Tag Archives: Betty Eisner

01/17/23

The Eye of the Beholder with Psychedelic Therapy

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Classical psychedelic drugs such as psilocybin, LSD, and mescaline were used and researched regularly in psychiatry before they were placed in Schedule I of the UN Convention in 1967 and in Schedule I of the US Controlled Substances Act in 1970. These actions legally defined these psychedelics as having no accepted medical use and a high potential for abuse. Without a clinical focus and the widespread use of LSD within the 1960s counterculture movement, research rapidly dwindled. But there has been a resurgence of clinical research interest in the use of psychedelics for psychiatric disorders such as major depression, PTSD, anxiety and addiction.

In “Psychiatry & the psychedelic drugs,” Rucker, Iliff and Nutt described clinical trials using psychedelics pre and post prohibition. They also discussed the methodological challenges of preforming good quality clinical trials, and suggested an approach to the existing legal and regulatory barriers to licensing psychedelics as a treatment in mainstream psychiatry.

Experimentation and clinical trials undertaken prior to legal sanction suggest that they are not helpful for those with established psychotic disorders and should be avoided in those liable to develop them. However, those with so-called ‘psychoneurotic’ disorders sometimes benefited considerably from their tendency to ‘loosen’ otherwise fixed, maladaptive patterns of cognition and behaviour, particularly when given in a supportive, therapeutic setting. Pre-prohibition studies in this area were sub-optimal, although a recent systematic review in unipolar mood disorder and a meta-analysis in alcoholism have both suggested efficacy. The incidence of serious adverse events appears to be low.

The term ‘psychedelic’ was coined by Humphry Osmond in a letter he wrote to Aldous Huxley in 1956. Osmond combined two ancient Greek words, psyché, meaning soul or mind; and delein, meaning to reveal. So psychedelic means ‘soul revealing.’ The earliest direct evidence for the use of psychotropic plants dates to around 3700 BC in the northeastern region of Mexico. Carbon-dated buttons of peyote and red beans containing mescaline were found in caves used by humans for habitation. Arthur Heffter isolated mescaline from the peyote cactus in 1897.

Albert Hofmann first synthesized LSD in 1938. Coming at a time before there were effective medicinal therapies, the discovery of LSD was of interest to psychiatry. Acute LSD intoxication appeared to mimic some of the symptoms of acute psychosis and drew the research interest of Humphry Osmond. There also seemed to be an increased awareness of repressed memories and other elements of the subconscious, which suggested it could be helpful in psychotherapy. Trials in depressive, anxious, obsessive and addictive disorders in conjunction with psychologically supportive contexts reinforced that view. “By the end of the 1960s, hundreds of papers described the use of mescaline, psilocybin and (most frequently) LSD in a wide variety of clinical populations with non-psychotic mental health problems.”

The widespread use of LSD outside of the carefully orchestrated clinical and research settings and the growing reports of adverse effects when under the influence of LSD and other psychedelics led to prohibition. Medical use stopped quickly when doctors could no longer prescribe it. The following graph taken from “Psychiatry & the psychedelic drugs” depicts how the annual number of publications listed in PubMed rapidly decreased after 1968.

Recently, there have been several studies and randomized controlled trials using psychedelics with various nonpsychotic disorders. In “LSD: can psychedelics treat mental illness?,” written by Anya Borrissova for the Mental Elf blog, Borissova reviewed the findings of Fuentes et al, “Therapeutic Use of LSD in Psychiatry.” This was a systematic review of randomized-controlled clinical trials with LSD. The authors identified 11 studies that met their inclusion criteria: randomized controlled trials of LSD that involved patients with a mental illness diagnosis. The qualities of the studies was scored with the Cochrane Collaboration Risk of Bias Assessment tool.

