Altered States of Consciousness.
Tart, Charles (ed.).
New York, 1969. [TC2]
Tart, C.T. Introduction pp.1-6
[TC2 5] The difficulty with studying ASCs by simply experiencing them is that we run as much risk of systematizing our delusions as of discovering truth. When we complement personal experience with scientific method the risk of simply systematizing our delusions is considerably reduced.
Deikman, A.J. Experimental Meditation, pp. 199-218
[TC2 202] Length of the [meditation] session was five minutes on the first day, ten minutes on the second, and 15 on the third and following days. Certain Ss wished to prolong the later sessions of meditation beyond 15 minutes and were allowed to do so. In those cases the sessions lasted from 22 to 33 minutes before S terminated them spontaneously. The 12 meditation sessions for each S were conducted over a period of three weeks.
[TC2 202] The classical literature on meditation emphasizes that instructions themselves are not sufficient to orient a subject adequately in meditation nor to guide him as he progresses in his meditation. The "guru," or teacher, is regarded as absolutely essential for success in attaining enlightenment. In Western religions the need for such a teacher receives less emphasis, but it often appears that the mystic has had a strong apprentice relationship to his spiritual "instructor" or "advisor." Accordingly, this experiment was designed in the belief that E should not be removed from the situation. It was anticipated that unconscious aspects of S's relationship to E would play an important part in the meditation training and, possibly, in the effects observed. No attempt was made to analyze such factors, however.
In the course of the meditation sessions E found it necessary to assume an active role, encouraging Ss to adopt the unfamiliar mode of thinking required and allaying anxiety arising from the experience of strange phenomena. This was done primarily by emphasizing the interesting nature of the phenomena, and by pointing out to Ss that they were capable of limiting the intensity and duration of the effects that occurred.
[TC2 203] Eight unpaid Ss were employed in the experiment. Four performed meditation for twelve sessions and four performed brief meditation control procedures. Ss were normal adults in their thirties or forties, well educated and intelligent. Most had a professional involvement in some phase of psychiatry. They were personally known to E and were selected primarily on the basis of having time available to give to the experiments. None had made a study of the mystic experience, although each recognized that meditation was connected with mystic practice.
[TC2 206] Pleasurable quality: All Ss agreed that the sessions were usually pleasurable, valuable and rewarding. Although one S "forgot" a testing appointment following a significant experience in the previous session, he returned and completed the series. All Ss achieved the 15 minutes or longer meditation period, even those who experienced some anxiety. When displeasure with the procedure occurred, it seemed to be due to (a) anxiety over the loss of controls required, (b) a feeling of failure to perform as expected.
[TC2 209] ln summary, the group of four Ss, taken together, present a continuum ranging from subject A, who had the most intense personal experience and the least difficulties with the method, through subject D, who reported the fewest phenomena and had the greatest difficulty complying with the instructions. Subject D reported phenomena of lower intensity than the other Ss, required more sessions of practice and instruction before she noticed any effects, and did not report any striking individual phenomena. Common to all or most Ss were: (a) perceptual changes relating to the vase (darkening of hue, increased color saturation, loss of the third dimension, changes in size and shape, blurring or dissolving of outlines and movement of the vase itself); (b) development of a personal attachment to the vase; (c) modification of the state of consciousness; (d) increased ability to "keep out" distracting stimuli; and (e) a general feeling that the sessions were pleasurable and valuable. Phenomena which were apparently individual responses to the procedure were: (a) merging and perceptual internalization; (b) radiation with heat effect and se+ual stimulation; (c) dedifferentiation of the landscape; and (d) transfiguration.
[TC2 210] Ss' reports support the hypothesis that the procedure of contemplative meditation is a principal agent in producing the mystic experience. On the basis of the mystic literature, two classifications of mystic experience were distinguished: "sensate" experiences of strong emotion, vivid perception or heightened cognition, and "transcendent" experiences beyond the usual modes of affect, perception or cognition (Deikman, Chapter 2, this book). The reports of these Ss are analogs of the sensate mystic experience and, in the case of subject A, who continued further meditation sessions beyond the conclusion of the experiment itself, a possible preliminary phase to the transcendent state.
Subject B's experience of the landscape in the seventh session ... is similar to descriptions of untrained sensate mystic experience.
[TC2 210] The "luminescence" and "beauty" reported by subject B may be equivalent to "divine glory" as descriptive terms, and if subject B had been a mystic yearning to be touched by God, his vision of the landscape on that day probably would have seemed to him like a divine communion.
[TC2 213] Hypnosis: The experimental procedure and setting suggest a similarity to hypnosis and raise the question of whether the phenomena are due to the same process. As discussed by Gill and Brenman (1959), three of the main features of hypnotic induction are: (a) extensive limitation is placed on S's sensory intake; (b) S's bodily activity is strictly limited; and (c) stimulation is provided of a particular and narrow kind. The first two features are found in the meditation procedure. With regard to the latter point, the music selections played on the background tapes, the simple meditative object, and the repeated instructions might all be viewed as such narrow stimulation. However, the prose and poetry selections were different for each session, were varied in type, and were often rich in meaning. A fourth point mentioned by Gill and Brenman, the attempt to alter the quality of the bodily [TC2 214] awareness of Ss, was not part of the meditation procedure. The absence of this feature is in accord with the absence in the meditative Ss of vivid spontaneous changes in body experience which Gill and Brenman believe are the most prominent phenomena of hypnotic induction. A striking similarity between hypnosis and the meditation experiment concerns the expectations of S. Gill and Brenman wrote, During the course of the steps of any successful hypnotic induction process, the hypnotist progressively persuades the subject that he is gradually losing control of himself and that this control is being responsibly taken over by the hypnotist. Usually implied, though sometimes explicitly stated, is the promise to the subject that if he permits the hypnotist to bring about the deprivations and losses of power we have discussed, he will be rewarded by an unprecedented kind of experience; the precise nature of this experience is usually left ambiguous. Sometimes the implication is that new worlds will be opened to him, providing an emotional adventure of a sort he has never known (Gill & Brenman, 1959, p. 10). All Ss in the present meditation experiment revealed by their comments a more or less vague expectation of this sort. Two of the meditation Ss used the term "hypnotic" to characterize some aspects of their concentration process. Clearly there are certain similarities in the physical setting, the expectations of S and the relationship to E in the two procedures.
In spite of these similarities, the phenomena of meditation seem to represent a state of ego organization different from that associated with hypnosis. The intense affective phenomena often found in the phypnotic induction period did not occur in the meditative sessions. Except for feelings of surprise or fear at the occurrence of a new phenomenon, Ss' emotional intensity could be described as mild. Subject C did experience a combination of physical and mental excitement during the most vivid of the perceptual phenomena but even this does not seem comparable in quality to the more intense hypnotic phenomena "ranging from the relatively minor explosions of uncontrolled weeping to the enactment of waking nightmares on a level of symbolism and with a quantity of feeling very similar to that known to us only in dream-life; poetry, or fairy tales" (Gill & Brenman, 1959, p. 19), found sometimes in the induction period of hypnosis. The surrender of will power, which is the cardinal feature of the hypnotic state, is encountered in meditation only insofar as S renounces his normal intellectual activities Ñ he does not consciously feel that he is turning control over to E. As in hypnosis, this renunciation itself is undertaken voluntarily, but the meditation Ss seem always to have been aware that they were able to bring themselves back at any time that they wished, whereas in the hypnotic state fluctuations in the depth of hypnosis appear to take place involuntarily (Brenman, Gill & Knight, 1952).
The basic difference between hypnosis and the classical mystic experience [TC2 215] is the difference in the experience itself. Hypnotic experiences do not appear to have the ineffable, profound, uplifting, highly valued quality of the mystic state and are not remembered as such. It may be argued that the difference is a function of suggestion. Orne has studied the nature of the hypnotic process and proposes that "the behavioral characteristics of hypnosis can be understood in terms of the subject's previous knowledge and the cues transmitted during the process of induction" (Orne, 1962b, p.1098). The hypothesis might be advanced that the phenomena of experimental meditation and of the mystic experience in general represent, as Orne suggests of hypnosis, "an historically developed artifact occurring along with a process, the essential behavioral manifestations of which are little known" (1962b, p.1098). Thus the difference between hypnosis and contemplative meditation might lie in the differing expectations of Ss and the "demand characteristics" of the two situations. Coe (1917, p. 253) has pointed out that the form and content of the mystic experience is usually congruent with the mystics' cultural and religious background; to put it simply, a Yogin will have a Nirvana experience, while a Roman Catholic will report communion with Christ. Such an hypothesis of demand characteristics, however, is not consistent with the fact that the highest mystic experiences are similar in their basic content despite wide differences in cultural backgrounds and expectations. These similarities are: (a) the feeling of incommunicability; (b) transcendence of sense modalities; (c) absence of specific content such as images or ideas; and (d) feeling of unity with the Ultimate. Lower forms of mystic experience do embody specific content related to each S's beliefs, and the absence of religious motifs from the accounts of Ss performing meditation as a psychological experiment indicates a definite role of S-expectation in determining the presence of or absence of the secondary features of mystic experiences. However, the phenomena common to all Ss do not permit such an explanation. Also, there are reasons for believing that the idiosyncratic phenomena, such as "merging," were neither a function of Ss' knowledge of the role of meditator, nor of the total demand characteristics imposed by the experimenter and the experimental design. To begin with, the occurrence of the phenomena of "merging," "radiation" and the like surprised both S and E. One S was sufficiently alarmed to end the phenomena by shifting her attention. On the other hand, the"deautomatization" effect was not noticed by subject B as being a special event, whereas it seemed of great significance to E. In addition, the two Ss (A and C) who took to the procedure with greatest facility and interest, developed markedly different effects. Finally the later experience of subject A, clearly a further development of "merging," appears to be a preliminary phase of the Unity phenomenon of the transcendent mystic experience. This S had no conscious knowledge of the mystic literature and her retrospective [TC2 216] account emphasized the strangeness, the unexpectedness and the startling quality of her experience.
The considerations discussed above do not rule out the presence of unconscious expectations on the part of Ss, nor unconscious as well as explicit expectations of the part of E. For the reasons given, however, it seems that the phenomena cannot be adequately explained as due to suggestion, and a careful examination of the transcripts gives one the strong impression that a unique process is involved.
