Notes on the Use of Drugs to Facilitate Group Psychotherapy

7/29/2019 Notes on the Use of Drugs to Facilitate Group Psychotherapy

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NOTES ON THE USE OF DRUC, TO, FACILITATE GROUPPSYCHOTHERAPYB Y B E T T Y G R O V E R E I S N E t ~ , P h. D.

I n t h e e o .tt r,s e o f u .s in g L S D - 2 5 ( d - ly s , e r g ie a c i d d i e t h y l a m i d e * )e x p e r i m e n t a l l y a n d t h e r a p e u t i c a l l y f o r m o r e t h a n f iv e y e a r s , an u m b e r . o f o t h e r d r u g s h a v e b e e n u s e d , . s i n g l y o . r i n d i f f e r e n t e , c ~ m -b in a tio r~ s ( L S D - m e s e a l i n e , L S D - a m p . h e t a m i n e , L , S D - d t a t i n , a n dm , e s e a l i n e - am p h e t a m i n e ) ; t h e e n v i ro n m e n . t h a s b e e n m a n i p u l a t e d( p h y s i c a l , se t ti n g , m u s i c , m i r r o r a n d p b o . t o g r a p h s , p r o ,d u e ,t io n o.fa r t w o .rk ) ; a n d t h e n u m b e r o f p e r s o n s p . re s e n t d u r i n g d r u g s e s -s i.o n s* * h ~s. b e e n v a r i e d , e i t h e r w h e n t h e d r ~ g - f .a e i I i~ a t e d t h e r a -p e u t i c p r o c e s s w a s e o n = c e n t . r a t . e d o n o n e i n d i v i d t m l o r w h e n i t i n -v o l v e d a g r o u p w h o s e m e m b e r s w e r e a l l u n d e r t h e d r u g e ffe c,ts .

T h i s r ep .o .rt c o n c e r n s e x t r a c t s o f m e a n i n g f u l o b s e r v a ti o n ,s, frownf o u r w e e k - t o n g g r o u p t h e r a p y . se m ilra .rs, h e l d i n t h e s am e , s e t ti n :gw i t h 10 .o r 12 pa r t i c i p an t s . T h e mem ber , s w e . re p a r t o f a lo ,o ,s,e ly -o r g a n i z e d g r o u p o f in d iv i du a l. s, e n g a g e d i n w h a s t h e y c a l l "~:eq u e s t f o r m e a n i n g , t h e s e a r c h fo .r o r i e n t a ;t i o n , t h e p u r s u i t o~f s e l f-f u l f i l l m en t , an d t h e r e a l i za t i o n o f ou r h i gh es . t p.o ten~ ti~ alifie~s." M em -b e r's o ,f t h e f o u r t h e r a p y s e m i n a r s w e r e d ra~ wn fr~ o m t h i s g r o u p ,w h i c h u s e s g r o u p m e t h o d s a s t h e m a i n v e ,h ie le o,f i n q u i r y . A l l h a v eb e c o m e lfi:g h ly e , o n v e r s a n t w i t h g r o u p p r o c e s s e s .of t h e . s e m i n a rt yp e ,, w h e r e i n t h e l e a d e r ' s f u n c. ti o n i s m e r e l y t o k e e p. t h e d i se u s ,s io no n t h e is~ su e b u t n o.t t o p r o m o t e a n y s p.e c if ie v i e w p o i n t .

M e ~ b e r s o f all. f o u r g r o u p s h a d b e e n t o a t l e a s t o n e "bas i e " fa n d o n e " e o ,n t i n u a t io n " ( b o t h n o n t h e r a p y - o . r ie n t e d ) : s e m i n a r ; a n ds u b s e q u e n t l y h a d a g r e e d t o t a k e p a r t i n t h e g'roulo~ h e r a p y ~ se m in a rbe ca u se .o ,f a des i , re to w o rk too, re de.ep~y on p,er,sor~al problems~.I n tr o d uc ~ o .r y a n d c o n t i n u a t i o n s e~ n in a rs a r e t te l d d u r i n g t h e m l m -m e r ; t h e r e s t o f th e y e a r i n t e r e s t e d i n d iv i ,d u a ls m e e t w e .e ld y i ns m a l l p o s t s e m i n a r g r o u p s f o r c o n t i n u i n g d i.seu .s~s~ o.~ s. M o s t o f

~ D - l y s er g i c a d d d i e t h y l a m i d e , a s y n t h e t i c e r g o t d e r i v a t i v e , w a s d i s c o v e r e d i n 19 4 3b y H o f m a n n l a n d h a s b e e n t h e s u b j e c t o f m u c h s t u d y . A . pp T e e ia ti o~ i s t e n d e r e d t oS a n d o z P h a r m a c e u t i c a l s , I n c . f o r a ll .o w i ng t h e e x p e r i m e n t e r s to p u r c h a s e t h e d r u g .

~ * B y " d r u g " i s l n e a n t t r e a t m e n t w i t h L S D , m e sc ~flin e, r i t a l i n , o r a m p h e t a m i n e , u s e da l o n e o r i n v a r i o u s c o m b i ~ a t l o n s .

I " B a s i e " o r " i n t r e d u e t o r y " s e m l n a i~ a r e c o n c e r n e d w i t h " i s s u e s" o f l i f e a s s e e ni n t h e t e a c M n g s o f J e s u s ; " c o n t i n u a t i o n " s e m i n a r s g o m o r e d e e p l y i n t o w h a t i s c o n -s id e r ed i m p o r t a n t t o c r e a t iv e l i v i n g ; f u r t h e r s e m i n a r s c o n c e r n th e m s e l v es w i t h p r o g re s -s i v e t r a n s l a t i o n o f t h e s e p r i n c i p l e s i n t o e v e r y d a y l i ~ e :


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BETTY GI~OVEI~ EISNERj PH.D. 311the p a r t i c i p a n t s o f th e f o u r t h e r a p y s e m i n a r ,s h ~ d b e e n i n p .r'evio~ ,ss ih m t io n .s , s e m i n a r o r p o s t s e m i n a r , w i t h e a e h o t h e r , t I o w e v e r ,n o n e o f t h e p r i o r s i tu a t i o n s h a d i n v o l v e d t h e a u t h o r ; n ~o ne o f~ he i n d i v i d u a l s h a d a t t e n d e d a g r o u p t h e r a p y s e m i n a r p r i o r to,th e, s e s s i o n s j u s t r e p o r t e d ; n o n e o f t h e g r o ,a p s h a d m e t b e f o r e a,,su n i t s ; n o r w e r e t h e r e m e m b e r ,s o f a n y g ro ,u p w h o ~ a,d n e t m e ta t l e a s t s i n g ] y i n o t h e r p r i o r g r o u p s .

A b r i e f d e s c r i p t i o n o f th e m a t r i x w i t h i n w h i c h ~ h e ra p e u ti a d r u gs e s s i o n s f u n c t i o n o p t i m a l l y a n d a n e x a m i n a t i o .n .oK t h e e f f e c t iv e -nests o.f a n i n f o r m a l g r ( m p a s a n a i d t o i n d i ~ d u ~ l L S D t h e r a p ya r e i m p o r t a n t i f o n e is to u n d e r s t a n d b a c k g r o u n d f a e t o r s i n d m lg -f a c i l i t a t e d g r o u p p s y c h o , t h e r a p y .

A f a i r l y u ~ i f o r m s e t t i n g e v o l v e d fro .m a n . ea rl ie r s t u d y o f t h eu s e o f L S D a s a t h e r a p . e u t i e t o o l ? , ~ D r u g s:e ssio ns~ h e l d w e e k l y ,w i t h a .n inere~a.s~e in d os ag e ea ch w ee k , to ,ok p l ac e N ,a ho~spi ta lro o~ m e o , m f o r t a b l y f u r n i s h e d w i t h r u g s , h o~ s~ eh o,ld f u r n i t u r e , .a n dp a i n t i n g s . T h e a u t h o r w a s p r e s e n t c o n t i n u a l l y f~ or t h e t ~ n er 'a p eu ties e s s i o n s , u s u a l l y s e v e n t o e i g h t h o u r s a t a tim e ,. A s t h e d r u g e f f e c twol fe ~o.ff, ,a p a t i e n t wa~s t a k e n to ' the ~ r~ t e t in ie to . w o rk in p as t e l.so r w a t e r e o ~ o r s . M u s i c w a s v e r y i m p o r t a n . t i n p o , t e n t i a ~ t h q g . d r ~ ga e ti o, n ~ d i n d u c i n g m o .o d c h a n g e s ~ A m i r ro . r w a s u s e d t o p r e c i p -i t a t e c o n s i d e r a t i o n o f s e l f - im a g e s , a n d p h ,o ~ .o gra ~h s o f f a m i l y m e m -be r, s an d e lo ,se f r i e n d s w er e f o un d he l p . f u l i n f o . e~ s i ng r'e la tio~n -s h i p p r o b l e m s . T h e r e w a s le s s a n x i e t y a n d o p t im M d r u g a c t io nw i t h a n a i t r a e t i v e p h p s i e a l e n v i r o n m e n t a~ nd so meo~ ne e o n ti nu .o u .s tyw i t h t h e p a t i e n t .

A p , hys ia} a~ * w ~ s p r e s e n t ~ s t i m e al,]~ ow .ed , a l w ay s j .o i r ~ ng t ] lep a t i e n t s a n d t h e N e r a p i s t f o r l u n ch . F r e q u e n t l y o n e t o th r e e a d d i -t i o n a l d o e t o .r s m i g h t b e p r e s e n t d u r i n . g s.e ssio ,n s. T h e p a t i e n t , i fhe .so . de s i r e d , w as al~s,o pe r m i t . t ed t o i nc l ud e a f r i e nd .

