In the preceding text, the phenomenology of the LSD state has been dissected and itemized for didactic purposes and the discussion has focused on separate levels of the unconscious and individual types of experiences manifested in the sessions. At this point, it is necessary to re-emphasize the complexity and the multidimensional nature of the LSD reaction, describe some of its general characteristics, and approach it more holistically. For theoretical and practical purposes, it is important to understand the way in which different levels of the unconscious exteriorized in the session are related to the personality of the subject, his present life situation, and his psychological problems, as well as to the general context in which such a session takes place. One must also be aware of all the variables determining the nature and course of the LSD experience and of the major sources of its experiential material.

The content of LSD sessions is always highly specific for the subject and expresses in a condensed symbolic dramatization the psychophysiological, emotional, intellectual, philosophical, and spiritual problems most relevant at the time of the session. This is particularly obvious for sessions of a psychodynamic nature, where the LSD experiences are more or less directly related to the individual’s present life circumstances and past biographical data. However, similar specificity can be demonstrated for various aspects of perinatal experiences and even transpersonal phenomena. This is true not only for ancestral and racial memories but also for archetypal dynamics and past-incarnation sequences. All these seem to have immediate relevance for the subject as a complex psychobiological and social entity and to be meaningfully related to his present life situation. There are some exceptions to this rule; certain advanced transpersonal phenomena, such as the experience of the Universal Mind or the Void, are of such a high degree of generality that they are applicable to the problems of the individual only in the broad and unspecific form of philosophical or spiritual guidelines.

A very important principle influencing the selection of unconscious elements for exteriorization and conscious representation in a particular LSD session is the definite preference for material with a strong emotional charge. It seems that the unconscious elements that are at the time connected with the most intense negative or positive affect will be activated by the drug, emerge into consciousness, and become the manifest content of the LSD experience. This specific affinity of LSD for emotionally highly charged dynamic structures has significant diagnostic and therapeutic implications. Because of this unusual property, LSD can be used as a kind of “inner radar” that scans the unconscious, identifies the areas of high affective tension, and brings them to the open. It helps the patient and the therapist to distinguish relevant material from the trivial and unimportant, establish proper hierarchies of priorities, and recognize the most urgent areas for therapeutic work. The phenomenology of LSD sessions thus reflects the key problems of the subject and exposes the roots and sources of his emotional difficulties on the psychodynamic, perinatal, and transpersonal levels. This can happen in a direct, immediate way that is self-evident and does not require any further clarification or interpretive work. At other times, the relevant connections are at first not obvious. In such cases, it is necessary to use free associations or explanatory comments by the subject in a way not dissimilar to psychoanalytic interpretation of dreams. Through the use of this approach in the session or especially during subsequent analysis of the material in question, it is usually possible to decipher the ingenious structure of the symbolic language of the LSD state. An individual’s associations to various aspects of his LSD session can lead in a surprisingly short time to the most relevant unconscious material. Freud once said of dreams that they were the via regia or royal way to study the unconscious; to an even greater degree this seems to be true for the LSD experience.

This unusual propensity of LSD to represent selectively important conflict-laden emotional themes can be illustrated in the case of Otto, in whom the phenomenology of a high-dose session was limited to a single manifestation.

Otto was a thirty-one-year-old technician with a schizoid personality and many unusual interests. He was admitted to our department because of severe depressions, excessive consumption of alcohol, bouts of anxiety, and a tendency to bizarre ideation. His first LSD session followed a long period of intense medication with Niamid, an antidepressive drug from the group of monoaminooxidase inhibitors; it was discontinued only three days before the session. As we discovered later, long premedication with Niamid enormously increases resistance to LSD and makes the person almost immune to its effects.* Otto had only one very brief, unusual experience during the entire session day although the dose of LSD was successively increased to 350 micrograms. In spite of the fact that the session was rather disappointing and uneventful, the postsession analysis of this isolated phenomenon brought interesting results.

During the preparation for this session, Otto repeatedly talked about his two recurring anxiety dreams. In the first one, he was being prosecuted and tried because he had murdered a man by cutting off his head; Otto had a suspicion that the victim might have been his father. In the second dream, a stranger approached him and started touching his genitals; at first, this man was just gently stroking his penis; later he began to wring and crush his testicles. Otto was afraid that these dreams might be indications of a latent sexual abnormality and asked for a checkup in regard to possible homosexuality.

