Four weekly ayahuasca sessions lead to increases in “acceptance” capacities: a comparison study with a standard 8-week mindfulness training program

This observational cohort study (n=20) compared the effects of four consecutive ayahuasca sessions with those of standard mindfulness training between two independent groups of healthy individuals. Although mindfulness training had an overall greater impact on mindfulness capacities, ayahuasca intake led to spontaneous increases in certain aspects of acceptance towards potentially distressing emotions and thoughts.

Abstract

“Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N-dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills.

Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A (n = 10) was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B (n = 10) was assessed before and after completion of a standard 8-week MBSR course.

Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring “acceptance.” Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions.

Conclusion: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the benefits of combining ayahuasca administration with mindfulness-based interventions. This will allow us to investigate if ayahuasca will improve the outcome of psychotherapeutic interventions.”

Authors: Joaquim Soler, Matilde Elices, Elisabeth Dominguez-Clavé, Juan C. Pascual, Amanda Feilding, Mayte Navarro-Gil, Javier García-Campayo & Jordi Riba

Summary

Ayahuasca, a tea obtained from the mix of Banisteriopsis caapi with Psychotria viridis or Diplopterys cabrerana, contains several alkaloids that have been shown to inhibit MAO and serotonin reuptake. DMT is the main psychotropic agent of ayahuasca, but the -carbolines may also have a relevant contribution to the overall effects. Ayahuasca has been consumed for ritual and medical purposes in the Amazon Basin. Research shows that habitual ayahuasca consumers show lower hopelessness and depression levels, and higher scores on certain personality traits like agreeableness and openness.

Ayahuasca might increase mindfulness-related capacities, which can be fostered through meditative practice. Mindfulness-Based Stress Reduction is a commonly used intervention that focuses on the cultivation of mindfulness through formal meditation practices and the integration of mindfulness-principles into everyday activities. In our previous study, we found that ayahuasca intake led to increases in three core mindfulness facets: decentering, non-judging and non-reacting. Moreover, MRI results showed that these facets were maintained 2 months later.

An exploratory-comparison study was conducted to evaluate the similarities and differences of two approaches to foster mindfulness capacities: participation in four consecutive ayahuasca sessions without the specific purpose of improving mindfulness capacities, and participation in a standard mindfulness training course.

Participants

We enrolled 20 individuals in the study, ten in each group. The EQ scale was used to match participants between groups, and there were no baseline differences between ayahuasca and MBSR groups.

Participants in the ayahuasca group needed to abstain from ayahuasca, medications or illicit drugs for 2 weeks before the initial assessment, and agree to abstain from taking any drug other than ayahuasca for the entire duration of the study.

The mindfulness group consisted of individuals naive to meditation who had enrolled in a MBSR course. They agreed to abstain from taking any psychoactive drug for the entire duration of the study.

Study Groups Ayahuasca Group

Participants were recruited from a pool of individuals who freely decided to participate in ayahuasca sessions in a non-religious setting. The sessions lasted between 6 and 8 h and questionnaires were administered before and after each session.

MBSR Group

Participants in this group practiced three types of mindfulness techniques: body scan, mindful hatha yoga postures, and sitting meditation. They were encouraged to conduct informal mindfulness exercises by carrying out everyday activities with a full awareness of the movements, sensations, cognitions, and feelings that may be involved in each particular task.

Measures

The Five Facet Mindfulness Questionnaire was used to measure five mindfulness components: observing, describing, acting with awareness, and non-judging the inner experience.

The FFMQ includes five factors: observing, describing, acting with awareness, non-judging, and non-reacting to the inner experience. Facet scores range from 8 to 40, with higher scores reflecting greater mindfulness.

The EQ was used as a measure of decentering, which is the capacity to observe one’s thoughts and emotions in a detached manner, considering them transient events of the mind.

The MINDSENS Composite Index was calculated using the 9 items of the EQ and 10 items of the FFMQ that are most sensitive to meditation practice.

Data Analysis

Between groups differences in mindfulness scores were explored by means of an ANOVA. Multivariate and univariate repeated-measures analyses of variance were conducted, and Student’s t-tests were used for post hoc analyses.

RESULTS

The multivariate-repeated measures ANOVA showed a significant effect of time group on the following FFMQ facets: Observing, Describing, Acting with awareness, and Non-Reacting. The ayahuasca group showed a significant pre-post improvement on Non-Judging.

A significant time – group interaction was found for EQ scores and MINDSENS Composite Index, and pre – post mindfulness scores were significantly higher in the mindfulness group than in the ayahuasca group.

DISCUSSION

The current study aimed to better understand the psychological mechanisms related to ayahuasca’s therapeutic effects by comparing its impact on mindfulness-related capacities. It showed that mindfulness training had an overall greater impact on mindfulness capacities, but ayahuasca intake led to spontaneous increases in certain aspects of the acceptance domain.

Our results replicate the findings obtained by our group in two prior independent studies that assessed ayahuasca users after a single session. Ayahuasca increased the scores on the Non-Judging and NonReacting subscales of the FFMQ, which focus on the “acceptance” domain of mindfulness abilities.

The present investigation found that both ayahuasca and MBSR improve acceptance, although only MBSR is a theoretical and practical training program specifically designed to foster mindfulness domains. Although larger studies are needed, the above finding is relevant for a number of reasons, including theoretical and clinical. Ayahuasca exposure is followed by a subsequent stage of increased acceptance, which has been found to be associated with lower depressive symptoms and anxiety. This combination of effects could be of great value in a psychotherapeutic context.

In a neuroimaging study using MRI, we found associations between Non-Judging increases and post-acute neurometabolic and connectivity changes. These changes were related to reduced excitatory glutamate – glutamine complex levels in the posterior cingulate cortex and increased functional connectivity between the anterior cingulate cortex and the medial temporal lobe.

Our previous study found that post-ayahuasca increases in Non-Reacting and EQ questionnaire scores returned to baseline levels 2 months later, while increases in Non-Judging remained elevated. This may be because Non-Judging is difficult to increase and thus less prone to show ceiling effects or erratic behavior.

The present study had several limitations, including a small sample size, lack of assessments in between sessions, and ceiling effects on some variables due to prior experience with ayahuasca and mindfulness training.

Participants were randomly assigned to either ayahuasca-nave or meditation-nature groups, and assessments could have been conducted at several time points along the study period. No formal medical history was obtained.

CONCLUSION

The current results suggest that ayahuasca can improve the acceptance domain of mindfulness capacities, and that a small number of ayahuasca sessions could be effective at improving acceptance, similarly to more lengthy and costly interventions.