unrestricted access to
LSD. Over subsequent years, I’ve consumed a large variety of mind-manifesting
agents (organic and chemical). With very few exceptions, all these journeys into
raw energy fields have proved rewarding, illuminating and life-changing.

Today I live a drug-free ‘monastic’ simple lifestyle but still advocate

consciousness expansion. That is alteration of the mindscape by a diversity of
methods --including enstatic chemicals like LSD. My present drug celibacy is
down to a simple personal psychic cul-de-sac. I found I was unable to progress
further with the psychedelic vehicle in an experiential, spiritual, creative, ego-
transcendence or reintegration of opposites way. The voyage of discovery was
becoming more of a state-of-the-art recreational buzz. This is a minor irritant of
my own ageing mindset and of no wider significance. The human animal
obviously needs recreational drugs and I’ve always tried to advise the preference
for less harmful ones (like marijuana) and caution the many real dangers of
opiates, amphetamines, tranquillisers, barbiturates, tobacco and alcohol. To point
out the danger of an activity is not necessarily an argument against its use. The
risks of mountain climbing and unprotected sodomy are obvious but they are both
valuable and meaningful activities and primarily a matter of choice. So is drug
use of all kind. Giving objective factual information of any potential danger is
always valuable and worthwhile but I haven’t yet discovered a valid argument
against the informed use of recreational drugs.

Truthful information and proven fact is the only valid drug education. Obvious
lessons from that disastrous North American prohibition era have seemingly not
been learnt or are being cynically disregarded. Capone’s Chicago nightmare
resurrects today in most urban areas and even in some rural settlements.

My late American poet friend William Wantling was a wounded Korean war
veteran, who became opiate addicted via hospital morphine treatment. One day,
souped-up on an acid laced drug cocktail, he played the leading role in a high
energy hard-core armed robbery. Wantling endured and survived five years in
San Quentin, as karmic payback for that disastrous psychedelic adventure. Bill
never blamed drugs or military conscription (as too many defense lawyers and
desperate banged-to-rights offenders knee jerk do) but rather his own inner
demons, limitations and inadequacies. Most psychoactive drugs are rarely good or
bad in themselves. They are organic or chemical tools, available mind-food, to be
used or abused as we freely choose. Despite myriad abuse and crime engendered
by illegality of supply, purchase and use, most psychedelic drug ingestion is
essentially victimless and a personal choice. Antisocial activities like murder,
legislation, blood sports and censorship have clear perpetuators and victims. If
somebody wants to shove morphine suppositories up their anus, pour raw alcohol
down their throats and drop every pill and capsule they can find--that’s their
choice alone. Their life, their death. A choice that’s very much part of being
human in the world. I don’t regret one hangover, one drug-cocktail nightmare
and wouldn’t deny that experience to any one else.

LSD is arguably the safest, and perhaps the most potentially valuable
psychoactive chemical. It’s enjoyed a full half-century of global clinical research
and creative countercultural experimentation. Much of it well documented in

38
scholarly papers, scientific reports and widely published folk literature. Nation-
State governments have consistently conspired against its constructive use and
their Military Machines have attempted to abuse and misuse the chemical. Its
proponents have been persecuted, prosecuted, jailed, vilified and libeled. Some of
them (like Timothy Leary) have been subjected to CIA dirty-tricks campaigns and
NATO inspired attacks. For over twenty years, world police forces waged war
against The Brotherhood of Eternal Love and its supporters. Ken Kesey’s
Pranksters, and countless LSD groups, organisations, magazines and newsletters
were similarly attacked by Authorities and media everywhere.

Much of the British anti-psychedelic offensive was predictably bizarre, surrealistic

and Monty Pythonish. In 1978 the playwright Heathcote Williams wrote to me
that a “...good old friend David Solomon abandoned his typewriter momentarily
to score some of the legally available fungus: ergotamine tartrate in Switzerland,
and has just picked up a rather large glob of porridge ... ten years. When I went
to see him in the slammer after, he was more upset that his mother’s ashes,
which were seized for analysis when he was busted, were to be destroyed along
with all the other exhibits at Aldermaston -- which means that his mother will
have the dubious privilege of being cremated twice. The Operation Julie
nightmare ... armed guards on the roof ... have just knocked off long piece about
it in current IT. The three policemen who tripped provided considerable comic
relief ... Strange that acid was discovered in the same year as the Bomb ... Every
action has an equal and opposite reaction.”

Rudi Wormser, a psychologist and psychotherapist teaching experimental

psychology at the University of Munich, capsulated LSD’s invaluable social
properties. “LSD is not known to have any harmful effects in a medical sense. It
is not an addictive drug. LSD is extremely helpful in psychotherapy (especially
with alcohol-addicts and psycho neurosis.) It is a stimulant for creative problem.
It reduces anxiety and increases awareness of personal conflicts and the wider
physical and social environment.”

Timothy Leary’s admirable, combative anti-authoritarian tendencies (as Aldous

Huxley accurately predicted) soon engendered his involuntary exit from official
academia and allowed him to become a catalyst of global cultural change and
technological acceleration. A leaked seventies internal NATO document regarded
the embryonic LSD and general countercultural initiative as “threatening the
survival of Western Civilisation”. I found myself in conflict with Leary’s traditional
middle-class elitist approach. He always argued that such powerful substances
should only be used in a proper set and setting for constructive ends by
experienced and seriously inclined people. He argued rightly that most people
would abuse these drugs and many would suffer as a consequence. Most people
abuse everything, including breathing in and out -- but that’s surely their
prerogative. Before the late fifties, such drugs had always been in the hands of
the magician, warlock, shaman, priest, sorcerer -- the powerful and the
privileged. I felt it a good thing that the feckless mass should at least be able to
experience and indulge; beyond the control of the powerful and rich. The same
libertarian argument is still valid today. Today, in these sterile nineties and New
Dark Ages, any kind of chemical kick-start is necessary and welcome.
The unprecedented acceleration of artistic and technological innovation in the
latter part of this century was largely fuelled by widespread psychoactive
substance use. When I exchanged information with New York’s Inner Space
editors in the early sixties, we all thought that we stood on the brink of a major
new human animal evolutionary advance. I still consider, rightly or wrongly, that
such enstatic substance consumption can lead to the next stage of evolutionary
development of the human nervous system. LSD experience (as deep-sleep,
trance, hypnosis, yoga, psychosis, meditation, rapture, deli

