“Meeting the Medicine Halfway”: Ayahuasca Ceremony Leaders’ Perspectives on Preparation and Integration Practices for Participants

Honesty and Respect

Several leaders emphasized that ceremony participants’ approach to drinking ayahuasca should ideally be grounded in honesty and in respect for the process. They suggested that participants adopt a serious and mindful approach by being honest with the ceremony leader about potential contraindications and by carefully adhering to prescribed preparatory dietary and behavioral restrictions. Referring to this approach, one leader stated,

I really feel that that’s where a healing experience starts. . . . A really authentic, true place. (Leader 2)

Other leaders noted the challenges associated with participants misrepresenting themselves to gain access to a ceremony. For example, one leader remarked,

I noticed that a lot of people hide things because they are afraid that, when I’m aware of them, I would deny them the access to participate in ayahuasca ceremonies. (Leader 15)

Recognition and Volition

Most leaders identified the importance of participants approaching ayahuasca ceremonies with an awareness of the personal issues or concerns to be addressed, and an authentic desire to heal. This stance was contrasted with participants who were simply seeking a novel experience. One leader remarked,

We’re always looking for the delta. Like, what is the change you want to make? . . . What is the stated problem? Be it an existential dilemma, or “I want to know myself deeper,” as a minimum, . . . [or] “Is this issue reoccurring?” or “This is a pain that I have.” That, for us, is a stated problem as opposed to a psychonaut who wants to have a drug experience. (Leader 11)

Leaders also conveyed that outcomes are more beneficial when participants come to ayahuasca ceremonies of their own volition and with intention to heal, rather than due to the influence of others. Some leaders described the former as having “heard the call” and suggested that individuals should only participate in an ayahuasca ceremony if they truly felt drawn to participate. As one leader stated,

Often, we will see somebody come and they will want to run out and tell the world they have just been enlightened, or healed. And, you know, try and drag their partner or their mother or their brother or their father to [a] ceremony before [those individuals] are ready, or without their own prayer to heal, to do this healing work themselves . . . Ayahuasca is not going to do the healing work for you without this intention to heal, without a whole-hearted intention to heal. (Leader 3)

Readiness and Willingness

Relatedly, most leaders explicitly identified the importance of a participant’s readiness and willingness to engage in a healing process. Leaders expressed that ceremony participants stand to benefit most when they possess an earnest desire for their own healing, which can take various forms (e.g., a desire to understand the nature of their suffering, live in alignment with their values, create a more fulfilling life for themselves and their loved ones). One leader described this mind-set,

I’m really hurting and I don’t know why. And I want to understand, and I want to heal . . . It’s that burning desire that really is the fuel that drives the healing. (Leader 6)

Ceremony participants were thought to receive the most beneficial results from ayahuasca when they were highly motivated toward growth and healing. Willingness to implement and integrate the lessons received during a ceremony, and to commit fully to healing, were cited by leaders as key participant characteristics for facilitating successful outcomes. One leader noted,

There’s a saying in our lineage that, when one approaches ayahuasca, particularly in a healing context, one has to do their part. . . . If you show up and expect ayahuasca to solve all your problems, you’re not going to get very far. In fact, it’s a huge hindrance. (Leader 10)

There was acknowledgment that this healing is often difficult and uncomfortable. Leaders said that participants needed to be ready and willing to face the challenges and potential discomforts associated with the healing process. As one leader commented,

The person has to be committed, and they really have to want to heal. They have to be willing to do all the work. And healing’s not comfortable. (Leader 12)

Another leader remarked,

The limitations [of ayahuasca], in general, have to do with the individual and their readiness. Some people are shown things and they want to unsee it. And they want to go back to the way it was, or it freaks them out, or they run away. And that’s a limitation: their willingness. Others have the same experience and it motivates them. It really fires them up to make changes. (Leader 13)

Internal and External Resources

Regarding preparation, a few leaders identified certain internal and external resources as helpful for improving outcomes. Internal resources included a baseline of bodily strength, and psychological and emotional fortitude, all of which were considered important qualities for facing the sometimes very challenging experiences arising during a ceremony, as well as for facilitating the postceremony integration of this material. For example, one leader stated,

