“Meeting the Medicine Halfway”: Ayahuasca Ceremony Leaders’ Perspectives on Preparation and Integration Practices for Participants

This interview study (n=15) explores the perspectives of ayahuasca ceremony leaders regarding preparation and integration. Four categories are identified, 1) preparation (honesty, respect, willingness, resources), 2) preparation and integration (therapy, spiritual practice, creative expression), 3) integration (sharing experiences, working with insights), and 4) ineffective integration.


“Ayahuasca is a psychotropic plant-based tea from the Amazon. Its ceremonial use for therapeutic and spiritual purposes has become increasingly common and stands to escalate based on current policy initiatives in some countries. As ceremonial ayahuasca use spreads there is a need to understand, from various perspectives, how best to improve outcomes and minimize potential harms. Clinicians and therapists encourage the use of preparation and integration practices that accompany ceremonial ayahuasca use; however, there is no research investigating the views of those conducting the ceremonies. This qualitative study explored the perspectives of 15 ayahuasca ceremony leaders regarding preparation and integration practices they consider helpful for ensuring safe and productive experiences for ceremony participants. Qualitative content analysis produced three main categories, each with relevant subcategories. The first category included factors that facilitate preparation, including participant honesty and respect; readiness and willingness; and internal and external resources. The second category encompassed several complementary modalities believed to facilitate both preparation and integration, such as psychotherapy, spiritual and contemplative practices, and other modes of creative expression. The third category included factors considered facilitative of integration, including sharing of experiences, and working with insights and lessons. Ineffective integration practices constituted a fourth subcategory. Consistent with reports from other stakeholders, the findings highlight a wide range of preparation and integration practices that may be useful for ayahuasca ceremony participants to consider when drinking ayahuasca.”


The ceremonial use of ayahuasca and other psychedelics predates written history. These ceremonies are often led by individuals who offer support to people before, during and after the psychedelic experience, whatever a person’s reason may be for seeking such an experience. These individuals act in a similar fashion to our modern-day psychotherapists who are now facilitating psychedelic experiences in hospitals, private clinics and state of the art research centres. With much of the modern therapeutic processes of psychedelic-assisted psychotherapy shaped by the ancient ceremonial use of these drugs, the insights of these ceremonial leaders are invaluable to modern research. Furthermore, given that these leaders often operate outside the constraints of biomedicine, they offer a different perspective on psychedelics and their therapeutic potential.

In the present study, 15 ceremonial ayahuasca leaders were interviewed regarding their perspectives on preparation and integration practices they consider effective and safe for their ceremony participants. These leaders ranged in age, levels of education and experience, with some having 20 years of experience working with ayahuasca ceremonially. The results of each interview were analyzed, resulting in the generation of common themes/categories which were shared by these leaders.

These categories and insights include:

  1. Factors Facilitating Preparation – within this category, leaders emphasized the importance of participants being honest and respectful of the process, recognizing the issues they want to address, having the readiness and willingness to surrender to the experience as well as having a sense of openness to the ceremony, among others.
  2. Factors Facilitating Both Preparation and Integration – the majority of leaders emphasized the benefits of engaging in practices which may complement the preparation and integration processes. These practices include spiritual practices, yoga and tai-chi.
  3. Factors Facilitating Integration – in order to facilitate the integration process, the leaders noted the importance of taking time to rest and process the experience, sharing insights of the experience with others and the ability of the participant to work with the insights they’ve gained.
  4. Ineffective Integration – in this category the leaders highlight that some participants fail to make any concrete changes based on the insight they’ve gained. Factors which may lead to ineffective integration include participants lack of readiness, motivation or a lack of a sufficient support network to help them during the integration process.

Although this study is based on the knowledge claims of a few individuals and cannot be seen as an accurate representation of all ceremonial leaders, the insights gained are useful for other leaders and prospective ayahuasca ceremony participants. Further research should explore the perceptions of indigenous ceremonial leaders as well as those participating in ayahuasca ceremonies.

Summary of “Meeting the Medicine Halfway”: Ayahuasca Ceremony Leaders’ Perspectives on Preparation and Integration Practices for Participants

Ayahuasca is a psychotropic plant mixture from South America that is traditionally used in ceremonial contexts by Indigenous peoples of the Amazon. It may cause visions, hallucinations, altered sensory perceptions, euphoria, and mystical experiences.

In recent years, the practice of drinking ayahuasca for therapeutic and spiritual purposes has become more common in Western society. Clinicians worldwide are recommending preparation and integration practices, making their use increasingly common among ayahuasca drinkers.

Individuals intending to participate in an ayahuasca ceremony must prepare by limiting meats, dairy, sugar, salt, alcohol, and sexual activity, and stopping many types of medications.

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