39
Tales of the Medicine Circle:
Sacramental Entheogen Use in Peri-millennial America: a
democratic form

Anna Eleusis

The Medicine Woman gathers up her ritual tools and heads toward the circle, as
the sun moves toward the western horizon on the eve of Spring Equinox. Her
tools:

The rattle: made on the New Moon after the death of her mother; of skin
embellished with Spirals and filled with pebbles from the stream running near a
friend’s land. She had walked along the stream for a full day, her own cells
vibrating with the cells of all nature around her, singing to the waters and the
stones beneath the current, giving praise to the great creation underlying all life,
and to the great teacher LSD.

The staff: a gift from one of her teachers, another Medicine Woman in a distant
city in a distant state, now working with another circle; the cycles have changed,
and they are both “elders” now. A simple peeled staff of ash, encircled with
carved serpent imagery, dangling ribbons with beads and baubles: winged Isis,
sage & feathers, a bubble wand, wrapped ‘round with skeins of colors from many
rituals.

The medicine: On a wooden platter, Trichocereus pachanoi cut in an array of 6

and 7-pointed stars, one piece for each circle participant; which they will taste to
“homeopathically” attune to the devas of mescaline and the abiding spirit of
Mescalito. And: a silver box holding 11 doses of “pedigreed” LSD, 100 mcg each,
and a bowl of pure water in which they will be mixed after invocation of
protective energies. This celadon bowl of sacramental medicine will be passed
around the circle throughout the night, sipped by all participants.

Work to prepare a circle in the woods began in mid-day. At the center of the
circle, over old ashes, wood forms a cone arching upward, prepared to light
quickly as the torch is laid at the invocation of fire. Wood is also stacked at circle
periphery. Preparations intensify as the sun sinks more deeply in the sky: ten
men and women in middle and elder years bring in piles of blankets in rainbow
and earthy shades, according to the taste and needs of their sitters. Blankets and
cushions are placed over low beach chairs, close to the ground, allowing sitters to
stay connected with the earth. Each individual creates his or her own circle within
the wider circle, placing favorite objects and rattles and drums in an arc around
them. They are close enough to touch, but not touching; and couples do not sit
by their partners. The voices are hushed, excited.

Several participants work with directly with Medicine Woman to prepare and
enact ritual elements of the circle. One is Medicine Man (a man or woman), who
has taken part of the day to prepare the entheogen that will be used as
sacrament for the night’s ritual. Two others are Fire People (1 man & one
woman), who prepare the fire, and will keep the circle brightly lit and warm,
always keeping flames high enough that faces are illuminated and all can make
eye contact. Nourishing and feeding the fire will directly nourish & feed the
circle’s energy throughout the night. Sage Woman (again, a man or a woman)
will use ceremonial sage and herbs to purify the circle & its participants.
Throughout the night, he will bring cleansing sage smoke to anyone flagging in
energy or having emotional or physical hardship.

40
At other circles, varying entheogens may be used as sacrament. This is
determined in part by the season, by the perceived or preferred ceremonial “set,”
and by the availability of selected entheogens. Sacred medicines used as
sacrament may include Peyote or San Pedro alone; synthetic mescaline; LSD and
MDMA in combination: and others. Mushrooms are not commonly used in this
circle form, due to their more soporific, chthonic, inward-drawing (and at times
sleep-inducing) energies; activating and energizing medicines are preferred and
“fit’ the circle form more closely. (Best recipes for entheogenic circle work with
Ayahuasca or pharmahuasca have yet to be determined. Medicine Woman
continues her experimentation in other settings, seeking a chemical and
alchemical balance of DMT and MAOI components to support the uniquely
participative form of this medicine circle...)

The night of sacramental ritual will be long. The circle will begin at dusk and
continue through the closing songs of dawn. Each person attending has
committed to sit with each other in a ritual circle throughout the night, remaining
“connected” from dusk to first morning’s light. They will journey & travel as “one
body”, “one entity,” or “one vehicle.” Significantly, they have also committed to
keep their eyes open and their awareness open to the circle as whole, staying
linked in that very direct way. The circle form asks that eye and heart be turned
both inward and outward, encouraging energetic and sensory alliance between
participants. This is the commitment that each member makes to the circle: to sit
up, to pay attention, to stay awake, and to contribute as fully as possible.

To begin, Medicine Woman will invoke the sacred boundaries of the circle, the
four elements & Earth & Sky. The medicine will be blessed and thanked, mixed,
tasted; and a piece of cactus and an offering of the entheogenic brew offered to
the fire. Medicine Woman will then sing the first song, staff planted firmly before
her, rattle rolling to find the rhythm she is riding, spine erect, unfurling to the
inner beat. In turn, each participant will lead the circle and sing; the rattle, staff,
and song moves from one participant to another. Each one becomes the staff-
bearer and rattle-shaker and song-crafter in turn, sharing the rhythms that pulse
through them, and guiding all “between the worlds” with their song’s melody.

Throughout the long night, all participants will sing rather than talk. They will sing
in English; and they will sing in unknown but somehow familiar languages: howls
and lisps; crackles and hums; trillings and whispers; cacophony and symphony.
Vowels and consonants will move together (and apart) in new ways; some new
sound forms will be discovered. Yet, even in known or shared languages, the
song is always new, improvised, created; it arises always from the heart of the
moment, and is a test (an initiation) of trust and breath.

