In an open-label naturalistic study of 54 retreat participants, ayahuasca use was associated with significant increases in gratitude, nature relatedness and nature appreciation at one week and one month post-retreat, with weak-to-moderate correlations between these increases and mystical-type experiences and awe but not ego dissolution. The findings suggest ayahuasca-occasioned mystical and awe experiences may lead to personality changes beneficial for mental health and prosocial behaviour, though further research is required.
Ayahuasca is a psychedelic brew that has been the focus of an increasing number of investigations for its potential therapeutic effects. In addition to psychiatric improvements, qualitative studies and anecdotal reports suggest that ayahuasca use may influence gratitude and relationships with nature. Yet, to date, these specific changes have been understudied. Here, participants (N = 54) completed surveys one-week before, one-week after, and one-month after attending an ayahuasca retreat center. There was a significant increase in gratitude, nature relatedness, and nature appreciation at the one-week and one-month follow-ups compared to baseline. Ratings of mystical-type experiences and awe, but not ego dissolution, were weakly-to-moderately correlated with increases in gratitude, nature relatedness, and nature appreciation. Although further research is needed to address study limitations, our results support that mystical-type experiences and awe occasioned by ayahuasca can be followed by changes in personality that are beneficial to mental health as well as prosocial.
Classic serotonergic psychedelics, including DMT which is the primary psychoactive component in the ayahuasca brew, have attracted renewed scientific and public interest because clinical trials pairing these drugs with psychotherapeutic support have reported therapeutic and prosocial effects. While earlier work has documented clinical improvements (for example in depression and substance use) and personality shifts such as increased openness and feelings of connection, several social and personality domains reported anecdotally after psychedelic use—specifically gratitude and relationships with nature—have been comparatively understudied. Aday and colleagues designed a naturalistic, open‑label, within‑subjects study to address this gap by measuring changes in gratitude, nature relatedness, and a related construct termed nature appreciation before and after attendance at an ayahuasca retreat. The investigators also tested whether acute subjective experiences during the most intense ayahuasca session—mystical‑type experience, awe, and ego dissolution—predicted post‑acute changes, and examined baseline predictors such as age and prior psychedelic use.
Papers cited by this study that are also in Blossom
Aday, J. S., Davis, A. K., Mitzkovitz, C. M. et al. · ACS Pharmacology and Translational Science (2021)
Aday, J. S., Heifets, B. D., Pratscher, S. D. et al. · Psychopharmacology (2021)
Aday, J. S., Mitzkovitz, C. M., Bloesch, E. K. et al. · Neuroscience and Biobehavioral Reviews (2020)
Anderson, B. T., Danforth, A. L., Daroff, R. et al. · EClinicalMedicine (2020)
Design and setting: The study used an open‑label, naturalistic, within‑subjects design conducted at Soltara Healing Center, an all‑inclusive ayahuasca retreat in Puntarenas Province, Costa Rica. Participants completed surveys one week before the retreat (T1), one week after the retreat ended (T2), and one month after the retreat (T3). Acute subjective measures referencing each participant's most intense ayahuasca session were collected at T2. Participants and intervention: Attendees registered for the retreat were invited to participate. Inclusion requirements included being at least 18 years old and completing a medical intake that screened out contraindicated psychiatric disorders (for example schizophrenia or bipolar disorder), contraindicated medications (for example lithium), and certain medical conditions (for example heart ailments). Retreat stays ranged 5–12 nights, and participants took part in 2–7 ayahuasca ceremonies (mean = 3.67, SD = 0.85) led by Shipibo curanderos. The retreat context included meals, accommodation, access to natural grounds, and optional recreational activities such as yoga and hiking. Measures and timing: Baseline demographics and lifetime psychedelic use were collected at T1. The main outcome measures administered at T1, T2, and T3 were a multifaceted gratitude scale (AS, analysed by facet and total score), the NR‑6 (a short nature relatedness scale), and an APR measure of nature appreciation. Acute measures collected at T2 (referenced to the most intense session) were the MEQ30 (mystical‑type experience questionnaire), the AWE‑S (awe scale), and the EDI (ego dissolution inventory). Participants completed surveys online via Qualtrics. Sample and attrition: Seventy‑seven participants completed the baseline survey. Sixty‑five (84% of baseline) completed the one‑week post survey, and 55 (71% of baseline) completed the one‑month follow‑up. One participant who did not partake in any ceremonies was excluded, leaving a final analysed sample of N = 54 (mean age = 41.17, SD = 11.24; 24 female). The sample was highly educated (88.9% college degree or higher), majority non‑Hispanic white (74.1%), and skewed toward higher income (38.9% > $125,000/year). A wide range of prior psychedelic experience was reported. Data analysis: Changes over time in AS total and its eight facets were tested with a 3 × 8 repeated‑measures ANOVA (Time × Facet). NR‑6 and APR totals were each analysed with one‑way repeated‑measures ANOVAs across the three time points. Relationships between acute subjective measures (MEQ30, AWE‑S, EDI) and change scores at one week (∆1 = T2 − T1) and one month (∆2 = T3 − T1) were examined using Pearson correlations. The investigators reported effect sizes and conducted planned pairwise comparisons where applicable.