As mentioned above, Otto had failed to respond to a very high dose of LSD; the only perceptual change that he had noticed during the entire session was a very vivid, concrete, and realistic feeling that his hands were transformed into his father’s hands. For reasons that he did not understand at first, he found this experience very frightening and felt a deep need to understand the nature and source of his fear. He was asked to focus on the phenomenon of the transformation of his hands and report his associations. After much hesitation and with strong affective involvement, Otto painfully and reluctantly described the tormenting incestuous problems that he had had for many years in the relationship with his mother. This issue was particularly precarious after his father’s death, at which time it had become the dominant theme in Otto’s life. According to his descriptions, his mother’s behavior toward him was very seductive and sexually stimulating. She insisted on sharing a double bed with him, used every opportunity for intimate physical contact, and systematically blocked his efforts to get married. She also repeatedly suggested that they live together for the rest of their lives and offered to care for his young illegitimate child. With further discussion, it emerged that the only symptom in Otto’s LSD session expressed in a condensed form many of the deep conflicts he had in regard to aggression, sex, and incest. The hands played a crucial role as instruments in a sexual relationship that had not and must never reach the level of genital union. The transformation of Otto’s hands into those of his father’s expressed his wish to substitute for his father in sexual activities. It represented a bridge to his mother and legitimized the approach to her as an erotic object, while still respecting the incest taboo in regard to actual intercourse. The hands were an important component in both recurring dreams; this connection revealed Otto’s strong ambivalence toward his father as being one important root and determinant of his truncated LSD experience. The feelings involved ranged from the need to be approached sexually by his father (caressing of the penis) to violent murderous impulses (parricide by decapitation) and castration fears with autopunitive elements (crushing of the testicles). Otto’s excessive and guilt-laden masturbation represented the link between the dream themes and the hand transformation in the LSD session. At this point, Otto had sudden insights into some of his unusual habits, particularly in regard to his collecting bizarre and peculiar items. In the course of many years, he had put together a most extraordinary museum occupying several rooms of a storage house. Its dark walls harbored a unique mixture of archaic hand organs, calliopes, and various music machines; animated figures and other ingenious automata; and skulls and skeletons resting on a black velvet background. The highlight of this panopticum was, however, a collection of wax imitations exhibited on dark shelves in a twilight atmosphere. The most important items of this little private Madame Tussaud museum were wax heads of famous murderers, together with casts of arms and hands damaged by vitriol, lightning, or tortures of the Spanish Inquisition. Other models showed genitals disfigured by syphilis, chancroid, and cancer. In addition to all these associations, Otto remembered that during his entire childhood his father had always put enormous emphasis on hands and the imperative necessity of keeping them neat, clean, and in good shape. The material uncovered during this discussion increased considerably Otto’s self-understanding and was very helpful in his subsequent therapy.

One more aspect of the LSD reaction should be reemphasized at this time—namely, its enormous complexity and the number of variables and determinants that are involved and can play an important role. Knowledge and awareness of these elements is essential for every therapist and guide. The present picture of what is happening in the sessions is very far from the original concepts of early experimenters who saw the LSD experience as a result of a simple interaction between the drug and the physiological processes in the brain. Observations made over several decades of LSD research have clearly indicated that, in addition to the basic pharmacological effects of the drug, numerous nonpharmacological (or extrapharmacological) factors have to be taken into consideration for a more complete understanding of the LSD state. In the following text, we will briefly review the most important areas the LSD therapist must be aware of, because they function in different combinations as potential sources of experiential material or as factors modifying the LSD reaction.

Environmental Stimuli and Elements of the Setting

The setting is an extremely important variable that can have a powerful influence on the nature of the LSD experience. It makes a great difference whether the session takes place in a busy laboratory milieu, in a comfortable homelike environment, in a sterile medical setting with white coats and syringes, or in a place of great natural beauty. Each of these settings tends to activate and facilitate the emergence of quite different matrices from the unconscious of the subject.

Also, various particularized external stimuli can codetermine the character and course of the LSD session, sometimes in a rather decisive way. Thus, a picture on the wall or in a book, photographs of close relatives, a glimpse of the shape and color of a certain piece of furniture, scenery briefly seen from the window, or a look at the toilet bowl during a physiological break in the session can trigger very specific sequences of experiences. Equally powerful in this sense are acoustical stimuli, such as a certain piece of music, the ringing of the telephone in the session room, the singing of a bird or barking of a dog, sounds of a jet plane or ambulance, as well as the monotonous buzzing of electrical appliances or laboratory gadgets. An especially powerful and complex stimulus from this category can be a single word, sentence, or a longer verbal communication coming from the therapist or accidentally overheard during the session. At times, other sensory modalities can be involved; pain associated with an injection, the pressure of a belt or a tight collar, holding of the hand or other forms of physical contact, the temperature in the room, a breeze or a draft, all these can become significant determinants of an LSD experience. The same is true of gustatory and olfactory stimuli; the taste of food or beverages, as well as various odors and distinct fragrances, can have a rather strong influence on the subject. Some internal stimuli coming from various organs of the body can be included here, since they have a similar function; thus, hunger, thirst, and the urge to urinate or defecate may initiate specific experiences.