Earlier in the day of this circle, Medicine Woman met with all participants to
review the purpose, and structure of the form. Everyone skipped meals, took
inward time to reflect or meditate or relax, and then returned for final
preparations Of the eleven attending this circle, 9 have come before and know
the form and 2 are new. These 2 have been involved in non-entheogenic circles in
the past, and have gathered before with circle members, to discuss the form and
determine if the circle would be a “good fit” for all concerned. They have also had
their own personal experiences with entheogenic medicines. The screening of new
participants remains primarily an intuitive process but specific experiences will be
also discussed thoroughly.

Among the basic attributes of the medicine circle, all activity moves deosil or
sunwise; i.e. clockwise. The staff and rattle, water & medicine will all be passed
clockwise, and this is the direction people will enter and leave the circle, as deosil

41
movement is considered to be energy-raising. No one will speak or pass medicine
or water in front of the rattle and staff-bearer as they are singing- only in the
times between songs. All attention is devoted to the singer. One cycle of staff and
rattle's passage around the circle constitute one "round," and 3 to 4 rounds will
take place this Equinox evening. One break will occur at midnight, for the whole
group. That break is taken in silence. Otherwise no one leaves, however briefly,
unless speaking with Medicine Woman. Even those becoming sick are asked to
remain, if at all possible. (If they need to leave someone would accompany
them.)

How does one sing a song that has never been sung before, in a circle between
the worlds? The Spirit of the Medicine reminds us: Be present. Who can find or
sing your song but you- or say how it lives and breathes and dies? Hold the staff
erect, and let it become a ‘lightening rod’ between the powers of Earth and Sky,
the forces of immanence and transcendence. Arising from the union of these
polarities, we access the wellspring of all song, all language, all prayer and
thanksgiving. It will not help (it never helps) to pre-think, pre-judge, pre-worry,
or get caught in time. No, your song will not be recorded, encased, delineated or
captured, perhaps no one will even remember how it goes (even you!) It will
dance like a tongue of sacred flame into the night- vibrantly alive, strong and
profound, yet evanescent as mist. It will linger in no form; it is a child being born
and going away. Expressing from the ‘you that is us’ and the ‘we that are you,”
your sacred songs will echo only in the NOW, beyond time, language & culture.

Book Review

The Secret Chief: Conversations with a pioneer of the underground psychedelic

therapy movement
by Myron J Stolaroff, 1997 (MAPS, Charlotte, NC, USA, ISBN O-9660019-1-5)

Reviewed by Jon Atkinson

Psychedelics are relatively new to us culturally and our relation to them is still in
a developmental stage. The Secret Chief describes a way of using them that is
currently unusual in our society. It seems likely that this will change though since
a similar kind of use is seen in the many cultures where they’ve been used for a
long time. As is also the case in these cultures, much of what is described in the
book extends far beyond the bounds of its therapeutic function.

I consider this to be a very important book because it contains a blueprint for

social forms that have the potential to enrich people’s lives in no small way. I will
present mainly a précis of the story that is told as I feel that this is what is of
most value in the limited space available. My own commentary will be brief.

The “chief” is given the pseudonym Jacob. He was a psychologist and originally
held the traditional psychiatric attitude towards hallucinogens. He considered
them to be “dangerous and bad,” and thought that anyone who used them must
be crazy. In the prologue Stan Grof notes that in retrospect history often highly
values those who violate the misguided laws of their time. In the forward Albert
Hofmann, the discoverer of LSD, adds that,. “Hardly any other science is as
conservative and tradition-bound as is medicine.”

Psychedelics are conceived to induce processes that contains their own resolution.
The therapist’s role is one of minimal intervention to the point where sitter is
probably a more appropriate term, because that is largely all that is involved. An
underlying belief is that techniques for helping people don’t work, and Jacob’s

42
approach is to “Just leave ‘em alone!” He describes himself as an instrument, not
providing the experience but only the opportunity since he doesn’t really know
what’s wrong with them, nor what it is that they need. And neither do those who
are taking the drug either, though it’s believed that they bring their own
experience to themselves, and it is this that is of most use to them.

One of the main values of having a sitter is for the reassurance given by the
presence of another person. But before entering into this relationship an
evaluation needs to be made as to whether it’s a good idea for this person to sit
with that person who will trip. Expectations will be discussed and what the person
hopes to get out of the experience. Each needs to trust and feel comfortable with
the other and the decision is based largely on intuition. Without the right feeling
and mutual trust it is better not to do it.

Sometimes people get frightened at the transition point between different stages
of awareness, and here they are encouraged to describe and go into it all the
way. Often this leads to a release into a state of rapture. Dramatic internal
conflicts can arise that are found difficult to confront. There’s a tendency to try
and get out of this situation by escaping through a variety of methods, such as
denial and distraction. But the more a person tries to run away the greater the
threat becomes. The advice is to “Look at what you’re afraid of, just look at what
you’re afraid of. All you have to do is just look at it; don’t do anything about it,
just look at it. Just keep on looking at it and tell me what you experience when
you’re looking at it.” and stay with it until it becomes transformed. When you’re
willing to face it the fear disappears, it gets resolved as a matter of course, “to
some degree at least.”

Some people who took LSD in this way with Jacob had already taken it many
times before. Yet after following the methodology he used they would consider it
to be another kind of experience altogether. One that resulted in a very different
outcome. Some had previously had bad experiences while tripping but had been
unable to move through these until they found the support to help them through
their fears.

The first session would be on a one to one basis with Jacob. The drug used is
LSD, and the dose begins at 250 mcg. This is usually enough, but occasionally
incremental booster doses are felt to be needed as individual sensitivity varies.
(In the 1990’s LSD is usually sold in doses of between 20 and 80 mcg.)

