Cura, cura, cuerpecito [Heal, heal, little body]:
Reflections on the therapeutic possibilities of ayahuasca†
v 2.0 - Jun 9, 2011
Original text in Ayahuasca y Salud [Ayahuasca and Health], 2011 (in press)
Citation: Labate BC, Bouso JC. "Cura, cura, cuerpecito [Heal, heal, little body]: Reflections on the therapeutic possibilities of ayahuasca." Erowid.org. Jun 9 2011. Online edition: Erowid.org/chemicals/ayahuasca/ayahuasca_article3.shtml
† This is a translation from the original: Labate, Beatriz C. & Bouso, José C. "Cura, cura, cuerpecito: Reflexiones sobre las posibilidades terapéuticas de la ayahuasca". In: Labate, Beatriz C. & Bouso, José C. (eds.). Ayahuasca y Salud [Ayahuasca and Health]. Barcelona, Los Libros de La Liebre de Marzo, 2011 (in press).
Skip to a summary and translation of the book's table of contents.
Skip to a summary and translation of the book's table of contents.
"Hello! I have a few personality traits which I describe below and which, as a consequence, cause many impediments in life. Some traits: Introverted; Neurotic (exaggerated preoccupation about what does not exist or suffering in anticipation); difficulty in talking and making friends; Self-critical; Perfectionist; Despairing; Lack of energy; Lack of enthusiasm; Nervous; Depressive (in treatment for 10 years without much progress); Intolerant; Impatient; Lack of initiative; Ill-humored; With heaviness in the head (perhaps originating from tension).
The question: By participating in the rituals and by ingesting ayahuasca, would I be able to change some of these traits that are part of my personality, or, at least, learn to live with some of them peacefully and without suffering, since antidepressants don't work for me? Hug, F.M."
-- Email message sent to Beatriz Caiuby Labate in 2008.
***Maria is a hard-working self-employed professional in a competitive Brazilian city. At 43 years old, her dream was to have a child. Recently she had gotten together with a certain man and they attempted in vitro fertilization. Each session (hormones plus fertilization) cost almost 12,000 dollars. The first two attempts failed, she was down to her last chance. The couple wasn't doing well and the man broke off the relationship. She was devastated. They had already paid for the third session and it was her last chance. What to do? Aside from the indecision, she didn't feel well mentally... Her therapist recommended a foreign ayahuasca healer who lived in a Brazilian metropolis. She called. The healer answered, with a distinctive portuñol accent (a mixture of Portuguese and Spanish), that he was busy that week detoxifying a young man who was addicted to cocaine and alcohol. He asked her to call the following week. She wasn't sure, but eventually called back. The healer proposed the following "treatment": three individual ayahuasca sessions including purification with tobacco smoke. She followed him to a house in a remote neighborhood in the city's periphery, hoping that something good would come from that intensive session with psychoactive plants and rituals of the Amazon.
***"Health should be understood from a psychobiological and sociocultural perspective... health beliefs and practices form a logical-conceptual system... illnesses are not a set of universal physical symptoms or static states, but rather processes mediated by culture... the body is not a reality that exists outside the social, nor precedes it... society fabricates the body... the cure is a collective process that requires constructing the sense/negotiation of meanings... it is necessary to understand how the sick person manages suffering and organizes the experience of the illness... contemplate how the illnesses are lived, dreamed, imagined... the social role of the subject -- like social class, age, gender -- count how he experiences pain... each society has its own illness classification systems and etiological theories... the doctor's office is also a ritual space... it is necessary to account for the doctors' ideas about illness and how they experience the treatment..."
Author B. Labate was reading such phrases repeated in various forms in the anthropological literature on health and illness when her readings were interrupted by the ringing of the telephone. On the other end of the line, a stranger spoke: "Hi! How are you? Listen, I want to take my cousin tonight to a neoshamanistic ritual group that takes ayahuasca. She has never done it and wants to go. But she told me she took sleeping pills last night. Do you think that's a problem? I don't know what the name is, but, you know, it's one of those prescription drugs. Do you think there could be some kind of interaction? Could anything happen?"
***Pronounced incurable by her doctors, with a brain tumor and a prognosis of certain death, a Spanish woman traveled to Céu do Mapiá, the main center of the Cefluris Santo Daime community in the Amazon interior, where she planned to take the Daime (ayahuasca), pray, and be close to nature. More than just cure herself, which at any rate at that point was impossible, she hoped to await her death in peace. In her final days, she wrote a beautiful diary that later came into the hands of a scholar, and was cited in his study about the Santo Daime doctrine. It is a simple and moving account about the full understanding and acceptance of death.
***"I want to thank you deeply for the indescribable experience and illumination you provided me... I want you to know that the ceremony and the journey changed my life. I truly felt light, peace and love in such a pure form, that I have no words to explain it. I am able to forgive people for terrible things they have done, etc., up until now I haven't smoked a single cigarette and up to the day of the ceremony I smoked about 15 a day. I wanted to stop for a long time but couldn't. Well, it really was a great and unexpected impact. I feel truly clean and renewed! I think it was the most important and incredible experience of my life, I was able to arrive at the essence of things. A big hug, S."
-- Email message sent to an ayahuasca healer by a male client after his first ayahuasca experience in São Paulo, December, 2008
"Health," according to the 1978 definition of the World Health Organization (WHO), is a state of "biological, psychological and social well-being" -- what is known as the "bio-psycho-social model." This definition, although widely accepted by diverse scientific disciplines (medicine, medical anthropology, health psychology, etc.), has been criticized by some authors for being naïve, by others for being Utopian, and by still others for being downright unspecific. However one chooses to define it, health in this book is taken in its broadest possible sense, not to encompass only "disease," but all experiences of suffering, ill-ease, ailment and discomfort, which is to say, not reducing to its physical dimension but as a physical-moral totality (Duarte 1998). In this sense, our objective is not to establish universalizing criteria for answering the question, "Does ayahuasca cure such and such an disease or not?" but instead, to understand ayahuasca use as part of what Foucault (2004) calls "technologies of the self" involved in shuffling the boundaries between pain and pleasure, or between waking and dreaming.
