In 2019 I completed a Master of Arts degree in Psychotherapy through Middlesex University. For my research thesis I chose to investigate how experienced psychosynthesis practitioners approach working with clients who use the psychoactive brew ayahuasca. I chose this topic for my MA thesis because at that time I had started to receive an increasing number of enquiries in my clinical practice related to ayahuasca use; either in relation to a need for ‘psychedelic integration’ or from those seeking ‘aftercare’ following a distressing ayahuasca-induced experience. I chose a qualitative phenomenological approach for the research and analysed the interview accounts using Interpretative Phenomenological Analysis (IPA).
Ayahuasca is a powerful psychoactive plant concoction with a history of healing and ritual use in the amazon basin of South America (Tupper, 2008; Winkleman, 2005). In recent years its use has expanded into many countries and cultures worldwide, a phenomenon sometimes referred to as the ‘globalisation of ayahuasca’. Whilst the increase in ayahuasca use globally appears to have been driven by its reputation for providing healing and catalysing mystical or transcendent states, there are a number of physical, psychological and spiritual risks associated with taking ayahuasca (Frecska et al., 2016; Trichter, 2010). Non-traditional users of ayahuasca appear to have little cultural support and understanding available to them, a factor which is thought to increase the risks stemming from its use. In response to this, several researchers have suggested that support from appropriately trained psychotherapists can act as a harm reduction intervention for ayahuasca users in contexts where its use is not well known or understood (Lewis, 2008; Ray and Lassiter 2016; Trichter 2010). Psychotherapy is thought to act as a harm reduction intervention in this context through its role in meaning making, supporting psychological preparation for ritual and providing a relational container for processing emergent unconscious material.
Through my research, I sought to investigate whether psychosynthesis, as a psychotherapeutic approach that integrates transpersonal, psychodynamic and existential perspectives, could provide a useful framework for practitioners who work with clients who use ayahuasca or similar psychedelic substances such as LSD or psilocybin containing mushrooms. I formed this hypothesis on the basis that psychosynthesis theory appears to have a number of potential applications to clinical work with ayahuasca users:
- Psychosynthesis theory references many of the experiences identified in the research literature as being associated with ayahuasca use, such as spiritual emergency, the emergence of repressed trauma, catharsis and the catalysing of peak experiences. Roberto Assagioli’s forerunning contribution to the theoretical conceptualisation of spiritual emergency through his paper on Self-realisation and psychological disturbances (1965) is one such example of this (Grof and Grof, 1989).
- Psychosynthesis is a relational psychotherapy (Firman and Gila, 2002; Millichamp, 2018; Whitmore, 2004), a factor considered important to productive outcomes in psychedelic therapy. A contention I put forward in my thesis was that where users of substances like ayahuasca are in a pre-existing, established therapeutic relationships, an internalisation of the therapeutic alliance can reduce risk to ayahuasca users through its impact on the non-drug variable of the mental ‘set’ – suggesting that ongoing psychotherapy can, therefore, act as a harm reduction measure.
- The psychosynthesis map of the psyche (Assagioli, 1965) provides a framework for conceptualising the non-specific amplification of consciousness that psychedelic substances engender (Grof, 1983; 1994) and can be thought of as analogous to an expansion of the ‘middle unconscious’ in the psychosynthesis model (Assagioli, 1965; Firman and Gila, 2002).
- Psychosynthesis is a model that contains many tools and techniques that may be relevant to working with the phenomenological aspects of the ayahuasca experience, such as the use of active imagination and creative expression through free drawing.
My research involved interviewing experienced psychosynthesis practitioners and found that:
- Many clients who seek psychotherapeutic support following ayahuasca use have taken ayahuasca on the basis of spiritual, healing or transpersonal motivations.
- There are however significant risks associated with ayahuasca use including spiritual or ‘transpersonal risks’ such as spiritual bypass and behavioural or ‘spiritual addiction’.