The person is asked to agree to five conditions which form the structure of the
event:

(1) They will not leave the house during the trip without prior clearance from the
sitter.
(2) They will not physically harm or be violent to themselves, the sitter, or
anything else.
(3) They will not reveal to anyone where or with whom they had the trip without
prior clearance, ever.
(4) There will be no sex taking place between them.
(5) If at any time during the trip if anything is going on and the sitter tells them
to stop doing it, and makes clear that, “This is under structure, it’s not just a
recommendation or suggestion,” they agree that they will stop it.

Or if the sitter tells them to do something, under structure, they agree that they
will do it. They are told to consider this last one very carefully indeed, and all
they have to go on is the amount of trust they feel.

43
Regarding (1), sometimes it is acceptable to go outside with the sitter when
they’re coming down. (2) makes people feel safe if they are afraid of unexpressed
anger. (3) is for the legal security of the sitter as a protection against the present
laws. (4) is to enable people not to suppress their sexuality, or be frightened of it,
but to find it and know they’re safe because nothing is going to happen.

The book, and the ritual itself, would be more complete with a similar structure
drawn up for the conduct of the sitter. The general qualities of a good sitter are
implicit in the text, but they are not spelt out as explicitly as is the appropriate
conduct of the client.

After agreeing to the structure they were given a prayer to read. The general gist
of this is: I don’t know what is most use to ask for. May I be given what I need. I
open myself to whatever happens. And trust it’s for the best. Then they take the
LSD, have a brief look at some photographs of people who are significant to
them, including themselves at various ages, perhaps talk about some dreams
from the night before, and just chat generally until they begin to feel the effects
coming on. They then go to urinate, come back and lie down. They put eyeshades
on to keep attention directed inwards and to avoid distraction. And put earphones
on for music if and when they want it. After an hour they are asked if they want a
booster dose. Then for the next five to eight hours there is no further interaction.

The only exception to this, unless they need the toilet again, is if they want a
hand to hold during a difficult transition stage, in which case they just put out
their hand or call out. But there is no talking or other communication, apart from
perhaps the sitter encouraging them to stay with whatever they’re afraid of, not
to try to do anything about it, just to let themselves be frightened. And to give
reassurance he’ll stay there with them throughout it.

When the effects have subsided enough for them to be able to talk, they sit at a
table and go through the photographs systematically. Whatever they might say
now is recorded on a tape. This can later reconnect them with the whole
experience.

Another baby-sitter, someone who they love and trust, has been asked to turn up
about eight hours after the beginning. They are briefed not to ask demanding
questions that night but just to listen or give whatever space is wanted. But when
they do come there’s often a lot of contact between them. The therapist doesn’t
leave until the client says this is ok, and then he leaves his phone number so they
can call for any reason and whenever they want.

After this there is the opportunity for group sessions which entail the shared
exploration of a spectrum of psychoactive substances. The setting becomes more
significant with the desire for a secluded environment including water and trees.
There are three sitters who remain straight and around ten to twelve people who
trip. Most of them know each other well as the group has been formed very
gradually. The same structure holds as for an individual trip but now there is an
extension to no sex for the weekend. This is so people can let go amongst
themselves without the worry of being misinterpreted. Agreement to the whole
structure is renewed as a ritual.

On the Friday night people talk to the group about what’s going on in their lives
and what they hope will happen during the weekend. The next morning has a
fairly quiet atmosphere. People stake out the place they want to trip. If there is a
couple present they are asked to trip in separate parts of the house to avoid the
temptation to externally act out any involvement with each other. Different
people then choose different drugs. Each takes his or her own at the same time

44
as everyone else. When they start coming up they each lie down and put their
eyeshades on.

From then on there is practically no interacting until they start coming down.
Some people on MDMA may want to hold hands or hug, but it’s also fine for
others not to, particularly if they are on something else. And once it’s done the
staff lie them back down again and return to the kitchen where they chat
amongst themselves. They don’t hear anything from the rest unless someone
needs a booster or the loo. When everyone’s down enough to function they get
together for a champagne ceremony. Then they have dinner, sit around, laugh,
chat, be alone, whatever. The next day they go around the group again and talk
about what happened. This is felt to be the best part of the trip for everybody.

This all happened once a month with forty odd active participants coming every
three or four months and around 100 less frequent members. Each time they aim
to have a balance between men and women. People also trip together at home
and in smaller groups with a sitter.

The different materials used, and their most common doses, include MDA
(150mg), harmaline(124mg) -taken with LSD(250mcg) or psilocybine mushrooms
(3g), mescaline(500mg), ibogaine(225mg) and MDMA(150mg). Ibogaine is a
heavier experience where blocks tend to be confronted and things come up that
one may have been trying to avoid or deny. It’s taken when someone wants to
work out some aspect of themselves, as can also be the case with harmaline. In
contrast MDMA tends to be more for having a good time as it’s predisposed to
feelings of love, beauty, acceptance and pleasure.

Boosters can sometimes be useful but usually they are not needed. When people
want a full “blast,” and they feel close but can’t get through, they think more of
the medicine can do it. Since high doses were already being used Jacob’s
response to such a request was often: “More is not better. Lay down and stay
down. No wandering around, because as soon as you start to be functional you
detract. You’ve got to get into your ego to be functional. Lay down and have your
whole trip.”

45
Schizophrenia - a disease or some ways of being human ?

Prof FA Jenner, ACD Monterio, JA Zagalo-Cardoso & JA Cunha-Oliveira, Sheffield

Academic Press, 1993.

An Alternative to Medical Psychiatry - part two of a review Article by P G Virden

I am! Yet what I am who cares or knows?