Beyond the analytic challenge of understanding situations such as those described above, certain practical motivations have also contributed to producing this collection: first, to systematically review the "state of the art" in biomedical understandings of ayahuasca consumption, which could be brought to bear in various judiciary cases that have afflicted ayahuasca users in different countries (many wind up in prison, while others win their freedom only after spending tremendous amounts of time, money and energy on lawyers as well as on improvised, amateur research collecting papers published about the topic). This objective obviously cannot be dissociated from analyzing the broader role of biomedical discourses about psychoactive substances in the social regulation of their use1 -- which in turn are often associated with criminal-legal and moral-religious discourses in establishing international control on drug use (Rodrigues 2004; Fiore 2007).
Another motivation behind this collection is our discomfort regarding the fact that the enormous expansion of ayahuasca consumption around the world has not been matched by a proportional growth in the quality and accessibility of literature on the subject.2 This lacuna creates a generalized lack of information which in turn falls back on researchers such as ourselves, who are often sought out by the general public searching for such information, and who get drawn into eclectic list-serves and "blogs" on the Internet. On the one hand, specialized texts -- sometimes technical, jargonized and not widely accessible -- have appeared in some biomedical and anthropological journals. On the other hand, Internet sites -- often pseudoscientific or superficially esoteric or spiritual -- devoted to these topics have proliferated. Finally, a few books on ayahuasca of varying quality have also appeared, though the subject of health is rarely contemplated. Thus, we sense an imperative to gather together a broad range of exemplary interdisciplinary works concerning diverse therapeutic issues related to ayahuasca use, and hope that these may prove useful to researchers, ayahuasca users and the general public.
The decisive factor in carrying out this project was the publication, in 2006, of the Final Report on the Multidisciplinary Group (GMT) on Ayahuasca (CONAD 2006; see also MacRae 2008), produced in collaboration between Brazilian government representatives, scientists of diverse specializations, and religious leaders from the main national ayahuasca religions. The text, which defined itself as a collection of "deontological ethics of ayahuasca use," seeks to establish parameters for regulating consumption in Brazil and was published years later in 2010 as an official decision after this book was completed (CONAD 2010). The document explicitly separates the "religious" from "therapeutic" use of ayahuasca. While the former is permitted, the latter is not. The actual text reads:
(...) For the purposes of this report "therapy" is understood to be an activity or process aimed at healing, maintaining or developing health, which takes into account scientific ethical principles.This excerpt demonstrates explicitly the difficulty of defining "religious" as opposed to "medicinal" use of ayahuasca,3 a distinction that appears to be based on fragile semantic distinctions. For example, if I state, "Jesus cured me in an União do Vegetal ritual," I would be expressing "my freedom of religious practice," whereas if I say, "Come take ayahuasca with me to cure yourself of depression," would I then be exercising the "illegal practice of medicine"? It is clear that other nuances are involved, and that this kind of problem does not involve only the question of ayahuasca consumption, but rather pertains to a larger conflict involving the State's attempts at control and hegemony over the human body. On such issues, the State is often in dialogue with Medicine, compounding an intricate biopolitics that should not be reduced, however, to the existence of a supposed mechanical, univocal conspiratorial alliance between the State and Medicine. These issues, though clearly relevant, cannot be discussed at length here.4
Traditionally, some spiritual traditions contain healing practices which make use of Ayahuasca, included within the context of religious faith. Such therapeutic use traditionally attributed to Ayahuasca within religious rites is not therapy in the sense defined above, rather it constitutes an act of faith and, being thus, it is not up to the State to intervene in the conduct of people, groups or entities making this use of the beverage within a strictly religious context. Those who use the beverage outside a religious context find themselves in a different situation. This has nothing to do with religious use, and such practices are not recognized as legitimate by CONAD, which limited itself to authorizing use of the substance in religious rituals.
The therapeutic use of Ayahuasca in the private activities of legally regulated professions depends upon professional licensing and support by scientific research, since otherwise such use would constitute illegal exercise of the profession or fraudulent professional practice.
Any practice that involves using Ayahuasca for strictly therapeutic ends, either of the substance alone or in association with other substances or therapeutic practices, should be prohibited until its efficacy is proven by means of scientific research carried out by research centers associated with academic institutions, obeying the scientific method. Thus, recognition of legitimate therapeutic use of Ayahuasca will occur only after the completion of research that proves its efficacy.
Based on the accounts of the representatives of the entities who use it, it was possible to verify that the cures and solutions to personal problems should be understood in the same religious context as other religions: as acts of faith, without any necessary relationship of cause and effect between the use of Ayahuasca and the cure or solution to problems.
For the time being, it is worth noting that defining the boundaries between religion and medicine -- beyond theoretical or speculative questions in social sciences -- takes a central place in public debate precisely to the degree that international anti-drug legislation treats some drug uses as legitimate and others as not. Thus, whereas in Brazil the "religious" (but not therapeutic) use of ayahuasca is permitted, and regulated per the parameters established in the above-mentioned report, in Peru, the public debate situates ayahuasca within the realm of "traditional medicine of indigenous peoples." The following is an excerpt of a resolution by the Peruvian National Institute of Culture, which recognizes ayahuasca as a national cultural patrimony (RDN INC 2008, our translation):
WHEREAS (...) said plant is known throughout the indigenous Amazonian world as a wise master plant that teaches the initiated about the very fundaments of the world and its components. The effects of its consumption consist of entering into the spirit world and into its mysteries, and in this manner at some point in their lives the traditional medicine of indigenous Amazonian peoples has been structured around the Ayahuasca ritual, being indispensable for those who assume the role of privileged transmitters of these cultures, which is to say those who are responsible for communication with the spirit world and those who express it dynamically (...)This book proposes to think through some of these issues.
AND WHEREAS the supporting information suggests that the practice of ritual ayahuasca sessions constitutes one of the fundamental pillars of the identity of Amazonian peoples, and that its ancestral use in traditional rituals, which guarantees cultural continuity, is directly bound up with the therapeutic virtues of the plant (...)
BE IT RESOLVED THAT (Sole Article): The knowledge and traditional uses of Ayahuasca practiced by native Amazonian communities are hereby declared National Cultural Patrimony as a guarantee of cultural continuity.
