HANDBOOK FOR THE THERAPEUTIC USE OF LYSERGIC ACID DIETHYLAMIDE-25
INDIVIDUAL AND GROUP PROCEDURES

1959 - D.B. BLEWETT, Ph.D. & N. CHWELOS, M.D.

OCR by MAPS, Edits by Erowid

In the 1950s and 1960s, mimeograph copies of the following Handbook were shared among pioneering therapists exploring the therapeutic utility of LSD. To this day, it remains one of the most relevant documented explorations of the guided psychedelic session.

• Acknowledgements
• Preface

1. Psychiatric Rationale
2. The Nature of the Drug Reaction
3. The Development of Treatment Methods
4. Individual and Group Methods
5. Research Implications
6. The Setting
7. Equipment
8. Indications and Contra Indications
9. The Preparation of the Subject
10. General Considerations Regarding Procedure
11. Dosage
12. Administration
13. Stages in the Experience:
      I. Pre-Onset
14.   II. Onset of Symptoms
15.   III. Self Examination
16.   IV. The Empathic Bond
17.   V. Discussion
18. Diminishment of Symptoms
19. The Meal
20. Termination of Session
21. After Contact with the Subject
22. Assessment of the Experience

• Appendix A : Assessment Scales I and II
• Appendix B : Results to Date
• Appendix C : Proposals for Psychedelic Research

Review of this Handbook, by Myron Stolaroff
References 
PDF Scan of the document (400KB)

1. The patient must realize that his present methods of behaving are inadequate and unsatisfying to him personally.
   
2. He must develop sufficiently strong motivation to carry him through the difficult and painful process of coming to understand and accept himself.
   
3. On the basis of this self-understanding, he must learn how to alter his
   
   

FEATURES OF THE EXPERIENCE

There are two reasons why the LSD experience does not lend itself readily to verbalization. Firstly, the sensory aspect of the experience is outside the bounds of the usual experience from which language has developed and for the description of which it is intended. Secondly, the experience is mainly in the sphere of emotions or feelings which are difficult to objectify or verbalize at the best of times.

Before attempting to draw any conclusions about the suggested value of LSD one would want to know something of the nature of the experience which the drug induces. Also, it is inevitable that effective methods of using the drug must be dictated by the nature of the experience.

Because of the difficulty in describing the experience in any but subjective terms, our knowledge of it has been built up bit by bit from personal LSD experience and through observations and reports of other individual and group experiences.

In reading accounts of the experience, one cannot fail to be struck by the fact that although there is tremendous variety in these reports there is a relatively consistent communality in certain areas of the experience. In an earlier report (13) we enumerated these commonly reported areas and illustrated them briefly with transcriptions from actual experiences as follows:

1. A feeling of being at one with the universe.
   "I had finally understood by experience. The feeling of union with the cosmos."
2. Experience of being able to see oneself objectively or a feeling that one has two identities.
   "If we had the gift to see ourselves as others see us, well, I did this morning. There seemed to be two of me and there seemed to be a conflict between these two."
3. Change in usual concept of self with concomitant change in perceived body.
   "I had the feeling of leaving my body and drifting off into space. I had no worldly connections and felt as if I was only a spirit.
4. Change in perception of space and time
   "I was looking deeply in the picture until the objects in the picture were beside me."
5. Enhancement in the sensory fields.
   "The flower was a thing of inestimable beauty as was its scent. It quite transfixed me in essential contemplation, ecstasy and timelessness."
6. Changes in thinking an understanding so that the subject feels he develops a profound understanding in the field of philosophy or religion. Associations of ideas are much more rapid and clear and one tends to see many alternate solutions to each problem. There is a great tendency to think anologically.
   "I found I was outside our bounds to space and time and had an understanding of infinity."
7. A wider range of emotions with rapid fluctuation.
   "During this period I was swept by every conceivable variety of pleasant emotion from my own feeling of well-being through feelings of sublimity and grandeur to a sensation of ecstasy."
8. Increased sensitivity to the feelings of others.
   "I was conscious of an extremely acute sense of awareness of perception of another's mood, almost thoughts. I likened it to the recognition of emotional atmosphere that the child or animal seems to have."
9. Psychotic changes. These include illusions and hallucinations, paranoid delusions of reference, influence, persecution and grandeur, thought disorder, perceptual distortion, severe anxiety an others which have been described in many reports on the psychotomimetic aspects of these drugs."

CHARACTERISTIC TYPES OF REACTION

These aspects of the experience tend to form various combinations and constellations which give rise to certain characteristic type of experience. It is important to attempt to identify and catalogue these since some such classification must form the basis for any scientific description or understanding of reaction patterns. The types of experience listed here have been found to be by far the most commonly occurring. They appear to be ranged along a continuum. Though the exact nature of this underlying variable is not clear, it does appear to be related to the individual's level of self-acceptance, which in turn, is closely related to the degree to which he is able to surrender his usual self-concept. To the extent that the postulated continuum does exist, these six types of responses might be regarded as various levels of such surrender.

Paradoxically the ability to abandon the established self-concept increases with self-acceptance and decreases with diminished self-regard. The person who does not accept himself fears the exposure of the unacceptable elements and struggles to maintain control in the face of the drug's effects.

Several of these levels are likely to occur within a single experience and a person may frequently move from one to another. However, the tendency is to move from the first two levels (in which the subject tries to deny that the drug has any psychological effect) though the 3rd and 4th levels (in which the attempt to explain and thus control the psychological effects leads to psychotic reactions) to the 5th and 6th levels (in which, having realized his inability to prevent, control, or explain the psychological effects within his usual frame of reference, the subject surrenders his habituated self-concept with its limitations, and accepts the psychedelic or mind-manifesting aspects of the reaction as real and useful).

ESCAPE REACTIONS

In the first two types of experience, the reaction is one of attempting to resist and escape from the effects of the drug.

1. The first type of experience might be called a flight into ideas or activity. The drug begins to disturb the individual's perceptions. He reacts against the effects of the drug by concentrating either upon concepts or things outside the self or upon some activity which can absorb his full attention. Any concept, such as, for example, abstract art, religious dogma, racial prejudice or unemployment may be seized upon and the person may devote his full attention to an elaboration to a variety of aspects of this concept while continuing to deny that the drug is having any effect upon him. In other cases, the individual may plunge into some particular activity-usually his own area of work, in which the familiarity of the activity lends reassurance and stability. He seeks to minimize the effect of the drug by this diversion and narrowing of interest.

He attempts, in this fashion, to control the emotional component of the experience and to minimize his awareness of any physiological or psychological change. He will report that nothing is happening. To an observer, it is evident that the individual is expending an amount of energy in his pursuit of the ideas he is considering; that he is excessively talkative and serious; that he grows progressively more irritable and intolerant of interruptions or questions and that, in many cases, he seems to be suffering from severe tension.

