Psycholytic psychotherapy

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Medical LSD

Psycholytic psychotherapy (also psycholytic therapy or substance-assisted psychotherapy ) is a psychotherapeutic treatment method in which the consciousness-changing properties of psychotropic substances are used to support the therapy . The aim is to loosen up the psychological defenses through changed inner ways of experiencing and thus find better access to repressed feelings and hidden abilities.

There are substances from the group of psychedelics , z. B. LSD , psilocybin and mescaline , the empathogens such as MDMA ("Ecstasy") or the dissociative , such as ketamine , used. Little or no substance-related dependency potential is ascribed to these substances.

Psycholytic therapy is controversial and research is hampered by legal restrictions on the use of psychotropic substances. Psycholytic therapies - apart from exemptions mainly issued in Switzerland - usually take place illegally, often as group therapies.

history

Albert Hofmann , 1993

The idea of ​​a healing treatment with the help of mind-changing substances basically goes back to shamanism from prehistoric times. Insofar as the religious cult is always about healing and salvation, the ritual use of psychotropic substances was always common among indigenous peoples and is still widespread in such cultures today.

The use of psychotropic substances in modern psychotherapy began in the 1930s. After the natural product chemist Albert Hofmann unexpectedly came across lysergic acid diethylamide in 1943, Sandoz brought this substance onto the market under the name Delysid (LSD 25) as a remedy - as the package insert indicated - “to relax the mind in analytical psychotherapy, especially for anxiety and obsessive-compulsive disorders . “From then on, substance-based psychotherapy, initially mainly known as" psychedelic psychotherapy ", enjoyed a strong boom. WV Caldwell listed 193 scientific publications on this topic as early as 1968.

Experts from England, Italy, Austria, Switzerland and Czechoslovakia came to a European symposium in Göttingen in 1960 and founded the "European Medical Society for Psycholytic Therapy" (EPT). However, after all further use of hallucinogens, including any further research in this area, was banned, the EPT ceased operations in 1971.

At the end of the 1970s, encouraged by the chemist Alexander Shulgin , MDMA ( Ecstasy ) was increasingly used in psychotherapy, as it increases the ability to empathize and does not distract from concentration on one's own inner process through hallucinations or visionary episodes. In the years 1988 to 1993 several members as well as Peter Baumann , the founder of the Swiss Medical Society for Psycholytic Therapy , received an exemption for psychotherapies under the administration of MDMA and LSD as well as for research.

research

Hanscarl Leuner

Over 500 previous publications, which are devoted to therapy with the aid of psychoactive substances, describe their effects under supervised psychoanalytic and other therapeutic settings ; a summary on psychotherapy with LSD, psilocybin and MDMA was published in 2008 by Jungaberle and colleagues.

In the United States, the Food and Drug Administration (FDA) approved a large study of psilocybin-assisted psychotherapy in the treatment of treatment-resistant depression in 2018 and granted it breakthrough therapy status.

At the same time, scientific investigations in this summary deal with changes in the physiology of the brain. The results allow the conclusion that these are processes that change consciousness and that the psyche is relaxed in the sense that access to unconscious material is facilitated and remains in consciousness even after the session. This in turn helps the patient to make insightful decisions in problematic situations in practical life, free from ingrained behavioral patterns, and to behave differently. The psychiatrist Torsten Passie , who specializes in the subject, judges

"Psychedelics such as LSD and psilocybin can be used to support psychotherapy due to their property of evoking a dream-like flow of experiences with largely clear awareness and good memory."

In this, previously repressed unconscious conflicts and memories can be activated and vividly revived, which makes them accessible for psychotherapeutic work through. Under the psychic activation, a loosening of psychological defense mechanisms and a favoring of psychotherapeutically valuable regressive experiences ("age regression") can also be observed. The pioneer of psychotherapy research with psychoactive substances in Germany, Hanscarl Leuner , came to a similarly positive result in 1981 :

"The overwhelming clinical evidence suggests that LSD activation makes psychodynamics more accessible to psychotherapeutic influence than without a hallucinogen level in the blood."

There has been some current research with LSD . a. 2017 in Switzerland.

hazards

The use of psychoactive substances such as LSD or psilocybin in self-experiment or as "self-therapy" is associated with greater risks than use in the context of a professionally guided therapeutic situation. But even in such a situation, psycholytic therapy is not always safe. Dangers come less from the psychoactive substances themselves than from their combination with improper treatment methods. The same effect, namely the increase in emotional sensitization and accessibility, can, as a dangerous suggestibility, make the treated person dependent on the therapist, especially if the potentially extremely increased transference process is not dealt with or the therapist does not deal with the power imbalance between him and the client exploits. Certain dangers are associated with the illegality of the treatment process in many countries, where the purity of the substances used and their correct dosage cannot be guaranteed, and there is also the risk of traumatizing arrests by the police during the therapy session. In 2009, psycholytic group therapy with illegal substances in Berlin resulted in deaths due to an overdose by the doctor who was under the influence of a drug (LSD) himself. In a clinical, legally secure context, however, the dangers due to the guaranteed purity of the substances used and a professional, stable environment are to be assessed as low.