Given the centrality of biomedical discourses (and let us remember that even these are not homogenous and univocal) in the cartography of power within the field of debates over the "drug question" -- and also considering that the field is highly polarized and moralizing -- taking on a subject such as "health" in relation to ayahuasca consumption implies a task of considerable responsibility. Perhaps the main challenge in a work like this, or at least its first challenge, is to define and choose the articles to be included, which, one must affirm clearly, reflects certain ideological options. On the one hand, there was a desire (and as we understand it, a legitimate one) to take on the "positive" aspects of ayahuasca use, for example, to review and unite several research efforts that have been carried out on the medical potential of psychedelic agents in general (cf. Winkelman & Roberts 2007), and to reflect on the therapeutic possibilities of ayahuasca in particular, including the important discussion concerning its apparent efficacy in treating addictions to alcohol, cocaine and other substances, or at least as prophylaxis for these addictions. We took as our starting point the objective to use this book to stimulate the development of clinical research protocols into the psychotherapeutic potential of ayahuasca consumption to improve mental health (which obviously cannot be separated from health more generally) of patients undergoing psychological treatment.
On the other hand, we wanted to produce a critical and plural work that could reach a broader audience; therefore, it was necessary to reveal and analyze dangerous, uncertain or darker aspects of the experience, which can be generically denominated as the occasional "risks" and "adverse effects" of taking ayahuasca. Thus we also began with the objective of problematizing a certain common understanding present in many areas of drug research -- which probably results from the encounter between humanitarian activism and certain sociological generalizations elaborated by social scientists, or else drawing on a superficial appropriation of sociological discourses by doctors, legislators and public policy makers -- namely, that the "ritual context guarantees the safe consumption of a psychoactive substance." Although we agree with this principle in general, and we recognize the centrality of setting to the experience, this generalization is not sufficient to fully account for the phenomenon. In other words, it is necessary to go beyond the ritual setting without at the same time falling into biomedical reductionism. Therefore, it seemed important to distance ourselves from the issue by asking, for example, "What could be considered 'non-ritual' contexts for psychoactive substances?" or, "Is it possible for a ritual context to present more problems than benefits in the consumption of a psychoactive substance?" or, "Can the setting of a scientific research laboratory be problematic for users participating in controlled studies?" and so on.
In sum, we do not intend to produce a book that vindicates the "benefits of ayahuasca" for an ayahuasca-using public (which would be mere preaching to the converted), nor one that attempts to convince certain opposing or detracting camps (the religious establishment, legislators, police and so on) to change their mind. Nor do we want to unnecessarily expose certain "negative" aspects (which are at any rate quite complex) that might be misinterpreted by those who care little for scientific debate, for they already know from the outset that drug use is wrong and should always be banned.
We will now share with the reader some of the issues we encountered during the process of creating this book, the type of issues that typically wind up strategically disguised or omitted in the final text: should we include an account of someone who allegedly had a psychotic episode with ayahuasca, or of someone who claims to have cured themselves of a serious illness like cancer or AIDS with this beverage? Would we be criticized for producing a book without scientific objectivity that creates false hopes for sick or afflicted people in general? How to address the darker sides of the experience without trivializing its profound mystical and hidden meanings for people belonging to different ayahuasca-using groups? Could we find a shaman willing to talk to us about sorcery, a fundamental element of ayahuasca use among Indians and mestizos? And, in this case, would it be dangerous to include these words here? Is it possible to use our own personal experience drawn from years of consumption of this psychoactive plant without unduly exposing ourselves, or falling into the uncritical assertion of ethnographic authority that, "I was present, I know what it is like"? How to reconcile the academic project with the enchantment, the awe, the strangeness of the experience? How to merge a desire to protect ayahuasca users from the unnecessary intrusions of the State in their private subjective sphere with the disappointing realization that there are so many empirical problems in the field of ayahuasca studies, not to mention the persistent disputes over power and legitimacy among the diverse shamans and religious groups?
We chose to focus on the theme of health from within an interdisciplinary perspective that contemplates the paradigms of social sciences, biomedical sciences and the subjective accounts of individual users, trying to bring these different ways of knowing into dialogue. We have walked on a tightrope between one extreme that treats the biomedical perspective as the only one capable of revealing the "true causes" of diseases and cures, and the other, that of total relativism that rejects completely the validity of scientific research and implicating, moreover, an equally problematic approach that insists on native knowledge as the only legitimate way of knowing.
We chose not to shy from the responsibility of calling attention to possible problems related to the ayahuasca experience, since no substance is a panacea, nor without problems, nor, obviously, of universal applicability. On the other hand, we do not intend to promote the medicalization of ayahuasca practices by conferring them legitimacy solely based on biomedical discourse (even though this might prove to be a welcome collateral effect in some instances), much less create parameters that seek to place ayahuasca use uniquely under the supervision of Western doctors and therapists, even though this modality could be considered legitimate alongside other, equally legitimate ones.
When we speak of interdisciplinarity and cultural dialogue, we do not intend to verify, for example, whether the rigorous indigenous dietary and behavioral prohibitions surrounding ayahuasca (e.g., "diets" to avoid certain foods, or the prohibition of menstruating women in the ceremonies) have a biological basis, or whether the efficacy of sorcery could be "proven" through double-blind placebo-controlled trials. In practice, we have sought not to privilege one type of knowledge over another but rather have tried to render different ontologies intelligible to one another. Finally, just as ayahuasca itself is used in the indigenous world, we have tried to use the discussion to open mediation and dialogue between different kinds of subjectivities in the universe.
The issue of psychotic episodes, mentioned above, deserves brief digression. Although public debate and the scientific literature includes a vast discussion of possible problems and disturbances related to the use of psychedelic substances, the idea that they can eventually unleash a psychotic episode -- which could even lead to suicide -- is probably the most emblematic of the "dangers of psychedelics" (cf. Strassman 1984; Frescka 2007). This idea is central to biomedical discourses, even though the topic runs into a dead-end once it is admitted that one can never know what precisely causes such extreme and rare circumstances, which are usually described as resulting from diffuse and multi-factorial background conditions (e.g., pre-existing psychological conditions, family histories of mental health problems, weak ego structure, severe addiction). For us it is clear that the original effect of the psychoactive substance could be enough to unbalance the brain's biochemistry and could produce a psychotic episode, comprised of biochemical characteristics and functional mechanisms still in need of investigation.
