May 14, 2011

LSD Visit To "Inner Space"

LSD - The Consciousness-Expanding Drug is the title of a classic anthology compiled by David Solomon in the mid-Sixties, that contained informative articles on the subject of LSD use by a cross-section of intellectuals and pop-culture figures of the day, including Aldous Huxley, Alan Watts, Timothy Leary, and William S. Burroughs. It became a best-seller; partly because it was itself a reactionary text written at a time when mainstream LSD use was coming under fire from the police, government, and the media, and partly because of the number of articles written by doctors and other experts that reported the amazing therapeutic effects of LSD use in psychotherapy as well as the treatment and care of alcoholism and other mental disorders. The Hippie revolution was in full swing, and people looked to comprehensive and authoritative-sounding work in order to justify their use of the drug as well as engage with others in debate and discussion. 

Solomon, in his preface, speak of his own LSD usage as well as experiments with mescaline and psylocybin:

"My first psychedelic experience was triggered by 400 milligrams of mescaline sulfate. It did indeed induce a flight, but instead of fleeing from reality, I flew more deeply into it. I had never before seen, touched, tasted, heard, smelled and felt so profound a personal unity and involvement with the concrete material world. My psychedelically accelerated mind did not merely grasp the symbolic poetic import, the utter simplicity and truth of William Blake's ecstatic vision: for the first time in my life I literally saw "the world in a grain of sand." My exponentially heightened awareness saw through the static, one-dimensional, ego-constricted, false front which is the consciousness-contracted reality of the everyday world. This was no evasive flight from, but a deep probe into reality."
One article by Houston Smith in the book discusses the religious import of LSD usage, and asks whether Prof. R. C. Zaehner's criticism of LSD-induced religious hallucinations as being of an inferior quality to the apparently genuine nature of 'authentic' religious visionary experience, is justified. I like the way he rebuts the question by, after briefly describing mystical drug usage in other religions, suggesting that to consider the phenomenology of the experience was more important than the ontology, fully aware of the limits of scientific research at the time and leaving it as an open question to be answered by future research.

The text also contains a rather long and experiential account of LSD intoxication by Alan Harrington, entitled 'A Visit to the Inner Space', after he embarked on a marathon trip with two friends:

"A twelve-hour session under the influence of the mind-dilating compound LSD-25 dispatched me on a trip through the cosmos inside my head. LSD enables everyone to become an astronaut of himself. During this flight beyond time into the depths of consciousness, to what must be the memory source of humanity, each of us can explore an inward universe filled with both violent and peaceful revelations ... Seventy-two hours after the night voyage, the emotional effect begins to fade. But details of the experience remain clear. Things seen by one's dilated eyes and the mind's eye will not be forgotten. Some of the more intellectual insights remain, too. I am speaking here of only one session—the initial, shocking one. You may be able to take off on other, much more easy, inward journeys. Unlike the first trip, these can be "programmed" to orbit you around a given life problem.
"A single LSD session will not be likely to produce a great and lasting change in one's life. But it shows the way to change. My first experience opened up paths of thinking that I never knew existed. I know that the vision revealed by psycho-chemicals can help overcome feelings of alienation and loneliness; it can make death appear somewhat less fearful. The common vision of immortality, revealed in one way or another to most people under LSD, indicates the possibility of my survival in some form, my ever-returning to life ... It began with a salty taste in my mouth, and my vision started to become prismatic. (One's pupils actually dilate and appear to be the size of quarters.) There was a pressure in my head. The curtains seemed to billow. There might be somebody behind them. The air crackled silently. I had a feeling of colored musical notes floating about, and the scene, I can remark now, was quite like a Klee drawing. I felt a bit queasy, but it passed. The music was louder and the guitar strings beautifully separated. Ralph was looking at me, and I began to laugh. I was going to flip on my tape recorder! What a ridiculous, hilarious thing to do! Why not, though? "Why not?" Frank said, and we both laughed. I couldn't stop. Everything that I could think about was insanely and pitifully funny. The world. The universe. All the poor sweet pitiful people I knew. Myself. What a scene! Filled with noble, ridiculous people! The world, the world!
"This reaction which is Cosmic Laughter was different from any way of laughing I had known. It came out of me as though propelled by a force much larger than the person laughing. It came right up from the center of my being. The force continued throughout the major part of the experience, no matter what I was feeling. It resembled both a mild and sustained electric shock passing through the body and spirit, and a mild and incomplete and continuing orgasm. A throbbing and rhythmic current which for want of a fresh image—and one is no longer afraid of being banal—could be described as the life force shakes you, as if you might be aboard or bestride, or being carried along with, the force that penetrates and then fills all being."
A lot of interesting things in this classic book, which may result in further articles here.