[TC2 218] A most striking finding of the meditation experiment is the ease and rapidity with which the phenomena were produced. Comparable phenomena have required more or less elaborate procedures of sensory deprivation or the use of potent drugs. In this study a natural environment was employed and the process was performed by Ss themselves. In less than half an hour, phenomena occurred that in other contexts have been described as "depersonalization," "hallucination," "delusion" or "visual distortion," "intensification" and the like. Such rapid, intense effects point to a capacity, under minimal stress conditions, for alteration in the perception of the world and of the self far greater than what is customarily assumed to be the case for normal people.
W. Kretschmer. Meditative Techniques in Psychotherapy, pp. 219-231
[TC2 219] The psychotherapist who wants to employ techniques of meditation must first be able to meditate himself. The book by the German psychiatrist, J. H. Schultz (Schultz, 1953, 1956; see Schultz and Luthe, 1959, for English translation) offers a step-by-step introduction to one technique of meditation. However, with meditation, as with psychotherapy, a study of the literature is seldom enough. A personal dedication is necessary. Without it, individual practice of meditation can be dangerous; especially the advanced stages of genuine meditation described by Schultz. In these advanced stages, after a general bodily relaxation has been achieved, symbolic fantasies are skillfully induced. Then colors and objects are visualized. One endeavors to experience a symbolic representation of ideas which are understood only abstractly, of one's feelings, of friends, and finally of higher moral questions, in a way which allows the psyche to make unconscious tendencies symbolically visible. Dreams are similar to meditation, except meditation gains the reaction of the unconscious by a systematic technique which is faster than depending on dreams.
But the Schultz technique only serves to raise, with a special emphasis, the question, "What is the goal of meditation?" Schultz sees this question clearly, but that this question is basically a religious one, or at least [TC2 220] connected with religion, Schultz does not conclude. Therefore, he limits himself to the formulation of "basic existential values." This means the meditator is encouraged to strive toward a reasonable view of life orientated toward self-realization, psychic freedom and harmony, and a lively creativity. At best, one achieves a Nirvana-like phenomena of joy and release. Maybe Schultz conceals decisive experiences which go further; because of the basically unlimited possibilities of meditation, we can always await such an extension of his ideas.
The technique developed by Carl Happich, the former Darmstadt internist, is meditation of the most systematic kind, and also of the widest human scope. It begins with physiology and ends in religion. Happich developed it out of his literary and practical knowledge of Oriental techniques. He combined their wisdom with the experience of modern depth psychology. He set forth his fundamental principles in two small works (Happich, 1932, 1939), and beyond these left only a small Introduction to meditation (Happich, 1948), which is concerned with religious symbolism. Unfortunately, he did not live to set forth his life experiences in a grand scientific frame. His importance lies, above all, in the practical techniques which he began to spread among theologians when physicians demonstrated no interest in them.
Happich took the level of consciousness he called "symbolic consciousness," which seems to lie between consciousness and unconsciousness, as the point of departure for all creative production and, therefore, also for the healing process. On this level the "collective unconscious" can express itself through symbolism. It is in the activation of the possibilities of symbolic expression that Happich, as Schultz, sees [as] the point of departure for meditation and its therapeutic possibilities.
How can we proceed practically? Assumed, as always, is the bodily solution which is attained systematically with the Schultz method or by more direct means. Happich placed great value in breathing as a graduated measure of the affective states which alters itself in the permissiveness of meditation. He encouraged, both before and during the therapeutic session, an increasing passivity of respiration. Most men can only achieve this through progressive breathing exercises.
After some experience with physiological reactions to breathing exercises has been gained, the first psychological exercise, the so-called "Meadow Meditation," can be attempted. The meditator must repeat to himself the words of his meditation-master and imagine that he (the meditator) leaves the room, goes through the city, over the fields, to a meadow covered with fresh grass and flowers and looks upon the meadow with pleasure. Then, he psychically returns the same way to the room, opens his eyes, and relates what he has experienced. When this exercise can be done freely (which [TC2 221] usually requires a number of sittings) it is followed by the "Mountain Meditation."
The meditator, as in the first meditation, goes into the country and then slowly climbs a mountain. He passes through a forest, and finally reaches a peak from which he can view a wide expanse. In the third step, the "Chapel Meditation" is explored. In it, the meditator passes through a grove and reaches a chapel which he enters and where he remains for a long time. Lastly, Happich has the meditator imagine himself sitting on a bench by an old fountain listening to the murmur of the water.
What does all this mean? One who is familiar with dream symbolism knows immediately that the three central symbols (meadow, mountain, and chapel) to which the meditator is led have an "archetypal" significance even though, in everyday life, they are quite ordinary and in no way help to bring about an especially deep knowledge.
However, when a certain depth of meditation is attained, such symbols lose their ordinary meaning and their symbolical value is slowly revealed. As the meditator returns to the meadow, he does not experience things as he would in the ordinary world. Rather the meadow provides a symbol of the hypnotic level of consciousness and stimulates the emotions on this level. The individual takes an ordinary situation as the means of experiencing the primordial content of the symbol of the meadow. The meadow presents youthful Mother Nature in her serene and beneficent aspect. In contrast a forest is also inhabited by demons. The meadow represents the blossoming of life which the meditator seeks. It also represents the world of the child. When one meditates on the symbol of the meadow, he regresses to his psychic origin in childhood. Once there, he does not uncover se+ual dreams of his childhood as might be expected. Nor does he find a "stump," which can also be a meaningful symbol. Rather he returns to the positive, creative basis of his life.
Every healthy man has in his psychic depths something corresponding to this meadow. He retains with him an active and creative "child." As the realm of this "child" is revealed through meditation on the symbol of the meadow, the meadow becomes a point of departure and crystallization for other symbols related to this psychic realm. These self-crystallized symbols are unmeditated expressions of the individual's adaptation to the realm of the "child" within his psyche. A healthy man will have a satisfying experience of a meadow in the flush of spring. He will populate the meadow with children or with the form of an agreeable woman. He will, perhaps, pick flowers and so on. In this way, the meditator discovers a symbolic representation of his psychic condition.
The psychically ill find it impossible to visualize a fresh meadow and during meditation cannot find one. Or the meadow may be seen as wilted or [TC2 222] composed of a single stump. Or all sorts of disturbing, negative symbols may be scattered around. From such manifestations of illness, one gains a diagnosis which must then be translated into a therapy. Often, the meditation must be repeated many times until the crippling effects of the fundamental psychic problem are undone and the meditation can proceed normally. Analytic conversation with the psychotherapist normally aids the whole process.
In climbing the mountain, the meditator will generally symbolize some obstacle in his way so that he must prove himself. Climbing in this psychic sphere always implies "sublimation," in the Jungian rather than the Freudian use of the term. The words transformation, spiritualization, or humanization might convey the idea better than the word "sublimation." In any case, the climbing is a symbol of a movement during which man demonstrates his capacity to develop toward the goal of psychic freedom, the peak of human being. The passage through the forest on the way up the mountain gives the meditator the opportunity to reconcile himself with the dark, fearful side of nature.
With the symbol of the chapel, the meditator is led into the innermost rooms of his psyche where he faces the simple question of how he relates to the possibilities of psychic transformation within man. When the meditator is able to comprehend the symbolic significance of the chapel, he can learn to use it to uncover and face in himself the central problems of human life. The chapel also provides a stage on which the resolution of these central human problems can be symbolically revealed. It is Happich's idea that the "religious function" is the most intimate and not an invisible factor in human life. Further, he believed that man, if he will be really healthy and psychically free, sometime and somehow must face these questions. One cannot avoid the fact that the special efficacy of Happich's therapy was the result of his religious attitude. He developed a Christian meditation.
That his system of meditation is based on sound psychological principles is confirmed by the work of the Jungian school. Dreams have been recorded where a mountain is seen in a landscape and on the mountain stands a church. Such symbolic pictures have been valued psychically as an indication of the end of the process of "individuation," as a symbol of the attainment of "spirituality." But in meditation one does not wait until the needed symbols are produced spontaneously, as during dream analysis. Rather, the meditator is forced to occupy himself with certain symbols selected by the therapist until he has explored the fullness of their meaning.
Happich directed his meditators to a higher step which he called "Design (or Mandala, a Sanskrit word literally meaning circle, but more specifically an abstract design used especially in Tibetan Buddhism as a stimulus during meditation) Meditation." The design which is meditated upon is a [TC2 223] kind of condensation, an abstraction of many symbols which are united into a generalized form. In the course of meditation on these designs, the meaning of the inherent symbolism can become obvious. With Mandala Meditation, the goal is not production of extensive fantasy, but rather a lively meditation revolving around the central meaning of the design. Eventually, the meditator is directed to psychically identify himself with the symbol and to integrate the meaning of the symbol with his psychic life. Properly speaking, these designs are not used as a technique of therapy, but rather in furthering the highest development of personality. An example of what can be experienced through meditation on a design can be read in the opening of Geothe's Faust, where Faust beholds the design ofthe macrocosmos.
A still more abstract form of meditation is "Word Meditation," directed toward unfolding the central human importance of a word or a saying. Meditation on designs and words are of the greatest importance in furthering religious development.
Happich holds the healthy principle of the equality of rational and irrational activity during the course of meditation.
On the other hand, one should not meditate on symbols or designs which stimulate dangerous negative emotions, as for example, a snake or a scorpion. The subject of meditation should be purified through thousands of years' experience of the wisest men, and be of proven value as is the case with many Egyptian, Hindu, and German symbols and also the holy symbols of the Greek church. The first requirement of such symbols is the impression of their positive transforming power, which can be regulated by man's psyche.
R. Desoille, a Frenchman, described one of the newest and most original techniques (Desoille, 1945, 1947, 1950). His procedure is not meditation in the classical sense. The emphasis is shifted toward more conventional depth psychology. But it deserves discussion as a technique of actively relating to the unconscious.
Desoille treats his patients in a state of limited consciousness, in which he suggests that symbols be plastically visualized and actively experienced. He directs his patients to psychically wander wherever they choose, availing themselves of any means, a kind of wandering into which most patients soon fall. They experience, for example, the climbing of a mountain or a tower, ascent into the clouds, etc. Especially important is the climbing, for reasons already discussed. In this wandering, all possible hindrances are eliminated. As in dreams, various symbolic forms are manifested from the "personal and collective unconscious"in both auspicious and horrible aspects. Meeting "archetypal" symbols is considered especially effective. The patient relates his psychic experiences as he has them, and the turning [TC2 224] point of the method is the therapist's reaction to them. As he is informed in each moment of the psychological scene, the therapist suggests to the patient a symbolic means of changing his (the patient's) situation by climbing or descending. The therapist does not suggest the whole fantasy; rather, he gives only a direction and maintains control of the fantasy by offering helpful symbols which can serve as points of crystallization for the fantasy. The technique is a good one. In the climb, Desoille realizes and makes use of the human ability for creative sublimation. In the descent, the patient comes to know psychic productions from the sphere of man's instinctual nature. The patient is led to the psychological execution of what Goethe poetically described as the way "from heaven through the world to hell." In other words, he penetrates through the patient's whole psychic report and provides symbolic expressions of inherent libidinal tendencies which motivate men on various psychic levels. Decisive for Desoille is the experience of meeting the "archetypes" which lead man to the absolutes of existence and the last decision, a decision of absolute and vast importance.
