Can an Ayahuasca Ceremony Heal Immigrant and Refugee Trauma?

Author’s note: This story was composed using an in-depth collection of interviews and surveys of the experience from those who attended an ayahuasca ceremony as part of an observational research study.  In an airy room overlooking the mountains, soft voices and the smell of sage surround an altar with carefully placed crystals, candles, instruments, and sacred herbs. The pale sun is low on the horizon, casting long shadows as each attendant is cleansed with sage and invited to take their place in the circle. Pillows, blankets, and mats encircle the room, reminiscent of an inviting childhood slumber party. The individuals seated in the circle are mostly Arabic-speaking women from the Middle East and North Africa (MENA), including immigrants and refugees of various backgrounds originating from Saudi Arabia, Iraq, Morocco, and the United Arab Emirates.     Those seated in the circle wear white to unify this space as sacred and allow for their movements to be seen in the growing darkness. As the circle forms, hushed voices become quieter and settle into silence. This circle represents the culmination of months of preparation, and participants are instructed to adhere to a range of other practices leading up to the ceremony, including psychospiritual preparation, dietary modifications, education about the plant medicine, the practice of intention setting, and cessation of many types of activites (e.g., limiting dairy, meats, alcohol, sugar, medication, and sexual activity). Dietary restrictions are particularly critical, as the monoamine oxidase (MAO) inhibiting effect which allows the psychoactive properties of ayahuasca to take effect also allows other potentially harmful chemicals present in food to enter the bloodstream, sometimes resulting in illness. These preparations have led to an unmistakable atmosphere of apprehension and excitement, which grows as the fruits of this labor draw closer.  

Preparing the Ayahuasca Ceremony

The Amazonian psychedelic brew prepared by boiling the stems of the Banisteriopsis caapi vine with the leaves of the Psychotria viridis or Diplopterys cabrerana plant goes by many names, including ayahuasca in Peru, yagé in Colombia and Ecuador, and caapi in Brazil, among others. In the Quechua language, ayahuasca translates to vine of the soul, and has been used by indigenous communities for over 5,000 years. It is a traditional medicine to approximately one hundred indigenous groups across the Amazon Basin, and has remained a central part of indigenous culture in medicine, religious ceremonies, and rite of passage. Different indigenous groups have developed complex variations of this medicine to modify or potentiate its effects, infusing up to 90 different plants into the brew. The stunning silence of the ceremony is briefly lifted when several helpers begin placing purging buckets at the foot of each mat, producing sideways glances and nervous laughter. Malek Asfeer, an award winning Saudi Arabian script writer and filmmaker and the organizer of this ceremony, sits cross-legged amongst the group, quietly reassuring. “My first experience with ayahuasca allowed me to meet a part of myself that I didn’t know existed.” Asfeer says of his own journey with ayahuasca. “I was able to access emotions I never thought I had, like joy and happiness. Those emotions were absent and strange to me. I had to teach myself to mimic how joy or happiness would look like until my first ayahuasca experience. Now, I can finally experience joy and happiness.”  

A Revolutionary Study on Ayahuasca for Refugee Trauma

Asfeer approached Unlimited Sciences, a Colorado-based psychedelic research nonprofit focused on education and awareness of psychedelic use, to observe and study this ceremony in the hope that their story would be shared with a broader audience. Research on ayahuasca is severely limited, in part due to the Controlled Substances Act of 1971, which halted research on psychedelic substances, classifying them under Schedule I as having “no currently accepted medical use and a high potential for abuse.” When asked why this ceremony was organized, Asfeer answered, “There are a few reasons, but the most prominent reason is that we have a community that is abused from different sides, but no one is actually providing these people with ways to heal in processing their trauma. Instead they are asked to share their trauma to advance political agendas. It was really important to study this retreat because we want to have more informed decisions in the future of how to serve the broader community.” This study will take place over the course of four months and has been reviewed and approved by an independent institutional review board (IRB). Under FDA regulations, an IRB is group that has been formally designated to review and monitor research involving human subjects. The study is led by the Director of Research for Unlimited Sciences, Matthew X. Lowe, Ph.D., and in collaboration with Robin Carhart-Harris, Ph.D., the Founding Director of The Neuroscape Psychedelics Division and newly endowed Ralph Metzner Distinguished Professor of Neurology and Psychiatry at the University of California San Francisco. It will be an evidence-based evaluation investigating positive and/or negative outcomes of ayahuasca in this community. As a nonprofit organization, Unlimited Sciences relies on donations and fundraising to cover the costs associated with research. “There are over 27 million refugees,” Asfeer continues, “and no one is stopping to see if these people are healing. When we look at the bigger picture, one day people are in their homes, living their lives, taking care of their family, and the next day they don’t have any of those basic human rights. They never chose that. They never decided to go to war or wanted to be part of war. When they lose their homes, they are losing everything. There is no ground for them to stand on.”  

