Toward a Psychedelic Medicine

1

Richard Yensen, Ph.D.
Yearbook for Ethnomedicine and the Study of Consciousness,
Issue 1, 1992, pp 51-69. VWB - Verlag fr Wissenschaft und Bildung,
1995.
Introduction and Goals
This paper seeks to delineate the need for a fusion of many existing
areas of study into a new discipline that focuses on practice,
research and study of the use of psychedelic substances as
medicine. For the duration of this paper I will call the new
discipline psychedelic medicine. This may not be the most
appropriate name for the new discipline and you are invited to
suggest better ones.

Four major areas will be discussed in this paper: 1) Psychedelic
medicine will be defined and placed in historical context. 2) An
analysis of the shortcomings of our current research methods will
be made. Specifically I will discuss how experimenter errors are
made because of the accepted dichotomy between subject and
object, experimenter and experiment. We will see how these errors
point to the need for an approach that acknowledges the basic
oneness of the psychedelic states of consciousness. I will also
discuss how research, which views psychedelics as pharmacologic
agents, obscures significant factors that determine human response
to these substances. 3) I will then present the process of treating a
terminal cancer patient as demonstration of a new model for

1
This papei was oiiginally piesenteu to the seconu annual confeience of the
Association foi the Responsible 0se of Psychoactive Agents, Esalen Institute,
Big Sui Califoinia, }une 16th22nu, 198S.

disclosing fully the experiences of all participants in a psychedelic
session. 4) I will then propose future directions for our
collaboration and suggestions for How to train the practitioners of
psychedelic medicine.

Definition and Historical Context
Psychedelic medicine does not seek to replace contemporary
allopathic medicine. Psychedelic medicine is deeply
complimentary to most of contemporary medical practice. Since it
deals with the deepest levels of human experience and motivation
through human relationship, psychedelic medicine reaches the
patient in important ways that allopathic medicine does not.
Psychedelic medicine helps individuals to find meaning in their
existence which produces an emotional healing that is
complimentary to the physical healing offered by allopathic
medicine. Since psychedelic medicine addresses the whole life
history of the patient as a meaningful context for healing to begin,
it is basically holistic in theory and practice. Psychedelic medicine
seeks to produce the deepest harmony possible between mind,
body and spirit. Psychedelic medicine is often most helpful at
times when the remedies of allopathic medicine have been
exhausted or the prognosis is terminal.

Psychedelic medicine is not actually new but is the resurrection
of an ancient discipline. A contemporary Native American healer
using psychedelic plants speaks of their effects on the mind and
what he knows of their history:

"By means of the magical plants anu the chants anu the seaich foi
the ioots of the pioblem, the subconscious of the inuiviuual is
openeu up like a flowei, anu it ieleases these blockages. All by itself
it tells things. A veiy piactical mannei... which was known to the
ancient's" (SBAR0N, 1978 P. 46).

Since the dawn of time psychedelic substances in the hands of
priests, physicians and metaphysicians have been used in culturally
significant rites of passage, death and rebirth, mystical quest for
meaning, membership and healing. The study of how the
appropriate use of psychedelic substances can be of continuing
benefit to humanity is the focus of psychedelic medicine. Although
variations of psychedelic medicine have been practiced throughout
history and are still practiced in certain groups, knowledge of
psychedelic medicine has been lost in other cultures and at this
time is being intentionally buried in our society.

Why call this area of research and study Psychedelic medicine?
First let us examine the origin and meaning of the word
psychedelic. In 1957 HUMPHREY OSMOND, an early researcher
in this area, introduces the name psychedelic to provide a label for
experiences of great and lasting benefit. Investigators of
compounds, which had been given a variety of non-descriptive,
pejorative or cumbersome labels, wanted a name that implied
positive potential. OSMOND had observed profoundly positive
personality changes in some of his subjects. These great spurts in
personal growth seemed to follow transcendental, mystical or, as
OSMOND proposed, psychedelic experiences with the compounds
he renamed. He proposed psychedelic as a new name for these
substances and their effects in the hope of liberating scientific
investigation from the enduring influence of more narrow and
negative labels that suggested limited fields of application and
ignored the enduring positive value of these substances. OSMOND
found that LSD, mescaline and psilocybin can be useful not only in
studying psychopathology, but also that they shed new light on the
greatest philosophical enigma of human existence, the purpose and
meaning of life:

"0ui subjects, incluue many who have uiunk ueep of life, authois,
aitists, a junioi cabinet ministei, scientists, a heio, philosopheis,
anu businessmen... Nost finu the expeiience valuable, some finu it
fiightening, many say that it is uniquely lovely. If mimicking mental
illness weie the main chaiacteiistic of these agents,
psychotomimetics woulu inueeu be a suitable geneiic teim. It is
tiue that they may uo so, but they uo so much moie... I have tiieu to
finu a moie appiopiiate name" (0SN0NB, 19S7).

Osmonds neologism was brought forth from the Greek roots
psyche and delos meaning mind and manifesting. In the years that
have followed Osmonds proposal the name psychedelic has come
to be associated with a counter-cultural lifestyle, wild innovations
in music and art, but most if all with the dangerous, unsupervised
and hedonistic use of these compounds. Certainly these
connotations were not part of lamentable failure of our society to
integrate, use, and understand psychedelics and their motive
potential. Nonetheless the name psychedelic is appropriate for a
wide variety of substances that can facilitate a broad range of
human experiences many of which can be of enduring value to the
individual and the culture. I call this a field of medicine to
acknowledge medicine in a sense mostly lost to this culture, the
aspects of medicine concerned with spiritual growth for its
practitioners and healing of mind, body and spirit for its patients.
This is a form of medicine more akin to that practiced by the
American Indians and Ancient Greeks than our modern
technological allopathic medicine. It is a medicine more concerned
with healing the soul than the body.

