Hallucinogenic Drugs and Hypnosis in Psychotherapy

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l_ Reprintedfromthe BritishJournalof Medical Hypnotism, ., Autu_ 1961. Vol. 13, No. 1

HALLUCINOGENIC DRUGS AND HYPNOSIS IN PSYCHOTHERAPY

_ by _ Isaac Gubel, M.D.

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w HALLUCINOGENIC DRUGS AND HYPNOSIS IN PSYCHOTHERAPY by ISAAC GUBEL, M.D. SociedadArgentinade Hipnoterapia(Argentina)

In the practice of psychotherapy, ment and the need of security, rises in the present-day state of medicine, an infinite feeling of solitude which the physician is still very far from is expressed in anxiety. possessing therapeutic resources of It does not matter whether this undoubted value for the treatment anxiety "becomes a thing" in a of psychological diseases, phobia, or a depression, or a definite Rather than diseases, it should be somatisation. said in this case, of a maladjustment The real fact is, that the anxiety of the external reality to the human of the human being, in his peculiar being, language, is a call for help, protec- The last statement constitutes tion and care, in the philosophical apparently a paradox, sense implied in these words. We are accustomed to hear it When the human being becomes said, with reference to emotional a "patient" and comes to the alterations, that these are due to physician s eekin g psychological a maladaptation to the social or homeostasis in a prescription or in • familial environment of the person a session of psychotherapy, we meet who suffers them. a new anxiety, this time, of the pro- This is, however, a mistake, fessional man who, in most cases, if because a human being cannot be he is intelligent and has a critical required to renounce to his liberties understanding of the possibilities of as such, in favour of a world that his science, feels unarmed for his imposed on him tasks and dutie_ fight against the psychogenic pain. which he, personally, has not A form of escape from the circle approved, inoperativeness-anxiety is to fanati- The environment is, generally, an cise oneself in a pre-established artificial creation of dogmas, preiu- therapeutic pathway, which comes dices, economical interests, sexual to a fault sometimes in an exagger- taboos, and ignorance, which exert ated psychologism, or in a rough a "stressing" impact on the sensi- organieism. bility of man. As in the patients, all this derives Some manage to carry the load to an end which is frequently related of a symbiosis of apparent mental with primitive magical thought, that health with their neurosis, while cannot be removed from the uncon- others cannot do it. From this scions and that is the basis for this , struggle between the hostile environ- apparent addiction to the infalli- 3 bility of a therapeutic system, how- acquires traits of fantastic subjec- _' ever it may be called, tivity. This may, perhaps, explain to us In my psychotherapeutic experi- the warm enthusiasm awakened by ence, I have often observed that the hypnosis, which has awakened, more intense the subjective experi- rescued from the dusty shelf of ences, either active (dramatisation) medicine, to become of interest to or passive (relaxation), the more i the physician, may be expected from our thera- ! Hypnosis, because of its spectacu- peutic responsibility-. | lar phenomenology, is experienced Some patients, because of their ! by the professional man and by the rigid psychological shell, meant to patient--unconsciously--as an "all- defend their neurosis, are scarcely powerful talisman", which will per- or not at all hypnotisable. Those mit both to liberate themselves from who are hypnotisable in spite of their respective anxieties, one re- this, have little motional plasticity- to ferred to his medical inperative- place themselves, in active or hess, and the other, to his vital passive manner, within the hypnotic inoperativeness, subjective experience. The hypnotic techniques em- This has led me to seek, in the i_loyed for therapeutic purposes group of psychotropic drugs, par- have, in most cases, strong emo- ticularlv the hallucinogens, a means tional contents, which are already whicl_, in alternate combination with experienced from the methodology hypnosis, would allow the breaking of induction, are exalted in the of this apparently unsurmountable subiect-matter of catharsis, or in barrier, for a speedy, and at the o_eiric dramatisation, and in the same time deep, psychotherapy. experiential regression. Thus, I used lisergic acid and Frequently, the hypnotherapeutic mescaline, in the manner of psycho- succession takes place in a climate tl_erapeutic catalysts. of tranquil relaxation. In it, the Some years ago, Stoll and Hoff- patient also passes through a spec- man. in Switzerland, working with tacul,qrlv intense experience, which products derived from the ergot of is characterised by a subiective loss rye, obtained bv synthesis, starting of his bodily relationship with the from amino-alcohols like ergobasine environment, and basofortine, the ethylamide of ] ! Many patients say that, under liser_ic acid and the di-ethylamide ! these circumstances, they. felt th,zm- of liser_ic acid (L.S.D. 25). [ selves floating in space, being only This compound is, possibly, the a head or a mind, not perceiving most pharmacologically active drug the existence of their arms, or known, because ½ to 1 gamma pero having visions of an unusual per- kilogram of weight, given orally or spective. In others, the world of parenthetically, is sufficient to pro- sounds and tactile perceptions duce in certain cases a temporary , 4 psychological