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The
Use
of
Psychedelic
Drugs
In
the
Treatment
of
Severely
Disturbed
Children:
A
Review
JOlIN C
RHEAD,
PH.D.*
INTRODUCTION
Aprevi
ous
review
of
the
use
of
ps
ychedelic
agen ts
wit h severel y
disturbed
children
(Mogar
&
Aldrich
1969)
concluded
that
th e
"collective
work
reviewed
...
argues
strongl
y
for
more
extensive
and
systematic
application
of
ps y che d el ic
drugs
in
the
treatment
of
autist
ic
schi
zophr
enic
children
."
This
conclusion
was
based
on
an ex a mi n a t io n
of
seven
studies
and
did
not
include
all
the
w
ork
that
had
been
published
up to th at
time.
A
number
of ad d iti o n al
studies
have b
een
published
since
th e pr evi
ous
rev iew,
including
som
e
follow
-up
studies
p
ert
aining
to
the
issue
of
chromosome
damage
. To
the
best
of
th e
author's
knowledge
the
present
review is
compreh
ensive
with
regard
to
the
extant
literature,
and
it is h
oped
that
it
appears
at a
time
when
the
public
furor
over
psy
chedelics
has
subsided
enough
to
allow
the
pursuit
of
any research
intere
sts
that
hereby
may
be
stimulated.
It
should
be
noted
that
in
the
course
of
this
paper
diagnostic labels will merely be
reported
as
they
were
used
by
the
authors
of
the
liter
ature
be ing reviewed,
and
no
attempt
will be
made
to
differentiate
or
interpret
differen
ces
between
terms
such
as
infantile
aut
ism ,
child
hoo
d schi
zophrenia,
childhood
psy
chosis,
etc
.
Issues
such
as et i o lo gy , diagnosis,
and
prognosis
have
b
een
examined
in
detail
elsewhere
(Bosch
1970;
DeMyer
et
al.
1973;
Des
Lauriers
1967
;
Kanner
1973;
Miller
•
Maryland
Psy chi
atric
Resear
ch
Cente
r. Box
3235.
Baltim
ore
,
Maryland
21228.
Journal
of
Psy
ched
elic Drugs 93
1975;
Ornitz
1973
;
Rimland
1964,
1972
;
Rutter
1972,1975;
Rutter
&
Bartak
1971;
Ward
1974)
,
and
will
not
be
specifically
discussed here.
REVIEW
OF
STUDIES
The
proceedings
of
a
conference
held
in
1959
and
published
the
following
year
(Abramson
1960)
contain
the
f
irst
five
refer
ences
to
the
use
of
ps
ychedelic
age n ts
in
the
treatm
ent
of
children.
These
reference
s,
which
arc
summ
arized
in
Freedman,
Ebin &Wilson
(1962)
,
contain
reports
of
the
treatrnen
t
of
a
total
of
twelve
children.
Although
extensive
clinical d
etails
are
not
av aila ble , it
appears
that
most
of
th ese c h ild r en received
LSD
(Lysergic
Acid
Dieth
ylamide)
as an
adjunct
to
ongoing
psychotherap
y,
and
that
the
r
esults
wer
e
quite
promising
in a
number
of
cases.
An
interesting
parallel
to
the
five
reports
in th e
1959
conference
was
published
in
1960.
Apparently
working
independently
of
the
North
Americans
whos
e
work
was
reported
in
the
conference,
Rojas- Berm
ude
z
(1960),
working
in
Argentina
,
described
the
treatment
of
four
cases he
diagnosed
as
schizophr
enia
and
two
he
diagnosed
as
early
infantile
autism
.
Although
work
ing
under
what
he considered
to
be
far
from
optimal
circumstances,
he
reported
"pr
ogressive
augmen
rat
ion
of
language
,
disinhibition
of
play,
greater
affective
cont
a
ct,
disappearance
of
self-destructive
behaviors,
mo
re ade-
quate
rea
ctions
to
stimuli,
integration
of
bod
yimage,
disappearance
of
hallucin
ations,
correction
of
m
orose-
ness,
diminution
of
learning
difficulties
and
of
behavior
disturbances
."
(Rojas-Bermudez
1960).
IIe
used
LSD
as
an adj
unct
to ps
ychoanal
ytic ps
ychotherapy
.
Vol.
9(No
. 2)
Apr-jun.
1977
Downloaded by [John Rhead] at 11:01 15 October 2015
RHEAD
Freedman,
Ebin
and
Wilson
(1962)
studied
the
effects
of
LSD
when
used
in
twelve
children,
ten
boys
and
two
girls,
who
were
selected
from
the
population
of
a
day
school
for
schizophrenic
children
and
who
carried
a
diagnosis
of
"autistic
schizophrenia".
Ten
of
the
children
were
given
one
exposure
to
LSD,
while
two
received
two
exposures
.
The
dosage
was
usually
100
J.1g
and
there
was
apparently
no
particular
structure
imposed
on
the
experi
ence
-
they
were
merely
given
the
drug
when
they
arrived
at
school
and
then
observed
during
the
course
of
the
ensuing
reaction,
usually
about
four
hours
or a
little
more
.
Reactions
under
th ese
circumstances
included
appetite
loss,
increased
bodily
awareness,
desire
for
physical
contact,
and
rapid
mood
swings
.
Although
there
was
definitely
an
increase
in
vocalization
in
terms
of
laughter,
sounds,
and
isolated
words
or
phrases,
"the
hoped
for
change
from
muteness
to
speech
did
not
occur."