Desoille's valuation of the "collective unconscious" is more radical and consequential than Jung's; in this he (Desoille) holds that the meeting with the "collective unconscious" is a decisive and unavoidable presupposition of the therapeutic process.
Desoille holds that when the patient can relate himself to the "archetypes of the collective unconscious," he can find in them the appropriate adjustment to the problems of life. The patient must learn to control the "archetypes" within himself, to be free from them, and thereby lose his fear of them. He can then comprehend and resolve his personal conflicts within the larger context of man's inherent problems. Thus, the patient experiences his personal conflicts as having an impersonal and collective background. The motivational (libidinal) conflict is not resolved by being transferred upon the therapist, as in psychoanalysis; rather, the patient uncovers, in himself, the basic roots of the conflict. The goal of the technique is to direct the patient toward the fulfillment of his human potentialities through the creative development of man's basic biological impulses into a higher and harmonic order. With this idea, Desoille enters the realm of ethics and religion. Religious sensitivity is, for Desoille, the highest psychic state and the source of great activity.
Desoille's techniques require the therapist to possess a rare knowledge and understanding of symbolism and great psychological intuition in order to evaluate the waking dreams of his patients and to retain control of the process of psychological development which the waking dreams initiate.
The technique is, in a unique way, both diagnostic and therapeutic and the seemingly irrational procedure is worthy of note. Penetration of the [TC2 225] psychic situation using reasonable conversation is given up. The therapeutic principle lies in the acceleration and furthering of effective development. It is a healing process which seeks the maximum transcendence of psychic limitations through symbolic ascensions and descensions. In this simple but most important principle, an earnest reminder can also be seen. Any therapist who would lead others to psychic heights and depths must, himself, be able to attain these heights and depths of the psyche. Contemporary psychotherapists will have to begin by training themselves to ascend and descend through their own psyche and thereby experience the manifold components within man and the driving forces behind human life. Who will accept Desoille's hypothesis and begin to look up and climb?
Walter Frederking calls his psychotherapeutic technique "Deep relaxation and symbolism" (Frederking, 1948). Frederking's technique is unsystematic, which implies nothing about its value.
Frederking also seeks freedom from dependence upon dreams by stimulating the unconscious to spontaneous productions of other kinds. To do this, he directs his patients in a progressive bodily relaxation during which they continue to describe their discoveries. One could also say he simply allows fantasy. The patient soon progresses from unclear visions to increasingly clearer productions of a kind of "symbolic strip thought." This symbolic thought, which has a significance similar to dream life, is allowed to flow by, scene by scene. The patient is both the playwright and the actors. He meets the contents of his "personal unconscious'' and, to a degree, the "collective unconscious" and is able to relate their contents directly and dramatically to his psychic problems. One could also say that the patient is directed to enter "hell" to conquer the fiendish demons. This meeting with generally unrecognized aspects of himself brings about a spontaneous healing through various transforming symbols. Frederking holds that "in dreams and symbols man is led through every sphere ofthe psyche, during which the forms of psychic force are able to resolve themselves without the use of other means and deep-going transformations are effected."
Frederking also allows the therapy to be regulated by the autonomous healing force of the psyche. The technique is also irrational. Frederking knows, as all who work in these spheres know, that the therapist is in no way indifferent during the course of the therapy. It is true that he only occasionally interjects himself to clarify and point out the course of the healing. But the therapist knows that the patient can only experience the most favorably significant symbols at his own opportunity. Although the therapist remains essentially passive and does not interfere, the patient is still in the therapist's psychic field and may receive direction or formulation of impulses.
[TC2 226] Friedrich Mauz has described another technique (Mauz, 1948). This technique is not meditation in the strictest sense, but it is related to it in many ways. With psychotics, the previously described methods are very dangerous and, therefore, rejected. Accordingly, the Mauz method is a severely restricted form of meditation in which the unconscious is most carefully tackled and channelled into productive performance.
Manz does not mention preference for any technical preparation. The technique develops directly out of conversation considering the role of conditioned reflexes occurring daily at the same time. This conversation is almost a monologue in which the therapist depicts the patient in plastic and sympathy-evoking representative pictures from childhood; the experience of a procession, Christmas celebration in the family, a children's song, etc. The depiction must have, for the patient, an appropriate and intuitive power as a "solvent picture." It should unlock and enliven the suppressed emotions of the psychotic so that later a real conversation can develop.
Manz aims, as does meditation in other respects, at the emotional level of the patient. Basically, he also leads the patient to the Happich childhood meadow, the creative ground of the psyche. But rather than wait for the patient to produce, Manz impregnates the meadow with symbols he knows will awaken positive feelings and meanings within the patient, such as the "security" of childhood with its guiltless pleasures. Through such feelings and symbols, the psychotic can again connect with the world around him. The creative power which flows from these feelings and symbols aids in closing the breach in the patient's personality.
It is noteworthy how Manz describes important fundamental principles of meditation which he apparently discovered completely intuitively in genuine human behavior. The symbolic scene is the effector of the therapy, but only if it is experienced as real and actual; that is, as in meditation. "The picture must be personal and impersonal at the same time." It leads into the "sphere" of impersonal knowledge and reality." "All that is loud, obtrusive, and harsh must be avoided." The decisive experiences of the past present themselves in the stillness. We must "identify ourselves with the psychotic opposites." "The therapist mixes himself into a common solution with the patient and aliows his own comfort to wait." One could say that the therapist must meditate on the patient. He must allow himself to be caught by the patient as the patient is caught by formulations of their psychic power. This is the mystical unity between the therapist and the sick. One must "not only analyze the illness," but also "know the possible health.'' The therapist must have before him a conception of the completely harmonic man and seek where he can find it again to develop it.
[TC2 227] What happens here is biologically and ethically one. "The emotion of security," says Mauz, "is both vegetative and psychic." With this idea Mauz grasps the whole anthropological aspect of therapy.
Decisive for Manz before all else, is "the simple human relationship." It appears most significant to the writer that a professional scientist like Mauz comes through his experience with meditation with the conclusion that "humanness" is the highest principle of therapy, an idea which is still far from scientific medicine today.
Now to gather together the viewpoints which characterize and are combined in the various techniques. All involve the active provocation of the unconscious, as the writer wishes to call it, in which the therapist chiefly has the function of a "birth helper." The patient is directed to place himself in relation to his unconscious, and thus make its creative possibilities available in the healing process. In contrast with the conscious, passive attitude employed in analytical methods of treatment, one takes an active, conscious, and oriented part in the healing process when using meditative techniques. Also in contrast with analytical methods, the meditative technique strives for a goal-directed, but individually adapted, formulation of man's nature in which a picture of the transformed man stands in the background. In this respect, Frederking is a relative exception. In contrast with the analytical-psychological techniques, the basic exercises of meditation are not only applicable to healthy men, but are very useful.
There is a value in the analysis of abnormality. Emphasis on the analytical is usually emphasis on our psychic past. During meditation, there is more dependence on the tendency toward health in the psyche. The orientation is synthetic rather than analytic.
Meditation helps the patient to an expanded consciousness and impersonal experience and knowledge. Meditation has an advantage in that it allows the transition to religious problems to consummate itself in a completely natural way. The course of therapy is shorter with meditation because one is not dependent upon the mood of dreams and comes more quickly, both diagnostically and therapeutically, to the psychic conflict. Finally, with meditation, the patient does not ordinarily transfer his problem onto the therapist and, therefore, the resolution of transference is usually unnecessary.
Opposed to the great range and efficiency of meditation is only one severe limitation. Meditation is limited by the subjectivity of both the therapist and the patient. Not without purpose are all the described experiences ascribed to a creator which none of the important schools has equalled. Unfortunately, each successful therapist forms his own school. Desoille and Mauz certainly demonstrate most unusual intuitions and artistic ability. Not every patient is equally able to fruitfully experience [TC2 228] the deeper levels of the psyche. Decisive is the problem of the psychic field of force described by Heyer, which is valid for all techniques which explore the deeper levels of the psyche. If the patient would resolve his intimate psychic problems, he must bring the symbols which expose them, either in dreams or in meditation, into higher levels of consciousness. Stimulation of the deeper levels of the unconscious is the art of psychotherapy, which really can be described only by the unscientific term "exorcism." Exorcism is not only the result of a learnable technique, but is rather the result of the whole personal influence of the therapist on the patient. Therefore, with all these techniques, competent therapists are required. With one therapist, the patient may experience only the most banal contents of his unconscious; and with another, the patient may have a decisive experience of psychic depths. Thus, the psychotherapist must have a sense of vocation as well as a technique. A sense of vocation is the consequence of natural gifts and skill. Such skill is not learned as a craft nor as a medical training, but rather through personal skill as it develops in the relationship between master and disciple. Great psychotherapy is unique and cannot be copied any more than a work of art. It is because the work of a master cannot be copied that one can learn from him.
Meditation has a good chance of eventually becoming one of the leading therapeutic techniques. [really???] All the newer systems with which the writer is familiar look for a development in this direction. But whether or not this development takes place depends completely on a deep-going reformulation of psychotherapeutic training and the practice of psychotherapy. It is of the greatest importance whether psychotherapy continues to be sought in the direction of meditation. We can only hope that psychotherapy will continue to develop into a genuine technique which can aid men in their goal of developing their highest psychic potentialities.
Shor, R. Hypnosis and the concept of the generalized reality-orientation. pp. 233-250
[TC2 243] Hypnosis is a complex of two fundamental processes. The first is the construction of a special, temporary orientation to a small range of preoccupations and the second is the relative fading of the generalized reality-orientation into nonfunctional awareness.
[TC2 244] Hypnosis ... is not unique in manifesting these two processes. Unlike related conditions, however, hypnosis has the character of occurring within a special kind of interpersonal situation where the task at hand (the special orientation) is to produce certain expected phenomena and act like a hypnotic subject. When the task at hand is instead a personal preoccupation in a small range of interests, the resultant complex is not labelled hypnosis but rather absent-mindedness, or daydreaming, or intense meditation.
