A Qualitative Study of Intention and Impact of Ayahuasca Use by Westerners

This qualitative interview study (n=41) found that ayahuasca use by Westerners (in group settings), led to many sustained positive outcomes. These related to mental health, substance use, interpersonal relationships, and also creativity, physical health, connection to nature. Two participants indicated problematic experiences (sexual assault, enduring psychotic symptoms).

Abstract

“Ayahuasca has gained the attention of researchers over the past decade as psychedelic-assisted therapy for MDMA and psilocybin have progressed through FDA approved clinical trials. In spite of the increase in research, there are relatively few clinical studies of ayahuasca and little qualitative research on the therapeutic or healing uses of psychedelics in general. The present study included 41 Western participants who were interviewed about their participation in facilitated group ayahuasca experiences (e.g., in shamanic, neoshamanic, spiritual, and religious settings). Participants were interviewed about their intentions for participating, along with the perceived impact of the experiences. In particular, we focused on impacts that participants perceived to be sustained and enduring. We identified an impressive range of beneficial impacts, including improvements in areas that are often a focus of psychotherapy, such as mental health and substance use, health behaviors, interpersonal relationships, sense of self, attitude. Extratherapeutic effects were also observed in areas such as changes in creativity, somatic sensations, physical health/pain, sense of connection to nature, spirituality, and concern for the greater good. Two participants also reported problematic experiences, apparently related to set and setting. Implications for research and practice, along with a humanistic framework for interpreting these findings is provided.”

Authors: Geoff J. Bathje, Jonathan Fenton, Daniel Pillersdorf & London C. Hill

Notes

About half of the participants had done ayahuasca 1-20 times (n=22), about 25% had done it 11-25 times (n=10), and the rest had done it more often. On average, the last time was just over a year before the interviews.

They had participated in a variety of ayahuasca ceremonies, spanning four continents (i.e. the setting between experiences varied).

The intention of most participants was to either improve their mental health or other growth-focused intentions (e.g. improving relationships with others). The researchers found that these were also the areas where the participants found improvements. “Many participants felt their intentions were fulfilled, for example, many who sought to improve their mental health (e.g., depression or anxiety) experienced corresponding improvement. Other participants stated that they eventually obtained their desired outcome, but in less direct ways.”

Within the cluster of changes in mental health, four themes were identified:

1. Less reliance on psychotropic medications (e.g. ADHD medication, SSRIs)
2. Improvements in specific conditions (e.g. depression, PTSD, anxiety)
3. Relationship to emotions (better tap into them)
4. Post-use acute mental health symptoms

The last point related to two negative experiences. One participant was sexually assaulted by another participant at that ceremony (showing again the trouble with the illegality of psychedelics). Another participant experienced psychotic symptoms for three months after the ceremony and required antipsychotic medication.

“I had some levels of depersonalization, dissociation. After 3 months it started tapering off. Then I went 3 months normal, other than I hope that doesn’t happen again.“

Participants reported lower use of alcohol and cannabis, and other drugs after the use of ayahuasca. Some indicated that the experience (not indicated if that was the last one or an earlier one) broke a decades long problematic use of morphine.

Three themes with relationship to physical health were identified:

1. Reduction in physical pain
2. Healing from illness or disease (self-reported remission of liver cancer)
3. Somatic changes in relationship to own body (e.g. feeling less stress)

With regards to self-care practices, four themes were identified:

1. Reconnecting through mind-body practices
2. Improvements in diet/nutrition
3. Increased mindfulness in daily activities
4. Stopping/reducing unhealthy habits

Creativity and career decisions were also impacted:

1. Change in career path
2. Enhanced work/career performance
3. Access to creative expression (through increased confidence)

TBC

Summary

A study was conducted with 41 Western participants who participated in facilitated group ayahuasca experiences. The study identified an impressive range of beneficial impacts, including improvements in areas that are often a focus of psychotherapy, such as mental health and substance use, health behaviors, interpersonal relationships, sense of self, attitude.

