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= LSD-assisted psychotherapy = LSD-assisted psychotherapy is the use of LSD in psychotherapy sessions. LSD is used in psychotherapy as a means of treating substance abuse and anxiety related to life-threatening illnesses. In 1952, Abram Hoffer and Humphrey Osmond recognized the value of LSD in psychiatric research as the observed effects demonstrated “model psychosis,” providing a new means of studying mental illness. LSD is one of the most potent psychedelic substances. When used in psychotherapy, it leads to an improved understanding of the self, greater empathic communication between the client and the therapist, and an increased awareness of oneself.

LSD produces effects that cause alterations in mood, perception, and cognition. Positive effects of LSD in the treatment of substance abuse were first observed in 1953, before its illegalization, which put LSD-related research on hold. The Drug Enforcement Administration (DEA) classifies LSD as a Schedule 1 drug, meaning it is thought to have a high potential for abuse and severe psychological/physical dependence. Being a Schedule 1 drug makes it difficult to obtain federal funding for research, making much of the work with LSD still in the experimental phase.

LSD was first synthesized in 1938 and discovered to have psychoactive effects in 1943 by Albert Hofmann. LSD is a semi-synthetic member of ergolines, a class of chemical compounds known for their therapeutic effects in migraines and Parkinson’s disease. LSD achieves its effects through serotonin receptors, in which it activates canonical G-protein-mediated signaling. Active doses of LSD in humans ranges from 0.05 and 0.20mg. LSD has the potential to last up to 12 hours, due to its slow dissociation kinetics at the 5HT2A receptor. It has recently been discovered that LSD selectivity activates all but one serotonin receptor, demonstrating “functional selectivity” as the drug itself can signal specific transduction pathways.

Procedure
LSD-assisted psychotherapy can take place in either individual psychotherapy or group therapy settings. With individual LSD-assisted psychotherapy, the participant consumes LSD while the therapist(s) observes and guides the participant through the experience; these sessions last approximately 7-8 hours. With group LSD-assisted psychotherapy, the participant is typically joined by two to three therapists in consuming LSD, with the therapists having experienced the effects prior. Group LSD-assisted psychotherapy are approximately 12-14 hours. Sessions in which LSD is administered are often paired with several non-psychedelic assisted psychotherapy sessions.

Setting
The setting should be quiet, with little distractibility. Individuals may become restless or violent, so it is recommended items in the room are durable. Bathrooms should be nearby to reduce the amount of distance participants are walking. It is suggested that water is available as participants may report dry mouth or throat. Music is essential to a positive experience and helping the participant step outside themselves. Mirrors can also prove useful in LSD-assisted psychotherapy as participants often view themselves more objectively.

Substance abuse
LSD demonstrates effectiveness in the treatment of substance abuse (commonly seen in response to trauma), as it induces a state of enlightenment that has reportedly led to continued sobriety. LSD provided individuals struggling specifically with alcoholism, with a fulfilled sense of meaning and value that was previously not established. Researchers were interested in determining if delirium tremens and LSD demonstrated similar effects. Individuals who reported experiencing delirium tremens and its “horrors” also reported it was the moment they hit rock bottom, an apparent hallmark in recovery and surrender. It was then predicted that LSD could activate similar experiences as delirium tremens and therefore, initiate recovery.

Anxiety
LSD reduces levels of anxiety in patients with life-threatening illnesses. Common responses to life-threatening illnesses involve isolation from others and hardening oneself in response to the threat of death. LSD improves psychological adjustment, allowing for greater responsiveness to others. Terminal patients have reported analgesic effects of LSD that outlasted psychological effects and a lesser need for pain-relieving medications. There have been a handful of reports of LSD treatment for obsessive compulsive disorder (OCD), with the few case studies that exist reporting effectiveness in reducing intrusive thoughts.

Other research
While MDMA is currently the focus of psychedelic-assisted treatment of posttraumatic stress disorder (PTSD), LSD shows great potential for the treatment of trauma-related symptoms. Anxiety and substance abuse treatment are both well-established therapeutic uses of LSD and are commonly developed symptoms following a traumatic event. LSD shows positive benefits regarding memory and its ability to reduce cognitive resistance. Due to the level of insight that is often achieved under the influence of LSD, individuals are more readily able to access previously repressed memories and/or suppressed emotions. Considering how memories of traumatic events are extremely difficult to revisit and process, LSD shows potential in aiding trauma survivors in accessing and addressing traumatic memories with greater self-understanding and insight. In the treatment of trauma, the effects of LSD in therapeutic settings can lead to increased introspection, allowing clients to observe their own emotions, cognitive processes and learn from within. LSD is thought to provoke psycholytic therapy, which is a term originating in Europe that suggests the release of conflicts and tension within the human mind.

Side effects
Hallucinogens can result in flashbacks, which perceptual changes occurring after the substance has worn off. Flashbacks can occur months or even years after use, but no relationship has been found between frequency of use and rate at which flashbacks occur.

Patients who consume LSD in psychotherapy have the potential to endure adverse side effects. Doses of over .075mg produce increased anxiety due to the intense perceptual and mood changes that occur. Patients may also experience escape reactions under the influence of LSD, in which they try to resist and escape the effects of the substance. Perceptual changes can cause patients to become confused and overwhelmed by visual changes. It is also not uncommon for patients to develop paranoid thinking as they begin to mistrust the validity and reality of their perception. Hallucinations created by LSD can cause patients to become frightened and distressed.

LSD can also provoke intense emotional reactions. In the 1950’s Stanislav Grof conducted research on LSD-assisted psychotherapy using a psychodynamic approach. LSD caused repressed memories to resurface for patients with traumatic childhoods, so much so that patients appeared to regress to childhood and relive traumatic memories paired with intense emotional reactions.