Even more relevant are various stimuli of an interpersonal nature; the outlook, clothing, and demeanor of the persons who are present in the session or briefly visit the subject, as well as the way they interact, can become critical determinants for the LSD experience.

Personality of the Therapist and the Therapeutic Situation

The personality of the therapist (sitter), his concept of the LSD session, and his specific approach to it, as well as the nature of his interaction with the subject are among the crucial variables determining the LSD experience. Besides the therapeutic relationship and the current transference problems, many other factors related to treatment can be important sources of material for the session. The general atmosphere in the therapeutic facility, the nature of the patient’s relationships with the nurses and fellow patients, the specificities of recent situational factors, and the information exchanged between the patients have the potential to shape certain aspects of the LSD experience.

Present Life Situation

The circumstances of the subject’s life situation at the time of his session are a factor the significance of which should not be underestimated. The most frequent source of experiential material for LSD sessions from this category are strongly emotionally charged and conflict-laden relationships, particularly those involving marked dependence and ambivalence. In some individuals, it can be with members of their family of origin; in others, the major focus might be on erotic, sexual, and marital relationships or problems with children. Current conflicts with employers and supervisors, coworkers and subordinates, and other difficulties in the professional area are another common theme in this group. Occasionally, economic, legal, or political problems can be instigative.

Past Life History

This is a very broad category covering a rather large time span and encompassing a variety of important events and problems from childhood, school years, adolescence, postadolescence, and adulthood. Some of them are traumatic; others reflect positive past experiences with parents, friends, or sexual partners; periods of personal success and happiness; encounters with elements of natural beauty; and exposure to artistic creations of high aesthetic quality.

Early Childhood and Infancy

This group includes biographical events from early stages of the developmental history; they are of a very basic nature and are associated with a strong negative or positive emotional charge. Most of them are related to the frustration or satisfaction of primitive instinctual needs of the child; this category was discussed in detail earlier in the context of core experiences of COEX systems.

Biological Birth and the Perinatal Period

Many LSD subjects refer to the circumstances of their biological birth as the deepest source of many agonizing as well as ecstatic experiences in the sessions. The varieties of physical, emotional, and psychological concomitants of the birth process have been discussed in the chapter on perinatal phenomena. A word of caution should be repeated in regard to the elements of this category and of the following ones: it remains to be established whether they are symbolic products of the unconscious or reflect events that once existed in objective reality.

Embryonal and Fetal Existence

This area becomes particularly significant in advanced stages of LSD psychotherapy. The re-enactment of events from various periods of intrauterine development of the fetus include embryonal crises, blissful aspects of fetal existence, and factual illustrations of embryological processes.

Transindividual (Transpersonal and Transhuman) Sources

As we have discussed earlier, much of the material occurring in LSD sessions cannot be adequately explained by biographical data and the biopsychological history of the individual. At the present time, this fact is quite enigmatic, and no satisfactory explanation can be offered for the mechanisms involved. When such material appears in LSD sessions, it has the form of ancestral and phylogenetic sequences; identification with other people, animals, and inorganic material; or of archetypal images; collective and racial memories; and past-incarnation experiences. From a medical point of view, we could also refer in this context to infraindividual sources, as when an LSD subject describes experiences of consciousness of individual organs, tissues, and cells of his own body.

To illustrate the complexity and multidimensional dynamic nature of the LSD experience, we will now complement the above synoptic survey of the individual levels and sources of material with concrete clinical examples. Although each of them is specially selected to focus on material from one particular level, elements from other levels are always simultaneously present. This overlapping of levels is a typical and essential feature of the LSD experience.

We were able to learn a great deal about the significance of environmental and situational stimuli in the early years of experimenting with LSD, when the nature and complexity of the drug reaction was insufficiently understood and the conditions for the sessions were far from optimal. I will describe here one of the most drastic external interferences in an LSD session I have ever witnessed.

One of the treatment rooms in the Psychiatric Research Institute in Prague was equipped with a one-way mirror when we started using it for LSD therapy. At that time, two eager but not very sensitive psychology students were interning in our department. One day, when I was running an LSD session with Armida, a young female patient with borderline psychotic symptomatology, they combined a disciplinary trespass with a serious technical error. Without permission from the patient or myself, they decided to watch the LSD session through the one-way screen. Ignorant of the fact that the proper use of this device required darkness in the observer’s room, they left the lights on while uncovering the rear side of the mirror. As a result, their ghostlike images appeared on the screen in the treatment room. Armida saw them, and she reacted with a combination of panic and extreme rage. For over an hour, she screamed, yelled, and flailed around, rolling on the floor; during this time, I had virtually no contact with her. After she calmed down and rapport was re-established, Armida was able to explain what had happened. When she had looked into the mirror, the whole scene suddenly changed into a frightening forest. The ghostlike figures of the psychologists were transformed into two aggressive young men with whom she had had a very traumatic experience at the age of seventeen. During the time when she was agitated and unable to communicate, she was totally absorbed in reliving this incident. According to her description, the two scoundrels exploited her naïveté and lured her into a dark forest. Helping each other, they successively raped her in spite of her desperate resistance. As a result of this incident, Armida contracted gonorrhea, which had a chronic course and caused her much gynecological trouble. The biological and emotional sequelae of this event contributed considerably to the problems of her sexual life.

