A blog by Araminta Jonsson
In 1965, Oak Ridge Hospital for the criminally insane in Penetanguishene, Ontario, Canada saw the arrival of its newest staff member, a budding young psychiatrist named Dr. Elliot Barker. He began working on a unit for the treatment of male psychopaths. Upon meeting these men, he feared they were doomed to incarceration for the rest of their lives unless a significant shift in their personalities could be reached. Barker set about obtaining a large amount of LSD from a Government sanctioned laboratory alongside selecting a group of psychopathic patients-most of whom were between 17 and 25. The patients were then taken to a small green room and asked to remove their clothes and participate in nude, LSD aided psychotherapy sessions.
These sessions have been reported to have lasted more than ten hours and involved patients sucking at straws inserted through the walls in order to gain nourishment from food. There were no distractions like television, calendars, clocks or clothes present in the patient treatment area where they were encouraged to revisit dark emotional states and share existing sexual fantasies that they may have held for each other. Former patients report how they witnessed peers clawing at the walls and suffering with sleep deprivation. The founder of the program, Barker, observed the men from behind a one-way mirror. Visitors were kept at bay through the means of them displaying photographs containing graphic violence which in turn discouraged the patients to visually engage with them.
Early reports of the use of LSD in Barker’s psychotherapy sessions were grim. Poor communication and engagement amongst patients saw the distribution of various punishments and the program appeared set to fail. Then in 1971, a documentary film maker visited Oak Ridge and witnessed and filmed a significant breakthrough in Barker’s LSD psychotherapy program. The participants were beginning to show signs of caring for one another. In fact, some patients insisted that they remain at Oak Ridge to complete their therapy program as opposed to being freed whilst facing their parole hearings.
In his 2011 book, The Psychopath Test, John Ronson reported that researchers in the nineties revealed that the percentage of psychopaths from Barker’s Capsule LSD psychotherapy program who went on to reoffend following release was 20 percent more than that of the average psychopath in society. (With the average being 60% and the Oak Ridge graduates 80%). Further criminal offences included the rape and murder of children and previous fellow inpatients. When interviewed by a journalist, one reoffender who had been safely returned to Oak Ridge Hospital stated “I did learn how to manipulate better, and keep the more outrageous feelings under wraps better”. He also went on to explain that he was of the belief that Barker’s sessions were influential upon his reoffending behaviour as he had learned to be devious through the lengthy and detailed conversations which explored the subject of empathy. These had taught him how to fake it.
Today, details of Dr. Barker’s use of hallucinogenic drugs in the name of psychiatry is viewed by some in a very different light. An article from the Canadian National Post published in April 2019 reported on the lawsuit brought against Barker and a fellow colleague by a large group of former Oak Ridge patients stated that ‘The plaintiffs say they were subjected to solitary confinement and sensory and sleep deprivation. They were stripped naked in front of others and given powerful hallucinogenic drugs such as LSD, they claim. They were also tied for long periods in extreme and painful stress positions, or had to sit quietly and motionless on a concrete floor for hours, they allege.’ Other recent sources refer to the use of LSD in treatment at Oak Ridge as “torture”, with blogger Bonnie Barstow asking, ‘Is it any wonder that those subjected to this "treatment" were severely traumatized?’.
It would be remiss to not note that perhaps the use of psychedelics by Dr Barker had the negative consequences it appeared to have, more down to the treatment of the patients throughout the process, than anything to do with the actual positive or negative effects the drug had on the patients. However, his experiment does no doubt contribute to much of the controversy that surrounds the more recent campaigns and studies for the use of psychedelics (psilocybin, LSD, and ayahuasca), and other drugs such as MDMA and Ketamine, which have secondary psychedelic properties, for treating mental health disorders via what is now known as psychedelic assisted therapy (PAT).
Psychedelic-assisted therapy is a form of therapy which involves the ‘professionally supervised use of ketamine, MDMA, psilocybin, LSD and ibogaine as part of elaborated psychotherapy programs. Clinical results so far have shown safety and efficacy, even for “treatment resistant” conditions.’ The taking of the drug has been demonstrated to induce an experience that provokes an intense, long-lasting psychological and behavioural change.
‘Psychedelic-assisted therapy has shown promise as a treatment for alcohol dependence, nicotine dependence, anxiety related to a terminal illness, and chronic PTSD, and research is underway to examine its efficacy in relation to obsessive-compulsive disorder, treatment-resistant depression, and social anxiety related to autism, among other potential applications.’
Since 1986, the Multidisciplinary Association for Psychedelic Studies (MAPS) has been developing medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana. They are not alone. For many years Professor David Nutt, Neuropharmacologist and iCAAD London 2018 speaker, has been campaigning for psychedelics to be allowed in scientific research for year. He says that the ‘schedule 1 classification of many potentially useful compounds “is the biggest censorship of life sciences research in human history”. Heroin and cocaine are both schedule 2 drugs, owing to their use in medicine, which means hospitals and universities do not need a licence to research them and the process is much easier and cheaper, despite scoring at the top end of the scale for harm to users and society. In comparison, Nutt says, psilocybin “scores the lowest on the physical and social harm scale of any drug that is misused”.’
Earlier this year Professor Nutt worked alongside Dr Ben Sessa, an addiction psychiatrist and senior research fellow at Imperial College London, on the first ever study of its kind in the UK, looking at MDMA treatment for alcohol addiction. The early results of the study have demonstrated that it is a safe drug to use for the treatment of alcoholism and that the outcomes have been encouraging; ‘Those who have completed the study have so far reported almost no relapse and no physical or psychological problems.’