How is it that psychedelic medicine could be an ancient
discipline? There is evidence that as long ago as 100,000 years
humans were using medicinal herbs. The use of plants to induce
altered states of consciousness has been documented circa 8,000
B.C. (FURST, 1976). So if we take into account the plant kingdom
it becomes clear that the use of psychedelic substances by humans
is not a recent development. Psychedelics are not associated with
counter-cultural forces in the rituals of cultures that use them. In
fact, many traditional societies use these substances as powerful
tools for renewing and passing on their basic belief system.

Psychedelics in the form of sacred plants appear to have played
an influential role in the formation of religions and the early
development of Western philosophy. R. GORDON WASS0N is
foremost among a new genre of scholars who call themselves
ethnopharmacologists and who specialize in examining the role of
pharmacologically active plants in history. His book Soma, the
Divine Mushroom of Immortality meticulously relates the
legendary Soma as described in the Hindu oral tradition of the Rig
Veda to Amanita muscaria, a psychedelic mushroom. Mr.
WASS0N'S scholarly efforts, not to be confused with the fanciful
proposals of others regarding mushrooms and religious practice
(e.g. ALLEGRO, 1970), amount to a profound interdisciplinary
analysis of how Amanita muscaria mushrooms fit the Rig Veda's
poetic imagery from the perspective of botany, chemistry,
pharmacology, anthropology and psychology. WA5SON presents
convincing evidence for his hypothesis that at the dawn of human
history the effect of a sacred plant were cornerstone in the
foundation of one of the great religions of the world. Not content
to allow this scholarly tour de force to stand alone, WASSON has
since joined with others to present strong evidence that the "wine"
consumed as part of the mysteries at Eleusis in ancient Greece was
made from ergot infested grain and hence possessed mystical,
sacred and psychedelic properties due to the effects of Iysergic
acid amides. These renowned mysteries were said to profoundly
affect the participants which included Plato and Socrates in Greece
and Pythagoras in Egypt (WASSON et al., 1978).

Clearly sacred plants and psychedelic medicine have played a
more significant role in human history than common knowledge
would suggest. The use of these plants has been in the context of
deeply meaningful ritual setting that invoked transpersonal
experiences of a mystical and spiritual nature. Cultures of oral
tradition have revealed to us their awe of the vast frontiers revealed
by these substances through the names they chose for these sacred
plants: semen of the sun, vines of the serpent, the tracks of the deer,
plant of the tomb, vine of the soul, mainstay of the heavens, herb
of divination and flesh of the gods (SCHULTES & HOFMANN,
1979).

Analysis of Current Research Methods
Psychedelics are a unique new frontier in our exploration of the
universe. People from all walks of life, who have sufficient
experience with the psychedelics in a supportive setting, discover
that there is a profound and basic unity to the universe that is more
real and true than the superficially apparent diversity and
separateness of our ordinary experience. Instead of realizing the
revolutionary implications of this insight our society attempted to
study these substances of if they fit neatly into our pre-existing
ways of understanding of the world. The scientific methods applied
to studying these substances in our culture ignored this crucial
insight about the nature of the universe.

In our culture the use and study of these compounds fell to the
disciplines of psychiatry and psychology. Both of these disciplines
had adopted methods for conducting research based on the
assumption that subject and object are separate and that the
experimenter is separate from the experiment. Although insights
exist from 20th century physics that under certain circumstances
subject-object experimenter-experiment dichotomies break down,
these insights were not incorporated into the design of scientific
research in either psychiatry or psychology. Psychologists and
psychiatrists tried to understand the actions of these substances by
integrating them into pre-existing conceptual frameworks for
understanding the actions of drugs.
2
The range and depth of

2
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psycheuelics is uiscusseu in uetail anu at some length in a piioi papei: !"#$
&'()*"+*( )# ,-"-.+/$(0 12$-3+)'4( 5#2"3*' 6"#$ (-7"*. ,8-3)( )# ,('79*.*8+7
."2/( (YENSEN, 1989).
understanding achieved through these methods is very limited. If
our healers couldn't understand the use of psychedelics, how could
they be used by the culture in a safe and meaningful way?

Psychedelic medicine accepts the basic unity implied by
psychedelics and psychedelic experience. This insight forces a
return to naturalistic reporting of our experiences along this new
frontier. We must begin the work of gathering information from all
participants in psychedelic sessions as a way of acknowledging the
basic unity of the phenomenon under study. This information will
assist us in making new maps of our consciousness and its
inseparable union with the universe. I believe that this important
unitive insight can be a fulcrum to lever our thinking about
psychedelics out of the l9th century and into contemporary thought
about the nature of the universe.

Our complex technological society has abandoned ways of
thinking about the world that would allow us to accept these
substance as sacred or divine. Yet we must take into account that
all cultures throughout history that used these substances
successfully, accorded them a sacred role. This perception of
psychedelics is actually quite reasonable. A substance that can
facilitate personal insight into the most meaningful dimension of
existence where the unity of all creation is perceived surely meets
the requirements for sacred status.

"|Theie is aj cuiious symmetiy between people who abuse uiugs
anu people who stuuy them. The peison who is convinceu that
highs come in uiugs, if he is negatively oiienteu towaiu society,
becomes a uiug abusei; if he is positively oiienteu towaiu society,
he becomes a uiug ieseaichei. But the two aie essentially the same,
because both aic laboiing unuei the iuentical mateiialistic illusion.
0nly theii mutual antagonism keeps them fiom iealizing they aie
two poles of the same way of thinking" (WEIL, 1972, P. 7u, 72).



The world-view prevalent in our culture has made it possible to
accept these substances only as drugs, pharmacologically active
agents. Since drugs are considered man made tools they are
anything but divine within this culture. To think of these
substances as drugs is an unfortunate error. Though it may be
impossible for us to think of them as divine. There are advantages
to such thinking. Clearly God is everywhere at once and so the
experience attained through such a sacramental substance is not
contained within this substance. This way of thinking about
psychedelics provides a conceptual schema superior to
pharmacology for understanding that the non-drug or ceremonial
factors are what determine the actions and effects of psychedelics
on human beings. Thinking in this way also gives the implicit
instruction that all experience engendered by these substances is to
be accepted even though it may be difficult or painful.