If, after the experience, the individual is asked to describe what happened, he is likely to state that little if anything occurred.

2. The second type of experience might be termed a flight into symptoms. This type of reaction seems to be correlated with an inability or unwillingness to direct one's attention to things outside oneself. When the drug begins to affect the individual, he tends to concentrate upon the physiological sensations. The strangeness of these becomes alarming to him and his alarm increases the physiological disturbances, altering his perception to a still greater awareness of bodily discomfort and malfunction. The individual may develop physiological symptoms of various kinds such as violent nausea; palpitations; feeling of constriction in the throat and chest; pain at the base of the skull; numbness of the limbs or violent headache. Sometimes he may express a fear of dying.

In this variety of experience, the individual will voice very frequent complaints about feeling unwell.

To an observer, he will seem to be extremely ill at ease and his nausea may lead to vomiting, although this is unusual.

Afterwards, when asked to describe his experience, the individual is likely to state that the drug's only effect is to make a person terribly sick.

In the first two types of experience, the self-concept is maintained despite the action of the drug. The individual is able to minimize the psychological effects of the drug by developing an idée fixe and by clinging desperately to it in a battle against the drug's effects.

The employment of small doses of the drug tends to contribute to the production of these types of experience. Little or no therapeutic benefit is derived from them, since the individual, by successfully fighting the drug's effects, succeeds in denying himself any possibility of therapeutic change.

Frequently such reactions develop early in an LSD experience as a result of pre-treatment apprehension. It is of particular importance that the therapist be aware of the possibility of the subject concentrating on the physical effects of the drug, for unless the subject's attention be diverted before the symptoms become oppressive, they can rapidly become so marked as to prevent the subject from being able to shift his attention.

PSYCHOTOMIMETIC REACTIONS

The next two varieties or levels of experience which are frequently observed are those which have given rise to the use of the terms hallucinogen and psychotomimetic agent in connection with LSD.

These states, offering as they do an opportunity to study the interior of certain psychotic conditions, have remarkable possibilities as staff training experiences. ON the other hand it is most unfortunate that so much stress has been placed upon these particular aspects of the LSD experience. Not only are they of limited therapeutic value, but, when regarded as the only levels attendant upon taking the drug, they cause the therapist who would otherwise be interested in its therapeutic possibilities to hesitate in including it among his treatment methods.

3. The third type of experience might be termed a confusional state. It is characterized by confused thinking and perceptual distortion. The individual attempts to rationalize what is happening to him but visual imagery and ideas flood into his awareness at so high a speed that he cannot keep up with them. He is like a person trying to listen to a foreign language with which he is only vaguely familiar. He rapidly falls behind and loses the context.

In this state the alterations in the various areas of perception become so overwhelming that they cannot be interpreted; the intellectual or rationalizing processes are swamped and the attempts to establish order fail. The subject is acutely aware of the confusion of visual and sometimes auditory perceptions which become a vast jumble, often frightening and unpleasant. This results in a state which would appear to be very much like an intensification of the schizophrenic breakdown, particularly as it occurs in catatonic and hebephrenic states.

4. The fourth type of experience is characterized mainly by paranoid thinking. It appears that in this type of response the individual reacts to the impact of the drug by rationalizing all of the aspects of the experience as being a function of the drug alone. All aspects of his perception appear to be enhanced or altered-music is felt physically; is heard with greater clarity and intensity and with new meaning; colors are brightened and seem more intense; patterns take on new significance; and an enhanced awareness of feelings of other is noticed. To a greater or lesser extent all of the senses may appear sharpened in their awareness. Smell, taste, texture, pain, temperature, and balance may also be sensed in a novel way.

The individual's thinking stresses the fact that his perceptions area altered by the drug. He mistrusts his own sense data and begins to question the validity and reality of everything he does and perceives. Thus, he interprets the state as delusional, implying that he is incapacitated and helpless. Further, we have previously mentioned that in the experience the subject seems to develop an acute sense of awareness of the feelings of other people. This is so unusual that the subject begins to misinterpret feeling as thought and believes that other people are becoming aware not only of his feelings, but of his thoughts as well. This feeling of empathic proximity seems to the subject to lay hare the unacceptable aspects of himself. He tries to hide his incapacities and imperfections from those around him. He feels that he is completely at their mercy and is uncertain as to whether or not he can trust them.

Ordinarily, small areas or phases of mistrust are not particularly important in interpersonal relations. In the experience, however, overwhelming feelings of inadequacy and inter-dependency tend to develop and the level of trust becomes an extremely important variable. In order to fully stabilize the experience at the psychedelic level, trust must be absolute. Huxley (26) has described this as "the willingness to be completely implicated". Osmond (41) in a personal communication points out " a minimal amount of trust is essential, how much we don't know but absolute trust is desirable and essential for using the psychedelic experience fully."

Inability on the part of the subject to accept others forces him to try to conceal both his present incapacity and those aspects of himself which he feels he cannot trust others to accept. Despite these efforts, he feels that those about him are aware of his weaknesses and his imperfections. When they act as though they were unaware of these things he feels that they are either toying with him or are too embarrassed to mention his difficulties. This feeling causes suspicion, referential thinking and a marked reduction of insight.

Occasionally, the subject reacts with aggression and hostility rather than withdrawal. In such cases there develops a grandiose contempt for the views or wishes of other people and a disregard for convention. This reaction may be characterized by such paranoid delusions as the feeling of being a God. The person may verbalize the idea that nothing matters any more. In some instances excitement may develop into manic-like behavior. We have found that such grandiose reactions are very rare, occurring not more than once in 50 cases. Their mention here is justified in part as a reassurance to the therapist, for although when they do occur, they tend to give way in a few hours to more amenable states, they can pose management problems. When this condition persists, beyond an hour the therapist should consider the administration of a booster dose of the drug. Although it would seem that increasing the drug dosage would simply add to the subjects discomfort, it does not do so. Rather, it helps him to extricate himself from the dilemma in which he finds himself.

These states tend to occur when the subject comes to a point in the experience at which he is aware of the short comings of his accustomed value system but finds the alternative values, growing out of the experience, unsatisfactory to him. In this situation he attempts to deny all value and may declare that nothing matters. Agitation and excitement may build up to a point at which some restraint is necessary. An additional dose of the drug permits him to assess old and new value systems much more objectively and he finds it much easier to accept what he finds in the process. As the subject begins to recover after an experience of this nature he may go through a phase of schizophrenic-like activity in which there may be markedly stereotyped behavior and the subject may seem to be completely unaware of the therapist. In cases we have observed, this phase lasts about an hour, after which the subject becomes completely rational and very calm and relaxed.

