Changes in mental health, wellbeing and personality following ayahuasca consumption: Results of a naturalistic longitudinal study

Abstract

Background: Naturalistic and placebo-controlled studies suggest ayahuasca, a potent psychedelic beverage originating from Indigenous Amazonian tradition, may improve mental health, alter personality structure, and reduce alcohol and drug intake. To better understand ayahuasca’s therapeutic potential and to identify factors that influence therapeutic efficacy, we conducted a naturalistic, longitudinal study of facilitated ayahuasca consumption in naïve participants using a comprehensive battery of self-report questionnaires.Materials and Methods: Ayahuasca naive individuals registering for ayahuasca ceremonies were asked to complete a range of validated questionnaires assessing mental health, alcohol/cannabis use, relationships, personality, and connection to self and spirituality, prior to and 1 month after attending an ayahuasca ceremony. Data for two mental health measures (the DASS-21 and PANAS) and acute subjective effects via the MEQ-30 were also assessed 7 days post-ceremony. Repeated measures ANOVA were used to examine pre-to-post changes, and Pearson correlations explored predictors of improvement in outcomes.Results: Fifty-three attendees (32 women, 21 men) completed pre and post ayahuasca assessments with 55.6% of the sample reporting a complete mystical experience based on the MEQ-30. One-month post-ayahuasca, significant reductions were identified in depression, anxiety, stress, alcohol and cannabis use, body dissociation, accepting external influence, self-alienation, impulsivity, and negative affect/emotionality. Significant increases were identified in positive mood, self-efficacy, authentic living, extraversion, agreeableness, open-mindedness, spirituality, and satisfaction with relationships. While facets of the mystical experience held little predictive validity on outcome measures, baseline traits, particularly high negative emotionality and body dissociation, and low sense of self-efficacy, robustly predicted improvements in mental health and alcohol/cannabis use, and alterations in personality structure which are linked to better mental health.Discussion: This study suggests facilitated ayahuasca consumption in naïve participants may precipitate wide-ranging improvements in mental health, relationships, personality structure, and alcohol use. Associations between baseline traits and therapeutic improvements mark an important first step toward personalized, precision-based medicine and warrant randomized controlled trials to confirm and elaborate on these findings.Contribution Statement: Longitudinal, observational studies and randomized clinical control trials suggest ayahuasca may exert therapeutic effects on mental health and alcohol/cannabis use, and alter personality structure. However, it is unclear if improvements are diagnosis-specific and factors that predict therapeutic gains have yet to be extensively elucidated. This longitudinal, observational study examined the effects of facilitated ayahuasca consumption in naive participants on mental health, alcohol and substance use/abuse, personality traits, relationships, and connection to self and spirituality. We found wide-ranging improvements 1-month post-treatment across these domains, and identified baseline traits which predict pre-to-post changes on primary outcome measures. Improvements were not diagnostic-specific, suggesting ayahuasca may be generally efficacious. Personality traits, body dissociation, and self-efficacy were strong predictors of therapeutic improvements, marking an important first step toward personalized, precision-based medicine. Randomized controlled trials are warranted to confirm and elaborate on these findings.

Psychotherapeutic and neurobiological processes associated with ayahuasca: A proposed model and implications for therapeutic use

“…Given the central place of somatic effects in ayahuasca's psychotherapeutic outcomes and the apparent enhanced somatic awareness window created (effects not generally seen with other psychedelics), the inclusion of additional somatic processing practices/tools and therapeutic frameworks incorporating a somatic dimension, is likely to be of significant benefit to participants. The inclusion of this focus in preparation and integration will support a deepening of the acute experience [this has been reported for yoga/tai-chi (Perkins et al, 2022)] and more effective post-administration processing of experiences and emotional content. While other psychedelic therapy approaches provide some guidance on incorporating somatic tools such as focused bodywork or breathwork, these are not integrated as a core element of the approach and are dependent on the prior training of the therapist.…”

“…Our previously published work regarding the influence of context on acute and longer-term outcomes identified minimal variation across traditional, church, and neo-shamanic contexts, suggesting common psychotherapeutic processes ( Perkins et al, 2022 ). Similarly, the number of times ayahuasca had been consumed has some influence on the magnitude, but not type of outcomes being attained ( Perkins et al, 2022 ).…”

“…This can include the well documented purge, which can even modulate emotional and visual experiences and is suggested to be therapeutic in nature (Shanon, 2002;Wolff et al, 2019). Similarly, ayahuasca drinkers 10.3389/fnins.2022.879221 have been reported to have more positive and persistent mystical experiences, compared with users of other psychedelics (Davis et al, 2019) and report levels of self-insights and significant life changes beyond those identified with other psychedelics (Perkins et al, 2022).…”

“…We also note that there are non-pharmacologically induced factors that have been identified as contributing to mental health outcomes associated with ayahuasca consumption. These include drinkers experience of support and safety, the quality of preparation support provided, complementary therapeutic activities, and social strong connections formed in the ayahuasca drinking setting ( Perkins et al, 2022 ). Other factors such as an individuals’ state of mind, or “set,” when consuming ayahuasca, and constituent levels in the brew itself, are also likely to influence their acute experience.…”

“…After drinking ayahuasca, participants have been found to experience a greater sense of self-awareness, self-acceptance, and presence in themselves, as well as enhanced self-love, leading to greater empathy and improved interpersonal relationships ( Kjellgren et al, 2009 ; Soler et al, 2016 ; Renelli et al, 2020 ). Such renewed Self-connection is evident in increased generalized self-efficacy, personal authenticity ( Perkins et al, 2022 ). These reported improvements in psychological wellbeing have been found to be strongly predictive of better current mental health ( Perkins et al, 2022 ).…”