Sample and retention: From 77 participants at baseline, 65 completed the one‑week follow‑up and 55 completed the one‑month follow‑up; after excluding one person who did not partake in ceremonies, analyses used N = 54. Participants attended on average 3–4 ceremonies during their retreat. Gratitude (AS): The repeated‑measures ANOVA for AS showed a significant main effect of Time (F(1, 53) = 34.97, p < .001, ηp2 = 0.40). Planned comparisons indicated AS total scores at one week (T2) and one month (T3) post‑retreat were significantly higher than baseline (T1), while T2 and T3 did not differ from one another. The main effect of Facet was also significant (F(1, 53) = 709.19, p < .001, ηp2 = .93), with every facet increasing at T2 and T3 compared to baseline. A Time × Facet interaction (F(1, 53) = 5.68, p < .001, ηp2 = 0.10) reflected that the ritual and interpersonal facets showed particularly clear increases at T2 and T3 versus baseline. Change in gratitude did not correlate with the number of ayahuasca sessions attended (r = .03, p > .05), and the authors reported no evidence of attrition bias. Acute subjective measures of awe (AWE‑S) and mystical‑type experience (MEQ30), but not ego dissolution (EDI), were weakly to moderately correlated with one‑week and one‑month increases in AS total scores. Nature relatedness (NR‑6) and nature appreciation (APR): For NR‑6, Time had a significant effect (F(1, 53) = 26.27, p < .001, ηp2 = 0.33): one‑week and one‑month scores were higher than baseline and did not differ from each other. APR exhibited a comparable pattern (F(1, 53) = 31.79, p < .001, ηp2 = 0.38), with T2 and T3 exceeding T1 and no difference between T2 and T3. As with gratitude, AWE‑S and MEQ30—but not EDI—showed weak correlations with changes in NR‑6 and APR. Mystical‑type experiences and baseline predictors: Using a criterion of scoring ≥ 60% on each MEQ30 subscale to define a "complete mystical‑type experience," 37 of 54 participants (68.52%) met that threshold. Regarding baseline predictors of acute effects, age was negatively correlated with MEQ30 scores (r = −.34, p = .010) and with AWE‑S scores (r = −.39, p = .004), but not with EDI (r = −.18, p = .140). Lifetime history of psychedelic use was not significantly related to acute MEQ30 (r = .11, p = .424), AWE‑S (r = .05, p = .703), or EDI (r = .11, p = .388) scores.
Aday and colleagues report that participants who attended an ayahuasca retreat showed sustained increases in gratitude, nature relatedness, and nature appreciation at both one week and one month after the retreat, relative to baseline. Acute reports of mystical‑type experience and feelings of awe during the most intense ayahuasca session predicted these post‑acute increases, whereas ego dissolution did not. The findings extend prior work with other psychedelics by demonstrating similar post‑acute changes following ayahuasca and by including a measure of nature appreciation that had not been used in previous psychedelic studies. The authors interpret the correlations between awe, mystical experience, and subsequent increases in gratitude and nature‑related constructs as consistent with a possible mechanism in which intense, awe‑provoking experiences create meaningful memories that elevate gratitude and foster a stronger bond with nature. They note that awe and mystical‑type experience were very strongly correlated in their data (r = .86, p < .001), which may reflect overlapping phenomenology in this setting. Several limitations are acknowledged. The open‑label, uncontrolled, naturalistic design precludes causal attribution to pharmacology alone, and the retreat context included non‑pharmacological influences (for example, access to nature, yoga, social interactions) that could have contributed to the observed changes. The sample was demographically homogeneous (high education and income, majority non‑Hispanic white), limiting generalisability. The authors also remark on the practical difficulty of double‑blind trials with psychedelics given their salient acute effects. Other limitations include the variable number of ceremonies per participant and reliance on self‑report rather than behavioural or observer measures. For future research, the investigators recommend incorporating blinded controlled designs where feasible, longer follow‑up intervals to assess durability of change, behavioural and third‑party measures of gratitude and pro‑environmental behaviour, and mediation analyses to test whether prosocial shifts contribute to clinical improvements seen in other psychedelic studies. They also highlight strengths of the current study—adequate power, good retention, multiple follow‑ups, ecological validity, and use of validated multi‑facet measures—and conclude that their results provide preliminary evidence that ayahuasca‑occasioned mystical experiences and awe are associated with sustained increases in gratitude and connection to nature, with possible implications for mental health and pro‑environmental behaviour. The authors emphasise the need for further well‑powered research to address the noted limitations.