Thus, the real circumstances of the session provided a massive and dramatic external stimulus; the latter was, however, transformed in the sense of an old traumatic experience, and, in turn, triggered the reliving thereof.

The importance of the therapeutic relationship as a major determinant of the content of an LSD session can be clearly demonstrated in the first session of Charlotte, a twenty-three-year-old nurse. Several years before her LSD therapy, she was hospitalized in a locked ward of a state mental hospital for a stuporous condition that was diagnosed as schizophrenia simplex. After discharge, she had systematic psychotherapy over a period of several years preceding her first LSD experience. During this time, she successively manifested symptoms of obsessive compulsive neurosis and conversion as well as anxiety hysteria. Important elements in her development were a cool and rigid family milieu without understanding of her needs and virtually no emotional support from her parents. The atmosphere at home was dominated by unrealistic religious demands and was particularly hostile to sexual manifestations of any kind. At the time of the session, Charlotte was completely isolated, and the therapist was her only emotional resource. She manifested a very intense transference and was preoccupied by the idea of breaking the artificial and professional framework of the therapeutic relationship, changing it into an erotic one, and integrating it into her life. This problem strongly influenced the content and nature of her first LSD session.

At the beginning of this session, Charlotte became aware of the strength of her emotional attachment to the therapist and was questioning whether he was interested in her only as a patient or whether “real human interest” was involved. She could not tolerate the idea that he had other patients and did not belong entirely to her. Moreover, the very fact of her being in the role of a patient seemed hardly acceptable. Suddenly, she looked at her body and with a peculiar smile made the comment, “I have the feeling that there is nothing on me … I mean, there is nothing to me; at least nothing you would be interested in. I don’t mean anything to you.” Shortly afterward, the tendency revealed in the preceding Freudian slip of the tongue fully emerged. Charlotte experienced herself as a beautiful nude model, and the therapist was transformed into a frivolous and lighthearted bohemian painter. The treatment room became a cozy and untidy Montmartre atelier. At that moment, everything seemed beautiful, and Charlotte felt extremely happy. This brief romantic interlude was brutally interrupted by visions of devils and infernal fire on the walls. When Charlotte looked at the therapist she imagined that his tongue was growing and saw his face becoming darker; she then perceived him as a devil with terrifying eyes and little horns on his forehead.

Later, Charlotte hallucinated a ravishingly beautiful woman with a black mask. She expressed her wish to be equally attractive, irresistible, and inaccessible, so that no man could resist her. When she looked at the therapist with a teasing expression and he did not respond to the cryptic seductive message, she saw the wall full of dull-looking oxen. To make sure that he understood this time, she apologized for her visions, stressing that they were involuntary and should not be taken personally. Next the entire room was filled with emblems and coats-of-arms of nobility|| composed of various love symbols, such as kissing doves, hearts, embracing couples, and stylized male and female genitals in union.

Shortly afterward, Charlotte envisioned numerous images of personified, bespectacled owls, sitting in a library filled with cobwebs and antique leather-bound volumes. They looked very funny and absurd, like caricatures of scientists. When she looked at the therapist, she burst out laughing, because he was also transformed into one of those learned birds. The visions of this symbolic aviary did not last long; soon the treatment room changed into a space laboratory where everything seemed cold and artificial. Plastic and metal surfaces and long cables dominated the scene (a dim-witted person who does not get the message promptly is referred to in a Czech idiom as having “long cables”). The therapist appeared to be dressed in the protective space suit of a cosmonaut, “safe from any changes of temperature and external influences.” In the scene that followed, the therapist was transformed into a nosy, pipe-smoking detective who looked like Sherlock Holmes himself. The room was being filled with pipe smoke; Charlotte commented that soon nobody would be able to see anything and enjoyed the prospect of such privacy. Not getting an encouraging response, she hallucinated donkeys with big ears and stupid expressions in their eyes. She again emphasized that she did not produce these visions on purpose and that nobody should feel offended by them. The last transformation of the therapist in this session was into a provincial barber dressed in a dirty white coat.