L S D se s:sio a~ s, u s e d a.s a n a d i u n e t t o. e o n v e n t i o n . M p s y c h o t h e r a p ya n d p .a .t t er ne d o n t h a s e j u s t d e s c r ib e d , h a v e b e e n s u p e r v i s e d b yD r . M ar io n D ak in , a .t the S o u th e rn C ,a lifo,rn~a Hos.p .i~ t!a l in Lo . sA n g d e s fo .r t h e la s,t f o u r y e a r, s. A n o v e l a p p e o ~ e h w a s i n t r 'o d u a e di n t h a t d i f f e r e n t i n d i v i d u a l s ( p a t i e n t s o ,r e ~:-p atie n~ .s, k n o w n :o ru n k n o ~ v n to t h e o . r ig i n a l p a t i e n t ) w e r e b , r o ~ g h t in to . t h e t o. or e - ~ h il eL S D t r e a t m e n t w a s in p r o g re s s . T h e r e e m e r g e d f r o m t h e s e p r o -~Dr. Sidney Cohen~ at that time assistant medical ehief~ Brentwocd Neu'ropsyehiatrieHospital, Veterans Administ ration at present ehief~ psychosomatic m e d i e i n e , W~asworthHospital , Veterm~s Administrat ion, Los Angeles.


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312 USE OF DRUGS IN GROUP PSXOHOTttERA:Pucedures a reeo~gnition of the group as a va]u~able faato.r in acceler-ating therapy and alleviating some of its too,re difficult aspeats.

Two distinct and quite different advantages appeared to, accruefrom the use of a number of per s.ons dur ing a single LSD therapyses,sion. One involved the psyehologi6al re-er~ation of early lifesituations. With a properly constituted group, it is possible torecapRul,ate the early family emotional setting and to oo~nfrontthe patient simultaneously with Oedipal and sibling pattelrn,s aswell as their interactions.

The other value appeared to lie in ,a eapacRy to dis churge eitherrepressed material~ or the e~oneomitaa't a ff~ec:t, .at a nonverbal level.In ,some ease,s the material never came to eon.sciou:s knowledgeo,f the pa:tient; in others, ~t seeped through gradually during aperiod of from three months to a year. The m~t.ter of nonverbaltherapy will be described elsewhere.4The direct and nonverbal confrontation of problem.s through~se of drugs and the presence of additional individuals does not.take place unt il some time has ela.io,sed during vehieh both conven-tional an d/o r drng treatments are used and the pafdent ha:s reacheda re,adiness, in time and capacity, to handle s~eh a .situation. TheneeessaTy factors seemed to b e : a relation.ship o.f trust with thetherap is t; enough familiarity~ with drug ,ac4,io:n to allo,w 1.owermgof defensive bar rie rs so that effective w o.rk can be don.e; capacityto tolera te interaction wRh others in a gr,oup setting, and the readi-ness 'to c,ome to gr ips with one's basic difficulties. These conditio.nsapply also to. the group situation.s described in ~hi.s study.The. c,apacity to " let one's ~self go" to the drug act ion is one ofthe most imp o.rt~ant determinants :of &rug threshold. It appearsto be re~ated inversely to an individual's rigidity--hi~s need tostay in e,ontrol under any circumstances, and ~s a function os bothpersonal ity structure and learning. Research t~as shown that artistsrepo.rted much deeper and more meaningful LSD experie~ee,s thanothers2 As a rule, the individuals without a profession experie~acedmore than the professional gr:o~p, which included l~eachers andengineer, . Rsyehiatrists, other physicians, and psyehoFlogists werethe too,st refractory, * to drug experiences among t~he 194 experi-mental subjects. This varying ~bility to "release" unconscious ma-terial is corro~borated by perso.nal o~bservations o,f p~tients and ex-perimental s~bjeets. Those who "fight" the drug either experience

"~'Kt compa rable dosages.


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B E T T Y Gt~OVER EISNtgR~ PII.D. 313very little drug effect or are subjected to a series of unplea.sant so-matic s;nnptoms, without insight, accompanied by considerablephysical pain.The ir~ability to "let go" appea.~s .to, be the result o,f strong ,a~drigid defen,ses, either against emer~ng unconscio~:s proee~sses,agains t the th reat of in terperso~nal relatior~s, or ,both. TMs, a~p~parently reflects fundamental defenses~ in ~ceept,anee and under-standing one's self and in relating to others. The proves,s of weeklysession.s with gradually increasing drug do,s~ge familiarizes p a.tier~ts with :the progressive bio,chemi,ea.l~y-il~duced relaxation ofeo,ntr'ots, ~nd allows a more meaningful therape.ut~_c r'etati,on s'~ipto be esta~blished.

MATERIALS AND ~]-ETI-IODSThe four group- the rapy seminars eo,nsisted of 4~2 par tic ipant swho were diagnost ical ly in the clinically normal group. T.hey hadno records of hospitalization for mental illness, .although .several

had had peri,ods of psyehother~apy. Ob~serva,tion a~nd retro~spectiveanalysis gave the clinical impression that ~hi.s w~s an overly- rigidgro,up of religious individuals with above-a~er~ge intellSgence, t%or-sehach examinations, given to a random hal:f of the sample, gavesuch a. wide scatter that no generalizations o,ther ttmn above-ave-rage intelligence could be dra~vn.

There were two alcoholics in remission (AA members) in. eachgroup, except seminar four. Here there were two persons wi.thpassive-aggressive, pa,ssive character di,so.rders, one with a seh.iz~o,i.dper sonali~. Each sem inar group contained :one olr two in.di~d~mlswith such str,ong projective mechanisms a:s to sugges.t paranoidideati:on tat times.The first, two semina,rs (nondrug) had four men and se~e,nwomen, while th~ two drug seminars had four men and .six women,and six men and four women, respectively. All participants wereCau~easian, exce~ot fo.r ,o,ne in the firs:t seminar who, was Mongo.-liamIlassian. The age range was from 22 to, 68 years, wi.th amedian of 35 years. The religi~ot~s b~ckgrouncls were ~s foilo~.s:72 per eent Pro.te.s~tant, 19 per e er~t Jew}sh, a~d 9 per cent Catholic.

All se~ninars were held for a week in the same is da te d mo.untainsetting. Ho,usekeeping tasks, except the coo,king, were performedby the gr,oup. The experimental study period ranged fr,om six 'to~See u]~o ~(>ta ~n Table.


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314 USE OF DRUGS IN GROUP PSYCtIOTHERAPYe i g h t h o u r s a d a y ; p a r t i c i p a n t s w e r e g a N e r e d i n a c i r c l e i n ar oo ,m o.f m o d e r a t e s iz e. T h e p r o c e d u r e w a.s a s f o l l o w s :

Th e p a r t i c ip an t s r o se a t 6 :3 0 a .m . Break fa s t was se rv ed a t 7 :3 0 a .m .Th e d ru g s were ad m in i s t e r ed a t 8 ,3 0 . Th e f ir s t an d seco n d sem in a r s we reh e ld wi th .o ut d ru ~s , wh i ]e in th e th i rd an d fo u r th sem in a r s d ru g s wereu s e d . T h e t h e r a p e u t i c work b eg an a t 9 an d co n t in u e d u n t i l 1 2 :1 5 p .m .Lu n ch was a t 1 2 :3 0 , an d th e sem in a r r eco n v en ed fo r an a f t e rn o o n se ss io no f th e r a p eu t i c wo rk o r a r t p a r t i c ip a t io n f ro m 1 :3 0 0o 4 :30 . Th e re was af r ee p e r io d f ro m 4 :3 0 to 6 :3 0 (wh ich was d in n e r - t im e) wh en p a r t i c ip an t scou ld res t , walk , s~ , im a t a nearby poo l o r in the somewhat-more-d is tan to cean . Th e two d r u g sem in a r s co n s i s t en t ly cho se to wo rk th ro u g h t h ~ p e r io da n d u s u M ] y s p e n t t h e t im e i n t h e a r t r o om p a i n t i n g o u t p r o b le m s i n p a s t e lso r w o r k i n g w i t h c l a y T h e f ir s t t w o n o n d r u g s e m i n a rs h a d t h r e e r eg u l a r ly -s c h e d u le d a r t p e r io d s a f t e r l u n c h d u r i n g t h e w e ek . A l l f o u r s e m i n a r g r o u p sf in ish ed u p a r t wo rk p e r io d s b y a sso c ia t in g to th e i r o wn an d to each o th e r 'sa r t p ro d u c t io n s . Th e re was n o wo rk a f t e r d in n e r . Mu s ic was p l ay ed f ro m8 p .m . to 1 0 ; p a r t i c ip a t io n so le ly o n a l i s t en in g lev e l was r eq u es t ed b u t n o tr e q u ir e d . T h e m u s i c w a s o f th e m o r e h a rm o n i c o r "inte~ating" ~type,a n d t h e p e r i o d p r o v e d Go b e u s e f u l i n i n t e g r a t i n g m a t e r i a l f r o m t h e d a y ' swo rk .

D r u g s w e r e g i v e n o r a l l y ( s e e t h e t a b l e ) . I n t h e t h i r d s ,e ~n M ar,m e s c a l i n e a n d d e x e d r i n e w . er e ~ v e n o n t h e .s ee o.n d, t h i r d , , an d f i f t hd a y s . I n t h e f o u r t h s e m i n a r , m e . s c a li n e a n d a m p J h .e t am i n e , a R e.r -h a t i n g w i t h L S D , w e r e g i v e n o n f i ve s u c c e ss i v e d a y s . T h e p h y s i -c i a n p a r t i e ip , a n t t o o k t h e s a m e d r u g s a s h is p a r t i c u l a r g r o u p , w h i let h e m l t h o r t o o k no d r u g s i n t'h e t h i r d s e m i n a r b u t d i d t a k e 22 r a g .o f . m e s .e a li n e a n d . o ne 1.5 r a g . d e x e d r i n e s p a n s u l e o n t h e t h i r d , f i f t h ,a n d s i x t h d a y s o f t h e f o u r t h s e m i n a r ( L S D d a y s f o r th e g r o u p ) .T h i s a d d e d a p a r t i a l l y p a r t i c i p a t i n g r o l e to t h a t o .f t h e o ,h s e rv e r-t h e r a p i s , t .

