The Bastiaans Method of Drug-Assisted Therapy
A preliminary follow-up study with former clients
Hans Ossebaard & Nicole Maalste
Bulletin of the Multidisciplinary Association for Psychedelic Studies, MAPS : 1999, Vol 9, N° 2, pp. 3-9
by a grant to MAPS from the Promind Foundation
The present pilot study is a preliminary investigation among former clients who participated in therapy supervised by Bastiaans and his collaborators (see MAPS Bulletin, VIII (2), p. 3; 1998) and conducted with the help of hallucinogenic drugs. This follow-up study aims to systematically establish the subjective judgements of clients, to work out a profile that correlates with success or failure of the treatment and to gain insight into the process of drug-assisted therapy. Moreover, we intend to map the possibilities for further follow-up studies for which we have obtained permission to make use of all the available relevant written and audiovisual archival material. This follow-up was conducted with the help of a small grant from MAPS of $5000 which permitted only a preliminary exploratory study.
Since the 1940s hallucinogenic drugs like mescaline, psilocybin and LSD have been utilized for therapeutic purposes. In the Netherlands the use of hallucinogens in psychotherapy was strongly, though not exclusively, associated with the work of psychiatrist Jan Bastiaans, a respected member of the scientific community at home and abroad (Bastiaans, 1974; 1977; 1979; 1982; 1986; 1987). His psychoanalytic background and his understanding of psychosomatics lead him to define the “KZ syndrome,” or Concentration Camp Syndrome. At the Jelgersma Clinic of Leiden University he treated hundreds of traumatized war survivors. The core of his therapy was to enable his clients to re-experience the traumatic event under therapeutic guidance and with the help of LSD or in some cases also ketamine or psilocybin. This kind of therapy was only indicated as a “last resort” option, when other interventions failed. The lysergic acid diethylamide (LSD) causes emotionally-laden hallucinations, affects ego-functioning and facilitates the recollection of past events and associated emotions. It also changes the perception of time-space dimensions. Ketamine and psilocybin have comparable effects on human consciousness. Dr. Bastiaans thought that clients with rigid defense mechanisms (“alexithymia”) would especially benefit from this treatment. The intended re-experience and re-attribution of meaning under therapeutic supervision were meant to catalyse the process of integration and the eventual recovery of these clients. Part of this process consisted of the patient’s listening to the audiotaped recording of the session.
During his career, Bastiaans and his staff members rarely evaluated and published the efficacy of their work. Moreover “Bastiaans’ method” became the subject of a public societal controversy. Opponents claimed his method could provoke psychoses or damage the brain. They questioned its scientific basis and sometimes criticized the psychiatrist and professor ad hominem. Proponents, mostly ex-clients, praised his expertise and commitment, and organized to defend him and his treatment. The government consulted the national Health Council to settle this delicate matter. After collecting the opinions from eight foreign experts, its advisory commission concluded that the use of hallucinogens in a therapeutic setting was no longer common practice because of the negative connotations of the non-medical use of LSD. Moreover, its clinical utility was presumed to be neither proven nor disproven. The commission thus urged that further empirical research be conducted (Gezondheidsraad, 1985). On appeal of the influential Bastiaans, who recognized the need for scientific investigation, the Ministry of Health financed a preliminary study of his prior work. This preliminary study took place during 1986-87. It was concluded that a quantitative retrospective study of Bastiaans’ work could not be conducted due to the lack of basic file data such as pre-treatment and post-treatment measures. Qualitative research, nevertheless, was deemed to be an important first step towards a rigorous prospective study (Van der Ploeg e.a., 1987). Applications for further investigations, however, were never approved (Boel & Boon, 1987), even though the controversy surrounding Bastiaans’ methods had calmed down. After Bastiaans’ official retirement in 1988, he gradually quit seeing clients and LSD treatment of severely traumatized patients came to an end in the Netherlands. Apart from Bastiaans’ work, Dutch research into the clinical use of LSD has been practically at a standstill since 1970 (Snelders, 1999). Contemporary scientific developments abroad indicate a revival of interest in the clinical use of hallucinogens (Mathias, 1993; Pletscher, A. & D. Ladewig; 1994, Greer & Tolbert, 1998, Grob et al., 1998). Against this background, a study of the work of Bastiaans could contribute to clinical studies in the field of drug-assisted treatments and may deliver valuable results that could be of benefit to interested psychotherapists and certain categories of patients.