by Krystle Cole, PhD candidate.
Patients diagnosed with terminal illnesses, like lung cancer and heart failure, typically experience a decline in psychological and spiritual well-being concurrent with the progression of their diseases. Pahnke (1969) explained that the process of dying is “very personal”, and it “can stir deep emotions in any person who is involved” (p. 3). Often times, patients also experience “profound existential anxiety and despair” (Grob et al., 2011, p. 79).
Various treatment approaches have been developed to address these issues including dignity therapy, music therapy, the meaning-centered approach, the supportive-expressive approach, and the religious approach. Nevertheless, many patients do not experience “emotional relief” from the currently available treatment protocols (Gasser et al., 2014, p. 2).
In 1973, Grof, Goodman, Richards, and Kurland administered either LSD or dipropyltryptamine (DPT) to 60 terminal cancer patients in an attempt to alleviate some of their emotional and psychological issues. DPT is a hallucinogen with similar effects to LSD; yet, the effects last for 2 to 4 hours rather than 8 to 12 hours (Shulgin & Shulgin, 1997).
Prior to the LSD and DPT therapy sessions, participants received preparatory counseling and were assessed with the Minnesota Multiphasic Personality Inventory (MMPI), the Personal Orientation Inventory (POI), and a researcher-designed measure for independent raters (Grof et al., 1973). After the sessions, participants received integration counseling and were assessed again with the MMPI, POI, and independent rater questionnaire. Grof et al. reported significant improvements in anxiety, depression, and fear of death. Nonetheless, the internal and external validity of the findings were limited.
Thus, Richards, Rhead, Dileo, Yensen, and Kurland (1977) conducted a quasi-experimental study to further examine the effects of psychoactive doses of DPT in 34 cancer patients. In particular, Richards et al. focused on investigating the differences between patients who experienced DPT-induced peak experiences and patients who did not. A variety of measures were administered at pretest and post-test including the Peak Experience Rating Form (PERF), the Psychedelic Experience Questionnaire (PEQ), the MMPI, and the POI. The Brief Psychiatric Rating Scale was also completed by independent raters at pretest and post-test. Richards et al. found that peak experiences were significantly correlated with “rapid therapeutic progress” as measured by the POI and MMPI (p. 9). Still, the results were mixed because independent raters did not observe significant differences between groups.
With regard to methodology, the internal and external validity of Richards et al. (1977) was limited. The researchers used non-probability sampling, and there was not a randomly assigned control group. Nonetheless, the use of multiple measures for data triangulation and the implementation of pretests and post-tests were strengths. As such, the results of this study provided preliminary evidence of a relationship between peak experiences and clinical improvements in cancer patients. This relationship may even be the underlying mechanism through which DPT therapy helped the cancer patients within the Richards et al study.
In a 1978 journal article, Richards put forth a logical argument regarding the theoretical basis of the efficacy of DPT therapy in cancer patients. According to Richards, Carl Jung’s theory of the collective unconscious might be related to the ability of DPT therapy to help dying patients. Essentially, the psychedelic experience may help cancer patients access aspects of the collective unconscious that are “universal and intrinsic to the human psyche” (Richards, p. 118). In turn, these experiences may “resonate profoundly with the subject’s existential needs in everyday life” (Richards, p. 118).
Kurland also wrote a journal article that provided an analysis regarding how psychedelic “peak psychotherapy” might have been helping cancer patients (Kurland, 1985, p. 281). Essentially, Kurland explained that psychedelic therapy has the ability to shift a person’s worldview by helping him or her to confront “shortcomings with less resistance”; likewise, the psychedelic experience may also “neutralize a sense of alienation” and stimulate an “experience of some of the inner goodness of the self” (p. 281).
To investigate this further, Richards et al. (1979) conducted another study that examined the effects of DPT alongside 12 hours of brief psychotherapy in 30 cancer patients. The MMPI and POI were administered at pretest and post-test. The Emotional Condition Rating Scale (ECRS) was also completed by independent raters at pretest and post-test. Richards et al. reported significant decreases in “fear of death”, as measured by the ECRS (p. 17). Nevertheless, decreases found within the subscales of anxiety and depression were not at a level of statistical significance. This finding may be due to low statistical power from the small sample size. That said, there were also other methodological limitations like a non-probability sampling strategy and the absence of a control group. Consequently, the results have limited internal and external validity.
Because of the methodological limitations of these past studies, more research is necessary in order to evaluate the effectiveness of DPT therapy for the emotional crises of terminal cancer patients. Unfortunately, as a result of feasibility issues related to United States drug policy, there have never been additional studies into the therapeutic potential of DPT for the terminally ill.
Gasser, P., Holstein, D., Michel, Y., Doblin, R., Passie, T., & Brenneisen, R. (2014). Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. The Journal of Nervous and Mental Disease. Advance online publication. doi:10.1097/NMD.0000000000000113
Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Archives of General Psychiatry, 68(1), 71-78. doi:10.1001/archgenpsychiatry.2010.116
Grof, S., Goodman, L. E., Richards, W. A., & Kurland, A. A. (1973). LSD-assisted psychotherapy in patients with terminal cancer. International Pharmacopsychiatry, 8(3), 129.
Kurland, A. A. (1985). LSD in the supportive care of the terminally ill cancer patient. Journal of Psychoactive Drugs, 17(4), 279-290. doi:10.1080/02791072.1985.10524332
Pahnke, W. N. (1969). The psychedelic mystical experience in the human encounter with death. Harvard Theological Review, 62(1), 1-21. Retrieved from csp.org/docs/PahnkeIngersoll1969.pdf
Richards, W. A. (1978). Mystical and archetypal experiences of terminal patients in DPT-assisted psychotherapy. Journal of Religion and Health, 17(2), 117-126. dx.doi.org/10.1007/BF01532413
Richards, W. A., Rhead, J. C., Dileo, F. B., Yensen, R., & Kurland, A. A. (1977). The peak experience variable in DPT-assisted psychotherapy with cancer patients. Journal of Psychoactive Drugs, 9(1), 1-10. doi:10.1080/02791072.1977.10472020
Richards, W. A., Rhead, J. C., Grof, S., Goodman, L. E., Leo, F. D., & Rush, L. (1979). DPT as an adjunct in brief psychotherapy with cancer patients. Omega, 10(1), 9-26. doi:10.2190/NGUB-V4RM-T7DC-XTH3
Shulgin, A., & Shulgin, A. (1997). Tihkal: The continuation. Berkeley, CA: Transform Press.