The psychedelic mystical experience in the human encounter with death

This early review (1969) investigates the mystical experience and its relationship to death, with a focus on terminal cancer patients who had received psychedelics at that time. The correlation between the profoundness of the experience and therapeutic (long-term/non-acute) outcomes is also discussed.

Abstract

From the introduction: “This Spring I received a long-distance telephone call from Dean Samuel Miller, who invited me to give this year’s Ingersoll Lecture on human immortality. Three days later, Dean Miller was dead. When I heard the sad news, I, as many of you no doubt, began to think about the way he had influenced me, especially during my theological training here at Harvard Divinity School. One of my most vivid memories was a point which he emphasized in his class on Religion and Literature. Sam Miller felt strongly that in our modern 20th century two of the most profound and important experiences of human life are becoming more and more insulated from everyday existence. These two experiences, birth and death, have the potential for affecting the character and quality of the rest of life. But in each instance, they are falling victim to modern technological efficiency and adding to the process of dehumanization rather than counteracting it.”

Author: Walter N. Pahnke

Summary

Introduction

Dean Samuel Miller, who invited me to give this year’s Ingersoll Lecture on human immortality, was dead three days after the lecture. I remember him emphasizing that two of the most profound and important experiences of human life are becoming more and more insulated from everyday existence.

How many fathers are present at their wives’ births? From my own experience delivering babies as a general practitioner in a wilderness community in Alaska, most of the time an alert, participating mother and father make human birth much more than just another medical procedure to be mechanically processed.

In spite of tragedy and sadness, death can have a creative emotional impact on those still alive.

In our culture, when someone is terminally ill, the fact of death is usually avoided, and heroic treatment measures are used to prolong physical life, but make meaningful interpersonal contact difficult or impossible. Family members are rarely given a chance to express their feelings about how or where they would like to die.

Before our society became so removed from birth and death, most babies were born and most people died in their own homes. This psychological experience was inescapable and profound.

The Situation of the Terminal Cancer Patient

In my work with dying cancer patients, I have become keenly aware of the fear, depression, anxiety, loneliness, and suffering that are usually present. This fear manifests itself in many ways, both consciously and unconsciously, and is basically a fear of the unknown.

The family is afraid to face the fact of death, so they avoid any show of powerful emotions and parry the patient’s direct questions with cheerful reassurance or adroitly avoid the subject by changing the subject or avowing ignorance.

At first, the patient may believe everything he is told, but as his condition worsens, he may begin to wonder if he is being told the truth. The family’s fears will reinforce the patient’s own private anxiety.

Family members wonder what the patient will think if he finds out that vital information has been withheld.

Deception can increase the psychological isolation of a cancer patient, who feels cut off at a basic level because his trust is undermined. The emotional pressure is increased for both patient and family, and it is no wonder that most patients become depressed.

The use of LSD, a powerful and sometimes dangerous psychoactive drug, is an attempt to alter this dehumanization in the course of events prior to death.

Review of Some Basic Facts About LSD and Psychedelic Experiences

There are five types of potential psychedelic experiences that can occur when LSD is administered to human beings. These experiences include psychotic experiences, paranoid delusions, total confusion, impairment of abstract reasoning, remorse, depression, isolation, and/or somatic discomfort.

The cognitive psychedelic experience is characterized by astonishing lucid thought. The creative experience may have something in common with this experience.

Aesthetic psychedelic experiences include seeing sounds, feeling objects pulsate, hearing music with great emotional power, and seeing beautiful colors, intricate geometric patterns, architectural forms, landscapes, and almost anything imaginable.

The fifth type of psychedelic experience, called psychedelic-peak, involves a sense of cosmic oneness achieved through positive ego transcendence. This experience can be experienced through the external world as well as the “inner world”.

William James named the Noetic Quality as a feeling of insight or illumination that subjectively has the status of Ultimate Reality.

All the research I have done with psychedelic drugs supports the hypothesis that the kind of experience is strongly dependent upon the necessary drug dosage, but also upon the crucial extra-drug variables of set and setting.

The psychedelic mystical experience is rare and can be achieved by only 25 to 50 per cent of subjects, but it can provide the fulcrum for transformations of attitude and behavior.

The Procedure of Psychedelic Psychotherapy in our Current Research with the Dying Patient

At Sinai Hospital in Baltimore, Maryland, we have been assessing the impact of psychedelic psychotherapy utilizing LSD, in the management of terminal cancer patients. The safety record of LSD when given by trained personnel under medically controlled conditions is comparable to that of other commonly used psychiatric procedures.

Patients are told that LSD will not cure their physical illness, but may give them more emotional strength to cope with what lies ahead.

After consent is obtained, intensive individual psychotherapy for 8 to 10 hours is conducted to get to know the person in as much depth as possible. Family members are drawn into the therapy both individually and in groups, with and without the patient.

After days of preparations, the patient is administered LSD in a private hospital room, decorated with flowers and objects which have meaning for the patient. The patient listens to classical music through stereophonic high fidelity earphones.

