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Ayahuasca IPA Short Version
Ayahuasca IPA Short Version
Ayahuasca IPA Short Version
Word counts:
Abstract: 247
I confirm that the research and the text in this document is my own except where clearly
Abstract
Ayahuasca, an Amazonian plant medicine brew, is increasingly popular with UK seekers of
psychological, emotional, biological and spiritual healing. These people are often frustrated
Psychotherapists can usefully develop knowledge and skills to better support clients
exploring psychedelics. People take psychedelics both in personal and formal settings,
including within an expanding field of psychedelic research in the UK. I explore what four
people from the UK told me about the sense they make of their ayahuasca experiences. I
focused on those taking ayahuasca in organised ceremonies for healing. I conducted an hour’s
semi-structured interview with each participant centred around the question, ‘What did you
Phenomenological Analysis (IPA), I grouped the findings into five themes suggested by the
participants’ responses: T1. Our telephone line back to source: insights that change
perspective; T3. Watch loads of ballet: ayahuasca amongst different paths of healing; T4.
Gets you off your head: ayahuasca as a drug versus (plant) medicine versus sacrament; T5.
Three guys with feathers: intercultural exchange, the socio-cultural field in which those in the
UK take ayahuasca. I explain why psychotherapists should research psychedelics, and how
I receive two or three enquiries a week from those struggling with serious, long-term
and chronic difficulties hoping for help from psychedelic experiences. Last week, it was a
mother bereft at the death of her child during his birth. The week before, there was someone
unable to feel any pleasure following childhood sexual abuse decades earlier. These callers
often report that they have tried psychotherapy, medication, psychiatry and other approaches
for years without success and are desperate for something else. They find new hope in recent
enquirers that I’m unable to help other than to offer psychotherapy and signpost further
resources, but whether psychedelics can deliver what these people hope for is an urgent
question. I have a pressing desire to find out how psychedelics and psychotherapy might
work together, and to apply the insights of the existential school to contribute something
My topic
Amazon, unique in its culture, history and effect (Shanon, 2010, p. 141). The brew induces
visual, auditory, psychological and bodily effects that comprise psychedelic experiences.
and spiritual healing (Knowles, 2019d; B.C. Labate & Jungaberle, 2011; Luke, 2015; Sessa et
al., 2017) amidst limits of existing treatments (Fava, 2003; Jakobsen, Gluud, & Kirsch, 2019)
their ability to offer preparation, integration and advisory services to those using psychedelics
(Forums & Events, 2019; Knowles, 2019c; The Psychedelic Society (UK), 2019; TRIPP
psychotherapy, meditation and yoga, my use of ayahuasca (legal ceremonies in Costa Rica)
coincided with my shift away from striving to make money in a capitalist mode toward
I want to know how ayahuasca has affected the lives of others in the UK and how
I hope to understand the sense that participants make of their ayahuasca experiences
and the impact of these experiences on their lives. I aspire to uncover what from these
participants, and what relationship ayahuasca has and could have to psychotherapy.
Qualitative methods can offer a rich, deep understanding of topics, different and
complementary to quantitative research (Maher & Neale, 2019). This research distinguishes
itself by its contemporary UK focus, its qualitative, existential, phenomenological basis and
Literature Review
Ayahuasca: A Primer
‘Ayahuasca’ means vine of the dead, spirits or soul (Shanon, 2010, p. 13). Ayahuasca
can refer to a plant (a woody vine), a medicinal brew made from this plant, and a traditional
ceremony of peoples of the Amazon based around this plant medicine brew.
(Spruce ex Griseb.) C. V. Morton and the leaves of the chacruna bush Psychotria viridis Ruiz
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 5
& Pav. The crushed ayahuasca vine and chacruna leaves work together (Nutt, cited in
Cocozza, 2014), alongside other ceremonial elements including incense and songs, to
Rather than random hallucinations, many speak of their visions as holding great
personal significance and meaning (Evans, 2019; Harris, 2017; Pollan, 2018; Shanon, 2010,
p. 13).
During their psychedelic journey the drinker may experience a range of difficulties
including nausea, vomiting, diarrhoea and sweating (International Center for Ethnobotanical
Education, 2017, p. 8; Loizaga-Velder & Verres, 2014, p. 68; Tafur, 2017, p. 99). I view
these an essential part of the process, so I do not label them side effects. Others take a more
The literature associates several deaths with ayahuasca (Sinclair, 2017), including that
of British teenager Henry Miller in 2014. The circumstances of Miller’s death highlight
problems for ayahuasca centres with hospital access, aftercare and regulation (Daniels, 2018).