Since just before the turn of the century Western scholars have
attempted to study psychedelics without being able to grasp the full
scope of the potential embodied in the knowledgeable use of
psychedelics. During this period of time, the psychedelics were
examined for their possible role as facilitators in psychological
healing, providers of insight into the mysteries of human existence
and stimulators of creativity. Of several factors limiting the
development of knowledge in this area a central one has been an
unwillingness of the scientists involved to look at the influence
they have exerted on their own research. Scientists have labored
under the commonly accepted misconception that they are
unbiased or can design clever studies to eliminate the influence any
bias might exert on the experiment. The dichotomized view of
reality where subject and object are separate entities with exactly
definable influences on each other was the state of our scientific
view of the universe at the turn of the century. The application of
this world-view to the design and interpretation of studies with
psychedelics has obscured and confounded research efforts.
Dogged adherence to methods that demand a clear separation
between experimenter and experimental subject to produce
meaningful results are continually suggested as the most
scientifically appropriate and in fact the only way to scientifically
study this area. Advances in our understanding have also been
limited by the materialistic illusion that pharmacologic activity
must be a prime determinant of any effects that these substances
might have on human beings including both the nature of the
experiences reported by people taking psychedelic substances and
their ultimate expression in human behaviour. Research with
psychedelic drugs, even after a significant amount of time and
study with thousands of published reports, is still at a frontier stage.
This does not signify, as some would have it that the psychedelics
are neither promising nor fruitful as area of study. Drug
researchers have floundered by applying prematurely rigid and
conceptually inappropriate, methodologies. They have refused to
report on their own important biases and emotional responses. This
has helped to maintain the fiction of the unbiased investigator.
They have thus conducted research that asks hopelessly incorrect
questions and may produce the results expected by mechanisms
overlooked in the original research design and conduct. So rather
than advancing understanding of a complex field of study, early
attempts obscured the important variables in this research while
laying undeserved claim to scientific status. There is no published
study where the experimenter describes their biases vis--vis
psychedelics or their own feelings during a psychedelic session
with subjects. This situation is rather like a chemist reporting that
he mixed two reagents together and they blew up but refusing to
disclose what the reagents were! From a scientific perspective
these researchers failed to report on significant independent
variables.

The inadequacy of contemporary models for research in this
area has combined with social concern over the threat of
uncontrolled use of these substances to lead the governments of the
world to impose restrictions on psychedelics which impede
scientific research. The need to control use of these substances by
the general public and the difficult nature of this goal has lead
regulatory agencies to over-regulate legitimate researchers.
For instance in the United States the Food and Drug
Administration insists that qualified investigators adhere in the
design of their studies to accepted views of how to investigate
other psychoactive substances where the direct chemotherapeutic
activity of a drug is being evaluated. Psychedelic research involves
a unique and complex interaction of psychotherapeutic,
pharmacologic and environmental factors. This completely ignores
the fact that psychedelics are unlike pharmacologic agents and
require a serious reconsideration of our methods and techniques for
conducting research. This control over the scientific community is
accomplished by appointing "peer review" panels of researchers
with little or no background in psychedelic research. Thus progress
in this area is effectively stopped by blocking any innovative study
that does not adhere to the methods and techniques deemed
appropriate by committees of researchers with no specific expertise
in the precise area they are offering expert opinions about.

"It is an inheient piopeity of intelligence that it can jump out of
the task which it is peifoiming, anu suivey what it has uone; it is
always looking foi, anu often finuing, patteins. Now I saiu that
intelligence can jump out of its task, but uoes not mean that it
always will" (B0FSTABTER, 1979, P S7).

For these reasons it is my opinion that a new interdisciplinary
field of study called psychedelic medicine must be inaugurated.
This new field should strive to adopt appropriate methodologies
for studying the states of consciousness that are facilitated through
the growing family of compounds that are best described as mind-
manifesting.

A Case History in Psychedelic Medicine
As a model for studying psychedelic medicine, I would like to
share with you the poignancy of an actual clinical experience with
psychedelic substances. I do this to foster the reader's appreciation
and understanding of the value of inherent in this way of producing
psychological healing, T would like to do this by giving a case
presentation of the psychedelic treatment of a terminal cancer
patient. I will describe this experience with the most candid and
complete disclosure of my experiences and those of others
involved in the process as possible. This is my attempt to fully
disclose of all the relevant variables in the situation in the manner I
suggest is appropriate for psychedelic medicine. I introduce this
material also because the moral, philosophical and religious
elements that are characterized by reverence for life and
appreciation of the infinite value of the individual human being are
illustrated in this account and they must be the central tenets of
psychedelic medical ethics. We cannot study the transcendent
realities of psychedelic consciousness without accepting the unity
that these experiences convey and fully reporting our own
experiences as participant-observers. For these reasons I choose to
look back 13 years to openly share my own first experience with
administering a psychedelic to a terminal cancer patient. I hope the
events that follow will highlight the complex interweaving of
meaning for me as a researcher, psychotherapist and human being
and do justice to the importance this treatment had for my patient.
Such an account has not to my knowledge found its way into the
literature before now. Most important, the study that provided the
context for this experience was not reported in a manner that did
justice to the remarkable nature of this and many other beautiful
human experiences that are the essence of psychedelic medicine.
3
I

S
This shoitcoming in the scientific liteiatuie is not meiely some lack on the
pait of the psycheuelic ieseaicheis involveu, but the fact that in oiuei to
have iepoits of psycheuelic ieseaich publisheu ieseaicheis aie foiceu to fit
came to know this man in the process of therapy as a remarkable
and unique person experiencing the exquisite crafting of the final
facets to the jewel of his lifetime. This experience had special
meaning for both of us because for each of us in our own way it
was both a first as well as a last experience. For Joe it was his first
and last experience with the drug DPT and our research therapy
team. For me it was my first experience with a terminal cancer
patient, a joyous loss of significant aspects of my virginity as a
psychedelic therapist. The whole team involved, myself, the co-
therapist and Joe emerged from this event with significant personal
growth. Although every psychedelic session is a first and has the
value of newness this experience has stayed with me over the years
as a special one that demands further analysis and understanding to
appreciate fully.