Seven of the 11 trials had recruited individuals diagnosed with what is now referred to as alcohol use disorder (AUD), 1 for AUD or neurotic diagnosis, 1 for heroin use disorder, 1 for anxiety associated with life-threatening diseases, and 1 with a neurotic diagnosis (depression, anxiety). The publication dates ranged from 1966 to 2014, which covered several changes in how mental disorders were labeled by the four different editions of the DSM, the 2nd through the 5th. The majority of the studies had a low risk of selection, attrition detection and reporting bias, as measured by the Cochrane Collaboration Risk of Bias Assessment tool. However, five of the studies had a high risk of bias due to blinding.

With the studies of alcohol use disorder, a significant effect of LSD was observed in four studies. “However, this effect was related to quality of life and general health in some of the studies, with no clear improvements in alcohol abstinence.” While there was a substantial improvement in total abstinence for the LSD group, there were not significant differences in the global adjustment scale. With regard to the two studies of neurotic symptoms, one study showed statistically significant improvement in symptoms at 6-8 weeks in most measurements. But it failed to reach statistical significance in six months, although all groups showed significant differences in a large number of variables. Fuentes et al concluded that LSD was a potential therapeutic agent in psychiatry; with the strongest evidence for its use in treating alcoholism.

Borissova said the heterogeneity of the studies did not allow for a meta-analysis, which made it difficult to draw firm conclusions. The earlier studies had different methodologies than what is used now, which limits the application of the results to modern research. The use of the gold standard of the double-blind methodology with psychedelics is extremely difficult, if not impossible to achieve, and five studies had a high risk of bias for blinding. The psychiatric diagnostic categories were also different in studies done over such a wide range of time. How the studies defined their ‘control group’ varied, with those that failed to use an active placebo having questionable validity.

When discussing the implications of Fuentes et al, she said LSD generally appears to be safe and potentially effective. The lack of consistency between the studies may have limited their ability to find an LSD effect. “On the basis of this review, we cannot conclude that there is strong evidence of positive effects.” She did think change in scheduling the drugs to allow for easier research into LSD was justified. Tellingly, she ended with this caution: “Psychedelic research inspires a lot of excitement; the danger is that this turns into hype.”

There has been a growing interest in psychedelics as an agent for reaching peak experiences, for self-care or wellness, and as an instrument of therapeutic change. Michael Pollan explored this psychedelic ‘renaissance’ in his 2018 best-selling book, How to Change Your Mind. In a New York Times article, he said now when you leave the airport in Quito, Ecuador, there are people with signs that say: ‘ayahuasca ceremony’ instead of ‘taxi.’ “These people became shamans, like last week. People are getting hurt.” He had positive things to say about his experiences with psilocybin, but cautioned against legalization: “Psilocybin has a lot of potential as medicine, but we don’t know enough about it yet to legalize it.”

The promise of pre-prohibition LSD and psychedelic studies and their potential as therapeutic agents has to be replicated within a modern, controlled context. A 2016 paper by Rucker with different researchers than those cited above, “Psychedelics In the Treatment of Unipolar Mood Disorders,” elaborated on some of the difficulties inherent in designing trials with psychedelics. Blinding is largely impossible. Therapeutic doses of psychedelics produce subjective and objective changes in thinking, feeling and behavior that are usually obvious to both the participant in the study and the observer. Because of this, placebo control is problematic because the absence of the psychedelic effect is obvious. The ‘set’ (psychological state) and ‘setting’ (the interpersonal and physical environment) within which the drug is experienced are inextricably linked to the therapeutic effect.

It appears that a particularly careful and well-considered balance between the needs of the participants and the needs of the trial will be required in studies using psychedelics. . . Trial designers will need, similarly, to be detailed and explicit about the environmental and psychotherapeutic milieu in which a study is to be performed. Clinical trials using psychedelics will need to be sufficiently methodologically detailed at the point of publication to allow genuine replication. Scientific mechanism studies will need, ideally, to be pursued alongside clinical trials if this is pragmatic and ethical. Within this multi-pronged approach to evidence gathering, and a sufficient degree of definition, replicable results and common threads of insight into the nature and applicability of psychedelics to medicine in general, and to psychiatry in particular, should emerge with time.