The literature does not evidence substantial, direct, lasting physical or biological harm
attributable to ayahuasca’s pharmacology (Bouso & Riba, 2011, p. 61). Ayahuasca may still
provoke short and long-term psychological, emotional and spiritual distress. Evidence of
long-term psychological distress is available for other psychedelics, especially LSD (Frecska,
A strong grip of self and consensus reality is necessary to undertake a journey that
often calls self and reality into question. The literature (International Center for
Ethnobotanical Education, 2017, p. 7) and ayahuasca centres (Soltara Healing Centre, 2019;
Temple of the Way of Light, 2019b) recommend those with diagnoses or a family history of
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 6
ayahuasca. Screening for the above and other contraindicated conditions is worthwhile but
International Center for Ethnobotanical Education, 2017, p. 10; Loizaga-Velder & Verres,
2014, p. 68) and ayahuasca does not build up a tolerance in the body (Horgan, 2014, p. 204).
My review of the literature suggests that ayahuasca has an acceptable safety profile
International Center for Ethnobotanical Education, 2017; Luke, 2015). Still, the dangers,
problems and cautions related to ayahuasca are serious and span the physical, emotional,
psychological, spiritual, cultural and environmental. We need further research to confirm the
Legality
alcohol, nicotine and caffeine (Gov.uk, 2015). The Misuse of Drugs Act 1971 schedules
DMT (present in ayahuasca) as a Class A drug (Walsh, 2016, p. 241). This classification
There are only two instances of ayahuasca coming under consideration by the UK
legal system. Both cases leave untouched the ambiguities regarding ayahuasca’s legal status
like Peru, Brazil (International Center for Ethnobotanical Education, 2017, p. 3) or Costa
Psychotherapy and psychedelics have a dynamic relationship going back at least fifty
years. The literature suggests the potential of ayahuasca for healing and insight (Blainey,
2015 ; International Center for Ethnobotanical Education, 2017, p. 3; Beatriz Caiuby Labate
I am wary of any idea of psychedelics as a panacea for a wide range of issues. Rafael
G Dos Santos, Sanches, Osório, and Hallak (2018) strike a sobering note of caution by
D/MADRS) days and weeks after ceremony evaporated in the longer-term when they
I agree with the conclusions of McKenna, Callaway, and Grob (1998, p. 73) and
Bouso and Riba (2011, p. 60) that the search continues for innovations that can help people,
and there are many further questions about the potential of ayahuasca to heal mind, body and
spirit.
While not taking the prospect of ayahuasca’s therapeutic potential as proven, the
Teams at both Imperial College London and King’s College London are researching
the therapeutic potential of psychedelics (King's College London, 2019; O'Hare, 2019).
The psychotherapy provided in these trials is broadly within the medical model. For
instance, the Imperial team use an ‘Accept. Connect, Embody (ACE)’ framework (Watts,
2019). This framework encourages participants, via exercises and guided visualisations, to
imagine their experience as a dive into the ‘sea’ of their experience, under the ‘waves’ of the
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 8
everyday, searching for ‘oysters’ that contain ‘pearls’ built around ‘grit’ of problems they
their experience in their own terms. Heidegger invites us to ‘make the scientific theme secure
by working out these fore-structures in terms of the things themselves’ (Heidegger, 2016, p.
195), by which he suggests not to impose patterns on data from outside, but to establish
patterns from within the data inductively. Heidegger, phenomenology and IPA insist on
questions, in terms of ‘figure and ground’ (Resnick & Parlett, 1995, p. 4), what is shown and
hidden amongst various possibilities. In these ways and others, existential psychotherapy is
distinct from other discourses on psychedelics and offers a needed and unheard perspective,
Methodology
I decided that quantitative methods that reduce rich phenomena to numbers and
statistical analyses are unsuitable for my question. I searched for a suitable qualitative
grounded in phenomenology.
