Bitter Medicine: What Happens When Ayahuasca Goes Wrong
Ayahuasca is a powerful medicine. While it has profound healing potential, there are risks, too. Discover what can go wrong post-ayahuasca, and how to address and prevent these issues.
It’s estimated that over four million people had drunk ayahuasca worldwide before 2023.
Indigenous Amazonian communities have used this medicine for spiritual connection and healing for centuries.
Research shows its potential for treating mental and physical health conditions, while thousands of first-hand accounts credit the brew with helping drinkers overcome traumas, improve their health, and make changes in their lives.
“But ayahuasca is not a magic wand that taps you and then — poof! — You’re healed!” says David Londoño, a Colombian psychologist with over 20 years of experience studying traditional indigenous medicines.
In fact, when not handled with proper care, people can experience adverse effects after drinking ayahuasca. These can range from psychological instability and retraumatization, to ego inflation and taking ayahuasca’s messages too literally, to energetic absorption and entity attacks.
Let’s explore what happens when things go wrong after ayahuasca — and how we may be able to mitigate these problems.
Challenging Integration or Bad Experience?
Let’s first define what adverse effects mean. Ayahuasca healing is not meant to be smooth-sailing — working with this medicine frequently digs up difficult psychological content, including past traumas and uncomfortable aspects of our subconscious.
While difficult, many people report that these aspects of the journey are ultimately beneficial.
One study that looked at the post-ayahuasca integration phase found that “integrating ayahuasca experiences can be challenging and take considerable time — though working through integration challenges can facilitate positive growth.”
However, some study respondents described unresolved or negative integration experiences: “I felt very neglected and unstable after the experience and had a hard time coping with my feelings,” said one of the participants.
The study identified the grey area between ultimately beneficial integration challenges and pathological experiences, and the importance of therapeutic reframing in finding healing and growth despite difficulties.
“It’s true that as part of a therapeutic process, the plants often confront you with difficult feelings and painful areas within yourself — places of suffering, confusion, and anguish,” — explains Londoño.
“So sure, you might feel worse before you feel better. But some people simply worsen and never improve. This can happen because the screening was poor or there was no screening at all, due to a lack of training in the facilitators or unsafe practices during the ceremony –– or the person was simply not a good candidate for ayahuasca, because it’s not for everyone,” — he continues.
“Sometimes facilitators exploit the idea that any worsening must be a 'healing crisis.’ But not all worsening is a healing crisis; sometimes it can be a destructive crisis if it’s not treated in time. So you have to learn to tell the difference.”
Destabilization & Disconnection Post-Ayahuasca
Londoño identifies several types of psychological challenges that can occur post-ayahuasca.
“One type of adverse effect is retraumatization. That is, people who go to work on a trauma, or who didn’t know they had a trauma, and then it surfaces during the ceremony, but doesn’t get resolved,” — he explains.
They then come out of the experience with the trauma like an untreated open wound, causing pain and suffering.
“Some people have a lot of fear, anxiety, and even panic attacks following ayahuasca ceremonies, all stemming from what they experienced during the night,” says Londoño. “While others leave and develop dissociation, which can involve some degree of disconnection from one’s body, emotions, or the environment.”
Ayahuasquera and CEO of Plant Medicine People, Kat Courtney, notes, “We see people that are disconnected from reality completely and can’t find their way back into a ‘normal' state, i.e., connected to their bodies, connected to their loved ones, or able to go to work. In extreme cases, we see psychotic breaks.”
Following their ayahuasca experience, one Reddit user reported, “I went through cycles of dissociation or shut down & everything seemed to overwhelm my system. Some days I felt non-verbal. It’s been hard on my relationship because sometimes I’m just not ‘there’. I’m just surviving and trying to function somehow.”
Referring to their post-ayahuasca integration period, another said, “I was feeling all the way from feelings of terror, fear, anxiety, and deep depression and grief. Sometimes I would feel feelings of claustrophobia of being alone, trapped in this body all the way to feeling that I had no ground, nothing to get a hold on almost like I was dissolving.”
What predisposes somebody to experiencing these issues?
“People who have psychotic traits or some difficulty with reality testing (such as with schizophrenia) are more prone to serious complications from an ayahuasca ceremony. People with borderline personality disorder, who already experience significant emotional instability, might be at risk too,” explains Londoño.
