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248 + THE SESSIONS Looking more closely at these sessions, it became clear that the vast majority of these problems were, if not especially minor, very brief. This reassured me to some extent. One of the primary reasons I chose DMT as the drug with which to resume clinical psychedelic research was that its effects were so short. I anticipated that no matter how bad things became, at least they wouldn't last too long. The research setting was ripe for the development of negative responses to the drug, and this may have contributed to the high frequency we saw. The clinical environment was quite unpleasant, even though it reassured some research subjects about our ability to respond to medical emergencies. In addition to the actual physical environment of the Research Cen- ter, the research attitude also created a tension that does not normally exist in typical psychedelic settings. The blood drawing, questionnaire administration, and various other experimental manipulations impacted our relationship with the volunteers. We wanted something from them other than just their own psychedelic experience, and that expectation was impossible to ignore. I expected nearly everyone to feel some anxiety as the DMT effects began. I knew many people would find themselves struggling to keep their bearings, especially with the higher doses. My respect for the deeply disruptive properties of DMT made it easier for volunteers to feel un- derstood in their natural apprehension before getting big doses of the spirit molecule. We did our best in attending to such details as smells, gestures, speech, emotional state, and the behavior of everyone in the room. This attention to detail went a long way in protecting our subjects from unnecessarily anxiety-provoking or otherwise disruptive influences. We realized that supportive, caring, and understanding attitudes and responses were the best insurance against serious adverse effects, and the best initial treat- - ee 1 ment should they emerge.’ The issue of adverse effects becomes extraordinarily important when we assess the risk-to-benefit ratio in working with psychedelics. Do ben- efits outweigh risks? Are the negative consequences of psychedelics' use worth accepting in light of their positive effects? This chapter addresses