Psychedelic substances have been described as being in a Renaissance, and increased interest in ayahuasca has been observed online and in media. Ayahuasca is a brew of plants originating with the indigenous peoples of the Amazon, and is used in response to illnesses that do not respond to traditional or Western medicines.

There is not much record of ayahuasca use prior to Hispanic colonization, but recent archeological findings indicate that ayahuasca was used over 1,000 years ago in shamanic rituals. Western interest in psychedelics has been marked by an increasing focus on their therapeutic potential, and ayahuasca has been associated with positive psychological health, optimism, treatment of substance use disorders, treatment of depression, treatment of eating disorders, increased creativity and problem solving, increased capacity for mindfulness, and cognitive flexibility. The process of drug approval through the FDA utilizes a medical model approach, which is clearly limiting given the vast number of potential applications of psychedelics.

There are few qualitative psychological studies on psychedelics, or on ayahuasca specifically, but they can be seen as disrupting status quo mental processes and creating a pivotal state, where change in a beneficial or harmful direction is possible depending on the quality of the holding environment. In the current study, we sought to understand why people consume ayahuasca and the impact of their experiences with ayahuasca. We focused on use in group religious, indigenous shamanic, and neoshamanic contexts.

We interviewed 41 participants who had taken ayahuasca from 1-10 times, 24.4% from 11-25 times, 14.6% from 26-49 times, and 4.9% more than 50 times. The average time since their last use was 13.34 months, and they attributed their self-reported outcomes to specific administrations of ayahuasca.

We recruited participants through announcements at venues where ayahuasca would be discussed, in person and online, and utilized snowball sampling to obtain participants from international ayahuasca retreats.

We conducted phone interviews with participants to examine their intention for trying ayahuasca and their perceived impact on their lives.

The present study employed a phenomenological approach to analyze qualitative data and identified eleven major themes, including lasting impact on mental health, substance use, physical health/somatic feeling, self-care practices, relationship to oneself, attitude and perspective, work or creativity, interpersonal functioning, connection to nature, concern for the greater good, and spirituality.

Participants reported going into their ayahuasca experiences with various intentions, including to improve their mental health, improve their relationships, learn more about themselves, heal from physical ailments or pain, augment creative or professional abilities, manage their substance use, have a spiritual experience, or have a new experience. I am taking steps to heal myself and my daughter. I know it won’t be easy, but I am not feeling hurt anymore. Some participants set out to change one aspect of their lives, but experienced a significant change in another aspect of their lives instead. This change was valued more than the original intention.

Change in mental health was the most common intention and second most common outcome of participants’ ayahuasca experiences. This theme was characterized by four subthemes: (1) less reliance on psychotropic medication; (2) improvements in specific conditions; (3) greater depth or healing from a past traumatic experience. Participants reported significant improvements in their depression, anxiety, and traumatic experiences after taking ayahuasca. These improvements appeared to stem from changing how they respond to thoughts and emotions. Greg, 38, White, heterosexual male, felt a weight was lifted off his back, and his grief for his brother was completely gone. He saw how much love people had for him.

Ayahuasca improved participants’ anxiety, including generalized anxiety, obsessive-compulsive disorder, death anxiety, panic attacks, and more. Participants reported facing fears during their ayahuasca experience or shifting their perspective to see their fears from a new perspective, which led to reductions in avoidance of fear. Some participants reported healing from traumatic experiences, such as being able to talk to themselves in the same way ayahuasca would talk to them, or being able to better understand how and why the trauma took place.

Ayahuasca was described as an autonomous entity that conveyed wisdom or that helped participants to face their psychological issues. Three participants endorsed experiencing greater depth and understanding of emotion following their ayahuasca experiences.

Two participants reported significant change in their anger after the use of ayahuasca, and one participant reported a sexual assault by another participant during a ceremony. This participant required temporary use of antipsychotic medication before resolving, and may have met criteria for Hallucinogen Persisting Perception Disorder.