Phenomenology
& Mooney, 2002, p. 1). One important concept here, which I return to later, is the
hermeneutic circle, being that one can only understand parts within the context of the whole,
and the whole within the context of its parts (Heidegger, 2016, p. 195), or more simply the
and Van Manen (2016) inhabit different positions on phenomenology (Giorgi, 2010, 2011;
Smith, 2010, 2018; Van Manen, 2017). After careful consideration, I selected IPA.
idiographic analysis, grouping the data into superordinate and subordinate themes.
Smith, Flowers, and Larkin (2012, p. 3) term IPA a double hermeneutic because the
(Smith et al., 2012, p. 36). I mention these concepts since I make use of them in the
Discussion.
Pringle, Drummond, McLafferty, and Hendry (2011), Paley (2017, pre-index page),
Giorgi (2011, p. 207), and Brocki and Wearden (2006) each offer a measured account of the
Conclusion
understanding of phenomenology (Gadamer, 2000). IPA lends itself to my skills and boasts a
good track-record in health psychology (Pringle et al., 2011). I endorse IPA’s encouragement
toward reflexivity and openness to discovery (Pietkiewicz & Smith, 2012, p. 362).
Method
Selecting and Recruiting Participants
My purposive sampling sought four participants that met eligibility criteria designed
to enable safe, ethical and effective research. I recruited from personal and professional
Ethical Considerations
and the risks of taking part, including that of incriminating themselves given the illegality of
DMT in the UK (Finch, 2001, p. 41). This research did not involve supplying ayahuasca,
beyond what they had already sought out in the past for separate reasons.
I furnished participants with a Participant Information Sheet, a Consent Form and the
participants.
Smith et al. (2012, p. 57), to use semi-structured interviews. I curated the interview schedule
participant lasting 45–60 minutes, made a digital audio recording of the interview and
Data Analysis
I processed the first transcript, grouping my notes and their associated text-passages
into themes. Then I created a hierarchy based on relevance to my research question with
superordinate and subordinate themes. I applied the same steps separately to my second then
third and fourth transcript before generating cross-cutting, superordinate and subordinate
subsuming, polarisation, contextualisation, numeration and function (Smith et al., 2012, pp.
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 11
96-99). The result was five themes. Finally, I rooted the analysis in the words of my
participants (Pringle et al., 2011, p. 21) by putting those words first for each theme.
It is important to assess this qualitative study by appropriate criteria rather than those
designed for quantitative studies such as the research being generalisable, repeatable, or
scalable. Yardley suggests worthwhile criteria of quality (cited in Smith et al., 2012, pp. 179-
185) highlighting rigour, validity and transparency. I kept these criteria in mind throughout
the research, and my hope is that they are in evidence in this report.
Findings
Introduction
Table 1
Cross-Cutting, Superordinate Themes
T1 Our telephone line back to source Insights that changed participants’ lives
shamanism
subordinate themes. I aimed to ‘ensure that the account produced is a credible one, not the
Table 2
Which Participants Contributed to Which Themes
Theme P1 P2 P3 P4 Theme
totals
mechanism of perspective
T1. Our Telephone Line Back to Source: Insights That Changed Participants’ Lives
This theme refers to expressions that the experience of ayahuasca lead to insights,
T1 uses words from P4, ‘all of these things they're our tools. Our telephone line back
to source’ (P4, Paragraph 25). P4 here alludes to the spirit of ayahuasca as ‘source’ and
ayahuasca providing a way to communicate with this, as if communing with nature, the
Universe, or God.
