TUNE IN, TURN ON AND CHEER UP

Swiss Psychiatrist Fights Fear with LSD

http://www.spiegel.de/international/zeitgeist/0,1518,638080,00.html

By Samiha Shafy
07/24/2009

A Swiss psychiatrist is treating severely ill patients with LSD to 
alleviate their fear of pain and death. Other psychedelic drugs are 
being tested on patients in the United States, Britain and Israel. 
Are psychotropic substances about to make a comeback in therapy?

Nothing's happening, Udo Schulz thought to himself with quiet regret. 
I must have been given the placebo. He was lying on a mattress in a 
brightly lit room, waiting for the first real drug experience of his life.

Schulz, 44, is German and suffers from cancer. He is also the first 
person in more than three decades who has been allowed to consume LSD 
legally in the context of a scientific study. The goal of the study 
is to determine whether lysergic acid diethylamide, the notorious 
drug of the hippy era, could be useful in the treatment of certain 
emotional disorders.

It was May 13, 2008, and it was quiet, as it usually is, in 
Solothurn, a small, picturesque Baroque town at the foot of the Jura 
Mountains in Switzerland. The Aare River, a tributary of the Rhine, 
flows at a more leisurely pace here than it does in the Swiss capital 
Bern, past Roman walls, the Krummer Turm ("Crooked Tower") and the 
imposing Cathedral of St. Ursus. There could hardly be a better spot 
for a study with such a potentially explosive impact on society than 
this inconspicuous little Swiss town.

The wall of the treatment room was decorated with a red tapestry, a 
gong, a drum and a portrait of a smiling Buddha. Peter Gasser, a 
psychiatrist, and fellow therapist Barbara Speich crouched next to 
the patient on thin foam rubber mats.

They sat there for at least half an hour, waiting. "Then I finally 
sensed that something was changing in my psyche," recalls Schulz. 
"Wow, it was fantastic!"

Transported to a Different World

Swiss chemist Albert Hofmann synthesized, ingested and discovered the 
effects of LSD in a laboratory at the pharmaceutical company Sandoz 
in Basel on April 19, 1943. Hofmann had originally intended to 
develop a circulatory stimulant derived from ergot, a fungus. 
Instead, he synthesized a highly potent hallucinogen. A single gram 
of LSD is sufficient to get 20,000 people high for hours.

Of course, the young scientist couldn't have known this on the day of 
his discovery. As a result, the first LSD trip in history began with 
a drastic overdose, when Hofmann swallowed 0.25 milligrams of the 
substance. "I was filled with an overwhelming fear that I would go 
crazy," he later wrote, describing his experience. "I was transported 
to a different world, a different time." Hours passed before he 
gradually became calm again. "Now I gradually began to enjoy the 
unimaginable play of colors and shapes," he wrote. The next day, he 
wrote, he was filled with "a feeling of well-being and new life."

Hofmann couldn't have dreamed that LSD would soon become the catalyst 
of a mass movement, glorified by artists like the Beatles, the Doors, 
Pink Floyd, the actor Cary Grant and the author Aldous Huxley. Little 
did he suspect that the CIA would secretly use it in interrogations 
or that the hallucinogen would send millions of people on spiritual 
and creative adventures but also drive some to madness and suicide. 
Nevertheless, he was convinced from the start that LSD had to be 
suitable for providing "mental relaxation."

Many psychiatrists shared Hofmann's hope that the substance he had 
discovered could help them gain insights into suppressed memories and 
trauma. Until the 1970s, LSD was frequently used to treat depression, 
anxiety and addiction and, less commonly, migraines, arthritis, 
paralysis and skin complaints. Thousands of scientific studies were 
published during that time, most of which were of dubious quality. A 
famous case was that of Auschwitz survivor Yehiel De-Nur, who, in six 
LSD sessions in 1976, relived his memories of the death camp. He 
later published a poetic and deeply disturbing book entitled 
"Shivitti: A Vision" about the experience.

