Running Head: MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 1

Making sense of ayahuasca experiences of those in the UK:

an interpretative phenomenological analysis.

Research Report for the BACP New Researcher Award 2020

Word counts:

Abstract: 247

Manuscript including references: 6583

I confirm that the research and the text in this document is my own except where clearly

indicated by citations. This writing is derived from my dissertation submitted September

2019 in partial fulfilment of the MA in Psychotherapy and Counselling at the Regent’s

School of Psychotherapy and Psychology at Regent’s University London.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 2

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

by the limits of existing approaches such as medication, psychiatry and psychotherapy.

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

make of your past, personal experiences with ayahuasca?’. Using Interpretative

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

participants’ lives; T2. I ended up in my father's psyche: ayahuasca's mechanism of

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

existentialism critiques the typical language, ontology and epistemology of ayahuasca

research. Written by a newly qualified psychotherapist, this research is unique in its

contemporary UK focus and qualitative, phenomenological basis.

Keywords: psychedelics, UK, psychotherapy, ayahuasca, phenomenology

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 3

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

research suggesting the therapeutic potential of psychedelic experiences. I explain to my

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

worthwhile and unheard to the relevant contemporary discourses.

My topic

Ayahuasca is a plant medicine brew important to indigenous communities of the

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.

Psychedelic experiences attract those in the UK seeking psychological, emotional, biological

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)

and a renaissance in psychedelic research (Confer, 2019; International Center for

Ethnobotanical Education, 2017; O'Hare, 2019). UK-based psychotherapists are considering

their ability to offer preparation, integration and advisory services to those using psychedelics

(Forums & Events, 2019; Knowles, 2019c; The Psychedelic Society (UK), 2019; TRIPP

Network, 2019; Watts, 2019).

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 4

Personal and Professional Rationale

This research has its foundations in my personal experiences. Alongside

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

helping others, including training as an existential psychotherapist. There is evidence of

others becoming a psychotherapist or researcher following psychedelic experiences (Nielson

& Guss, 2018; Zigler, 2019).

I want to know how ayahuasca has affected the lives of others in the UK and how

psychotherapists might best support ayahuasca as a path to insight and healing.

Aims of This Research

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

experiences is worthwhile or problematic, positive and negative, therapeutic or traumatic to

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

its connection to psychotherapy.

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.

As a brew, ayahuasca is a decoction of the ayahuasca vine Banisteriopsis caapi

(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

produce visual, auditory and bodily sensations termed a psychedelic journey.

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).

Dangers, Problems, Cautions

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

negative stance (Reddit, 2019).

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,

2011, pp. 159-160).

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

psychosis, schizophrenia, disassociation, depersonalisation or borderline personalities avoid

ayahuasca. Screening for the above and other contraindicated conditions is worthwhile but

does not eliminate risk.

There is little chance of overdose or addiction to ayahuasca (Frecska, 2011, p. 152;

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

(Barbosa, Mizumoto, Bogenschutz, & Strassman, 2012; R. G. Dos Santos, 2013;

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

safety and longitudinal effects of ayahuasca.

Legality

It is illegal in the UK to take, carry, make or sell psychoactive substances, excluding

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

makes illegal all uses of DMT, including for medical research.

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

in the UK (Walsh, 2016, p. 253).

At present, to participate in legal ceremonies, those in the UK need to travel to places

like Peru, Brazil (International Center for Ethnobotanical Education, 2017, p. 3) or Costa

Rica. Others participate in UK ceremonies with an uncertain legal status.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 7

Ayahuasca's Therapeutic Potential

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

& Cavnar, 2016; Ryan, 2015; Schmid, 2011; Shanon, 2010).

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

demonstrating that the substantial reductions recorded by inventories of depression (HAM-

D/MADRS) days and weeks after ceremony evaporated in the longer-term when they

followed up with the participants 4 – 7 years later.

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

current literature inspires further research.

The UK and An Existential Perspective

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

have faced. This standardised approach suits their purposes.

In contrast, following my existential approach, I encourage people to make sense of

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

grounding interpretations in the participant's words and sense-making.

Existentialism assumes a plurality of perspectives rather than a singular truth, and

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,

towards which I seek to contribute with this research.

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

method. After considering a range of other methodologies, I pursued a methodology

grounded in phenomenology.

Phenomenology

Phenomenology, with its origins in philosophy, is an approach to understanding

things of the ‘unprejudiced, descriptive study of whatever appears to consciousness’ (Moran

& 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

importance of a holistic understanding.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 9

In terms of phenomenology as a research method, Giorgi (2011), Moustakas (1994)

and Van Manen (2016) inhabit different positions on phenomenology (Giorgi, 2010, 2011;

Smith, 2010, 2018; Van Manen, 2017). After careful consideration, I selected IPA.

