Contract on My Life

1. Contract on My Life Mr. Polsen, a 42-year-old married African American postal worker and father of two is brought to the emergency room by his wife because he has been insisting that “there is a contract out on my life.” According to Mr. Polsen, his problems began 4 months ago when his supervisor at work accused him of tampering with a package. Mr. Polsen denied that this was true and, because his job was in jeopardy, filed a protest. At a formal hearing, he was exonerated and, according to him, “This made my boss furious. He felt he had been publicly humiliated.” About two weeks later, Mr. Polsen noticed that his co-workers were avoiding him. “When I’d walk toward them, they’d just turn away like they didn’t want to see me.” Shortly thereafter, he began to feel that they were talking about him at work. He never could make out clearly what they were saying, but he gradually became convinced that they were avoiding him because his boss had taken out a contract on his life. This state of affairs was stable for about 2 months, until Mr. Polsen began noticing several ‘large white cars” new to his neighborhood, driving up and down the street on which he lived. He became increasingly frightened and was convinced that the “hit men” were in these cars. He refused to go out of his apartment without an escort. Several times when he saw the white cars, he would panic and run home. After one such incident, his wife finally insisted that he accompany her to the emergency room. Mr. Polsen was described by his wife and brother as a basically well-adjusted, outgoing man who enjoyed being with his family. He had served with distinction in Vietnam. He was little combat there, but was pulled from a burning truck by a buddy seconds before the truck blew up. When interviewed, Mr. Polsen was obviously frightened. Aside from his belief that he was in danger of being killed, his speech, behavior and demeanor were in no way odd or strange. His predominant mood was anxious. He denied having hallucinations and all other psychotic symptoms except those noted above. He claimed not to be depressed and, although he noted that he had recently had some difficulty falling asleep, he said there had been no change in his appetite, sex drive, energy level or concentration.

2. Discussion of “Contract on My Life” Mr. Polsen’s anxiety stems from his belief that his boss has taken a contract out on his life. There is no reason to believe this; thus, we must conclude that he has a delusion. Because contract killers ar sometimes hired in real life, the delusion is non-bizarre. Mr. Polsen has no auditory or visual hallucinations, no manic or depressive syndrome, and no evidence of a general medical condition or the use of a substance that might have caused the disturbance. His behavior, apart from the delusion and its ramifications, is not odd or bizarre. These are the characteristics of Delusional Disorder. Because the content of his delusion involves the theme of being malevolently treated in some way, the disorder is specified as Persecutory Type. People with the Persecutory Type of Delusional Disorder are often reluctant to seek help. Mr. Polsen, however, was frightened enough to allow his wife to take him to the emergency room. Follow Up Mr. Polsen was hospitalized. During the first week of hospitalization, he received an antipsychotic drug. He remained delusional, however, and in fact became convinced that several of the other patients on the ward with Italian names were part of the “hit team” sent to kill him. Over the ensuing three weeks, with continued treatment, these beliefs faded. At discharge, 1 month after admission, he stated: “ I guess my boss has called off the contract. He couldn’t get away with it now without publicity.” Mr. Polsen was followed up over a period of 18 months, during which time he had two relapses into more active delusions, all with the same content, and each occurring after he stopped taking his medication. Both episodes resolved relatively rapidly with outpatient treatment with an antipsychotic drug.

3. Original LSD experience “In afternoon of 16 April, 1943…. I was seized by a peculiar sensation of vertigo and restlessness. Objects, as well as the shape of my associates in the laboratory, appeared to undergo optical changes. I was unable to concentrate on my work. In a dreamlike state I left for home, where an irresistible urge to lie down overcame me. I drew the curtains and immediately fell into a pecular state similar to drunkeness, characterized by an exaggerated imagination. With my eyes closed, fantastic pictures of extraordinary plasticity and intensive color seemed to surge toward me. After two hours this state gradually wore off.” (source- journal of Albert Hofmann at Sandoz) when synthesizing LSD-25)

4. First LSD Dosing Experiment “After 40 minutes, I noted the following symptoms in my laboratory journal: slight giddiness, restlessness, difficulty in concentration, visual disturbances laughing… Later: I lost all count of time. I noticed with dismay that my environment was undergoing progressive changes. My visual field wavered everything appeared deformed as in a faulty mirror. Space and time became more and more disorganized and I was overcome by a fear that I was going out of my mind. The worst part of it being that I was clearly aware of my condition. My power of observation was unimpaired….Occasionally, I felt as if I were out of my body. I thought I had died. My ego seemed suspended somewhere in space, from where I saw my dead body lying on the sofa…. It was particularly striking how acoustic perceptions, such as the noise of water gushing from a tap or the spoken word, were transformed into optical illusions. I then fell asleep and awakened the next morning somewhat tired but otherwise feeling perfectly well.” (source- journal of Albert Hofmann at Sandoz) when synthesizing LSD-25)

