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the dying was pursued at the Spring Grove State Hospital in Maryland, and

later at the Maryland Psychiatric Research Institute. Walter N. Pahnke, the

director of the cancer project from 1967 until his accidental death in 1971,

was a doctor of divinity as well as a psychiatrist, and he first reported on

his work in 1969. Seventeen dying patients received LSD after appropriate

therapeutic preparation; on-third improved "dramatically," one-third

improved "moderately," and one-third were unchanged by the criteria of

reduced tension, depression, pain, and fear of death.19 [52] The results of

later experiments using LSD and dipropyltryptamine have been similar.20 [53]

These studies lacked control groups, and there is no sure way to separate

the effects of the drug from those of the special therapeutic arrangements

that were part of the treatment.

COMPLICATIONS AND DANGERS

The main danger in psychedelic drug therapy is the same in any deep-probing

psychotherapy: if the unconscious material that comes up can be neither

accepted and integrated nor totally repressed, symptoms may become worse,

and even psychosis or suicide is possible. The potential for harm has,

however, been exaggerated, for two reasons. First, much irrational fear and

hostility is left over from the cultural wars of the 1960s. Second, and more

generally, we tend to misconceive drugs as something utterly different from

and almost by definition more dangerous than other ways of changing mental

processes. Actually, the dangers in work with LSD do not seem obviously

greater than in comparable forms of therapy aimed at emotional insight.

The most serious danger is suicide, and there are several reports of suicide

attempts or actual suicide among patients in psychedelic drug therapy. But

many people who have worked with psychedelic drugs consider them more likely

to prevent suicide than to cause it. H Clark and R Funkhouser asked about

this in a questionnaire distributed to 302 professionals who had done

psychedelic drug research and to 2230 randomly chosen members of the

American Psychiatric Association and American Medical Association. Of the

127 answering in the first group, none reported any suicides caused by

psychedelic drugs, and 18 thought they had prevented suicide in one or more

patients; of the 490 responding in other groups, one reported a suicide and

seven believed suicidal tendencies had been checked.21 [54]

All available surveys agree that therapeutic use of psychedelic drugs is not

particularly dangerous. In 1960, Sidney Cohen made 62 inquiries to

psychiatrist and received 44 replies covering 5000 patients and experimental

subjects, all of whom had taken LSD or mescaline a total of 25,000 drug

sessions. The rate of prolonged psychosis (48 hours or more) was 1.8 per

1000 in patients and 0.8 per 1000 in experimental subjects; the suicide rate

was 0.4 per 1000 in patients during and after therapy, and zero in

experimental subjects.22 [55] Other studies have confirmed Cohen's

conclusion that psychedelic drugs are relatively safe when used

experimentally or therapeutically.

All these studies have serious limitations. Many psychiatrists may have

minimized the dangers out of therapeutic enthusiasm and reluctance to admit

mistakes; a few may have exaggerated them under the influence of bad

publicity; long-term risks may have been underestimated if follow-up was

inadequate. The problem is the absence of a basis for comparison between

these patients and others with similar symptoms who were not treated with

psychedelic drugs or not treated at all. However, psychedelic drugs were

used for more than 15 years by hundreds of competent psychiatrist, who

considered them reasonably safe as therapeutic agents, and no one has

effectively challenged this opinion.

CONCLUSION

When a new kind of therapy is introduced, especially a new psychoactive

drug, events follow a common pattern. At the beginning, there is spectacular

success, enormous enthusiasm, and a conviction that it is the answer to a

wide variety of psychiatric problems. Then the shortcomings of the early

work become clear: insufficient follow-up, absence of controls, inadequate

methods of measuring change. More careful studies prove disappointing, and

the early anecdotes and case histories begin to seem less impressive. Later,

psychiatrists fail to obtain the same results as their pioneering

predecessor. As Sir William Osler said, "We should use new remedies quickly,

while they are still efficacious."