My friends forsake me like a memory lost.
I am the self-consumer of my woes;
They rise and vanish, an oblivious host,
Shadows of life, whose very soul is lost.
And yet I am - I live - though I am toss’d
into the nothingness of scorn and noise,
Into the living sea of waking dream,
Where there is neither sense of life, nor joys,
But the huge shipwreck of my own esteem
And all that is dear. Even those I loved the best
Are strange - nay, they are stranger than the rest.
I long for scenes where man has never trod -
For scenes where a woman never smiled or wept -
There to abide with my creator, God,
And sleep as I in childhood sweetly slept,
Full of high thoughts, unborn. So let me lie -
The grass below; above, the vaulted sky.

John Clare (1793 -1864)

In Part 1 of this review, in ASYLUM, 11, 2, it was shown that orthodox psychiatry
is very muddled about what schizophrenia is and how to deal with it; that
perhaps the symptoms bear some relation to creative and outsider stances; that
the orthodox definition and understanding of the symptoms leaves much to be
desired in terms of both precision and common sense ascription of motive; and
that both neurobiological and genetic research beg far too many questions and
are really beside the point.

A condition to be explained by causes, or understood as meanings?

The category ‘schizophrenia’, meaning a splitting of the mind, is in practice

applied to patients perceived as unacceptably unintelligible. Denoting a bundle of
symptoms, the term has been in use about a hundred years. Unlike the signs and
symptoms of any physical disease, however, its signs don’t lead to a categorical
diagnosis. It wasn’t until the 1950s that Schneider suggested a description of
clear signs and symptoms, and since then they have been identified and grouped
together in the diagnostic catalogues used by psychiatry world-wide.

As opposed to the mainstream, however, Jenner et al.. contend

46
 “Delusions, hallucinations, formal thought disorders and catatonic
symptoms are striking and unusual to most of us but they are
perhaps susceptible to meaningful interpretations within the context
of the patients’ life histories...To understand or not to understand is
an alternative very often decided not by the nature of the illness but
by the power struggles fought amongst mentalhealth professionals
and between them and their patients. Time, concern and intellectual
interest in our patients’ problems are precious commodities which
professionals have in short supply...The ability to understand depends
to a great extent on the psychiatrists’ imaginative powersand also on
their commitment to the patient.”

The overwhelming psychiatric consensus is that schizophrenic speech and

behaviour is “beyond human understanding”, and this re-enforces hopes for a
simple biochemical or genetic explanation. Much research and theoretical use is
made of statistical variations, even though classifications are admittedly rough
and ready and there is not very good agreement between psychiatrists classifying
the same case. This would not be so for the diagnosis of, say, measles, where
symptoms and simple physical tests would give 100% agreement about diagnosis
and treatment. Doesn’t this indicate that schizophrenia, or any mental illness, is
not illness like a bodily illness, but perhaps demands a completely different mode
of analysis and explanation?

The current orthodoxy seems to imply that we can distinguish clearly between
understandable human problems and those for which scientific, medical
explanations must be sought because they are actually mental illnesses.

“In other words the concept of schizophrenia depends on accepting that some
things can be understood and other things cannot, although we can’t quantify and
objectify them statistically.”

But why should we assume we aren’t able to understand someone else, just
because their speech and behaviour is not immediately clear? In such cases we
should rather study the patient’s life in detail, trying to get some sort of a
biography. Jenner et al. suggest this would make psychiatry in such cases more
like trying to tease out the meaning of a poem than finding determinative causes
of behaviour, which is the way the sciences of physics and chemistry operate on
the world of objects and processes. Certainly we can only catch glimpses of other
people’s motives and experiences, and are bound to be biased, but what the
authors call “the ideographic approach” will give a more vivid and insightful
picture of the patient than one which merely assigns him to a category by totting
up a number of symptoms.

“In fact, if psychiatrists do not believe in the possibility of understanding what a

particular patient says or does they will simply try to gather what they see in
advance as the relevant symptoms, in terms of the main nosological entities
defined by the diagnostic code with which they agree. They will [merely] confirm
their own prophecies.”

Naming and labelling just give the illusion of discovery. Instead the psychiatrist
should try to understand the behaviour, engage in a discussion at the patient’s
level, and take him seriously as a person trying to communicate something - or
perhaps simultaneously trying to avoid communicating something.

47
Through discussion the psychiatrist should try to offer the patient his ideas about
the patient’s ideas.

“We hope this exchange of worldviews (and the demonstration of our

understanding and concern) will eventually lead to a kind of negotiation between
us and the patient, and even perhaps to a more or less profound and lasting
modification of patients’ beliefs and lifestyles.”

As against a simple-minded anti-psychiatry, they are here talking about suffering

and perplexity, not the romantic’s idea of some heroic, more lucid voyage into
inner space. The distance between the psychiatrist and the patient needs
reducing by simple human contact and conversation that could lead to
understanding. As it is, the supposedly objective and scientific view of the patient
renders him essentially strange and alien, a person inhabiting a completely
different and non-human reality. This re-enforces the ‘clinical’ idea that we can
deal with such people in a ‘detached’, ‘objective’, ‘scientific’ manner, ruling out
human contact and dialogue, and only ‘explaining’ pathology by ‘natural causes’.

There are emotional and political reasons for the ‘scientific’, ‘medical’ approach.
But the pretence to science and regular medicine is pure myth: medicine and
science are not even like the way psychiatry tries to be. For example, for a
century post-Newtonian physics has recognised the reciprocal relationship of
observer and observed. Isn’t it time organised psychiatry recognised a similar
position in its relations with its ‘subject matter’, its patients? The orthodox
language of psychiatry fossilises both patient and psychiatrist not into therapy but
into a ritual confirming a dominant politics and ideology.

