Iseemed at one point to be in a brown, barren desert. I could see in the distance something small, dark, fluttering on the ground. It was one moth wing . . . attached to what had been a body but was now a small mound of earth . . .
"I saw a peacock feather move across my vision. The eye of the feather fell off and became a beautiful blue jewel and a teardrop at the same time, and landed on the moth.
"The moth came to life as a monarch butterfly, and I thought, 'Of course I would be a monarch, not some lesser moth or butterfly' . . . I felt I'd come back to life after years."
This vision came to cancer patient Maria Courie during a recent LSD trip. She used the drug -- lysergic acid diethylamide -- under a doctor's supervision as therapy for the anxiety and depression she experienced as a result of her battle with cancer.
Although surgery had removed her cancer in 1975, the then-50-year-old Washingtonian, fearing it would return, had become depressed. Traditional psychological therapies failed to help, so in 1981 she consulted Dr. Francesco Di Leo, an assistant clinical professor of psychiatry at the University of Maryland who has Food and Drug Administration approval to use LSD experimentally to help people cope with the emotions of cancer.
Under Di Leo's direction, she confronted her fears in three sessions with LSD.
When she thought of her cancer while on the drug, a black hole appeared. "I tumbled through that black hole and found myself lying in my crib, a baby, and my mother and father were going by a mile a minute," she recalled. "I was wiped, cleaned, bathed . . . but I wasn't really bonded, I wasn't really loved."
The scene shifted and Courie found herself visiting her mother in her coffin. "I told her it was all right for her to be a dead, I understood . . . while I regretted not having been a better daughter, I knew she'd regretted not having been a better mother."
Her mother dissolved into the peacock feather, which turned into the teardrop. Then a Robert Frost line, which had recurred throughout the session, reminded her that she "had to keep going on with this journey. I had 'miles to go before' I could sleep."
Other images, including her father trying to help her build stamina, led her to a mountain. "I finally got to the top, and there was this great golden light . . . I had a sense of having died and gone through several steps of judgment. This light ahead was somehow my mother, which then became like the Great Goddess, the Mother of all Time, a feminine something in what felt like a masculine void . . ."
The LSD sessions resolved her depression, Courie said. She overcame an abiding fear of death and developed an understanding that "life is sacred and precious."
LSD is a compound of lysergic acid -- a naturally occurring ergot (grain fungus) derivative -- and the laboratory-added synthetic diethylamide. In 1943, Swiss chemist Albert Hofmann apparently absorbed some through his skin (he was never quite sure what happened) and discovered the power of extremely small doses to trigger exotic visual phenomena, time-and-space orientation changes and intense emotional experiences.
"LSD seems to inhibit brain serotonin," Di Leo said. Since serotonin appears to affect brain activity, Di Leo and others believe LSD activates unused parts of the brain. "The net effect is like having dreams while you're awake. You're unlocking some network of mental energies usually closed to everyone but saints, psychotics or dreamers."
But with reports of suicidal "freak-outs" from street use, the drug was made illegal in the mid-1960s. Amateur use of black market LSD flourished. Scientific investigations -- now more stringently controlled -- dwindled.
Di Leo "fought to keep the embers of psychedelic research alive," said Columbia, Md., psychotherapist William Richards, a former colleague of the veteran LSD investigator.
"It's important work," said Harvard Medical School psychiatry professor Lester Grinspoon, adding that no similar research is under way in this country.
Di Leo, 45, has studied LSD since 1972. He first became intrigued by the drug as a medical student at the University of Southern California. After medical school he did research at the Maryland Psychiatric Research Center in Catonsville. Research at the center suggested terminal cancer patients, chronic alcoholics, narcotic drug addicts and severe neurotics enjoyed some short-term mental health benefits from one or a few well-controlled LSD sessions. Di Leo believes repeated treatments may actually help cure those problems.
Both earlier studies and Di Leo's current work suggest LSD has pain-killing effects as well.
Currently, under two FDA-approved projects, he's examining its impact on anxiety, depression and physical pain in cancer patients, and on depression and anxiety in subjects who are physically healthy. He said he has found most cancer patients don't experience physical pain during the treatment, and seem to need less painkiller afterward, possibly as a result of the improved mental outlook most subjects have reported.
"Depression and anxiety add a lot of pain," he said.
Di Leo's theory is that LSD activates a psychological healing process that could also occur by non-drug means, such as meditation, but with more difficulty. Di Leo said his current work differs in a critical way from previous research in that cancer patients receive multiple LSD sessions. (The study of depressed patients who don't have cancer has only begun and is limited to 10 treatments.)
The FDA's drug abuse staff chief, pharmacologist Edward Tocus, said he's skeptical the drug has potential for "any real therapeutic use, but that doesn't mean it shouldn't be investigated."
Jerome Levine, a University of Maryland psychiatric researcher who studied LSD for the National Institute of Mental Health, said LSD's psychiatric value has never been proved in controlled studies, except for what he called "weakly positive results" obtained in one Catonsville study of neurotics done before Di Leo came to the psychiatric research facility.