Classic psychedelic drugs include serotonin 5-HT2A receptor agonists such as lysergic acid diethylamide (LSD), psilocybin, mescaline, and N,N-dimethyltryptamine (DMT). DMT can be directly administered, but also is the primary psychoactive component in ayahuasca, a hallucinogenic brew that is found in regions of Central and South America. Psychedelics are currently of high scientific, public, and regulatory interest because of the promising therapeutic effects that have been demonstrated in clinical trials when the drugs are paired with psychotherapeutic support. Indeed, recent studies of so-called "psychedelic therapy" have demonstrated positive clinical outcomes in patients with depression, substance misuse, and end-of-life distressas well as prosocial changes, such as increased openness to experience and feelings of connection. However, there are many areas of social functioning and personality, such as gratitude and relationships with nature, that have been reported to be altered as a result of psychedelic experiences, but have been as of yet under examined. The current study was designed to assess potential changes in these aspects of personality following the administration of ayahuasca in a retreat setting. To begin, there are myriad converging lines of evidence suggesting that individuals may feel more grateful after psychedelic experiences. One possible psychological mechanism by which psychedelics could increase gratitude is through inducing powerful experiences of the emotion of awe, which has been noted with the substances, and linked to increased gratitude in other contexts. There is also direct anecdotal and qualitative evidence suggesting individuals experience increased gratitude after psychedelic experiences. For example, in a psilocybin study for smoking cessation, one participant remarked 'I've learned how to be more grateful, which is probably the biggest thing'. Finally, there is tentative empirical evidence that psychedelic experiences may increase gratitude from, who gave two high doses of psilocybin to healthy volunteers and assessed changes in gratitude using the sixquestion Gratitude Questionnaire (GQ-6). At the 6-month follow-up, they found that gratitude was increased in their two high-dose psilocybin groups, but not in the low-dose control group. The degree to which one had a mystical-type experience (i.e., characterized by strong feelings of connection, positive mood, ineffability, and transcendence of time and space) during dosing sessions predicted increases in gratitude in the high-dose groups. Yet, discussion of these findings was limited given that gratitude wasn't the primary measure of interest, and it is still unclear which facets of gratitude may be affected given the general and brief nature of the GQ-6. It is also unknown the extent to which other psychedelic drugs, such as ayahuasca, may affect gratitude as well as how other mechanisms, such as awe and ego dissolution (i.e., loss of sense of self or self-boundaries), may account for these changes. In addition to gratitude, another prosocial change that has been linked to psychedelics is alterations in one's relationships with nature.found that lifetime experience with psychedelics predicted greater pro-environmental behavior and these differences were mediated through increases in nature relatedness (i.e., how connected one feels with nature;. Following up on this cross-sectional study, Lyons and Carhart-Harris (2018) administered psilocybin to patients with treatment-resistant depression in an openlabel trial and found that participants exhibited increases in nature relatedness that were maintained at the 7-12-month follow-ups. Another study examined individuals planning to use a psychedelic in a naturalistic setting and found that compared to the week before administration, participants showed increased nature relatedness at the 2-week, 4-week, and 2-year follow-ups. Further, increases in nature relatedness were related to enhanced wellbeing and predicted by the extent to which participants experienced ego dissolution during their psychedelic experience. However, no published studies have examined nature relatedness in relation to ayahuasca specifically. Additionally, a related, but psychometrically distinct, concept to nature relatedness is nature appreciation (i.e., the extent to which individuals value experiences with and in nature;, but measures of this construct have not been included in any psychedelic study to-date. Lastly, it should be noted that a systematic review byfound that baseline traits, such as age, past history of psychedelic use, and personality variables, could be used to predict acute reactions to psychedelics. In particular, this systematic review of the literature found that older age and increased previous experience using psychedelics were both related to generally less intense effects with the drugs. Further study into these relationships is a critical area of research for identifying which individuals are likely to benefit from psychedelic use as well as informing risk assessments and dosage selection. The current study was designed to address the aforementioned gaps in the psychedelic literature. Detailed measures of gratitude, nature relatedness, and nature appreciation were given to participants one-week before (T1), one-week after (T2), and one-month after (T3) attending an ayahuasca retreat in Costa Rica. We also administered scales assessing the extent to which participants endorsed feelings of awe, ego dissolution, and mystical-type experiences during their most intense ayahuasca session to identify potential predictors of post-acute change and collected demographics to explore baseline predictors of drug effects.