Some amount of toughness [is needed], frankly, to see ugly things and follow through on the changes that are needed on that front. (Leader 13)

Having external supports and resources were also described as helpful for promoting participants’ fulsome engagement in the healing opportunities offered by ayahuasca, from the preparation period through to integration. One leader commented,

The motivational conditions are that [participants] feel internally, or around them, that they have the support they need to be able to do what wants to be done after the experience, or during or in preparation for it. (Leader 5)

Cleansing

Most leaders identified the importance of adhering to preparatory behaviors and diet for a period of time before a ceremony. These included restrictions aimed at physically and energetically cleansing the participant, bringing awareness to (and ceasing) negative behavior patterns, and helping guide the participant into the proper mental and physical state for ayahuasca to have a beneficial effect. One leader noted,

There are some restrictions around food and diet, [such as] . . . avoiding intoxicants for a period of time, avoiding sex for a period of time, avoiding pork, and then making sure that there aren’t any contraindicated medications or supplements. (Leader 10)

Although leaders reported various preparatory restrictions according to their different lineages and traditions, many mentioned those related to sexual activity, cannabis and other substance use, contraindicated medications such as antidepressants, some nutritional supplements, and certain foods. A number of leaders spoke specifically about the potential of pharmaceuticals, alcohol, and other drugs to inhibit the healing potential of ayahuasca. One leader stated,

People who have been on pharmaceuticals for a long time . . . a lot of times, they have a really, really hard time with the medicine. And it takes a long time for them to get benefit. (Leader 9)

Another leader remarked,

If you talk about what can actually diminish the healing benefits and effects of ayahuasca, it’s drinking alcohol or, for some but not for all, smoking marijuana or taking other drugs. (Leader 15)

A few leaders also highlighted the value of participants slowing down and attending to their frame of mind prior to a ceremony, which was understood to be a behavioral form of approaching the medicine as “clean” as possible. For example, one leader stated,

As much as you can create a space of going into an ayahuasca experience just with a kind of calmness in your life, [that] is really, really good. When people tend to come into ayahuasca experiences really busy, coming right off of a work week and not really having time to center themselves and ground, I think the experience is often less therapeutic and effective. (Leader 2)

Intention Setting

More than one-half of the leaders described participant intention setting as one of the more important aspects of ceremony preparation. Setting an intention was described as a deliberate process whereby the participant established their purpose for attending a ceremony, including clarifying their hopes and goals. Having an intention was perceived as helpful for psychologically grounding participants and guiding their experiences during the ceremony. As noted by one leader:

Intentionality is a huge part of preparation into an ayahuasca experience, to really know why you are being called to it and what you want to get out of it. Even though ayahuasca can communicate in mysterious ways, and we don’t always get what we ask for, I think the process of going into that space in oneself is really important and a big part of the preparation. (Leader 2)

Nonattachment, Openness, and Surrender

Nearly one-half of the leaders recommended that participants not be attached to a particular ceremony outcome, but rather that they remain open to the process and surrender to the experience. As one leader explained,

You have your intention, and then you let go of your intention so that you can be in whatever the experience is. (Leader 11)

Leaders noted that this stance involved participants letting go of explicit and implicit demands of the leaders and the medicine itself, as well as expectations regarding how the healing process might unfold, including its duration. One leader elaborated,

There is an issue [and] it needs to be addressed. And then it’s an active, recurring pursuit [of] active-non-acting . . . where, yes, you’re there, you’re showing up, and, at the same time, one needs to let the medicine do its work without the attitude of “heal me.” . . . It’s a, “I’m here, I want to be healed,” and, at the same time, “I’m surrendering to and trusting the medicine.” (Leader 10)

Leaders reported that participants’ openness to surrender to the ayahuasca experience was a facilitative factor, as was their capacity to maintain an open mind about the ways in which lessons, messages, and healing were transmitted during a ceremony. One leader said,

The first and most important thing is that the person really has to come into the space with an attitude of both surrender and also meeting the medicine halfway. Like, being willing to take the lessons that ayahuasca gives, and implement and integrate them into their lives. (Leader 6)

Another leader commented,

[It is helpful to be] receptive to the medicine, to the messages, to what [participants] are seeing. Not fighting it, not resisting it. Those are qualities that are very helpful in terms of healing outcome. (Leader 13)

Last, a few leaders perceived that favorable ceremony preparation necessitated participant education about ayahuasca, including the considerations outlined above. They remarked that, if participants do not have a proper understanding of ayahuasca, this may negatively affect their experience or limit the benefits.

