The LSD Therapy Career of Jan Bastiaans, M.D.
JAN BASTIAANS WAS 23 YEARS OLD and a medical student at the University of
Amsterdam when the German army invaded the Netherlands. The German
occupation (1940-1945) had a lasting influence on his life and work. The
first aim of Bastiaans' use of LSD and psilocybin in psychotherapy was to
help victims of World War II: the survivors of the war who had become
extremely traumatized by their experiences in the German and Japanese
prisons and concentration camps.
During the occupation Bastiaans had from the beginning been involved in
the student resistance. "As a result," he wrote, "I was the first student
at the University of Amsterdam who was expelled in the summer of 1941.
Because of an accident, I could only participate in the resistance in a
limited way from the autumn of 1942 on. Several of my friends died because
of the war."
THESE EXPERIENCES had a decisive influence on Bastiaans' work as a
psychiatrist after the war. His work was mainly aimed at helping victims
of the war who needed psychiatric care. Bastiaans identified with the
problems of the former members of the Resistance. Just like them he
regarded himself as an idealistic fighter. In the setting of psychiatric
treatment, and more specifically in sessions with LSD or psilocybin, he
took the position of the father-figure who gave his patients the warmth
and understanding they needed. The organisations of the former Resistance
would give Bastiaans much support in the 1980s, in his political struggle
for the continuation of his LSD therapy.
Almost 140,000 Dutch people were deported during the war to German
concentration camps. Only a minority of these people had been active in
the Resistance. Among them, 110,000 were Jews. Of the 140,000, only
15,000, of whom 8,000 were Jews, returned to their home country after the
war. In the years after the war it became clear that many of these
survivors were no longer capable of an optimal participation in society.
For their syndromes the term "KZ-syndrome" was coined: KZ is the German
abbreviation for concentration camp.
Theoretical background of Bastiaans' therapy
In the medical literature, a KZ-syndrome is actually not a syndrome, but a
process of four phases that contains different conventional syndromes: 1)
a shock phase with the feeling of extreme powerlessness; 2) an alarm
phase, with alarming emotions and fears that have the function of
preparing the drive for solutions; 3) an adaption phase, with flight- or
fight-mechanisms; and 4) an exhaustion phase. In the theoretical analysis
of the KZ-syndrome that Bastiaans developed in the 1950s he was heavily
influenced by two psychiatric traditions: Freudian psychoanalysis and
psychosomatic medicine. Bastiaans was a psychoanalyst of the second
generation since Freud. From 1954 till 1961, he was president of the
Psychoanalytic Institute in Amsterdam, a major bastion of psychoanalysis
in the Netherlands. Before this time, from 1946 till 1954, Bastiaans had
been a collaborator of Groen, then head of the second Department of
Internal Medicine at the University of Amsterdam. Groen was influenced by
American ideas on psychosomatic medicine, in particular the hypothesis of
psychosomatic specificity. According to this hypothesis, specific mental
problems can lead to specific physical diseases among those people who are
vulnerable because of the structure of their personality. Groen and
Bastiaans both became convinced advocates of the theory of psychosomatic
specificity, although this was (and is) a disputed theory within the
Correlating war and childhood experiences
In his analysis of war victims, Bastiaans correlated their actual
traumatizing experiences in the war with their psychosomatic syndromes, as
well as with a psychoanalytic interpretation of their childhood.
Psychosomatic syndromes seemed to be an aspect of delayed reactions to
traumatizing stress, especially found under "highly self-controlled
personalities who had expended considerable will-power and energy on
trying to control, suppress or repress the painful traumatic consequences
of the war." The result was a psychotrauma, "a mental injury marked by the
fact that a human being is fixated in a state of "affect lameness," in a
state of powerlessness usually associated with intense suppression and
repression of anxiety, grief and anger. This state of partial mental
isolation makes it impossible for the victim to cope in a healthy manner
with the traumatising stress situation." Whether this would develop into a
post-traumatic stress disorder was dependent on the inbuilt capacity of
the traumatized person for adaptation, and on the severity of the stress
situation. It also depended on whether the traumatizing experiences
re-actualized traumatizing experiences from childhood. In Bastiaans'
psychoanalytic view, these last experiences were the main determinants of
If the person couldn't cope with the stress situation, part of his past
became undigested and he couldn't free himself. He became fixated in a
state of powerlessness. This affected his relation with the world at
large, resulting in loss of mental freedom and a state of mental
isolation. "Here the individual consciously or unconsciously locks himself
into mental invulnerability-structures of a psychotic, psychoneurotic or
In 1963 Bastiaans became professor of psychiatry at the University of
Leiden. In this decade he started to use the term KZ-syndrome not only for
war victims, but also for other patients: everyone who had suffered from
man-made disasters or wars or who had been kept as hostages. In the 1990s
Bastiaans would also use his methods to treat heroin addicts. In a
metaphorical sense his work implies that everyone who suffers from
traumatizing experiences lives in his own mental concentration camp.