This participant had consumed ayahuasca alone, in addition to participating in several ceremonies. He experienced flushings every day for 3 months, and then the effects tapered off.

Participants reported improved mental health and a change in substance use following experiences with ayahuasca. The change was due to various factors, including resolving other issues and receiving spiritual messages.

Someone put out a pile of cocaine on the table, and I took the entire AYAHUASCA INTENTION IMPACT 16 lot. It didn’t have any effect whatsoever.

Participants described spiritual and psychological experiences that impacted their view of their substance use, and nine reported lasting changes in their physical health or somatic experience after consuming ayahuasca, including reduction in physical pain, healing from illness or disease, and somatic changes in relationship to one’s body.

Some participants sought to treat physical illnesses or conditions by taking ayahuasca, and four reported recovering from illnesses or diseases following ayahuasca ceremonies. Ten participants reported feeling different in their body after taking ayahuasca, including feeling less chronic stress in the body, feeling more in tune with bodily sensation, and feeling more energy.

Brett, 30, White, gay, male, started transcendental meditation after ayahuasca and it has really leveled him out.

Xavier, 27, White, gay male, needed to see his bad habits to make himself stable.

Twelve participants identified that they permanently changed their career paths following their ayahuasca use, with many moving into helping professions. They included life coaches, counseling, shamanism, massage therapy, arts, and agriculture and sustainability.

Nicole quit her job to study documentary film and has since made several films.

Four participants highlighted that ayahuasca allowed them to express themselves creatively, such as through art, dance, singing or music.

Twelve participants reported increased self-understanding and authenticity, including a greater sense of personal boundaries and rights. One participant explained how ayahuasca helped him accept his sexuality.

Following their ayahuasca experiences, participants became more open to looking at their limitations and mistakes, critically reflecting about themselves without judgment, and increased self-efficacy. Some participants changed professions and altered their personal relationships.

A participant reported that his ayahuasca use created an opportunity for him to critically reflect on areas for self-improvement, despite not having the profound ayahuasca experience that he expected.

Ayahuasca gives you a perspective on your egocentric default setting, while also reassuring you that everything is going to be fine.

Eleven participants said they gained a sense of personal meaning or purpose in life after taking ayahuasca, and 20 acknowledged having experienced basic attitudes changes.

Lorrie, 36, White, heterosexual, female, felt pathetic for feeling depressed, but learned to feel grateful that she was alive and well.

Five participants reported general increases in feelings of optimism and hopefulness, including when under stress.

Ayahuasca users reported improved interpersonal relationships, sense of community, understanding attachment and relationships, deeper empathy, access to love, and capacity to connect.

Participants reported lasting close friendships with other attendees at ayahuasca ceremonies, and improved relationships with significant others. One participant, who reported an Asperger’s diagnosis, insisted that his ability to be comfortable in an intimate relationship with his significant other was due to using ayahuasca.

Participants reported being able to interact with work colleagues more enthusiastically, forming closer connections with family members, and changing the way they interacted with their three adult sons.

Three participants explicitly attributed a lasting change in their ability to love others to their ayahuasca use. They stated that they placed more value on love.

Ten participants reported feeling closer to or more connected to nature following their experiences with ayahuasca, including visiting nature, having more plants at home, or growing their own food.

We live in the middle of the rain forest, and dedicate our lives to the teaching and learning of plants.

Eleven participants reported changing their views on a range of issues following their experiences with ayahuasca, including materialism, consumerism, environmental destruction, and various forms of oppression and social control.

After having their eyes opened up, it can be tough acclimating back to this crazy world afterwards. Four participants indicated that their experience with ayahuasca motivated them to become more active in improving the world. Plants have guided me into alignment with the planet, and I’m now building a business that focuses on repairing ecological systems and helps look at the economic and political and cultural systems that cause people and other species here to be sick. Six participants spoke about the potential impact of ayahuasca on the world if used properly, or about concerns of misuse. They developed a strong belief that the consumption of ayahuasca could help make society a better place if used properly.

