‘Everybody’s creating it along the way’: ethical tensions among globalized ayahuasca shamanisms and therapeutic integration practices

Abstract

Ayahuasca has a variety of traditional uses, yet there is a growing global interest in its potential therapeutic benefits for mental health conditions. Novel approaches to psychotherapy are emerging to address the needs of ayahuasca users to prepare as well as to guide them in 'integrating' their powerful psychedelic experiences, yet there is little discussion on the ethical frameworks that may structure these therapeutic processes or the social and cultural assumptions that influence the assignment of ayahuasca as a medicine. Based on ethnographic fieldwork in San Martín and Loreto, Peru, I examine the varied social meanings and uses of ayahuasca in the Peruvian vegetalista tradition and the potential ethical tensions among curanderos, mental health practitioners, and ayahuasca retreat centres. Practitioners and ayahuasca centres are left with navigating globalized concepts of mental health and ethics while attempting to remain authentic to local ontologies of healing, care, and safety.

Psychedelic-induced mystical experiences: An interdisciplinary discussion and critique

“…' Psychedelic scientists and humanists should also explore more ways of relating 'naturalistic' psychedelic experiences to the experiences of trial participants in clinical settings, using a mix of quantitative and qualitative methods. Some recent contributions from medical anthropologist Olivia Marcus (81)(82)(83) and multidisciplinary scholar David Yaden (21,84) offer excellent models for this type of work. Marcus' long-term fieldwork at a psychedelic retreat center in the Peruvian Amazon investigates what she calls 'therapeutic pluralism' in the treatment of mental health conditions.…”

Ethics of Psychedelic Use in Psychiatry and Beyond—Drawing upon Legal, Social and Clinical Challenges

“…In altered states of consciousness, patients become more vulnerable and may be unable to protect their own interests. For instance, psychedelics are empathogens and increase suggestibility/susceptibility [30], resulting in a vulnerable state of mind [31] that makes patients susceptible to abuse from their treatment providers (nurses, psychiatrists, therapists) as after intake they might be less likely to refuse physical touch and sexual advances and engage in sexual behaviors that they later (in a clearheaded state) consider forms of abuse [32][33][34]. Such vulnerability exposes them to potential abuse from therapists, doctors, or practitioners.…”

“…It is important to acknowledge the lack of safety and effectiveness guarantees in current interventions with psychedelics, as well as the potential for illegal practices. Moreover, the induced altered state could enable (even healthy) subjects to fail to protect their rights, e.g., be lured into cults, become vulnerable to sexual harassment [32,33], and risk other forms of abuse [30]. The medical community must adhere to ethical principles, ensuring that interventions are evidence-based and provided at reasonable prices.…”

Critical Doses: Nurturing Diversity in Psychedelic Studies

“…Non-dualist ways of thinking are also powerfully emphasized in the article ‘Mysticizing medicine: incorporating nondualism into the training of psychedelic guides practices’ (Marcus 2022 online, in this thematic issue). Valeria McCarroll speaks from her wealth of expertise in helping clients integrate their psychedelic experiences and describes how the integration process can create an expansive, deeply rooted feeling-knowing of nondualist worldviews.…”

“…The articles challenge, in detail, different practices and hierarchies of power in psychedelic discourses and practices. They are in-depth studies, some building their arguments on ethnographic fieldwork of ways of knowing and intersubjective practices that are different from our Euro–US-American worldview, such as the work by Valeria McCarroll (2022, in this thematic issue) and Olivia Marcus (2022, in this thematic issue). Other articles use methods of conceptual and historical analysis to critique power moves within the dominant societies and discourses in the current psychedelic landscape (Hauskeller et al, 2022, in this thematic issue; Breau and Gillis-Smith; Webb).…”