[TC2 246] When the generalized reality-orientation fades (a) various mental contents excluded before can now flow more freely into phenomenal awareness, and (b) primary-process modes of thought may flow into the background of awareness to orient experiences. ...as the usual reality-orientation fades, its derivative distinctions between wishes, self, other, imagination and reality fade with it, as do many inhibitions, conscious fears and defenses, and primary-process material and primary-process modes of thought can flow more easily into awareness, and if they do, a new kind of orientation is created which shares some of the qualities of the dream. Thus, trance states can be in much greater communication with an individuals unconscious functioning than in the usual waking [TC2 247] state, and it is not surprising that nonconscious strivings may be more easily implemented.
[TC2 247] To the extent that the usual reality-orientation fades from the background of awareness, the greater the possibility that other experiences will occur which could not have fit into the usual reality-orientation, the greater the possibility that new, special orientations may be constructed at profound levels without recourse to the logic, knowledge, and critical functions of the usual reality-orientation, and the greater the possibility that primitive, syncretic contents and modes of thought will come into awareness.
[TC2 248] ...distinction between trance and hypnosis [and meditation]. Trance is the superordinate concept used to refer to states of mind characterized by the relative unawareness and nonfunctioning of the. Hypnosis is a special form of trance developed in Western civilization, achieved via motivated role-taking, and characterized by the production of a special, new orientation to a range of preoccupations. [If I rephrase it like: Meditation (and sannyas) is a special form of trance developed in Eastern civilization, achieved via motivated role-taking, and characterized by the production of a special, new orientation to a range of preoccupations, it sounds almost like becoming a sadhu! Sadhuism as a permanent hypnotic state.]
[TC2 253] Trance depth is the extent to which the usual generalized reality-orientation has faded into nonfunctional awareness.  Trance, so defined, is not a strange mystic occurrence happening only in hypnosis, religious ecstacies, and such esoterica. Trance becomes seen as a daily, commonplace occurrence, a somewhat larger way of conceptualizing selective attention, and as familiar as the chaotic oblivion of the mind during sleep.
[TC2 254] Depth of archaic involvement is (a) the extent to which during the hypnosis archaic object relationships are formed onto the person of the hypnotist; (b) the extent to which a special hypnotic transference relationship is formed onto the person of the hypnotist; (c) the extent to which the core of the subjects personality is involved in the hypnotic processes.
[TC2 254] [transference, etc. is]...unconscious fixation of the libido on the person of the hypnotizer by means of the masochistic component of the se+ual instinct; nostalgic reversion to that phase of life when passive-receptive mastery represented the primary means of coping with the outside world; an appeal to that universal core which longs for wholesale abdication, unconditional obedience; security through participation in the limitless powers of the all-powerful parent; the evocation of archaic, infantile wish-fantasies regarding the parent-like magic omnipotence of the hypnotist.
Autogenic Training: Method, Research, and Application in Medicine Luthe, Wolfgang. [TC2 309-319]
[TC2 309] Autogenic training is a psychophysiologic form of psychotherapy which the patient carries out himself by using passive concentration upon certain combinations of psychophysiologically adapted stimuli. In contrast to the other methods of psychotherapy, autogenic training approaches and involves mental and bodily functions simultaneously. Passive concentration on Autogenic Standard Formulas can be so tailored that a normalizing influence upon various bodily and mental functions will result. From a neurophysiologic point of view there is clinical and experimental evidence indicating that certain changes of corticodiencephalic interrelations are the functional core around which autogenic training revolves (Schultz & Luthe, 1959).
About 40 years ago the founder of the method, J. H. Schultz, psychiatrist and neurologist in Berlin, wrote the first publications about clinical and experimental observations of what he called "autogenic organ exercises" (1926a,b). In 1932, the first edition of Autogenic Training became available (Schultz, 1932). Since then, 10 German editions have appeared, translations into Spanish (1954), Norwegian (1956), and French (1958), [TC2 310] as well as a recent American edition (1959). During the last three decades autogenic training has become widely known in Europe and today it is regarded as a valuable standard therapy in various fields of medicine. It has also been integrated into the training programs of many universities (Schultz & Luthe,1959;Durand de Bousingen, (1962a),1962; Luthe,1962a; Muller-Hegemann,&Kohler,1961 ;Muller-Hegemann&Kohler-Hoppe,1962).
The steady increase of interest in autogenic training is reflected by the progressively increasing number of publications of a clinical and experimental nature (Luthe, in Stokvis, Ed., 1960). During each of the last three years more than 100 articles on the subject were published in medical journals and books. It is interesting, however, that only about I per cent of a total of about 1,000 publications were written by English speaking authors (Schultz & Luthe, 1959).
Background Of The Method
The beginning of autogenic training stems from research on sleep and hypnosis carried out in the Berlin Institute of the renowned brain physiologist Oskar Vogt during the years 1890 to 1900. Vogt observed that intelligent patients who had undergone a series of hypnotic sessions under his guidance were able to put themselves for a self-determined period of time into a state which appeared to be very similar to a hypnotic state. His patients reported that these "autohypnotic" exercises had a remarkable recuperative effect (Schultz & Luthe, 1959, 1961).
At the time he observed that these short-term mental exercises, when practiced a few times during the day, reduced stressor effects like fatigue and tension. Other disturbing manifestations, as, for example, headaches, could be avoided and the impression was gained that one's over-all efficiency could be enhanced. On the basis of these observations Vogt considered such self-directed mental exercises to be of definite clinical value. He called them "prophylactic rest-autohypnoses" (Prophylaktische Ruhe-Autohypnosen).
Stimulated by Vogt's work (Schultz,1951)J. H. Schultz became interested in exploring the potentialities of autosuggestions. His aim was to find a psychotherapeutic approach which would reduce or eliminate the unfavorable implications of contemporary hypnotherapy, such as the passivity of the patient and his dependency on the therapist.
During subsequent years, while investigating the question of hallucinations in normal persons, Schultz collected data which appeared to link up with Vogt's prophylactic mental exercises (1932). Many of Schultz's hypnotized subjects reported to have experienced, almost invariably, two types of sensations: a feeling of heaviness in the extremities often involving the whole body and frequently associated with a feeling of agreeable warmth. [TC2 311] Schultz concluded that the psychophysiologic phenomena related to the experience of heaviness and warmth were essential factors in bringing about the changes from the normal to a hypnotic state.
The next question was whether a person could induce a psychophysiologic state similar to a hypnotic state by merely thinking of heaviness and warmth in the limbs. The systematic pursuit of this question was the actual beginning of autogenic training. Under certain technical circumstances and by the use of passive concentration on verbal formulas implying heaviness and warmth in the extremities, Schultz's subjects were able to induce such a state, which appeared to be similar to a hypnotic state.
The self-directed nature of the approach had a number of clinical advantages over the conventional techniques of hypnosis, among them, the active role and the responsibility of the patient in applying the treatment and the elimination of dependence on the hypnotist.
From Schultz's clinical work a number of useful verbal formulas gradually evolved which, according to their more bodily or mental orientation, formed two basic series of mental exercises: the Standard Exercises and the Meditative Exercises.
The six standard exercises are physiologically oriented. The verbal content of the standard formulas is focused on the neuromuscular system (heaviness) and the vasomotor system (warmth); on the heart, the respiratory mechanism, warmth in the abdominal area, and cooling of the forehead.
The meditative exercises are composed of a series of seven exercises which focus primarily on certain mental functions and are reserved for trainees who master the standard exercises.
Later, as more clinical and experimental data became available, a number of complementary exercises specifically designed for normalization of certain pathofunctional deviations evolved. These were called special exercises.
Psychophysiologically, autogenic training is based on three main principles: (a) reduction of exteroceptive and proprioceptive afferent stimulation; (b) mental repetition of psychophysiologically adapted verbal formulas; and (c) mental activity conceived as "passive concentration."
A reduction of afferent stimuli requires observation of the following points: the exercise should take place in a quiet room with moderate temperature and reduced illumination; restricting clothes should be loosened or removed; the body must be relaxed, and the eyes closed, before the mental exercises are begun. Three distinctive postures have been found adequate: (a) the horizontal posture; (b) the reclined arm-chair posture; and (c) the simple sitting posture. All three training postures require careful [TC2 312] consideration of a number of points. When certain details are not observed, disagreeable side-effects or after-effects and ineffective performance of the exercises have been reported.
The first exercise of the autogenic standard series aims at muscular relaxation. The functional theme of the verbal formula is heaviness. Right-handed persons should start out with passive concentration on "My right arm is heavy." Left-handed persons should begin with focusing on the left arm.
During the very first exercises about 40 per cent of all trainees will experience a feeling of heaviness predominantly in the forearm. During subsequent periods of regular training, the whole arm becomes heavy and the feeling of heaviness will spread to other extremities. This spreading of a certain sensation (the heaviness, tingling, warmth) to other parts of the body is called the "generalization phenomenon." Along with the development of the generalization phenomenon, passive concentration on heaviness will be extended to the other arm or the homolateral leg. Usually the heaviness training continues until heaviness can be experienced more or less regularly in all extremities. This may be achieved within two to eight weeks. Clinical investigations of larger groups of trainees, however, indicate that about 10 per cent of the patients do not experience a sensation of heaviness. This fact is one of the reasons why patients should be told that the Heaviness Formula (and others) functions merely as a technical key to bring about many different functional changes in the brain and bodily system, and that a sensation of heaviness may or may not occur.
Furthermore, it has been found helpful to tell a patient that many changes of bodily functions occur (see section on experimental data) which one cannot feel. It is also important for the patient to know that according to experimental observations, the exercises are effective as long as they are performed correctly, even if one does not feel anything at all. Apart from this it is necessary that the therapist is familiar with the therapeutic problems resulting from different forms of autogenic discharges which may start while the patient is in an autogenic state (Geissmann, Jus, & Luthe, 1961; Luthe, Jus, & Geissmann, 1962).
Subsequently, passive concentration on warmth is added, starting, for example with "My right arm is warm." This formula aims at peripheral vasodilation. Depending on the generalization of the feeling of warmth in other limbs, the training progresses until all extremities become regularly heavy and warm. This training may take another period of from two to eight weeks.
After having learned to establish the feeling of heaviness and warmth, the trainee continues with passive concentration on cardiac activity by using the formula "Heartbeat calm and regular." Then follows the respiratory mechanism with "It breathes me," and warmth in the abdominal region: [TC2 313] "My solar plexus is warm." The final exercise ofthe physiologically oriented standard exercises concerns the cranial region which should be cooler than the rest of the body. Here, one applies the formula "My forehead is cool."
