Living with the Medicine: A Qualitative Study of Post-Retreat Integration Experiences Among Ayahuasca Participants

Background and Purpose: Ayahuasca is a psychoactive plant medicine traditionally used in Amazonian healing practices. As interest in psychedelic-assisted healing grows, ceremonial ayahuasca retreats in the Amazon have attracted global attention as pathways to psychological, emotional, and spiritual transformation. Existing research has largely focused on acute effects of ayahuasca, but little is known about how individuals integrate these experiences into daily life over time. This study examines the long-term integration process following ayahuasca use, with a focus on how individuals make meaning of their experiences after returning home, and the personal, relational, and cultural factors that shape this process.

Methods: This qualitative study is part of a larger longitudinal project examining ayahuasca’s effects on mental health outcomes. IRB approval was obtained and all participants provided informed consent. Sixteen participants (ages 22-67, mean=42.7, SD=11.5) were recruited from a pool of individuals who had completed previous survey timepoints and indicated interest in follow-up interviews. Efforts were made to ensure diversity in background. Participants completed in-depth, semi-structured interviews via Zoom. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Two researchers independently coded the transcripts using a structured codebook. A third researcher reviewed transcripts and coding to resolve inconsistencies and identify missing content. Coding discrepancies were discussed in weekly team meetings to reach consensus. Data were managed in NVivo, and codes were refined iteratively as patterns emerged to enhance analytic consistency.

Results: Thematic analysis identified four overarching themes reflecting how participants interpreted and integrated their ayahuasca experiences. (1) Psychological transformation and empowerment: Participants described emotional and cognitive shifts as they processed trauma, emotional pain, and internal conflict. Many reported confronting long-standing childhood trauma or grief, which led to improvements in self-perception, emotional regulation, and stress coping. For some, the retreat marked a turning point from emotional exhaustion to renewed perspectives. (2) Integration strategies and challenges: Participants engaged in practices such as meditation, journaling, and therapy to sustain integration, while some returned to retreats to deepen inner work. Some encountered emotional setbacks and struggled to maintain changes without structured support. Expectation mismatches, such as absence of anticipated visions, sometimes led to confusion or disappointment. (3) Social support and relationships: Participants who received encouragement or validation from others often described greater ease in applying their insights in daily life. Conversely, lack of understanding often led to silence, isolation, and relational tension due to stigma or fear of judgment. (4) Cultural context and barriers: Participants reported structural barriers, such as financial constraints, lack of culturally informed care, and psychedelic stigma as obstacles to integration. Participants also expressed discomfort with the commercialization of ayahuasca and emphasized the need for open dialogue and accessible resources.

Conclusions and Implications: Ayahuasca integration is a complex, individualized process shaped by various factors. While many participants reported meaningful transformation, some experienced setbacks or lacked support. Findings highlight the need for integration frameworks that are trauma-informed, culturally-responsive, and extend beyond the retreat setting. This study offers practical implications for mental health professionals supporting post-retreat integration through safe, inclusive, and culturally-grounded practices.