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Five Case Reports of Positive Psychedelic Experiences in Patients with Mental Disorder

by Ben Sessa, Consultant Psychiatrist and Research Associate, Psychopharmacology Unit, Bristol University – submitted on October 17, 2008

Abstract:

This paper collates a collection of five anecdotal users’ experiences using psychedelic drugs as part of treatments for their pre-existing mental health problems. Some of these case histories involve users’ recreational use of these drugs and some describe psychiatry’s historical use of psychedelic drugs as part of prescribed treatments; a practice that has since ceased everywhere for almost 40 years. Subjects describe their use of the drugs LSD and MDMA to manage mental disorders such as OCD, chronic fatigue syndrome, anorexia nervosa and depression. These anecdotal histories are discussed contextually alongside the growing renaissance in medical research for revisiting psychedelic drugs as possible treatments for mental disorder.

Relative Safety of Psychedelic Drugs:

The hallucinogenic or psychedelic drugs are used recreationally by millions of people. Amongst 16 to 59 year olds in the UK an estimated 1.7 million people sampled in 2006 have used LSD in their lifetime and 2.3 million have used the drug MDMA, or ecstasy 1. The media usually present an entirely negative bias of their use, but in reality the vast majority of users do not develop serious mental or physical health problems requiring presentation to medical services as a consequence of these drugs.

After five decades of gathered data and millions of cases of their use, the ‘classical psychedelics’, of which LSD is an example, have a low risk of dependency 2,3 and cause no significant acute or chronic physiological harm 4,5. And whilst the drug ecstasy, MDMA, has been linked to neurotoxicty in very high dose animal studies 6, despite heavy prolonged recreational use in humans for over 20 years it too has consistently produced only a very low mortality and psychiatric morbidity rate when considered in relation to it’s prevalence of use 7,8. And in instances when psychedelic drugs are linked as the aetiological factor for mental illness the direction of causality is often disputed 9,10.

Psychedelic Drugs as Treatments for Mental Illness:

Uses by the Medical Profession:

Fifty years ago psychedelic drugs were studied extensively as proposed treatments for mental illness after LSD was distributed to doctors as an adjunct for psychotherapy. Despite progress in the field, this practice was shelved for socio-political reasons in the wake of the 1960s explosion of recreational drug use 11. Subsequently LSD was made illegal in 1966 and research stopped abruptly, where after recreational use of the drug increased dramatically. MDMA has taken a broadly similar path. Before being banned the drug was being used by doctors as an adjunct to psychotherapy in the early 1980s. After becoming an illegal drug in 1986 research ended and recreational use became widespread in society.

There has recently been a renaissance of psychedelic research within medicine. There are studies are underway looking at MDMA-assisted Psychotherapy to treat resistant PTSD 12,13 and further studies are exploring psychotherapy assisted by Psilocybin 14 and LSD 15 for treating the anxiety and pain associated with terminal cancer. Completed psychedelic psychotherapy studies include psilocybin-assisted psychotherapy to treat Obsessive Compulsive Disorder 16, Ketamine-assisted psychotherapy to treat Alcohol and Opiate Dependence 17,18 and a study exploring psilocybin’s role in a mystical-type experience 19. Future studies in the planning include the possible role of LSD and psilocybin as analgesics to treat the severe pain of Cluster Headaches 20.

Uses outside the Medical Profession:

Pre-dating modern medicine’s interest in psychedelics, the ancient use of hallucinogenic plants as therapeutic or spiritual agents is well documented 21. Many recreational users today claim these drugs induce feelings of spiritual well-being. The revelatory nature of these phenomena has lead successive generations of people to use psychedelic drugs to re-address the fundamental structure of their lives. Whilst undoubtedly a large proportion of today’s recreational users enjoy these drugs for their social, sensory and euphoric effects alone; there exists a significant population who use these drugs for spiritual reasons or as self-medication for mental illness. Evidence of this employment can be found on organised user-group forums such as Blue Light 22 and Erowid 23. These groups strive to distance themselves from a purely hedonistic approach to drug use by advocating a cautious and informed technique. Whilst doctors and politicians alike may frown at the existence of these practices, they nevertheless reflect an important user population with a voice worthy of understanding by clinicians.