PSYCHEDELIC REACTIONS

The next two varieties or levels of experience are those referred to by the term psychedelic. A work of explanation seems necessary here to clarify our differentiation between psychotomimetic and psychedelic experience. We have used Osmond's (40) terms in this regard. He pointed out that the LSD experience can be broken into two categories-the psychedelic (mind manifesting) aspect during which the person learns only of the inside world of madness. He related the perceptual changes in the LSD experience to what William James has termed "unhabitual perception". James felt that the essence of genius lay in the ability to perceive the world in an unusual manner, i.e. with the absence of one's usual rigidity and Osmond (40) suggests that the ability to perceive the world in a new and unaccustomed manner permits the reorganization of one's system of values.

When a state of unhabitual perception comes upon one through disease process as in schizophrenia or when it is induced by LSD it can be a frightening and distressing experience. As long as the unhabitual perceptions are not organized into an understandable pattern, the person in whom they occur remains confused, uncertain of his reality. Unless they are aided in this process by people familiar with the drug experience they can spend many hours in very uncomfortable circumstances. Because of this fact, LSD has most frequently been described as a psychotomimetic or hallucinogenic drug.

It undoubtly does have this potential. However, when an individual who takes the drug is offered support and guidance in the experience by people who have already established order and organization to the unhabitual perceptions, he is usually able to do so himself in a short time. Such organized unhabitual perception makes up the so called psychedelic experience which offers marked therapeutic possibilities.

In the psychedelic reactions the person is no longer concerned with escaping from or explaining the drug effects but accepts them as an area of reality worthy of exploration. They might be termed stabilized experiences in that the distressing effects of the drug tend to be minimized and the individual is enabled to gain remarkably in terms of increased insight and self-understanding.

There are the levels at which the therapeutic possibilities of the drug are most fully realized. These types of experience are closely related and while the difference between them may not actually seem great enough to merit their separate considerations, the levels of stabilization which they represent differ so markedly that they have both been outlined.

5. The fifth type of reaction is one in which the effects experienced are accepted as comprising a separate but equally real and valid reality to which the drug gains one entry. The person accepts as genuine his apparently enhanced intellectual capacity and his ability to empathize with and to appreciate, accept and understand others. His thinking may be somewhat disrupted by a frequent involvement in what Levey (23) has termed the dilemma of alternates. This is a sort of parallel awareness of opposites which impeded the usual flow of thought. The subject may also find himself increasingly aware that he is thinking analogically; that there is a tendency to extend logical classification beyond the usual bounds and that his perception increasingly tends toward the breakdown or subdivision of usual gestalts.

In this state the person is keenly aware of the possibility of slipping into a psychotic state for madness appears an ever-present possibility and he feels that he is walking a razor's edge, gaining slowly in confidence as he goes.

6. In the sixth type of reaction the experience is accepted as offering a new and richer interpretation of all aspects of reality. The person feels strongly that there is a unifying principle underlying all things, an essence with which he feels in complete accord. He may feel that he is a part of all things and all things are a part of him. His self-concept is in no way limited by the usual restraints of body image. These feelings or beliefs are accompanied by feelings of reality so intense that conviction is inevitable. William James in writing of such intense feelings of reality states, "they are as convincing to those who have them as any direct sensible experience can be, and they are, as a rule, much more convincing than results established by mere logic ever are".

At this level of experience no doubts remain as to the reality and usefulness of the experience and the individual, freed from this concern feels no possibility of unpleasant or psychotic features developing. Once this level is attained it is doubtful if any manipulation of the environment could induce a psychotic state in the experience.

Some may feel that the individual has already, by accepting the experience as reality, fallen into a delusional or psychotic state and, indeed, there is no ready criterion to determine whether or not this is actually the case. The only method of accessing this possibility seems to be that of "By their fruits ye shall know them".

These brief notes upon the nature of the experience are in no way complete. No individual reaction will fit neatly into the categories outlined. There will be frequent overlapping of levels and in some cases little or none of the experience may accord with the reactions outlined above. The classification is intended only as rough chart of a largely unknown area rather than as a detailed guide.

More exact mapping of the area will attend the observations of many therapists over a number of treatment sessions. However, we believe the present classification to be useful, chiefly as an indication that although the LSD-25 or mescaline induced experience is vast and rapidly shifting, communalities in the experience may be catalogued in a way that will eventually offer a sounder scientific understanding of this area of experience.

INDIVIDUAL REACTIONS

There is much individual variation in regard to the levels of experience attained. Most people pass though a phase in which they struggle against the effects if the drug and a period in which they try to explain the effects themselves. Only individuals seem to attain the psychedelic level rapidly in the first experience and, if they lapse at all into denial, confusion or paranoid thinking, do so but briefly and infrequently. Still other individuals may spend as much as a half a dozen sessions being frightened or ill or paranoid or otherwise distressed before they attain the psychedelic experience. The methods utilized by the therapist play a critical part in determining both the level which subject can attain and the disease with which it is accomplished.

In terms of procedure the drug experience can be broken down into a number of stages or phases. In each of these the subject is involved in a different aspect of the experience and in each he requires appropriate guidance and reassurance. Since no two sessions are the same, any handbook can offer only relatively crude guidance, particularly until such time as specific principles and procedures in the use of the drug are widely studied and become firmly established scientifically. It can, however, suggest those areas of experience and those methods which are likely to prove therapeutically profitable at each stage and it can help to eliminate procedures which are likely to be distressing and wasteful. However, such a manual is no substitute for awareness and understanding on the part of the therapist. As has been pointed out, this understanding is markedly increased by the therapist's having taken the drug several times himself. It is maximized when the therapist joins the subject in the experience and it is for this reason that we have dealt with the use of group as well as individual procedures. The group method serves both as a training for the therapist and as a means of being maximally aware of what is happening to the subject.

In terms of procedure the drug experience can be broken down into a number of stages or phases. In each of these the subject is involved in a different aspect of the experience and in each he requires appropriate guidance and reassurance. Since no two sessions are the same, any handbook can offer only relatively crude guidance, particularly until such time as specific principles and procedures in the use of the drug are widely studied and become firmly established scientifically. It can, however, suggest those areas of experience and those methods which are likely to prove therapeutically profitable at each stage and it can help to eliminate procedures which are likely to be distressing and wasteful. However, such a manual is no substitute for awareness and understanding on the part of the therapist. As has been pointed out, this understanding is markedly increased by the therapist's having taken the drug several times himself. It is maximized when the therapist joins the subject in the experience and it is for this reason that we have dealt with the use of group as well as individual procedures. The group method serves both as a training for the therapist and as a means of being maximally aware of what is happening to the subject.

