Search

Ayahuasca is a psychotropic plant-based tea from the Amazon. Its ceremonial use for therapeutic and spiritual purposes has become increasingly common and stands to escalate based on current policy initiatives in some countries. As ceremonial ayahuasca use spreads there is a need to understand, from various perspectives, how best to improve outcomes and minimize potential harms. Clinicians and therapists encourage the use of preparation and integration practices that accompany ceremonial ayahuasca use; however, there is no research investigating the views of those conducting the ceremonies. This qualitative study explored the perspectives of 15 ayahuasca ceremony leaders regarding preparation and integration practices they consider helpful for ensuring safe and productive experiences for ceremony participants. Qualitative content analysis produced three main categories, each with relevant subcategories. The first category included factors that facilitate preparation, including participant honesty and respect; readiness and willingness; and internal and external resources. The second category encompassed several complementary modalities believed to facilitate both preparation and integration, such as psychotherapy, spiritual and contemplative practices, and other modes of creative expression. The third category included factors considered facilitative of integration, including sharing of experiences, and working with insights and lessons. Ineffective integration practices constituted a fourth subcategory. Consistent with reports from other stakeholders, the findings highlight a wide range of preparation and integration practices that may be useful for ayahuasca ceremony participants to consider when drinking ayahuasca.

Objective: To identify patients’ perceptions of the value of psilocybin as a treatment for depression. Method: Twenty patients enrolled in an open-label trial of psilocybin for treatment-resistant depression participated in a semistructured interview at 6-month follow-up. Thematic analysis was used to identify patients’ experiences of the treatment and how it compared with previous treatments. Results: Two main change processes were identified in relation to the treatment. The first concerned change from disconnection (from self, others, and world) to connection, and the second concerned change from avoidance (of emotion) to acceptance. A third theme concerned comparison between psilocybin and conventional treatments. Patients reported that medications and some short-term talking therapies tended to reinforce their sense of disconnection and avoidance, whereas treatment with psilocybin encouraged connection and acceptance. Conclusions: These results suggest that psilocybin treatment for depression may work via paradigmatically novel means, antithetical to antidepressant medications, and some short-term talking therapies.

The psychological mechanisms of action involved in psilocybin-assisted psychotherapy are not yet well understood. Despite a resurgence of quantitative research regarding psilocybin, the current study is the first qualitative study of participant experiences in psilocybin-assisted psychotherapy. Semistructured interviews were carried out with 13 adult participants aged 22 to 69 years ( M = 50 years) with clinically elevated anxiety associated with a cancer diagnosis. Participants received a moderate dose of psilocybin and adjunctive psychotherapy with an emphasis on the process of meaning-making. Verbatim transcribed interviews were analyzed by a five-member research team using interpretative phenomenological analysis. General themes found in all or nearly all transcripts included relational embeddedness, emotional range, the role of music as conveyor of experience, meaningful visual phenomena, wisdom lessons, revised life priorities, and a desire to repeat the psilocybin experience. Typical themes found in the majority of transcripts included the following: exalted feelings of joy, bliss, and love; embodiment; ineffability; alterations to identity; a movement from feelings of separateness to interconnectedness; experiences of transient psychological distress; the appearance of loved ones as guiding spirits; and sharing the experience with loved ones posttreatment. Variant themes found in a minority of participant transcripts include lasting changes to sense of identity, synesthesia experiences, catharsis of powerful emotion, improved relationships after treatment, surrender or “letting go,” forgiveness, and a continued struggle to integrate experience. The findings support the conclusion that psilocybin-assisted psychotherapy may provide an effective treatment for psychological distress in cancer patients. Implications for theory and treatment are discussed.