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Ethnopsychedelic Therapy for Alcoholics· Observations In the of the

PAUL PASCAROSA, M.D.* & SANFORD FUTTERMAN **

Ancient methods of treating illness were rooted in a structured psychotherapeutic session, is effective in holistic concept of health that is largely foreign to the treating alcoholics (Chuelos, 1959; MacLean, 1961; myriad of specialists who treat 20th century hospital Smith, 1958). Today, the United States Public Health patients. The scientific method, with its strict attention Hospital in Clinton, Oklahoma, uses peyote treatment in to the rational, intellectual aspects of man's , has its alcoholic services program, with encouraging results dominated the development of Western medicine and (Albaugh, 1974). This is a beginning, but we have only . Holistic practitioners concern themselves begun to explore the use of pharmacologically-induced not only with the rational and intellectual parts of man, altered states of consciousness in clinical practice. but also with his inner self and his unity with mankind This paper describesan Arapaho peyote ritual, and and nature. In departing from this holistic view, modern relates the reflections of the au thors who attended many medicine has given up something of great value that it is meetings where peyote was used. The ceremony is an only now beginning to rediscover. For example, when essential ritual of the quasi-Christian, Native American the principles of folk , which has successfully Church. Official organization as a church, in 1918, was cured physical and mental illnesses for thousands of necessary to forestall enforcement of Federal prohibi- years, are used in a modern context, the success rate tions on the use of peyote (La Barre, 1938). Since the compares well to that attained in modern psychotherapy congregation is rich with recovered alcoholics, many of (Thetford, 1952; Kiev, 1966). whom recovered after only one meeting, this approach The medicine man of the American plains uses a deserves consideration by therapists who treat - , peyote, to intensify the therapeutic experience and ics. The meeting merges three powerful psychotherapeu- enhance the patient's insights. The Indians have used the tic modalities: the master or guide, the ritual or peyote cactus in this way for centuries (La Barre, 1941; marathon group session, and the psychotropic drug Malouf, 1942). Recently, modern medical researchers Lophophora williamsii (Lemaire), better known by the found that psychedelic medication, used in a properly Aztec name, Peyotl (Myerhoff, 1974). The meeting frequently achieves quick and lasting changes in the attitudes and behavior of alcoholics. Many participants 'Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences, 358 Mowbray Arch, P.O. Box 1980, report unprecedented periods of mental clarity, during Norfolk, VA 23501. which they see visions of their fu ture life as an alcoholic. ., University of Texas Health Science Center at San It is as if they "hit bottom", and are then ready to begin Antonio, Division of Drug and Alcohol Abuse, Department of the arduous task of adjusting to a drug-free life. The Pharmacology, 7703 Floyd Curl Drive, San Antonio, Texas peyote ritual produces heigh tened awareness and 78284. enhanced perceptual ability that is lasting and that may This work was supported in part by Grant # ST01 AA 07006-02. account for the enviable recovery rate of alcoholics in

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.... _---_._------._---_._-- PASCAROSA & FUTTERMAN ETHNOPSYCHEDELIC THERAPY this organization. elder of the tribe who has profound understanding of the Indian . He is a stable figure who possesses a STRUCTURE OF THE RITUAL working knowledge of the ritual and of peyote. Just as Each meeting is held for a particular purpose which psychotherapists define sanity and insanity, the all members know, and which serves as a unifying theme Roadman defines the Indian way ("this peyote way") throughout the meeting. Regardless of its purpose, each and "that other way." He deciphers directional "signs" ritual follows a similar pattern. Services generally begin and crossroads, hence the name Roadman. at sunset in a tepee constructed solely for one meeting. An altar is made from wet clay or sand in the shape of a THE ROADMAN AS THE THERAPIST crescent moon with the closed end to the west. Unlike traditional Western psychotherapists, the Participants sit around the fire, with the chief and his Roadman openly discusses his own feelings, and offers officers at the west side. The officers are the chief's reassurance, verbal suggestions and encouragement. He immediate assistants: the Drurnrnan, a Cedarman (who generally begins each meeting in a humble tone, throws cedar chips on the hot ashes for blessings), and a requesting the su pport of the participants. Fireman who tends the fire through the night. " ... I feel honored that each and everyone of After an opening remark, the chief usually begins by you people would come over here this evening. passing around the circle. Each smoke is My son-in-law over there is going to carry drum accompanied by a prayer. The sacramental cactus, for us tonight, and I want all of you to help him peyote, is then passed to each participant in the form of out with this meeting. I am going to keep the fresh cactus, dried ground powder, "gravy" and "tea". smoke right here, and when you want to make The Drumman begins a repetitive beat while the chief, smoke, just ask for it. So everybody here will be holding a staff strung with sage, feathers and a rattle, able to speak, like that, you know. I want all of sings his choice of four peyote chants. As the drum is you to help me out, each and everyone. I want to enjoy good fellowship, each of us is going to passed clockwise around the circle, each person plays it help the other person out, like that, so we can and then sings one of the four songs. Between songs any all feel good, that's what I want, but I will need participant may ask for tobacco to "make smoke" and your help. I can't do anything by myself, 'cause pray. The opening of the tepee is always to the east, and I don't know nothing, but I try to help out the rising sun streaming in signifies an end to the when you ask me. I have been coming to these meeting. A breakfast of game, corn, berries and sweets is meetings all my life but I still don't know eaten and participants chat in a relaxed manner as they nothing. I don't know how to talk good, so I await the feast that will begin around noon. want all to help me out, like that, you know."

