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280 © TAKING PAUSE something really was going on. The rating-scale data also nicely straddled the clinical and objective realities; that is, the questionnaire provided objective validation of subjective effects. Nevertheless, the most fasci- nating and rewarding data were obtained by listening to and watching our volunteers in Room 531. However, once we began the required mechanism-of-action research, the biomedical model was going to exert greater restrictions upon the types of studies we would be allowed to perform. In chapter 8, "Getting DMT," I described these follow-up DMT studies, which examined the effects of pindolol, cyproheptadine, and naltrexone. We combined these receptor-blocking drugs with DMT and compared responses to this com- bination with those of DMT alone. We thus could infer the role of the relevant receptor in mediating specific effects of the spirit molecule. These types of studies no longer placed the subjective effects of DMT at the forefront of our inquiry. The mechanisms were now more important than the experience. The explicit setting had shifted in a titanic manner. These protocols now approached our subjects less as individuals under- going a psychedelic experience and more as biological systems with which we could define drug mechanisms more precisely. Te wera nnlt anaes ta han an antheeniantin ahavt thane It wasn't easy to be as enthusiastic about these studies as the earlier ones. In fact, volunteers did as much to encourage me to perform them as I did to request their participation. Adding to this discomfort was my sense that I had learned something deep and basic about the workings of the spirit molecule. In the last chapter, I describe this conclusion—that is, that lasting or substantial benefit from high-dose DMT sessions in our setting was difficult to see. Combined with the gradually growing inci- dence of adverse effects, I saw the risk-to-benefit ratio turning less favorable. I needed to change the model to one in which people might benefit from participating in the studies. The two frameworks that might contain projects where people "got better" were the psychotherapeutic and the spiritual. A spirituality-based project was unlikely in a clinical research environment. So I began work on a psychotherapeutic project, a psilocybin-assisted psychotherapy study with the terminally ill.