(Freedman,
Ebin
&
Wilson
1962).
Probably
the
most
outstanding
contribution
to
the
literature
on
the
usc
of
psychedelic
drugs
with
children
has
been
made
by Dr.
Lauretta
Bender
and
her
colleagues.
Over
a
period
of
several
years
a
number
of
publications
wc re
issued
bv
this
group
(Bender
1966,
1967a,
1967b,
1970;
Bender,
Cobrinik
&
Farctra
1966
;
Bender,
Fa
retra
&
Cobrinik
1963;
Bender,
Goldschmidt
&Siva
Sankar
1962;
Fa
rct
ra &
Bender
1965)
pertaining
to
their
research
on
the
effects
of
LSD,
psilocybin
and
UML
(f-mcthvl-d-lvscrgic
acid
but
anolamidc
,a
methvl.ucd
d
criv
at ivc
of
LSD
marketed
by
Sandoz
as
Sansert
®
or
Mcthysergide
and
used
in
the
treatment
of
migraine
headaches).
The
bulk
of
this
work
involved
the
use
of
LSD,
which
was
administered
to
a
total
of
89
children
ranging
in
age
from
six
to
fifteen
years
.
Initial
dosages
of
LSD
were
25 J.1g/week ,
which
was
gradually
increased
as
the
safety
of
the
procedure
was
demonstrated.
Some
children
were
ultimately
treated
with
daily
dosages
of
150
J.1g
for
periods
of
as
long
as
two
years.
LSD
was
administered
as a
chemotherapeutic
agent
without
imposing
any
formal
psychother
apeutic
structure
beyond
what
was
already
part
of
the
hospital
ward
where
t
hcv
resided
.
In
order
to
understand
Dr.
Bender's
work,
it is
necessary
to
have
some
knowledge
of
her
theoretical
orientation
.
She
defines
childhood
schizophrenia
as
"a
disorder
in
maturation
characterized
by an
embryonic
primitive
plasticity
in all
areas
of
integrative
brain
functioning
from
which
behavior
subsequently
arises
."
(Bender,
Cobrinik
&
Faretra
1966).
Although
in
some
places
reference
is
made
to
chil
drcn
who
are
merely
diagnosed
as
"autistic"
,
the
term
"autistic-
schizophrenic"
is
more
common,
and
seems
to
imply
}olll'lhd
ofPsycbcdcl
ic Dm}!.s 94
TREATMENT
OF
DISTURBED
CHILDREN
that
autism
is
viewed
as
one
of
man
y
possible
symptoms
or
forms
of
childhood
schizophrenia.
Autism
is in
turn
described
as
"a
withdrawal
or
denial
defense
against
disturbing
sensations
arising
from
disturbed
au
tonomie
function
and
perceptual
function
and
anxiety
in
the
young
child
with
lagging
and
atypical
maturation."
(Bender,
Cobrinik
&
Faretra
1966).
Although
Dr.
Bender
and
her
colleagues
were
originally
interested
in
the
possibility
that
the
psychedelic
effects
of
LSD
might
"break
through
the
autistic
defenses
of
severely
schizophrenic
children"
(Bender
1966),
they
soon
became
more
intrigued
by
the
effects
on
the
au
tonomic
nervous
system
of
repeated
administrations.
It
seemed
that
regular
administration
tended
to
normalize
the
plasticity
and
lack
of
maturation
noted
above,
resulting
in
improved
reality
contact,
a
reduction
in
the
reporting
of
bizarre
fantasies
and
preoccupations,
weight
gain,
improved
gastro-
intestinal
regulation,
normali
zation
of
sleep
patterns,
increased
scores
on
the
Vineland
Social
Maturity
Scale,
a
rise in
IQ
on
the
WISC
(Wechsler
Intelligence
Scale
for
Children),
normalization
of
the
blood
pressure
response
to
epinephrine
injectio n ,
improved
comp
r
ehension
of
speech,
reduction
in
stereotyped
motor
play,
lower
anxiety,
and
elimination
of
the
need
for
tranquilizing,
antidepressant
and
sedative
medication
which
most
of
the
children
had
been
taking
prior
to
treatment
with
LSD
.
Although
most
of
these
results
were
described
for
various
subsarnples
of
the
entire
population
studied,
and
the
studies
generally
lacked
controlled
designs
and
statistical
analyses
of
the
data,
nevertheless
one
could
certainly
consider
their
results
to
be
promising
.
UML
was
tried
by
the
Bender
group
on
the
grounds
that
it
might
have
the
same
impact
on
the
autonomic
nervous
system,
without
being
hallucinogenic.
Although
it
did
seem
to
have
considerable
promise
in
this
regard,
it
was
associated
with
side
effects
of
muscular
spasms
and
occasional
vasomotor
changes
in
the
legs,
leading
to
cyanosis
of
the
legs in
one
case.
When
such
side
effects
appeared,
the
children
were
switched
to
LSD
without
difficulty
.
Psilocybin
was
only
given
to
ten
children
(Farerra
&
Bender
1965),
and
was
used
in
the
context
of
an
eight-week
stud
y
of
the
ability
of
LSD,
UML
and
psilocybin
to
normalize
autonomic
nervous
system
responses
to
injections
of
saline,
epinephrine
and
pilocarpine.
It
was
concluded
that
there
was
no
difference
in
the
effects
of
LSD,
UML
and
psilocybin
in
this
regard,
with
the
results
suggesting
that
all
three
drugs
tend
to
potentiate
the
responses
of
the
sympathetic
system
with
less
effect
on
the
parasympa-
thetic
system.
