Sunday, April 7, 2013

Ayahuasca and Health

Ayahuasca y Salud (Ayahuasca and Health):
Ayahuasca y Salud (Ayahuasca and Health)
Beatriz Caiuby Labate and José Carlos Bouso (eds.)
Los Libros de La Liebre de Marzo, 2013
Purchase the book

Summary: This collection is composed of 22 articles, an introduction and a foreword. It
brings together perspectives from the social and biomedical sciences as well as personal
accounts of ayahuasca shamans and practitioners in order to address diverse indigenous,
mestizo and Western concepts of health, illness and curing related to the use of
ayahuasca. Through a comparative analysis of the different contexts in which this
psychoactive substance is consumed, this work investigates the boundaries between
shamanism, religion and medicine, while examining hybridization across the diverse
knowledge-bases of ayahuasca practices. The diversity of cultural and regional situations is
reflected in, for example, different traditions of governmental regulation of ayahuasca
consumption: While Brazil permits religious (but not medicinal use) of ayahuasca, Peru has
recently enshrined indigenous medical traditions surrounding ayahuasca as part of its
national heritage. This work also presents some of the latest biomedical findings
concerning the medical and therapeutic possibilities of ayahuasca. Numerous contributions
highlight both agreements and disagreements between the “traditional” and the biomedical
approach to health and health risks.

Co-editors Biographies:
Beatriz Caiuby Labate has a Ph.D. in Social Anthropology from the State University of
Campinas (Universidade Estadual de Campinas, UNICAMP), Brazil. Her main areas of
interest are the study of psychoactive substances, drug policies, shamanism, ritual, and
religion. She is Visiting Professor at the Drug Policy Program of the Center for Economic
Research and Education (Centro de Investigación y Docencia Económicas, CIDE – Región
Centro) in Aguascalientes, Mexico. She is also Research Associate at the Institute of
Medical Psychology, Heidelberg University, co-founder of the Nucleus for
Interdisciplinary Studies of Psychoactives (NEIP), and editor of its site
(http://www.neip.info). She is author, co-author, and co-editor of eight books, two with
English translations, one journal special edition, and several peer-reviewed articles. For
more information, see: http://bialabate.net/

José Carlos Bouso is clinical psychologist and has a PhD in pharmacology from the
Universidad Autónoma de Barcelona. His studies address preliminary data on the safety of
MDMA in the treatment of chronic post-traumatic stress disorder (PTSD) as a result of a
sexual assault. He also has been conducting neuropsychological research into the long-term
effects of drugs such as cocaine and cannabis. He has done transcultural research,
extensively studying the long-term effects of ayahuasca use in different cultures and
ecosystems, both in Spanish and in Brazilian communities. José Carlos Bouso is co-author
of several scientific papers and book chapters. He currently combines his activity as a
clinical researcher at the IMIM (Institut Hospital del Mar d’Investigacions Mèdiques) with
his work as Scientific Projects Manager at ICEERS (International Center for
Ethnobotanical Education, Research and Service: www.iceers.org).

Table of contents
Foreword: “Ayahuasca at the crossroad of different forms of knowledge” – by Renato
Sztutman (Anthropology Universidade de São Paulo)
Cura, cura cuerpecito (‘heal heal little body’): reflections on the therapeutic possibilities of
ayahuasca, by Beatriz Caiuby Labate (Drug Policy Program, Center for Economic Research
and Education – CIDE Región Centro, Aguascalientes) and José Carlos Bouso (Human
Pharmacology, Neurosciences Research Program, Hospital del Mar Medical Research
Institute, Barcelona)

First part: Shamanism and Religion

1. Luisa Elvira Belaunde (Anthropology Universidad Nacional Mayor de San Marcos) –
Interview with Herlinda Agustin, a woman Onaya from the Shipibo-Konibo indigenous
nation
This interview with Herlinda Agustín (in memoriam) presents the personal narrative of a
woman who is an onaya or ayahuasca shaman of the Shipibo-Konibo indigenous nation of
the Peruvian Amazon. It allows us to follow, through her words, the paths that led her to
consecrate herself as a healer, combining her role as a mother and married woman with the
difficult and hazardous apprenticeship of the rao or “plant teachers”. Her experiences
represent a novel and much needed approach to the study of gender in Amazonian
shamanism and, in a singular and human manner. The article shedss light on critical
aspects of the cosmovision of the Shipibo-Konibo, for example, the transmission of
ancestral powers, the search for spiritual protection, the practice of plant “diets” and the
relationship with foreigners who attend shamanic sessions.

