Healing Powers of Ayahuasca
Rodman Walsh
The Healing Powers of Ayahuasca in the Treatment of Trauma
Ayahuasca is traditionally a tea with psychoactive properties that is derived from plants and roots found in the Amazon, with the main psychoactive compound being dimethyltryptamine or DMT (Dominguez-Clave, 2016). Administration of the plant medicine typically induces a state of altered consciousness that are often characterized by visions, introspection, enhanced emotions and the recollection of memories or experiences (Dominguez-Clave, 2016). It has been theorized and researched that ayahuasca may be useful in the treatment of substance use disorders, anxiety, depression, and trauma.
Ayahuasca is considered a Schedule I drug in the United States, along with other hallucinogens and psychedelics, which has created a certain stigma and bias towards the use of this plant based medicine as a therapeutic method and intervention to treat various disorders. However, research in the area of substance dependency and relapse prevention indicates that it can serve as a valuable therapeutic tool that in structured settings can catalyze neurobiological and psychological processes that support recovery (Loizaga-Velder & Verres, 2014). Those who have attended ayahuasca rituals and ceremonies report personal growth, spiritual development, self-awareness and deeper introspection, as well as healing from various psychological and physiological afflictions (Loizaga-Velder & Verres, 2014). Participants also reported that ayahuasca assisted them in gaining a better understanding of underlying causes of their addictions by overcoming aspects of psychological issues that had hindered their functioning in the past, as well creating positive resources such as self-efficacy expectations (Loizaga-Velder & Verres, 2014). In another study, subjects reported, and qualitative data supports that ayahuasca users are engaged in an authentic spiritual process whereby they were able to reduce their alcohol intake, improve diet, improve mood and greater self-acceptance as well as feeling more loving and compassionate in their relationships (Gurel & Harris, 2012).
Many seek the use of alternative medicines and treatments to combat symptoms and psychological issues pertain to complex trauma and post-traumatic stress disorder (PTSD). Approximately, 40-60 % of adults have been exposed to a traumatic event in their lifetime, and potentially 12% will develop PTSD; this figure rises to 22-31% in the case of combat veterans (Megler & Nielson, 2014). Although awareness and treatment strides have been made to assess for PTSD, symptoms may be undetected under co-morbid conditions such as substance abuse, major depressive disorder, somatization disorder, and anxiety spectrum disorders (Megler & Nielson, 2014). Antidepressants, somatic based therapies and exposure therapies are common interventions used to treat symptoms of trauma or PTSD. Ayahuasca is considered to be complementary in treating PTSD and trauma much like substance use disorders due to their prevalence and co-occurrence (Megler & Nielson, 2014). Brain imaging studies suggest that ayahuasca significantly activates the frontal and paralimbic brain regions that play a prominent role in emotional processing and memory formation (Megler & Nielson, 2014). The amygdala processes implicit memories and the hippocampus explicit memories. Ayahausca activates of the hippocampus can allow for implicit memory formation that may have been previously disrupted by a traumatic event; trauma survivors have the opportunity during an ayahuasca journey to change how they react to memories in the ways that are similar to other interventions like exposure therapy and EMDR (Megler & Nielson, 2014). A major aspect of working with ayahuasca is reliving the trauma in a safe and contained environment usually under the guidance of healers that can be transformative.
Previous research also indicates that ayahuasca acts as a serotonergic agonist, similar to SSRIs and SNRIs that are used to treat depression and trauma symptoms (Megler & Nielson, 2014). This research also indicates that regular ayahuasca use results in long-term modulation of the serotonin systems in the brain further supporting that there may be a link between the elevation of serotonin transporters seen with long-term ayahuasca use and positive behavior changes (Megler & Nielson, 2014).
The purpose of this paper to further outline and describe the benefits of ayahuasca as an alternative treatment method and intervention to treat the commonly occurring symptoms of trauma and PTSD as well as using ayahuasca to treat substance use disorders. The compilation of this research is designed to prove that ayahuasca, used in conjunction with psychotherapy, can be a powerful healing process for those who may not have not had success using more traditional treatment methods.