Of course, with the specific psychoactive substance in question, biochemical mechanisms and functioning still require much study. But, at least according to certain spiritual-therapeutic viewpoints (e.g., Grof & Grof 1989), there is an important distinction between "psychotic episode" and "spiritual emergency." The latter, while dramatic and painful, can be beneficial and necessary in the process of psychological and spiritual development for some people. Nevertheless, is important to neither romanticize mental illness nor to superficially mix up indigenous initiation rites with psychological problems experienced by the Western users of ayahuasca (Lewis 2008).
The concept of "psychotic episode" is closely associated with that of "risk," a topic that has been widely discussed in the studies about the biomedical discourse on drugs.5 While the alleged biomedical risks associated with drug use can serve as camouflage for the moral agendas behind the juridical persecution of drug use, denying these risks will not unmask this camouflage, but rather it will only help to legitimate it. Therefore, an analysis of the risks leads necessarily to a maximization of the benefits.
It is important to note that these ideas are also present in some form or another within the imagination of ayahuasca users themselves. First, such ideas appear to function as a signal of identity for the users in relationship with the broader society: "We are the ones who have had the courage to go down these unknown and inscrutable pathways... we are the 'initiates.'" At the same time, these themes are present in the accusations leveled among different ayahuasca-using groups: "With them you cannot be sure what might happen... but here you are safe." Thus in this book, we do not include accounts of either psychotic episodes or miraculous cures induced by ayahuasca, despite having encountered examples, to various degrees, of both in our research trajectories and empirical experiences in this realm. We continue to circle around this particularly delicate subject, waiting for a better opportunity for reflection.
The purists, but the ones of the other side, will accuse us of starting on the wrong foot from the beginning, since ayahuasca is not a drug. In this sense, we preferred to begin by initiating dissension with radicals on all sides...
This book, composed of 21 previously unpublished articles, is divided into two parts. The first, "Shamanism and Religion," addresses the use of ayahuasca in indigenous and mestizo settings and among the Brazilian ayahuasca religions (Santo Daime, Barquinha and União do Vegetal), taking as our point of departure the approach of both anthropologists and ayahuasca users themselves. As we demonstrate, within these viewpoints ayahuasca takes on diverse possibilities, as medicine, sacrament, and as means to knowledge or socialization, among others. The second part, "Science and Therapeutics," focuses on the perspectives of biomedicine and psychology regarding the mechanisms of ayahuasca's activity, as well as its therapeutic possibilities and limitations, especially in the treatment of addiction and in its effects on mental health. In this part, the articles concentrate on the use of ayahuasca in diverse native contexts as well as in clinical and laboratory settings. A preliminary glance might lead to the assumption that the book is thus divided into two antagonistic or opposing halves: magic/religion vs. science, social vs. biomedical sciences, culture vs. nature, spirit vs. body, etc. But upon closer examination, this turns out not to be the case: there are many fluid connections, many comings and goings between the diverse contexts of ayahuasca consumption, and, to some extent, between different ways of addressing them.
In the two parts of the work, we observe processes of hybridization between Western and indigenous health concepts and therapeutic practices, revealing similarities and differences between "traditional" approaches and biomedical discourses on health. The book seeks to unravel historical connections, and thus reconstruct processes that could allow, for example, asking novices aspiring to participate in Santo Daime rituals to first fill out medical evaluation forms; or indigenous Amazonian shamans to prohibit the users of certain psychopharmacological agents (substance-entities duly incorporated into their cosmologies) from participating in ayahuasca sessions, or to relax classic dietary and behavioral prohibitions of the indigenous ayahuasca world based on a relativistic anthropological discourse; or the creation of research laboratory settings inspired by the contexts and concepts of native ayahuasca consumption. The processes of indigenization of biomedicine (Fóller 2004), and, by the same token, scientifying or medicalizing of religion and shamanism, are well reflected in diverse web sites that offer the ayahuasca experience in resorts in the Peruvian Amazon, and in the popular literature circulating on the Internet concerning iconic psychologist-shamans, anthropologist-shamans, shaman-scientists, spiritual master-psychiatrists, guru-psychologists, and other hybrid characters that populate the pages of this book (including some of the chapter authors).
Together, the articles allow us to rethink a series of concepts found in the conventional wisdom and sometimes even in scientific discourses (both social and biomedical), as well as, in some cases, the self-representations of ayahuasca users themselves. Here, we briefly discuss a few of these concepts as treated in several of the articles:
- The idea that ayahuasca is always associated with health. This idea is related in turn to the tendency to assume great antiquity for the therapeutic use of ayahuasca, a point of view that has been challenged by authors such as Gow (2004), Bianchi (2005), and Calavia Sáez (2000) who suggest that such therapeutic uses are more recent than one would imagine; ancient contexts of use of ayahuasca were oriented towards practices of divination, cosmological intervention and to improve luck in hunting and warfare. Some articles in this collection demonstrate various uses of ayahuasca not associated with the strictly "therapeutic" dimension, at least according to Western terms. In some cases, multiple uses overlap within the same context (e.g. sacred and recreational); there are also multiple indigenous concepts of health, illness and cure that come into play.
- An obsessive emphasis on the psychoactive agent, as if "ayahuasca" always comprised an identical uniform substance (when in fact it is the result of diverse mixtures depending on the context), or was always used by itself (when in fact it is often ingested with other plants), or that the indigenous, mestizo and urban populations who use it conferred upon it an absolute centrality (which is not the case); or as if, moreover, the active principle is necessarily the main aspect of the experience, or is that which produces the "cure." The articles gathered here demonstrate that much debate is still required on this subject, and some suggest that "extra-psychedelic" aspects may be responsible for the therapeutic possibilities of ayahuasca.
- An exaggerated attention to the role of ritual performance. Although there is dissonance among specific articles regarding this theme, as a whole they relativize the idea that performance -- with its articulation of multiple elements (narrative, drama, aesthetic) and its emphasis on experiential and bodily dimensions -- should be taken as the exclusive analytical framework for understanding the efficacy of cure, independent of consuming the substance among other variables (keeping in mind that, in many cases, it is the shaman and not the patient who takes ayahuasca).