Legal situation

Many psychotropic substances were banned in the late 1960s, which led to the termination of much promising scientific research. Their scientific research was resumed under restrictive conditions in the late 1980s. Outside of such research projects, there was also a non-public use of illegally traded psychotropic substances. In many countries, many psychotropic substances were heavily regulated under the UN Convention on Psychotropic Substances of 1971. In some countries the traditional therapeutic or religious use of some psychedelic substances is regulated or tolerated by law.

Germany

In Germany, psychotropic substances are divided into three groups according to the Narcotics Act (BtMG): "not marketable" (BtMG Annex I ), "marketable but not prescribable" (BtMG Annex II ) or "marketable and prescribable" (BtMG Annex III ) . LSD, mescaline, psilocybin and MDMA are not marketable in Germany, while ketamine is an approved drug.

In the run-up to two deaths, in the course of psycholytic psychotherapy in September 2009, a medical psychotherapist used the narcotic drug MDMA, which is legally non-marketable. Thereupon the responsible medical association warned strongly against using “non-marketable” or “non-prescription” substances from BtMG appendices 1 and 2, because psycholytic therapy is not illegal as such in Germany, but the medical psychotherapist acts illegally if he does uses such substances.

Switzerland

In Switzerland from 1988 to 1993 there was an exemption from the Swiss Federal Office of Public Health for psycholytic therapy with LSD and MDMA. Since then, only less suitable substances have been allowed, for example anesthetics and painkillers containing ketamine and ephedrine .

See also

literature

  • Stanislav Grof : The Adventure of Self-Defense: Healing through Altered States of Consciousness, A Guide. Rowohlt, Reinbek 1994
  • Henrik Jungaberle, Peter Gasser, Jan Weinhold, Rolf Verres (eds.): Therapy with psychoactive substances - practice and criticism of psychotherapy with LSD, psilocybin and MDMA. Hans Huber, Bern 2008, ISBN 978-3-456-84606-4 .
  • Hanscarl Leuner : Hallucinogens, psychological limit states in research and psychotherapy. Hans Huber, Bern 1981, ISBN 3-456-80933-6 .
  • Claudio Naranjo : The journey to the self, psychotherapy with healing drugs, treatment protocols. Fischer Taschenbuch Verlag, Frankfurt am Main 1987, ISBN 3-596-23381-X .
  • Torsten Passie: Psycholytic and Psychedelic Therapy Research 1931–1995: A Complete international Bibliography. ( crfdl.org ).
  • Torsten Passie: Psilocybin in modern psychotherapy. In: Curare , magazine for medical ethnology. H. 18. 1995, pp. 131-153.
  • Ben Sessa: Can psychedelics have a role in psychiatry once again? In: The British Journal of Psychiatry. 186, 2005, pp. 457-458. PMID 15928353 (abstract), bjp.rcpsych.org (full text).
  • Claudia Möckel Graber: Entry into healing states of consciousness - basics of psycholytic practice. Nachtschatten Verlag, Solothurn 2010, ISBN 978-3-03788-200-9 .
  • Hansjörg Heinrich: Hallucinogens - the forbidden help of the psychiatrist. In: Frankfurter Rundschau. 17th December 1994.
  • Manfred Josuttis, Hanscarl Leuner (ed.): Religion and the drug. A symposium on religious experiences under the influence of hallucinogens. Kohlhammer, Stuttgart / Berlin / Cologne / Mainz 1972.
  • Thomas Illmaier: The colors of heaven and hell, symposium for the 50th anniversary of LSD. In: Science and Technology. November 20, 1993.
  • Hans-Peter Waldrich : Brainwashing or Cure? Experience with drug-based psychotherapy. Hamburg 2014
  • Samuel Widmer : Listening to the heart of things. Unwanted psychotherapy. From the growing up of love. about MDMA and LSD. Solothurn 1989, ISBN 3-907080-03-3 .