See Reality Studio for more information on David Solomon.

May 10, 2011

Michael J. Fox on Parkinson's Disease

Michael J. Fox is a much-loved actor most famous for his endearing roles in the Back To The Future trilogy, Teen Wolf, and the Vietnam-inspired Casualties of War. In 2005, he appeared on James Lipton's Inside The Actor's Studio to talk about his life and career. The last twenty minutes or so of the interview dealt with Fox talking about his diagnosis with Parkinson's Disease as well as his charity work and coping strategies.

I transcribed the relevant parts when it was broadcast on Sky Atlantic recently.
(The discussion develops from Michael's reminisces of his portrayal of hapless Deputy Mayor Mike Flaherty in the acclaimed sitcom Spin City)

James Lipton: Your final one-hour episode received the highest ratings in the show's history. What did you want to achieve in that final episode?

Michael J. Fox: There was a lot of personal stuff going on because I was leaving for health reasons and everybody knew that. And we were kind of dealing with this thing where people know your situation and you want to preserve the purity of the character, and the integrity of what we were trying to do in terms of presenting a fiction. You have to, on some level, find something very similar to it, and we did that in that [the character's] departure was not necessarily voluntary. And in playing that, it was the closest as I've ever been to line between my life and my work. That was the challenge that week and we were all really feeling the pressure. It was one of those things where we were rewriting it every day, trying not to make it too maudlin or over-emotional, but it was so affecting to all of us that it was a tough week.

JL: When did you discover that you had an illness?

MJF: I first felt the symptoms in 1990, but in 1991 I was diagnosed.

JL: As?

MJF: Parkinson's.

JL: And how did you deal with it during the show?

MJF: Well, the first couple of years was just trying not to let anyone know.

JL: How did you tell them?

MJF: It just got to a point where I couldn't hide it any more. I was afraid of the people I was working with, so I decided the time had come.

JL: Told the cast?

MJF: Yeah. (hand trembles as he sips water) As a matter of fact, can I take two minutes?

JL: Do.

MJF: (turns to audience) Because I couldn't do this, what I'm doing now. I need to take two minutes to wait for a pill to kick in.

(MJF walks offstage to take medication, returns few minutes later to applause)

MJF: (to JL and audience) That was basically what was happening during the show. When I was waiting for a pill to kick in, I was waiting to feel better and I knew there was a [full] house out there and I couldn't go out. And I couldn't say 'this is why I can't come out'. I thought, can I be funny if people know I'm sick? Is it OK to laugh at a sick person? So now, just to be able to say 'just give me five minutes' and then come back here and say 'I love it when the drugs kick in'. (audience laughter) So, you know? That's what I needed to do.

(The interview progresses to discussion about Fox's autobiography, Lucky Man)

JL: Where did the book's profits go?

MJF: Any profits I made went to the [Michael J. Fox Foundation for Parkinson's Research].

JL: And what does the Foundation do?

MJF: We're an aggressively entrepreneurial group that are trying to find a cure for Parkinson's.

JL: And how are they doing?

