Ayahuasca and Spiritual Crisis: Liminality as Space for Personal Growth

This anthropological analysis of phenomenological case reports examines how ayahuasca ceremonies occasion liminal spaces, wherein participants undergo a period of transformation characterized by the process of stripping away one’s prior beliefs, identity, and social status, which can also lead to the emergence of spiritual crises. On the basis of a case study within the context of ayahuasca tourism, the authors highlight the need for clinical support to integrate challenging experiences through the exploration of their spiritual and psychological meaning.

Abstract

“There is an increased controversy surrounding Westerners’ use of ayahuasca. One issue of importance is psychological resiliency of users and lack of screening by ayahuasca tourism groups in the Amazon. Given the powerful effects of ayahuasca coupled with lack of cultural support, Western users are at increased risk for psychological distress. Many Westerners who experience psychological distress following ayahuasca ceremonies report concurrently profound spiritual experiences. Because of this, it may be helpful to consider these episodes “spiritual emergencies,” or crises resulting from intense and transformative spiritual experiences. Although the author warns readers to avoid romantic comparisons of Western ayahuasca users to shamans, ethnographic data on indigenous shamanic initiates along with theory on liminality may be of some use to understand difficult experiences that accompany ayahuasca use. Given that psychotherapy is culturally sanctioned, therapists trained in treating spiritual crises can help Western ayahuasca users make meaning of their distress. Three case studies are offered as examples of individuals working through various sorts of crises following ayahuasca ceremonies.”

Author: Sara E. Lewis

Summary

Westerners who use ayahuasca are at increased risk for psychological distress, but ethnographic data on indigenous shamanic initiates and theory on liminality may help explain these experiences. Psychotherapists trained in treating spiritual crises can help Western ayahuasca users make meaning of their distress.

States

Anthropology of Consciousness, 19(2), 109–133, 2008.

introduction

Ayahuasca, a botanical hallucinogenic brew used in South America, can lead to powerful experiences that are often experienced as spiritual in nature and may be incongruent with Western worldviews and normative cultural value systems.

Three people who suffered psychological distress following an ayahuasca ceremony stressed the religious or spiritual significance of this distress. The clinicians argue that more training on religious and spiritual issues is necessary.

To understand the transformation process, I draw upon classic anthropological theory involving liminal states. I argue that this theoretical model is also applicable to transitional states in contemporary Western society, and that there are loose similarities between indigenous shamanic initiates and crisis experiences of Western ayahuasca users.

I argue that psychotherapy can help Westerners who use ayahuasca make sense of their experiences and integrate them into culturally relevant methods of learning.

Researchers have begun using ayahuasca outside traditional South American contexts, and have focused on treating addiction.

Laypeople around the globe have developed an interest in ayahuasca, with many traveling to the Amazon to participate in ceremonies. These tours are controversial with indigenous Amazonians and Western anthropologists.

Although ayahuasca is an extremely powerful hallucinogen, its danger is psychological in nature. Curanderos state they use the substance to leave their bodies, travel to spiritual realms, and engage with spirits.

Ayahuasca is an admixture of banisteriopsis caapi and psychotria viridis, and is often mixed with brugmanisa, a flowering tree plant belonging to the Solanaceous genus. Brugmanisa can cause convulsions, blindness, delirium, and coma if ingested in toxic doses.

Westerners who use ayahuasca can develop distressing psychological symptoms as a result of a powerful positive experience.

A new diagnostic category, Religious or Spiritual Problem, has been added to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders to address psychological symptoms concurrent with religious or spiritual issues.

People dealing with spiritual emergencies often seek clinical treatment for their anxiety and other distressing symptoms. These symptoms should be treated as a normal reaction to a stressful event.

Spiritual emergencies differentiate transformational crises from psychiatric disorders, and are often quite severe. The psychological distress associated with spiritual emergencies may be an opportunity for deep healing and transformation.

A shamanistic initiatory crisis is a type of spiritual emergency that can occur when a nonshaman has spiritual experiences analogous to shamanic activities. Non-Amazonian people who experience shamanistic activities during an ayahuasca ceremony are at risk for spiritual emergencies due to lack of cultural support.