2. Peter Gow (Anthropology University of Saint Andrews) – “Asleep, Drunk, Hallucinating
– Altering Bodily States through Consumption in Eastern Peru
The text adopts a phenomenological approach in order to deal with different aspects of the
life of the native inhabitants of the Lower Urubamba River, in East Peru, within the
interpretative framework of symbolic anthropology. In these tribes, the mastery of the lived
experience plays a fundamental role. Four body sates that are defined as “modified” are
dealt with: sleeping, drunkenness, sickness and the hallucinogenic experience. The author
claims that these states function as icons of specific acts of sequences of acts, and are
related to the consumption of substances and the field of social relations. By defining
sickness and the hallucinogenic experience as two different states of intense bodily
transformation, the “corporal dimension” is said to constitute a central part of the natives’
experience. An emphasis is laid on the importance of the lived experience in everyday life,
in an effort to demonstrate that the central cultural values of these natives rest on the
importance of immediate experience and not only what lies in their minds or overriding
abstract models.

3. Esther Jean Langdon (Anthropology Universidade Federal de Santa Catarina) – “The
Symbolic Efficacy of Rituals: From Ritual to Performance
The paper explores the concept of “healing” among Amazonian shamanic rituals,
examining the meaning of healing from a broader perspective than that of biomedicine. It
focuses on rituals in which psychotropic tea-like substances commonly referred to as
ayahuasca or yagé, have a central role in the ritual’s efficacy. These substances are made
from made from Banisteriopsis sp. and admixtures and can produce strong conscious
altering effects. However, it is important to point out that the patient does not always drink
the mixture, which may be ingested by only the shaman or by participants other than the
patient. For Amazonian peoples, illness is not limited to purely biological processes and
spiritual and social factors are important causes of illness in a universe that is endowed with
intention, that is, a universe populated by diverse predatory beings that are capable of
causing illness. The article examines the concept of “heal”, as well as reviews the current
theories that attempt to account for the ritual efficacy. Differing from the those who
emphasize the instrumental results of substances ingested or who affirm that faith is the
necessary factor for “miracle” cures, this work shall demonstrate that healing efficacy must
largely be attributed to the performative aspects of ritual.

4. Els Lagrou (Anthropology Universidade Federal do Rio de Janeiro) – “To control
fluidity of form: prophylactic cosmopolitics in the use of Nixi pae among the Cashinahua
(Kaxinawá)
The Cashinahua (Kaxinawá) do not, usually, use ayahuasca (Nixi pae) in the context of
healing rituals, nor do they restrict its use to the specialty of the shaman, notwithstanding
the fact that its use is closely related to the maintenance of the health and wellbeing of the
people (usually men) who consume it and of the community as a whole. Small children do
not drink ayahuasca and women exceptionally do so. The visionary experiences produced
by ayahuasca intends to promote a differentiated interaction with the yuxin beings, invisible
in daily light: the doubles of animals, the owners of the rivers, foreigners, and spirits living
far away. The intention of the experience is to gain knowledge and control over the
agentive constellation surrounding present and future events, events which do influence a
person’s health. A healing specialist can look for the cause of an illness and the right herb
to treat it with, and people involved in conflicts can try to have access to the hidden
intentions of their adversaries. The use of ayahuasca constitutes, in this way, a prophylactic
weapon and instrument of negotiation in a sociocosmological world where predation is
understood to be inherent to the construction of life itself. This predation, however, is
situated in a subjective environment: the beings in interaction, being intentional subjects,
can take revenge or offer their collaboration in the human battle for the control of fluidity
of form. In this quest, the intention of humans is to conquer thinking solid and healthy
bodies, with strong hearts (huinti kuxi), not easily afraid nor easily weakened by illness.