Participants were recruited from Soltara Healing Center in Puntarenas Province, Gigante, Costa Rica (www.soltara.co). Soltara is an all-inclusive ayahuasca retreat center where attendees pay to participate in ayahuasca ceremonies with indigenous Shipibo curanderos (i.e., "healers" specializing in plant medicine) from Peru. All meals, sleep accommodations, and transportation were provided by the center. The setting was located in a biodiverse region that included beaches and hiking trails on the grounds as well as various yoga and meditation classes on-site for recreation. The retreat required that attendees be at least 18 years old and that they complete a medical intake form confirming that they did not have contraindicated psychiatric disorders (e.g., schizophrenia, bipolar disorder) medications (e.g., lithium), or medical conditions (e.g., heart ailments;. Participants were eligible for compensation via a drawing to win one of five prizes ($100.00 USD). Participants were recruited through email after registering for the retreat as well as a posting on the retreat's website. All participants provided informed consent and the study was approved by the Central Michigan University Institutional Review Board.
The following demographic variables were collected during the first survey session: age, gender identity, highest level of education completed, annual household income, ethnoracial identity, country of permanent residence, range of lifetime history of psychedelic use (Never, Once only, 2-5 times, 6-10 times, 11-15 times, 16-25 times, 26-50 times, 51-100 times, >100 times), and an exact estimate of the number of times they have used psychedelics. The rest of the measures included in the study are summarized in Table. Table. Summary of measures administered. Pre/Post (P) measures were collected at T1, T2, and T3. Acute (A) measures were collected immediately after the retreat ended (i.e., T2) and indexed the subjective effects of participants' most intense ayahuasca session.
Participants stayed at the center for 5-12 nights and participated in 2-7 ayahuasca ceremonies during their retreat (M = 3.67 SD = 0.85). Following enrollment in the study, participants were emailed a link to the first survey session one week before their retreat was scheduled to begin to collect informed consent and baseline measures (T1). Surveys were administered using Qualtrics, and participants could complete them using a computer or mobile device. During the first survey session, the following measures were collected: demographics, AS, NR-6, and APR (Figure). Figure. Participants completed surveys one-week before (T1), one-week after (T2), and onemonth after (T3) attending the retreat. Next, participants traveled to Soltara to attend the ayahuasca retreat. Procedural details of the ayahuasca ceremonies are described by. The day after the participants' retreat had ended, they were emailed a link to the second survey session and asked to complete it within one week (T2). The second survey session included the same measures as the first session (except demographics) as well as the MEQ30, AWE-S, and EDI. Participants were instructed to answer questions in the MEQ30, AWE-S, and EDI in reference to their most intense ayahuasca experience during the retreat. One month after the participants' retreat ended, they completed the same measures as the first survey session (except demographics) and had one week to complete the survey (T3). After completing the third survey, participants were debriefed on the nature of the experiment and notified if they were one of the raffle winners.
A 3 × 8 repeated-measures analysis of variance (ANOVA) was run on AS total scores with three levels of Time (T1, T2, and T3) and eight levels of Facet ("have focus", awe, ritual, present moment, self/social comparison, gratitude, loss adversity, interpersonal). NR-6 and APR total scores were analyzed using two separate one-way repeated measures ANOVAs with three levels of Time (T1, T2, and T3). Scores on the MEQ30, AWE-S, and EDI were correlated with one-week and one-month changes (∆) in AS, NR-6, and APR total scores with two-way Pearson correlations. One-week change scores (∆1) for the AS, NR-6, and APR were calculated by subtracting baseline (T1) total scores from one-week post-retreat (T2) total scores for each respective measure (e.g., T2-T1 =∆1). One-month change scores (∆2) for the AS, NR-6, and APR were each calculated by subtracting baseline (T1) total scores from one-month post-retreat (T3) total scores for each respective measure (e.g., T3-T1 = ∆2).
