About a decade ago, popular interest in ayahuasca, a hallucinogenic brew, started taking off in Europe and North America, driven by high profile tales of its supposed mentally transformative healing powers. Lindsay Lohan, for example, notably claimed that it helped her let go of “the wreckage of [her] past life,” resolving old traumas and allowing her to move forward. Responding to these accounts—and building on the overall revival of scientific interest in the potential medicinal uses of psychedelics—researchers have started looking into ayahuasca’s potential to help treat everything from addiction to depression to eating disorders to post traumatic stress disorder.

Although provisional, the results of this research have been promising enough that a few labs are exploring ways of isolating the psychedelics’ active compounds, turning them into medications with minimal side effects. Others are exploring ways of integrating ayahuasca and other psychedelics into mainstream Western therapy settings and practices. A few have even reportedly started to offer underground therapy sessions using psychedelic substances—which are, to be clear, illegal.

Yet few people interested in ayahuasca see the value in pharmahuasca pills, or in tripping in therapists’ offices. Western medical approaches, most of them feel, are too sterile, too cut off from holistic views of world. Many want to take part in what they see as authentic, traditional ayahuasca rituals, whose structures they believe will give them the insight and guidance they need to unlock the brew’s true healing potential. That’s why thousands of Westerners visit Iquitos, Peru, the epicenter of ayahuasca ritual tourism, every year. It’s also why the people who organize regular ayahuasca rituals in major American and European cites often get a shaman from the Amazon, ayahuasca’s homeland, to run them. Shaman being a catch-all Western term for a broad variety of specialists, ranging from curanderos—folk healers steeped in highly local herbal and spiritual traditions—to ayahuasqueros—specialists in brewing and serving ayahuasca who are not necessarily healers—to vegetalistas—distinctly mestizo-syncretistic folk plant healers—and beyond. Peter Gorman, one of the first writers to cover ayahuasca in America, says enthusiasts have been touring Amazonian shamans around the country since at least 1994. (Gorman married into an Amazonian river tribe community and has done and run ayahuasca rituals many times.)

“If someone is from the Amazon,” adds Evgenia Fotiou, an anthropologist who studies Western ayahuasca usage, “they bring some legitimacy” to an ayahuasca ritual, at least in the participants’ eyes.

But the widespread belief in the power of authentic, traditional rituals and the shamans who lead them is problematic at best, outright dangerous at worst. For starters, there is no true or authentic ayahuasca ritual, or even set of rituals. But more importantly, says Rubén Orellana, a Peruvian archaeologist and curandero, ayahuasca traditions were developed for people coming from specific cultural backgrounds. As such, even though the brew itself, and even some of the ritual practices surrounding it, may have similar raw effects on anyone, they will likely generate very different overall experiences—different risks and benefits—for outsiders than for insiders.

At best, this means that many Westerners may be shelling out large sums for experiences they are not well situated to fully understand or benefit from. In the process, they contribute to the wanton commodification and fetishization of the cultures whose practices they wish to insinuate themselves into, or to co-opt. At worst, it means that some individuals may expose themselves, through their misreadings of context and content, to serious physical or mental dangers.

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Ayahuasca is just one of many names—the Quechua name, to be precise—for a concoction of Banisteriopsis caapi vines and leaves from the Psychotria viridis shrub or, at times, related plants. The former contains an inhibitor that allows humans to fully digest the psychedelic DMT contents of the latter, which produce powerful hallucinations, disorientation, and, in some, a sense of disembodiment or even ego death—a dissolution of the sense of a distinct self.

Although researchers consider ayahuasca largely safe, many fear that taking it could exacerbate serious mental health issues, like schizophrenia. The psychedelic researcher Charles Grob notes its effects on drinkers’ serotonin levels also often interact poorly with any selective serotonin reuptake inhibitor (SSRI) antidepressants in their systems. The resultant palpitations and seizures can be lethal. The brew also increases most drinkers’ blood pressure and heart rates, so ayahuasca is not always safe for people with cardiovascular issues. Doctors urge caution in approaching the brew among individuals with fat metabolism issues or glaucoma, as well pregnant people, and those on medications like dextromethorphan. Ayahuasca has been implicated in the deaths of almost a dozen Peruvian tourists, and in a rising number of calls to American poison control centers. These concerns have led many established providers to start screening potential drinkers for health issues before letting them take part in rituals, and in some cases to keep allopathic doctors on call during sessions to respond to any unexpected medical emergencies that develop.