In “Psychedelics In the Treatment of Unipolar Mood Disorders,” Rucker et al referred to and quoted Rick Strassman’s 1984 literature review, “Adverse reactions to psychedelic drugs.” Strassman noted that the description and reporting of adverse reactions to psychedelics was subject to the investigators’ attitudes towards psychedelics.

With the available data, it appears that the incidence of adverse reactions to psychedelic drugs is low when individuals, both normal volunteers and patients, are carefully screened and prepared, supervised and followed up, and given judicious doses of pharmaceutical quality drug. The few prospective studies noting adverse reactions have fairly consistently described characteristics predicting poor response to these drugs. The majority of studies of adverse reactions, retrospective in nature, have described a constellation of premorbid characteristics in individuals seeking treatment for these reactions where drugs of unknown purity were taken in unsupervised settings.

The authors repeated an assessment of the perceived psychotherapeutic mechanism identified by Betty Eisner and Sidney Cohen in their 1958 article, “Psychotherapy with Lysergic Acid Diethylamide.” Eisner and Cohen said their review of the existing literature in 1958 suggested that 1) LSD lessened defensiveness; 2) there was a heightened capacity to relive early experiences with accompanying release of feelings; 3) therapist-patient relationships were enhanced; 4) there was an increased appearance of unconscious material. Eisner and Cohen went on to describe their exploration of the therapeutic possibilities of LSD with 22 patients with diagnoses ranging from neurotic depression, anxiety, character disorder, borderline personality and schizophrenia. Improvement was noted in 16 of 22 cases, where improvement was judged as continued success in behavioral adaptation.

Rucker et al concluded that psychedelic therapy may represent a kind of “catalyzed psychotherapy,” where the psychedelic drug hastens the breakdown of entrenched, maladaptive ways of thinking and behavior in supportive environments. While the evidence from pre-prohibition literature is unsystematic and methodologically inadequate, it suggests further research is worth doing. But there are limitations to the future research of psychedelic psychotherapy that researchers need to be aware.

As discussed above, it is essentially impossible to develop a double-blind methodology with psychedelics because of the unique characteristics of the drugs. This opens investigations into psychedelic therapy to the potential bias of the researchers—one that cannot be eliminated. Strassman raised this warning in Rucker et al, where he was quoted as saying it is important to use caution when discussing the idea of adverse reactions to psychedelic drugs. Whether the researcher views the drug-induced state as a pathological one, or as trying to reach a “higher” level of consciousness, “The description and/or reporting of adverse reactions to psychedelics is, therefore, subject to some degree of investigators’ perspective on the use of these drugs.”

Given the potential bias of researchers into psychedelic therapy and the current inability of medical research to neutralize it, caution when interpreting the conclusions of any research is necessary. As Anya Borissova said, although psychedelic research inspires a lot of excitement; “the danger is that this turns into hype.” This danger cuts both ways, whether a particular researcher sees the drug-induced state as a pathological one, or as an attempt to reach a “higher” level of consciousness. At the very least, it seems researchers should declare any personal bias with regard to psychedelics within any written or published research into psychedelic therapy.

As an illustration, does knowing that Betty Eisner and Sidney Cohen both personally used LSD at least once (and probably more than just once) alter your assessment of their endorsement of psychedelic therapy? It was 1958 and their failure to do so is not an ethical misstep, but that awareness added to the inability to adequately blind their research should lead to some reservations with their conclusions endorsing psychedelics. Michael Pollan acknowledged the concern of potential bias in psychedelic research:

Western science and modern drug testing depend on the ability to isolate a single variable, but it isn’t clear the effects of a psychedelic drug can ever be isolated, whether from the context in which it is administered, the presence of the therapists involved, or the volunteer’s expectations. Any of these factors can muddy the waters of causality. And how is Western medicine to evaluate a psychiatric drug that appears to work not by means of any strictly pharmacological effect but by administering a certain kind of experience in the minds of the people who take it?