MJF: We're doing pretty good. We clearly haven't finished yet (audience laughter) but it's going really well. There's an amazing group of people that are working on it and amazing support from the public. We've been able to, in the last four years, put $50million towards research. (Audience applaud) Thank you.

JL: (to audience) Michael has said that the biggest thing is that I can be in this situation and love life as much as I do.

MJF: Well, it's funny, it's really not that bad. It's kind of like, as I was saying to my son the other day, it's a disease that makes you uncomfortable. So, all things considered, that's not too bad. I've described it as a gift, and people say to me 'how can you say it's a gift?' I say out loud it's a gift that keeps on taking. (Audience laughter) But it's still a gift that makes one alive. Again, to see what I've lost makes me look at what I've gained and what I have. So it's a tremendous opportunity and for that, I'm really lucky that I'm in this situation where I can help, because people have a relationship with me and feel they know me because of my work. But that goes to the fact that I've been able to do the work and have those relationships in the first place. And if that doesn't make me lucky, I don't know what does.

(Later in the interview, Fox fields questions from the audience members. One question asked further about his Parkinson's Disease.)

Audience Member: Hi, my name is Megan. I'm a first-year actor, and I just ..(cries).. I just wanted to say you're a great inspiration to me. About the same time when you came out and told everyone, I was diagnosed with dystonia which is neurological, covers like half your body. And it was wonderful to see that there could be people out there in the industry who were doing what they loved to do, even if they might be affected by it. So I just wanted to say thank you so much because, having the opportunity to meet you, it means a lot.

Michael J. Fox: Thank you.

Audience Member: (continues) And I also wanted to ask how ... (giggles)... because you're Michael J. Fox and I'm just Megan from Arizona who doesn't know anything or know anyone, how realistic is it for you to come out and tell everybody about what you have and about your disability, and be so open about it?

Michael J. Fox: Well, in a lot of ways my disease made me, once again, Mike Fox from Burnaby. It's a great leveller in a way. One of the things I had difficulty with was when I tried to put people at ease about how I felt and how I was OK with it, and that it was my reality and I accepted it, is that I didn't want to say it's a piece of cake or water off a duck's back. In a way that's a slight to people who really struggle with it and don't have the advantages I have, and have to worry about losing their insurance and their jobs, and have to worry about other people's perceptions. Shortly after I made my situation public, someone said "Oh yeah, that's what Michael J. Fox has", and they felt it made them easier to carry on in this world. That's a tremendous privilege and gift to me to be in that situation. It's purely not my design, it's the way it's worked out. 

I think in anything, we're talking about acting, but in life too it really is ... just be honest and do the next right thing, and you'll know what the next right thing is for you. Dystonia is really a challenge. I sometimes get facial dystonia which is awful. It's like, imagine eating a lemon and the face you make, it's stuck like that for half and hour, 45 minutes, and it's quite painful. You just have to go to another place in your head and wait it out until it's done. And it's all about accepting and surrender and saying this is something - not to get too 12-Step - but it's what's in my power, what's in my control. Do I have to throw in the towel and have a tantrum about it? Or kill myself? Or what? None of these are acceptable to me. The only one that's acceptable is to go on and see what happens. And what I find cool is that there is great stuff out there, when you walk through this stuff, when you walk through this fear, when you walk through what people are gonna think about it, or what's gonna happen. Well, something's going to happen and we don't know what is, but chances are at least 50/50 that it'll be pretty good. So I'm willing to take that risk.

May 3, 2011

Future of Clinical Psychology in the NHS

Nature (21 April 2011 edition) recently ran a series of special articles on the future of the PhD., all of which asked serious questions about the value of the doctorate in a job market that no longer appears to properly compensate the hard work of students with rewarding careers of their choice. Mark Taylor's editorial was quite frank: "Reform the PhD. system or close it down", suggesting updated and relevant curricula as well as cross-disciplinary communications as ways to move forward, and to discontinue 'redundant' programmes and use their resources for more productive lines.