The time usually needed to establish these exercises effectively varies between four and ten months.
The trainee's attitude, while repeating a formula in his mind, is conceived as "passsive concentration." Passive concentration may best be explained in comparison with what is usually called "active concentration." Concentration in the usual sense has been defined as "the fixation of attention," or "high degrees of intensity of attention," or "the centering of attention on certain parts of experience." This type of mental activity involves the person's concern, his interest, attention, and goal-directed investment of mental energy and effort during the performance of a task and in respect to the functional result.
In contrast, passive concentration implies a casual attitude during the performance and with regard to the functional result. Any goal-directed effort, active interest, or apprehensiveness must be avoided. The trainee's casual and passive attitude toward the psychophysiologic effects of a given formula is regarded as one of the most important factors of the autogenic approach. Furthermore, the effectiveness of passive concentration on a given formula depends on two other factors namely (a) the mental contact with the part of the body indicated by the formula (for example, the right arm); and (b) keeping up a steady flow of a filmlike (verbal, acoustic or visual) representation of the autogenic formula in one's mind. Passive concentration on a formula should not last more than 30 to 60 seconds in the beginning. After several weeks the exercises may be extended to three or five minutes; after a few months up to 30 minutes and longer.
The state of passive concentration is terminated by applying a three-step procedure, namely (a) flexing the arms energetically, then (b) breathing deeply, and (c) opening the eyes. Usually three exercises are performed in sequence, with about a one minute interval between each of them.
After the standard exercises have been mastered satisfactorily, one may train to modify the pain threshold in certain parts of the body or train the time sense for waking up at a specific time. The therapy may be continued by applying autogenic principles for approaching specific functional disorders or even certain organic diseases. A number of special formulas and procedures have been worked out for meeting the therapeutic requirements of various functional and organic disorders like bronchial asthma, writer's cramp, hemorrhoids, brain injuries, esophagospasm, pruritus and others.
The meditative exercises should not normally be started until after six to 12 months of standard training, and the trainee should be able to prolong [TC2 314] the autogenic state up to 40 minutes without experiencing any disagreeable side-effects or after-effects.
The meditative series begins with passive concentration on phenomena of visual imagination, as, for example, the spontaneous experience of certain colors. Later, the trainee may focus on seeing all colors at will. When that is achieved, the meditative series continues with visual imagination of objects. This training phase may take several weeks before results are obtained. It is followed by imagining abstract concepts like "happiness" or "justice" in different sens-al modalities (musical, chromatic, plastic). Still later, one may meditate on one's own feelings and, in contrast, try to evoke the image of another person. Finally, at the deepest level of meditation, an interogatory attitude may be assumed in expectation of answers from the unconscious.
Autogenic training at the meditative level may be applied as what has been called "Nirvana Therapy" (Schultz,1932. Schultz & Luthe,1961) in clinically hopeless cases(for example, advanced cancer) or in monotonous and desperate situations as may occur under exceptional circumstances. The meditative exercises have also been found to be of particular value in depth-dimensional psychotherapy. In general, it has been observed that the effects of more physiologically oriented standard exercises are reinforced by the meditative training. However, the meditative exercises are not introduced to the average patient. The average clinical therapy centers on the standard formulas in combination with special exercises and intentional formulas specifically designed to meet the therapeutic requirements of relevant functional or organic disorders.
From experimental data and clinical results we know that passive concentration on the standard formulas induces multidimensional changes of a mental and organismic nature. In principle, two categories of effects may be distinguished: immediate effects, occurring during passive concentration on the different formulas, and effects resulting from practice of autogenic exercises over periods of weeks and months. Information about the immediate effects during the exercises is still incomplete. However, the experimental data available indicate clearly that each of the standard formulas induces physiologic changes of certain autonomic functions which are coordinated by diencephalic mechanisms.
During passive concentration on heaviness, Siebenthal (1952), Schultz, (1952), Wittstock (1956), and Eiff and Jorgens (1961) recorded a significant decrease of muscle potentials. Along the same lines Schultz found a significant reduction of the patellar response during passive concentration of heaviness [TC2 315] in both legs (1932). Determinations of motor chronaxie (musc. extensor digit. comm. dexter) by Schultz, Lewy, and Gaszmann (1932, 1961) indicated that the intensity of the stimulus has to be increased during the heaviness exercise because the excitatory threshold rises from its resting value.
Changes in peripheral circulation during passive concentration on heaviness and warmth have been verified by a number of independent authors (Schultz, 1926,1932:Schultz & Luthe,1959; Binswanger,1929; Stovkis, Renes &Landmann,l961). The most extensive study was carried out at the University of Wurzburg by Polzien(1955,1959,1962,a,b.c). Polzien found the rise of skin temperature was more pronounced in distal parts of the extremities than in the more proximal areas. Simultaneously variable changes in the rectal temperature were recorded. Depending upon the subject, and the duration of passive concentration, the increase of skin temperature in the fingers varied between 0.2 and 3.5°C. These findings are in accordance with other results reported by Siebenthal (1952) and Muller-Hegemann (1956). Using special devices, both authors independently recorded an increase of weight in both arms during passive concentration on heaviness. The measured increase of weight has been ascribed partly to the relaxation of regional muscles and partly to an increase of blood flow in the arm (Schultz&Luthe,1959).
More recently, Marchand (1956, 1961) demonstrated that the standard exercises and passive concentration on warmth in the liver area induce certain changes in the trainee's blood sugar level. During the first three standard exercises there is a slight increase of blood sugar. The fourth standard exercise (It breathes me) coincides with a slight drop in blood sugar, which is followed by another slight increase during passive concentration on "My solar plexus is warm" (fifth standard exercise). Subsequently passive concentration on warmth in the liver area is associated with a significant rise. The control values obtained after termination of the exercises indicate a sharp drop of blood sugar values, which, however, are slightly higher than the control values determined before starting the standard exercises. White cells counts during this investigation (24 subjects) indicated that the first four standard exercises are associated with a slight but progressive decrease in white cell values. This trend was reversed during the fifth standard exercise and during passive concentration on warmth in the liver area which was associated with a marked increase. The highest white cell values were obtained three minutes after termination of the exercises. Subsequent determinations corresponded to values obtained before starting the exercises (Marchand, 1956, 1961).
Various electroencephalographic studies (Schultz &Luthe,1959;Geissmann, Jus&Luthe,1961; Luthe, Jus & Geissmann,1962; Franek & Thren,1948; Heimann & Spoerri,1953; Israel & Rohmer,1958; Israel, Geissmann & Noel,1960; [TC2 316] Jus & Jus, 1960; Geissmann & Noel, 1961, Jus & Jus, 1961; Luthe, 1962) during passive concentration on the standard formulas revealed that the different standard exercises and the autogenic state were associated with certain changes which are similar to, but not identical with, patterns occurring during sleep or hypnosis (Luthe, Jus, & Geissmann,1962; Luthe,1962).
According to the observations reported by P. Geissmann and C. Noel (1961) no true psychogalvanic reactions appeared during the standard exercises in completely relaxed trainees; certain reactions which were observed in a number of subjects seemed to be due to difficulties related to the experimental arrangement.
A systematic study of the respiratory changes occurring during the standard exercises revealed a significant decrease of the respiratory frequency which was associated with a gradual and significant increase of the thoracic and abdominal respiratory amplitude and a corresponding significant augmentation of the inspiration/expiration ratio (Luthe, 1958; 1962; Luthe, in Stovkis, Ed., 1960; Schultz & Luthe, 1959). Furthermore, it was observed that passive concentration on heaviness in the limbs is associated with a significant decrease of the respiratory volume and that the different standard formulas may produce a number of qualitative changes of the trainee's respiratory pattern. In asthmatic patients an almost instantaneous normalization of a disturbed pattern of respiratory innervation has been observed frequently (Schultz & Luthe, 1959).
The close physiologic and topographic relations between respiratory and circulatory mechanisms stimulated further studies of the effect of standard exercises on cardiac activity (Schultz& Luthe,1959), blood pressure (Schultz & Luthe,1959; Luthe,1960), the electrocardiogram (Schultz & Luthe, 1959; Luthe, 1960; Polzien, 1962b) and certain variables more closely related to metabolic processes (Hiller, Muller-Hegemann & Wendt,1961; 1962;Marchand,1956; 1961; Polzien,1955; 1959; 1962a,b,c; Schultz & Luthe,1959). In a group of normotensive subjects it was found (Schultz &Luthe,1959; Luthe, in Stokvis, Ed., 1960) that passive concentration on heaviness produces a slight but significant decrease of the heart rate (5 to 10%) and a tendency toward lowering of the blood pressure. In hypertensive patients regular practice of the two first standard exercises usually produces a significant drop of the systolic (10-25%) and the diastolic (5-10%) blood pressure (Schultz, 1959; Luthe, in Stokvis, Ed., 1960).
Electrocardiographic changes during autogenic standard therapy were reported by various authors (Schultz & Luthe,1959; Luthe in Stokvis, Ed.,1960; Jus&Jus, 1960; Geissmann & Noel, 1962; Polzien, 1962b; Schultz &Luthe, 1961). The relevant observations may be summarized as follows: during passive concentration on heaviness (and warmth) the heart rate usually decreases. In relatively few cases an increase of the heart rate has been observed. [TC2 317] This paradoxic reaction is regarded as resulting from autogenic discharges (Luthe, 1961; 1962; Luthe, Jus, & Geissmann, 1962).
During the Third World Congress of Psychiatry in Montreal (1961), Polzien reported that 28 out of a group of 35 patients with confirmed ST depressions showed an elevation of the ST-curve and an increase of the T-wave by .05mV or more during the first standard exercise. In five cases the ECG remained unchanged and two patients reacted with further deterioration. In a control group of 20 patients with normal curves, an elevation of the ST-curve or the T-wave by .O5mV or more was observed in 10 trainees. It is of particular interest that a correlation between the heart rate and the ST and T-wave changes did not exist. This finding is in contrast to the physiologic correlation which normally exists between the heart rate and the elevation of the "ST segment-T wave phase." In other words, it is not possible to explain the elevation of the "ST segment-T wave phase" as observed during autogenic training, by the simultaneously occurring changes (decrease, increase) of the trainee's heart rate (Polzien, 1962b).
More recent investigations carried out at the University of Wurzburg have verified the normalizing effect of the standard exercises on certain hyperthyroid conditions(Polzien,1962a). 0ther experimental studies dealing with the effect of autogenic training on bodily work and subsequent recuperation have been carried out at the University of Leipzig (Hiller, Muller-Hegemann, & Wendt, 1961; 1962).
