Join me on a journey into the ayahuasca underground of North America, where people are drinking a medicine that has been used for thousands of years by the indigenous tribes of the Amazon. The medicine is a tea composed of two plants — the ayahuasca vine, Banisteriopsis caapi, for which the brew is named, and the leaves from the Psychotria viridis bush. Part of my journey includes research I conducted from 2008 to 2012 on the use of ayahuasca, and it also includes my own stories of mystical experiences, slow healing, and ontological crises. As a cautious researcher and an enthusiastic psychotherapist, I’ve talked with hundreds of people about their ayahuasca ceremonies, sometimes taking research notes, at other times encouraging therapeutic insight, and always asking: “What happened next? How did you change? How is your life different?”

      During my journey, I received frequent emails from strangers searching for information about the medicine. Some wanted to participate in the research study, others wanted to share their experiences, but most were seeking a source for the medicine. Those emails struck a consistent note. In one way or another, they said, “I’m suffering.”

      Like any good therapist, rather than suggest taking an illegal substance, I recommended they go to a psychotherapist, try antidepressants, and trust their doctor to find the right combination and dosage from the panoply of psychiatric drugs. Inevitably, those people wrote back, “I’ve done all that for years. Nothing’s helped.”

      These people were suffering with what psychiatrists call treatment-resistant depression — they were the unlucky 30 to 50 percent of depression sufferers who don’t respond to antidepressant medications.¹ Rightfully, they felt demoralized, but with what little hope they had left, they were seeking help from Grandmother Ayahuasca. They were willing to try anything, including a medicine from the Amazon jungle whose active ingredient, DMT (dimethyltryptamine), was and is illegal. Today, the US Drug Enforcement Agency lists it as a “Schedule I” drug — meaning they consider it as having a high risk of abuse as well as being dangerous with no therapeutic benefits.² After thirty-five years of private practice in psychotherapy, I’ve seen a few people with treatment-resistant depression. One client stands out, however, as possibly the most depressed man I’ve ever seen in my office. He was in his midthirties, married with a young child. Although very bright, he could barely work as a house painter, struggling to get out of bed in the mornings. In my office, as I tried unsuccessfully to engage him with questions, he remained a rumpled lump sitting on the sofa. Not easily discouraged, I noticed he was barely breathing and asked if we could do some bodywork to improve his respiration. He was too depressed to resist, and I cajoled him to lie on the carpeted floor and focus on the movement of his ribs, feeling them expand with every inhale. He was able to take in bigger breaths and to relax with every long, slow exhale. I was encouraged. Perhaps a body-oriented approach could reach him.

      Then I’m not sure what happened. I might have said, “Find a position that feels the most comfortable to you.” With renewed energy, he made his way into a pile of pillows I had stacked against a wall. He burrowed in deep, creating a cave for himself, and leaving me alone on the floor in the center of the room. I had lost my client.

      Undaunted, I moved closer to the stack of pillows and encouraged him to come out. I tried metaphors — a bear hibernating and awakening to the spring thaw, an infant waiting to be born. I whispered for him to rest and rejuvenate in his cave, to gather his strength in the quiet darkness before he emerged into the light. No movement ensued.

      Finally, I asked, “What would entice you to