Albert Hofmann's Problem Child

LSD discoverer Albert Hofmann died at the age of 102 on April 29, 
2008 -- just two weeks before Udo Schulz was to travel by train from 
Murnau in Bavaria to Solothurn to take LSD as the first subject in 
the study. Schulz hoped that the substance could help him face the 
fears that had tormented him ever since he was diagnosed with cancer.

Hofmann had always warned against the dangers posed by his "problem 
child," and yet he continued to believe in the drug's healing powers 
up until his death. For the old man, the fact that research into the 
medical uses of LSD was now continuing after a 35-year hiatus 
represented the fulfillment of his "greatest wish in life."

Study director Gasser carries a heavy burden of responsibility. It 
isn't just a question of doing justice to Albert Hofmann's legacy. 
Many scientists from the United States and Europe, who have been 
fighting for years to be allowed to continue research into LSD and 
other psychedelic substances, are now pinning their hopes on the 
Solothurn-based psychiatrist.

"I would welcome it if it were easier to use psychoactive substances 
in therapy," says Rolf Verres, medical director of the Department of 
Medical Psychology at the University of Heidelberg Hospital. "In 
Germany, there is simply a deficit in this respect."

Elsewhere, however, a comeback of hallucinogens in psychotherapy 
seems possible. In the United States, Britain, Israel and 
Switzerland, a number of studies have been recently approved 
involving the use of Ecstasy and psilocybin, an agent derived from 
hallucinogenic mushrooms. The goal of the research is to determine 
whether these substances can help in the treatment of traumatized war 
veterans and patients with anxiety disorders. Some of the researchers 
involved in the studies say that initial results are consistently encouraging.

But before Peter Gasser embarked on his study, no researcher had 
dared to use LSD, the strongest and most notorious of the 
hallucinogenic drugs. The outcome of his study will play a key role 
in determining how authorities handle similar applications in the future.

'I Am Not a Messiah'

Gasser, 49, ignored media inquiries from around the world for almost 
one-and-a-half years, so as not to jeopardize his sensitive 
experiment. Today, as he invites SPIEGEL to visit his practice for 
the first time, the first thing he does is to make one thing clear: 
"I am not a messiah, nor am I someone who aims to change society." He 
is interested exclusively in research, not creeping legalization of 
the drug, says Gasser, and he wants to demonstrate that LSD can play 
a positive role in psychotherapy.

Gasser is the president of the small Swiss Medical Society for 
Psycholytic Therapy, which advocates the therapeutic use of 
hallucinogens. The organization has about 50 members, of which about 
one-third are based in Germany. In the early 1990s, Gasser completed 
supplementary therapeutic training with psychedelic drugs, when it 
was still possible to do so in Switzerland with a special permit. He 
also tried LSD as part of the training.

The drug's effect has a lot to do with the setting in which it is 
taken, says Gasser. "We create a relaxed atmosphere here, which is 
why the patients remain calm." Music is sometimes played in the 
background during a session, and Gasser occasionally plays the drum 
which is hanging on the wall. So far, none of the subjects has had a 
bad trip, he says, and the sedative that is kept on hand for 
emergencies has never been used. "If you handle LSD with care," the 
psychiatrist claims, "it isn't any more dangerous than other therapies."

The drug is chemically related to serotonin, a neurotransmitter 
produced naturally in the body. It affects the same regions of the 
brain, particularly the limbic system, where sensory input is 
filtered, processed and evaluated emotionally. LSD essentially 
disables the filtering function, so that the brain is flooded with 
information. It also elevates the release of the neurotransmitter 
dopamine in the so-called corpus striatum, further amplifying sensory overload.

As a result, the drug influences sensory perception, thought and 
moods. The sense of space and time changes, and the boundary between 
the self and the environment becomes blurred. This can be perceived 
as an exhilarating feeling of becoming one with the environment, or 
as a frightening loss of control over one's body and thoughts. 
Experts are unanimous in the view that LSD is not physically or 
emotionally addictive, however.