Briefly, the experimental data indicate that passive concentration on physiologically oriented formulas influences autonomic functions which are coordinated by diencephalic mechanisms. Both clinical results and experimental data indicate that autogenic training operates in a highly differentiated field of bodily self-regulation and that with the help of autogenic principles it is possible to use one's brain to influence certain bodily and mental functions effectively. It is evident that this type of psychophysiologic manipulation requires proper training, adequate medical background knowledge, critical application, and systematic control of the effects of the treatment (Luthe, 1961). Furthermore, I hope it is quite clear that autogenic training is neither a simple relaxation technique nor a self-persuasive approach as applied by Coue.*
*Dr. Luthe stated in a letter accompanying this article, that `'Passive concentration on autogenic standard formulas (or any others) is a very potent 'interference' with 'normal' functions. Even the trial of the First Standard Formula should be thoroughly discouraged unless a careful medical and psychodynamic evaluation has been carried out before, and unless the trainee is under supervision by a physician who himself has adequate practical experience with the method. Undesirable and regrettable consequences may result in case autogenic techniques are applied without careful adaptation to each individual case."Editor.
[TC2 318] The long-range effects resulting from regular practice of the standard exercises are manifold and depend largely on the psychophysiologic constellation of the individual and the nature of the patient's condition. Briefly, one could say that a gradual process of multidimensional optimalization develops. This process is reflected in psychodynamic changes which can be verified by physiologic measurements and projective tests.
In line with reports on gradual changes in the patient's behavior (Schultz & Luthe,1959; Luthe, in Stovkis,Ed.,1960; Luthe, in Speer, Ed.,1958; 1962d), I have observed a characteristic pattern of projective changes, for example, in the Drawing-Completion test: Progressive differentiation of the projective responsiveness, increase of output, more shading, elaboration of details, stronger pressure of lines, increase of dynamic features, better integration and composition of the drawings, less rigidity, fewer inhibitions, faster performance, and better adaptation to the different stimuli. Corresponding changes have been observed in the Draw-A-Person test (Luthe, in Speer, Ed., 1958).
Our observation that a patient's progressive improvement jumps ahead after four to eight months of regular practice of the standard exercises is reflected objectively by the patient's performance in the control tests which I administer at regular intervals during autogenic standard therapy. With respect to these clinical observations it is of particular interest that the EEG also reveals significant differences between trainees who have practiced autogenic exercises for two to four months and others who have practiced the standard exercises for much longer periods (Geissmann, Jus, & Luthe, 1961; Luthe, Jus, & Geissmann, 1962). Subjects practicing two to four months show an EEG pattern similar to the EEG pattern seen in states of "predrowsiness," for example, bursts of anterior theta waves with a tendency to spatial generalization in anterior posterior direction in association with a preserved alpha activity. In contrast, subjects with longer training periods (6 to 36 months) pass very rapidly from the pattern of a normal state to a pattern characterized by (a) a flattening of the baseline pattern with theta oscillations; (b) the alpha main frequency shows an increase of rapidity (1 unit/sec.); and (c) brief paroxysmal bursts of thetawaves in temporal-posterior derivations (Geissmann, Jus, & Luthe, 1961; Luthe, Jus, & Geissmann, 1962; Franek & Thren, 1948; Heimann & Spoerri,1953; Israel & Rohmer, in Aboulker, Chertok, & Sapir, Eds., 1958; Israel, Geissmann, & Noel, 1960; Jus & Jus, 1960; Geissmann & Noel, 1961;Jus&Jus, 1961; Luthe, 1962e; Schultz & Luthe, 1961; Luthe, 1962b).
These electroencephalographic differences between short-period and long-period trainees seem to indicate that the regular practice of the standard exercises over longer periods of time brings about certain functional changes in the trainee's brain.
[TC2 319] Clinical and experimental observations gathered over the past 35 years have indicated that the physiologic changes occurring during autogenic exercises are of a highly complex and differentiated nature, involving autonomic functions which are coordinated by diencephalic mechanisms. The physiologic changes which occur during the standard exercises coupled with the fact that the regular practice of autogenic training over longer periods of time has a normalizing influence on a great variety of bodily and mental disorders led to the conclusion that autogenic training exerts a therapeutic action on certain mechanisms which are of pathofunctional relevance for many different types of bodily and mental disorders. In summarizing my experimental and clinical findings I hypothesized (Schultz, 1959; Luthe, in Stovkis, Ed., 1960; Luthe, Jus, & Geissmann, 1962) that the therapeutic key factor lies in a self-induced (autogenic) modification of cortico-diencephalic interrelations, which enables natural forces to regain their otherwise restricted capacity for self-regulatory normalization. The hypothesis implies that the function of the entire neurohumoral axis (cortex, thalamus, reticular system, hypothalamus, hypophysis, adrenals) is directly involved and that the therapeutic mechanism is not unilateraly restricted to either bodily or mental functions.
Implications of LSD and Experimental Mysticism Pahnke, Walter N. & William A. Richard [TC2 399-428]
[TC2 416] Implications for Theology.
On the basis of the research findings discussed above, it now appears possible to select almost any normal, healthy person and, combining a sufficient dose of a psychedelic substance with a supportive set and setting, enable that person to experience various altered forms of consciousness. The mystical experience seems the most difficult to facilitate, perhaps because of the as yet undetermined roles of personality variables; but nonetheless, these phenomena are now sufficiently reproducible to allow mysticism to be studied scientifically under laboratory conditions. Thus at long last, research into mysticism need no longer be limited to the scholarly scrutiny of various devotional or metaphysical documents left behind by such historic personages as Shankara, Plotinus, Meister Eckhart, William Blake, and Teresa of Avila. Persons can be studied extensively both before and after the experience of mystical consciousness in controlled settings. As noted above, experimental subjects who have experienced this form of consciousness have made powerful claims of increased personality-integration, of greater sensitivity to the authentic problems of other persons, of a responsible independence of social pressures, of both sensing deeper purposes in life and losing anxieties about death, guilt, and meaninglessness, and so forth. If research continues, there is no reason why such claims cannot be studied empirically and then either accepted as valid or dismissed as instances of emotional exaggeration and wishful thinking.
To some theologians, the awareness that it appears possible to experience mystical consciousness (samadhi in advaitan Hinduism, satori in Zen Buddhism, the beatific vision in Christianity) with the help of a drug on a free Saturday afternoon at first appears ironic and even profane. Such experience is the goal of life for most followers of the Hindu, Buddhist, and Taoist religions. In Christianity, Judaism, and Islam, it has generally been viewed as a gift bestowed by God upon certain saints and prophets who have lived [TC2 417] lives of exceptional stature. It is understandable that throughout Christian history, certain leaders have responded defensively whenever such biochemical aids to mystical consciousness have been encountered. Padre Nicolas de Leon, a Spanish missionary in Mexico who found that the Aztecs were using peyote (the natural source of mescaline), for example, included the following questions in the confessional that priests were instructed to employ in their examinations of penitent Indians:
Art thou a sooth-sayer? Dost thou foretell events by reading omens, interpreting dreams, or by tracing circles and figures on water?... Dost thou suck the blood of others? Dost thou wander about at night calling upon demons to help thee'? Hast thou drunk peyote or given it to others to drink . . ? (LaBarre, 1964)
More recently, a very able professor of comparative religions at Oxford, R.C. Zachner, has responded to the psychedelic drugs in a similarly irrational and defensive manner. Zachner even submitted himself to "artificial interference with consciousness" at one time for the purpose of proving that "this state . . . has nothing at all to do with what Christians . . . mean by the Beatific Vision. (Zaehner, 1954)" As might be expected, Zaehner did not experience mystical consciousness in this session, but had a rather shallow aesthetic experience, typical of subjects with considerable anxiety and resistance. Unfortunately the publication of his experience did not prove the existence of the Thomistic gulf between the natural and the supernatural as he had hoped, but rather reflected the mental set of a dedicated Roman Catholic convert (Zachner, 1961, pp. 212-226).
Perhaps one of the reasons mysticism has come to be considered otherworldly in the sense of being an escape from social responsibilities lies not in the nature of mystical consciousness itself, but rather in the poor methods that have been used by men to gain such experience. The medieval monk in his darkened cell and the hermit in the deep recesses of his cave, for example, used not psychedelic substances, but the tools of sensory deprivation, sleep deprivation, meditative disciplines, and fasting to elicit biochemical changes and unlock the door to unconscious levels of mind. The Hindu yogin uses similar methods in addition to autohypnosis and breath control, the latter increasing the amount of carbon dioxide in the blood and triggering unconscious levels of mind (see Meduna, 1950). Altered forms of consciousness often occur unexpectedly and spontaneously when one is undergoing great mental stress and is exhausted physically. It would appear logical to suggest that whenever altered forms of consciousness occur, whether they are anticipated or come as a complete surprise, underlying biochemical activity may be involved. Thus the Hindu yogin practicing breath control or the Christian monk spending long hours in solitary prayer may be seen to be influencing body chemistry in the same direction as the [TC2 418] modern man who ingests a psychedelic drug. In all seriousness, one may ask if the yogin or monk has much time for social action when perhaps a major portion of his life is spent in withdrawal from the world. Furthermore, such ascetic practices are poor means of unlocking the unconscious and may be similar to the ingestion of extremely small doses of the psychedelics. One thus enters aesthetic realms of experience more often than mystical consciousness itself. It is granted that other nonmystical forms of experience that may be considered "religious" are also known to occur, with and without the assistance of drugs. There is reason to think that otherworldliness may be a result, not of going too deep into the unconscious mind, but rather of not going deep enough. [I dont agree] It seems significant that persons who have experienced mystical consciousness generally feel thrown back into the very heart of life in this world and feel also that they have been given the inner strength to cope with suffering and struggle in society. It would seem better for a person to have a drug-facilitated experience of mystical consciousness, enjoy the enriched life that may follow, and serve other persons during the greater part of his life than to live a life that may be inauthentic and withdrawn until old age, when such an experience may occur by means of ascetic practices.