The sample began with 77 participants who completed baseline (T1). From this sample, 65 participants (84% of initial sample) completed Survey 2 one-week post-retreat (T2) and 55 participants (71% of initial sample) completed Survey 3 one-month post-retreat (T3). One participant who completed all three surveys indicated that they did not partake in any ayahuasca ceremonies while at the retreat and thus was removed from all analyses, leaving a final sample of N = 54 (Mage = 41.17, SD = 11.24; female = 24). The sample was highly educated (88.9% college degree or higher), had generally high incomes (38.9% >$125,000/year), and was predominantly non-Hispanic white (74.1%). There was a wide range of previous experience with psychedelics among participants, with 18.5% reporting "never" having used a psychedelic drug, 29.6% 1-5 uses, 13% 6-10 uses, 9.3% 11-15 uses, 7.4% 16-25 uses, 13% 26-50 uses, 3.7% 51-100 uses, and 5.6% >100 uses.
To assess changes in overall gratitude as well as which facets were altered, the individual facets of the AS were analyzed with a 3 × 8 repeated-measures ANOVA. The main effect of Time was significant (F(1, 53) = 34.97, p < .001, etap 2 = 0.40). Planned pairwise comparisons revealed one-week (T2) and one-month (T3) post-retreat AS total scores were significantly higher than scores at baseline (T1); one-week (T2) and one-month (T3) post-retreat AS scores did not differ from one another (p > .05; Figure). The main effect of Facet was significant (F(1, 53) = 709.19, p < .001, etap 2 = .93. Every facet increased at the one-week and one-month follow-ups compared to baseline and there were no significant differences between the one-week and one-month follow-ups for any facet (Table). The Time × Facet interaction was significant, F(1, 53) = 5.68, p < .001, etap 2 = 0.10, such that the ritual facet and interpersonal facet were significantly different at the one-week (p = .014) and one-month follow-ups (p < .001), but not at baseline. Changes in gratitude did not differ as a function of the number of ayahuasca sessions attended (r = .03 p > .05), and there was no evidence of attrition bias. Scores on the AWE-S and MEQ30, but not the EDI, were weakly-to-moderately correlated with one-week (AS∆1) and onemonth (AS∆2) changes in AS total scores (Table).
NR-6 and APR total scores were analyzed using two separate one-way repeated measures ANOVAs. For the NR-6, the effect of Time was significant (F(1, 53) = 26.27, p < .001, etap 2 = 0.33), such that one-week (T2) and one-month (T3) post-retreat NR-6 scores were significantly higher than baseline (T1) scores (Figure); one-week (T2) and one-month (T3) post-retreat NR-6 scores did not differ from one another (p > .05). For the APR, the effect of Time was significant (F(1, 53) = 31.79, p < .001, eta p 2 = 0.38), such that one-week (T2) and one-month (T3) post-retreat APR scores were significantly higher than baseline (T1) scores (Figure); one-week (T2) and one-month (T3) post-retreat APR scores did not differ from one another (p > .05). Scores on the AWE-S and MEQ30, but not the EDI, were weakly correlated with one-week (T2) and one-month (T3) changes (∆) in NR-6 and APR total scores (Table) Figure. Nature relatedness and appreciation of nature increased at the one-week and one-month follow-ups compared to baseline.
Previous research has established the frequency and impact of mystical-type experiences in psilocybin sessions (e.g.,, but the literature is unclear regarding ayahuasca.defined "complete mystical experiences" as scoring 60% or higher on all four subscales of the MEQ30. To examine what proportion of our sample met this criterion, a percentage score was calculated for each facet of the MEQ30 for each participant. We found that 37/54 (68.52%) of participants met the criterion for a complete mystical-type experience. This is in-line with, who found that across two groups administered two high doses of psilocybin in a controlled setting, 61% and 64% of participants met this same criterion. The slightly higher proportion reporting a complete mystical-type experience in this study is likely due to having more chances to experience an intense effect (i.e., participants here took ayahuasca on average 3-4 times over their retreat and completed the MEQ30 in reference to their most intense session).