Method:

Since my first publication of an editorial on psychedelic drugs as treatments for mental illness four years ago I have received spontaneous correspondence from eight individuals who have used these drugs to treat their mental disorder – either recreationally or in formal therapy with clinicians in the 1960s.

These individuals were emailed or telephoned to gain their consent to take part in this study. It was not possible to contact one of them. Of the other seven contacted all were keen to be involved in the project and they were sent the questions below. One of them was subsequently excluded as his description of drug use was for pure recreational rather than therapeutic reasons. Another individual was excluded because he described heavy use of LSD, Ketamine, MDMA and cannabis in the context of a severe psychotic disorder. Despite his report of predominantly positive experiences with these drugs, there is near unanimous agreement amongst clinicians advocating psychedelic research that the therapeutic use of psychedelic drugs is contraindicated in cases of psychosis.

The participants were asked to answer the following questions:

  • Give a description of your mental health problem and describe which traditional psychiatric treatments you have used.
  • Give a description of how you have used psychedelic drugs to treat your health problem.
  • Describe your subjective experience of the positive benefits of using psychedelic drugs to treat your mental health problem
  • Describe any problems you have encountered in using psychedelic drugs
  • What are your thoughts on the future of researching psychedelic drugs as potential psychiatric treatments?

In writing up the data received I have used fictional names.

Anecdotal reports:

1. ‘Tabitha’ – Describes using LSD for treating her Depression

Demographics :

Artist, in her 50s.

Been on psychiatric disability for 16 years.

Description of Mental Health Problem and traditional treatments used:

“I suffered major depression as a child and adolescent.  I didn’t have good emotional bonding. After my 2nd divorce I suffered with further depression.”

“I have been on every medication, psychotherapy and ECT. Including Psychoanalytical Psychotherapy, cognitive therapy, prayer, meditation, biofeedback, hypnotism and group work with little results.”

“I have had lots of side effects with medication.  Right now I am on Selegiline and Quetiapine with not much effect on the depression although I do have a bit more energy.  My mood still is low as a base.  I live on faith.”

Description of use of Psychedelics to treat health problem:

“I experienced LSD (recreationally) in my twenties. I have had no access to psychedelic drugs since the 1970′s. That was the only time I have experienced LSD.”

Positive Benefits of using Psychedelics to treat mental health problem:

“LSD allowed access to the soul and the heart in a profound manner.  I was opened to a realm of love, awe and sense of reverence I call God that I had never experienced before. It touched my soul and gave me a sense of oneness. I could feel the Holy Spirit. How does one describe LOVE?”

“I would like to use LSD in Therapy again to gain insight and grow or at the least be able to gain insight in consciousness through reflection or contemplation.”

Problems experienced with psychedelics:

“I did not experience any problems with LSD.”

Thoughts on the future for Psychedelic Research:

“LSD was a profound tool and I just hope science, government and the powers that be work together to allow further access to relieve suffering.  We have an epidemic in our culture with depression. Society is obsessed with achieving at the expense of the soul. I would like to see research done at Universities and the FDA allow doctors to get the go ahead to proceed.”

2. ‘Albert’ – Describes using LSD for treating his OCD and Chronic Fatigue Syndrome

Demographics:

79 years.

Retired bachelor.

Description of Mental Health Problem and traditional treatments used:

“I was diagnosed with OCD and Chronic Fatigue Syndrome in my early 20s whilst at university in the late 1940s. I had ten years of traditional (psychoanalytic) psychotherapy, twice a week, including Group Therapy. I also received prescribed drug treatments with Dexamphetamine and minor tranquillisers. No treatments effected any demonstrable change.”

Description of use of Psychedelics to treat health problem:

“In 1961 I read in Time Magazine about LSD Therapy and began this treatment. I immediately noticed a breakthrough. I began to tackle persistent neuroses and symptoms remitted.”

“I was receiving LSD doses of 175micrograms i.v. every week.”

“The therapy stopped in 1964 and I had a severe relapse of symptoms, was hospitalised and received Insulin therapy.”