Vol.
9(No
.2)
Apr-jun.
1977
Downloaded by [John Rhead] at 11:01 15 October 2015
RHEAD
In an
attempt
to
replicate
Bender's
findings
using
a
more
rigorous
methodology,
Rolo
ct
al.
(1965)
studied
one
twelve-ycar-old
schizophrenic
boy
intensively
for
49
days.
Silcnt
motion
pictures
were
made
of
the
child
on
cight
occasions,
each
timc
while he was
exposed
to
various
motor
and
social tasks.
Four
of
the
filmings
took
placc
during
the
course
of
a
28-day
trial
of
LSD in a
daily
dosage
of
100
J.lg.
Subseyuent
blind
ratings
of
thc
films by
professional
and
nonprofcssional
judges
failed
to
produce
cvidcnce
of
therapeutic
effccts
of
the
LSD.
The
authors
note
that
no
conclusions
can
be
drawn
from
thcir
data
bccausc
of
thcir
limited
sample
size,
and
close
with
a
statcment
of
their
intention
to
explore
the
procedure
with
a larger
population.
However,
no
publisiH:d
rcports
of
further
studies
by
this
group
have
appeared,
and
it has
since
been
lcarncd
that
"the
expcrimcnts
werc
discontinued
for a
numbt:r
of
reasons"
(Abramson
197 5
).
Anothcr
snies
of
studies
that
seem
to
have
been
directly
stimu
l
ated
by
Bender's
work
was
carried
out
by
Simmons
and
his
colleagues
(Simmons
et
al.
1966;
Simmons,
Be
nor
& Daniel
1972;
Simmons,
Sparkes
&
Blake
1974).
A
total
of
nineteen
children
ranging in age
from
four
years
nine
months
to
thirteen
years
were
treated
with
a
uniform
dose
of
50
J.lg
of
LSD
on
from
two
to
five
occasions.
Of
the
seventeen
boys,
two
were
labcllcd
autistic,
while
the
remaining
fifteen
boys
and
the
two
girls in
the
sample
were
referred
to
as
schizophrenic.
Precise
and
objective
ratings
were
made
of
behavior
undcr
the
influence
of
LSD as well as
during
control
(non-drug)
periods
and,
in
one
study,
two
subjects
were also given a
double-blind
inert
placebo
on
two
occasions.
While
noting
the
difficulties
encountered
because
of
the
high intra-
and
inter-subject
variability
in
behavior,
the
authors
nevertheless
reported
the
following
effects:
I)
Substantial
affect
changes:
all
but
one
subject
showed
strong
positive
affect
on
at
least
one
occasion,
although
seven also
showed
numerous
fear
responses
(the
one
child
who
failed
to
show
any
positive
effect
failed
to
show
any
changes
in
effect
whatsoever).
2)
Decreased
sci
£-stimulation
in
nine
of
the
seventeen
children
who
characteristical
ly
manifested
this
symptom
.
3)
Marked
diminution
of
motor
activity
in
ten
children.
4)
Periods
of
apparent
preoccupation
with
some
internal
or
external
event
in
thirteen
children.
5) A
tendency
to
seek
close
contact
with
the
adult
who
was
present,
while
at
the
same
time
being
less
responsive
to
tasks
and
commands
presented
directly
by
the
adult.
joumal
nf
Psyc he d elic Drugs
95
TREATMENT
OF
DISTURBED
CHILDREN
6)
A
diminution
in aggressive
behavior.
Bos
(1971)
reports
the
usc
of
LSD as an
adjunct
to
dynamically
oriented
psychotherapy
with
four
scvercly
disturbed
children,
ranging
in age
from
three
and
one
half
years
to
eight
years.
Three
drug
sessi
ons
are
described
for
one
patient,
with
one
each
for
the
other
three
.
The
dosage
range was 1.1-1.3
J.lg/Kg,
and
an active
therapeutic
approach
was
emp
l
oyed,
using
music,
symbolic
play
with
puppets
and
dolls,
modeling
with
clay
and
(in
the
case
of
the
3Yz-ycar-old
boy)
extended
holding
of
the
patient
in a
female
therapist's
arms.
Significant
imp
rovement
is
noted
for
three
of
the
patients,
although
it
seems
to
be
implied
that
it
was
of
a
transitory
nature
for
one
of
the
three.
o
indication
of
outcome
is
given
for
the
fourth
patient.
Refering
to
these
four
cases
and
"other
experiences"
Bus
concluded
with
the
following:
"In
the
hands
of
the
dynamically-
oriented
child
psychotherapist
LSD
can
in
this
way
become
a
key
to
the
primary
process
(Frcud),
a
tool
of
the
positive
disintegration
(Dabrowski)
of
thc
psycho
-
pathological
structures
of
the
fomutivc
period
of
development
of
the
child's
personality,
that
is,
the
structures
therapeutic
ally
up
to
now
most
inert."
In his
book
describing
a large
research
program
using
psychedelics
as
adjuncts
to
psychotherapy,
Fontana
(1965)
devotes
a
relatively
small
number
of
pages
to
the
treatment
of
children.
Nevertheless,
he
seems
to
imply,
without
giving
specific
figures,
that
he
and
his
colleagues
have
had
fairly
extensive
experience
in
treating
children.
He
reports
having
given
individual
treatment
to
children
three
years
of
age
and
older
who
present
"severe
psychic
disturbances,
many
of
them
affected
by
severe
mental-organic
deficit."
