Embracing change: impermanence acceptance mediates differences in death processing between long-term ayahuasca users and non-users.
Jonathan David, Aviva Berkovich-Ohana, Yair Dor-Ziderman
Psychopharmacology April 23, 2025 DOI: 10.1007/s00213-025-06792-0 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 107 |
| Population | Ayahuasca veterans and non-users |
| Intervention | Ayahuasca |
| Topics | Ayahuasca Ego dissolution |
| Keywords | Death acceptance Death anxiety Fear of death Impermanence Psychedelics Death & mortality Consciousness & ego Spiritual practices Mental health |
| Citations | 2 |
| Key findings | Ayahuasca veterans showed lower death anxiety, fear, and avoidant behavior, and greater death acceptance than non-users, with impermanence acceptance mediating the group differences. |
Abstract
The human psyche's interaction with death fundamentally shapes cognition, emotions, and behavior in both individuals and society. Death-related psychological phenomena have been shown to be influenced by psychedelic interventions. However, the literature lacks a comprehensive assessment of death-related processes in non-clinical settings, the mechanisms underlying long-term changes, and particularly the effects of ayahuasca on these dimensions. This cross-sectional study investigates death processing, potential mechanisms of change, and their predictors in ayahuasca veterans (N = 54) compared to non-users (N = 53). A battery of questionnaires and behavioral assessments were used to evaluate different aspects of death processing in both ayahuasca veterans and non-users. These assessments measured death fear and anxiety, death-acceptance, death-avoidant behaviors, and the accessibility of death-related thoughts. Mediators tested included personality traits, beliefs about the afterlife, trait mindfulness, and the concept of impermanence. The findings demonstrated lower levels of death anxiety, avoidant behavior, and fear of death, as well as greater death acceptance in ayahuasca veterans. Mediation analyses revealed that group differences were not due to demographics, personality, trait mindfulness, ontological beliefs, or impermanence awareness, but rather to impermanence acceptance. Finally, within the ayahuasca group, lifetime ego dissolution experiences predicted the degree of impermanence acceptance. These findings reveal significant, multi-dimensional differences in death processing between ayahuasca and non-psychedelic users. Impermanence acceptance emerged as the key mechanism of change. Additionally, the results highlight the role of acute ayahuasca experiences in producing lasting effects. Future interventions may focus on promoting impermanence acceptance as a strategy for managing existential fear.
Comparable studies
Other cross-sectional and survey studies on ayahuasca, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Survey of subjective "God encounter experiences": Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT Adults reporting a single most memorable God encounter experience, either nondrug or... | 2019 | Cross-sectional survey | n = 4,285 |
| Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. Ayahuasca users from more than 50 countries who completed an online survey | 2022 | Cross-sectional survey | n = 10,836 |
| Ayahuasca in adolescence: a preliminary psychiatric assessment. Adolescents from a Brazilian ayahuasca sect and matched controls | 2005 | Controlled cross-sectional study | n = 80 |
| Psychological and neuropsychological assessment of regular hoasca users. Regular hoasca users from a U.S. branch of União do Vegetal and matched non-user controls | 2016 | Cross-sectional study | n = 57 |
| Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey People with cluster headache | 2015 | Cross-sectional survey | n = 496 |
Citations in the library
Cited by 2
Cites 71
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and 66 more in the library