condition of definite (1956), Alvarez de Toledo, Fontana characteristics, y P_rez Morales (1958), Abadi The clinical picture has been com- (1958), J. M. David (1960), Gubel pared by some authors with a tern- v Achaval (1960). porary eruption similar to schizo- Some of the aforementioned phrenia, while others (Bonfanti, authors used the hallucinogenic , Gamma, Villata) deny that the drugs as auxiliaries in psychoanalytic symptomatology of lisergic drunken- work, individual or in groups. ness has any resemblance to the They found a considerable reduc- psychotic disorders of schizo- tion in the time of treatment, due to phrenia, an increase in introspection (insighb A similar action is found in mesca- under the action of hallucinogens. line, which has been used from pre- At the same time, it has been Columbian times by the natives of indicated that these drugs permit a northern Mexico and the South of more direct approach to the uncon- the United States of North America. scious, through the study of the rich The natives obtain it from peyote, fantasies the patient experiences a cactus growing in that region, whep. under the action of these sub- using it to have mystical xisions stances. which they interpret as an approach The author of this work does this to the "world of spirits", not only through the symbols repre- The followers of the Aboriginal sented ]n visual, auditory images or Christian Church in the U.S.A. take tactile perceptions, but also con- this drug (0.50gr., a pharmaco- siderin_ the postural attitudes or logically active dose) for mystic kinetic manifestations which must exaltation during mass. not be underestimated since the5' The drug wassyntheticised in the express, bv means of somatic Laboratories Merck. Its formula is mimics, psychological dynamisms, 3, 4, 5_Trimetoxy-B:ta-Fenatil- sometimes with greater clarity than amine. This made possible a study facial mimics alone. of its psychotropic properties and This last point becomes very its possibilities for psychotherapy, evident for us in a patient who to_ether with L.S.D.25 (D_lyside was the starting-point for further Sandoz). observations in this direction. She The first investigations were pub- presented an anxiety which had, for lished in 1926 by Routier, who used a substractum, an Aedipic com- mescaline, but only after 1938 ponent, that was symbolised bv appeared the first puN!cations and copulation-like movements of the reports of major importance on the pelvis, while she was dialoguing with use of mescaline and lisergic acid_ the observer of the therapeutic Buck and Johnson (952), 8andyson, session, Dr. Corazzi, whom she had Savage (1954), Abramson (1955), identified with the paternal image. and, in our counttaJ, Tallafferro It is interesting to indicate that 5 kinetic dynamisms also appear under opiate dreaminess, where a musical hypnosis, of cours,e in a more attenu- stimulus often serves as leit-motiv ated manner, implying symbols for the experiential arabesque drawn which the therapist's watching eye by the lisergicised's imagination. can interpret for a better under- Others, on the other hand, having standing of the psychological con- broken the barriers of imagination, tents expressed by them in their pass through a Dantesque experi- peculiar language, ence of "inflation" of pers,ecutory The experiences causedby mesca- paranoid elements, not revealed line and lisergic acid do not always during history-taking, or manifesta- adjust themselves to clearly hallu- tions of a sadistic, masochistic, or cinatory manifestations, as may be verbally aggressive (sometimes actu- inferred from the genetic denomina- ally) kind towards the therapist who tion of "hallucinogens". is often identified by the dynamism Many subjects experience situa- of transference, with the bad obiect, tions that may be homologued to a the destruction of which means sensation of disintegration and liberation. death. Others experience a fusion It is to be stressed that in the hyp- with a totality or, using the adequate notic state there is also some degree word-picture of Freud, have an of this "softening" or sensibilisation "oceanic feeling" to successive rehypnotisations, such In hypnosis, whether it is induced as we observe with the repetition of by the hypnotist or is developed by the drugs under consideration. the patient himself by means of During the deep hypnotic state -' Schultz's autogenic training, there is, there are always experiences of de- practically always, this kind of depersonalisation which are felt in personalisation experiences. Such very varied ways by the subject, experiences are probably the most similarly to what occurs with hallu- intense effects determined by hallucinogenic drugs. cinogens and, coincidently, consti- A patient who presented as tute in their essence the basis of the symptom a psychogenic stammering hypnotic subjective experience, on being hypnotised for the first It is interesting to indicate that time, told us: the behaviour of the patient under- "I feel, in general, as if my mind _oes under the action of these drugs were paralysed, as if I saw every- a process of "softening" or sensi- thing white, and the encephalic mass bilisation, after each new intake, were becomin_ smaller till it floated which is usually repeated with inter- within the head.... " vals of ten or twelve days. Most of the lisergicised present This sensibilisation brings about, manifestations coincident with those of course, a more frank and spon- seen under hypnosis, as regards de- taneous conduct of the subject, personalisation. Some abandon themselves to an For example, another patient (a 6