- The mistake of attributing necessarily to the ritual the role of organizing and conferring meaning to the experience. Although this does occur in many cases, the diverse settings described -- from minimalist laboratory settings to complex sacred technologies -- invite us to think about how certain rituals function even when the participant doesn't share the same logic, semantic system and cultural symbols of a given context; for example, foreigners taking ayahuasca with Indians in Peru. Perhaps the efficacy of such rituals resides precisely in their non-intelligibility to some members of the audience, allied as well with ayahuasca's particular psychoactive effects.
- The idea that it is possible to establish clear and defined limits between cure/health and illness/harm. In some contexts, the cure may involve the dangerous procedure of returning a magical aggression to its instigator, causing that person harm or even death. Although the subject of the aggressive capabilities of sorcery is not discussed in depth in any article, it is present in several, providing a glimpse of a complex plot of attacks and counter-attacks.
- An association between ayahuasca use and self knowledge. Several articles reflect upon the important role of ayahuasca in what could be termed the process of "obsessive interiorization of the modern individual"; however others included here make clear that the psychologization of the ayahuasca use does not extend to all contexts.
- The idea that the visionary element represents the central dimension of the ayahuasca experience, or that it is responsible for its therapeutic action. Visions may or may not occur; if they occur, they are merely one part of the experience. The articles suggest how this dimension is very valued in some contexts, including by many ayahuasca scholars (perhaps related to the primacy of vision in the West), but also affirm that this certainly is not universal. In addition, there are different manners of understanding what the "visions" are.
- An exaggerated emphasis on the bodily dimension. This approach can take on a positive attitude that reads ayahuasca as a powerful purgative that cleans bodily and spiritual impurities through vomiting and diarrhea, or a negative one in which the physical purge results in "intoxication" by the plant. The articles demonstrate that various dimensions -- bodily, visionary, intellectual, and emotional -- constitute the phenomenon and all should be taken into account.
- The idea that ayahuasca consumption is a unique experience, qualitatively different from the consumption of other psychoactives, or states produced by practices such as fasting, illness, sleep, meditation or sexual relations. The experience of taking ayahuasca, like diverse other practices that require their own particular disciplines, constructs the body and subjectivity. Similar to these other practices, abandoning control over body and mind may often constitute an active stance. The use of ayahuasca should be understood, therefore, within a broad symbolic economy of mind/body states and moods.
Ayahuasca and Health
Edited by Beatriz Caiuby Labate and José Carlos Bouso
by Renato Sztutman (Anthropology, Universidade de São Paulo)
Cura, cura cuerpecito ('heal heal little body'): reflections on the therapeutic possibilities of ayahuasca
by Beatriz Caiuby Labate (Research Associate, Institute of Medical Psychology, Heidelberg University) and José Carlos Bouso (Centro de Investigación de Medicamentos, Hospital de la Santa Creu y Sant Pau, Barcelona)
First part: Shamanism and Religion
- Interview with Herlinda Agustin, a woman Onaya from the Shipibo-Konibo indigenous nation
by Luisa Elvira Belaunde (Anthropology, Pontificia Universidad Católica del Perú)
This interview with Herlinda Agustín6 presents the personal narrative of a woman who is an onaya, or ayahuasca shaman of the Shipibo-Konibo indigenous nation of the Peruvian Amazon. It allows us to follow, through her words, the paths that led her to consecrate herself as a healer, combining her role as a mother and married woman with the difficult and hazardous apprenticeship of the rao, or "plant teachers". Her experiences represent a novel and much needed approach to the study of gender in Amazonian shamanism, in a singular and human manner. The article sheds light on critical aspects of the cosmovision of the Shipibo-Konibo, for example, the transmission of ancestral powers, the search for spiritual protection, the practice of plant "diets" and the relationship with foreigners who attend shamanic sessions.
- Asleep, Drunk, Hallucinating -- Altering Bodily States through Consumption in Eastern Peru
by Peter Gow (Anthropology, University of Saint Andrews)
The text adopts a phenomenological approach in order to deal with different aspects of the life of the native inhabitants of the Lower Urubamba River, in East Peru, within the interpretative framework of symbolic anthropology. In these tribes, the mastery of the lived experience plays a fundamental role. Four body states that are defined as "modified" are dealt with: sleeping, drunkenness, sickness and the hallucinogenic experience. The author claims that these states function as icons of specific acts of sequences of acts, and are related to the consumption of substances and the field of social relations. By defining sickness and the hallucinogenic experience as two different states of intense bodily transformation, the "corporal dimension" is said to constitute a central part of the natives' experience. An emphasis is laid on the importance of the lived experience in everyday life, in an effort to demonstrate that the central cultural values of these natives rest on the importance of immediate experience and not only what lies in their minds or overriding abstract models.
- The Symbolic Efficacy of Rituals: From Ritual to Performance
by Esther Jean Langdon (Anthropology, Universidade Federal de Santa Catarina)
The paper explores the concept of "healing" among Amazonian shamanic rituals, examining the meaning of healing from a broader perspective than that of biomedicine. It focuses on rituals in which psychotropic tea-like substances commonly referred to as ayahuasca or yagé, have a central role in the ritual's efficacy. These substances are made from made from Banisteriopsis spp. and admixtures and can produce strong conscious altering effects. However, it is important to point out that the patient does not always drink the mixture, which may be ingested by only the shaman or by participants other than the patient. For Amazonian peoples, illness is not limited to purely biological processes and spiritual and social factors are important causes of illness in a universe that is endowed with intention, that is, a universe populated by diverse predatory beings that are capable of causing illness. Besides examining the concept of "healing", this paper reviews the current theories that attempt to account for the ritual efficacy. Differing from the those who emphasize the instrumental results of substances ingested or who affirm that faith is the necessary factor for "miracle" cures, this work shall demonstrate that healing efficacy must largely be attributed to the performative aspects of ritual.