OBs~m~A:rm~sA l t h o u g h L S D , m e s c a l i n e , a n d t h e a m p h e t a m i n e s d i f f e r i n m a n y

w a y s , i n t e r e s t i n g s i m i l a r i t i e s e x i s t .* A l l th~ ree d r u g s a . p p e a r t:oe n h a n c e r a p p ~ o r t a n d e m p a t h e t i e c a p a c i t i e s , t o w e r e g o d e f e n = s i v e -h e s s , a n d f . a e i li t a t e a c c e s s i b i l i t y o f u n e o n s e i o . ~ s m a ' t e r i a l . ~, ~ T h i sw a s v e r y e v i d e n t no .t o n l y t o th e t h e r a p i s t b u t t o e v e r y p a r t i c i p a n t

*The members of the four th seminar were unable to differentiate between effective-hess of mesc alin e/amp heta mine and th e 10 to 25 gamma of L,SD ~. Del~ h os actionseemed to correlate more with psychic state aud interaction than with the drug taken.ITowever, the last drug day was an exception when all patr took 25 or 50gamma in an a tte mpt to experience the integ rati ve aspect of LSD rathear tllan jus tits therapeutic facilitation.


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7/19

316 USE OF DRUGS IN GROUP PSYCHOTHERAPYin a d ru g se minar, and p art icu lar ly to tbo,se member.s of the th irdand fot tr th semin ars who acted ~s their own eont:rols on no nd ru gdays .Vari .ous par t ic ipants s ta ted:

Concerning the use of the drug, I can only say that I have never beenable to open up so quickly or completely,

I think the m/.d~ had a dual effect on me. First it loosened me up sothat I could speak more easily; second it loosened the other members whichallowed me to be more free to speak.

. .. little or no physical effect of the d r u g . . . I am sure however thematerial would not have flowed forth with such incredible 'emptying-out-ness' if we had not had our controls weakened or knocked down by some-thing.

The feeling was that the membrane that separates the eonscious andthe uneo.nseious h.ad become porous and that the unconscious was seepingthrough by osmosis. Rather than going down ,for information, informationwas coming up.

In the therapy the di~g seemed to have three effects which combinedto heighten the intensi ty and the effectiveness of what took place. In thefirst place, I found myself mere than usually willing to talk about myself.There was a noticeable decrease in my relucta~,ce to expose mysetf*~ andI felt quite willing to say anything that seemed appropriate.

Second, I found myself much better able to eoncentraie. I was moreeffective in my introspection, better focused, and less troubled by attentionbecoming dif fu~d or by irrelevancies causing me to lose my focus. WhenI tried to go after something, I found I was able to stay with it muchmore effectively than I ordinarily can.

Finally, ,and most important, was my ability to go deeper into myself.My resist~ance tc probing (by myself and the therapis t) was decreasedand I fett as though my conscious mind could go down into deep layersof awareness--could penetrate into areas which had been deeply repressedand toward the center of my consciousness. There was less tendency toturn away from what looked distasteful and a willingness to pall out andlook at whatever I found. Also, intangible resistance which usually blocks

~Mesealine and dexedrine.~E xp os e in the psychologies] sense (author ).


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B E T T Y G t~ OV ER E I S N E R t P H . D . 317me was r edueed and I f e l t as tMugh I was pene t ra t ing th rough l aye~-swhieh were ord inar i ly r es i s t an t and impenet rab le .

T h e e ff e~ t,s ,o n m e m b e r s o f t h e f o u r t h ~ s,e m in ar w e r e e v e n t oo ,r em a r k e d t h a n t h e t h i rd . O n e p ar ti ci p,a n ,t sp o k e t w o m o n t h s l a t e ro f " t h e t r e m e n d o u s a c c e l e r a t i o n o f m y l i fe ( b o t h o ~b je ctiv e a n ds u b j e c t i v e ) . " A n o t h e r s a i d :

Whi le I had a shaky t ime of i t , i t was a necessary shaking tha t beganto lay bare at leas t some of the roots of m y bl indne ss an d despair andtrus t and creat ivi ty .

D r u g a n d n o n d r u g g r o u p s c o u ld be s , h ar p ly d i f f e re n t i a ,t e d b yt h e i r a b i l i t y t o b e c o m e a c o h e s i v e w h o l e a n d t o c o m e t o gI~ip,s w i t hp r o b l e m s . W h i l e i t t o o k t h r e e d a y s f o r t~he f i rs t t w o n o n d r u g s e m -i n ,a r s t o p r o d u c e a g r o u p f e e l i n g o~f e m p a t h y s u f f ic i e n t t o a ll,o,wd ~s cu sM o n o f m e a n i n g f u l m a th in s o c c u r r e d i n t h e t h i r d a n df ou r,t 'h s e.in in a r,s w i t h i n o n e o r t w o h o u r s a f t e r d r u g a d m i n i s t r a -t i o n . T h e g ro ~a p.s i n t h e l a t t e r s e m i n a r : s a c t e d ~ s u n i t s . T h i s a n i t ys e e m e d to. b e s i g n a l l e d , t o t h e t h e r a p i s t ~ t 1.e~ st, b y a s u d d e n p s y c h i cq u i e t w h i c h a p p e a r e d t o p e r v a d e t h e e n v ir o .n a a en t a n d t h e p , ar ti -e4p,a.~t:s. P r o b l e m s w h i c h w o u l d o ~ h e r w i se h a v e b e e n d e a l t w i t hi n t e l l e c t u a l l y s u d d e n l y c a m e a l i v e ; a f f e c t w ~ s d i s c h a r g e d ; a n d t h ep sy c hi c, ex M t, m e n t a n d t e n s i o n e q u i l i b r iu m , p r e s e n t o n l y w h e nt h e r e i s i n v o.l ve ~ m e nt w i t h d e e p p r o ib t e m s , be c a n a e r a a n i f e s t . I n ,d i-v i d u a l s s e e m e d g a l v a n i z e d i n to p a r t ic i p a t io n .

I n t h e ts vo . n o n d r u g s e m i n a r s , f e w F r 'o b l e m s a ro ,s e t h a t w e r ed i s t u r b i n g e n o u g h to d i s c h a r g e a f f e c t o r t o p r e c i p i t a t e e m o t io ,n a le l~ is es. T w .o excepd ion . s w e r e a w o , maa i n t h e f i r s t s e m i n a r w h,oh a d r e c e n t l y b ee .o m e a w i d o w a n d w h o b r o k e d o w n f o l l o w i n g o .n eo.f t h e t h e r a p y s es sio .n s a n d h a d t o w i t h d r a ~ f r o m F a r t~ c ip a .t io nf r o m ..th e a f t e r n o o n s e s s io n , k e e p i n g o n e o f t~ be o t h e r m em be~r~sw i t h , he r f o r c o m f o r t . I n t h e s e c o n d s e m i n a r ) th e M o n g o l i~ n - R u :s -Man, a wom,a~n w h o , d u r i n g h e r 68 y e a r s , h a d a p p a r e n t l y m a d e u pf o r h e r f e e l i n g s o f b e i n g d i ff e re n ,t f r o m o t h e r s b y " s e r v i n g " ,~ny-one s he c ,ould , w as s u dd en l y c :on~ fro .n ted w i t h t h i s i n t he g r o ,up .S h e ~ r e fu s ed t.o r ec o gn ~ iz e w h a t t h e m e m b e r s w e r e s . ay i ng , b u t s h ed i d n ' t a . p p e ar f o r l u n c h t h a t d a y . O n e o f t h e y o u n g c o~ up}es i n t h eg r o u p s o u g h t h e r o u t a n d c o , re to r te d h e r t h r o u g h t h e i m p a c t o f t h ei n s ig h , t a n d h e r s a b s e q u e n t te a r,s . I n e o n t r a ,s t , i n t h e d r u g - f a c i l~ t -


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318 vsE OF DRUGS IN GI~OUP PSY CHO THE I~A I~a t e d s e m i n a r s , t h e b r e a k d o w n o,f e g o d e f en se fs a n d t h e c o , n c o m i t a n te m o t i o n a l u , ps e ts o c c u r r e d i n th e g r o u p s e t ti n g .

A ~s,o, a p r o c e s s o c c u r r e d w i t h t h ,r e e m e m b e r s o f th e: t h i r d ,s,em i-n a r a n d w ~ th e v e r y m e n c b e r o f t h e f o .u r th s e m i n a r w h i c h i s c a~ le da " c r i s i s a n d b r e a k t h r o u g h , " a b r e a k i n g d:e~w n o~ d ec en ,s e s a n d r e -c o n s t i t u t i o n o~ e g o s t r u c t u r e a t a m o r e r e a l i s t i c a n d f l e ~ b l e l ev e l .

