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Potential Use of Ayahuasca in Grief Therapy

  • Universidad Isabel I
  • International Center for Ethnobotanical Education, Research and Service (ICEERS)

Abstract and Figures

The death of a loved one is ultimately a universal experience. However, conventional interventions employed for people suffering with uncomplicated grief have gathered little empirical support. The present study aimed to explore the potential effects of ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people who had attended peer-support groups, measuring level of grief and experiential avoidance. We also examined themes in participant responses to an open-ended question regarding their experiences with ayahuasca. The ayahuasca group presented a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief, showing benefits in some psychological and interpersonal dimensions. Qualitative responses described experiences of emotional release, biographical memories, and experiences of contact with the deceased. Additionally, some benefits were identified regarding the ayahuasca experiences. These results provide preliminary data about the potential of ayahuasca as a therapeutic tool in treatments for grief.
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Potential Use of
Ayahuasca in
Grief Therapy
´bora Gonza
, Marı
´a Carvalho
Jordi Cantillo
, Marc Aixala
, and Magı
The death of a loved one is ultimately a universal experience. However, conventional
interventions employed for people suffering with uncomplicated grief have gathered
little empirical support. The present study aimed to explore the potential effects of
ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people
who had attended peer-support groups, measuring level of grief and experiential
avoidance. We also examined themes in participant responses to an open-ended
question regarding their experiences with ayahuasca. The ayahuasca group presented
a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief,
showing benefits in some psychological and interpersonal dimensions. Qualitative
responses described experiences of emotional release, biographical memories, and
experiences of contact with the deceased. Additionally, some benefits were identified
regarding the ayahuasca experiences. These results provide preliminary data about
the potential of ayahuasca as a therapeutic tool in treatments for grief.
grief, ayahuasca, peer-support group, therapy, continuing bonds
OMEGA—Journal of Death and
0(0) 1–26
!The Author(s) 2017
Reprints and permissions:
DOI: 10.1177/0030222817710879
ICEERS—International Center for Ethnobotanical Education Research & Service, Roosendaal, The
Centro de Estudos em Desenvolvimento Humano (CEDH), Faculdade de Educac¸a
˜o e Psicologia,
Universidade Cato
´lica Portuguesa, Rua Diogo Botelho, Portugal
Autonomous University of Barcelona, Barcelona, Spain
Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain
Corresponding Author:
´bora Gonza
´lez, International Center for Ethnobotanical Education Research & Service, Carrer de la
Cendra, 8, 08001 Barcelona, Spain.
Grief associated with the death of a loved one is nearly universal, being one of
the most painful experiences we will all likely have at some point in our lives. In
the early aftermath of a death, people can experience feeling stunned or shocked,
emotionally numb, difficulty accepting the loss, mistrust of others, bitterness
over the loss, confusion about one’s role in life, a diminished sense of self,
and difficulty moving on with life (Prigerson et al., 2009). Healthy and adaptive
people typically find the uncontrollable emotionality of acute grief disconcerting
or even shameful or frightening (Zisook & Shear, 2009). When some of these
symptoms persist for at least 6 months and are associated with significant func-
tional impairment, they have been called prolonged grief disorder (PGD;
Prigerson et al., 2009).
Interventions available to providers to target grief include pharmacotherapy,
counseling, peer-support groups, and psychotherapy interventions. There is a
growing interest in the development of new intervention models for PGD that
show potential as effective interventions to ameliorate the prolonged grief
response (Peri, Hasson-Ohayon, Garber, Tuval-Mashiach, & Boelen, 2016;
Wenn, O’Connor, Breen, Kane, & Ress, 2015). These cases represent the
extreme end of a continuum of bereavement responses that affects 9.8% of
the population (Lundorff, Holmgren, Zachariae, Farver-Vestergaard,
O’Connor, 2017). However, qualitative (Jordan & Neimeyer, 2003; Schut &
Stroebe, 2005; Schut, Stroebe, Van den Bout, & Terheggen, 2001) and quanti-
tative reviews (Currier, Neimeyer, & Berman, 2008; Murphy, Lipp, & Powles,
2012; Waller et al., 2015) have found that little empirical support exists for the
effectiveness of universal interventions employed with the majority of people
who suffer from uncomplicated grief.
Peters, Cunningham, Murphy, and Jackson (2016) have reviewed harmful
and beneficial interventions reported by family members affected by the suicide
of a loved one. Peer-support groups were among the higher rated interventions
because they allow sharing memories of their loved ones with others, and par-
ticipants can reconstruct meaningful relationships with their inner and social
worlds. Walter (1999) claims that the purpose of grief is to enable bereaved
individuals to construct a durable autobiography, so they can integrate the
memories of the deceased into their continuing lives. The benefits of peer-sup-
port groups have been reflected in other studies, which claim that peer-support
groups allow people to express their feelings without judgment, feel less lonely
and isolated (Aho A
˚stedt-Kurki & Kaunonen, 2013–2014; Murphy, 2000;
Stevenson et al., 2016), maintain attachment to the deceased (McCreight,
2004), and deal with spiritual issues (Geron, Ginzburg, & Solomon, 2003;
Reilly-Smorawski, Armstrong, & Catlin, 2002). However, those experiencing
grief also indicate that they did not feel ready or emotionally capable of parti-
cipating in a peer-support group because it was emotionally difficult or they
simply did not want to share their experiences or feelings (Stevenson et al.,
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These findings reflect how highly personal in nature reactions to loss are and
how each person copes with the loss in qualitatively different ways. The intensity
and duration of grief can vary not only in different people dealing with osten-
sibly similar losses but also in the same individual over time or after different
losses. Multiple factors determine the intensity and duration of the grief, such as
the individual’s genetic makeup and unique vulnerabilities; preexisting person-
ality; attachment style; the nature of the relationship; the number of losses,
support, and resources; and type of loss, age, health, cultural identity, or spir-
ituality (Zisook & Shear, 2009). Given the wide range of ways one may experi-
ence grief, our efforts have focused on the search for potential new tools for
assisting the bereaved in clinical practice.
Ayahuasca as a Therapeutic Tool
The word ‘‘ayahuasca’’ is derived from Quechua language—aya meaning ‘‘dead
person, spirit, soul, or ancestor’’ and huasca meaning ‘‘rope or vine’’ (Metzner,
2005). Ayahuasca is a pan-Amazonian botanical psychoactive concoction, which
traditionally has been used by indigenous and mestizo populations of Amazonian
countries as a herbal medicine for magical–religious and therapeutic purposes
(Schultes & Hofmann, 1992). The concoction is produced by boiling the stems of
the Banisteriopsis caapi liana with the leaves of the Psychotria viridis shrub (Schultes
&Hofmann,1992).B. caapi is rich in beta-carbolines, which have monoamine
oxidase-inhibiting properties, the main pharmacological mechanism of many anti-
depressants currently used in clinical practice (Meister et al., 2016). P. viridis con-
tains the hallucinogenic tryptamine N,N-dimethyltryptamine (DMT) that acts as
an agonist of 5-HT-2A receptor sites, also associated with antidepressant and
anxiolytic effects (Domı
´et al., 2016). Moreover, the agonist at this
receptor increases glutamatergic transmission that stimulates brain-derived neuro-
trophic factor release, promoting neurogenesis and neural plasticity (Baumeister,
Barnes, Giaroli, & Tracy, 2014). Recent research has also shown the cerebral
neuroplasticity triggered by DMT via activating the sigma-1 receptor (Fontanilla
et al., 2009). However, clinical research about the therapeutic effects of ayahuasca is
still incipient, even if studies regarding its therapeutic potential on emotional symp-
toms are rapidly growing (Oso
´rio et al., 2015; Sanches et al., 2016), as well as on
other types of psychopathological symptomatology (Bouso et al., 2012; Dos
Santos, Landeira-Fernandez, Strassman, Motta, & Cruz, 2007; Halpern,
Sherwood, Passie, Blackwell, & Ruttenber, 2008). Regardless of this scenario,
there is abundant evidentiary literature of ayahuasca’s pharmacological safety in
healthy users (Dos Santos, 2013; Dos Santos et al., 2012; Riba et al., 2003).
The phenomenology of the experience of ayahuasca has been thoroughly
described (Riba et al., 2001, 2003). Forty-five minutes after taking ayahuasca,
people tend to feel the necessity to close their eyes and experience the onset of
´lez et al. 3
visual imagery, similar to a dream-like state. However, the awareness that the
visions are drug induced is never lost which is why they should not be considered
‘‘hallucinations.’’ In this introspective state, people tend to reflect on meaningful
personal themes, interlacing memories, thoughts, and emotions in a spontaneous
way. This type of experience holds great value for people who drink ayahuasca,
as they may be able to unlock emotions as well as have new insights into
personal concerns. It is not uncommon that ayahuasca-induced experience is
characterized as analogous to a psychotherapeutic intervention. After this initial
onset, the overall intensity then gradually decreases, returning to baseline at
between 4 and 6 hr after intake. However, one clinical trial in patients with
depression found that the antidepressant effects of ayahuasca are maintained
up to 3 weeks after intake of a single dose, especially with regard to symptoms
referring to a depressed mood, feelings of guilt, suicidal ideation, and difficulties
at work (Sanches et al., 2016).
Given the growing interest in alternative medicines and therapeutic practices,
ayahuasca use has expanded across the world (Labate & Feeney, 2012).
Ayahuasca is used by Western and Amazonian people as a medicine, a sacra-
ment and a ‘‘teacher plant’’ (Tupper, 2008). This means that ayahuasca use has
been exported to the West while maintaining a ceremonial and ritual context
based on indigenous or religious traditions. These traditions often get inter-
twined with Western cultural elements related to therapeutic or personal
growth purposes (Sa
´nchez & Bouso, 2015).
The principal objective of this study was to explore the effects of ayahuasca
on grief and to compare its potential therapeutic benefits with peer-support
groups in a sample of grieving people.
Material and Method
Study Design
This study was a mixed method, cross-sectional study, using an online survey
method. To develop it, we used the platform operated by Limesurvey (https://, which allowed the collection and preservation of the data
on a secure server that is accessible only to the researchers via a password.
Participants interested in participating could follow a link to enter the research
page, which included an introduction of the study and participants’ rights and
obligations. Participants then provided consent by clicking on corresponding
buttons on the page and then began completing the online questionnaire.
Participants who were taking ayahuasca during their grief process were recruited
via ICEERS’ blog ( The survey was created in Spanish
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(40%) and in English (60%) because this nonprofit organization has access to a
large international community who speak these two languages. Participants who
attended peer-support groups were recruited through the social media
(Facebook) pages of several organizations that deal with the theme of grief,
such as ‘‘Duelo compartido’’ (shared grief), ‘‘Grupos de ayuda mutua en
duelo’’ (grief support groups), ‘‘Creciendo a trave
´s del duelo’’ (growing through
grief), ‘‘Tanatologı
´a: muerte, duelo y aceptacio
´n’’ (thanatology: death, grief, and
acceptance; 100% Spanish). Finally, the Foundation Hospital Sant Jaume i
Santa Magdalena (Spain) also facilitated the collection of a pencil and paper
version of the interview protocol from participants of their peer-support groups.
