Treatment of Childhood Schizophrenia Utilizing LSD and Psilocybin
Gary Fisher, Ph.D.
Now that the FDA has permitted research with LSD and psilocybin to resume,
we feel it is important to share examples of a remarkable experiment, the
results of which were not sufficiently taken into account because this
line of research was prematurely halted in the mid-sixties due to
political considerations. Childhood schizophrenia is still a difficult
problem to treat and causes much suffering. It is a terrible shame that
research done 35 years ago is still the last word on the use of
psychedelics to treat these conditions. - Ed.
Hypothesis
The working hypothesis of this study is that psychosis is a massive
defensive system of repression-avoidance-denial in the service of
protecting the individual from experiencing early childhood trauma. The
repression is so massive that the individual ceases to experience himself
with any validity. The individual exists isolated in a world without
feelings and this world becomes meaningless. One of our little patients
told me that he lived in a world of "no nothingness." It was
hypothesized that the psychedelic drugs could break through this massive
repression wherein the child would re-experience these traumatic events
and release the pain bound to those experiences. He or she would
acknowledge his own history. Furthermore, through experiencing the loving
attention of the staff in a milieu of total acceptance, the child could
begin to experience himself as a positive and valid person. The team
consisted of a psychiatrist (who chose not to have an LSD experience but
was medically responsible for the research), four psychology graduate
students and three psychiatric nursing technicians. The author acted as
lead therapist of this group. For any one session there were usually three
to four staff, relieving each other throughout the day as the sessions
were extremely intense and required very active participation by the
staff. All staff had had their own experience with LSD and psilocybin, as
it is accepted practice that in order to understand what was going on with
the children one had to have had personal experiences with the drugs. As
we progressed with the work it emerged that one staff person would become
the primary therapist for each patient. Each session was continuously
recorded for the verbalizations and behavior of the patient. Besides
spending time with the patient during the treatment session itself, a
total program had to be developed for each patient and that program
communicated to all ward personnel to attempt consistency in the
therapeutic approach. We were careful to include ward personnel who were
not part of the treatment team in the ongoing progress of each patient and
to enlist their cooperation in the development of a consistent attitude.
As the ward personnel began to see the remarkable changes occurring in the
children, they became involved and supportive in the ongoing care of each
child.
Ward Conditions
The ward in which these children lived was in a state of constant
pandemonium. The ward housed some sixty children ranging in age from four
to twelve who were the most severely disturbed children of a larger
hospital population. There was constant screeching, fighting and
destructive behavior. Many children were destructive towards the
environment, to each other, to the staff and to themselves. The primary
duty of the ward personnel was damage control. The noise level was always
high, as many of the children were extremely hyperactive and vocal. Other
children were very withdrawn, involved in repetitious physical motions and
when interfered with would lash out at the intruder. There was little
interactive or parallel play and any toys or material brought into the
ward were soon destroyed. Feces smearing and random urinating were a
constant problem. To say the least the environment was not conducive to
good mental health.
New Behavior
After nine months of the program and fifty-eight treatment sessions it was
decided to continue the program with five patients of the initial twelve.
The children discontinued from the program were characterized by a lack of
speech and infantile autism and were the least responsive to treatment.
They were extremely withdrawn and had no ability to relate to other
children or adults. In spite of their severe limitations, all of them did
have some marked response to the treatments. During the sessions they
showed little responsiveness although some of them became hyperactive and
were obviously having some sensory experiences and more interaction with
the staff. One girl had a prolonged fear response. Marked changes occurred
in the days following the sessions. They showed much more interest in
relating to the treatment staff, became animated and playful and
remarkably less withdrawn. One girl evidenced extreme frustration at not
being able to verbally communicate as she had no language development. The
youngest (four years old) and least developed child kept trying to lead a
treatment staff person down to the room where we did sessions. They all
had interest in making physical contact with the treatment staff and one
very autistic child became quite demanding to be held. This was all new
behavior for these children. Consequently they all had behavior changes
but their potential in relation to other patients was much more limited
and we had limited time available to treat them.
Among the children with whom we discontinued treatment, one twelve year
old girl had progressed so remarkably that she was able to attend public
school during the day and return to the hospital in the evenings. It was
felt that she had sufficiently improved, was function ing satisfactorily
in the school system and that further treatment was not crucial. Patty was
the only patient who was not psychotic. She responded to the treatments
more rapidly than the more disturbed patients. A short summary of her
treatment will help illustrate the work.
