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Treatment of Childhood Schizophrenia Utilizing LSD and Psilocybin
Gary Fisher, Ph.D.

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(introduction from the eiditor of the MAPS bulletin)
Now that the FDA has permitted research with LSD and psilocybin to resume, we feel it is important to share examples of a remarkable experiment, the results of which were not sufficiently taken into account because this line of research was prematurely halted in the mid-sixties due to political considerations. Childhood schizophrenia is still a difficult problem to treat and causes much suffering. It is a terrible shame that research done 35 years ago is still the last word on the use of psychedelics to treat these conditions. - Ed.


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Hypothesis

The working hypothesis of this study is that psychosis is a massive defensive system of repression-avoidance-denial in the service of protecting the individual from experiencing early childhood trauma. The repression is so massive that the individual ceases to experience himself with any validity. The individual exists isolated in a world without feelings and this world becomes meaningless. One of our little patients told me that he lived in a world of "no nothingness." It was hypothesized that the psychedelic drugs could break through this massive repression wherein the child would re-experience these traumatic events and release the pain bound to those experiences. He or she would acknowledge his own history. Furthermore, through experiencing the loving attention of the staff in a milieu of total acceptance, the child could begin to experience himself as a positive and valid person. The team consisted of a psychiatrist (who chose not to have an LSD experience but was medically responsible for the research), four psychology graduate students and three psychiatric nursing technicians. The author acted as lead therapist of this group. For any one session there were usually three to four staff, relieving each other throughout the day as the sessions were extremely intense and required very active participation by the staff. All staff had had their own experience with LSD and psilocybin, as it is accepted practice that in order to understand what was going on with the children one had to have had personal experiences with the drugs. As we progressed with the work it emerged that one staff person would become the primary therapist for each patient. Each session was continuously recorded for the verbalizations and behavior of the patient. Besides spending time with the patient during the treatment session itself, a total program had to be developed for each patient and that program communicated to all ward personnel to attempt consistency in the therapeutic approach. We were careful to include ward personnel who were not part of the treatment team in the ongoing progress of each patient and to enlist their cooperation in the development of a consistent attitude. As the ward personnel began to see the remarkable changes occurring in the children, they became involved and supportive in the ongoing care of each child.

Ward Conditions

The ward in which these children lived was in a state of constant pandemonium. The ward housed some sixty children ranging in age from four to twelve who were the most severely disturbed children of a larger hospital population. There was constant screeching, fighting and destructive behavior. Many children were destructive towards the environment, to each other, to the staff and to themselves. The primary duty of the ward personnel was damage control. The noise level was always high, as many of the children were extremely hyperactive and vocal. Other children were very withdrawn, involved in repetitious physical motions and when interfered with would lash out at the intruder. There was little interactive or parallel play and any toys or material brought into the ward were soon destroyed. Feces smearing and random urinating were a constant problem. To say the least the environment was not conducive to good mental health.

New Behavior

After nine months of the program and fifty-eight treatment sessions it was decided to continue the program with five patients of the initial twelve. The children discontinued from the program were characterized by a lack of speech and infantile autism and were the least responsive to treatment. They were extremely withdrawn and had no ability to relate to other children or adults. In spite of their severe limitations, all of them did have some marked response to the treatments. During the sessions they showed little responsiveness although some of them became hyperactive and were obviously having some sensory experiences and more interaction with the staff. One girl had a prolonged fear response. Marked changes occurred in the days following the sessions. They showed much more interest in relating to the treatment staff, became animated and playful and remarkably less withdrawn. One girl evidenced extreme frustration at not being able to verbally communicate as she had no language development. The youngest (four years old) and least developed child kept trying to lead a treatment staff person down to the room where we did sessions. They all had interest in making physical contact with the treatment staff and one very autistic child became quite demanding to be held. This was all new behavior for these children. Consequently they all had behavior changes but their potential in relation to other patients was much more limited and we had limited time available to treat them.

Among the children with whom we discontinued treatment, one twelve year old girl had progressed so remarkably that she was able to attend public school during the day and return to the hospital in the evenings. It was felt that she had sufficiently improved, was function ing satisfactorily in the school system and that further treatment was not crucial. Patty was the only patient who was not psychotic. She responded to the treatments more rapidly than the more disturbed patients. A short summary of her treatment will help illustrate the work.