All the aforementioned phenomena are related to the patient’s transference problems and have a clearly ambivalent character. Charlotte’s feeling that she did not have anything on and that there was nothing to her expresses in a condensed way her desire to change the therapeutic situation into an erotic one and, at the same time, her concern that she was not attractive enough to be interesting to the therapist. The next scene is a wishful erotization of the situation. Instead of a doctor with his patient, there is a messy atelier, a lively artist, and his nude model. The pictures of the sexualized coat-of-arms is another variation of the same theme. The scenes involving devils have a complicated ambivalent meaning. In regard to Charlotte’s strict religious upbringing, they symbolize punishment for forbidden wishes; on the other hand, they are expressions of unleashed instinctual tendencies of a sexual and aggressive nature (the devil as seducer). The visions of owls are an ironical reaction to the fact that the therapist did not respond to her overt seductive maneuvers and maintained an objective and “scientific” attitude. According to Charlotte’s associations, the experience involving the space lab reflects her perception of the therapist’s coolness and inaccessibility and the sort of protective outfit that he used against her coquetry. The astronaut’s voyage to the stars symbolizes Charlotte’s fantasies concerning the future scientific career of the therapist. Many of the visions in the session also express Charlotte’s dissatisfaction, irony, and criticism of the psychiatrist’s lack of understanding of and response to her erotic signals. This includes the visions of oxen, asses, owls, and long cables in the lab. The transformation of the therapist into a barber represents another attack on the therapeutic role by redefining the function of the white coat, a common symbol of the medical profession. The discussion of this session and detailed analysis of its content proved very helpful in identifying and resolving the transference problems so vividly manifested in its content.

On occasions, even a single image in an LSD session, if thoroughly analyzed, can be an important source of information about the transference process. We can use as an illustration one brief experience from Charlotte’s second session. This example also shows the intricate dynamic structure of the LSD phenomena on the psychodynamic level.

At one point Charlotte opened her eyes and saw a speck of lint on the rug illusively transformed into a funny-looking mouse with unusually large ears; it was dressed as a pilot and was sitting astride a helicopter. Subsequent analysis using the patient’s associations revealed the auto-symbolic character of this image. The mouse represented Charlotte and the complexity of her feelings in regard to the session and the transference situation. Earlier in the session, Charlotte had used several maneuvers to drive the therapist into various complementary roles; he had responded with certain therapeutic countermeasures. She did not like this approach and had the feeling that it resembled the play of a cat and mouse. Immediately afterward, she thought about the novelty of LSD therapy and felt like a laboratory animal on whom a new drug was being tested. During her nurse’s training, she had often seen experimental mice in such a role. As she was mulling over these ideas, Charlotte began to sweat profusely; a Czech idiom used for this condition is “sweating like a mouse.” At the time when the lint changed into the mouse-pilot, the idea of a mouse as a symbol for herself was thus already strongly overdetermined by several independent trends of thought. Before the lint was illusively transformed, Charlotte watched it and associated it with her low self-esteem: “I feel very funny, as if I am an absolute zero, a nothing, like that lint over there, waiting for the vacuum cleaner.” In our discussion after the session, Charlotte also shared interesting associations to the symbol of the helicopter. The two directions that characterize its flight, namely upward and forward, symbolized to her the trajectory of a successful life career; the helicopter represented the therapist from whom she expected help in realizing this aim. This composite image reflected Charlotte’s ambivalence in the transference relationship. On one hand, she felt inadequate and expected help and support; on the other hand, she wished to manipulate and control. This was expressed in the ambiguous role of the mouse who was a passenger of the helicopter but at the same time functioned as its pilot.

The mouse/helicopter symbol was based on actual elements of the treatment situation, such as lint on the floor, the testing of a new drug, and excessive sweating; at the same time, it reflected Charlotte’s life feelings and problems in the therapeutic relationship. In addition, several connections were later traced to important childhood experiences—especially to her phobia of storms and strong wind.

The above clinical example can be used to demonstrate a general principle that deserves special notice. Free associations to Charlotte’s auto-symbolic image clearly indicated that individual experiential elements in psychodynamic LSD sessions are sensory or motor exteriorizations of important “nodal points” of the unconscious dynamics. These points occupy the “crossroads” of several association chains connecting areas with emotionally strongly charged unconscious material. Detailed analysis shows that the elements selected for manifest representation (mouse and helicopter in Charlotte’s case) are quite regularly those which allow for condensed symbolic expression of a greater number of relevant emotional themes. These individual themes then participate in the resultant manifest experiences in a pars pro toto fashion; in other words, each of them is represented by the partial component that they all share. It is often found that the same image or element expresses several significant and often conflicting themes and tendencies of the subject. At the same time, it is also meaningfully related to various aspects of the environment and the treatment situation.

The importance of the present life situation for the content and course of LSD experiences can be shown in the case of Peter, whose basic biographical data were given earlier (page 49).