The onset of symptoms occurs sometimes between 15 minutes and 120 minutes and usually about half an hour after taking the drug. The period of waiting for the drug to have an effect is important since the psychological set which is established at that time can determine much of what follows. The therapist should aim at avoiding the development of certain unfortunate psychological states in the subject. Boredom on the part of either the subject or therapist must be avoided. The therapist should also aim at preventing the development of a pattern in which the subject is waiting intently for any change which might be ascribed to the drug. Finally, the therapist should be particularly careful to prevent the build-up of apprehension in the subject. Each of these points seems worthy of some consideration.

Boredom is destructive of the therapist-subject relationship. It must, therefore, be carefully avoided in the period of waiting for the drug to take effect. It is, of course, most likely to develop when the onset of symptoms is slow to occur. Then anticipation is apt to be followed by slight anxiety and premature feelings of disappointment followed by boredom. The therapist should avoid develop in interests which the subject does not share. At this time the close relationship which is to develop between them can be fostered through consideration of mutually interesting material. This is fostered through consideration of mutually interesting material. This is particularly necessary when the therapist has himself taken the drug. He must avoid becoming too intent upon the development of his own symptoms for the slow boiling of the watched pot may engender frustration.

The subject's attention must also be directed from waiting for developing symptoms and frequently this can be done by directing his attention to poetry, paintings or photographic collections. The Family of Man collection, for example, is not only very useful at this time as an interesting diversion but the subject will very likely find that he wants to refer back to many of the pictures later in the experience. Certain of the photographs often seem to symbolize questions or conclusions which arise as the experience develops. In some cases such pictures form a frame of reference within which the subject may be able to work through some of his emotional problems.

Music used at this time as a background may prove relaxing. However, at the onset of symptoms the function of the music changes and the therapist should be aware of the effect the music is having particularly as symptoms begin to develop. This point is further expanded in the section dealing with the onset of symptoms.

At the time of taking the drug it is helpful for the therapist to suggest to the subject that he will come to notice some very definite changes which the therapist would like to know about. It can be pointed out that when watches for change one may observe many irrelevant things. Since the effects of the drug do not need to be closely watched for, a quiet relaxation is recommended.

Having suggested this at the outset, the therapist should avoid a mistake which is easily made - that of repeatedly asking the subject, "How do you feel now?", "Have you noticed any changes yet?", and etc. If the therapist questions too insistently along these lines it tends to focus the subject's attention almost exclusively upon developing symptoms. These may take on an uncomfortable and unpleasant tone which will tend to have an unfortunate effect upon at least the early stages, if not all, of the ensuing experience.

It is at this point that the subject is most likely to begin to develop a nausea or some other somatic complaint. This can become sufficiently acute, if his interest be centered upon it, to make it impossible for him to concentrate on any other aspect of the experience. Indeed, it seems that here the subject begins to learn one of the fundamental facts of the LSD experience. He learns that concentration upon the self and the use of the self-concept as his exclusive reference point tends to produce difficulties and discomfort in the experience. At this time, it may be well to point this out to him for his subsequent consideration and evaluation.

Despite this need to direct the subject's attention from his symptoms, however, there are, paradoxically, two additional but opposite eventualities which should be avoided. Firstly, it is unwise to so interest the subject in any activity that he becomes unaware of the development of symptoms until they are so far advanced as to shock and frighten him when they suddenly intrude. Secondly, should the subject become so interested in what he is doing as to resent being interrupted, he may well find the developing symptoms a bother and may fight against them to maintain the psychological set which gives him pleasure. This set may also tend to color at least the early stages of the experience and may cause the subject to think along relatively constricted and confined lines by setting up a series of trains of thought which add an unwanted constriction to the situation.

Finally, the production of fear or panic at this stage should be avoided as much as possible. It is likely to prove very destructive as far as the therapeutic use of the later phases of the experience is concerned.

In general the therapist should aim, during this period, at giving the subject such support and assurance as will relieve his anxiety; at making the subject aware of the developing changes induced by the drug and at keeping him from feeling that these changes are threatening, alarming or in any way unusual for people taking the drug. The therapist can call upon his own experience at this time and use them as a source of reassurance to the subject.

1. Who are you?
2. How much does your identity determine your behavior?
3. Where are you in space and time?
4. Where do your thoughts come from?
5. How are you different from other people?
6. How are you the same as others?
7. What is the basis of your system of values?

1. If all people are the same in essence, what keeps them separate?
2. What is love?
3. What is wisdom?
4. What is trust?
5. If you could have any single wish come true, what would you wish for?
6. Why are some people more pleasant than others?

PROBLEMS IN ASSESSMENT

Assessing change effected by treatment is one of the major problems in every branch of psychiatric research. Researchers often use such gross criteria as discharge from hospital and re-hospitalization. In the treatment of alcoholism the criterion often used is complete abstinence for a particular period of time. The alternative to such criteria is the establishment of some variety of rating scale which permits the measurement of less obvious degrees of change. Here the problem becomes that of demonstrating that the validity and reliability of the criterion scale.

Such refined measures call for the objective assessment, by adequate judges, of selected, relevant areas of behavior. Their development calls for a high level of knowledge of the changes to be anticipated; for painstaking trial and error selection of items relevant to these areas of change; for a further selection and refinement of items such that ambiguity disappears to the extent that scoring agreement between independent raters is obtained. When this task is completed one has a scale which samples areas of behavior and which can be expected to show a relationship to clinically observed change. In the development of such scales it is a further complicating factor, that the criterion against which the scale must always be assessed is that of clinical judgment, a notoriously unreliable standard.

The assessment of change growing out of the LSD experience is especially difficult. If changes are to be rated by independent, objective raters, then the areas which can be assessed must be either observable physiological phenomena such as blanching, tremor, dilation of pupils, shivering, apparent dizziness, vomiting, micturation, moistness of the palms and so forth or must be the results of psychological tests. Much work has been done in this area principally by Abramson and his co-workers (4), (5), (6).

Unfortunately the presence of observers or the administration of tests almost invariably alters the entire nature of the experience. The probability that a transcendental experience may occur is much reduced if the subject must direct his attention for some time to answering the questions of the M.M.P.I. or if he concentrates his attention for any prolonged period upon problems in arithmetic.

This difficulty has caused a great deal of confusion in drug studies. There are two methods of approach to the determination of the drug effect. The first method aims at cataloguing the alterations in specific areas of behavior which follow upon the ingestion of a given drug. Here the researcher is concerned with alterations in test scores or in observed physiological changes, on the basis of which he can assess the effect of a particular drug or draw comparisons between differing dosages, drugs, or conditions of administration.

The second method seeks to observe differences in the individual's usual functioning which are occasioned by taking the drug. Here the concern is not with special tasks but rather with attitude, feeling, mood, etc. such information can only be obtained by asking the subject relevant questions.