I n t h e t h i r d s e m i n a r , a m a l e e n g i n e e r w h o h a d h a d r e a l d i ff ic u lW i n c l o sein t e rp e r s o n .a l r e l a t i o n s h ip s a l t h o u g h v e r b a l l y i n s i s t in g o n h i s l o n g in g fo ra w i f e a n d c h i ld r e n , w . a s p r o g r e s s i v e l y c o n f r o n t e d b y t h e g r o u p w i t h t h ed i c h o t o m y b e t w e e n w h a t h e sa i d h e w a n t e d a n d w h a t h e a c t i v e l y s o u g ht .S u d d e n l y , h e s h u t h i s e y e s a n d s e e m e d t o b e in s o m e s o r t o f t r a nc e . L a t e rh e d e s c r i b e d h is r e a c t i o n a s " s i n k i n g d o w n i n s i d e " h i m s e l f w h e r e h e e x p e r i -ence d l~ imself as a s tee l ba l l . I - Ie obse rved tha t th i s ba l l wa s beg in n in g toc h e e k a n d t o c r a ck . A l l o w i n g t h i s to h a p p e n , a s t h e t h e r a p i s t d i r e c te d ,a w a v e o f a n x i e t y o v e r c a m e h i m , a n d h e f e l t t h a t h e w a s g o i n g t o d i e .A s m e m b e r s o f t h e g r o u p f e l t h i s a n g u i s h a n d g a t h e r e d . a r o u n d t o s u p p o r th im , b o th p h y s i c a l l y an d p s y ch o lo g i ca l ly , h e w~ s ab l e t o co n s id e r co n -s c i o u s ly h i s f e a r o f d is t i n te g r a t io n . W i t h a t e r r ib l e p s y c h i c w r e n c h h es e e m e d i n o n e m o v e m e n t t o fl y a p a r t a n d c o m e t o g e t h e r a g a i n. H e g r a d u a l l y" c a m e u p " a n d f e l t t h a t s o m e t h in g v e r y i m p o r t a n t h a d h a p p e n e d . H i sn eed t o eo n ~ o l h im s e l f was o b s e rv e d t o h av e d im in i s h ed , h e co u ld r e l a t eb e t t e r t o o C he r m e m b e r s o f th e g r o u p , a n d w a s o b s e r v e d t o h a v e m o r ef l ex ib i l i t y an d f r eed o m . @ @ @

T h e c r i s i s o f t h e o t h e r e n g i n e e r i n t h e t h i r d s e m i n a r o c c u r r e d w h e n h ewas d i s cu s sin g a s e r i e s o f h i s f iv e ab s t r ac t , b r i g h t l y -co h ) red p a in t i n g s i nt h e f o r m o f s y m b o ls . H e s u d d e n l y b e c a m e a w a r e o f t h e s h o o ti n g s t a r o fh i s y o u n g e r b r o t h e r a n d h o w it c u t a p a t h b e t w e e n h is g o l d en s t a r a n d t h eh a l f c i r c le o f h i s p r e v i o u s l y - d o t i n g m o t h e r. I t w a s a s t h o u g h h e h a d b e e nh i t b y a b l o w to h i s s o l a r p le x u s , a s t h e k n o w l e d g e s t r u c k o f h o w h e h a db e e n c u t o ff a n d i n t u r n h a d c u t o t h e r s o ff. T h e n f o l lo w e d a n e x p e r i e n c ef o r h i m w h i c h 'h e v e r b a l iz e d a t t h e t i m e a s " g o i n g p s y c h o t i c " w h e r e b y a l l o fr e a l i t y ,se em ed t c f r a g m e n t a n d w h i r l a r o u n d h i m i n m e a n i n g l es s c h a os . A st h e g r o u p q u i e t e d a n d f o c u s e d e n t i r e l y o n h i m i n s i l e n t s u p p o r t , t h e s p i n -n i n g s p l i n t e r s o f t h e u n i v e r s e s l o w e d d o w n a n d b e g a n t o f o r m a c o n s t e l la t io ni n t o a n e w w h o l e , w h i c h h e l a t e r e x c l a i m e d o v e r a s b e i n g " d r e n c h e d i nc o l o r , " a n d s e e m i n g t o g l o w f r o m w i t h i n .

A n u n m a r r i e d w o m a n t e a c h e r i n h e r m i d d l e t h i r t i e s w a s c o n c e r n e d w i t hth e l ack o f fu l f i l lm en t o f h e r b io lo g i ca l ro l e u s wo m an . As m em b ers o f t h eg r o u p p o i n t e d o u t h o w s h e u n d e r c u t a n y m a n s h e w a s w i t h a n d h o w s h ep a t ro n i zed ch i l d ren , ev en t h o u g h s h e p ro fe s s ed t o l o v e t h em , s h e b ecam em o r e te n s e a n d r ig i d . T h e g r o u p a t t e m p t e d i n d if f e r e n t w a y s t o b r e a k


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BETTY GI%OYER EISNER, pI I,D. 319t h r o u g h t h e r i g i d i t y a n d l a c k Of i n si g h t. F i n a l l y o n e m e m b e r a l m o s t s h o u t e da t h e r .a r e c a p i t u l a t i o n o f h e r b e h a v i o r t o w a r d t h e m a n i n th e g r o u p w h o ms he f e l t s h e h a d l o v e d f o r m a n y y e a r s . A s t h e i m p a c t o f h e r o x~ n d e s t r u c -t i v e n e s s a n d r e v u l s i o n f o r m e n h i t h e r . t h e te a c h e r w a s s p e e c h le s s w i t hw h a t a t f i rs t s e e m e d to b e r a g e . T h e n s h e b u r s t i n t o u n c o n t r o ll a b l e s o b b i n ga s t h o u g h f r o m a ! m o s t u n b e a r a b l e p a i n . A s t h e g r o u p f e l t h e r d e f e n s e -l e ss n e ss a n d a g o n y , th e m e m b e r s ] e f t t h e i r s e a ts a n d g a t h e r e d a r o u n d , g i v i n gs u p p o r t i n s il en c e. T h e a w a r e n e s s o f t h e g r o u p f e e l i n g o f e m p a t h y s u d -d e n l y c u t t h r o u g h t h e p a i n , a n d s h e w a s a w e s t r i c k e n t h a t e v e n t h o u g he v e r y o n e k n e w w h a t s h e h a d s o l o n g t r i e d t o h id e , i t d i d n ' t r e s u l t i n h e rr e j ec t i o n .

I n t h e f o ~ rt ~h s e m i n a r , w h e r e L S D w a s altem rn~ated w i t h m , e se M i n e -a m p h e t a m i n e f o r f i v e o f t h e s e v e n d a y s , t h e r e w a s a e .o nst~ aa t u n -r o l l i n g o f d r a m a t i c e v e n t 's a n d a e o n t i n u o t l s f lo av o.f m ,a t e r i a l f r o md e e p e r l e v e l s . E v e r y m e m b e r o f t h e g r o u p w a s v i s i b l y a f f e c te d , a rrde a c h in th e g r o u p w e n t t h r o u g h a p er s o , n a l c r i s i s .

On e co u p l e we re m es h ed i n a v e~ T co m p l i ca t ed s ad o m as o ch i s t i c r e l a t i o n -s h i p w i t h a h i s t o r y o f a p o s s i b l e e a r l y m o l e s t a t i o n o f t h e w i f e b y h e ra l co h o li c f a t h e r a n d t h e h u s b a n d ' s t o r t u o u s r e l a ti o n s M p w i t h h i s re l i-N o u s l y - f a n a t i e m o t h e r . D u r i n g t h e d r u g s e s si o ns t h e c o u p l e a c t e d o u tt h e i r s ad o m a s o ch i sm . O n e m o r n i n g t h e h u s b a n d h a d s h o u t e d v i t u p e r a t i o na g a i n s t t h e w o r l d f o r a n h o u r . H i s w i f e w a s f i n a l ly g o a d e d i n to a v i o l e n tv e r b a l a t t a c k ' a g a i n s t t h e g r o u p m e m b e r o n w h o m s h e p r o j e c t e d h e r a l c o -h o l i c f a t h e r . F i n .a l ly , i n a f r en zy , sh e s t a r t e d t o w ard t h e m an . M i d w ays h e s p u n a r o u n d a n d s h i f t e d h e r a t t a c k o n to t h e t h e r a p i s t . A f t e r a f e ws h o u t e d im p r e e a t i o n s , s h e ~ a r t e d f r o m a c r o s s t h e r o o m to " d r i v e h e r t h r o u g ht h e w a l l ." l t a ! f w a y a c r os s t h e r o o m t h e v i o l en c e se e m e d to c l i m a x, a n d t h e nt h e d e s t r u c t i v e w i s h e s d i s i n t e g r a t e d a s t h e p a t i e n t r e a c h e d t h e t h e r a p i s t ,f a l l i n g o n h e r k n e e s a n d t h r o w i n g h e r a r m s a r o u n d h e r .

T h i s t r a n s c e n d e n c e o f v i o l e n c e - - t h e s u d d e n s h i f t o f h a t e , t o t a l l yf e l t , in to , l o v e , w a s o b s e r v e d s e v e r a l t h n e s d u r i n g t h e f o ,u r t hs e m i n a r .

