Thursday 18 November 2010

1571 The use of LSD in psychiatric treatment

In my own field of experience those engaged in social work and in local social services administration gain considerable personal information about individuals which can be used against them, making them open to blackmail and affecting their future lives and future relationships. It is right that he position of clients should be protected by law. But it is not a black or white situation either. Yesterday I made reference to the collected papers of the psychoanalyst Jung and he, as do other analysts use case studies extensively to explain their work and justify the generalizations which they make from individual cases. They do not always appear to obtain the approval of their clients to do so even though all potential identifying information is removed from the case study which is then published and available world wide for ever more. They usually do so not to make money, or to achieve greater recognition or status for themselves, but in order that others can help other human beings to overcome similar problems which are adversely affecting their lives and affecting others and to promote greater understanding of their work and the problems people face. I will give a practical example of such a situation from my personal experience

I was much impressed by a County Psychiatrist in the 1960’s who used abreactive drug treatment to release the devil within individual patients. He used a form of L.S.D : Lysergic acid diethylamide or acid.

The substance became a recreational drug in the sixties because of its psychedelic qualities in which users saw the world in brilliant colours, patterns and movements, in which time became distorted and they felt themselves possessed of great powers including the ability to fly. It also became widely used by those seeking to enter prolonged periods of mediation and to transcend normal human experience. However its primary use was in psychotherapy in exceptional controlled conditions by patients who “voluntarily” submitted to its use.

There were two reason why the drug became banned for recreational use and for active treatment use although there are several institutes who continue to undertake research in its potential use for medical purposes. Recreational users would talk of having a bad trip, with some killing themselves throwing themselves off buildings or high points because of the belief that they could fly, an experience which many people have as part of normal dreams. However it could cause ongoing psychological damage. Taking individuals on a controlled bad trip was at the core of the work of the County Psychiatrist who managed a large psychiatric hospital and found the drug almost 100% effective in treating those patient which he first diagnosed as suitable subjects.

He was what I describe as a natural Freudian in that be believed as I do to an extent, that most all self destructive behaviour in individuals arises from the twins devils of sex and getting rid of wishes in childhood. The argument is that it is natural for children to have subconscious sexual urges, often incestual but these are worked through as part of development and socialization. However if a child was to engage in sexual activity in some way and made aware that it was wrong whether with another child or with an adult then that child could become overwhelmed with a sense of guilt at, having done wrong and being a bad person and they would then get into trouble, often repeating the same offence, until there was no alternative but for them to be punished. There is a similar argument that most children have the urge to get rid off siblings and parents and that such feelings can be overwhelming at times but are temporary and become balanced by being part of a loving relationship and are worked through as part of the normal process of growing up and family life, but what if for example a child wishes a brother or sister were not there and then they die in an accident or from a serious illness. However from my experience the same sense of overwhelming guilt is often experienced by children whose parents break up, whether they continue to see one or both parents, often experience by children who find themselves in care. How many parents still say if you are bad you will end in care or the bogey man will get you as such like? In others words I believe that some adults are severely and adversely affected by experiences in their childhood whether real or imagined. This is also true for all Catholics because of the sense of original sin created in them and the Catholic attitude towards sex, even if the attitude is a good one.

L.S.D was used to take that the person usually an adolescent or young adult, on a controlled bad trip which involved regression, another aspect of the effects of this substance is that users could remember things about their childhood experience long since buried. Because the psychiatrist would deliberately search for dark experiences which had so overwhelmed and terrified the individual in childhood that they blocked them out, patients often had to be strapped down while they regressed. What they said and expressed in session was recorded and played back in the cold light of day and during this process the psychiatrist was able to convince the adolescent or adult that what had happened had happened as a child, and usually involved an adult and therefore they were in effect a victim and not a perpetrator and therefore the incident or incidents should not be allowed to govern the rest of their lives