Unpacking Immigrant and Refugee Trauma

High numbers of refugees and immigrants experience complex and multilayered forms of trauma, including physical and sexual violence, persecution, experiences of war and torture, life threatening situations, and traumatic migration journeys prior to and during the process of migration. These experiences can have lasting and severe long-term mental health consequences, yet few studies have examined the impact of trauma experiences after migration. “We come from a culture that is based on community, and when we come to this capitalistic world in the West, we lose that connection,” Asfeer says of why community-based healing has been an important part of this event. “Ayahuasca is the perfect medium because it’s community based. The whole idea of healing, for me, with this community, is about creating a safe space that people can come to despite their background, whether they’re artists, journalists, activists, or anyone else, to feel safe and heal and process trauma in an environment that feels familiar with other people that share their cultural background.” Many of the individuals attending this ayahuasca ceremony bring with them the hope that this experience will help them heal. The majority (80%) of the community indicated that they had been or were currently experiencing mental health challenges, including an anxiety (67%) or mood (53%) disorder. Taking this into consideration, the ceremony itself has been organized with profound consideration for the safety of those participating, engaging a licensed therapist experienced with psychedelic therapy and several helpers sensitive to the unique needs of those in attendance.  

Setting the Space for the Ceremony

As the sun touches the surrounding mountains, the guide takes her place at the altar and breaks the silence by welcoming the circle. In traditional ayahuasca ceremonies, facilitators, often called shamans, curandero, or medicine carriers, play a crucial role by guiding individuals through the various stages of an ayahuasca journey. Their burden of responsibility is heavy, encompassing preparation of the plant medicine, ensuring honesty, respect, safety, readiness and willingness of those present, guiding individuals through their ayahuasca journey, and facilitating the process of integration (integrating the insights of a psychedelic experience into daily life). She invites each member of the circle to introduce themselves and write down the name of a person or persons of love to be sung into the ceremony with gratitude. “By singing, we sing in the medicine of life,” she says of the ceremony. “Some of these songs that we will sing have been sung for hundreds of years with the energy of love. Open your ears and listen to the love inside of the songs.” Many of these traditional ceremonial practices haven’t been recorded in writing, but rather passed down from centuries of knowledge and generations of teachers. The guide explains that these songs are sung in many languages, including the Quechua language, “but mostly it’s with the language of the heart.” During the ceremony, a sacred space is opened and blessed through the invocation of prayer, often through song. These traditions are varied, but the purpose of these songs are often to invite positive energies to call for healing and express gratitude. As the guide unpacks and reveals the ayahuasca to the circle, which is a viscous liquid contained in dark glass bottles, she explains the history of this medicine. “This medicine is from the heart of Pachamama,” she says, referring to the goddess revered by the indigenous people of the Andes as an Earth mother. “This is a medicine of gratitude, a medicine of life, a medicine of nature, and a medicine of ourselves.” The guide invites and encourages each member of the circle to sing together during the ceremony in a celebration of life, reciting a mantra to the group, “I am another you. You are another me. Your healing is my healing. My healing is your healing. Your tears are my tears. My tears are your tears. Your laughter is my laughter. My laughter is your laughter. Your purge is my purge. My purge is your purge.”  

The Ayahuasca Ceremony Begins

The sun has now disappeared behind the peaks of the nearby mountains, and darkness begins to settle over the room. “In many ways, these ceremonies are for ourselves and for all our relations,” she continues. “We are co-creating this ceremony. Thank you for creating this ceremony with me.” The circle stands to honor the medicine and the “exquisite tapestry of creation” which is always around us, offering gratitude to the grandmother, Pachamama, in the East, South, North, West, from above, from below, and from within. Following breathwork to calm and center the circle, participants are asked to share their intentions, an important step in guiding the experience to come. It has been well documented that set and setting significantly influence the response to psychedelic substances (“set” is an individual’s mindset and “setting” refers to their physical and social environment), and setting an intention is an integral part of this process. The intentions of those participating are varied, but include self-exploration (87%), creativity (60%), mental health (53%), physical health (33%), therapy (27%), productivity (27%), and recreation (13%) amongst others. These intentions included words such as clarity, purpose, love, God, connection, learning, spirituality, and healing. One by one, each member of the circle approaches the altar to receive the medicine, a brown molasses-like liquid, bitter and earthy with a sweet aftertaste. Each recipient chooses how much medicine they wish to receive, ranging from approximately a half ounce to two ounces of ayahuasca. The guide pours and anoints the medicine, offering the cup forward. “Salud!” the guide exclaims, and the sentiment is echoed across the room. There is a nervous, yet jovial, energy as some drink the medicine silently, while others try to stifle an involuntary gag as the medicine passes their lips, rushing back to their seats to closely clutch their purging bucket.  