“People with severe or complex trauma can go, but if they’re not in a very carefully guided setting with experts who know how to handle trauma, the experience can erupt so suddenly and intensely that it becomes impossible to process,” he adds.
“And then there are people who really need to be in control — going into a ceremony where there’s a huge element of letting go can be harmful for them.”
“Ayahuasca Told Me…” But Was It True?
Have you ever felt like you received a message or instruction directly from the spirit of ayahuasca?
It turns out that this can be risky too.
“There’s another group of adverse effects that I’d label as ‘illusions and confusions’ with ayahuasca. This group, in my view, is very common, and also the hardest to detect because it can happen under the radar,” says Londoño.
"These ‘illusions and confusions’ involve people receiving lessons that they perceive to come from the spiritual world or the plant itself," he explains.
These messages can be about critical life decisions, such as breaking up with a partner, moving forward with medical treatment (or not), or quitting your job. However, this guidance is not necessarily coming from ayahuasca.
The medicine often brings up aspects of our psyche — our fears, fantasies, and desires — disguised as external direction from the plant. When we take these messages too literally, we can harm ourselves and others.
“I’ve seen this happen to all kinds of people,” says Londoño. “Ayahuasca guides who have been serving for 15 or 20 years, psychologists, even integration specialists. It’s pretty common.”
“There’s no specific profile for it, partly because there’s very little education on the topic,” he adds.
How can we discern messages that come from ourselves versus those of the plant?
Londoño advises considering the common good when interpreting messages from plant medicines. The plant will never send a message to hurt someone, make you feel pathologically guilty about something, tell you that you’re a shaman, or that you should donate all of your money to the facilitator — he explained in an article for ICEERS.
He also advises speaking to an integration specialist to decipher messages, as this can help you explore their deeper meaning.
Ayahuasca & the Ego Trap
An often unaddressed adverse effect that can happen post-ayahuasca is ego inflation.
“Ayahuasca is referred to as a ‘plant of power,’ so sometimes people feel strong, powerful, and clear after drinking it,” says Londoño. “Moving from that feeling of great power to ego inflation is a very small step.”
Londoño says that some healers say that ayahuasca ‘tests’ the ego. That’s why many indigenous groups that work with ayahuasca have a strong practice of cultivating humility, alongside the study of the plant. “A good ayahuasquero has to constantly keep their ego in check.”
"It’s no surprise that people with narcissistic traits or narcissistic personality disorder are more predisposed to ego inflation through ayahuasca use. But that doesn’t mean the plant can’t help them — with good integration work, and the right processing of experiences, it’s possible to make progress on these tendencies," explains Londoño.
“Spiritual Parasites:” Energetic Discipline
Amazonian healers say that ayahuasca doesn’t just work on the conscious mind and physical body. It also works on the energetic body.
Londoño explains that according to indigenous curanderos, the energetic body ‘opens up’ during the ceremony, so the plant can come in, do a deep cleansing, and integrate positive energies.
But if we are not energetically ‘closed up’ at the end of a ceremony, we leave it energetically open, which is like leaving your house unlocked for anyone to come in.
From the indigenous perspective, energies and spirits enter the space during an ayahuasca ceremony. If the space isn’t well-contained, energetically speaking, we can end up absorbing these toxic influences, carrying them with us afterwards.
“To guide ceremonies, you have to maintain spiritual and energetic purity, have a clear mind, and a pure heart,” says Taita Henrri Muchavisoy, a traditional healer from the Inga community of Putumayo, Colombia.
“You also need to have a lot of discipline in the ceremony to be able to strengthen the people who come to you. When there is a lack of discipline or mental order in the Taita who is serving the medicine, instead of being healed, people leave more sick, charged with bad energy, feeling unwell,” he explained.
“That’s why you have to be very careful about who you drink yagé [ayahuasca] with.”
Courtney describes a moment when she realized that she was burdened with energies that weren’t hers.
“About four years into my apprenticeship with ayahuasca, I relapsed on alcoholism and Bulimia. It happened because I had no sense of protection in the ceremony space,” — she explains.
