Ayahuasca improves emotion dysregulation in a community sample and in individuals with borderline-like traits

This observational study (n=45) suggests that ayahuasca may have a beneficial effect on psychological functioning by improving mindfulness-related capacities. The authors suggest that ayahuasca-assisted therapy could play a role in treating those with borderline personality disorder (BPD) traits.

Abstract

“Background: Research suggests that mindfulness-based interventions may improve mindfulness-related capacities (e.g., decentering, non-judging, and non-reacting) and emotion regulation. Previously, our group reported that ayahuasca could be a potential analogue of mindfulness practice. The main aim of the current study was to examine the effects of ayahuasca on emotional regulation and mindfulness-related capacities. Secondarily, we sought to explore the effects of ayahuasca on individuals with borderline personality disorder (BPD) traits.

Method: This is an observational study of 45 volunteers who participated in an ayahuasca session. The volunteers completed various self-report instruments designed to measure emotional dysregulation (Difficulties in Emotion Regulation Scale (DERS)) and mindfulness traits (Five Facet Mindfulness Questionnaire (FFMQ)-Short Form and Experiences Questionnaire (EQ)) prior to and 24 h after the ayahuasca session. The volunteers were divided into two subgroups based on their score on the McLean Screening Instrument for BPD (MSI-BPD). Twelve participants were grouped into the BPD-like traits subgroup while the rest of them were included in the non-BPD-like subgroup. We performed within-subjects and between-group analyses.

Results: Overall, the participants showed significant improvements on the FFMQ subscales observing, acting with awareness, non-judging, and non-reacting and also significantly improved on decentering (EQ scale) and on the DERS subscales emotional non-acceptance, emotional interference, and lack of control. The BPD-like subgroup also showed significant improvements on the DERS subscales emotional interference and lack of control but not in mindfulness capacities.

Conclusions: These findings suggest a potential therapeutic effect for ayahuasca in emotion regulation and mindfulness capacities (including decentering, acceptance, awareness, and sensitivity to meditation practice). Based on these results, we believe that ayahuasca therapy could be of value in clinical populations, such as individuals with BPD, affected by emotion dysregulation.”

Authors: Elisabet Domínguez-Clavé, Joaquim Soler, Juan C. Pascual, Matilde Elices, Alba Franquesa, Marta Valle, Enric Alvarez & Jordi Riba

Summary

Research suggests that ayahuasca may improve mindfulness-related capacities and emotion regulation. The current study examined the effects of ayahuasca on individuals with borderline personality disorder traits.

Introduction

Ayahuasca is a drug that has long been used for religious purposes in the Amazon basin, but has recently spread worldwide among non-indigenous people in the Western world. It is usually ingested as a tea, generally by mixing Banisteriopsis caapi with Psychotria viridis.

Ayahuasca induces a dream-like but conscious state characterized by introspection, visions, enhanced emotions, and recollection of personal memories. These effects have been associated with DMT and the intracellular sigma-1 receptor.

Ayahuasca may have positive effects on depression, anxiety, substance abuse, and other mental disorders, as well as on overall well-being. It is believed that ayahuasca may enhance mindfulness-related capacities such as decentering and acceptance, which can be trained through mindfulness practice.

Emotion regulation (ER) is a core symptom in many psychiatric disorders, particularly borderline personality disorder (BPD), and improving ER might facilitate more reflective and less emotion-driven responses, which are crucial to improving the daily life of patients with BPD.

Although no studies have yet been carried out to investigate the effects of ayahuasca on the capacity to regulate emotions, the present study explored the potential effects in a subset of individuals with BPD-like traits.

Participants and procedure

All of the participants were enrolled in the study in the context of ayahuasca experience. They completed a series of questionnaires prior to the ayahuasca sessions and a follow-up questionnaire after the ayahuasca experience to determine if they had experienced any changes in their feelings or behavior.

We administered a BPD screening measure to 45 volunteers and divided them into two groups based on McLean Screening Instrument for BPD (MSI-BPD) scores: 12 individuals with BPD-like traits and 33 individuals without BPD.

Measures

The Difficulties in Emotion Regulation Scale (DERS) was used to explore the various facets of ER. It contains 28 items divided into 5 subscales, with higher scores indicating greater difficulty of regulating emotions.

The Five Facet Mindfulness Questionnaire – Short Form (FFMQ-SF) was used to explore various facets of mindfulness. It contains 24 items measuring five different factors, including observing, describing, putting words to, or labeling the internal experience, acting with awareness, non-judging the inner experience, and non-reacting to the inner experience.

The Experiences Questionnaire (EQ) measures an individual’s ability to observe thoughts and emotions as temporary objects of the mind. Higher scores indicate a greater decentering capacity.

The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a simple and rapid 10-item self-report questionnaire that is scored dichotomously (true – false). It has good psychometric properties and an optimal test – retest reliability.

Data analysis

The sociodemographic data of the two subgroups were compared by paired t tests and chi-square tests, and changes in ED and mindfulness capacities were assessed using multivariate and univariate analyses of variance.

Characteristics of the sample

The mean age of the 12 individuals in the BPD-like subgroup was significantly older than that of the non-BPD subgroup, and the BPD-like subgroup had a significantly higher mean score on the MSI-BPD scale than the non-BPD subgroup.

Effects of ayahuasca on emotion regulation and mindfulness-related capacities

A two-way repeated measures ANOVA did not identify any pre-post differences between the groups, except for the DERS subscale lack of control. The pre-post changes were also assessed in the same analysis and showed a significant evolution in time for the DERS subscales.

There were significant increases in observing, awareness, non-reacting, and non-judging on the EQ, and significant changes in the MINDSENS index on the DERS, but no significant increases in emotional non-acceptance, lack of clarity, and emotional awareness.

Discussion

To our knowledge, this is the first study to assess the potential beneficial effects of ayahuasca on emotion regulation in individuals who exhibit BPD-like traits. The study found that ayahuasca improved three out of five DERS subscales, indicating an overall improvement in ER.

We found significant differences in two of the DERS subscales in the subgroup of individuals with BPD-like traits: emotional interference and lack of control. However, the group-dependent effect for the latter subscale was not revealed by the two-way repeated measures ANOVA.

Ayahuasca has similar effects to mindfulness practice on mindfulness-related capacities and decentering, with the exception that the non-judging subscale remained elevated 2 months after the ayahuasca session.

Ayahuasca increased the non-judging and non-reacting FFMQ subscales in participants, which are two mindfulness characteristics related to the “Acceptance” domain of mindfulness. This could be important for individuals with bipolar disorder to be able to reflect on their experiences without getting carried away by their thoughts and their emotions.

Individuals with BPD suffer from impulsivity and ED symptoms that may be severe or even disabling. Ayahuasca may be an interesting option for clinical practice, but more research is needed to examine this possibility.

This exploratory study was performed in healthy volunteers without any formal diagnosis of BPD. Although the sample size was small, the results seem promising, and future studies should compare long-term vs. naive ayahuasca users to determine whether the usage history affects certain capacities.

Conclusions

Ayahuasca may positively influence emotion regulation and mindfulness capacities, which opens new horizons for the therapeutic use of this ancestral substance in several mental disorders.