He was 70 years old and his cancer began in the eye then it
spread to his prostate and ultimately insinuated its way into the
other abdominal organs. His surgeon noted that the patient had
signs of depression and a markedly increased need for pain
medication, this led the doctor to recommend our experimental
treatment with psychedelic drugs. He had seen the treatment help
other patients dramatically so Joe would improve too. For me this
was a very special event, Joe was the first cancer patient I had the
opportunity to treat as a research psychotherapist. The staff person
at the Maryland Psychiatric Research Center who was in charge of
the project laughed as he told me that I should have fun treating
this man because he had lived with his mother for his whole life.
This was still the case even though Joe was 70 years old!

As I walked up to the Cancer Unit I prepared myself for what I
anticipated would be a significant experience in my career as a
therapist. I remembered that for me it seemed a very important part

the piesentation of iesults into the uominant paiauigms helu by euitois anu
ievieweis of scientific jouinals.

of my role as a healer to assist people in experiencing the fears and
joys that are hallmarks of confrontation with the boundaries of
human existence. I was quite proud of my accomplishments
because against all odds I had been able to join the clinical stall of
the only psychedelic research project in the country working with
human subjects and psychotherapy. For me this was a dream
realized. I had disdain for the fact that medicine seemed to
emotionally abandon people near death and was resolved to learn
everything I could from this experience.

Joe was in a room with several other patients and when I asked
the nurse who showed me in where we might go for some privacy
she acted surprised. After walking us out to the hall she quickly
darted in and out several doors and then apologetically offered us
the janitor's room. There were brooms and pails strewn around the
small office and she moved a couple of chairs into the closet sized
room. She then said she hoped we wouldn't be disturbed by
janitors looking in for their tools. My pride was a bit tarnished by
the idea of meeting in a broom closet, but there seemed no other
alternative.

He was quite jovial when I asked him about his stay in the
hospital. He chatted off-handedly about the excellent treatment he
was receiving and told me loudly of his implicit trust in the doctors.
Then he informed me that the doctors might have to remove his
eye because of the cancer. He told me this with such a matter-of-
fact and emotionless tone that he could have been describing the
cosmetic removal of a wart rather than a vital organ of sight. When
I asked him how he felt about possibly losing his eye, Joe replied
without a moment's hesitation that whatever the doctors decided he
would accept. Then he quickly went on to say that there were
many more important things for us to discuss. I prepared myself
for him to say something about his impending demise, but to my
astonishment he said that he needed to understand labor unions. I
decided that although that wasn't my agenda for our meetings I
would have to allow Joe to express whatever was on his mind.
What sometimes sounded like a lecture on how to organize a labor
union slowly changed into a recollection of the important events in
Joe's life. I began to feel the power and beauty of the life Joe had
led and to appreciate the privilege of hearing his story.

I learned that Joe was an electrician and had worked with his
hands all of his life. Five years earlier he had been retired from a
position in local industry. Joe spoke at length about his life as a
working man and activities in organizing a labor union. When Joe
was six his father had been blackballed from working as a riveter
in the United States because he was involved in early attempts at
organizing a union. Because of his union efforts Joe's father had to,
with a group of friends, gather together enough money to get over
the border to Canada. They could only gather enough funds for one
of their group to cross the border at a time. In order restrict the
immigration of vagrants into Canada, you needed to post a $ 50.00
bond before crossing the border. Once a man was able to secure a
job in Canada the he would send his first paycheck back to fund
the transfer of another friend into Canada. Joe was outraged that
this had been the plight of early union organizers who were trying
to improve working conditions.

Joe, his brother and one sister, were raised in a northern state
where they struggled to survive on the meager income from his
father's Canadian job. When Joe was 11 his father was able to
secure permission for him to work as a water boy on the riveting
gang. This took Joe out of school, but he was glad for the
opportunity to help support the family. Joe described his father as a
hard working, hard drinking man who was very kind to his
children. He remembered playing ball with his father on weekends
and listening to his fascinating stories about working and
organizing.

Joe described for me the working conditions riveters faced in
that area. The men worked in cruelly confining spaces on hot days
made hotter by the blazing coal fires used to heat the rivets. When
the supervisors were away, Joe's father had allowed him to work as
a "holder on". This job involved using all of his youthful strength
to hold a red hot rivet in place while another worker peened the
end of it. Joe was especially proud of the way he had cleaned up
the crew's water bucket which had been rusty and dirty when he
arrived. He had first asked that the company purchase a new water
bucket, but when they refused he was able to clean up the old one
so the men could drink clean water.

Joe's mother was the backbone of the family. She was still living
though his father passed away many years before. Joe said her
faculties were undiminished even though she was 90 years old. Joe
lived with her and his only sister, Jean. He said his mother was a
warm, comforting and emotionally available person throughout his
childhood. However the family had very little material means. Joe
told me that he never married; he had a girlfriend when he was in
his twenties and though he proposed marriage to her, she didn't
accept because of her family's counsel against marrying a man who
drank as much as Joe did. I asked if he really drank that much and
Joe said, "I must admit I could really put it away." Quickly adding
that his fellow workers did the same. As a way of explanation this
Joe told me that throughout his childhood the men all worked in
gangs and the foreman of each gang received the weekly pay in
gold. So on payday the entire gang of men would adjourn to a
tavern immediately after work. At the bar, in the process of
dividing up the money, they inevitably drank a fair measure of
their income. Joe spoke of alcohol fondly almost as though he were
talking about a person, a working man's friend and entertainer,
who gave a few moment's respite from the grueling daily labor that
made up the lives of the men. He said he had to give up drinking in
1955 because he suffered heart damage from an accidental
electrical shock at work. Though he was sad to lose the
companionship he apparently had no great difficulties in giving it
up.