The inclusion criteria included having been confronted with the loss of a first-
degree relative (spouse, parent, child, or sibling) within the last 5 years (60
months). In order to increase group homogeneity participants who rated very
low on the Past Feelings Scale were excluded, using a cut off of Texas Revised
Inventory of Grief (TRIG) Past Feelings Scale 13, which was the minimum
obtained in the ayahuasca group. We excluded 32 participants (14 from the
ayahuasca group and 18 from the peer-support group) who did not fill the
criteria or presented over 25% incomplete answers. We identified n¼60 parti-
cipants (n¼30 ayahuasca group; n¼30 peer-support group) who met the
required inclusion criteria.
General Characteristics Bereavement Questionnaire. We designed a questionnaire for
online completion, drawing on topics that emerged from grief literature
(Prigerson et al., 2009; Zisook & Shear, 2009). We sent this questionnaire to a
preliminary group of 10 people to facilitate revisions. The final questionnaire
contained 30 closed-ended questions and one open-ended question. Closed-
ended questions covered respondents’ sociodemographics, bereavement
characteristics in subset of grievers, early treatments, and psychological and inter-
personal dimensions influenced by the treatment (ayahuasca or peer-support
groups). The last variable was dichotomous (yes/no items).
At the end of the questionnaire, participants in the ayahuasca group were
asked one open-ended question—‘‘Finally, we would appreciate it if you
described in your own words your personal experience of how ayahuasca influ-
enced your grieving process’’—a method has been used by other researchers
(Davis, Nolen-Hoeksema, & Larson 1998; Uren & Wastell, 2002). The purpose
of this question was to collect data about the most significant components of the
ayahuasca experience related by the grievers. Participants could elect to not
answer this question and still be included in the study.
Texas Revised Inventory of Grief. The TRIG was designed by Faschingbauer (1981)
to evaluate the level of grief in bereavement from the loss of a loved one.
´lez et al. 5
This questionnaire includes two scales: Past Feelings Scale, which uses 8 items to
measure the initial grief response following the death of a loved one, and Present
Feelings Scale, which uses 13 items to measure the current emotional state at the
time of completion of the questionnaire. Participants indicate their response to
each question using a 5-point scale (1 ¼completely false;5¼completely true).
The TRIG was scored by calculating the average scores in each subscale corre-
sponding to a higher level of grief in bereavement. The validation of the instru-
ment in Spanish was done by Garcı
´a, Petralanda, Manzano, and Inda (2005). It
showed a high internal consistency of both scales. In the present study, the
English and the Spanish versions of the questionnaire were used.
Acceptance and Action Questionnaire (AAQ-II). The AAQ-II was developed by Bond
et al. (2011) to measure experiential avoidance. The AAQ-II contains seven
items that assess only one scale called experiential avoidance. Participants indi-
cate their response to each question using a 7-point scale (1 ¼never true;
7¼always true). The AAQ-II was scored by adding all the items, with higher
scores corresponding to greater experiential avoidance. The validation of the
instrument in Spanish was done by Ruiz, Luciano, Cangas, and Beltra
´n (2013).
In the present study, the English and the Spanish versions of the questionnaire
were used.
Ethical Considerations
The protocol was approved by a local research Ethics Committee (CEIC-Parc de
Salut Mar, Barcelona, Spain), and the study was conducted in accordance with
the Declaration of Helsinki. Participants signed an informed consent and were
not financially compensated for their participation.
Data Analysis
Quantitative data analysis. The data were analyzed using the SPSS 15.0 statistics
package. Results are presented as means and percentages. Differences between
groups were analyzed using a ttest in the case of continuous variables (or
Mann–Whitney U test) and using a
test for categorical variables (in some
cases Fisher’s test). A value of p<.05 was considered statistically significant.
Qualitative data analysis. Qualitative data from the only open-ended question gen-
erated a rich amount of data. These data were analyzed with qualitative content
analysis (Graneheim & Lundman, 2004). We used directed content analysis—the
deductive use of existing theory or prior research to better understand a pre-
viously explored phenomenon and establish key concepts or variables as initial
coding categories (Potter & Levine-Donnerstein, 1999)—to validate or concep-
tually extend a theoretical framework (Hsieh & Shannon, 2005). The first and
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second authors analyzed the qualitative data from the questionnaires indepen-
dently. The analysis was performed in several steps. First, the text was read
several times, and text relevant to the research was marked. Meaning units
were then identified, condensed, and grouped together into subthemes and
themes through an inductive and deductive approach (Graneheim &
Lundman, 2004; Patton, 2002). Thus, units were counted at the level of the
respondent, so that participants who provided longer written narratives were
not given more weight in the analyses. Throughout the analysis, themes and
subthemes were discussed between the authors to ensure the results were inter-
preted as objectively as possible. Any differences were discussed until a consen-
sus was reached. This method leads to a deeper understanding of the results by
allowing us to identify the most relevant aspects of the ayahuasca experience. It
is important to note that eight participants mentioned aspects from more than
one experience with ayahuasca that related to their grief process. Finally, we
identified n¼180 independent meaning units across participants’ responses.
Quantitative Findings
Sixty participants were included in the final analysis (n¼30 ayahuasca group;
n¼30 peer-support group). Demographic characteristics were similar between
groups (Table 1). We noted no significant differences in age, sex, university
degree, and religion.
No differences were found in death-related variables, such as time since death
(ayahuasca group: 33.17 months (SD 18.64; 6–60 months); peer-support group:
28.10 months (SD 20.87; 4–60 months; p¼.224), and number of losses of sig-
nificant people (ayahuasca group: 2.93; SD 2.203 (1–7); peer-support group:
3.00; (SD 1.82; 1–8; p¼.887). Bereavement characteristics in subset of grievers
are displayed in Table 2.
For the ayahuasca group, the average number of ayahuasca sessions whose
content had direct repercussions on their process of grief was 6.07 (SD 7.64;
[range: 1–30]). Of the 30 participants, 18 (60%) took ayahuasca with the inten-
tion of addressing the issue of grief, six people (20%) were not sure about their
intentionality and for six participants (20%) the content related to grief arose
spontaneously. Twenty-five participants (83.3%) believed their ayahuasca-drink-
ing experience had a very positive influence on their grieving process and five
(16.7%) felt it had a positive influence. Of the seven participants who attended
psychotherapy, four did it before taking ayahuasca, two participants were parti-
cipating in both psychotherapy and ayahuasca sessions during the same period of
time, and just one attended psychotherapy after doing ayahuasca.
With the peer-support group, participants attended a peer-support group
during a mean of 12.18 months (SD 9.5 [range 1–36]). Seventeen participants
´lez et al. 7
(56.7%) believed it had a very positive influence on their grieving process and 13
(43.3%) a positive influence.
Psychological and interpersonal dimensions influenced by ayahuasca or by
the peer-support group for grief are shown in Table 3.
Differences were found regarding preoccupations with thoughts and mem-
ories (p.01), ability to forgive oneself and others (p.05), self-conception
(p.01), recoding life history (p.01), the ability to give sense to their life
(p.01), and the integration of transcendental dimension of life and death
(p.01). In these items, the ayahuasca group obtained higher benefits compared
with the peer-support group.
Outcomes in TRIG show differences in the current emotional Present
Feelings Scale (p.001). AAQ-II shows no differences in experiential avoidance
between groups (p>.05) (Table 4).
Qualitative Findings
We identified two different themes in the narratives that emerged from the open-
ended question asked to the ayahuasca group, regarding:
1. The content of the experience, and
2. The benefits of the ayahuasca experience related to the grief process.
Table 1. Demographic Data of the Study Sample.
Variable Ayahuasca group Peer-support group
Age (year; mean [SD]; range) 42.33 (8.79); (25–62) 46.43 (11.196); (26–70)
Gender (female) (%) 66.7 76.7
University degree (%) 70 60
Marital status (Column %)
Single 46.7 3.3
Married 43.3 60
Separated 10 10
Widowed 0 26.7
Number of children (mean; [SD]; (range) 0.73 (0.907); (0–2) 1.53 (1.14); (0–4)
Number of cohabiting people 1.33 (1.32); (0–5) 1.80 (1.5); (0–7)
Religion (Column %)
Atheist 90 83.3
Catholic 0 16.7
Santo Daimes 6.7 0
Sikhs 3.3 0
Note. Patients who had taken ayahuasca (n¼30) or attended a peer-support group (n¼30).
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Content of the experience. Three subthemes were identified within the narratives of
the ayahuasca experience: emotional release, biographical memories, and contact
with the deceased. Another subtheme emerged to agglomerate other themes that
did not fit any of the major themes: others.
Table 2. Loss-Related Characteristics of Grievers Who Had Taken Ayahuasca (n¼30) or
Attended a Peer-Support Group (n¼30).
Variable Ayahuasca group (%) Peer-support group (%)
Relationship to respondents
Father 40 6.7
Mother 23.3 10
Sibling 16.7 6.7
Child 10 50
Partner 10 26.6
Quality of the relationship
Positive 76.7 89.7
Ambiguous 23.3 10.3
Cause of death
Suicide 6.7 3.3
Miscarriage 10 26.7
Accident 13.3 16.7
Illness 70 43.3
Homicide 0 6.7
Medical negligence 0 3.3
Current pain
None at all 18.5 3.6
A little 48.2 39.2
Quite a bit 25.9 28.6
A lot 7.4 28.6
Attended psychotherapy 24.1 63
Impact of the psychotherapy
Scarcely 28.6 0
Positively 71.4 95.8
Negatively 0 4.2
Medication 6.9 85.7
Impact of the medication
Scarcely 100 28.6
Positively 0 71.4
´lez et al. 9
Emotional release. Almost to all participants (22/23) referred to an emotional
dimension of the ayahuasca experience. The tonality of those emotional dimen-
sions varies being in some cases a positive emotion such as extremely happy or
amazing joy and in other cases a more negative emotion such as confusion or
fear. About a third of the participants (8/23) refer to experiences of confronta-
tion with grief, sadness and suffering, expressing themselves in terms of grief,
struggle, pain or sorrow. Further, some participants recognized they had been
Table 3. Percentages of Participants Who Responded Affirmatively to the Items Included
in the Survey.
During the grieving process ...
(ayahuasca or peer-support group)
had a direct beneficial impact on ...
group (%)
group (%) pValue
...accepting the loss 80 65.5 .211 emotional state 83.3 85.7 >.999z preoccupation with thoughts and memories 93.1 62.1 .005 ability to appreciate human relationships 72.4 55.2 .172 ability to forgive myself and others 66.7 34.5 .013
...the conception I had of myself or of the roles I had
...adopted in my life
93.1 63.0 .006
...the way I perceived my past or my life history 71.4 35.7 .007 attitude and my outlook on the future 92.6 75.0 .143z ability to make sense of my life and life itself 86.2 53.6 .007 ability to integrate a transcendental dimension
...of life and death
76.7 42.9 .009
zFisher’s exact test.
