The Peyote Meeting, as analyzed here, has a ritual process that involves a dialectic between therapeutic emplotment and consciousness modification. Ritual symbolism emplots the patient in a drama of sacred reflexivity, divine communication, and transformative redemption aimed at changing the patient's behavior, personal narrative, and view of his or her life. Peyote ingestion has the potential to support this process pharmacologically by altering attentional processes, suggestibility, and self-awareness in a way that makes the mind more malleable and open to change. Ritual experiences awaken the conscience and energize the spiritual life. Peyotist ritual experiences are self-referential, often revealing aspects of the Peyotist's life that need to be worked on, and these experiences become important memories and guides for the individual. Peyotists report that the ritual helps them make important decisions, solve problems, set goals in such a way that they become spiritually binding commitments, and express important emotions and thoughts in the context of a shared ritual ordeal. Healing in the NAC also involves the mobilization of help networks and interpersonal support from the family and larger community. Therapeutic intervention in the NAC involves not only situational/remedial interventions, applied in response to particular crises or illnesses, but also preventative/developmental interventions applied as a part of socialization and throughout the life course. An important aspect of the latter path is the development of a relationship with the benevolent and omniscient Peyote Spirit. If socialization is successful, the gaze of the Peyote Spirit will become omnipresent in the life of the child, discouraging violations of the ethical code such as use of alcohol and drugs of abuse. The therapeutic process at the heart of the Peyote Ceremony clashes with modem Euro-American understandings of psychopharmacological and psychotherapeutic intervention. Euro-Arnerican theories of psychopharmacology derive from a materialistic agonist/antagonist paradigm while Peyotist psychopharmacology can be described in terms of a semiotic/reflexive paradigm. Euro-American theories of psychotherapeutic efficacy tend to be dyadic and focused on the quality of the patient/healer relationship (e.g., warmth, empathy, and genuineness). In contrast, therapeutic efficacy in the NAC seems to be built into cultural structures of meaning and practice and is communal rather than dyadic in form. Whatever the differences in structure, the NAC is obviously at the heart of recovery for many thousands of Native Americans and this role is acknowledged by the U. S. IHS in spite of the status of Peyote as a "Schedule 1 drug."