The Medicine Starts to Work

With darkness now embracing the room, the guide explains that purging can occur in a variety of ways, all of which are normal and part of the medicine’s effect, including “vomiting, convulsing, crying, sweating, and diarrhea.” While not everyone will vomit after ingesting ayahuasca, most individuals share in this experience because of ayahuasca’s effect on the postrema, a part of the brainstem that controls the urge to vomit. ”For some,” the guide cautions, “the medicine is immediate, but for others it could take hours. You will know when the medicine takes you.” She advises members of the circle to embrace the effects of the medicine. “You may go away, but you will come back.” Surrendering to the medicine and embracing what follows is believed to be critical for this experience. “My mind was fighting with the medicine,” says one participant after the medicine took hold. “I got a rollercoaster trip inside my body at the beginning, and then I gave the medicine the permission to do its work.” Over the next few hours, the circle expands and contracts like a living heart beating to an orchestra conducted by the guide. Displaying her multifaceted talents and explemlifying the importance of her role, the guide moves from one instrument to the next, offering support to those who need it, and singing a variety of songs, some ancient and rehearsed and others improvised from the heart. Shadows dance in the deep darkness of the room, lit only by softly flickering candlelight, and quickly the room erupts into a frenzy of activity with ecstatic and joyful dancing, hysterical laughter, painful screaming, uncontrollable sobbing, professions of love, and singing. These experiences are often a reaction to the intense visual and auditory hallucinations produced by the powerful psychoactive brew. Ayahuasca contains the psychoactive compound N,N-dimethyltryptamine (DMT), which can induce brief but intense psychoactive effects, including visual hallucinations. DMT acts on specific serotonin receptors in the brain that are widely distributed in the central nervous system and play a key role in the regulation of cortical function and cognition, including learning and memory. Agonists of these receptors mediate hallucinogenic activity, and may produce antipsychotic, antidepressant, and anxiolytic effects.  

Experiencing the Ayahuasca Visions

“Whenever I closed my eyes or went under the blanket, I saw creatures like snakes with sharp thorns slithering all over the place,” says one participant of their experience of these intense hallucinations. “I saw vines intertwined. I saw eyes. And I heard a soft whisper of an old lady trying to say something but I couldn’t understand what she was trying to say so I kept asking ‘what?’ but I still didn’t understand.” The ayahuasca experience can produce significant alterations to one’s sense of self and reality, cognitive and emotional processing, and spatiotemporal orientation. Experiences after ayahuasca ingestion are likened to intense psychotherapy, leading ayahuasca to have strong potential as a treatment for trauma and related disorders by reactivating autobiographical memories that may have been otherwise suppressed. “I started seeing and feeling all my childhood coming out,” shared one member of the community of her past trauma and experiences of abuse. “I started with my mother, because she abused me a lot. I started telling her that I’m not going to forgive you because you’ve done a lot of harm to me. But then step by step I started talking to her about everything, one by one, from the betrayal, to the abuse, to the rape that I went through and all that was inbetween.” While some circle members immediately embrace the shared community during their experience, coming together to sing, dance, and talk exuberantly, others are at first overwhelmed and retreat under the safety of their blankets or seek quietness elsewhere, such as outside under the myriad of stars. The helpers work tirelessly and expertly navigate these obstacles to clean and replace purging buckets and offer emotional and physical support for those who need it. Throughout the experience, the guide remains a pillar of strength, never once stopping her efforts to ensure a beautiful ebb and flow to the ceremony which guides participants in and out of their waking dreams.  

Coping with Challenging Experiences

“It was terrifying at first for all the difficult physical sensations, feelings, visions, memories, or revelations,” says a participant of the ceremony, “but in the end they helped me realize what my priorities are and make important decisions.” During the experience, participants indicated a range of temporary challenging physical symptoms that are common after ingestion of ayahuasca, including tremors, nausea and/or vomiting, increased heart rate, heart pounding, physical pain, insomnia, confusion, headaches, restlessness, sweating, irritability, blurred vision, drowsiness, depression or low mood, fever, fatigue, lack of appetite, and anxiety. The guide shifts the energy of the room through the use of sound and movement. A heart-wrenching array of softly-played instruments work their magic, calming the chaos of the circle and drawing teary-eyed and awe-struck participants closer. Approximately four hours after ingestion of the first cup of ayahuasca, the medicine begins to subside, and the circle reconvenes to share their experiences. Tomorrow morning after they wake, they will begin the process of integration and share their journeys with the community.  