COMPARISON WITH PSYCHOTHERAPY On one occasion a Roadman gave a detailed account of his own history of . Another chief related Therapeutic techniques in the peyote ritual have his deviation from the Indian way of life: analogues in individual psychotherapy, group process, family systems theory, psychedelic therapy, trans- "This is my home place here, my children are personal psychology, and social networks. Kiev (1966) here, grandchildren, my wife. You know my has outlined features that modern psychotherapy and mother just passed away last month. She was 99 healing have in common: years old. I have been traveling a lot lately and did not take enough time to sit and talk with They include initial distress of the patient, her, like that, you know. I loved to sit and talk arousing of hope through dependence upon a with her even though her voice was weak and socially sanctioned healer, a particular repetitive slow, but I did not sit and talk with her much ritualistic relationship with the healer, a socially the last few months. Now I feel sad that I did shared set of assumptions about illness and not sit with her. In my own way, I am going to healing (the existence of which cannot be pray for her. I want each person here to pray disproved by the sufferer's failure to respond), the way you like; pray for your parents, your mobilization of guilt, heightening of self-esteem, children, and pray for yourselves, any way you detailed review of the patient's past life, changes like, that's the way I like it. If we all think in attitudes and behavior. about these things together, maybe something In the Native American Church, selection of a good will happen for each of us." "socially sanctioned healer" to lead the ritual is a The Roadman may skillfully interject parables from gradual process. The chief, or Roadman, is generally an Indian legend or personal experiences to mobilize guilt

journal of Psychedelic Drugs 216 Vol. 8 (No.3) j ul-Sep, 1976 PASCAROSA 8: FUTTERMAN ETHNOPSYCHEDELIC THERAPY or increase self-esteem, but he rarely offers specific guilt with nuclear and extended family members present. solutions to problems. His skillful application of these Frequently this is the first opportunity the family has recollections stimulates dramatic confessions from had to confront these issues in the presence of friends: participants long before peyote has taken effect. "I was raised in this church but then I got a big "It also seems to affect their mood. It is very job in the city and stopped coming to these difficult to assess the role of pharmacology in meetings; you know I thought I was like a white producing the group feeling of a meeting. man and went to his church; thought I would Emotions are deeply felt and freely expressed. never come back to the tepee, sit on the ground, Speakers often cry and there is a great sense of like that. I was a big shot, too big for Indian communion with God and the other worship- ways. Then I started fighting with my wife, pers. It would be easier to assume that these started drinking and almost lost my job. phenomena were caused by peyote if they were Tonight I heard you were having a meeting and not frequently observed in the part of the we came over here to ask all of you to help us. I meeting before any medicine is eaten." (Steiger, got a terrible problem here, my wife is ready to 1974). leave me and I'm about to lose my job if I don't do something. I came here tonight to drink this The leader often facilitates group interaction to help medicine and maybe it will do me some good new members feel more comfortable: (crying) ... " "Vernon, you have been away a long time and had much trouble. Now you are trying to The feeling of extended family is heightened by the change and it's hard, but you talk to David over practice of addressing old and dear friends as though there, and he will tell you about this peyote. they were blood relatives. Elders frequently refer to You just keep coming to these meetings and younger members as "son" or "nephew"; an intimate take this medicine, this wonderful herb, peyote. friend becomes a "brother". Indeed, from their attitude There is a full moon Up there tonight. You stay toward each other, it is impossible to differentiate home now, we need you here to help us out friends from biological relatives. with your good thoughts. You just stay behind this holy sacrament, peyote, and it will lead you During a meeting the Roadman spoke to the the right way." younger Fireman: With the Roadman's permission, other members "I want to thank my nephew over there for poking fire tonight. I call him nephew, he calls frequently encourage new participants: me uncle. I ask him to come here tonight and "Joseph, that's good what you said, I know how poke fire for us. Thank you nephew for a good the white man's world makes you feel small and fire on this cold night. My nephew kept us rha t alcohol makes you feel big. I used to drink warm all night and for that I want to thank him, and fight all the time. Then John invited me to like that, you know." come to his meeting. So I did and I've been coming here for eleven years now. You drink In another conversation concerning the ritual that medicine and stay with your people, it will experience, a young Arapaho related: help you, make you feel good and make you "You ask me what this ritual is like but I say go think good. It's good, this peyote way." in