“Ayahuasca turned on my mind’s eye”: Enhanced visual imagery after
ayahuasca intake in a man with “blind imagination”(aphantasia)
RAFAEL G. DOS SANTOS
1,2,3
*, SCOTTY ENYART
4
, JOSÉ CARLOS BOUSO
3
, ÒSCAR PARES
3
and JAIME E. C. HALLAK
1,2
1
Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento,
Hospital das Clínicas, Universidade de São Paulo, Ribeirão Preto, Brazil
2
National Institute of Science and Technology –Translational Medicine, Ribeirão Preto, Brazil
3
ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain
4
The Enyart Group, Los Angeles, CA, USA
(Received: April 12, 2018; revised manuscript received: June 14, 2018; accepted: June 18, 2018)
Background and aims: Aphantasia (“blind imagination”) is a poorly described condition with an uncertain etiology,
characterized by reduced or lack of voluntary visual imagery. Preliminary evidence in humans suggests that
hallucinogenic or psychedelic drugs that act as agonists of cortical 5-HT
2A
receptors [lysergic acid diethylamide,
psilocybin, and dimethyltryptamine (DMT)] enhance visual imagery. Methods: Interview and description of the
case are presented in this study. Results: A man self-diagnosed with long-lasting aphantasia that he attributed to a
traumatic separation from his father when he was young and to a difficult relationship with him described sustained
improvements in his visual imagery following ingestion of a single dose of the South American botanical hallucinogen
ayahuasca, which is rich in DMT. Although improvements were modest, they were sustained and significative for the
subject. Conclusions: It is suggested that the described improvements were possibly attributed to biological and
psychological processes, including stimulation of cortical 5-HT
2A
receptors, subsequent increased activity in the visual
cortex, enhanced imaginative andimagery capacities, and psychosomaticresolution of a previous psychological trauma.
Further trials could elucidate the role of 5-HT
2A
agonists, especially ayahuasca, in aphantasia.
Keywords: aphantasia, visual imagery, psychedelics, hallucinogens, ayahuasca
INTRODUCTION
Visual imagery is usually experienced by humans in mem-
ory processes, day-dreaming/mind-wandering, dreaming,
imagination, and creativity. Some techniques, such as
breathing exercises, imagery training, and psychoactive
drugs, can and have been used to stimulate visual imagery
and creativity (Schultes & Hofmann, 1992). The neural
basis of voluntary imagery involves activation of frontal
and parietal brain regions associated with memory and
executive functions and of occipital regions related to visual
processing (Zeman, Dewar, & Della Sala, 2015).
Aphantasia is a term proposed by Zeman et al. (2015)to
describe a rarely recognized phenomenon characterized by
“reduced or absent voluntary imagery.”The neural basis of
this apparently rare condition is not well-understood but
seems to involve deficits of information processing in the
same brain regions that are involved in visual imagery,
i.e., frontoparietal and occipital cortices. Moreover, deficits
in visual memory and other cognitive functions also seem to
be involved (Zeman et al., 2015;Zeman, Dewar, & Della
Sala, 2016). Some authors have suggested that aphantasia
may have a psychological origin, instead of an organic basis
(de Vito & Bartolomeo, 2016). Consistent with this perspec-
tive, aphantasia is often associated with depressive, anxious,
and dissociative disorders. Thus, several possible interacting
factors may contribute to this condition. To the best of the
authors’knowledge, there are no treatments for this condition.
