The Dream Drugstore: Chemically Altered States of Consciousness

Hobson notes that the purpose of this book is to develop a "three-way analogy between dreaming, psychosis, and psychedelic experience." These varied states of consciousness share underlying mechanisms mainly involving a subtle shift in neuromodulatory systems. He relates that the "larger implication of this goal is to promote the concept of a unified theory that could account for all spontaneous and induced alterations of consciousness, whether they are produced and experienced in the context of natural life, scientific experimentation, therapeutic treatment, or recreational use." Of that final topic, I enjoyed his rendering of hallucinogen usage as "recreational psychopathology." By this, he neither maligns psychopathology nor hallucinogen usage (at least as a productive research tool). According to the theory that unites this often dissociated book; dreaming, psychosis, and psychedelic experience are facets of the same gem. While The Dream Drugstore: Chemically Altered States of Consciousness imparts numerous interesting points about dreams and dream physiology, its scope is much broader. Hobson's other books, such as Dreaming: An Introduction to the Science of Sleep or The Dreaming Brain: How the Brain Creates Both the Sense and the Nonsense of Dreams are surely the ones to consult for more detailed reviews of dream theories. An important point he relates is that during REM sleep, working memory and areas of the frontal lobe are inhibited. This helps to explain the capricious shifts in themes, plots, and characters that are typical of dream experience. Moreover, the disruption of these systems is linked to the sequestration of monoamines (esp. serotonin and norepinephrine) during sleep. During the day the dominance of aminergic over cholinergic systems is typical while at night the opposite ensues. He sees these two systems as locked in a competition that affects all aspects of consciousness. Hobson provides a solid review of the main categories of psychotropic drugs and explains their mechanisms of action with a particular eye toward supporting his ideas about the diurnally shifting balance of neuromodulators. Numerous long-winded accounts of Hobson's own dreams pepper the book. Reading others' dream journals is none too rewarding but Hobson's point is well made: dreams can be just as odd, transcendental, or psychedelic as any acid trip. Though a psychiatrist, Hobson derides the casually prescribing druggists of his profession. He believes a more circumspect approach is necessary even in the use of well-tested psychotropics, such as the SSRIs. According to his research, SSRIs can profoundly affect the architecture of sleep and potentially lead to long-term change in neuromodulatory systems, some beneficial, others not. He's not an absolutist and would hardly eschew the use of drugs to treat serious conditions but insists that a more careful cost-benefit analysis be employed in all cases. As he notes, "the sad conclusion is that the medical profession and the pharmaceutical industry may be collaborating in an unwitting and unplanned program of experimental medicine." Hobson makes a reasoned critique of "selective" psychotropics by writing that even the selectivity of some drugs to influence a single neuromodulator or receptor type becomes problematized once we recognize the complex dynamics of neurophysiology; in short, we're talking about a `wet' system here, not a `dry' one. This is biochemistry, not a clockworks. The book is extremely dense in some places. It's important to remember that insights from a 40 year career are compressed into these pages. The almost impressionistic way Hobson relates some complex issues can be hard-to-follow by the non-specialist. But the book abounds in fascinating ideas and theories. I found the last third especially fruitful, so reading all the way through rather than giving up too soon has its rewards.