Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution

This longitudinal study (n=57) investigated the effects of ayahuasca and found improved convergent thinking/creativity, decreased ratings of depression and stress up to four weeks later. These changes were significantly correlated with the level of ego dissolution experienced during the acute trip/ceremony.

Abstract

“Rationale: Ayahuasca is a psychotropic plant tea from South America used for religious purposes by indigenous people of the Amazon. Increasing evidence indicates that ayahuasca may have therapeutic potential in the treatment of mental health disorders and can enhance mindfulness-related capacities. Most research so far has focused on acute and sub-acute effects of ayahuasca on mental health-related parameters and less on long-term effects.

Objectives: The present study aimed to assess sub-acute and long-term effects of ayahuasca on well-being and cognitive thinking style. The second objective was to assess whether sub-acute and long-term effects of ayahuasca depend on the degree of ego dissolution that was experienced after consumption of ayahuasca.

Results: Ayahuasca ceremony attendants (N = 57) in the Netherlands and Colombia were assessed before, the day after, and 4 weeks following the ritual. Relative to baseline, ratings of depression and stress significantly decreased after the ayahuasca ceremony and these changes persisted for 4 weeks. Likewise, convergent thinking improved post-ayahuasca ceremony up until the 4 weeks follow-up. Satisfaction with life and several aspects of mindfulness increased the day after the ceremony, but these changes failed to reach significance 4 weeks after. Changes in affect, satisfaction with life, and mindfulness were significantly correlated to the level of ego dissolution experienced during the ayahuasca ceremony and were unrelated to previous experience with ayahuasca.

Conclusion: It is concluded that ayahuasca produces sub-acute and long-term improvements in affect and cognitive thinking style in non-pathological users. These data highlight the therapeutic potential of ayahuasca in the treatment of mental health disorders, such as depression.”

Authors: Malin V. Uthaug, K. van Oorsouw, Kim P. C. Kuypers, M. van Boxtel, N. J. Broers, Natasha L. Mason, S. W. Toennes, Jordi Riba & Johannes G. Ramaekers

Summary

Ayahuasca, a psychotropic plant tea from South America, may have therapeutic potential in the treatment of mental health disorders and can enhance mindfulness-related capacities.

Ayahuasca affects well-being and cognitive thinking.

The degree of ego dissolution experienced after ayahuasca consumption was assessed.

Ayahuasca ceremony attendants experienced decreased depression and stress, improved convergent thinking, and increased satisfaction with life after the ritual. These changes persisted for 4 weeks.

Ayahuasca produces sub-acute and long-term improvements in affect and cognitive thinking style in non-pathological users.

Ayahuasca and creativity

Introduction

Ayahuasca is a psychotropic plant tea from South America that contains DMT and -carboline alkaloids that inhibit the action of monoamine oxidase (MAO), allowing DMT to reach the central nervous system for a prolonged period of time, causing intense alterations in sensory integration and awareness.

Ayahuasca may be a useful additive to psychotherapy to promote personal reflection and insights about attitude and belief. Adolescents who regularly consume ayahuasca show less signs of anxiety and are more optimistic, self-confident, insistent, and emotionally mature than their peers.

Ayahuasca may affect thinking style by increasing acceptance of thoughts and feelings experienced by the individual, and by decreasing convergent thinking. This may be therapeutic for individuals who experience persistent negative thoughts, and may also help to strengthen psychological flexibility and allow adaptive coping styles.

Ayahuasca has been shown to decrease depressive symptoms in three females and remain at 66% below their baseline 2 weeks after intake. This suggests that ayahuasca has fast-acting antidepressant properties that can last for up to 3 weeks.

In the current study, participants experienced long-lasting changes on affect and creativity after ayahuasca intake. These changes were correlated with subjective ratings of ego dissolution.

Participants

Participants of ayahuasca ceremonies in Colombia and the Netherlands were invited to enter the study. The study was approved by the standing ethical review committee.

Group 1: the Dutch sample

Thirty volunteers were included in several ayahuasca ceremonies in the Netherlands. Most participants were from Europe, the rest were from Asia and North America, and none were currently on any medication that could have affected their ayahuasca intake.

Group 2: the Colombian sample

Twenty-seven volunteers from Colombia completed a test battery, including 11.1% from Africa and 18.5% from North America. They reported various motivations for using ayahuasca, including understanding themselves, solving issues, curiosity, and other.

Study procedure

In this observational study, 57 participants completed pre- and post-ayahuasca assessments, and 31 participants completed the 4-week follow-up. They completed a 30-min test battery consisting of questionnaires and a psychometric test at baseline, and an ego dissolution questionnaire.

Group 1: the Dutch sample

Ayahuasca ceremonies were held in the Netherlands in tipis or big hotel rooms. Participants were screened for motivation, medicine use, and medical and psychological history.

Group 2: the Colombian sample

Ayahuasca ceremonies were held in Colombia in secluded locations in the rainforest, and participants remained in a dimly-lit ceremonial building called maloca. The shamans provided support for participants going through a challenging time.

