A powerful hallucinogenic, “mind-expanding” drug used for experimental and therapeutic purposes.In its natural form, lysergic acid diethylamide, LSD-25, is a derivative of ergot, a parasitic fungus that grows on rye. It was first isolated in 1938 by a Swiss chemist, Albert Hofmann. In 1943 he reported a peculiar experience involving “fantastic images of extraordinary plasticity,” which was traced to inhalation of a small quantity of the substance during laboratory research. Subsequent investigation has demonstrated that LSD is far more potent than other hallucinogens, such as psilocybin and mescaline. When a solution containing a barely visible speck of LSD (one 10,000th of a gram) is injected or swallowed, it produces a full-blown psychedelic, or mind-expanding, experience lasting eight to twelve hours.A full LSD experience is virtually indescribable, but its outstanding characteristics appear to be these: vivid sensations of sight and sound that produce either transcendent ecstasy or unspeakable horror; the feeling that the personality is disintegrating and “coming apart at the seams”; extreme time distortions, especially the sense that time is standing still and that nothing exists but the present; synesthesia, or crossed perception, in which colors are heard, music smelled, and textures tasted; an illusory feeling of surpassing understanding and speeded-up mental processes; perceptual distortions in which objects, parts of the body, pictures, and people are contracted, expanded, or twisted out of shape (see PLATES 24, 25, 26); and a feeling of oneness with all of humanity and the universe at large, resembling a religious experience. As a result of these “mystical” reactions, attempts have been made to form a cult based upon the use of the drug. Many individuals have sought not only an expanded inner life but a meaning for existence in their “trips”—a search that has almost invariably resulted in disappointment.The drug is nonaddictive, and rarely produces lasting aftereffects when administered in controlled doses to carefully selected patients under medical supervision. However, it is unpredictable in its effects and can be extremely harmful if taken without proper supervision—and for this reason legislation has been enacted to limit its distribution. It is particularly dangerous in the hands of thrill seekers and cult- ists, since it can produce terrifying reactions and precipitate outright psychoses in unstable persons. Louria (1967), president of the New York State Council on Drug Addiction, has reported that out of 114 cases treated at Bellevue in an eighteen-month period, “13% entered the hospital with overwhelming panic. There was uncontrolled violence in 12%. Nearly 9% had attempted either homicide or suicide. Of the 114, 1 out of 7 had to be sent to long-term mental hospitalization and half of those had no history of underlying psychiatric disorder.” He concludes flatly that “there is no other drug used promiscuously under uncontrolled circumstances that is as dangerous as LSD.” We might add that there is some indication that the drug may break down cell chromosomes and even produce congenital defects in children bom to LSD users. This possibility is now under active investigation.Even in stable individuals—as the excerpts at the end of this article indicate —LSD produces “psychotomimetic” effects, particularly symptoms that simulate acute schizophrenic reactions of the paranoid type. (Other psychotomimetic drugs are adrenochrome, harmine, bu- fotenin, mescaline, and tetrahydrocannabinol.) The discovery of these effects has led to the theory that actual schizophrenia might result from the release of a hallucinogenic chemical in the body. Attempts have therefore been made to use LSD as an investigating tool. It has been suggested that the substance might interfere with the chemistry of one of the adrenal hormones and perhaps release a substance (possibly adrenoxin) that produces the psychotic symptoms. The next step would then be to find a drug that would counteract the noxious effects of this substance. The adrenal gland is known to be involved in mobilizing the body’s energy when it encounters situations of stress—and many researchers feel that schizophrenia is a stress disease. So far, however, there is no clear- cut evidence for this theory, and the crucial chemical, if there is any, is yet to be discovered. See HALLUCINOGEN.LSD is also used experimentally in psychotherapy, and appears to be of value in a number of ways. Various investigators report that it can help to establish rapport between patient and therapist, facilitate the uncovering and reliving of repressed memories, increasethe patient’s ability to communicate his thoughts and feelings, enable him to see himself and his problems in a more detached manner, free him from internal conflicts, and help him attain a clearer vision of his purposes and goals. MacLean et al. (1961) have found it particularly effective in treating cases of chronic alcoholism and character disorders which have proved resistant to ordinary psyehotherapy. Godfrey (1967) has reported that out of 350 alcoholic patients treated with LSD in a homelike setting at the Topeka VA Hospital “25% became abstinent and much improved, 25% much improved, 25% improved and 25% no better or worse.” An English psychiatrist, D. M. Ling, has concluded, on the basis of twelve years of experience, that the drug can shorten the psychoanalytic process by many months. Hans Karl Leaner and others on the continent have reported similar results. H. A. Abramson (1960) has found that some patients are able to release and resolve powerful conflicts stemming from childhood experiences which they had been unable to face without the drug. These applications appear promising but are still considered experimental.The therapeutic uses of LSD are limited to neuroses and personality disorders, and are usually contraindicated in the treatment of psychotics as well as persons with marginal adjustment, due to the risk of releasing latent psychotic tendencies (Dahlberg, 1963). It must always be taken under direct psychiatric supervision. Godfrey (1967) warns, “There is no doubt that this powerful, most psychologically potent drug is a great threat to the psychological life of a person when it is taken without adequate professional guidance. It can be completely overwhelming to an individual who has not been adequately prepared for the