Interpretative Phenomenological Analysis (IPA)

IPA comprises an open-ended research question with data collection followed by an

idiographic analysis, grouping the data into superordinate and subordinate themes.

Smith, Flowers, and Larkin (2012, p. 3) term IPA a double hermeneutic because the

researcher interprets the experience of participants as interpreted by them. Another ‘double

hermeneutic’ is that of alternating between the hermeneutics of empathy and suspicion

(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

applications and limitations of IPA, which I am unable to cover further here.

Conclusion

I chose IPA because it is a good match for my research question and my

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

networks, excluding anyone that already knew me.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 10

Ethical Considerations

Ahead of the interview, I informed participants of my commitment to confidentiality

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,

taking ayahuasca or involvement in ayahuasca ceremonies for the researcher or participants

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

Interview Schedule. I anonymised text at the point of transcription.

These considerations met the ethical requirements of my institution. No problems

have yet arisen. I remain alert to my ongoing commitment to the confidentiality of my

participants.

Data Collection via Semi-Structured Interviews

I considered a range of data collection methods before deciding, as suggested by

Smith et al. (2012, p. 57), to use semi-structured interviews. I curated the interview schedule

in collaboration with my academic supervisor. I set up a face-to-face interview with each

participant lasting 45–60 minutes, made a digital audio recording of the interview and

transcribed the audio.

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

themes. To achieve a small number of superordinate themes, I used patterns of abstraction,

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.

Rigour, Validity & Transparency

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

Signifier Quotation from a transcript Theme

T1 Our telephone line back to source Insights that changed participants’ lives

T2 I ended up in my father's psyche Ayahuasca's mechanism of perspective

Ayahuasca amongst different paths of

T3 Watch loads of ballet
healing

Ayahuasca as a drug versus (plant)

T4 Gets you off your head
medicine versus sacrament

Intercultural exchange; the socio-cultural

T5 Three guys with feathers field in which those in the UK take

ayahuasca; the reinterpretation of

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 12

ayahuasca for a UK audience, urban

shamanism

The above is a summary of my more detailed master table of superordinate and

subordinate themes. I aimed to ‘ensure that the account produced is a credible one, not the

only credible one’ (Smith et al., 2012, p. 183).

Table 2
Which Participants Contributed to Which Themes

Theme P1 P2 P3 P4 Theme

totals

T1. Our telephone line back to source: insights that 13 38 32 48 131

change participants’ lives

T2. I ended up in my father's psyche: ayahuasca's 4 17 14 17 52

mechanism of perspective

T3. Watch loads of ballet: ayahuasca amongst 19 12 15 30 76

different paths of healing

T4. Gets you off your head: ayahuasca as a drug 14 36 7 16 73

versus (plant) medicine versus sacrament

T5. Three guys with feathers: intercultural exchange 67 31 18 18 134

Participant totals 117 134 86 129 466

This table alludes to the idiographic nature of my analysis, as required by IPA, in

showing the uneven distribution between participants and themes.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 13

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,

some of which provoked changes in participants’ lives.

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

lifetime of distress in that regard.

T2. I Ended Up in My Father's Psyche: Ayahuasca's Mechanism of Perspective

T2 comprises comments on the different perspectives granted by ayahuasca

ceremonies and the changed perspectives that result post-ceremony.

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

perspective of being a father.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 14

T3. Watch Loads of Ballet: Ayahuasca Amongst Different Paths of Healing

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

in combination. Participants highlight a variety of attitudes to the integration of and

alternatives to ayahuasca found in the data, including psychotherapy.

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

further in the Discussion.

T4. Gets You Off Your Head: Ayahuasca as a Drug Versus (Plant) Medicine Versus
Sacrament

Participants comment on whether ayahuasca is a drug or a medicine, sometimes

taking up alternative positions at different points in the interview, each offering different

connotations and implications.

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

other, more manufactured substances.

Participants struggled with the ‘drug’ label of ayahuasca, suggested that it prejudiced

their view, and preferred different language post-experience to reconcile these differences,

particularly that of ‘medicine’.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 15

T5. Three Guys With Feathers: Intercultural Exchange

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

lacking in the UK compared to South America and the East.

P1 and P3 found problematic differences in culture, while P2 and P4 considered the

difference and diversity in favourable terms.

Discussion
Ayahuasca and Other Paths of Healing

Participants suggest that ayahuasca is one amongst many paths of healing (T3). I

imagine what nests within what in terms of conceptual size.

Figure 1
One Theme Inside Another
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 16

I intend to show:

1. Intercultural exchange contains everything, influences everything; nothing is beyond

it. Everything has a context in a dynamic field of socio-cultural constructions,

knowledge, understanding, and truth-building (Gadamer, 2000; Heidegger, 2016).