In both countries, experienced shamans with a background in healing with plant medicines held ceremonies. Participants were advised to not eat red meat, watch violent TV programs, and engage in sexual intercourse to conserve energy, calm the mind, and increase mindful introspection.

Ayahuasca samples

Ayahuasca samples were obtained from Colombia and The Netherlands. The alkaloid concentrations were determined using high-performance liquid chromatography-electrospray ionization-time-of-flight mass spectrometry, and the samples contained 371.6 mg of DMT, 485.5 mg of harmine, and 892 mg of harmaline.

Picture concept task

A creativity task with non-verbal stimuli was used to measure convergent thinking. The picture concept task was composed of stimuli from the Wechsler Preschool and Primary Scale of Intelligence and the Wechsler Intelligence Scale for Children. Participants were asked to provide as many alternative associations as possible by sticking to the rule; one item per row. Three parallel versions of the PCT were used at baseline and the two follow-up measures after the ceremony to avoid learning effects.

Depression, Anxiety, and Stress Scale

The Depression, Anxiety, and Stress Scale (DASS-21) is a shorter version of the original 42-item long self-report questionnaire. It has a coefficient alpha of 0.93 and a Cronbach alpha coefficient of 0.96 for the English version and 0.95 for the Spanish version.

Satisfaction with Life Scale

The Satisfaction with Life Scale is a 5-item self-report scale that is used to assess someone’s satisfaction with life. It has good psychometric properties and has been validated in Spanish and Dutch.

Five Facets Mindfulness Questionnaire

The Five Facets Mindfulness Questionnaire (FFMQ) is a 39-item self-report questionnaire that assesses five different factors: observe, describe, act with awareness, non-judgment, and non-reaction. The total FFMQ score is obtained by adding the subscale scores. This study used the original English version of the FFMQ in addition to a validated translation in Spanish and Dutch.

Ego Dissolution Inventory

The Ego Dissolution Inventory (EDI) is an 8-item self-report scale that assesses the participant’s experience of ego dissolution during the ayahuasca ceremony.

Statistical analyses

Data was analyzed with SPSS. A linear mixed model was constructed with session, country, and session country as main factors, and a Pearson’s correlation analysis was conducted to examine the relationship between ego dissolution during the ayahuasca ceremony and changes in outcome measures over time.

Picture concept test

The number of correct solutions increased after the ayahuasca ceremony, and reached significance 4 weeks after. None of the divergent thinking parameters were affected by any of the main factors or their interaction.

Depression, Anxiety, and Stress Scale

Mixed-model analysis revealed main effects of session on stress and depression, and a main effect of country indicating lower stress and depression scores in the Colombian sample as compared to the Dutch sample.

Satisfaction with Life Scale

Mixed-model analyses revealed a main effect of session and a difference between the Colombian and Dutch samples in satisfaction with life ratings.

Five Facets Mindfulness Questionnaire

Four mindfulness parameters were affected by the ayahuasca ceremony: observe, non-judge, aware, and non-reaction. There were no significant differences between countries for other mindfulness parameters, and interactions between session and country never reached significance.

Ego Dissolution Inventory

The ego dissolution index (EDI) was negatively correlated with stress and depression on day 1 and positively correlated with awareness, non-judgment, non-reactivity, and satisfaction with life on day 4 after the ayahuasca ceremony.

Experience with ayahuasca

Ayahuasca did not differ between participants with no experience and those with previous experience for any of the outcome parameters.

Discussion

A total of 57 visitors to ayahuasca ceremonies in Colombia and the Netherlands completed subjective questionnaires and a creative thinking task prior to, the day after, and about 4 weeks later. They reported decreased depression and stress, improved convergent thinking, and increased satisfaction with life.

Subjective ratings of stress and depression significantly decreased after a single ayahuasca ceremony, and remained significantly lower throughout the following month. This suggests that ayahuasca can reduce symptomatology in depressed patients as well as in a broad spectrum of users who display non-pathological levels of depression.

The mechanism underlying the long-term effects of ayahuasca on affect is presently unknown, but animal studies suggest that Banisteriopsis caapi preparations produce antidepressant activity through hippocampal neurogenesis. This mechanism may also be involved in the effects of ketamine and psilocybin.

Ayahuasca produced significant sub-acute improvements in subjective ratings of mindfulness and satisfaction with life. However, the improvements were much smaller than changes in symptoms of depression and stress, and the 4-week follow-up may have affected the results.

Ayahuasca exposure increased convergent thinking as assessed with the picture concept task, both sub-acutely and at the 4-week follow-up. Convergent thinking may not prosper during a psychedelic experience, but may prosper afterwards because it relies on mindfulness capabilities.

Post-ayahuasca changes in affect and thinking style may be due to uncontrolled confounders such as psychological expectations of participants prior to and after the ayahuasca ceremony. However, several strong indicators suggest that these changes were directly related to the intake of ayahuasca.

Improvements in affect and cognition were significantly correlated with the strengths of ego dissolution during the ayahuasca experience. This strongly suggests that changes in mood and thinking were intrinsically related to the actual ayahuasca experience.

This study shows that ayahuasca can improve affect and cognitive thinking style in non-pathological participants, and that these improvements are larger in participants who experience strong ego dissolution.