In 2001 A. R Pentney reported that psychotherapists who used MDMA, (commonly recognised as a “party drug today”) in the 1970’s found the substance increased levels of communication and diminished perception of danger. Therapy sessions would typically be held in the home environment of the patient. MDMA assisted empathy contributing towards a patients journey of self discovery was the dominant theme in these sessions. Substance misuse, relationship and couples counselling, depression and premenstrual syndrome were examples of problems MDMA assisted therapy was reported to have treated. ‘Therapists who used MDMA in their practice were impressed by the results. Anecdotally, MDMA was said to greatly accelerate therapy.’
Ketamine is another so called “party drug” that has also been gaining momentum as a treatment for mental health disorders, specifically for depression. According to an article in Harvard Health, because of the antidepressant effect through a new mechanism, ketamine has the properties to help people successfully manage depression following previous unsuccessful attempts such as medication, ECT or counselling. Ketamine binds to NMDA receptors in the brain which in turn increases the amount of the neurotransmitter, glutamate in the spaces between neurons. The next phase involves glutamate activating connections in the AMPA receptor. Both these actions lead to the release of other molecules which assist neurons to communicate with each other along new pathways. This is called synaptogenesis and affects mood, cognition and thought patterns.
One of the difficulties when treating depression is how varied the symptoms can be. The exciting thing about using ketamine to treat it is that, unlike other antidepressants, ketamine seems to be able to combat most if not all of the diverse symptoms that people present with. ‘Studies have shown positive effects in patients with anxious bipolar depression, PTSD, anhedonia or loss of pleasure and suicidal thoughts. All this led Thomas Insel, the former director of the US National Institutes of Mental Health, to describe ketamine as potentially “the most important breakthrough in antidepressant treatment in decades”’.
Another substance that has become increasingly common in recent years, is ayahuasca. Ayahuasca is a psychoactive brew or tea, which contains various compounds including DMT. It has proved to be of specific interest to researchers due to its potential for treatment substance abuse disorders. According to MAPS, ‘although preliminary, current research suggests that when administered in therapeutic settings, ayahuasca may help reduce problematic substance use by helping promote personal or spiritual insights or self-knowledge.’
Like ayahuasca, ibogaine has been gaining momentum as a drug to help treat substance use disorders, specifically opiate addictions. ‘Ibogaine is a psychoactive alkaloid naturally occurring in the West African shrub iboga. While ibogaine is a mild stimulant in small doses, in larger doses it induces a profound psychedelic state.’ Although illegal in The United States and the UK, it is legal in Mexico and New Zealand. MAPS has completed two observational studies'’ of the long-term effects of ibogaine treatment on patients undergoing therapy at independent ibogaine treatment centres in Mexico and New Zealand. Results of these studies have ‘found that larger doses of ibogaine can significantly reduce withdrawal from opiates and temporarily eliminate substance-related cravings.
The future for psychedelics in treatment is most certainly intriguing and even exciting. Most of the research that has managed to pass clinical and political restrictions has led to outcomes suggesting efficacy, however there still isn’t a definite conclusion. There are also other concerns to consider, such as if these drugs do become approved as therapeutic treatments, will they become even more easily available and therefore used and abused more often?
It is obvious that there still a lot of debate to be had, and further research to be undertaken. So, while exiting and provocative we should acknowledge that using drugs like this as a standardised treatment modality is still a way off, and is not without its societal risks.
- ↑ Ronson, J (2011) The Psychopath Test. Picador. London.
- ↑ https://www.pressreader.com/canada/national-post-latest-edition/20190430/281612421820732 accessed 4/12/2019
- ↑ https://rabble.ca/blogs/bloggers/toward-world-commons-and-without-psychiatry-bonnie-burstow-blog/2017/07/recent accessed 4/12/2019
- ↑ Schenberg, Eduardo Ekman. “Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development.” Frontiers in pharmacology vol. 9 733. 5 Jul. 2018, doi:10.3389/fphar.2018.00733
- ↑ https://www.psychologytoday.com/gb/basics/psychedelic-assisted-therapy accessed 7/12/2019
- ↑ https://www.pharmaceutical-journal.com/news-and-analysis/features/psychedelics-entering-a-new-age-of-addiction-therapy/20066899.article?firstPass=false accessed 7/12/2019
- ↑ https://www.theguardian.com/society/2019/aug/19/mdma-treatment-alcoholism-relapse-study accessed 5/12/2019
- ↑ Pentney, A R. “An exploration of the history and controversies surrounding MDMA and MDA.” Journal of psychoactive drugs 33 3 (2001): 213-21 .
- ↑ https://www.nytimes.com/2005/01/30/magazine/dr-ecstasy.html accessed 4/12/2019
- ↑ https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673 accessed 5/12/2019
- ↑ https://www.theguardian.com/science/2019/mar/23/ketamine-can-it-really-be-antidepressant accessed 5/12/2019
- ↑ https://maps.org/research/ayahuasca accessed 07/12/2019
- ↑ ibid
- ↑ Thomas Kingsley Brown, Ph.D., & Kenneth Alper, Ph.D. (2017): Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes, The American Journal of Drug and Alcohol Abuse, DOI: 10.1080/00952990.2017.1320802
- ↑ Geoffrey E. Noller, Ph.D., Chris M. Frampton, Ph.D., & Berra Yazar-Klosinski, Ph.D. (2017): Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study, The American Journal of Drug and Alcohol Abuse, DOI: 10.1080/00952990.2017.1310218
- ↑ https://maps.org/research/ibogaine-therapy accessed 7/12/2019
- Q&A with Paula Shields from Asia’s first gender responsive trauma-informed addiction treatment for women.
iCAAD Online 2020