2. Elements build successively toward a small nugget of wisdom of the insights that

change participants' lives.

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

brain, and nervous system, then to the neurotransmitters implicated in ayahuasca's

pharmacology. Macroscopic to microscopic.

That insights from ayahuasca ceremonies helped my participants make improvements

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).

I then asked myself what insights other diagrams might foreground.

Figure 2
Ayahuasca and Psychotherapy as Different Paths of Healing
MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 18

What I show in this figure is:

1. The field of intercultural exchange offers both ayahuasca and psychotherapy as

different paths of healing, amongst others.

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.

3. Ayahuasca leads to changes in participants’ lives; psychotherapy leads to changes in

participants’ lives; both together can lead to changes in participants’ lives.

Ayahuasca and Psychotherapy

My participants sometimes discuss ayahuasca and psychotherapy together. P3

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

of ayahuasca and psychotherapy, while P4 had a negative experience of the combination.

By ‘psychedelic psychotherapy’ I am not suggesting psychotherapy that takes place at

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.

Understanding this, therapists in contemporary trials conduct psychotherapy before

and after the psychedelic experience not during. For example, the MAPS protocol is to offer

psychotherapy the morning after MDMA (Multidisciplinary Association for Psychedelic

Studies, 2016, p. 4). Similarly, legal ayahuasca centres offer pre-ceremony preparation

programmes based on psychotherapeutic theories and practices (Ayahuasca! Now what?,

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

support than shamans, scientists, doctors, psychiatrists, nurses or underground therapists

(Knowles, 2019c; The Maudsley Psychedelic Society Integration Group, 2019; The

Psychedelic Society (UK), 2019; TRIPP Network, 2019). This suggestion merits further

discussion of ayahuasca as a drug or medicine, bringing in T4.

Ayahuasca as a Drug or Medicine

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-

Velder & Verres, 2014; McKenna et al., 1998).

Conceiving of ayahuasca as a medicine, in contrast, brings different difficulties. Much

contemporary research risks proposing psychedelics as a biological solution to a biological

problem. In contrast, Schmid (2011, p. 259) says, ‘ayahuasca should not mainly be

appreciated as a pharmacologically active substance. It is more adequately interpreted as a

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

understood within a bio-psycho-socio-spiritual model (Frecska et al., 2016). That suggestion

is something that existentialism offers (Van Deurzen, 2014, p. 157). Ayahuasca is no single

thing; its status as drug, medicine or sacrament depends on the context.

Relevance to and Implications for Practice

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

perspectives made available by ayahuasca experiences.

Limitations

By design, my findings, while verifiable, are not generalisable or replicable. I studied

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

over time and longitudinal findings.

MAKING SENSE OF AYAHUASCA EXPERIENCES OF THOSE IN THE UK 21

Future Research and Development

T1 and the differences and potential alliances between psychotherapy and ayahuasca

deserve further investigation, particularly from a qualitative, phenomenological and

existential perspective. Further studies might consider the needs of psychotherapy trainees

and CPD needed for existing psychotherapists. Thought is welcome on what

psychotherapeutic frameworks might offer ayahuasca centres, including ethical guidelines,

facilitator certification and supervisory structures. Research could bridge quantitative with

qualitative approaches, linking neurological and genetic measurements with a deep

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

topic myself as I consider taking on a PhD.

Reflection on Myself as a Researcher

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

events in support of psychedelic harm reduction (PsyCare, 2019). Inspired by my experience

on my Masters in Psychotherapy and Counselling, I have decided to be not just a practising

psychotherapist but in equal part an ayahuasca researcher.

I will now take up some of my own suggestions for further research in my PhD within

the Department of Psychological Sciences at Birkbeck University. Following recent

discussions linked to this research, Professor Jonathan Smith, founder of IPA, has agreed to

be my supervisor. My research will also be part of a meaningful collaboration that I have

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

much to contribute, justifying further research.

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

psychotherapists. In my Findings, I present the five themes T1 - T5 under which I group

relevant participants responses. I evidence these themes in the data via quotes from the

transcripts of the interviews.

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

implications for psychotherapeutic practise and areas for further research.

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

UK-focus or that is compatible with the unique contribution of existential thought.

There are implications for psychotherapists and psychotherapy training, which merit

our attention. Participants encounter the dilemma of whether to conceive of ayahuasca as a

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

I reflected on myself as a researcher and acknowledged the impact on me conducting

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.

It was my honour to hear what my participants had to say of their ayahuasca

experiences, and I am grateful for their time, energy and care. I hope to do their experiences

justice in this writing.

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

to be innovative, bringing perspectives from existential philosophy that productively

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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