“I took on some energies, and when they were removed, it made me realize I was identifying with this relapse of self-sabotage and destruction. But in fact, it was an energy that wasn’t my own. Because I hadn’t fully healed those wounds, there was an entry point for that entity to find me.”
According to Courtney, these adverse entities are like spiritual parasites — they can harm us without us even knowing they’re there. “That’s what makes them so nefarious,” she says.
Not Just Folklore: Realities of the Spirit World
Londoño highlights the tendencies of Westerners who are unfamiliar with indigenous ways of knowing to brush off the energetic elements of ceremony as folklore.
The Union of Traditional Amazonian Healers in Colombia, UMIYAC, released a code of ethics emphasizing the necessity of respecting this ancestral wisdom and the practices they have used for millennia.
“Non-indigenous people tend to regard our practices as folklore or simple superstition; our tools and ceremonies are commonly seen as senseless and ineffective. We would respectfully request that our practices not be prejudged without a thorough examination of how our medical knowledge functions.”
“For us, life is full of visible things and invisible things. The teachings of our ancestors have afforded us the opportunity to believe in, see, and know unseen things,” — writes UMIYAC.
Drinking With Discernment
The good news is that many of these post-ayahuasca problems can be mitigated through proper intake, preparation, and integration support, and energetic hygiene practices.
Many factors can determine whether someone gets worse after ayahuasca, says Londoño. This ranges from prior screening to the individual’s preparation, the medicine ceremony itself, the dosage, and how the person processes their experience.
Ayahuasca isn’t for everyone. Any facilitator should screen the participant for physical and psychological contraindications and get a clear sense of why they want to drink the medicine. Plus, as Taita Henrri mentioned earlier, the guide needs to have gone through the necessary training (this can often last up to a decade or more) under a mentor and with a specific lineage.
“Sometimes people sit in circles that are just not well-intended,” — says Courtney. “There are facilitators who shame them, or who give them a lot of medicine and then try to control or repress the potential outburst.”
“That right there is a recipe for disaster in ceremony. The don’t think, drink motto.”
When it comes to energetic protection, Londoño emphasizes the importance of Master Plant dietas and other tools such as tobacco, plant essences, plant baths, and specific songs and prayers.
“Traditional medicine is an entire system of knowledge, and it typically takes years of rigorous training to develop the skills to offer energetic care and protection to participants.”
Finding Your Way Back to Wholeness
If you are experiencing difficulties after ayahuasca that feel destabilizing or are impacting your daily functioning, it’s important to seek professional help. Ideally, this should be an integration specialist (like David Londoño) who has knowledge of psychedelic integration and can provide a safe therapeutic container.
You could also attend virtual and in-person integration circles (like the ones we host at Colibri Garden), which serve to help you unpack your experiences and receive support in a safe group environment.
Londoño also advises against jumping back into more ceremonies, especially if you feel pressured by your facilitator to go back. Sometimes this can deepen the wound instead of healing it, so it’s important to pause, step back, and gain perspective, he says.
Other problems that come from spiritual or energetic imbalances often require spiritual intervention. Ideally, Londoño explains, you want a combination of both psychological and shamanic interventions. “Having both perspectives in mutual respect, working together to heal, can be very powerful.”
Ultimately, Courtney says, much of this process is about “trusting that a breakdown will facilitate a breakthrough. Make self-care a priority, go slow, and remember that the darkness tries to tell us that things are permanent — they are not.”
Walking the Ayahuasca Path With Care
As this powerful medicine becomes even more globally accessible, we must approach it not with blind reverence or fear, but with humility, discernment, and deep respect — for the plants, the traditions, and our own limits.
In the end, going to ceremonies is not about seeing colorful visions and listening to beautiful songs — it’s about how we carry the insights into our lives afterwards. And this process starts the moment we commit to an ayahuasca ceremony, well before we drink our first cup.
Curious about the practices and tools that can help you integrate your ayahuasca experience? Read: Putting in the Work Post-Purge: How to Integrate Your Ayahuasca Experience.
Further Reading
Ayahuasca Prep Guide: Steps to Prepare Mind & Body for the Ceremony
Building a Safe & Responsible Plant Medicine Culture: Q&A with Jerónimo Mazarrasa of ICEERS
Healing Isn’t a Performance: Why New Age Psychedelic Culture Is Missing the Point
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