Literature Review
Some traditional trauma-based models are rooted in exposure therapy. Exposure therapy is fast acting and effective at targeting traumatic memories of complex trauma and PTSD (Megler & Nielson, 2014). During the course of the therapy, patients may be exposed to a feared object or context, without danger allowing them to re-experience the traumatic event in a safe and controlled environment, in the hopes of creating opportunity to resolve the pathological memory by integrating information (Megler & Nielson, 2014). The intensity of the distress that are associated with frightful or disturbing implicit memories is decreased through the confrontation of situations, people, and emotions associated with traumatic triggers (Megler & Nielson, 2014). During the ayahuasca journey, individuals can explore emotions, sensations, and thoughts associated with trauma in an effort to discharge and resolve the symptoms. Additional research compiled indicates that ayahuasca intake increases certain facets of mindfulness related to acceptance and the ability to take a detached view of one’s thoughts and emotions (Dominguez-Clave, 2016). Ayahuasca shows promise as a therapeutic tool by enhancing self-acceptance and allowing safe exposure to emotional events which is potentially useful in treatment of impulse related, personality and substance use disorders, and the healing of trauma (Dominguez-Clave, 2016).
Complex trauma and PTSD may manifest themselves in different ways in the human experience, some of which may be unconscious. Research states that complex unconscious psychological stresses underlie and contribute to all chronic medical conditions from trauma to cancer and/or addiction; Therapy that is assisted with psychedelics, with the right support and in the right context, can bring these dynamics to the surface and thus help a person liberate themselves for their influence (Mate, 2014). Mate suggests that there are no “bad trips” in the ayahuasca experience, but only experiences to learn (2014). Mate goes onto to state that the painful and frightening visions or emotional states are not the reasons that make an ayahuasca journey bewildering or disturbing- only the lack of meaning a person may be left with or for the lack of proper guidance and support: In the right context, ayahuasca helps to reveal meaning (2014).
Ayahuasca can evoke direct but long-suppressed memories of trauma. Peter Levine teaches, “trauma is simply not what happens; it is our inability or lack of opportunity to move through the process of trauma” (Mate, 2014). Trauma may be suppressed, deeply ingrained, sublimated, diverted, and compensated for in maladaptive ways that can often be the source of addictive patterns and coping mechanisms that lead to many illnesses of the body and mind. The ayahuasca ceremony gives the opportunity to go beneath the false world-view developed and formed during childhood and reveal the pain underneath the coping mechanisms of the false self (Mate, 2014).
In an effort to better understand complex trauma, research looks at childhood development and child’s learning processes. Impact of prior traumas on resilience indicate that psychotherapeutic interventions aimed at integrating and diminishing the effects of the traumatic experience must target the precipitating event as well as the other traumas that may have occurred due to the fact that neurodevelopment is achieved though synchronizing the child’s nervous system with the attachment figure (Megler & Nielson, 2014). Emotional learning occurs implicitly and without synchronization to primary attachment figure, the child loses the capacity to adequately regulate physical and emotional states (Megler & Nielson, 2014). Successful therapeutic interventions are achieved when a patient and client interact on an emotional level to develop and strengthen pathways that were disrupted or insufficiently developed in the limbic system of the brain (Megler & Nielson, 2014). Psychotherapy often aids in the healing process of a person because one person can help restructure the limbic brain of another which will led to greater emotional health and regulation; Ayahuasca opens the limbic pathways of the brain to affect the emotional core of the trauma in a way similar to effective psychotherapy (Megler & Nielson, 2014). Ayahuasca also impacts higher cortical areas to allow the patient to assign a new context to their trauma and help them understand and move through it; brain imaging also shows activation of the same emotional brain centers with ayahuasca administration as in attachment relationships (Megler & Nielson, 2014).
