There’s a particular kind of question I get asked over and over by people considering their first ayahuasca retreat. It’s not does it work? — that’s the easy one. It’s what is it actually like? What happens in the body, in the mind, in those long hours between the first sip and sunrise? And does the experience of a Western traveller in the upper Amazon look anything like the textbook descriptions of plant medicine and master plants we read about online?

A few years back, a group of researchers sat down with nine foreign participants at a retreat centre in Peru and asked them, in the gentlest possible way, to describe what they’d just gone through. No leading questions. No checklists. Just: tell me about your ceremony. The patterns that emerged are some of the most useful reading I can recommend to anyone weighing a booking decision — not because they tell you what will happen to you, but because they sketch the shape of what tends to happen across very different people in the same ritual container.

Here’s what stood out, and why it matters if you’re considering ayahuasca for addiction, depression, trauma, or one of those stuck life patterns nothing else seems to touch.

The Study, in Plain English

The setup was straightforward. Nine Western participants attended six ceremonies over the course of a traditional retreat in the Peruvian Amazon. The morning after the second ceremony — close enough that memory was vivid, far enough that they’d slept on it — researchers conducted open narrative interviews. People were invited to talk freely, and the transcripts were combed for recurring themes using qualitative content analysis.

What’s nice about this approach is that it doesn’t force the experience into a pre-shaped box. Quantitative studies on psychedelics are useful — we need them — but they tend to flatten the texture of what people actually live through. Numbers can tell you that depression scores dropped at week five. They can’t tell you about the hour you spent crying about your father, or the strange certainty that a forest of geometric vines was teaching you something about your marriage.

Three big buckets emerged from the interviews: what happened during the ceremony itself, how participants made sense of the process afterwards, and how prepared (or unprepared) they felt going in. Inside the first bucket, the researchers found a familiar list — physical symptoms, visions, received messages, emotional reactions, cognitive shifts, and the meaning people attached to all of it.

The Body Comes First

One of the things that surprises new drinkers most is how physical ayahuasca is. About an eighth of everything participants talked about in the study was somatic — body sensations, temperature shifts, tingling, pressure, nausea, the famous purge. This isn’t a footnote to the psychedelic experience; for many people, it is the experience.

Veterans of the ceremony often describe the onset as something foreign moving in — an energy, a presence, a current that takes up residence in the nervous system. That language sounds woo-woo on the page, but it’s remarkably consistent across cultures and decades of reporting. And brain imaging gives us a partial explanation: ayahuasca lights up regions like the anterior insula and paralimbic cortex, areas tied to interoception (your sense of what’s happening inside your body) and emotional processing. Disruption in these same regions has been linked to depression, addiction, PTSD, and complex trauma. So when the medicine cranks up your felt sense of your own body, it’s plausibly working on the exact circuitry that trauma has muted.

And then there’s the purge. Vomiting, sometimes diarrhoea, occasionally both — what curanderos call la purga. The harmala alkaloids in the brew interact with stomach enzymes, and the DMT acts on serotonin receptors in your gut. The chemistry is real. But in the tradition, this isn’t a side effect to be managed; it’s the medicine doing its job. Participants in the study, and in pretty much every ayahuasca account I’ve read, describe the purge as something that releases — old grief, old anger, a knot they didn’t know they’d been carrying since they were nine. Some Amazonian lineages call it getting well. After enough ceremonies, you start to understand why.

Emotions That Don’t Stay Tidy

Every single person in the study reported significant emotional release. Not a polite tear or two — actual catharsis. Researchers sorted these into three rough categories: pleasant, unpleasant, and what they called hedonistic. The most interesting pattern was the sequence. Unpleasant emotional states tended to be followed by pleasant ones, as if the medicine were walking people through a difficult room and then opening a window on the other side.

This matches something therapists have known for a long time: avoidance keeps pain alive, and contact with it — under the right conditions — is what allows it to move. Ayahuasca seems to dismantle the psychological defences people normally lean on, which is both why it can feel terrifying and why it can be so useful. You can’t intellectualise your way out of what the vine is showing you. You have to feel it.

Research with psilocybin has found that what predicts long-term improvement isn’t whether the trip was pleasant — it’s whether the difficult parts got worked through. There’s a concept called emotional breakthrough that closely echoes the old psychoanalytic idea of catharsis: a hard experience, met fully, that resolves into something. Ayahuasca seems to produce these breakthroughs reliably, which is one reason it shows up in conversations about addiction recovery and trauma healing alongside ibogaine and psilocybin-assisted therapy.

Participants also described things that sound almost gentle by comparison — heightened self-love, more empathy, the strange experience of meeting themselves with kindness for the first time in years. There’s growing evidence that ayahuasca drinkers score higher on measures of self-acceptance and present-moment awareness, the kinds of qualities that mindfulness-based therapies spend months trying to cultivate.

Visions, Messages, and the Question of Entities

Three of the nine participants reported direct communication with what they described as entities or presences — supportive figures, sometimes recognisable, sometimes not. This is one of the more delicate parts of any honest conversation about ayahuasca. If you’ve never had the experience, it sounds either embarrassing or alarming. If you’ve had it, you know that explaining it to someone who hasn’t is a fool’s errand.

What the research is careful about — and what I think any prospective retreat-goer should be careful about too — is the question of what to do with these encounters. Are they projections of the unconscious? Genuine non-human intelligences? Something the Western frame doesn’t have a word for? You don’t need to settle that question to benefit from the experience. What matters, practically, is that the messages tend to feel meaningful to the person receiving them, and that they often connect to whatever the person came into ceremony carrying.

Visions, similarly, ranged from the abstract — geometric patterns, lattices of light — to the deeply personal, like watching scenes from one’s own childhood replay with new context. The participants didn’t describe these as entertainment. They described them as instruction.

What This Means If You’re Considering a Retreat

A few honest takeaways from sitting with this material — and from sitting in ceremonies myself.

• The body will be involved. If you’re queasy about purging, or you’ve been taught to clamp down on physical discomfort, this practice will challenge you. That challenge is part of the work, not a bug.
• You can’t plan the experience. People often arrive with a list of issues they want addressed and end up dealing with something else entirely. The medicine has its own agenda. The ones who do best are the ones who stop wrestling with it.
• Preparation matters more than most people realise. The third theme in the study was about how prepared participants felt — and those who’d done the dietary, emotional, and logistical groundwork generally had a different ride than those who hadn’t.
• Difficult is not the same as bad. A hard ceremony, fully met, is often the one people point back to a year later as the turning point.
• Integration is half the work. What you do in the weeks after — journaling, therapy, lifestyle changes, community — is what determines whether the insights stick.

Choosing Where to Sit

If you’re shopping retreats, the things to look for are surprisingly mundane. Medical screening. A clear policy on antidepressants and other medications. Facilitators who can name their lineage and their teachers without getting cagey. A sensible participant-to-shaman ratio. Aftercare, or at least a real handoff to integration support. Honest cost transparency — and yes, a real ceremony with experienced practitioners is rarely cheap, but exorbitant prices aren’t a quality signal either.

Red flags? Anyone promising specific outcomes. Anyone discouraging you from talking to your doctor. Anyone running ceremonies so large that the shaman can’t actually see what’s happening to each person. Anyone framing the medicine as a one-shot fix rather than the start of work you’ll continue on your own.

For readers ready to take this further, a range of vetted ayahuasca retreats and other plant-medicine programmes can be browsed on our marketplace here. Sit with the decision; the right time tends to make itself known.