Sidney Cohen—Betty Eisner

Sidney Cohen and Betty Eisner formed part of the Los Angeles group that brought LSD into psychotherapy and helped shift its interpretation away from the idea that it simply induced temporary psychosis. Their work joined a practical therapeutic program—weekly sessions that gradually increased the dose—to a changing account of what patients experienced. They also treated Bill Wilson, whose interest in LSD arose from the possibility that a drug could occasion the spiritual awakening he associated with sobriety. The results they reported were striking, but the history of their work also shows why promising outcomes cannot be separated from the setting and expectations in which treatment takes place.

The Los Angeles Collaboration

Cohen was an internist who had begun experimenting with Sandoz LSD in 1955; Eisner was a young psychologist who had recently completed her doctorate at UCLA. Along with Oscar Janiger, they became leading figures in a Los Angeles research hub. Their collaboration belonged to a wider, loosely connected network: by the mid-1950s, perhaps a dozen such centers operated in North America and Europe, sharing techniques, discoveries, and sometimes drugs. The traffic among researchers was described as more cooperative than competitive, a structure that helped practices and interpretations travel beyond any single clinic.

The pair’s work with Wilson made their partnership especially visible. In the mid-1950s, Wilson, cofounder of Alcoholics Anonymous, learned of Humphry Osmond and Abram Hoffer’s treatment of alcoholics and wondered whether LSD might help recovering alcoholics undergo a spiritual awakening. Through Osmond, he was put in touch with Cohen. Beginning in 1956, Wilson had several LSD sessions in Los Angeles with Cohen and Eisner. These sessions were not merely an outside demonstration of a drug: Wilson was testing a possibility central to his own understanding of recovery, while the clinicians were exploring whether the experience might have a therapeutic role for others.

From Psychosis to Therapy

Cohen and Eisner’s practice took shape as the psychotomimetic model—the view of LSD as a means of temporarily reproducing psychosis—came under pressure. Cohen’s own first LSD experience, in October 1955, sharply contradicted his expectation that the drug would trap him inside the mind of a madman. Instead, he experienced profound tranquillity and a sense of insight that he felt could not be described as temporary psychosis. Eisner later reported that Cohen came to call this state unsanity, meaning a condition beyond the control of the ego. Her account preserves an important part of the collaboration: Cohen’s experience challenged his prior model, and Eisner helped record the conceptual language through which he made sense of that challenge.

In Los Angeles, Cohen, Eisner, and Janiger incorporated LSD into weekly therapeutic sessions. They increased the dose from week to week, aiming to give patients access to subconscious material, including repressed emotions and buried childhood memories. Their patients were mainly neurotics, alcoholics, and people with minor personality disorders: people described as functional and articulate, with intact egos and a desire to improve. The group also treated hundreds of painters, composers, and writers, reasoning that if creativity drew on the subconscious, LSD might broaden access to it. Their work therefore extended beyond the treatment of illness into an inquiry about the possible uses of the same method for creative life.

Outcomes and Their Limits

The Los Angeles therapists and their patients expected LSD to be therapeutic; Cohen and Eisner reported that sixteen of their first twenty-two patients showed marked improvement. A later review of papers on psycholytic therapy published between 1953 and 1965 estimated success rates of 70 percent for anxiety neurosis, 62 percent for depression, and 42 percent for obsessive-compulsive disorder. These figures made the approach appear powerful, but few attempts had been made to replicate the results in controlled trials. The reports were evidence of a promising clinical signal, not definitive proof that LSD alone caused the improvement.

A Canadian effort to reproduce earlier LSD treatment for alcoholism illustrates how much the conditions of treatment mattered. In the early 1960s, the Addiction Research Foundation in Toronto sought to isolate the drug’s effects using neutral rooms and instructions that clinicians avoid engaging with participants except to administer questionnaires; volunteers were also restrained or blindfolded. The results did not match those obtained by Osmond and Hoffer, and more than a few participants had terrifying experiences. The contrasting conclusions—that LSD treatment worked less well under rigorous controls, and that attention to set and setting was essential—could both be true. This comparison does not establish the specific conditions in Cohen and Eisner’s sessions, but it makes clear why outcomes from therapeutic encounters cannot be understood as drug effects detached from human contact and environment.

A Shared Therapeutic Legacy

Wilson’s experience with Cohen and Eisner strengthened his belief that LSD could reliably occasion the kind of spiritual awakening he thought necessary for sobriety. He did not consider the experience equivalent to delirium tremens, adding to the evidence against the psychotomimetic account. He thought LSD therapy might have a place in Alcoholics Anonymous, but the fellowship’s board disagreed, fearing that approval of a mind-altering substance would blur the organization’s identity and message. The disagreement marked a boundary between an individual’s therapeutic conviction and the institutional judgment of the group with which he hoped to connect it.

Cohen and Eisner’s collaboration thus belongs to a transition in both practice and interpretation. They used LSD in a structured therapeutic rhythm, reported substantial improvement among their early patients, and worked with a participant whose interest in spiritual awakening tied clinical experimentation to recovery. At the same time, the limited replication of psycholytic results and the sharply different experiences produced by contrasting treatment conditions caution against treating their reports as a simple verdict on the drug. Their historical significance lies in that conjunction: clinical optimism and a changing theory of experience, accompanied by evidence that made the therapeutic relationship and the circumstances of a session impossible to ignore.