Patty's First Session
Patty had three sessions over a period of three months. Dosage for the
sessions were 100 micrograms of LSD, 100 micrograms of LSD with 10
milligrams of psilocybin, and 200 micrograms of LSD. She was hospitalized
because of her inability to function at home, in the school or in the
community. Her behavior fluctuated from being withdrawn and
uncommunicative to very aggressive and sadistic towards smaller children.
She stole food and other items from other smaller children and when
thwarted in her behavior had violent temper tantrums and had to be
physically restrained and isolated. Although her IQ was tested at 72, her
low functioning seemed to be caused by severe personality problems and it
was estimated that her potential was near the normal range. During the
first session she spent the entire seven hours regressing to an infantile
oral state. She incessantly repeated, "I'm hungry" and when
asked what she was hungry for, she did not reply but only restated her
hunger. During the entire session she chewed and sucked on her clothes or
others, her fingers, arms and anything or anyone she could reach. She was
given an empty baby bottle with cotton stuffed in the nipple and she
chewed and sucked on this for hours. It was clear that she was trying to
draw nourishment from anything in her environment. During the session one
staff member would sit with her, holding her hand or arm and gently
hugging her or stroking her. We gave her constant tactile care. For about
two hours she aggressively bit the nipple, stretching it and gnawing on
it. She finally appeared to become exhausted and uncommunicative for
almost an hour. In the latter stages she held hands with staff and smiled
quietly without verbalizing. She appeared to be making genuine
interpersonal contact.
The Second Session
In the month following her treatment Patty was much
more subdued and did not want to talk a great deal about the first
session. During the second session she spent a great deal of time sucking
on the baby bottle but this time she said she wanted milk in it and we
complied. She then went into a panic-like state and talked a great deal of
her fear of being rejected by her parents. She insisted that we call them
immediately and have them come and take her home. She was extremely
anxious that she would be abandoned by them and at one time sadly said of
her mother, "She doesn't love me." After some three hours of
constant turmoil concerning her familial relationships and her severe
agitation over the rejection by her parents, she slipped into a quiet
state for a period of time. She then suckled on the milk bottle and when
she took it out of her mouth she would repeat, "I am loved."
After some four hours she said "I love my mother, my father, my
brothers and my sisters, I never felt this way before. I love them."
She said that she had never felt that she was loved and the feeling of
being loved and loving that she was now experiencing was new to her. She
then went into a state for about two hours which is best described as a
deep trance state. She was completely still with no movement whatsoever,
and was unresponsive to all verbal or tactile stimuli. She finally came
out of it and started smiling but still remained unresponsive to any of
our inquiries. After about another hour she got up and wanted to go for a
walk outside. She was happy and smiling and occasionally would laugh out
loud.
Following this session Patty again was much more subdued, her behavior
changed remarkably in that her temper tantrums ceased and she was relaxed
and content. She interacted with new maturity toward the staff and had a
very positive relationship (it looked like adolescent adoration) with one
of the male psychology students. They spent a good deal of time with each
other.
The Third Session
The third session, two months later, was initially characterized by more
oral regressive behavior. She asked for the baby bottle with milk and
spent over two hours, biting on it, suckling it trying to swallow the
whole bottle, but this behavior did not have a desperate quality to it.
She seemed to be more playing with it, enjoying it, and her demeanor was
quiet and content. She suckled for long periods and would drift off into a
peaceful, tranquil state, completely relaxed, smiling at the sitters when
making eye contact. She wanted to be quiet and we were quiet with
her - touching her, hugging her, holding her hand when she reached out. She
responded to visual stimulation such as a rose with delight and amazement.
She thoroughly enjoyed the attention and affection of the staff. Again
following the session she was much more mature, interested in relating to
adults and wanted to go to school with kids her own age. Her temper
tantrums and rage reactions and her stealing behavior had completely
ceased. It was felt she was ready to try school off hospital grounds. She
was excited about this new situation and did not have any relapses. Patty
did not seem to experience fear of the new situation but was excited about
the opportunity to be in new surroundings and she did very well. She
continued to stay at the hospital after school hours and continued her
supportive relationship with the staff. She became a very affectionate and
loving child and her personality was fairly subdued and quiet.
