This article applies a Medical Anthropology perspective to analyze the medicinal and spiritual use of ayahuasca within seculars and religious networks across Catalonia. They find that the biomedical separation of religion and medicine is unsustainable in this context, as many participants exhaust other therapeutic treatment options before seeking support through these alternatives, which often disguise their therapeutic practice in religious settings due to its precarious legal status. Furthermore, the authors highlight a strong connection between psychedelic substances and religious/spiritual experience, and psychological introspection, as demonstrated by ayahuasca sessions that emphasize the ‘insights’ and the ‘biographical review’ gained by this faculty.
Abstract
“Ayahuasca is a psychoactive beverage from the Amazon, traditionally used by indigenous and mestizo populations in the region. Widespread international use of the beverage began in the 1990s in both secular contexts and religious/spiritual networks. This article offers an analysis of these networks as health care systems in general and for the case of Spain and specifically Catalonia, describing the emergence and characteristics of their groups, and the therapeutic itineraries of some participants. The medical anthropology perspective we take enables us to reflect on the relationship between medicine and religion, and problematize the tensions between medicalization and medical pluralism. Closely linked to the process of medicalization, we also analyze prohibitionist drug policies and their tensions and conflicts with the use of ayahuasca in ritual and ‘health care’ contexts. The paper ends with a reflection on the problem of ayahuasca as ‘medicine’, since the connection between religion and medicine is a very difficult one to separate.”
Authors: Ismael Apud & Oriol Romaní
Summary
Introduction
Ayahuasca is a psychoactive beverage traditionally used by indigenous and mestizo populations in the Amazon basin. It is made from Banisteriopsis caapi and Psychotria viridis, and contains beta-carbolines and DMT.
The origins of the name ‘yagé’, which means ‘vine of the spirits’ or ‘vine of the dead’, are uncertain. It is widely used across the Amazon region and has become popular in the west.
Ayahuasca became more internationally visible from the 1990s onwards, partly as a result of the frequent exchanges between foreigners and specialist native shamans, and the rapid transnationalisation process of the churches emerging in Brazil.
We propose to analyze spiritual/religious networks as health care systems from a critical medical anthropology perspective, by exploring the use of ayahuasca as a cultural practice circulating in different medical systems, with a focus on the therapeutic uses within the spiritual/religious networks of Spain and especially Catalonia.
The second part of the paper analyzes the relationship between medicalization and drug policies, focusing on the case of ayahuasca in Spain, and the legal exceptions that allow the use of psychoactive drugs on the grounds of religious freedom.
Medicine, medicalization, and medical pluralism from a critical medical anthropology perspective
Medicine is an inherent activity among human beings, and its core aspects involve the living being’s spontaneous effort to dominate the environment and organize it according to his values as a living being. Humans are capable of complex cultural achievements.
Every society has its own methods of healing in situations of crisis and illness, and its own interpretations of their causes. Medicine must be framed within a universal anthropological history.
A health care system involves all practices and knowledge related to the causes and treatment of health-illness problems. It could also include religious institutions, traditional healing practices, and alternative therapies.
The process by which biomedicine became hegemonic involves the appropriation of the health care field and the control and delegitimization of other competing practices within it. The State’s role in this process is fundamental, providing the legitimization that allows social control by the medical profession.
Medical pluralism is an intrinsic feature of all societies in every time and place. It is made up of four basic forms of health care: self-care, professional medical care, self-help and self-management, and alternative care.
Baer mentions India, Zaire, Bolivia, Haiti, and Japan as pluralist medical systems, and also notes the increasing incorporation of alternative therapies in the United States such as homeopathy, herbalism, acupuncture and attempts made to establish a more ‘integrative’ medicine.
In recent years, non-hegemonic knowledge and practices have met with greater recognition. The WHO’s Traditional Medicine Strategy 2002 – 2005 advocates the availability of traditional medicine for rational use.
