Blending Traditions - Using Indigenous Medicinal Knowledge to Treat Drug Addiction
Ancestral medical practices are based on a highly sophisticated practicalknowledge and view the controlled induction of non-ordinary states ofconsciousness as potentially beneficial, even in the treatment of themodern phenomena of drug addiction. These ancestral practices stand incontrast to the clumsiness with which Western peoples induce alteredstates of consciousness. Drawing from his clinical experience in the HighPeruvian Amazonian forest, the author describes the therapeutic benefitsof the wise use of medicinal plants, including non-addictive psychoactivepreparations, such as the well-known Ayahuasca tea. Within aninstitutional structure, a therapeutic system combining indigenouspractices with contemporary psychotherapy yields highly encouragingresults (positive in 2/3 of the patients). This invites us to reconsiderconventional approaches to drug addiction and the role of the individual’sspiritual journey in recovery.
The Backwards Approach
Some take this new tolerance of drug use further, for example by proposingto ravers that they learn about the drugs they consume, the risks thatthey run, and the best way to avoid the negative consequences of theirconduct3. In this model, the drug user is considered a thinking andconsenting subject, who is invited to take responsibility for his actions.The “repressive machine” that tends to substitute itself for the subject,making his decisions, revoking his responsibility, and, in the end,reinforcing an internal pattern of dependence, gives way to an approachwhich appeals to the user’s intelligence. This model accepts theauthenticity of the user’s quest, even if it is often unconscious, for atrue liberty that can be confused with caprice.
While this attempt at finding meaning by exploring new realms ofconsciousness can be chaotic and confused outside of a controlled setting,it is reminiscent of more purposeful undertakings among traditionalpeoples. In fact, one finds the induction of altered states ofconsciousness for the purposes of initiation and therapy in alltraditions. Such experiences, always guided by a ritual frame, oftendepend upon a fine understanding of the animal and vegetable substancesthat serve as their catalysts. One may also affirm that, sometimes, thesame substances that serve as the “remedy” in indigenous cultures are the“poison” in Western society. Hence the coca leaf, which is well integratedinto daily life in the Andean world, becomes a highly addictivecocaine-based paste when taken out of context. Similarly, cannabis, poppy,and tobacco may generate either remedy or poison according to the mode ofconsumption and the context of ingestion.
It is noteworthy that biologists observe that all animal species consumenatural psychoactive substances with great eagerness when possible(Siegel, Ronald, 1990). In fact, Siegel considers this conduct a fourthinstinctual instance of animal biology, as if life tends spontaneouslytowards a broadening of perceptions and a concomitant amplification ofconsciousness. It becomes difficult, then, to extract man from this vastbiological movement that embraces all animal life.
This phenomenon also works for ethnic groups strongly affected bysubstances such as alcohol, which represents for them, inversely, animported product removed from its context. Hence, the healers of thePeruvian coast treat their alcoholics through the ritual use of themescaline cactus with a high rate of success (around 60 per cent, afterfive years) (Chiappe, Mario, 1976). The Native North Americans reduce theincidence of alcoholism on their reservations considerably and quiterapidly by reviving their ancestral practices, including the ritual use ofpeyote and tobacco (Hodgson, Maggi, 1997).
These considerations lead to the following conclusion: not only must we nolonger take a position of passive tolerance toward an inevitableconsumption of psychoactive substances, but, on the contrary, we mustactively explore the coherent therapeutic use of psychoactive substanceswithout the outcome of dependence. Even more broadly, we must be open toevery induction of altered states of consciousness through diverse methods(such as music, dance, fasting, isolation, breathwork, physical exercise,pain, etc.) This calls for the application of therapeutic techniques thatcreate both a space of temporary containment and an authentic symbolicframe which, as in the indigenous ritual space, integrates therapists andusers. Traditional peoples also teach us that substances consumed in theirnatural form, used with respect to the body’s digestive natural barriers(that is, orally), do not induce dependence, in spite of their powerfulpsychoactive effects. The risk of toxicity is also lower because theiractive principles are similar, if not identical, to the neuromediatorsnaturally secreted by our bodies. In case of overdose (which is generallydifficult to produce given the extremely disagreeable flavor of thebeverages), these substances are eliminated naturally by vomiting. Thisself-regulating phenomenon provides for safe prescription and is anintegral part of the expected effects of ingestion, as well as those ofpurgation-detoxification (hence their special role in the domain of drugaddictions). The context of ingestion requires rigorous dietary, postural,and sexual regulations. In the course of successive ingestions,sensitivity increases instead of creating a habit. As a result, the dosesgradually decrease: their use in addiction therapy is not, then, a simplesubstitution.
