HALLUCINOGENIC DRUGS AND HYPNOSIS IN PSYCHOTHERAPYl Isaac Gubel, M.D.2 In the present-day state of medicine, comes a patient and comes to the phy- the physician engaged in psychother- sician seeking for psychological bal- apy still lacks therapeutic resources of ance by way of a prescription or by a unquestioned value in the treatment session of psychotherapy, we meet a of psychological disease. Perhaps, new anxiety. This time it is the anxi- rather than to use the term "disease," ety of the professional man, who, in maladjustment in relation to external most cases, if he is intelligent and has reality would be the better conceptual- a critical understanding of the possi- ization. bilities of his science, feels compara- Weare accustomed to hear said, tively unarmed in his fight against the with reference to emotional malad- psychogenic pain of his patient. justments, that these result from a One form of escape from the vicious lack of adaptation to the social and circle deriving from subjective reac- familial milieu of the person who suf- tions of therapeutic inadequacy and fers from them. This may be a mis- appreciation of the patient's anxiety is statement because there are circum- orientation of the therapist in terms of stances in which a human being can- a pre-established therapeutic formula- not be required to renounce his liber- tion with psychological over-weight- ties in favor of a world that imposes ing, or retreat into its opposite, dog- on him tasks and duties of which he, matic organicism. Thus, the basis for personally, has not approved. The so- the frequent apparent addiction to a cial milieu is essentially an artificial belief in the infallibility of a thera- creation. It comprehends dogma, pre- peutic system, however it may be judice, economical interests, sexual called, may lie in its unconscious taboo, etc., all of which exert an im- identification with primitive magical pact upon the sensibilities of man. thought. This may explain to some Some make an adjustment as if in extent the warm enthusiasm awakened psychobiological symbiosis, in a bal- by hypnosis, which, rescued from the ance of apparent mental health with dusty shelf of medicine, has become of their neurosis, while others cannot. vital interest to the physician because From the struggle between the hostile of the seeming promise it offers of all environment and the need of security, of the potentialities and mysteries of there arise feelings of isolation and the human personality itself. inadequacy expressed in anxiety. This Hypnosis, because of its spectacular anxiety may manifest itself in pho- phenomenology, may be accepted un- bias, depressions, or in definite soma- consciously both by the professional tizations. man and by his patient as an "all- The fact remains that the anxiety of powerful talisman," permitting both to a human being, in his peculiar lan- liberate themselves from their respec- guage, is a call for help, protection and tive anxieties, the one arising from care. When such a human being be- subjective medical inadequacy, and the ether, from his sense of vital inoper- 1Also being published in Spanish in La Revista Latino-Americana de Hipnosis ativeness. The hypnotic techniques Clinic a, issued in Argentina by La Socie- employed for psychotherapeutic pur- dad Argentina de Hipnoterapia. poses have, in most cases strong dra- 2 Montevideo 945, Buenos Aires, Argen- tina. matic content, which, already being 169 170 GUBEL experienced from the methodology of basine and basofortine the ethylamide induction, becomes further manifested of lysergic acid and the di-ethylamide in the subject matter of the catharsis of lysergic acid (L.S.D. 25). This lat- and in experiential regression. ter compound is possibly the most Frequently, the hypnotherapeutic pharmacologically active drug known. session takes place in a climate of The clinical picture of the response to tranquil relaxation. But also the pa- this drug has been compared by some tient may pass through spectacularly authors to a temporary irruption sim- intense experiences, characterized by ilar to schizophrenia, while others a subjective loss of his bodily rela- (Bonfanti, Gamma, Villata) deny that tionship with the environment, and the symptomatology of lysergic acid even a loss of body image and body intoxication has any resemblance to awareness. Many patients say that the psychotic disorders of schizo- under these circumstances they feel phrenia. themselves floating in space, becoming A similar action is found in mesca- only a head or a mind, losing the per- line which has been used from pre- ceptions of the existence of their limbs, Columbian times by the Indians of or having visions of an unusual per- northern Mexico and the southwest spective. In others, the world of area of the United States. The natives sounds and other sensory perceptions obtain it from peyote, a cactus grow- acquires subjective traits of an unreal ing in that region, ingesting it to in- quality. duce mystical visions which they inter- In my psychotherapeutic