Hanscarl Leuner
Pioneer of Hallucinogen Research and Psycholytic Therapy

Torsten Passie, M.D., M.A.

Hanscarl Leuner was born in January 1918 in the City of Bautzen in Germany. He was the only child of a leatherware factory owner. His father intended for him to take over the factory, but after going through three years of training as a harness maker there were some doubts about his qualifications as a businessman.

In searching for his own field of interest Leuner became interested in psychotherapy. Upon meeting him, the prominent psychologist Fritz Künkel recommended that he should study medicine-and "forget the half of it afterwards"-and to go through the educational process of a psychotherapeutic institute.

He studied medicine at Frankfurt University and Marburg University (1939-1946), interrupted by his military service in World War II. In these years he studied the autogenic training methods developed by J.H. Schultz and the medical psychology of Ernst Kretschmer. From these two approaches Leuner set up his special interest in mental imagery and "catathymic influences," or the interaction of mental contents and emotional processes.

In 1946 he began his educational psychoanalysis with the Jungian psychotherapist Professor Dr. Schmaltz. This humorous and very human teacher facilitated Leuner's interest in the action of dream symbolism and the power of so-called transference in psychotherapy.

His clinical education in psychiatry and neurology was influenced by two major impressions: the assimilation of the subtle psychopathological approach of his teacher, Klaus Conrad ("conditional-genetical and functional psychopathology"), on which he later based his monograph about experimental psychoses; and the curious opposition of most of his psychiatric colleagues against psychotherapy. The latter led him to make attempts to prove the principles and efficacy of psychotherapy in a scientific manner. After a short period of orientation his special interest focused on the symbolization processes in dreams and daydreams. In the periphery of the literature he found a reference about inducing daydreams with imaginative elements in a conventional psychoanalytic couch- setting. Consequently, he conducted a series of experiments about the relationship of emerging symbol-constellations in mental imagery and the basic conflicts of the individual. In this process he discovered the potent therapeutic effectiveness of psychotherapy with guided daydreams. Later, he facilitated the process by giving the patients standard motifs such as "mountain," "river," or "flower" to start their imaginary trip with. In the early fifties, he developed a standardized treatment technique based on this research, and named it "Guided Affective Imagery."

Leuner's personal capacity to observe sensitively and subtly describe intrapsychic emotional processes made him able to use mental imagery to stimulate emotional catharsis, in contrast to the mostly cognitive verbal psychotherapies.

As a result of his experiments with guided mental imagery, Leuner developed in 1955 the idea of intensifying and facilitating cathartic emotional processes by the use of low doses of LSD-25, which was known at that time to induce daydream-like states of consciousness and nonspecific affective stimulation. Over the next five years, he conducted more than 1,300 individual sessions with different hallucinogens (LSD, mescaline, psilocybin, atropin derivatives, etc.) with neurotic patients and normal volunteers. Through precise observation of these experiments he gained the empirical foundations for his principal model in his monograph, The Experimental Psychosis (1962). Leuner used the most advanced psychopathological approach of his time to theorize about the LSD reaction-not because this elaborate theorizing seemed most appropriate to him, but mainly because it seemed to be the only possible way to bring the unusual experiences of his subjects to the attention of the scientific community. His strictly scientific model should also serve to demonstrate that these experiences have their own specific laws and structures which can be conceptualized by accepted psychopathological theories and could be controlled by educated physicians.

One of the main concepts derived from this comprehensive study was the empirical consideration of three different courses which the LSD reaction can take: the continuous-scenic course, the stagnant-fragmentary course, and the extreme psychotic course.

It is not possible here to go into detail about them, but the main importance of this empirical finding lies in the fact that the type of course is mainly a function of the dose of the substance, provided the setting is safe. This means the principal course of the experience can be controlled by individually adjusted doses. This is especially important in psycholytic therapy where it is necessary to retain an "ego-residue" in the patient to make him able to reflect and partially control the ongoing experience. This is possible only in the "continuous-scenic course." In view of the psycholytic pioneers only this course with its specific attributes is usable for therapeutic processing and allows the patients to explore their unconscious freely and without dangers of (re-traumatizing) overstimulation.

A relationship of trust between the doctor and patient and a warm atmosphere of the treatment facilities are also necessary for healing. Another main concept of Leuner's comprehensive monograph is the "Psychotoxic basic syndrome" which characterizes the basic psychopathological features of the LSD reaction:

1. Functional regression of psychic functioning to earlier stages.
2. Changes in consciousness from normal waking consciousness to "protopathic" consciousness (Conrad) which implies stronger involvement of emotions in determining perceptions and contents of consciousness and autosymbolic visual imagery. Leuner made scientifically evident the similarity of contents and symbolization processes in hypnagogic imagery and the "continuous-scenic" course of low-dose hallucinogenic drugs.
3. Amplification of endogenous stimuli-production, especially sensory alterations and nonspecific affective stimulation.