Table 4. Outcomes in the Survey Response.
Ayahuasca Peer-support
Measures group group pValue
TRIG Past Feelings Scale (SD) 22.68 (7.7) 19.7 (5.5) .082
TRIG Present Feelings Scale (SD) 43.51 (9.1) 34.3 (11.0) .001***
AAQ-II (SD) 2.52 (1.03) 2.77 (1.39) .433
Note. AAQ ¼Acceptance and Action Questionnaire.
10 OMEGA—Journal of Death and Dying 0(0)
avoiding their feelings (3/23) and were confronted with their emotions during the
ayahuasca experience.
I was partying to forget until I drank ayahuasca, [...] confronting me with my grief
and loss. It was comforting and felt good to let the emotions flow, letting go of
everything. (12)
As exemplified in this excerpt, the references to the positive impact emerging
from emotional release are frequent. A woman who lost her mother expressed
herself more abstractly and metaphorically:
In this process, I cried a lot out of love and in every cry I placed my mom in my
heart and soul, and all that good will be passed on generation to generation. (6)
Some findings refer to experiencing deep emotional empathy regarding the life
circumstances and the emotions experienced by the deceased (3/24). In these
experiences, the intensity of the emotional component promotes closeness and
understanding toward the loved one. A woman had lost her brother who had
bipolar and substance abuse disorder explains:
I could feel the pain he experienced when he was alive. It was the worst kind of
psychological, emotional and physical pain imaginable. (9)
Two participants describe unique experiences. Under the effects of ayahuasca,
they experienced archetypal visions and the emotional burden the griever carried
seemed to be transferred to the archetype. In one of these cases, we identified a
single example of psychosomatic healing described. This category was not antici-
pated in the analysis since there are no references to this kind of experience in the
theoretical framework of conventional psychotherapy. Therefore, this category
emerged inductively from the data. Both participants were women:
I had one ceremony when a wolf came to me and somehow I turned into this wolf
and the anger I was feeling was given a container in this animal spirit. It’s hard to
explain but it helped enormously. (4)
I had a vision of a giant black Buddha/ Hindu-like God reach down and suck the
pain from my heart. I had been experiencing physical tenderness and pain in my
chest area for over two years (yes, my broken heart). After this ceremony, it was
completely gone. (10)
Biographical memories. Some participants (6/23) refer to having reexperienced
biographical memories. Some of them refer to reexperiencing death-related
´lez et al. 11
events. However, others refer to reexperiencing long-forgotten events involving
the deceased or reviewing their personal history to arrive at new meanings for
their own life history. This process seems to promote the understanding of
meaningful life events from a different point of view, regarding the deceased
as well as oneself. A young man who had struggled during childhood with the
feelings of being neglected by his family because of his father’s marriage to
another woman decided to take ayahuasca following his father’s traumatic
death, with the intention of finding answers for his painful process:
Aya [ayahuasca] took me back to my childhood and showed me memories of times
with my parents and other family members, a time when I was loved and accepted.
They were good memories and reminded me I had a good foundation to go back to.
It helped me see that subsequent events (losing my mom at age 10 and sick sister)
affected my father and how he coped and found new love and how that is what
he needed. He did not love me less, he just needed a woman more. Hard lesson, but
aya transmitted this to me in a gentle way. (11)
Experiences of contact with the deceased. Surprisingly, over half of the parti-
cipants (15/23) shared having experienced direct contact with the presence, essence,
soul or energy of the deceased, having been able to establish some form of com-
munication with them. In some cases, this communication allowed for the resolu-
tion of issues that had remained unresolved, in a way that was seen as potentially
affecting the future: ‘‘He [the deceased] told me some profound things that could
occur in the future for our family.’’ In other cases, the encounter allowed a fare-
well that wasn’t possible in real life. The following participant describes:
’I had the feeling of losing consciousness, but I did not lose it. [...] A force drew
from my chest a heart-wrenching cry when I felt that caress on my fist, which made
me let go of the shawl I was holding. There was a breath of life and of death, that
led me to a perfect connection of my being with that of my father. And, like the
flight of a hummingbird, it left with the soft perfume of pipe tobacco (my father
smoked it). I had the real sensation that my father had come to say goodbye to me
physically on earth with that last caress. (17)
Others. Other types of experiences were found in the data. An experience
occurred with purging and no visions and two experiences were focused on love.
Benefits from the ayahuasca experience related to grief. All participants indicated
perceived benefits related to the loss that had resulted from the ayahuasca
experience. In fact, eight participants mentioned that the experience was an
opportunity,agreat help, or a blessing that marked their lives very significantly,
as if it were possible to define a before and after in life, offered by ayahuasca.
12 OMEGA—Journal of Death and Dying 0(0)
Six subthemes emerged from the ayahuasca experience: positive feelings, forgive-
ness and family healing, reorganizing identity and sense of self, changes in the
internal representation of the deceased and maintenance of connection, and
changes in global beliefs and personal growth
Positive feelings. Over half of the participants (7/23) expressed that ayahuasca
had helped them accept the loss of their loved one as part of a process, as
something natural or as part of the cycle of life. The use of expressions to describe
their emotional states was also common (16/23), such as celestial peace, love,
tranquility, understanding, enlightenment, quietness, thankfulness and happiness.
In the words of a woman who had lost her mother:
We had a difficult relationship but by the end I had dropped into a very simple,
profound love for her and I am profoundly grateful to ayahuasca for that. (4)
Forgiveness and family healing. Several participants (6/23) expressed having
been able to forgive the deceased, themselves or their family members
through the ayahuasca experience: ‘‘I found true forgiveness for my brother
for his suicide. I also found true forgiveness for myself for not being able to
stop him.’’ In some cases, forgiveness seems to emerge following the resolu-
tion of past issues during the experiences of contact with the deceased and,
in other cases, it seems to emerge after having empathized with the life
circumstances or the feelings the deceased expressed during his or her
own life.
Family healing is also a recurring theme (5/23), which is sometimes expressed
as a long process, which originates in the ayahuasca sessions, through a deepened
understanding of the significant aspects of family relationships and, other times,
as a result of experiencing ‘‘insights.’’ The following participant expresses it in
this way:
In all these sessions, I healed a lot of the relationship with my whole family espe-
cially regarding the relationship with my parents and things from the past and
childhood. (6)
Reorganizing identity and sense of self. More than a third of participants (8/
23) refer to a personal change in self-concept through the experience with
ayahuasca that manifests in different facets. Some people refer to seeing
themselves through others’ eyes, having discovered unknown parts of them-
selves. Another way in which the change is expressed is becoming aware of
the roles that they had adopted in the past and embarking on a new way of
relating to others. Other people express that ayahuasca has ‘‘shown them who
´lez et al. 13
they really are’’. One of the participants explained her experience in the
following way:
I have died and been resurrected, all of my traumas wiped clean and I was given a
chance to start again [. . .]. I am finally back to my essence and there is no way that
is good enough to express my deep gratitude. (5)
Changes in the internal representation of the deceased and maintenance of
connection. Experiences of contact with the deceased often foster a change in
the internal representation of the loved one (10/23), shifting from being dead to
being a spiritual guide or a teacher. In cases in which the death occurred due to
miscarriage, these experiences allow the conception of an external representation
of the baby, as this woman explains:
I met my baby who died (he was stillborn) so I had never seen him animated and
experiencing this vision was very healing for me. (23)
Depending on the beliefs of the participant, these experiences allow one to have
the certainty that the person is ok after leaving their body, that he or she is happy
or resting in peace. For those who comprehend the experience with the deceased
as a subjective reality, this type of experience also has a therapeutic impact. The
following participant had the experience of his deceased father stroking him with
his hand trying to heal his endless grief and explains the experience in the
following way:
Of course, it was me that was stroking my head, but I understood that my father
was in me, in the form of my blood, my cells, as irreversible as death itself, as
transcendent as the very essence of life. [...] I understood that my father would
never be here again but that he once was, and that I was an unquestionable part of
his presence. [...] I now know that I will never be with my parents again but that, at
the same time, they will never stop being with me. (18)
All the experiences of contact with the deceased allowed the final development of
positive internal representation and the maintenance of a connection.
I feel like his help is always accessible now and I also know he has important work
where he is to continue with. Things are easier. (8)
Changes in global beliefs. Several participants (7/23) report how the experience
with ayahuasca caused a change in their beliefs and the way in which they had
perceived the world, primarily referring to spiritual matters. Some refer to being
14 OMEGA—Journal of Death and Dying 0(0)
able to see that there are different levels of existence, that there is life after death,
that bonds are eternal, or feeling that they belong to something greater than
oneself. Others refer to more existential matters such as the fact that a singular
meaning does not exist, rather a consciousness that asks and responds, or that one
chooses one’s own life.
Personal growth. Finally, there are frequent (7/23) allusions to personal
growth, describing the positive ways in which their lives have changed as a
result of their ayahuasca experiences related to grief. People refer to being
more positive, being more centered, aware,moreconnected, highly creative,
more assertive, to having confronted their fears, of having reached new spaces
of comprehension and understanding.
They also refer to an increased appreciation of personal relationships and of
having learned to relate with others in a new way. One father who had lost his
daughter explains his experience with ayahuasca:
I cried from the grief, the loss, the shock, the sadness, the emptiness, but I also cried
in gratitude for having been able to have my wife by my side during the entire
process, appreciation for that wondrous ‘‘other side’’ that this painful experience
resulted in, since it made us grow as individuals and as a couple. (21)
Finally, reference is also made to an enrichment of life that happens through
changes in the manner of relating to the earth or plants, by appreciating the
beauty of life and perceiving its mystery.
It [ayahuasca] has given me an expanded view of my existence in this world.
My whole life is richer because of what I have experienced in ceremony,
even my sadness is a richer emotion than the debilitating grief I had been experien-
cing. (7)
This is the first study to explore the therapeutic potential of ayahuasca in griev-
ing processes. The findings from this study indicate that people who used aya-
huasca reported lower level of grief than people who attended a peer-support
group. This result stems from the fact that although both groups were compar-
able in the level of grief at the moment of death, the level of grief presented in the
Present Feelings scale (TRIG) was lower in the ayahuasca group. Also, a sig-
nificantly greater proportion of ayahuasca participants reported direct benefits
on some of the psychological and interpersonal dimensions that are central to
grief processes. In this discussion, we elaborate on these findings in terms of the
relevant theories, empirical research in the field, and protocols for manuals of
´lez et al. 15
treatment, while highlighting the clinical implications of the qualitative results
and the theoretical models to which they relate.