“I resumed LSD therapy in 1965. This continued (through four different therapists with dwindling supplies of LSD) on a regular basis using doses in the range of 200 to 300 micrograms until 1975, when the final therapist ran out of their supply of LSD. Thereafter no therapists were able to get hold of the drug. I have had no LSD therapy since 1975. I have never used LSD or any other drug recreationally or without medical supervision.”

“In 1979 I began Holotropic Breathwork © and I continue to use this therapy today. In 1983 I had a severe relapse of symptoms and was hospitalised and given chlorpromazine and haloperidol.”

Positive Benefits of using Psychedelics to treat mental health problem:

“I feel LSD was the first, and only, form of therapy that has helped me. I am a very tough case; very difficult to help. But I‘m a fighter.”

“LSD melts the ice and allows you to do something about the emotions that are trapping your neurosis in place.”

Problems experienced with psychedelics:

“During those 15 years of LSD therapy I did have many very intense, scary experiences. I have experienced intense ‘near-death and re-birthing’ experiences under the influence of LSD. But these experiences were nevertheless vital. They are essential, despite (or rather because of) them allowing important material to be realised as part of the therapy.”

Thoughts on the future for Psychedelic Research:

“I want to get myself well. And I want other people to get well but I feel strongly that taking LSD must be adequately supervised and lead by a trained guide in order to reap the benefits of the powerful experience and minimise the adverse effects.”

“Since my LSD therapy ended in 1975 I have continued to battle for the resumption of psychedelic therapy. I want to encourage the medical profession to re-introduce LSD therapy.”

3. ‘Adam’ – Describes using MDMA for treating his OCD

Demographics:

Aged 41.

Living alone. On incapacity benefit.

Description of Mental Health Problem and use of traditional treatments:

“The OCD began age 11 but I didn’t receive any treatment until age 15. However this was only psychotherapy and I was not given an accurate diagnosis. It wasn’t until age 21 when I was diagnosed as having OCD.”

“I have been treated with 3 or 4 of the SSRI drugs as well as Clomipramine, along with several courses of CBT and behavioural/exposure therapy.”

“I found the positive effects of the SSRIs to be beneficial; however the side-effects were so strong they outweighed the efficaciousness of the medication, so I could never tolerate being on them for long. Overall the CBT and SSRIs have been unsuccessful in my case hence my exploration into alternative forms of treatment such as psychedelics.”

Description of use of Psychedelics to treat health problem:

“I have used MDMA. I am unsure of the exact dosage – just a few grains of the pure crystal crushed. I find I only need to take a miniscule amount for it to work. I have had 3 doses in the last 3 months, approximately 1 per month. 1st time was with 2 friends in a recreational situation. After an hour I noticed the OCD symptoms subside, along with feelings of empathy towards my friends; I experienced a more profound appreciation of the music playing; I felt more introspective and insightful into my own mind and thoughts; I felt completely in control of myself throughout the evening; overall a very pleasant and enjoyable experience.”

“About 3 weeks later I tried it again but this time alone and a slightly smaller amount. This time it was in a working environment (my home recording studio). It was a positive experience in that it stimulated some creative ideas and once again alleviated the OCD symptoms. However it was difficult to look at the computer monitor for extended periods. Perhaps working with an assistant may have helped with this.”

“3 or 4 weeks later I tried again taking the same amount in a working environment but with another person. This time it was more successful. The work was more straightforward and required less concerted periods of concentration. And the interaction with the work colleague went well, where in the past it had been strained. Again the OCD was improved.”

Positive Benefits of using Psychedelics to treat mental health problem:

“MDMA works better for me if I am in company, be it a social or working environment. A couple of weeks after taking a dose I sometimes get small flashes of insights or inspiration regarding my views on certain things, the direction my life is taking and how to rectify where I could perform certain tasks more efficiently, or interact with others more harmoniously.”

“I noticed myself having moments of deep retrospections over my past and the course my life has taken up to this point; with feelings of great loss and sadness as well as great joy and happiness.”

