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It is one of the richer ironies of psychedelic history that Kesey had his first LSD experience courtesy of a government research program conducted at the Menlo Park Veterans Hospital, which paid him seventy-five dollars to try the experimental drug. Unbeknownst to Kesey, his first LSD trip was bought and paid for by the CIA, which had sponsored the Menlo Park research as part of its MK-Ultra program, the agency’s decade-long effort to discover whether LSD could somehow be weaponized.

With Ken Kesey, the CIA had turned on exactly the wrong man. In what he aptly called “the revolt of the guinea pigs,” Kesey proceeded to organize with his band of Merry Pranksters a series of “Acid Tests” in which thousands of young people in the Bay Area were given LSD in an effort to change the mind of a generation. To the extent that Ken Kesey and his Pranksters helped shape the new zeitgeist, a case can be made that the cultural upheaval we call the 1960s began with a CIA mind-control experiment gone awry.

• • • IN RETROSPECT, the psychiatric establishment’s reaction was probably unavoidable the moment that Humphry Osmond, Al Hubbard, and Aldous Huxley put forward their new paradigm for psychedelic therapy in 1956–1957. The previous theoretical models used to make sense of these drugs were, by comparison, easy to fold into the field’s existing frameworks without greatly disturbing the status quo. “Psychotomimetics” fit nicely into the standard psychiatric understanding of mental illness—the drugs’ effects resembled familiar psychoses—and “psycholytics” could be incorporated into both the theory and the practice of psychoanalysis as a useful adjunct to talking therapy. But the whole idea of psychedelic therapy posed a much stiffer challenge to the field and the profession. Instead of interminable weekly sessions, the new mode of therapy called for only a single high-dose session, aimed at achieving a kind of conversion experience in which the customary roles of both patient and therapist had to be reimagined.

Academic psychiatrists were also made uncomfortable by the spiritual trappings of psychedelic therapy. Charles Grob, the UCLA psychiatrist who would play an important role in the revival of research, wrote in a 1998 article on the history of psychedelics that “by blurring the boundaries between religion and science, between sickness and health, and between healer and sufferer, the psychedelic model entered the realm of applied mysticism”—a realm where psychiatry, increasingly committed to a biochemical understanding of the mind, was reluctant to venture. With its emphasis on set and setting—what Grob calls “the critical extra-pharmacological variables”—psychedelic therapy was also a little too close to shamanism for comfort. For so-called shrinks not entirely secure in their identity as scientists (the slang is short for “headshrinkers,” conjuring images of witch doctors in loincloths), this was perhaps too far to go. Another factor was the rise of the placebo-controlled double-blind trial as the “gold standard” for testing drugs in the wake of the thalidomide scandal, a standard difficult for psychedelic research to meet.

By 1963, leaders of the profession had begun editorializing against psychedelic research in their journals. Roy Grinker, the editor of the Archives of General Psychiatry, lambasted researchers who were administering “the drugs to themselves and . . . [had become] enamored with the mystical hallucinatory state,” thus rendering them “disqualified as competent investigators.” Writing the following year in the Journal of the American Medical Association (JAMA), Grinker deplored the practice of investigators taking the drugs themselves, thereby “rendering their conclusions biased by their own ecstasy.” An unscientific “aura of magic” surrounded the new drugs, another critic charged in JAMA in 1964. (It didn’t help that some psychedelic therapists, like Betty Eisner, celebrated the introduction of “the transcendental into psychiatry” and developed an interest in paranormal phenomenon.)

But although there is surely truth to the charge that researchers were often biased by their own experiences using the drugs, the obvious alternative—abstinence—posed its own set of challenges, with the result that the loudest and most authoritative voices in the debate over psychedelics during the 1960s were precisely the people who knew the least about them. To psychiatrists with no personal experience of psychedelics, their effects were bound to look a lot more like psychoses than transcendence. The psychotomimetic paradigm had returned, now with a vengeance.

After quantities of “bootleg LSD” showed up on the street in 1962–1963 and people in the throes of “bad trips” began appearing in emergency rooms and psych wards, mainstream psychiatry felt compelled to abandon psychedelic research. LSD was now regarded as a cause of mental illness rather than a cure. In 1965, Bellevue Hospital in Manhattan admitted sixty-five people for what it called LSD-induced psychoses. With the media now in full panic mode, urban legends about the perils of LSD spread more rapidly than facts.* The same was often true in the case of ostensibly scientific findings. In one widely publicized study, a researcher reported in Science that LSD could damage chromosomes, potentially leading to birth defects. But when the study was later discredited (also in Science), the refutation received little attention. It didn’t fit the new public narrative of LSD as a threat.

Yet it was true that the mid-1960s saw a surge of people on LSD showing up in emergency rooms with acute symptoms of paranoia, mania, catatonia, and anxiety, as well as “acid flashbacks”—a spontaneous recurrence of symptoms days or weeks after ingesting LSD. Some of these patients were having genuine psychotic breaks. Especially in the case of young people at risk for schizophrenia, an LSD trip can trigger their first psychotic episode, and sometimes did. (It should be noted that any traumatic experience can serve as such a trigger, including the divorce of one’s parents or graduate school.) But in many other cases, doctors with little experience of psychedelics mistook a panic reaction for a full-blown psychosis. Which usually made things worse.

Andrew Weil, who as a young doctor volunteered in the Haight-Ashbury Free Clinic in 1968, saw a lot of bad trips and eventually developed an effective way to “treat” them. “I would examine the patient, determine it was a panic reaction, and then tell him or her, ‘Will you excuse me for a moment? There’s someone in the next room who has a serious problem.’ They would immediately begin to feel much better.”

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