Ayahuasca experiences of those in the UK: an Interpretative Phenomenological Analysis

A Research Report

Adam Knowles

Ayahuasca, a psychedelic Amazonian brew, is increasingly popular with UK seekers of psychological, emotional, biological and spiritual healing. Adam Knowles' research explores how four people made sense of their ayahuasca experiences in a therapeutic context.

Photo by Jairo Galvis Henao on Flickr
Photo by Jairo Galvis Henao on Flickr

Abstract
Ayahuasca, a psychedelic Amazonian brew, is increasingly popular with UK seekers of psychological, emotional, biological and spiritual healing. I explore what four people from the UK told me about the sense they make of their ayahuasca experiences in settings aimed at therapeutic use. I present three themes from my interpretative phenomenological analysis (IPA): ‘Our telephone line back to source: Insights on how ayahuasca changed participants’ lives’, ‘I ended up in my father's psyche: Ayahuasca's mechanism of perspective’, ‘Watch loads of ballet: Ayahuasca amongst different paths of healing’. I explore the increasing connections between psychedelics and psychotherapy. Written by a newly qualified psychotherapist, this research is rare in its contemporary UK focus and qualitative, phenomenological basis.
Keywords: ayahuasca, psychedelics, psychotherapy, phenomenology, existential, IPA

Introduction
Ayahuasca, broadly illegal in the UK (Walsh, 2016, p. 241), is a plant medicine brew important to indigenous communities of the Amazon, unique in its effects and history (Shanon, 2010, p. 141). The crushed ayahuasca vine and leaves of the chacruna bush work together (Bouso and Riba, 2011) to produce the visual, auditory and bodily sensations characteristic of a psychedelic journey. This journey often holds great personal significance and meaning (Shanon, 2010, p. 13; dos Santos et al., 2016) via experiences that people report as helpful and healing (Labate and Cavnar, 2013; Blainey, 2015; ICEERS, 2017, p. 3). These healing effects are best understood with a bio-psycho-socio-spiritual model (Frecska, Bokor and Winkelman, 2016), rather than a simpler biomedical model, which might be more suitable to understand perhaps insulin for diabetes or ibuprofen for a headache.

Like dreams, ayahuasca experiences can be ambiguous and difficult to understand, so some find it helpful to discuss their experience with a psychotherapist. Psychotherapy and psychedelics have a dynamic relationship going back at least 50 years, when various combinations of the two were tried out using LSD and other substances (Caldwell, 1968; Carhart-Harris and Goodwin, 2017). The ayahuasca experience may be intensely distressing. The participant is likely to experience a range of bodily difficulties including vomiting, diarrhoea and sweating (Loizaga-Velder and Verres, 2014, p. 68; ICEERS, 2017, p. 8). Mentally, a strong grip of self and consensus reality is necessary to undertake a journey that often calls self and reality into question. While ayahuasca has an acceptable safety profile in controlled settings (ICEERS, 2017; dos Santos et al., 2018), the dangers of the experience span the physical, emotional, psychological, spiritual, cultural and environmental realms.

In this research, I set out to better understand the therapeutic potential of ayahuasca and the implications for psychotherapists, from a viewpoint informed by existential philosophy.

Methodology & Method
I sought a suitable qualitative method to better understand the ayahuasca experiences of those in the UK. I was attracted to the invitation to ‘make the scientific theme secure by working out these fore-structures in terms of the things themselves’ (Heidegger, 2016, p. 195), to work inductively and avoid imposing patterns on the data from my prior assumptions and conceptions. Due to its grounding in Heideggerian phenomenology, suitability for small samples and reputation in health psychology, I decided to use interpretative phenomenological analysis (IPA).

I sought four participants who met eligibility criteria for safe, ethical and effective research. I recruited from my personal and professional networks, excluding anyone who already knew me, and used semi-structured interviews to gather data, as suggested by Smith, Flowers and Larkin (2009, p. 57). Participant demographics are listed in Table 1.