It seems impossible for psychedelic psychotherapy to be separated from its set or setting; and for research into its effectiveness to be reliably evaluated by a double blinded research methodology. The effectiveness (or not) of psychedelic therapy will necessarily be in the eye of the researcher and beholder.

For more on Betty Eisner, Sidney Cohen and early LSD research look, see: “Bill W. and His LSD Experiences.”

Originally posted on October 13, 2020.

11/3/20

Bill W. and His LSD Experiences Part 2

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Betty Eisner was an American psychologist who pioneered the use of hallucinogens, particularly LSD, as adjuncts to psychotherapy. Along with Sydney Cohen, she originated the practice of using both male and female therapists during psychotherapeutic hallucinogenic sessions. She also served on the board of advisors for the Alfred Hofmann Foundation. Hofmann was a Swiss scientist and the first person who synthesized and then accidentally ingested LSD, thus learning of its psychedelic effects. But it also seems Eisner was present when Bill W., cofounder of A.A., first tried LSD.

In 2002, Eisner completed an unpublished manuscript that documented her recollections and correspondence about the early work with psychedelics, “Remembrances of LSD therapy past.” “Remembrances” contains several references to W. or W. Wilson (Bill W.) and Tom Powers. She said in the fall of 1956 and early 1957, there was a boiling pot of activity surrounding dozens of people who had taken LSD and/or mescaline.

And we discussed them, Sid and I – and Al, and Humphry Osmond when he visited, and people like Tom Powers who came from the east coast to experience LSD, bringing W. Wilson from AA on several trips. Every one of the people wanted to talk about their experiences, experiences which were so unique that each one of us was busy trying to make sense of all the phenomena which were occurring, and to fit them into some intelligible description, category, and understanding.

In a January 12, 1957 letter to Ewing Reilly, who was funding Cohen and Eisner’s research at the time, she mentioned that one of the hypotheses she wanted to test was that when A.A.’s were really close to accepting the Third Step, were they also “really open to what LSD can do for them.” In a February 13, 1957 letter to Tom, Betty said after dropping him off at Miramar, she had the thought that while he spoke well about not being able to help Bill (W. Wilson, co-founder of A.A.), “the words are not yet synchronized to the music.” She closed her letter asking Tom to give Bill her best regards and tell him it was a real pleasure to meet such an interesting, extraordinary, and powerful person—and challenging problem to himself and others.

On February 16, 1957, Sid, Betty Tom and Bill all participated in the very first “group session” with LSD. It had been Betty’s idea, as she wanted “to see what would happen” if everyone simultaneously took LSD, blurring the line between patient and facilitators. Not sure what the result would be, she conservatively proposed that they should all take a low dose of 25-gamma LSD. On previous occasions they had all taken larger doses of LSD. When Bill came into the room, she knew it would be his session.

Sid was waiting for us in his office at the hospital and there were warm greetings to Tom and W. At 12:20 we took the drug… W. had taken 50 gamma — the rest of us 25. When offered the little blue pills and was told by Sid to take what he wanted, he said — ‘Never say that to a drunk,’ and took two… it was 35 minutes later when he said he felt stirred by the music, and 10 minutes after that when he began talking. Throughout the session he rarely would admit feeling the drug or its action, but about the time he started talking quite a bit in a more relaxed way his face changed, he looked much younger, and the tension began to go.