As an existentialist philosopher and a psychiatrist, Jaspers’ influence upon

modern psychiatric thinking has been profound. Writing in the period between the
two World Wars, he thought that empathy with a schizophrenic was not possible.
Before him, Freud, too, thought that his own analytic technique could work with
people only so far gone as neurosis. He didn’t think it could work with psychotics,
who, by definition, have gone beyond reason. However, Freud’s ideas about the
fragmented, self-contradictory nature of the personality, alienated from its own
experience, provides a crucial lever to understanding. For Freud all expression
has meaning, however obscure it may seem at first glance. Since Freud it makes
sense to view mad behaviour as replete with meaning, however deviant it may
appear.

If we look at the personal worlds of patients, at their social and historical

contexts, we are less likely to view their behaviour or ideas as completely
incomprehensible and alien to human nature. But we must then attend to the
meanings of the expressions and behaviours, not ignore possible meanings just
because they are presented in a bizarre form. Unfortunately, faced with the
bizarre, psychiatry calls it ‘symptoms of schizophrenia’ and simply refuses to see
them as forms of action, intention or motive.

Why? For one reason, because to begin to try to interpret the meanings of bizarre
and severely dysfunctional behaviour exposes psychiatrists to the judgements of
the public. The public, too, interprets meanings, as a normal matter of daily life.
So wherein lies the psychiatrist’s expertise? Listening to someone and
interpreting his replies also, when people are in trouble, usually allows no easy
and rapid solutions. So instead a psychiatric jargon develops, behind which
psychiatrists can hide from other professionals, the public, the patients, and, not
least, themselves. Patients’ predicaments and problems can then be neatly side-
stepped. The pseudo-medical jargon is used ideologically by psychiatrists and

48
their institutions as a political bludgeon. It is obviously very tempting to
transform human problems into illnesses and then use an unchallenged ‘medical’
power to decide the fate of patients by shuffling them into pigeonholes subject to
pre-arranged processes.

These ‘medical’ rituals and jargons that psychiatrists use are a form of scientism,
of scientific-seeming ideology, devices to persuade us all that psychiatry is almost
precisely correct and scientific in its questions, terminologies and procedures.
Psychiatrists are themselves trapped in a cage of their own medical language and
education.

The clear definition of schizophrenia is a prime example of a political decision that

the profession took. When Schneider spelled out his concept of schizophrenia in
1955 - from which all later psychiatric thinking and research has stemmed - he
stressed that the concept was no more than a conventional linguistic device, not
a proven disease entity, and should be cautiously used as such by clinicians. But
his technical language soon became fetishised, his caveats ignored, and the
conceptual ‘syndrome’ is used as a dogma to settle questions that still await a
proper solution.
Although by now educated people should know that a disease consists usually of
multi-factoral changes in biological processes, the image of disease as a rigidly
defined, unchanging, uni-causal object inflicted on the body and distinct from it
has a strong hold on people’s imaginations. This ‘common sense’ notion is only a
little less concrete than that of the Esquimo who brushes or blows illness away.
Despite their medical training, it still seems to grip the imagination of most
psychiatrists.

Another myth that mainstream psychiatry has imported from medicine proper is
that of explanation solely by way of the scientific analysis of the material body.
For four hundred years doctors have developed better and better ways of seeing
further beneath the surface of life. Clinical medicine has delved deeper and
deeper until illness has ceased being viewed as something descending upon the
body, but as developing within it, perhaps by invasion, perhaps not. This century
the focus has moved from cells to micro-biology to genetic structures. It is rare
for a clinician to consider living relationships beyond the boundaries of the human
body. There is a medical indifference to external influences and human behaviour,
which are nevertheless the predominant determinants of health and disease. It
hasn’t been clinical medicine that has in the last 150 years or so improved
general health so much as improvements in sanitation and diet: matters of social
life. Yet most sick people are pretty much left to their own devices by doctors
when medical measures working on the inside of a person are not appropriate.

Of course, all psychiatrists are first trained medically. They share the views of
medicine. They cannot conceive of neuroleptics not being the appropriate
treatment for the disease of schizophrenia. Why look to improve the living
conditions of schizophrenics? They cannot think that perhaps the better form of
treatment is not drugs to dampen ‘the symptoms’, but a removal of the
influences from which the abnormal behaviour emerges. Perhaps the most useful
research to be done today would be to compare schizophrenic with non-
schizophrenic populations: an epidemiology, but sensitive to as much nuance as
possible.

Trained medically, and believing in the twin ideologies of doctoring and

psychiatry, the keepers of the schizophrenic currently use the wrong words and
ask the wrong questions of the patients and their symptoms. Why assume one
cause? Is a personality (a person) subject to one cause? Why approach the

49
problem in terms of cause, anyway, so fragmentarily, uni-dimensionally and
naively? Why this obsession with genetic or bio-chemical cause? Better to reflect
on motives, meanings and the coded messages that appear to be expressed in
schizophrenic speech and behaviour.
Reassessing the schizophrenic response

Of course chemicals do have an effect on schizophrenic symptoms. The currently

favoured drugs are phenothiazines. But the body is a constantly changing,
immensely complex biochemical feedback system that exists in, and always
reacts to, an environment. What do we certainly know about the human body-
and-soul and the context in which it grows?

We know that everybody develops needing nurture, love and significance. We

know that there can be no human life outside of a social life, and hence all
‘natural’ development is into an artificiality of history and culture, and is more or
less controlled, socialised and lived under more or less tension. A self-imposed
restraint and calmness is needed to adapt to the social and cultural conditions in
which the person finds himself. Most of our waking lives the higher centres have
to suppress the automatic activity of the central nervous system. The cortex must
be kept from over-arousal by fears and frustrations. Perhaps schizophrenic
behaviour is due to excessive dopaminic activity? Certainly it is a life process, and
all human life is lived within contexts of lesser or greater - sometimes excessive -
frustration. Perhaps sometimes frustrations cannot be managed without
exhibiting schizophrenic symptoms.