Ayahuasca exerts psychoactive properties that also affect the serotonergic and dopamine systems, which are often associated with pleasure and links to disorders such as anxiety and depression (Loizaga-Velder & Verres, 2014). Research suggests that regular use of ayahuasca, when it is taken in the ritual context in a supportive environment, is reasonably safe and shows no long-term toxicity; no evidence of maladjustment, deterioration of psychological health, cognitive impairment, or psychosocial effects commonly associated with drug abuse were shown among investigated ayahuasca-using groups (Loizaga-Velder & Verres, 2014). Modalities used in psychedelic-assisted psychotherapy range from informal support from religious or spiritual groups, which provide humanistic services to outpatient programs that, complement more traditional therapeutic programs by offering monthly ayahuasca sessions as well as inpatient programs, which may offer regular ayahuasca sessions as an integral part of therapy (Loizaga-Velder & Verres, 2014). This is a paradigm shift from traditional psychiatry, which supports Engel’s biopsychosocial model, which suggests that illness and health are a result of an interaction between biological, psychological, and social dimensions (Megler & Nielson, 2014). Integrative medicine is a multidisciplinary approach that combines conventional treatments with alternative therapies; it uses the biopsychosocial model to look at each aspect of the self and move toward a harmonious whole (Megler & Nielson, 2014). Spirituality is often additional incorporated, as in the ayahuasca experience for most people that has a significant impact on health behaviors, coping, physical and emotional symptoms, and quality of life (Megler & Nielson, 2014). Ayahuasca has tremendous therapeutic potential in this context, as it’s implementation weaves together the core dimensions of mental health: psychopharmacology, psychotherapy, psycho-education, psychosocial rehabilitation, and spirituality (Megler & Nielson, 2014).
Other findings show that the therapeutic benefits with the proper use of ayahuasca indicate similarities with mindfulness-based therapy (Dominguez-Clave, 2016). Ayahuasca appears to enhance self-acceptance and decentering which are critical aspects associated with therapeutic treatment outcomes in several psychiatric disorders (Dominguez-Clave, 2016). From a neurological perspective, neuroimaging studies have shown that following ayahuasca intake there is reported activation in the areas associated with emotional processing and memory formation; these results suggest that similar to exposure therapies, allows reviewing emotional events with increased vividness and perceived “reality” (Dominguez-Clave, 2016).
However, research also suggests that the use of ayahuasca as a therapeutic intervention is not without some risk or limitations. In this context, it is important to revisit trauma and how it affects and manifests in an individual. Trauma can happen with any overwhelming circumstance and a hallmark of the traumatic experience is anything that is “too much, too fast, too soon” for a particular human nervous system to handle (Moran, 2019). A key factor in whether an experience generates last trauma is how innately resourced a person is which has a great deal to do with the degree of secure attachment and support an individual receives during childhood (Moran, 2019). Individuals that lack secure attachment are more likely to develop PTSD in circumstances that might disturb a securely attached person, but would not create a chronic disorder. Ayahuasca may give an individual a chance to reconfigure themselves and generate greater stability, but the feelings of fragmentation during the experience can be distorting and chaotic (Moran, 2019). The chaotic nature of certain difficult ayahuasca experiences, which can be overwhelming sensations, incomprehensible surges of powerful emotions like terror, grief, or despair, parallel the overwhelming feelings a small child might experience during a traumatic event (Moran, 2019). Disconnection is the essence of trauma and not all individuals have cultivated resilience, which is knowing that you can move through distress and ultimately be okay (Moran, 2019).
Trauma-specific integration and support is crucial following a ceremony or experience because ayahuasca is highly effective in opening past trauma, but it does not always resolve it in the space of one experience or retreat (Moran, 2019). It is often not recommended that people resume their “normal” daily life directly following a retreat due to the potential of an insufficiently supported environment and expectation by the individual to function immediately without the support of integration (Moran, 2019). Active integration is part of the work and it can help immensely if integration support is trauma-specific. Additional research suggests that safety, preparation, and expectation are causes for concern especially for travelers going to foreign countries and retreats where sexual assault and misconduct has been reported (Callicott, 2016). This research also suggests that, in the ayahuasca experience, the move from moral conviction to moral behavior is not guaranteed which is a logical fallacy known as “fundamental attribution error” (Callicott, 2016). The tendency to overestimate the degree to which an individual’s behavior is determined by his or her abiding personal characteristics, attitudes and beliefs to minimize the influence of the surrounding situation on that behavior, does not necessarily lead to change or healing. (Callicott, 2016).