The Integration Begins

“It felt like the feeling was familiar and that I was returning to a place I had been before,” recalls an attendant. “I felt imbued with a deep sense of purpose and a mission on this earth. It allowed me to reframe my conscious experience and get a new outlook on deep issues like trauma, death, purpose and healing.” For many, the experience is revelatory, offering an opportunity to come to terms with past challenges, heal, and embrace new opportunities. “In my ayahuasca journey, I went deep within myself with the intention of love and healing,” says a participant of their experience. “I felt a powerful connection with Allah (creator). There was ease in tuning into the present moment. This made me feel immense gratitude that I felt radiating from my body. I found myself in the quantum realm of possibilities. There was a continuous increase in awareness. It made me connect with myself and others. Also, it showed me the positive impact I have on the community. Before this trip, I felt isolated from the community. Now, I feel more inclined to engage in social activities without the fear of judgment. That I’m also able to create a home wherever I choose to and that it is not limited to a physical place.”  

Integration and Difficult Experiences

Ceremonial leaders have cautioned that participants may encounter difficulties when processing their experiences. An ayahuasca journey is often not without tribulations. “I don’t feel I want to do it again, but I believe that it was a needed and very good one,” said a participant of the event. “It mentioned and answered almost all my intentions but in a very tough way. I feel blessed and satisfied but still, feel a lot of confusion.” For people who have difficulty really seeing themselves, new knowledge of what their own truth is can be difficult, and participants can struggle if their community doesn’t provide adequate support. Without this support, a difficult experience with ayahuasca can be destabilizing, isolating, and potentially leave these individuals in a worse place. “I’m very overwhelmed, confused, vulnerable, broken and shattered,” says a participant who indicated her experience involved extremely challenging visual hallucinations, “I was a better person before.” Despite the challenges of this experience, preliminary data indicates the majority of individuals described their overall experience as positive (94%), and most as “extremely positive” (80%).  

Life After the Ceremony: You are the Medicine

“Right before we left the retreat, some people said this was the best experience in their entire life,” says Asfeer, reflecting on the retreat. “Every day since the retreat I’ve been receiving messages from those who told me how they can now be their true selves. How they can be authentic with their family and community.” For many who participated in this ceremony, this is merely the beginning of a profound personal and spiritual transformation. One of the most important components of an ayahuasca experience is meeting the medicine halfway, which is the willingness to take the lessons that ayahuasca gives, and integrate them into your life. The work of integration can extend for weeks, months, or even years after the ceremony ends. The coming days and weeks represent a crucial and pivotal moment in time where insights are translated into action. “I invite you to remember and connect with the child inside of you,” says the guide in the brightly-lit morning sun. “Remember that you are the medicine. All of our intentions in coming here are like seeds, and they can become real if we tend to them. Now the work is to tend to them in your life. Think of yourself and your life as a garden, and how to nourish the seeds of your intentions.” The process of integration is not just one of learning, but of actively applying and living these lessons in our daily lives. “For those of you who had intense journeys, this is a reminder that the medicine is working ancestrally,” the guide says of the difficult and profound journeys encountered during the ceremony. “The medicine will go to the trauma. This is a tender time and it’s important to take care. The way out is through.” “As for investing in yourself,” the guide continues, “as you take care of yourself you are taking care of others. Creating a healing space for yourself, especially your body. We have experienced pain. We are each learning to give love to those painful parts. This retreat is for community and for building connections. Supporting yourself going deeper afterwards is going to be important.”  

Rebuilding Community Through Ceremony

The community has become visibly closer, tenderly embracing those around them on this final day. “We’re stronger together,” says the guide to the emotional group in front of her. “If you feel isolated, alone, or depressed, one way to help that is to know that we are all a community. Connect with the planet even if you live in the city. Life is happening all around you. Be of service. Notice what life is asking.” Indigenous communities have recognized ayahuasca’s therapeutic potential for thousands of years, but it’s only in recent years that Western society has begun to explore its associated benefits for a range of physiological and psychological maladies, including depression, suicidality, anxiety, trauma, grief, addiction and substance use. By focusing our efforts on preserving, honoring and respecting the vast roots and indigenous knowledge of ayahuasca use, we may see a growing number of communities seek out and benefit from this entheogen. Although the circle draws to a close, the ayahuasca journey is far from over, and the guide shares one final reminder to embrace and support the community that sits before her. “You are another me, and I am another you. As we help others we help ourselves.”