LSD,
psilocybin
and
mescaline
were
given in
doses
of
1. 5
J.lg/Kg, 1-6 mg
and
0 .1 g
respectively,
without
any
complications
attributable
to
the
drugs.
Emphasis
is
placed
on
the
need
for
the
establishment
of
good
therapeutic
rapport
before
the
drugs
arc
introduced
into
the
therapy.
The
authors
make
a
point
of
mentioning
that
the
drug
sessions
should
be
conducted
in
the
same
room
where
the
non-drug
interviews
take
place.
Music
and
food
are
offered
during
the
period
of
drug
act
i
on,
along
with
interpretations
of
transference
that
seem
to
be
based
largely
on
the
object
relations
theory
of
Melanie Klein.
Results
are
described
as
being
successful
in
the
majority
of
cases.
The
brevity
of
Fontana's
(1965)
description
of
his
work
with
children
is
particularly
unfortunate
in
that
he
seems
to
be
the
only
author
who
has
worked
with
psychedelics
as
adjuncts
to
group
psychotherapy
with
children.
The
groups
usually
have six
to
eight
children
and
meet
once
each
week
for
one
hour
in a
conventional
Vol.
9(No.
2)
Apr-jun,
1977
Downloaded by [John Rhead] at 11:01 15 October 2015
RHEAD
therapeutic
format.
Drug
-assisted
therap
ysessions are
introduced
into
this
ongoing
regimen
about
once
every
six
months,
using
the
same drugs in
the
same
dose
ranges
descri bcd a bove for use in individual
psychotherapy
.
It
is
reported
that
the
group
approach
seems
indicated
primarily
for
children
"with
particular
maladjustments
in social
environments
appropriate
for
their
ages ."
(Fontana
1965).
Probabl
y
one
of
the
most
fascinating articles in
the
lit
erature
is
the
case
study
published
by
Fisher
(1970)
.
. His
report
was derived
from
a
study
of
twelve
autistic
and
schizophrenic
children
who
were
treated
with
psilocybin
and
LSD.
The
study
had
to
be
terminated
prematurely
due
to legal
restraints
that
came
to be
placed
un
the
use
of
the
drugs in
the
early
1960's
,
and
no final
report
was ever
published.
Consequently
the
o nly
information
available on
the
study
is
contained
in
an
unpublished
interim
report
(Fisher
&Castille
1963),
which
is
partially
described
in Mogar
and
Aldrich
(1969),
and
Fisher's
case
study
(Fisher
1970).
The
case
presented
by
Fisher
is
that
of
a
twelve
-year
-old girl who was
hospitalized
in a large
state
institut
ion for
the
mentall
y
retarded
which
had
many
severely
emotionally
disturbed
children
in its
popula-
ti on .
She
was
born
prematurely
to a
paranoid
-
schizophrenic
mother
and
suffered
from
congenital
dislocation
of
the
hips
and
knees
,
congenital
heart
murmur
and
retrolental
fibropl asia.
Her
development
had
been
slow
and
marked
by
hospitalization
and
repeated
evaluations,
during
the
course
of
which she
received
"a
variety
of
diagnoses
including
CNS
pathology,
childhood
schizophrenia,
mental
retardation,
severe
emotional
disturbance
and
severe
brain
injury
from
birth."
(Fisher
1970).
Likewise
her
behavior
had
been
described
as
"biza
rre, grossly regressive,
retarded
,
hyperactive
,assaultive,
erratic
and
destructive."
(Fisher
1970).
At
the
time
she was
evaluated
for
treatment
with
psychedelics,
after
a
number
of
drugs
and
ten
ECT
(electro-convulsive
therapy)
treatments
had
produced
no
improvement,
she was
described
in
the
following
manner
:
"
...
she was
acutel
y ps
ychotic
and
had
virtually
no
contact
with
an
yone.
She
was a
rather
large girl
for
her
twelve years,
quite
blind,
apparently
onl
y
able
to see very
little
when
she
held
an
object
within
a
couple
of
inches
of
one
eye
. When she
moved,
she
bounded,
with
a
pronounced
lurch
and
limp
and
it was
amazing
she
had
as
few
falls
and
crashes as she did.
lIer
hair
was
rather
long,
oily
and
stringy
and
her
skin
was
covered
with
acne
.
She
always
appeared
dishevelled
and
was
quite
an
ugly sight. Her
typical
day was
spent
sitting
in a
.Io urnal
of
Psychedelic
J)mg
s96
TREATMENT
OF
DISTURBED
CHILDREN
corner
of
the
ward
with
two
major
activities,
one
was
protecting
herself
from
the
assaults
of
other
children
and
the
sec
ond
was
twirling
bits
of
paper
in
her
long
fingers ,
constantly
rocking
herself
,
masturbating
and
talking
wo rd-s a lad
almost
incessantly."
(Fisher
1970)
.
She
was given a
total
of
thirteen
treatment
sessions
using LSD (in a
dose
range
from
100
to
300
/lg),
two
treatment
sessions using
psilocybin
(l0
mg
once
and
30
mg
once),
and
one
treatment
session
combining
the
two
(200
/lg LSD
and
10 mg
psilocybin).
The
treatment
approach
placed
great
emphasis
on
the
importance
of
the
interpersonal
element
in
producing
psychothera-
peutic
change,
and
was based on a
conceptualization
of
psychosis as
"a
massive defensive
system
of
repression-
avoidance-denial in
the
service
of
protecting
the
individual
from
experiencing
his feelings."