Where the first type of research has lead, for instance, to the conclusion that arithmetic test scores decline as a result of the ingestion of LSD the conclusions drawn from the second type of research would be that the ingestion of LSD makes a person feel less inclined to work at problems in arithmetic.

While each of these types of research are useful and necessary they cannot be combined in the same project. One must decide which type of research he intends and must then adopt an appropriate methodology. It is nonsensical to complain that he results of research aimed at measuring drug effected changes in specific test scores yield little information about drug induced personality change. It is equally useless to protest that unless a quantitative score can be assessed it is impossible to discuss any change.

It is our contention that at the present stage of our knowledge research into the effect of LSD should aim at observing differences in the individual's functioning and at detecting changes in the feelings, values and beliefs which underlie these modifications in behavior.

It is unfortunate that much of the present stage of our knowledge research into the effect of LSD should aim at observing differences in the individual's functioning and at detecting changes in the feelings, values and beliefs which underlie these modifications in behavior.

It is unfortunate that much of the present research aimed at quantification of LSD induced change is dealing with extraneous or unimportant variables and it therefore largely irrelevant to any assessment of the therapeutic effect of the drug. In a search for relevant variables we must adopt very specific criteria of validity for in this assessment the establishment of correlation between drug ingestion and variation in a given measure does not offer sufficient grounds for the acceptance of that measure as a valid means of describing the nature of the drug induced changes. To be relevant a variable must be related to the experience described by subjects who have taken LSD. For this reason, we feel that it is extremely unprofitable to use conventional psychological tests to assess the drug effects. The results of these are altered by the fact that under LSD, tests are boring and uninteresting. The administration of such tests completely alters the drug experience and produces a compounding of drug effect and situational effect which cannot be sorted out.

If a person watching a delightful ballet were presented with a series of arithmetic tests at various times throughout the performance, his scores, would be lowered by distracting stimuli. It would, however, be unfortunate to conclude that attending the ballet disturbs thought processes. Very likely his experience of the ballet would be remarkably qualified and modified by the testing.

While we may question the aptness of studies using this objective approach, we must realize that the collection and publication of subjective reports on individual experiences offers no basis of quantification of the components of the experience. Such methods, by themselves, will not permit a description of the drug effect which can be scientifically useful. Unfortunately in our search for a quantified measure of the LSD experience we are confronted with the fact that, present techniques for measuring changes in feeling and value, are so crude that only holistic, subjective data can be drawn from the experience and its sequel.

These difficulties in no way alter the importance of this type of investigation into the phenomenon. They simply indicate that we are ill prepared to describe it or to make specific assessments relating to its therapeutic consequences.

Because of the difficulties in assessment, it would seem useful to attempt the development of a self-rating scale which would require the individual to indicate both any area in which he felt that changes occurred and the extent of any changes which he felt he had undergone as a result of taking the drug. The Nowlis' (38), (39) studies into drug induced mood alteration have demonstrated that quantification through introspection provides a particularly useful methodology for the study of psychological change induced by drugs. This method has been adapted in an attempt to gain some quantitative assessment of the psychedelic experience both in terms of areas of overlap of experience between individuals and between sessions an din terms of individual reaction constellations or typical response patterns.

Any assessment of the validity of such ratings would be difficult. For in behavioral terms the validity of psychotherapeutic change can only be established upon the basis of the ancient but as yet unmodified criterion "by their fruits ye shall know them". We might, however, hope for an approximate validity check by obtaining corresponding ratings of the subject by people who know him well. Although in this procedure error variation will result from differences between raters in keenness of awareness and observation of change, if the drug be as effective therapeutically as it is claimed, at least some of the changes induced by the experience in the behavior of the subject should be so obvious as to be readily observable.

The development of such a scale will take much time and energy. Abramson and his co-workers ( ), Nowlis and Nowlis (38), Wendt (51) and many others have made important contributions toward such a development. There is as yet, however, no scale aimed at the assessment and description of the psychedelic experience and its after-effects. For this reason a tentative scale is presented below in the hope that it may be useful as a basis for further investigation.

THE ASSESSMENT SCALE

In this attempt to evaluate the psychedelic experience, it was not the intention to cover all areas of drug induced change. A scale which attempted to cover all areas of drug induced change. A scale which attempted to do so would be very long for practical purposes. For this reason the items of the scale have been selected because they deal with changes commonly reported or observed during and subsequent to the LSD experience.

An examination of a subject's ratings on these selected items will indicate the level of experience which he attained and will provide information regarding his assessment of the therapeutic efficacy of the experience he has undergone. In this regard, it may also be used to study the differential effect of various dosages. By comparing records the frequency of occurrence of the various facets of the experience can be established. Over a series of sessions, consistent individual patterns can be distinguished and when a sufficient number of cases are tested differences brought about through repeated experiences can be studied.

It is hoped that by having both the subject and people who know him well complete Scale 2, some inferences may be drawn as to the social validity of the subject's belief that he has changed.

It is not intended that either scale be administered during the session itself. They can be administered at any time subsequent to the experience, preferably scale 1 should be completed with the next few day. It would be wise to delay obtaining responses to Scale 2 for some weeks or months as it takes some time and he will be unable to assess the degree of change for some time. When other people are asked to rate a subject it is wise to wait a similar period of time to give them ample opportunity to observe any changes which may have taken place.

It should be remembered also that the drug sometimes appears to have a delayed action upon behavior. No change may be noted for two or three months, but the alteration after this period is sometimes sudden and dramatic. While such change can be ascribed to other factors, this behavioral change occurring some months after an LSD session which has apparently been therapeutically unsuccessful, is not uncommon. This would seem to offer a further reason for delaying the completion of the assessment.

GENERAL

There has been a very large number of reports of the results of LSD therapy including such studies as those of Abramson (1), (2), (3), Busch (10), Chwelos (13), Eisner (16), Frederking (18), Hubbard (24), Lewis and Sloane (35), Osmond (40), Sandison (43), and Smith (15). Most of these studies have been used as an aid in overcoming resistances to ventilation. There now seems little doubt that LSD used in this way is a very worthwhile aid in psychotherapy.

However, in seeking to obtain the maximal value of the induced experience, we have based our techniques upon the use of large doses. Our aim has been that of producing an experience in which the overwhelming of the customary frame of reference, permits a general re-appraisal of values.

There are, of course, common elements in the experience regardless of the size of the dose ingested. With smaller doses, however, many of the procedures and precautions outlined in the Handbook may be unnecessary or unprofitable, though the potency of the drug and the frequent lack of behavioral reflections of its psychic impact should incline the therapist to risk erring upon the side of caution.

