Sacred Mushroom of Visions

by Ralph Metzner

  C. Group therapy interspersed with psycholytic group sessions.

  Fontana (1961, 1963) studied the use of psilocybin and LSD in depth psychological group sessions on more than 240 patients. A group of 7 to 8 patients that had consistently met once or twice a week over a period of several months was offered the opportunity to participate in psycholytic group sessions. The participants met in suitable rooms within the clinic and received low dosages of psilocybin (8–12 mg) or LSD (50–150 mcg). Without asking for interaction within the group, participants were expected to surrender to their own experience uninhibitedly. According to their individual needs, participants were also encouraged to communicate with other group members. The group therapist in charge and the co-therapist acted as chaperones and would only interfere when problems occurred.

  Recently, Swiss psycholytic therapists (Benz 1989; Styk 1994; Gasser 1995) have worked utilizing a similar method. Scientists see particular advantages of this method in the activation of the group dynamic and intensification of transference-phenomena, as well as in the individual patient’s ability to understand and visualize his/her own defense mechanisms. Here, the group also supports the individual who thus experiences fewer fears and feelings of isolation.

  Fontana (1963) describes the dynamic of a carefully planned group session as “comparable with that of a musical group, in that the melodies and rhythms of each one serve to form a collective rhythm and a complete melody not interfering with the individual melodies.” In spite of particularly intensified transference reactions within the group, due to careful preparation no difficulties in supervising the meeting were observed (Fontana 1963; Styk 1994; Gasser 1995). Johnson (1964), however, reported difficulties with group application of psycholytic agents. He found increased confusion within the group dynamic and that individuals encountered interference with their personal experience. These problems can probably be traced back to the change from group therapy to interaction demands in psycholytic sessions. Follow-up analysis of the experiences is conducted in groups and, when necessary, in one-on-one sessions.

  Fontana (1963) recognized the special indications for group treatment to be useful in cases of character neurosis (clarification of otherwise ego-syntonic defense mechanisms), hypochondriacs (a dissociation between psychic and somatic entities is experienced under the influence of psycholytic agents and often helps the patient to recognize their interactive effect), adolescents (intense confrontation with specific patterns of conflict during this particular phase in life: relationship with the outside world and severance from the maternal influence). Otherwise, the indications described under A and B apply.

  D. Preparation in group therapy and high dosage (psychedelic) in a supportive group setting.

  This is the practice of administration of high dose psilocybin in group sessions for the purpose of inducing religious experiences that effect personality changes. The group associated with Leary (Leary 1961; Leary et al. 1963; Metzner et al. 1963, 1965; and also Pahnke 1962) researched the effect of high dosage psilocybin with over one hundred healthy volunteers in natural settings (nature, private homes, churches). Based on the observations of these normal subjects, therapists began to work with subjects with behavior problems (prison inmates). They utilized the deep changes in the experience of the self and the world while under the influence of psilocybin to improve therapeutically-effective self-realization in their subjects. This was based on the hypothesis that, with a given supportive setting and satisfactory agreement of the subjects: “(psilocybin) produces a state of dissociation or detachment from the roles and games of everyday interaction . . . This can provide insight and perspective about repetitive behavior or thought patterns and open up the way for the construction of alternatives.” (Leary et al. 1965). The project at Concord Prison in Massachusetts, initiated by Leary et al., was laid out as a six-week program for behavioral changes. Each subject underwent regular group therapy sessions (under the premises of transaction analysis) as well as two psilocybin sessions in small groups characterized as improving self confrontation. The subjects were informed about the scope and purpose of the program as well as the effects of psilocybin. Following a few organized group sessions, the subjects received 20–30 mg of psilocybin in the first session and 50–70 mg in the second one. These latter sessions took place in specially prepared rooms within the infirmary of the prison. They were initially conducted with 5–10 subjects and later reduced to only four subjects and one psychologist. The sessions were marked by intense experiences and self-confrontation that were subsequently discussed in groups. Despite careful postanalysis, instances of depressive aftereffects and difficulties in the emotional integration of the psychedelic experiences were sometimes observed (Leary et al. 1965). The authors also documented a reduced number of repeat offenders, particularly in respect to recurring criminal acts among participants of the study (Leary et al. 1968; see Doblin, chapter 6 this volume).

  The Norwegian scientist Alnaes (1965) closely followed the group therapeutic approach developed by Leary et al. He worked with a group of twenty psychoneurotic patients to help them gain deep insight into their own experience and behavior. He utilized a depth psychology group process that was interspersed with high dosage psilocybin (20–50 mg) sessions to achieve experiences of self-transcendence. After preparation in psychotherapeutic one-on-one sessions, the patient would receive psilocybin or the derivative CZ 74 in group session in supportive surroundings (cozy treatment rooms with pictures, candle light, and music). In the afternoon, immediately following the session, the experiences were discussed and interpreted in a group setting. Alnaes reported improvement of his patients but did not provide detailed evaluation.

