LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects

Peter Gasser, Katharina Kirchner and Torsten Passie

Journal of Psychopharmacology, 2014, 1, 12

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DOI: 10.1177/0269881114555249
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Abstract
Objective : A recently published study showed the safety and efficacy of LSD-assisted psychotherapy in patients with anxiety associated with lifethreatening diseases. Participants of this study were included in a prospective follow-up.
Method : 12 months after finishing LSD psychotherapy, 10 participants were tested for anxiety (STAI) and participated in a semi-structured interview. A Qualitative Content Analysis (QCA) was carried out on the interviews to elaborate about LSD effects and lasting psychological changes.
Results : None of the participants reported lasting adverse reactions. The significant benefits as measured with the STAI were sustained over a 12-month period. In the QCA participants consistently reported insightful, cathartic and interpersonal experiences, accompanied by a reduction in anxiety (77.8%) and a rise in quality of life (66.7%). Evaluations of subjective experiences suggest facilitated access to emotions, confrontation of previously unknown anxieties, worries, resources and intense emotional peak experiences à la Maslow as major psychological working mechanisms. The experiences created led to a restructuring of the person’s emotional trust, situational understanding, habits and world view.
Conclusions : LSD administered in a medically supervised psychotherapeutic setting can be safe and generate lasting benefits in patients with a lifethreatening disease. Explanatory models for the therapeutic effects of LSD warrant further study.

Keywords : LSD, psycho-oncology, psycholytic therapy, psychedelics, hallucinogens

ClinicalTrials.gov identifier: NCT00920387

Introduction
The use of mind-altering drugs for religious and healing purposes has been known for thousands of years. The drug-induced altered state of consciousness is used to travel to other realms of consciousness to integrate and heal the state of disorder (Eliade, 1975; Schultes and Hofmann, 1980). When the intense psychological effects of LSD were discovered in 1943, a rich period of scientific and therapeutic investigations into mind-altering substances started (Hintzen and Passie, 2010). LSD was used in the treatment of anxiety, depression, psychosomatic diseases and addiction (Abramson, 1967). After Kast’s accidental discovery of LSD’s effects on pain alleviation and psychological well-being in patients with end-stage cancer (Kast, 1967), some studies on LSD-assisted psychotherapy were conducted in this group of patients (e.g. Kurland, 1985; Pahnke, 1969; Richards et al. 1977). Psychological treatment of people experiencing the existential challenge of suffering from a life-threatening disease and those who are in the process of dying is still mostly inadequate. Typically, these patients suffer from isolation, anxiety and depressive symptoms. There is obviously a need for more effective treatments (Schweizer Krebsliga, 2005). The present study was designed to investigate one approach to this dilemma that appears promising: sensible and carefully supervised use of LSD in conjunction with intensive psychotherapy. In line with another recent investigation (Grob et al., 2011), the present pilot study included patients suffering from existential anxiety induced by a life-threatening disease. Results relating to safety and efficacy have already been published (Gasser et al., 2014). In the present study, we evaluate long-term effects on anxiety and explore subjective experiences and lasting psychological changes.