Who Ayahuasca Is Not For
Updated: Oct 14
We turn people away. Not many, but consistently, and it is the part of this work I am most confident is right.
Almost nothing written about ayahuasca addresses this honestly, because retreat centres are businesses and a page about who should not come is a page that costs money. But the alternative is that people find out in the room, which is a bad place to find out.
So: the exclusions, and the reasoning behind each.
Psychiatric exclusions
Psychosis and schizophrenia — including family history
This is the firmest line and the one most often blurred.
Serotonergic psychedelics can precipitate psychotic episodes in vulnerable people, and vulnerability is substantially heritable. A first-degree relative — parent or sibling — with schizophrenia or a psychotic disorder is a genuine risk factor, even if you have never experienced symptoms.
People find this unfair, particularly when a distant relative is involved and the person feels entirely well. I understand that. But an induced psychotic episode is not a difficult night that resolves by morning. It can require hospitalisation and can persist. This is not a risk we accept on someone's behalf.
Bipolar I disorder
Mania is a real risk with psychedelics, and the medications that manage bipolar disorder — lithium in particular — are themselves contraindicated. That double bind is why we treat bipolar I as an exclusion rather than a caution.
Active suicidality
A ceremony can be destabilising before it is stabilising. Someone in acute suicidal crisis needs clinical care, not four hours in the dark with unprocessed material and a nervous system already at its limit.
This is not a permanent no. It is a not-now that frequently becomes a yes later, after the acute phase has passed and there is support in place.
Active eating disorder
Several things collide here: the dieta and food restriction, the induced purging, and the frequent bodily dysregulation. Any of those can be re-triggering. A history in remission is a conversation. An active disorder is not.
Cardiac and physical exclusions
Ayahuasca reliably raises heart rate and blood pressure — an ordinary pharmacological effect, and an unremarkable one for most people.
It is not unremarkable if you have a serious heart condition, an arrhythmia, uncontrolled hypertension, or a recent cardiac event or stroke. Add the physical demand of a long night, dehydration and vomiting, and the load is real.
Epilepsy is an exclusion, and the medication that controls it should never be stopped in order to attend.
Pregnancy and breastfeeding — not enough is known, and the appropriate response to not knowing is not to proceed.
Significant liver or kidney impairment — both organs metabolise the alkaloids. Requires medical assessment, not a blanket no.
The situational category — the interesting one
These are not medical. They are the ones our screening most often catches, and none of them are permanent.
Acute crisis, right now
Someone left three weeks ago. A death two months back. A diagnosis last week. The impulse to do something enormous is completely understandable, and usually it is the wrong month.
In acute grief or crisis you are already at your limit. Adding a ceremony often produces overwhelm rather than insight. Six months later, the same person frequently has a profound experience. The material has not gone anywhere. It has settled enough to be worked with.
Looking for someone else to fix it
If the underlying expectation is that the medicine will do the work while you receive it, the retreat will disappoint. Ayahuasca surfaces material with considerable force. What it does not do is process, integrate, or change your behaviour. Those remain your job, and the people who benefit most are the ones who already know that.
Under pressure from someone else
A partner who did it and now thinks you should. A friend who booked for you. This happens more than you would expect, and it never goes well. Consent in this work has to be genuinely yours.
No support to return to
If you will come home to an environment with nobody to talk to and no capacity to take a slow week, that is worth solving before you book rather than discovering in week three.
Not willing to prepare
Someone unwilling to do the dieta, unwilling to have the health call, unwilling to stop drinking for two weeks — that is information. Not about their worth, about their readiness. The preparation is not an administrative hurdle before the real thing. It is part of the real thing.
Almost every "no" we give is a "not yet." Very few are permanent.
If you have been turned away
It is worth saying that being declined is not a judgement on you, and it is emphatically not a statement that you cannot heal.
Ayahuasca is one route. There are others — therapy, somatic work, breathwork, and for some people microdosing under proper guidance, which carries a very different risk profile. A centre that declines you should be willing to talk about what else might serve, and if it simply says no and moves on, that tells you something about the centre.
It is also worth being wary of the opposite. If you have been turned away by one centre for a medical reason and another accepts you without discussing it, they have not found something the first one missed. They have just not looked.
Note. Educational content, not medical advice. Retreats are not medical treatment or a substitute for professional care.
If you are not sure which side of any of these lines you are on, that is exactly what a health evaluation call is for. It is a conversation, not a test.
Ritshi Zenati, Speaker & Life Coach
Founder at Holistika Center.
Holistika Center holds plant medicine retreats across Barcelona, Málaga, Mallorca, Switzerland, Germany, Norway, Colombia and Mexico.
Also, different programs like Microdosing, Life and Spiritual Guidance, etc.
Visit Holistika Center to explore upcoming programs.
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