experience. This is more especially so in adolescents. We feel the drug should always be restricted to research and treatment by those most responsible scientists who are especially trained in psychodynamics and psychotherapy and who have had experience in the actual LSD treatment of patients.”The following excerpts are both firsthand accounts of the effects of LSD, the first based on tape recordings made during a carefully controlled experiment performed by Max Rinkel (1955), who brought the drug to this country, and the second from an article written by a Canadian journalist. Both accounts were made possible by the fact that the drug does not cloud the subject’s consciousness or impair memory to any great extent.Illustrative Case: At 8:15 A.M. two doctors were sitting in a laboratory chatting. A white-coated young attendant walked in, looked around at the older doctors, and smiled cheerfully. One of the doctors dropped a carefully measured quantity of a chemical into a glass of water and handed it to the attendant to drink. The young man put it to his lips, then remarked that it didn’t taste like anything except water. As he drank, the other doctor flicked the switch of a tape recorder, saying, “Now tell us every thought, every sensation you experience. Speak freely, talk as much as you like.”In a few minutes the attendant began speaking: “It’s sort of chilly in here—my feet especially. I’d close the window, only my knees are shaking. Guess it’s because I didn’t get my morning coffee.” One of the doctors holding a pad jotted down: “8:38, coldness of extremities. Subjective tremor, no outward evidence.”The attendant stared vacantly for a few moments, and when he spoke again, his voice had lost its cheerful tone: “this, Madame Tussaud’s Waxworks The way you sit there staring at me—you don’t look human.” The doctors looked at each other knowingly. The one with the pad wrote: “8:47. Emotional flatness. Distorted vision.” The powerful drug was taking effect. . . .At 9:05 A.M. the attendant’s voice had a droning quality: “You know, I think all this is a trick. You just gave me plain water to see if I was suggestible.” One of the doctors reminded him that he saw the drug dropped into the glass. Immediately, the attendant responded, “Then the drug company must have tricked all of us.” The doctor insisted that this could not be. The young man looked at him with the utmost annoyance and said, “Don’t scowl at me like that. And don’t come so close. Your head looks enormous—a leering gargoyle. And you don’t need to shout. I can hear you, I’m not deaf!”The doctor had not moved an inch, nor had he changed his expression or the quiet tone of his voice. His colleague noted: “Suspiciousness. Feelings of persecution. Perceptual distortion.”Soon the young man developed morbid feelings, breaking “like waves” over the mind. For a while, he felt that his feet were missing; though he looked at them, he could not believe they were there. When he closed his eyes a phantasmagoria of colors “like the fourth of July” flared up before him. At one point, he had sensations of floating off into space: “I feel that I am separated from my body.” Some time later, on being questioned, the attendant remarked that his actions were not his own—they all stemmed from the power of others.The subject of the experiment was a completely normal man. For several days he had submitted to a battery of rigid tests: heart examination, blood tests, psychological tests. Yet this man, within minutes, had developed the major symptoms of one of the severest mental diseases afflicting mankind—schizophrenia.” (Goldenson,1954) Illustrative Case: On the morning of Thursday, June 18th, 1953, I swallowed the drug which, for twelve unforgettable hours, turned me into a madman. For twelve hours I inhabited a nightmare world in which I experienced the torments of hell and the ecstasies of heaven.I will never be able to describe fully what happened to me during my excursion into madness. There are no words in the English language designed to convey the sensations I felt or the visions, illusions, hallucinations, colors, patterns and dimensions which my disordered mind revealed.I saw the faces of familiar friends turn into fleshless skulls and the heads of menacing witches, pigs and weasels. The gaily patterned carpet at my feet was transformed into a fabulous heaving mass of living matter, part vegetable, part animal. An ordinary sketch of a woman’s head and shoulders suddenly sprang to life. She moved her head from side to side, eyeing me critically, changing back and forth from woman into man. Her hair and her neckpiece became the nest of a thousand famished serpents who leaped out to devour me. The texture of my skin changed several times. After handling a painted card I could feel my body suffocating for want of air because my skin had turned to enamel. As I patted a black dog, my arm grew heavy and sprouted a thick coat of glossy black fur.I was repeatedly held in the grip of a terrifying hallucination in which I could feel and see my body convulse and shrink until all that remained was a hard sickly stone loeated in the left side of my abdomen, surrounded by a greenish-yellow vapor which poured across the floor of the room.Time lost all meaning. Hours were telescoped into minutes; seconds stretched into hours. The room I was in changed with every breath I drew. Mysterious flashes of multicolored light came and went. The dimensions of the room, elastic-like, stretched and shrank. Pictures, chairs, curtains and lamps flew endlessly about like planets in their orbits. My senses of feeling, smelling and hearing ran amok. It was as though someone had rooted out the nerve nets in my brain which controlled the senses, then joined them together again without thought of their proper placings.But my hours of madness were not all filled with horror and frenzy. At times I beheld visions of dazzling beauty, visions so rapturous, so unearthly that no artist will ever paint them. I lived in a paradise where the sky was a mass of jewels set in a background of shimmering aquamarine blue; where the clouds were apricot colored; where the air was filled with liquid golden arrows, glittering fountains of irridescent bubbles, filigree lace of pearls and silver, sheaths of rainbow light all constantly changing in color, design, texture and dimension so that each scene was more lovely than the one that preceded it. (Katz, 1953)