5. Rama Federica Leclerc (PhD in Anthropology Nanterre-Paris 10) – “Shipibo traditional
medicine and French therapies
This article offers an analysis of the interaction between the traditional healing practices of
the Shipibo indigenous group and some modern alternative therapies practiced by French
therapists. Recent investigations reveal that the modes of representation found in Shipibo
practices appropriate the discourse of their Western counterparts. On the one hand, the
Shipibos, to harmonize the two cultures, adapt their discourse to that of the Westerners.
Nowadays, with the idea of setting themselves forth as the representatives and guardians of
nature and the spirits of the plants, their healers have radicalized their discourse and
practices with regard to the use of medicinal plants. On the other hand, the French healers
include these practices in their forms of therapy. It was evident that some of them regard
the spirit of ayahuasca as a kind of therapist with whom the patient establishes a personal
link. The therapeutic use of ayahuasca thus becomes a self-therapy guided by a healer. This
study also investigates new ideas about the relation between body and spirit, the role of
mental imaginings (visions and dream experience), and verbalization, among others.

6. Isabel Santana de Rose (Anthropology Universidade Federal de Minas Gerais) –
Spiritual healing, biomedicine and intermedicality in Santo Daime
This article deals with the therapeutic use of ayahuasca in Santo Daime. The first part
introduces Santo Daime and the implications of the expansion of the Brazilian ayahuasca
religions. This is followed by a discussion of the case of the Santo Daime community Céu
da Mantiqueira, which defines itself as a healing center, explaining its health care system
and the native conceptions of health, illness and disease. The text reflects specially about
the presence of an expressive number of health care professionals and the introduction of
biomedical practices in Céu da Mantiqueira. Based on the concept of intermedicality, this
study seeks to show how in this context the spiritual paradigm characteristic of the Daime
doctrine and the scientific one which usually characterizes biomedicine coexist in an active
and dynamic way and give rise to new syntheses.

7. Marlo Meyer (MA in Cultural Anthropology California State University) and Matthew
Meyer (PhD Candidate in Social Anthropology University of Virginia) – “Ayahuasca and
Pregnancy: A Preliminary Report
In the United States, it is common knowledge that the use of illicit drugs during pregnancy
is detrimental to fetal development, and the women who use illicit drugs during their
pregnancies are seen as abusive mothers. This paper offers a preliminary discussion of an
urban church in the Brazilian Amazon that contradicts these expectations by valuing
positively the use of the hallucinogen ayahuasca during gestation and parturition. The use
of ayahuasca during pregnancy and shared cultural views by church adherents are examined
and the interface between pregnant church members and the biomedical establishment is
considered.

8. Denizar Missawa Camurça (Biologist University of Guarulhos), Beatriz Caiuby Labate
(CIDE Región Centro), Sérgio Brissac (PhD in Social Anthropology Museu Nacional-
UFRJ) and Jonathan Ott (Organic Chemist, HydroXochiatl/Mexico) – “Hoasqueira
Ethnomedicine: The traditional use of the Nove Vegetais in the União do Vegetal
The article deals with a tradition of the Centro Espírita Beneficente União do Vegetal
(Beneficent Spirit Plant Union Center, or UDV), which occasionally used in the past
what became known as the Nove Vegetais brew (Nine Plants brew), that is, ayahuasca with
the addition of nine species of plants specifically aimed at healing. The use of these plants
distinguishes the UDV from the other Brazilian Ayahuasca religions and resembles the
traditional practices of Amazonian healers. There is a body of evidence about the properties
of these species and of another one that was occasionally used, the João Brandinho. These
species are compared with those used by mestizo or indigenous populations described in
the specialized literature: among the ten plants adopted by the founder of the UDV, Mestre
Gabriel, five are reported to have been used by traditional healers of the Amazon region.
The article explains that these plants do, in fact, possess medicinal properties, indicating
the need for further research into the therapeutic potential of the Nove Vegetais and of
the João Brandinho.

9. Alberto Groisman (Anthropology Universidade Federal de Santa Catarina) – “Health,
risks and religious use in disputes about the legal status of the use of ayahuasca:
implications of recent judicial developments in the United States
Among others, the categories health and risk – and the eventual contents which they evoke
– have been referenced in criminal processes as negotiation and disputes objects. These
categories (which are never free of a particular semantic attribution), are simultaneously
receivers and providers of meaning. According to circumstances and
contexts, these words, and the eventual significance they refer when inserted in contexts of
negotiation and dispute, constitute themselves as meaning aggregating, or meaning
disaggregating particles. They are furthermore political aggregators, here when they
articulate social and institutional forces in these disputes. My intention from this
article is to approach implications of the use of these categories – and the associated
meanings – in a particular context: that of the production of relevant texts in the disputes
concerning the status of the “religious use” of psychoactive substances, particularly of
ayahuasca. My focus is the judicial field, in which “health risk” for eventual users, and the
presumed potential “thread” their use implies for the health of religious groups participants,
always constitute themes of a relevant debate.