Ayahuasca is a psychoactive botanical preparation with
a long history of ritual and therapeutic uses in the
northwestern Amazon. It is prepared by the decoction of
the stalks of the harmine-rich liana Banisteriopsis caapi
together with the leaves of the Psychotria viridis bush, which
contains dimethyltryptamine (DMT; Schultes & Hofmann,
1992). Harmine and related beta-carbolines are reversible
inhibitors of monoamine oxidase, and DMT acts as an
agonist at cortical 5-HT
2A/2C/1A
receptors. Open-label and
controlled studies showed that a single ayahuasca dose
was associated with significant reductions in depressive
symptoms in patients with treatment-resistant depression
(Palhano-Fontes et al., 2018;Sanches et al., 2016). Interest-
ingly, ayahuasca –as other agonists of cortical 5-HT
2A/2C/1A
receptors, such as lysergic acid diethylamide (LSD)
* Corresponding author: Rafael G. dos Santos, PhD; Faculdade de
Medicina de Ribeirão Preto, Departamento de Neurociências e
Ciências do Comportamento, Hospital das Clínicas, Universidade
de São Paulo, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão
Preto, São Paulo, Brazil; Phone/Fax: +55 16 3602 2703; E-mail:
banisteria@gmail.com
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License,
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and
source are credited, a link to the CC License is provided, and changes –if any –are indicated.
© 2018 The Author(s)
CASE REPORT Journal of Psychedelic Studies
DOI: 10.1556/2054.2018.008
and psilocybin –enhances visual imagery (Carhart-Harris
et al., 2016;de Araujo et al., 2012;dos Santos, Os´orio,
Crippa, & Hallak, 2016;Roseman et al., 2016).
In October 2016, the authors were contacted by a
39-year-old man, Scotty Enyart (SE), who claimed that
ayahuasca improved his aphantasia.
CASE PRESENTATION
SE believed that his symptoms began early in his life, since
he recalls from an early age that his “inner experiences were
different from others.”According to SE, he was diagnosed
with poor visual imagery in elementary, middle, and high
schools. For instance, reading never evoked visual imagery
and at the age of 16, he could not visualize the patterns of
words, and he described his spelling ability as: “was that of
an eleven-year-old and my reading comprehension was
even more delayed than my spelling.”Moreover, during
this period, he had low self-esteem and had to receive
special education classes and extended hours of practicing
tasks, including typing: “Looking back at my life it became
clear that my spelling ability developed to an age appro-
priate level only when I learned how to type. A component of
being a good speller is remembering patterns of words; so,
when someone can’t recall how to spell a word they will
visualize the word. Learning how to type allowed me to
understand words through touch, so if I can’t recall a word I
will use my fingers, muscle memory, to feel the word out.”
At that time, in the mid 1990s, there was not a formal
diagnosis of aphantasia since the term had not been pro-
posed yet. SE first noticed that he had aphantasia in 2001,
during a cognitive psychology course in his undergraduate
program, when he was 24 years old: “The professor asked us
students to close our eyes and recall an image of a clock.
Once we identified an image he then asked us to draw that
image on a piece of paper. The other students began to draw
detailed clocks. I closed my eyes several times trying to
bring forth an image of a clock, yet nothing came.”He self-
diagnosed his aphantasia in 2015 after watching a BBC
special report on a man with the same diagnosis (Gallagher,
2015). SE explained to us that: “When I close my eyes I
cannot see my wife’s face, I cannot see my children. If I close
my eyes and think about my wife or kids I sense physical
space, facial features that are unique to my wife and kids are
not seen but the feeling of these features is there. I can sense
my emotional attachment to them deeply. I can hear their
voices, I can sense their touch, but I cannot see them.”
Moreover, he told us that he does not see anything in his
dreams: “My dreams are felt spatially and emotionally but
the visual doesn’t exist. When dreaming about being chased
by a monster I can feel I am moving through space and I
experience intense fear, but the monster has no form, it is a
terrifying felt presence that is coming after me.”
SE reported that when he was a teenager, he experi-
mented with hallucinogens/psychedelics, such as LSD and
psilocybin, but according to him, these experiences were
“external”with visual effects experienced only with opened
eyes: “The settings were with others walking around during
the day hours watching walls melt in public places or seeing
people with distorted faces pass by in the parks. We all sat
around laughing and watching the lines formed by our
hands as we waved them in front of our faces.”According to
SE, these early experiences with hallucinogens brought
about meaningful experiences to him. However, there were
no eyes-closed effects on visual imagery.
