Ayahuasca Research with Dr Simon Ruffell

What Is Ayahuasca?
The word ayahuasca is derived from the phrase “vine of the dead”, or “vine of the soul” in Quechuan languages – succinctly capturing its mystical and spiritual role in South American cultures. Ayahuasca is a psychedelic plant brew composed of two primary ingredients: 1) Banisteriopsis caapi and 2) Psychotria viridis. N,N-dimethyltryptamine (DMT), found within the Psychotria viridis component of ayahuasca, is responsible for the hallucinogenic properties of the brew. Betacarbolines, found within Banisteriopsis caapi, prevent the breaking down of DMT within the body, subsequently enabling the absorption.
The consumption of ayahuasca induces profound changes in sensory, cognition, and emotional changes – often presenting in the form of purging (both physical and emotional), visions, deep introspection, and feelings of connection with the divine. The powers of ayahuasca have been harnessed for a number of purposes, including as medicine, sacrament, spiritual development, and warfare.

 

Ayahuasca Tourism
Within the last 10-20 years, it has become increasingly more common for people to seek out the ayahuasca experience, both within the rainforest and in the global north. Consequently, it becomes more and more vital to understand the associated risks. The increasing popularity raises environmental concerns, including both the sustainability of ayahuasca production going forwards, and the increased air travel required to get Westerners to the Amazon rainforest. Critically, ayahuasca tourism has no central regulating authority – enabling the opportunity for psychological, physical, sexual, and/or financial exploitation by individuals falsely claiming to be shamans 1,2. Adding to this, ethical considerations are fundamental to exploring the culture of ayahuasca. As a result of the developing Western interest, certain ayahuasca centres have tailored the experience they provide in order to accommodate individuals from the Western world, creating concern that this outside interest may be diluting the tradition. This commodification may represent a form of neocolonialism and cultural appropriation (biopiracy) that ultimately leaves locals disadvantaged. Ayahuasca is meant to promote healing, meaning, and community – values that could potentially be directly contradicted by Western involvement if not handled carefully. In fact, if cultural concerns are handled with sensitivity and cross-cultural dialogue, it may represent an opportunity to preserve and protect a beautiful tradition.

 

Modulatory Effects of Ayahuasca on Personality Structure in a Traditional Framework
In the study Modulatory Effects of Ayahuasca on Personality Structure in a Traditional Framework conducted by Netzband, Ruffell, Lington, Tsang & Wolff (2020), the researchers focused on the effects of ayahuasca on personality, adding to the growing body ayahuasca research, and the effects of psychedelics on personality (eg. psilocybin, LSD). Additionally, the study was created with the intention of assessing possible clinical implications, and examining the importance of set and setting.
This study was conducted in the MAPS (Multidisciplinary Association for Psychedelic Studies)-associated Riosbo research center within the Allpahuayo-Mishano national reserve of Peru. This centre is situated within the local Shipibo community (80 indigenous people), two hours away from the nearest town, and with no electricity, phone signal or internet. This study enlisted the use of an observational repeated-measures design, with assessments before the first ceremony (pre), following the final ceremony (post), and six months after the final ceremony. Semi-structured interviews were also conducted during the retreats and were included in a separate qualitative publication. The retreats lasted 12 days, encompassing 6 ayahuasca ceremonies.

The sample group (n=24; 9 female) included in the study was a majority Western population, and all vetted by the Ayahuasca Foundation: 12 have/had a psychiatric condition, 14 with a present chronic ailment, and 4 fully-healthy individuals. In regards to psychedelic history, 6 individuals were psychedelic-naive, 10 psychedelic-experienced, and 8 with experience with ayahuasca specifically. The control comparison group in this study consisted of individuals in nearby hostels who were not drinking ayahuasca, intended to control for the effects that accompany simply travelling to South America.
The measures used for this study included the NEO-PI3, a measure of the five primary personality traits (openness, conscientiousness, extraversion, agreeableness, neuroticism), and the Mystical Experience Questionnaire (MEQ30).

Prior to the study, the researchers hypothesised that the participants would show:
a) Increased openness; in both short-term (immediate), and long-term (six-month follow-up)
b) More intense perceptions of a Mystical/Peak Experience, with more pronounced changes in personality, and
c) Changes in neuroticism in subjects with affective disorders.

 

