|LSD “can bring the best therapeutic results in the shortest possible time and with the least risk of complications” 131). There’s no limit to the number of LSD sessions required for therapy. There are three steps to consider: “preparation period,” “drug session,” and “non-drug interviews in the post-session period” (131).|
Because LSD therapy can be emotionally stressful, screen out people with heart problems. Screen out pregnant people because LSD might interfere with fetal development. “A disposition to seizures may be a contraindication for a psychedelic session unless a well-equipped pharmacy is readily available. In individuals with a history of epilepsy LSD can occasionally trigger a sequence of seizures, or status epilepticus, which can be extremely difficult to control outside of a medical setting” (137). In fact LSD may lead to “the frequent occurrence of tremors, jerks and complex twisting movements in the subjects during LSD sessions,” which “can be observed even in individuals without an epileptic disposition” (137).
Preparation therapy should be between five and twenty hours total. This psychodynamic therapy is for “recognize certain recurrent themes, repetitive patterns, vicious circles, and self-perpetuating elements in the client’s personal interaction” (132).
Grof characterizes psychoanalysis in order to both relate himself and differentiate himself to it, “The psychoanalytic approach is primarily concerned with psychopathology, and thus focuses selectively on the negative aspects of patient’s personality. The Freudian image of man is instinctivistic and essentially pessimistic. Psychoanalysis sees human behavior as motivated by primitive impulses of a sexual and aggressive nature, and interprets any higher values as reaction formation or compromise with the repressive forces of society. Unhappiness is the normal human condition; the purpose of psychotherapy is to change the excessive suffering of the neurotic into normal human suffering. The psychoanalyst is basically non-directive; he or she avoids value judgments and any active guidance of the patient” (132). Grof agrees that “the psychoanalytic principles are certainly justified” when it comes to “specific guidance on concrete life situations,” but Grof opposes psychoanalysis by claiming, “it is more correct to see human nature as divine than as bestial” (133). This means we should offer value judgments and direct advice in general, where a ‘divine’ anthropology puts “the emphasis on life in the here-and-now” (133). For successful LSD therapy it is crucial that the patient trust the therapist. This requires a personal relationship that is taboo in psychoanalysis.
We might think that Grof defies psychoanalysis by centering therapy on “good self-image and positive feelings about oneself” as well as “the ability to enjoy the life process,” but the goal seems to be more the enabling of these enjoyments, which is compatible with Freud’s model of treatment (133). Further, this enabling does not occur through an affirmation of the sexual, but through a “deep confrontation with death” (133). Grof does not intend to reach his goals directly through cooperation of the patient, because for the typical patient of psychoanalysis “self- and life-validating goals will trap the individual into a net of vicious circles without bringing the expected satisfaction” (134). Much like Lacan we see Grof’s theory “emphasizes orientation on the process, rather than on the outcome or goal” (134). Unlike typical psychoanalysis Grof wants to de-emphasize the role of the patient’s past.
Don’t use specific religions as a schema for LSD therapy, since specific religions are too complicated to act as stable ideals in the drug session, but you may appeal to “what Albert Einstein described as cosmic religion” to facilitate transpersonal trips (135). Cosmic versions of mainstream religions include Christian mysticism, the Kabbalah, or Sufism.
In the final preparatory meeting, which should be the day before the drug session, discuss technical factors and the patient’s remaining concerns. Tell the patient that they will dream while awake - this should give the patient a conceptual alternate to insanity by which they may understand their hallucinations, “It is important to emphasize that LSD is a catalyst or amplifier of mental processes, a tool facilitating deep self-exploration” (143). Tell the patient not to intellectualize the experience, and warn them that they may feel completely new dimensions of reality because “such a warning can save the candidate from shock and panic during the session” (143). In the preparation period inform the patient of potential problems during the LSD experience in order to mitigate the problems. Explain that the experience of dying is good because it gives an opportunity to ‘give in’ to the experience and elevate the trip to a transpersonal level, where we “face the experience of ego death in all its complexity” (136). The fear of insanity, or the fear that the trip will never end, should also be taken as threshold beyond which stability may be reached, and again “the fastest way out of this condition is to accept the content of the experience” (144). If there is a fear of becoming homosexual, “reassure the subject that this is a very unique opportunity to gain access to the experiential world of the opposite sex,” whatever that means (144). Let the patient know that you will interpret supposedly organic symptoms of LSD usage to be psychosomatic. If the patient loses trust, tell them to find the source of mistrust in themselves. Let the patient know that the LSD experience should largely be kept internalized. Externalization is a sign of resisting self-exploration. “In the most general sense, and with some reservations, it is possible to talk about the Freudian [biographical], Rankian [death-rebirth process], and Jungian [metaphysical/philosophical/cosmic] phases of psychedelic therapy” (147).
LSD therapy sometimes requires that symptoms worsen after one session before they get better in another session.