While doing a PhD in psychology, he traveled to the
Amazon region to try ayahuasca. Thirty minutes after
ingesting a single dose, he began vomiting and described
the experience of being physically in the Amazon jungle,
but his mind was “back in the city”:“I saw my life being
acted out in front of me as if I was watching a play from the
balcony.”Suddenly his experience changed into fear, when
he felt “spiraling through a colorful tunnel.”The healer
started chanting and calmed him. With his eyes closed, he
saw his father, who had passed away years ago: “I could see
him clearly, hear his voice, and even smell the distinct smell
that he picked up from working in the oil fields. I was seeing
in visual imagery for the first time in my life as I laid there
with my eyes closed.”
SE then described a complex scene involving the difficult
relationship that he had with his father, who left him when
he was very young. This early separation seemed to be quite
a traumatic and painful event to SE, who later developed a
difficult relationship with his father: “My father left when I
was too young to remember. My first memory of my father
was seeing him years later and of him getting upset at me
because I didn’t know who he was. My brother and I used to
travel during the summer breaks to visit him. These visits
were pleasant but short and, as I grew older, confusing. My
father used to take me into grocery stores and put food into
my clothes and walk out of the store without paying. He
would tell me, my brother, and my step-brother to steal
televisions from the store while he distracted the store
clerk –and if we got caught he would punish us in front
of the clerk. I have many similar stories, stories that made
no sense to me, but their importance lies not in the facts but
in the pain under the stories. We were never close, and when
he eventually moved back to be closer with us, I was an
angry teenager. This anger of course made me want to
reject him, and his response was to put as much blame back
on me as he could.”
This difficult relationship persisted until the death of his
father some years: “When I was 19 he was burned in a steam
fire and developed a staph infection. We knew he was dying
and one day after my classes at the local city college I visited
him. I was alone with him and at this point he no longer was
breathing on his own, and he lay there unresponsive. The
nurse encouraged me to speak to him, saying that he could
hear me, but I couldn’t say anything. I just sat there in the
corner of the room watching his chest go up and down with
the timing of the machine. I was young and didn’t know
what to feel or how to process all of the mixed emotions. I
left without saying a word or even touching him. The next
day I was told that he had passed away.”
SE then reported that he saw his grandfather in a
peaceful place, but his father was in a state of agony since
he “could not visit my grandfather because I had not
released him from his guilt. My anger became evident to
me and I felt it in all cells in my body. I didn’t realize it was
still there after all these years. I was convinced I had
dealt with it. But it was there, and it had control over me.
2|Journal of Psychedelic Studies
dos Santos et al.
My anger transformed into hurt, a feeling of abandonment
overcame me, and then the feeling of worthlessness
became stronger than ever.”
The scene then developed into SE forgiving his father
and accepting their differences: “My father pleaded for me,
not to forgive him, but to forgive myself. He wanted me to
know that none of what I felt was my fault and he opened
himself up to make it all clear to me. I began to cry, and my
father was finally able to move on to be with my grandfa-
ther. I had forgiven him; I had forgiven myself. A drum
started to beat lightly, and it gradually intensified deep in
my heart. This vibration overcame my entire body until I
was chanting strongly aloud. I felt worthy. I felt like a good
person. When I released my father from his guilt, he
released me from my feelings of not being good.”
After the experience, SE developed the ability to visual-
ize: “I can now bring forth faint pictures in my mind. They
fade quickly but they are there. When dreaming I now see
faint, quickly fading images. It feels like this experience with
ayahuasca has slightly opened up my mind’s eye and
allowed me to experience internal images like I have never
had before. Ayahuasca turned on my mind’s eye, even if it is
faint.”
While the authors have never met him personally, he
approved and actively participated in the manuscript pro-
duction. Since we did not know SE before his experience
with ayahuasca, it was not possible to assess his imagery
skills before that time. Thus, to have an idea of his
experience, we asked SE to retrospectively answer the
Vividness of Visual Imagery Questionnaire used by Zeman
et al. (2015) in his research. SE answered the questionnaire
in December 2017 and his score was 30, which, according
to Zeman et al. (2015), would classify him in the “minimal
imagery”group (score >16, range: 17–30), compared
with the “no visual imagery”(score =16) and control
(score >57) groups. Although his score was no more than
“minimal”group, SE felt that his imagery had improved, as
reported above.
