Obituary for Ronald Sandison, M.D., 1916-2010

Winter 2010 Vol. 20, No. 3 2010 Annual Report

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ON JUNE 18, 2010, Ronald Arthur Sandison, M.D., ‘Ronnie’, died peacefully at home attended by his wife Beth. He will be remembered fondly by both the mainstream medical community and by the small but growing psychedelic research community as a doctor whose pioneering work bridges these two seemingly disparate fields.

He was born in the Shetlands, a tiny outcrop of weather-beaten islands 200 miles north of Scotland. He started his pre-clinical studies in 1934, and during World War II served with the Royal Air Force as a physiologist studying the effects of high altitude in Spitfire bomber pilots. In 1945 he became a trainee psychiatrist at Warlingham Park Hospital, Surrey, where he developed what was to become a life-long interest in Jungian psychology. The fantasies and dreams patients experienced during insulin coma therapy, which with ECT and lobotomy were then popular treatments for psychiatric patients, fascinated him.

In 1951, he applied for his first consultant post and moved to Powick Hospital in Worcestershire, then a bleak and dilapidated 19th century psychiatric hospital with over 1,000 patients. He introduced a broader range of psychotherapeutic methods to the treatment program.

In 1952, whilst on a tour in Switzerland, he visited the Sandoz laboratories in Basel. Dr. Sandison had no prior knowledge of the work being done by Albert Hofmann and his colleagues on the then-experimental compound LSD, but was fascinated by what he saw. After a second visit a few months later, he returned to the U.K. with 100 vials of Delysid (the pharmaceutical name for LSD-25) given to him by Hofmann, making Dr. Sandison the first person to bring LSD into Britain.

At that time, LSD had only been used by a handful of people, but there was already a theoretical basis for using the drug as an adjunct for psychotherapy. Impressed by the reports of LSD’s effects in altering human consciousness, Dr. Sandison felt it could be of use in unblocking his patients who were unable to progress in various stages of psychoanalysis. It was certainly a remarkable drug, being virtually inert physiologically, with no addictive or physically toxic qualities, yet immensely powerful as a psychotropic agent at minute doses.

He began giving LSD to his patients before their psychotherapy sessions, initially at a dose of 20 micro-grams, building up the dose depending upon their response. Some patients required only a few sessions with the drug; others had weekly doses for longer periods of time. He noticed immediate positive results, even with the most unremitting cases who had failed to respond to previous treatments. Dr. Sandison recognized three core features of the LSD state that aided psychotherapy:

1. The patient had hallucinations of a dream-like quality, which far from being chaotic, directly reflected their personal unconscious mind.

2. The patient was able to relive forgotten memories.

3. The patient experienced impersonal or collective unconscious images.

In 1954, the same year that Aldous Huxley published The Doors of Perception, a popular account of his mescaline experience, Dr. Sandison published a paper with colleagues Spencer and Whitelaw describing the use of LSD-assisted psychotherapy on 36 patients with severe neurotic disorders, in which the treatment was overwhelmingly helpful and no serious or enduring adverse effects were observed.

In 1955, Dr. Sandison developed the world’s first purpose-built LSD unit on the grounds of Powick hospital. The new building allowed for up to five patients to receive LSD therapy simultaneously, each in their own room equipped with a couch, a chair, a blackboard for recording images, and a record player. Dr. Sandison and his team would oversee the sessions and at the end of the day patients would come together for a group session to discuss their experiences.

LSD therapy quickly became a much talked-about treatment and the Powick model became the blueprint used in many clinics springing up in Britain and across the world. In 1955, Dr. Sandison travelled by ocean liner to speak at the American Psychiatric Association about his work. And in 1961, he was invited to edit the minutes of the quarterly meeting of the Royal Medico-Psychological Association which was devoted entirely to hallucinogen therapy. At this point LSD therapy was at its peak, considered to be “the next big thing” in modern psychiatry, possibly to supersede ECT, insulin therapy, and psychosurgery as an effective tool for psychiatrists.

But as the Sixties progressed the drug became increasingly abused. Countless ßpeople used LSD in non-medical circumstances without the safeguards practiced by clinicians. Like many psychiatrists at the time, Dr. Sandison reluctantly had to distance himself from LSD as the growing media attention and reports of unsafe usage appeared. The drug was made illegal in 1966 and although recreational use continued, the controlled clinical use ground to halt almost everywhere.

In 1964, after twelve tiring years dedicated to seeing thousands of patients through LSD-assisted psychotherapy, Dr. Sandison ended his work at Powick and took a job at Knowle Hospital near Southampton. Frustrated by the psychiatric profession’s increasing dependence on daily-prescribed psychotropic drugs, he found himself gravitating towards psychotherapy. He joined the Group Analytical Society and for the next ten years ran workshops offering group therapy. Other projects included developing a therapeutic community and a day hospital. He remained dedicated to keeping psychotherapy firmly embedded in psychiatric practice in the National Health Service and taught group dynamics at the University of Southampton, where he encouraged registrars to take diplomas in psychotherapy and recruited medical students to the newly formed Southampton Medical School.

Between 1975 and 1982, Dr. Sandison returned to his native Shetland to overhaul the threadbare psychiatric services there, visiting patients in their homes on remote islands. For the last ten years of his working life he returned to London, edited the journal of the Group Analytical Society, and used his psychotherapy skills in the field of psychosexual medicine and family planning at the Margaret Pyke Centre, before retiring in 1992. He spent his last eighteen years living in beautiful country surroundings of Ledbury in Gloucestershire with his wife Beth.

He described the 20th century as “a century of psychotherapy” and strove to explore many manifestations of it. Despite his broad career, he will be remembered by many for his pioneering work with LSD. He considered the contemporary use of medication to mask symptoms in stark contrast to LSD, which when used carefully in a controlled environment allowed psychic material to be worked through in a positive psychotherapeutic environment. In Albert Hofmann’s book, LSD: My Problem Child, he credits Dr. Sandison with coining the term “psycholytic,” to mean “mind loosening,” which Dr. Sandison always preferred to the heavily popularized word “psychedelic.”

I got to know Ronnie in the last five years of his life when we worked together on a couple of projects, including planning Royal College symposia about contemporary hallucinogen therapy and a BBC documentary on LSD. Like Hofmann, Dr. Sandison was thrilled to discover that in recent years his subject, which he had loved so dearly at the beginning of his career only to see it harshly demonized later, is now being re-explored with new research.

He was a deeply compassionate and caring doctor, not afraid to thoughtfully push the boundaries of tradition in order to explore potential new health benefits for his patients. A true pioneer in medicine, he will be missed.