Patty's First Session

Patty had three sessions over a period of three months. Dosage for the sessions were 100 micrograms of LSD, 100 micrograms of LSD with 10 milligrams of psilocybin, and 200 micrograms of LSD. She was hospitalized because of her inability to function at home, in the school or in the community. Her behavior fluctuated from being withdrawn and uncommunicative to very aggressive and sadistic towards smaller children. She stole food and other items from other smaller children and when thwarted in her behavior had violent temper tantrums and had to be physically restrained and isolated. Although her IQ was tested at 72, her low functioning seemed to be caused by severe personality problems and it was estimated that her potential was near the normal range. During the first session she spent the entire seven hours regressing to an infantile oral state. She incessantly repeated, "I'm hungry" and when asked what she was hungry for, she did not reply but only restated her hunger. During the entire session she chewed and sucked on her clothes or others, her fingers, arms and anything or anyone she could reach. She was given an empty baby bottle with cotton stuffed in the nipple and she chewed and sucked on this for hours. It was clear that she was trying to draw nourishment from anything in her environment. During the session one staff member would sit with her, holding her hand or arm and gently hugging her or stroking her. We gave her constant tactile care. For about two hours she aggressively bit the nipple, stretching it and gnawing on it. She finally appeared to become exhausted and uncommunicative for almost an hour. In the latter stages she held hands with staff and smiled quietly without verbalizing. She appeared to be making genuine interpersonal contact.

The Second Session

In the month following her treatment Patty was much more subdued and did not want to talk a great deal about the first session. During the second session she spent a great deal of time sucking on the baby bottle but this time she said she wanted milk in it and we complied. She then went into a panic-like state and talked a great deal of her fear of being rejected by her parents. She insisted that we call them immediately and have them come and take her home. She was extremely anxious that she would be abandoned by them and at one time sadly said of her mother, "She doesn't love me." After some three hours of constant turmoil concerning her familial relationships and her severe agitation over the rejection by her parents, she slipped into a quiet state for a period of time. She then suckled on the milk bottle and when she took it out of her mouth she would repeat, "I am loved." After some four hours she said "I love my mother, my father, my brothers and my sisters, I never felt this way before. I love them." She said that she had never felt that she was loved and the feeling of being loved and loving that she was now experiencing was new to her. She then went into a state for about two hours which is best described as a deep trance state. She was completely still with no movement whatsoever, and was unresponsive to all verbal or tactile stimuli. She finally came out of it and started smiling but still remained unresponsive to any of our inquiries. After about another hour she got up and wanted to go for a walk outside. She was happy and smiling and occasionally would laugh out loud.

Following this session Patty again was much more subdued, her behavior changed remarkably in that her temper tantrums ceased and she was relaxed and content. She interacted with new maturity toward the staff and had a very positive relationship (it looked like adolescent adoration) with one of the male psychology students. They spent a good deal of time with each other.

The Third Session

The third session, two months later, was initially characterized by more oral regressive behavior. She asked for the baby bottle with milk and spent over two hours, biting on it, suckling it trying to swallow the whole bottle, but this behavior did not have a desperate quality to it. She seemed to be more playing with it, enjoying it, and her demeanor was quiet and content. She suckled for long periods and would drift off into a peaceful, tranquil state, completely relaxed, smiling at the sitters when making eye contact. She wanted to be quiet and we were quiet with her - touching her, hugging her, holding her hand when she reached out. She responded to visual stimulation such as a rose with delight and amazement. She thoroughly enjoyed the attention and affection of the staff. Again following the session she was much more mature, interested in relating to adults and wanted to go to school with kids her own age. Her temper tantrums and rage reactions and her stealing behavior had completely ceased. It was felt she was ready to try school off hospital grounds. She was excited about this new situation and did not have any relapses. Patty did not seem to experience fear of the new situation but was excited about the opportunity to be in new surroundings and she did very well. She continued to stay at the hospital after school hours and continued her supportive relationship with the staff. She became a very affectionate and loving child and her personality was fairly subdued and quiet......

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