DISCUSSION
Recent neuroimaging studies with LSD and psilocybin,
agonists of cortical 5-HT
2A/2C/1A
receptors as DMT, sug-
gest that imagery is heightened by these drugs. It seems
that these drugs induce more parts of the brain to process
visual information, and that the brain interprets these
effects like “real”visual perceptions (Carhart-Harris
et al., 2016;dos Santos et al., 2016;Roseman et al.,
2016). Regarding ayahuasca, an open-label study showed
that, during an imagery task, ayahuasca induced significant
activation in the primary visual area comparable to the
activation levels of a natural image with the eyes open
(de Araujo et al., 2012).
It is interesting to note that SE reported previous use of
other hallucinogens that act as 5-HT
2A/2C/1A
agonists, such
as LSD and psilocybin, but improvements in his aphantasia
were noticed only with ayahuasca. Although these drugs
share a common pharmacological mechanism, SE reported
that his previous experiences were meaningful but at the
same time were restricted to visual alterations with opened
eyes, and usually happened in public places, such as parks,
suggesting recreational use. Although ayahuasca also has
harmine and related beta-carbolines in its composition, the
main role of these compounds in the human pharmacology
of ayahuasca seems to be restricted to the reversible inhibi-
tion of peripheral monoamine oxidase, which renders oral
DMT active. Moreover, it is highly unlikely that a single
ayahuasca dose could have induced structural, permanent
changes in SE’s brain.
Thus, another possible explanation could be related to
non-pharmacological or environmental factors, such as the
difference between the contexts where he had his experi-
ences. For instance, ayahuasca was used in a ritual and
therapeutic setting where SE experienced a meaningful
curative experience that was emotionally intense and appar-
ently cathartic. This experience was characterized not only
by visual perceptions, but also by emotionally charged
memories and insights, which seem to have caused a
psychological change in him. Those aspects were not
present in his experiences with LSD and psilocybin, which
were used in recreational contexts and did not cause mean-
ingful or emotionally intense feelings in him. Therefore, it is
plausible to speculate that his absence of voluntary imagery
was related to a confused relation with his father and thus to
a psychological origin, especially when we consider his
statement: “I traveled back in time through my visual
memory and discovered the traumatic moment in which
the mind’s eye closed.”Moreover, SE reported that “::: in
moments in which I feel most centered, most confident in
myself, the most sure of my path, is when the images are
strongest.”
The last possibility is that SE was depressed and/or had
posttraumatic stress disorder (PTSD), and ayahuasca could
have caused an antidepressant response in him (Palhano-
Fontes et al., 2018;Sanches et al., 2016). Thus, we could
speculate that the trauma could have induced a functional
deficit that was resolved by ayahuasca. However, this is
unlikely because SE did not report depressive or PTSD
symptoms.
Considering that aphantasia has a low incidence but is
usually lifelong and no treatment is available, future re-
search should assess if people with aphantasia may improve
after using ayahuasca or other serotonergic hallucinogens.
Future studies should also assess whether aphantasia is due
to trauma or something else (such as functional changes in
brain dynamics), so that the theory proposed here can be
tested.
Acknowledgements: The authors would like to thank SE for
allowing us to report his case and for participating in the
manuscript production.
Conflict of interest: RGdS is Fellow of the Brazilian
National Post-Doctorate Program (PNPD/CAPES) and
member of the ICEERS Advisory Board. JCB and OP
are ICEERS employees or collaborators. ICEERS is a
non-profit organization that promotes the scientific research
of ayahuasca. JECH receives a CNPq (Brazil) Productivity
Fellowship Award. For the remaining authors, none were
Journal of Psychedelic Studies |3
Ayahuasca and aphantasia
declared. None of the authors received any specific funding
for participating in this investigation. All authors had full
access to all the data and had final responsibility for the
decision to submit for publication.