  The Mexican psychiatrist Roquet used psilocybin and other psycholytic substances in a different way. After initially following Leuner’s (1962) guidelines for treatment, in 1967 Roquet developed his own methodology by incrementally integrating certain practices of Native American healers and combining them with modern audiovisual instruments (Roquet et al. 1975, 1981). In the beginning, the patient is carefully prepared through depth psychology in group or individual therapy. The patients are then subjected to a sequence of experiences involving hallucinogenic plants or substances in a group setting of six to thirty-five patients (Villoldo 1977).

  The day of the session the participants gathered in the morning for relaxation exercise. Later they met in special rooms that featured modern lighting and pictures of existential meaning. Once the effect of the drug took hold, the participants, who were in a sensitized psychic state, were subjected to strong sensory stimuli (sounds, music, movies, slides), which produced distinct emotional reactions. The sensory bombardment was produced deliberately to cause a severe psychic irritation with a concurrent breakdown of inner emotional defense mechanisms and mental concepts. The confrontational nature of this procedure aimed to evoke and stimulate personal and transpersonal emotional conflicts that were subsequently integrated into consciousness with the help of follow-up psychotherapy.

  Roquet et al. (1981) used this procedure to treat patients with character neuroses, sexual neuroses, and drug addiction. Nine hundred fifty patients were treated in this manner and, according to a scientific follow-up study, approximately 80% of those treated showed distinct improvements (Roquet et al. 1981). Table I summarizes the information on these studies.

  In addition to psilocybin, two related tryptamines have been used in psycholytic therapy. CZ 74, which has been clinically tested and applied in psychotherapy by Leuner (1967), Johnson (1967), and Alnaes (1965), should be of great interest for future research in psycholytic therapy. This derivative of psilocybin remains effective for only three hours and is entirely free of somatic side effects. Another related tryptamine derivative with an effective duration of 2–4 hours named DPT (dipropyltryptamine) was studied as an alternative to LSD in context of a research project of the Baltimore group led by Grof (1972–1973), Grof et al. (1973) and Soskin (1975; Soskin et al. 1973). The authors thought the sho
rt-term effectiveness of these substances also to be suitable for ambulatory psycholytic treatment (Leuner et al. 1965).

  COMPARISON OF PSYCHOLYTIC THERAPY WITH TRADITIONAL SHAMANIC PRACTICES

  The methods of psychoanalytic therapy described above are strongly influenced by the premises and procedures of Freudian and Jungian psychoanalysis. Psychoanalysis employs methods that are suitable for the exposure of traumatic experiences and hidden conflicts in personality development. Methods include hypnosis, dream evaluations, active imagination, free association, and guided visualizations, what Leuner calls “katathymic imagery.” The use of psycholytic agents, which enhance introspective experience and activate subconscious material, thus produces fruitful results in the hands of psychoanalytically-oriented therapists and was quickly established as an experimental procedure among researchers. The activation of unconscious conflicts and the recollection of dreams achieved greater depth in psycholytic sessions than with conventional treatments. It was observed that recollection with psycholytic agents could reach childhood memories as early as the first year of the patient’s life, producing a vivid and realistic recollection of events and making them available for therapeutic analysis.

  In shamanistic healing, unconscious conflicts and illness-related memories are equally stimulated, recognized as root causes of the illness, and subsequently interpreted by the shaman. Classical psychotherapists encourage the patient to surrender to emerging material and to try not to interfere with the state of inebriation, while some indigenous healers exploit the sensitized state of their patients to make specific suggested cathartic interventions. The European psycholytic method puts more emphasis on the activation and analysis of unconscious conflicts and memories.

  In traditional applications of very low dosages, suitable material appears mostly in the form of dream fragments. These fragments have been shown to possess personality-related characteristics; therefore it makes sense to integrate them into the therapy process of depth psychology. Missing from depth psychology is the psycho-dramatic momentum, as the stimulation/manipulation of the experience is limited to the playing of quiet music in a darkened room. The awareness of the self remains intact and allows the patient to observe from the perspective of a spectator.