The rise and decline of LSD, however, took an unusual course. In 1960, 10

years after it was introduced into psychiatry, its therapeutic prospects

were still considered fair and the dangers slight. Then the debate received

an infusion of irrational passion from the psychedelic crusaders and their

enemies. The revolutionary proclamations and religious fervor of the

nonmedical advocates of LSD began to evoke hostile incredulity rather than

mere natural skepticism about the extravagant therapeutic claims backed

mainly by intense subjective experiences. Twenty years after its

introduction it was a pariah drug, scorned by the medical establishment and

banned by the law. In rejecting the notion that psychedelic drugs are a

panacea, we have chosen to treat them as entirely worthless and

extraordinarily dangerous. Perhaps the time has come to find an intermediate

position.

If therapeutic research becomes possible again, it might be good to begin

with the dying, since in this case only short-term effects have to be

considered. Psychedelic drugs might also be used to get past blocks in

ordinary psychotherapy: to help patients decide whether they want to go

through the sometimes painful process of psychotherapy, or to help a

psychiatrist to decide whether a patient can benefit from the kind of

insight that psychotherapy provides. In addition, MDA, harmaline, ketamine,

and other psychedelic drugs with unique effects still need to be evaluated.

Psychedelic drug therapy apparently still goes on unofficially. People would

not continue to practice it under difficult conditions unless they believed

they were accomplishing something. Many regard it as an experience worth

having, some as a first step toward change, and a few as a turning point in

their lives. It would simplify matters if we would be sure that they were

deceiving themselves, but we do not know enough about what works in

psychotherapy to say anything like that. No panacea will be discovered any

more than in psychoanalysis or religious epiphanies. Nevertheless, the field

obviously has potential that is not being allowed to reveal itself.

