The influence of ceremonial settings on mystical and challenging experiences occasioned by ayahuasca: A survey among ritualistic and religious ayahuasca users

Recent research recognises that non‑pharmacological factors — especially set and setting — moderate the subjective effects of psychedelics, including ayahuasca. Ayahuasca is a DMT‑ and β‑carboline‑containing decoction used in a variety of ritual and religious contexts (notably União do Vegetal (UDV), Santo Daime, and neo‑shamanic groups). Prior work suggests that ritual elements such as music, leadership and the physical environment may facilitate mystical experiences (characterised by unity, sacredness, ineffability and peace) or, conversely, affect the risk of challenging experiences (e.g. fear, paranoia, dissociation), but empirical characterisation of which specific setting elements matter is limited. The researchers set out to examine associations between multiple dimensions of ceremonial setting and the intensity of mystical and challenging experiences reported after recent ayahuasca use across three traditions (UDV, Santo Daime and neo‑shamanic). They applied a recently developed Setting Questionnaire for the Ayahuasca Experience (SQAE) alongside established measures of mystical (MEQ‑30) and challenging (CEQ) experiences, analysing cross‑sectional online survey data to identify which setting dimensions predict mystical and/or challenging outcomes and whether these relationships differ by tradition.

The study used a cross‑sectional online survey implemented in Qualtrics, with recruitment in Brazil and the Netherlands. Brazilian recruitment used invitations sent to members of ayahuasca churches and neo‑shamanic communities, including an institutional email circulated to registered UDV members; Dutch recruitment targeted organisations that hosted ayahuasca retreats. Participants were asked to respond thinking about their most recent ayahuasca experience. Reported inclusion criteria were being aged 18 or older and having consumed ayahuasca for at least six months before the study. Exclusion criteria applied were incomplete questionnaires, completion in under five minutes, or giving identical answers to all items. The extracted text reports 2,751 valid participants (2,263 Brazil; 488 Netherlands), but elsewhere in the extraction a different total (3,070) is mentioned; the extracted text is inconsistent on this point. Participants were classified into one of three traditions for analysis: (neo)shamanic, UDV, or Santo Daime. Demographic summaries in the extracted text indicate 47% male and 53% female; age distribution and education levels are reported (e.g. 82% with some higher education). Self‑reported prior ayahuasca exposure ranged from first‑time (8%) to over 100 times (50%). Measures comprised the Setting Questionnaire for the Ayahuasca Experience (SQAE), the Mystical Experience Questionnaire (MEQ‑30) and the Challenging Experience Questionnaire (CEQ). The SQAE assesses six setting dimensions (Leadership, Decoration, Infrastructure, Comfort, Instructions and Social context) with 28 Likert items (1–5), plus descriptive questions about music, activities and disruptive stimuli. The MEQ‑30 asks respondents to rate 30 items from 0 (not at all) to 6 (extremely) describing mystical phenomena; the CEQ comprises 26 items across seven factors (e.g. sadness, fear, insanity) rated on a 0–6 scale. The SQAE was translated to Dutch for the present study. Analyses were performed in SPSS v26. Descriptive statistics were calculated, and one‑way ANOVAs (with Bonferroni post hoc tests) tested differences in SQAE ratings between traditions. Two‑tailed Pearson correlations were computed between SQAE dimensions and MEQ/CEQ scores; the authors considered correlations stronger than r > 0.10 as relevant and used p < 0.01 as the significance threshold. Stepwise regression (backward elimination, p < 0.05) assessed which SQAE dimensions predicted MEQ and CEQ total scores. Chi‑square tests examined differences in presence of musical elements across traditions. Supplementary material (referenced in the extraction) reportedly contains per‑tradition correlations and regressions.

