LSD, de-patterning, and death: Terminally ill patients reenvision the end after psychedelic therapy

After escaping from the lab in the 1960s, acid is again being evaluated by scientists. The first therapeutic study of lysergic acid diethylamide (LSD) in decades has found that the mind-altering drug can help people with a life-threatening disease cope with their own death.

The double-blind, placebo-controlled, randomized clinical trial of twelve participants found that LSD-assisted psychotherapy can generate lasting psychological benefits in patients with a life-threatening illness.

“Dying is as usual or unusual as life itself. You cannot separate it. I simply have to familiarize myself with the idea and the process. And for that an LSD session is of priceless worth,” one patient in the study said.

Swiss physician Peter Gasser and his colleagues provided the patients with 6–8 psychotherapy sessions over the course of three months. Two LSD experiences were embedded in the psychotherapy sessions at a 4–6-week interval.

The patients’ LSD experiences were guided by two therapists, who provided comforting music along with psychological support. The patients were encouraged to “focus their awareness and mindful attention inward to follow their personal process of perception, emotion, and cognition,” the researchers explained. After the 8-10 hour LSD experience, the patient stayed overnight in the physician’s office. They were released the following day after an integrative talk.

The results of the study were published online November 11 in the peer-reviewed Journal of Psychopharmacology.

All of the patients reported benefits from the LSD-assisted psychotherapy, and none of them reported lasting negative effects 12 months after treatment. About 77 percent of them reported sustained reductions in anxiety. An equal percentage reported less fear of death.

“Psychological treatment of people experiencing the existential challenge of suffering from a life-threatening disease and those who are in the process of dying is still mostly inadequate. Typically, these patients suffer from isolation, anxiety and depressive symptoms. There is obviously a need for more effective treatments,” the researchers said.

The patients’ description of their LSD experience helps explain why the psychedelic drug can aid the process of psychotherapy.

Gasser and his colleagues noted that LSD has been described as a “non-specific amplifier of the unconscious.” The drug tends to intensify all emotions — whether they are good or bad. Many of the patients said emotions that had been repressed or ignored were able to break through to the other side during their psychedelic experience.

“I had the strong impression that things can be seen, which usually rest under the surface. … a lot of emotions were hidden for a long time that are usually not noticed at all became very, very present in that state when you have a break-through somehow,” one patient explained.

This experience wasn’t always a pleasant one, however, and some patients described it as an emotional “roller coaster” or “an endless marathon.”

“The first time it was very brutal, painful, at least emotionally very painful. I could not even say in which direction – it just hurt, like heartache, like being disappointed, like everything you once had experienced as a negative feeling. … It was pure pain,” a patient described.

This wilderness of pain was resolved in their next LSD experience, the patient said.

“During the second time it was sublime. Really. Love, expansion, holding, I knew that this sometimes happens, that participants talk about spiritual experiences. I thought they just meant this dissolution of oneself – everything is okay, everything is great. That was a very important experience for me. Very, very important.”

The psychedelic experience also provided the patients with a profoundly new frame of reference from which to view their own life, the researchers reported.

“I had the opportunity to relax,” a patient said. “I rather connected to my inner world. Closed eyes. It was less about my illness. I was able to put it into perspective. … Not to see oneself with one’s sickness as centre. There are more important things in life. … The evolution of humankind for example. … Your Inner Ego gets diminished, I believe, and you are looking at the whole.”

This new frame of reference lead to a shift in values, and the patients said the psychedelic experience increased their quality of life.

“Maybe that material values were not that important anymore. That other values have priority. Health and family, such things… When you have a job and the job has priority and the family comes last. You don’t even notice it anymore. To realize there, stop, what is actually important? That the family is fine, that the kids are doing well,” a patient explained.

Overall, Gasser and his colleagues said that LSD could help psychotherapists and their patients by breaking down “fixated psychological habits, defense mechanisms and entrenched thought patterns.”

“The patients interviewed in the present study referred to ‘de-patterning’ in terms of previously fixated physical, psychological and thought patterns, which led to increases in relaxation, an imperturbable calmness and an acceptance of their own self and basic situation.”