A Psychotherapeutic View on the Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Addiction
MAPS Bulletin Special Edition, Spring 2013, 36-40.
Ayahuasca is a traditional plant preparation of the Amazon basin with psychoactive properties. In recent decades ayahuasca has gained the attention of researchers in multiple disciplines worldwide due to its acclaimed therapeutic and spiritual qualities. It is an admixture of two plants : the harmaline containing vine Banisteriopsis caapi, and the DMT-containing leafs from the Psychotria viridis bush. It is typically administered by a trained expert in a ritual context.
The use of ayahuasca has spread beyond the Amazon in the last few decades, reaching around the globe in contexts of religious, shamanic, psychotherapeutic, and hybrid ayahuasca rituals (Labate & Jungaberle 2011; Tupper 2008). Many participants report gaining benefits from ayahuasca rituals in ways such as acquiring deeper knowledge of oneself, personal and spiritual development, or healing for a variety of psychological and physiological afflictions, including substance dependencies (see Groisman & Dobkin de Rios 2007; Labate et al. 2013; Labate et al. 2010; Mercante 2009; Santos, Carvalho de Moraes & Holanda 2006; Schmid 2008; Thesenga & Thesenga 2012).
Based on observations of the positive therapeutic effects that ayahuasca ceremonies can have on people with addiction issues, informal and formal support for recovery from addictions is currently provided in diverse settings. These include rituals offered by indigenous healers, ayahuasca circles, or psychotherapists, and more or less structured ayahuasca-assisted, inpatient and outpatient addiction treatment programs. Such approaches are rooted either in indigenous Amazonian medicine traditions, the Brazilian Ayahuasca Religions, psychedelic-assisted psychotherapy, or consist in a hybrid combination of these. Some multidisciplinary intercultural pilot projects have shown promising preliminarily therapeutic outcomes (Fernández & Fábregas in press; Giove Nakazawa 2002; Mabit 2007) that warrant further scientific confirmation through controlled clinical trials.
This author conducted an exploratory study using qualitative research methods based on a combination of participant observation and problem-centered interviews (Witzel 2000), in order to describe the therapeutic value of ayahuasca in addiction treatment from a psychotherapeutic perspective, and to provide guidelines that may help improve therapeutic efficacy for traditional and modern ayahuasca-assisted addiction treatment. Research data was evaluated and conceptually structured with qualitative data analysis according to Miles and Huberman (1994).
The qualitative study included: (1) a review of seven therapeutic projects which apply ayahuasca in the treatment of addiction in diverse settings, (2) interviews with four traditional healers and 11 mental-health professionals with expertise in both treatment of addictions and therapeutic ayahuasca use, and (3) interviews with 14 individuals who had undergone ayahuasca-assisted therapy for addiction in diverse settings (Presser- Velder 2012).
The findings of this research indicate that participation in ayahuasca rituals can help certain individuals gain abstinence from, or reduce, the abuse of harmful psychoactive substances in a substantial way. In an appropriate context, ayahuasca can be a valuable therapeutic tool and can act as a catalyst that can render psychotherapeutic processes more effective in less time, and sometimes allow for Body-oriented detoxification, anti-craving, increased body awareness Personal overcoming denial mechanisms, introspection and self-analysis, therapeutic insights, emotional processes, improvement in relationships, discovery of new psychological resources Transpersonal awareness of a power greater than oneself, spiritual renewal and sense of meaning in life, reorientation in value system, sensation of inner peace
critical interventions when several other therapeutic strategies have been unsuccessful. Substance dependency can be conceptualized as a multi-factorial problem that requires comprehensive and integral
intervention strategies. Ayahuasca seems to provide multidimensional subjective experiences that can facilitate interconnected body-oriented, psychological, and spiritual processes with observable
The most relevant findings of this study concerning the therapeutic value of ayahuasca from the perspective of therapists and ritual participants are illustrated graphically in the figure to the left.
Due to the intense physical experiences that are commonly associated with the ingestion of ayahuasca, ayahuasca-assisted treatment can be characterized as a body-oriented approach. Body-oriented effects of the ayahuasca experience may include subjective experiences of detoxification, anti-craving effects, and increased body awareness. Intense experiences of purging that many participants undergo during the ayahuasca induced non-ordinary states of consciousness can, according to both the interviewed therapists and ritual participants, assist the detoxification process significantly and can also help release tensions, physical blockages, and psychological burdens, inducing a subjective feeling of relief, inner peace, and mental clarity.
The purging works on physical and psychological levels… there are many interesting cases were patients describe…expelling psychological issues and the accumulated intoxication of the drug…others expel emotional hang-ups like rage or anger through vomiting…this vomiting really has an impact [on the life of the patients]; it’s not just symbolic. (Interview with Therapist G.) Figure 1: Therapeutic value of ayahuasca.
Most of the interviewed ritual participants reported that purging during the ayahuasca experience was accompanied with experiences of unloading psychological burdens, such as guilt, negative emotions, negative attitudes, and negative thoughts. Purging was oftentimes followed by a sense of redemption, new beginning, and an increased awareness of responsibility toward their health and well-being. The emetic effect of ayahuasca can also contribute to attenuated withdrawal symptoms and drug cravings. Both psychological and physical mechanisms may underlie this effect (see also Brierley & Davidson 2012; Liester & Prickett 2012; Presser-Velder 2012). Further clinical studies on the anti-craving mechanisms of ayahuasca are highly recommended.