(Fisher
1970).
During
the
course
of
the
sixteen
drug-assisted
sessions
the
patient
made
quite
dramatic
inroads
into
her
own
" massive defensive
system"
.When
the
project
had
to
be
terminated
she was
described
as follows:
"It
was
obvious
th at J
became
much
better,
She
ceased
her
isolated,
autistic
behavior
to
avery
large degree - she no
longer
sat
in a
corner
,
twisting
papers,
masturbating
and
talking
word-
salad.
She
had
chores
which
she
did
on
the
ward.
She
talked
to
people
rat
ionally
and
helped
with
the
smaller
children
.
Her
comments
about
other
patients,
and
sometimes
staff,
were
painfull
y
accurate.
She
tried
to
learn
but
found
it
almost
impossible
because
of
her
blindness."
(Fisher
1970).
Most
of
the
improvement
appears
to
have
been
maintained
during
the
five
years
when
it was possible to
obtain
follow-up
information
.
At
the
end
of
that
time
she was
discharged
to
her
parents.
CHROMOSOME
DAMAGE
ISSUE
The
question
of possible
chromosomal
damage
as a
result
of
the
ingestion
of
LSD has
been
a
controversial
one,
and
can
be
expected
to
elicit especially
heated
debate
when
children
are
being
considered
for
treatment.
Fortunatel
yan
excellent
and
comprehensive
review
of
the
literature
is available
(Dishotsky
et
al.
1971),
as well as follow-up
chromosomal
evaluat
ions by
two
of
the
research
teams
whose
work
is reviewed
above
(Bender
&Siva
Sankar
1968;
S
immons,
Sparkes
&Blake
1974).
Dishotsky
er al.
(1971),
after
examining
carefully
a
great
deal
of
data
on
chromosomal
damage
in
subjects
who
were users
of
illicit LSD
of
unknown
puri
ty,
as
contrasted
with
those
who
received
the
drug
in
pure
Vol.
9(No.
2)
Apr
-jun.
1977
Downloaded by [John Rhead] at 11:01 15 October 2015
RHEAD
form in a medical a
nd/or
research
setting
,
came
to
the
conclusion th a t
"chromosome
damag
e,
when
found,
was
relat e d to
the
effects
of
drug abuse in general
and
not
,
as
initia
ll
y repo
rt
ed ,
to
LSD alone
."
The
a
uthors
offer
their
beli
ef
in
the
mo re general
statement
that
:
"
..
. pure LSD ingested in
moderate
doses does
no t damage
chromosomes
i11
vi vo, does
not
cause
detectable genetic damage, a
nd
is
not
a
teratogen
or a carcinogen in man. Within these
bounds,
therefore,
we
suggest
th
at,
other
th
an
during
pregna n
cy,
there
is
no
pr
ese
nt
co
ntr
a
indication
to
the
co
ntinu
ed
controlled
experimental
use
of
pur
e
LSD."
Among the
reports
on which
Di
s
hotsk
y et al.
(1971)
based the ab ove conclusions was the
on
e
by
Bender
and
Siva
Sankar
(1968).
In
the
later
re
port
,
the
a
uth
ors
describe a
compariso
n
of
chr
omoso
me a
bn
or
ma liti es in
seve n c hildre n previousl y
treated
with
LSD versus
twent
y who h
ad
n
ot
been so
treated.
It
is
of
interest
not
only
that
they failed
to
fi
nd
differences b
etwee
n these
two
gro
up
s,
but
that
the LSD was given in
"daily
doses
of
100
to
150
JJ.g
for 5
\lz
to
35
months
." This would
imply a
minimum
to t al dosage
of
16,
800
p g
and
po
ssible
m
ax
imum
of over
159
,
000
JJ.g
.
The D
is
ho t sky
et
a
l.
(1971)
review,
of
cours e did
not include the more rece
nt
report
by
Simm
on
s,
Sparkes
and Blake
(1974).
The
lat
er
group
of
investigators
examined
the
ka ry o t y pe s
of
each
of
four
schizophr
enic
children
at
fo ur
points
in
time : b
efore
treatment
with
LSD, immediately
after
a six-
to
ten-week
co
urse
of
LSD
tr
eat
me
nt
during whi c h a
tot
al
of
270
pg
to
450
pg
of
the
dr
ug was admi
nister
ed,
three
months
after
treatment,
and
a
ppr
oxima
tely
one
yea
r
after
treatment.
Individu
al
doses were from 50 !lg
to
75
pg
,
and
at no
time was there fo
und
to
be an increase in
chromosome
damage over t he pr
e-
tr
eat
ment
baseline.
Taken
together,
the
a
bo
ve re
ports
on c
hromosom
al
damage
as
a result
of
LSD leave
little
cause for
concern.
The
sum
m
ary
by
Di
sh
otsky
et a
l.
(1971 )
to
the effect
tha
t " pure LSD ingested in
moderate
doses
do
es n
ot
pr
od
uce c
hromosome
damage
detect
able b y ava
il
able
meth
ods"
is
still va lid , and the d
ata
from
the
Bender a
nd
Siva
Sankar
(196
8)
study
would
seem
to
indica te
that
a
liberal inte
rpret
at
ion of
"moderate
doses"
doe
s
not
invalidate it.