- Psychosynthesis was considered by the research participants to be a valuable approach to working with ayahuasca users through its emphasis on meaning making, its commitment to a transpersonal perspective and its methods of grouding and differential diagnosis. The illicit nature of ayahuasca use in many countries was however found to act as a potential barrier to ayahuasca users accessing therapy and to the establishment of an effective therapeutic alliance.
The conclusion of my research stated that:
- As a transpersonally informed psychotherapy which works explicitly with unconscious processes, I argued that the psychosynthesis model can help clients develop a working knowledge of unconscious processes – through the use of guided imagery and similar psychosynthesis tools and techniques and that this may further reduce risks related to the use of psychedelic substances like ayahuasca.
- That there are however important ethical considerations for any practitioner who works in this area to consider, particularly in relation to striking a balance between the ethical principles of respecting client autonomy and the risk of colluding with client self-harm. Where Ayahuasca use is illegal this leads to additional ethical considerations for any practitioners who may work with clients who take it.
Whilst my research didn’t focus on whether there were potential benefits in the use of ayahuasca as an adjunct to psychotherapy, there is a growing body of research which indicates that psychedelic substance use opens up a therapeutic window which supports deeper engagement with psychotherapy through increased insight and emotional release (Nutt, Erritzoe and Carhart-Harris, 2020). Whilst this may indeed be the case, it is important to recognise that ayahuasca use is risky and illegal in many parts of the world. Accordingly, my research did not aim to promote or condone the use of ayahuasca but was rather aimed at investigating psychosynthesis psychotherapy as a potential harm reduction measure.
Assagioli, R. (1965) Psychosynthesis: a collection of basic writings. New York: Hobbs Dorman & Co.
Firman, J. and Gila, A. (2002) Psychosynthesis: a psychology of the spirit. Albany, NY: State University of New York Press.
Frecska, E., Bokor, P. and Winkelman, M. (2016) ‘The therapeutic potentials of ayahuasca: possible effects against various diseases of civilization’, Frontiers in Pharmacology, 7(35), pp. 1-17.
Grof, S. (1983) ‘New perspectives in psychotherapy: observations from LSD research’, in Grinspoon, L. and Bakalar, J. B. (eds.) Psychedelic Reflections. New York: Human Sciences Press. pp. 164-176.
Grof, S. (1994) LSD Psychotherapy. 2nd edn. Alameda, CA: Hunter House.
Grof, S. and Grof, C. (1989) Spiritual emergency: when personal transformation becomes a crisis. New York: Jeremy P. Tarcher/Putnam.
Lewis, S. E. (2008) ‘Ayahuasca and spiritual crisis: liminality as space for personal growth’, Anthropology of Consciousness, 19(2), pp. 109-133.
Millichamp, S. (2018) Transpersonal Dynamics. London: TransPersonal Press.
Nutt, D., Erritzoe, D. and Carhart-Harris, R. (2020). Psychedelic Psychiatry’s Brave New World. Cell, [online] 181(1), pp.24–28.
Ray, R. R, and Lassiter, K. S. (2016) ‘Ayahuasca treatment center safety for the western seeker. Anthropology of Consciousness, 27(2), pp. 121-150.
Trichter, S. (2010) ‘Ayahuasca beyond the Amazon: the benefits and risks of a spreading tradition’, Journal of Transpersonal Psychology, 42(2), pp. 131-148.
Tupper, K. W. (2008) ‘Ayahuasca healing beyond the Amazon: the globalization of a traditional indigenous entheogenic practice’, Global Networks, 9(1), pp. 117-136.
Whitmore, D. (2004) Psychosynthesis Counselling in Action (3rd Edition). London: Sage Publications.
Winkleman, M. J. (2005) ‘Drug tourism or spiritual healing? Ayahuasca seekers in Amazonia’, Journal of Psychoactive Drugs, 37(2), pp. 209-218.
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