Demystifying Psychotic Breaks on Ayahuasca and Other Plant Medicines
In every single Ayahuasca ceremony, there’s one thought most participants have before the medicine kicks in:
I hope I don’t lose my shit tonight.
Almost no one is fond of losing control, but doing so in an altered space with a gaggle of other strangers who are also highly sensitive and deep in the entheogenic portal makes it all the more horrifying. Yet we all know each time we mosey up to the altar and take our next cup of Ayahuasca (or any other potent entheogen), it could be the one to trigger an uncontrollable outburst, or even more a dramatic, a full psychotic break.
And still, thousands of us show up, time and time again, to test our fate. We are brave spiritual warriors, we medicine people – but is it really just fickle fate who decides whether someone has a grand ceremony breakdown, or is there a method to the madness?
What It Means to Have a Psychotic Break on Entheogens
Before we explore whether an episode is predictable or preventable, we must first define what a psychotic break really is.
Going into a portal with a powerhouse medicine like Ayahuasca carries the risk that we may discover a box inside of ourselves that says “Don’t Look Here.” Inside that hidden corner of our psyches lies something we’ve been resisting. It could be a traumatic memory, or painful emotions like fear or anger that have been buried beneath layers of denial and resistance. It could also be the reality that all of us have darkness, all of us have the capacity to cause harm, and sometimes it’s our turn to come to peace with that so we don’t act out in the future.
When we bring our awareness to any part of ourselves, it is illuminated – no longer in the shadow. This is sacred work. This is healing work. But it’s not for the faint of heart.
Work with Plant Medicines long enough, and you’re almost guaranteed to at some point have a mental breakdown. These consist of big hard purges, tears, shaking, expressed fear; the whole gamut of traversing difficult emotions, projections, and traumas. Mental breakdowns are par for the course, as it’s our opportunity to release these dense energies, these suffering-laden stories, and come out the other side lighter and more conscious/aware. We want our false sense of mental control to get obliterated, because it’s in that illusion of control where the suffering is birthed and the limiting stories are in a death grip.
Breakdowns are not easy, but they do bring profound rewards. Because these are such a signature of plants like Ayahuasca, we always want to work with her in safe settings with trained guides that have our backs. This is often what allows a breakdown to manifest a very fast breakthrough. If this occurs in a solo setting or in one that is not safe, we could be facing a trauma that needs additional healing, instead of an experience that is healing itself.
A psychotic break, however, is essentially an extreme version of a mental breakdown. A safe sense of reality is completely obliterated, and the individual typically loses conscious awareness and acts out from a primal space of emotion. That could manifest as screaming, crying, bolting in/out of the ceremony space, laughing uncontrollably, speaking in tongues or speaking in nonsensical sentences, clinging to helpers, etc. These look and sound very frightening to other participants, but the person having the break either barely remembers anything or recalls witnessing the whole affair but in a dissociative state. In a poetic way, psychotic breaks prevent the individual from being in the intense trauma of the emotions – it’s one of the ways the brain protects us from immersion into primal emotions like terror.
This means that psychotic breaks are not inherently bad, just challenging. They are very hard for those witnessing the affair to deal with, especially because we are all typically deep in the medicine space and in a sacred ceremony. These are the processes that trained guides are most responsible for; and there’s two essential things a shaman must do when a psychotic break occurs:
1. Ensure safety for the person in the process and everyone in the space. We need to protect the individual from physical harm, and hold them in unconditional love and compassion as they move through the experience, while assuring all those witnessing the episode that everything is ok. We do that through singing icaros, through using our energetic healing tools and plant allies, and through words themselves – coaxing the person into a calmer state, and calling back in the soul that has schism-ed. This takes years of training and profound trust in the medicine, and ourselves. If we do not wholly trust that everything is and will be ok, that will be felt by the person in the process and the entire space. Fear is contagious. The guide must anchor back in a sense of grounded safety, or the whole ceremony can go sideways into chaos.
2. We also must be very aware of when the individual “comes back in,” and is conscious again. The danger is always that once the person is aware of what is happening once more, they could slip into a horrible spiral of guilt and shame over what they may perceive was a disruption of sacred space. I always tell participants that their best is good enough, and if they become aware they’ve been emoting or expressing loudly, there is nothing to be ashamed of. That’s what facilitators are there for, in part; to take care of folks when they lose the capacity to take care of themselves. Sometimes it’s just our turn to ask others to hold space for our release, and we can’t contain it, we should never, ever feel shameful or guilty.
A good guide holds the space tightly as the process completes itself, coaxes the being back into a conscious and grounded space, and compassionately welcomes the return of the aware ego without any judgment or shame.
Psychotic breaks are expressions of fear and trauma, not brokenness or flaws. They are not easy, but they hold immensely sacred information.
Dealing with the Aftermath of a Psychotic Break
If you think it’s difficult dealing with the actual psychotic break in a ceremony, wait till you get to the integration. (Said in both a serious and a light-hearted tone!)
As mentioned above, the biggest sensitivity in the aftermath of a ceremony-induced psychotic break is the onslaught of a horrendous wave of guilt and shame. One of the core reasons most of us are terrified of losing control in this fashion is how we might impact other peoples’ journeys. So the tendency to go into a shame spiral once someone is aware they’ve been disruptive is profoundly real, and wholly unnecessary.
This is the first thing I’m always on guard for. As the integration begins, I emphasize that breaks like this literally happen to the best of us, and it’s a rite of passage to be proud of rather than a mistake to be ashamed of. What we want to focus on is the information at the core of the resistance and the schism, not to feel bad that other people were a witness.