To explore the relationships between baseline variables and acute drug effects in the current study, we ran planned two-tailed Pearson correlations between baseline variables (e.g., age and past history of psychedelic use) and measures of acute effects (e.g., MEQ30, AWE-S, and EDI). In line with, we found that age was negatively related to intensity of acute effects as measured by the MEQ30 (r = -.34, p = .010) and AWE-S (r = -.39, p = .004), but this relationship was not significant with the EDI (r = -.18, p = .140). Contrasting with, past history of psychedelic use was not related to acute effects as measured by the MEQ30 (r = .11, p = .424), AWE-S (r = .05, p = .703), nor EDI (r = .11, p = .388).
Public and scientific interest into the therapeutic applications of psychedelic drugs has increased markedly in recent years. Ayahuasca retreat centers, in particular, have emerged as a popular method for individuals to experience psychedelics in a legal and controlled environment. However, several drug effects that are commonly anecdotally noted by psychedelic users have seemingly been overshadowed in the scientific literature by the promising clinical applications and left understudied. Specifically, a renewed sense of general gratitude as well as increased interest and engagement with nature have been notable changes linked to psychedelics in subjective reports that have received limited systematic study. Here, we addressed this gap in the literature using a naturalistic, open-label, and within-subjects design at an ayahuasca retreat center. We found that compared to one-week before the retreat, participants reported greater levels of gratitude, nature relatedness, and nature appreciation at the one-week and one-month follow-ups. Measures of awe and mystical experience in response to ayahuasca weakly-to-moderately predicted increases across these domains, but ego dissolution did not. Our findings are consistent with, who found that mystical-type experiences during psilocybin dosing sessions were associated with increased gratitude at the six-month follow-up. Our results provide novel evidence that in addition to psilocybin, ayahuasca may lead to similar changes in gratitude as well, and indicate that changes in gratitude seem to be non-specific, as every facet of the AS increased at both follow-ups (T2 and T3) compared to baseline (T1). Although awe has been linked to increases in gratitude in other contexts, the current results are the first to show that awe is related to increased gratitude with psychedelics. This should perhaps be unsurprising given that awe and mystical-type experiences in response to ayahuasca were very strongly correlated in the current study (r = .86, p < .001). In terms of a mechanistic explanation, experiences that provoke strong feelings of awe can lead to meaningful memories which may increase gratitude and buffer against emotional distress by serving as a powerful reminder of the positive aspects of life. Overall, the results support the hypothesis that psychedelics can induce experiences that are associated with individuals feeling more grateful after the acute drug effects have worn off. Our study also found that participants reported increased nature relatedness and appreciation of nature for at least one month after taking ayahuasca, and these changes were predicted by acute mystical-type experiences and feelings of awe during ayahuasca consumption. The findings support a growing body of literature indicating psychedelic experiences can alter one's relationship with natureand are the first published results to confirm that these pro-environmental effects generalize to ayahuasca use. Given the retreat setting involved in drug administration, it could be argued that non-pharmacological factors contributed to these effects. However, pro-environmental effects have also been documented when synthetically manufactured psychedelics are administered in modern research laboratories)-suggesting that these changes are likely driven, at least in-part, by direct drug effects. It remains to be seen how one's expectations for connecting with nature and motivations for usage contribute to changes in one's relationship with nature after taking a psychedelic. This may be an important point to note with ayahuasca in particular asfound that ayahuasca users expected to connect with nature while under the influence of the drug more than with other hallucinogens. Nonetheless, given the rapidly developing environmental crises and increasing disconnection many people have from nature in modern civilizations, further exploration of the potential for psychedelics to strengthen an individual's connection to, and appreciation of, nature is an important area of future research. There are also important limitations that should be kept in mind when interpreting the results and rectified with future research. First, our study was limited by an open-label design that did not include a blinded placebo control condition. However, it is currently being debated whether or not it is even possible to ever adequately design a true "double-blind" study with psychedelics given their intense and easily identifiable