The Takiwasi Patient's Journey
Michel Mabit
First contact: improving his motivation
The patient's journey begins when he presents himself at the center for an
explanation of the rules. As a preliminary test of his motivation, he must
come to Takiwasi freely and unaccompanied by family members, every day for
eight days. He will then talk to a therapist and take his first purges
(milk of magnesia with coconut milk). Raw vegetable oil is taken to
provoke biliary flushing. This vesicular cleansing is combined with an
enema the following morning. This will prepare the first Yawar Panga, a
detoxifying emetic plant which works on his energies and is administered
within a ritual setting. This session is generally tiring (2-3 hours of
vomiting) and is followed by a deep and revitalizing sleep. The patient
notes an immediate improvement the following day, feeling cleansed and
more clear-minded, encouraging him to persevere. The withdrawal symptoms
are thus somewhat alleviated.
During this week, the cost of the treatment is discussed. The patient or
his family is asked to contribute what they realistically can. The cost
varies according to the center's running costs at the time. Really poor
patients pay nothing at all for their treatment. Takiwasi has never
refused any patient for lack of money. The most important element is the
patient's motivation to stop taking drugs. Many initial contacts do not
result in enrollment as after a few days, the drug addict does not return.
If the future patient maintains his motivation and reports to the Center
during one week, he is then admitted to follow the complete treatment as
an inpatient.
Physical rehabilitation
The first two months of the treatment are basically dedicated to
physically rehabilitating the patient. At the health center associated
with Takiwasi, he receives a comprehensive medical examination including
laboratory tests on blood, urine and faeces, HIV and hepatic tests and
screening for intestinal parasites. During all his treatment, medical
check-ups are subsequently made according to individual progress and
always at the end of a patient's stay here. Even patients who arrive in
the worst of states completely recover physically in 2 months. Most
patients also require treatment for certain "energy disorders".
This involves taking Camalonga (strychnos sp.), a detoxifying seed
containing strychnine, which is taken for ten days, combined with a
no-sugar diet.
Numerous plants are used to treat the frequent infections that manifest
during the recovery of the patient's normal eliminatory functions in the
detoxification process. Modern medicine is sometimes employed in case of
emergency, minor surgery, certain infections and dental requirements but
we don't use pharmaceutical psychotropics.
Isolation
The patient is first isolated in a separate bungalow for 8 to 15 days. He
may leave the bungalow but is not permitted contact with the other
patients. His food is brought to him. During this period his only
activities will be reading and drawing. This phase of silence and solitude
permits introspection and puts to the test his initial motivation while
avoiding the risk of his bodily emanations (smelling of basic paste of
cocaine) deterring the other patients. The Yawar panga session will be
repeated two or three times on the first two weeks. With each new session
the recovery process is accelerated. Throughout his stay the patient may
request another session with this plant if he feels the need. This purging
with Yawar Panga, besides eliminating toxic drug residues and other
contaminants, will help the body to assimilate the psychotropic plants
used during the following sessions. Saunas with medicinal plants,
massages, daily interviews with a therapist, a well-balanced diet,
rest-periods and showers all complement these Yawar Panga sessions. The
patient is told that, no matter what time of day or night, he can call a
therapist if he is feeling bad. Any withdrawal or angst crises that arise
are dealt with through work on the body's energies. This isolation also
avoids the risk of longer-term patients recounting to him their
experiences with psychotropic plants, thus preventing him from forming his
own conclusions during his first treatment with psychotropics.
The commitment
When the isolation period is over, the first and essential act of the new
patient is to sign a written commitment to respect the rules of
admittance. This pledge is made in front of all the members of the center
and a statue of the Virgin representing the sacred nature of his promise.
Takiwasi in no way requires the patient to follow a specific religion,
such as Catholicism, but tries to open the patient to a true and personal
spiritual search. This aim will be present during the following months and
is crucial to the treatment. The commitment signed by the new patient
summarizes the Takiwasi philosophy:
- The patient agrees not to leave the center without permission; if he
does then this is considered to be a breach of contract and abandonment of
his treatment and the patient will not be readmitted to the center.
However, the center is open and there is no strict control over the
patient. His stay is 100% voluntary and he must renew on a daily basis his
motivation for being here.
- Violence is prohibited while verbal expression is encouraged.
- The patient must wait for the "green light" from the
therapists that treatment is complete, the minimum time prescribed being 8
months (several patients stayed for over a year). There is no contact with
family or friends for the first 3 months and afterwards depending upon the
therapists' opinions.