How to break out of this camp and achieve mental liberation? After the war
it had become already clear that many war victims suffered from
alexithymia and were unable to talk about their situation. Traumatizing
experiences, like torture by the SS, were suppressed in their memories.
Many patients who had been to camps like Auschwitz didn't have any faith
in their therapists, who hadn't been there and couldn't know what it
really had been like.
To resolve this situation Bastiaans had started to use chemical means as
early as 1946. Narcoanalysis, using barbiturates to put patients in a kind
of dream-sleep and to trigger their memories, was a highly acceptable
method for exploring the human psyche in the years after the war.
Bastiaans used Sodium Penthotal in combination with psychoanalysis and
psychodrama. Although he later claimed that in the right climate of safety
and security, "an average number of eight sessions is usually sufficient
to free the patient," he came to the conclusion that in the most rigid
cases, there weren't sufficient results. Besides, people did not always
remember actually saying the things they had said under narcosis.
Bastiaans began to look for other methods. This search was stimulated by
the conclusions of a research program on prognosis and effect of
psychoanalysis and psychotherapy at his Psychoanalytic Institute. This
program concluded that there was no difference in the changes in neurotic
patients after some years, whether or not they had gone through
In 1961, Bastiaans started to use psychedelics in his treatments: mainly
LSD, but also psilocybin. From 1963 till 1985 he was professor of
psychiatry at the State University of Leiden. Many patients were helped in
the Jelgersma clinic in Oegstgeest, where he worked until 1988. After some
experience, he came to the conclusion that for three categories of
patients, treatment with LSD was advisable: 1) psychosomatic patients with
an intensive rigidity of their defense and coping mechanisms; 2) patients
with survivor or concentration camp syndromes; and 3) patients who after
many years of psychoanalysis did not achieve the prognosticated positive
Bastiaans has given in his articles several accounts of successful
treatments with LSD. One example of this concerns one of the great Dutch
Resistance fighters--we shall call him X. In his treatment, X. got eight
LSD sessions. Although he relived all the fears of the concentration camp
and even started to cry--something he hadn't done in the whole war--there
was no real therapeutic progress. This changed with the eighth session.
X. remembered a horrifying torture by the SS guards. He had given food to
some Jewish prisoners and was caught by the SS. They beat him up. Next,
they pulled one of the Jews up with a cable tied to his penis, and then
let him fall down on the floor. His skull cracked. One guard pushed X.'s
face in the open skull, yelling that, "friends of Jews should drink blood
of Jews." After this the guards warned X. never to talk to anyone about
X. did talk about it, to three fellow prisoners. They were all dead within
a few months. Since then X. had become completely traumatized: he felt
that he was responsible for their deaths, and hadn't spoken about the
experience to anyone since, not even to his wife. After the LSD session X.
couldn't sleep for seventeen days. The turning point came when he saw
Bastiaans' car in the parking lot of the clinic and realized that he was
not dead. X. felt reborn. Unfortunately, however, not all his fears had
disappeared, and besides, he had become very afraid of taking LSD again.
X. started helping other war victims too strenuously and died of heart
failure a year after his last session.
Another example of Bastiaans' treatments has been published in English by
a patient: the Israeli writer Yehiel De-Nur, who published his account in
1986 under the name K-Zetnik 135633, his prisoner number in Auschwitz.
This very moving account is not typical of Bastiaans' methods, because in
it he does not succeed in getting to the heart of De-Nurs' issues and in
analyzing his traumatizing experiences. In the book, De-Nur has come to
Bastiaans in 1976, thirty years after his liberation: but mentally he is
still a prisoner. In his first three LSD sessions he relives the hell of
Auschwitz, but he doesn't talk to Bastiaans about it. In the fourth
session De-Nur breaks through. He dies in the death march of Auschwitz and
hovers over the camp. Because he had sworn that he would be (in his books)
the voice of the prisoners, he had stayed alive. But now he surrenders and
dies. He feels his split personality unite. After this session he
discontinues treatment, despite the wish of Bastiaans to the contrary.
Bastiaans wants to more deeply analyse De-Nurs' traumatizing experiences.