DISCUSSION
The
ph ysica l and ps yc hol ogic al
safety
of
the
respo nsibl e use
of
psychedelic age nts with severely
disturbed
children seems
to
be relatively
we
ll
esta
b-
lish ed. The
data
of Be
nder
a
nd
S
iva
Sanka r
(1968),
Di
sh o tsky
et
al. (1971
),
a
nd
Simm
ons , Spar kes &
Bl
ake
97
TREATMENT
OF
DISTURBED
CHILDREN
(197 4)
indicate
that
ther
e
is
no measurable risk
of
chromosome
dam
al!e with
th
e use
of
LSD ,
even when dail y doses
from
100
to
150
pg
are given for
as
long
as
35
month
s.
Nor
is
there
reason
to
sus
pect
any
other
form
of
ph ysical
or
psychological risk with
individual doses
as
high
as
400
pg (Fisher & Castile 1963 ;
Magar & Aldrich
1969)
.
From
a ps
yc
hological
standpoint,
the
worst
o
utcome
report
ed
IS
no
impro
ve
ment.
Although
such an
outcome
might
be
co
nsidered t o be ps
yc
holog
ic
a
ll
y delet e
ri
ous
to
the
extent
that
it
engendered a feeling
of
fa ilure or
disa
ppointment
, such a feeling
is
certainly
n
ot
a novel
one
for
this
population
-o
r for
the
ther
apists
who
treat
them.
The
fact th a t
tr
eat
ment
failures have
been
re
ported
,
and
will n o
doubt
continue
to
occur,
deserves e
mph
asi
s.
Much
of
the
ea
rl
y research with ps
yc
hedelics ca n
be
characterized
as
representing a
shift
from
the
"medical
model "
to
the
"magical
model"
.
The
l
atter
te rm is
mea
nt
to
co
nnot
e an
expectation
tha t all pati e
nt
s in a
given
group
will be
dram
atically
and
mir
aculousl y
improved if
tr
ea
ted
with psych edelics . Such an
expectation
seems
to
ha
ve
been
implied by
Freedman,
Ebin
and
Wils
on (
1962)
when
they
co nclude
their
article
on
twelve
mute
(o r nearly
mut
e) schi
zo
phreni
c children
who
were given an ave rage
of
slightly over
100
!lg
of
LSD o n
one
or
(for
two
subjects)
tw
o occasio ns , with
the
statement:
"The
hoped
for change from
mut
eness
to
speec h
did
not
occur. "
Another
co
nn
ota
ti
on
of
the
magical mo del
is
that
ps
yc
hedelics will be effective o
nl
y
if
the
y a re given in high enough
do
sage a
nd/or
on
eno
ugh occasions, with little
or
no regard for
the
critical
import
an ce
of
the
interper
sonal
context
in which , and
the
intent
with which, the drugs are used . "
Str
eet
trippers"
who
rep
ort
several
hundr
ed
exposures
to
high
dosages
of
LSD
without
observable
per
sonality chang es
attes
t t o th e fallacy
of
this
model,
and the po
int
is
underscored
by
Fisher
(1970)
in his case rep o
rt
when he
no t es tha t "If there
is
anything
to
be learned from this
tre
at
me
nt
atte
mpt
it
is
that
little
of
what
may be called
health or gr
ow
th
can
occur
without
intimate a
nd
h o nest
relationships
betwe
en p
eo
pl
e."
The
issue
of
interpersonal
contact
when
a
psychedelic
is
a
dministered
derives directly from
the
th
eo
retica l sta nce one
tak
es regarding th e
mode
of
action by which
the
ma
nif
ested
effects
of
treatment
are
produced
.
The
two
most
basic
th
eo
r
et
ic
al
positions
are
the
chemotherapeutic
and
the
ps
yc
h
ot
her
ape
utic
.
In
the
forme
r,
the
drugs ar e viewed
as
chemical age nts ac ting
on the bi ological organism in a dir
ect
and
pr
e
dict
abl e
manner
to
produce
relatively
uniform
results (in the way
tha t aspirin migh t b e
expected
to
reliably d
emo
ns
tr
ate
Vol.
9(No
. 2) Apr-
jun
. 1
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RHEAD
analgesic
properties),
regardless
of
the
status
of
most
cx
trapharrnacological
and
interpersonal
variables.
In
the
latter,
the
drugs
are
regarded
as
powerful
adjuncts
to
ongoing
psychotherapeutic
involvement
characterized
by
deep
and
stable
rapport
between
the
patient
and
members
of
the
treatment
team.
There
is
ncar
unanimity
among
serious
investigators
that
the
psychotherapeutic
approach
is
the
one
holding
the
greatest
promise.
Although
Bender's
positive
results
seem
at
first
glance
to
have
been
produced
in an
essentiall
y
chemotherapeutic
framework,
Mogar
&
Aldrich
(1969)
astutely
point
out
th
at
"her
reports
are
replete
with
descriptions
of
spontaneous
interactions
between
staff
and
children
."
Several
different,
and
at
tim es ov
erlapping,
concep-
tual
models
might
be
offer
ed to a cc o u n t for
the
manner
in
which
psychedelic
agents
can
be
of
usc as
adjuncts
to
the
treatment
of
severely
disturbed
children
within
the
ps
ychotherapeutic
framework.
Some
of
these
models
are
merely
extensions
and/or
modifications
of
rel
atively
traditional
approaches
to
treatment
in
which
the
ps
ychedelic
serves to
enhance
the
established
treatment
;
others
are
rather
novel
and
based
on
the
more
unique
properties
of
the
drugs.