Westerners having shamanistic experiences violate cultural concepts of normalcy, which can produce anxiety. If they are treated by a clinician who does not take the spiritual aspects of the situation seriously, they become even more anxious.

Stanislov and Christina Grof argue that clinicians should be trained to work with patients coping with spiritual emergencies, but are not accustomed to treating patients outside of a disease model.

Patients with near-death experiences and communication with dead relatives present with familiar symptoms, but the etiology is unfamiliar territory. This marks a slew of moral and ethical clinical issues.

In some ways, psychiatry and psychology have always struggled with religion. I argue that treating the spiritual experience as unreal is not an effective way to help patients manage, analyze, and integrate their transformative experiences, and that one must be wary not to romanticize mental illness itself.

I do not disagree with Foucault, Laing, Szasz, and others that there are no behaviors inherently pathological. However, I do believe that individuals who experience a spiritual crisis might experience psychological distress, which could lead to personal growth and positive transformation.

accounts of spiritual crises following ayahuasca ceremonies

Three Americans who claim to have suffered spiritual crises following ayahuasca ceremonies were interviewed. They have been given pseudonyms to protect their anonymity.

Emma

Emma, a woman in her midtwenties, participated in eight ayahuasca ceremonies over a period of 3 years before the particular ceremony leading to her spiritual crisis. She experienced a wide variety of mental disorders and symptoms including severe panic, paranoid delusions, auditory and visual hallucinations, profound depression, catatonia, obsessive compulsions, mania, and dissociative symptoms. Emma fell into a severe depression after taking a hallucinogen. She saw a clinical psychologist who felt she induced a major depressive disorder with psychotic features, but Emma rejected this diagnosis believing there was something important she needed to learn.

Sophie

Sophie, a woman in her late forties, started a 3-month traditional diet where she ingested a ”teacher” plant (nonhallucinogenic) every day and abstained from sugar, salt, pork, shellfish, particular fruits and vegetables, alcohol, and sexual activity. This diet triggered a spiritual emergency. Sophie reports that after a large dose of ayahuasca she couldn’t move, speak, or think, and the next morning she ”crashed”. She had an understanding for the first time how someone would prefer suicide to life.

Will is a man in his early thirties who uses hallucinogens to cure his mental suffering. After his wife left him, his depression, anxiety, and suicidality increased, motivating him to check into a psychiatric hospital and begin a course of antidepressant medication.

I use phenomenological accounts of spiritual crises following ayahuasca ceremonies to argue that there are serious psychological risks involved. I will discuss the theoretical aspects of liminality and transition, and how clinicians can help their patients manage spiritual crises.

liminality and transition

Theory on liminal states stems from Arnold van Gennep’s work on rites de passage, and has been expanded on by anthropologists, focusing mostly on initiation rituals, and other highly symbolic activities. Victor Turner employed theory on liminality to analyze ritual practices among Ndembu.

Rites of passage are marked by three phases: separation, liminality, and reaggregation. In the separation phase, one is suddenly detached from his or her previous state, and in the liminal phase, one has an ambiguous identity.

Many theorists focus on the liminal phase in rites of passage, where vulnerability is ascribed to those existing in liminal states. This vulnerability can ultimately lead to a move into a higher or more prestigious status.

Although one can move from a lower status to a higher status as a result of ritual experience, this period is marked by anxiety, discomfort, pain, or altered states of consciousness.

The liminal period, as mentioned above, is associated with distress, in particular psychological distress. Emma was diagnosed with induced major depressive event and was prescribed mood-stabilizing drugs to restore her health.

Emma, who was resistant to psychiatric medication, experienced a wide range of mental illnesses during ayahuasca ceremonies. She believes she was ”called” by a divine force and experienced mental illness to develop a profound sense of empathy that is necessary in healing work.

shamanic initiation and illness

Shamanism has been linked with mental illness in some Western interpretations. I argue that strange behavior with mystical characteristics does not make one a practicing shaman, and that some shamans seem to discover their ”callings” upon falling ill.

In many shamanic cultures, people are ”called” to become shamans by a divine source. The act of becoming a shaman is discussed in such a way that it seems more like a birthright than an occupation one may choose.