  A further difference from traditional applications is the repeated administration of psycholytic drugs, where the patients are subjected to a series of ten to seventy weekly or monthly sessions. In traditional settings, singular sessions centered around conflict and including psycho-dramatic elements are customary. Indigenous healers frequently make use of follow-up sessions, but they focus on acutely-occurring illnesses. To achieve a strong impact with these short-term interventions, suggestive, psycho-dramatic, and religious aspects of the induced altered experiences are utilized. Shamans will interfere in the process of the session much more decisively than modern therapists will in psycholysis. The latter offer help with interpretation and therapeutic analysis solely during drug-free intervening sessions.

  The fact that the shamans include family members and relatives probably intensifies the impact of occasional interventions. Due to less frequent but higher dosages in shamanistic treatment, the awareness of the self is subject to greater fluctuation. In contrast, psycholytic therapists concentrate on the treatment of chronic neurotic diseases in the course of serial sessions. These chronic problems are usually based on structural distortions of the personality, so long-term treatment in psychotherapy promises success.

  The time of day that sessions take place is another difference. The indigenous healers exclusively hold sessions at night, whereas classical psycholytic therapists administer substances in the morning to utilize the afternoons for follow-up sessions. The procedures described above in section D (psychedelic), however, more directly follow various aspects of the religious cultural applications of hallucinogenic substances. Therapists were aiming at religiously ecstatic experiences for participants who were specifically prepared and received higher dosages of these agents. Such experiences often entail conversion experiences with personality-changing effect.

  This effect was scientifically proven by Pahnke (1962) and suggested the concept of “psychedelic therapy,” as developed by American LSD therapists (Chewelos et al. 1959; Savage 1962; Sherwood et al. 1962). Here the setting resembles that of the practices and rituals among traditional indigenous cults: dimly lighted, specially prepared rooms, semi-religious preparation, music, and other circumstances favorable to absorption of the experiences. These create a feeling of security and set the mood for the participants. Also, in contrast to the psycholytic method, no psychodynamic interpretation and analysis of the experiences takes place.

  Further differences include the fact that psychedelic therapy sessions only take place with individuals or in very small groups. On the other hand, traditional healings that are inspired by religious traditions are always performed in group settings with a ritual structure (LaBarre 1938; Myerhoff 1980). While in single settings the course of the experience is largely determined by the relationship between the therapist and the patient, in traditional group rituals the patient’s experience is dependent on the structure of the entire group and the follow-up work consists of a joint discussion of the pertaining experiences. In psychedelic therapy, just as in traditional applications, a small number of sessions over a period of time utilize higher dosages of the drug.

  Both groups offer professional observation of the participants, necessary because of possible fluctuations after the treatment. The traditional healers hold nightly sessions and meetings on the following day and the psycholytic therapists utilize an in-patient setting.

  Combining the several advantages found in psycholytic and psychedelic approaches was suggested by Grof (1967) and applied by Alnaes (1963) and Roquet et al. (1981), as well as by the Swiss psycholytic therapists Styk (1994) and Gasser (1995). These authors favored psychedelic/mystical forms of experience, adhering to the traditional setting (group sessions with higher dosage, ingestion at night, ritualistic structure, natural surroundings, etc.), as well as long-term therapeutic analysis of the psycho-dynamic biographical experience.

  SUMMARY

  In summarizing the historic development in the use of psycholytic substances in modern psychotherapy, I observed two lines of development. One direction is outlined in the psycholytic method in Europe, which integrates evocation of unconscious materials through psycholytic agents with the methods of classic depth psychology. The other direction is depicted in the development of the psychedelic method, which provides the base for therapeutic treatment by closely adhering to the traditional settings and procedures with semireligious experiences of mystical self-transcendence.

  In regard to results of treatments with psilocybin in modern psychotherapy, I will only point toward the research by Mascher (1966), Schulz-Wittner (1989), Leuner (1994), and the studies of the Baltimore-group (Yensen et al. 1995). These authors could (in agreement with many others) document a significant improvement in approximately 65% of the patients with serious and chronic neuroses. However, part of the evaluation seems problematic because it was conducted during the 1960s, when psycholytic substances were still being researched, and could only satisfy the standards of psychotherapy evaluation at that time.

  According to current standards, these evaluations seem to be lacking important data (Pletscher et al. 1994). Further research and examination of the promising treatment successes of those days are desirable under the following guidelines: 1. Specification of the diagnoses according to DSM IV/ICD-10; 2. The use of standardized instruments in understanding the psychopathology of the patient; 3. Specification of variables concerning the therapists and the environment; 4. Operational standardization of outcome variables; 5. The use of control groups. Some studies following these guidelines are in process now, in the United States and elsewhere, as described in a following chapter “A Note on Current Psilocybin Research” by Rick Doblin.

  Translation of this essay from the German by Corde
lia Ballent and Ralph Metzner.

  References

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