10. André Viana (Journalist Trip Magazine) – “Dream and Fear on a Summer Night
This text is a report of a journalist’s experience in the night of Marc 3rd, 2002, when he and
four anthropologists took part in an ayahuasca ritual performed by members of the
Kaxinawa tribe in a ranch in the outskirts of Rio Branco, Acre, Brazil. An experience that –
however difficult to duplicate – is far from forgotten.
Second Part: Science and Therapeutics

11. José Carlos Bouso (Hospital del Mar Research Medical Institute), Josep María Fábregas
(Centro de Investigación y Tratamiento de las Adicciones – CITA, and Instituto de
Etnopsicología Amazónica – IDEAA), Sabela Fondevila (Universidad Complutense de
Madrid), Débora González (Hospital del Mar Research Medical Institute), Marta Cutchet
(CITA and IDEAA), Xavier Fernández (in memoriam, IDEAA), Miguel Ángel Alcázar
(Universidad Autónoma de Madrid), Gregorio Gómez-Jarabo (Universidad Autónoma de
Madrid) – “Long-term effects of the ritual use of ayahuasca on mental health”
Scientific research about long term effects of hallucinogens is, in general terms, poor. Until
now, only 3 studies exist in which this issue was investigated in depth. In 2004, our
research team stayed in Mapiá and Rio Branco developing longitudinal studies in order to
assess the long term ayahuasca effects on mental health. In the first study we administered
personality, neuropsychological, general health, psychosocial wellbeing and spirituality
tests to 60 daimistas versus 60 non ayahuasca users from Boca do Acre. Those same tests
were administered 8 months later in order to see if the scores were stable across time. In
this chapter we present the preliminary findings.

12. Beatriz Caiuby Labate (CIDE Región Centro), Rafael Guimarães dos Santos (PhD in
Pharmacology, Universitat Autònoma de Barcelona), Rick Strassman (Psychiatry,
University of New Mexico, School of Medicine and Cottonowood Research Foundation),
Brian Anderson (MD Candidate, Stanford University) and Suely Mizumoto (MA in Social
Psychology Universidade de São Paulo) –- “Effect of Santo Daime Membership on
Substance Dependence
Previous clinical research on hallucinogen-assisted psychotherapy reported efficacy in
treating substance abuse disorders, similar to what has been report in naturalistic studies of
peyote use among Native American Church members. Urban use of the Amazonian
hallucinogenic brew, ayahuasca, is increasingly common in syncretic Brazilian ayahuasca
religions, and anecdotal reports suggest recovery from substance dependence among those
who participate in their rituals. We sought to assess more quantitatively effects of Brazilian
ayahuasca-using church membership on substance dependence. We employed a modified
questionnaire using DSM-IV criteria to determine the presence of substance dependence
within a sample of members of a branch of the Santo Daime Brazilian ayahuasca religion.
Nearly half of church members reported substance dependence before joining the religious
organization; of these, 90% reported cessation of use of at least one substance upon which,
before church membership, they reported dependency. While these preliminary data
require confirmation using more rigorous criteria, they suggest a potential role of
ayahuasca, within a particular context, in the treatment of substance dependence.

13. Interview with the psychiatrist Evelyn Xavier – Beatriz Caiuby Labate (CIDE Región
Centro), Rafael Guimarães dos Santos (PhD in Pharmacology, Universitat Autònoma de
Barcelona), José Carlos Bouso (Hospital del Mar Medical Research Institute) and Isabel
Santana de Rose (Anthropology Universidade Federal de Minas Gerais)
14. Jordi Riba (Human Experimental Neuropharmacology, Medicine Research Center and
Universitat Autónoma de Barcelona) and Manel J. Barbanoj (in memoriam, Medicine
Research Center and Universidad Autonoma de Barcelona) – “Clinical pharmacology of
ayahuasca: research with Spanish volunteers
Throughout the past decade, the authors have carried out a series of clinical trials in healthy
volunteers, with the objective of investigating the human pharmacology of ayahuasca. The
studies demonstrate that it is feasible to safely administer ayahuasca to people who have
prior experience in the use of visionary substances with the purpose of evaluating its effects
in a research setting. In this way, research has spanned from the pharmacokinetics of the
alkaloids found in ayahuasca to effects on brain activation observed through neuroimaging,
including the measurement of cardiovascular, neuroendocrinological and
neurophysiological variables. These studies intend to achieve a better understanding of the
effects of ayahuasca on the body, as well as to delve into the mechanisms of visionary
substance activity in the human brain. This chapter presents the studies and results that
have been obtained.