Another intention of Leuner's work was to prove the close relationship between the contents of hallucinogen-induced experiences and the history of the individual. For this purpose, serial sessions with neurotic patients were especially useful and led him to the first publication, Psychotherapy in Model-Psychoses, in 1959. The patterns of emergence of events from the patient's personal history seemed to be astonishingly consistent. Leuner conceptualized this coherence in upcoming unconscious conflicts in respect to memories as generated by "transphenomenal dynamic guiding systems." These systems constellate complexes of memory material and emotions and structure the emerging unconscious material in the psycholytic process. This concept is related to the "psychic complexes" of Eugen Bleuler and Sigmund Freud. Later the famous LSD therapist Stanislav Grof hypothesized about "systems of condensed experiences" (COEX- systems)" which may try to explain the same thing. This obvious involvement of coherent personal contents in psycholytic experiences strictly differentiated these states from other types of "exogenous psychoses," i.e. psychoses produced by massive biochemical aberrations of organismic functioning.

In 1960 Leuner transferred from Marburg to Gšttingen University and established a psychotherapy department there. Impressed by the therapeutic possibilities of hallucinogen-assisted psychotherapy, Leuner initiated in 1960 the First European Symposium on Psychotherapy under LSD-25 at Gšttingen University. Experienced colleagues came from Denmark, the Netherlands, England, Norway, Czechoslovakia, Italy and Germany. At this occasion the leading psycholytic therapist from England Ronald Sandison proposed the name "psycholysis" (i.e. "soul-loosening) or "psycholytic therapy" for the new method which was unanimously accepted by all participants. This term is still in use in Europe today. The next European symposium, Hallucinogenic Drugs and Their Psychotherapeutic Use, was initiated by the British Royal Medico- psychological Association in London in 1961. After this meeting, Leuner tried to organize interested psychotherapists in the European Medical Society of Psycholytic Therapy (EPT) which was founded in 1964. At this time psycholytic therapy was practiced in 18 European treatment centers and by many out-patient private-practice psychotherapists. It seemed to be a scientifically established effective and safe treatment with an extremely promising future. In many severely disturbed neurotic patient, to which most psycholytic therapists devoted their efforts, the new method proved to be especially effective.

In 1965, when the nonmedical use of psychedelics reached its first height, Leuner was invited by the American National Institute of Mental Health (NIMH) to do expert evaluations on the few remaining American research projects involving hallucinogens. Unfortunately, at the end of the sixties, in the emerging world of drug hysteria and governmental suppression of legitimate research, most researchers world-wide were "voluntarily" leaving their original field of investigation because of negative headlines about LSD and moral recriminations by their colleagues. Out of that reason the EPT was dissolved after its fifth symposium in 1971.

Nevertheless, Leuner retained his license until his retirement in 1986. Ever since he became a professor at Gšttingen University in 1965, his daily routine included psycholytic therapy at his psychotherapy department. He focused on the treatment of so-called "therapy-resistant" chronic severely neurotic patients and developed the "stationary interval treatment," where the patient is in out-patient psychotherapy and is only briefly hospitalized for the psycholytic sessions. In this way the patients can be observed long enough after enough session at a lower cost. A similar model was practiced at many British "day hospitals" during the sixties.

Leuner also conducted basic research on different topics with normal volunteers and patients. There is not enough space here to show the broad scope of research with hallucinogens conducted by Leuner and his colleagues at his department but here is a list of major projects:

• consciousness disorders in experimental psychoses;
• toxic ecstasy in intercultural perspective;
• therapeutic mechanisms of psycholytic therapy;
• oral regression under the influence of hallucinogens (dissertation by Fernandex-Cerdeno, 1964);
• the womb and birth motif in experimental psychoses (dissertation by Schmeling, 1965);
• international review of evaluation studies of psycholytic therapy (dissertation by Mascher 1966);
• clinical safety and psychopathological studies of the psilocybin derivatives CZ-74 and CEY-19 (dissertation by Baer, 1967);
• similarities of low-dose experimental psychoses and beginning schizophrenia (dissertation by Schšnfelder, 1967);
• chromosome studies in psilocybin patients, problems of misuse of LSD;
• significance of hallucinogenic experiences for the psychology of religion (book by Josuttis/Leuner, 1972);
• catamnesis efficacy studies of the psycholytic patients in his department (dissertations by Mascher, 1966, and Schultz-Wittner, 1989);
• experiential contents of the anal phase of psychic development in psycholytic therapy (dissertation by Adler, 1981);
• dream-like experiences under the effects of ketamine (dissertation by Bolle, 1985); and
• psychotropic effects and therapeutic use of the phenethylamine DMM- PEA (LE-25) (dissertation project by Schlichting, 1985).

