This excerpt is taken from "The Trials of Psychedelic Therapy: LSD Psychotherapy in America” by Matthew Oram, available now. Published by Johns Hopkins University Press © 2018. Reprinted by permission of the publisher.
On 4 August 1965, Sarah* reported to cottage 13 of Spring Grove State Hospital, just outside of Baltimore, Maryland, to receive the psychedelic drug LSD, or lysergic acid diethylamide. Sarah was suffering from terminal cancer and hoped LSD could help bring peace to her final days. As a member of the hospital’s professional staff, Sarah was familiar with the institution’s large research program investigating the therapeutic potential of LSD with alcoholic and neurotic patients. However, she had not been directly involved with it. In fact, she had been “violently opposed” to LSD, dismissing claims of its benefits to patients and ridiculing the mystically oriented treatment procedure.
Nevertheless, she now believed LSD could help her to become more “acutely aware of the world” and make the most of her remaining days. Her friend, psychologist Sidney Wolf, a member of the psychedelic research team, had suggested the treatment. He believed that, behind her guarded facade, Sarah had led an unhappy life and was a “frightened, unstable individual.” He concluded that LSD therapy could help her to attain insight into her life, resolve inner conflicts, and “gain the inner strength necessary to . . . die with dignity.” Further, he hoped the psychedelic experience could help her to “understand the purpose of life, love and death.”
To prepare for her LSD session, Sarah underwent approximately thirty hours of intensive psychotherapy with Wolf. During this, the pair deeply explored Sarah’s low self-esteem and poor relationships with her mother and husband, and together they “began to expose unresolved conflicts, unfulfilled needs, crippling fears, and a psychological foundation that was shaky, hollow and rotten.” By the end of her preparation, Sarah had gained profound insight into herself and her past, and her relationships with her husband and children had greatly improved. She had also come to peace with her troubled relationship with her mother. Sarah’s husband and children also met with Wolf, and, after discussing their anxieties regarding the procedure, gave their full support.
Sarah arrived on treatment day feeling confident, eager, and at peace. As her car pulled up to the cottage, a group of colleagues associated with the research program—psychiatrists, psychologists, and secretaries—gathered on the front lawn to wish her well as she made her way to the specially furnished treatment room. As the drug began to take effect, she reclined on a sofa wearing eyeshades and headphones, which played a carefully curated selection of music. Soon she began to feel “fused to the music” and was transported into experiences where she reassessed her life, values, and concept of self and discovered new perspectives:
"Mainly I remember two experiences. I was alone in a timeless world with no boundaries. There was no atmosphere; there was no colour, no imagery, but there may have been light. I was in a kind of maelstrom, bodiless, lofted and buffeted. Suddenly, I recognised that I was a moment in time, created by those before me and in turn the creator of others. This was my moment and my major function had been completed at and by my birth. By being born, I had given meaning to my parents’ existence. Why then the rat race, the need to achieve, to attain the meaningless goals we spend our lives chasing?
"Again in the void, alone without the time-space boundaries. Life reduced itself over and over again to the least common denominator. I cannot remember the logic of the experience, but I became poignantly aware that the core of life is love. At this moment I felt that I was reaching out to the world—to all people—but especially to those closest to me. I wept long for the wasted years, the search for identity in false places, the neglected opportunities, the emotional energy lost in basically meaningless pursuits."
In the late afternoon, as the drug effects began to diminish, Wolf took Sarah outside to walk among the trees on the hospital grounds. She communed with the natural setting, stretched, and “took a deep breath for the first time in months.” Her colleagues again gathered around, and all were moved to tears by her transformation. Immediately after her treatment, Sarah took a two-week lakeside holiday with her family, where, as Wolf later recollected, she “experienced a joy, an intimacy of contact, a freedom of relationships and a freedom to live that [she] had never known before.”
