This article reviews the role of
psychedelic drugs as potential tools for psychiatric research and practice. The decline in the utilization of these substances is linked to social reactions, which led to
psychedelics being scheduled as
controlled substances and consequently unavailable for human research. Three different paradigms for the use of
psychedelics in psychiatry are reviewed: the psychotomimetic, the psycholytic, and the
psychedelic approaches. The psychotomimetic paradigm, which viewed
hallucinogens as agents for temporarily inducing
psychoses, proved to be of limited value to the understanding and treatment of
mental illness. The psycholytic approach, which was derived from the psychoanalytic paradigm, is a technique employing low doses of
psychedelic drugs to reduce psychological defenses and to release unconscious information. The high-dose
psychedelic paradigm frequently produced reports of mystical or spiritual experiences, thus recasting the psychiatrist as the modern-day shaman. This paradigm has alienated many in the psychiatric profession and has led to a reaction against the use of
psychedelics in psychotherapy. If the opportunity should arise to pursue sanctioned clinical research with these unique psychoactive substances, however, it will be imperative to learn from the traditional models of shamanic healers in order to optimally assess true clinical efficacy and safety.