When I was working in the Psychiatric Research Institute in Prague, Czechoslovakia, I was asked as consultant to see two employees of the pharmaceutical laboratories that were involved in the production of LSD. They had both suffered delayed adverse effects of an accidental intoxication with LSD, while synthesizing the drug. One of them, a man in his forties who was heading the department, showed symptoms of deep depression with occasional bouts of anxiety, a sense of meaninglessness of existence, and doubts about his sanity. He dated these symptoms to the time of his intoxication with LSD and subsequent brief hospitalization in a psychiatric facility. His assistant, a woman in her twenties who had experienced accidental intoxication with LSD several months after he did, complained about bizarre sensations in her scalp; she was convinced that she was rapidly losing her hair, although there were no objective signs to support this.
During the diagnostic interviews with them I tried to reconstruct the circumstances of their LSD experiences and the dynamics of the problems they presented. The story that I heard, although unbelievable of LSD therapists or people familiar with the nature of psychedelic states, is unfortunately a typical example of crisis intervention based on the conventional medical and psychiatric models. The pharmaceutical laboratories that were involved in the production of LSD were situated approximately two hundred miles from Prague, where most of the clinical and laboratory research with psychedelics was happening at that time. When the management received the order to start the synthesis of Czechoslovakian LSD, it was felt that, because of the nature of the substance, the staff should be informed about its effects and instructed about the necessary measures in case of accidental intoxication. The director invited from the nearby state mental hospital a psychiatrist who had no personal or professional experience of LSD and prepared himself by reading a few papers on the-model psychosis" approach to schizophrenia. During the seminar with the staff, this superficially informed psychiatrist managed to paint an apocalyptic picture of LSD. He told them that this colorless, odorless and tasteless substance could insidiously enter their system, as had happened to Dr. Albert Hofmann, and induce a state of schizophrenia. He suggested that they should keep a supply of Thorazine in their first-aid kit and in case of accidental intoxication bring the tranquilized victim without delay to the psychiatric hospital.
As a result of these instructions, both laboratory workers received Thorazine shortly after they had started to feel the effects of the drug, and were rushed in an ambulance to the locked ward of the state mental hospital. There they spent the rest of the intoxication period and a few following days in the company of psychotic patients. While under the influence of the LSD-Thorazine combination, the department chief witnessed several grand mal seizures and had a long discussion with a patient who was showing him his wounds after a suicide attempt. The fact that he was put by mental health experts in the company of severely disturbed patients contributed considerably to his fear that he might himself be developing a similar condition. Analysis of his LSD state, which was only incompletely truncated by the Thorazine medication, showed that he was experiencing elements of BPM II,* and the confinement in the locked ward and his adventures there represented a powerful reinforcement of his desperate state.
The experience of his research assistant was more superficial; her reaction to the atmosphere of the locked ward was to pull herself together and maintain control at any cost. Retrospective analysis of her experience showed that she was approaching a traumatic childhood memory, but because of the external circumstances she suppressed it and prevented it from surfacing. Her feeling of losing her hair turned out to be a symptom related to this deep psychological regression; the infantile body image corresponding to the age when she experienced the traumatic event involved hairlessness as a natural condition.
During their visit to the Psychiatric Research Institute in Prague these two pharmaceutical workers were able not only to work on their symptoms, but also to change their image of LSD and the negative feelings associated with it. We explained to them the nature of the LSD state and discussed with them our therapeutic program and the principles of conducting sessions. Before they left they had ample opportunity to discuss the effects of LSD with patients undergoing psycholytic treatment who had experienced their sessions under substantially different circumstances. I assured them that there was no reason for alarm if someone was intoxicated by LSD; as a matter of fact, we were producing situations like that routinely in our program. They were advised to have a special, quiet room where the intoxicated individual could spend the rest of the day listening to music in the company of a good friend.
Several months later, I received a call from the department chief. He told me that they had had another "accident"; a nineteen-year-old laboratory assistant had experienced a professional intoxication. She spent the day in a comfortable room adjacent to her laboratory in the company of her friend and "had the time of her life." She found her experience very pleasant, interesting and beneficial.
In my third year in Big Sur, California, I was awakened at 4:30 one morning by a telephone call. It was the night guard from the nearby Esalen Institute asking for help. A young couple called Peter and Laura, who were traveling down the coast, had parked their VW camper on coastal route 1 in the vicinity of the Esalen Institute and had decided to take LSD together. They rolled out the bed in their car and shortly after midnight both of them ingested the drug. Laura-s experience was relatively smooth, but Peter progressively developed an acute psychotic state. He became paranoid and violent, and after a period of verbal aggression he started throwing things around and demolishing the car. At this point Laura panicked, locked him in the car and sought help at Esalen. She appeared at the guard shack completely naked, holding the car keys in her hand. The night guard knew about my previous work with psychedelics and decided to give me a call; he also woke up Rick Tarnas, a resident psychologist who had done his dissertation on psychedelic drugs.
While the guard was taking care of Laura, who calmed down and had a pleasant, uncomplicated LSD experience, Rick and I walked to the camper. As we approached the car we heard loud noises and shouting; when we came closer we noticed that several of the windows were broken. We unlocked the car, opened the door and started talking to Peter. We introduced ourselves and told him that we had had considerable experience with psychedelic states and had come to help him. I tentatively stuck my head inside the door and looked into the camper; a half-gallon bottle missed me by about four inches and landed on the dashboard. I repeated this several times, and two more objects came flying in my direction. When we felt that Peter had nothing more to throw, we quickly moved into the camper and lay down on the roll-out bed on either side of him.
We continued talking to Peter, reassuring him that everything would be all right in an hour or two; knowing that he and his girlfriend had taken LSD after midnight, we could give him this definite time limit. It became obvious that he was in a paranoid state and saw us as hostile FBI agents who had come to fetch him. We held his arms in a comforting and reassuring way, changing this into a firm grip whenever he made an attempt to escape, but avoiding real physical antagonism and struggle. All the while, we kept talking about having had difficult experiences ourselves, and finding them retrospectively useful. His condition oscillated for about an hour between mistrust with anxiety-laden aggressive impulses, and episodes of relief when it was possible to connect with him.
As time went by and the LSD state became less intense, Peter slowly developed trust. He was more and more willing to keep his eyes closed and face the experience, and we were even able to start working carefully on the blocked parts of his body, encouraging full emotional expression. By seven o'clock all negative elements completely disappeared from Peter's LSD experience. He felt cleansed and reborn, and was thoroughly enjoying the new day. His previous hostility turned into deep gratitude and he kept repeating how much he appreciated our intervention.
At about half-past-seven Laura appeared at the camper and joined us; she was herself in very good condition, but was naturally concerned about Peter. Rick and I helped dispel the negative aftermath of the dramatic events of the night and facilitated their reunion. We advised them strongly against driving that day. They spent a leisurely day by the Pacific Ocean and the next day continued their journey south. They were both in good spirits, although somewhat worried about the bill for the repair of their damaged camper.
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