Dozens of Amazonian cultures from Bolivia to Colombia to Venezuela, both indigenous and mestizo, have used ayahuasca for centuries, even millennia. Recognition of this heritage has led to the piecemeal legalization of ayahuasca drinking rituals in countries worldwide—including the U.S., which issued religious exemptions to its Draconian drug control laws for a couple of Amazonian-rooted churches.

However, these cultures do not all brew ayahuasca in the same way. Some spike it with additional hallucinogens like Brugmansia suaveolens, for example. “There are a dozen, two dozen, three dozen ways to make and consume it,” Gorman explains. Variations hinge on factors as minute and particular as “whether the leaves are cooked, whether it’s cold infusion, whether it’s steeped for 12 or 20 hours, or whatever. Different groups use it differently.”

Nor do they all consume it in the same concentrations or dosages, or for the same reasons. On a trip up the Purus River in 1968, the scientists Jan-Erik Lindgren and Laurent Rivier noted that in most of the Pano-speaking indigenous communities they visited, only healers consumed the brew to interface with a spiritual plane of existence, to figure out the metaphysical causes of, and to help resolve, patients’ illnesses. But in two communities, one Pano-speaking, one non-Pano-speaking, average men (and very rarely women) just drank ayahuasca together in casual settings, with little ritual, to bond socially through their visionary experiences.

Two years earlier, the botanist Melvin L. Bristol noted that healers in some Sibundoy communities in Colombia used ayahuasca for spiritual diagnoses. But he also observed that both healers and everyday men and women used the brew to learn more about nature and the spirits within it, or even to psychically visit family while out on long trips and feeling lonely.

The reasons for using ayahuasca, the rituals surrounding that usage, and the frequency of usage seem to change over time in many communities to fit the needs of the moment. Some groups likely even gave up and later re-adopted ayahuasca drinking over the centuries. The ethnobotanist Glenn H. Shepard points out that anthropologists actually observed at least two indigenous communities (of Matsigenka and Yora peoples, respectively) developing novel ayahuasca traditions in the twentieth century. This constant evolution—an apparently situational change in rituals—anthropologists argue, is a hallmark of traditional Amazonian beliefs and cultural practices.

When people describe authentic, traditional ayahuasca rituals in the West today, they are usually actually describing something like the rituals practiced by indigenous and mestizo communities in and around Iquitos, which the medical anthropologist Marlene Dobkin de Rios and others observed in the late 1960s, and documented extensively in Western journals and media outlets in the ‘70s and ‘80s: Groups of people who often did not know each other met up in clearings or at the homes of local curanderos, and they all drank ayahuasca together. They abstained from eating certain foods, like fats and salts, for one or more days beforehand. The curanderos often lightly hit them with a branch right before they drank. Once the brew hit, the curanderos sang icaros, special songs, and often shook a leaf-bundle chakapa rattle. The curanderos also at times smoked, and let participants smoke, narcoticized tobacco and sucked at points of symbolic or literal pain on their bodies. The trip itself could last anywhere from two to ten straight hours.

“There was, and still is, an ayahuasca curandero on every couple of blocks in Iquitos,” Gorman says. After ayahuasca tourism started to take off in the late 90s—and especially in the mid-aughts—upwards of 100 tourist-focused ayahuasca centers sprung up on the edges or just outside of town as well. Alan Shoemaker, an American who visited Iquitos in the 90s, organized one of the first shaman’s tours in the U.S., trained as a curandero, and now runs a center near Iquitos, says that local police tell him “they believe that on any given Friday night 10 percent of the population is in a ceremony.” That’s out of a metro area population of about 500,000 Peruvians.

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Most people who take ayahuasca, regardless of their background or the particular ritual context in which they take it, report similar basic experiences: Soon after drinking the brew, they get nauseous and often vomit and void their bowels. Many users view this as a beneficial purge of one’s system. They may start to sweat and shake and feel their heartbeat race. They may even get agitated, feeling tense, dizzy, or uncoordinated. Then they usually see colors and geometric shapes for a few minutes (although it may seem like much longer) before gradually moving on to witness varied hallucinations, often of humanoid and animal figures. They may also get a sense of being visited or inhabited by an alien consciousness, of moving beyond their bodies, of flying through diverse and fantastical landscapes, or any other number of hallucinatory experiences.

