Purging to Cleanse: A Qualitative Study of Ayahuasca Healing at a Drug Treatment Center in Peru

Objective: Ayahuasca, an entheogen from the Amazon rainforest, has garnered growing interest for treating substance dependence. To date, there is little research concerning the act of ayahuascarelated purging (mainly vomiting), which is considered to be central to healing during ayahuasca rituals. This study explored practitioner perspectives on purging during ayahuasca rituals at the Takiwasi Center in Peru. Method: We conducted in-depth interviews with curanderos (healers), plant preparers, and psychotherapists (N N = 11) at the Takiwasi Center between August and October 2021. Interviews were conducted and transcribed in Spanish. Interviews were analyzed using a thematic analysis approach. Results: Participants described purging as a fluid concept that went beyond the act of vomiting. Participant narratives around purging were organized into three central themes or accounts: spiritual-oriented, which highlighted the relationship between purging and spiritual development; Amazonian-oriented, which emphasized purging as a cathartic expulsion of embodied cargas (loads) that are perceived to lead to sickness; and clinical-oriented, which stressed that purging generates a range of empirically observable therapeutic benefits. All of these explanatory models emphasized the pivotal interconnection between purging and healing during ayahuasca-assisted treatment for substance dependence at Takiwasi. Conclusions: This study highlights practitioner perspectives on purging at the Takiwasi Center, who offer three main explanatory models for this aspect of healing during ayahuasca-assisted therapy for substance dependence. This research contributes to the limited literature on the role of purging in ayahuascarelated healing, which may inform further investigation into differential understandings of the role of purging for therapeutic benefits. (J. J. Stud. Alcohol Drugs, 85, 619-626, 2024)