Subjects of research partaking in ceremonies also reported that there was some sharing and integrative work following the ceremony, but many reported they did not have the opportunity to discuss their experiences with the shaman or the leaders (Gurel & Harris, 2012). This particular study also noted additional limitations to the research such as there was no random selection of subjects nor was there any control over the chemical content or amount of ayahuasca used in ceremony (Gurel & Harris, 2012). There are other difficulties in controlling variables of ceremonies due to the fact that ayahuasca is still considered a Schedule I drug in the United States, which poses challenges to future research.
In addition, the use of ayahuasca is contraindicated with certain psychiatric and physical conditions such as predispositions to psychosis, lesions of the gastrointestinal track, severe liver and kidney impairment, cardiovascular and cerebral vascular diseases, and uncontrolled hypertension (Loizaga-Velder & Verres, 2014). Ayahuasca can also interact adversely with some pharmaceuticals, dietary supplements, and alcohol and drugs that are being abused (Loizaga-Velder & Verres, 2014). It is recommended that those using or taking psychotropic medication discontinue their use prior to ingesting ayahuasca. Mate further explained that those with a history or psychosis or mania should not be accepted to a retreat; not for fear of what would emerge, bur for the impossibility of providing long-term care and integration in a safe context (2014). Active drug users should not be accepted to participate in an ayahuasca ceremony as the issues of craving and withdrawal would vitiate the experience and proper medical assistance may not be available if needed (Mate, 2014).
Methods:
Studies in humans have assessed the impact of ayahuasca on substance abuse disorders and depression-anxiety related to trauma and comorbidity of traumatic experiences. One case reported a remission of drug or alcohol abuse/dependence in an ayahuasca community sample (6.5 years average membership) (Dominguez-Clave, 2016). In another case series, authors found a statistically significant reduction in cocaine use after ayahuasca-assisted therapy in a sample of the First Nations community in Canada that had no prior experience with ayahuasca. The research found improvements in mindfulness, empowerment, hopefulness, quality of life-outlook and quality of life-meaning (Dominguez-Clave, 2016). Similar effects on substance use were found in two case-control studies. Research showed remission in alcohol, depressive, and anxiety disorders and changes in behavior and attitudes towards others and outlook on life in 15 long-term sample of ayahuasca users, compared to 15 matched controls with no prior history of ayahuasca ingestion (Dominguez-Clave, 2016). Research also reported an improvement in alcohol use and cessation of drug use (except cannabis) in two groups of jungle and urban-based ayahuasca users compared to non-ayahuasca users; findings were maintained at one-year follow-up (Dominguez-Clave, 2016).
Other descriptive studies such as observational pilot studies, reports and informal interviews have presented preliminary evidence suggesting a potential beneficial role for ayahuasca in the treatment of trauma and substance use disorders (Dominguez-Clave, 2016). An open trial of 23 psychiatric inpatients with trauma history were evaluated on the effects of a single dose of ayahuasca. Researchers observed statistically significant reductions of up to 82% in depressive scores between 1, 7, and 21 days after administration. (Dominguez-Clave, 2016).
In an additional research study, researchers conducted an exploratory study using a qualitative reconstructive method based on the paradigm of symbolic interactionism (Loizaga-Velder & Verres, 2014). This approach aims at grasping subjective perspectives of the interviewees and providing comprehensive and multidimensional phenomenological representation of the field study; data were gathered through field observation, problem-centered interviews and textual resources (Loizaga-Velder & Verres, 2014). The qualitative study included a review of seven therapeutic projects located in South America; interviews with 13 therapists who apply ayahuasca professionally in treatment; interviews with 2 expert researchers on the topic of addiction and trauma; and 14 individuals who had undergone ayahuasca-assisted therapy (Loizaga-Velder & Verres, 2014).
Kerry Moran, MA, LPC and Dr. Gabor Mate, MD contributed additional expert opinion provided for research. Kerry Moran is a psycho-spiritual therapist who specializes in integration of psychedelic and plant medicine experiences, trauma, depth psychotherapy, depression, grief, anxiety, mindfulness and meditation. Gabor Mate is a renowned physician and author who specializes in childhood development and trauma, and in their life long impacts on physical and mental health.