REFERENCES

1. McGlothin W, Cohen S, McGlothlin MS: Long lasting effects of LSD on

normals. J Psychedelic Drugs 3:20-31, 1970

2. Sherwood JN, Stolaroff MJ, Harman WW: The psychedelic experience a new

concept in psychotherapy. J Neuropsychiatry 2:59-66, 1967

3. Savage C., Hughes MA, Mogar R: The effectiveness of psychedelic (LSD)

therapy: A preliminary report. Br J Soc Psychiatry 2:59-66, 1967

4. Grof S: Realms of the Human Unconsious: Observations from LSD Research.

New York, Viking Press, 1975

5. Naranjo C: The Healing Journey. New York, Ballantine Books, 1975

6. Newland CA: My Self and I. New York, New American Library, 1962

7. Ling TA, Buckman J: Lysergic Acid (LSD 25) and Ritalin in the Treatment

of Neurosis. London, England, Lambarde Press, 1963

8. Vanggard T: Indications and counter-indications for LSD treatment. Acta

Psychiatr Scan 40:427-437, 1964

9. Leuner H: Halluzinogene in der psychotherapie. Pharmakopsychiatr

Neuropsychopharmakol 4:333-351, 1971

10. Savage C, McCabe OL: Residential psychedelic (LSD) therapy for the

narcotic addict: A controlled study. Arch Gen Psychiatry 28-808-814, 1973

11. Kurland AA: The therapeutic potential of LSD in medicine, in DeBold R,

Leaf R (eds): LSD, Man and Society. Middletown, Connecticut, Wesleyan

University Press, 1967

12. Maclean JR, Macdonald DC, Ogden F, et al: LSD 25 and mescaline as

therapeutic adjuvants, in Abramson H (ed): The Use of LSD in Psychotherapy

and Alcoholism. New York, Bobbs-Merrill, 1967

13. Hoffer A: A program for the treatment of alcoholism: LSD, malvaria and

nicotinic acid, in Abramson H (ed): The use of LSD in Psychotherapy and

Alcoholism. New York, Bobbs-Merrill, 1967

14. Smart RG, Storm T, Baker EFW, et al: A controlled study of lysergide in

the treatment of alcoholism. Q J Stud alc 27:469-482, 1966

15. Sarett M, Cheek F, Osmond H: Reports of wives of alcoholics on effects

of LSD-25 treatment on their husbands. Arch Gen Psychiatry 14:171-178, 1966

16. Ludwig AM, Levine J, Stark LH: LSD and Alcoholism: A Clinical Study of

Treatment Efficacy. Springfield, Ill, Charles C Thomas, 1970

17. Roy C: Indian peyotists and alcohol. Am J Psychiatry 130:329-330, 1973

18. Huxley LA: This Timeless Moment. New York, Farrar, Straus, & Giroux,

1968


19. Pahnke WN: The psychedelic mystical experience in the human encounter

with death. Harvard Theol Rev 62:1-21, 1969

20. Grof S, Goodman LE, Richards WA, et al: LSD-assisted psychotherapy in

patients with terminal cancer. Int Pharmacopsychiatry 8:129-141, 1973

21. Clark WH, Funkhouser GR: Physicians and researchers disagree on

psychedelic drugs. Psychol Today 3:48-50, 70-73, 1970

22. Cohen S: Lysergic acid diethylamide: Side effects and complications. J

Nerv Ment Dis130:30-40, 1960

23. Malleson N: Acute adverse reactions to LSD in clinical and experimental

use in the United Kingdom. Br J Psychiatry 118:229-230, 1971

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[56]


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++++Message 1767. . . . . . . . . . . . Smitty Passes On

From: Lash, William (Bill) . . . . . . . . . . . . 4/23/2004 7:09:00 AM

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I just got word this evening of the passing of a very special friend of this

fellowship. Around 2 this afternoon, Thursday April 22 our friend Robert Smith

Jr. - son of Dr. Bob Smith passed over. Smitty was probably the last living

person who had witnessed the birth of AA. He was a young boy of 15 when his

father had that first eventful meeting with Bill Wilson in May 1935.

He went into the hospital on the 7th of April, and has went downhill from

there. I know you'll join me in sending prayers of comfort to Mona, his bride

of only a couple of years.

Please help pass the word.

Mona Sides-Smith

Mailing address: 2660 Stage Coach Drive, Memphis, TN 38134-4437

Yours in shared sorrow,

Maria Hoffman

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++++Message 1768. . . . . . . . . . . . Chan F. Talk About Pat C. (1978)

From: Lash, William (Bill) . . . . . . . . . . . . 4/22/2004 2:46:00 PM

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From a talk by Chan F. at the Annual Founder's Day Banquet, November 11, 1978

(thanks to Ken R. for this):

It started with a light rain and moderate temperatures in November, 1940 and

continued through the Armistice Day Blizzard.

There was the football game between the University of Minnesota and Michigan

for the Little Brown Jug (a trophy passed back and forth to the annual

winners).

Up from Chicago came two members of A.A., Bill L. and Chan F. The day after

the football game they proceeded to call on a list of A.A. prospects that they

had received from Ruth Hock, Bill Wilson's secretary. The fourth person on the

list wouldn't come to the door when they knocked. They had no luck until

calling on the last name on the list - Pat C. - at his apartment at 1704 1st

Avenue South.

Chan gave us more of the story in a talk at the 38th Annual Founder's Day

Banquet on November 11, 1978:

"Pat lived in a rear room on the second floor. He seemed glad to see us and

greeted us with a warm smile.

Though he was suffering from the granddaddy of all hangovers, it was apparent

that he desperately wanted to quit drinking.

No problem about the First Step; he admitted he was licked and obviously his

life had become unmanageable.

He told us his story, the usual sad one, and that he expected to get fired -

again - from his job on the WPA (Works Progress Administration - A New Deal

employment program) Writers Project next day because he had really messed

things up.

He seemed almost convinced about AA, but we left him without much real hope he

would make it - all by himself - though we promised to keep in close touch by

letter and phone.

It was snowing pretty good when we went back to the Kenesaw Hotel, a cheapie

on Hennepin Avenue about Twelfth Street. We were staying there because the

father of a friend of mine managed the hotel and would put us up for free.

