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In the brief space allotted, I would like to touch on three points raised by Dr. Flarsheim's interesting paper: (1) the meaning of drug and drug use to this patient; (2) a problem of methodology; and (3) a problem of technique.
Dr. Flarsheim attempts to focus primarily on the psychologic meaning of the use of marijuana and LSD. He suggests that marijuana was used to withdraw from the threatening world into “idyllic, beautiful, blissful feelings.” LSD, however, was seen “as one of a variety of threatening situations in her life.” This view of the meaning of these drugs might be summarized as marijuana means pleasure and LSD means unpleasantness. Such a formulation appears to me to be only a first step towards the understanding of the significance of these drugs in this individual's life: we know that not all drug users perceive LSD as threatening. Perhaps in order to understand why this patient so perceives it, one needs to look at other aspects of the drug experience: the drug and the social setting in which it is taken.
As Schilder suggests, and it is particularly true for processes which so
directly implicate brain biology, the experience must be examined from a number of viewpoints. “We have the three specific categories of world, body, and personality. It is one of the main functions of philosophy and and psychology to determine the relations of these categories to each other.”1 Both marijuana and LSD have specific drug effects, and it is partly in response to these that an individual attaches a particular meaning to the drug experience in the light of his prior life experience. The ability to generalize from specific formulations of the meaning of the use of drugs is likely to derive from the universality of aspects of the drug experience and of growth and development in our society.
I would speculate that this patient's use of marijuana to deal with anxiety was, in part, related to the specific sedative effects of tetrahydrocannabinols. Her response to LSD is