Results of our Research

We have treated 17 patients with LSD plus associated psychotherapy. No patients seemed to have been harmed, even those who were physically quite ill, and one-third were helped somewhat and one-third were helped dramatically.

The direction of the change, especially in those patients who were helped the most, seemed to be towards a decrease in fear, anxiety, worry, and depression, and an increase in serenity, peace, and calmness. There was also a decrease in the fear of death.

A 49-year-old woman with inoperable cancer of the pancreas was brought to the hospital by her husband and daughter because of her increasing agony. The family was concerned that she might discover the true nature of her “tumor” and become even more depressed.

The patient was given an LSD session that was filled with religious symbolism. She felt the presence of God and released guilt feelings about certain of her past actions, and her pain was controlled with narcotic drugs.

A few days after her LSD session, the patient asked me directly if she had cancer. I explored with her the meaning of such a diagnosis if it were indeed true, and she indicated that she would have to learn to live with it. The patient’s physician was in the hallway, and the patient asked him the same question she had asked me. He answered, “Well, it’s cancerous,” and the patient sighed, saying that her family hadn’t told her.

After discussing the issue with the husband and daughter, I suggested that we go and see the patient together. The daughter became visibly upset and reluctantly agreed to go in.

The patient’s husband broke down and began to sob uncontrollably when she told him she was going to die. The patient took him in her arms and consoled him, explaining that they would all get through this together.

The patient had a second LSD session, during which she had a vision of all her grandchildren standing by her beside, and she was able to resolve the issue of how she would explain her condition to them.

The patient’s husband and daughter were able to care for her satisfactorily at home during the month before she died. She was able to see her grandchildren each day and discuss with them her own death.

Discussion

The psychedelic mystical experience seems to open up channels of positive feeling that were previously closed or clogged, and may help patients feel more love, joy, and peace.

Negative feelings of depression, despair, and anxiety are released most fully when there is complete surrender to the ego-loss experience of positive ego transcendence. At this point, unless the patient previously had experienced mystical consciousness spontaneously, the patient becomes intensely aware of completely new dimensions of experience. This insight can transform attitude and behavior, and allow the patient to face the unknown with a new sense of self-confidence and security.

William James said that the brain is a filter of consciousness, and that it can transmit a part of the Vaster Consciousness of Reality into the dimension of ordinary reality perceived by individual normal waking consciousness.

The psychedelic mystical experience is a form of consciousness that occurs when a person loses individuality and becomes a part of a Reality Greater-than-self. However, the person still maintains some self-consciousness so that some memories are preserved.

LSD used in conjunction with psychedelic psychotherapy is not another chemo-therapeutic method to achieve a euphoric death, such as increasing doses of painkillers. Instead, it allows the patient to deal with the fear surrounding death and enhance the quality of life in the days before death.

A patient with metastatic breast cancer received LSD treatment, and her son’s first reaction was to make his mother die with a smile on her face. However, the treatment established their relationship on a new creative level.

Does this treatment threaten to manipulate the human mind in an unethical and dehumanizing manner? No, it helps the patient become more fully human and able to use the last days of his life in a meaningful way.

A new experimental procedure must be considered in terms of the proportionate degree of risk compared to the potential benefit. LSD is a dangerous drug depending on how it is used.

The mystical experience is an inevitable consequence of the use of drugs. The use of drugs to give comfort to the dying patient hardly seems an abuse, and God can work through any part of his creation.

The psychedelic mystical experience is possible with the aid of a drug, but much preparation is needed and follow-up integration is necessary for the experience to be therapeutically useful.

Implications

If further research substantiates the promise that psychedelic psychotherapy has shown in the treatment of the dying patient, religious professionals could be of tremendous help in integrating these new insights.

In the future, it might be possible to establish centers where dying patients can have a psychedelic experience in the most optimal setting. These centers would include psychiatrists, psychologists, and religious professionals.

If psychedelic psychotherapy for dying patients becomes widespread in our society, there might be a change in our whole approach toward death.

Conclusion

Although the question of human immortality may always remain an enigma, the psychedelic mystical experience can prepare one to face that moment with a sense of open adventure.

In large scale research projects with LSD, permanent adverse effects have been quite rare. There have been two transient post-LSD disturbances that have subsequently responded well to conventional treatment, but it is possible that the results were due to powerful suggestion implemented by the intensive psychotherapy.

Research shows that giving LSD mainly as a chemotherapy without adequate preparation and suggestion does not provide any advantage over psychotherapy alone in the treatment of alcoholism. The results show that patients who have a profound psychedelic peak experience achieve greater clinical improvement.

The best results with cancer patients seem to be due to a combination of set, setting, and drug, with the placebo effect being a necessary, but not sufficient condition.

I do not feel that terminal cancer causes much useful purpose, and the introduction of psychedelic drugs to the medical armamentarium against human suffering cannot be objected to on the grounds that man has no right to interfere with an element of human life.