The scores concerning the Past Feelings scale from the Revised Inventory of
Grief are within the range of scores obtained by other studies (Grabowski &
Frantz, 1993). Nevertheless, when we compare our results obtained from the
Present Feelings scale with those originally obtained by Faschingbauer (1981),
the peer-support group scored within normal range, while the ayahuasca group
scored above this range. Therefore, we questioned how the griever can best get
out of this state, as the adaptive model of grief suggests. The adaptive model of
grief is focused on identifying key personal growth aspects despite complications
(Gamino, Sewell, & Easterling, 2000). Variables such as positive changes in self-
perception, closer family and interpersonal relationships, ability to make sense
of the world or a richer existential and spiritual life have been identified as
important domains of posttraumatic growth (Tedeschi & Calhoun, 2004). Our
study found differences regarding the impact of both resources (ayahuasca and
peer-support group) on self-conception, ability to forgive others, ability to make
sense of life, as well as to integrate a transcendent dimension. It is possible that
the differences found in these variables might have impacted the scores obtained
from the questionnaire. The fact that the peer-support group presented a higher
percentage of loss of children, and a higher presence of deaths by homicide,
traumatic death and younger age of the deceased did not influence the ability for
personal growth (Gamino et al., 2000).
The qualitative analysis of the experiences with ayahuasca reveals that emo-
tional confrontation with the reality of loss is a common experience in the
bereaved, including in those who avoided connecting with their feelings.
However, despite the pain and sadness that can be felt under the acute effects
of ayahuasca, this type of experience often leads to feelings of peace and accep-
tance of the death. Emotional confrontation is at the heart of the majority of the
contrasted models in grief intervention, utilizing techniques such as imaginal
revisiting (Shear, 2010), exposure (Boelen, de Keijser, van den Hout, & van
den Bout, 2007; Rosner, Pfoh, & Kotouc
´, 2011), retelling the narrative of
the death (Neimeyer, 2012), or written disclosure (Lichtenthal & Cruess, 2010a;
Wagner, Knaevelsrud, & Maercker, 2006). Through these techniques, patients
are exposed to the most difficult internal pictures, or cognitions, surrounding the
death of their loved ones (Rosner et al., 2011). These techniques are used in
order to process the loss at an emotional and cognitive level, promoting mastery
of difficult material (Wetherell, 2012). Consequently, it increases recognition of
the reality of the loss and reduced intrusive memories (Boelen, Van Den Hout, &
Van Den Bout, 2006). Nevertheless, in our accounts, we also find the description
of experiences in which the emotional burden of the loss is transferred to an
archetype, or is purged, partly relieving this grief. These types of experiences
provide a psychosomatic therapeutic value that has not been described by any
therapeutic models to date.
16 OMEGA—Journal of Death and Dying 0(0)
However, beyond reliving the traumatic experience of the moment of death,
several participants mentioned recalling memories they had forgotten or experi-
encing autobiographical reviews that allowed them to understand specific epi-
sodes from another point of view. This type of experience could facilitate the
redefinition of their relationship with the deceased and of their own life history.
Constructivist grief therapy seeks this same result using biographical techniques,
such as narrative writing (Neimeyer & Sands, 2011). Through these techniques,
‘‘significant life chapters’’ are captured, where one can trace strands of consistency
between the life of the patient and the deceased, in order to reaffirm secure attach-
ment (Neimeyer, 2006, 2004; Neimeyer & Sands, 2011). Furthermore, according
to autobiographical memory theorists, the way we compose our life stories is
closely related to the way we understand ourselves (Fitzgerald, 1988). Thus, the
reconstruction of one’s life history can prevent the consolidation of internal,
stable and global attributions, in which the trauma will be related to stable char-
acteristics of the self that pertain across situations (Gillies & Neimeyer, 2006). Our
results reflect this type of process, since most people who recount experiences of
biographical memories also allude to experiencing a change in their own identity.
As we have seen, under the effects of ayahuasca, people can feel confronted
with their emotions and reorganize their identity recalling their biographical
memories, not being exclusive categories within the same experience. In either
case, these experiences lead to the revitalization of an adaptive regulatory pro-
cess for the mourner, just as the dual process model predicts (Stroebe & Schut,
1999). Although this model introduces a dichotomous concept such as that of
oscillation, it takes into account the natural fluctuation that occurs in the griev-
ing process between loss-oriented coping (such as crying about the deceased or
yearning for the person) and restoration-oriented coping (such as developing
new identities). With the aim of accompanying this process, modules for narra-
tive reconstruction have recently begun to be included in the cognitive beha-
vioral therapy protocols (Peri et al., 2016). Thus, in addition to the emotional
confrontation that exposure to the traumatic memory involves, the experience
facilitates its integration into the individual’s life history, including psychody-
namic references to the subjective personal meaning of the event for the patient,
associated with their past experiences.
However, it is possible that the greatest therapeutic impact of ayahuasca
comes from the experiences of contact with the deceased, as they promotes a
new representation of the loved one and facilitate maintenance of the bond
through the establishment of a new relationship. This type of experience has
also been described in a case of grief resolved spontaneously under an altered
state of consciousness induced with ketamine (Gowda et al., 2016). Attachment
theory (Bowlby, 1977) and the construct of continuing bonds (Field, 2006;
Russac, Steighner, & Canto, 2002) are an underlying component of bereave-
ment and an important element of coping with the grief (Barrera et al., 2009;
Darbyshire et al., 2013; Klass, 2006; Neimeyer, 2006). Furthermore, these
´lez et al. 17
experiences permit the resolution of outstanding issues, such as saying goodbye
to the loved one or communicating matters that were left unsaid. Unfinished
business is thought to be one possible manifestation of difficulties in the con-
tinuing bond, being one prominent risk factor for developing PGD and lowered
meaning made of the loss (Klingspon, Holland, Neimeyer, & Lichtenthal, 2015).
For this reason, various forms of imaginal psychotherapeutic dialogues with the
deceased have been incorporated into the cognitive behavioral therapy protocols
(Shear, 2010), in the constructivist model, through the writing of letters to the
deceased (Neimeyer, 2016) or in integrative cognitive behavioral therapy,
through the empty chair technique (Rosner et al., 2011). Rosner (2015) has
identified including confronting painful aspects and allowing reconciliation
and integration of the new and changed relationship to the bereaved among
the ‘‘ingredients’’ of successful intervention of grief therapy.
The benefits obtained through the experiences of grief with ayahuasca are
similar to those described in cases of posttraumatic growth (Calhoun, Tedeschi,
Cann, & Hanks 2010) or stress-related growth (Park, Cohen, & Murch, 1996).
These terms refer to positive psychological change that goes beyond adaptation,
and it is an experience of improvement that for some people is deeply profound
(Tedeschi & Calhoun, 2004). For this reason, based on the model of growth in the
context of grief (Calhoun et al., 2010) and in the theory of shattered assumptions
(Janoff-Bulman’s, 2010), constructivist therapy has developed a meaning-
oriented approach to grief therapy to reaffirm or reconstruct a world of meaning
that has been challenged by loss (Neimeyer, 2016, 2001; Neimeyer & Sands, 2011).
The benefits discovered in our reports, such as acceptance, changes in identity,
changes in global beliefs, personal growth, changes in family bonds, valuing
relationships and spirituality, are ways of bringing meaning to stressful life experi-
ences (Bogensperger & Lueger-Schuster, 2014; Gillies, Neimeyer, & Milman,
2014; Lichtenthal, Currier, Neimeyer, & Keesee, 2010b; Park, 2010). However,
as far as our knowledge reaches, other benefits such as forgiveness of oneself, or of
others, as well as the change in the internal representation of the deceased, have
been scarcely described in the literature as such. Several studies of Western people
who have used ayahuasca show that these types of benefits are common after
experiences with ayahuasca, especially those related to changes in the way one
relates to oneself or promoting ‘‘self-acceptance,’’ feeling more loving and com-
passionate in their relationships, gaining a new perspective on life and spiritual
development (Harris & Gurel, 2012; Kavenska
´& Simonova
´, 2015; Prayag, Mura,
Hall, & Fontaine, 2015; Trichter, Klimo, & Krippner, 2009).
Furthermore, we cannot ignore that ayahuasca is a natural compound that
has antidepressant and anxiolytic effects mediated by the agonist action of DMT
on 5-HT 1A/2A/2C receptors (Dos Santos et al., 2007; Sanches et al., 2016). In
addition, the intake of ayahuasca is usually carried out as part of a ritual or
ceremony where the use of music and singing is common. Performing a ritual
that symbolizes the passage from one phase to another, as well as the use of
18 OMEGA—Journal of Death and Dying 0(0)
music therapy, is also beginning to be incorporated into more current treatment
protocols (Neimeyer, 2016; O’Callaghan, McDermott, Hudson, & Zalcberg,
2013; Smid et al., 2015).
However, despite these benefits, there are risks to be considered when plan-
ning a therapeutic model for grief with ayahuasca. First, several cases have been
described of crises caused by the lack of a theoretical model or worldview that
supports the integration of these experiences (Lewis, 2008). Additionally, the
active component of ayahuasca, DMT, is capable of inducing aversive psycho-
logical reactions that resolve spontaneously in a few hours (Gable, 2007). Such
experiences can be traumatic if not properly understood and integrated.
Secondly, there is a lack of knowledge about clinical diagnoses with which
ayahuasca could be contraindicated (Szmulewicz, Valerio, & Smith, 2015).
Thirdly, ayahuasca increases diastolic blood pressure (Riba et al., 2003), so
extreme caution should be taken in those suffering from cardiovascular pro-
blems or diseases that may affect the heart. Finally, potential adverse health
effects can be derived from the use of ayahuasca in combination with other
serotonergic substances (Boyer & Shannon, 2005). Nevertheless, we believe
that if the risks mentioned above are considered, new treatment protocols for
grief where ayahuasca is integrated as a therapeutic tool could be successful.
There are several limitations that should be addressed. Firstly, this study is a
cross-sectional retrospective design, so it does not allow us to draw conclusions
about causality. Future studies with longitudinal designs are needed to confirm
current findings. Second, our analyses relied on a small sample size, some self-
selected and heterogeneous samples, where the groups differ in terms of relation-
ship to respondent, in that there were more children in the peer-support group.
This group is also affected by unnatural death causes such as homicide, whereas
the ayahuasca group presents a higher percentage of death following a disease.
The fact that the peer-support group has suffered with more unnatural deaths
might have a direct influence in the presence of traumatic grief in this
group.Future studies are needed to examine the generalizability of the present
findings to more homogenous and larger samples. A third limitation is that the
participants belong to different samples. This could cause the samples to not be
comparable. A fourth limitation is the lack of an assessment of Complicated
Grief, or PGD, having used self-report measures rather than clinical interview.