There are many ethnographic examples illustrating the degree to which shamanic callings are taken seriously by the community. Some people even try to reverse their calling by drinking their own urine.

Shamanic communities often believe that if a person refuses a calling to become a shaman, they will become insane. Therefore, it is not surprising that shamanic callings are often discussed in relation to mental illness.

Emma felt that her experience of mental illnesses during the ayahuasca ceremony brought her to the realization that she wanted to be a healer.

Carol Kats, a licensed clinical social worker, realized she wanted to be a psychotherapist after recovering from third-stage melanoma.

Kats’ shamanic calling involved overcoming a potentially life-threatening illness, and also a rebirth into her proper place in the world. This is consistent with ethnographic data on shamanism, and in particular with the idea that death – rebirth scenarios are common among initiates.

Franz Boas recounts the experience of a shaman who was called to be a healer and was given magical power to be a successful hunter in return for his help.

The hunter was visited again by the wolf in another vision, and was given the power to heal, project energy that makes people ill, and catch lost souls. He became a shaman, and was literally saved from death by the wolf.

In liminal states, individuals are associated with death and destruction, and are treated like corpses. They are likened to embryos, newborn infants, or sucklings, and are considered neither living nor dead from one aspect, and both living and dead from another.

According to Turner, spiritual emergencies are marked by experiences of undoing, dissolution, decomposition, and the reformulation of old elements in new patterns. Ayahuasca users’ death rebirth experiences are different from traditional shamanic initiates’ experiences because there is no culturally supported symbolic meaning.

Kalweit explains that when one emerges from ritual death, one can see life and nature undistorted, because the mask of earthly ignorance and delusion was removed from his eyes. Before one can achieve this state of illumination, one must undergo the pain and suffering characteristic of liminal states.

Shamanic skill is usually attributed to natural ability and spontaneous knowledge acquisition. Initiation is usually through songs, dances or chants.

In the Amazon, one must purify their body through special diets to acquire knowledge through magical songs.

Ayahuasca ceremonies are marked by knowledge acquisition, and the integration of knowledge into a new identity. Clinical treatment can aid in the integration of distressing material, and should focus on the meaning of the spiritual crisis, rather than diagnosing a pathological condition.

The concept of illusion holds great value in ayahuasca ceremonies, as they often lead to spiritual emergencies that are difficult to negotiate in terms of objectivity.

Winncott used the term ”illusion” to make sense of Emma’s narrative, and I argue that an effective clinician helping a patient overcome a spiritual crisis will recognize the significance of meaning making.

In the West, mental illness is always considered negative and undesirable. However, in some cases, sickness and suffering can be considered a process of physical and psychic transformation, an opportunity for healing, learning, and personal growth.

Gutzmann’s philosophy on crises reflects my argument that a spiritual crisis can be a powerful source of knowledge. However, general psychiatry does not share this philosophy.

Dr. Thomas Kramer, a psychiatrist, argues that the stress – diathesis model gives a satisfactory explanation for spiritual emergencies following ayahuasca ceremonies.

Kramer argues that individuals who manage the stress associated with drinking ayahuasca are less vulnerable to developing psychological symptoms such as anxiety or depression.

In a spiritual crisis concurrent with psychological symptoms, it is essential that one comes to understand his or her distress as a process of transformation. Sophie’s statement indicates that she experienced pain from a ”crack” in her armor, but there is a larger process at work.

Sophie, a Peruvian curandero’s apprentice, feels estranged from her teacher due to cultural difference, but also estranged from her own culture.

Fortunately, more clinicians are recognizing the need to deal with religious and spiritual issues in therapy. However, there is little formal training offered in religious and spiritual issues in clinical graduate programs and psychiatric residencies.

discussion

I have suggested that theory on liminality accurately frames spiritual crises following ayahuasca ceremonies. The distress that may come about is a normal reaction to a stressful event, and can be considered a process of transformation.

Ayahuasca users who develop psychological distress should seek support from sensitive and properly trained psychotherapists. This support can help them work through spiritual crises and find knowledge and healing.