RAPID PERSONALITY CHANGE
An increasing number of subjects, patients, experimenters, and psychiatrists--spontaneously or with priming--have declared their drug experiences to be transcendental, mystical, cosmic, visionary, revelatory, and the like. There seems to be difficulty in finding the right name for the experience, even among the professional so-called "mystics":
There is no really satisfactory name for this type of experience. To call it mystical is to confuse it with visions of another world, or of god and angels. To call it spiritual or metaphysical is to suggest that it is not also extremely concrete and physical, while the term "cosmic consciousness" itself has the unpoetic flavor of occultist jargon. But from all historical times and cultures we have re ports of this same unmistakable sensation emerging, as a rule, quite suddenly and unexpectedly and from no clearly understood cause.67
Whatever this type of experience is called, however, a growing body of "ex pert" testimony apparently confirms the possibility of its induction by drugs. Watts, the dean of current Western Zen scholars, has recently described "cosmic consciousness," courtesy of LSD, in exquisite detail.68 Seminary students and professors in the Boston area are said to have definitely concluded that their contact with psilocybin was "mystico-religious" (as to whether or not it was "Christian," however, they are still in doubt).69 Huxley has been most out spoken about the capacity of the drugs to induce "traditional" mystical-visionary states:
For an aspiring mystic to revert, in the present state of knowledge, to prolonged fasting and violent self-flagellation would be as sense less as it would be for an aspiring cook to behave like Charles Lamb's Chinaman, who burned down the house in order to roast a pig. Knowing as he does (or at least as he can know, if he so desires) what are the chemical conditions of transcendental experience, the aspiring mystic should turn for technical help to the specialists .... 70
Nearly invariably, whenever dramatic personality change has been noted following the use of these drugs, it has been associated with this kind of experience--that is, one called transcendental or visionary--with the particular name the experience is given seemingly most de pendent upon whether the investigator focuses on affect or content. These experiments in drug-induced behavior change will shortly be reviewed in detail.
Examples not Associated with Drugs
Since accounts of behavior transformations attendant on paranormal experience are not without precedent, it may be helpful to set the stage for present developments by citing some examples not connected with drugs. James reported on the phenomenon in its most familiar and per haps prototypic context:
In this lecture we have to finish the subject of conversion, considering it first through striking instantaneous instances of which St. Paul's is the most eminent, and in which, often amid tremendous emotional excitement or perturbation of the senses, a complete division is established in the twinkling of an eye between the old life and the new.
After adducing numerous examples, James continued:
I might multiply cases almost indefinitely, but these will suffice to show you how real, definite, and memorable an event a sudden conversion may be to him who has the experience. Throughout the height of it he undoubtedly seems to himself a passive spectator or undergoer of an astounding process performed upon him from above. There is too much evidence of this for any doubt of it to be possible. Theology, combining this fact with the doctrine of election and grace, has concluded that the spirit of God is with us at these dramatic moments in a peculiarly miraculous way, unlike what happens at any other juncture of our lives. At that moment, it believes, an absolutely new nature is breathed into us, and we become partakers of the very substance of the Deity.71
One may also recall to mind the "vision-seeking" American Indians whom Ruth Benedict immortalized. Adapting Nietzsche's designation "Dionysian" to characterize their cultural pattern, she portrayed its fundamental contrast with the "Apollonian" Zuñi-Pueblo way of life. The Dionysian "seeks to attain in his most valued moments escape from the boundaries imposed on him by his five senses, to break through into another order of experience." He values "all means by which human beings may break through the usual sensory routine.72 Widespread among the western Indians (except in the Pueblos) was what Benedict called the "Dionysian dogma and practice" of the vision-quest--sought by fasting, by torture, and by drugs. The point of interest, of course, is that when the vision came, it could apparently trigger large-scale behavior alterations which had the stamp and reinforcement of social approval.
. . . on the western plains men sought these visions with hideous tortures. They cut strips from the skin of their arms; they struck off fingers; they swung themselves from tall poles by straps inserted under the muscles of their shoulders. They went without food and water for extreme periods. They sought in every way to achieve an order of experience set apart from daily living.