In fact Schneider’s set of schizophrenic symptoms have not been reasonably

demonstrated to apply only and exclusively to a particular group of people
clinically diagnosed as schizophrenic. His First Rank Symptoms can be found in
patients suffering from functional psychoses psychiatry assigns to other
categories. What we can safely say is that a person is diagnosed as schizophrenic
who displays certain symptoms, has been clinically referred, and is “...a highly
sensitive person living in a more or less permanent state of emotional turmoil,
especially when interacting with people he sees as threatening...”

And the environment, most significantly for the human animal, other people, has
a great effect on psycho-physiological measures of agitation.
As against the medico-’scientific’ mainstream, “...Proper scientific standards are
defences [psychiatrists] used to avoid getting involved with... patients in a
dialogue bound to be coloured by [the psychiatrists’] and [the patients’] world-
views.”

And yet the evidence for the effect of psychiatry upon the behaviour of patients is
readily available from various studies over the last forty years and more. Recent
work, for example, has shown that trials of maintenance phenothiazines are little
better than placebos when used in a hospital setting. But they have significant
effects on out-patients. This suggests that the hospital acts as a shield from the
stresses of life back home and in the community. Schizophrenics in the
community not on drugs relapse at a higher rate.

In orthodox psychiatry the social context, the environment, crises and life
changes are recognised, but only play “...an accessory role...in the overall
context of the officially accepted aetiopathogenic theory of schizophrenia.”

The underlying assumption is of a medical disease process, which, it is generally

assumed, will itself create problems in the home and community. Put simply,
orthodoxy assumes a disease creates social problems, whereas it could equally be

50
assumed that social problems create the disease. And any assumptions could and
should be investigated by anybody trying genuinely to get to the root of the
matter. So do we need to postulate entirely hypothetical medical diseases in
order to account for the mental states and behaviours of schizophrenia? Can the
symptoms not be read as the results of an interaction of a personality with an
environment?

A clue is given by cross-cultural studies. The course and prognosis for

schizophrenia is significantly more favourable in Third World countries than in the
First World. There are much higher rates of return to normality, the ending of
symptoms, and less relapse of mild schizophrenia in Mauritius than in the UK
(although no differences for severe schizophrenics, where little improvement
occurs). Similar results have been found between Tongan and Australian
subjects.

The best explanation of these differences is that the social and cultural conditions
are better suited to recovery in the Third World. There patients do not get
trapped into an established sick role, and can find an ‘explanation’ of the onset in
terms of locally approved superstitions, and can inhabit culturally defined roles
that embrace their strange behaviours. The Third World also imposes less
pressures from competition and constant social change, and tends to find
traditionally allocated roles for its populations rather than demand that each
should spend a life making his own decisions about who to be and what to do. In
other words, they present less constant, competitive, atomised social stress. And
it is well known that, in general, the social and cultural environment has a big
effect on the nature and course of schizophrenic episodes.

So the authors would rather investigate the phenomenon of schizophrenia from

the point of view not of a discretely dysfunctioning body, not of an object for
medicine to operate on, but of a person active in his world. They propose an
“ideographic approach to schizophrenic patients’ behaviour and the writing of
biography as a means of understanding their acts and experiences. This implies
that schizophrenia is more akin to some varieties of life processes than a specific
kind of disease.”

However, “being akin to” is not the same thing as “being”. Implication is not
outright assertion. There is a whiff of an attempt to not completely affront the
psychiatric orthodoxy in this qualified and tentative proposal. Nevertheless, the
authors quote the authority of the younger Bleuler:

“...schizophrenics flounder under the same difficulties with which all of us

struggle all our lives. In spite of our own inner discords, or ambivalences, and our
ambitendencies, all of us must find ways and means for establishing an
awareness of our own ‘egos’ and for confronting the world with our own wills. As
long as we recognise the schizophrenic as a fellow sufferer and a comrade-in-
arms, he remains one of us. But when we see in him someone whom a
pathological heritage or a degenerate brain has rendered inaccessible, inhuman,
different or strange, we involuntarily turn away from him. Yet it is so very
beneficial to the schizophrenic for us to stay close to him!

“...even in healthy people there is some disposition in the direction of a

schizophrenic psychic life and...such disposition might perhaps be a normal part
of human nature. This, indeed, has been proved by research into the psychology
of the healthy; beneath the surface of healthy psychic life enabling us to adapt to
others and to the real world there is hidden in every man a chaotic inner life
which goes on without consideration of reality. This chaotic and illogical inner life

51
cannot be distinguished from the schizophrenic way of thinking, imagining and
living...”

However, Jenner et al. then disagree with Bleuler’s rather gloomy conclusion that
the chaotic and illogical features of a schizophrenic patient’s inner life is
completely inexplicable and has nothing to do with his actual experiences in life.
That is the attitude of the old psychiatric orthodoxy. Instead, why not assume
that there is method and meaning in the madness, and that we can hope to tease
the meaning out, if only we give it chances to emerge?

There is already plenty of evidence to show that there is no such thing as a

specific, completely pessimistic schizophrenic career. Schizophrenia is more like a
life process, open to a great variety of influences and outcomes, rather than a
physical illness with a specific, uniform progression. The person should be of
greater account than the diagnosed illness. And psychotherapy is the best
treatment.

In which case the person diagnosed schizophrenic would be seen not as a passive
victim of a complex of morbid factors, but as an active protagonist of a history
and destiny. Discussions should be opened with the patient about the role played
by his personal responsibility vis-a-vis not only his past and present misery but
also the making of his future.

“The patient’s own participation in the incubation, emergence and course of his
psychiatric illness” will mean different clinical interventions according to each
patient. His own choices, decisions, projections and value-judgements have an
effect on his career as a mentally abnormal person.

The “pharmacological tricks” of restraint are sometimes necessary but entirely

secondary to the meaningful relationship of the doctor to the patient. That must
become a dialogue, a negotiation, involving compromise and the disclosure of the
doctor’s worldview, not a ritual of supposedly detached clinical observation. Why
try to hide the doctor’s views on the patient’s self-destructive behaviour when the
patient can usually guess them anyway?