Complementary Modalities

Many leaders described the benefits of engaging in complementary modalities to augment participants’ preparation and integration processes. Those mentioned specifically included psychotherapy, spiritual or contemplative practices, art therapy, bodywork, yoga, Chinese medicine, qi gong, tai-chi, and journaling. One leader stated,

I think it helps to have some kind of a spiritual practice, psychotherapy, meditation practice, or contemplative practice that [participants] are working with when they’re not in ceremony. (Leader 12)

More than one-half of the leaders expressed that some form of daily practice could help individuals more easily navigate and benefit from ayahuasca experiences. The most frequently mentioned practices were contemplative in nature (i.e., meditation and mindfulness). Several leaders indicated that daily engagement in such practices was the most important factor in successful ceremony processes and outcomes. For example, one leader stated,

Meditation is number one. That’s an opinion that . . . is held both in modern syncretic contexts, and also very much in traditional contexts: that meditation and contemplation is the best path to self-knowledge. (Leader 8)

Another leader remarked,

I find that people who come in with years of meditation work already have those neurological pathways mapped in their brain. They already have these connections that are very strong, that habitually go to love, and opening your heart, and [the] energy of surrender. Whereas the persons who do not have those neurological pathways already set, it’s like . . . that analogy with putting too much electricity through the wire. So, they almost can’t even ground what’s happening. . . People who meditate, or do yoga, or . . . tai-chi or whatever the practice, as long as it’s about being centered within, and disciplined—even disciplined while moving—they tend to do much better in the medicine work. (Leader 14)

Journaling was mentioned by one third of the leaders as being helpful for preparing and integrating ceremony experiences. Several leaders also referred to individual counseling or psychotherapy (especially if provided by someone with knowledge of ayahuasca ceremonies, including preparation and integration) as being helpful for processing and making meaning of ceremony experiences. One leader stated,

[Psychotherapy] would certainly allow the person to integrate the experiences of the medicine. It would allow people to get in touch with some of the emotions that are brought up in the ceremony, and get in touch with them in . . . a setting that maybe feels safe for them. (Leader 1)

Last, a few leaders identified the value of nonlinguistic opportunities to process experiences, such as through artistic and creative expression. They highlighted that people process experiences in different ways, and sometimes words limit the process. As one leader noted,

Any kind of creative expression, whether it’s music or art, . . . helps people to integrate . . . the unspeakable, when you can’t figure out how to talk about it. People can draw a picture, paint a mandala, or sing, or dance. All different ways of creative expression [are] helpful. (Leader 12)

Time

Leaders asserted that participants benefited from having dedicated time to rest and process what emerged after an ayahuasca ceremony (or series of ayahuasca ceremonies). One third of the leaders described the importance of participants intentionally taking time away from work, other responsibilities, and normal distractions to reflect on, process, and make meaning of their ceremony experiences. One leader noted,

In terms of integration, again, just having the time to be able to integrate the experience is really important. (Leader 2)

Another stated,

What I always tell people is to not watch the news anymore. Turn off the television. And then less time, if you can, on the internet. Be more at yourself, on your own. Because, when you return home, and you have all these other influences, they can actually influence your emotional state. And then you’ll get away from that feeling you had after ceremonies . . . and working on your healing and working on yourself. These things can actually distract you from that. (Leader 15)

Leaders acknowledged the challenges faced by participants in allotting this time and mental space for themselves, particularly in the context of already-busy lives. As one leader stated,