Joe said he moved to an Eastern Seaboard city and where he
began his efforts to create a union. He said it all started with a few
men meeting in bars after work dreaming of how things could be.
He told me of the fantastic battle with the management, of the dirty
tactics the company used in trying to scare the men out of strike,
and of his persistence and dedication to the men in the yard. As our
meetings became more intimate he recalled some of his
disappointments, at one point he discovered other men stealing
from the union funds and he was especially hurt when one of them
turned out to be a trusted friend. Joe said he always tried to handle
these incidents with care and secrecy, encouraging the man to pay
back his debt and resign the elected office he held.

Joe's attitude during the early interviews was heavily pedantic.
Our meetings had the tone of a class on labor relations. He strongly
denied any fears of losing his sight and spoke optimistically about
the future. Joe's surgeon assured me that he had discussed the
diagnosis and prognosis with him though Joe was discharged from
the hospital at this point. He was complaining of constant
abdominal pain and was receiving substantial doses of narcotic
medication without great effect.

Our meetings were continues at the Maryland Psychiatric
Research Center where we were able to meet in one of the
comfortable drug meeting suites which was furnished like a living
room. Our meetings began to have a more relaxed, less cramped,
janitorial and medical atmosphere. During our second interview at
the center I suggested to Joe that he try listening to some music
over stereo headphones while wearing eyeshades so that he could
see perhaps a small glimpse of what the psychedelic drug treatment
session would be like. I talked to him about how important this
experience might be if he could use the drug effects to go within
himself and see where the feelings about his illness and pain were
coming from. Joe, exuding confidence and bravado, allowed me to
place the earphones and eyeshades on him. As soon as the music
was played, his tone became complaining and angry. At first the
music was too loud and then he found it reminiscent of riveting.
When I asked Joe what riveting reminded him of he became panic
stricken and removed the eyeshades and earphones. He paled
visibly and in a frightened voice told me that he was unable to
continue and would I please turn off the music. I complied and Joe
then told me that he was suddenly experienced fear of losing his
sight. He said that up to this point he had not realized how
frightening this might be. Joe's attitude toward me changed
drastically, when he became frightened the authoritarian manner
dissolved revealing a man genuinely scared of what the future
might bring. Over the next few interviews Joe and I discussed his
claimed ignorance of the possible outcome of his illness. When I
would suggest to him that he discuss the prognosis with the
physicians, Joe took refuge in the belief that they would tell him as
soon as the test results were in.

One day Joe complained of pain during the beginning of an
interview, I asked him if he wished to know what the medical
findings were in his case. He said yes, and I informed him of how
the cancer had spread throughout his body and that the doctors
found in cases where this happened that the most likely thing,
though no one could predict the future with certainty, was death.
Joe didn't act surprised or shaken instead he said he'd secretly
suspected for some time that he was dying. He had taken special
precautions to shield his mother from any knowledge that he was
ill. He said that it was clear to him now this attitude of protection
was also his attempt at shielding himself. "If I pretend my cancer
doesn't exist for my mother's benefit then I don't have to look at it
myself".

As part of preparation for Joe's session I interviewed his sister
Jean, who lived in Joe's mother's house with him. Jean was quite
upset about Joe's illness and ultimate demise which she considered
fait accompli. During a short interview I attempted to communicate
to her that it was possible for Joe's last days to be a beautiful time
of enhanced closeness and interpersonal warmth for the whole
family. Jean seemed somewhat reassured by our talk, but she still
seemed more focused on her own grief and feelings of
abandonment than on relating to her brother as the alive human
being that I was coming to appreciate more and more in my
interviews. I offered Jean the opportunity for additional therapy
sessions; however, it became clear that she did not wish to consider
herself as needing help. I made it clear to her that often in times of
severe stress such as this, talking with someone about the
difficulties could help and that I would be available to her
throughout Joe's illness. In watching Joe and Jean together, it
seemed that the attitude of fear and denial on both of their parts
was responsible for diminished human contact at a time when
warmth and love were the best treatment available. I asked myself
what I could possibly do to change this state of affairs. There was
no ready answer to my question.

Joe and I discussed his upcoming drug session as a special
opportunity for him to review and express the feelings he had
inside himself. Joe was confused as to what I meant by his
"insides". He had never imagined that there was a possibility of
inner experience until our meetings and hadn't felt that he could
change anything about the way he felt about himself or his life
situation.

With some trepidation, I scheduled Joe's drug session. It was my
feeling that we had established good rapport; however, it was still
extremely difficult for Joe to introspect and share his emotions. Joe
continued to use denial as a way of fending off his fear of death.
Although we had been able to break through his barrier sometimes,
Joe in his daily life still constantly spoke of the future as though
his complete recovery were certain. I experienced great hesitation
in telling him that death was almost inevitable. It was my fear that
this news might be taken as a verdict or a death certificate
indicating that there was no hope. I tried to convey clearly the fact
that medical understanding of cancer is incomplete and that
recovery could take place though it wasn't likely. We talked about
death as something facing all men and I told Joe that coming to
terms with our fear of death can lead to enhanced enjoyment of
what life remains.

I introduced Joe to my co-therapist for the drug session, Mrs.
Nancy Jewell. Nancy was in her early 60's, a psychiatric aide who
had been working with the director of the Research Center for
years. I liked Nancy very much and sometimes would thing of her
privately as my "West Virginia Mamma" when I heard the words
of a then popular song by John Denver. When I brought them
together there was such an immediate rapport that I was amazed
and a bit jealous that Joe and Nancy took to each other so suddenly
and completely. I had been building my relationship of trust with
Joe gradually and tentatively for several weeks now.

On the day of the drug session Joe arrived in considerable pain.
According to my instructions, he had discontinued his pain
medication on the day prior to the session. Nancy and I made him
as comfortable as we could on the couch in the treatment suite. At
9 A.M. Nancy administered 90 mg of dipropyltryptamine
intramuscularly, a dosage capable of producing profound
experiences in a willing individual. I placed the eyeshades and
earphones on Joe and suggested that he allow the music to carry
him through the experience. I also advised Joe to confront
whatever experience should present itself. Joe began to complain
of pain and I advised him to enter the pain as fully as possible. Joe
began to scream "God damn it!" "This is terrible, I can't stand this
any longer!" he asked me repeatedly if he could remove the
eyeshades and earphones. I asked him to trust Nancy, myself, and
himself by facing the feelings no matter how terrible they might
seem. I encouraged him to yell, scream, and express the powerful
emotions in any way he could. Nancy reassured him when he
expressed concern that his cussing might offend her.

