Proposing this to a relative/friend

Proposing an ayahuasca session to a relative or friend can be a delicate issue. It is very important that the final decision about whether or not an individual participates in an ayahuasca session is made by the individual, without any pressure of the family or friends. The person needs to take full responsibility over his/her therapeutic process and related decisions. To convince a person to take ayahuasca can be totally counterproductive and even harm their relationship with you. Better than trying to convince someone is to share objective information about its effects, potential risks and benefits. This can be found on the page interested in taking ayahuasca.

Because of the variety of contexts in which ayahuasca is offered and the large quantity of centers and people offering sessions—which includes opportunism, bad practice and lack of minimal safety standards—it is important not to just recommend a place for doing an ayahuasca session. Also, participation in a specific context often requires one to adopt the world view of the context. For example, in a shamanic context, it is often believed that the causes of a personal issue are external (e.g. spirits, witchcraft, etc.), while in a therapeutic context these causes could be interpreted as being of an intrapsychic nature. In a religious context, certain experiences could be interpreted as ‘possession states’, while they would be interpreted as the manifestation of a part of the psyche of the person in a therapeutic context.

While these differences in interpretation are not trivial, for certain people certain contexts and interpretations can make a therapeutic experience confusing.

Therefore, the first thing to do if someone wants to participate in an ayahuasca session is to identify where he/she finds themselves in life, which problems he/she experiences, how they affect the personal growth process and how they can be resolved. These elements will determine whether an ayahuasca experience could be useful or not, as well as the type of session and place one chooses.

How to support a therapeutic process

As close family members or friends, we can help by having a receptive and sincere attitude towards the changes one wants to make. It is all about facilitating the possibility of change, which is easiest if there is open dialogue about the intentions of the person who wants to make the changes. In that sense, the person going through the personal process involving the use of ayahuasca is most supported by the empathy and confidence of the family or close friends.

The evolution of a therapeutic or personal growth process can fluctuate; improvements as well as fall-backs can occur over time. This should be accepted as part of a natural process, as change is never made at once and needs time to consolidate. It is important that we, as relatives or friends, try to support the person at all moments, accepting the rhythm of his/her process without judging.

A basic attitude to support their process is to provide a safe and comfortable space and sufficient time for the person to integrate the experience in his/her daily life. Offering a listening ear without pressuring them and allowing them to share what needs to be shared can be very beneficial.

Also, we need to assume our own responsibility in the process and adapt any behavior that could inhibit its fruition.

Criteria for the selection of an appropriate place

• The price of a session is not a valid indicator of the quality of the service or therapeutic outcome.
• A pre-selection of potential participants of the ayahuasca session, based on medical and psychological exclusion criteria, reduces the risks and is a minimum guarantee for quality and professionalism.
• If the intention of partaking in the ayahuasca session is of therapeutic nature or for personal growth, it is advisable to choose a place where the sessions have a small volume of participants. The more people participate, the less the personalized attention and greater the risk in case of complications.
• There are various contexts in which ayahuasca is used, mainly: therapeutic or personal growth; religious (e.g. churches such as Santo Daime, Uniao do Vegetal or Barquinha); or shamanic. If your intention is therapeutic, the proper context should take a broader therapeutic process into account. In shamanic contexts, healing can be the focus of the session, but this is considered merely the effect of the ayahuasca or concrete intervention of the shaman. Although there are groups or centers where follow up of the personal process is offered, very often this is not the case.
• One should distrust those who offer ayahuasca as a miracle panacea. Ayahuasca can catalyze a therapeutic process, but it is not a substitute for the process.
• The possibility to maintain contact with the therapist or provider after the session is an indication of quality. It is convenient to choose a place where the integration process is taken into account and support after the session is offered.
• It is a positive indicator of professionalism if the session is facilitated by a team instead of one person. It is important to have assistants present during the session in order to help participants if necessary.
• It is wise to get in contact with those responsible for the session beforehand, so that you can form your opinion on the care they offer and the information they provide.
• Getting in touch with people that have assisted sessions at the place where you are planning to go can be very useful.
• Any form of sexual contact or other lack of professional ethics such as taking advantage of power (e.g. authority, inequality in the therapeutic relationship, etc.) should never be tolerated.
• The best selection criterion is common sense combined with contrasted information.

Adverse events. What to do?

In certain instances, it is possible for the altered state of consciousness induced by the use of ayahuasca to be more prolonged in time than expected. In healthy people without a history of mental illness or related crises, this doesn’t need to be a problem in itself. However, it is crucial to deal with this situation in an adequate manner.

Ideally, the facilitator of the session is prepared for such possibilities, and has experience in assisting people with prolonged effects. The way to support such participants is the same as during the session. In the large majority of the cases, the duration of such effects is temporary; in a few hours they return to their ordinary state of consciousness. Enough time is simply required to process the subconscious material that has emerged.

Occasionally, however, it can occur that a participant has to return home while still experiencing the effects of ayahuasca. In these cases, the person can show strange behavior, have difficulties communicating, or have emotional reactions of greater intensity than usual. Although this can be perturbing for the people in his/her environment, it is important to treat this as part of the personal process.

Traditional psychiatry understands these symptoms as manifestations of psychological pathologies, and therefore the objective is to suppress them using antipsychotic medication, which goes generally accompanied by a diagnosis that can sometimes be deemed lifelong. However, the therapeutic potential of ayahuasca is based on processing repressed subconscious material, which therefore has to be accessed and experienced. If this process is allowed to unfold, the symptoms tend to disappear in the course of hours or days. It is therefore important to carefully determine the seriousness of the situation before taking it to a hospital. However, it is important to know that on certain occasions, the administration of psychiatric medication can be necessary to avoid a serious episode and prevent complications. In these cases it should always be a medical doctor that prescribes the medication. Ideally the doctor should have training or experience with the use of ayahuasca, or have the necessary knowledge to take objective decisions.

It is important to take into consideration that not all psychological processes that emerge should be supported. If the person has a clear disconnection from reality, with ideas of reference (e.g. “everybody looks at me”), delirium (e.g. “there is a conspiracy to kill me”) accompanied by disorganized thoughts (incoherent thinking or lack of clear sense), and these type of symptoms continue over a prolonged period of time, it is necessary to seek the help of a psychiatrist.

If we find ourselves in the rare case of accompanying a relative or friend that is suffering adverse effects after the ingestion of ayahuasca, a good strategy is the following:

• Provide the person with an adequate context: space and information. Create a safe space where he/she cannot hurt him/herself and have sufficient intimacy to continue their process without having to deal with other people or external situations. Transmit the idea of the healing potential that the process he/she is going through holds.
• Accompany the person in his/her process, allowing it to unfold without repression; listening and offering support.
• If the situation does not improve over the course of days, or it is necessary to seek help, contact a professional who is familiar with these types of situations. It is important that it is someone experienced in dealing with altered states of consciousness if possible.
• When things have seemingly returned to normal, a professional should be consulted, the use of ayahuasca interrupted and a structural integration process initiated.