The Untold Story of Women Psychedelic Therapists: 5 Questions with historian Zoë Dubus
Dubus discusses how three women changed how LSD was given to patients.
You’ve likely heard of Albert Hoffman, Timothy Leary, Aldous Huxley, and Humphrey Osmond as important figures in the psychedelic scene of the mid-20th century. Perhaps the names Sidney Cohen and Walter Pahnke, the therapist and researcher, are familiar too. What about Margot Cutner? Betty Eisner? Joyce Martin? In the 1950s and 1960s, these three women treated thousands of people, usually with LSD, and revolutionized the way psychedelics were administered. Yet their names have been largely forgotten.
Zoë Dubus, a historian at the French National Institute of Health and Medical Research in Paris, is trying to change that. Her research focuses on charting the medical uses of psychoactive substances over time. One of the women Dubus has been tracking is Margot Cutner, a psychoanalyst and philosopher who started doing LSD therapy at Powick hospital in Worcestershire in the 1950s. Yet it wasn’t until this month, seven years into studying her, that Dubus managed to source her photo from a man who responded to an ad that Dubus placed online, while searching for anyone who had known her.
Among the other women Dubus is trying spotlight is Joyce Martin, a Freudian psychoanalyst and early LSD therapist at the Marlborough Day Hospital in London. Another is Betty Eisner, an American psychologist who practiced in Los Angeles, and who is often credited with developing the guidance that both a man and a woman therapist should be in the room with a tripping patient.
The Microdose talked to Dubus about the rich and complex legacy of these three women psychedelic practitioners, how their work led to the creation of “set and setting,” and changed ideas about therapists touching clients.
We’re going to talk about the therapeutic techniques of some lesser known women psychedelic therapists: Joyce Martin, Margot Cutner, and Betty Eisner. First can you give us an idea of what psychedelic therapy was like before they started working?
A lot of the methods developed by these therapists have been adopted without ever crediting their names. For example, Better Eisner was the first to say that patients should never be left alone, that sessions should take place in a space that feels warm and welcoming, that music should be used, and so on. These women contributed a great deal to psychedelic therapy and have been completely erased from this history. It’s rare to see them quoted in clinical trials involving their techniques.
To really understand the process and the importance of what these women brought into the history of psychedelics, we have to go back to the period before psychedelics were used—the 1930s. It was a time when psychiatry didn’t have any medication to relieve mental illness, and in this context, doctors came up with the idea of what they called shock therapy.
It followed an observation made during the First World War that when some soldiers came back from the battlefield, they were completely traumatized. Sometimes, if they were exposed to a shock, they would recover. Techniques were developed, like electroshock therapy, putting patients into comas and waking them up, and even lobotomies, for instance. These were really violent techniques, but they did work in some cases. It was the only thing that a psychiatrist had at the time.
When mescaline and LSD started to be used in psychiatry, they were initially used as a shock method. They would take the patient, not explain anything about the drugs’ effect, inject them with very high doses, and leave them in the empty room with bright light for several hours.
Very quickly, many doctors in England and Canada, and throughout the western world, stopped doing this. They didn’t want to traumatize their patients. They realized that the method didn’t actually work, and they started looking for something else. In 1954 in England, the psychiatrist Ronald Sandison was the first to propose a method of psychedelic-assisted psychotherapy. It was no longer about shock at all. The method, on the contrary, was to try to encourage and to support the patients to develop what we now call set and setting, the technique to reassure the patients.
In this new therapy, the person who was responsible for reassurance, for instance, putting the hand on the forehead of the patient or taking their hand, it wasn’t the doctors who had this responsibility. It was a nurse. At that time, physical touch was completely taboo between doctors and patients, and on top of that, the nurses were women. They were seen as naturally suited to this role. Doctors, who were mostly men, had to have a very distant attitude towards the patients.
Women like Betty Eisner and Margot Cutner were the practitioners themselves. How did they bring into their practice these ideas about reassurance and touch?
For these women, the work was based on their own self-experimentation of the substance. That was something that was completely normal and even expected from the medical profession. You shouldn’t administer LSD before you have self-experimented multiple times.
They self-experimented, and they understood that it was really important to respond to the patient’s request for physical contact. Very often the patients were explicit in asking to have their hand held, to be hugged, or to be cuddled. The doctors wouldn’t respond to that. Unlike their male colleagues, these women, they agreed to touch. They didn’t just agree to the request of touch, they actually turned touch into a therapeutic element in itself. In their view, responding to the need for physical contact during a psychedelic-assisted therapy could repair something, often a lack of love in early childhood, and this would help patients to heal more effectively from their trauma.