Over the next 45 minutes Joe trashed, struggled and experienced
difficulties in breathing. We monitored his respiration rate as
slightly elevated. The struggle culminated when Joe said, "I guess
in the end you just have to give in." This statement was followed
by a deep sigh and a profound relaxation of his musculature. He
listened to the music peacefully with a contented smile on his face
for about thirty minutes.

Joe then called Nancy and me over to the couch. He held our
hands. He spoke of being a child, of the difficulties he experienced
being poor, of the joys of his profound identification with his
father and the struggle that was his father's. Joe said he was
experiencing that his father's struggle was also his own and at the
same time it was the struggle of all men. The struggle to overcome
life's difficulties; the pain, the disillusionment, and the horror of
being alive. Joe said, "I feel like I am becoming the blood that
flows through my veins, It's Irish blood. There is strength here, I
feel the strength of the Irish people. The noble strength of working
men. I can feel the meaning of the struggle, of my Irish ancestors.
They are stubborn and strong." Joe said he experienced the ideals
and dreams that brought people and others to this country as
immigrants. "They wanted to overcome pain, injustice and
suffering with their strength, not just for themselves but for all of
us. I share this struggle. It has been my struggle to carry forward
these ideals through my work with the union."

Joe's face softened and looked young. He spoke about his early
jobs. He had dropped out of school and worked as a child so that
his brothers and sister could have shoes and could attend school.
He remembered working while a teenager for the railroad in their
roundhouse as an apprentice mechanic. He smiled and told us of
his foolish pride and overblown confidence in his abilities as a
boxer. He illustrated the ephemeral quality of physical strength for
us by describing an encounter he had with a fireman. He told this
fireman where to go because a guy left a locomotive in a mess for
Joe to clean up. As they fought Joe realized that he'd met his match
in boxing, but Joe's pride would not allow him to admit defeat even
though he was clearly losing the fight. The fireman finally knocked
him unconscious. Joe said this was valuable lesson for him, he
learned to have humility about his virtues. "No matter how big you
are, you act too big or too proud."

Joe recalled the girl wanted to marry with definite sorrow. I
encouraged him to use the session as his chance to express all his
feelings. I asked him not to hold anything back to share all of
himself with us. Joe said in his family he had learned that a man
can do many things but one thing he should never do is let another
man see him cry. I told Joe that crying is part of being human and a
person's strength can grow through letting tears express what word
cannot. Joe described his feeling of longing for his fiancee. He told
us how much he loved this girl and wanted to marry her. I watched
as his psychological conflict over crying expressed itself in a
physical struggle. Joe was holding his breath and tensing his
muscles as though trying to hold back a heavy burden of his
feelings. Finally he surrendered and deep sobs racked his now frail
looking body.

After crying Joe went on to describe his role in organizing the
labor union in the shipboard, the long hard struggle with
management, the difficult working conditions and how he was
moved to action when he saw men suffer. What was most striking
was the complete way in which he shared and relived all of this
intense life experience emotionally. He was able to cry now with
less of a struggle and he expressed in beautiful openly flowing
tears his compassion for fellow worker's suffering. He fumed and
spit his hatred for those managers and foremen more interested in
production quotas than in human welfare. The drama and grand
sweep of this man's life and his efforts seemed all the more
poignant as he shared the depth of his humanity so openly.

There was a broad satisfied smile on Joe's face as he shared his
exultation over the inauguration of a new four million dollar union
hall. He had helped inaugurate the new building a few years before
his retirement. As he beheld the costly new building he contrasted
this victory with the experience he had close to 40 years before
when a local merchant was not willing to accept a check written on
the union's first checking account. Joe's expression changed
suddenly and he was able to admit for the first time the pain that
his mandatory retirement had caused him. He told us how much it
meant to be called "Mr. Union" by his friends and even by his
enemies at work. Joe described the sinking of feeling he felt when
he was told that because he was now retired he could no longer
prepare union cases for arbitration, the emptiness he felt at being
excluded from participation purely on the basis of age. He said that
if he knew he were going to live long enough he would take on the
struggle for the rights of older people.

At this point Joe's sister and niece arrived to pick him up. Joe
was able to sit up comfortably in a chair. I asked him if he was still
in pain. In a cheerful manner and with a smile he admitted that he,
"hurt something of fierce." Joe was relaxed and joyous reminiscing
with his family about happy events in their childhood. His positive
mood was infectious and soon all present were enjoying the
pronounced psychedelic afterglow. I allowed Joe to leave the
center at about 3.30 P.M. after making an appointment for the
following day.

The next morning Joe arrived for his appointment promptly an
announced that he was uncertain as to exactly what had take place
the day before. He claimed that his mind was completely blank. I
asked whether he felt any relief from his pain. He said that he
hadn't. At this point when Joe failed to remember his session even
after I mentioned some highlights to him. I became openly
disappointed with him. I told him that I could not believe that he
had no recall for the moving and profound experience that he had
narrated so eloquently the day before. Nancy was also present
during this interview and I experienced her presence as very
important in that it allowed me to confront Joe more powerful than
I would have dared to were I alone with him. I openly challenged
his denial repeating for him his own description of the content of
his experience. I bluntly told him that if this was an example of
how he expected to deal with death that I was sure he would find
his death hard, but that if he could recall his experience of the day
before where he looked death right in the eyes and continues to do
that, death should be kind and gentle.

