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peutic principles or techniques, it was out of clinical necessity or prudence. 4 4t . . . We scrupulously avoided working on a psychological level with the vast 276 * TAKING PAUSE be evidence of basic changes in her everyday pattern of interactions and reactions to her world. Hers was one of the earliest cases causing me some reluctance in accepting at face value the transformative power of even the most profound and incredibly spiritual experiences. It was especially disappointing that no one began psychotherapy or a spiritual discipline to work further on the insights they felt on DMT. The few people for whom therapy was an issue returned to therapy, or restarted antidepressants, because of relapses into depression at some point after their high-dose DMT sessions. That is, they sought help for possible ad- verse effects rather than capitalizing on psychological or spiritual breakthroughs from their sessions. Why wasn't there more obvious benefit to our volunteers? Within sessions, we were not focusing on helping people with prob- lems. These were not treatment studies. Volunteers were relatively well-adjusted. Neither did we intend to treat our research subjects. We planned to, and mostly did, sit by and support them rather than steer or guide them in any particular direction. When we did apply psychothera- majority of our volunteers. In fact, one of my most pressing questions was whether a neutral environment would lead to positive responses in those having powerful DMT experiences. Another answer became clearer only as the study progressed. This was the deep and undeniable realization that DMT was not inherently therapeutic. Instead, we again had to face the crucial importance of set and setting. What the volunteers brought to their sessions, and the fuller context of their lives, was as important, if not more so, than the drug itself in determining how they dealt with their experiences. Without a suitable framework—-spiritual, psychotherapeutic, or otherwise—in which to pro- cess theirjourneys with DMT, their sessions became just another series of intense psychedelic encounters.