It would be relevant for future studies to examine the effectiveness of ayahuasca
on people with these diagnoses. Regarding the qualitative analysis, several of the
reports are limited, and since the sample is self-selected, it is likely that the only
people to have responded are motivated to do so because their experience has been
positive. To reach generalizable conclusions randomized, placebo-controlled
trials should be conducted that would include a wider sample of participants.
´lez et al. 19
These preliminary findings show the therapeutic potential of ayahuasca in the
grieving process. We obtained similar scores following the death of a love one in
the TRIG in both groups but a reduction in the level of grief at Present Feelings
scale in people who used ayahuasca. Also, ayahuasca intake during a grieving
process can evoke experiences whose contents could facilitate the intrinsic nat-
ural regulation of the grieving process, promoting posttraumatic growth. These
preliminary findings can inform future research to develop refined intervention
protocols that can be put into clinical practice.
The authors wish to thank Sara Wilkins for translating the article.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
The author(s) received no financial support for the research, authorship, and/or publica-
tion of this article.
Aho, A. L., A
˚stedt-Kurki, P., & Kaunonen, M. (2013–2014). Peer supporters’ experiences
of a bereavement follow-up intervention for grieving parents. Omega,68(4), 347–366.
Barrera, M., O’connor, K., D’Agostino, N. M., Spencer, L., Nicholas, D., Jovcevska,
V., ...Schneiderman, G. (2009). Early parental adjustment and bereavement after
childhood cancer death. Death Studies,33(6), 497–520.
Baumeister, D., Barnes, G., Giaroli, G., & Tracy, D. (2014). Classical hallucinogens as
antidepressants? A review of pharmacodynamics and putative clinical roles.
Therapeutic Advances in Psychopharmacology,4(4), 156–169.
Boelen, P., de Keijser, J., van den Hout, M., & van den Bout, J. (2007). Treatment of
complicated grief: A comparison between cognitive-behavioral therapy and supportive
counseling. Journal of Consulting and Clinical Psychology,75(2), 277–284.
Boelen, P., van den Hout, M., & van den Bout, J. (2006). A cognitive-behavioral con-
ceptualization of complicated grief. Clinical Psychology: Science and Practice,13(2),
Bogensperger, J., & Lueger-Schuster, B. (2014). Losing a child: Finding meaning in
bereavement. European Journal of Psychotraumatology,5(0), 1–9.
Bond, F., Hayes, S., Baer, R., Carpenter, K., Guenole, N., Orcutt, H. K., ...Zettle, R. D.
(2011). Preliminary psychometric properties of the acceptance and action question-
naire–II: A revised measure of psychological inflexibility and experiential avoidance.
Behavior Therapy,42(4), 676–688.
20 OMEGA—Journal of Death and Dying 0(0)
Bouso, J., Gonza
´lez, D., Fondevila, S., Cutchet, M., Ferna
´ndez, X., Ribeiro Barbosa, P.,
´rcoles, M. A
´., ...Riba, J. (2012). Personality, psychopathology, life atti-
tudes and neuropsychological performance among ritual users of ayahuasca: A lon-
gitudinal study. PLoS ONE,7(8), e42421.
Bowlby, J. (1977). The making and breaking of affectional bonds. II. Some principles of
psychotherapy. The fiftieth Maudsley lecture. The British Journal of Psychiatry,
130(5), 421–431.
Boyer, E. W., & Shannon, M. (2005). The serotonin syndrome. New England Journal of
Medicine,352(11), 1112–1120.
Calhoun, L., Tedeschi, R., Cann, A., & Hanks, E. (2010). Positive outcomes following
bereavement: Paths to posttraumatic growth. Psychologica Belgica,50(1–2), 125.
Currier, J., Neimeyer, R., & Berman, J. (2008). The effectiveness of psychotherapeutic
interventions for bereaved persons: A comprehensive quantitative review.
Psychological Bulletin. 2008,134(5), 648–661.
Darbyshire, P., Cleghorn, A., Downes, M., Elford, J., Gannoni, A., McCullagh, C., &
Shute, R. (2012). Supporting bereaved parents: A phenomenological study of a tele-
phone intervention programme in a paediatric oncology unit. Journal of Clinical
Nursing,22(3–4), 540–549.
Davis, C., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting
from the experience: Two construals of meaning. Journal of Personality and Social
Psychology,75(2), 561–574.
´, E., Soler, J., Elices, M., Pascual, J., A
´lvarez, E., de la Fuente Revenga,
M., ...Riba, J. (2016). Ayahuasca: Pharmacology, neuroscience and therapeutic
potential. Brain Research Bulletin,126, 89–101.
Dos Santos, R. (2013). Safety and side effects of ayahuasca in humans—An over-
view focusing on developmental toxicology. Journal of Psychoactive Drugs,45(1),
Dos Santos, R., Grasa, E., Valle, M., Ballester, M., Bouso, J., Nomdede
´u, J., ...Riba, J.
(2012). Pharmacology of ayahuasca administered in two repeated doses.
Psychopharmacology,219(4), 1039–1053.
Dos Santos, R., Landeira-Fernandez, J., Strassman, R., Motta, V., & Cruz, A. (2007).
Effects of ayahuasca on psychometric measures of anxiety, panic-like and hopelessness
in Santo Daime members. Journal of Ethnopharmacology,112(3), 507–513.
Faschingbauer, T. R. (1981). The Texas revised inventory of grief manual. Houston, TX:
Fitzgerald, J. (1988). Vivid memories and the reminiscence phenomenon: The role of a
self narrative. Human Development,31(5), 261–273.
Field, N.P. (2006). Continuing bonds in adaptation to bereavement: Introduction. Death
Studies,30, 709–714.
Fontanilla, D., Johannessen, M., Hajipour, A., Cozzi, N., Jackson, M., & Ruoho, A.
(2009). The hallucinogen n,n-dimethyltryptamine (DMT) is an endogenous sigma-1
receptor regulator. Science,323(5916), 934–937.
Gable, R. (2007). Risk assessment of ritual use of oral dimethyltryptamine (DMT) and
harmala alkaloids. Addiction,102(1), 24–34.
Gamino, L. A., Sewell, K. H., & Easterling, L. W. (2000). Scott and White grief
study—Phase 2: Toward an adaptive model of grief. Death Studies,24, 633–660.
´lez et al. 21
´a, J., Landa Petralanda, V., Trigueros Manzano, M., & Gaminde Inda, I. (2005).
Inventario Texas Revisado de Duelo (ITRD): Adaptacio
´n al castellano, fiabilidad y
validez. Atencio
´n Primaria,35(7), 353–358.
Geron, Y., Ginzburg, K., & Solomon, Z. (2003). Predictors of bereaved parents’ satis-
faction with group support: An Israeli perspective. Death Studies,27(5), 405–426.
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward
a model of meaning reconstruction in bereavement. Journal of Constructivist
Psychology,19(1), 31–65.
Gillies, J., Neimeyer, R. A., & Milman, E. (2014). The meaning of loss codebook:
Construction of a system for analyzing meanings made in bereavement. Death
Studies,38(1–5), 207–216.
Gowda, M. R., Srinivasa, P., Kumbar, P. S., Ramalingaiah, V. H., Muthyalappa, C., &
Durgoji, S. (2016). Rapid resolution of grief with IV infusion of ketamine: A unique
phenomenological experience. Indian Journal of Psychological Medicine,38(1), 62–64.
Grabowski, J., & Frantz, T. T. (1993). Latinos and anglos: Cultural experiences of grief
intensity. Omega,26(4), 273–285.
Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing
research: Concepts, procedures and measures to achieve trustworthiness. Nurse
Education Today,24(2), 105–112.
Halpern, J. H., Sherwood, A. R., Passie, T., Blackwell, K. C., & Ruttenber, A. J. (2008).
Evidence of health and safety in American members of a religion who use a hallu-
cinogenic sacrament. Medical Science Monitor,14(8), 15–22.
Harris, R., & Gurel, L. (2012). A study of ayahuasca use in North America. Journal of
Psychoactive Drugs,44(3), 209–215.
Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis.
Qualitative Health Research,15(19), 1277–1288.
Janoff-Bulman, R. (1992). Shattered assumptions. New York, NY: Free Press.
Jordan, J. R., & Neimeyer, R. A. (2003). Does grief counseling work? Death Studies,
27(9), 765–786.
´, V., & Simonova
´, H. (2015). Ayahuasca tourism: Participants in shamanic
rituals and their personality styles, motivation, benefits and risks. Journal of
Psychoactive Drugs,47(5), 351–359.
Klass, D. (2006). Continuing conversation about continuing bonds. Death Studies,30(9),
Klingspon, K. L., Holland, J. M., Neimeyer, R. A., & Lichtenthal, W. G. (2015).
Unfinished business in bereavement. Death Studies,39(7), 387–398.
Labate, B. C., & Feeney, K. (2012). Ayahuasca and the process of regulation in Brazil
and internationally: Implications and challenges. International Journal of Drug Policy,
23(2), 154–161.
Lewis, S. E. (2008). Ayahuasca and spiritual crisis: Liminality as space for personal
growth. Anthropology of Consciousness,19(2), 109–133.
Lichtenthal, W., Currier, J., Neimeyer, R., & Keesee, N. (2010). Sense and significance: A
mixed methods examination of meaning making after the loss of one’s child. Journal of
Clinical Psychology,66(7), 791–812.
Lichtenthal, W. G., & Cruess, D. G. (2010). Effects of directed written disclosure on grief
and distress symptoms among bereaved individuals. Death Studies,34(6), 475–499.
22 OMEGA—Journal of Death and Dying 0(0)
Lundorff, M., Holmgren, H., Zachariae, R., Farver-Vestergaard, I., & O’Connoer, M.
(2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic
review and meta-analysis. Journal Affective Disorder,212, 138–149.
McCreight, B. (2004). A grief ignored: Narratives of pregnancy loss from a male perspec-
tive. Sociology of Health and Illness,26(3), 326–350.
Meister, R., von Wolff, A., Mohr, H., Ha
¨rter, M., Nestoriuc, Y., Ho
¨lzel, L. & Kriston, L.
Comparative safety of pharmacologic treatments for persistent depressive disorder: A
systematic review and network meta-analysis. Plos One, 11(5), e0153380.
Metzner, R. (2006). Sacred vine of spirits: Ayahuasca. Rochester, VT: Park Street Press.
Murphy, F. A., Lipp, A., & Powles, D. L. (2012). Follow-up for improving psychological
well being for women after a miscarriage. Crohane Database Systematic Review,14(3),
Murphy, S. (2000). The use of research findings in bereavement programs: A case study.
Death Studies,24(7), 585–602.
Neimeyer, R. (2001). Meaning reconstruction and the experience of loss. Washington, DC:
American Psychological Association.
Neimeyer, R. (2004). Fostering posttraumatic growth: A narrative elaboration.
Psychological Inquiry,15(1), 53–59.
Neimeyer, R. (2006). Bereavement and the quest for meaning: Rewriting stories of loss
and grief. Hellenic Journal of Psychology,3(3), 181–188.