But De-Nur feels cured and is no longer plagued by the Holocaust in his
dreams. He has come to realize that it wasn't Satan who created the
mushroom clouds above the burning chimneys of Auschwitz, but you and I.
Us. In other words, he realized that man--rather than "the Devil"--was
responsible for the Holocaust, which made the problem mentally manageable.
De-Nur had a death and rebirth-experience that brought him out of his
mental concentration camp.
End of the LSD therapy
As professor of psychiatry at Leiden University, Bastiaans treated some
300 patients with LSD and psilocybin. There has been no systematic study
into the effects of this treatments. A report on the possibilities of such
a study was published in 1987 on behalf of the State Department of Public
Health. Its conclusion was that the study was not feasible, because there
were too few complete dossiers of patients. The report was part of a
political struggle over the continuation of Bastiaans' LSD therapy that
arose with his retirement in 1985. As in other countries LSD therapy had
become discredited in the Netherlands as a result of the role of LSD in
the Sixties rebellion. Bastiaans was the last Dutch psychiatrist to
conduct LSD therapy. He wanted to continue this therapy after his
retirement and to train successors. Although he was supported by the
former Resistance, his position within psychiatry was completely isolated.
Other psychiatrists recognized his therapeutic abilities, but regarded the
use of LSD as too dangerous. Some of them disliked Bastiaans' methods
because of the mystical implications of the LSD experience. Malcolm Lader,
professor of clinical psychopharmacology at the University of London,
wrote in a recommendation to the Dutch government in 1985: "The
continuation of apparently legitimate therapeutic uses of LSD detracts
from the work of people trying to contain the enormous drug problem...
Enthusiastic proponents of LSD stress the transcendental and mystical
nature of the experience and maintain that it enables the patient to gain
new insight into both himself and the cosmos... Unfortunately I find much
of the tone of Prof. Bastiaans' claims to be rather in this vein."
Bastiaans himself concluded that, "It does appear as if medieval fears of
insanity or of the confrontation with psychotics are evoked again, leaving
one with the impression that society has a need for eliminating as swiftly
as possible that which seems to pose a threat to its own existence."
After his retirement as professor of psychiatry in 1985 and at the
Jelgersma clinic in 1988 Bastiaans did not have the facilities for therapy
with psychedelics. This changed in 1992, when he began working with Howard
Lotsof and a Dutch self-help organi-zation for heroin addicts. Bastiaans
began treating heroin addicts with the use of ibogaine. After an addicted
woman died in 1994 from as yet unknown complications during the course of
one of these ibogaine sessions, Bastiaans, as supervising medical doctor,
was accused of neglect before the Medische Tuchtraad, the Dutch
supervisory board of the medical profession. He was asked to end his
therapeutic practice. By then his health was already failing. He died in
October 1997. In his last years he had become bitter over the lack of
recognition for his methods in the medical profession.
The work of Bastiaans is analysed in more detail in a chapter of my
forthcoming Ph.D. thesis on LSD and Psychiatry in the Netherlands. This
study has been made possible by the Dutch Foundation for Historical
Research (Stichting Historische Wetenschappen). At the moment
possibilities for a publication of the thesis in English are being
- Bastiaans, Jan, Psychosomatische gevolgen van onderdrukking en verzet,
- Bastiaans, J., Childhood determinants in the genesis of psychosomatic
medicine. VIIth Congress of the International Association for Child
Psychiatry and Allied Professions, Jerusalem 1970.
- Bastiaans, J., Mental liberation facilitated by the use of hallucinogenic
drugs. Psychedelic Reflections, edited by Lester Grinspoon and James B.
Bakalar, New York 1983.
- Bastiaans, J., Life against life. The psychosomatic consequences of
man-made disasters. Stress and Anxiety Vol. 9 (1985), edited by C. D.
Spielberger and I. G. Sarason, 111-118.
- Bastiaans, J., Isolement en bevrijding, Amsterdam 1986.
- DeRienzo, Paul, Dana Beal and others, The Ibogaine Story: Report on the
Staten island project. Internet: www.ibogaine.desk.nl.
- K. Zetnik 135633 (Yehiel De-Nur), Bestendig voor ogen. De paddestoelwolk
van Auschwitz, Kampen 1989.
- Snelders, Stephen, The use of psychedelics in Dutch psychiatry 1950-1970:
The problem of continuity and discontinuity. Curare. Journal for
Ethnomedicine 18(1995)2:415-425. Internet:
Steven Snelders is the editor of Pan-Forum Magazine, a Dutch magazine that
reports on psychedelics.
Vrije Universiteit Amsterdam
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