Psychosis and schizophrenia should be seen as “...the prices men must pay for
being thrown into a world where they have to find, and make,
their own way without the help of any concrete set of norms, valid for all times
and places.”

But schizophrenics are so insecure that they fail to handle chaos except with a
pathological belief system. A curtain of fantasy makes everything clear to them -
but fantastically clear, not actually clear.

In the experiences of the authors, schizophrenic patients, though sensitive and

mistaken, can become less disturbed and suspicious if they can be persuaded that
they are able to act and think as responsible and socially effective people who still
have plenty of time to make good sense of their lives. As R D Laing said: “A good
deal of the skill of psychotherapy lies in the ability to appeal to the freedom of the
patient.”

In which case physical treatments and unnecessary sedations can positively

obscure the issue, if only by persuading the patient that his brain is diseased and
there is nothing he can do to help, but can only expect help from the outside
delivered by technical experts.

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Of course there are risks in adopting the humanist position. For one thing, you
enter the ideological battle between protagonists of neurophysiology and
psychodynamics, biochemists, social workers, civil liberties agencies, neighbours,
relatives, friends, nurses and their unions, police, judges...But psychiatry bears a
certain responsibility towards those for whom it cares . It invented the term
‘schizophrenia’ and then foisted the category on people by just assuming the
symptoms were of some unknown and still to be discovered disease. Jaspers
bears a large responsibility for establishing the idea that the onset of such
madness is unpredictable and independent of peoples’ life histories and the
meanings of events within them. Now it is time to rescue the category, and those
who suffer under it, for a humane and effective treatment.

The authors favour a view of schizophrenia that concurs with the recently
proposed notion of ‘nascent states’. “The world of the marvellous” is experienced
by creative people, by lovers, by religious mystics - and by schizophrenics. Such
states of mind question the stabilities and routines of established institutional life.
And the institutions - family, school, community, church, psychiatric facilities -
exist to neutralise and domesticate such states of mind which are all dangerous
to the stability of the status quo.

Franca Basaglia sees schizophrenia as the most individual and least contagious
nascent state. Psychiatry is used to reducing the schizophrenic’s responsibility for
his vision and to defining his state as a disease. Science-cum-medicine is used
ideologically to depict his state as a defect internal to the individual, not as a
vision about a social norm that he contends because he experiences it as
defective.

To suffer schizophrenia is to inhabit a Kafka-esque world where any accomplice to

the status quo can denounce you and yet only the accused become notorious.
Once caught and defined as schizophrenic a person loses his humanity rather
rapidly. It is a polarisation of Us and Them. To be normal is not only to tolerate
power but to sympathise with it against its powerless opponents.

Szasz has spoken against this for many years. Historically, Medicine replaces
Theology, doctors replace the Inquisition, mental patients replace witches. Mass
religious movements are replaced by mass medical movements, and the
persecution of the heretic by the persecution of the mentally ill.

In our modern, supposedly enlightened world, reason persecutes unreason, but in

the name of care and cure. Unreason is supposed to issue from inhuman origins,
or to be unworthy of the category ‘human’. It is supposed to be “an historico-
anthropological atavism”, a genetic error, a viral infection, a biochemical fault.
And yet there was no such thing as schizophrenia until, at the turn of the old
century, the psychiatrists constituted it by gathering together a number of
defined symptoms.

The trouble is that all nascent states release conflict, instabilities, particularities
and unforeseen consequences. They will upset the insecure - which means almost
everybody - and the centralising and regulating powers that bulwark our
insecurities. The potency of the threat of chaos vs. structure is strong in modern
societies. Science is the legitimating agency of the rational modernity that holds
chaos at bay. Science is expected to know and be able to control everything that
ever occurs, including, and especially, conflicts. Medicine is supposed to be able
to cure all ills, and its junior partner, psychiatry, is supposed to regulate both
localised rational conflicts and those generated or inflamed by the presence of
nascent states of being. Biochemistry and genetics are, it is taken for granted,

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scientific, and to them is delegated the job of providing a technical fix for a nice,
tidy, identikit conformity.

In fact, however, people always live with tensions between their own and other
people’s needs and psychological states. And nobody can have complete
ontological confidence in the world. Most of the time the normal person lives
easily with common sense notions of time, space, matter, God, freedom, self,
morality and responsibility. It is often dangerous to question these issues
publicly. In the Renascence the sophisticated still burnt people to death for
suggesting the earth circled the sun, and Galileo himself was forced to stop
talking about it. As regards schizophrenic dissidents, Jenner et al. say

“Strange ideas tend to develop when beliefs begin to fail, when interpretation is
not rewarded, when one is socially and personally stranded and alone in a
strange world and perhaps angry and hurt. The attempt to go it alone can then
lead to a spiral of rejection, to isolation, to false
perceptions and/or experiences and segregation and diagnosis. Worse still, one
cannot escape. There is nowhere to get away from the social nexus and the
reality in which one’s emotions are so intimately and inevitably enmeshed ...

“The formidable task of being alone and struggling to produce a new language
with which to speak to nobody and yet to blame everybody else for one’s
discomfort produces unbearable tensions. One wishes to be very special but one
is not. In order to be secure, core constructs are tenaciously, almost randomly,
sought and maintained. What is face-saving in one’s mind, which is damaging to
one’s image in others, seems essential. Vacillation and thrashing around in a
rough sea, grabbing hold of this or that plank of belief...in order to survive and
breathe freely, follows. Everything makes everything worse, especially those who
think they are helping.”

People manifesting such strange speech and behaviour are insufferable and so
are called ‘schizophrenic’. But if psychiatry is to help such people rather than just
contain them and control them for the sake of socially organised power, its
mainstream must begin to understand what schizophrenia is: some ways of being
human.

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