Amytal and thiopental narcoanalysis (historical)

Domain VI · Brief, integrative, trauma, hypnosis & coaching · William Bleckwenn, Roy R. Grinker, John P. Spiegel · 1930 · University of Wisconsin, USA

What it is

What it was. A clinician gave a sedative barbiturate to bring the patient into a drowsy, disinhibited state. The clinician then interviewed the patient. The aims varied:

Format

• This was not a staged psychotherapy with a fixed number of sessions. It was a procedure embedded in medical or psychiatric care. Its typical course, as the sources describe it, is set out below.
• Phase B: the drug interview. This was usually one session, sometimes repeated. The patient was sedated and interviewed while drowsy. Diagnostic interviews tested whether a stupor or mutism lifted, and what the patient then said about their mental state. Uncovering interviews used free association…

Evidence status, as the guide reports it

• Session count and criteria for moving on. No standard criteria are given in the sources cited. A 1992 controlled trial in catatonic mutism judged "response" by whether the patient began to speak during the drug interview, and found that only about half responded.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.