Persisting effects of ayahuasca on empathy, creative thinking, decentering, personality, and well-being

This provisionally accepted study (n=40) explored the effects of ayahuasca on processes involved in stress-related psychopathologies. Volunteers attending an ayahuasca ceremony were given a series of questionnaires at baseline, the morning after and one week after the experience. Researchers found ingesting ayahuasca is associated with positive therapeutic outcomes.

Abstract

“Naturalistic and placebo-controlled studies have suggested that ayahuasca, a traditional Amazonian beverage, could be helpful in the treatment of psychopathologies like depression and anxiety disorders by changing otherwise disturbed cognitive and emotional processes. To better understand its full therapeutic potential, one way is to study the effects on processes like flexible thinking, empathy, and well-being, which are normally compromised in stress-related psychopathologies. Volunteers attending ayahuasca ceremonies were asked to complete a test battery at three separate occasions: baseline, the morning after, and one week after the ceremony. We included the constructs of creative thinking (measured by Picture Concept Task), empathy (Multifaceted Empathy Test), satisfaction with life (Satisfaction with Life Scale), decentering (Experiences Questionnaire), and personality (Big Five Inventory) into the test battery. Additionally, the psychedelic experience was quantified with the Persisting Effects Questionnaire, the Ego Dissolution Scale, and Visual Analogue Scales. In total, 43 attendees (males= 22; females= 21) completed parts of the baseline assessment, 20 (males= 12; females= 8) completed assessments in the morning after the ceremony, and 19 (males= 14; females= 5) completed assessments at the one-week follow-up. At one and seven days post-ceremony, cognitive empathy, satisfaction with life, and decentering increased, while divergent thinking (Fluency corrected for Originality) decreased, when compared to baseline. Implicit emotional empathy increased at one-week follow-up, whereas ratings of the trait neuroticism decreased. The study suggests that a single ingestion of ayahuasca in a social setting is associated with enhancement of subjective well-being, an enhanced ability to take an objective and non-judging stance towards the self (decentering), and the ability to correctly recognize emotions in others, compared to baseline, lasting up to one week post-ceremony. To understand the therapeutic potential related to these effects, further research with clinical populations is needed in which these effects can be assessed, including its link with therapeutic outcomes. Together, this will increase our understanding of the effectiveness and breadth of future therapeutic options.”

Authors: Maggie K. Kiraga, Natasha L. Mason, Malin V. Uthaug, Kim I. van Oorsouw, Stefan W. Toennes, Johannes G. Ramaekers & Kim P. C. Kuypers

Summary

INTRODUCTION

Ayahuasca is a psychoactive decoction used by indigenous groups of the Amazon for magical, ritual, and medicinal purposes. It has also been used by non-Amazonian populations to seek insights.

Ayahuasca is made from the stalk of the Banisteriopsis caapi vine and the leaves of the Psychotria viridis shrub. It produces psychedelic effects.

Ayahuasca may help people with stress-related psychopathologies by improving their mental and cognitive processes, like flexible thinking, empathy, metacognitive awareness, and well-being. Researchers have found that attendees of ayahuasca ceremonies showed enhanced flexible (divergent) and convergent thinking, as well as improved self-reported levels of life satisfaction and depressive symptoms. Additionally, ayahuasca was found to be beneficial for mindfulness-related capacities, assertiveness and joy, anxiety reduction, optimism, and self-confidence.

A study was set up to investigate the effects of ayahuasca on cognitive and psychological processes, including flexible thinking, empathy, and satisfaction with life. Additionally, a personality assessment was included to explore the effects of ayahuasca on neuroticism and openness.

Participants

Participants were volunteers attending ayahuasca retreats in the Netherlands, stemming from across four different locations, between 2017 and 2019. They completed three tests: a baseline assessment, a sub-acute measurement, and a follow-up measurement.

This study was conducted in accordance with the Declaration of Helsinki and subsequent amendments concerning research in humans. All volunteers gave their written informed consent to participate.

Study Procedure Ayahuasca Ceremonies

The facilitators of neoshamanic ceremonies conducted personal intakes prior to participation in the ceremonies.

Participants stayed in a large house together, were acquainted with one another, and discussed desired outcomes of the experience before ingesting ayahuasca. After ingesting ayahuasca, participants stayed in one room lying on a mattress or floor mat.

The ceremonies differed regarding happenings before, during, and after ayahuasca intake. The acute effects of ayahuasca start between 30 and 60 min post-administration, reach maximum intensity between 60 and 120 min, and can last up to 4 h after administration.

Ayahuasca Sample

Four ayahuasca samples were obtained from different ceremony sites and their alkaloid concentrations were determined using high-performance liquid chromatography-electrospray ionization-time-of-flight mass spectrometry.

Assessments

Six questionnaires were filled out: the demographic section, the multifaceted empathy test, the picture concept test, and the Satisfaction with Life scale. These were filled out three times: at baseline, sub-acute, and follow-up.

Multifaceted Empathy Test

The Multifaceted Empathy Test (MET) consists of 40 photos of people in complex emotional states, both negative, and positive (50% pictures of each valence). Cognitive empathy (CE) is evaluated based on a recognition task, and emotional empathy (EE) is assessed by participant’s ratings of arousal and concern.

Picture Concept Test

The picture concept test (PCT) was used to assess creativity. Participants had to find an association between one of the pictures in each row and provide one solution only.