O n e o f t h e p a r t i c i p a n t s , a s u rg e o n , h a d b e e n s u b l i m a t i n g s e x u a l a n dag g re s s i v e d r i v e s t h ro u g h h i s p ro fe s s i o n a l wo rk . I I e d ev e l o p ed a ca ta t o n i c -l ik e st a te , f r o m w h i c h h e w a s a r o u s e d t o p h y s i c a l a tt a c k . H e h a d b e e nl y i n g h t t h e c o r n e r w h i l e another m e m b e r o f t h e s e m i n a r " c a m e a l i v e "( s ee t h e fo l l o wi n g ) . ] f i n a l l y , w i t h g o ad i n g , t h e g ro u p was ab l e t o g e t h i n tt o j o i n t h e c i r c l e , wh e re h e s a t i n s t u p o ro u s s i l en ce , r e fu s i n g t o s p eak .S u d d e n l y , a f t e r a v e r y p o i n t e d i n t e r p r e t a t i o n b y th e t h e r a p i s t, h e w a s o u to f h i s cha , t , p a s t t h e i n t e rv e n i n g t wo i n d i v i d u a l s , an d h ad t h e t h e rap i s tb y t h e l oo s e f o l d s o f j a c k e t a c r o s s th e c h e s t a n d h a d l i f t e d h e r o ff t h ef lo o r . A s o t h e r m e m b ers o f t h e g ro u p ro s e t o i n t e r f e re , s h e s ai d , "L e t h i m


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320 U S E O F D R U G S I N G R O U P P S Y C H O T I - I E R A P Yalone; it's all right," and they stood watching while he slowly put herback on the floor. The patient subsequently said that if there had beenany fear in the therapist he would have dashed her down on the floorin an attempt to smash her to pieces. The next day this patient was freeenough from previously-operating inhibitions to beat his hands on thefloor as he re-lived and abreacted the guilt about masturbation instil]e.dby his restrictive, seductive, inhibited mother.

One of th e Inore touc hing epi,sodes occ urr ed w hen a no,ther Inein-ber o~f thi s se mi na r wa s "bo rn. "~ He was a l aw ye r wh,o had n.everreally "becoine hiinself."

On the fourth (dn~g) day of the seminar he witl~drew to a corner ofthe room while the group therapy was in progress. Suddenly the grouprealized that his breathing had changed; he was breathing heavily ~ith anincreasingly .steady, deep rh~hra. As attention was called to his behavior,the group gathered around him. He reported the "coming alive" of differentparts of h~s body as he was "being born." The process culmi~ate,d ~1 anexperience of ecstatic freedom for him, wherein for the first time he feltthat he knew who he was and the purpose and meaning of life, for him.Three years later he reported himself much more succ~sful in relation-ships with people, both persona] and in business, and he was seen to bemuch freer 'and less inhibited than he had been before the seminar.Th er e was an enorino.us re]eas,e o.f c.reative e ne rg y~ si i~ gi ng ,dancing~ pai nt ing, ease in rel~ating---al] th!r~o,ugh the week o.f thefo,urth grou~p. However, it Inu,st be einphasized tl~at ~his se~ninarclimaxed a long prio r process of working to,ward individuM crea-t,ivity ,and free doin .

An unexpected observation was that the experiinental do,sageunifo,rmly had grea ter- than -exp ecte d re,suits in spite of the sinM1amoun'ts used. This became apperen~t the ~l~st da y in th e th ir dse mi na r v~h:en Inesc,Mi.ne an d de xe dr in e wer e u~sed. I t was a~s th oughtongues had suddenly loosened, defenses become ]no,re fluid, andthe group more cohes.ive. This had never before been o.bserved in anewly-for]n ed gro up ; it is usua lly o.bserved o,nly af te r thre e to MxIno.nth.s o , f group work. In the fo~arth seininar there were severalIneinbers who had had individual LSD sessions before the: gro,upth er ap y seminar, and they exp resse d amaze ment that feelings., sen-so ry s~hifts an d openness, which th ey h ad expe rie nced ~at do,sages] 0 t~ines higher , w ere apparelat with the lowe r d~s,es, even tho~lgh

* R e ,b i rt h o r b h t h e ~ p e r le n c e s a r e v e r y c o m m o n l y se e n w i t h p a t i e n t s u n d e r t h e s ed~ -ag s.~ , ~ T h e r e i s s o m e c o n t r o v e r s y a s t o w h e t h e r t h e s e a r e s y m b o l i c o c c u r r e n c e s o rh a v e s om e b as i s i n fa c t . F r o m r e p e a te d o b s e r v a t i o n s o f th e s e p h e n o m e n a a n d f r o m,~ cc a.s io n al o p p o r t u n i t i e s t o c h e c k t h e f a c t s , t h e y a p p e a r t o b e a e o m b i n a t i .o n o f t h e t w o .


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B E T T Y G R O V ER E I S N E R ~ P H . D . 321t o l e s s e r d e g r e e s . I n t h e t h i r d se m in nar o .n e y o u n g s M e s m a n e v e nh a d 'twr incide .nts of colo .red i m a g er y wi th 20 m g. .o .f mescoJl inean d 10 m g. o .f dexedrinne. H eig hte .ne d ,sen,s i tiv i ty , bo th of s ,ensoryan d o f a f fec tua l n a tu re , occ ur re d w i th a l l o f the l~o~w do~ses w he reb e f o r e t h e y h a d b e e n s e e n in i n d i v i d u a l s e s s io n s o n l y w i t h m u c hg r e a t e r a m o~un :ts o f t h e d r u g s u s e d .W i t h r e s p e c t t o t h e a u t h o r , L S D e v e n in s m a l l a z n o u nt s h a d b e e nf o u n d p e r s : o ~a l l y s o c o m p e l l i n g t h a t e i t h e r o b j e c t i v e a c t i o .n m u s . tbe .suspended , ~ r th e d ru g a .c tio .n pos tpon ed .* A de xe dr in e spa r~s,ule ,15 m g . , i s o f t e n u s e d b y t h e a u t h o r w h e n w o r M n g w i t h i n d i v i 4 u a l su n d e r d r u g s , a~ nd s h e r o u t i n e l y e x p e r i e n c e s L S D - l ik . e f e e l in g s , e v e ni n c l u d i n g t h r e e - d i m e n s i o n a l c o lo r ed i m a g e r y a n d b o d y s e n s :a ti on s ,~ h i l e s ~ p e c v i s i n g h ig h -4 o ,s e L S D s e s s io n s . T h i s o c c u r s m o r e o ~te.nw h e n s e v e r a l p e r s o n s h a v e t a k e n L S D t h a n i n s e s s i o n s w i t h as i n g l e i n d i v i d u a l . I t i s h o p e d t h a t t h i s e x p e r i e n c i n g o f d r u g e f fe c ts ,almo,s'.t, b y "eon tag~o .n ," wi l l be be t t e r un de rs t oo d w i th fur~th~rr e s e a r c h .

W i t h r e s p e c t t o t h e f o u r g r o u l o - t h e r a p y s e m i n a r s , t h e m l t h o vt o o k n o d r u g d u r i n g t h e f i r st t h r ee . D u r i n g t h e f o u r th , s h e t o o k2 2 r a g . o f m e s c a l i n e , w i t h a d e x e d r i n e s p a n s u l e o ~ 1 5 r a g . , o n t h et h i r d , f i f t h , a n d s i x t h d a y s - - t h e d a y s t h a t t h e r e s t o f t h e g r o r ~ ph a d L S D . T h e m e s c a li n e - d e x e d ri n e a c t e d m u c h ~ s t h e d e x e d r i n eh a d i n t h e p a s t , e n h a n c i n g e m p .a th y , s e n s i t i v i t y , a n d a w a r e n e s sf o r t h e a u t h o r . N o r e a c t i o n s s p ec if ic t o m e s c a l i n e o r p s y c h e d e l i c sw ere feu o , the r than on the l a s t d ay wh en the g ro~up 's L S D d ,o ,sagew ~ s h i g h e r ; t h e e f fe c ts o n t h a t d a y n o t o n l y p r o v i d e d g r e a t e rs e n s ' i ti v i t y , a w a r e n e s s , a n d e m p a t h y f o r th e. t h e r a p i s t , b u t w e r ea l s o i n t e g r a t i v e , a n d c o ] o r w a s g r e a t l y e n h a n c e d .

D i s c v s s m l gO n e o f t h e i n t e : r e s t i n g a n d u n e x p e c t e d o b s e r v a t io n , s w a ~s t h ee f f e c t i v e n e s s .o f v e r y s m a l l a m o u n t s o f d r u g s . T w e .n b T m a d 2 2 r a g .

,o.f m e s c M i n e , u ~se d w i t h d e x e d r i n e ,or m e t h e d r i n e , i s c o n s i d e r a b l yl e s s th a .n t h e 3 00 t o 4 00 r a g. w h i c h i s t h e a v e r a g e e f f e c t iv e i n d i v i d w a lm e s c a l i n e d,o,se, I n b o t h d r u g s e m i n a r s t h e r e w a s e v e n h e i g h t e n e d~ A t o n e s e s s io n a t t h e B r e n t w o o d V e t e r a n s A d m i n i s t r a t i o n I - Io sp it al~ th e a u t h o r

a n d D r . C o h e n e x p e r i m e n t e d w i t h 2 5 T o f L S D , b e i n g j o i n e d b y t y r o e t h e r r e s e a r c h e r s ,m i d f o u n d t h a t t h e i r L S D r e a c t io n s w e r e " p o s t p o n e d " s p o n t a n e o u s ly a n d u n c o ns c io u s lyf o r f i ve h o u r s w h e ~ a c r i t i c a l t h e r a p e u t i c p r o b l e m w h i c h h a d t o b e d e a l t w i t h i m m e d i a t e l ya r o s e w i t h o n e o f t h e m e m b e r s o f t h e g r o u p . B o t h d o c t o r s s u d d e n l y e x p e r i e n c e d t h ei n i t i a t i o n o f t h e ' ~ L .S D s t a t e ' ; o n l e a ~ i n g t h e h o s p i t a l f iv e h o u r s l a t e r - - a s t a t e w h i c hc o n t i n u e d f o r t h e u s u a l s p a n o f s i x t o e i g h t h o u r s .


