Using LSD to Treat the Fear of Dying

Using LSD to Treat the Fear of Dying 

A Swiss psychiatrist would like to help terminally ill people with LSD. This is the first official attempt to use the hallucinogenic drug for therapeutic purposes.

By Jean-Martin Büttner
Solothurn

Shortly before noon, he asked for 100 micrograms of LSD. His wife administered it to him by injection directly into the muscle, followed by a second dose two and a half hours later. He was oblivious to the flickering television screen in the next room – images from Texas. It was the morning of November 22nd, 1963, the day John F. Kennedy was shot in Dallas. In the late afternoon Aldous Huxley fell asleep and dreamed no more.

The author died of cancer of the throat. Doctors had prepared his wife for a dramatic end, since the final phase usually involves attacks of asphyxia. “He passed away quietly and peacefully, however”, recounts Albert Hofmann, the Swiss chemist, who discovered LSD in 1943 in the Sandoz laboratory in Basel. Hofmann celebrated his 102nd birthday yesterday and says that “my life’s greatest wish is now being fulfilled: LSD is finally becoming a medication again.”

Hallucinogen therapy

After the end of the war, Sandoz recommended LSD to doctors and psychiatrists “for purposes of psychological relaxation in analytical psychotherapy, particularly in cases of phobias and compulsive disorders.” Over sixty years later, a Swiss psychiatrist once again wants to research this quality. Peter Gasser is president of the “Swiss Association of Doctors for Psycholytic Therapy”, an organization with the aim of facilitating the therapeutic approach using hallucinogens. He has undergone the appropriate education, while still possible with special approval, but has not treated others with hallucinogens. He would now like to do so in the context of a scientific study.

In October, after eight months of consideration, the ethics committee responsible granted him approval; in December, the Federal Health Authority concurred. Gasser is permitted to conduct and scientifically analyze short-term therapy using LSD with twelve subjects. The therapy will involve terminally ill patients suffering from acute anxiety. (See interview).

Patients closely monitored

After comprehensive checks have been performed, Peter Gasser will treat these patients for three months and during this process administer two doses of 200 micrograms LSD, i.e. a medium dose, to each. The LSD sessions occur every four weeks. The patient spends the day – and the next night as well – under observation in the practice. He/she is to relax in a prone position on a mattress; the therapist will sit next to the subject. There will be little talk during the session, but music will be played occasionally and physical exercise encouraged. Only once the effects of the substance have slowly subsided, in other words, after about four or five hours, will a discussion take place with the patient about what he or she has experienced and the findings of this therapy explored.

Convey a feeling of security

Four of the twelve patients will constitute the control group and will receive an active placebo, a barely effective dose of 20 micrograms of LSD. The comparison is required to be able to measure the therapeutic effect of the substance; Gasser will, however, offer the control group the correct therapeutic treatment at a later stage. All the patients will keep a pain diary and provide information on their anxieties. The LSD is to be used as a catalyst – it is to make the patients conscious of their fears and at the same time provide them with a feeling of security and trust – the experience that Aldous Huxley described in dry British fashion as feeling “that the universe is somehow in order”.

Peter Gasser receives you in his bright, spacious treatment room. The 48-year-old appears reserved and argues objectively and calmly. The egomaniacal excess that is so often found in drug pioneers is completely absent. Gasser shares the opinion of the German drug researcher Günter Amendt that intoxication should be discussed soberly. And he also shares Albert Hofmann’s conviction that LSD has yet unimaginable potential in the treatment of depression, compulsive disorders and nightmares.

Over five thousand studies had, in fact, been published before the substance was banned at the end of the sixties. Most of these studies are, however, of no methodological use or are obsolete. Gasser’s pilot study is the first official therapy world-wide for more than 35 years. The results are to be published year after next. The trial has sparked global interest and is co-financed by the “Multidisciplinary Association for Psychedelic Studies” (MAPS), which has committed itself to research in hallucinogen-supported therapies in the US.

Swiss pragmatism

Gasser believes it’s no coincidence that Switzerland is the country responsible for facilitating scientific research in LSD. Two years ago, at an international symposium in Basel on the occasion of Albert Hofmann’s 100th birthday, experts launched an appeal calling for the approval of hallucinogens for research purposes. Soon thereafter, Gasser received a letter from Pascal Couchepin. The Health Minister wrote that no obstacles to such research existed, provided that scientific and ethical conditions for such experiments had been met. The ethics committee, too, debated with complete objectivity. One of Switzerland’s strengths, Gasser states, is that it treats such issues with pragmatism and liberalism.

The psychiatrist wishes to demonstrate two claims with this study – that such therapy is completely safe for the patients and that LSD can help the terminally ill to cope better with their fate. The challenges are great, but so are the hopes. The last word uttered by Aldous Huxley before he died was “Yes”.

Interview in box

“As therapist, I’m the driving instructor; it is the patient who steers”

The psychiatrist from Solothurn, Peter Gasser, explains the effect that LSD should have with very ill patients suffering from extreme anxiety.

Jean-Martin Büttner spoke with Peter Gasser* in Solothurn

You would like to treat terminally ill patients with LSD; what kind of patients are they?

I will not be working with patients in the final phase of life, but with people who expect to die and have an existential need to clarify their lives. These might include cancer patients, but also those who are HIV-positive or suffer from multiple sclerosis. They should all, however, still be able to exercise judgment, i.e. not be too close to dying. How would it be for them to once again experience a condition in which pain doesn’t exist for a certain period of time? Research was already being conducted and good experience obtained in the sixties regarding this indication. So I am continuing from the point at which the research was halted.

LSD is still associated with the risk of bad trips. How do you intend to prevent this for your patients?

Indeed, there are patients who have taken LSD once before and had very bad experiences. The key difference is that we will closely monitor the patients. We will help them to overcome their fears; this can include playing music or physical therapy exercises. In a worst case scenario we would use medication, in other words, sedation. But I have no fears in this respect. The dosage is not very high. Furthermore, we will select patients carefully and thoroughly educate them in advance on medical and psychological aspects.

How can the substance help in the case of such profound fears? Is there not a risk that anxieties may even be reinforced?

I am not treating fear, but rather am conducting a more comprehensive psychotherapy. I am concerned with a holistic approach and this is precisely where LSD can help significantly. Patients can experience the feeling of being connected to their environment, to nature and also to themselves. This can also have an extremely positive effect on their anxieties. Fear is to a great extent associated with lack of trust and uncertainty. An experience like this can help them regain some of this trust. A trip such as this can, it is true, also trigger feelings of fear. The patients will then experience anxiety, but can also experience that anxiety can be overcome.

How do you view the therapist’s role during the LSD session?

In moments such as these as the therapist, I am like a driving instructor. It is the patient who steers and even I don’t know where the journey is leading us. But I can help the patient and, if necessary, grab the wheel.

You claim that LSD also elicits spiritual experiences. What do you mean by this?

I have difficulty with this concept. I practice psychotherapy and must leave promises of spirituality to the mystics and theologians. But it is true that the LSD experience has a spiritual side. What I think is important in this process is the experience of being connected. Not so much in terms of natural religion as the perception of a creator, but as a feeling of connectedness within yourself – the feeling that everything belongs together and has an influence on you. If someone who, in fact, is confronting death, feels the presence of God while under LSD, I am not going to qualify this in any way. But I will not address the issue myself.

Caption under picture:
The possibility of liberation – the experiment is to show whether LSD can help.

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