Tripping into the Future of Therapy

By Joe Zamaria, Fall 2010

“Psychedelics are being used to enhance psychotherapy and help people? I thought those were terrible, illegal drugs that can only cause harm.” This is the typical (and unfortunate) reaction I get when I mention to others that there is research taking place in the United States and abroad involving psychedelic substances as an adjunct to psychotherapy.

Psychedelics refer to a broad category of psychoactive drugs and include such substances as psilocybin (the active component in “magic” mushrooms) and lysergic acid diethylamide (LSD). Psychedelics are couched in the even broader chemical category of hallucinogens, but unlike other hallucinogens, they are characterized by their relative lack of physical toxicity. Additionally, and ironically, they do not typically elicit true hallucinations.

Humans have used psychedelic substances safely for thousands of years. However, since the free and unsupervised usage of these substances by the American counterculture in the 1960s, there has been a particular stigma in our society attached to the word “psychedelic.” Images of hippies using excessive amounts of acid in conjunction with other drugs at Grateful Dead or Jimi Hendrix concerts may come to mind. The perpetuation of the supposed dangers of these drugs continue to exist in colloquial sound bites such as, “I’ve heard they can burn holes in your brain,” “I think I know of a friend of a friend of a friend who took 20 hits of acid and then died,” and my personal favorite, “I heard that if you have taken seven doses or more of LSD in your life, they won’t let you join the military and you can’t testify in court.” Other urban myths include, “LSD can become lodged in your cerebrospinal fluid, and when it dissolves at random times, that’s when a flashback happens,” and, “Psychedelics usually cause flashbacks and permanent psychosis.” Such beliefs demonstrate an unfortunate failure to understand the actual physiological and psychological effects of psychedelic substances.

Anything taken to excess or used in unsupervised circumstances can be risky. Psychedelics are powerful substances and they should be researched and used carefully. Two of the best analogies I have heard to describe psychedelics were posited by psychiatrist and researcher Stanislav Grof. Originally from Czechoslovakia, Grof per-formed LSD therapy studies in his home country in the 1960s. He was later invited to teach psychiatry at Johns Hopkins University and to continue his research at the Maryland Psychiatric Research Center. When asked if psychedelics are good or bad, he responded that it is like asking if knives are good or bad—it depends on who is using them, why they are using them, and how they are using them. A dangerous person can injure or kill with a knife; a surgeon can save lives with a scalpel. Moreover, in an August 2009 interview with The Sun magazine, he described quite elegantly the mainstream medical community’s general distaste and closed-mindedness toward psychedelics as being based on social and political beliefs created by the misuse that took place during the 1960s. “It would be like a group of teenagers breaking into a radiology lab and playing with the x-ray machine,” Grof said, “and the doctors would have to give up x-rays because the incident revealed how dangerous the machine was.’”

Currently, studies involving the use of psychedelic substances as an adjunct to psychotherapy are taking place in the U.S. at clinics affiliated with such universities as Johns Hopkins, NYU, and UCLA. Studies include using a combination of psilocybin and psychotherapy to treat the anxiety of people suffering from terminal illness, as well as using MDMA (ecstasy) and psychotherapy to treat individuals suffering from posttraumatic stress disorder. These studies, which have institutional review board and FDA approval, are in the early Phase I and Phase II stages, and safety is a number one priority. Due to the physiological course of the drugs, the therapy sessions are long (usually several hours and performed by a dyad of therapists) and few in number.

Much more research needs to be done on the therapeutic benefit of psychedelics. However, the results, while not yet conclusive, are promising. “It’s basically like years of therapy in two or three hours,” said one army veteran who participated in the research to treat his intense and debilitating PTSD. “You can’t understand it until you’ve experienced it,” he said.

Before you criticize the idea of psychedelics used in psychotherapy, consider the people they are currently helping, as well as the people they could potentially help in the future.