Timmy
One ten year old severely autistic boy was continued on the program more
as a challenge, as he was very resistant to abandoning his psychotic
defenses. He was given a series of ten sessions over a period of ten
months, with dosages up to 400 micrograms of LSD. Before treatment he was
highly encapsulated, repeating a few phrases and displaying repetitive and
catatonic posturing. His only contact with people was looking up their
sleeves, he seemed to be checking if and how arms were attached. He would
not allow himself to be touched and had no interaction whatsoever, other
than attacking other children if they approached or touched him. His
treatment sessions were characterized by agitation, fear, panic and
anxiety. Occasionally he could relax and allow staff to hold him, rub him
and gently feed him. He had long periods where he was totally out of
contact with his surroundings. During a later session after some two hours
of being out of contact, he sat up rather suddenly, his eyes widened with
astonishment and he whispered, "I saw God." During later
sessions he evidenced a much larger vocabulary and abandoned his echolalia
and repetitive speech.
Timmy's first four sessions were almost exclusively devoted to biting,
chewing and aggressive oral behavior. We observed this with all patients,
evidencing extreme oral rage. In later sessions patients would attempt to
eat us and everything in sight to fill the emptiness they felt. In spite
of us not witnessing a lot of what we could identify as conflict
resolution during the sessions, his behavior underwent a marked change.
His physical attacking behavior subsided and he became interested in
relating to other boys his age as well as the treatment staff. He wanted
physical contact, became playful and enjoyed himself. His parents began
taking him home for weekends due to these behavioral changes and they
repeatedly told us that they were amazed at his improvement.
Jenny
This nine year old girl had eight sessions over a period of six months.
Her IQ at age five was eighty-two. She had good verbal ability. Her
behavior was impulsive, erratic and unpredictable. She was often very
aggressive to other children, especially smaller ones, and attacked them
viciously without provocation. When she attacked it was often with very
flat affect, not associated with anger or retaliation. She was very oral,
eating anything she could obtain and attempted to eat inedible objects.
She would make sexual advances to adult males. She was socially isolated,
did not participate with others, and showed a pronounced inability to make
any meaningful relationship with anyone, children or adults.
Jenny's sessions were characterized by her reliving sexual abuse and her
fear and alarm and ambivalence over the attention given her. She regressed
back to her early infancy and gave repeated evidence of her neediness from
her mother and her anger at not being properly cared for (both parents
were alcoholics). She was extremely orally aggressive and had to be
restrained a good deal as she acted out her anger by biting, scratching,
pinching, kicking and attacking staff. Much of the time that she was
acting out her affect was quite flat, other times she would be screaming
and there was a great deal of conflict over toilet training and power
struggles related to this event.
In later sessions Jenny became much more stabilized and she started
verbally expressing her hatred of both males and females and wanted to
kill babies and children. Behavior changes on the ward were significant.
The affect became much more appropriate and she developed a buddy
relationship with another one of the female patients, a twelve year old
girl. Her erratic, aggressive behavior towards younger children completely
subsided; she became much more interested in doing activities with her
friend and interacting with adult ward personnel. She began to see herself
as more grown up and took pleasure in her new identity. She went to school
and was able to function satisfactorily in that setting. Her changes were
remarkable and she became quite functional and was no longer a management
problem.
Stevie
This nine year old, very small boy had a total of thirteen sessions over a
ten month period. Prior to treatment Stevie was extremely withdrawn and
isolated and responded to no one. He vacillated between extreme catatonia
and excited catatonic rage reactions. He would become assaultive and
destructive and especially physically aggressive towards younger and more
helpless children. During these times he had to be placed in camisole
(full straight-jacket) and seclusion. He never spoke to anyone, made no
eye contact and lived exclusively in his own world. What was unique about
this boy's psychedelic experiences was his ability to enjoy sensory
experiences that are commonly experienced by the normal person. During the
first two hours he would delight in the visual and auditory experiences
and constantly comment about what he was experiencing.