I’ve held space for dozens of breaks like these in ceremony, and I can honestly say it’s never just about the individual. There’s always a co-created lesson. Sometimes we can intimately relate to the pain that’s reflected. Sometimes we even feel the individual in the process is helping us to process our pain and fear too. Sometimes people are deeply triggered and upset by the episode – that, too, is a divine teaching. How we react to anything is solely our responsibility. A psychotic break is not an intentional outburst, and it’s also never just about the person having the experience. We are all in this together, and this is especially felt in the ceremony setting.
Once we can set aside any sense of shame about the experience, the next step in the integration is to stabilize. Just because someone has returned to a normal conscious state does not mean the experience isn’t still creating a shaky mental and emotional foundation. We do that in a number of ways, but the number one priority is creating a strong foundation through a daily spiritual practice that revolves around a sense of safety. Traditional therapy is often very welcomed in this part of the process, and even pharmaceutical medications if the aftermath has severe instability and panic. The individual should also work with a Plant Medicine integration coach or therapist with an expertise in both Plant Medicine and trauma healing; this is the best recipe for having an ally that can help map out a personal road to recovery.
Finally, integrating the aftermath is all about feeling into the heart of the breakdown. What exactly was happening with the medicine when the slip from reality began? It’s often about a resistance to either a primal emotional energy, a memory, or some aspect of our darkness that we don’t think we can handle or face. Sometimes the set and setting play a huge factor into the experience, especially if anything about it felt unsafe, or if the dynamics present triggered a past trauma. There are SO many elements to investigate; this is precisely why it’s essential to have expert assistance, as we aren’t supposed to decipher this personal psyche mysteries all by ourselves.
Can We Actually Prevent a Psychotic Break?
Let me emphasize once again that a psychotic break is NOT something to fear or work feverishly to avoid, as any resistance to the experience can actually work to co-create it instead. While it can be intense and challenging to move through and integrate, a break like this is still sacred information, full of learning opportunities, and not only survivable, but something that can vastly improve our lives and healing journeys too.
Psychotic breaks are not required, but they need not be feared either.
But can we do anything proactively to learn in a more graceful way?
Yes. Yes we can!
Here’s the truth about the spiritual journey: We can learn through wild romps involving a massive breakdown, but we don’t have to.
I don’t advocate trying to avoid anything, but I do celebrate our ability co-create anything, too.
So how do we set ourselves up to learn in a gentle yet equally profound way? By having the maturity to prepare ourselves to traverse the darkness, and the discernment that tells us when we are unsafe. Where there’s smoke, there’s fire.
These are the elements that helps us better the odds that we can enter an altered space and not have a full scale breakdown:
Have a daily spiritual practice that involves checking in with ourselves, being curious about how we feel, what we might be avoiding, and what we are currently working with.
Cultivate a deep relationship with the experience of safety – we learn what that means to us, and the various ways we can cultivate that. This happens through the use of plants (Sage, Mugwort, Rosemary, Tobacco, etc.), crystals (Onyx, Obsidian, Tourmaline, etc.), visualizations, mantras, meditations, connection with spirit guides and animal totems – The list is wonderfully long and varied! It doesn’t matter WHAT we do, only that we deeply resonate with that chosen relationship, and that we comment to creating a sense of safety for ourselves when we are not in the intensity of an altered portal.
Choose very carefully the people and spaces we agree to journey inside of – yes, it takes a lot of effort to vet potential shamanic guides, but that’s a key to knowing we really are safe. Why is this so relevant to learning in a graceful way? Because the safer we feel, the more we trust that everything is ok, that someone has our back, the less likely we are to resist anything that comes up in our journeys. Safety is everything.
Be completely transparent about our health history, our fears, and our intentions with the people holding space for us. As a facilitator, this helps me know how sensitive someone is, how much trauma they are carrying, and that can both properly inform dosage and alert me to be extra aware of what a sensitive and frightened participant might need. Plus, it’s safe to be honest with ourselves about what we’re dealing with – we can’t receive support if we don’t have the integrity to admit we need it.
That’s just the tip of the psychotic iceberg, but I hope it provides inspiration.
In addition to all the preparation listed above, the most powerful thing we can do for ourselves to avoid a psychotic break is to actually give full permission to lose control and have one. Although that may seem contrary, the less we resist and attempt to avoid any situation, the less likely we are to call it in. It took me nine years of ceremonies, but I eventually had the honor of being the one having a big ole, very loud, out of control process. I ugly cried and sobbed and knocked over a chair and pretty much spewed my not ok-ness all through the space. But I needed to have an experience my mind couldn’t control, and absolutely no one in that circle did anything but love me through it. Rite of passage indeed, and one I cherish, as I no longer fear it.
So if and when it’s your turn to flip out, surrender to that, too. We get to be human. We get to be messy and emotional and if our best involves a full scale breakdown, then let’s just love ourselves – and each other – through the process so we can reap the lessons and rewards. Control is not the goal in working with Plant Medicines, healing is. And sometimes healing means we let it all out.
Be safe out there, and come as you are :)
About the Author
Tina “Kat” Courtney is an 18 year veteran of Plant Medicines, and a traditionally trained Ayahuasquera and Huachumera, and the author of Plant Medicine Mystery School Vol 1: The Superhero Healing Powers of Psychotropic Plants. Kat is a pioneer in the Psychedelic Integration space. Her coaching expertise includes existential and spiritual crises, interpretation of plant communications, navigating the darkness and a dark night of the soul, addiction recovery, and the integration of all major Plant Medicines and psychedelics. Kat is also a certified Death Doula honored to help people make peace with the inevitable and beautiful transition into the afterlife. She has spent her adult life cultivating a bonded and trusting relationship with the darkness, and she’d love to help you do the same.