- To control fluidity of form: prophylactic cosmopolitics in the use of Nixi pae among the Cashinahua (Kaxinawá)
by Els Lagrou (Anthropology, Universidade Federal do Rio de Janeiro)
The Cashinahua (Kaxinawá) do not usually use ayahuasca (Nixi pae) in the context of healing rituals, nor do they restrict its use to the specialty of the shaman, notwithstanding the fact that its use is closely related to the maintenance of the health and wellbeing of the people (usually men) who consume it and of the community as a whole. Small children do not drink ayahuasca and women exceptionally do so. The visionary experiences produced by ayahuasca are meant to promote a differentiated interaction with the yuxin beings, who are invisible in daylight: the doubles of animals, the owners of the rivers, foreigners, and spirits living far away. The intention of the experience is to gain knowledge and control over the agentive constellation surrounding present and future events, events which do influence a person's health. A healing specialist can look for the cause of an illness and the right herb to treat it, and people involved in conflicts can try to have access to the hidden intentions of their adversaries. The use of ayahuasca constitutes, in this way, a prophylactic weapon and instrument of negotiation in a sociocosmological world where predation is understood to be inherent to the construction of life itself. This predation, however, is situated in a subjective environment: the beings in interaction, being intentional subjects, can take revenge or offer their collaboration in the human battle for the control of fluidity of form. In this quest, the intention of humans is to achieve solid and healthy bodies, with strong hearts (huinti kuxi), not easily afraid nor easily weakened by illness.
- Shipibo traditional medicine and French therapies
by Rama Federica Leclerc (Anthropology, Nanterre-Paris 10)
This article offers an analysis of the interaction between the traditional healing practices of the Shipibo indigenous group and some modern alternative therapies practiced by French therapists. Recent investigations reveal that the modes of representation found in Shipibo practices appropriate the discourse of their Western counterparts. On the one hand, the Shipibos, to harmonize the two cultures, adapt their discourse to that of Westerners. Nowadays, with the idea of setting themselves forth as the representatives and guardians of nature and the spirits of the plants, their healers have radicalized their discourse and practices with regard to the use of medicinal plants. On the other hand, the French healers include these practices in their forms of therapy. It was evident that some of them regard the spirit of ayahuasca as a kind of therapist with whom the patient establishes a personal link. The therapeutic use of ayahuasca thus becomes a self-therapy guided by a healer. This study also investigates new ideas about the relationship between body and spirit, the role of mental images (visions and dream experience), and verbalization, among others.
- Spiritual healing, biomedicine and intermedicality in Santo Daime
by Isabel Santana de Rose (PhD in Social Anthropology, Universidade Federal de Santa Catarina)
This article deals with the therapeutic use of ayahuasca in Santo Daime. The first part introduces Santo Daime and the implications of the expansion of the Brazilian ayahuasca religions. This is followed by a discussion of the case of the Santo Daime community Céu da Mantiqueira, which defines itself as a healing center, explaining its health care system and the native conceptions of health, illness and disease. The text reflects especially on the presence of a significant number of health care professionals and the introduction of biomedical practices in Céu da Mantiqueira. Based on the concept of intermedicality, this study seeks to show how in this context the spiritual paradigm characteristic of the Daime doctrine and the scientific one which usually characterizes biomedicine coexist in an active and dynamic way and give rise to new syntheses.
- Ayahuasca and Pregnancy: A Preliminary Report
by Marlo Meyer (MA in Cultural Anthropology, California State University) and Matthew Meyer (PhD Candidate in Social Anthropology, University of Virginia)
In the United States, it is common knowledge that the use of illicit drugs during pregnancy is detrimental to fetal development, and the women who use illicit drugs during their pregnancies are seen as abusive mothers. This paper offers a preliminary discussion of an urban church in the Brazilian Amazon that contradicts these expectations by valuing positively the use of the hallucinogen ayahuasca during gestation and parturition. The use of ayahuasca during pregnancy and shared cultural views by church adherents are examined and the interface between pregnant church members and the biomedical establishment is considered.
- Hoasqueira Ethnomedicine: The traditional use of the Nove Vegetais in the União do Vegetal
by Denizar Missawa Camurça (Biologist, University of Guarulhos), Beatriz Caiuby Labate, Sérgio Brissac (PhD in Social Anthropology, Museu Nacional-UFRJ) and Jonathan Ott (Organic Chemist, HydroXochiatl/Mexico)
The article deals with a tradition of the Centro Espírita Beneficente União do Vegetal (Beneficent Spirit Plant Union Center, or UDV), which occasionally used in the past what became known as the Nove Vegetais brew (Nine Plants brew), that is, ayahuasca with the addition of nine species of plants specifically aimed at healing. The use of these plants distinguishes the UDV from the other Brazilian ayahuasca religions and resembles the traditional practices of Amazonian healers. There is a body of evidence about the properties of these species and of another plant that was occasionally used, the João Brandinho. These species are compared with those used by mestizo or indigenous populations described in the specialized literature: among the ten plants adopted by the founder of the UDV, Mestre Gabriel, five are reported to have been used by traditional healers of the Amazon region. The article explains that these plants do, in fact, possess medicinal properties, indicating the need for further research into the therapeutic potential of the Nove Vegetais and of the João Brandinho.
- Health, risks and religious use in disputes about the legal status of the use of ayahuasca: implications of recent judicial developments in the United States
by Alberto Groisman (Anthropology, Universidade Federal de Santa Catarina)
Among others, the categories health and risk -- and the eventual contents which they evoke -- have been referenced in criminal processes as objects of negotiation and dispute. These categories (which are never free of a particular semantic attribution), are simultaneously receivers and providers of meaning. According to circumstances and contexts, these words, and the eventual significance to which they refer when inserted in contexts of negotiation and dispute, constitute themselves as meaning-aggregating or meaning-disaggregating elements. They are furthermore political aggregators, here when they articulate social and institutional forces in these disputes. My intention with this article is to approach implications of the use of these categories -- and the associated meanings -- in a particular context: that of the production of relevant texts in the disputes concerning the status of the "religious use" of psychoactive substances, particularly of ayahuasca. My focus is the judicial field, in which "health risk" for eventual users, and the presumed potential "threat" their use implies for the health of religious groups' participants, always constitute themes of a relevant debate.
- Dream and Fear on a Summer Night
by André Viana (freelancer journalist and translator, Companhia das Letras)
This text is a report of a journalist's experience on the night of March 3, 2002, when he and four anthropologists took part in an ayahuasca ritual performed by members of the Kaxinawa tribe in a ranch on the outskirts of Rio Branco, Acre, Brazil. An experience that -- however difficult to duplicate -- is far from forgotten.