Joe looked somewhat sheepish and asked that I got a little easy
on him. He acknowledged that he could remember what had
transpired the day before and said that it was so new and different
an experience to him that he found it difficult to understand and
accept. Nancy and I reassured him that the experience was genuine
and worked with him by discussing the different aspects of the
session. When Joe returned for his next interview he described to
me that he dad been having a great time going through his tools.
He said that for him one of the deepest pleasures of being alive
was the ability to give pleasures to the others. He had gathered
together all of his tools and made up three tool boxes. One of these
went to his brother, one to his nephew and the third to the
workshop of the blind. Joe said that it was plain to him through his
physical deterioration that death was near he told me that this was
no longer frightening and said he planned to spend as much time as
he could with his family.

This was the last meeting I had with Joe. I tried unsuccessfully
to reach him by telephone several times, but was informed that the
telephone would not reach his bed. Joe's niece relayed messages
from him sending his regards and she told me that Joe spoke so
warmly of me she wished she could arrange another meeting for us.
I told her that I would be glad to come out to the house and visit
Joe. She said that Joe's sister was still trying to keep Joe's mother
from knowing how sick he was. the mother had recently broke a
hip and was bedridden in another part of the house. They therefore
preferred that I not visit the household.

Joe died peacefully about two months after his drug session.
One of the secretary's at the Research Center saved the obituary for
me and I felt my body tingle and could feel tears welling up in my
eyes as I read the headline: "MR. UNION DIES". I knew that Joe
would have really been pleased by his obituary!

The experience with Joe was an especially meaningful one in
my training. I gained insight into my own feelings and how they
affected my conduct as a therapist. I marvel still at the amazing
confluence of coincidences that allowed this event to happen. In
looking at the session and the events that surround it I am struck by
the blending of the meaning in each of our lives into a harmonious
whole. I had my own, at times proud and arrogant, at times humble,
goals for helping Joe to confront his fears and emotions through
facing death, an experience that is one of the mysteries of human
existence. How could a 22 year old young man such as I was feel
that he could have anything to offer his elder facing such an
enigma? My own training experiences with psychedelics had
provided me the utterly convincing feeling of confronting death on
many occasions. This gave me the conviction that although I hadn't
physically died I knew something of the human emotions that
surround such an event, how they might manifest themselves in a
person, respond to the effects of a psychedelic and how I might
manage them helpfully.
I needed for my own growth and development as a healer to
confront death in many aspects, both in my own psychedelic
experiences and in work with patients like Joe. A different
experience at this juncture could easily have changed my area of
interest. In order for this experience to be valuable it needed to be
preceded by the series of sessions in which I confronted many
aspects of my own fears and feelings about death. These sessions
also involved confronting the fact that I grew up with the notable
absence of a fathering figure. These factors added to the emotional
import of this first experience with a dying person. I felt that in
accompanying Joe through his treatment process I experienced him
as offering me something a great value, a deep sharing of his
wisdom as an older man reflecting on the meaning of his life.
Certainly this is one of the more meaningful levels of the nurturing
between father and son. It fascinated me that the process was
mutually rewarding and beneficial, that somehow my need to listen,
understand, and help joined with his need to tell the story of his life
to produce an experience of deep meaning and healing for us both.

Most striking of all is the basic unity of the shared experiences
around the psychedelic session. The way in which the inter-related
factors of my own personal history and training combined with my
prior relationship with Nancy Jewll, my developing relationship to
each of us added together to create a complex set and setting for
Joe's experience. It is not really Joe's experience or my experience
or Nancy's experience but rather the amazing confluence of
meaning in this session that proved moving and significant for
each of us.

I think that such accounts such as this one must be a definite part
of the reporting process in psychedelic medicine. The history and
personality of all parties involved in a psychedelic session are
relevant background to the experience that ostensibly unfolds only
in the person taking the drug. In fact Joe's experience was not only
psychedelic for Joe, but also for me and for Nancy even though we
were not under the pharmacological influence of any drug at the
time. We cannot reduce an experience such as Joe's to a set of
before and after measurements and hope to justly report useful
information. We do not yet know or fully understand all the
elements that influence the process and outcome of experiences
with psychedelics so we must try to bare our psyches and those of
our subjects for there is no clear subject in these experiments and
we must not prematurely dissect into components such exquisite
experiences. We must first gather together enough of this
naturalistic data that we allow a new and more comprehensive
view of this process to emerge.

The need for sweeping revision of the paradigms that organize
our approach to the clinical investigation of psychedelic drugs as
significant elements in a complex process of human healing and
transformation can be clarified by turning to mathematics. KURT
GODEL brought a famous paradox from philosophy into
mathematics and it seems to have relevance for research with
psychedelics as well. GODEL'S theorem holds that the logical
consistency and completeness of a system may not be assessed
from within that system, in fact in order to assess such properties
one must build another system from which to observe and assess
the first. With this situation we may then make an assessment of
the logical consistency and completeness of the first system but
may not be sure of the consistency or completeness of the system
that we are observing from. If one applies this to psychedelic
research it becomes apparent that when researchers sought to apply
previously existing conceptual frameworks to the startling new
phenomenon of psychedelic drugs they influenced the results
through mechanisms outside of their awareness at the time. The
logical systems they sought to apply to psychedelics were
incomplete, but they nonetheless served the limiting and
organizing function described for scientific paradigms (KUHN,
1970).