In citing the results to date we have limited our consideration to results based upon the method outlined in the Handbook. In the main we are concerned with the studies carried out by Hubbard, Smith and Chwelos.

Quantified results are not available on Hubbard's very large series of subjects. His was pioneer work in this field and he found the treatment to be so outstandingly successful as to rule out any questioning of its efficacy.

Smith used the drug with chronic alcoholics. His initial study was done upon 24 patients each of whom had an extremely unfavorable prognosis. Many very different cases were included in his study. All but four of these subjects has tried A.A. but had failed to remain dry despite the help offered by the program. Diagnostically half the group were classified as psychopaths, 8 were classified as character disorders and 4 were classed as borderline or actual psychotics. The average period of uncontrolled drinking was over 12 years.

Of this unpromising group, half showed marked improvement and of these 6 did not drink again. These results were obtained at a time when the method was undergoing improvement and refinement.

Chwelos using the modified method which had been developed out of the work of Hubbard and Smith has treated a number of alcoholics since January, 1958.

In evaluating the results obtained to date it should be born in mind that the assessment is based upon the specific method being used and that negative results may derive primarily from the method rather than from therapeutic inefficacy of the experience. This is particularly important since the method has been developed within the last two years. It remains relatively unrefined and further experience could be expected to render it more effective.

SUBJECTIVE ASSESSMENT OF RESULTS

We must seek to appraise the nature and extent of any change which the individual feels that the treatment process has affected him. This change appears to take place in the person's motivational pattern. His attitudes and his value system appear to undergo a change which in turn affects his behavior.

Changes of this kind can be assessed to some extent from reports written by individuals after the experience. This is an extremely inexact method, however, and a great deal of classification and interpretation is necessary to obtain any quantifiable results. No other method was available however, until a few months ago. At least two groups, on in California () and the other in Saskatchewan are currently working upon this problem. At present the California assessment method, although similar in principle to the scale presented in the following chapter, is adapted to the use of electronic computers covers a tremendous range of material. The method used by the authors is an attempt to rely more heavily upon an intensive investigation of certain apparently relevant areas of LSD-induced experience in which attitude change is to be anticipated.

The use of such a criterion of change is of course open to the criticisms that the person may be incapable of any insightful self-assessment; that he may deliberately alter his answers to put himself in a good light and finally, that subjective feelings of being "better" need not necessarily bear any relationship to the person's actual behavior.

All these criticisms are valid. By itself, subjective assessment is a poor criterion. However, therapy is an experience about which both therapist and patient hold a rather well defined set of expectations. The therapist seeks to provide an experience which will alter the attitudes - and subsequently the behavior - of his patient. The patient seeks help in learning how to cope with troublesome problems. When these expectations are not met therapy is largely unsuccessful. The measure of subjective validity which we have employed gives a fairly clear picture of the extent to which these expectations have been met.

Assessment Scale 1. was devised for use within a few days of the treatment to determine how the subject has responded and the extent to which the subject feels that the experience engendered new attitudes. Scale 2. was devised to determine, some months after treatment, the extent to which the subject felt that his pre-treatment attitude pattern had been apparently permanently altered. The results obtained from these scales are reported at the end of the section.

OBJECTIVE ASSESSMENT OF RESULTS

Generally in the assessment of treatment, the therapist notes changes in the patient's behavior and indicates the nature and extent of such alteration on some variety of rating scale. This can vary from a single two point scale of, unimproved - improved, to very complex measures involving hundreds of separate ratings. Generally the question is answered in the final analysis by stating that the patient is or is not improved.

In this report we have made use of this variety of assessment by obtaining ratings on the changes in the people treated by the therapist and by the Bureau of Alcoholism.

One assessment of reliability of treatment effect can be approached by determining the commonalities in the experiences of the subjects treated. Commonalities of experience can rapidly be calculated from the data collected on Scale 1. Consistent changes can be assessed by comparing the results of subjects on Scale 2. Again consistent changes can be assessed by the therapists or by other raters in relatively gross terms by determining the percentage of patients whose condition is regarded as improved subsequent to treatment. These results are reported in tables.

It can be seem from this discussion that the proposed methods have need of much further testing. Some may feel that the presentation of a handbook which draws upon so meager a background is unwarranted. There are three arguments against this point of view each of which seem to offer sufficient justification for the production of a manual at this time.

Firstly, although only 47 cases are represented in the Smith and Chwelos studies, the work of Hubbard upon which their methods are based is very extensive. The work is continuing and many cases have been treated too recently to be reported. Much has been learned from the administration of the drug to staff members and to volunteers. Some 500 individuals have taken LSD in various settings in research into the nature of the drug effect and its therapeutic implications. The authors have been present as observers at some 200 of these sessions and have each participated as subjects in more than 100 group sessions involving 2 to 6 individuals. Through consultation with other investigators having a wide range of experience in LSD work, the authors have been able to learn much which was of great help to them. It is hoped that the handbook may succeed in relaying some of this information.

Secondly, although the sample is small, the treatment does appear to offer remarkable promise. By whatever clinical yardstick one applies, the results appear most interesting. This is evident not only in view of the poor prognosis of the cases dealt with, but also in regard to the fact that in some 35% of the cases treated, a single therapeutic session led to an apparently permanent relief of symptoms.

Thirdly, it is the view of a considerable number of people who have worked with LSD that the re-discovery of the psychedelic properties of certain substances by modern psycho-pharmacologists marks a most important advance in the field of psychology. Harrison (22), James (27), Kluver (31), and a number of others long ago pointed out the importance to psychology of this area of experience but their work was not followed up. Psychology, in its desire to become scientific, attempted to do so by accepting as sufficient the methods of the other sciences. In adopting these it has been forced to restrict its scope to the measurement of the observed behavior of the individual. This concentration upon behavior has precluded the examination, except through reflection in activity, of the awareness, the feelings, the motives, the values and the beliefs from which behavior arises. In neglecting these areas, psychology has omitted those aspects of human individuality which differentiate man from the other animals.

Much has been learned through the behavioristic approach and much more will be learned in the future. However, the tendency to regard this as the only possible avenue to the understanding of human psychology is currently undergoing a change. The growth of interest in the origin and nature of motives, value systems, beliefs, attitudes, mood, etc., is clearly reflected in the literature.

The discovery of LSD by Hoffman and the early investigations by Stoll have led to extensive trials and there is little doubt that work with psychedelic agents will help to accelerate this change in the climate of scientific thinking.

In this process of broadening the scope of scientific psychological investigation the psychedelic drugs are likely to prove extremely important. They offer great promise in therapeutic procedures. Even more remarkable, however, are their potentialities as research tools in the investigation of personality and social relationships.

During the last 150 years there has been a prodigious acceleration of the rate of advance in the physical sciences and their attending technology. The psychedelic drugs may prove to offer the means of a parallel advance - or indeed revolution - in social understanding and human relations.