Neimeyer, R. (2016). Meaning reconstruction in the wake of loss: Evolution of a research
program. Behaviour Change,33(02), 65–79.
Neimeyer, R. A. (2012). Retelling the narrative of the death. In R. Neimeyer (Ed.),
Techniques of grief therapy: Creative practices for counseling the bereaved
(pp. 86–90). New York, NY: Routledge.
Neimeyer, R., & Sands, D. C. (2011). Meaning reconstruction in bereavement: From
principles to practice. In R. Neimeyer, D. Harris, H. Winokeur & G. Thornton
(Eds.), Grief and Bereavement in Contemporary Society: Brinding research and practice
(pp. 9–22). New York, NY: Routledge.
O’Callaghan, C., McDermott, F., Hudson, P., & Zalcberg, J. (2013). Sound continuing
bonds with the deceased: The relevance of music, including preloss music therapy, for
eight bereaved caregivers. Death Studies,37(2), 101–125.
´rio, F., Sanches, R., Macedo, L., dos Santos, R., Maia-de-Oliveira, J., Wichert-Ana,
L., ...Hallak, J. E. (2015). Antidepressant effects of a single dose of ayahuasca in
patients with recurrent depression: A preliminary report. Revista Brasileira de
Psiquiatria,37(1), 13–20.
Park, C. (2010). Making sense of the meaning literature: An integrative review of meaning
making and its effects on adjustment to stressful life events. Psychological Bulletin,
136(2), 257–301.
Park, C., Cohen, L., & Murch, R. (1996). Assessment and prediction of stress-related
growth. Journal of Personality,64(1), 71–105.
Patton, M. (2002). Two decades of developments in qualitative inquiry: A personal,
experiential perspective. Qualitative Social Work,1(3), 261–283.
Peri, T., Hasson-Ohayon, I., Garber, S., Tuval-Mashiach, R., & Boelen, P. (2016).
Narrative reconstruction therapy for prolonged grief disorder—Rationale and case
study. European Journal of Psychotraumatology,4(7), 30687.
´lez et al. 23
Peters, K., Cunningham, C., Murphy, G., & Jackson, D. (2016). Helpful and unhelpful
responses after suicide: Experiences of bereaved family members. International Journal
of Mental Health Nursing,25(5), 418–425.
Potter, W. J., & Levine-Donnerstein, D. (1999). Rethinking validity and reliability in
content analysis. Journal of Applied Communication Research,27(3), 258–284.
Prayag, G., Mura, P., Hall, M., & Fontaine, J. (2015). Drug or spirituality seekers?
Consuming ayahuasca. Annals of Tourism Research,52, 175–177.
Prigerson, H., Horowitz, M., Jacobs, S., Parkes, C., Aslan, M., Goodkin, K.,...
Maciejewski, P. K. Prolonged grief disorder: Psychometric validation of criteria pro-
posed for DSM-V and ICD-11. PLoS Medicine, 6(8), e1000121.
Reilly-Smorawski, B., Armstrong, A., & Catlin, E. (2002). Bereavement support for
couples following death of baby: Program development and 14 year exit analysis.
Death Studies,26(1), 21–37.
Riba, J., Rodrı
´guez-Fornells, A., Urbano, G., Morte, A., Antonijoan, R., Montero,
M., ...Barbanoj, M. J. (2001). Subjective effects and tolerability of the South
American psychoactive beverage Ayahuasca in healthy volunteers.
Psychopharmacology,154(1), 85–95.
Riba, J., Valle, M., Urbano, G., Yritia, M., Morte, A., & Barbanoj, M. J. (2003). Human
pharmacology of ayahuasca: Subjective and cardiovascular effects, monoamine
metabolite excretion, and pharmacokinetics. Journal of Pharmacology and
Experimental Therapeutics,306(1), 73–83.
Rosner, R. (2015). Prolonged grief: Setting the research agenda. European Journal of
Psychotraumatology,6(0), 27303.
Rosner, R., Pfoh, G., & Kotouc
´, M. (2011). Treatment of complicated grief. European
Journal of Psychotraumatology,2(0).
Ruiz, F. J., Luciano, C., Cangas, A. J., & Beltra
´n, I. (2013). Measuring experiential
avoidance and psychological inflexibility: The Spanish version of the acceptance and
action questionnaire-II. Psicothema,25(1), 123–129.
Russac, R., Steighner, N., & Canto, A. (2002). Grief work versus continnuing bonds: A
call for paradigm integration or replacement? Death Studies,26(6), 463–478.
Sanches, R., de Lima Oso
´rio, F., dos Santos, R., Macedo, L., Maia-de-Oliveira, J., Wichert-
Ana, L., ...Hallak, J. E. (2016). Antidepressant effects of a single dose of ayahuasca in
patients with recurrent depression. Journal of Clinical Psychopharmacology,36(1), 77–81.
´nchez, C., & Bouso, C. (2015). Ayahuasca: From the Amazon to the global village.
Drug Policy Briefing,43, 1–23.
Schut, H., & Stroebe, M. (2005). Interventions to enhance adaptation to bereavement.
Journal of Palliative Medicine,8(supplement 1): s-140–s-147.
Schut, H., Stroebe, M. S., Van den Bout, J., & Terheggen, M. (2001). The efficacy of
bereavement interventions: Determining who benefits. Washington, DC: Sage.
Schultes, R. E., & Hofmann, A. (1992). Plants of the gods: Their sacred, healing, and
hallucinogenic powers. Richester, VT: Healing Art Press.
Shear, M. (2010). Complicated grief treatment: The theory, practice and outcomes.
Bereavement Care,29(3), 10–14.
Smid, G., Kleber, R., de la Rie, S., Bos, J., Gersons, B., & Boelen, P. (2015). Brief eclectic
psychotherapy for traumatic grief (BEP-TG): Toward integrated treatment of symp-
toms related to traumatic loss. European Journal of Psychotraumatology,6(0), 27324.
24 OMEGA—Journal of Death and Dying 0(0)
Stevenson, M., Achille, M., Liben, S., Proulx, M., Humbert, N., Petti, A., ...Cohen, S. R.
(2016). Understanding how bereaved parents cope with their grief to inform the ser-
vices provided to them. Qualitative Health Research,4, pii.
Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement:
Rationale and description. Death Studies,23(3), 197–224.
Szmulewicz, A., Valerio, M., & Smith, J. (2015). Switch to mania after ayahuasca con-
sumption in a man with bipolar disorder: A case report. International Journal of
Bipolar Disorders,24(3), 4.
Tedeschi, R., & Calhoun, L. (2004). Posttraumatic growth: Conceptual foundations and
empirical evidence. Psychological Inquiry,15(1), 1–18.
Trichter, S., Klimo, J., & Krippner, S. (2009). Changes in spirituality among ayahuasca
ceremony novice participants. Journal of Psychoactive Drugs,41(2), 121–134.
Tupper, K. (2008). The globalization of ayahuasca: Harm reduction or benefit maximiza-
tion? International Journal of Drug Policy,19(4), 297–303.
Uren, T., & Wastell, C. (2002). Attachment and meaning-making in perinatal bereave-
ment. Death Studies,26(4), 279–308.
Waller, A., Turon, H., Mansfield, E., Clark, K., Hobden, B., & Sanson-Fisher, R. (2015).
Assisting the bereaved: A systematic review of the evidence for grief counselling.
Palliative Medicine,30(2), 132–148.
Walter, T. (1999). On bereavement: The culture of grief. Buckingham, England: Open
University Press.
Wagner, B., Knaevelsrud, C., & Maercker, A. (2006). Internet-based cognitive-behavioral
therapy for complicated grief: A randomized controlled trial. Death Studies,30(5),
Wenn, J., O’Connor, M., Breen, L. J., Kane, R. T., & Rees, C. S. (2015). Efficacy of
metacognitive therapy for prolonged grief disorder: Protocol for a randomised con-
trolled trial. BMJ Open,5(12), e007221.
Wetherell, J. L. (2012). Complicated grief therapy as a new treatment approach.
Dialogues in Clinical Neuroscience,14(2), 159–166.
Zisook, S., & Shear, K. (2009). Grief and bereavement: What psychiatrists need to know.
World Psychiatry,8(2), 67–74.
Author Biographies
´bora Gonza
´lez is a clinical psychologist with a PhD in Pharmacology. Her
Masters research and PhD studies received a pre-doctoral fellowship granted by
the Ministry of Health for a 36-months project at the Department of Human
Pharmacology and Clinical Neurosciences and Drug Addiction Unit
(IMIM—Hospital del Mar Medical Research Institute). She is coauthor of sev-
eral scientific papers and book chapters about ayahuasca, 2C-B, Salvia divi-
norum, and research chemicals. Actually, she is leading a longitudinal
research project conducted with Beckley Foundation at the Temple of the
Way of Light on the long term effects of ayahuasca on well-being and psycho-
pathological symptoms of Western users.
´lez et al. 25
´a Carvalho is a clinical psychologist and a doctor and MSc in Psychology.
She is a lecturer at the Faculty of Education and Psychology—Catholic
University of Porto and a researcher at the Centre for Studies in Human
Development at the same University. She has been vice-president of the
International Center for Ethnobotanical Education Research and Service since
2008 and Kosmicare project manager (Crisis Intervention in Situations Related
to Psychoactive Substance Use in Recreational Environments) since 2010. She
has been lecturing and researching in the field of Qualitative Research and
Nvivo Software for qualitative data analysis since 2006. She is an author of a
number of publications about psychoactive substance uses especially among.
Jordi Cantillo graduaded with a degree in Statistics at the Polytechnic University
of Catalonia. He currently works at the IMIM—Institut Hospital del Mar
d’Investigacions Me
`diques as Data Manager in the projects PANPAIN
(Efficacy of Pregabaline in the treatment of pain of pancreas cancer),
TKAPAIN (Painful knee protesis: relacionship between endogenous analgesia
and persisting post-operation pain), and for a project on the safety of the
analgesic epidural. He also collaborates in the project GENDOLCAT (cronifi-
cation of pain after the inguinal heniorraphy, histerectomy, and cardiotoracy:
Analysis of the predictive factors and association with genetic polymorphisms).
He has written various medical publications and scientific communications.
Marc Aixala
´is a telecommunication engineer and psychologist with post degree
studies in Integrative Psychotherapy and Strategic Therapy, and is trained in the
therapeutic use of Non-Ordinary States of Consciousness, and in MDMA
assisted-psychotherapy for PTSD. He works as a psychotherapist in
Barcelona, is a Holotropic Breathwork facilitator, and a member of the staff
for Grof Transpersonal Training.
