The LSD Therapy Career of Jan Bastiaans, M.D.

Stephen Snelders

Newsletter of the Multidisciplinary Association for Psychedelic Studies, MAPS : 1998, Vol 8, N° 1, pp. 18-20

 

JAN BASTIAANS WAS 23 YEARS OLD and a medical student at the University of Amsterdam when the German army invaded the Netherlands. The German occupation (1940-1945) had a lasting influence on his life and work. The first aim of Bastiaans’ use of LSD and psilocybin in psychotherapy was to help victims of World War II: the survivors of the war who had become extremely traumatized by their experiences in the German and Japanese prisons and concentration camps.

During the occupation Bastiaans had from the beginning been involved in the student resistance. “As a result,” he wrote, “I was the first student at the University of Amsterdam who was expelled in the summer of 1941. Because of an accident, I could only participate in the resistance in a limited way from the autumn of 1942 on. Several of my friends died because of the war.”

THESE EXPERIENCES had a decisive influence on Bastiaans’ work as a psychiatrist after the war. His work was mainly aimed at helping victims of the war who needed psychiatric care. Bastiaans identified with the problems of the former members of the Resistance. Just like them he regarded himself as an idealistic fighter. In the setting of psychiatric treatment, and more specifically in sessions with LSD or psilocybin, he took the position of the father-figure who gave his patients the warmth and understanding they needed. The organisations of the former Resistance would give Bastiaans much support in the 1980s, in his political struggle for the continuation of his LSD therapy.

Almost 140,000 Dutch people were deported during the war to German concentration camps. Only a minority of these people had been active in the Resistance. Among them, 110,000 were Jews. Of the 140,000, only 15,000, of whom 8,000 were Jews, returned to their home country after the war. In the years after the war it became clear that many of these survivors were no longer capable of an optimal participation in society. For their syndromes the term “KZ-syndrome” was coined: KZ is the German abbreviation for concentration camp.

Theoretical background of Bastiaans’ therapy

In the medical literature, a KZ-syndrome is actually not a syndrome, but a process of four phases that contains different conventional syndromes: 1) a shock phase with the feeling of extreme powerlessness; 2) an alarm phase, with alarming emotions and fears that have the function of preparing the drive for solutions; 3) an adaption phase, with flight- or fight-mechanisms; and 4) an exhaustion phase. In the theoretical analysis of the KZ-syndrome that Bastiaans developed in the 1950s he was heavily influenced by two psychiatric traditions: Freudian psychoanalysis and psychosomatic medicine. Bastiaans was a psychoanalyst of the second generation since Freud. From 1954 till 1961, he was president of the Psychoanalytic Institute in Amsterdam, a major bastion of psychoanalysis in the Netherlands. Before this time, from 1946 till 1954, Bastiaans had been a collaborator of Groen, then head of the second Department of Internal Medicine at the University of Amsterdam. Groen was influenced by American ideas on psychosomatic medicine, in particular the hypothesis of psychosomatic specificity. According to this hypothesis, specific mental problems can lead to specific physical diseases among those people who are vulnerable because of the structure of their personality. Groen and Bastiaans both became convinced advocates of the theory of psychosomatic specificity, although this was (and is) a disputed theory within the medical sciences.

Correlating war and childhood experiences

In his analysis of war victims, Bastiaans correlated their actual traumatizing experiences in the war with their psychosomatic syndromes, as well as with a psychoanalytic interpretation of their childhood. Psychosomatic syndromes seemed to be an aspect of delayed reactions to traumatizing stress, especially found under “highly self-controlled personalities who had expended considerable will-power and energy on trying to control, suppress or repress the painful traumatic consequences of the war.” The result was a psychotrauma, “a mental injury marked by the fact that a human being is fixated in a state of “affect lameness,” in a state of powerlessness usually associated with intense suppression and repression of anxiety, grief and anger. This state of partial mental isolation makes it impossible for the victim to cope in a healthy manner with the traumatising stress situation.” Whether this would develop into a post-traumatic stress disorder was dependent on the inbuilt capacity of the traumatized person for adaptation, and on the severity of the stress situation. It also depended on whether the traumatizing experiences re-actualized traumatizing experiences from childhood. In Bastiaans’ psychoanalytic view, these last experiences were the main determinants of the syndrome-formation.

If the person couldn’t cope with the stress situation, part of his past became undigested and he couldn’t free himself. He became fixated in a state of powerlessness. This affected his relation with the world at large, resulting in loss of mental freedom and a state of mental isolation. “Here the individual consciously or unconsciously locks himself into mental invulnerability-structures of a psychotic, psychoneurotic or psychosomatic nature.”

In 1963 Bastiaans became professor of psychiatry at the University of Leiden. In this decade he started to use the term KZ-syndrome not only for war victims, but also for other patients: everyone who had suffered from man-made disasters or wars or who had been kept as hostages. In the 1990s Bastiaans would also use his methods to treat heroin addicts. In a metaphorical sense his work implies that everyone who suffers from traumatizing experiences lives in his own mental concentration camp.

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