Technical consultation to a screenwriter of episodes for The Next Generation, Deep Space Nine, and Voyager series of Star Trek drew upon the new discipline of dynamic neuropsychiatry to originate ideas for the alien experiences in the science fiction scripts. In particular, the neurologic misidentification syndromes, which elicit complex neuropsychic defenses and illustrate the psychodynamics of object relations, provided a sense of strangeness. The wide, creepy popular appeal of the syndromes, described here, reveals a latent mental defensive structure that is activated by psychopathology and neuropathology, but that is also somehow sensed by those who are more or less neurologically intact. Illustrative examples are drawn from these series and the more recent Enterprise series that has been aired since the consultation. In addition, the changing persona of the physician character in Star Trek is a projection of our changing status in American society.