Part 2: 'A Feeling of Mystical Oneness'

But can the high truly help people to overcome their fears? Borwin 
Bandelow, a psychiatry professor at the University of Göttingen and 
Germany's most prominent expert on anxiety, is skeptical. "For every 
therapy in the world, you will find someone who tells you this sort 
of thing," he says. Nevertheless, says Bandelow, he would like to see 
the effects of psychoactive substances for the treatment of anxiety 
examined in well-controlled studies. "It's an extremely interesting 
subject," he says.

Altered sensory perception, objects that suddenly seem alive and the 
feeling of floating in mid-air are all spectacular, of course, says 
Gasser -- but they are merely secondary phenomena. More important, he 
says, is the deep self-awareness and the trusting relationship the 
patient can quickly develop with the therapist. "It can only be 
achieved at this intensity using LSD," he says.

Within the framework of the study, Gasser is permitted to treat 12 
patients suffering from anxiety disorders as a result of a severe 
physical illness. Eight of them receive a capsule of 200 micrograms 
of LSD each, in two full-day sessions spaced several weeks apart. The 
remaining four patients, the control group, receive a dose of 20 
micrograms, which is too small to have much of an effect. "With a 
substance like LSD, a placebo-controlled procedure is, of course, 
questionable," Gasser admits, noting that the patient quickly 
realizes what he or she has swallowed. But that is just the way 
things are done in medicament research, he says.

The three patients who have received the effective dose to date have 
all benefited from the treatment, says Gasser, but the study is still 
underway. Besides, he adds, a study group of only 12 patients is much 
too small to be able to make statistically valid statements. "What we 
hope to demonstrate in the end is that no serious incidents occurred, 
and that the results suggest that this is an effective treatment method."

'The Entire Room Suddenly Came Alive'

Udo Schulz finds it difficult to articulate his drug experience. He 
hesitates as he begins his account. "The potted plant, the tapestry, 
the entire room suddenly came alive," he says, interlacing his 
fingers and gazing meditatively out the window. And then, after a 
pause, he says: "You could say it was a feeling of mystical oneness."

Schulz's problems began in the spring of 2006. He had just started a 
new job as an orderly in a nursing home. At first, he attributed a 
growing loss of appetite to the stresses of the job. Then he noticed 
a feeling of pressure in his stomach after meals. He ate less and 
lost weight. Finally, a doctor sent him to the nearest hospital. 
After being hospitalized for several days, he was handed his file and 
sent to a final examination. "On the way there, I read the file, and 
I saw that the diagnosis was stomach cancer."

How does one react to this kind of information? "Well, at first I 
thought: This isn't my file. It's impossible. I've always lived a 
healthy life," says Schulz, twisting his mouth into a thin smile.

But he realized that he had to undergo surgery. One-third of his 
esophagus and a large part of his stomach were removed. The doctors 
did not find any signs that the cancer had spread and so Schulz did 
not need to do chemotherapy.

After that, however, fear began to dominate his life. He was 
tormented by the thought of never being productive again, of never 
regaining his strength, of losing his job and having to give up. He 
exhausted himself with his efforts to return to work and he suffered 
from insomnia. Conversational therapy with a psychologist did not 
help very much.

When Schulz happened upon an article on the Internet about the LSD 
study in Switzerland, it immediately appealed to him. "The 
preliminary tests showed that I'm apparently a person who suffers 
from these symptoms of anxiety," he says.

It has been a year since the LSD therapy, and Schulz is now working 
full-time again. Several months ago, he began working in outpatient 
geriatric care, which allows him to schedule his time more flexibly 
and take breaks. He hopes that the changes will enable him to cope 
with full-time work. He keeps himself physically fit by riding his 
bicycle and playing table tennis several times a week.

Schulz is convinced that the LSD helped him. The drug, he says, gave 
him a gentle push, an energy boost at a time when he felt miserable 
and listless. During the trip, he says, he felt for the first time 
his entire sadness and anger at the cancer. "All of a sudden, I was 
able to cry like a baby," he says, smiling again.

There is only one thing he regrets, says Schulz: The two sessions 
were much too short. "I would like to continue the LSD therapy," says 
Schulz, staring out the window. "But not if it's illegal."

.


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