experi- pret as an approach to the "world of ence, I have often observed that when spirits." The followers of the Native the subjective experiences are in- American Church in the United States tense, either actively (dramatization) of America take this drug for the ef- or passively (relaxation) , a better fects of mystic exaltation during their therapeutic result can be expected. religious services. Some patients are scarcely or not at The drug was synthesized in the all hypnotizable because of rigid psy- Merck Laboratories, and thus became chological defenses built up to protect available for a study of its psycho- their neurosis. Many who are hypno- tropic properties and its possibilities tizable in spite of this, have little emo- for psychotherapy, together with tional plasticity to permit placing L.S.D. 25 (Delyside Sandoz). themselves adequately in an active or The first investigations on the use passive relationship within the hyp- of mescaline were published in 1926 notic subjective experience. by Routier. The first publications and This has led to a search for a group reports of major importance on the of psychotropic drugs, particularly the use of mescaline and lysergic acid hallucinogens by means of which, used appeared after 1938. Recent research- in alternation with sessions of hypno- es include Busch and Johnson (1950), sis, there might be a dissolution of this Sandison, Savage (1952), Abramson protective barrier, and a more rapid (1955) and, in Argentina, Tallafferro and at the same time, deeper psycho- (1956), Alvarez de Toledo, Fontana therapy. To this end, use was made and Perez Morales (1958), Abadi of lysergic acid and mescaline, both as (1958), J. M. David (1960), Gubel and presumed psychotherapeutic catalysts. Achavel (1960). Some years ago, Stoll and Hoffman Some of the aforementioned authors working in Switzerland with products used the hallucinogenic drugs as aux- derived from ergot, obtained by syn- iliaries in psychoanalytic work, both thesis from amino-alcohols like ergo- individually and in group therapy. ---.-------- ----_ .. ----- HALLUCINOGENIC DRUGS AND HYPNOSIS 171 They found a considerable reduction the "Nirvana" or the "oceanic" feel- in the time of treatment due to an ings. increase in introspection and conse- In hypnosis, whether hetero- or auto- cuent insight following the use of the hypnosis, there is, practically always, hallucinogens. At the same time, it this type of depersonalization experi- has been indicated that these drugs ence. Such experiences are also prob- permit a more direct approach to the ably the most intense effects deter- unconscious and easier study of the mined by hallucinogens and, coinci- rich fantasies the patient experiences dentally, constitute, in their essence, under the effects of these substances. experiences comparable basically to The author of this work has been certain hypnotic subjective experi- studying not only the symbols rep~e- ences. sented in visual, auditory, and tactile It is interesting to note that the be- images and memories in the drugged havior of the patient under the action state but has also given equal consid- of these drugs undergoes a process of eration to postural attitudes and kin- "softening", that is, an increased re- etic manifestations which should not sponsiveness after each new intake, a be underestimated since these too can process which is usually repeated at be even more highly expressive than intervals of ten or twelve days. This facial expressions alone. psychological sensitization brings about This last point became most evident more frank, spontaneous and informa- to us in a patient whose behavior led tive conduct by the subject. to further and more extensive obser- Some patients abandon themselves vations in this direction. She present- ed an anxiety state which had, for a to an opiate-like dreaminess, where, for example, a musical stimulus can substratum an Oedipus component serve as a leit-motiv for an experien- that was symbolized by copulative-like tial flight of fantasy. Others, on the movements of the pelvis while she was other hand, having broken the barriers conversing with the observer of the and defences against imagination, may therapeutic session, Dr. Corazzi, and whom she had identified with a pater- pass through a Dante-esque experience of "inflation" by persecutory paranoid nal image. elements, not always revealed during It is interesting to note that kinetic history-taking, or there may be mani- dynamisms may also appe~r under festations of a sadistic, masochistic, hypnosis. These usually are m a more sado-masochistic, or verbally aggres- attenuated form, but sufficiently clear sive behavior (sometimes actively so) symbolizations to permit ready int.er- toward the therapist who is often iden- oretations for a better understandmg tified by the dynamics of the trans- ~f the psychological significances are ference situation with the bad environ- thereby expressed. ment, the destruction of which means The subjective experiences evoked liberation.