The Ritual Use of Hoasca: Comments and Advice
Francisco Assis de Souza Lima, M.D.

The legalization of hoasca (Ayahuasca) for use in religious rituals in Brazil represents a decisive step towards the attainment of religious freedom by the communities which make use of the tea. Brazilian authorities had questioned the tea's psychedelic properties some years ago. This resulted in a temporary prohibition of the use of the tea. There has been a revitalization of religious values, a trend which can be observed through the world with the revival of mystic, healing traditions. Within the new scientific paradigm, there is a growing interest in consciousness-expanding vehicles and their undeniable contribution to the development of humankind's spiritual healing.

As a member of the UDV for seven years and a regular user of the tea at the Samaúma Nucleous in São Paulo, I have observed that the tea can penetrate critical inner spaces and trigger off what Stanislav Grof and his school calls "spiritual emergencies." I also observed that even crises with psychotic symptomology can be resolved with a wider process of healing or spiritual evolution, depending on the individual's personality structure, as well as the context in which they appear. It's important to be aware of the nuances with which a clinical picture is organized. The integration process is hard work and no one escapes from suffering at times. Genetic factors, socio-economic status, family structure levels, personal history and individual vulnerability are decisive elements for the emergence of crises, as well as for the opportunity to make them beneficial. In general, crises lead to resolutions, and they involve efforts, sometimes extreme, to overcome multi-layered difficulties. The human development process is not linear. It holds, in the psychic point of view, the overlapping of missing, conflicting or even split aspects. One should keep in mind the fact that each case is unique, hence generalization should be avoided.

On the other hand, the importance of the community and the ritual context are remarkable. Because the tea is a consciousness-expanding vehicle, during the "burracheira," one might engage oneself in a work of contention and balance with the mobilization of inner resources in strong interaction with what occurs in the tea session. This requires a firm orientation, experience and responsibility from the conducting Master. The ritual structure is of inestimable value, the UDV chants of force and light, the music, the teachings of the Master and the "oratory," where the oral transmission of knowledge takes place in a participatory, directed way are all valuable elements of great import for the use of Hoasca's spiritual dimension. By means of mental concentration, the tea enables users to carry out the work of equilibrium, contention and expansion, according to each person's need and understanding.

However, due to the sensibility caused by the tea in its users, the social responsibility from the institutions which administer the tea becomes larger in terms of prevention and follow-up of possible psychiatric cases. The incidence of such clinical (and spiritual) emergencies are not outstanding in the routine of the UDV nucleous, which I directly know. Although there are no formal statistical figures yet, empirical observation points to a low incidence of such emergencies, not meaningful in terms of quantity. In this matter, however, qualitative data is especially relevant and the mere occurrence of one crisis requires some concern.

"Spiritual emergencies" in its strict sense occur when the search for spiritual development is closer to consciousness and favors the integration of adverse aspects. These require, due to their characteristics and implication, a careful approach not always provided by the present psychiatry. In the field of psychopathology and clinical-psychiatric emergencies, is there anything which is not "spiritual emergency" of some kind? What do affective disorders, chronic deliriums and schizophrenia represent for the spirit? Be it a genetic predisposition, grief, symbolic fault or even a radical, disruptive action of archaic sorrows, deep inside we suffer from a demand, not always manifest, for love and a willingness for a higher level of consciousness. The problem is how to deal with all that.

The limitations of psychiatry, traditional psychology and even psychoanalysis are clear enough to legitimate the search for new resources (i.e. holistic and transpersonal approaches) and the revival of ancient values and practices such as shamanic traditions and the ritual use of entheogenic plants to induce expanded states of consciousness. The goal to be achieved does not imply exclusion, prejudice or random syncretism, but the synthesis, the possible balance between mainstream and alternative approaches for Western and Eastern "art of healing," each with its own resources.

I believe the transcendental perspective, within which the use of the tea more fully applies, can be enriched with the medical practices open to spiritual questions, the key point in this new paradigm. Therefore, it is of fundamental importance that the communities which make use of the tea be conscious of their duties, as well as their limits and responsibilities.

Practical measures

The Center of Medical Studies (CEM) of the União do Vegetal (UDV), under the direction of Dr. Glacus de Souza Brito, through its Mental Health Commission, under the coordination of Dr. Mauro Bilharino Naves, has developed a project aimed at establishing regulations for the safe use of the tea in cooperation with representative master and the other UDV leaderships.

For this purpose, the CEM organized the first Mental Health Conference during the third CEM Health Congress in November 1996 in Rio de Janeiro. At the event, besides the exchange of experiences among mental health professionals, CEM gathered elderly masters in order to discuss, based on their experiences with related situations, the concept of mental health from the medical and spiritual of view and to study the direction left by Master Gabriel, the founder of the UDV, in relation to this issue. The projects in development by the above-mentioned Commission include the registration of UDV mental health professionals, the introduction of an Occurrence Notification, as well as the development and follow-up of mental health research within the UDV. Also important was the establishment of medical-psychological support for those who drink the tea for the first time, together with a detailed guide for situations which suggest closer investigation. This applies not only to newcomers but also to regular users of the tea once an emergency occurs.

The idea is to prevent adverse situations from happening, and to ensure that more attention is paid to people with psychiatric records, under medication or presenting symptoms which call for closer investigation. Such concerns meet recent CONFEN's (Federal Council of Narcotics) recommendations, which restrain people with psychiatric records from drinking the tea.

For us to have a balanced judgment in this matter, it's important to bear in mind each person's traits and nature so as to avoid misunderstandings which might trigger a witch-hunt: generalizations and radical prohibition of the tea to those who have had some kind of crisis with a psychiatric hue. On the other hand, considering the knowledge we now have of the pharmacological characteristics of the tea, preventive measures are necessary so as to avoid the interaction of the tea and some other medicine.

Concerning this aspect, the precaution and recommendations apply basically to the following cases: to the occurrence of the so-called "serotonergic syndrome" from the combination of the tea and SSRI antidepressants, which makes the consumption of the tea together with such substances inadvisable; high blood pressure (depending on dosage) due to association with tricyclics and MAO inhibitors; possibilities of unpredictable alterations due the combination of several compounds used in diet formulas; possibility of crisis occurrence in epileptics. Depending on the case, a smaller amount of the tea may be indicated.

Nevertheless, it will be through the continuity of the hoasca use in a ritual context, together with the development of bio-medical, pharmacological research, as well as therapeutic ones (i.e. with drug addicts and alcoholics) that new light will be brought to questions which have been only generically mentioned here.

Acknowledgments

Thanks to Maria Elizabeth Maranhão Pessao for the suggestions and to Francisco Vasconcelos de Lima for the English version. Dr. Glacus de Souza Brito, director of the Center of Medical Studies (CEM) of the União do Vegetal (UDV), can be reached at demec@udv.org.br.