Therapeutic Applications of LSD and Related Drugs
Robert E. L. Masters and Jean Houston
From: PSYCHEDELICS, The Uses and Implications of Psychedelic Drugs
edited by Bernard Aaronson and Humphry Osmond Doubleday & Company, 1970.
©Aaronson & Osmond.
Introduction by Peter Webster
In the mid-1960s, legislation in the United States
instituted a prohibition on the use of psychedelic drugs, not
only the supposedly alarming use by hippies, intellectuals,
beatniks, college students, etc., but also use by scientific
researchers and mental health professionals. The ban on
practically all research and therapy was soon forced upon the
rest of the world by international treaties and also, no
doubt, by covert pressure from the CIA and other U.S.
government agencies. LSD and the other psychedelic drugs were
classed as "Schedule 1" substances, supposedly
having no medical value or recognized uses.
Yet a significant body of scientific literature of the
time indicated quite clearly that psychedelic drugs most
certainly did have valuable uses in both therapy and pure
research. Work that had been going on for more than a decade
in Canada, for instance, had shown LSD psychotherapy to be
the most effective treatment for alcoholism ever devised.
Other studies had begun to show similar effectiveness for
treatment of addictions, personality disorders, and a whole
range of conditions.
A review of the pertinent scientific literature of the
time is of great importance today, for a general review of
the whole situation of the War on Drugs is increasingly
leading to calls by important and influential individuals for
a serious re-evaluation of that policy, if not an outright
reversal leading to complete legalization of "drugs of
abuse". A close scrutiny of the basis and justification
for the War on Drugs is revealing not only inconsistencies,
but gross deception, blatant lies, and the worst kind of
propaganda used to institute and promote that War. The
recognized therapeutic applications of cannabis, for
instance, are still being resisted by Drug Warriors in spite
of evidence that would long ago have been sufficient to get
government approval had cannabis been a "new drug"
invented by a pharmaceutical company. Yet cannabis remains a
Schedule 1 substance.
The following essay is the introductory section of a paper
published in 1970 that reveals a similar, if not even greater
ignorance in the current official attitude toward therapeutic
use of the psychedelic drugs. The authors are noted
scientific researchers who had been working with psychedelics
for many years. Their work, like that of many others, was
brought to an abrupt and premature conclusion by the
anti-drug hysteria which still today, perhaps more than ever,
is doing far more to poison Western Civilization than any
sort of "drug abuse" could possibly do.
TOWARD AN INDIVIDUAL PSYCHEDELIC PSYCHOTHERAPY
ROBERT E. L. MASTERS AND JEAN HOUSTON*
Widespread therapeutic use of LSD-25 and similar psychedelic
drugs did not begin until the 1950s. By 1965, there had appeared
in scientific journals more than two thousand papers describing
treatment, of thirty to forty thousand patients, with
psychedelics (Buckman, 1967). Since 1965, the literature has
continued to grow and now includes book-length works as well as
the shorter reports published in journals and anthologies. Yet
spokesmen for the American psychiatric establishment continue to
tell the public that there is no evidence to demonstrate the
value in therapy of psychedelic drugs.
Reports of therapeutic successes have come from hundreds of
psychotherapists working in many of the countries and cultures of
the world. The psychedelic drugs have been used as
"adjuncts" or "facilitating agents" to a
variety of existing psychotherapeutic procedures. Some efforts
have been made to develop new, psychedelic therapies specifically
grounded in the drug-state phenomena and the new models of the
psyche that have been suggested by the psychedelic experience.
The diversity of the approaches to therapeutic use of
psychedelics makes the evidence supporting their value for
therapy all the more impressive. Individuals and groups of
therapists of various persuasions have worked with one or more of
an ever-expanding family of psychedelic drugs and with a great
many drug combinations. Dosages administered have varied
enormously—in the case of LSD, anywhere from 10 to 1500mcg or
more. The psychedelic treatment has been considered as consisting
of from one to well over one hundred drug sessions.
In general, therapists working with small doses—such as 25-50 mcg of LSD—do so only to facilitate conventional therapy, most
often psychoanalysis. Such doses may heighten suggestibility and
facilitate recall, association, and emergence of unconscious
materials. This type of treatment might involve weekly sessions
that continue for months or even years.
When the very massive dose is administered—LSD: 750-1500
mcg—the intent is to achieve the therapeutic result in a single,
overwhelming session. The patient's values are changed and
personality otherwise altered by means of a transcendental-type
experience akin to a religious conversion. This type of treatment
has been used mostly with alcoholics.