On the western plains they believed that when the vision came, it determined their life and the success they might expect. If no vision came, they were doomed to failure .... If the experience was of curing, one had curing powers; if of warfare, one had warrior's powers. If one encountered Double Woman, one was a transvestite, and took woman's occupations and habits. If one was blessed by the mythical Water-Serpent, one had super natural power for evil, and sacrificed the lives of one's wife and children in payment for be coming a sorcerer. 73
The final example which will be noted here of rapid personality change not induced by drugs has emerged quite recently from Maslow's studies of "self actualization." Maslow reports that the occurrence of a dramatic "peak experience--"defined or alternatively described as a "cognition of being," or as "mystic" or "oceanic"--is a major event in the life histories of his "self-actualizing" subjects. Maslow avers "unanimous agreement" among his subjects as to the "therapeutic" aftereffects of such peak experiences for example, that they were so profound as to remove neurotic symptoms forever; or were followed by greater creativity, spontaneity, or expressiveness; or produced a more or less permanently changed, more healthy worldview or view of self, and so on.74
Drug Associated Personality Change: A "New Concept" in Psychotherapy
It is an intriguing historical accident that, on the one hand, anthropological studies of the Native American Church (Peyotism) consistently record the peyote associated reformation of alcoholic and generally reprobate characters,75 and, on the other hand, LSD has been increasingly utilized in the treatment of the white man's "firewater" ills. LSD was first systematically administered to non Indian alcoholics in order to explore a putative similarity between the so called model psychosis and delirium tremens. Two independent undertakings along this line, one in the U.S. and one in Canada, resulted in highly unexpected and sudden "cures." 76
Investigators in Saskatchewan pursued this serendipitous result aggressively. The outcome, with lately evolved refinements in technique, has been an explicitly formulated "new concept" in psycho therapy." The following narrative, pieced together from Hoffer's statements at the Macy LSD conference, describes the conditions under which the rapid change phenomenon seems first to have occurred in sizeable numbers:
. . . we have what we call the "businessman's special," for very busy people, the weekend treatment .... They come in because the police or Alcoholics Anonymous or others bring them in. They come in on day one. They know they are going to take a treatment, but they know nothing about what it is. We take a psychiatric history to establish a diagnosis. That is on day one. On day two, they have the LSD. On day three, they are discharged. Our objective [in using 200-400 gamma doses] is to give each patient a particular LSD experience. The results are that 50 per cent of these people are changed [that is, they stop drinking or are much improved] . . . As a general rule . . . those who have not had the transcendental experience are not changed; they continue to drink. However, the large proportion of those who have had it are changed.78
The only other investigators to report a "weekend treatment" are Ball and Armstrong.79 They describe a small series of "sex perverts," at least two of whom had had, over a number of years, "a variety of forms of psychotherapy, including psychoanalysis... [resulting in] no improvement whatever." The large-dose LSD experience, however, is said to have had "remarkable, long-lasting remedial effects.'' 80
MacLean and his coworkers in British Columbia, Canada, have reported on a series which included 61 alcoholics and 33 neurotics (personality trait disturbance and anxiety reaction neurosis),81 Each patient was carefully and intensively prepared for the 400-1500 gamma, "psychedelic LSD-day" which was jointly conducted by a psychiatrist, a psychologist, a psychiatric nurse, and a music therapist. Their follow-up data (median follow-up was for 9 months) were interpreted to yield a "much improved'' or "improved" rating for over 90 percent of the neurotics and 60 per cent of the alcoholics, with just under 50 percent of the alcoholics found at follow up to have remained "totally dry." 82 The results of this single LSD session with the alcoholic cases seem most impressive, in view of the picture provided:
These were considered to be difficult cases; 59 had experienced typical delirium tremens; 36 had tried Alcoholics Anonymous and were considered to have failed in that program. The average period of uncontrolled drinking was 14.36 years. The average number of admissions to hospital for alcoholism during the preceding 3 years was 8.07.83
Since Hoffer's account, procedures in Saskatchewan have apparently been modified to incorporate considerable "psychotherapy"--as an adjunct to, and preparation for, the LSD experience. In a re cent report, Jensen has described a greatly expanded treatment method and its results:
The treatment program includes three weekly A. A. meetings. The patients are strongly encouraged, but not forced, to at tend. There are also 2 hours of group psychotherapy, in the course of which those who are not already familiar with the A. A. program are indoctrinated mainly by the other patients' discussion . . . Because of the fairly short time available, the group therapy is superficial in nature and primarily educational.
Toward the end of hospitalization (which averaged 2 months), the patients were given an LSD experience. They routinely received 200 gamma of the drug .... 84
Of 58 patients who experienced the full pro gram, including LSD, and were followed up for 6 to 18 months, 34 had remained totally abstinent since discharge or had been abstinent following a short experimental bout immediately after discharge; 7 were considered improved, i.e., were drinking definitely less than before; 13 were unimproved; and 4 broke contact.
Of 35 patients who received group therapy without LSD, 4 were abstinent, 4 were improved, 9 were unimproved and 18 were lost to follow-up.
