Lower-dose psycholytic therapy - A neglected approach

Abstract

Lysergic acid diethylamide (LSD) and similar psychoactive drugs have been used in psychotherapy since 1949, when the first clinical study with lower-dose LSD showed therapeutically relevant effects. This caused an intense interest among psychotherapists and researchers, alike, on an international scale. In 1960, the use of serial lower-dose LSD/psilocybin sessions in a psychoanalytical framework, which was dominant at the time, was named "psycholytic therapy". Psycholytic therapy was usually conducted in clinical environments, on both an inpatient and outpatient basis. Psycholytic therapy was developed and established over a 15-year period on the European continent, where it was used at 30 clinical treatment centers and by more than 100 outpatient psychotherapists. Psycholytic approaches were employed minimally in North America, where the psychedelic approach (use of one or two high-dose sessions for "personality-transforming mystical experiences") became the dominant method in use. The leading figure in psycholytic therapy was Professor Hanscarl Leuner in Germany, who laid the ground with his uniquely fine grained analysis of the LSD reaction in a 1962 monograph. He was central in establishing and distributing psycholytic therapy in Europe and abroad. The article provides comprehensive background information and outlines the essential features of psycholytic therapy. Evidence for the efficacy of psycholytic therapy is reviewed and a case for the inclusion of the psycholytic approach in the field of substance-assisted psychotherapy is made.

Keywords: LSD; MDMA; hallucinogens; lower-dose LSD therapy; mystical experience; psilocybin; psychoanalysis; psycholytic therapy.

FIGURE 1

Chemical structures of the main psycholytic substances lysergic acid diethylamide (LSD), psilocybin, the psilocin derivatives CEY-19, CZ-74, and the phenethylamine 2C-D.

FIGURE 2

Overview of the psycholytic therapy treatment process.

FIGURE 3

The illustration shows a treatment facility specific to psycholytic therapy as it was held in various clinics in the 1960s.

FIGURE 4

The illustration shows a treatment room with furnishings typically used in psycholytic therapy.