5. Sensory Stage of LSD Trip “For the lack of anything else to do, I stared at the dial light of the table radio,nodding my head to a jazz piece I did not recognize. I realized that the light was changing color kaleidoscopically with the different pitch of the musical sounds, bright reds and yellows in the high register, deep purple in the low. I laughed. I had no idea when it had started. I simply knew it had. I closed my eyes, but the colored notes were still there.” (from: LSD- My Problem Child, 1976 by Albert Hofmann, referring to the experience after 200 micrograms of LSD taken with half a glass of water)

6. Symbolic Stage of LSD Trip “To be shaken out of the ruts of ordinary perception, to be shown for a few timeless hours the outer and inner world, not as they appear to an animal obsessed with words and notions, but as they are apprehended, directly and unconditionally, by Mind at Large- this is an experience of inestimable value to everyone and especially the intellectual” (from: The Doors of Perception, 1954 by Aldous Huxley referring to the experience after 0.4 gm mescaline)

7. Recollective-Analytical Stage of LSD Trip “I realized that in the horror of the passing night I had experienced my own individual condition: selfishness. My egotism had kept me separated from mankind and had led me to inner isolation. I had loved only myself, not my neighbor; loved only the gratification that the other offered me. The world had existed only for the satisfaction of my greed. I had become tough, cold and cynical. ” (from: LSD- My Problem Child, 1976 by Albert Hofmann, referring to the experience after 200 micrograms of LSD taken with half a glass of water)

8. A DMT Injection turns into a ‘hellish’ experience: “I had been up for three days and two nights working on a manuscript. That was the first mistake. The room where the “experiment” was to take place was a dirty, dingy, insanely cluttered pesthole. That was the second mistake. I was told that I would see God. That was the third and worst mistake of all. The needle jabbed into my arm and the dimethyl-tryptamine oozed into my bloodstream. At the same time the steam came on with a rhythmic clamor and I remembered thinking that it would be good to have some heat. Within thirty seconds I noticed a change, or rather I noticed that there had never been any change, that I had been in this dreamy unworldly state for millions of years. I told this to Dr. ---, who said, “good, then it is beginning to pass the blood-braiin barrier.” (from Varieties of Psychedelic Experience, R. Masters and J. Houston Holt, Rinehart and Winston, New York, 1966 p 163.)

9. A DMT Injection turns into a ‘hellish’ experience (cont’d 2): It was so fast. Much too fast. I looked up at what a minute ago had been odors and cabinets, and all I could see were parallel lines falling away into absurdities. Dimensions were outraged. The geometry of things crashed blindly into one another and crumbled into chaos. I thought to myself, “But he said that I would see God, that I would know he meaning of the universe.” I closed my eyes. Perhaps God was there, behind my eyeballs. Something was there, all right. Something, coming at me from a distant an empty horizon. At first it was a pinpoint, then it was a smudge, and then--a formless growing Shape. A sound accompanied its progress towards me- a rising, rhythmic, metallic whine; a staccato meeyow that was issuing from a diamond larynx. And then, there it loomed before me, a devastating horror, a cosmic diamond cat. It filled the sky, it filled all space, there was nowhere to go. It was all that was. There was no place for me in this---Its universe. I felt leveled under the cruel glare of it’s crystalline brilliance. My mind, my body, my vestige of self-esteem perished in the hard glint of its diamond cells.

10. A DMT Injection turns into a ‘hellish’ experience (cont’d 3): It moved in the rhythmic spasms like some demonic toy; and always there was this voice---a steely, shrill monotony that put an end to hope…The chilling thing was that I knew what it was saying! It told me that I was wretched, pulpy, flaccid thing; a squishy-squashy worm. I was a thing of soft entrails and slimy fluids and was abhorrent to the calcified God. I opened my eyes and jumped up from my chair screaming: “I will not have you! I will not have such a God! What is the antidote to this? Give me the antidote!” But as I said this I doubted my own question for it seemed to me that this was the only reality I had ever known, the one I was born with and the one I would die with. There was no future beyond this state of mind, there was no state of mind beyond this one. “There is no antidote,” said Dr. ---. “Relax, it’s only been about three minutes. You’ve got at least twenty-five more minutes still to go.”

11. Anti-anxiety Drugs

12. Hypnotics