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322 U S E O F D R U G S I N G R O U P P S Y C t I O T H E R A P Yp e r c e p t i o n o.f c o ~ o r a a d s o m e i m a g e r y , s u r p r i s i n g ~ o .r s u c h l o wdo ,ses . These e f f ; e~t s were no ted on ly in pass ing , and were no . tr e l e v a n t t o t h e t h e r a p e u t i c p u r p o s e o f t h e s e m i n a r . H o w e v e r , a o . l o re n h a n c e n ~ e n t .. a n d i m a g 'e ~ y h a d n e v e r b e e n o b s e r v e d p r e v i o u s l yo n le,s,s t hr e. e t i m e s th e d o s a g e u s e d . W i t h L S D 7 ~ i s t h e s m M -l e s t a m .o u nt h a v i n g a n y r e p o . r te d a c t i v i t y , a n d e f f e c t s a t t h i s d o sa g,ea r e n o t . o , b s e r v e d i n a l l s u b j e c t s ? T h e a v e r a g e L S D d o s e u s e d b ym o s t i n v e s t i g a t o r s i s f r o m 7 5 t o 1 50 ~,. E f f e c ts . w e r e f e l t b y a l l m e m -b e r s o,f t h e f o u r t h s e m i n a r w h e n o n l y 1 07 w e r e u s e d .

T his po~ten 't~a tion o .f d r u g dosag e , obs e rve d fo r a l l memb.e rs o,ft h e g r o u p a n d w i t h a l l o f t h e d r u g c o.m b in at~ io ns u s e d , h a s s e v e r MposM~ble ca us es : the g r 'oup s i tu a t io n , the s p . e c ~ f i c s ,e t t ing, the typ,eof ind iv id uM s p.art ie~pat ing~ the m ate .r ia l un d er d i.s,eussio.u, thef a m i l i a r i t y a n d o r i e n t a t i o n o f t h e g r o u p m e m b e r s t o w a r d e a c ho t h e r a a d t h e g e n e r a l m a t e r i a l , o r a c o m b i n a t i o n o.f f a e t o ,r s. l-Io w -e ve '.r, s e t t i n g ~a nd p r e v i o u s g r o u p e x p e r i e n c e do, n o t s e e m t o b ep r im e de te rm in an ts ; he ig~h tened ef fe ,e t. ive~es,s ,o~ do sag e w as o ,b -s e r v e d w i t h t h e f i r s t g r o u p e x p e r i m e n t s a t B r e n t ~v o ,o d V e ~e . r a n sA d m i n i s t r a t i o n H o s p i t a l , w h i c h w e r e h e l d i n a n o r d i n a r y o,ffieem no ng inves ,tiga.t,o rs w ho kne w each o th e r s l ig h t ly ; po tent J~a~ono,f d o ,s ag e w i t h d r u g s u s e d i n g r o u p s h a s b e e n n o t e d u n i f o ,r m l yd e s p i t e t h e e n v i r o n m e n t a n d l a c k o.f m u t u a l f a r a i l i a r i t y . P o t : en t ia -t ~o n h a s o c a u r r e d i n i n d i v i d u a l s e s s i o n s w h e n p a r ~ t i 6 ~p a n t s w e r eb r o u g h t i n , w h e t h e r k n o w n t o t h e i n d i v i d u a l u n d e r th e, d r u g o r no~ t;i t h a s , be en o b s e r v e d m o is t s t r o n g l y i n s i t u a t i,o n s w h e r e a w h o l eg ro up ,, w e l l k n o w n t o e a c h o t h e r , a r e o p e r a t i n g t h e r a p e u t i c a l l yu n d e r , d r u g c o n ~ t i o n s .

I t a l m o s t a p p e a r s a s t h o u g h - - u p to t h e p o i n t o f a n u n w i e l d yg r o u p ~ t h . e ~a r g e r t . h e n u m b e r o f g r o u p - o r i e n t e d p , a r t i e i p , a n t s w h .oa r e k n o w n t o e a c h o t h e r , t h e s m a l l e r t h e d o s a g e s r e q u i r e d . I n t , h i ss i t u a t i o n , d o , sa g e s f r o m o n e- ~h al f t o o n e - t e n t h t h e u s u a l a v e r a g ea m a u n t s ~are e ff .e c ti ve , t h e d i f f e r e n c e s d e p e n d i n g o n t h e . . s p e c if i cs .e ~tin g, t h e . e m o t io n a l m a t e r ~a l b e i n g d e a l t w i t h , a n d t h e t h r e s h o l d so f t h e i n d i v i d u a ] , s t a k i n g t h e d r u g s . A e ,o m m o n g oo d, s u c h a s m o v e -m e r i t ~ o w a r d c r e a t i v i t y o r t o ~ a r d m e a n i n g f u l n e s s .o~ l if e , h a s b e e nob serv ed to po ten t ia te th e dosag e , a s does a .ttr~aetiveness an d sec lu -s i (m of the s .e t ting . F in a l ly , the d eep er the emo;f io ,nal l eve l o f them a t e r i a l d e a l t w i t h , t h e s t r o n g e r t h e . d r u g a c t i o n a p p , e a r s t o b e , .A n a d d e d o b s e r v a t i o n f o l l o w i n g a n u .m b e r .o.f y e a r s o f d r u g w o .rki s t h a t f a m i l i a r i t y w i t h t h e s p e c i f i c d r u g o r w i t h ~h e g e n e r . a t c a , r e -


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B E T T Y G R O V E R E I S N E R , p I -I ,D . 323g o r y o f p sy ca he de ~ic s i n g e n e r a l M s o 1,o we r,s t h r e s h o l d s . H o w e v e r ,w i t h v e r y , s tr o n g l y - d e f e n d e d i n d iv i d u a l,s , a b r e a k t h r o u g h o f c o . n -t r o l s m u s t o c c u r befo ~re t h e p r o g r e s s i v e l o w e r i n g o,f t h r e s h o l d s i sp o s s i b l e .

F r o . m t h e v iew .po.in t, o.f th .e t h e r ap i s t , p r ob ab l y t h e mo i s t s : t r i k i ngd i f f e r e n c e b e,tw ee.n n o n d r u g a n d d r u g g r o,u p s w a s t h e s h o r t e n i n go f t h e. t im e . n e c e s s a r y f o r t h e e m e r g e n c e o f t h e g r,o up , a:s .a n e n t i t y ,a n d t h e d e .e p ,e n in g o f t h e t h e r a p e u t i c p r o c e s s , as a w h o l e . W i t hre sp e c t t.o g roup , dyn ,a ,nfic .s~ th e sk i l l in t e . ehniques , i,s r e m a rk a b lef o r ~ th e p a .r e ~ t p o p u l a :t io n f ro .m w h i c h t h e s e m i n a r s w e r e d r a w n ;t h e b e a u t i f u l i s o l a t e d s p e c i a l s e t t i n g a l s . o h a s a . s a l u t a r y e f f e e . t o ng r o u p c o h e s i v e n e s s . W h e r e t h e a v e r a g e g ro .u p w h i c h w o r k s t.o~ge r b e r on ce o ,r t w i c e a w ee k d oe s n o t co , a le s ee i n to . a. w ho l e he , fo r et h r e e t o. s i x m o n t h s , t h e s e .r n in a rs ( e .o m p a r a b l e t o n o n d r u g g ro ~a ps )r o u t i n e l y e o n s t e l l a t e b y t h e e n d o f th e t h i r d d a y . ~ o~ weve .r, wid thth e d ru g ~semin ,a rs , g ro u p co he s io n to ,ok p l ac e w i t h in ~o~ne, o t~wo.ho~ ur s a f t e r t he d r u gs w e , r e i nges . t ed . I t i s t he . r apeu t i , c a l l y i.m-p ,o .r 'taat ~.o h av e a g ro u p of 10 pe o p le b ec om e a f e e~ ing un l it , a .s i fi t w e r e a s i n g l e i n d i v i d u a l , w i t h i n a n h o ~ u r. T h i s iLs a r a r e o c c u r -r e n c e e v e n i n g r o u p s w h i c h h a v e ~ o , r k e d to ,b e *h e r f o r s e v e r ny e a r s ; i n o r d i n a r y n o n d r u g g ro u p, t h e r a p y , n ot. o n l y l o n g f am i l -i a r i t y a M s t ro . n g r a p p o r t a r e n e c e s: s: ar y a .m .o ng m e m b e r s ., b u t a ~ som a t e r i a l w h i c h i s d e e p l y m e a n i n g f u l to. a ll o f t h em . W o r k i n g w i t hs k il l. ed gro~up.s u n d e r . d r ugs , g r o u p u . n i ty can oe .eu r i n j u s t a,s m uc ht i m e a s i,s r e q u i r e d fo ur t ~ e d r u g t:o b e e o n l e e f f e c t i v e .

I t i s m u c h m o r e e f fi c ac io u s t h e r a p e u t % a l l y t .o w . o rk i n a si~ u, t i o nw h e r e d e f e n s i v e b a r r i e r s a r e l o w e r e d e n o u g h s.o. t ha co .m m ~n ~ea-t i o n s r e gi.s ,te r i m m e d i a t e l y , w i t h c o n c o m i t a n t .a ffe ct. T h e e n h a n c e de m p a t h y a n d l o w e r e d d e f e n s iv e n e s s m a k e d e e p e r f e e l in g l ev e lsa v a i l a b l e f o r t h e p a r t ie . i p a n t s, t h u s d e e p e n i n g t h e p r o c e s s fo .r a l le o n e e ,r n e d . T h e s e w e r e u n d o , u b t e d l y fa .c to r s i n a l l o w i n g @ e l a w y e rt,o, b e " b o t rn " i n t i le f o u r t h , s e m i n a r a n d a ~so i n p e r m i t t i n g t h ea s s a u l t i v e h o s t i l i t y w h i c h b r o o k e i n t o l o v e a n d f r e e d o m f o , r t h em a s : oc h i. s~ c w i f e a n d t h e ~ f i l t . .l a d e n s u rg , eo n .