The entheogenic or visionary effects of this beverage have been hastilycalled “hallucinogenic,” stigmatizing a compound which could be asignificant topic of research. Its potential as such risks being dismissedby the academic community due to a stance less indebted to scientificrationality than to society’s collective fears. We have argued that theimages stimulated by the use of Ayahuasca in a therapeutic contextsymbolically manifest the content of the unconscious. Moreover, theseimages are not without an object, whether it be psychological orotherwise, which differentiates them completely from the “illusionswithout object” that are by definition “hallucinations” (Mabit, 1988). Theexploration of the unconscious through Ayahuasca permits the rapidextraction of extremely rich and highly coherent psychological material,which can then be worked through with various psychotherapeutic methods.Visions, like dreams, indicate the beginning of an integration at thesuperior cortical level. The effects of Ayahuasca are not merely visual,but embrace the entire perceptual spectrum, as well as the non-rationalfunctions tied to the right brain and to the paleoencephal or so-calledreptilian brain. The patient’s clinical experience fosters the developmentof not only the projective but also the integrative functions ofsymbolization, enabling the progressive readjustment of personalitystructures. These explorations touch cross-cultural psychological depthsand, hence, may be applied in extremely broad and varied contexts of humanlife.
The program, in which no method of coercion is exercised, accepts groupsof no more than fifteen voluntary patients. The location is a five acrepark bordered by a river, just outside the city of Tarapoto, in thePeruvian High Amazon, in the piedmont of the Andes (Mabit, Giove, Vega,1996).
The therapy is based on a three-part method which includes the use of theplants, psychotherapy, and community life. The guided experiences ofaltered consciousness generate psychological material which issubsequently discussed and evaluated in the psychotherapy workshops andthen directed towards expression in community life. In reverse, everydayactivities supplement the therapeutic sessions (with or without plants).
The initial use of purifying, sedative, and purgative plants reduceswithdrawal syndromes, rendering any return to prescription medicationduring the stay unnecessary. Then, the psychoactive plants intervene,powerfully facilitating the psychotherapy. From the brief sessions to theeight day isolation in the forest with rigorous rules pertaining to food,sex, external contacts and daily activities, each ingestion ofpsychoactive plants is governed by specific conditions. Each session isalso facilitated by a trained therapist, and clearly inscribed into aprecise and rigorous symbolic frame, which improves the chance of successfor the session and its subsequent integration into the subject’s life.
Two-thirds of the patients consumed mainly a highly addictive anddebilitating cocaine-based paste. 80% consumed alcohol alone or inaddition to other drugs. More than half of the patients (53.5%) hadalready tried treatment, one-third of which had tried psychiatricservices. For 49%, the gateway drug was alcohol, and for 42%, cannabis.The average age was thirty years and the average duration of consumptionof psychoactive substances at the time of entrance was 12.5 years. At31.3%, with a tendency to augmentation, the index of retention (percentageof prescribed exits out of total exits) gives proof of the relativeacceptance of this therapeutic method. The voluntary exits make up themajority (52%) compared to prescribed exits (23%), runaways (23%), and therare expulsions (3%).
This method, officially recognized by the Peruvian authorities, hasexpanded into a number of programs including educational programs (forstudents), psychiatric and anthropological research, and outreach (writtenand audio-visual media, and seminars for personal development).
The high degree of diffusion of the drug phenomenon in the 50’s and 60’swas born of the contact between a few intellectuals with traditionalpeoples, and, in particular, of North Americans with Amazonian Indians(Ginsberg, Leary, Alpert, etc., — see Leary, Metzner, Alpert, 1964).These intellectuals believed that they could appropriate ancestralknowledge while only retaining the physical substance, reducing “theapproach of the gods” to the consumption of an active principle, playingneurochemists like apprentice sorcerers (see Leary’s delirious work,1979). This oversimplified view of substances and their potential hasgenerated a terrible drama. The phenomenon of substance addiction ischaracteristic of Westernized societies and continues to be practicallyunknown in indigenous populations or among peoples free from prolongedWestern influence.