For these reasons it would seem that any guide which could hope to widen the use of the drug would be useful. Should the guide contain errors, these can only be corrected as more and more investigators come to understand the use of the drug and to pool their information.

RESULTS OBTAINED BY THE AUTHORS

Scale 1. for the assessment of LSD experience was devised, in part, to ascertain the extent which the expectation of the therapeutic process, which we have outlined below, are met by the phenomena comprising the LSD experience. The questions to be used to tap these areas are indicated by number in the text and are listed below. Table 1, shows the extent to which the subjects felt that the various phenomena were present in their experience.

Almost universally, therapy is seem as a relationship in which the patient can permit himself to surrender many of his previously held attitudes (Question 43, 59) and can escape from his deeply ingrained perspective into a situation allowing for unhabitual perception (Question 2) with its potentiality for change. By so doing he can get a relatively objective view of his motives and can both discern their etology (Question 47, 48) and scrutinize and re-assess their contribution to the psychological valencies of the various elements of his environment (Question 52).

Enhanced understanding (Question 66) developing from this increased self-knowledge and self-acceptance (Question 44) permits him to participate with greatly reduced emotional reservation in inter-personal relationship (Question 65, 38, 42) to come, in fact to see himself not only as a unique individual but also as an integral part of a larger social unity (Question 63). Requisite to any therapeutic effect, however, is his acceptance of the validity of the treatment and what he experiences must seem real and very convincing (Question 37), if it is to be remembered (Question 22) and incorporated in his day to day behavior.

The question asked to study the extent to which the expectations of the therapeutic process were realized, were as follows:

Question 43. Did you feel that you were able to give yourself up completely to the experience?

Question 59. Did you feel in the experience like laughing at many of the ideas you held prior to it?

Question 48. Did you feel that you were aware of the long ago?

Question 2. Did you feel that anything unusual happened in the experience?

Question 52. Did you notice any change in the significance of things or events?

Question 66. Did you feel that your understanding was enhanced?

Question 44. Did you feel that you became more self-accepting?

Question 42. Did you feel a high level of trust and affection for others in the experience?

Question 65. Did you feel that you gained a more complete acceptance of others?

Question 38. Did you feel emotionally very close to others in the experience?

Question 63. Did you feel yourself a part of a larger unity?

Question 37. Did you feel that the experience was very real?

Question 22. Do you feel that you remember much of the experience clearly?

The negative or non-therapeutic aspects of the LSD experience are also covered by the questionnaire. These include physical discomfort (Question 16), anxiety and tension (Question 19 and 8) or confusion (Question 18, 21, 25) which distract the patient, and mistrust (Question 27, 34) which leads to resistance (Question 33) and counter transference.

Questions asked to elicit information with regard to negative or non-therapeutic aspects of the experience were:

Question 16. Did physical discomfort distract you from everything else?

Question 19. Was the experience frightening?

Question 8. Did you feel particularly tense during most of the experience?

Question 18. Did you find yourself confused much of the time?

Question 21. Did the experience seem too complicated to understand?

Question 25. Did you feel that you were insane at any time?

Question 27. Did you feel suspicious of other people?

Question 34. Did you feel that other people were influencing your thoughts against your will?

Question 33. Did you feel that other people might find out more about you than you wanted them to know?

Data derived from these questions are summarized in Table II.

1. there appears to be a marked sensory enhancement - color, sound, smell, taste, touch.
   
2. There appears to be an extension of the time sense.
   
3. There appears to be a disruption of distance perception.
   
4. There appears to be a disuption of perception of body image.
   
5. There appears to be a tendency toward an instability of perception of gestalts.
   
6. There appears to be a disruption of balance.
   
7. There appears to be a disruption of temperature sensing.
   
8. There appears to be a decrease in sensitivity to pain.
   
9. There appears to be an overlapping of sensory modalities.
   

1. as a result of sensory enhancement
   
   1. There will be an increased capacity for fine discrimination between colors and an enhanced ability to match colors.
      
   2. There will be a finer discrimination between differing smells.
      
   3. There will be a finer discrimination between tones and sound.
      
   4. There will be a finer discrimination between degrees of loudness of sounds and an enhanced ability to match sounds of equal loudness.
      
   5. There will be a finer discrimination between differing tastes.
      
   6. There will be an enhancement of touch discrimination (e.g. determining what is written on one's hand, two touch discrimination or the identification of objects by touch.
      
      
   7. There will be an extensin of limens in the perception of light on the basis of intensity.
      
   8. There will be an extension of limens in the perception of color into the areas of intrared and untraviolet.
      
   9. There will be an extension of limens in the perception of color.
      
   10. There will be an extension of limens in the range of perception of pitch.
       
   11. There will be an extension of limens on the basis of intesnity of sound.
       
2. As a result of extended time sense
   
   1. There will be higher speed of recognition of tachisticopically presented material.
      
   2. There will be finer discrimination between very short periods of time.
      
   3. There will be increased speed of autokimetic movement.
      
   4. There will be a shorter period of after effect (e.g. Archimedes Spiral).
      
   5. There will be a higher frequence required to produce flicker fusion.
      
3. As a result of disruption of distance perception
   
   1. There will be less sensitivity to size illusions.
      
4. As a result of the disruption of body image
   
   1. There will be better mirror drawing performance.
      
   2. There will be an increased ability to perform dissociative physical tasks such as circling one hand while moving the other up and down.
      
5. As a result of the instabiliy of perceptual gestalts
   
   1. There will be an increased ability to find hidden or imbedded pictures.
      
   2. There will be an increased ability to break down gestalts in such tasks as letter finding.
      
   3. There will be an enhanced ability of gestalt completion tests.
      
   4. There will be an enhanced performance of tasks calling for the restructuring of presented gestalts (e.g. anagrams, scrambled or reversed words or sentences).
      
   5. There will be a swifter shift to alternate concept in concept bridging series.
      
6. As a diruption of the sense of balance
   
   1. There will be less proneness to dizziness.
      
   2. There will be less directional disorientation as a result of spinining while blindfolded.
      
   3. There will be elss proneness to motion sicknes.
      
   4. There will be an enhancement of body sway and static ataxia.
      
7. As a result of disruption of sense of temperature
   
   1. There will be greater tolerance of heat and cold.
      
8. As a result of decreased senstivity to pain
   
   1. There will be a greater tolerance of painful stimuli.
      
9. As a result of overlapping of sensory modalities
   

1. There will be a decreased ability to discriminate between longer periods of time (i.e. intervals in excess of five seconds.
   