But, he said, "it may well be that in certain patients having a hard time coping with terminal illness and imminent death, the profound and moving nature of the LSD experience may help them have insights into life and dying. But not given as a medical treatment, maybe as part of a hospice movement . . .
"It might give them a different perspective," Levine said.
LSD's most therapeutic moment occurs with the occasional "peak" experience, when the subject feels merged with a "higher consciousness," said Di Leo. This experience is often later described in mystical or religious terms.
"LSD's so funny," said cancer patient Courie. "You're both doing it and watching it at the same time." As vivid mental images emerged during her sessions, she said, she felt out of control only once -- during the reliving of a life event in which she'd felt out of control. But her emotional experiences ranged from feeling "just awful" to feeling "absolutely blessed." Such a range is not unusual, Di Leo said.
"I don't see how anybody could use it recreationally," Courie said. "It's a rough drug."
As a result of her work with Di Leo, the two conduct non-drug-oriented personal growth workshops together. LSD can trigger amusing moments, too.
"At one point I was a beautiful golden eagle soaring through the sky on a sunny day," recalled Courie. "Then I ran smack into a bigger golden eagle who promptly beat me up. I fell with a thud into my nest, and then I was a baby golden eagle under my mother's wing . . . I realized the other eagle was my father, but he hadn't really hurt me, he'd taught me not to fly any higher than I was able to.
"I sat up and laughed and laughed . . ."
Di Leo is trying to predict which cancer patients might tend to have peak experiences, but he said so far no personality profile has emerged.
"If psychological tests could tell who might peak, then you could aim LSD therapy toward them," said Di Leo.
About half of the 11 cancer patients he's seen so far have peaked, he said. While even non-peakers seem to obtain mental health benefits, said Di Leo, peakers have more marked improvements in anxiety and depression.
The "peak" may be preceded by a devastatingly frightening experience of near-death called "ego death" by Di Leo and others. After this event, subjects may feel they know what real death will be like.
"You've confronted your fears, grieved for unfulfilled hopes and dreams, you've done a lot of emotional detaching, disconnecting -- and you may have this peak experience that somehow tells you that even when you face the end, when you enter that darkness and nothing is there, everything has stopped -- something else happens."
Former LSD researcher Levine expressed skepticism about the significance of LSD-triggered insights. "When you take people looking for change, who're stressed, it's not surprising they'll report various kinds of insights," he said. "If there's one thing that characterizes one of these LSD experiences, it's the feeling of profoundness or meaningfulness . . . It's a feeling that something very important has happened to you, but even if it does last, it doesn't seem to bring about lasting changes in behavior."
Washington psychiatrist Peter Bourne, who advised President Carter on drug abuse issues and is now president of the American Association for World Health, investigated the drug in the 1950s and holds mixed views about it.
"The general scientific conclusion was its usefulness was relatively limited," said Bourne. "But if there's one area in which it probably has some potential, it's in the death-related area -- for stable and emotionally intact people."
Attaining spiritual resolution before dying can be very important for religious people, said Bourne, and "LSD has the ability to hasten the resolution of religious, social and psychological loose ends."
But "LSD can be like going after an ant with a shotgun -- you don't know what you'll stir up," Bourne said. "It stirs up deep elements and demands one have the psychological strength to resolve them, but the elements can be overwhelming." But he said those elements "would take an enormous amount of time to resolve in conventional therapy."
Bourne said LSD therapy would hold more risks for depressed and anxious persons who are not terminally ill, because it may be hard to predict their capacity to cope with drug-triggered stresses.
"Hopefully, they would get some insights, but it might make the person profoundly worse," said Bourne, noting the well-publicized instances of LSD-catalyzed suicides.
But Di Leo said the inherently dangerous street use of LSD must be considered separately from its use in carefully managed LSD psychotherapy, in which a skilled therapist can handle unexpected episodes and be available for consultation afterward. He said the drug's nightmarish possibilities have gotten the most attention because that's the side most professionals see -- in hospital emergency rooms.
Bourne said LSD research has a modest, selective future.
"In the hands of someone using it regularly, who knows exactly what he's doing -- like someone approved by the FDA -- it probably is a useful drug in the right circumstances," he said.
Harvard Medical School's Grinspoon said if the public attitude toward LSD hadn't become so hostile -- as reflected in tightened research laws -- "We'd be a lot further along in knowing what this substance is useful for."
Much of that hostility was directed at former Harvard psychology professor Timothy Leary, who gained fame in the 1960s when he cheer-led the massive baby boom generation into extensive, unapproved private LSD research. Leary is now promoting his "Futique" computer company and a software product called "Mind Mirror." He resides in Los Angeles, lecturing mainly at engineering schools and sometimes publicly debating G. Gordon Liddy.
The FDA's Tocus said that while enough time has passed since the LSD "epidemic" to give the drug another look, "we're not as naive as we used to be. We're not looking for the magic gun."