This case report of Friederike Meckel Fisher contextualizes her underground practice MDMA-, LSD-and 2-CB-assisted individual and group psychotherapy in Zurich up until 2009 before she was arrested. It highlights that only a small percentage of her clients received these drugs, as part of psycholytic group therapy, and outlines the practical schedule of their sessions. Her arrest was occasioned by an ex-client, who had attributed her husband’s decision to end their marriage in response to therapy as ‘brainwashing’, and reported her to the police. The commentary provides a wider discussion of ethical considerations with respect to this case study, and in regard to future developments in psychedelic-assisted therapies.
Abstract
“Underground psychedelic-assisted psychotherapy has persisted in Europe despite the banning of the substances LSD and MDMA in the 1960s and 1980s, respectively. This article describes the work of a Zurich-based psychotherapist providing individual and group psycholytic psychotherapy, whose practice persisted for several years before she was arrested in 2009. The article provides commentary on the psychopharmacological, moral, ethical and legal issues of this case and discusses these issues in the context of the growing medical research of psychedelic substances as mainstream treatments for psychiatry.”
Authors: Ben Sessa & Friederike Meckel Fischer
Summary
Psychedelics were used for thousands of years by archaic and non-Western cultures for psycho-spiritual healing. Psychedelic research ended by the 1970s, but there have been some small pockets of continued underground use of these compounds for psychotherapy.
and training
Friederike trained as a medical doctor in Germany, and worked in her own private psychotherapeutic practice providing non-drug psychotherapy, Holotropic Breathwork group therapy and Family Constellation work. She joined a psycholytic therapy training group in Switzerland in 1988.
Friederike mended by word-of-mouth, but most had already had extensive non-drug psychotherapy with her. Only a small percentage of her clients went on to drug-assisted therapy, and they were only offered MDMA after being deemed to be ‘stuck’ or failing to progress in traditional non-drug psychotherapy.
Friederike led the psycholytic group sessions herself, and her husband Konrad attended most sessions. The participants were aged 18 to 70, and the average length of stay was 25 sessions.
Structure of the group sessions
The psycholytic group met over a weekend once a month (10 times a year) at the home of Friederike and Konrad. They took MDMA together and laid down after taking the first medicine and confirmed the promise to keep silence about the present people.
Friederike took the substance as the participants, led them in their individual and group work for three hours, and then broke at 1 pm, when everyone used the bathroom and ate, then gave them the second substance. The session ended at 9 pm.
The guests settled their invoices and went home, with some staying behind to help with chores. They sent a written report of their experience to Friederike.
Most psycholytic sessions began with MDMA, then LSD or 2-CB were added mid-way. Sometimes other substances were used, such as ayahuasca or psilocybin.
psychotherapeutic agent
MDMA exerts its effects at 5-HT2A and 5-HT2B receptors, alpha-2 receptors, dopamine and the hypothalamus, creating feelings of calmness and relaxation, original and innovative thinking, empathy and bonding. Friederike describes three successive stages of the psycholytic therapy, akin to a client’s personal development: ‘Primary School’, ‘Middle School’ and ‘High School’. The Self Reflecting I and The Empathic Observer are fundamental skills required to work with MDMA and other substances.
Friederike guided the participants through a re-living of a traumatising moment, often requiring live-body work. This cut the link between the event and the trauma, and allowed the participants to distinguish between the present and the past.
The ‘Primary School’ stage leads to the ‘Correcting New Experience’ stage, where the clients address specific personal issues and previously unexplored relationship dynamics. They may experience dramatic personal revelations and may wish to make major life changes, such as marrying their partner, taking new responsibilities or leaving their job.
Clients who have fully integrated the concepts of being still and not attaching to emotional experiences can conduct psycholytic sessions on their own and acquire mindfulness, which provides peace and tranquillity to cope with their life problems in a new way.
Almost all clients who underwent psycholytic psychotherapy described improvements in their relationships and well-being at home and work. Some stayed with their partners, some left, some developed new interests, lifestyles and employment.
The ex-client informed the police that the couple had used MDMA and LSD in their therapy, and that Friederike and Konrad had ‘brainwashed’ her husband. The police put Friederike and Konrad’s house under surveillance and tapped their telephone and emails looking for evidence of drug dealing.
Arrested and put on trial
The police raided the couple’s home and found MDMA and LSD. They were arrested and put into custody for almost two weeks, but were released after finding no evidence to suggest they were dealing drugs. Friederike and Konrad were charged with endangering society with their use of LSD, but their defence showed that they were using the drug with great care and attention in a therapeutic setting.
The judge sentenced Konrad and Friederike to a 2-year probation sentence and 10,000 Swiss Francs (£6500) in fine, with a 16-month suspended sentence and a following probation period of two years.
Friederike and Konrad were conducting ‘sex orgies’ as part of a cult and pushing drugs upon unsuspecting or vulnerable people for vast personal profits. The Zurich Health Council threatened to remove Friederike’s professional license.
Friederike’s project was idiosyncratic in that she could not consult widely with other clinical colleagues for supervision and relied entirely upon trust to keep the project under wraps. However, at some point a client may wish to complain and Friederike had no such supports available.
Friederike was judicious in selecting clients for psycholytic therapy, and only 4% of her available pool of clients were using drugs. She was not cavalier in using drugs, and the negative press reports reflect the public’s critical feelings about illegal drugs. Many people believed Friederike made great profits from her work, but she actually made a loss because she had to pay the police for providing her clients with illegal therapy.
therapy?
There are dozens of underground psycholytic psychotherapy groups using MDMA, LSD and other agents throughout Switzerland and the UK.
In 2009, two deaths occurred in the context of an underground psycholytic therapy group session in Berlin. The deaths highlight the particular risks associated with a lack of quality controls involved with underground therapy. Decades of anecdotal examples of the positive use of psychedelics for healing are now being backed-up with contemporary clinical trials. Within the next 10 to 15 years, clinicians will be able to carry out psychedelic-drug assisted psychotherapy using regulated, legal and appropriately monitored structures.
To encourage the mainstream medical community to embrace psychedelics as viable clinical tools, we need to choose an appropriate medical language with which to describe the therapeutic effects, and tackle the out-dated drug classification and scheduling regulations that are severely restricting this type of research.
Ben Sessa is an addictions psychiatrist conducting the UK’s first clinical study with MDMA for post-combat veterans with treatment-resistant PTSD. He is interested in the development trajectory from childhood trauma to adult mental disorders.
Meckel trained as a psychotherapist, worked as a facilitator in Holotropic Breathwork, and developed her own setting, tools, and integration steps for working with drug-induced altered states of consciousness. She was put on trial for drug-induced psycholytic methods, and was given a 16-month suspended sentence.