During his entire childhood, Peter suffered from severe emotional deprivation; as a result, he craved affection and maternal love in his adult life. In one of the early LSD sessions of his psycholytic series, there was a long, unusual episode characterized by joyful Christmas scenes alternating with tragic funeral sequences. When he looked out of the window, Peter saw a fairy tale–like winter landscape (the session took place on a sunny November day at least a month before the advent of snow) and the treatment room had “Christmas acoustics.” He visualized and smelled his favorite dishes that used to be served on Christmas Eve when he was a child; he heard Christmas bells and the sounds of Christmas carols, and saw scenes depicting traditional yuletide customs performed in his native village. The therapist changed into a magnificent, richly lighted and decorated Christmas tree with various children’s toys hanging from its branches.

During the alternating tragic episodes, the atmosphere was very sad and heavy. In a spot on the wall, Peter saw a funeral cortege with many people clad in black and following a hearse. Trivial sounds from the environment that were perceived earlier as capricious Christmas chimes now sounded like death bells. The opaque lamp became a large, ominous-looking phosphorescent skull. Another psychiatrist present in the room looked as if he were dying of a serious illness and he seemed to have the livid color of a corpse. Finally, he was transformed into a skeleton with a scythe, the traditional symbol of the Grim Reaper.

This sequence was rather unclear until it was analyzed with the help of Peter’s associations. During his whole life, he had been attracted to maternal women, attempting to get the affection he had missed in the relationship with his own mother. The latter was now eighty years old, and he expected her death any day. The LSD session took place six weeks before the Christmas holidays, during which he planned to visit his mother and spend some time with her. Peter thought of this visit as his last chance to see his mother alive. In his fantasies, he anticipated that she would give him on this occasion a warm hug and kiss and allow him to put his head on her lap. Thus, the idea of the imminent death of his mother was intimately linked with the Christmas atmosphere and the theme of blissful reunion.

Although the material in this sequence reflected the problems of Peter’s current life situation, the deepest roots of the themes involved could later be traced to basic perinatal matrices; the imminence of death and the funeral motifs were related to BPM II and the element of union with the mother to BPM I.

The multilevel overdetermination of a single experience in an LSD session by material from various periods of an individual’s past history can be illustrated by the following clinical example.

Paul was a thirty-two-year-old chemist admitted to our department after an unsuccessful suicide attempt, with the diagnosis of severe character disorder, drug addiction, and alcoholism. He was addicted to fenmetrazine (Preludine), an antiappetite drug with psychostimulant properties. In the past, he kept increasing the initially prescribed dosage of 25 milligrams three times a day until his average daily consumption amounted to about 1500 milligrams. At that time, he developed symptoms of an acute paranoid psychosis with panic anxiety, multiple acoustic hallucinations, and delusions of persecution. After several days spent in a Kafkaesque world, running and hiding from imagined persecutors, he attempted to kill himself and was brought to our institute.

In one of his LSD sessions, Paul had the intense feeling that his body was shrinking and becoming progressively more and more emaciated. Using the technique of free association, we could reconstruct the ideational and emotional content of this experience. Some of the associations led us to the circumstances that precipitated Paul’s drug addiction. During prolonged inactivity following the fracture of his leg, Paul became quite obese. He was very unhappy about his appearance and the desire to lose weight rapidly was the main reason he started using fenmetrazine. As a result of this medication, he was actually losing weight drastically.

Another chain of associations linked this experience with Paul’s feelings about his father. Paul was born of a mixed marriage; during World War II, his Jewish father spent several years in a Nazi concentration camp, and he himself was persecuted and frequently humiliated. As the war progressed, he used to watch the transportation of starved prisoners in cattle cars; on these occasions, he always thought about his father, concentration camps, and the tragic destiny of the Jews. This very painful and traumatic period of his life represented one important root of the experience of emaciation in the LSD session.

Additional associations led to Paul’s overinvestment in the cultivation of his intellect and to his fear of aging, decrepitude, and death. Paul’s brilliance was his major asset and his primary compensatory tool. He had an insatiable intellectual hunger and was continually tortured by the feeling that he was aging too quickly. One of his most terrible nightmares was related to his failure and inability to live up to his ambitions and the lack of time to achieve all his goals. Experiencing emaciation in his LSD session, he had on several occasions the strong feeling that he was undergoing accelerated aging and was actually mutating into a decrepit senile man. The most frightening aspect of this experience was the realization of the loss of intellectual functioning that characterizes senile dementia. Thus, the experience of becoming emaciated was also an expression of the most significant fears of his life. Subsequent sessions showed that, in addition, the experience of shrinking also involved an element of age regression into a major traumatic memory of his early childhood.

Paul’s experience could be used as another illustration of the exteriorization of nodal points of unconscious dynamics in LSD sessions. In this case, a single experiential theme (shrinking and emaciation) seemed to represent and express many relevant traumatic areas and periods of his life.

The next example involves experiences from a more advanced session of a psycholytic series. The most obvious sources of its content are traumatic experiences from childhood, but there is a strong participation of perinatal elements (BPM III).

