The Power of Social Attribution: Perspectives on the Healing Efficacy of Ayahuasca

In this commentary (2021) the applications surrounding the indigenous use of ayahuasca are compared to recreational use and the Western therapeutic and clinical applications currently taking place. It is argued that these three modes of ayahuasca use are ontologically/categorically different.


“During the last decades, ayahuasca gained much popularity among non-Indigenous and out-of-Amazonia based populations. In popular culture, it has been advertised as a natural remedy that was discovered by Indigenous peoples ante millennia and that has been used for shamanic healing of all kinds of ailments. This “neo-shamanic,” and often recreational, use of ayahuasca, however, has to be distinguished from traditional Indigenous praxes on the one hand, and, on the other hand, from medical investigation in the modern world. The former, Indigenous use mainly understands ayahuasca as an amplifying power for interacting with non-human beings in the animal, plant, or spirit realms. Within this paradigm, efficacy is not dependent on the drug, but on the correct communication between the healer (or sorcerer) and the non-human powers that are considered real and powerful also without resorting to ayahuasca. The latter, modern mode of understanding, contrastingly treats the neurochemical processes of MAO inhibition and dimethyltryptamine activity as trigger mechanisms for a series of psychological as well as somatic responses, including positive outcomes in the treatment of various mental conditions. I argue that there is an ontological incommensurability occurring especially between the Indigenous and medicinal concepts of ayahuasca use (with recreational use in its widest understanding trying to make sense from both sides). Modern medical applications of ayahuasca are so fundamentally different from Indigenous concepts that the latter cannot be used to legitimate or confirm the former (and vice versa). Finally, the deep coloniality in the process of appropriation of the Indigenous by the modern has to be questioned and resolved in any case of ayahuasca application.”

Authors: Bernd Brabec de Mori


Ayahuasca has been in use by at least three large groups in recent times: traditional Indigenous and Mestizo people within their communities, neo-shamanic and recreational users all over the world, and patients of mental health facilities. All of these uses are still situated in a colonial structure of power relations and appropriation.

Westerners viewed ayahuasca as a medicine, but Indigenous peoples used it for divination, (counter-)witchcraft, warfare, and communal religious rituals. The idea of ayahuasca as a medicine dates back to the rubber boom and its exploitation and genocidal mistreatment of Indigenous populations.

Despite the constructed quality of “ayahuasca shamanism”, the qualities that are attributed to this complex are significant. These qualities are shaped by the discourse about ayahuasca, which in turn is shaped by the assumptions of Alterity.

Ayahuasca is used in three modes, which overlap and interact. Some people use it in other modalities.


I conducted fieldwork among the Peruvian Shipibo-Konibo from 2000 to 2006, and continued through visits until 2019. I describe the healing-sorcery practices as observed among médicos.

In traditional Shipibo medicine, an apprentice would embark on lengthy “diets” that involved the intake of other plants, and seldom animal or inorganic substances. These diets were essential for many forms of learning, including becoming a good hunter, producing precious artwork, or being a good soccer player or musician. Illness was understood as a reciprocal process, stemming from a source, which had to be tricked, seduced, or overthrown to heal.

Efficacy is attributed to the power of a healer from close kin who accomplished many lengthy “diets”, had vast social relations with animals, plants, and spirits, and knew a great repertoire of magical songs. The use of ayahuasca was totally optional, and the most powerful healers did not use it at all.

Among all the Indigenous healers I worked with, high-intensity hallucinations were avoided, and vomiting was not a topic.


Indigenous use of ayahuasca prior to the ayahuasca boom attributed efficacy to the healer’s power, knowledge, and experience, while Westerners cannot but attribute efficacy to the substance-as-ingested.

Western researchers and drug and healing tourists triggered a transformation in Amazonian Indigenous and Mestizo “traditions” toward communal ayahuasca-drinking sessions that became known as “ceremonies”. These sessions are now held exclusively for “white” or other non-Indigenous, non-local people.

In neo-shamanic contexts, diets are varied, and sometimes omitted. They are also recommended to strengthen the effects of ayahuasca, but are rarely considered important for anything beyond the ayahuasca complex.

Ayahuasca is considered beneficial to health, spiritual growth, inspiration, and general well-being, and is therefore considered acceptable among “shaman apprentices” with a history of minor mental disorder or at least some issues with mental or social instability.

People with a background of experience-seeking, of spiritual, psychological, ecological, or socio-economic discontent, or with diagnosed health problems tend to attend ayahuasca ceremonies, where immense healing power is attributed to the substance and its immediate effects.

I observed that many White shaman apprentices in Peru were surprisingly uninterested in the lived world of the “non-ayahuasca-drinking” locals and their situation of marginalization and often extreme and illness-causing poverty.


There is strong support for the use of psychedelic drugs in the treatment of non-psychotic mental conditions, including depression, anxiety, and drug addiction.

Pioneer studies on the chemistry and human pharmacology of ayahuasca were mostly undertaken in un-controlled settings, and studies about the efficacy of ayahuasca on health-related conditions were conducted “in the wild” in (more or less legal) ayahuasca ceremonies.

Most clinical studies on ayahuasca are methodologically well designed and solid, but they cling to un-referenced and never tested assumptions that ayahuasca per se was a medicine, even though this “healing” was recently constructed during the second half of the 20th Century.

Ayahuasca may cause mental health problems, but this is rare and mostly caused by triggering pre-existing latent disorders. In most countries, healthy individuals are not allowed to drink ayahuasca while ill people may obtain a legal exception.

Ayahuasca, along with other hallucinogens, may be very useful in treating certain mental disorders. However, the power of social attributions remains un-attended in many studies.


People form general beliefs about ayahuasca based on their social environment, and then seek and create situations that trigger certain experiences that strengthen the general belief.

There are many contextual and psychological factors to be understood when studying ayahuasca, and the three modes of ayahuasca use I briefly presented here are ontologically different. Therefore, it is not enough to heed some “cultural” factors, and research designs have to be separated from Indigenous concepts.

Study details

Compounds studied

Topics studied
Equity and Ethics

Study characteristics