Ayahuasca en el tratamiento de adicciones: Estudio de cuatro casos tratados en IDEAA, desde una perspectiva interdisciplinaria / Ayahuasca in the treatment of addictions: Study of four cases treated in IDEAA, using an interdisciplinary perspective

RESUMEN

La ayahuasca es una sustancia psicoactiva de origen amazónico, usada tradicionalmente con fines espirituales, médicos y religiosos. En la década de los ‘90 adquiere gran popularidad, tanto a través de las redes internacionales de espiritualidad y religiosidad, como en el denominado renacimiento de los estudios psicodélicos, donde se retoma la investigación y experimentación sobre los posibles usos clínicos de estas sustancias. El presente artículo tiene como objetivo la descripción y análisis de los procesos de cura de cuatro casos de adicciones tratados en el Instituto de Etnopsicología Amazónica Aplicada (IDEAA), un centro dedicado al tratamiento de adicciones, con pacientes españoles llevados al Amazonas de Brasil. El procedimiento ha implicado una metodología cualitativa del tipo biográfica, bajo una mirada interdisciplinaria que integra enfoques cognitivos y culturales. En los resultados, se describen el proceso de intervención utilizado en el centro y las narrativas biográficas de los casos estudiados. Se realiza una descripción de los distintos tipos de experiencias recurrentes durante los rituales de ayahuasca revisiones biográficas, insights psicológicos, experiencias emocionales y/o trascendentales. Se analiza la importancia de la memoria de la experiencia, en tanto disparadora de nuevas reconfiguraciones en las narrativas biográficas de los sujetos, mostrándose la centralidad de dicha dinámica en el proceso terapéutico. Se analizan otros mecanismos específicos interviniendo en el proceso de cura de cada caso psicosomáticos, simbólicos, de cognición social y psiconeuroinmunológicos. Se concluye sobre la relevancia terapéutica del contexto ritual, social y cultural, así como de las estrategias de integración de la memoria de la experiencia en las narrativas biográficas de los sujetos.

ABSTRACT

Ayahuasca is an Amazon psychoactive compound traditionally used for spiritual, religious, and medical purposes. In the 1990s the brew gains popularity, both through the transnational networks of religiosity/spirituality and the renaissance of psychedelic studies, where these kinds of substances are investigated for its possible clinical applications. The goal of the current article is to describe and analyze the therapeutic process of four cases from IDEAA, a center located in the Brazilian Amazon forest, dedicated to the treatment of addicts taken from Spain. An interdisciplinary perspective is proposed, combining cognitive and cultural insights from different fields (medical anthropology, cognitive science of religion, psychoneuroimmunology, qualitative sociology, cultural psychology). Ritual of ayahuasca will be considered as a way of producing a variety of experiences, and the memories of these experiences as ways of producing new biographic narratives. Biographic narratives are considered as a higher mental competence that includes functions related to self-knowledge, episodic memory, reflexivity, and psychosocial homeostasis. Under the appropriate set & setting, this process of narrative reconstruction helps the individual to cope with difficult situations, including addictions. The procedure used in this research consisted in a qualitative biographic methodology. The four cases described were treated in the period between 2000 and 2007. They started as poly drug users in the 1980s, at the end of the dictatorship period, when heroin made its entrance to Spain. The results describe the process of intervention used in the center, and the biographic narratives of each case. Most common types of experiences are mentioned biographical revisions, psychological insights, emotional and transcendental experiences. Specific therapeutic mechanisms are also described. In the first case, a psychosomatic style of expression, where the subject describes strong embodied experiences of suffering his illnesses, and embodied expressions of coping with them. In the second case, a therapeutic process that includes the recognition of the former biographic narrative as a “lie”, and a symbolic way of producing new narratives of the self that spins around the presence of the jaguar. This animal acted as symbolic figure that triggered different meanings, useful for there covery of the patient. The third case is a subject who was involved in drug traffic, robberies, and violent activities. Experiences related to social cognition (e.g. empathy, shame, self-forgiveness) played a major role in his therapeutic process. Last, the narrative of a woman addicted to heroin is analyzed. Biographical remembrances and self-forgiveness played an importantrole, but also her symbolic experiences with the proximity of death, related to her medical conditions (addiction to heroin, hepatitis C, HIV). The case is also a good example of how the treatment had a positive psychoneuroimmunology impact in the HIV viral load of the patient. As we will analyze, the effect cannot be explained by ayahuasca itself (in fact, the scientific literature suggest a negative or neutral impact), but by the therapeutic strategy as a whole, with its various components. The article concludes addressing the importance of the “memory of the experience” of the ritual as catalyzer of new meanings in the biographic narratives of the patients. The new narratives can be considered assystem for self-regulation in the different, psychological, social, and cultural levels. Besides, it can also triggers different top-down psychoneuroimmunology and psychosomatic effects. The production of new narratives is related to what is usually called “integration”, and involves different psychological, social and cultural elements that are of great importance for a positive or negative therapeutic outcome.