This article reviews archival Spring Grove (later Maryland Psychiatric Research Center) training data and explores psychedelics as a training program for psychedelic therapists to inform current practice.
Abstract
“The therapeutic use of psilocybin in psychedelic-assisted therapy models is currently being tested for a variety of indications, necessitating the training of hundreds of therapists. At present, training programs do not include the provision of a psilocybin experience for therapists, and the last time such an experience was offered with a similar compound was through the Spring Grove LSD Training Study between 1969 and 1974. This article explores archival Spring Grove data to inform training programs and efforts to establish or provide training experiences with psilocybin or otherwise include experiences with nonordinary states of consciousness in the training of psychedelic therapists.“
Author: Elisabeth M. Nielson
Summary
Psilocybin is being tested for a variety of indications, but training programs do not include a psilocybin experience. This article explores archival Spring Grove data to inform future training programs.
Introduction
Lysergic acid diethylamide (LSD) is one of the most potent drugs known to humankind, both chemically and socially. In the 1990s, psychedelics were reintroduced to clinical research settings, with MDMA being used as a treatment for severe posttraumatic stress disorder.
The reemergence of psychedelic-assisted therapy research has led to a need for training programs for therapists to provide this treatment on a larger scale. This article explores the ethical considerations in offering and providing such training experiences.
Background
In 1969, the Maryland State Psychiatric Institute’s Spring Grove campus conducted a study that allowed 100 participants to take LSD as a training experience for psychedelic therapists. The data collected were never published, but participants reported finding the experience helpful.
There is no research study training programing that offers personal experience with LSD or psilocybin in the United States. However, therapists who train with the MAPS as clinicians for their Phase 2 and 3 clinical trials may have the opportunity to receive a single dose of MDMA.
Ketamine is a dissociative anesthetic with psychedelic properties that is gaining attention for use in psychedelic-assisted therapy. Ketamine therapists can more openly discuss their experiences with the drug than psilocybin or MDMA therapists who may experience repercussions due to the legal status of their experiences.
The Absence of Training Experiences for Psilocybin Researchers
Psilocybin is a naturally occurring serotonergic hallucinogen found in several species of mushrooms. It has several advantages over LSD as an adjunct to psychotherapy, including a gentler side effect profile and a shorter duration of action. While both drugs are relatively safe, psilocybin is presently the drug of choice for psychedelic-assisted therapy research. It has been investigated for existential distress related to a cancer diagnosis, for smoking cessation, and for alcohol dependence.
Unlike researchers who can take MDMA and ketamine for training, psilocybin researchers cannot have training experiences that involve taking any serotonergic hallucinogen. This makes it difficult to discuss personal experience with psilocybin and to justify starting a training program that includes it. Psychedelic drugs as training experiences are suffering from the same quandary as research on psychedelic drugs for the treatment of psychiatric disorders. Fewer researchers and practicing clinicians can openly discuss their experiences with psilocybin and LSD.
Revisiting Spring Grove
In light of the above, the present research reviews data collected at Spring Grove during the LSD Training Study between 1969 and 1974 to answer questions relevant to the potential creation of a training experience program with psilocybin.
Method
The author consulted with the principle investigator of the postdoctoral fellowship that provided support for the research and with her present institution’s institutional review board representative, who advised that no IRB approval was needed to review de-identified public research records.
Data included answers to 22 open-ended questions and 75 items for rating on a numerical scale. Six open-ended questions and six items from the rating scale were analyzed.
Sampling
The present analysis is based on 26 of the 100 available files. 3 files were chosen as representative files, and 23 files were chosen by selecting every 5th file from the full data set.
Data Analysis
Seven questionnaires, 17 rating scale responses, and participant demographic data were compiled in a Microsoft Excel spread sheet, and the mean, standard deviation, and p value were calculated.
Questionnaire Responses
Participants’ responses to the selected questionnaire items are presented verbatim from the questionnaire. Minor corrections to spelling were made for clarity.
Questionnaire: How has your psychedelic drug experience been relevant to your life? My experience has been relevant in opening up my personal structure to a greater variety of depth of emotions.
The drug session has been relevant to my life in several ways, including opening up a simpler, more satisfying approach to all of life’s situations, and bringing to consciousness several issues that had been plaguing me at an unconscious level. The experience helped me deal with a wide range of emotions and needs, relieved me of all shame, helped me become truly self-accepting, and helped me become emotionally centered.
The experience of taking LSD has affected many people’s attitudes toward psychedelic experiences. For some people, the experience has made them more tolerant of drug use, while for others, it has made them more appreciative of the potentialities of altered state.
Five participants directly answered “no” to the question of having any spontaneous recurrence of psychedelic drug effects since the experiment, and one participant answered “regretfully, no” but stated that she often experienced “slight effects” when hearing meaningful music that was played in her session.
The fourth selected question asked about negative outcomes, and all participants answered “no” or “not more than usual”.
Discussion
The Spring Grove study was the first known attempt to systematically analyze and draw conclusions from data collected during the LSD Training Study.
Although some participants felt they benefited from the experience, others were unwilling to repeat it outside of a medical setting. The present data do not indicate that the LSD Training Study increased participants’ desire to take LSD again outside of a controlled setting.
Ethical Considerations for Future Training Experiences
The Spring Grove study was positive, but there are several ethical and logistical questions to answer when using psychedelics for training.
The Spring Grove study was conducted before IRBs and scientists were increasingly called on to justify risk to participants. Today, only two studies with MDMA have been approved, so researchers should carefully consider the risks and benefits of such studies.
A research study like this is rare in modern times because it requires regulatory approval, IRB approval, appropriate space, licensure, and staff, and funding from sources such as grants, drug sponsors, or donors.
In the event that psilocybin or MDMA is approved for medical use, training programs may offer psychedelic sessions to trainees. However, if off-label use is allowed, training programs may have to be distinct from therapists/treatment providers to protect trainees from potential exploitation.
The modern psychedelic medicine field should consider how the use of psychedelics as a training experience may affect diversity among therapists, and should consider how the stigma associated with the use of psychedelics may affect diversity among therapists.
Limitations
The data could not be determined how many participants worked as psychedelic therapists before or after their participation in the study, and 19 files did not contain answers to the questionnaire.
Future Directions
The present analysis indicates several considerations for the design of future training programs that endeavor to include experience with psychedelic compounds. These considerations include documenting the state and attitudes of participants before and after receiving the psychedelic, and comparing the active drug session training method with other methods.