Ayahuasca session
The isolation period ends with the first ayahuasca session.(1) After this,
the new patient will join the rest of the patient group. These sessions
are repeated once a week and bring to the surface various psychic elements
(dreams, fears, etc.) buried within the subconscious. They provide the
crux of the therapy. These psychic elements revealed during the sessions
will be worked upon later using group dynamics, personal interviews,
drawing, etc. Ayahuasca can be compared to an accelerated
self-psychoanalysis where the patient understands and "sees" by
himself his problems and the solutions to them and in this way accepts
change more easily.
Everyday Life
The patient then rejoins the group and is incorporated in communal tasks.
This means participating in early-morning exercises and in a practical
area that interests him that is chosen from agriculture, animal husbandry,
construction, handicrafts or cooking. All maintenance and meal preparation
is carried out by the patients themselves. Patients may abstain from
exercises or duties if they are not feeling well. Variety is provided by
walks in the forest, birthdays and regular workshops given by therapists
from outside the center (for example mask-making, storytelling, clown and
mime workshops, theatrical dynamics etc.) Through each patient's way of
coping with everyday situations we get to observe many character traits,
crises and conflicts to be worked on during therapy sessions. The patient
is never alone and always has recourse to a therapist to sort out any
serious crisis that arises. The response we propose is to find a way to
communicate instead of bottling-up potentially explosive feelings.
Second Month
By the end of a patient's second month at the center his chances of
completing the entire treatment are much more realistic. He is
congratulated for having resisted the initial temptations to leave. He is
considered to have attained his physical recovery, allowing him to
concentrate on deepening his self-knowledge, exploring his identity and
his most intimate self-motivations, although this self-awareness really
began on Day 1.
The Diet
The diet is an ancestral technique of the Amazonian healers involving
complete isolation in the forest in order to create the necessary
conditions for ingesting especially subtle plant preparations. The
patient remains alone in a hut, deprived of all distractions and with
nothing to do except be there. Food is restricted and very basic. Every
morning he drinks a preparation of purgatives and psychotropics which may
cause vomiting depending upon how he reacts to the diverse effects
produced; drowsiness, "drunkenness," surges of emotion, vivid
visions or, upon shutting his eyes, a resurgence of forgotten memories
etc. In some way doors are opened allowing both the elimination of
misplaced "energies" ingrained in his body (in the most general
sense of the word) and access to his interior world. While asleep powerful
dreams make him conscious of elements buried in his psyche which will
serve to guide him on his personal quest. His rapport with the natural
world around him compensates for the isolation and lack of human contact.
During these eight days the patient follows strict rules designed to avoid
any "energy disturbances," given the vulnerability produced by
the combination of the plant preparation and the complete absence of salt
in his diet. Besides complete sexual abstinence, he must avoid exposure to
sunlight and contact with rain and fire. He must not bathe and must always
bury his excrement.
The therapist responsible for the dieter(s) is always within earshot but
leaves the patient alone. He brings the plant preparation in the morning
and delivers the two daily meals, giving him a chance to make sure the
patient is all right and to reassure him if necessary.
This ancestral technique of modifying states of consciousness will be
re-applied three times during the treatment (usually the 3rd, 5th and 7th
month) and a fourth time if necessary. A great variety of different plant
preparations are employed, each one giving a different orientation to the
diet. For example "sanango" generally induces memories of
childhood traumas while "qilluhuiqui" reinforces the
"I" and self-identity. All this manifests on physical, mental
and spiritual planes simultaneously. The diet consists of eight days'
complete isolation followed by 15 days of partial isolation at the center:
the patient resumes a more varied diet but abstains from certain foods
(spices, sugars, pork, coffee). He remains with his fellow dieters and
resumes normal activities. Meanwhile he must avoid all contact with the
sick persons, new patients still in the detoxification phase (since they
give off a strong odor) and menstruating women (a recommendation based on
the experience of every curandero, because during menses a woman's
energetic system undergoes an upheaval). Avoiding stuffy, noisy
atmospheres and deranged or disturbed persons is also recommended. Those
recommendations are to avoid perturbations as the patient's sensitivity is
highly developed in all aspects. The patient feels highly alert,
experiences meaningful dreams, perceives insights and observes
synchronicity phenomena... all this will be worked on in due course.
There are no ayahuasca sessions during the diet and the subsequent period
of semi-isolation.
Other Therapeutic Techniques
There is a range of therapeutic techniques which are used in Takiwasi
according to individual or group needs. These include the main shamanic
techniques:
- "Soplada": regulation of a patientŐs energies by blowing
smoke or atomizing perfumes over certain energy points
("Chakras") on a patient's body.
- "Ikarada": the use of sacred chants to "energize"
the plant preparations, the ayahuasca, the perfumes used for the soplada,
etc.