Second part: Science and Therapeutics
- Long-term effects of the ritual use of ayahuasca on mental health
by José Carlos Bouso, Josep María Fábregas (Centro de Investigación y Tratamiento de las Adicciones [CITA] and Instituto de Etnopsicología Amazónica [IDEAA]), Sabela Fondevila (Cognitive Neuroscience Unit, UCM-ISCIII Center for Evolution and Human Behavior, Madrid), Débora González (PhD Candidate in Pharmacology, Institut Municipal d'Investigació Médica and IDEAA), Marta Cutchet (MA in Psychopathology, CITA and IDEAA), Xavier Fernández (Doctoral candidate in Drug Dependences, University of Santiago de Compostela and IDEAA), Miguel Ángel Alcázar (Psychology, UAM) and Gregorio Gómez-Jarabo (Psychobiology, UAM)
Scientific research about the long-term effects of hallucinogens is, in general terms, poor. Until now, only three studies exist in which this issue was investigated in depth. In 2004, our research team stayed in Mapiá and Rio Branco developing longitudinal studies in order to assess the long-term effects of ayahuasca on mental health. In the first study we administered personality, neuropsychological, general health, psychosocial wellbeing and spirituality tests to 60 daimistas versus 60 non-ayahuasca users from Boca do Acre. Those same tests were administered eight months later in order to see if the scores were stable across time. In this chapter we present the preliminary findings.
- Effect of Santo Daime Membership on Substance Dependence
by Beatriz Caiuby Labate, Rafael Guimarães dos Santos (Universitat Autònoma de Barcelona), Rick Strassman (Clinical Associate Professor of Psychiatry, University of New Mexico School of Medicine and President, Cottonwood Research Foundation), Brian Anderson (Medical student, Stanford University ) and Suely Mizumoto (MA candidate in Social Psychology, PUC-SP)
Previous clinical research on hallucinogen-assisted psychotherapy reported efficacy in treating substance abuse disorders, similar to what has been reported in naturalistic studies of peyote use among Native American Church members. Urban use of the Amazonian hallucinogenic brew, ayahuasca, is increasingly common in syncretic Brazilian ayahuasca religions, and anecdotal reports suggest recovery from substance dependence among those who participate in their rituals. We sought to assess more quantitatively effects of Brazilian ayahuasca-using church membership on substance dependence. We employed a modified questionnaire using DSM-IV criteria to determine the presence of substance dependence within a sample of members of a branch of the Santo Daime Brazilian ayahuasca religion. Nearly half of church members reported substance dependence before joining the religious organization; of these, 90% reported cessation of use of at least one substance upon which, before church membership, they reported dependency. While these preliminary data require confirmation using more rigorous criteria, they suggest a potential role of ayahuasca, within a particular context, in the treatment of substance dependence.
- Interview with the psychiatrist Evelyn Xavier
by Beatriz Caiuby Labate, Rafael Guimarães dos Santos, José Carlos Bouso and Isabel Santana de Rose
- Clinical pharmacology of ayahuasca: research with Spanish volunteers
by Jordi Riba (Centro de Investigación de Medicamentos, Sant Pau Hospital, Barcelona) and Manel J. Barbanoj7 (Centro de Investigación de Medicamentos Hospital de Sant Pau, Barcelona, and Universidad Autonoma de Barcelona)
Throughout the past decade, the authors have carried out a series of clinical trials in healthy volunteers, with the objective of investigating the human pharmacology of ayahuasca. The studies demonstrate that it is feasible to safely administer ayahuasca to people who have prior experience in the use of visionary substances with the purpose of evaluating its effects in a research setting. In this way, research has spanned from the pharmacokinetics of the alkaloids found in ayahuasca to effects on brain activation observed through neuroimaging, including the measurement of cardiovascular, neuroendocrinological and neurophysiological variables. These studies intend to achieve a better understanding of the effects of ayahuasca on the body, as well as to delve into the mechanisms of visionary substance activity in the human brain. This chapter presents the studies and results that have been obtained.
- Possible risks associated with the use of ayahuasca
by Rafael Guimarães dos Santos (Doctoral candidate in Pharmacology, Universidad Autonoma de Barcelona)
In the last decades, the use of ayahuasca has been increasing in Brazil, the United States and Europe. Little is known about the eventual risks associated with this consumption. The objective of this study is to provide information about the possible risks associated with the consumption of this drug when it is combined with medication, foods and other chemical substances. Ayahuasca has serotoninergic agonist components -- inhibitors of the monoamine oxidase enzyme and the tryptamine N,N-dimethyltryptamine (DMT) -- and other chemical substances. The risks associated with the ingestion of these substances are mainly related to serotonin syndrome, tyramine intoxication and the manifestation of psychopathologies. A review of the specialized literature shows that the risks of ayahuasca consumption are mainly associated with its pharmacological composition. These pharmacological characteristics must be considered in order to reduce eventual risks with ayahuasca preparations.
- Ayahuasca sessions in the case of a recidivist murderer
by Ede Frecska, MD, PhD (Chief of Psychiatry, National Institute of Psychiatry and Neurology, Budapest)
We have limited resources available for the treatment and prevention of violent behavior. The usefulness of the most commonly used medications, namely the selective serotonin-reuptake inhibitor [SSRI] agents for the above purpose is a debated issue in the psychiatric literature. The aim of this case report is to add an ethnopharmacological perspective to the management of human aggression. Particularly, attention is called to the potential cohesive, prosocial effect of the Amazonian beverage, ayahuasca -- a decoctum that has been used traditionally for multiple medico-religious purposes by numerous indigenous groups of the Upper Amazon and has been found to be useful in crisis intervention and achieving redemption, as well as eliciting cathartic feelings with moral content.
- Moments of insight, healing and transformation -- a cognitive phenomenological analysis
by Benny Shanon (Psychology, Hebrew University of Jerusalem)
In this chapter I examine moments of special significance in people's experience with ayahuasca. Specifically, I consider moments in which psychological insights are gained, and personal transformation and/or healing take place. The analysis consists in a structural typology of these facets of the ayahuasca experience and is based on empirical data gathered in the framework of a broader study that sets itself to present a systematic charting of the phenomenology of the special state of mind induced by this brew. The analysis and discussion are taken from a phenomenological cognitive-psychological, not clinical-psychological or medical, perspective.
