I liked this book a lot - it's a bit of Monkey's Paw, a bit of Fisherman's Wife, and a whole lot of thinking.
George Orr is a dude. A completely normal 50th percentile all over, totally forgettable normal dude. He isn't blindingly intelligent, he doesn't have a large or strong personality, and yet he's changing the world - changing reality, over and over again. The best part is - no one knows.
He dreams intense ('effective') dreams sometimes, and his dreams are true. And they change the world. As it is, as it ever was.
He goes to see a shrink, who doesn't just (eventually) believe him, but tries to use George's dreams to make the world a better place (but not just for humanity, he also decides to further his own gains). George's position also gets better, though it does not make him happy. The problem is, one must be careful what one wishes for.
George has a hard time accepting reality as *real.* He created it, right? How real is real? How much control do we really have? What will it take to make everything break? How much better, or even how do you even make things better? What will the mind accept and what will it create? This is a delightfully juicy psychological book.