´is medical doctor and specialist in Clinical Pharmacology. Actually,
he is the head of the Clinical Pharmacology Unit at Hospital Universitari
Germans Trias I Pujol in Badalona and professor of Pharmacology at the
School of Medicine of the Universitat AutŒnoma de Barcelona. During the
last 20 years has worked in the human pharmacology of different substances
including MDMA, GHB, flunitrazepam, tramadol, cannabis, and alcohol and
its interactions. In recent years, he has collaborated in some European projects
about Novel/New Psychoactive Substances. His recent investigations include the
acute pharmacological effects of 2C-B and mephedrone in humans. In addition,
he has been interested in the pharmacological treatment of addictions (mainly
cocaine) and the therapeutic use of cannabis and hallucinogen drugs.
26 OMEGA—Journal of Death and Dying 0(0)
... Grief also seems to be improved through the ayahuasca experience. González et al. [36] developed a study where they explored the effects of ayahuasca consumption on grief. To this end, they designed a study that measured the level of grief and experiential avoidance in 30 people who participated in peer support groups compared to 30 people who took ayahuasca [36]. ...
... González et al. [36] developed a study where they explored the effects of ayahuasca consumption on grief. To this end, they designed a study that measured the level of grief and experiential avoidance in 30 people who participated in peer support groups compared to 30 people who took ayahuasca [36]. The results indicate that ayahuasca consumers showed benefits in some psychological and interpersonal dimensions since the level of grief was lower on the Present Feelings Scale of the Revised Texas Grief Inventory [36]. ...
... To this end, they designed a study that measured the level of grief and experiential avoidance in 30 people who participated in peer support groups compared to 30 people who took ayahuasca [36]. The results indicate that ayahuasca consumers showed benefits in some psychological and interpersonal dimensions since the level of grief was lower on the Present Feelings Scale of the Revised Texas Grief Inventory [36]. This group also described, in an open-ended question, biographical memories, emotional release and experiences of contact with the deceased [36]. ...
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Traditional therapies, resorting to the use of plants, have acquired a great demand over the years, both for economic reasons and the preference for natural treatments. Some studies suggest that ayahuasca may have beneficial properties in treating some physical and psychological imbalances. Thus, we carried out a systematic review of studies published up to December 2022, where these themes were addressed. The search was carried out in the PubMed database, and only studies written in English and published in peer-reviewed journals were included. Thus, 228 publications were identified, of which 66 were included in the present study. The reviewed studies suggest that ayahuasca may have beneficial effects on various physical and psychological conditions, namely in the treatment of depression, anxiety and various diseases of the neurobiological system, as well as anti-inflammatory and antimicrobial properties, demonstrating its therapeutic potential. The number of studies that address this issue has also been growing, demonstrating interest in the search for alternative treatments. However, to the best of our knowledge, this is the first systematic review where all the findings of therapeutic effects associated with the consumption of ayahuasca are reviewed.
... One exploratory observational study (González et al., 2017;n = 30) and a one-year follow-up to that same study (González et al., 2020;n = 50) found significant reduction in grief associated with the death of a first-degree relative (parent, sibling, spouse, child) after participating in traditional ayahuasca ceremonies at an Amazonian ayahuasca retreat center. In the mixedmethods observational study, González et al. (2017) compared the ayahuasca-drinking participants with 30 people who had attended peer support groups and found that people who drank ayahuasca had lower reported levels of grief than the comparison group. ...
... One exploratory observational study (González et al., 2017;n = 30) and a one-year follow-up to that same study (González et al., 2020;n = 50) found significant reduction in grief associated with the death of a first-degree relative (parent, sibling, spouse, child) after participating in traditional ayahuasca ceremonies at an Amazonian ayahuasca retreat center. In the mixedmethods observational study, González et al. (2017) compared the ayahuasca-drinking participants with 30 people who had attended peer support groups and found that people who drank ayahuasca had lower reported levels of grief than the comparison group. Significant reported themes from ayahuasca drinkers included emotional release, biographical memories, and contact with the deceased, all of which were reported to be helpful in bereavement acceptance and letting go (González et al., 2020). ...
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A rapid review synthesizing published research on the possible therapeutic applications of psychedelics.
... These gains were maintained over a one-year followup period. A qualitative study that analyzed descriptions of an ayahuasca experience among bereaved individuals found that participants commonly experienced contact with the deceased, emotional confrontation and release, reorganization of one's identity, changes in the internal representation of the deceased, and personal growth (González et al. 2019). ...
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Grief, a common reaction to loss, can frequently become problematic or impairing. Available treatments for prolonged grief disorder are promising but leave room for considerable improvement. Qualitative accounts of psychedelic experiences after bereavement reveal themes that parallel core components of prolonged grief disorder therapy. However, few studies have investigated the therapeutic potential of psychedelics for symptoms of grief. The present study surveyed recreational psychedelic users (N = 363) who had suffered a bereavement event. They reported retrospective grief symptoms before and after the psychedelic experience as well as subjective reactions to the psychedelic, including emotional breakthroughs and challenging experiences. Results indicate improvements in grief symptoms after a psychedelic experience, with a large effect size (Cohen's d = 0.83). The occurrence of emotional breakthroughs was positively associated with improvements in symptoms of grief, while the converse relation was observed for challenging experiences. Findings provide preliminary evidence that support the development of a psychedelic-assisted therapy protocol to target symptoms of grief. Psychedelic-assisted therapy might offer an alternative to current grief treatment options.
... Our principle finding was that reexperiencing adverse life events was common among all participants, with four in ten non-veteran participants reporting reexperiencing of adverse life events, and over a quarter reporting reexperiencing of more severe adverse life events, i.e., excluding stressful experiences and sexually uncomfortable experiences. These observations are consistent with observations from clinical trials 17,18,20 and naturalistic studies 21,22 of autobiographical reexperiencing under psilocybin and ayahuasca. Participants notably rated their reexperiences at a relatively high intensity (i.e., average rating of 3.94 out of 5 for adverse life events), which is consistent with Carhart-Harris and colleagues' 12 observations of functional hyperactivation of visual and sensory brain areas and vivid subjective recollections under LSD when cued to recollect autobiographical memories. ...
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The present study examined the safety and efficacy of the ceremonial use of ayahuasca in relation to reports of heightened life event reexperiencing under psychedelics. The study examined (1) the prevalence of specific types of adverse life event reexperiencing, (2) characteristics predictive of reexperiencing, (3) the psychological character of reexperiencing, and (4) the impact of reexperiencing on mental health. Participants were recruited from three ayahuasca healing and spiritual centers in South and Central America (N = 33 military veterans, 306 non-veterans) using self-report data at three timepoints (Pre-retreat, Post-retreat, 3-months post-retreat). Reexperiencing adverse life events under ayahuasca was common, with women showing particularly high probability of reexperiencing sexual assault, veterans reexperiencing combat-related trauma, and individuals with a self-reported lifetime diagnosis of post-traumatic stress disorder exhibiting a substantively higher prevalence of reexperiencing. Reexperiencing was associated with states of cognitive reappraisal, psychological flexibility, and discomfort during ceremonies, and participants who reexperienced adverse life events exhibited greater reductions in trait neuroticism following their ceremonies. Clinical implications of these results for the application of psychedelics to mood and stress disorders are discussed.
... Both the alignment process and the strengthening of social ties are aspects that allow non-native users, when they attend ayahuasca ceremonies, to find better health as a result [10,11]. Biomedical scientists are now interested in finding clinical applications for ayahuasca, having found improvements in clinical and non-clinical conditions like affective disorders [12][13][14][15][16], drug dependence [17,18], emotional regulation in personality disorders [19], grief [20,21], mindfulness and psychological flexibility capabilities [22][23][24][25][26][27], creativity [28,29], neuropsychological performance [30], human neuroplasticity [31], and some other psychological and physical diseases of contemporary civilization [32]. ...
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Introduction Ayahuasca is a plant-based decoction native to Amazonia, where it has a long history of use in traditional medicine. Contemporary ritual use of ayahuasca has been expanding throughout the world for mental health purposes, and for spiritual and personal growth. Although researchers have been conducting clinical trials and observational studies reporting medical and psychological benefits, most of these do not report ayahuasca’s immediate or medium-term adverse effects, so these are underrepresented in the literature. With the expansion of ayahuasca ceremonies from their traditional contexts to countries around the world, there is an important public health question regarding the risk/benefit balance of its use. Methods We used data from an online Global Ayahuasca Survey (n = 10,836) collected between 2017 and 2019 involving participants from more than 50 countries. Principal component analysis was performed to assess group effects. Logistic regression analysis was performed to test for adverse effects associated with history of ayahuasca use, clinical, context of use and spiritual effect variables. Results Acute physical health adverse effects (primarily vomiting) were reported by 69.9% of the sample, with 2.3% reporting the need for subsequent medical attention. Adverse mental health effects in the weeks or months following consumption were reported by 55.9% of the sample, however, around 88% considered such mental health effects as part of a positive process of growth or integration. Around 12% sought professional support for these effects. Physical adverse effects were related to older age at initial use of ayahuasca, having a physical health condition, higher lifetime and last year ayahuasca use, having a previous substance use disorder diagnosis, and taking ayahuasca in a non-supervised context. Mental health adverse effects were positively associated with anxiety disorders; physical health conditions; and the strength of the acute spiritual experience; and negatively associated with consumption in religious settings. Conclusions While there is a high rate of adverse physical effects and challenging psychological effects from using ayahuasca, they are not generally severe, and most ayahuasca ceremony attendees continue to attend ceremonies, suggesting they perceive the benefits as outweighing any adverse effects. Knowing what variables might predict eventual adverse effects may serve in screening of, or providing additional support for, vulnerable subjects. Improved understanding of the ayahuasca risk/benefit balance can also assist policy makers in decisions regarding potential regulation and public health responses.
... Furthermore, ayahuasca participants were more likely to answer affirmatively to survey questions regarding psychological dimensions central for grief processes, including reexperiencing forgotten events with the deceased, forgiving, generating new meanings for their life history, and integrating transcendental dimensions of life and death. Qualitative self-reports described experiences of emotional release, biographical memories, and contact with the deceased ( González et al., 2019 ). ...
The therapeutic potential of the psychedelic brew ayahuasca has been investigated in preclinical and clinical studies. Currently, the most consistent evidence refers to depression. However, various studies suggest that ayahuasca may comprise therapeutic benefits in other health conditions. This narrative review provides a comprehensive, up-to-date overview of ayahuasca's therapeutic effects in diverse clinical conditions in human (clinical, cross-sectional, observational, and qualitative) and preclinical (animal and in vitro) studies. In addition to summarizing and discussing the most commonly studied conditions, such as depression, anxiety, and substance use disorders (SUD), we also examine less frequently studied psychiatric, neurological, and physical conditions. Moreover, we discuss evidence from epidemiological studies on the impact of regular, long-term ayahuasca use on health and psychosocial outcomes. Overall, evidence for depression and SUD is more consistent, with numerous and diverse studies. However, a growing body of evidence suggests that other conditions equally relevant to public health might be promising targets for ayahuasca's therapeutic effects. This includes preliminary studies indicating potential for grief, eating disorders, posttraumatic stress disorder, personality disorders, Parkinson's and Alzheimer's disease, and severe physical illnesses (e.g., cancer, chronic conditions). Moreover, preliminary evidence in long-term ayahuasca users does not suggest detrimental effects but possible benefits for individual and collective health. In light of the emerging evidence of psychedelic drugs as therapeutic agents, it is essential to further investigate in rigorous designs the therapeutic potential of ayahuasca in conditions other than depression.