In western societies, new therapeutic alternatives to biomedicine were popularized in the 1960s, against the background of a general lack of belief in the paradigm of modern western emancipation. These new models were mainly based on western imaginaries of more exotic otherness.
Ayahuasca and medical pluralism
Kleinman (1980) brought back Clifford Geertz’s ‘cultural system’ concept to analyze biomedicine, and Vallverd (2010) showed that religious/spiritual practices can be considered as medical practices.
From a critical medical anthropology perspective, we propose to consider health care systems as a plurality of systems, which are generally in tension with hegemonic systems. Ayahuasca use can be considered within the frame of the plurality of medical systems.
The traditional use of ayahuasca by native Amazon populations is difficult to pinpoint in time, but includes the Tukano in Colombia and Brazil, the Shipibo-Conibo in Peru, and the Shuar in Ecuador. All these groups use ayahuasca within the framework of a native pharmacopeia.
The churches in Brazil were born from a syncretism between Umbandism, Kardecian spiritism, popular Catholicism, and Amazonian shamanism, and were promoted in the main by Mestre Irineu Raimundo Serra. These churches used ayahuasca for diagnosis and healing in a region where medical and health care were practically nonexistent.
The gradual transnationalization of ayahuasca in recent decades has seen the coming together of various religious-spiritual-therapeutic contents, such as holistic centers, alternative individual therapies, homeopathy, Chinese medicine, yoga schools, ethnic and ecotourism, meditation, holotropic breathwork, New Age, neoshamanism, spiritism, transpersonal psychology, and Gestalt psychology.
Ayahuasca and medical pluralism in Spain and Catalonia
According to Perdiguero (2004), complementary and alternative medicines arrived fairly late in Spain and began to acquire visibility after the dictatorship. They are mainly used by upper and middle class women and are related to several streams related to the ‘new cultural imaginaries’.
Spain came early to research on the psychotherapeutic properties of psychedelic drugs, but in the mid-1950s doctors began to consider them as toxic and not beneficial in any way. This was due to political pressure, and in the 1960s rock music became popular and LSD began circulating.
Ayahuasca started to arrive in Spain at the end of the 1980s through Claudio Naranjo, a follower of Fritz Perls and his school of Gestalt psychology. Naranjo organized a joint meeting in Spain with the Santo Daime church.
In the 1990s, anthropologist Josep Maria Fericgla made his first trips to Ecuador to visit the Shuar, and founded the Institut de Prospectiva Antropolgica, which later became the Societat d’Etnopsicologia Aplicada i Estudis Cognitius.
In Catalonia, Corbera (2012) identifies 17 ayahuasca groups with a wide range of activities: shamanic ceremonies, rituals in Brazilian churches, ceremonies connected with therapies and alternative psychologies, and sessions for treating addictions run by Latin American healers and/or western ‘guides’.
Some groups were created after their founders came into contact with ayahuasca on pilgrimages to South America. Some groups are run by spiritual seekers, others by wounded healers who returned from their pilgrimages with ayahuasca as a medicine and teacher plant.
In all the cases described above, there is a ‘cultural translation’ from one context to another, which involves a resignification of native cosmologies in psychological and/or New Age terms, and a ‘ritual redesign’, which implies the creation of a ‘metaphoric religiosity’.
Spain is internationally renowned for scientific study in the field of psychedelic drugs, and many Spanish researchers are working on the substance ayahuasca from different disciplines including psychology, psychiatry, pharmacology, and anthropology.
Therapeutic itineraries in Catalonia: ayahuasca and introspection
Many ayahuasca participants come to these alternative health networks after trying out different treatments in different health care systems, and this is the bricoleur user, who wanders through a range of therapeutic systems in search of a solution to a personal or psychological problem.
Jaime spent fourteen years in treatments, first for physical decay, then mental decay, and finally a financial black hole. He finally tried ayahuasca as a last resort, considering that none of the conventional treatments had worked for him.