REFERENCES
Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman, L.,
Kaelen, M., Droog, W., Murphy, K., Tagliazucchi, E.,
Schenberg, E. E., Nest, T., Orban, C., Leech, R., Williams,
L. T., Williams, T. M., Bolstridge, M., Sessa, B.,
McGonigle, J., Sereno, M. I., Nichols, D., Hellyer, P. J.,
Hobden, P., Evans, J., Singh, K. D., Wise, R. G., Curran,
H. V., Feilding, A., & Nutt, D. J. (2016). Neural correlates of the
LSD experience revealed by multimodal neuroimaging. Proceed-
ings of the National Academy of Sciences of the United States of
America, 113(17), 4853–4858. doi:10.1073/pnas.1518377113
de Araujo, D. B., Ribeiro, S., Cecchi, G. A., Carvalho, F. M.,
Sanchez, T. A., Pinto, J. P., de Martinis, B. S., Crippa, J. A.,
Hallak, J. E., & Santos, A. C. (2012). Seeing with the eyes shut:
Neural basis of enhanced imagery following ayahuasca
ingestion. Human Brain Mapping, 33(11), 2550–2560. doi:10.
1002/hbm.21381
de Vito, S., & Bartolomeo, P. (2016). Refusing to imagine? On
the possibility of psychogenic aphantasia. A commentary on
Zeman et al. (2015). Cortex, 74, 334–335. doi:10.1016/j.
cortex.2015.06.013
dos Santos, R. G., Os´orio,F.L.,Crippa,J.A.S.,&Hallak,
J. E. C. (2016). Classical hallucinogens and neuroimaging:
A systematic review of human studies. Neuroscience and
Biobehavioral Reviews, 71, 715–728. doi:10.1016/j.neu
biorev.2016.10.026
Gallagher, J. (2015). Aphantasia: A life without mental images.
Retrieved from http://www.bbc.com/news/health-34039054
(accessed on: April 12, 2018).
Palhano-Fontes, F., Barreto, D., Onias, H., Andrade, K. C.,
Novaes, M., Pessoa, J., Mota-Rolim, S., Os´orio, F. L.,
Sanches, R., dos Santos, R. G., Tofoli, L., Silveira, G.,
Yonamine, M., Riba, J., Santos, F. R. R., Silva-Junior,
A. A., Alchieri, J., Galvao-Coelho, N., Lobao-Soares, B.,
Hallak, J., Arcoverde, E., Maia-de-Oliveira, J., & de Araujo,
D. B. (2018). Rapid antidepressant effects of the psychedelic
ayahuasca in treatment-resistant depression: A randomised
placebo-controlled trial. Psychological Medicine. Advance
online publication. doi:10.1017/S0033291718001356.
Roseman, L., Sereno, M. I., Leech, R., Kaelen, M., Orban, C.,
McGonigle, J., Feilding, A., Nutt, D. J., & Carhart-Harris, R. L.
(2016). LSD alters eyes-closed functional connectivity within
the early visual cortex in a retinotopic fashion. Human Brain
Mapping, 37(8), 3031–3040. doi:10.1002/hbm.23224
Sanches, R. F., Os´orio, F., dos Santos, R. G., Macedo, L. R.,
Maia-de-Oliveira, J. P., Wichert-Ana, L., de Araujo, D. B.,
Riba, J., Crippa, J. A., & Hallak, J. E. (2016). Antidepressant
effects of a single dose of ayahuasca in patients with recurrent
depression: A SPECT study. Journal of Clinical Psycho-
pharmacology, 36(1), 77–81. doi:10.1097/JCP.00000000000
00436
Schultes, R. E., & Hofmann, A. (1992). Plants of the gods: Their
sacred, healing, and hallucinogenic powers. Rochester, VT:
Healing Arts Press.
Zeman, A., Dewar, M., & Della Sala, S. (2015). Lives without
imagery –Congenital aphantasia. Cortex, 73, 378–380.
doi:10.1016/j.cortex.2015.05.019
Zeman, A., Dewar, M., & Della Sala, S. (2016). Reflections
on aphantasia. Cortex, 74, 336–337. doi:10.1016/j.cortex.
2015.08.015
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