that meeting, take the medicine and learn to pray. Maybe the chief (Roadman) will ask you EXPRESSION OF FEELINGS AND CONFESSIONS to talk, maybe you will drum or maybe an The expression of deeply held feelings or confes- Indian will give you a family name." sions is an integral part of any therapeutic group process and is a dynamic means of stimulating emotions and THE INTROSPECTIVE JOURNEY expiating guilt. Frank (1961) believes this procedure Periods of silence, personal prayers, peyote chants brings the patient's vague, chaotic, conflicting and and drumming guide meeting participants on an mysterious feelings to the center of his attention and introspective journey. The steady, pulsating beat of the places them in a self-consistent conceptual system. waterdrum can be heard for miles. Many participants Labarre (1966) has described confessions in peyote describe going into a trance state whenever they hear the rituals of the Algonquian, Sioux, Crow and Winnebago, deep monotone of this ancient instrument. The sliding, and notes that the Iowa formally call for confessions at agglutinative peyote chants are sung in the native midnight. tongue. Like Christian hymns, the medodious chants During the meeting, participants often confess their praise God or nature and elevate the hearer's mood while journal of Psychedelic Drugs 217 Vol. 8 (No.3) Iul-Sep, 1976 PASCAROSA & FUTTERMAN ETHNOPSYCHEDELIC THERAPY diminishing intellectualization. Furst (1972) translates a meditation form of ZaZen is generally performed peyote chant: "sitting in stillness, eyes open and gaze non-receptively "For we are all directed, body and mind unified through breathing, we are all posture and unbiased, non-reactive collectedness of we are all the children of mind" (Shimano, Roshi and Douglas, 1975). This we are all the children of perfectly describes the Indians as they sit quietly erect A brilliantly colored flower around the fire. The strict discipline of Zen meditation is A flaming flower also echoed in the peyote ritual. Participants are not So pretty, so pretty." allowed freedom of movement and speech during the Tribal chants, many so ancient they predate the peyote ceremony, and distracting activity is discouraged. ritual itself, are sung with great emotion and volume. Participants are fully aware of the beneficial effects of Many Indians say that if one suspends all thought and meditation in the meeting, and able to describe the only listens to the drum, letting its rhythm merge with clarity and peace it brings them. one's heart beat, a song comes forth and one sings it "Some say we take peyote to escape reality. spontaneously. Long periods of drumming and singing They continue to suffer with their idea of are interrupted only when someone calls for a smoke reality. In that tepee that's real. Some people and prepares it in meditative silence. Most members say this is real out here and that the meeting is spontaneously whisper a long, repetitious prayer, much illusion, that peyote creates illusion, but they like a Hindu mantra or Catholic rosary, in their tribal have it backwards. If this is reality, why is it so language. During these periods introspection leads on to confusing, why all the anxiety, why the continual struggle in your mind? In the tepee it insight and awakening. is all clear how to live day by day. When you The power of introspection and awakening is come out in the morning you have watched all well-known to another organization that is notably your troubles go away and you feel good." successful in work with alcoholics - Alcoholics Anony- mous. A co-founder of AA describes a spirited This realm of consciousness, often evaded by those awakening in the following words: who use psychedelics without guidance, is facilitated by the structure of the ritual. Carlos Casteneda (1972) has "Suddenly the room lit up with a great white referred to this state of mind as "stopping the world" or light. I was caught up into an ecstasy which there are no words to describe. It seemed to me ceasing the inner dialogue. in the mind's eye, that I was on a mountain and that a wind, not of air but of spirit, was WHY PEYOTE WORKS blowing. And then it burst upon me that I was a When the effects of peyote are at their height, ego free man. Slowly the ecstasy subsided. I lay on functioning alters. The drug-dependent person who did the bed, but now for a time I was in another not have the patience or willpower to attain the world, a new world of consciousness ... " meditative state is able to attain it with the aid of Awareness, that encompasses self and universe, and peyote. Beyond this, there is no single explanation for is termed transpersonal appears to be a turning point on the therapeutic power of the states of consciousness we the path to recovery from alcoholism. In an experience have called meditative transpersonal, or introspective. not unlike a religious conversion, the toxic veil of The introspective state strengthens the power of the will, alcoholic encephalopathy lifts and is replaced with a and can open the mind to new attitudes that are not universal consciousness. normally received during the conscious state (Lettem, In the peyote ritual, meditative processes that lead 1975). LaBarre, (1975) refers to this altered state of to transpersonal consciousness are encouraged. The consciousness as "ego alien primary process mentation." Roadman refers to the