Bender
offers
an
example
of
the
enhancement
of
an
established
treatment
when
she
suggests
that
LSD
can
be
us
ed
to
replan
:
the
traditional
tranquili
zers
in
the
ward
management
of
schizophrenic
children,
without
the
usual
side
effe
ct
of
making
them
groggy
and
sleepy
(Bender
et al .
1966).
She
hypothesized
that
this
enhancement
of
the
effectiveness
of
an
apparently
chemotherapeutic
approach
is
due
to
the
fact
that
LSD
has a
"normalizing
effect
upon
the
labile
plastic
auto no mic
system
characteristic
of
schi
zophrenic
child-
ren
."
(Bender
1970)
.
Although
the
cxtrupharrna
cologica
l
factors
noted
by
Mogar
&Aldrich
(1969)
m ay
have
accoun ted
for
some
of
Bender's
positive
therapeutic
results,
her
application
of
psychedelics
was
certainly
within
the
framework
of
a
traditional
therapeutic
milieu.
Whether
one
conceptuali
zed
the
moue
of
action
of
the
drugs
in
terms
of
ward
management
or
some
other
model,
whatever
influence
the
drugs
had
was
exerted
by
means
of
enhancing
the
effectiveness
of
the
established
treatment
approach
.
Another
treatment
modality
that
has
gained
significant
ac ce p ta n c e in
the
professional
community
is
the
behavior
al
approach
pioneered
by Lov
aas
(Lovaas
ct
a1.
1973)
.
This
approach
relics
heavily
on r
esponsiveness
to
direct
interpersonal
exchanges,
a
responsiveness
that
Richer
&
Richards
(1975)
have
shown
to
be
vcry
much
lacking
in
autistic
children
.Hence it
appears
that
the
techniques
developed
by Lova as
arc
hampered
by
the
ch
aracteristic
behavior
of
the
very
patients
for
whom
.1
fI/lJ"I/
(7!
or
Psv« be'dt'! ic
J)mg
s
TREATMENT
OF
DISTURBED
CHILDREN
they
arc
intended.
Interestingly,
Lovaas
is a
co-author
of
the
paper
by
Simmons
ct
al.
(1966)
tha
t
contains
the
results
of
two
expcrimen
tal
studies
in
which
two
au
tistic
male
five-year-old
identical
twins
were
exposed
to
a
number
of
experimental
situations
after
receiving
either
50/J.g
of
LSD
or
a
placebo
.
Although
these
experimental
situations
wer
e
not
designed
specifically
to
be
therapeutic
in
and
of
them
selves,
they
were
clearly
meant
to assess
the
impact
of
LSD
on
the
k
inds
of
interpersonal
rcsponsivity
so
critical
to
a
beh
avioral
approach
to
tre
atment
. In
discussing
the
results
of
these
studies,
the
au th
ors
n
otc
.
"Therapeutic
intervention
in
severely
retarded
or
regressed
children
ut
ilized
to
a
great
extent
close
physic
al
interaction
to
which
the
child
must
respond.
In
thc
usual
st
ate
it is
often
difficult
to
intrude
upon
the
child
because
of
a
general
lack
of
responsiveness
coupled
with
the
random
character
of
responses
when
they
arc
obtained.
The
barrier
to
external
stirn uli is
further
increased
by
self-stimulatory
behavior
with
a
high
percent
time
appearanc
e
both
in
the
resting
state
and
when
stimuli
are
presented
from
the
external
environ-
ment.
The
results
of
our
experiments
clearly
demonstrate
changes
[with
LSD]
in
exactly
these
areas
with
increas
ed
attendance
to
physical
and
face
contact
with
an
attending
adult
and
concomitant
reduction
of
competing
self-
stimulatory
behavior."
(Simmons
ct
a1.
1966).
The
usc
of
psychedelics
to
enhance
a
more
analytic
ally-oriented
appro
ach
to
therapy
is
illustrated
in
the
work
of
Fontana
and
of
Fish cr.
Fontana
(1965)
claims
that
LSD,
psilocybin
and
mesc
aline
cause
an
initial
augmentation
of
habitual
defense
mechanisms,
followed
by a
reduction
in
defenses
and
a
significant
increase
in regressive
behavior
.
The
therapist
serves
largely
as a
target
for
the
child's
projections,
especially
during
the
regressions,
and
through
the
therapist's
interpretations
"a
sane
and
complete
relationship
with
the
object
is
reestablished
."
Fisher
(1970)
seems
to be
referri
ng to a
similar
eonceptualiza
ti
on
of
the
utility
of
LSD.
Recall his
definition
of
psychosis
as
"a
massive
defensive
system
of
repression-
a
void
ance-denial
in
the
service
of
protecting
the
individual
from
experiencing
his
feelings
."
Within
this
theoretical
framework
he
reasons
that
psychedelics
would
be
capable
of
enhancing
the
rap
y
as
follows
:
"The
rationale
behind
the
usc
of
psychedelic
agents
with
psychotic
children
was
that
these
drugs
have
the
capacity
to
activate
or
chemically
energi
ze
various
areas
of
the
brain
to
an
extreme
degree
resulting
in vivid
experiencing
in
the
area
of
Vol.
9(No
.2)
.vpr-]
un,
1977
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RHEAD
perception,
emotion,
memory
and
feeling. In
addition,
these agents seem
to
inhibit
the
higher
brain centers which are considered responsible for
such functions
as
inhibition, intellectual abstrac-
tions and cognition.