We soon discovered Stevie had an extensive vocabulary which he never used
in his usual state. He would say such things as "the music is
following the designs," he would laugh and say, "I love you,
designs. Heart designs, ahhh, what a beautiful lady, a whole house full of
changes." He rhythmically moved his body very gracefully to the
music. He became extremely animated, smiling, sometimes giggling and
appearing very much enchanted by his experiences. The long duration of
this type of reaction was most unusual with these children. He would also
become extremely quiet and peaceful, radiating a serene countenance that
is witnessed when individuals are experiencing transcendental states.
After the first few sessions he became very excited when told that he was
going to have another session. He would run down to the treatment room and
participate in preparing it by setting out the things that we would
typically bring - fruit, cookies, flowers, pictures, record albums and so
forth. When the room was set up he would take a wash cloth, dampen it with
cool water, fold it and lay down on the couch and cover his eyes with it,
a ritual we would frequently use in attempting to get patients to travel
inwardly. He would then want the music started. He was acting like a
typical normal person in preparing themselves for a session.
In the second phase he would exhibit intense turmoil, conflict, fear and
agitation. He indulged in the entire gamut of behaviors and emotions,
biting, spitting, profuse and prolonged swearing and extreme
hyperactivity, destructiveness and total catatonic withdrawal. He would
carry on extended dialogues between two or possibly more people,
evidencing conflict between his mother, father and himself. There was a
great deal of anal and genital content to his conversation, with endless
repetitions about "shit, piss, penis, nasty, black BM, death, black
hearts, throw up, black breasts, black diarrhea, chew it, afraid, burn it
hurts." He would interrupt these dialogues by going to the bathroom,
standing in front of the toilet, turning in a few circles and then
urinating and when he ran out of urine he would continue this behavior
twenty to twenty-five times. After an exhausting three to four hours he
would appear very beaten up and would allow staff to sit with him, touch
him and hold him, feed him and nurture him.
Touching moments would often occur with these small patients, near the end
of one session a male sitter was sitting beside Stevie, holding his hand
and Stevie opened his eyes and said, "Will you talk to me,
David?," David said, "Yes Stevie" and after a moment said,
"I don't know what to say?" to which Stevie replied, "Just
talk to me with your eyes." This coming from a child who in his usual
state was either catatonic or wildly destructive. Very often we had no
idea how to interact with the children when they were obviously back in
time wrestling with the demons of their pasts. They would be unaware of
our presence and often the most we could do was to sit it out with them.
Remarkable changes occurred with this boy. He started to relate to
treatment staff and wanted to be touched and held. His manic and
destructive behavior disappeared and he started relating to boys of his
own age and older ones and struck up a bond with another boy on the
program. They became good buddies. He became well enough to attend school
and was able to function well in that setting. His parents were amazed at
the changes and started to visit him and then began taking him home every
weekend. He was very verbal, became very playful with the treatment staff
and was behaving like a normal boy.
Floyd
This ten year old boy had a total of sixteen sessions over a period of
eleven months. He had a history of extreme deprivation. His mother was an
extremely agitated, narcissistic woman who made no effort to relate to him
at all. For the first two years of his life, he was confined to a crib
without any toys or any kind of stimulation. Prior to treatment he was
constantly hyperactive and agitated, not wanting contact with others. He
spent his days in the yard being completely involved in finding and
looking at small bugs. When not in the yard he looked at two books which
were about insects and bugs. When staff attempted to interact with him, he
would only ask repetitive questions about bugs but was uninterested in any
one responding to his questions. He appeared to be actively hallucinating
much of the time. He would not carry on a verbal exchange.
In his first
session Floyd had a remarkable response to the drug. Within thirty
minutes he was obviously experiencing sensory changes and became relaxed
and smiled a genuine human smile. His first words were, "What did you
do with me? He's not dead yet." He looked at pictures in his book and
said, "I'm not making it real, no I'm not." A staff member said
"You're alive, aren't you?" to which he replied, "No, no,
no, I can't be alive, this is too good." He looked back at the book
and said, "Okay, it can't be, turn it off, turn it off, who's doing
it." Looking at one of the staff he said, "Oh Judy, don't be
real, don't be real." He touched another staff member, looked in his
eyes and said, "Don't be real, don't be real, I've got to get out of
here. I don't want to be alive, I am afraid of me, turn that off. Tom,
don't be real. I'm not real no more. I'm blind. No, no, no, I can
see." He then relaxed, looked at various staff members and said,
"How come we are all the same?" He didn't ask this in an
inquiring way but more as in a declarative way. He then drifted off,
listening to the music and went into interior experiences. This lasted for
some five hours. Finally, he started to become aware of his present time,
became agitated and tense and started to cry, and sadly said, "I want
outside." He kept repeating this phrase which we took to mean that
the expanded experience he had was receding and he did not want to go back
into his isolated world. This was a very painful time for the staff as
well and we didn't know how to help him stay alive. This was a unique
experience for us in that Floyd had such an immediate response and was
able to leave his psychotic defensive posturing and experience himself as
a real living being.