Dana, a thirty-eight-year-old high-school teacher with a doctorate in philosophy, had suffered for many years from a complicated neurosis. Her symptoms included suicidal depressions, bouts of free-floating anxiety, hysterical seizures, and various psychosomatic manifestations; however, the most paralyzing problem was an obsessive-phobic attitude toward her daughter. For eight years, ever since the girl was born, Dana had been experiencing strong impulses to hurt her—stab her with a knife, throw her out of the window, or strangle her. This alternated with a panicky fear that something bad could happen to the child; every elevation of fever was perceived as a possible symptom of fatal illness; the baby bottles, plastic nipples, and diapers were never clean enough to insure the elimination of all dangerous bacteria, and every absence from home was seen as a potentially serious hazard. In addition, Dana, as a person of high moral standards, was vexed by agonizing guilt and self-accusations because of her destructive tendencies against her own daughter.

A picture showing the resolution of the problems illustrated by the preceding drawings. The spiritual element symbolized by Jesus is rising above biology (stomach, intestines, genitals, bladder, and human embryos) and separated from it. The patient’s hands are reaching for the Black Sun, the “inner reality” that is even “beyond Christ.”

One of Dana’s LSD sessions was completely dominated by monstrous, blasphemous distortions of religious themes. The most sacred elements were contaminated by “obscene” and brutal biology. She saw, for example, scenes of the crucifixion in which Christ’s face was disfigured, his fingers were changed into bloody claws, and he was urinating from the cross; mangy, dirty rats were running over  Calvary desecrating this holy place with saliva, feces, and urine. After several hours of experiences of this kind, she relived a traumatic event from her adolescence; this was the first concrete and personal example of a situation from her life which involved confusion of religion and “obscene” biology. Her boy friend, a divinity student who appeared on the surface to be a pious and rigidly religious person, exhibited toward her what she considered to be perverse sexual behavior. Later, after excessive resistances were reduced, the session was dominated by reliving traumatic childhood memories. When she was ten, her psychotic father suffered a cerebral hemorrhage and was kept at home in spite of his rapidly deteriorating physical and mental condition. In the LSD session, Dana had to re-experience and suffer through many scenes in which, as a young girl, she saw her father neglecting bask aspects of hygiene. Severely decompensated as a result of his psychotic process and organic brain damage, he frequently performed various physiological functions in her presence. The father was a religious fanatic who had holy pictures, little altars, and various liturgical objects in every room of the house. Many of the scenes relived in Dana’s LSD session showed her father’s uninhibited behavior in this overly religious setting; this had been an important source for the confusion of religion and biology in the session.

The deepest roots of this intimate fusion of religious feelings and “obscene” biology were later found in the experiences related to BPM III. On the perinatal level, the feelings of identification with Christ and his suffering and the element of spiritual death and rebirth were accompanied by biological reliving of the birth trauma, with the emphasis on its brutality, monstrosity, and obscenity. Simultaneously with her own birth, Dana also relived the birth of her daughter. She found the source of her aggression toward this child in the feelings that she experienced during early stages of her delivery, at a time when the uterine cervix is still closed and the mother and child are inflicting pain on each other. After full reliving and integration of this memory, Dana could experience for the first time in her life genuine maternal feelings free from aggression, guilt, and anxiety.

Toward the end of her LSD session, Dana had the vision of a purified and radiant Jesus separated from biology; this was associated with genuine Christian feelings and a new intuitive understanding of Christ’s message. At the same time, she felt that there was something even beyond Christ, and she used for this principle the symbol of the Black Sun. Dana’s description of this transcendental symbol resembled in many ways the concept of Atman in Hinduism.

The last example is a description of an advanced LSD session of Michael, a nineteen-year-old schizophrenic student who was the youngest person we treated with psycholytic therapy. He was the brother of Eva, a hysterical patient who also participated in LSD therapy; the condensed history of both siblings was presented earlier in the section dealing with the authenticity of relived childhood memories (page 66). In spite of very serious clinical symptomatology, Michael was able to make rapid therapeutic progress; he moved relatively quickly through the psychodynamic and perinatal stage of his treatment to transpersonal levels. The following outline is of his thirty-second session, which he had shortly before termination of therapy.

The session started with a feeling of “pure tension” that was building up to higher and higher levels. When the tension was transcended, Michael had an experience of overwhelming cosmic ecstasy; the universe seemed to be illuminated by radiant light emanating from an unidentifiable supernatural source. The entire world was filled with serenity, love, and peace; the atmosphere was that of “absolute victory, final liberation, and freedom in the soul.” The scene then changed into an endless bluish-green ocean, the primordial cradle of all life. Michael felt that he had returned to the source; he was floating gently in this nourishing and soothing fluid, and his body and soul seemed to be dissolving and melting into it. The experience had a distinct Indian undertone; he asked the therapist whether this state of unity of the individual self with the universe was described in Indian religious scriptures. He saw numerous visions of Hindu worship, mourning ceremonies on the Ganges River, and Indian yogis practicing in the monumental setting of the Himalayas. Without having had any previous knowledge of Hatha Yoga, Michael intuitively assumed several of the classical body postures (asanas) because they seemed best suited to his present state of mind.