Sixteen participants reported significant changes in their spirituality following their ayahuasca experiences. These changes were characterized by three subthemes.

Participants reported experiencing a sense of spiritual immortality and interconnectedness after taking ayahuasca, and some reported becoming more spiritual afterward. Some participants stated that they had not been very spiritual before taking ayahuasca, though some did become more spiritual afterward. Lorrie, 36, White, heterosexual, female, changed her spiritual belief systems after her interaction with shamans.

Many participants reported becoming more spiritual after their experiences with ayahuasca, and three reported moving from atheist to spiritual. Others reported moving from believing in a religion to being spiritual but not religious. Ayahuasca has led me to a place where I don’t attach myself to belief systems and what I think I know anymore. I’m very spiritual, but not religious at all, and I’ve grown profoundly since doing it. The last night I was there, I connected with the Earth and saw a net all around me, like a leaf from a tree looking down.

Six participants reported that their new spiritual attunement profoundly affected their daily living, including being more mindful, expressive, and appreciative of all their life experiences.

Participants compared the effectiveness of ayahuasca to other treatment modalities, including mental health therapy, psychiatric medications, and mind-body and meditative practices.

AYAHUASCA INTENTION IMPACT 35 feels like years of therapy condensed into a couple of hours. You learn so much about your own psyche.

Five participants reported that ayahuasca was more effective than prescription medication for their mental health struggles, whereas none found medications to be more effective.

Xavier, 27, White, gay male, meditates and practices different dreaming techniques, but ayahuasca is the most helpful in facing the most difficult things.

Participants stated that meditation, yoga, and Reiki were complementary to ayahuasca, as they allowed for tapping into a similar state of consciousness and aided in the integration of beneficial ayahuasca experiences.

Participants spoke to the importance of a safe setting, an experienced facilitator, and a readiness to participate in an ayahuasca ceremony.

One of the other participants fondled and touched me inappropriately while I was in a paralyzed state. I didn’t know how to handle it and questioned whether I brought it with my energy, so I decided to just hold space and not drink ayahuasca. Participants reported positive experiences with ayahuasca ceremonies, but reported a desire for more diversity among participants, a gender balance, and more racial/ethnic diversity. They also reported the importance of the shaman or facilitator in creating a safe and healing space.

Participants often cited the unfolding nature of their ayahuasca experiences, which sometimes required time to work through temporary emotional dysregulation or disruption of their usual psychological state.

In this study, participants experienced a diverse range of outcomes resulting from participation in various types of facilitated, group ayahuasca experiences. These outcomes included positive changes in psychological health, increased mindfulness, spirituality, sense of well-being and sense of purpose, and reduction in substance use.

The impacts of the ayahuasca experience were broader than the participants’ intentions, and often played out in surprising ways. The revelatory nature of the ayahuasca experience seemed to show some participants the need to change, while for others, problematic substance use appeared to be a functional response to cope with deeper issues. Participants who were open to the ayahuasca experience made statements that reflected their openness to the medicine. This openness may be an important component of one’s set that allows for wider range of changes to occur.

Participants who used ayahuasca for therapeutic or healing reasons showed increased Openness and decreased Openness, which suggests that ayahuasca may be seen as less of a recreational substance. The rich descriptions of our participants demonstrate that narrow clinical labels and symptoms cannot fully capture the nature of the change process. Many participants also reported receiving emergent insights or teachings, and many experienced rapid change in foundational areas like attachment, beliefs, attitudes, and perspectives.

AYAHUASCA INTENTION IMPACT 41 relapses are not diminished by conversion experiences, and the recipient remains identified with the experience despite relapses. Participants reported feeling guided through their experiences with ayahuasca, and a sense of connection to truth was evident. This may have led to questions about harmful socialization and aspects of their culture, as well as a comfort with being “different” and following their internal compass.