- "Sahumerio": a cleansing of energies using the
strong-smelling smoke of burning herbs, incense, etc.
- Baths: in waterfalls, rapids or with plants, sometimes combined with
massages, "cleansing": of bodily energies with the aid of an
absorbent substance or object such as alum stone, eggs and special woods
(palo chonta); etc.
The originality of the Takiwasi treatment is also to associate the use of
plants and shamanistic techniques with modern therapies or other
introspection techniques such as Holotropic breathing after the Stan Grof
model, Bach flower essences, massage, saunas with medicinal plants, group
dynamics, artistic and bodily expression, meditation, breathing exercises
and other purges taken during specific lunar phases.
The Patients
During its first three years in existence, Takiwasi has treated 141
patients. This number includes patients who received treatment for drug
addiction (64%) and those who received treatment as outpatients for
psychological problems and alcoholism (36%). Of the addicts, all but two
were using basic paste of cocaine, sometimes mixed with alcohol and
marijuana.
An average of 30% of initial contacts with the family or patient resulted
in a treatment. This average may seem low but it should be noted that
Takiwasi is an open center which uses non-coercive methods, believing that
true motivation to cure oneself and will power are indispensable for
treatment. Practically all the patients have been Peruvians, preference
being given to residents of this region. Until now, only two patients have
come from other countries. Both were good Spanish speakers, a prerequisite
for treatment at Takiwasi. In any case, it's essential for any prospective
patient to contact us first and send us a written application. We cannot
accept patients who simply turn up on the door step. The average age is
between 20 and 30, with some adolescents admitted. So far all but two have
been male. Only two women have been admitted for treatment because the
female addict population is smaller than the male one. Also, women tend to
be more embarrassed about coming out in public about their problem.
Generally, here in Peru, they take drugs at home. Their experience of the
treatment was the same as the men's but they did not complete the full
treatment. Social backgrounds are very diverse, ranging from indigenous
"campesinos" to well-travelled, university-educated
intellectuals.
Almost all the patients are consumers of basic paste of cocaine (which is
highly toxic and alienating), together with alcohol and marijuana. Often
they have used other psychotropic substances (medications, LSD, cocaine,
etc.) Most have been involved in minor, if not major crimes and have spent
time in prison. On average they have been taking drugs for 10-15 years.
Some patients show signs of serious physical deterioration; severe anemia
(one patient had 4,6 gr. on arrival), hepatic deficiencies, edema of the
legs, etc.
Results
It's usually agreed that five years' abstinence is the minimum necessary
to know if someone is really free of drugs. That is why the evaluation
realized during Takiwasi's first two and a half years is based on other
criteria such as the patient's evolution in relation to himself, his
family and society. Amongst the drug-addicted patients, 18% finished the
treatment and stayed on average nine months (ranging from six to fourteen
months). More than half of the patients left within the first three months
against the advice of the therapists who can only try to convince them to
stick with the treatment. Twenty five percent "escaped" within
the first three weeks without trying to discuss their decision with the
therapists. As the treatment is refined, the percentage of
"escapes" has decreased significantly. The trial week with
emetic plants has allowed a "natural selection" of the most
highly motivated. Three patients were expelled for disruptive behavior.
Even though the majority have tried drugs again, usually for a short
period or only once, this does not mean that regular consumption began
again. Clearly those patients who "escaped" or were expelled run
a high risk of re-addiction. Those who left the treatment before the end
run a somewhat smaller risk. Those who finished the entire treatment have
the best prospects of beginning a new life. An interesting proof of faith
in the treatment is that 75% of past patients have come back to Takiwasi
as visitors to ask for advice or help when in difficult periods of their
lives. Some have asked to take plant purges again. We note that those who
finished the treatment have a much better perspective on life than those
who left before the end. Relapses are basically due to fragility or the
lack of faith in the patient's own healing, inability to react
appropriately when confronted by frustration or anger and failure to
integrate transcendence into their daily life. The treatment proposed by
Takiwasi consists of a radical change of life-style and is for that reason
a long and evolutionary process. Since Takiwasi is an Experimental and
Research Center, the treatment can be refined and improved in the
following years. But we consider that addiction is a consequence of the
loss of values in society, a distortion of the relation between the man
and his external and internal environment, and finally, as the loss of the
sacred and the spiritual dimensions.
English translation by Jamie Moir
- See the description of an ayahuasca session in Dr. Jacques Mabit's
article "L'hallucination par l'ayahuasca chez les guérisseurs
de la Haute-Amazonie Péruvienne," 1988, Bulletin de l'IFEA
(English translation available in Takiwasi).
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