To assess divergent thinking, participants were asked to provide as many alternative associations as possible between the colored pictures. The originality and fluency of the answers were calculated, and the ratio of both was used to reflect the quality of divergent thinking.

Satisfaction with Life Scale

The Satisfaction With Life Scale (SWLS) is a five item questionnaire that asks participants to rate their life satisfaction on a seven point Likert scale. Higher scores indicate greater life satisfaction.

Big Five Inventory

The 44-item Big Five Inventory (BFI), developed by John et al. (1991), was used to measure personality traits. The BFI scales have shown substantial internal consistency, retest reliability, and clear factor structure.

Ego Dissolution Inventory

The Ego Dissolution Inventory is an eight-item self-report scale that assesses the participant’s experience of ego dissolution during the ayahuasca ceremony.

Visual Analogue Scale

Participants were asked to rate the intensity of various aspects of their acute ayahuasca experience using 10 visual analogue scales the morning after the ceremony.

Statistical Analyses

Data analyses and visualizations were performed using the Matplotlib, Statsmodels, and Pingouin libraries for Python3. A separate multi-linear regression model using the ordinary least square method (OLS) was fit for each outcome variable.

Ayahuasca treatment effects on empathic processes were correlated with increased satisfaction with life. A one-sided Pearson’s correlation was run between variables of empathy and satisfaction with life.

Participants

The majority of the participants were males, 42% were females, and 3% chose not to answer the question. Most were from Europe, most had completed an academic level of education, and most had previously used psychedelics other than ayahuasca.

Ayahuasca Sample

The average amount of DMT, harmine, and harmaline consumed per participant was 57.44 mg, 127.08 mg, and 59.84 mg, respectively.

Persisting Effects Questionnaire

2 participants rated the experience as the single most meaningful experience of their lives, 9 rated it among the 5 and 10 most meaningful experiences of their lives, and 1 rated it once a month.

8 out of 10 participants rated the experience as the most spiritually significant experience of their lives, whereas 4 out of 10 participants rated it as among the 5 most spiritual experiences of their lives.

2 out of 10 people said it was the single most difficult or challenging experience of their lives, 6 out of 10 said it was among the five most difficult or challenging experiences of their lives.

4 out of 10 respondents stated the experience to be among the 5 most insightful experiences of their lives, and 1 out of 10 stated it was no different from every other psychologically insightful experience.

DISCUSSION

We used a comprehensive test battery with participants attending ayahuasca ceremonies to examine the effects of ayahuasca on flexible cognition, empathy, satisfaction with life, and personality. We found decreases in the personality trait neuroticism.

The findings demonstrate that post-ayahuasca ceremony increases in participants’ ability to correctly recognize emotional states, and medium increases in participants’ ratings of arousal towards positive emotions, contrast with previous research that demonstrated unaffected or impaired emotional recognition after the administration of psychedelics. The current study adds to the body of literature by pointing out the possible long-term enhancements of emotion recognition/ awareness, which might bring interesting therapeutic applications of psychedelics’ use for stress-related psychopathologies. A hypothesis-driven correlation analysis suggested that sub-acute increases in ratings of emotional empathy were positively correlated with 7-days increases in satisfaction with life. However, future research should more formally assess a causal relationship between (positive) empathy and well-being.

The study showed that convergent thinking was significantly increased at 1 week post-psychedelic ceremony, but not the morning after. Practice effects cannot be ruled out.

The current study found decrements in divergent thinking at both post-ceremonial assessments, but an increase in spontaneous creative insight 7 days later. This suggests that time- and test-related differentiation of effects on creative thinking should be considered when assessing creativity in future studies.

Self-rated satisfaction with life increased during the sub-acute and long-term assessments when compared to baseline. The participants’ scores increased up to average and marginally high levels of SWL, respectively, and are consistent with the previous studies showing positive psychological changes after psychedelics use.

Although some ayahuasca compounds have a long half-life, it seems unlikely that they are responsible for the acute psychoactive effects of ayahuasca.

The present study found decreases in neuroticism 1 week after the ayahuasca ceremony, and the other four traits were unaffected. This is interesting because individuals with low psychological well-being and higher scores of neuroticism report consuming psychedelic substances with the achievement of positive outcomes.

In the current study, we found significant increases in ratings of decentering ability and interrelated mindfulness capacities 24 h and 7 days after ayahuasca intake. When individuals are directed to analyze negative autobiographical experiences from a self-distanced, decentered perspective, they demonstrate less acute emotional and physiological reactivity, and are less likely to ruminate over time. This is interesting to think about in light of what individuals report during a psychedelic experience.

Decentering may be a key concept in psychedelic therapy, and may play a role in the long-term clinical outcomes being observed in psychedelic clinical trials.

Limitations and Conclusion

The strength of this study is also its greatest limitation, as it is self-selected and suffers from typically high drop-out rates. However, the findings are in line with previous studies, some of which were placebo-controlled, so the findings might be related to the psychedelic ceremony. Despite promising findings, the high heterogeneity of methodological approaches and the sparse number of studies hamper the formation of comprehensive conclusions. Further investigation of the preliminary benefits reported by the current and previous findings is of major importance.

AUTHOR CONTRIBUTIONS

The authors of this paper conceived of the idea, collected data, conducted statistical analyses, and wrote the manuscript.