This book is a highly readable, intriguing, provocative description of Rick Strassman’s theories and research concerning the effects of N, N-dimethyltryptamine (DMT)—a short-acting and powerful plant-derived psychedelic chemical that is endogenously produced in the human brain—and what its evolutionary and psychological function might be. In this intellectually courageous book, which reads more like a novel than a scientific text, Strassman, Clinical Associate Professor of Psychiatry at the University of New Mexico School of Medicine, recounts the history of psychedelic research; the bureaucratic labyrinth he had to navigate to begin the first clinical research with psychedelic substances approved by the Drug Enforcement Administration in more than 20 years; his methods and results (including case descriptions of what his volunteers encountered while taking the drug); the dangers of experimentation with psychedelics as well as possible beneficial effects; and speculations regarding the body’s built-in mechanisms for contacting spiritual realms. Throughout, Strassman shares his feelings about his research and the personal and ethical dilemmas he encountered along the way in an authentic and honest manner, which makes him a narrator who seems not only sympathetic but familiar.

Beginning in the 1950s, DMT had been studied as a possible cause of schizophrenia, before the 1970 Congressional law made further research nearly impossible. Strassman begins with the question, What is DMT doing in our bodies? He wonders why the brain so actively seeks it out, transporting it across the blood-brain barrier and very quickly digesting it. He hypothesizes that DMT is produced by the pineal gland—what Descartes termed "the seat of the soul" and what he calls the "spirit gland"—and is released during naturally occurring psychedelic states, including childbirth, the dying process, dreams, and a variety of subjective mystical experiences. Thus, Strassman posits that human beings have been designed with a biological mechanism that enabling us to have spiritual experiences.

The research that Strassman describes, conducted at the hospital of the University of New Mexico between 1990 and 1995, includes a dose-response study, a tolerance study, and mechanism-of-action studies to determine which brain receptors mediate DMT’s effects. Sixty volunteers participated. There was no development of tolerance. Findings were inconclusive as to which serotonin receptor regulates DMT’s effects. Throughout the studies, Strassman monitored the effects of the drug on heart rate, pulse, hormone levels, and body temperature. For some subjects, he used an EEG or magnetic resonance imaging head scan to measure which brain sites were most active during a DMT experience. Throughout his report, he is sensitive to issues of set and setting; his orientation as a clinician is evident in the way he counsels volunteers through their psychedelic sessions and in his thoughtful follow-up with them.

Strassman emphasizes his frustration with trying to fit his spiritual questions into a biomedical research design. His ultimate goal was to establish the safe use of psychedelics under supervision and eventually shift to psychotherapeutically oriented studies. Unfortunately, Strassman never undertook his next wave of research—which was to involve work with the terminally ill—because of a multitude of obstructing factors, including family issues, lack of collegial support, criticism by his Buddhist community, the complexity of working with volunteers, ethical dilemmas regarding the use of psychedelics with the terminally ill, and questions as to the long-term benefits of psychedelics.

A major portion of the book is devoted to detailed descriptions of what the volunteers encountered during their sessions. These include the exploration and resolution of personal psychological issues; out-of-body states in which people experienced their own deaths; a variety of mystical states in which volunteers experienced a unifying presence of God within and without the self and a felt sense of love as the underlying fabric of the universe; and—surprising to Strassman—a large number of reports of contact with alien beings of various kinds doing intrusive experiments and/or healing work. Most volunteers had positive experiences, but there were some scares and some "bad trips." One volunteer nearly had a heart attack because DMT normally leads to a flight-or-fight physiological response. Another older volunteer almost went into shock. One young man had a traumatic vision of being raped by alligators. Despite some of the beautifully uplifting experiences of many of the subjects, Strassman was disappointed to find in his follow-up interviews that the experiences did not typically produce real change in the volunteers’ lifestyles in terms of their behavior. None began psychotherapy or a spiritual discipline to further integrate his or her insights. However, several reported a stronger sense of self, less fear of death, and a greater appreciation of life (benefits Strassman may underemphasize).

After allowing himself to venture creatively into hypotheses that DMT allows contact with dark matter or parallel universes, Strassman argues that DMT must have provided an adaptive advantage to our ancestors in allowing access to alternate states of consciousness and thus perhaps greater problem-solving abilities and greater creativity. Clearly, there is a need for further research into many of Strassman’s theories, and he ends by describing ways to investigate the role of the pineal gland in DMT production and how DMT might be involved in dreams, childbirth, meditation, and mystical visions as well as in mediating the exit of consciousness from the body. He also describes his ideal psychedelic research center and the best use of this research to promote the highest good, research one hopes Strassman himself may conduct one day.

This book will be of great use both to researchers and clinicians with an interest in spiritual/mystical issues and/or in psychedelics as well as to laypeople. It will undoubtedly also raise concern among those who worry that Strassman is promoting or condoning the widespread use of psychedelic drugs. However, he is quite clear about possible negative effects, urges close medical supervision, and questions the long-term beneficial effects of psychedelics without the support of concurrent therapeutic work or disciplined spiritual practice. Strassman clearly sees a beneficial use for these chemicals and expresses anger about the ways that psychedelic research has been mishandled in the past and is hampered as a consequence.

This book opens up doors of perception and encourages us to consider far-reaching questions. Strassman quotes Jean Toomer in his epigram, "We do not possess imagination enough to sense what we are missing." This book does a good job in painting for us the myriad possibilities.