Ayahuasca allows you to have an intense, powerful introspective experience, which is what I found most helpful. I saw my attitudes and thought, “My God, look at yourself!”
Jaime tried ayahuasca as a last resort after conventional therapies failed to deal with his addiction problem, but for others it was a way to pursue their spiritual, religious, existential or psychonautical quests.
I got into a mental state of biographic review, in which I could see things I normally cannot see, and it was really useful.
Jaime and Antonio were both secular users of the brew, and their explanations retain a psychological level of analysis, with no mystical or religious attributions added to their narratives. However, Hernan considers himself a non-religious but spiritual person.
Hernan was a good student, but his school grades began to worsen at 12 years old. He went to a psychologist but it was no use, and at 18 years old he decided to travel to Peru and drink ayahuasca for the first time.
All these narratives mention strong ‘insights’ or introspective experiences during the ceremonies. This is something that has been described as a key therapeutic tool not only in ayahuasca studies, but also since the beginnings of psychedelic research.
Ayahuasca and drug policies
The medicalization process involved the delegitimization of popular pharmacopeias and home remedies, which were used freely until the end of the nineteenth century. The efficiency of the prohibitionist model has been called into question in recent decades, and there have been some experiments with alternatives.
The substance DMT is included on the United Nations 1971 Vienna Convention’s ‘List 1’, but the INCB states that ayahuasca is not subject to control under international convention, although it recommends that each country control and monitor its use along with other similarly classified substances such as peyote and iboga.
The case of ayahuasca is related to the right to religious freedom, and has its precedents in the United States with the Native American Church and the ritual use of peyote. In 2009, the Santo Daime won their lawsuit against the US government for the right to drink their sacrament legally.
Feeney and Labate (2013) identify three legal barriers in Europe for ayahuasca centers and churches: (1) the legality of ayahuasca due to its DMT content; (2) the ambivalence over whether the religious practices of these centers and churches are regarded as legitimate in terms of fundamental human rights; (3) the threat to public health, morals and security.
The Spanish constitution recognizes the rights to freedom of worship and religion, but limits these rights if they impact on health and public order. This conflict led to a lengthy lawsuit by the Santo Daime church.
The Santo Daime church was registered as a religious institution by the General Directorate for Religious Affairs of the Ministry of Justice, but Alberto Varela was arrested for possession of the beverage as a public health offense and was eventually absolved.
Religion or medicine?
In all these cases, tensions circulate in three core categories: drugs, public health and religious freedom. In the case of ayahuasca or peyote, a human rights perspective in terms of freedom of worship can tip the balance in some countries, although the ritual practices are still not accepted as medicine.
Calabrese (2014) finds contradictions in his fieldwork among native Americans in the NAC and their use of peyote, which is classified as a Schedule I drug. However, peyote ceremonies fulfill a central function in native medical practices.
The use of ayahuasca and peyote in underdeveloped communities has a positive impact on health, and there is sufficient research to claim that in the right set and setting, these ‘medicines’ have positive therapeutic effects. However, there are also studies evidencing negative effects and contraindications of ayahuasca. Research into both positive and negative effects of ayahuasca and other psychedelics is essential for their potential scientific-therapeutic uses.
Conclusions
In the present article we have tried to rethink the religious/ spiritual networks wherein ayahuasca is drank as an essential element of a medical system, using a theoretical framework from critical medical anthropology.
In Spain and specifically Catalonia, ayahuasca is used in religious/spiritual networks, where psychologists, psychiatrists, anthropologists, spiritual seekers and wounded healers participate. These participants come to these networks after a long trek through different therapeutic options.
We illustrated how the medicalization process is also involved in the regulation of certain substances, considered ‘illegal drugs’. We also discussed the tensions that have arisen in Spain around three core categories: drugs, public health and religious freedom.
We believe that evaluations are necessary to favor participants/consumers themselves, minimizing risks and maximizing benefits, without failing to respect their practices and beliefs. However, medical anthropology has shown the impact of social and cultural factors in our modern western medical model.