Table 1: Participant demographics

Signifier Gender Age Nationality Occupation Number of ceremonies
Brandon Male 42 British Bodyworker 2
Samuel Male 53 British Entertainment [did not wish to disclose]
Katherine Female 38 British Entrepreneur [did not wish to disclose]
Patricia Female 63 British Semi-retired 25+

My interview questions were aimed at eliciting detailed, first person accounts of ayahuasca ceremonies and their effect. I conducted a 45 to 60-minute face-to-face interview with each participant, personally transcribed the audio recordings and then analysed the transcripts following IPA (Smith, Flowers and Larkin, 2009, pp. 79–106), as follows. I processed the first transcript by reading and re-reading, making initial descriptive, linguistic and conceptual notes, grouping these initial notes into themes, then looking for connections across themes. I then applied the same steps separately to my second, third and fourth transcript, before looking for thematic connections across the transcripts to generate overall superordinate and subordinate themes. Finally, I rooted the analysis in the words of the participants (Pringle et al., 2011, p. 21), putting their words first for each theme. The resulting themes are an abstraction of what the participants told me, and one amongst other valid interpretations possible (Smith, Flowers and Larkin, 2009, p. 183).

Ethics
The research gained formal ethical approval from Regent’s University London and incorporated the ethical requirements of my professional body, the United Kingdom Council for Psychotherapy. To protect participants’ confidentiality, I use pseudonyms throughout. Each participant granted their informed consent to the research via written and signed forms, including the use of anonymised, transcribed excerpts from their interview in reports for publication. My research received no outside funding, and I declare no conflicting interests.

Findings
I list five superordinate themes in Table 2, which also shows the number of times each participant made comments that I categorised under each theme.

Table 2: Super-ordinate themes and theme prevalence

Super-ordinate theme Brandon Samuel Katherine Patricia Theme totals
T1. Our telephone line back to source: Insights on ayahuasca changed participants’ lives 13 38 32 48 131
T2. I ended up in my father’s psyche: Ayahuasca’s mechanism of perspective 4 17 14 17 52
T3. Watch loads of ballet: Ayahuasca amongst different paths of healing 19 12 15 30 76
T4. Gets you off your head: A drug? 14 36 7 16 73
T5. Three guys with feathers: Intercultural exchange 67 31 18 18 134
Participant totals 117 134 86 129 466

In this report, I present three themes, selected for their relevance to psychotherapy.

T1. Our telephone line back to source: Insights on ayahuasca changed participants’ lives

This theme refers to insights from ayahuasca experiences that participants linked to substantial changes in their lives. This theme uses Katherine’s words: ‘all of these things [indigenous techniques such as drinking ayahuasca] they're our tools. Our telephone line back to source’.
Here, Katherine alludes to ayahuasca providing a way to communicate with a ‘source’, whether nature, the Universe or perhaps God. After several ayahuasca experiences, Katherine gave up a successful career that she found encouraged an unhealthy self-obsession. She now makes her livelihood as a shaman, helping others. Elsewhere, Samuel credits ayahuasca with helping him escape long-term drug addiction. Patricia reports that ayahuasca helped her understand her troubled relationship with her father after a lifetime of distress related to that relationship, which I discuss next. Brandon did not report any meaningful changes, although he put this absence down to his practice of other healing modalities linked to the later theme ‘different paths of healing’. In summary, all participants except Brandon reported that their insights from ayahuasca changed their lives in some way for the better.

T2. I ended up in my father’s psyche: Ayahuasca’s mechanism of perspective

This theme is based on comments about the different perspectives granted by ayahuasca ceremonies and their effect post-ceremony. The theme label uses Patricia’s words:
‘I ended up in my father's psyche … I could feel what he was feeling when he was little, which was horrible. It was rage’. This new understanding of something pivotal in Patricia’s father’s life was a startling revelation for her. Previously, Patricia could not make peace with her father’s treatment of her, despite long-term psychotherapy and trying many other paths of healing. Here, she relays that by inhabiting her father’s point-of-view she began to see him differently herself. Patricia credits her revelation on ayahuasca with a meaningful relief for her via greater compassion and understanding of her father’s life. Katherine, Samuel and Brandon also reported worthwhile new perspectives from their ayahuasca experiences.

T3. Watch loads of ballet: Ayahuasca amongst different paths of healing

Participants stress that ayahuasca was necessary but not sufficient for the changes they made and that also they value non-ayahuasca paths of healing. They highlight a variety of attitudes to the integration of and alternatives to ayahuasca, including psychotherapy. Samuel’s words feature in the title for this theme: ‘you might watch loads of ballet, you might go running on the beach. Anything that helps you become conscious of yourself’. Brandon agrees, ‘there are just different paths’. For all four participants, psychotherapy before and after their psychedelic experiences is one of these paths. Patricia mentions that she was sometimes taking magic mushrooms around the same time in her life as, though separate to, weekly cognitive behavioural therapy. Samuel had a positive experience of subsequent psychotherapy helping him make sense of his ayahuasca experiences, while Katherine had a negative experience of psychotherapeutic support for psychedelics, preferring ayahuasca alone.

