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Psycholytic and Psychedelic Therapy 1931-1995: A Complete International BibliographyTorsten Passie, M.D., M.A. To order from MAPS: Psycholytic and Psychedelic Research 1931-1995:
In the last three years, much of my time and energy has been devoted to compiling and editing the Psycholytic and Psychedelic Research 1931 - 1995: A Complete International Bibliography, which is now available in print. Besides the electronic bibliography project co-sponsored by the Albert Hofmann Foundation, Heffter Research Institute and MAPS, this is the first project of its kind since the Catalogue of the Literature on Delysid by Sandoz Ltd. (1960-63) and A Bibliography of LSD and Mescaline by Janiger and Paltin (1971). Unlike the earlier bibliographies, this new volume focuses on therapeutic applications and is more comprehensive. The bibliographic assessment of published material was intended for three purposes: to collect and organize the widely dispersed material, to illustrate the breadth of international research and to make published studies available for future researchÑespecially for "meta-analysis" of older studies. The incompleteness of new computerized medical and psychological bibliographies (i.e. Index Medicus, Psyndex, etc.) for different reasons made it necessary to use a kind of "snowball" approach of checking references of publications to go more deeply into the earlier, less widely known publications and conference proceedings. To organize references, three categories were used: General Approach and Basic Research, Psycholytic Therapy, and Psychedelic Therapy. This was necessary because psycholytic and psychedelic therapy differ significantly in their therapeutic paradigms and practices, so that they have to be distinguished from one another. All publications were personally examined by the author to classify them for the comprehensive subject index. Origins and methods The first publication about the use of psychedelics in psychotherapy was the Confessions in Mescaline Inebriation of the Italian psychoanalyst Baroni in 1931. He used a mixture of mescaline, seeds of Datura stramonium and Cognac to facilitate the emergence of unconscious material. Along with the technique of "Narcoanalysis," which used barbiturates in therapeutic interviews, Baroni's work marks the origins of the psycholytic approach in Europe. Further development of the field was facilitated by the discovery of LSD and lead to the standardized practice of psycholysis, which is based on psychoanalytic concepts and repeated low dose sessions in long-term psychotherapy. After a wave of publications, psycholytic treatment was practiced at 18 EuropeanÑand several AmericanÑtreatment centers and by many private practice physicians. Psychedelic treatment favored personality change by one high dose session, a quasi-religious patient preparation and a specialized treatment setting. References show that development and use of psychedelic therapy was almost entirely restricted to the United States and Canada. This may be due to the fact that the psychedelic approach originated from the ritual use of peyote by Native Americans and the unconventional American therapist Al Hubbard, who inspired clinicians to use LSD in the treatment of alcoholism. Later research projects in psychedelic therapy conducted by Grof, Yensen et al. at the Maryland Psychiatric Research Center (MPRC) concluded that a more effective future approach should combine features of both approaches. They conceptualized the "psychedelytic" approach which was used in their last studies in the mid-70's and a few from 1988-1993 in Switzerland. This seems to represent a higher synthesis of research in Europe and the United States. Trends Table 1 illustrates how most of the basic research was done in the U.S., Canada and Germany. One trend noted is French researchers have done a lot of research on psilocybin. The 687 publications included included in the Bibliography show a specific distribution pattern over time (Table 2). At first, it is the typical picture of a new scientific and therapeutic approach, with steadily growing numbers of publications and peaks when experiences were exchanged at scientific conferences. Statistics also show the abrupt decline of research when problems with non-medical use arose at the end of the sixties. In regard to the types of substances mentioned, it seems that in the United States, Canada and England LSD was primarily used. In Europe, LSD was also dominant, but its use decreased as milder and shorter-acting substances like psilocybin gained favor. By today's standards, the more than 100 efficacy studies on hallucinogen- assisted psychotherapy conducted in the fifties and sixties had very low methodological standards. This may be due to the low standards of psychotherapy evaluation at that time as well as to the experimental character of the method. Nevertheless, some late studies by the MPRC group and in Germany by Leuner et al. presented evidence which is worth further study. The number of treated patients extrapolated from all publications (excluding double counting) shows that approximately 7,000 patients were treated with the psycholytic method and around 2,500 with the psychedelic method. Another 1,000 patients were treated by Roquet et al. with another unconventional method. U.S. and British surveys Larger surveys into possible dangers and safety issues of therapeutic work with psychedelics were done in the United States (Cohen 1960) and in England (Malleson 1971). These studies showed very low rates of complications: attempted suicides - 1.3:1000 (Cohen and Malleson); completed suicide - .4:1000 (Cohen) and 2.1:1000 (Malleson); psychotic reactions - 1.8:1000 (Cohen) and 4:1000 (Malleson). This seems low in view of the problems encountered in the experimental phase of work with a new substance and approach, and was steadily lowered by optimization. Furthermore, these numbers are comparable to incidents arising in conventional psychotherapy or in neurotics who remain untreated. Both the authors concluded that LSD treatment under controlled conditions is a safe procedure. Results published on psychedelytic psychotherapy with over 170 patients in Switzerland also showed no serious incidents such as hospitalizations or suicides (Gasser 1995). References
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