fire as a symbol of the higher Naranjo (1975) believes that certain psychedelic drugs mental communication of the physical with the spiritual. enable people to face and resolve inner conflicts that He suggests this image: Negative thoughts, regrets or they normally repress. He sees much neurosis as bondage guilt flow from the participants through their eagle- to the past and uses psychedelic therapy to help his feathered fans into the fire and the flames rise through patients break into the unburdened present. Slatkin the top of the tepee to merge with higher planes of (1956) has stated that peyote increases sensitivity to consciousness. relevant stimuli and lowers sensitivity to irrelevant The meditative techniques have much in common stimuli, allowing mental peace from trivial but with Eastern forms of meditation. The Zen Buddhist anxiety-provoking thoughts. Free-floating anxiety is

Journal of Psychedelic Drugs 218 Vol. 8 (No.3) jul-Sep, 1976 PASCAROSA & FUTTERMAN ETHNOPSYCHEDELIC THERAPY replaced by anxiety that relates directly to the person's heard you were having a meeting. Then when problems and provokes constructive change. McGlothin we got here everyone was in the tepee and my (1967) conducted long-term studies of patients given dad asked me to come in and say something. I LSD therapy and found their undifferentiated anxiety came in and sat down but never did say nothing was reduced. until I drank some medicine. I was kinda scared since I was drinking that very day and I know It is as if the broadens the this peyote doesn't mix with alcohol. Boy, I scope of one's consciousness, allowing escape from ego started crying and talking about myself. Then I domination. Albert Einstein has called ego-oriented felt good. I have been coming to these meetings consciousness a prison: ever since then and only been drinking one time A human being is a part of the whole, called by in over a year, or nearly two years." us "universe," a part limited in time and space. He experiences himself, his thoughts and As we have seen, various Western investigators have feelings, as something separate from the rest - a advanced theories to explain peyote's power to cure. kind of optical delusion of his consciousness. The Indians themselves are less interested in explana- This delusion is a kind of prison for us, tions. Often Indians will warn new members not to try restricting us to au r personal decisions and to to figure out peyote. They say, "don't get ahead of it," affection for a few persons nearest to us. Our meaning, just experience the medicine and do not task must be to free ourselves from this prison intellectualize about it. Indians may have good reason to by widening our circle of compassion to take this position, since theorizing about peyote embrace all living creatures and the whole experiences may hinder development of one's intuitive nature in its beauty (Einstein, 1973). and imaginary powers. A church maxim is "the only way Thus, universal or transpersonal consciousness to find out about peyote is to take it and learn from makes possible a finer appreciation for nature and peyote yourself" (Slatkin, 1967). Indians are more improved ability to make warm and fulfilling contact willing to reveal their conceptions of the source of the with others. For an alcoholic, enhanced appreciation of transpersonal power manifested in meetings. To some nature and supportive relationships with others are participants questioned about this, the power is in the crucial steps toward recovery. chief. To others it is in the peyote. Most, however, refer Although heightened perceptions are therefore to a su preme energy source. Regardless of the perceived essential to therapeutic success, these perceptions may source of this power, all participants allude to it in be confusing or distracting persons who use psychedelic confessions, statements or prayers. drugs without supervision. A skilled psychedelic therapist such as the Roadman directs attention away IN DEFENSE OF PEYOTE from distracting perceptions, and continually seeks to It would be a grave misconception to enVISIOn center the participants. He guides them toward the participants in the peyote ritual using the drug to oceanic sense of oneness, that comes to those who sense passively retreat from reality, or to escape personal both the quiet place within and an expanded universe. responsibility for their problems by entering a bizarre Under his guidance, awareness extends inward to the su pernatural world. This point should be clear from the unfiltered solid self. the meditative state, the atman, and foregoing description of the meeting. However, given the outward to the outer self of personal anxiety and widespread fear and ignorance concerning use of neurosis, and to the whole of society. Extended psychedelics, the true nature of the ritual is worth awareness brings participants a new understanding of the underlining. Although participants report that their sight world and their place in it, and this new knowledge is and hearing are enhanced, they rarely mention having not consistent with their behavior as alcoholics. If they dramatic supernatural visions. They may speak of being clearly perceive the inconsistencies, their attitudes and "helpless as a baby," but always couple this with their behavior may change immediately. A recovered alcoholic intention to gain a new sense of purpose in life. One recounted how he underwent such change. recalls the first step in Alcoholics Anonymous: "We admitted we were powerless over alcohol - that our lives "I want to thank you for inviting me and my had become unmanageable" (Twelve Steps and Twelve dad to this meeting. I always enjoy coming over to your place, seeing your family, like that. Last Traditions, 1974). Passivity is rare in the peyote year, or nearly two years now I only came in meeting. Frequently, participants give vigorous expres- here to say hello and I planned to leave. My dad sion to highly charged emotions. Emotions are not asked me to bring him over here because he had allowed to run unchecked, however, and participants do journal of Psychedelic Drugs 219 Vol. 8 (No.3) jul-Sep, 1976 PASCAROSA 8: FUTTERMAN ETHNOPSYCHEDELIC THERAPY