psychoactive effects. Open-label naturalistic studies focusing on mechanistic work may be a cost-effective alternative to traditional double-blind randomized control trials. A further limitation is that participants were recruited from Soltara Healing Center, where attendees receive ayahuasca a variable number of times and its administration is embedded into a broader retreat context. Non-pharmacological factors, such as the retreat amenities (e.g., hiking trails, yoga/meditation classes, etc.) and social relationships developed at the retreat with attendees and staff, could have contributed to the documented changes. As noted before, however, many of these changes have been noted in qualitative reports when psychedelics are given in laboratory settings without these confounding factors. It remains to be seen if there are potential additive or synergistic effects from integrating psychedelics into retreat settings as compared to laboratory or hospital administration. In one test of non-pharmacological factors,found that there were not significant differences in gratitude between those administered a high dose of psilocybin with high compared to standard support for spiritual practice-once again suggesting that direct drug effects and dose may be more pertinent in predicting post-acute changes. Lastly, the homogenous background of the sample (e.g., highly educated, high income) is a limitation to the generalizability of the findings. Future studies should expand upon our results by addressing the aforementioned limitations as well as incorporating behavioral measures and ratings from outside observers. Doing so would provide more objective measures of these changes and reveal if individuals not only report feeling differently, but behave differently as well. Indeed, Tsang (2007) created a behavioral test of gratitude that could be incorporated into studies with psychedelics to this end. Behavioral measures of pro-environmental behavior have been developed as well and have already been shown to be sensitive to the effects of psychedelics. Additionally, future researchers should examine if the prosocial changes reported here (e.g., increased gratitude, nature relatedness) mediate clinical improvements documented with psychedelics given that strengthening gratitude and one's relationship with nature have been causally linked to positive mental health outcomes in other contexts. Another open question is how long changes in gratitude, nature relatedness, and nature appreciation are maintained.found that participants demonstrated increased levels of gratitude for at least six months after administration of psilocybin, but lengthier longitudinal designs are needed. Finally, it is also important to underscore the strengths of our study. The study was adequately powered, had strong participant retention, included multiple post-acute follow-ups, was high in ecological validity, utilized validated and multifaceted measures of gratitude and relationships with nature, and identified mechanisms predictive of post-acute changes. To conclude, the current study supports that mystical experiences and awe induced by ayahuasca are linked with sustained increases in gratitude, nature relatedness, and nature appreciation. Given the relationships between these constructs and positive mental health outcomes, these results could have important implications for clinical populations and society more broadly. Although future well-powered studies are needed to address study limitations, our findings validate anecdotal and qualitative reports regarding several post-acute effects of psychedelic drugs and suggest preliminary mechanisms associated with these changes.
Create a free account to open full-text PDFs.
Bogenschutz, M. P., Ross, S., Bhatt, S. R. et al. · JAMA Psychiatry (2022)
Carhart-Harris, R. L., Bolstridge, M., Rucker, J. et al. · Lancet Psychiatry (2016)
Carhart-Harris, R. L., Erritzoe, D., Haijen, E. C. H. M. et al. · Psychopharmacology (2017)
Carhart-Harris, R. L., Giribaldi, B., Watts, R. et al. · New England Journal of Medicine (2021)
Carhart-Harris, R. L., Goodwin, G. M. · Neuropsychopharmacology (2017)
Forstmann, M., Sagioglou, C. · Journal of Psychopharmacology (2017)
Griffiths, R. R., Johnson, M. W. · Journal of Psychopharmacology (2016)
Griffiths, R. R., Johnson, M. W., Richards, W. A. et al. · Journal of Psychopharmacology (2017)
Nunes, A. A., Dos Santos, R. G., Osório, F. L. et al. · Journal of Psychoactive Drugs (2016)
Hendricks, P. S. · International Review of Psychiatry (2018)
Luke, D., Gandy, S., Irvine, A. et al. · Psychoactives (2023)
Kettner, H., Gandy, S., Haijen, E. C. H. M. et al. · International Journal of Environmental Research and Public Health (2019)
Muthukumaraswamy, S., Forsyth, B., Lumley, T. · Expert Review of Clinical Pharmacology (2021)
Nour, M. R., Evans, J., Nutt, D. J. et al. · Frontiers in Human Neuroscience (2016)
Riba, J., Urbano, G., Morte, A. et al. · Psychopharmacology (2001)
Neil, J. C., Nutt, D. J. · Journal of Psychopharmacology (2022)
Studerus, E., Kometer, M., Hasler, F. et al. · Journal of Psychopharmacology (2010)
Van Mulukom, V., Patterson, R. E., Van Elk, M. · Psychopharmacology (2020)