All we could do was to go back to Chicago the next day and hope that through

some miracle Pat would catch fire, quit drinking on his own, read the Big Book

we had left him and stay sober.

Next morning we woke up late and looked out of our room into lower Nicollet

Avenue. It was Armistice Day. The sky was a strange gray, the snow was

swirling down and it didn't look like a good time to start that long drive

back to Chicago.

We dressed and went to breakfast. Afterward we looked out to where the old

Chevy was parked, already up to its hubcaps in snow.

'You'd better get the car off the street,' said Bill. 'Then we'll wait and see

what to do.'

I bundled up and drove a couple of blocks south on Nicollet up to a garage

whose door was already coming down with a 'full-up' sign on its side.

I honked desperately. The attendant opened up again and shouted, 'OK, OK.

We'll make room. But that's the last one.'

Bill and I holed up for another night at the friendly Kenesaw, whiling away

the evening hours in a long bull session just like AAs anywhere.

Next morning, we woke up late and looked outside.

The snow was waist-high and still swirling. Some places it had drifted nearly

to the second stories of buildings.

No way we could get out of town. What to do?

Our new pigeon, Pat C., lived just around the corner on First Avenue and a

couple of blocks south. That might give us an excuse to get out of the hotel

before we started climbing the walls.

'Let's try it,' I said to Bill. 'Maybe we can make it - even without

snowshoes.'

We wrapped mufflers around our faces, stayed close to buildings and trudged

through deep snow until we got to 1704.

Pat was really surprised and was he glad to see us!

He said he was toying with the idea of getting a bottle to shake off the

shakes. Now he wanted to talk.

Pat and I found we had quite a lot in common, besides alcoholism. He had once

worked on the Minneapolis Tribune as an ad salesman and he knew a couple of my

old drinking friends.

Our conversation went round and round for what seemed like hours. Pat could

partially accept the program, but he had lots of doubts.

'It's easy enough for you fellows,' he said. 'You've got a group and can help

each other. But I'm really alone and I'm not sure I could ever convince any of

my drinking pals to try AA.'

He used some of his Irish blarney to fend us off, then he'd grin and listen

some more."

"We told him there were other loners scattered about the country who were

staying sober just by reading the Big Book, trying to practice the program and

work the Twelve Steps as best they could - and looking for other alcoholics to

whom they could carry the message.

His face brightened. But in a moment he shot back: 'Anyway, I've got problems

that won't go away even if I quit drinking.'

So we tried to brainstorm his problems; each time he would bring up another,

we would try to put it into perspective. As he got them out, one by one, he

admitted they didn't seem quite so desperate.

His main problem, he said, involved a personal relationship. And it seemed

impossible that he could work it out. He might even get tossed into jail.

Gloom again.

We asked him how much he spent on booze. When he gave us his figure - not

really monumental in those years of cheap whisky - we pointed out that if he

stayed sober those tidy little sums of drinking money - in regular payments -

would help take care of the big problem. He hadn't thought of that.

When we left his room late in the day, Pat flashed that smile so many of you

knew so well and he said he'd give it a whirl.

'But for godsake,' he said to Bill and me, 'be sure to keep in touch.'

Next morning we got the Chevy out of the garage and headed for Chicago. The

blizzard, that had taken the lives of a number of Minnesota duck hunters in

the sloughs over in the Wheaton area, was over, the main highways had been

plowed.


The snowdrifts ended by the time we got to Hudson, Wisconsin, and it was clear

the rest of the way. We did stop overnight at the home of Harry S., the loner

who was making it in Madison and who had a lot of prospective members right at

his own doorstep. Harry was the chef at the Wisconsin State Hospital.

Now for what happened to Pat after we got back to Chicago.

Last week I ran across a batch of letters written that first year, and carbon

copies of some of my answers. I'm sure he wouldn't mind my sharing some of his

paragraphs with you.

Maybe he's even looking over my shoulder.

I'm sure the spirit of Pat C. is in the room every time two or 20 or 1,700 of

you - as tonight - get together in fellowship.