not lose touch with the reality of their lives. As Caldwell failed to reveal any increase in abnormalities (Dorrance, (1968) states: 1975). Peyote is not used to cope with the pressures of This socially directed maneuver, the constant daily life. It is only the white medicine man who focus upon 'social reality,' that which one has maintains his patients on daily doses of mind-altering to deal with in daily life, is the decisive counter drugs, while offering psychotherapy in none-too- balance to potential psychic mayhem that could frequent interludes. Indeed, Western medicine's chief occur with psychedelic use. wea pon against is another addicting Nor is the ritual open to the criticism that its , methadone; and Western physicians often therapeutic effect dissipates for lack of continuing employ tranquilizers and sedative-hypnotics to maintain therapeutic contact with participants. The insights alcoholics in peaceful stupors. Indians use the achieved and resolutions made by recovered alcoholics drug-altered state of consciousness only to facilitate are reinforced between meetings by a supportive social insight and communication during the meeting. Their network. Often members of the church come together daily life patterns are in no way dependent on use of the during the week for a drum tie. This is an informal drug. The Indian's attraction to peyote and the ritual gathering, usually at someone's house, where members corresponds to Western man's reliance on his psycho- stretch animal hide over a three-legged iron pot to create therapist, and does not constitute an addiction or a water drum and sing peyote chants. At such gatherings chemical dependency. In addition to our own study, newly recovered alcoholics talk openly about their field studies by psychologists, physicians and anthropol- problems and receive support from their new friends. If ogists have documented the safety and effectiveness of a younger participant mentions a problem during the psychedelic therapy. The authors fervently hope that the meeting, he may be approached at the Sunday meal or a federal government will finally understand this and not few days later by a respected elder. The problem is continue to challenge the Indians' use of this highly briefly recounted and the young man is invited to a useful medicine. We also hope federal agencies will relax secluded place for a smoke. During this smoke, the elder their stringent restrictions on well-controlled medical will attempt to build a counseling relationship. Such research using psychedelic drugs, and allow this therapy relationships may last for years as the lad is guided along to be developed, documented, and safely used by all "the right way to live day by day, the Indian way, this races of Americans. peyote way." CONCLUSION Other criticisms of peyote therapy are based on fear that the drug's use might spread beyond the meeting, For a selected group of Indian alcoholics - possibly and suspicion that peyote may have harmful effects. those in search of a personal, cultural and spiritual There is little danger of peyote use outside the meeting. identity - peyote use within the confines of ritual Peyote is considered a sacred medicine and its use is meetings can have a lasting and permanent effect. This confined to the ritual. Bergman (1971) has stated that it regimen offers more than a stable adjustment to life's is an uncommon practice for Indians to use peyote frustrations and a cure for alcoholism. It promotes outside their meetings and these authors have verified self-actualization, and a spiritual consciousness missing the accuracy of his report. Bergman studied a population from most western alcoholic treatment centers. Indeed, of over 200,000 people and uncovered no reports of a merger of psychological and theological disciplines peyote abuse or dependency. Nor is there cause to worry may be the common factor underlying the success of that peyote will be abused by whites. Peyote has an such disparate organizations as Alcoholics Anonymous unpleasant taste and produces nausea, intestinal cramps and the Native American Church. and frequent vomiting. Only those committed to the REFERENCES seriousness of the meetings repeatedly ingest this cactus. It is possible for non-Indians to be committed Albaugh, B.].; and Anderson, P.O. Peyote in the treatment of alcoholism among American Indians. Am J Psychiatry, participants, however. These writers visited many 131(11):1247-1251,1974. non-Indian church members who have dramatically Anonymous. Twelve steps and twelve traditions. 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