Research Findings & Implications
Ruffel and his colleagues found that the ayahuasca-intervention group saw significant reductions in neuroticism immediately after the event, as compared to the control group. Amazingly, they found that these effects were long-term, as they were maintained six-months down the line. Similarly, they found that ayahuasca increased agreeableness both in the short-term (immediately after) and in the long-term (six-month follow up). Additionally, they found a significant moderate relationship between the increasing intensity of the ‘mystical experience’ and the reduction in neuroticism.
These long-term reductions in neuroticism suggest therapeutic potential in treating psychiatric conditions such as anxiety and depression. The neuroticism findings from this study were in line with Dr. David Erritzoe’s research on psilocybin and personality, however Ruffell and his colleagues did not see the same decrease in openness that both Dr. Erritzoe and Dr. Katherine MacLean have found in their psilocybin research. It is worth noting that this could possibly be due to a variance in starting points in openness – individuals willing to adventure into the rainforest for an ayahuasca experience are likely already fairly open-minded personalities.
While this study presents encouraging and intriguing evidence for the therapeutic potential of ayahuasca, it was not without limitations. As a consequence of conducting the study in the Amazon rainforest, access to research equipment was naturally more limited than in a traditional research setting. In a similar vein, the tradition of an ayahuasca ceremony does not focus on drug dosages, but rather an amount that the shaman sees fitting. While this strengthens the authenticity of an observational study, it does create limitations in determining dose-dependent effects. Similarly, the ayahuasca used in this study was unable to be analysed for MAOI (monoamine oxidase inhibitor) and DMT content. The sample itself was relatively small, with just 24 participants, limiting the power of the study. Additionally, the amount of time between the post-measure and the long-term follow-up (six months) leaves plenty of time for life changes (eg. meditation, new job) to occur, affecting personality measurements independent of ayahuasca effects.

 

The Impact of Ayahuasca on Trauma-Related Condition in an Adapted Traditional Setting
Most recently, Dr. Ruffell and his colleagues have explored the effect of ayahuasca on short-term and long-term mental health and well-being in individuals with varying degrees of childhood trauma. Specifically, they sought to understand the extent to which overgeneralised autobiographical memory recall and mystical experiences can mediate these changes. With a sample of 65 participants, they conducted semi-structured interviews alongside a number of pre-test, post-test, and 6-month follow up scales including:
– Beck Depressive Inventory (BDI),
– State and Trait Anxiety Index (STAI),
– Self-Compassion Scale (SCS),
– Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), and
– Sentence Completion for Events from the Past Test (SCEPT).

Additionally, demographics and a Childhood Trauma Questionnaire (CTQ) were obtained pre-test only, while the Mystical Experience Questionnaire (MEQ30) was completed post-test. Outside of psychological measures, saliva samples were collected to assess DNA expression, or epigenetic outcomes.
The results from this study found significant reductions in depression and anxiety outcomes, as measured by the BDI and STAI, respectively – both in the short-term and long-term. Similarly, participants’ self-compassion (SCS) and global distress (CORE-OM) both significantly improved in the short-term and long-term. Interestingly, they also found that participants recalled negative memories from the past with a more positive perspective, as measured by the SCEPT, at both short-term and long-term timepoints. However, the MEQ and CTQ questionnaire did not exhibit any significant correlations with outcome measures. Of the epigenetic outcomes, they found that the SIGMAR gene, a gene associated with trauma and neuroplasticity, was expressed at significantly elevated levels, however it is vital to note that 65 participants is a very limiting sample size for an epigenetic study. Nonetheless, this provides encouraging evidence that epigenetic effects of ayahuasca are indeed worth further research. Notably, a small number of individuals from the sample reported increases in depression and anxiety, although, as in the case of long-term positive effects, any significant life event or life change between the post-measure and long-term measure (six months) could be responsible for this change, and not necessarily solely attributable to ayahuasca.

 

Future Research
Going forwards, Dr. Ruffell will be exploring ayahuasca in relation to chronic trauma, perception of trauma, and veteran-related PTSD, as well as including epigenetic analysis and ayahuasca sample analysis in future research.

 

Is Ayahuasca Research Ethical?
With the renewed fascination in psychedelics in the scientific community, it becomes important to reflect on the ethics of studying a substance like ayahuasca. With the booming popularity of ayahuasca globally, access to reliable data regarding the substance becomes increasingly vital to safe consumption. Additionally, the development of novel treatments in psychiatry has become relatively stagnant in the recent past, with newly developed ideas generally being modified versions of existing treatments – psychedelics such as ayahuasca represent an opportunity for fresh therapeutic avenues. However, the prospect of medicalisation of ayahuasca is not without risks – namely, the potential for manipulation by ‘big pharma’. Further, while the existing research appears to depict a positive outlook, anecdotes of poor ayahuasca experiences do exist, and it is crucial that they are not blindly discounted. As mentioned earlier, cultural context plays a critical role in ethical research – it would be easy for a Western approach to devolve into a form of cultural and/or spiritual appropriation. In a similar vein, we must remember that a Western scientific approach to the mechanism of ayahuasca is just one ontological explanation for the changes occurring in individuals. Nevertheless, ethical research into ayahuasca is very much possible, further enabled by organisations such as Alianza Arkana3, Chaikuni Institute4, and Regenerative Agroforestry Impact Network5 that seek to reciprocate aid to these areas while reducing the risk of destabilisation that a purely financial transaction may incur.

 

Dr. Simon Ruffell is a psychiatrist based in South London with King’s College London, and member of the Medical Psychedelics Working Group, who conducts research focusing on the use of ayahuasca in Peru.

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1 For further information regarding awareness of sexual abuse in ayahuasca tourism, you can visit: www.chacruna.net
2 Ethical code of ayahuasca tourism: www.plantaforma.org/codigo-etico-eng

3 Alianza Arkana: https://www.globalgiving.org/donate/10471/alianza-arkana/
4 Chaikuni Institute: https://chaikuni.org/
5 Regenerative Agroforestry Impact Network: rainumbrella.org