15. Rafael Guimarães dos Santos (PhD in Pharmacology Universidad Autonoma de
Barcelona) – “Possible risks associated to the use of ayahuasca
In the last decades, the use of ayahuasca has been increasing in Brazil, the United States
and Europe. Little is known about the eventual risks associated with this consumption . The
objective of this study is to provide information about the possible risks associated with the
consumption of this drug when it is combined with medication, foods and other chemical
substances. Ayahuasca has serotoninergic agonist components – inhibitors of the
monoamine oxidase enzyme and the tryptamine N, N-dimetiltriptamina (DMT) – and other
chemical substances. The risks associated with the ingestion of these substances are mainly
related to the serotoninergic syndrome, tyramine intoxication and the manifestation of
psychopathologies. A review of the specialized literature shows that the risks of ayahuasca
consumption are mainly associated with its pharmacological composition. These
pharmacological characteristics must be considered in order to reduce eventual risks with
ayahuasca preparations.

16. Ede Frecska (National Institute of Psychiatry and Neurology, Budapest) – “Ayahuasca
sessions in case of a recidivist murderer
We have limited resources available for the treatment and prevention of violent behavior.
The usefulness of the most commonly used medications, namely the selective serotoninreuptake
inhibitor [SSRI] agents for the above purpose is a debated issue in the psychiatric
literature. The aim of this case report is to add an ethnopharmacological perspective to the
management of human aggression. Particularly, attention is called to the potential cohesive,
prosocial effect of the Amazonian beverage, ayahuasca — a decoctum, which has been
used traditionally for multiple medico-religious purposes by numerous indigenous groups
of the Upper Amazon — and has been found to be useful in crisis intervention, achieving
redemption, as well as eliciting cathartic feelings with moral content

17. Benny Shanon (Psychology Hebrew University of Jerusalem) – “Moments of insight,
healing and transformation – a cognitive phenomenological analysis
In this chapter I examine moments of special significance in people’s experience with
Ayahuasca. Specifically, I consider moments in which psychological insights are gained,
and personal transformation and/or healing take place. The analysis consists in a structural
typology of these facets of the Ayahuasca experience and is based on empirical data
gathered in the framework of a broader study that sets itself to present a systematic charting
of the phenomenology of the special state of mind induced by this brew. The analysis and
discussion are taken from a phenomenological cognitive-psychological, not clinicalpsychological
or medical, perspective.

18. Walter Moure (PhD in Social Psychology Universidade de São Paulo) – “The
accompaniment (care) given in the Peruvian Amazon Indigenous tradition
Based on his experience of living regularly with maestros de plantas (shamans) of the
Peruvian Amazon, the author tries to understand the nature of accompaniment (care)
given in the therapeutics of that tradition. He offers a vision derived from his reflections on
Amazonian indigenous and mestizo knowledge, his own experience as a patient and his
contact with Western patients that underwent shamanic treatments, using for that purpose
the deconstruction of certainty – tool of ethnopsychoanalysis -, the Winnicottean
psychoanalysis and other Western authors who were meaningful in his life. The result aims
to clarify themes relating to human suffering and possible approaches to it.

19. Xavier Fernández (in memoriam, IDEAA) and José María Fábregas (IDEAA and
CITA) – “Using ayahausca for treatment of drug dependency in the Brazilian Amazon
The article presents the experience of the Institute of Applied Amazonic Ethnopsycology
(IDEAA), created by a spanish group in the Amazon with the goal of studying and applying
the use of ayahuasca in aiding processes of personal growth and the treatment of drug
addictions. It starts whit a short description of its basic concepts, as well the theoretical
perspectives underpinning its ayahuasca´s applications, which include transpersonal
psychology, the Santo Daime religion, chamanism, and various eastern disciplines. The
next section shows the practical activities, paying special attention to rituals, looking
indepth into the healing process through a model of help based on minimally interventionist
guidance. With a content analysis the main thems of ayahuasca sessions for addicts were
revealed, and then discussed and related with dinamics of transformation. The final part of
the text concludes with the clinical observations emerging from the years of practice.