¢ ',?y,_, !.p_bic case), who received by injec- The image of "rebirth" acquires "ti6n 200 gammas of L.S.D.25, pre- a rational character through the ,:s_rg:edas an only response to the interpretations the therapist gives of :dml_ a sudden anxiety, as he felt the material which comes to the that "his bodywas becoming smaller surface in the hypnotic or lisergic 'tiil"fhe infinite" session. ....P-,!ul Schilder defined the cor- These interpretations are lived as '_p0t_aiimage or schema as "the tri- a world of vital new-experiences, _fligif_nsional mental representation where the old or traumatic experi- ,ea_ of us has of himself", ences come to belong to the previous :_vidently, this "representation" gestalt, which has been replaced by does not only have the character of a "different" gestalt, through the £"6_ntemplative schema of the spectacular action of the therapeutic somatic I, but also involves a unitary procedure. image of the psychical and the These facts were translated, in a0_mical self, forming part of the the simplified words of one of my Being which, in the last instance, is patients, into : "I felt dishumanisecl, a,. _ynthesis or trilogy of: Body. now I feel something strange. Now, PsyChe-Pathos. I am not I". _"'_'his conception, which may be This tells us that hypnosis or hallu- c_lled ontological or "existencial", cinogens_powerful catalysers of of the patient, must play a dynamic mental processes open for us the r0te_in the gestalt of that person, doors of an unfathomable mystery, • _h.i_h is suddenly upset, either by in which emotions are transformed ti_e action of hypnosis or by the into architects of a new psycho- _iction of the drugs we are consider- logical homeostasis. i_.. SUMMARY _.:Bath situations, the first one A study is presented on neuroses, fno-,redby exclusively psychological understanding them to be the ex- _eans" the second, by chemical pression of a feeling of loneliness, achon with a possible interference determined by the surroundings in the enzymatic processes of cortex which are felt by the human being Dr reticular system, causes as a as a hostile environment. corollary, the experience of deper- The author reports that hypnosis sonalisation, to which we have or hallucinatory drugs, mescaline, referred repeatedly in this article, a lisergic acid_L.S.D. 25) are experi- new gestalt, enced, unconsciously, by the thera- This produces a phenomenon of pist and t_e patient like "magically disintegration-integration, which is powerful things" because of their experienced as the effects of a spectacular phenomenology, especi- ".magical tah_m°_ an '' bv the subject, ally in the emotional sphere. b_ emerges from this'strange chaos It is sustained that the value of i,th:a feeling of rebirth, the material for interpretation and • _, 'y,. 7