- The accompaniment (care) given in the Peruvian Amazon Indigenous tradition
by Walter Moure (PhD in Psychology, USP)
Based on his experience of living regularly with maestros de plantas (shamans) of the Peruvian Amazon, the author tries to understand the nature of accompaniment (care) given in the therapeutics of that tradition. He offers a vision derived from his reflections on Amazonian indigenous and mestizo knowledge, his own experience as a patient and his contact with Western patients who underwent shamanic treatments, using for that purpose the deconstruction of certainty (a tool of ethnopsychoanalysis), the Winnicottean psychoanalysis and other Western authors who were meaningful in his life. The result aims to clarify themes relating to human suffering and possible approaches to it.
- Using ayahuasca for treatment of drug dependency in the Brazilian Amazon
by Xavier Fernández (Doctoral candidate in Drug Dependences, University of Santiago de Compostela and therapist at IDEAA) and José María Fábregas
The article presents the experience of the Institute of Applied Amazonian Ethnopsychology (IDEAA), created by a Spanish group in the Amazon with the goal of studying and applying the use of ayahuasca in aiding processes of personal growth and the treatment of drug addictions. It starts with a short description of IDEAA's basic concepts, as well as the theoretical perspectives underpinning its application of ayahuasca, which include transpersonal psychology, the Santo Daime religion, shamanism, and various eastern disciplines. The next section shows the practical activities, paying special attention to rituals, looking in depth into the healing process through a model of help based on minimally interventionist guidance. With content analysis the main themes of ayahuasca sessions for addicts were revealed, and then discussed and related with dynamics of transformation. The final part of the text concludes with the clinical observations emerging from the years of practice.
- Shamanic Yajé: Neither religious sacrament nor remedy for "chemical dependence"
by Jonathan Ott
This article will discuss the differences between use of yajé in indigenous shamanism and western medicine. Both systems seek to "cure" via medicaments, although in the case of shamanism the "doctors" typically consume some drug, which is effectively prohibited in academic medicine. By way of example, it will examine the peculiar attempt of the medical establishment to endeavour to deal with habituations to the ingestion of drugs as "diseases," commonly treated with other, different drugs. Some physicians employ yajé itself as one such drug to combat habituation to other drugs, at times in collaboration with Amazonian shamans. This has its parallels in modern syncretic religions such as União do Vegetal, which involves the ingestion of yajé as a sacrament to combat alcoholism, tobaccoism, cocainism, etc. For believers in these religions, just as for physicians who employ yajé as a drug to combat the use of other drugs, yajé is a "medicine" [holy] to fight "abuse" [sic] of a "drug" [evil], for instance cocaine. This is pharmacological chauvinism and is parallel to the situation with cannabis: for certain religious believers (Rastafarians) and some ludible users, marijuana is a "herb" [holy]; while cocaine (indeed for some, yajé itself) is a "drug" [evil]. Of course, for criminal law effectively in the entire world, any non-medical use of many "drugs" [evil]--heroine, LSD, psilocybine, etc.--is a crime, if not a "mental illness" [sic]. There is a discussion of the semiotic confusion implicit in deforming the word addiction into meanings quite distinct from those of its synonym, devotion, to the point, in English and Castillian, of creating a substantive form, addict, to stigmatize the users of certain drugs. It will include some reflexions on shamanism as an empirical system of natural philosophy or science, the while modern science transmogrifies itself ever more into a dogmatic religion.
- Changes in the value profile after an experience with ayahuasca: Comparison of results of the Hartman test administered before and after a session of ayahuasca in a group of volunteers
by Josep Maria Fericgla (Societat d'Etnopsicologia Aplicada i Estudis Cognitius, Barcelona)
This research was done in 1999 and has remained unpublished until now. It consisted of applying the Hartman Test to twenty five individuals before taking ayahuasca, and 24 hours after it. This axiological test measures changes induced by the experience of ayahuasca drinking. The article discusses the advantages of this test in relation to other psychological and clinical tests. It is argued that the Hartman test is more appropriate to analyze the experience of people who seek ayahuasca and do not have mental conditions and are not especially ill. Further, the author affirms that the test is more efficient in measuring "world views" and the personality and structural aspects of the subjects. The results of the test are presented and discussed. The article also points out the difference between "illness" and "disease" and "healing" and "cure."
- Some thoughts from an anthropology of science point of view
by Stelio Marras (Anthropology, Instituto de Estudos Brasileiros, Universidade de São Paulo)
The book's essays will be analyzed from the point of view of the problem of dualism, that is, of a world divided in two (by a binocular view). The article proposes, as an alternative, the opposite approach, that is, a multi-ocular or multi-focal view which seeks to examine the design of networks formed by the diverse agencies (human and non-human, natural and supernatural) which motivate action. This opens up the possibility of questioning the convention of interpreting the world and action on the world in terms of reified agents, that is, as if they have always been that way. Instead, taking a step back, the article focuses on how the agents come to be what they are (and thus before considering what they are). In other words, ontogenesis before ontology. This approach dares to ask whether the world, seen in this way, may reemerge re-enchanted, proposing, among other challenges, to sharply question the notion of cause, considering that the agents, influenced by the mutual causation of a network, act upon each other.
Back cover blurb: Rick Doblin
About the Editors:
Beatriz Caiuby Labate has a Ph.D. in Social Anthropology from the Universidade Estadual de Campinas (Unicamp), Campinas, Brazil. Her main areas of interest are the study of psychoactive substances, drug policy, shamanism, ritual, and religion. Currently she is a Research Associate at the Institute of Medical Psychology, Heidelberg University and a member of the Collaborative Research Center (SFB 619) "Ritual Dynamics - Socio-Cultural Processes from a Historical and Culturally Comparative Perspective." She is also researcher with the Nucleus for Interdisciplinary Studies of Psychoactives (NEIP) and editor of its website. She is author, co-author and co-editor of seven books, two with English translations, and one journal special edition. Her book A Reinvenção do Uso da Ayahuasca nos Centros Urbanos (Mercado de Letras, 2004) received the prize for Best Master's Thesis in Social Sciences from the National Association for Graduate Studies in Social Science (ANPOCS) in 2000. For more information, visit www.bialabate.net.
José Carlos Bouso is a Clinical Psychologist working at the Drug Research Center, Hospital de Sant Pau, Barcelona, researching the neuropsychopharmacology of hallucinogens and their neuropsychological long term effects.