“But the way we interpret” these experiences, says Fotiou, “the way we talk about them, the story we tell about them, is definitely shaped by our cultures,” our distinctive backgrounds.

Since the 1960s, Western scientists have recognized that one’s mindset and physical setting play a major role in shaping one’s experiences on psychedelics. The psychologist Timothy Leary and his LSD acolytes did a lot to popularize this notion, as well as to popularize and liberate psychedelics more generally. To wit, the unwitting victims of the American Central Intelligence Agency’s MK-Ultra studies in the 50s and 60s on the potential of LSD and other drugs for use in mind control, interrogation, and torture projects, were hit by unexpected hallucinations, often in distressing environments. They usually had terrible experiences, at times leading to lifelong trauma. Meanwhile, artists who volunteer for studies on LSD’s effects on creativity, are prepped for their experiences, and undergo them in calm and pleasant contexts, often have positive experiences of the same raw physiological effects, and maybe even the same basic hallucination patterns.

Authors often discuss set and setting in highly individualized terms, but these ideas encompass one’s cultural context, too—the learned expectations one has for experiences, and the frameworks one has for reading and processing them. In 1959, the anthropologist Anthony Wallace notably showed that indigenous groups with frameworks for consuming peyote could take it and almost all have positive and spiritual experiences, while the vast majority of European-descended Americans consuming the same peyote felt distress and experienced more reliably gloomy visions, which may have haunted them for years. Wallace later advocated for cultural controls in drug trials—instead of or in addition to placebo controls.

Most Amazonian rituals, Fotiou explains, are heavily grounded in distinct local beliefs and cultural systems. Prohibitions on eating certain foods around Iquitos, for example, reflect the widespread belief that every plant—including the vine in ayahuasca—has a powerful yet neutral spiritual force within it that must be propitiated if you want it to help you. The whisking and sucking on painful body parts reflects beliefs about the negative spiritual forces that underlie all sorts of illnesses—and the ways they supposedly enter and reside within people’s physical bodies. The icaros, if sung by a curandero who learned them from another curandero (or from spirits), almost have their own life force, and their own unique powers, so particular sequences of them are meant to shape and guide circle members’ visions in very specific ways.

“These are not part of Western ontologies,” Fotiou stresses. So, Westerners often do not catch on, or react in ideal or intended ways, to the deeper embedded meanings of ayahuasca ritual acts.

Often, Western outsiders read dietary restrictions as a way of preparing their bodies for the experience of ayahuasca—readying themselves so that the plants can do their work. They ignore or fail to recognize practices like whisking that reflect a belief in spiritual maladies and sorcery. (Ross Heaven, a prominent British shaman describes these sorts of rituals in his book The Hummingbird’s Journey to God in an almost sneering tone, as cultural accretions that distract from the true goal of an ayahuasca ritual: sitting with your own thoughts.) And they view icaros as grounding but meaningless background music that reflects a curandero’s role: to keep them safe and calm while they go on personal journeys, determined by their own personal intentions, or their underlying cultural expectations.

Because of these different frameworks and levels of understanding, Fotiou says, Iquitos locals often seem to focus on how a trip feels within their bodies—on what they see as the spiritual-physical actions of the animate essence of ayahuasca within them. They read their visions of people and animals, which often reflect their environments, as interactions with spirits. They may also read their visions as representations of the incident or individual who caused their ailments, and may even see panoramas of their curandero, or some symbolic representation of that individual, duking it out with another who supposedly had some role in their predicaments.

Meanwhile Westerners, Fotiou adds, talk far more often about out-of-body experiences, with far more conceptual or psychological language, often honing in on the acute sensations of ego death. They read their visions as repressed memories, or as metaphors for their own mental states or experiences. They talk about icaros less as forces guiding them and shaping their visions, more as raw tools to ground them in their own internal journeys of self-reflection and -revelation. Or, as Fotiou puts it rather succinctly, everything they experience “may well be the same, but it would be interpreted differently.”