20. Jonathan Ott (Organic Chemist, HydroXochiatl/Mexico) – “Shamanic Yajé: Neither
religious sacrament nor remedy for “chemical dependence
This article will discuss the diferences between use of yajé in indigenous shamanism and
western medicine. Both systems seek to “cure” via medicaments, although in the case of
shamanism the “doctors” typically consume some drug, which is effectively prohibited in
academic medicine. By way of example, it will examine the peculiar attempt of the medical
establishment to endeavour to deal with habituations to the ingestion of drugs as “diseases,”
commonly treated with other, different drugs. Some physicians employ yajé itself as one
such drug to combat habituation to other drugs, at times in collaboration with Amazonian
shamans. This has its parallels in modern syncretic religions such as União do Vegetal,
which involves the ingestion of yajé as a sacrament to combat alcoholism, tobaccoism,
cocainism, etc. For believers in these religions, just as for physicians who employ yajé as a
drug to combat the use of other drugs, yajé is a “medicine” [holy] to fight “abuse” [sic] of a
“drug” [evil], for instance cocaine. This is pharmacological chauvinism and is parallel to
the situation with Cannabis: for certain religious believers (Rastafarians) and some ludible
users, marijuana is a “herb” [holy]; while cocaine (indeed for some, yajé itself) is a “drug”
[evil]. Of course, for criminal law effectively in the entire world, any non-medical use of
many “drugs” [evil]—heroine, LSD, psilocybine, etc.—is a crime, if not a “mental illness”
[sic]. There is a discussion of the semiotic confusion implicit in deforming the word
addiction into meanings quite distinct from those of its synonym, devotion, to the point, in
English and Castillian, of creating a substantive form, addict, to stigmatize the users of
certain drugs. It will include some reflexions on shamanism as an empirical system of
natural philosophy or science, the while modern science transmogrifies itself ever more into
a dogmatic religion.

21. Josep Maria Fericgla (Societat d’Etnopsicologia Aplicada i Estudis Cognitius
Barcelona) – “Changes in the value profile after an experience with ayahuasca: Comparison
of results of the Hartman test administered before and after a session of ayahuasca in a
group of volunteers
This research was done in 1999 and has remained unpublished until now. It consisted of
applying the Hartman Test to twenty five individuals before taking ayahuasca, and 24 hours
after it. This axiological test measures changes induced by the experience of ayahuasca
drinking. The article discusses the advantages of this test in relation to other psychological
and clinical tests. It is argued that the Hartman test is more appropriate to analyze the
experience of people who seek ayahuasca and do not have mental conditions and are not
especially ill. Further, the author affirms that the test is more efficient in measuring “world
views” and the personality and structural aspects of the subjects. The results of the test are
presented and discussed. The article also points out to the difference between “illness” and
“disease” and “healing” and “cure.”

22. Stelio Marras (Anthropology Instituto de Estudos Brasileiros, Universidade de São
Paulo) – “Some thoughts from an anthropology of science point of view
The book´s essays will be analyzed from the point of view of the problem of dualisms, that
is, of a world divided in two (by a binocular view). The article proposes, as an alternative,
the opposite approach, that is, a multi-ocular or multi-focal view which seeks to examine
the design of networks formed by the diverse agencies (human and non-human, natural and
supernatural) which motivate action. This opens up the possibility of questioning
the convention which interprets the world and action on the world in terms of reified
agents, that is, as if they have always been that way. Instead, taking a step back, the article
focuses on how the agents come to be what they are (and thus before considering what they
are). In other words, ontogenesis before ontology. This approach dares to ask whether the
world, seen in this way, may reemerge re-enchanted, proposing, among other challenges,
to sharply question the notion of cause, considering that the agents, influenced by the
mutual causation of a network, act upon each other.

Further info: http://www.bialabate.net/wp-content/uploads/2010/10/Ayahuasca_Salud_English1.pdf