Psychedelics and Psychosis

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The startling resemblance between schizophrenic and psychedelic experience has been elaborated in a number of scholarly papers that find the effects of psychedelic drugs and symptoms of schizophrenia to be almost the same (Stockings 1940; Osmond and Smythies 1952; Savage and Cholden 1956; Bowers and Freedman 1966; Jones 1973; young 1974). Both conditions involve heightened sensory responses, symbolic projection, changes in time sense and feelings of regression in time, preoccupation with usually disregarded details, impairment of judgment and reasoning, and unusually strong ambivalent emotions: on one hand, anxiety, dread, suspicion, guilt, fear of disintegration, and on the other hand, awe, bliss, a sense of certainty, feelings of extraordinary creative awareness or spiritual breakthrough, dissolution of the self in a greater unity. The extreme variability of schizophrenic symptoms also corresponds to the variety of psychedelic experiences. A condition similar in some ways to schizophrenia is acute delirium or toxic psychosis, which can be produced by high fever, extreme thirst and hunger, or any of hundreds of chemicals. But the differences between delirium or toxic psychosis and schizophrenia—symptoms like clouded senses, disorientation, gross physical disturbances, and often subsequent amnesia—make the resemblances between schizophrenia and psychedelic drug effects all the more remarkable. It is not surprising that psychedelic drugs were long regarded as a potential tool of special value in the study of endogenous psychoses.
But the drug effects differ from schizophrenia in significant ways too. Visual hallucinations or rather pseudohallucinations are dominant rather than auditory ones (imaginary voices). There are more perceptual changes, including the characteristic dreamlike imagery. The drug taker's mood is more likely to be pleasant or euphoric, he is rarely apathetic and emotionally numb, he suffers less disorganization of thought, and he is much more subject to influence and suggestion (kleinman et al. 1977). Besides, psychedelic drugs can mimic the symptoms of many other disorders besides schizophrenia—manic depressive psychoses, hysterical conversion syndromes, and so on. In one experiment listener who compared tape recordings of schizophrenics and LSD subjects (about 50 to 100 micrograms) had no trouble distinguishing between them (Hollister 1962). But the drug takers' greater education and intellectual capacity may have given them away, and the dose may not have been high enough. A comparison between twenty hospitalized chronic schizophrenics and thirty LSD subjects (100 micrograms) showed that LSD effects did not resemble undifferentiated schizophrenia; one-forth of the LSD subjects, said to have paranoid tendencies to begin with, suffered reactions that in some ways resembled paranoid schizophrenia. Two acute schizophrenics had much more intense and bizarre symptoms than the LSD subjects (Langs and Barr 1968). When LSD or mescaline is administered to schizophrenics, their responses vary as greatly as those of normal people. Apparently they can distinguish psychedelic drug effects from their own hallucinations and illusions (Feinberg 1962). Some studies suggest that psychedelic drugs intensify the symptoms of acute schizophrenia but produce little response in chronic schizophrenics. But other experiments show striking temporary changes in chronic schizophrenics: a hebephrenic who speaks seriously to the psychiatrist about his “pathetic” state, a mute catatonic who sobs, laughs, talks, and dances for the first time in years (Cholden et al. 1955).

pp. 248, 249 Psychedelic Drugs Reconsidered by Lester Grinspoon and James B. Bakalar (1997)