“All of this has been helpful in terms of giving me a greater overall perspective of my life - past, present and future, and how I see my place in relation to the world around me. I feel more confident in the path I have chosen and have a greater faith in my talents, abilities and character…perhaps a little wiser too.”

“During this time I have also found the OCD symptoms, as dreadful as they are, have perhaps not brought on quite as much anxiety as they previously have.”

Problems experienced with psychedelics:

“The only downside was feeling somewhat tired the following day; and the problem of availability of course.”

Thoughts on the future for Psychedelic Research:

“I can only see myself using MDMA sporadically. My hope was that it would help me with the work I do alone in my studio, but unfortunately this was not the case. I understand there have been some quite successful psilocybin trials in other countries for treating OCD. This is something I would also be keen to try.”

4. ‘Stan’ – Describes using LSD for treating his OCD

Demographics:

77 years old. Retired dentist.

Married, with 4 grown-up children.

Description of Mental Health Problem and use of traditional treatments:

“I was fine as an under-graduate and in my house jobs. Then aged 25 years old, when in National Service, I started becoming anxious and agitated with excessive checking and intrusive thoughts. I was discharged from the RAF on medical grounds and advised to see a psychiatrist, who diagnosed OCD.”

“I started fortnightly psychoanalysis with a private psychiatrist in Harley Street in 1957. Then I had a major breakdown and was admitted to psychiatric hospital and given Stelezine. I was discharged after thirteen weeks and then off work for a further thirteen months with very disabling symptoms of OCD.”

“In 1961 I became a supply teacher, as there was no way I could return to dentistry because of my OCD symptoms.”

Description of Experiences with psychedelic drugs:

“In 1961 I was given LSD by an NHS consultant psychiatrist. I had very little preparation. I don’t know what dose I was given. There was a nurse with me. I immediately began reliving memories of my childhood. It felt very intense and very real.”

“I continued to have LSD sessions over the next six years, during half-term and school holidays. I had about 20 sessions in all.”

“Sometimes I didn’t get any effect at all. But eventually it began to work. Everything clicked into place about my childhood and my relationship with my parents. I credit this to LSD.”

“The symptoms of OCD disappeared completely and I was able to return to dentistry. Thereafter I thrived in my job and became a high achiever in the field of academic dentistry.”

“LSD allowed me to once-and-for-all understand and overcome the illness. Not just treat the OCD symptomatically and risk relapse. Before LSD I merely existed. After LSD it all went. I owe it all to LSD!”

Problems experienced with psychedelics:

“Once I had a very frightening experience on LSD. I was terrified and shaking. I required a lot of support from the nurse and the resident doctor.”

“I would never use recreational LSD. I would never want to have a negative experience without close medical supervision on hand.”

Thoughts on the future for Psychedelic Research:

“I utterly support further research. The sooner the medical profession can re-use LSD the better. It is important to differentiate between it’s use recreationally and it’s use therapeutically.”

“I am delighted to help in anyway I can.”

5. ‘ Alice’ – Describes using LSD for treating her anorexia nervosa

Demographics:

26 years old.

Post-graduate student.

Description of Mental Health Problem and use of traditional treatments:

“I have a ten year history of severe anorexia. I was experiencing all the classic symptoms of extreme low weight, plus the recent onset of extreme obsessive-compulsive rituals.”

“In the past I saw a child psychiatrist for several years and had therapy sessions both alone and with my family. During finals at university I had a course of CBT, which helped in the short-term to increase my food intake and get through the exams. I also had one entirely dissatisfying session with a more traditional psychoanalyst.”

“I have been taking Fluoxetine for almost four months, at a daily dose of 60mg.”

“My BMI is currently 15.7 and I am currently enrolling on a programme of measured weight gain supported by cognitive behavioural therapy, part of a clinical trial into treatment methods for eating disorders.”

Description of Experiences with psychedelic drugs:

“I have taken LSD twice: two years ago and again this year.”

Positive Benefits of using Psychedelics to treat mental health problem:

“The first time I took LSD my powerful passion for starvation and control was only heightened by the drug. But my recent experience was very different. I was in Devon, by the sea, with a friend of mine and my mother. I took 75 micrograms, my friend 75, and my mother just 25, to act as our guide.”