T h e u s e o.f d r u g s f a c i l i t a t e d e a s e o f e o.m m u n ic ,a ti.o n a m o n g m e m -b e r s o f t h e g r o u p i n t w o w a y s : h e i g h t e n e d c a p a c i ty to, v e r b a l i z ea b o u t o n e ' s s el f , a s n o t e d b y a l m o s t a ll p a r t i c i p a n t s a n d a s r e p o r t e di n 'th e s ta .t e.m e n t s o f t h e t h i r d s e m i n a r m e m b e r , s ; a n d a . g r e a t e rf lo w o f n o n v e r b a l f e e l i n g a m o n g t h e g r ou p , m e m b e r s . T h i s w a sp a r t i c u l a r l y t r u e w h e n e m o ti on .M m a t e r i a l d e a l t w itc h e a s y .devel.o~ .-


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324 USE OF DRUGS IN GROUP PSYCHO'THERAP Ym e n t a l le v e l s o f t h e p ar t i e ip , an t s . T h i s e f f e e t s e e m s h e i g h t e n e db y t h e a d d i t io n o f o t h e r p a r t i c i p a n t s w h o ~ re f a m i l i a r w i @ t h ep r o c e s s, a s h a s b e e n n o t e d d u r i n g i n d i v i 4 u a l s ~ ss io n s.T h i s p o t e n t i a t i o n m a y p o s s i b l y be p s y c h o g e n i c i n t h a t t h e g ro ,u ps i . ~ . a t i . on u s u~ a l l y i nvo l ves s ome f o r m o f r e - e r ea t i o , n o f ea r l y l ~ . f esitu~a tio .n s. F r e a d ' s em p , has i s on t he. O ed i l ~ a l s i t ua t i o n s ee m s to .h a v e o ~b ,se ure d, a s A d l e r e . o r re e t l y n o .t ed , t h e g r e a t i m p o . r t a n e e o fs i b l i n g re l a ti o ,n s h i p s . M a n y t i m e s o l d e r s is te r: s a n d b r o t h e r s s u p,e r-s e d e p a re n t~ a l fig ~u re s; o f t e n N e s i b l i n g s i t u a t i o n r e e ~ p i t .u l a t e st he O ed i p~ l s co m pl e x an d s e r ve s t o ,se t i t i :n m o r e de ep l y ; .o,ee,a-s i ona l l y t he 0ed i pa l r e l a t i o . n , s ~ h i p and t he s i b l i ng r e l , a t i . ons h i p pu l lth e eh i ld i n %o.posi~ce ~d en t i f i ea t ion d i r ee t .ion . s an d in i t i a t e iden~ t i tyeon f l i e t s .

W i N a p ro p er e . ans't itu ,t ed gro~up, i.t s e em s po .s ,s ib le to r e .ca-p i t u l a t e t h e e a r l y f a m i l y e m o t i o n a l se t ti n g ' a n d t o e o n f r o n t t h ep .a ,t ie n t s i m u l t a n e o u s l y w i t h 0 e d i p , a l a n d s i b l i n g p a . t t e r n s , a:s w e l la s w i t h t h e i r i n t e r a c t i o n s . W h i l e t h i s c a n p r o d u c e s :tr e li ni e.a lr e a e~ i o n s, t h e s e c a n b e c e n t re . li e d . B e s i d e s , g ro u p , p r e s s u r e s t e n dt o s .o e ia li ze t h e e m e r g i n g t h o u g h t s a n d a cti.o ~s . T h e " r i g h t to.r e j e e t o.r w i t h d r a w " o f t h e p a t i e n t o r g r o u p m e m b e r s is a b r o g a t e db y t .h e t h e r a p i s t w h e n e v e r it i s f e l t t o b e o ,n ly r 'e s i st a n e e . T h ep a t i e n t m u ' s t c o m e t o t e r m s w i t h t h e i n d iv i d a a .1 .h e w arL ts t o, e l i m i -n m .e . A s t h is i s a c c o m p l is h e d , p e n e t r a t i n g i n s i g h t s o f t e n e n s u ea n d p r o b l e m s fro wn e a r l y c h i l d h o o d a r e r e s o l v e d . T h e re e ,o n ,s titu -t i o . n o . f e a r l y . e m o t i o n a l e n v i r o n m e n t s m a y i n e r ' e a : s e ' t h e a . f f e e t i v ed i s ,c h a r g e a n d a p p a r e n t l y p o te n ti ~ at es t h e d r u g e f fe e t . A e t u a l l y ,i t m a 5~ w e ~ l b e t M t u n d e r t h e s e e on ditio ~n .s, t ~ e d r u g d,o s a g e ~ s , e d% r i n d i v i d u a l t r e a t m e n t e .an b e d e c r e a s e d .T h e p .roce~s s o f m o v i n g on h . eT ond ea r l y emo~ t io~ a l b l o ,eks i.sp a r t i c u l a r l y a p p a r e n t a t c e r t a in p o i n t s i n t r e a t m e n t . W h e n t h ei n d i v i d u a l i s a b l e t o r e v e a l h i m s e l f t o a n . o , t h e r , ~ h e t h e r a p . i s t ~ . m n -o N e r p e r s o n i s a d m i t t e d i nt o. h i s u n i v e r . s e a n d ~ t r e- er ea .t :e s tl aetk m .e w h e n t h e c h i ld d i f f e r e n t i a t e s h i m s e l f f r o m m o t h e r , tt~.enadrni t ,s m o , ~ r t o h i s u n i v e r s e . W h e n a s,eeo~r~d m e m b e r .of t h eg r o u p , i s , a l l a w e d - - i s r e l a t e d t o - - t h e 0 e d ip a .1 , s it u a t io n o ~ t en isr e - e r e a : t e d . F i n a l l y a s m o c e t h a n t w o i n d i v i d u a l s a r e a l l . o , w e d i ns imu l t a ,ne . o~ s r e l a t i o ns h i p , t he s i b l i ng re la tio ,r~ s a r e r ec ap i t u l a t ed .I n e s s en ce , t he r e i s a lmo~s t a s t ep - w i s e b ,u i ld i ,ng o f t h e eh i l dho : odf a m i l i a l p a


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B E T ' s G R O V E R EIS2q:EI~ P H . D . 3 2 5A n a na lo ~g y f r o m g e o i n e t r y p r e s e n t s i ts ,e lf t o r e p r e s e n t th e s.e

c r i ti c a l p o i n t s o f o p e n i n g - u p - t o - r e l a t i o n s h i p f a r fihe i n d i v i d u a l .O ne d o t i s a to ta l~ i ty , a un iv e r s e in an d o ,f i t s, e l f, as i s a e~ lid :,p s y c h i c a l l y ; w i t h t w o d o.ts, a n e w f i g u r e e ,o in e s i)n to , b e i n g - - . t h el in e , w h i c h m i g h t s y m b o l i z e ti le I n o t h e x - c h i l d r.el, t i o n s h i p ; t h r e edot:s, o ,r the. c .onju nc. t ion o f t h re e l ines~ be,c .orae.s a ~r ia n gl e a n dr e p r e s e n t s t h e l o c k i n g t o g e t h e r o f m o t h e r , f a t h e r , a n d c ~h ild (',th et r i a n g l e b . e ing t h e t oo ,s t s t ab l e ge om e t r i c f oe /m) ; t he f,o ,u r do,t,s o ,rt h e c o n j u n c t i ,on o f f ou r l i ne s I nake : s a r ee f , ang l e ( o~ f t en a s qua r e )w h i c h m i g h t w e , l] r e p r e s e n t t h e i n~ tr'oduc.tion an d i nc ; o r po . ra t i on o fa s i b l in g ( w h i c h a v p e a r s t o b e , n e x t t o t h e s h i f t f r o i n o n e d o tt o t h e l in e , t h e m o s t d i f~ a u lt t h e r a p e u t i c t r a n s i t i o n ) ; a n d la .s tly ,t h e e o n t i m f i n g p r o c e s s o f a d d i n g d o . t s- - o r m o r e s id e ,s -- t,o t h e p o l y -g o n , u n t i l e v e n t u a l l y t he r a r e s o m a n y s id eL s t h,a t t h e s q u a r e h a sb e c o m e a c i r c l e .