P4 gave up her successful but self-focused career and now bases her livelihood on
using shamanism to help others. P2 credits ayahuasca with helping him leave behind a
lifelong drug addiction. P1 did not report significant changes, but reports that, unlike most, he
practices other healing modalities linked to the theme of ‘different paths of healing’. P3
reports that ayahuasca helped her understand her troubled relationship with her father after a
The T2 theme label uses the words of P3, ‘I ended up in my father's psyche … When
my father was five, six, basically his mother disappeared, but / she died, but they didn't tell
him what had happened … and then he ended up living with various other people’ (P3,
Paragraph 341). For P3 this is a startling revelation. P3 could not make peace with her father
via therapy or other paths of healing, then gains via ayahuasca a relevant insight. This
revelation granted a significant release for her toward compassion and understanding. P2 and
P3 spoke at length about ayahuasca offering insights to do with their fathers and of the
Participants are keen to stress that ayahuasca was necessary but not sufficient for the
changes they made and that they value non-ayahuasca paths of healing and insight alone and
P2’s words feature in T3’s title, ‘you might watch loads of ballet, you might go
running on the beach. Anything that helps you become conscious of yourself’ (P2, Paragraph
184). P1 colludes, ‘there are just different paths’ (P1, Paragraph 38). Therapists could help
with this integration, aligned with the approach I have previously set out, which I explore
T4. Gets You Off Your Head: Ayahuasca as a Drug Versus (Plant) Medicine Versus
Sacrament
taking up alternative positions at different points in the interview, each offering different
The T4 theme uses P2 in its title, ‘when I sat down with the lady, she said “Look, it's
a medicine. We call it medicine for a reason”. And that day I was like “Rar rar it doesn't, gets
you off your head, it's a drug rar rar.”’ (P2, Paragraph 54). Here, P2 squares this circle via the
notion of ayahuasca as a medicine, that is a drug, but a legitimate one. P2 struggled with life-
threatening drug addictions for decades before his ayahuasca experiences, so ayahuasca as a
drug was a big problem. P4 as P2 prefers the term ‘medicine’ to ‘drug’, differentiating it from
Participants struggled with the ‘drug’ label of ayahuasca, suggested that it prejudiced
their view, and preferred different language post-experience to reconcile these differences,
Passages under this theme centre on intercultural aspects, positive and negative. Most
of these comments concern ceremonies, and others the longer-term or broader situation.
P2, providing the words to the theme, enjoys the rooting of ritual in cultural history,
‘When there's three guys with feathers. And you just, I'm like, “well this was <year>,
actually, I'm watching thousands of years of ceremony right in front of me. This guy could be
his grandfather ten times.”’ (P2, Paragraph 148). The cultural differences can seem exotic
and attractive to Westerners, as can integrating the spiritual into everyday life, which is often
Discussion
Ayahuasca and Other Paths of Healing
Participants suggest that ayahuasca is one amongst many paths of healing (T3). I
Figure 1
One Theme Inside Another
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 16
I intend to show:
2. Elements build successively toward a small nugget of wisdom of the insights that
3. This maps a journey from outer to inner, a relationship zooming in on the planet as
the world, then society, the plants from the forests, then the human individual, the
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 17
in their lives (T1) finds support in the literature that ayahuasca has therapeutic potential
(Frecska, Bokor, & Winkelman, 2016; International Center for Ethnobotanical Education,
2017; Beatriz Caiuby Labate & Cavnar, 2016; Luke, 2015; Miller, 2017; Tupper, 2009).
Figure 2
Ayahuasca and Psychotherapy as Different Paths of Healing
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 18
2. Ayahuasca and psychotherapy can interact. While a small zone of contact historically,
this zone is expanding as ayahuasca and psychotherapy move closer over time.
mentions Cognitive Behavioural Therapy (CBT) finding that the therapy and the magic
mushrooms worked together to help her. In contrast to P3, Ryan (2015, p. 31) found that his
participant Sarah judged ayahuasca more useful than her CBT. P2 had a positive experience
the same time as people undertake a psychedelic experience, though that approach happened
in the past (Caldwell, 1968). It is difficult to talk coherently with someone amidst a
psychedelic experience.
and after the psychedelic experience not during. For example, the MAPS protocol is to offer
Studies, 2016, p. 4). Similarly, legal ayahuasca centres offer pre-ceremony preparation
2019; Soltara Healing Centre, 2019; Temple of the Way of Light, 2019a). Post-ceremony,
some people may find that friends, family, books and conferences offer enough support. For
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 19
others, psychotherapists are better placed to offer serious, informed, committed, long-term
(Knowles, 2019c; The Maudsley Psychedelic Society Integration Group, 2019; The
Psychedelic Society (UK), 2019; TRIPP Network, 2019). This suggestion merits further
According to Nietzsche, ‘unspeakably more depends on what things are called than on
what they are’ (Hacking, 2008; Nietzsche, 2001, § 58). Participants highlight differences
between ayahuasca and other drugs, including its non-addictive character, its natural origins,
and that overdose and abuse are unlikely. Their arguments align with the literature from
International Center for Ethnobotanical Education (2017, p. 10), Horgan (2014) and Frecska
(2011, p. 152).