2. There will be decreased performance on size - distance tests.
   
3. There will be a decresased ability to estimate distance.
   
4. There will be a decreased ability to make fine discrete motor responses.
   
5. There will be a decreased ability to discriminate between fine differences in weight.
   
6. There will be a decreased ability to discriminate between fine differences in temperature.
   
7. There will be a decreased ability in tasks calling for a sense of balance.
   
8. There will be a decrement in performance on tests of persistance.
   
   

1. Associations appear to be made a higher speed.
   
2. Associations appear to cover a wider range.
   
3. There appears to be an enhanced ability to see alternatives.
   
4. There appears to be an enhanced ability to relate ideas across usual boundaries in thinking (frames of reference).
   
5. There appears to be an enhanced ability to reason by analogy.
   
6. Time appears to be more readily transcended inthinking.
   
7. There appears to be an enhancement in deductive ability.
   
8. There appears to be an enhanced ability to draw inferences from given date.
   
9. There appears to be a tendency to think more abstractly.
   
10. There appears to be a decrased ability to limit associations.
    
11. There appears to be a decreased span of attention.
    
12. There appears to be a decreased ability to attend selectively.
    
13. There appears to be a decreased ability to select from among a series of possible alternatives.
    

1. As a result of higher speed of association
   
   1. Greater fluency of timed tasks of association.
      
   2. Increased ability to suggest criteria for classification.
      
   3. Increased ability to determine the bsis upon which presented classifications have been made.
      
   4. Increased capacity for symbolic communication. (e.g. in such tasks as identifying caricatures, playing Boticelli, charades, etc.)
      
2. As a result of a wider range of association
   
   1. More inclusive concepts will be used on classification or sorting tests.
      
   2. There will be an enhanced capacity to see "missing links" in a series of concepts.
      
3. As a result of increased capacity to see alternatives
   
   1. Given datea for which alternative solutions are possible there will be a more rapid identification of these.
      
   2. Given a series of alternatives the basic datea will be more rapidly determined.
      
   3. There will be an increase in the speed of reversal of ambiguous perception.
      
   4. There will be an enhanced ability to determine missing steps in a series.
      
4. As a result of enhanced ability to relate ideas across accustomed frames of reference.
   
   1. Enhanced capcity on taks calling for a shift of context (e.g. Zen koans).
      
   2. Enhanced ability to solve riddles or to predict the endings for jokes which rely upon a sudden change of frame of reference.
      
   3. Faster learning of paired nonsense syllables or unrelated concepts.
      
5. As a result of an enhanced ability to reason by analogy
   
   1. Increased performance on tests based on analogical thinking.
      
6. As a result of an enhanced ability to transcend time
   
   1. There will be an enhanced ability to see similarities in historically disccreet events.
      
   2. There will be an enhanced pre-cognitive capacity.
      
   3. There will be an increased tendency to think in terms of process rather than in terms of discreet events
      
   4. There will be an enhanced capacity for the recall of specific instances in one's past.
      
7. As a result of entrancement of deductive ability
   
   1. Increased performance of ntests based on analogical thinking.
      
8. As a result of enhanced ability to draw inferences from given data
   
9. As a result of the tendency to think more abstractly
   
   1. More abstract answers will be given in such tests as proverbs, similarities, etc.
      
      

1. There will be a decreased capacity for the selection of "sight" answers from a series of posible related alternatives.
   
2. There will be a dcreased capcity to limit associations in accordance with various restrictive instructions or frames of reference.
   
3. There will be a decrement in performance in tasks calling for trial-and-error learning.
   
4. There will be a decrement in performance in tasks calling for prolonged selective attention.
   
5. There will be a decrease in zarganic effect.
   
   

1. There appears to be an enhancement of emotional sensitivity to the moods and feelings of others.
   
2. In group experiences there appeaers to be a direct non-verbal communication of feeling.
   
3. In group experiences there may be non-verbal communication of ideas.
   
   

1. As a result of enhancement of emotional sensitivity
   
   1. There will be an increased ability to identify emotion from photographs.
      
   2. There will be an increased ability to determine when another person is lying and when h is telling the truth.
      
2. As a result of enhanced communication of feeling in group experiences.
   
   1. There will be an increased capacity in determining how others have responded, are responding or will respond, to various stimuli, (e.g. Dymond type empathy tests).
      
   2. Capacities for such activities as psychodrama and role playing or for such activities as charades will be very much enhanced.
      
   3. Agreement should be found between ratings by group members, (e.g. adjective check tests scored to indicate how each group member in turn responds to stimuli such as music, paintings, etc.).
      
3. As a result of non-verbal communication of ideas
   
   1. Using a group in which one subject knows the answer to a series of problems, the performance of the other group m embers should be enhanced.
      - This situation should be studied under several conditions.
      
      1. when the subjects are face to face.
         
      2. When the subjects are in the same room but cannot see each other.
         
      3. When the subjects are at a distance.
         
      - It should also be studied in variou qualities of settings ranging from the friendly and accepting to the cold and hostile.
      - This situation should also be studied using various types of content for communication ranging from such abstract material as Zeno cards to highly effective material.
      - The situation should also be studied using various doses.
      
      

1. There appears to be a tendency toward an enhancement of appreciation and enjoyment of various art forms, particularly music.
   
2. This appreciation appears to be colored and qualified by each participant in a group experience.
   
3. There appears to be a tendency for belief to shift toward:
   
   1. greater self-acceptance and self-understanding
      
   2. greater acceptance, appreciation and respect for other people.
      
4. There appears to be a tendency for belief to shift toward the acceptance of prime casue.
   
   

1. As a result of enhanced enjoyment and appreciation of music and other art forms.
   
2. As a result of qualification of appreciation oby other group members
   
3. 1. As a result of the tendency for values to shift toward greater self-acceptance and self-understanding
      
      1. The subject will report the above on self ratin scales.
         
      2. The behavior of the subjet will become less defensive.
         
   2. As a result of the tendency for values to shift toward greater acceptance of others.
      
      1. Persons who know the subject will indicate that such a change has taken place.
         
      2. The behavior of the subject will become less hostile.
         
      3. Scores obtained on attitude, adjustment, personality or interest inventories will reflect better adjustment.
         
      4. Lowered scores on scales of Authoritarianism and on such scales as Eysenek's scale of Tough-mindedness.
         
         

1. In group experiences, within group communication is improved.
   
   

1. 1. Group decisions will be arrived at more rapidly.
      
   2. Limitations imposed on communication will have less effect.
      
   3. There will be less expression of annoyance and hostility.
      
      

1. Group efficientcy
   
2. Levels of empathic relation between members.
   
3. Group Solidarity or unity.
   
   

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9. Bradley, P. B., Elkes, C. and Elkes, J.: J. of Psychology, 121, p. 50, 1953.
   
   
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23. Omitted in manuscript.
    
    
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