Beatriz Caiuby Labate and José Carlos Bouso (eds.)


(On-line cover: illustration “Ayahuasca Caduceus”, by Clancy Cavnar)

This collection brings together perspectives from the social and biomedical sciences as well as personal accounts of ayahuasca users 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 the 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.

Table of contents:

Jacket text: Glenn H. Shepard Jr.

Back cover blurb: Rick Doblin

Foreword: “Ayahuasca at the crossroad of different forms of knowledge” – 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 (Associate Researcher Institute of Medical Psychology Heidelberg University) and José Carlos Bouso (Centro de Investigación de Medicamentos, Hospital de la Santa Creu y Sant Pau, 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 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 – 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 – PhD in Social Anthropology Universidade Ferderal de Santa Catarina –“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 and Matthew Meyer – MA in Cultural Anthropology California State University and 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, Beatriz Caiuby Labate, Sérgio Brissac and Jonathan Ott – Biologist University of Guarulhos; Associate Researcher Institute of Medical Psychology Heidelberg University;  PhD in Social Anthropology Museu Nacional-UFRJ and 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, Josep María Fábregas, Sabela Fondevila, Débora González, Marta Cutchet, Xavier Fernández, Miguel Ángel Alcázar, Gregorio Gómez-Jarabo – Centro de Investigación de Medicamentos, Hospital de la Santa Creu y Sant Pau, Barcelona/ Centro de Investigación y Tratamiento de las Adicciones (CITA) and Instituto de Etnopsicología Amazónica (IDEAA)/ Universidad Autónoma of Madrid (UAM) and IDEAA/ PhD Candidate in Pharmacology Institut Municipal d´Investigació Médica and IDEAA/ MA in Psychopathology, CITA and IDEAA/ Doctoral candidate in Drug Dependences University of Santiago de Compostela and IDEAA/ Psychology UAM/ Psicobiology UAM – “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, Rafael Guimarães dos Santos, Rick Strassman, Brian Anderson and Suely Mizumoto – Associate Researcher Institute of Medical Psychology Heidelberg University/ Doctoral candidate in Pharmacology, Universitat Autònoma de Barcelona/ Clinical Associate Professor of Psychiatry en University of New Mexico School of Medicine and Presidente, Cottonowood Research Foundation/ Medical student, Stanford University/ MA candidate in Social Psychology, PUC-SP – “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, Rafael Guimarães dos Santos, José Carlos Bouso and Isabel Santana de Rose – Associate Researcher Institute of Medical Psychology Heidelberg University/ Doctoral candidate in Pharmacology, Universitat Autònoma de Barcelona/ Centro de Investigación de Medicamentos, Hospital de la Santa Creu y Sant Pau (Barcelona)/ PhD in Social Anthropology Universidade Ferderal de Santa Catarina

14. Jordi Riba e Manel J. Barbanoj – Centro de Investigación de Medicamentos Sant Pau Hospital (Barcelona) and  Centro de Investigación de Medicamentos Hospital de Sant Pau (Barcelona)/ 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 – Doctoral candidate 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 – M.D., Ph.D. – Chief of Department 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 serotonin-reuptake 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 clinical-psychological or  medical, perspective.
18. Walter Moure – PhD in Psychology USP – “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 and  José María Fábregas – Doctoral candidate in Drug Dependences University of Santiago de Compostela and therapist at Instituto de Etnopsicología Amazónica Aplicada (IDEAA)/ Instituto de Etnopsicología Amazónica Aplicada (IDEAA) and Centro de Investigación y Tratamiento de las Adicciones (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. 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.