It seems legitimate to consider ayahuasca a drug, given its pharmacology and the
rapid, reliable and extensive physical effects (International Center for Ethnobotanical
Education, 2017, p. 4; Riba & Barbanoj, 2011). Due to the drug label, people may assume
ayahuasca to be on the wrong side of the ‘war on drugs’ (Walsh, 2016, p. 241). In contrast, as
P2, some literature supports the use of ayahuasca to help people address drug addictions
(Bouso & Riba, 2016; Fernández & Fábregas, 2016; Liester & Prickett, 2012; Loizaga-
problem. In contrast, Schmid (2011, p. 259) says, ‘ayahuasca should not mainly be
psychological catalyst that unfolds within a field of sociocultural ideas’. This proposal is
attuned to ayahuasca as a traditional plant medicine, a definition that encompasses not just
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 20
the drink but the shaman, the sacred space, the songs (icaros), rituals and so on (Theberge,
2019).
Aligned with that idea, I propose that psilocybin for depression or MDMA for PTSD
are not analogous to insulin for diabetes or ibuprofen for a headache. Ayahuasca is best
is something that existentialism offers (Van Deurzen, 2014, p. 157). Ayahuasca is no single
In the USA, psychedelic therapies are on a fast track to the mainstream (Guardian
staff and agencies, 2019; Multidisciplinary Association for Psychedelic Studies, 2018). In the
UK, psilocybin and MDMA may gain some licences for limited medical use within a few
years (Forums & Events, 2019). There is a growing need for psychotherapists to consider
their relationship and skill in psychedelic engagement (Confer, 2019; Forums & Events,
2019; Knowles, 2019d). Psychotherapists can amplify, question and assist people with new
Limitations
only four participants, and a greater number would generate further relevant data. My
participant criteria limit the findings. Issues of research ethics and legality create further
limitations. For example, I warned participants about the risk of incriminating themselves,
and this may have created a sense of caution in what they said.
Amongst other limitations, I will mention that I collected data at only one point-in-
time, so have no insight, beyond what participants informed me themselves, into changes
T1 and the differences and potential alliances between psychotherapy and ayahuasca
existential perspective. Further studies might consider the needs of psychotherapy trainees
facilitator certification and supervisory structures. Research could bridge quantitative with
understanding of subjective experiences. Studies using scales and inventories could partner
with data based on interviews and interpretation. I seek to conduct further research on this
During this process, I have given my first tentative talks on ayahuasca research at two
conferences (Knowles, 2019a, 2019e) and published a thought piece in the Journal of the
Society for Existential Analysis (Knowles, 2019b). Most weekdays, I offer integration
support to those with planned or past psychedelic experiences, and I volunteer at public
I will now take up some of my own suggestions for further research in my PhD within
discussions linked to this research, Professor Jonathan Smith, founder of IPA, has agreed to
created with the medical and scientific research team at King’s College London.
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 22
Conclusion
I set out in the Introduction the relevant background, my research focus and aims, the
value of this research, and my personal and professional reasons for conducting it. The
literature review evaluates the context for this research and the thinking that has informed it.
My review demonstrated that little of the literature speaks to the approach that I suggest has
I interviewed four UK participants to find out what sense they make of their
ayahuasca experiences. My analysis of what they told me derived five themes, and I
discussed those findings in the light of extant literature, with a focus on the implications for
relevant participants responses. I evidence these themes in the data via quotes from the
My discussion takes up the main themes from the findings and sets them within the
broader context and amongst the literature. I establish the limitations of this study, suggest
What I draw from those findings is my argument that there is an increasing need for
the psychotherapeutic community to explore how psychotherapists can help people seeking
out psychedelics for healing and insight. Psychotherapy and ayahuasca have much to offer
each other, yet there is little analysis and practical integration available, especially with a
There are implications for psychotherapists and psychotherapy training, which merit
drug or medicine (T4), the complexities of intercultural exchange (T5) and ayahuasca
amongst different and to some extent competing paths of healing (T3), including that of
psychotherapy.
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 23
this research. The hermeneutic circle applies to the research itself in that it is only having
completed the whole piece that I understand the importance and place of the individual
elements.
experiences, and I am grateful for their time, energy and care. I hope to do their experiences
Psychotherapists are only just beginning to explore this valuable area and, following
my career change inspired, in part, by ayahuasca, I am just starting out. I believe this research
challenge existing discourses. As the new term starts on my PhD, I look forward to the next
chapter.
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 24
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