Ideally, people take a full week off [of] work. . . . One of the things I’ve struggled with is [that] you’ll have people come in, do just a ceremony, [and] then they’ll leave and go right back into their workplace and have almost no time to integrate. (Leader 4)

Another leader remarked,

It comes down to the integration time. . . . That’s the non-sexy part. That’s actually what people don’t want to do. And so that, to me, is the linchpin. (Leader 11)

Sharing Experiences

Leaders were nearly unanimous in their views that sharing ayahuasca experiences with others after ceremonies was a critical aspect of a positive integration process. Postceremony gatherings in which coparticipants discussed and reflected on their experiences were considered particularly important. One leader commented,

The integration—people talking in the morning about the visions they saw—just that alone is a healing thing. (Leader 14)

Another said,

The social support [is helpful]. . . . You could call it group therapy, if you want. But, some kind of group process to talk about, and share, and integrate the experience. (Leader 13)

Leaders also noted the importance of participants accessing supportive and understanding individuals and community in the weeks and months following ceremony experiences. Many leaders remarked that participants may encounter difficulties when sharing and processing their ayahuasca experiences with people who have not themselves experienced ayahuasca. As one leader stated,

I definitely think that the participant needs to have someone that they can reach out to, and a community that they can speak to. Because, a lot of times, after you go through experiences like this, it’s really hard to discuss anything with someone who hasn’t had the same. (Leader 6)

Many leaders perceived there was value for participants in being connected to a broader community familiar with ayahuasca, so that they could continue to share their integration experiences and receive support. One leader stated,

I think the community aspect is very important, as far as one’s healing [goes]. It’s very hard to do just by yourself. (Leader 9)

Another commented,

Support is critical. . . . People come through these experiences and they have a number of issues come up, a lot of self-doubt, and they’re confused. Like, “My life isn’t working, and I don’t know how to change it. I’m stuck, I’m struggling with this.” To be alone in that experience is definitely problematic. So, making sure people aren’t alone in these experiences, and that they have some way to seek counsel, or share, or be part of a community [is important]. . . . To help people [is important], or at least give people the option of sharing [their] integration experience, or if they’re having a sort of crisis around integration, or any issues around integration, or their life not working. . . . Just talking about it makes things make more sense and seem less of a daunting challenge. (Leader 4)

Several leaders perceived it was important for participants to have opportunities to share and process their ceremony experiences with people who were knowledgeable about ayahuasca, in particular to help them integrate any difficult material that emerged. As noted by one leader:

Some people get that insight and understanding in the experience, depending on their own level of self-awareness, and emotional intelligence, and things like that. . . . But, for people who have difficulty with really seeing themselves, . . . I think it’s very important for them to have someone who can objectively walk them through things and help them to see it from different angles. (Leader 8)

Relatedly, numerous leaders identified risks for participants in not having knowledgeable, safe, and supportive individuals and a community with whom to share their experiences. They emphasized that the absence of such support could cause some participants to struggle, revert back to old patterns, or, worryingly, could be deleterious. One leader remarked,

Ayahuasca can be quite a shock for many people if they have not experienced anything like this in their life, or [have] not been accustomed to living in a place of their own truth. So, to go out into the world with a new knowledge of what their own truth is can be very difficult. And if the community is not providing follow-up, or a place where they are showing up in support, the participant can struggle. (Leader 3)

Another leader stated,

If people don’t have support after a difficult experience and the kind of scaffolding—and just support, really—then it can be a very isolating experience. To have had a difficult experience with ayahuasca and then [to] not have anybody to talk to about it, or any support to have, that can definitely leave one destabilized and, potentially, in a worse place. (Leader 2)

To mitigate these risks, some leaders described a best practice of following up with participants over time to ensure they were supported, but admitted the near impossibility of doing so with everyone who had attended their ceremonies. In most cases, leaders reported leaving the onus of responsibility for follow-up on ceremony participants.