Individual evidence

  1. ↑ Stanislav Grof: The Adventure of Self-Defense: Healing through Altered States of Consciousness, A Guide. Rowohlt, Reinbek 1994.
  2. ↑ Jungaberle et al., 2009.
  3. ↑ Schmidtbauer et al., 2003.
  4. ↑ University of Bristol press release: New "matrix of harm" for drugs of abuse . University of Bristol press release. March 23, 2007.
  5. ↑ Franz-Theo Gottwald, Christian Rätsch (ed.): Rituals of healing. Ethnomedical knowledge of nature and healing power. Aarau / Switzerland 2000 - Adolf Dittrich, Christian Scharfetter (Ed.): Ethonpsychotherapie. Psychotherapy using extraordinary states of consciousness in western and indigenous cultures. Stuttgart 1987.
  6. ↑ Hanscarl Leuner: Changed states of consciousness in psychotherapy. In: Adolf Dittrich, Albert Hofmann, Hanscarl Leuner (eds.): Worlds of consciousness. Volume 1: An interdisciplinary dialogue. Verlag Wissenschaft und Bildung, Berlin 1993, pp. 113–147, p. 133.
  7. ↑ Albert Hofmann: LSD - my problem child. The discovery of a "miracle drug". Munich 1993, p. 55.
  8. ↑ Leuner, ibid., P. 141 ff. - Stanislav Grof: Psychedelic therapy and holonomic integration. Therapeutic potential of extraordinary states of consciousness. Observations in psychedelic and holotropic therapy. In: Adolf Dittrich, Christian Rätsch: Ethnopsychotherapy. Pp. 162-180.
  9. ^ WV Caldwell: LSD Psychotherapy: An Exploration of Psychedelic an Psycholytic Therapy. Grove Press, New York 1968.
  10. ↑ Hanscarl Leuner: Hallucinogens. Psychological limit states in research and psychotherapy. Bern / Stuttgart / Vienna 1981, p. 26.
  11. ↑ Alexander Shulgin, Ann Shulgin: Pihkal. A Chemical Love Story. Transform Press, Berkeley / CA 1995, p. 72 ff.
  12. ↑ Hans Gros and the editors of the natural sciences: intoxication and reality. A cultural history of drugs. Volume 1, Ernst Klett Verlag, Stuttgart / Munich / Düsseldorf 1996, p. 140.
  13. ↑ a b Swiss Medical Association for Psycholytic Therapy (SÄPT) - portrait
  14. ↑ Henrik Jungaberle: Therapy with psychoactive substances. Practice and criticism of psychotherapy with LSD, psilocybin and MDMA . Huber, 2008, ISBN 978-3-456-84606-4 .
  15. ↑ FDA approves magic mushrooms depression drug trial . In: Newsweek . August 23, 2018 ( newsweek.com [accessed September 22, 2018]).
  16. ↑ Deutscher Ärzteverlag GmbH, editor of the Deutsches Ärzteblatt: Cancer: Fungal hallucinogen relieves depression and takes away fear of ... ( aerzteblatt.de [accessed on September 22, 2018]).
  17. ^ Robin L Carhart-Harris, Leor Roseman, Mark Bolstridge, Lysia Demetriou, J Nienke Pannekoek: Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms . In: Scientific Reports . tape 7 , no. 1 , October 13, 2017, ISSN  2045-2322 , doi : 10.1038 / s41598-017-13282-7 ( nature.com [accessed September 22, 2018]).
  18. ↑ COMPASS Pathways Receives FDA Breakthrough Therapy Designation for Psilocybin Therapy for Treatment-Resistant Depression - COMPASS. Retrieved December 6, 2018 (American English).
  19. ↑ Torsten Passie: Psilocybin in modern psychotherapy. In: Curare, magazine for medical ethnology. H. 18, 1995, pp. 131-152, p. 136.
  20. ↑ Hanscarl Leuner: Hallucinogens. P. 92.
  21. ↑ UEOT. The good side of LSD - report on the experiment by Peter Gasser (2014)
  22. ↑ Ralf H. Bolle: Transfer and countertransference in psycholytic therapy. In: Adolf Dittrich, Albert Hofmann, Hanscarl Leuner (eds.): Worlds of consciousness. Volume 4: Importance for psychotherapy. Verlag für Wissenschaft und Bildung, Berlin 1994, pp. 129-137, pp. 132 ff.
  23. ↑ Hans-Peter Waldrich: Brainwashing or Cure? Experience with drug-based psychotherapy. Hamburg 2014.
  24. ↑ Hans-Peter Waldrich: Brainwashing. Pp. 123-130.
  25. ↑ Deaths during psychotherapy. on: zeit.de , September 21, 2009.
  26. ^ Matthias E. Liechti: Modern Clinical Research on LSD . In: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology . tape 42 , no. October 11 , 2017, ISSN  1740-634X , p. 2114-2127 , doi : 10.1038 / npp.2017.86 , PMID 28447622 .
  27. ↑ Hanscarl Leuner: Hallucinogens: Psychological limit states in research and psychotherapy. Huber, Bern 1981, ISBN 3-456-80933-6 . P. 17 ff.
  28. ↑ Ben Sessa: Can psychedelics have a role in psychiatry once again? In: The British Journal of Psychiatry. 186 (6) May 2005, pp. 457-458.
  29. ^ Nicolas Langlitz: Neuropsychedelica. The Revival of Hallucinogen Research since the Decade of the Brain. University of California Press, Berkeley / Los Angeles 2013.
  30. ↑ bz-berlin.de .  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.@1@ 2Template: Toter Link / www.bz-berlin.de  
  31. ↑ buzer.de: Annex I BtMG (narcotics not marketable) *) Narcotics Act .
  32. ↑ "Completely wrongly assessed" . May 7, 2018.
  33. ↑ Warning against taking drugs as part of psychotherapy. Statement by the Berlin Medical Association, Berlin Doctors 11/2009, 12 (PDF; 819 kB).