Tom and Betty took turns in the role of therapist; Sid Cohen was mostly quiet. There were two important dynamics to the problem(s) uncovered that she was hesitant to say much about. The issues were Bill’s experience of himself as unloved and the perception that it was because of his parents that this occurred. Bill’s family history noted in Pass It On is consistent with these two interpretations. She thought Tom jumped “too many levels and lost W.” At other times, she thought he was “off the beam.” At around 4 pm, Bill appeared to be coming out of it and rebuilding his defenses. Later at dinner, she thought her husband Will really got through to Bill a couple of times on “the shared bridge between them of depression.”

On February 26, 1957, Tom wrote to Betty, saying her report of their February 16th session came that day. He said he thought that both her and Will were good for Bill, because they were among the few people who were interested and loving enough to deal with him forthrightly and outside of “the highly forced and artificial context of his position in A.A.” He thought their session did Bill a lot of good— “and I think you and the LSD are very largely responsible.” Bill did not write until March 22, 1957, when he said: “Please forgive this late response in thanking you for all the friendship you gave so freely on my last trip to the coast. More often than you can guess, I have continued to think of you.” He added that since returning home, he felt—and hoped he acted—exceedingly well. “I can make no doubt that the Eisner-Cohen-Powers-LSD therapy has contributed not a little to this happier state of affairs.”

There was further correspondence back-and-forth between Betty and Tom in “Remembrances of LSD therapy past,” but nothing more from Bill. Tom assured Betty in an April 13, 1957 letter that his interest in LSD continued to be very keen and he was looking forward to another planned meeting and an optimum LSD session. He said the total effect of the three sessions had profoundly changed him for the good. He added that Bill was also strongly affected for the good and others noticed how much better he was. “He himself is very happy about it and realizes clearly what it is that has done it.”

In Bill W., Francis Hartigan said Bill’s enthusiasm for LSD convinced his wife Lois and Nell Wing, his secretary, to try LSD. He even convinced Farther Dowling, his spiritual advisor, to try it. Hartigan said under the supervision of a psychiatrist from Roosevelt Hospital, Bill continued with LSD experiments in the late 1950s. The New York participants were all sober. The purpose was to determine if LSD could might produce insights that were preventing people from feeling more spiritually alive. Bill agreed with Huxley’s statement that LSD’s power was that it could open “doors of perception.” He described his first experiences with LSD as similar to what he had experienced in Towns Hospital the night his obsession with alcohol was lifted.

In a long letter Bill wrote to Sam Shoemaker in June of 1958, he discussed his LSD use. He admitted he had taken it several times over the last two years and also collected considerable information about it. He rejected the allegation that LSD was a new psychiatric toy of “awful dangers.” He named several researchers he’d met in his own investigation of LSD, including Sidney Cohen, and said they found no tendency to addiction; no physical risk whatever. “The material is about as harmless as aspirin.”

He thought that prayer, fasting, meditation, despair, and other conditions that predispose an individual to mystical experiences had their chemical components. He then theorized that these chemical conditions helped shut down normal ego drives; and to that extent, “they do open the doors to a wider perception.” Presciently, he saw it would be a huge misfortune if LSD got loose in the general public without careful preparation about what the drug is and what the meaning of its effects could be. “And do believe that I am perfectly aware of the dangers to A.A. I know that I must not compromise its future and would gladly withdraw from these new activities if ever this became apparent.”

As Pass It On noted, Timothy Leary and Richard Alpert (later known as Ram Dass), were experimenting with LSD at Harvard. Until that time, LSD experiments has been quiet and uneventful. Their work erupted in a scandal when two of the students in their studies, both minors, has distressing flashback experiences. Leary left Harvard and went on the be famous for the slogan, “Turn on, tune in, drop out.” He tried to get involved with Bill’s LSD work in the late 1950s, but Bill did not want to include him. Bill kept putting him off until eventually, Leary stopped asking.

In “Remembrances of LSD therapy past,” Eisner mentioned Leary in a December 1962 letter to Humphry Osmond, saying it had been fun to see Leary and Alpert. The two of them had been out to California for a weekend of lectures and workshops. She noted there seemed to be quite a movement gathering around Leary and Alpert for personal research in expanding consciousness. She said she was bothered by a separateness, or special sort of language that seemed to be developing with Leary and Alpert.  She then mused, “I wonder why so much of the drug work has led to fractionation rather than fusion.”