This ecstatic condition was suddenly interrupted and the sense of harmony deeply disturbed. The water in the ocean became amniotic fluid, and Michael experienced himself as a fetus in the womb. Some adverse influences were endangering his existence; he had a strange, unpleasant taste in his mouth, was aware of poison streaming through his body, felt profoundly tense and anxious, and various groups of muscles in his body were trembling and twitching. These symptoms were accompanied by many terrifying visions of demons and other evil appearances; they resembled those on religious painting and sculpture of various cultures. After this episode of distress passed, Michael re-experienced his own embryological development, from the fusion of the sperm and egg through millions of cell divisions and processes of differentiation to a whole individual. This was accompanied by an enormous release of energy and radiant light. The sequences of embryonal development were intermingled with phylogenetic flashbacks showing the transformation of animal species during the historical evolution of life.

Toward the end of the session, Michael returned to the feelings of fusion and melting in the ocean alternating with identification with the entire universe. On this general background, he had numerous visions of ancient Egypt, with pyramids, royal tombs, majestic granite sculptures, and various deities and mythological figures. These ecstatic visions continued until late at night; the last vision in the session was a triumphant cruise of an Egyptian princess with her elaborate retinue on the Nile River.

The following day, Michael was in the calmest, most joyful, and most balanced emotional condition he had experienced in his entire life. After this session, his psychotic symptoms never reappeared. Several years later, he got married and left Czechoslovakia. He has been able to take full responsibility for himself and his family and to cope successfully with all the hardships associated with the life of an emigrant.

We will conclude this discussion of the multilevel and multidimensional nature of the LSD experiences with several remarks that have direct bearing on the use of this drug for personality diagnostics and the therapy of emotional disorders. Clinical applications of the theoretical principles outlined in this volume will be discussed in detail in the forthcoming book focusing primarily on practical aspects of LSD psychotherapy.

Many of the examples used in this chapter clearly illustrate that LSD activates emotionally important material in different areas and on various levels of the personality; the resulting multiple overdetermination of the manifest content is one of the most characteristic features of the LSD experience. It has been a common observation in LSD therapy that patients present several relevant, mutually overlapping, and logically consistent interpretations of a single symbolic experience. However, in the case of complex sequences, one of the levels is usually in the center of the experiential field and “in the spotlight” of consciousness. Additional levels can be tangentially alluded to in the periphery of the perceptual stream while the main theme is unfolding; at other times, they are revealed by systematic analysis after the session with the use of the patient’s free associations, or emerge spontaneously in subsequent LSD sessions. The variables determining the depth of the prevailing level are the personality of the subject, the facilitating influence of the therapist, the dosage of LSD, the intensity of the emotional charge connected with the material involved, the degree of resistance and strength of the defense system, the set and setting, and the number of previous LSD exposures. The latter factor deserves special explanation because of its significance for understanding the nature of the LSD reaction, the inter-and intraindividual variability of the content of the sessions, and the dynamics of LSD psychotherapy.

Different subjects are in very different situations at the time when they have their first LSD session. Some of them are heavily defended against unconscious material from any level; others have easy access not only to psychodynamic phenomena but also to perinatal and even transpersonal experiences. In the process of consecutive LSD sessions, the major experiential focus tends to shift, by and large, from abstract and psychodynamic elements to the problems of death and rebirth, and eventually to various transpersonal sequences. Advanced LSD sessions are usually dominated by mystical and religious themes and are all transpersonal in nature; elements of the levels worked through in earlier sessions do not reappear in this stage. In a series of LSD sessions, these consecutive shifts of focus from one level of the individual’s unconscious to another are accompanied by corresponding changes of the personality structure, emotional sets, values, attitudes, belief systems, and often the entire world view. The understanding of this process and its specific dynamics forms the basis for sensitive guidance and optimal utilization of the therapeutic and growth potential of the LSD procedure.

* Our short and casual paper on this finding,9 which we considered theoretically interesting but quite marginal to our research efforts, aroused an unexpected response. Although the article was published in a rather obscure journal, we received within several weeks literally hundreds of requests for reprints from military centers from all over the world. This made us realize that the use of LSD was being seriously considered for other purposes than the intensification and acceleration of psychotherapy.

|| The patient later explained that she knew the Hungarian meaning of the word gróf, which (like the German Graf) denotes a member of the nobility.