Discussion:
Research supports that ayahuasca may be useful as an intervention to treat trauma, however, more research is needed. The study of ayahuasca, outside of its traditional, sacred ceremonial use, is a relatively new in the treatment of trauma and other disorders such as substance use and depression. Although psychedelic research has existed since the 1950’s in the United States, ayahuasca and many other hallucinogens remain a schedule I drug making it illegal or very difficult to test in a clinical setting. Research on ayahuasca as a therapeutic treatment method in the psychology communities and western medicine has only existed for about 20 years and has only been popularized in roughly the last 10 years. Many of the studies consist of very small sample sizes in specific communities. Controls during experiments differ and are not as easily measured due to the subjective and individualistic experience of the user.
Although ayahuasca functions in ways that exposure therapy does on the brain, exposure therapy is typically conducted in a clinical, controlled setting with an experienced clinician or therapist. Exposure therapy may take place over the course of a necessary timeframe depending on the tolerance, nature, and resilience level of the individual client. Ayahuasca ceremonies often take place in a predetermined, short period of time, often a weekend or 24-hour period. For this reason, it is important that integrative work with a professional clinician or spiritual advisor continue following the ceremony to properly process the trauma work.
Research also suggests that an ayahuasca experience should not be the only mode of therapeutic intervention when processing trauma or other disorders. Psychotherapy or another form of therapeutic processing may provide better results when done concurrently or as an adjunct to the ayahuasca experience. A high level of motivation and personal research should be considered by the individual before partaking in an ayahuasca retreat. Preparation for a ceremony may be specific and rigorous that could take place weeks or months in advance of a retreat.
It is also important to note that many medications and pre-existing conditions can counteract with the medicine that can have potentially harmful results. Those seeking ayahuasca as an intervention for substance use should not consider this as a frontline treatment. Ayahuasca ingestion requires a period of abstinence from most addictive substances and those considering ayahuasca should consult a physician and/or a psychiatrist depending on the nature of the ailment or dependency.
Ceremonies and retreats differ in experience and range from many countries around the world. It is suggested as a result of this research and personal experience, that individuals seek shamans, religious affiliates, and companies that meet certain criterion and provide the utmost safety to the user. The vetting process and guidelines to participate in the ayahuasca experience should be thorough and detailed by those offering the ceremony. Individuals should be sure to speak to representatives or staff that will be conducting the ceremony if services are found online. It is suggested that ceremonies provide medical staff, trained and experienced clinicians, preferably those who are licensed psychotherapists or psychologists. All staff should have some experience with the medicine, either in its administration or personal experience and should be active in post integrative work following the ceremonies. Credible retreats should provide some form or lodging and meals for the duration of the retreat. Other services and amenities offered that are suggested are yoga, meditation, rapay, breathworks, massage, and individual therapy sessions available if needed.
References
Callicott, C. (2016). Introduction to the special issue: Ayahuasca, plant-based spirituality, and the future of Amazonia. Anthropology of Consciousness, 27, 113-120.
Dominguez-Clave, E. (2016). Ayahuasca: pharmacology, neuroscience, and therapeutic potential. Elsevier, 126, 89-101.
Gurel, L., & Harris, R. (2012). A study of ayahuasca use in North America. Journal of Psychoactive Drugs, 44(3), 209–215. https://doi-org.antioch.idm.oclc.org/10.1080/02791072.2012.703100
Loizaga-Velder, A., & Verres, R. (2014). Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence—qualitative results. Journal of Psychoactive Drugs, 46(1), 63–72. https://doi-org.antioch.idm.oclc.org/10.1080/02791072.2013.873157
Mate, G. Psychedelics in unlocking the unconscious: From cancer to addition. In B. Labate & C. Caynar (Eds.) The therapeutic use for ayahuasca (pp. 217-226). Berlin, Germany: Springer
Megler, J.D., & Nielson, J.L. (2014). Ayahuasca as a candidate therapy for PTSD. In B. Labate & C. Caynar (Eds.) The therapeutic use for ayahusca (pp.41-58). Berlin, Germany: Springer.
Moran, K. (2019). We need to talk about when people feel worse are ayahuasca. Retrieved from https://kahpi.net/after-ayahuasca-trauma-integration/