On her return, Sarah described her psychedelic experience as having had a profound positive effect on her mental state, her experience of her illness, and her relationships:
"What has changed for me? I live a different value system. I am no longer on the merry-go-round chasing a tarnished brass ring. I am living now, and being. I can take it as it comes. Some of my physical symptoms are gone. The excessive fatigue, some of the pains. I still get irritated occasionally and yell. I am still me, but more at peace. My family senses this and we are closer. We no longer talk about the issues that were opened, but should we want to, the avenues of communication are open. All who know me well say this has been a good experience."
These positive results were supported by data from psychological tests, which were performed one week prior to her session and two weeks after. They showed a significant reduction in depression and a general lowering over several other ratings of psychiatric pathology. Five weeks after her treatment, Sarah died when her condition suddenly worsened.
Wolf described the scene at her deathbed as free of the desperation and denial that frequently accompanied terminal illness: “There was such peace and acceptance that no one suffered.”
Sarah’s treatment was a particularly successful case of “psychedelic therapy,” a form of psychiatric treatment originally developed in Canada in the 1950s. Most commonly used to treat alcoholism, psychedelic therapy used a high dose of LSD, within a framework of brief, intensive psychotherapy, to elicit a mystical “psychedelic” experience. This experience had the power to reorient patients’ perceptions of themselves and their place in the world, in ways that could lead to lasting positive changes in their values, attitudes, and behaviour.
By 1965, a Canadian pioneer of the treatment, Abram Hoffer, reported data from eleven North American studies showing that, out of a total of 269 alcoholic patients, just over 50 percent were “much improved” and only 30 percent had not improved to some degree. LSD had been used in widespread clinical research in the United States since 1949, in the context of the breakthrough era of psychopharmacology research, which saw the development of the first effective drugs to treat psychosis, severe depression, and anxiety. Many psychiatrists believed LSD would join these drugs in revolutionising the discipline. Researchers found success treating not only alcoholism and distress associated with terminal illness but also a variety of neurotic illnesses, and narcotic addiction.
Yet in 1965, despite more than fifteen years of clinical research in the United States, LSD remained officially an investigational new drug, not approved for sale or use beyond clinical research. Over the decade, LSD psychotherapy research declined, before coming to a close in the 1970s.
In the mid-1960s, LSD was of course not only a promising tool of psychiatry. Recreational use of the drug increased over the decade hand in hand with the rise of the politically and socially rebellious youth countercultural movement. Preaching a utopian vision of peace and love, members of the counterculture believed that the “consciousness-expanding” effects of LSD had the potential to liberate American society by facilitating a spiritual revolution. To mainstream Americans, the drug represented escapist hedonism that could corrupt the minds of youths, threatening the nation’s social fabric. Inflamed by sensationalist media reports, LSD use became a major public and political controversy, and the dominant perception of the drug shifted from an unconventional but promising tool of medicine to a dangerous drug of abuse. Less than one month before Sarah’s treatment, Congress passed the Drug Abuse Control Amendments of 1965, beginning the drug’s criminalisation. By 1970, the Controlled Substances Act listed LSD in its most restrictive category of regulation—Schedule I—alongside heroin and marijuana.
The established narrative of the history of LSD psychotherapy has followed the close correlation between the decline in research and the rise in controversy and prohibitive legislation surrounding LSD to conclude that, intentionally or unintentionally, the government backlash against non-medical use of LSD killed medical research with the drug.
This, however, was not the case. A closer analysis of the provisions and enactment of the various regulations that impacted LSD over the 1960s and early 1970s reveals that the federal government never significantly restricted psychedelic research. In fact, it actively supported research for much longer than has been recognised. Further, where research has often been depicted as coming to a close in the mid- to late 1960s, limited research with LSD and other psychedelics continued until 1976, long after both the apex of the controversy over LSD’s non-medical use in the late 1960s and the drug’s prohibition. This later research was still focused on establishing treatment effectiveness, which remained a contentious issue. Considering this, perhaps the most significant question in the history of LSD psychotherapy research becomes not why did research end but why, despite more than twenty-five years of study, were researchers still trying to prove LSD’s efficacy? Why, in 1976, was LSD still an “investigational new drug”?
*Not her real name.