Since these investigators had no vantage point outside the
logical systems they sought to apply they were blind to the manner
in which their own theoretical and scientific orientations were
influencing the psychedelic experiences of their patients and
subjects. When one looks from the vantage point offered by history
it becomes apparent that this is how at least three differing and at
times mutually exclusive views of nature, effects and possible
usefulness of psychedelics came into being. Each system had ways
for dealing with its competitors and each system had its own blind
spots and inadequacies. What has been missing from our Western
scientific approach to psychedelics has been the original awe and
humbleness necessary when approaching an entirely new
dimension, a new frontier in the study of the human mind and
consciousness. Awe, wonder and open minded, open hearted
description of the human experiences of all parties involved in
psychedelic journeys with the quality of a beginners mind is what
must be used to begin a new science of consciousness. Surely as
we grasp the new view of consciousness and the universe that will
emerge from these early naturalistic studies and their careful
analysis our mind will distinguish new pictures, new paradigms,
new views of human nature. These insights will lead us in turn to
the development of appropriate analytic instrumentation and new
research methods to reflect and enhance the detail of the emerging
picture of humanity and its relation to the cosmos. In order to make
the necessary conceptual leaps we will have to abandon our
precious status as unbiased and knowledgeable scientists. We will
lose little in doing this for psychology and psychiatry, the
disciplines most involved in psychedelic research to date, currently
tend to make poor use of research methods and techniques derived
from l9th century physics. This subject object dichotomized view
is simply not applicable to substance since it denies the basic unity
at the core of any psychedelic experience and relies for validity on
the presence of boundaries that are clearly transcended by the
states of awareness possible when humans take psychedelic
substances.
"Nany gieat physicists ovei the yeais have become ueeply
absoibeu in the iole of the minu in constiucting ieality.
Schiouingei, foi instance, iemaikeu that exploiing the ielationship
between biain anu minu is the only impoitant task of science. Be
once quoteu the Peisian mystic Aziz Nasafi: 'The Spiiitual woilu is
one single spiiit who stanus unto a light behinu the bouily woilu
anu who, when any single cieatuie comes into being, shines
thiough it as thiough a winuow. Accoiuing to the size anu kinu of
the winuow, less oi moie light enteis the woilu.' Westein thinking
is tiying to objectify eveiything, Schiouingei saiu, 'It is in neeu of
bloou tiansfusion fiom Eastein thought.' A Binuu sutia pioclaims,
'Theie is nothing in the moving woilu but minu itself,' a view
echoeu by physicist }ohn Wheelei: 'Nay the univeise in some
stiange sense be biought into being by the vital act of
paiticipation."' (FERu0S0N, 198u, PP. 172-17S).

The scope of substance is clearly interdisciplinary because of the
many different disciplines can bring useful techniques and partial
understandings to this new area of study. Disciplines that can both
enrich the study of psychedelics and be themselves enhanced by
psychedelic medicine include: anthropology, philosophy, religion,
physics, psychiatry, ethnobotany, history, pharmacognosy,
pharmacology, psychoanalysis, psychiatry, psychology, sociology.
Psychedelic medicine may also be called transdisciplinary in that it
can offer scholars and scientists more as a unique whole than does
a simple collection of the separate insights from the individual
disciplines that combine to form this new field.

The possession of a degree in allopathic medicine or any other
existing discipline should not be taken as a qualification to practice
psychedelic medicine, neither should such degrees disqualify an
individual. Training in psychedelic medicine involves a series of
explorations employing the technique of full disclosure reporting
by all participants in the training sessions. Through the series of
training sessions the trainee is exposed to progressively deeper
layers of consciousness ultimately including profound experiences
of a mystical-unitive nature. During this process the trainee will
inevitably suggest modifications to the naturalistic method on the
basis of their training and background in other scientific disciplines.
Creativity enhancement has been documented to occur in properly
planned and conducted psychedelic sessions. It is therefore
reasonable to expect that trainees will gain creative insight into
their own disciplines and psychedelic medicine in addition to
experiencing personal and transpersonal insights into human
condition. This training is conducted by a core training-group of
psychedelic therapists and the trainee is qualified for practice by a
consensus of the training group.

The field of psychedelic medicine will eventually develop its
own methodology out of the initial purely descriptive naturalistic
phase that we must begin now. The basic paradigm of psychedelic
medicine is that the psychedelic phenomenon can only be studied
by methods that accept the basic unity of the process under study.
Furthermore the study of human experience with psychedelic
substances must always take into account the infinite value of the
individual and must always seek to do justice to the human
qualities of the psychedelic experience. This means that our
techniques of study must not lump together different varieties of
human beings and their experiences in such a manner as to efface
the meaning and significance of individual experience. Much use
of statistics in research studies with human subjects involves such
lumping together of these scores across individuals without regard
to differences. Though this may be necessary at a certain point it is
not apparently useful at the beginning stages of investigation and
in fact often obscures the meaningfulness of individual experiences
and their relationship to psychological change and growth.

The profound challenge of conducting significant research with
psychedelic and empathogenic compounds can only be met by
creating a new discipline: psychedelic medicine. This new outlook
allows us to overcome the existing paradigms that limit and
confound scientific research with these substances. We are called
to incorporate a quantum leap in honesty and completeness of
scientific reopening in this research. Work in this area also requires
that respect and empathy play a central role in the design and
conduct of studies with human beings. And foremost, ways must
be found to overcome the fear and misunderstanding so prevalent
in our society's reaction to this new frontier.


References
Allegro, John M. 1970 The Sacred Mushroom and the Cross;
Fodder and Stoughton, London.
Ferguson, Marilyn 1980 The Aquarian Conspiracy; Tarcher, Los
Angeles.
Furst, Peter T. 1976 Hallucinogens and Culture; Chandler & Sharp,
San Francisco.
Hofstadter, D.R. 1979 Godel, Escher, Bach: An eternal braid;
Basic Books, New York.
Kuhn, Thomas S. 1970 The structure of scientific revolutions;
University of Chicago Press, Chicago.
Osmond, Humphrey 1957 A review of the clinical effects of
psychotomimetic agents; Annals of the New York Academy of
Sciences, p. 66; pp. 418-434.
Schultes, Richard E. & Albert Hofmann 1979 Plants of the Gods;
McGraw-Hill, Maidenhead.
Sharon, Douglas 1978 Wizard of the Four Winds: A Shaman's
Story; The Free Press (Macmillan), New York.
Wasson, R. Gordon 1968 SomaThe divine Mushroom of
Immortality; H.B. Jovanovich, New York.
Wasson, R. Gordon, Albert Hofmann & Carl Ruck 1978 The Road
to Eleusis; H.B. Jovanovich, New York.
Weil, Andrew 1972 The Natural Mind; Houghton Mifflin, Boston.
Yensen, Richard 1989 From Mysteries to paradigms: Humanity's
journey from sacred plants to psychedelic drugs; in: Chr. Rtsch,
Gateway to Inner Space: pp. 11-53; Prism Press, Bridgeport,
Dorset.