Some persons concerned with religion are disturbed by drug-facilitated mystical experiences because of the apparent ease of production, implying that they are "unearned" and therefore "undeserved". Perhaps the Puritanical and Calvinistic element of our Western culture, especially in the United States where most of the controversy about psychedelic drugs has centered, may be a factor in this uneasiness. Although a drug-facilitated experience might seem unearned when compared with the rigorous discipline that many mystics describe as necessary, the available evidence suggests that careful preparation and expectation play an important part, not only in determining the type of experience attained, but in determining the extent of later fruits for life. By no means is positive mystical experience with the psychedelic drugs automatic. It would seem that this specific "drug effect" is a delicate combination of psychological set and setting in which drug itself is only the trigger or facilitating agent. Rather than a psychedelic experience being an easy way to achieve growth, many subjects report that the subjective sense of work done during the drug session entails as much suffering and exhaustion as would be encountered in several years of living. But perhaps the hardest work comes after the experience when insights must be integrated. Unless such an experience is integrated into the on-going life of a person, only a memory remains rather than the growth of an unfolding process of renewal that may be awakened by the mystical experience. If the person has a religious framework and discipline within which to work, the integrative process is encouraged and stimulated. In this respect, Huston [TC2 419] Smith's (1964, p. 165) distinction between "religious experiences" and "religious lives" is especially noteworthy. Many persons may not need the drug-facilitated mystical experience, but there are others who would never become aware of the undeveloped potentials within themselves or become inspired to work in this direction without such experience. "Gratuitous grace" is an appropriate theological term in this connection, for the psychedelic mystical experience can lead to a profound sense of inspiration, reverential awe and humility, perhaps correlated with the feeling that the experience is essentially a gift from a transcendent source, a gift that can never be earned or deserved by any man.
In a paper of this scope, it is impossible to deal adequately with any of the theological questions raised by this field of research. Suffice it to say that there is an increasing need for contemporary theologians to include mystical consciousness in their rational reflections. Among experimental subjects who have known this dimension of experience, some have reported an enrichment of their understanding of Christianity, claiming that dead dogmas have suddenly come alive; others with less theological sophistication have despaired at the seeming indifference of dogma-centered churches to mystical experience and have turned towards the religions of the East. Tillich has perceptively noted that "The alliance of psychoanalysis and Zen Buddhism in some members of the upper classes of Western society (those within the Protestant tradition) is a symptom of dissatisfaction with a Protestantism in which the mystical element is lost" (Tillich,1963, p.243). Perhaps basically, theologians need to acknowledge the reality of other worlds, other dimensions of Being, to which man has access through the mystery of mind, but which no man would claim as his own personal property any more than the tourist who once visited Paris would claim that Paris was part of himself. Besides the works of Tillich, the recent impassioned attempt of Karl Jaspers (1962, 1963) to relate his Existenzphilosophie to Christian theology could prove valuable to theologians concerned with this creative area of thought.
In general, mysticism and inner experience have been stressed much more by Eastern than by Western religions. Perhaps Western culture is as far off balance in the opposite direction with its manipulation of the external world as exemplified by the emphasis on material wealth, control of nature, and admiration of science. As mentioned above, mysticism has been accused of fostering escapism from the problems of society, indifference to social conditions, and disinterest in social change. While the possibility of such excesses must be considered, the beneficial potential of mystical experience in stimulating the ability to feel and experience deeply and genuinely with the full harmony of both emotion and intellect has been indicated in the course of psychedelic research.
[TC2 420] Further, the experience of mystical consciousness may enable Western scholars better to understand the so-called elusive "Eastern mind". In the approaching era of unprecedented cultural interaction, this possibility could be of profound significance. Not only the religious systems of Hinduism, Buddhism, and Taoism, but also Eastern political traditions and even Eastern forms of architecture may be seen to have largely originated in various forms of altered consciousness. After such experience, contemplation may take on new meaning for the Western man who finds little time to ponder the meaning of his own existence and the philosophical presuppositions upon which his religious, political, scientific, and ethical convictions rest.
It is also possible that psychedelic drug experiences carefully employed in a religious setting (as in the experiment described above) could illumine our understanding of the dynamics and significance of worship. Increased understanding of the psychological mechanisms involved might lead to more meaningful worship experiences for those who have had neither spontaneous nor drug-facilitated experiences. Light might be shed upon doctrines of the Holy Spirit and the efficacy of sacraments, for example, thus enriching worship through psychological understanding. Such considerations raise the question of the place of emotion as opposed to cognition in religious worship. An even more basic question inquires into the validity of mystical consciousness in terms of religious truth. Reactions to such questions and possibilities will vary with theological positions and presuppositions, but the field under discussion invites thoughtful examination by those persons concerned with the lack of meaning reported by many contemporary church members in conjunction with religious worship.
The ethical implications relevant to this field of inquiry also merit careful examination. Any research that uses human volunteers must examine its motives and methods to make certain that human beings are not being manipulated like objects for purposes that they neither understand nor share. But in research with powerful mental chemicals that may influence the most cherished human functions and values, the ethical problem is even more acute. Historically, mystical experience has filled man with wondrous awe and has been able to change his style of life and values; but it must not be assumed that increased control of such powerful phenomena will automatically result in wise and constructive uses. Potential abuses are equally possible. The degree to which brainwashing techniques could be enhanced by the psychedelics is at present unknown. As persons in the deeper states of altered consciousness are so hypersensitive to the fine nuances of interpersonal communication, especially in terms of love and honesty, deception and manipulation may be minimized. In this sense, the drugs may be seen to have a "built-in control." Yet there are many varieties of psychedelic [TC2 421] experience that do not entail such Buberic communication and may certainly be prone to suggestive influences, either for good or evil.
Implications for Psychiatry.
Turning from the religious implications of these drugs to their possible applications in psychiatry, we find that in the more than twenty years during which LSD has been investigated under medically controlled conditions, two major methods of therapeutic application have evolved. The first, called psycholytic therapy and predominant in Europe, involves a small-dose technique (e.g., 25 to 100 mcg. of LSD) in weekly or bi-weekly sessions order to facilitate the release of unconscious material and aid psychotherapy or group therapy. Sandison and Spencer (Sandison, Spencer, & Whitlaw, 1954) in England and Leuner (1962) in Germany have pioneered in this method. Leuner in particular uses a psychoanalytic approach in working through the material during the drug sessions themselves as well as during the time between subsequent sessions. Mascher (1967) recently reviewed the research presented in forty-two scientific papers that describe the method and results of psycholytic therapy in sixteen-hundred patients during the past fifteen years. LSD sessions are considered superior to Amytal interviews, for example, insofar as the patient remains alertly conscious during the experience and has much less amnesia afterwards.
The second method, called psychedelic therapy and used mainly in the United States and Canada, involves a much smaller number of sessions, or even a single session, but at a higher dosage in order to produce an experience with such an overwhelming impact that the patient's view of the world and himself may be radically changed in a healthful and therapeutic manner. The primary aim is to achieve a breakthrough to a "psychedelic peak" that has the characteristics described above in the definition of mystical consciousness. Relatively high dosage is a necessary, but not a sufficient, condition for eliciting a psychedelic peak. Through careful preparation, a trustful bond of rapport with the therapist must be established as in any effective therapy. Special skill on the part of an experienced psychedelic therapist must be used for guiding the patient during the actual drug session. Careful planning of both the emotional atmosphere and the physical environment is important. Stimuli such as classical music (symphonic and choral) with long, flowing phrases, beautiful flowers, and reproductions of great works of art have proved helpful. After the drug session, the therapist must accept the crucial task of helping the patient integrate what he has learned during this intense, existential experience. Frequently this entails the direct confrontation of problematic situations in the patient's everyday world. Descriptions of this method have been written [TC2 422] by Chwelos and co-workers (Chwelos, Blewett, Smith, & Hoffer, 1959), MacLean and co-workers (MacLean, MacDonald, Byrne & Hubbard,1961), and Sherwood and co-workers (Sherwood, Stolaroff, & Harman, 1962). Also instructive is Unger's excellent review article (1963) and his description of the English language literature (1964b).
If the claims of therapeutic help from such experiences are substantiated in the controlled, clinical trials now being conducted, the need for, and relevance of, interdisciplinary discussion in this area between psychiatry and religion is accentuated. At the Spring Grove State Hospital in Baltimore, two projects that have been supported by the National Institute of Mental Health are in progress. There the effects of psychedelic therapy are being investigated on two groups of hospitalized patients: chronic alcoholics and severe psychoneurotics. Although the final results must be judged by the statistical evaluation of long-term follow-up studies in comparison with control groups, the early reports are encouraging (Kurland, Unger, & Shaffer, 1967; Savage, 1966). Mystical consciousness is being experienced by these patients, many of whom were not previously interested in either religion or mysticism.
A project in Massachusetts began to investigate the possible effectiveness of psychedelic therapy in the rehabilitation of prisoners, but unfortunately was interrupted and remains incomplete and inconclusive (Leary, Metzner, Presnell, Weil, Schwitzgebel, & Kinne, 1965; Leary, & Clark, 1963). It is probable that such a procedure would have the highest chance of success if it were co-ordinated with a treatment program that included job placement.
At the Federal Narcotics Hospital in Lexington, Kentucky, drug addicts have been treated with a combination of LSD and hypnosisso-called hypnodelic therapy. This technique is now also being applied to chronic alcoholics in a study at the Mendota State Hospital in Madison, Wisconsin (Levine & Ludwig, 1967; Ludwig, 1966).
When LSD was compared with narcotics as a pain-relieving agent for terminal cancer patients at the Cook County Hospital in Chicago (Kast, 1964), a marked analgesic effect was noted; but of greater significance, it appears possible that psychedelic therapy can provide an opportunity for the dying patient to view his life and death in a new perspective (Cohen, 1965). Useful possibilities of working with such experiences by those who care for and minister to the dying open up an area for investigation that has all too often been a depressing embarrassment to physicians in spite of the triumphs of modern medicine and surgery. Because of the unique effects of mystical consciousness upon attitudes and interpersonal relationships, not only the patient, but also his family may be able to approach and view death in a new way. Old barriers and defenses can crumble within the patient, making possible meaningful dialogue with family members and [TC2 423] friends concerning issues and feelings of mutual importance. This as yet relatively unexplored area of psychedelic research needs much more attention and careful study. Again the obvious religious implications highlight the intersection of psychiatry and religion.
Even if the therapeutic effectiveness of psychedelic therapy is eventually demonstrated empirically in carefully controlled clinical research, a further problem still remains. As yet there is no adequate theory to explain why the experience of mystical consciousness should facilitate therapy. Some of the researchers have claimed that "the root of the therapeutic effectiveness of the LSD experience is its potential for producing self-acceptance" (Chwelos et al., 1959, p. 589). This view has definite parallels with aspects of Paul Tillich's thought. The renewed sense of self-esteem noted in some patients after such experience may be due to a realignment of ego defenses and boundaries. Alcoholics who have experienced psychedelic mystical consciousness are surprised to discover that they have some internal, intrinsic worth as members of the human race and seem to gain a new self-concept involving goodness and love.