Each participant experienced one or more variations of shamanic, neo-shamanic, Western spiritual, or ayahuasca religion ceremonial group setting. They influenced their set through dietary preparation leading up to ceremonies, by setting intentions for the experience, by approaching the experience with openness, and by researching ayahuasca. Ayahuasca participants reported that their intentions were either met by their ayahuasca experience or led into deeper dynamics, but that their intentions did not give them control over the experience.

We found that shamanic models of psychedelic facilitation are more effective than narrow biomedical models for understanding the effects of psychedelics, and may have much to offer Western treatment models that are often narrowly focused on symptoms within the individual.

Ayahuasca use in combination with certain medications can have potential adverse effects, such as serotonin-shock syndrome.

Ayahuasca intention impact 44 (Grady & Stahl, 2012) reported that one participant experienced possible HPPD and another reported experiencing sexual assault during her ayahuasca retreat. Resources are needed to support those who experience harm or adverse experiences during psychedelic experiences. Sexual abuse by facilitators has been reported in all settings with psychedelics, whether by indigenous shamans, Western facilitators, or therapists in research settings. Scholars and participants have also committed sexual abuse.

AYAHUASCA INTENTION IMPACT 45 facilitators of psychedelic experiences need to have a strong sense of ethical boundaries, clear boundary agreements with participants, and awareness of their own countertransference. While the psychedelic experience itself is powerful and often beautiful, joyful, transcendent, spiritual, and cathartic, participants often reported feeling emotionally vulnerable and raw after revisiting traumas, experiencing “shadow content”, disrupting their defenses and coping mechanisms, or feeling their minds were disrupted or restructured.

Most participants commented on the importance of the facilitator and physical space, and demonstrated giving some attention to integration through wellness practices, psychotherapy, spiritual practices, creative/artistic practices, or supportive communities.

Several limitations of our study must be noted, including that participants came from Western societies/regions and were voluntary. Additionally, many participants had significant experience with other psychedelics, which could raise questions about which substance caused the reported effects.

Overall, we were impressed by the diversity and depth of impacts reported by our participants, and hope that as ayahuasca continues to enter Western societies, adequate attention will be given to the knowledge and practices of the indigenous peoples of South America.

A study of ayahuasca users found that they had a variety of personality traits, psychiatric symptoms, and quality of life issues, and that they were more likely to report having a pivotal mental state during their ayahuasca sessions.

Ayahuasca intentional impact: A survey of pharmacy education researchers’ perceptions of and experiences conducting qualitative research; Fotiou, E. (2016). The globalization of ayahuasca shamanism and the erasure of indigenous shamanism; Gable, R. S. (2006).

Ayahuasca is used in the treatment of addiction, as well as in the treatment of mental health disorders. It has been shown to have positive effects on the brain and the body, and may help with the recovery from eating disorders.

Ayahuasca, a plant used in shamanic rituals, is thought to have therapeutic effects in the treatment of substance dependence. Chemical evidence for the use of multiple psychotropic plants in a 1,000-year-old ritual bundle from South America has been found.

Ayahuasca and its alkaloids may have therapeutic effects on opioid dependence, including improved mindfulness and cognitive flexibility. A randomized, controlled pilot study of MDMA (+3, 4-methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic post-traumatic stress disorder (PTSD) is currently ongoing.

Ayahuasca has been shown to have antidepressant effects in a randomized placebo-controlled trial in patients with treatment-resistant depression. The effects are also seen in ayahuasca shaman-participant interactions and in the quality of acute psychedelic experience.

Ayahuasca intention impact is a topic covered in the text, and several references are made to the text, such as Sessa (2018), Shephard G.H. Jr. (2014), Swift T.C., Belser A.B., Agin-Liebes G., Devenot N., Terrana S., Friedman H.L. … Ross R. (2017).