During the next session, a month later, there was a similar reaction to
the drug. After he started experiencing sensory changes he asked, "Is
it real? Is the music real?" then incredulously stated, "We're
real, are the feelings doing it?" He was told that having feelings
made life real. He then repeatedly asked, "Is it real?" to which
we gave affirmation. He then drifted off and started smacking his lips and
making lots of movements with his tongue and lips. He said, "I am
with Mommy, Daddy is here too, why don't you love me?" His speech
then became incoherent and he remained in this state for two hours.
Finally he desperately started crying and said, "I want out. I want
outside. I want out of here. Please, please, help me open the door, help
me, help me, I'm real, I'm Floyd and I'm real. My own little boy." He
then looked at staff and said, "Give me some more, please give me
some more." We asked more of what and he replied, "Pills. Just
give me some more, I want to get out." Staff told him that
essentially he had to make himself real, that the pills let him know that
he was real but that the pills wouldn't do it, that he had to do it. Floyd
finally settled down out of this agitation and became very pensive and
very, very sad looking. He went to a window, looked out and quietly said
to himself, "Fountain View State Hospital. What a funny place to come
back to." Obviously this was incredibly touching and the staff were
tearful. The empathy we felt for him was deep, as we all had had the same
feeling after coming out of a profound experience back to our usual
normative reality.
The next four sessions were very similar to each other and markedly
different from the earlier two. These sessions were characterized by his
regression to earlier experiences where he had been physically abused and
threatened. He repeatedly called the phrases, "I'll be good from now
on. I'm sorry. I promise, don't hurt me, stop, stop, help me, help
me." He frequently yelled, "Oh, oh, ouch, it hurts," and
was physically trying to get away from being beaten. He would also have
periods when he would attempt to strike out at the staff, smash himself
against the wall and plead to be left alone. He was also very orally
fixated and we gave him a baby bottle which he could suck, chew on and
then violently fling away.
The seventh session was markedly different in that he did not appear to
regress but rather stayed in contact with staff but became very
belligerent, aggressive and sexually provocative. He would want to be
cuddled by a female, rest his head on her breast and then make an
aggressive biting gesture at her breast or suddenly start pounding her
breast. He would also climb on a female, make undulating hip movements on
her body and would attempt take his pants off. He would also approach a
male, be sensual and want to be held and cuddled and then aggressively
grab at the male's genitalia or scratch or bite his face. He would run
around the room attempting to slap and punch everyone. He would growl and
make guttural sounds, howl and become feral and aggressive. The
following three sessions were similar in many respects in that he acted
out alternately oral aggression and his need to orally take in good things
in the universe. At one time he took the author's fingers, sucked them,
opened his mouth as wide as he could and attempted to swallow my hand. He
put his hand on my elbow and pushed it in an attempt to eat my hand and
arm. I said, "You are so empty you want to swallow me
completely." His eyes became very wide and he vigorously nodded his
head affirmatively acknowledging that's exactly what he wanted to do. He
would also swing into seductive sexual behavior and alternate between
being tender towards staff and then biting and trying to eat us. In
subsequent sessions, he became obsessed with wanting to be taken to our
homes. He would verbalize this precisely saying, "I am very unhappy
here, I want to go to your home. I want you to take me to your
house." Various staff would take him home after a session and he
invariably was very calm, serene, extremely happy to be there and behaved
admirably. He was affectionate, ate well, went to bed when told and
evidenced none of his hyperactive, anxiety-ridden behavior. He also
totally abandoned all preoccupation with bugs and stopped asking endless,
meaningless questions.
After a number of these home visits a lot of Floyd's session time was
spent in trying to convince staff to let him live with them permanently.