Of 45 controls, consisting of patients admitted to the hospital during the same period who received individual treatment by other psychiatrists, 7 were abstinent, 3 improved, 12 unimproved, and 23 lost to follow-up.85
Among the reservations that might be expressed about Jensen's study, two are outstanding. First, there is some ambiguity about the assignment of patients to the different treatment conditions--it does not seem to have been entirely random. Second, Jensen's assumption that patients who broke or refused follow-up contact with the hospital staff are safely categorized, for statistical purposes, as "treatment failures" would seem some what overweening. At any rate, on his count, the difference in percentages of patients "abstinent or improved" between the "full program-LSD" group (41 out of 58, or 71 percent) and the "individual psychotherapy" group (10 out of 45, or 22 percent) was highly statistically significant.
The present "official policy" of the Saskatchewan Department of Public Health may be of interest. A recently issued document, which reviews the results of four such follow-up studies as Jensen's, concludes with the directive that the single, large-dose LSD treatment of alcoholism is to be considered "no longer as experimental," but rather, "to be used where indicated." 86
There seem to have been only two efforts in the U.S. to explicitly and systematically follow the Canadian model. In quite different contexts, both are reported as at least "doing well." Leary and his co-workers at Harvard, over the last two years, have conducted a research and treatment program at Massachusetts Correctional Institution, Concord, "designed to test the effects of consciousness-expanding drugs on prisoner rehabilitation.'' 87 This undertaking, which emphasizes the crucial importance of drug-induced "far-reaching insight experiences" --prepared for, supported, and reinforced by group therapy sessions--has resulted in a recidivism rate considerably reduced from actuarial expectation. The number of post-treatment cases on which this evaluation is based, however, is only 26. The program is ongoing.88 In a much more familiar setting, a group of workers on the West Coast has been treating the full range of garden variety neuroses The patients are intensively prepared over a two- to three-week period for a large-dosage, "transcendental'' drug session. The stated intent is to induce a "single overwhelming experience . . . so profound and impressive that . . . the months and years that follow become a continuing growth process." 89 Thus far, in over 100 treated cases, at least "marked improvement" in the condition for which treatment was sought has been reported in about 80 percent--after one so-called overwhelming experience.90
It is a commonplace that new psychiatric treatments seem to effect remarkable cures--at least for a short time and in the hands of their originators. In raising the specter of the powerful placebo effect,91 it need hardly be pointed out that the results reviewed above should be regarded with healthy skepticism. On the other hand, they are more than merely trifling.
Explanatory Concepts
In addressing a recent international assemblage at Copenhagen, Leary asserted:
The visionary experience is the key to behavior change. [In its wake] change in behavior can occur with dramatic spontaneity . . . 92
Van Dusen, who bids fair to become the psychologist-philosopher of the "new concept'' movement, puts the issue as follows:
There is a central human experience which alters all other experiences . . . not just an experience among others, but.., rather the very heart of human experience. It is the center that gives understanding to the whole. . . . It has been called satori in Japanese Zen, moksha in Hinduism, religious enlightenment or cosmic consciousness in the West . . . Once found life is altered because the very root of human identity has been deepened . . . the still experimental drug d-lysergic acid diethyl amide (LSD) appears to facilitate the discovery of this apparently ancient and universal experience.93
Although reminded on all sides of the incommunicableness of "the transport," as James called it, of its ineffability, one may, before following him in the descent toward "medico-materialistic" explanation, inquire further of its nature. James proffered the traditional demurrer " . . . it is probably difficult to realize [its] intensity unless one has been through the experience one's self . . ."94 He then proceeded, with seeming aplomb, to de scribe it:
The central [characteristic] is the loss of all worry, the sense that all is ultimately well with one, the peace, the harmony, the willingness to be . . .
The second feature is the sense of perceiving truths not known before . . . insight into depths of truth unplumbed by the discursive intellect . . . The mysteries of life become lucid . . . illuminations, revelations, full of significance and importance, all inarticulate though they remain . . .
A third peculiarity . . . is the objective change which the world often appears to undergo. "An appearance of newness beautifies every object" . . . clean and beautiful newness within and without . . . 95
In James' view, "melting emotions and tumultuous affections" were the constant handmaiden of "crises of change." 96 Also Benedict, in the context of the vision quest, remarked on " . . . very strong affect, either ultimate despair or release from all inadequacy and insecurity." 97 Chwelos and his co-workers, describing the transcendental drug experience as "mainly in the sphere of emotions or feeling,'' 98 exemplify this by quoting an alcoholic patient:
I was swept by every conceivable variety of pleasant emotion from my own feeling of wellbeing through feelings of sublimity and grandeur to a sensation of ecstasy.
Finally now, turning from the poetry of phenomenal experience to medico-materialism, how did James approach the matter of explanation?