... Zbavuje negativních myšlenek, předsudků, přetvářek, arogance, agresivity, egoismu a strachu. Pozoruhodné je potencionální využití ayahuascy v paliativní péči o pacienty, kteří trpí nějakou nevyléčitelnou nemocí v pokročilém nebo terminálním stadiu (Ellens, 2009;González et al., 2017). Může totiž uživateli zprostředkovat prožitek blízké smrti (angl. ...
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The COVID-19 pandemic has had a devastating impact on the health and wellbeing of the global population. This paper presents the results of a longitudinal transcultural study that was begun at the peak of the pandemic (in April, 2020). An online survey was used to collect data from English-, Spanish-, and Portuguese-speaking participants. The survey collected information about sociodemographics, lifestyle activities, COVID-19-related circumstances, and drug use (with an emphasis on hallucinogenic drugs), as well as involving psychometric questionnaires. Users of hallucinogenic drugs had higher psychological well-being and lower scores on psychopathology scales, both at baseline and during follow-ups. This difference was larger when users were distinguished by frequency of use, as regular users scored higher on psychological well-being and lower on psychopathology scales. Subjects with more psychological distress had lower scores for all scales of post-traumatic growth, but if they were regular hallucinogens users, they had higher scores for post-traumatic growth. When comparing the results between cultural contexts, heterogeneous results were obtained. There were more English-speaking regular users of hallucinogenic drugs. Further research should analyse the potential role of hallucinogens in large-scale catastrophes, with a special focus on post-traumatic growth.
Metaphors, analogies, and similes commonly appear in narratives of drinking the potent psychedelic "ayahuasca", presenting an intriguing transcultural pattern. Based upon survey and field research at an ayahuasca healing center in Pucallpa, Peru, the article investigates conceptual metaphors in narratives of ayahuasca experiences made by the visiting international guests. Bodily metaphors and visionary analogies frequently appear in narrative plots where they can express the reappraisal, overcoming, and sometimes emboldening of symptoms diagnosed by psychiatry. Moving beyond the literal-figurative divide, the article explores the intrinsic "metaphoricity" of psychedelic experiences and advocates for a literacy of conceptual metaphors regarding both clinical and non-clinical psychedelic narratives. Developing this literacy can broaden approaches in psychedelic psychiatry that analyze and treat syndromes and disorders, while also being applicable to social science and humanities research that examine psychoactive drug use beyond medical frameworks.
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Ayahuasca is a psychoactive Amazonian plant brew. It is usually made from the Banisteriopsis caapi vine (Spruce ex Griseb. Morton, Malpighiaceae), which contains three primary harmala alkaloids, along with the leaves of Psychotria viridis (Ruiz et Pavon, Rubiaceae) in which the potent psychedelic dimethyltryptamine (DMT) is found. DMT-harmaloid concoctions have gained popularity in recent years, due to growing anecdotal and scientific reports of therapeutic benefits associated with their consumption. Ayahuasca is now ingested in a variety of different settings across the globe, from traditional ethnobotanical to so called “neo-shamanic” ceremonies. Furthermore, related preparations involving alternative sources of DMT and harmala alkaloids are becoming increasingly common as knowledge of ayahuasca continues to spread internationally. This article reviews the existing literature and draws on original qualitative data from a large cross-sectional study of ayahuasca drinkers, to propose a model of psychotherapeutic processes associated with the consumption of ayahuasca. We assert that it is these processes, facilitated by a range of neurobiological effects, that lead to beneficial mental health and wellbeing outcomes. Our proposed model identifies five key psychotherapeutic processes or effects inherent to the ayahuasca experience; somatic effects; introspection and emotional processing; increased Self-connection; increased spiritual connection, and finally the gaining of insights and new perspectives. We note some important differences in these processes compared with other classic psychedelics as well as the implications of the model for the therapeutic use of ayahuasca. Improved understanding of the psychotherapeutic processes involved with the ayahuasca experience will better equip practitioners to work with this potentially transformative concoction and enable the optimization of therapeutic treatment models for potential clinical use.
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We aimed to compare the safety of antidepressants for the treatment of persistent depressive disorder (PDD) with each other and with placebo. We conducted a systematic electronic search and included randomized controlled trials that investigated antidepressants for the treatment of PDD in adults. Outcomes were the incidence of experiencing any adverse event, specific adverse events and related treatment discontinuations. We analyzed the data using traditional and network meta-analyses. Thirty-four studies that comprised 4,769 patients and examined 20 individual agents in nine substance classes were included. Almost all analyzed substance classes were associated with higher discontinuation rates than placebo including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), antipsychotics, and the serotonin antagonist and reuptake inhibitor (SARI) trazodone. The odds of experiencing any adverse event were significantly higher for TCAs and serotonin noradrenaline reuptake inhibitors (SNRIs) compared to placebo. Pairwise comparisons among the substance classes revealed that more patients receiving TCAs or SNRIs experienced any adverse event and that more patients receiving TCAs or the SARI trazodone discontinued treatment. The complementary treatment with acetyl-l-carnitine showed lower rates of experiencing any adverse event and related discontinuations than all other comparators. TCAs were primarily associated with (anti-)cholinergic and sedating adverse events. SSRIs primarily showed gastrointestinal adverse events. Patients treated with the antipsychotic amisulpride were more likely to manifest weight gain and endocrine adverse events. The comparative evidence for further agents was insufficient or lacking. The identified safety differences may be used to inform the selection among the antidepressants.
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Background: Prolonged grief disorder (PGD) is a potentially disabling condition affecting approximately 10% of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of memory, is involved in the development of PGD. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD) in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms. Objective: In light of findings that cognitive behavior therapy (CBT), including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients. Method: The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic. Results: Evaluations conducted before and after treatment and at a 3-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives. Conclusions: This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed.
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Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. © 2016 Indian Psychiatric Society | Published by Wolters Kluwer - Medknow.
Background: Prolonged grief disorder (PGD) is a bereavement-specific syndrome expected to be included in the forthcoming ICD-11. Defining the prevalence of PGD will have important nosological, clinical, and therapeutic implications. The present systematic review and meta-analysis aimed to estimate the prevalence rate of PGD in the adult bereaved population, identify possible moderators, and explore methodological quality of studies in this area. Methods: A systematic literature search was conducted in PubMed, PsycINFO, Embase, Web of Science, and CINAHL. Studies with non-psychiatric, adult populations exposed to non-violent bereavement were included and subjected to meta-analytic evaluation. Results: Fourteen eligible studies were identified. Meta-analysis revealed a pooled prevalence of PGD of 9.8% (95% CI 6.8-14.0). Moderation analyses showed higher mean age to be associated with higher prevalence of PGD. Study quality was characterized by low risk of internal validity bias but high risk of external validity bias. Limitations: The available studies are methodologically heterogeneous. Among the limitations are that only half the studies used registry-based probability sampling methods (50.0%) and few studies analyzed non-responders (14.3%). Conclusions: This first systematic review and meta-analysis of the prevalence of PGD suggests that one out of ten bereaved adults is at risk for PGD. To allocate economic and professional resources most effectively, this result underscores the importance of identifying and offer treatment to those bereaved individuals in greatest need. Due to heterogeneity and limited representativeness, the findings should be interpreted cautiously and additional high-quality epidemiological research using population-based designs is needed.
As theories of bereavement have evolved, so too have evidence-based interventions to mitigate complications in post-loss adaptation. This article reviews one line of programmatic research grounded in a conceptualisation of grieving as an attempt to reaffirm or reconstruct a world of meaning challenged by loss. Anchored in therapeutic encounters with the bereaved, a meaning reconstruction approach to loss has grown over the past 15 years to generate an increasingly substantial research base, as well as to develop and refine a wide array of contributions to psychological assessment and therapy. By summarising the major models, measures and methods resulting from this collaborative work, it offers an introduction to meaning reconstruction for those unfamiliar with it, noting its contributions to date, its areas of future development, and its relevance for clinical practice.
Individuals who are bereaved by suicide and other traumatic natured deaths are thought to be at greater risk of psychological complications, than people bereaved by other means. While it is recognized that interventions can influence the bereavement process, there remains limited communications about both helpful responses and those that may adversely influence the grieving process for the suicide bereaved. This paper presents findings from a narrative study, which sought the experiences of family members after the loss of a loved one as a result of suicide. The study findings demonstrated that responses by agencies are often insensitive and not aligned with the needs of those bereaved. We argue that training is paramount for all services to increase awareness of the needs of people bereaved by suicide and available support services. Changes to organizational policies in relation to finance support would greatly support the bereaved during their time of grief and heightened distress.
Ayahuasca is the Quechua name for a tea obtained from the vine Banisteriopsis caapi, and used for ritual purposes by the indigenous populations of the Amazon. The use of a variation of the tea that combines B. caapi with the leaves of the shrub Psychotria viridis has experienced unprecedented expansion worldwide for its psychotropic properties. This preparation contains the psychedelic 5-HT2A receptor agonist N,N-dimethyltryptamine (DMT) from P. viridis, plus β-carboline alkaloids with monoamine-oxidase-inhibiting properties from B. caapi. Acute administration induces a transient modified state of consciousness characterized by introspection, visions, enhanced emotions and recollection of personal memories. A growing body of evidence suggests that ayahuasca may be useful to treat substance use disorders, anxiety and depression. Here we review the pharmacology and neuroscience of ayahuasca, and the potential psychological mechanisms underlying its therapeutic potential. We discuss recent findings indicating that ayahuasca intake increases certain mindfulness facets related to acceptance and to the ability to take a detached view of one’s own thoughts and emotions. Based on the available evidence, we conclude that ayahuasca shows promise as a therapeutic tool by enhancing self-acceptance and allowing safe exposure to emotional events. We postulate that ayahuasca could be of use in the treatment of impulse-related, personality and substance use disorders and also in the handling of trauma. More research is needed to assess the full potential of ayahuasca in the treatment of these disorders.
Our objective was to develop a rich description of how parents experience their grief in the first year after the death of their child, and how various bereavement follow-up and support services helped them during this time, with the aim of informing follow-up and support services offered to bereaved parents. Our findings situated parents' individual experiences of coping within the social and institutional contexts in which they grieved. In the first year after the death of their child, parents regulated their intense feelings of grief through loss-oriented, restoration-oriented, and/or meaning reconstruction strategies. Often, parents' relationships with others and many of the bereavement follow-up and support services helped them in this regard. This article also explores how the results may aid service providers in accompanying parents in a way that optimizes outcomes for these parents.