He started to attend school and was also able to function well in that
setting. He developed a positive relationship with his teacher and
developed intense relationships with three of the treatment staff and
wanted to dominate their time. However, when they were with other patients
he did not become aggressive to the other patients as he had earlier but
patiently waited his turn. It was very painful for staff not to be able to
meet all of his needs. He did start to relate to other children his age
and had meaningful interaction with another boy his age but always
preferred to be with the attending staff. His withdrawn, isolated behavior
never reoccurred. He attended school and was well behaved on the ward,
always looking out for staff to be with and to talk to.
Nancy
This eleven year old girl was the most difficult and challenging person we
treated. When first introduced to me, she was in complete retraints
twenty-four hours a day. She was in full camisole and her legs were tied
to the bed. This was necessary due to her extreme self destructive
behavior. If her hands were free, she would gouge out her eyes, hit
herself in the head as hard as possible, bite her fingers, tear out her
tongue. She was totally emaciated, covered with swellings and bruises,
black eyes in sunken sockets. She was incontinent and refused to eat. She
was IV fed, she looked like a beaten up, starved, wild, eighty year old
woman. She made no eye contact, did not respond to any physical stimuli,
attempted to make guttural noises and spit, but unsuccessfully, as she was
so exhausted. The attending physician felt that she would probably die.
All known drugs had been tried. It was frightening to treat her with LSD,
as my concern was her extremely frail physical condition and that she
might die during a session.
Nancy was to be our first patient to treat and the physician's attitude
was essentially that she was going to die anyway so we may as well attempt
LSD as nothing else was available. I was fearful that this would be our
first and last LSD session. She was given 200 micrograms of LSD. The
session was very long and tumultuous. After thirty minutes she started
intense screaming. She briefly stopped, muttered very softly, "I'm
sorry" and went back to screaming. She looked petrified, made rocking
motions, furtively looking around as though she were trying to avoid being
attacked. She began to verbalize "Gary, hold on tight, hold on tight,
hold me." She would scream, "Mummy, ow, oh, hurt, oh." She
would go in and out of contact with her surroundings. She remained
extremely agitated and frightened, alternating vehement screaming with
animal growling. After about seven hours of this violent behavior and
screaming, out of exasperation and exhaustion I said to her, "How
long are you going to scream?" She stopped flailing about, became
very quiet and still, looked at me very directly in the eyes and said very
quietly, "I am going to have to hurt for a very long time, so just
leave me alone." She then proceeded to flail around, resuming her
screaming.
In the following session she was markedly different. She developed a
voracious appetite, was very talkative with the staff and required no
restraints. As she went by the dining room she stopped, looked in and said
with amazement, "My God look at that, they're eating, that's
nice." She then regally flourished her hand and said, "Let them
eat." Later in the day she told one of the staff, "We went to
see Dr. Fisher, Gary, didn't we? I had a camisole test. It was good."
The next session, a week later, she was looking forward to the session,
telling me in the early morning, "Let's get the test now." She
was much more verbal and a great majority of the time was spent in
regressing back to conflict with her grandfather. It was obvious she was
reliving a sexual trauma, wailing and screaming, "No Grandpa, no, I
can't stay like this. I can't do it, hurt Grandpa, hurt, bye Grandpa bye,
I don't have to." She would moan and wail. She then began to attack
herself and had to be restrained.
The following few sessions were characterized by extreme conflict over
pleasure and pain, much of it sexual in nature. In her regressions she
would evidence marked sensual/sexual pleasure, laughing, giggling and
saying "Don't do it. Oh Honey, no fair. Oh Honey let go, let go. They
will kill us. No more. Love me, love me." She would then alternate to
fear and anguish, become agitated, start lashing out at herself. When
physically held by staff she would bite, spit, claw and scratch at them.
This alternation between indulgence and conflict went on hour after
hour.