In a May 26, 1963 letter from Osmond to Eisner, Humphry said he was worried about Tim Leary, and found it hard to maintain contact with him. He said Leary had failed to get an adequate advisor on psychopharmacology and acted as if the powerful chemicals he was experimenting with were harmless toys: “They aren’t.” Osmond said in illnesses like alcoholism they may be harmless relative to the likely outcome, but that was something different.

In March of 1966 Time magazine reported that the US was suffering from an LSD epidemic. By June both California and Nevada had legislated against LSD, and by October, LSD was illegal in the whole country. All this was too much for Sandoz, which had been taking an increasing amount of flack because of LSD and psilocybin, and in April of 1966, Sandoz terminated all research contracts involved with the two drugs and indicated their willingness to turn over all their supplies to the FDA. For 26 years there was no more legal psychedelic research in the United States.

IF you are interested in reading more about Bill W. and LSD, try “Bill W. and His LSD Experiences Part 1,” or “As Harmless as Aspirin?” For more information on the therapeutic use of hallucinogens, see “Back to the Future with Psychedelics;” “The Unique Scientific Value of Ibogaine” Part 1, Part 2 and Part 3; “Ayahuasca Anonymous,” Part 1 and Part 2; “Psychedelic Renaissance?;” “Give MDMA a Chance?” and more.

10/27/20

Bill W. and His LSD Experiences, Part 1

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Bill W., the co-founder of Alcoholics Anonymous, has an acknowledged history of LSD use in the 1950s. This was when LSD was an unknown, experimental chemical, with no regulations or restrictions regulating its use. The A.A. published story of Bill Wilson and how the A.A. message reached the world, Pass It On, openly discussed Bill’s interest in LSD. It mentioned individuals who were known by or became friends to Bill—Gerald Heard, Aldous Huxley and Humphry Osmond—and who also happen to be important figures in the history of psychedelics. Yet by 1959, “Bill had personally withdrawn from the LSD experiments,” so that he would not compromise the future of A.A. But there is more to the story of Bill W. and LSD than what is found in Pass It On.

It began in the winter of 1943-44 when Bill and his wife Lois set out on a cross-country trip visiting A.A. groups that had sprouted up since the 1939 publication of the Big Book. According to Susan Cheever in My Name is Bill, Bill and Lois met Gerald Heard and Aldous Huxley while they were in Palo Alto, California and there was an immediate attraction between Wilson and Huxley. Heard and Huxley believed the betterment of society would come from an experiment in community and community education. Bill and A.A. were the practical application of that philosophy. Heard and Huxley invited Bill and Lois to spend New Year’s week at Trabuco College, a retreat center in the desert established by Heard to study comparative religion, and research meditation and prayer. The Wilsons returned to New York on January 22, 1944, but an important friendship was formed.

Pass It On said Bill and Huxley had an immediate rapport, one that Bill was immensely proud of. “They had much in common, although Huxley was not an alcoholic.” Huxley would later say he considered Bill to be a “modern saint” and “the greatest social architect of the twentieth century.” It was through Bill’s friendship with Huxley that Bill first heard about, and eventually decided to try LSD.

Humphry Osmond began his research with LSD and mescaline at St. George’s Hospital in London, where he was employed after WW II. In 1951, he moved to Saskatchewan, Canada to join the staff at Weybrun Mental Hospital. At Weybrun he organized the hospital as a design-research laboratory where he conducted a variety of studies into the use of hallucinogenic drugs. He was initially investigating the possibility that schizophrenia arose primarily from distortions of perception similar to those experienced by individuals under the influence of mescaline or LSD. But unexpectedly, Osmond began to see the potential of these drugs to foster mind-expanding, mystical experiences. It was during this time of experimentation that Aldous Huxley began a correspondence with Osmond and eventually asked him if he would kindly supply Huxley with a dose of mescaline.