The drug in effect achieved within a few sessions over a matter over weeks what can take an average of seven years through psychoanalysis. The psychiatrist spoke of a number of cases in some detail to promote the treatment and brought with him a patient who was willing for her story to be told. For many years her life had gone from bad to worse, she had become a prostitute, she had several children by different men who were taken into care, she had a succession of bad relationships and had periods in prison. She was in her early thirties when she had the treatment as an alternative to going back to prison and the cure had been instant. She not only ceased the behaviour which led to prison but also transformed her life. However as she and the Psychiatrist emphasised this did not undo what had happened before. She had to live with the fact that she had children who had spent their lives in care, she had committed crimes and been to prison. She had to learn to live with these things. On one hand she was no longer putting herself in harms way or setting out to harm others. However she had lost the greater part of her earlier life.

While I was impressed with what the psychiatrist had to say I was not sure about the decision to use the woman in this way, in terms of revealing what she had been through. However I was not her physician and only knew part of her story. I then was confronted with the case of a young man who was repeatedly committing offences and my supervising officer suggested that the adolescent might be a suitable case for the treatment. I therefore advised the court who agreed that the young the boy should be placed in care rather than sent to an approved school and that as a condition application was made for the treatment. The young man had the treatment and was at the hospital for less than a month. Such was its effectiveness that he was not only immediately placed home on trial but I went back to court within a few months and requested a discharge of care order. Several months after this I went for a haircut in the area where I worked and he was also there and I as not sure that he would want me to recognise him I said nothing. I will add that he was the kind of young person unable to express himself through words and one often had to do the talking. Not only did he address me by name but waited for me and we went had had a cup tea and he told me about his work, that he had a girl friend and about the relationship with his family. I wish I could claim credit for what happened although I played a part in convincing a court not send him to an approved school. However while I have written about what happened without identification I have not and would reveal what he disclosed to the psychiatrist and which in turn with the boy’s permission it was important to reveal to both parents.

My reason for mentioning this experience is that I have no idea if in fact the explanation for behaviour revealed under the drug was correct. The important aspect is that the boy himself and his family, and the court were all convinced that this was so. I also do not know how much of the success was due to the drug or to the personality of the psychiatrist and to relationship of trust and confidence he was able to establish with the boy and with me. Similar my impression is that the success of treatment was due in part to the skill of the psychiatrist in selecting the right young people for treatment and where he felt the indications were they would be able to put what had happened behind them and led a life which they would be happy about. The problem is that the drug used by someone without the skill and the personality on the wrong person might lead to the situation being worse. The same applies to providing politicians with information even if you are confident about the its importance, about the likely impact an consequences for yourself, and have confidence in the politician.

It also touches on a fundamental issue which is at heart of British sense of justice and which will bring me back to the main issue of the day. It is has been fundamental to British Justice that if a person is convicted under the law of an offence he should be punished as described under that law and that once the punishment has been carried out the slate is wiped clean and there are penalties if for example the media or prosecution refer to what is described as spent offences. In criminal trial for example if a man has committed the same kind of offence before, and if this information is introduced before a finding is made, it could influence a jury to decide against the man even though the facts in the present case did not prove he had committed the similar offence. However once the case had been proven his previous offences should be considered in determining the form of sentence. Just as in situations where previously it was not possible to try and convict a person for the same offence at which he had been acquitted, the law has been modified to meet new circumstances, especially in the significance of being able identify and match DNA, the law has always adjusted to changing circumstance and is tempered with realism as well as with mercy.

It is not generally known that in addition to the usual requirement for police evidence in criminal proceedings to be evaluated by the Crown prosecution service, consideration is also given to the public interest, so that even if the C.P.S, is of the opinion that the available evidence is sufficient to gain a conviction, it can rule that the matter should not come to court because it is not in the public interest, and the converse is also true, that even if they are not convinced that the evidence is sufficient to gain a conviction. they can bring the matter to court because it is in the public interest to do so.

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