After five sessions, Nancy's ward behavior was totally different. She
wanted lots of interaction with the treatment staff, became very demanding
of attention and was jealous of other children getting attention. She
became bossy, started ordering other children around and took on an
"I'm in charge here" attitude. She wasn't hurtful to them, only
making it clear that they were inferior and that she knew what was best
for everyone. When another child was going to have a session, she would
attempt to maneuver her way to the treatment room and when removed became
verbally, but not physically, angry. When told one day that she couldn't
have a "test" (her word for the session) whenever she wanted it,
she said, "Oh, then let's talk. Let's go down to the visitor's room
(where sessions were held) and talk." Once there she would lay down
on the couch, close her eyes and tell us to be quiet. I went over, pulled
her up and sat her in my usual chair and I lay down on the couch. She got
quite indignant and told me, "You don't need help, I do. I want the
test." She began evidencing behavior which indicated she considered
having a session a privilege. She went on her best behavior when informed
she was going to have the next session - helping other children, being
polite and neat, smiling and being very charming. Prior to her seventh
session one of the ward staff, Van, asked her what she was going to see
during her next "test," she replied, "God and Van." He
laughed and asked her how she could tell the difference. Very seriously
she replied, "I'll show you. You'll be there and I'll show you."
Van asked, "Where will that be?" She replied incredulously,
"Why, in the visitor's room. That is the only place you can see
God."
During the next few sessions, Nancy's behavior became quiet, she was
always wanting to be in physical contact with one of the staff and
especially with one of the males. She would pet and stroke his arm, softly
caress his face, smile and sing softly. She wanted to be cuddled and not
interrupted in her pleasure. Coming out of the session was usually
stressful, she would cry and occasionally revert to soft biting. When told
she couldn't bite, she would lick and kiss.
After five months of treatment the focus became on her self-destructive
behavior. It was felt that she was no longer psychotic and was using her
hitting herself as a way of manipulating and controlling staff for
whatever she happened to want at that moment. This was a sure way of
getting attention, it was very clear that she wanted to be the sole focus
of staff's love, attention and care. We decided that everytime she hit
herself we would pinch her, step on her toes, and if we were outside, grab
her and run her until she was exhausted. She was extremely indignant about
this and gave up most of her self-destructive behavior. One day in a fit
of pique she said, "Well I can't fool the A.M. staff anymore but I
can still fool the P.M. staff." I looked at her directly and her
mouth dropped open as in, "Oh, oh, I shouldn't have given that one
away." That evening I met with the P.M. staff, made Nancy sit in the
meeting, told them what she had said and clearly outlined how they all had
to behave, just like the A.M. staff. She looked daggers at me but she knew
that she had been nailed. She then took to placing small pieces of paper
on her hands, telling us that the paper prevented her from hitting
herself. When we saw her with a piece of paper we would go over and knock
it out of her hand and dare her with our stares, to do anything about it.
She would often mutter, "God damn" and either pick the paper up
or walk away. She then gave up the paper and started to carry kleenex
around with her. When we would see this kleenex she would say, "Oh,
I've got a cough" or "My nose is running and I need it," we
would just look at her and mutter, "oh yea, I bet" and look at
her with a message "How dumb do you think I am?" Soon she gave
up the Kleenex routine.
The staffperson who was primarily working with Nancy left at the end of
the fifth month and she was badly shaken by his departure. Her response
was amazingly mature, she became depressed, sad and mournful and cried a
great deal. She did not act out against herself or others. Another male
student from the treatment staff, whom she knew well, took his place and
she was grateful for his attention. She would become frustrated at her
lack of sufficient language in trying to describe her feelings to him.
Sometimes she just held him and sobbed about her loss.
She began to attend school on half days and was able to adjust to the
setting. It was hard for her to share adult attention and other children
her age did not have her sophistication. She was very bright and didn't
miss a thing. She had become affectionate and warm, loved to be physically
touched, and smiled happily a great deal of the time. She had given up her
self-destructive behavior and wanted to identify with the treatment staff
and to be included in the grown-up world. Unfortunately she was often
bored because there was a gross lack of stimulation available for her in
the ward setting.
Jeannie
Jeannie was a girl who, when initially seen, lived in a totally
encapsulated world. Her behavior consisted of hyperactive twirling,
yelling a meaningless "word-salad," screaming, and violent
attacks towards anyone who came within her personal space. She would work
herself up into such manic frenzy that she would collapse in physical
exhaustion. During her treatment course with psychedelic therapy Jeannie
experienced a number of transcendental phenomena which established the
core recovery from her psychosis.