In a letter dated November 22, 1940 - just 10 days after we talked with him in

his room at 1704 - Pat wrote, in part:

'Dear Chan & Bill:

I am working this Friday to make up some time. So this joint letter to you is

on WPA time...'

(Pat didn't lose his WPA job. The day after we left him, he trudged a couple

of miles through deep snow to get to work. That heroic performance was so

unlike Pat of the drinking years that his boss was flabbergasted and gave him

back his job with another final warning. For those of you unfamiliar with such

Depression gobbledegook as WPA and such, WPA (Works Progress Administration)

was a Roosevelt creation of the Depression years to give employment to the

millions of jobless. The Writers Project, on which Pat worked, employed

thousands of talented writers and editors, artists and photographers in

producing state guidebooks that are now collectors' items and other creative

work.)


To go on with Pat's letter:

'Father C. is taking things slowly in the field of propagation of our faith or

code. You will be happy to know, however, that I have been definitely arid

since your departure, even going so far as to turn down a full quart of

McCormick's Special on Wednesday night for which Gabriel has appropriately

credited me with two gold stars, I hope...

I have had several rebuffs in my zeal for converts; guess you have to catch

them at the right time. George M. is reading the book right now; he drinks

spasmodically, mostly through lonesomeness, but he shoots his wad when he does

go...


Remember Joe B. who used to work on the project with me? A card from him

advises that he is in Inglewood, California. Like all rummies he was cute

enough to give his address as General Delivery. I wrote him right away telling

him about AA, requesting that he forward his street address. Armed with that,

I can turn the Los Angeles chapter loose on him.

(I wonder if AA ever caught up with Joe; Pat never mentioned him again.)

Pat goes on:

I am going to write Ed K. at Eau Claire tomorrow, a line from me might help.

(Bill L. and I had called on Ed K., a loner, on our way from Chicago that

fateful weekend.)

Pat again:

Haven't missed a day from work since your appearance here; my next check will

be quite, quite! But Lord, you should see this one...

Let me know that secretary's name at the AA Foundation in New York, the one

who wrote me. If she has any more inquiries from the Twin Cities I will be

glad to look them over and see if I can line them up.

Fraternally,

Pat C.'


"As far as I am concerned, I haven't had a drop since you called on me; got

the guard up and it hasn't bothered me"

"Paradoxically, however," Pat wrote, "all my drunken friends who have heard I

am dry pay me regular visits for the purpose of putting the bite on me for two

bits or half a buck to make up the balance on a pint."

"Those guys will never surrender with their present set-up so I have given up

trying to interest them at present."

"I haven't got that unselfish spirit as yet - looking out for the other guy -

and I know it is necessary to acquire it"

Then on January 21, 1941 - two and a half months dry on his own - Pat wrote

that things were really perking up!

"Lo and behold," he wrote, "Bill L. sent me a letter last week, the first I

have heard from him. Told me that Chicago was looking forward to an article in

the Saturday Evening Post which was expected to bring many inquiries."

"Chan, I bought a new suit of clothes and some haberdashery and am beginning

to feel respectable once more."

"(I) suppose you saw Winchell's reference to AA in his column last week. He

said the head of AA in New York was a famous trans-Atlantic flier; my guess is

that he refers to Clarence C. who was always quite a lush."

"Trust you are doing well in material things and that you are dry as I am. Had

no trouble at all during the holidays; I ducked and sat in movies, etc., ran

away from it rather than face it."

I hadn't seen the Winchell squib, but bits and pieces of information and

misinformation about AA were beginning to appear in newspapers around the

country. No doubt even the garbled versions sent desperate alcoholics hunting

for an AA contact.

In Chicago, a famous columnist named Howard Vincent O'Brien attended an open

meeting and wrote about it: "this miracle of regeneration."

Writing about the alcoholics at the meeting, O'Brien said: "Some of these

people I had known for a long time. I know what they once were, and I know

what they are now. Something has happened to them. I do not know what that


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