Ayahuasca and the Healing of Eating Disorders
Marika Renelli, Jenna Fletcher, Anja Loizaga-Velder, Natasha Files, Kenneth Tupper
and Adele Lafrance
Eating disorders (EDs) are complex mental health issues that involve cognitive, physical and emotional symptoms (Golden et al., 2003; Polivy & Herman, 2002). It is widely accepted that the avoidance of challenging emotions is central to the development and maintenance of an ED (Harrison, Sullivan, Tchanturia, & Treasure, 2009). Many have theorized that an individual’s focus on and negative view of body image, along with attempts to change their body are more strongly related to the embodiment or acceptance of emotion, rather than physical weight and shape (Sim & Zeman, 2005). Negative affect is projected onto the body and engaging in ED behaviors offers temporary relief from unmanageable emotions. EDs also have the highest mortality rate of all the psychiatric disorders (Hoek, 2006) and are considered highly treatmentresistant, especially anorexia nervosa (Waller, 2016). As such, the field has called for innovative treatments to be considered, and as EDs are now a global phenomenon, therapeutic modalities from across cultures must also be explored (Hay, 2013).
Anecdotal reports have indicated that some individuals with EDs have explored the use of the traditional Amazonian plant medicine ayahuasca with positive results. A growing body of research points to promise of its utility in the healing of various mental health issues, including depression, anxiety, substance use disorders, and post-traumatic stress disorder (Fábregas et al., 2010; Halpern, Sherwood, Passie, Blackwell, & Ruttenber, 2008; Loizaga-Velder & Verres, 2014; Osório et al., 2015; Sanches et al., 2016; Thomas, Lucas, Capler, Tupper, & Martin, 2013). Recent research has also found ayahuasca to have therapeutic benefit for individuals along the continuum of recovery from EDs, with respect to symptom reduction and embodiment, among other positive outcomes (Lafrance et al., 2017). Researchers from around the globe are working to understand the therapeutic mechanisms of ayahuasca (Labate & Cavnar, 2014). Preliminary results suggest that ayahuasca works in a holistic manner, including the physical, psychological, and spiritual. For this reason, ayahuasca is a healing tool that has the potential to assist in moving towards an embodied and integrated sense of self.
Ayahuasca, meaning “vine of the soul” in the Quechua language, is a psychoactive substance that originates from the Amazon. It is a brew prepared by boiling the Banisteriopsis caapi vine with other plants, but most commonly with the leaves of the Psychotria viridis shrub (Rivier & Lindgren, 1972). The plants contain the short-term reversible monoamine oxidase inhibitor (MAOI) alkaloids harmine, harmaline and tetrahydroharmine (B. caapi) and the psychoactive alkaloid dimethyltryptamine or DMT (P. viridis). The typical effects of the brew involve changes in perception and cognition (e.g. vivid visual and auditory sensations), newfound insights, recollections of memories, strong emotional experiences (e.g. happiness, sadness, fear), bodily sensations, and spiritual and transpersonal experiences (Riba et al., 2001; Shanon, 2002; Strassman, Qualls, Uhlenhut & Kellner, 1994). Certain acute effects of ayahuasca are nausea and purging in the form of vomiting, diarrhea, crying, yawning, sweating and shaking (Barbosa, Giglio, & Dalgalarrondo, 2005).
Archaeological evidence suggests that ayahuasca’s ritual use by indigenous Amazonian tribes dates back at least several hundred years (Grob, 2013). Currently, at least 75 indigenous Amazonian tribes use ayahuasca for ritual and medical purposes (Luna, 2011). Ayahuasca has also been used as a sacrament in the Brazilian-based churches of the Santo Daime since the 1930s, and the União Vegetal since the 1960s. Over the past 25 years, the use of ayahuasca as a psychotherapeutic and spiritual tool has spread throughout North America, Europe and other parts of the world (Tupper, 2008).
The ritual and contextual uses of ayahuasca vary. In traditional practices, a ceremony can involve setting an intention and ingesting the brew in a group, with experienced leaders, or “ayahuascqueros” presiding (Luna, 1986). Ceremonies normally begin after sunset and last several hours. The ceremony leaders may chant, whistle, and sing melodies referred to as “icaros”—believed to assist with the healing process—throughout the ceremony (Luna, 1986). Typically for indigenous-style rituals, dietary and behavioral restrictions are adhered to several days before and after consuming the brew. The restrictions may relate to the consumption of recreational drugs, alcohol, red meat, dairy, salt, sugar, and sexual activity.
The Study: The Role of Ceremonial Ayahuasca Use in the Healing of an Eating Disorder
There has been a recent resurgence in the scientific literature exploring the therapeutic potential of psychedelics, which include ayahuasca, for the treatment of mental health issues such as anxiety, mood disorders, and substance use disorders (Tupper, Wood, Yensen, & Johnson, 2015). The low remission rates of ED coupled with anecdotal reports of ayahuasca’s positive effects point to a need for further inquiry. In response, Lafrance et al. (2017), conducted interviews with 16 individuals with a history of both an ED and ceremonial ayahuasca drinking. Preliminary data revealed behavioral and psychological improvements, including ED symptom reduction or cessation, improved mood, decreased anxiety and problematic substance use, and improved capacity to process, regulate and embody emotions. Other significant outcomes included insights about the illness, and an improved relationship with the body. Some risks were also reported. For example, some participants noted that the preparatory diet resulted in some familiar ED thoughts. Also of note, one participant shared an experience of inappropriate sexual
advances by a facilitator — raising the very important issue of personal safety of this indigenous therapeutic practice without adequate regulatory structure. As a whole, this pioneering study opened the door for the exploration of ayahuasca’s use as a potential healing modality among those with a history of an ED. Given the breadth of data collected, the purpose of this study is to report on additional outcomes from this sample.