On average, Leadership and Infrastructure received the highest SQAE ratings across the full sample, followed by Social aspects. Correlation analyses showed that all SQAE subscales were inversely associated with self‑reported challenging experiences (CEQ), with reported r values between 0.21 and 0.36 (direction: higher endorsement of setting elements associated with fewer challenges). For mystical experiences (MEQ), correlations with SQAE scales were weaker: Leadership correlated positively with total MEQ score (r = 0.132, p < 0.001), while other dimensions showed smaller or non‑significant relationships. In stepwise linear regressions using all denominations combined, Comfort and Leadership remained predictive of MEQ total scores, with the final MEQ model accounting for 14% of variance. For CEQ total scores, the final regression retained Social, Decoration, Comfort and Instructions as predictors, together explaining 41% of variance in CEQ ratings. Analyses by tradition revealed statistically significant differences in SQAE ratings across traditions for all six dimensions (all F's > 10.48, all p's < 0.001). The largest between‑tradition difference was for the Social subscale (F2,2749 = 178.526, p < 0.001), with UDV members rating Social context as most important, followed by Santo Daime, and lowest in neo‑shamanic participants. Correlations of setting dimensions with MEQ were generally stronger in neo‑shamanic and Santo Daime groups than in UDV, whereas inverse correlations with CEQ were observed in all traditions but were stronger in the religious traditions (UDV, Santo Daime) than in neo‑shamanic groups. Analyses of secondary setting elements found that the presence of certain musical elements correlated with MEQ scores across traditions: music in a foreign language (r = 0.301, p < 0.001), religious music (r = 0.221, p < 0.001) and icaros (traditional South American ayahuasca songs; r = 0.314, p < 0.001). However, the SQAE appeared to under‑capture a core UDV feature (live a cappella chants called chamadas) because UDV members may not have classified chamadas as "music"; the authors note this as an instrument limitation. Enjoyment of activities differed between traditions, and only in the neo‑shamanic tradition were dancing and praying positively associated with MEQ (r = 0.234 and r = 0.268, respectively). No activities were related to CEQ in any tradition. The extracted text reports demographic and exposure summaries: 47% male, 53% female; age and education breakdowns; 8% first‑time users, 50% reported over 100 ayahuasca sessions. There is an inconsistency in the extraction concerning total participant counts (see Methods).

The authors interpret their findings as evidence that the quality of ritual setting is an important moderator of challenging and, to a lesser extent, mystical experiences occasioned by ayahuasca. Across traditions, higher SQAE ratings (indicating better perceived Leadership, Comfort, Decoration, Instructions, Infrastructure and Social context) were associated with fewer challenging experiences. Regression results suggested that feeling socially integrated with the group, physical comfort, agreeable decoration and having had adequate instructions together predicted fewer self‑reported challenges. For mystical experiences, adequate leadership and comfort were associated with higher MEQ scores in the combined sample, although per‑tradition analyses revealed variation in which setting elements mattered most. The authors situate these results within prior literature emphasising the role of non‑pharmacological factors and suggest mechanisms: leadership may increase trust and confidence in the experience; social integration may provide support that reduces distress; and decoration and organisation of space can contribute to feelings of safety that reduce challenging episodes. They note that neo‑shamanic settings emphasise individual experience (e.g. individual mattresses, less group interaction), which may explain why Infrastructure, Comfort and Decoration were more consistently correlated with MEQ in neo‑shamanic participants, whereas social elements were comparatively more important in the communal religious traditions (UDV, Santo Daime). The authors acknowledge several limitations reported in the extracted text. The sample was heavily weighted toward UDV members and neo‑shamanic visitors, with Santo Daime participants comprising about 10% of respondents, limiting representativeness for that tradition. About 50% of participants reported more than 100 prior ayahuasca sessions, which may influence how setting parameters and adverse effects are perceived. The large sample size raises the possibility that small correlations may reach statistical significance without clinical relevance; the authors attempted to mitigate overinterpretation by applying thresholds for p and r but caution remains. They also identify measurement limitations: the SQAE failed to capture certain tradition‑specific musical practices (e.g. UDV chamadas), signalling the need for instrument refinement. Finally, the authors suggest practical implications consistent with their findings: maximising the quality of setting elements (social support, leadership, comfort, decoration, instructions and infrastructure) may reduce the likelihood of challenging experiences and may promote mystical experiences. They propose that the SQAE could be used to monitor and guide the design of rituals and the social/physical environment of ayahuasca ceremonies.