Other therapists work with a "moderate" dose—LSD:
150-400 mcg. Exact dose is individually specified on the basis of
the patient's body weight, drug sensitivity (if that can be
determined ), and personality factors. The dose should be
sufficient to allow for a full range of psychedelic response; at
the same time, the patient should not be overwhelmed or made
confused or unable to communicate effectively. A brief therapy,
one or a few sessions in a few weeks or months, is the aim.
Types of conditions repeatedly stated to respond favorably to
treatment with psychedelics include chronic alcoholism, criminal
psychopathy, sexual deviations and neuroses, depressive states
(exclusive of endogenous depression), phobias, anxiety neuroses,
compulsive syndromes, and puberty neuroses. In addition,
psychedelics have been used with autistic children, to make them
more responsive and to improve behavior and attitudes; with
terminal cancer patients, to ease both the physical pain and the
anguish of dying; and with adult schizophrenics, to condense the
psychosis temporarily and to help predict its course of
development.
Almost all therapists reporting these successes have stated
that the incidence of recovery or significant improvement was
substantially greater than with other therapies used by them in
the past. The treatment typically required much less time and was
accordingly less costly for the patient.
Treatment with psychedelics has most often been described as
ineffective in cases of hysterical neurosis and hysteria,
stuttering neurosis, infantile personality, and long-term
neurotic invalidism. Despite reported successes, compulsive
syndromes, criminal psychopathy, and depressive states are also
mentioned as contraindicated. The risks frequently have been
considered too great for paranoids, severely depressed persons,
outpatient psychotics and prepsychotics, and those with a history
of suicide attempts or who may be currently suicidal. However, as
we have previously suggested (Masters and Houston, 1966),
psychedelic therapy may be indicated in cases where suicide seems
probable and imminent. By his being enabled to die symbolically
and then be reborn, the patient's need to die may be subsequently
eliminated.
That psychedelic drugs have value for psychotherapy has
usually been most vigorously challenged or denied by therapists
who have done no work at all with the drugs. Lack of adequate
controls to allow more objective assessment frequently is
mentioned. However, it is very hard to devise fully satisfactory
controls where such drastic alterations of consciousness are
involved. Some veteran workers with psychedelics believe
meaningful controls to be impossible. On the other hand, what one
research team regards as adequate double-blind conditions has
been achieved by administering a light dose of LSD (50 mcg) to
the control group, while the experimental group received 450 mcg.
The small dose produced definite changes in consciousness but did
not permit a full-fledged psychedelic reaction (Unger, et al.,
1966).
Other charges from opponents of psychedelic therapy have
attributed bias and excessive enthusiasm to workers with the
drugs. Certainly, some of the early papers were extravagant, as
tends to happen with new therapies. But the time has long passed
when psychedelics could be hailed as a panacea; and it should be
remarked that the bias of the advocates only rarely approaches
that of some "distinguished" critics. Some of these
critics seem ideologically and emotionally threatened by
psychedelic therapy. This has been especially true of
psychiatrists heavily committed to psychoanalysis. Psychedelics
emerge at a time when analysis is increasingly under strong
attack. Much of the opposition to the drugs is thus
understandable, but also unjustifiable.
Finally, psychedelic therapy has been assailed as too
dangerous. Very definitely, the evidence does not bear this out;
and in fact, when the drugs are administered by those therapists
and researchers who are most effective, the "dangers"
are negligible. This is borne out by studies involving many
thousands of patients and experimental drug subjects.(1)
(1) For example, Pollard, J., Uhr, L, and Stern, E.(1965): no
"persistent ill effects" in experiments with eighty
subjects over a five-year period; Masters, R. E. L., and Houston,
J. (1966): no psychotic reactions or unfavorable after-effects in
206 sessions over a combined fifteen years of research; Unger,
S., et al. (1966): one adverse reaction in 175 cases treated, and
that one "readily reversible"; and Cohen, S. (1960): in
one thousand LSD administrations to experimental subjects, less
than one in one thousand psychotic reactions lasting over
forty-eight hours. In therapy patients, per one thousand
administrations, there were 1..2 attempted suicides, 0.4
successful suicide, and 1.8 psychotic reactions. The results
compared favorably with incidence of complications following
electroshock treatments in common use. As compared to almost any
other therapy, LSD seems outstandingly safe when properly used.
(*) This essay is an excerpt from a paper of the same title in
Psychedelics, edited by Bernard Aaronson and Humphrey
Osmond, Anchor Books, Doubleday & Company, New York 1970.
Copyright 1970 by Bernard Aaronson and Humphrey Osmond.