T h e .see.o~nd v a l u e o f a g r o u p u s e d i n c o n ju n e ,t io .n w i t h d r u g s - -t h e f a c i l i ta t i o n o f t h e d i s c h a r g e o f r e p r es :s e d m a t e r i a l o r a t lea, s ti t s c o n c o m i t a n t a f f e c t , n o n v e r b a l l y - - i s n o t u n de rs:t.o .o ,d , n o r i s t h em a n n e r c le a r b y w h i c h t h e p r o c e s s is I n e d ia t ed . T h e p h e n o m e n o no f " e m o t i o n a l e o n t a # o n " is f a m i l ia r t o a ll w h o h a v e b e e n c ,a ng htu p i n t h e j o y o r s o r r o w o.f o t h e r s . S y m p ~ a t h e t ie l is te n e ~r s e l i c i tm o r e m a ~ t e ri al ; a l o v i n g m o t h e r c a n h e a l p a i n w ith c m L ~ sp ea ]d n ga w o r d . T h i s i,s e m p a t h y a t t h e i n d i v i d u a l le v e l. T h e s a m e p h e n o i n -e n o n h o l d s tr~ ae f o r g r o . u p s : g a n g s a r e k n o ,w n to b e m o r e l ab ile .t h a n i n d i v i d u a l s ; a m o b c a n b e t u r n e d t o v i o l e n c e v e r y q u i ck l y ,a s w i t h l y n c h i n g s , l ~ e li g io n s e x p e r i e n c e s i n p r i m i t i v e g r o u p r i ' t ~ l s ,i n e , ei 'ta in e m o t i o n a l l y - o r i e n t e d d e n o m i n a t io n , s l ik e t h e " H o l y R o l l -e r s , " a n d i n t h e I n d i a n p e y o t e c u l t , o . f f e r e x a m p l e s o f n o n v e r l b a le m o : ti o n a l e a t h a r s i s i n a g r o u p s e t. ri ng .O n e m i g h t s p ,e c u la te a b o u t t h e l i f t i n g o f i n h i b i t i o n s i~n t h e t o n -' t ex t o f t h e l a r g e r u n i t y o f th e g r o u p , a n d t h e i n t e r a c t i o n o ,f t h ew h o,le b e i n g g r e a t e r t h a n t h e s u m o f t h e p a r t s . F m : t h e r , t h e r ea pp .e a,r s to . b e s o .m e a l l e v i a t i o n o f g u i l t ; c e r t a i n l y t h e l i f t i n g o ff a l s e l y - i m p o s e d g u i l t is o b s e r v e d ~ l m o s t u n i v e r s a l l y w i t h t h e t h e r a -p e u t i a u s e o f p s y c h e d e l i c d r u g s . P e r h a p s t h e e ff ee ti ve n e s~ s o~f e m o -t io n ,a l c a t h a r s i s t h r o u g h t h e g r o u p i s d u e t o S o , he e o ~ n b in a t ~o n o~l i f t i n g o f g u i l t , th e g r e a t e r a c c e s s t o d e e ,p e r l e v e l s o f a f f e at , a ~ dt h e e n h a n c e d e m p a t h y a n d "securi ty" o f a g r o u ~ . , e m b a r k e d o n am u t . l m l p ro ,c es.s w h i c h e . re a t e s a l a r g e r u n i v e r s e w i t h i n w h i c h t h ei n d i v i d u a l s a r e a b l e t o f i n d g r e a t e r i n t e g r a t i o n .


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326 U S E O ]? D R U G S I N G I % O U 1 P S Y C I - I O T ! ~ l g I ~ A I ~ ZThese speculations may also be per'tinen~t, in the c:o.n,sideration

of how and why groups appear to potentiate drugs so that muchsmaller do.sages are needed for memb.ers skilled in group pro-cedures than for indixddual.s who experience the drug reaction bythemselves.

Another factor which appears to be inher,en4, in skilled, em-pathet ic groups is the abil ity of the group, to help, indivicluN mem-bers thro.ugh emo4ional cri.ses with less pain and more rapid in-tegrati,o.n. The psychological support can be .strongly fel t withdrug groups; the support available through the gathering of thegroup around an indi~ddual and touching him in a crisis, is so. ap-parent that it almost seems a palpable enti ty. Th'e lo,we.ri~.g .ofbarr iers is experienced remarkably among group mew_ber~s~ evenby participant observers. At times it. seems as though the groupwere. not. only a psychic enti ty with no barrier~s be~w.een indi-viduNs; when ta~e.re is elo.se eontae.t in e,onjunetfon with physicalsuppor% i.t o,ften feels as though even p,hysieM boundaries are inabeyance. Group members o,ft.en report not knowirLg w~at is par to,f their o~-n body and w.hat belongs to that .o.f other individualsin ghe group.While it ~s difficult t,o sort out how much of the t,her'apeutie im-provement reported as a result of the seminars was due to the skillof the participant.s, the settfng, and the seriousness of the membersin thei r pur,suit of "self-fulfihnent," it is po~s.s~bte to. make somesta tements with respect to the effect of the drugs, .sine,e ,all .o,f theocher faeto,rs were present in both .drug and nondr~g gro,ups. Itseemed tha t rappo,rt, depth of feeling and psychic activity, ,and theamount of ehang,e .o,bserved in individuN:s (both at the seminarsand su,bsequently) were greater for drug semirmr:s than for non-drug, and grea ter for the fourth seminar where drug4s were usedfive consecutive days o.ut of seven, in eontro~st to the thi rd seminarwhere the?- were used three days of week. Since. the effee~.sand the changes were g reater with drugs thorn witho.ut drugs, aaldin the fo,urth seminar than in the third semin,ar, it appears asthough the use .o.f LSD, mescaline, and the amphetamines .did in-deed facilit~ate the group therapy process wheal r~s,ed with member,sskilled in gr.oap dynan~ies.At an evaluative meeting of fourth seminar member:s, severnmonths a.fter the seminar was over, "the desirability .of havingsimilar seminars in the future" was diseu~ssed, along with "the r~s.e


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BETTY GROVER EISNER~ PII.D, 327of LSD or other aids at such seminars." "A.s to the first questionit was the sense of the gro .up. ., that the eontimtanee o,f snell s,emi-nars woutd be o.f substant ial benefit. As to.. the second ques,tfi,o~a,the future use of LSD .and related mater ials at s~a:ch seminars ,we felt generally ~hat sueLh ~s'e was o.f consider~b.te help. in ourseminar, .eo,ntributing materially to the depth and sigalifieanee ofthe "material."

An examination is made o,f four gro~up therapy s,e~ingr~s, o,f com-parable e(~mpositio.n and fro.m the same parent population, heldin the s,a.me :setting for the duration of one week, two og which useddrugs in a~a attempt t.o facilitate the gr.o.up t~herap,eutie processand two of which .did not.TJhe evoh]fion of a matr ix for therapeut ic drag sessions was .dis-c~s:sed, a~d the background wa's given for the use o,f additionalindividuals 'to speed up the handling o~f problems a~rising fromearly family rela.fionsh~ps.From the eomparis.on of the nondrug and the drug group,s, andof the two..druid groups themselves, it seems, app,aren~ that the use.of LSD, mescaline, and amphetamine did in f,a,et lower defensivebarriers, enhance empathy, facilitate verbal and nonverbal eom-m~. ieatio.n anaong group members, and make available deep,erlevel,s, of feeling. More "chang,e" o,f the type assoe~at~ed wi*h hn-prove.merit .appeared to occur in the seminar where .drugs were usedthe sec,ond, third, and fifth .days o.f the week than in the. n.ondrugseminars; an even greater amour~t of "c]aange" was associated widththe fourth s~eminar where drugs were used five consecut ive daysout of the seven.

T~helre was e OhMs:tent observation of po,tentiati,o.n o~f the drugdo,sage, probably primarily beeause o.f the gro.np s~tua,tion. Theb.aekground a~]d fa'miliarity of the members of the group with thepr.o,ees~s and wi th each other, and the partieulars of the sett'mg nodoubt also added to the enhanced ,action of the, drugs. Much lowerdo,ses of LSD and mesealine-a.mphetamine,when used wi*h a group.,seemed to. ~e ld results equivalent to the signi.fieantly higher dose,snecessary for individual drug session,s.Speea]lations were made concerning the means by which drugsfaeil.itate the group processes and by w'hi'ell skil led gro,up, memberspo.tentiate drug dosages, and note was made that the setting i'tselfis a}so an imp,ortant fae,to.r.


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328 U S E O F D R U G S I N G R O U 1 P S Y C : K O T H E R A Y YACKNOWLEDGMENTS

The aut,hor is deeply indebted to Dr. Herman C. B. Denber forhis critical and cre:ative editing and his ge~erous help with tkisand with other work. Measureless thanks are also due to Dr. MarionJ. Dakin for her untiring support, witho,ut which many of theseprojects could not have come to fruition.1334 Westwood BoulevardLo~s Angele,s 24California

R E F E R E N C E S1 . t t o f m a n n , A . : D i s c o v e r y o f d - l y s e r g i c a c i d d ie t h y la ~ l m i d e -L S D . S a n d o z E x c e r p t a( S a n d o z P h a r m a c e u t i c a l s , H a a o v e r , N . J . ) , V I I : l , 1 9 4 3 .

2 . C o h e n , S ., a n d E i s n e r , B . G . : U s e o f L S D i n a p s y c h o t h e r a p e u t i c s e t t i n g . A . M . A .A r c h . N e u r o l . a n d P s y c h i a t . , 8 1 : 6 1 5 ~ 6 1 9 , 1 95 9 .3 . E i s n e r , B . G . , a n d C o h e n , S . : P s y c , h o t h e ra p y w i t h l y s e r g i c a e i d d i e t h y la x a i d 2 .

J.N.I~[.D., 127: 528-539, 19~8.4 . E i s n e r , B . G . : U n p u b l i s h e d o b s e ~ z a ti o n s .5 . J a n i g e r , 0 . : P e r so n a l c o m m n n i c a ti o n a n d u n p u b l i s h e d d a t a f r o m e x p e r i m e n t s a n d

f o l l o w - u p q u e s t i o n n a i r e m a t e r i a l6 . D e n b e r , H . C . B . : P e r s o n a l c o m m u n i c a t i o n .7 . O s m o n d , H . , a n d I { n b b u r d , A . : P e r s o n a l c o m m u n i c a t i o n .8 . Den be r , I -I . C . B . , an d l~ i nke l , M . (ed i t o r s ) : Psyc l m dyn azni c an d t he ra pe ut i c a spec t s

of me sca l i ne an d ]yse rg i e a~c id d i e t hy l ami d e . J . N . M . D. , 12 5: 42 :3-451 , 1957.9. G rien er , T . ; Burc~h, N . R. , an d E~delberg, R. : Ps yc ho pa tho log y an d psychophysiol (~gyo f m i n i m a l L S D - 2 5 d o s a g e . A . M . A . & r ch . N e u r o l . a n d P s y c h i a t . , 7 9 : 2 0 8- 21 0,1958.

Notes on the Use of Drugs to Facilitate Group Psychotherapy

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