¹ Huxley, Aldous, Island (New York: Harper & Row, 1962)Google Scholar.

² Pahnke, Walter N., and Richards, William A., Implications of LSD and Experimental Mysticism, Journal of Religion and Health 5 (1966), 175–208CrossRefGoogle ScholarPubMed.

³ Pahnke, Walter N., LSD and Religious Experience. In LSD, Man and Society, Leaf, and Debold, (ed.) (Middletown, Connecticut: Wesleyan University Press, 1967)Google Scholar.

⁴ Pahnke, Walter N., , Drugs and , Mysticism: An Analysis of the Relationship between Psychedelic Drugs and the Mystical Consciousness. Unpublished Ph.D. thesis. Cambridge, Massachusetts: Harvard University, 1963Google Scholar.

⁵ For a summary of this experiment, see Pahnke, Walter N., The Contribution of the Psychology of Religion to the Therapeutic Use of the Psychedelic Substances, in The Use of LSD in Psychotherapy and Alcoholism, Abramson, H. A. (ed.) (Indianapolis: Bobbs-Merrill, 1967), 629–52Google Scholar.

⁶ James, William, The Varieties of Religious Experience (Modern Library Edition) (New York: Random House, 1902), 37ifGoogle Scholar.

⁷ Kurland, A., Pahnke, W., Unger, S., and Savage, C., Psychedelic Therapy (Utilizing LSD) with Terminal Cancer Patients, Journal of Psychopharmacology Vol. II (in press, 1968)Google Scholar.

⁸ In the several large-scale research projects which have been approved by the U.S. Government in the last few years, permanent adverse effects have been quite rare. At the Spring Grove State Hospital, for example, over 300 patients have been treated with LSD without a single case of long-term psychological or physical harm directly attributable to the treatment, although there have been two transient post-LSD disturbances which have subsequently responded well to conventional treatment.

⁹ The fact that there was no control group against which to measure these results immediately raises the possibility that our findings were due to powerful suggestion implemented by the intensive psychotherapy rather than anything to do with the administration of LSD. It might be argued that a placebo control group would attain the same results, but other experimental evidence concerning the occurrence of psychedelic mystical experience tends to cast some doubt on this argument. In two previous series of psychedelic drug experiments that I have helped to plan and supervise, double blind control groups were utilized. In each instance the psychedelic mystical experience occurred to a statistically significant degree in those persons who received a high dose of psilocybin when compared to control groups which had exactly the same preparation, expectation, and suggestion, but received only a placebo or control substance with active physiological effects. (W. N. Pahnke, thesis, op. cit.; and W. N. Pahnke, LSD and Religious Experience, op. cit.)

Consideration of the powerful placebo effect is certainly important. Recent research has demonstrated that giving LSD mainly as a chemotherapy without adequate preparation and suggestion does not provide any advantage over psychotherapy alone in the treatment of alcoholism. (A. Ludwig, J. Levine, and L. Stark, A Clinical Evaluation of LSD Treatment in Alcoholism, Paper presented to the American Psychiatric Association meeting in Boston, Massachusetts, May 15, 1968; and Johnson, F. G., LSD in the Treatment of Alcoholism, Paper presented to the American Psychiatric Association meeting in Boston, Massachusetts, May 15, 1968.)Google Scholar This finding underlines the importance of utilizing suggestion to the maximum in combination with LSD as has been our practice. For example, at the Spring Grove State Hospital in Baltimore, the double blind control study of psychedelic peak therapy utilizing LSD has demonstrated that one out of four alcoholics who received 450 micrograms of LSD had a profound mystical experience compared to one out of ten who received only 50 micrograms (total N = 122). Both groups received exactly the same amount of pre-LSD psychotherapy and identical preparation for the LSD session. In this particular study the results in terms of clinical outcome are not yet completely evaluated, but early trends in the data show that those patients who had a profound psychedelic peak experience achieved greater clinical improvement. (A. Kurland, S. Unger, C. Savage, J. Oxsson, W. Pahnke, Psychedelic Therapy Utilizing LSD in the Treatment of the Alcoholic Patient: A Progress Report, paper presented to the American Psychiatric Association meeting in Boston, Massachusetts, May 15, 1968.)Google Scholar Thus, in the research with cancer patients there is reason to suppose that the beneficial results observed are not due to either the psycho-pharmacological effects of LSD or the placebo effect (suggestion and preparation) alone, but rather a combination of set, setting, and drug. For the best results it seems essential that the placebo effect be utilized to the utmost in conjunction with the psychedelic drug which is then seen to be a necessary, but not sufficient, condition.

¹⁰ James, William, Human Immortality: Two Supposed Objections to the Doctrine, The Ingersoll Lecture on Human Immortality, 1898, in William James on Psychical Research, Murphy, Gardner and Ballou, Robert (eds.) (New York: The Viking Press, 1960), 279–308Google Scholar.

¹¹ Kurland, Albert A., with Savage, Charles, Shaffer, John W., and Unger, Sanford, The Therapeutic Potential of LSD in Medicine, in LSD, Man and Society, Leaf, and Debold, (ed.) (Middletown, Connecticut: Wesleyan University Press, 1967), 34Google Scholar.

¹² Those who have lived fully and deeply know that suffering can have a redemptive value in terms of personal growth and understanding. Yet in my medical experience the slow and tortuous devastation to the human spirit caused by the usual course of terminal cancer is mostly on the negative side. Reflecting my bias as a physician dedicated to the alleviation of suffering, I do not feel that this kind of emotional and physical torment serves much useful purpose. For this reason, I feel that the addition of psychedelic drugs to the medical armamentarium against human suffering cannot be objected to on the grounds that man has no right to interfere with an element of human life which may serve a useful purpose i n God's plan for man's development. Such an argument is too similar to the theological objections raised against the introduction of smallpox vaccination or the invention of rapid transportation.

¹³ Saunders, Cecily, The Treatment of Intractable Pain in Terminal Cancer, Proceedings of the Royal Society of Medicine, Vol. 56, No. 3 (March, 1963), 191–97Google ScholarPubMed.