Case-in-point: Numerous locals’ accounts of their visions include tableaus of snakes entering or exiting their or another circle member’s mouths. These locals usually interpret and experience this as an ambivalent nature spirit entering their bodies to do the work necessary to help them heal their ailments. But when Vox writer Sean Illing took ayahuasca and saw dozens of snakes coming out of someone’s mouth and gushing down his own gullet, he read and felt it as an expression of her pain passing into him—itself a deeper metaphor, in his mind, for his own selfishness and a message to remember that sometimes things in this life just aren’t about him. This is a valid takeaway, perhaps, but one deeply grounded in Western understandings of the symbology of the snake.

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This doesn’t mean that ayahuasca rituals and ceremonies, even thoroughly Amazonian ones, have no potential value for outsider participants. Illing’s account, and countless others, clearly show that Westerners can find exactly the sort of transformative experiences, the kind of introspective insights and personal growth, that they’re looking for within them. It just means that they may be fetishizing cultural frameworks and practices that were not clearly created to abet, and almost certainly are not vital for, the kinds of cathartic visions and revelations they are interested in.

It’s easy to read this fetishization as harmless, or even as beneficial for Amazonian communities. After all, it drives outsiders who travel to Iquitos and similar ayahuasca hubs to shell out up to $250 for a liter of the brew and up to $4,000 for all of the healer and lodge services surrounding it, when pre-tourism ceremonies in the same regions used to cost just about $10 per person.

But ayahuasca tourism critics note that many lodges are owned by outsiders, at best limiting the economic benefits—the wealth and autonomy—that they can bring to local communities. They acknowledge that the demand local centers and foreign circles create for ayahuasca’s components may keep some farmers, brewers, and merchants employed. But it has also jacked up ayahuasca costs for locals, in some cases by upwards of 300 percent over the last decade, functionally limiting their access to their own healing traditions, a cornerstone of their cultural heritage.

A report last year indicated that ayahuasca tourism has boosted jaguar poaching and other environmentally destructive activities, as well. Charlatans manage to convince unwitting outsiders that a big cat’s tooth or some similar trinket is a traditional spiritual enhancer for their ceremonies, when in fact it is patently not. It is just a symbol of destructive ignorance.

This is impossibly insulting to indigenous communities, who often faced active persecution—saw their healing psychedelic plants burned and their ceremonies belittled or criminalized—by militias, missionaries, and officials motivated by racism, or by the American-led War on Drugs. Sudden outsider interest in their plants and ceremonies can come off less as empowering respect, more as extractive exploitation and appropriation of locally meaningful practices for more powerful groups’ needs.

As Fotiou once put it, this fetishization creates a “one-sided romantic image” of curanderos, their rituals, and their communities that “hides the complexity of indigenous peoples’ situations by erasing the injustices they have experienced and continue to experience.”

Fetishization, so often grounded in caricature and conviction rather than concrete understanding, can also be dangerous for the outsiders who engage in it. It makes it easy for charlatans with little-to-no training as curanderos, and in far too many cases from Amazonian communities that do not have a living ayahuasca-drinking tradition, to pass themselves off as master shamans. Gorman told me, for example, about meeting some female shamans who actually just sing the lullabies they grew up with rather than icaros. Many of these charlatans may not be prepared to help people through dark or disturbing visions, much less to handle the mental and physical health emergencies that occasionally crop up in sessions.

It also makes it hard for outsiders to recognize when a shaman, whether a charlatan or a trained curandero, is crossing a line. Westerners often project notions of saintlike flawlessness or purity onto ayahuasca shamans, when their own cultures typically view them as normal people, just with special spiritual training or talents. They are as prone to attempting to abuse their power, especially with vulnerable and isolated outsiders, as anyone else. The belief that this abuse is just part of the ritual, part of some esoteric foreign magic, has reportedly played a major role in an increasingly visible tide of sexual abuse and coercion cases linked to ayahuasca rituals.

Yet none of this, dark and painful as it may be, necessarily means that Westerners need to step away from ayahuasca. It just means that outsiders need to be far more conscientious of how and why they are engaging with other cultures’ ayahuasca traditions—and to consider building their own.