Noah Gray, a senior editor at Nature, elaborated:
"..At some point we have to expand our view beyond academia and ask which jobs really need a PhD. and which don't. Academia asks a lot from its graduate students and isn't prepared or capable of providing a return on the investment of blood, sweat and tears made by the students. It only seems logical to contract somewhat, for the good of the students who are not aware of this difficult reality, rather than continue to exploit masses of under-compensated labor who may ultimately invest far more energy and time into a endeavor that will not place them in an adequate career."

In general it sounds a lot worse than it is; assuming that the ideas discussed in this series come to fruition, it becomes mainly an attempt at streamlining rather than wholesale cutting down.

It got me pondering the situation in the UK. Two years ago, the Feb 2009 issue of Clinical Psychology Forum (forum magazine of the Division of Clinical Psychology of the British Psychological Society) published an interesting article/study regarding the future of clinical psychology placements within the NHS. While it is well known that clinical psychology is a highly competitive area and that more applications are turned down than accepted, there seems to be newer causes for worry other than excellence in academia or training. Harriet Francis-Ehnholm and Tanya Petersen (hereafter "the authors") introduce the topic by describing their attempt to undertake a survey of ClinPsy. trainees and their opinions about clinical psychology during a conference held at the University of Hertfordshire. In the 1990s a shortfall in NHS clinical psychologists was remedied by increasing the number of training places, 583 places were available in 2007 which was a huge improvement from 321 places in 1997. (The situation has improved since; Leeds Clearing House report 617 places were available in 2010, although it is humbling to note that 11,319 applications were made.) However in the face of funding cuts the reduction in the number of clinical psychology posts results in fewer clinical placements for those already in training, leading trainees to wonder about the availability of jobs after completing the course.

To get an idea of the trainees' views, the authors carried out a survey questionnaire that covered three main topics:

  • What were trainees' thoughts about the future of the profession?
  • Had working in an 'uncertain' climate affected trainees' views of clinical psychology?
  • How does the next generation of psychologists intend to make the future more certain?
The surveys were distributed to the sample of 40 trainees, though only 24 returned a response! The results were more or less what one would expect: before the commencement of training job and security expectations were varied, which significantly narrowed after embarking on training and which resulted in envisaging a more constrained career path along with less security and choice. The interesting thing is that despite experiencing negative effects of funding cuts such as low morale and the threat of job cuts/service closures, all of them indicated that they still wanted to continue training to be clinical psychologists. Although it came to light that trainees felt they might benefit from advice on alternatives to working in the NHS and also on how to market the profession effectively to the public, they remained generally optimistic about the future of clinical psychology.

The authors concluded that while University of Hertfordshire trainees were fortunate not to experience the effects of any cuts in training places, they nevertheless experienced the effects of NHS funding crises on their clinical placements and of working in a climate of uncertainty. Now that things have moved on from 2009, that climate is sure to have worsened with service cuts, poor results and the resultant low morale that has emerged in clinical services across the board. A recent blog at The Psychologist by Christian Jarrett reports a disconcerting outlook for psychology as a whole in the UK as a result of the Conservative-Liberal Democrat coalition government's spending review; a 50% slashing of PGCE Psychology places, research councils announcing a redirection of neuroscience-allocated funds in line with their research priorities, and a possible restructure of client services.

It all begs the question as to what clinical psychology trainees might think now in this bleaker situation. If the authors' snapshot article is anything to go by, the anxiety and stress felt by current trainees is likely to be amplified even more in this uncertain situation of global economic worries. However, a surprising suggestion of the authors is for the NHS to modify their programmes and training accordingly, even to the extent of suggestion that trainees be provided with teaching in private practice and how to set about this type of work, in spite of the fact that this may cause a conflict of interest (you know, getting trained by the NHS to work in the NHS and then uh,... not doing that).

Considering all of this, what can prospective clinical psychologists look forward to? More uncertainty? Faint light on the horizon? Is it time to call for an open discussion?