Ayahuasca and Trauma Recovery: When It Heals and When It Harms

Written by Roland Bal

Ayahuasca has become increasingly visible in conversations about trauma recovery. Having done several sessions myself and having spoken at length with people who have worked with plant medicine across very different settings, I want to offer an honest account of what I have seen. Much of what follows draws on a conversation I had with Charles Shaw — a filmmaker, director of Exile Nation and Soldiers of the Vine, and someone who has navigated severe trauma and a decade of working with ayahuasca across very different contexts.

Not a promotion and not a dismissal, but a practitioner's perspective on when ayahuasca can genuinely support trauma recovery and when it makes things worse.

Listen to the full conversation below:

Setting and Containment: Why Context Determines the Outcome

The single biggest factor in whether ayahuasca helps or harms is the setting. This is no different from what we know about trauma therapy in general — containment is everything. Without a safe container, the emotional material that surfaces during a ceremony has nowhere to go. The nervous system gets overwhelmed again, and what was meant to be healing becomes another layer of traumatic activation.

In large, unstructured ceremonies — mixed groups of strangers, inexperienced facilitators, no screening, no follow-up — the conditions for retraumatisation are high. There is a growing problem with unqualified providers charging large sums for ceremonies that are not facilitated in any meaningful therapeutic sense. Abuse has happened in these settings, and it is not uncommon.

What makes the difference is a deliberately created container: a small group with shared intention, experienced and trustworthy facilitators, and a genuine commitment from everyone involved to work through what surfaces rather than performing an experience. When that container is in place, the results can be remarkable.

What the Veterans Discovered Underneath the War Trauma

I had a conversation with a filmmaker who spent ten years working with ayahuasca across different settings and who joined a pilot programme taking combat veterans to the Amazon. What struck both of us was what surfaced once the ceremonies began. The assumption going in was that war trauma would be the core issue — the firefights, the explosions, the violence. And while those experiences were undeniably difficult, they were not what carried the deepest charge.

What came up instead was childhood. Dysfunctional families, absent parents, environments that led these men into the military in the first place because they had few other options. And the shame of what happened after — bringing their traumatic stress home and turning it on their families. That was the material that held the most pain, and it is consistent with what I see in my own practice. The acute event is often not the root. Underneath it, there is almost always developmental trauma that set the stage.

When Ayahuasca Compounds the Problem

Ayahuasca is not inherently healing. It opens the door, but what happens next depends entirely on what you bring and what support is around you. When someone without a sense of personal boundaries or internal containment goes through a powerful ceremony, the experience can be contraindicated — it overwhelms rather than heals, because the system is flooded with more activation than it can process.

This is the same principle that applies to catharsis in therapy. An emotional release without containment does not integrate. It re-overwhelms. The person feels something has shifted, but the charge rebuilds because it was never actually processed — it was just discharged without a container to hold it.

There is another risk that is less discussed. In certain settings, particularly among those who build an identity around the psychedelic experience, ayahuasca can feed narcissistic constructs — a sense of special mission, messianic interpretation, spiritual bypassing. The medicine becomes another form of dissociation dressed up as awakening. I have watched people I know get lost in this for years.

The acute event is often not the root. Underneath it, there is almost always developmental trauma that set the stage for everything that followed.

Integration: Why the Ceremony Is Only the Beginning

The ceremony itself — whether ayahuasca, five-MeO-DMT, or any other plant medicine — can release, reconnect, and provide awareness. It can help you forgive. It can briefly lift the weight of decades of carrying traumatic stress. But then it sets you down and asks: what are you going to do with this?

This is where most people get stuck. They come out of a powerful experience and go straight back into the same dysfunctional life, the same relationships, the same patterns. Without integration support — without someone helping them retain and build on what was opened — the insight fades and the old wiring takes over. The nervous system defaults to what it knows.

A proper approach involves preparation before the ceremony, support during, and structured integration afterwards. It may also involve working with other plant medicines to cleanse and prepare the body, and it almost certainly involves a period of sustained therapeutic work to make the shifts stick in daily life. Dropping someone into a ceremony and sending them home is not treatment. It is an experience without a framework.

The Habit of Illness and the Fear of Moving On

Something that came up in the conversation — and that I see constantly in my work — is the fear not of reliving the trauma, but of actually letting it go. We become addicted not just to substances but to the thought patterns, the identity, the known suffering. The habit of illness is familiar. Letting go of it means stepping into the unknown, and for many people that is more frightening than the pain they are in.

This is compounded when the people around you are invested in your old identity. Family members who pushed you to change may not actually be willing to let you become someone different. They may remind you of who you were, hold your worst moments against you, or feel threatened by the shift. The social environment can actively work against recovery, and without the ability to set boundaries with those dynamics, the old patterns pull you back.

Vulnerability, Boundaries, and What Recovery Actually Looks Like

What I have observed — both in people who have done deep work with plant medicine and in those who have done it through sustained somatic therapy — is that genuine recovery shows up in two capacities. The first is the ability to be vulnerable again after having been hurt. The second is the ability to set boundaries. These two together form the framework for being in relationship with others without either shutting down or being consumed.

Recovery is not a straight line. It involves cycles of healing and relapse, periods where old stresses return and old habits resurface. Someone can do a powerful reset — through ayahuasca, through therapy, through any genuine process — and still slip back when life delivers a new blow. That is not failure. It is the nature of working through layered trauma, where the acute event sits on top of developmental patterns that take time and repeated work to resolve.

The people who come through it are the ones who build a support system, who accept that the process is long, and who stop looking for the single experience that will fix everything. Plant medicine can be part of that process. But it is never the whole of it.