Most research was published in international journals and Leuner's monograph entitled Halluzinogene (1981). Of special significance for the future may be Leuner's meticulous studies into the efficacy of psycholytic therapy and the introduction of the short-acting substances CZ-74 (a psilocybin derivative) and LE-25 (a phenethylamine). Both are easy to use and produce virtually no side-effects. They seem to be the ideal substances for future applications of psycholytic therapy. Unfortunately Leuner's attempts to use MDMA in psychotherapy studies were rejected by the German Ministry of Health in 1985.

Non-drug therapies

Beyond his hallucinogen research, especially since this research was internationally restricted, Leuner was very engaged in propagating and establishing his "Guided Affective Imagery" psychotherapy system in the German-speaking countries. He founded a central organization, created standardized education guidelines, held workshops and published steadily on the subject. Today, this system is well established in the German psychotherapeutic community. His books about it are translated into several languages.

Since the middle of the seventies, he also put much energy into the creation of an electronically-aided respiratory feedback system (RFB). This device was developed to help psychosomatic patients to reach states of deep relaxation similar to those achieved with autogenic training in a minimal time-span. Until now, this "non-pharmacological medicine" proved to be an effective treatment for cases of hypertonia, neurotic anxiety, sleep disturbances, terminal pain and other tension states. In the past ten years he conducted some scientific studies and wrote a new book about this method. Leunomed respiration feedback devices are used by approx. 4,000 physicians in Europe and the United States today. In 1985, together with other important researchers in the field, Leuner founded the European College for the Study of Consciousness (ECSC) and acted as its president. This international organization brought researchers together to share information, organize congresses and educate the general public (see MAPS newsletter, Vol. 4, no. 4, Spring 1994). Since its founding, the ECSC has initiated seven symposia on specific topics and two major international Worlds of Consciousness congresses. From 1991- 1996, Leuner and Michael Schlichting, MD edited the Yearbook of the ECSC. In his seventies, Leuner was still doing psycholytic work, when I had the opportunity to work with him for some time. It was an elucidating experience, because he knew how to create the the necessary warm and comfortable atmosphere in his treatment rooms and in his handling of patients, who came in a range of characters, professions and ages. Most of them suffered from severe neurotic disturbances and couldn't be treated by conventional methods.

His personal appearance was that of a wise old man. Thanks to his unfaltering sense of humor and willingness to approach individual problems with empathy, he helped many patients out of their negative "father transferences." He had a special kind of relaxed attentive seriousness which helped patients to work through their experiences and problems. Interacting with his patients with a youthful and humorous temperament, he organized the therapeutic processing with playful authority and unconventionality.

He suffered a heart attack in February, and after recovering from it he developed other health problems in June and died after a short time of hospitalization.

In his late years, the grandfather of psycholytic therapy was still sad about the fate of this powerful method of therapy and hoped for a more serious public assessment in the future. The future will show if his hopes, partly embodied in the European College for the Study of Consciousness, will be fulfilled.

Selected Bibliography

Monographs:

1. Die Experimentelle Psychose. Berlin/Gšttingen/Heidelberg, 1962; Second ed. Berlin, 1996.
2. Halluzinogene. Bern/Stuttgart/Vienna, 1981.
3. Guided Affective Imagery: Mental Imagery in Short-Term Psychotherapy. New York, 1984.

Articles:

1. Effects of Psychotomimetics. In: Kline, N.S. & Lehmann, H.E. (eds.): International Psychiatry Clinics: Practical aspects of pharmacotherapy. New York, 1965.
2. Basic Functions Involved in Psychotherapeutic Effects of Psychotomimetics. In: Brill, H. & Cole, J.C. et al. (eds.): Neuropsychopharmacology. Amsterdam,1967; pp. 445-448.
3. Hallucinogens as an aid in psychotherapy: Basic principles and results. In: Pletscher, A., Ladewig, D. (eds.): 50 Years of LSD. Current Status and Perspectives of Hallucinogens. New York/London 1994, pp. 175-190.
4. The role of imagery in psychotherapy. In: Arieti, S., Chrzanowski, G. (eds.): New Dimensions in Psychiatry: A World View. New York/London/Sydney/Toronto 1975.
5. Guided Affective Imagery: An Account of its Developmental History. In: J. of Mental Imagery 1 (1977), pp. 73ff.