In trying to account for the phenomena associated with mystical consciousness, the concept of regression has been proposed (Prince & Savage, 1965). Such aspects of mystical consciousness as "unity" and "deeply felt positive mood" are certainly suggestive of the prenatal life of a foetus. Theories that dismiss mystical consciousness as "mere regression" or "an oceanic feeling of primary process," however, fail to wrestle with the noetic aspects of "objectivity and reality" and "transcendence of space and time." The mind appears to gain the ability of operating on many levels at once, while grasping interrelations of psychic functioning. The concept of time does not merely lose meaning, but, more impressively, is seen in a new perspective. Subjects assert that they felt "outside of" time, beyond both past and future, as though they were viewing the totality of history from a transcendent vantage point. The feeling of profundity and truth that insights acquire under the influence of psychedelic drugs may be a delusion: but this quality seems to provide the motivation for the patient to affect behavior change, especially if the insight gained holds true for the particular person when examined and tested later when the rational mind is again in full command. Because the life experience and learning acquired over the years are retained while in this altered state of consciousness, perhaps the term "regression in the service of the ego" is more appropriate.
Implications for Society
As is unfortunately true with many potentially beneficial but powerful discoveries, such as fire or atomic energy, misuse and abuse are possible if the discoveries are improperly handled. The psychedelic drugs are no [TC2 424] exception, as the growing black market ominously testifies. There are an increasing number of people who are obtaining these drugs illegally and ingesting them without psychiatric screening, preparation, supervision or follow-up therapy.
Such practices will inevitably lead to psychiatric casualties as have already been reported in the medical literature (Frosch, Robbins, Stern, 1965). When certain borderline or pre-psychotic persons take psychedelic drugs without capable psychiatric supervision, there is a risk of prolonged psychosis, irresponsible behavior, or suicide. Even persons who are in good physical and mental health can become quite emotionally shaken when they discover that their usual sense of control is suspended. Fighting to overcome the drug effect can lead to intense fear and a psychotic reaction. [The same holds true for all mystical experiences, is thus not specifically drug-related]
Most of the cases coming to psychiatric attention are acute panic reactions that are usually reversible with proper drug treatment and temporary hospitalization. There are also some persons who seem to experience a spontaneous recurrence of the LSD effect months after having last taken the drug. Usually these persons are under stress when the symptoms recur. Although much more rare, the cases of prolonged psychosis following LSD and lasting more than a week are more alarming. A direct, causal relation to LSD cannot always be determined, however, because an examination of the case histories usually reveals severely disturbed persons who probably were in severe psychological trouble prior to taking the drug. Not all persons who seek psychiatric help after LSD, however, are in acute distress or in need of hospitalization. There are also a growing number of persons who mistakenly thought they were in good mental health, but discovered during their drug experience that many repressed problems came to the surface. This realization may encourage such persons to work out their problems, whereas previously they may have denied their reality or sought some form of escape. Paradoxically enough these are people who probably should have been in psychiatric treatment before, but only now are motivated to do so. In the long run, with proper help, many of them may be guided towards better mental adjustment, but at best this is a risk-filled method of self-diagnosis.
In any discussion of the dangers of psychedelic drugs, it is essential to consider the incidence rates of harmful effects. Cohen has collected the only statistics of this nature published to date and found that, in a survey of 5,000 persons who had taken psychedelic drugs a total of 25,000 times, there was a suicide rate of one per 2500 persons among psychiatric patients undergoing treatment, and no attempted or completed suicides among experimental subjects. Psychotic reactions lasting longer than forty-eight hours had an incidence of one per 555 among patients and one per 1200 among experimental subjects (Cohen, 1960).
[TC2 425] In commenting on Cohen's statistics, Levine and Ludwig (1964) have emphasized the relative safety of LSD when compared with other methods of psychiatric treatment. Since Cohen's survey was published in 1960, much more has been learned about treatment procedures with LSD-type drugs and the art of avoiding psychotic reactions. With this increased knowledge, coupled with improved therapist training, the use of LSD should become even safer. It must be emphasized, however, that Cohen gathered his data from a survey of doctors engaged in clinical research with these drugs. These statistics and comments, therefore, refer only to the properly controlled, medical use of LSD.
The current increase in dangerous after-effects is almost entirely caused by the indiscriminate use of LSD among untrained persons. Such use takes place outside legitimate research auspices without medical supervision. These very real dangers must not be allowed to obscure the potentials of a powerful therapeutic tool. To offer an analogy, little benefit would be expected to come from an x-ray machine if an untrained person were allowed to shoot x-rays in all directions indiscriminately. In fact, unless the intensity and frequency of the x-rays were carefully controlled, much harm could result in the form of radiation sickness and permanent damage.
Although neither physiological addiction nor tissue damage has been reported in the case of LSD, psychological dependence might be expected if the experience were continually repeated. The intense subjective pleasure and enjoyment, at least of aesthetic forms of experience, could lead to escapism and withdrawal from the world. An experience capable of changing motivation and values might cut the nerve of achievement. Wide spread apathy toward productive work and accomplishment could cripple a society. It is unfortunate that, at present, public opinion concerning these drugs is being molded primarily on the basis of the response of the beatnik dimension of society, a dimension that contains many persons already in poor states of mental health. Such persons are accused of numerous forms of irresponsible behavior, and also the sin of quietismof claiming inspiration, but producing few concrete works of social, literary, or artistic promise.
There are relatively few experimental studies that provide information concerning the possible continuing benefits of psychedelic drug experiences in normal, mentally healthy persons who have already established a responsible and creative position in society. In fact, these people cannot legally take the drugs unless they happen to live near one of the few qualified research projects. Increased legitimate opportunities for both average and gifted people to take these drugs under adequate supervision will be needed before the possible beneficial effects for individual persons and society can be assessed.
[TC2 426] Practically speaking, the reality of the black market must be confronted. LSD can take the form of a clear, odorless, tasteless liquid. It can be quite easily and inexpensively manufactured in a home laboratory by any good organic chemist. Two hundred millionths of a gram constitutes a powerful dose that is no larger than a drop of water. At present there is a 1000% to 3000% mark-up from manufacturer to consumer. So it is that attempts to control the black market by police force face serious obstacles and almost certainly will prove futile. There is, in fact, a growing demand for these drugs, not only among the rebellious element of society, but also among our future leaders who are now attending universities. Many of the sensationalistic articles in the popular press that have presented somewhat slanted accounts of the bizarre and lurid effects of these drugs rather than their potential usefulness have only attracted more interest and curiosity from the very people who should not take the drugs, and have tended to decrease support for responsible investigation.
If the recent estimate is correct that one million doses of LSD will be consumed in the United States in 1966 (Rosenfeld & Farrell, 1966), the usage will probably grow at an even faster rate because each person who has a positive experience will introduce at least one or two of his friends to the drug. Positive experiences are much more common than negative ones, and it is a human fallacy to believe that a bad reaction "won't happen to me". How then can we deal constructively with the problems posed by the black market?
It would seem that not suppression, but informed education and an expanded program of research with an interdisciplinary approach is urgently needed. Education needs a basis of empirically derived facts on which to draw. To gather such facts, concerning both dangers and possible benefits, increased, responsible research in all realms of application is needed before research is stopped because of the growing public hysteria in the face of the black market. We propose carefully controlled studies in which drug dosage, setting, personality variables, experimenter expectation, experimental procedure, and follow-up can be regulated. Only then can answers be found to questions concerning the personality characteristics or disturbances that contra-indicate the use of the drugs, the optimal treatment procedures to insure the most beneficial effect, and the best screening procedures to identify persons most likely to be harmed or those who should be singled out for special handling. Patients with various symptoms and relatively normal subjects both need to be intensely studied in such experiments.
Because persons who take the drugs on their own are most interested in aesthetic and mystical experiences, research needs to be focused on the possible benefit or harm resulting from such experiences. Another [TC2 427] variable needing elucidation [is] the effect of frequency of ingestion. It is conceivable that benefit might result from an experience once or twice a year, whereas weekly exposures might cause chronic deleterious changes in personality.
Because these drugs are without a doubt the most powerful psychoactive agents known to man, their use needs to be supervised by persons who have received specialized training. In view of the wide range of potential applications, an interdisciplinary approach to their use is essential. A training and research center for psychedelic therapists [how incredibly optimistic, utopian, when seen now] will probably need to be established. The staff of such a center should include psychiatrists, clinical psychologists, and professional religious personnel.
The results of increased knowledge from such research on the drugs may provide an answer to the problem of the black market. If legitimate medical uses and methods are confirmed and the dangers and benefits are determined accurately, socially sanctioned centers for persons desiring this form of human experience can be establised. Most persons would then probably prefer the safety of medical supervision to the risk of blackmarket usage. Admittedly, this kind of solution may lie a long way in the future and will depend upon the results of careful yet imaginative and daring research. But this may be the only way to deal effectively with this problem.
What would be the effect of relatively broad use of the psychedelics in some future decade? Would people become more creative than ever before? If the garbage collector experienced mystical consciousness, would he collect garbage more passionately than ever before, or would he escape to the forest or the university? Could these drugs enrich society or do they threaten to destroy it? If the latter should prove to be the case, are there ways in which this threat can be lessened? These are questions whose crucial answers are at present unknown. Not only are they unknown, but research aimed at finding answers to them is severely limited in the United States.
Religion has long been accused by sociologists of being a prime illustration of the phenomenon of the "cultural lag." Bruno was burned at the stake for his adherence to the Copernican view of the universe. For the same heretical belief, Galileo was condemned and forced to recant, even though the truth of the panoramas he had seen through his telescope were indelibly fixed upon his mind. Similarly, Darwin was condemned for his heretical theory of evolution. Yet, in retrospect, Christian theology, including biblical interpretation, has been greatly enriched by the convictions of these men. New glimpses into the nature of reality always seem first to evoke defensive reactions of fear and, only later, reactions of wonder and praise.
[TC2 428] With these drugs, science stands on an awesome threshold. Some religious leaders would undoubtedly consider it improper for man to tread upon the holy ground of the unconscious, protesting against the exploration of "inner space" as they have campaigned against the exploration of outer space. But man's apparent destiny to seek an ever greater comprehension of the nature of reality cannot be thwarted or suppressed. The importance of research proceeding in harmony with the highest known ethical principles, however, is clear. Those who undertake such research carry a heavy responsibility.