Working With Insights and Lessons

Leaders overwhelmingly described a productive integration process as defined by the participant’s ability to use the insights or lessons received in ceremony to implement positive changes in their lives. They elaborated that some insights and lessons may be clear and easily understood, whereas others may require reflection and interpretation. A number of leaders noted the value for participants in intentionally reflecting on their ayahuasca experiences and the broader implications. As one leader commented,

The people that actually actively engage with the experience and recall the experience—into their body, and in their heart, and in their mind, and in their spirit, specifically—do much better. (Leader 5)

Another stated,

A positive integration process is one where . . . the person is picking up the pieces, and they’re making sense of them. (Leader 8)

Several leaders remarked that participants may need to face challenging memories from the past, and accept the role those experiences had played in contributing to their current health and wellbeing. Referring to this process, one leader said,

Then comes the next step, [which] is actually accepting that it happened, understanding what . . . kind of impact it has on your life, on your psychological state, on your emotional state, on your feeling of wellness. (Leader 15)

A strong majority of leaders described the importance for participants of being able to make changes in their everyday lives based on the insights and lessons gleaned from an ayahuasca ceremony. One leader stated,

What I think distinguishes good integration is continuing to be mindful and aware, and attempting to manifest shifts in their life based on the awareness [and the] openings that came to them over the course of the [ceremony] weekend. (Leader 5)

Leaders noted that the way in which the process of implementation and change unfolds can vary considerably, depending on the participant. One leader provided the following example:

Someone comes out of [an ayahuasca ceremony] and goes, “Wow, I understand now that . . . I invite a lot of negativity into my life because I don’t feel that I have any self-worth. So, what can I do to change that?” And they’ll really try to find passions in their life, and actually take time to engage in self-love and self-worth exercises. Like, just . . . reading a book, and not always being subject to everybody’s beck and call, and being a bit more selfish about their own healing [and] their own wellness. Specifically, meditation is a huge one. Just being comfortable with who you are and sitting peacefully. And what comes of those processes, and being okay with that, and all of the above. And accepting it and moving forward. (Leader 4)

Ineffective Integration

Several leaders described the experience of ineffective integration, whereby participants received insights or lessons from an ayahuasca ceremony but were not able to make any concrete changes. They observed participants returning to the same patterns and behaviors that they had described as problematic prior to the ceremony. As one leader elaborated,

A bad integration experience . . . is [when] someone is shown [during a ceremony] what they need to do and changes they need to make. . . . They come in miserable. [Then] they’re cleaned up, they feel great, they’re inspired, they’ve been shown, “This [is] what I need to make these changes in my life.” And they go back and they don’t make any changes. The circumstances take them right back to where they were before. So, they just kind of go back to where they were. (Leader 13)

Leaders typically attributed the poor integration in these cases to a combination of individual factors (e.g., lack of readiness and motivation) and social and structural factors (e.g., lack of adequate support, challenging work environment, unstable housing). Regarding individual factors, leaders described participants who did not subsequently engage in continuing to emotionally process the content arising in their ceremony, particularly the difficult material. Two leaders noted the tendency of some individuals to repeatedly attend ayahuasca ceremonies, or to engage in other modes of “spiritual bypass,” in order to avoid the challenges potentially related to the changes necessary to feel better outside ceremonial settings. One of these leaders stated,

They come to ceremony, and they get something out of it that they then depend on instead of actually doing the integration. So, they just keep coming back. (Leader 5)

Regarding social and structural factors, leaders described the impact on integration of the environment to which participants return after the ceremony. They highlighted that, if participants return to unstable, overly busy, or stressful environments, it can be very difficult for them to successfully integrate their ayahuasca experiences and incorporate changes derived from the lessons and insights received. One leader noted,

People who just jump right back into a situation that is so corrosive and so toxic that they just can’t handle it, it kind of corrodes them again. (Leader 4)

Another commented,

Sometimes what can happen is they’ll have this really profound experience, really profound insights into their life. And then they go home and make these changes, and they are stuck in their job, and they can’t get out of this job that doesn’t support their spiritual side. And so, they had this spiritual opening and a very profound experience, and they go back to work . . . and the experience is very—it’s like suffocation that can happen. And, they don’t know how to get out of their job. And it can lead to more suffering than there was beforehand. They aren’t able to put the insights from the ceremony into their everyday life. (Leader 9)