In spite of being blind, burdened with congenital dislocation of hips and
knees and raised by a completely psychotic mother, this girl overcame
horrendous madness in a devastatingly sterile and chaotic environment of a
state hospital ward, to become one of the most tender, loving,
compassionate and courageous persons the author has ever known. If Jeannie
had had the opportunity to continue her sessions in a benign, safe and
nurturing environment, she would have become a functionally superior human
being. Our experience with this one girl was all the proof that was needed
to attest to the dramatic usefulness of psychedelic drugs in treating the
most seemingly intractable psychotic states.
It is most noteworthy to report that at least four of the children had
identifiable transcendental experiences and were capable of communicating
such experiences to us. It may be that some of the other children had
similar experiences but were unable to communicate to us. However, given
the age and degree of psychopathology of these children we were amazed
that these spiritual experiences occurred.
The Work Ends
Our work was cut short by the political climate that developed after LSD
hit the streets. Our project was closed down very quickly in mid 1963 and
the staff associated with the project soon left. The abandonment of these
children was an extremely painful experience for all of us. We were very
surprised and touched with how supportive and acccepting the children were
of our departure when we said our good-byes. A follow-up was attempted ten
years later but proved to be futile. The administration of the hospital
was extremely agitated that the media would learn that LSD therapy was
done there in the early sixties, as in the early seventies the political
landscape around LSD was still very volatile.
To separate out the contribution of the drugs from our intense, devoted
and caring commitment to these children was not an issue with which we
struggled, although it was an issue often raised by other professionals.
The author had worked for over four years with psychotic children in these
same settings without drugs with very minimal success. The psychiatric
technicians on staff had worked with these same children for many years,
again without any significant results. It is only through personal
experience with these compounds does one appreciate the potential they
offer. However, a strong cautionary word is offered. These materials are
so potent that a person interested in using them must have very clear his
intention and needs to have guides attend him who are experienced
travelers in the realms of consciousness that are unfolded and revealed.
We used to say that the most important ingredient in LSD was the person
taking it. The second most important ingredient is the guide who sits with
that person.
One issue that is generally not addressed in the literature is the
vulnerability the psychedelic therapist feels which is inherent in this
work. Often included in the expanded state of awareness achieved by the
drug-taker is intimate knowledge of the therapist and his state of grace -
or lack thereof. The therapist cannot hide from being "seen."
Experienced therapists know this well (and hence the emergence of
counter-transference) and one's vulnerability is total when sitting with a
psychedelic voyager. We had not anticipated this phenomenon to occur with
these children as they all appeared to be so disturbed and out of contact
with "reality." We were amazed when, in sessions, they would
tease us by mimicking us, sorely hitting our most vulnerable and protected
spots. Happily, this was done with compassion, humor and acceptance, but
nevertheless we got the message. Our humanity and humility were often
tested and we were stunned by the children's perceptiveness and their
ability to embrace us in our shame - we had so much and they had so
little.
Acknowledgment
Invaluable work of the dedicated treatment staff is gratefully
acknowledged: Con Cowan, Dave Dion, Bob Haynes, Phyllis Mesker, Tom
Parsons, Ethel Pett, Suni Strom. The donation of LSD and psilocybin for
the study by Sandoz Pharmaceuticals is also gratefully acknowledged.
References
- Fisher, G; The psycholytic treatment of a childhood schizophrenic girl.
International J. of Social Psychiatry; 1970, 16, 112-130.
- Fisher, G; Psychotherapy for the dying: principles and illustrations with
special reference to the utilization of LSD. Omega, 1970, 1, 3-16.
- Fisher, G and Martin, Joyce; The psychotherapeutic use of psychodysleptic
drugs. Voices: The Art and Science of Psychotherapy; 1970, 5, 69-72.
- Fisher, G; Some comments concerning dosage levels of psychedelic
compounds for psychotherapeutic experiences. The Psychedelic Review,
1963, 1, 208-218.
- Fisher, G; Psychedelic drug usage: socio-political and psychological
consideration. California School Health, 1968, 4, 40-54.
- Blewett, DB and Chwelos, N; Handbook for the therapeutic use of LSD-25:
Individual and Group Procedures. Unpublished manuscript; Regina,
Saskatchewan, 1959.
Gary Fisher, Ph.D.
1750 E. Ocean Blvd. #705
Long Beach CA 90802
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