If you open the chapter on Association, of any treatise on psychology, you will find that a man's ideas, aims, and objects form diverse internal groups and systems, relatively independent of one another . . . When one group is present and engrosses the interest, all the ideas connected with other groups may be excluded from the mental field . . . Our ordinary alterations of character as we pass from one of our aims to another, are not commonly called transformations . . . but whenever one aim grows so stable as to expel definitively its previous rivals from the individual's life we tend to speak of the phenomenon and perhaps to wonder at it, as a "transformation.''
Whether such language be rigorously exact is for the present of no importance. It is exact enough, to recognize from your own experience the fact which I seek to designate by it.
Now if you ask of psychology just how the excitement shifts in a man's mental system, and why aims that were peripheral become at a certain moment central, psychology has to reply that although she can give a general description of what happens, she is unable in a given case to account accurately for all the single forces at work.
In the end we fall back on the hackneyed symbolism of mechanical equilibrium. A mind is a system of ideas, each with the excitement it arouses, and with tendencies impulsive and inhibitive, which mutually check or reinforce one another .... A new perception, a sudden emotional shock.., will make the whole fabric fall together, and then the center of gravity sinks into an attitude more stable, for the new ideas that reach the center in the rearrangement seem now to be locked there, and the new structure remains permanent.100
More modern discussions of rapid personality change seem, in large part, to be variations on the theme of "melting emotions and tumultuous affections." There have been two relatively recent efforts to deal with rapid change associated primarily with conversion. Wallace, who attempted an heroic amalgam of Selye's "stress" theory and cultural anthropology, summed this up as follows:
. . . the physiologic events of the general adaptation syndrome [in situations of massive emotion] establish a physicochemical milieu in which certain brains can perform a function of which they are normally incapable: a wholesale re-synthesis that transforms intellectual insight into appropriate motivation, reduces conflict by partial or total abandonment of certain values and acceptance of others, and displaces old values to new, more suitable objects.101
Sargant has linked along an axis of abnormal "anger, fear, or exaltation" such "abrupt total re-orientations" in personality as attend religious and political conversion experiences--as well as violent abreactions in therapy, spontaneous or narcosynthetic. His explanatory scheme derives directly from Pavlov--in the final analysis, sudden alterations in behavior are attributed to "paradoxical" and "ultra-paradoxical" brain processes, and the like, induced by extreme emotion.102
To return to LSD-related developments, Ditman and his co-workers have reviewed a whole range of considerations and theories which might "rationalize" the sudden change phenomenon--including a highly libidinized psychoanalytic formulation.103
It remains to raise just one final query. Rapid personality change, translated into language more congenial to behavioral psychology, could be taken to describe a situation in which formerly dominant or high-probability responses, overt or mediational, were suddenly greatly reduced in frequency of occurrence; and, vice versa, uncommon responses, or those formerly low in a hierarchy, appear with greatly elevated frequency. The only experimental results which even approximate this order of events seem to be those which have arisen with the aid of direct intracranial electrical stimulation. With response-contingent reinforcement of this kind--that is, with electrical "trains" delivered to the hypothalamic, so-called pleasure or reward centers--the repertoires of many rats and monkeys have been dramatically altered in a very few moments: Utterly new behaviors have been shaped, old responses eliminated.104 The degree to which such "artificially induced" learning has been sustained has been a function, as with all behavior, of the ebb and flow of environmental contingencies. Thus, to point the issue: Do transcendental experiences at the human level, however they are interpreted, tread in this area of super-reinforcement--with a potential for radically altering the probability of occurrence of "heuristic" mediating processes (for example, positive rather than negative self-concepts) which might channel behavior, at least temporarily, in new directions, toward a "new beginning"?
With Ruth Benedict's "Apollonian" Zuni, the tendency of the modern West is to regard paranormal experiences, indiscriminately and often with little idea of their nature, as "pathological"to be distrusted, feared, avoided. The Zuni Indian, said Benedict, "finds means to outlaw them from his conscious life . . . He keeps the middle of the road, stays within the known map, does not meddle with disruptive psychological states:" 105 It would seem unfortunate were this Zeitgeist to unduly prejudice the exploration of therapeutic potential in the drugs here discussed.
In conclusion, let it be noted that the public health implications of drug-associated rapid personality change, should this phenomenon prove not to be a will-of-the-wisp, are apparently great. Intensive investigation would seem a reasonable order of the day. The procedures and time in volved are manifestly economical--in truth, there seems little to be lost.
LABORATORY OF PSYCHOLOGY
NATIONAL INSTITUTE OF MENTAL HEALTH
BETHESDA 14, MARYLAND
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