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elaboration, which emerges during (9) Jaspers, Karl: Esencia y Critica de la_/_ the use of these procedures, deter- Edterapia.itora, 1Buenos959. Aires. Ed. Cfa Gral. _lO_lD,al_bril mines an unconscious image of (10) Karen, Homey: La Personalidad Ne_Jff_i "rebirth" in the neurotic person, de Nuestro Tiempo. Buenos Aires. E(_i _ Thus, he elaborates a new gestalt Paid6s,1958. .".._'i_.:l_ which displaces the previous one (11) Kretschmer,Ernest: Psicologfa _._a_ Barcelona, Editorial Labor, 195 through a mechanism of disintegra- (_2) Mira y Lopez, Emilio: Cuatro Gigan_'s_clel tion and integration of the Self Alma. Buenos Aires, Ed. E1 Ateneo_-_571 ("I") as an effect of the experiences (13) Torino,Romero,Ed.AnMinervdrea:aL'IpnosiM_dica, in1960.Psicot_i._ _ of depersonalisation, which are _4) Rosen, Harold: Hypnotherapy in (_a_il common to hypnosis and hallucina- Psychiatry. New York, Ed. Julian fl_:, tory, drugs. 1953. ._,,_,,_. BIBLIOGRAFIA (15) Schilder,Buenos AirePaul:s, Ed.TratadoPaid6s, 1947de .Psico_i'a[_ii.1_ -"_ (1) David, Jorge M. : Aeei6n de la Dietilamida (16) Seguin, Carlos A. : Existeneialismo y del Acido D--Lis6rgico (L.S.D. 25) en las atria. Buenos Aires, Ed. Paid6s, 1960.___'Pi Neurosis Obsesivas. La Semana M_dica, (17) Solovey, G.,y Milechnin, A.:EI _p;_ 1960, 36. tismo de Hoy. Buenos Aires, Ed. _ih_ (2) English, O. S., y Pearson, G. H. J. : Prob- 1958. ;ll_ct lemas de la Conducta humana. Barcelona, (18) Solovey, G., y Milechnin, A. : Hypnli_ .1_ Ed. Caralt, 1959. the Substractum of Many Different l_h._ (3) Erickson, M., Hershman, S., Secter. I. : therapies. The American Journal of C4_tl Medical and Dental Hypnosis. New York, Hypnosis, 1960, I. k_.J.., 1961 Ed. Julian Press, 1961. (4) Freud, Sigmund: Introducci6n a la Psico- (19) Stokvis, B. : La Hipnosis como un l_lli_ analisis--Buenos Aires. Ed. S. Rueda, 1953. y Principio de Investigation acerca _.. 1/_ "' Fundamentos Psicosom_iticos. Revista L,Itino- _5) FontDrogasana, RsicotropiAlberto:cas.El RusoelatoClinidelco 2°deCon-las Americana de Hipnosis Clfnica, 1960_,j.r,,_ greso Argentino de Psiquiatria, 1960. (20) Sullivan, Stack Harry : La Entrevista _;fi_- *' _61 Gubel, I. : Discussion of Milton H. Erickson's atra Buenos Aires, Ed. Psique, 1959i :_-;!_ Paper. Anales del 35th Anniversary Congress (21) Tallaferro, A. : Mesealina y L._,,ij_ de la Asociaci6n M_dica Pan Americana, Buenos Aires, Abeledo, 1956. ; ; 1960. (22) Tallaferro, A. ; Milano, J. A. ; Altur_; (7) Gubel, I., y Achaval, A. : Acido Lis6rgico G.D. ; Paz, C. ; Polito, R. : Acci6iL'_.la en al Alcoholismo (Catalizador psicotera- Mescalina de la L.S.D. 25, segtin el _._L._ p_utico). Relato del 2° Congreso Argentino Funskenstein, 1959, 1. _,,,qr_ de Psiquiatrfa, 1960. (23) Taragana, F. : Psicodinamismos del Es_lu_a (8) Gubel, I., Meson, H., Corazzi, E. S. : Hip- Corporal. Acta Neuro-Psiq. 1959, 1. ;1)'_.:_ nosis--Teorfa, Tdcnica y Terap6utica en (24) Wolberg, Lewis R. : Medical Hypnosil_.:;iql_ Prensa. York, Ed. Grune & Stratton, 1948. _I "J.¢'_ _ ,_;_

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