Ayahuasca combined with grief therapy shows promise in easing severe bereavement

Combining the psychedelic brew ayahuasca with specialized psychotherapy may help ease the severe psychological pain that follows the loss of a close family member. An exploratory clinical trial published in Scientific Reports found that participants receiving this combined treatment experienced greater reductions in grief severity than those receiving therapy alone or no treatment. The results suggest a potential new avenue for early intervention in severe bereavement.

Losing a parent, child, or spouse often triggers profound emotional turmoil. For most people, the intense distress gradually subsides over time as they adapt to their new reality. A substantial portion of the population goes on to develop prolonged grief disorder, a condition characterized by persistent, functionally impairing yearning and preoccupation with the deceased.

The first year of bereavement is a particularly vulnerable period. It carries elevated risks for psychiatric illness, cardiovascular decline, and suicide. Standard psychological interventions and antidepressant medications have not proven highly effective at preventing prolonged grief when administered soon after a loss.

Researchers led by psychiatrist Oscar Soto-Angona at the Universitat Autonoma de Barcelona in Spain wanted to explore a novel approach to early grief support. They designed a study to test whether a psychedelic plant mixture could enhance a specific form of counseling called meaning reconstruction therapy.

Meaning reconstruction therapy operates on the premise that a central challenge of mourning is integrating the loss into a person’s life narrative. The therapeutic protocol is structured around three phases. First, therapists help patients process traumatic memories related to the death event. Next, they work to redefine the patient’s ongoing attachment to the deceased person. Finally, they help the bereaved rebuild their own sense of identity as a survivor.

The researchers hypothesized that ayahuasca could act as a catalyst for this psychological work. Ayahuasca is a traditional Amazonian brew made by boiling the stems of the Banisteriopsis caapi vine and the leaves of the Psychotria viridis shrub. The leaves contain the psychoactive compound DMT, which stimulates the brain’s serotonin receptors. The vine contains compounds that prevent the digestive system from breaking down the DMT before it can reach the central nervous system.

Previous observational studies and anecdotal reports hinted that the brew might facilitate emotional processing. Studies have shown that serotonergic psychedelics can temporarily enhance neuroplasticity, psychological flexibility, and creative thinking. The research team suspected these acute effects could help people find existential meaning and reorganize their identity after a traumatic loss.

The clinical trial enrolled 84 adults who were experiencing severe grief symptoms. All participants had lost a first-degree relative within the previous twelve months. The research team assigned the participants to one of three groups.

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One group received nine weekly online sessions of meaning reconstruction therapy. A second group served as a no-treatment control condition.

The third group received the same nine-week therapy course but also attended two weekend ayahuasca retreats. These group retreats involved consuming a medium dose of the brew under medical supervision. The psychedelic sessions were accompanied by specialized online integration meetings, which gave participants a space to discuss and process their altered states of consciousness.

To track progress, the researchers asked participants to complete standard questionnaires. These surveys measured normal grief severity, symptoms of prolonged grief disorder, post-traumatic growth, and overall quality of life. The assessments were administered before the interventions began, immediately after the nine-week period, and at a three-month follow-up.

The research team found that participants in all three groups experienced some reduction in grief severity by the end of the study. This kind of general improvement is common in bereavement research. It often reflects the natural passage of time as participants adapt to their loss, as well as the positive psychological effects of simply being enrolled in a supportive clinical trial.

The group receiving ayahuasca-assisted therapy experienced the largest improvements across nearly all measures. These participants reported greater reductions in normal grief severity and prolonged grief symptoms compared to those in the therapy-alone and no-treatment groups.

The psychedelic-assisted treatment was also associated with larger increases in post-traumatic growth. This psychological concept refers to positive personal changes that result from struggling with a major life crisis, such as a renewed appreciation for life or a deeper sense of spiritual connection. Participants in the ayahuasca group also reported better scores in psychological health and social relationships than the control groups.

These improvements appeared stable over the short term. When the researchers checked in with the participants three months after the interventions ended, the ayahuasca group maintained their improved scores.

The psychedelic brew was generally well tolerated by the participants. Nobody required psychiatric medication or experienced serious adverse events following the dosing sessions.

Some participants reported minor, transient side effects during the experience, such as nausea, vomiting, or temporary headaches. These are common physical reactions to ayahuasca. A few participants in the experimental group chose to skip their second ayahuasca dose, with some citing that they did not feel psychologically prepared for another session so soon after the first.

The study provides an early look at a novel combination therapy, but several limitations shape how the results should be interpreted. Due to logistical constraints related to the COVID-19 pandemic during the study’s early phases, the researchers could not randomize the group assignments. Instead, participants were sequentially allocated to the groups.

This non-randomized design increases the risk that outside factors influenced the outcomes. Differences in pandemic-related stress at different times of the year could have impacted the participants’ baseline mental health.

The open-label nature of the trial means that participants knew which treatment they were receiving. This awareness can inflate the reported benefits due to expectation bias. The researchers noted that nearly three quarters of the participants had previously used psychedelic substances, suggesting they may have held favorable preconceptions about the treatment going into the trial.

The study design did not include a group that received ayahuasca without psychotherapy. The current results cannot separate the effects of the pharmacological substance from the intensive therapy and group support environment.

Future research will require larger, randomized, and double-blind clinical trials to confirm these early observations. Such studies could help determine exactly how the altered states of consciousness induced by psychedelics interact with therapeutic attempts to rebuild a person’s sense of meaning after a devastating loss.

The study, “Ayahuasca-assisted meaning reconstruction therapy as an early resource for bereavement: a non-randomized clinical trial,” was authored by Oscar Soto-Angona, Oscar Andión, Pablo Sabucedo, Robert A. Neimeyer, Josep Maria Haro, Julia Javkin, Magí Farré, and Débora González.