Discussion
Figure 1 shows the relationship between the three themes. Participants suggest that ayahuasca is one amongst many paths of healing (T3). The finding that insights or new perspectives from ayahuasca ceremonies can help people improve their lives (T1) relates to literature that sets out ayahuasca’s therapeutic potential (Labate and Cavnar, 2013; dos Santos et al., 2016; ICEERS, 2017).

Adam Knowles Image 1

Figure 1: Relationship between themes

The world offers both ayahuasca and psychotherapy as different paths of healing (T3), amongst others. Ayahuasca and psychotherapy can interact. While a small zone of contact historically, this connection will expand as more in the UK have experiences with both ayahuasca and psychotherapy over time. The participants sometimes discussed ayahuasca and psychotherapy together. Since talking coherently with someone amidst a psychedelic experience is difficult, most modern approaches suggest psychotherapy happens in the weeks and years after a psychedelic experience (Multidisciplinary Association for Psychedelic Studies, 2016, p. 4; Soltara Healing Centre, 2018; Temple of the Way of Light, 2019). The alternative is to attempt psychotherapy during the psychedelic experience, which is now mainly a thing of the past (Caldwell, 1968). For many, psychotherapists are better placed to offer serious, informed, committed, long-term support than shamans, scientists, doctors, psychiatrists, nurses or underground therapists (Calvert, 2013; Barone et al., 2019). There is likely to be room for psychotherapists supporting those undertaking psychedelic experiences and for psychedelics supporting a process of psychotherapy. Either way around raises questions about how best to develop the knowledge, experience and training available to psychotherapists in this regard.

Reflexivity
As a note of reflexivity, I have personal reasons for researching this area. Alongside psychotherapy and yoga, my encounters with ayahuasca were pivotal in my shift away from operating in a relatively selfish, capitalist mode toward one focused more on helping others, including training as an existential psychotherapist. I wanted to know how ayahuasca had affected the lives of others in the UK and how psychotherapists might best help those people. As a psychotherapist, I often receive enquiries from people struggling with serious, long-term and chronic difficulties who are hoping for a new way forward by undertaking psychedelic experiences. These people often report that they have tried psychotherapy, medication, psychiatry, body therapies and other treatments for years without success. They hope for better from their ayahuasca experiences (Labate and Cavnar, 2013).

Limitations and further research
In terms of limitations, this was my first attempt at academic research, and I had no prior experience of doing IPA. My interviews could have been more focused, and my analysis more idiographic in its attempt to understand individual, personal experience, before cross-cutting themes. Due to its brevity, this report offers only an introduction to three of my five themes, limiting the depth of analysis and breadth of supporting samples that I can include. Further studies could be conducted which mix quantitative with qualitative approaches, linking neurological and genetic measurements with an analysis of subjective experiences. These studies might examine changes over time with longitudinal elements. Studies using scales and inventories could be partnered with data based on interviews and interpretation.

Conclusion
The key theme to emerge from three of the four UK participants with ayahuasca experiences was that of meaningful life improvements. Their ayahuasca experience offered these participants insights and new perspectives, which they combined with other paths of healing, including psychotherapy, to improve their lives. More people in the UK are seeking out psychedelic experiences (Walsh, 2016), perhaps due to the growing evidence of potential therapeutic effects of ayahuasca (Labate and Cavnar, 2013). More research is needed. Psychotherapy and ayahuasca have much to offer each other, yet there is little formal training or literature available, especially with a UK-focus or an existential perspective. There is an increasing need for training organisations and psychotherapists to address this.

Adam Knowles is a queer, piano-loving, yogic Mancunian-in-London exploring his radical edge. He works as an existential psychotherapist in private practice 1-1 and in small groups, and conducts PhD research into psychedelics. Adam led technology teams for 20 years then, after ayahuasca and psychotherapy, spent five years training as a psychotherapist at Regent’s University London, specialising in the existential approach. For his Master's at Regent's, he conducted qualitative research with UK participants about their ayahuasca cere-monies. Breaking Convention, Europe’s largest psychedelic conference, awarded this re-search their 2019 prize in Social Sciences. Publications include the SEA Journal, Reflec-tions, Therapy Today, and the Hermeneutic Circular. Other interests include yoga, cryp-to/decentralised finance and LGBT+ issues.
Twitter: @therapymind. Websites: ayaresearch.com, adamknowles.co.uk. Email: [email protected]
Adam Knowles

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