The
psychedelic drugs
tend
to
release experiences
of
phenomena
normally
repressed
or
denied or
not
considered essential in
meeting
the
demands
of
one's
own
and
others'
egos. Experiences and feelings ordinarily denied
awareness receive
proportionately
more energy
causing
them
to
break
into
a
state
of
consciousness
which
is
less strongly
dominated
by
the
usual
defenses and values which one has developed.
Without the usual
complicated
defensive
structures
and censures,
the
individual
is
able
to
re-
experience himself
in
a far less
distorted
way
and
to
re-evaluate
the
worthiness
of
his essential self."
(Fisher 1 970).
Two
rather
novel approaches
to
the
treatment
of
severely disturbed children, which almost
undoubtedly
have their roots in
the
same existential issue, are based
on the ability
of
the psychedelics
to
catalyze experiences
having
to
do with
birth
and
death
.
Grof
(197
5) has
postula
ted
that
many psychological disturbances have
their
roots
in
the birth
trauma,
and
that
psyc hedelics
provide a unique
opportunity
for the working through
of
the effects
of
the
traum
a. Torrey, Hersh
and
McCabe
(1975)
have
pointed
out
that
a
number
of
recent
studies
(Bender &
Faretra
1961;
Gittleman
& Birch
1967;
Harper & Williams
1974;
Hinton
1963;
Lobascher,
Kingerlee & Gubbay
1970;
Osterkamp
& Sands
1962;
Pollac k & Woerner
1966;
Taft
&
Goldfarb
1964;
Vorster
1960;
Whittam, Simon & Mittler
1966;
Wing,
O'Connor
&
Lotter
1967)
have indicated an association between
autism
and/or
childhood
schizophrenia on one
hand,
and
comp
li
cations
of
pregnancy
and
delivery on
the
other.
Although it
is
clear
that
some significant percentage
of
severely
emotionally
disturbed
children
suffer
from
mental
retardation
and
other
organic
impairments
(whether
a result
of
complications
of
pregnancy
and
delivery or not), some
show
no measurable sign
of
organicity. Perhaps
those
without
organic damage are
at
least
in
part
manifesting severe disturbances in behavior
as
a result
of
the psychologic al trauma
of
birth,
a
nd
might therefore be
expected
to
respond
to
a
mode
of
ther
apy
that
addresses this issue ,
as
Grof
(1975)
suggests
psychedelic
psychotherapy
does. In this regard,
Fontana
(1965)
reports
having observed
"dramatizations
of
birth"
in some
of
the children he
treated
.
On the
other
side
of
the same existential coin from
birth
is
death. Bender
(1969)
states
that
there
is
an
"ever-present core
anxiety"
at
the
heart
of
the
joumal
of
Ps
ych
edelic Dmgs
99
TREATMENT
OF
DISTURBED
CHILDREN
disordered behavior
of
autistic and schizophrenic
children. She
attr
ibut
es this
anxiety
to
a
"global
disorganization in physiological and psychological
functions
that
...
are characterized by plasticity
in
patterning,
in
boundaries,
and
in
relationships." Such
disorganization
of
function
is
in
turn
traced
to
"a
combination
of
inherited tendencies
and
noxious
or
traumatic
events, intra-uterine or
perinatal."
Hence
one
might say
that
Bender considers this
core
anxiety
to
be
at
least in
part
the resu
lt
of
the
fact
that
these children
have
had
unusually
traumatic
births, as described above.
However, the fact
that
Bender describes this core
anxiety
as
being
"ever-present"
makes
it
sound
very
much
like the
conceptualization
that
other
authors
have
attempted
to
a
pply
to
the fear
of
death.
Becker
(197
3 ),
for
example, hypothesizes
that
death
"is
the
basic fear
that
influences
al
l others, a fear from which
no
one
is
immune,
no
matter
how
disguised it may
be."
The
parallels
between
the
traumas
of
birth
and
death
arc
great
enough
to
have led Kastenbaum & Aisenberg
(1972)
to
include a
chapter
entitled
"Birth
and Death:
Some Mutual Implic
at
i
ons"
111
their
book
The
Psycbology
of
Deatb . In
that
chapter
they
review
anthropological
data
as
well as
the
psychoanalytic
works
of
theorists such
as
Rank and Ferenczi, and
note
the
similarity between
birth
and
death
in
th
at they
both
represent a separation. One
might
postulate
that
there
would be a positive
correlation
between
the
severity
of
the
birth
tr
a
uma
and the average level
of
a person's
"core
anxiety"
or
fear
of
death . LSD h
as
alr
eady
demonstrated
that
it
can
be
of
significant benefit, when
used
in
the
context
of
brief, intensive
psychotherap
y,
in
reducing the fear
of
death
in
adults
who
are facing the
prospect
of
imminent
death
from
cancer
(Richards
eta!.
1972).
There
seems
to
be no reason
to
believe th a t
it
would
not
be
of
similar utility
in
dealing with the birth
trauma,
fear
of
death,
or
core
anxiety,
of
children.
In sum, the relative safety
and
ther
apeutic promise
of
the
use
of
psychedelic
compounds
such
as
LSD
when
used in a ps yc
hother
a
peutic
context
with severely
disturbed
children are well established.
Further
research
will be required
to
determine
the
degree
to
which
that
promise
can
be reliably fulfilled .
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ACKNOWLEDGEMENTS
The
author
is grateful to
jo
se Arana,
Richard
Yensen
and
Dolores Martin for
their
assistance in
translating
Rojas-
Bermudez.
The
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Vol.
9(No.
2)
Apr-juri,
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