In some cases, this created somewhat controversial therapeutic techniques, like those used by Joyce Martin. How did she use touch?
Joyce Martin and her colleague, Pauline McCririck, were two London-based psychoanalysts. Martin was also a psychiatrist, which means that she was able to prescribe LSD. She’s said to have treated somewhere between 1000 to 3000 patients with LSD over a period of about 15 years. She worked at an [English] hospital and in her private practice, located in her own home.
For a small portion of patients, not every patient, but those who had suffered deeply from a lack of maternal love, Joyce Martin and Pauline McCririck invented a method that they called “fusion.” After several sessions, once trust and a strong therapeutic alliance has been established between the therapist and the patients, the patient was familiar with the effect of LSD, and had given verbal consent—which at that time basically never happened—they would gradually move closer to the patient, session after session. First to the bed where the patient was lying, then they would sit next to them, and eventually they would lie down fully with them, holding them. Sometimes they would give them warm milk. There is a very strong maternal imagery, as you can see.
The idea was that for about an hour to an hour-and-a-half, depending on what the patient wanted, over one, two, or three sessions—again, depending on the patient’s need—the patient could experience a feeling of unconditional maternal love. After that, in the following session, the intense and intimate physical contact was stopped, and the therapy would move to other stages.
Today, the question of whether therapists should touch their patients at all during psychedelic sessions or during regular therapy sessions is controversial and hotly contested. When you look back at these techniques—even ones that we would be uncomfortable with today—what lessons do you take from them?
We’re uncomfortable thinking of Joyce Martin lying in a bed with a patient for an hour and a half. But what is interesting is that at that time, it was not seen as so controversial. A lot of different doctors came to the hospital to follow the training of this woman. They published a lot, and they would speak about her techniques at conferences. There was even a movie made about Joyce Martin’s techniques that have been lost, unfortunately.
Another thing is that these women emphasized that LSD is not for everyone. Patients needed to be really selected very carefully, and this was very new. At that time, doctors would give LSD to anyone. For these women practitioners, only some people can actually benefit from it, and according to them, it’s also absolutely crucial to explain everything clearly before the session. What is the substance? Why is it being used? What is expected from the effect? What might happen, and what are the rules? How should you behave when you are under the effect of LSD? In their clinics, patients could be touched if they asked for it, but they were also allowed to touch the therapist themselves. That was really revolutionary, but it required very strict rules to be put in place.
Another thing that was absolutely central for them was putting the patient at the heart of the treatment, listening to what they ask for, understanding what they need, and acting accordingly. That meant that it was impossible to have standardized rules. You had to be able to adapt to every situation, and this required a very intense level of involvement from the therapist.
Today in clinical trials, doctors are much more restricted in what they can do, because sessions need to be reproducible in order to be evaluated as objectively as possible. But what we see in Switzerland, for example, where for more than 10 years now doctors have been legally allowed to use LSD, MDMA, and psilocybin in their private practice—outside clinical trials—is that if they have a government authorization, there is an incredible diversity of practices. There are some doctors who have a garden, and take patients outside. There are some doctors who run group sessions. Others allow relatives to be present during the session. The doses are chosen jointly by doctors and the patients. Basically, there is a lot of freedom, and it’s the same when it comes to touch. Doctors work based on their training and on the patient’s needs. For now, it seems to be working quite well.
People worry about touch in part because of known instances of sexual assault and problematic touch in psychedelic-assisted therapy. Given that, how do you think we should view the legacy of Eisner, Martin and Cutner and the techniques they pioneered?
These substances became prohibited for decades. It was the underground scene that kept alive the knowledge of some of the methods of Eisner, Martin, Cutner, and many other therapists. Many of the people practicing this therapy illegally were very committed, well intentioned, and deeply dedicated to their patients.
The problem is that some of the methods developed by these women were taken up by certain underground therapists as self-evident practices without having had the time when it was legal to properly evaluate their safety, their effectiveness, and also their risks. In a context where there was no official training available it was often underground therapists who ended up training. As a result, some potentially dangerous methods were transmitted into official practices. Today, unfortunately, there are cases of sexual assault or abuse coming to light in psychedelic-assisted therapy, sometimes in the underground, but also in clinical trials.
This is a very serious issue, but thankfully, the psychedelic field is actively confronting it. So there are many conferences, articles, even special issues in scientific journals addressing the problem and trying to offer ways forward.
This interview has been edited and condensed for clarity and length.