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In the early twentieth century, many urban Catholic Brazilians, most with little to no clear connection to or knowledge of indigenous culture and traditions, moved into the deep Amazon to tap rubber to feed the rise of cars and other modern industrial tools. Once there, they encountered ayahuasca drinking traditions and, like modern North Americans and Europeans, recognized something valuable in it. But rather than adopting and importing the rituals they encountered wholesale, some rubber tappers started building their own rituals, based on experience with and training in indigenous practices and knowledge of their and their peers’ own cultural frameworks.

They ultimately developed three new and distinct Brazilian ayahuasca religions: Barquinha, Santo Daime, and the União do Vegetal (UdV). The Santo Daime faith, which has thousands of followers, mostly in Brazil but also in Europe and North America, portrays its rituals as works, drawing on Catholic views about the practice of faith and attainment of salvation, which they use to explore and resolve their inner turmoil. Their rituals work Catholic saints, as well as significant figures in their own and other Brazilian spiritualist movements, into the hymns they sing in place of icaros, and into the visions they see. Increasingly, the faith reflects its growing wealthier urban following’s belief in the power of spirit possessions, interpreting their trips through this lens and, by so doing, making spirit possessions an almost clockwork feature of their rituals.

Grob, who studied the effects of ayahuasca on UdV members in the early ‘90s and again in the early aughts, says that he “was very impressed with how the UdV created optimal set and setting for its cultural context,” fostering positive experiences.

The Santo Daime also adopted a communalist view, in which one person’s internal exploration in works has a bearing on the spiritual well-being of everyone else, necessitating a firm and common praxis. That’s a big part of why they and other new ayahuasca religions often make sure that outsiders, who may not engage in their rituals for their intended purposes, stay out of ceremonies.

These religions’ recent genesis and apparent success suggest that Westerners can, and probably should, approach ayahuasca as a tool that they can work into their own systems of practice. Doing so would arguably be the more adaptive Amazonian shamanic thing to do (rather than trying to shoehorn their way into existing frameworks and traditions). In many ways, we already are building distinct Western traditions—just not necessarily in ideally conscious or respectful ways.

Marc Aixalà of the International Center for Ethnobotanical Education, Research, and Service, a group that’s trying to help societies navigate their newfound contacts with ayahuasca and other psychoactive plants, points out that the framing of and practices in traditional shaman-led ayahuasca rituals in the West, and at tourist-focused lodges in the Amazon, increasingly diverge from those of ceremonies for insiders in order to meet Westerners’ needs and demands. Broadly, he says, they’ve flattened out or eliminated rituals connected to abstract Amazonian spiritualism or magic, reducing anything that doesn’t directly speak to the quest for internal psychological healing and transformation.

That change notably often involves ditching icaros for more general soothing and supposedly grounding background music. They’ve also expanded the scale and duration of pre-ritual dietary restrictions, matching wellness discourses in the West, and added rituals to the end of the ceremonies to help people process their experiences. In some cases, they’ve switched up the recipes of their brews to promote more and more vivid and disorienting visions, as well.

“We have built a whole religion around ayahuasca,” says Gorman, a new set of beliefs and practices living right on top of old ones, “and I kind of shake my head sometimes.” As do a number of anthropologists and indigenous groups, who view this trend as a form of colonization.

However, Fotiou points out that in ayahuasca ceremonies in the U.S. especially, a number of people are actually consciously moving away from aping or tweaking Amazonian traditions, and towards developing their own practices, grounded in their own needs and cultural contexts. “They realize that a lot of the things that are offered in the authentic context are not for them,” Fotiou explains, and that they and their communities may be better served by novel approaches.

Hopefully, these novel approaches can include the local cultivation of materials to reduce over-consumption and prices for Amazonian communities. And they can still acknowledge, and ideally compensate, the indigenous cultures they do at times converse with or borrow from.

Rick Strassman, a leading voice in DMT research and popular discourse, suggests that, if we want therapeutic experiences, then building rituals that merge ayahuasca circles with Western therapy could be a useful pathway. Which brings us full circle to what many of the ayahuasca researchers in the West are already exploring—and what enthusiasts often reject and run from.

But what is ayahuasca, in the Western conception at least, if not a space for reevaluating biases and fears—including those about pursuing ayahuasca in therapeutic, Western settings?

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