In May of 1953 Osmond traveled to the Los Angeles area for a conference, where he provided the requested dose of mescaline and supervised Huxley’s experience with mescaline. Huxley would write The Doors of Perception (1954), which enthusiastically described his experience. He wrote: “The mystical experience is doubly valuable; it is valuable because it gives the experiencer a better understanding of himself and the world and because it may help him to lead a led self-centered and more creative life.” Gerald Heard tried mescaline in 1954 and then tried LSD in 1955. Heard felt that properly used, these psychedelics had the potential to enlarge a man’s mind, by allowing him to see beyond his ego.

Huxley and Heard would have naturally thought of what LSD could mean for Bill W., but Bill was initially opposed to giving drugs to alcoholics. In Pass It On, Osmond said: “I went down and was introduced to Bill and told him about it, and he was extremely unthrilled. He was very much against giving alcoholics drugs.” Huxley was apparently able to convince Bill of the mystical potential of LSD. Osmond reported that when alcoholics were given LSD, they reported having a new clarity of vision, a new vividness of experience. From his observations of the LSD work with alcoholics, Bill concluded LSD temporarily reduced the forces of the ego, which allowed the influx of God’s grace.

If therefore, under LSD we can have a temporary reduction, so that we can better see what we are and where we are going—well, that might be of some help. So I consider LSD to be of some value to some people, and practically no damage to anyone. It will never take the place of any of the existing means by which we can reduce the ego, and keep it reduced.

While Bill was debating the wisdom of trying it for himself, there were two other individuals taking the LSD plunge—a man and a woman who would have an important role in Bill’s exploration of LSD.

Dr. Sidney Cohen, a psychiatrist at Wadsworth VA Hospital in Los Angeles, first took LSD on October 12, 1955, reporting that the “problems and strivings, the worries and frustrations of everyday life vanished; in their place was a majestic, sunlit, heavenly inner quietude.” He immediately began doing his own research with Huxley. And on August 29, 1956 at Trabuco College, he supervised Bill Wilson’s first experience with LSD. Gerald Heard took notes; Aldous Huxley and Tom Powers, an A.A. friend of Bill’s from New York, stood by. According to Susan Cheever in My Name is Bill and the A.A. approved book Pass It On, Bill loved LSD and felt it helped him eliminate many of the barriers erected by the ego that stood in the way of his direct experience of God and the universe. It reminded him of his initial “hot flash” experience in Towns Hospital.

Betty Eisner, a psychology grad student, was Cohen’s initial research subject in 1955. As a result of her intense interest in his LSD work, Betty began meeting periodically with Sidney Cohen. A case report of her LSD experience was included in an article published in The American Journal of Psychiatry in July of 1958, “Subjective Reports of Lysergic Acid Experiences in a Context of Psychological Test Performance.” Eisner completed her Ph.D. by the end of July 1956 and was a coauthor of this paper along with Cohen and Lionel Fichman.

Eisner and Cohen began to think LSD could be helpful in facilitating psychotherapy, as well as curing alcoholism and enhancing creativity. They coauthored, “Psychotherapy with Lysergic Acid Diethylamide,” which was published in the Journal of Nervous and Mental Disorders in 1958. For a time, Bill W. was an integral part of their exploration of the psychotherapeutic benefits of LSD. Eisner maintained an active interest in hallucinogens throughout her career. Cohen would eventually become a director for the National Institute of Mental Health, but was always opposed to the counterculture movement’s use of LSD. He thought it was only safe when used under medical supervision.

In Part 2, we’ll look at the time period between the fall of 1956 and early 1957, what Eisner described as a boiling pot of activity surrounding LSD and mescaline. And Bill W. was in the middle of the pot.