“All day food was an ‘issue’, as it is every day. My interactions with it moved from self-conscious anxiety, to calm acceptance, to supreme ease.”

“The day’s greatest revelation was of the possibility of being, totally, without any fear or desire and the knowledge that the way I have lived this past decade has precluded, with perfect efficiency, precisely this.”

“It was beautiful, that freedom, at last, from the guilt of desiring.”

“And I realized that hunger has been so divine because it promises such an escape. But what, really, does it mean to feel hungry? It means, as I’ve experienced and idealized it all these years, resisting.”

“I learnt that pain, like hunger, exists only when you resist. And the same with hunger as with pain: it loses all the meaning I’ve invested it with if you just eat when it comes.”

“I have since found my daily meditation altogether different: easier, and a great and productive pleasure.”

“I have had the chance of making a direct comparison between the immediate effects of LSD and the initial stages of mainstream CBT. The LSD, worked immediate and powerful cognitive changes. From my own experience there is nothing else which compels one to confront the workings of one’s own mind, without protection or pretence, as this drug does. Therefore there is also nothing else so profoundly capable of providing mental insight and, crucially, effecting mental change.”

Problems experienced with psychedelics:

 I have not experienced any significant problems while using psychedelics.”

Thoughts on the future for Psychedelic Research:

“One of the saddest consequences of prohibition is that it precludes detailed and systematic research into the clear potential that psychedelic drugs may have for aiding in the treatment of spiralling mental health problems. If funding for such research were made more easily available, such drugs could be researched in a safe, condition-specific, and controlled way to treat mental-health sufferers.”

Discussion:

Gathered here are five very different stories and varying circumstances. Whilst far from a homogeneous group, there are a number of similarities between the subjects. A ll the individuals involved in the study describe coming to psychedelic drugs alongside a subjective lack of efficacy with traditional treatments. Similarly a ll the patients talked about using these drugs to offer new insights into themselves and their mental disorders; with a resulting reduction in the burden of their symptoms and an improvement in their functioning.

All of them were enthusiastic to participate in this project and keen to see further research done. Whilst some of these patients show no interest in using recreational drugs and were therefore resigned to go without them, others were prepared to break the law in order to obtain their chosen medicine. And all the subjects described their frustration at modern medicine’s slow progress in researching these drugs as treatment for mental disorder.

No doubt some people will feel concerned by some of the stories here. Clinicians might feel some of these patients’ current psychiatric problems may be a result of their past or present drug use. And they certainly may not credit the psychedelic drugs as the cause of the subjective benefits the participants are alleging.

However, subjectively at least, these drug experiences have given these patients glimpses of relief, relaxation, hope and enlightenment in their otherwise painful history of problems with unremitting mental disorder.

Limitations of this report:

The study looks at a very small number of subjects, without quantitative or even formal qualitative methods of measurement. All reports are only anecdotal and the selection of subjects has been biased in that only positive reports are included for discussion here. (However, it is noteworthy to mention that in my years researching this area I have never received any correspondence from patients specifically wishing to alert me of their negative experiences with psychedelic drugs).

Because of the lack of controls it is impossible to accurately infer the subjects’ use of psychedelic drugs as being the beneficial factor in their stories of improved well-being. Indeed, the concurrent drug use may be a confounding factor in explaining apparent benefits or even a cause of their problems.

Conclusion:

Despite the limitations described above, the role for further research is clear. Mental health service users’ comments are important. Valuable research in all fields of medicine frequently emergences in the first instance from initial positive findings of anecdotal case histories. It is too easy, and a legacy of the historical demonization of LSD since the 1960s, to dismiss all recreationally used drugs as having no possible valid medical uses.

For the sake of that population of patients who have benefited from these drugs in the past and will, undoubtedly, continue to take them in the future – with or without sanctioning by the medical profession – the role of the ‘experienced user’ with their subjective reports must be given space to drive the imaginations of clinicians and researchers to explore this area of psychiatry.

Acknowledgements:

Thank you to those patients who contacted me and spoke so freely about their experiences. I wish them all the best of luck in the future.

Conflict of Interests:

None

References:

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