Navigating the Aftermath: My Harrowing Year Following an Intense Ayahuasca Ceremony

Overview: Steve Elfrink, a psychedelic somatic interactional therapist and Webdelics’ Subject Matter Expert, recounts a harrowing year following an intense ayahuasca ceremony in Wisconsin. Despite an ideal setting, the aftermath involved severe anxiety, depersonalization, and episodes of excruciating pain that led to a near-death experience from serotonin syndrome. Elfrink’s journey included unsuccessful attempts to find answers from psychedelic specialists, revealing the critical need for better understanding and management of adverse reactions to psychedelic therapy. He later discovered that his torment stemmed from severe birth trauma, eventually finding resolution through a psychedelic somatic approach using cannabis. Elfrink emphasizes the importance of addressing unresolved childhood trauma and calls for improved education and support for those undergoing psychedelic experiences.

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A  Prelude to Transformation

In the quiet serenity of a sacred valley in Southern Wisconsin, I embarked on a three-night ayahuasca ceremony guided by an esteemed ayahuasquero, a disciple of the legendary Don Jose Campos. The sacred brew, crafted by Don Jose himself, hinted at a deep, transformative journey.

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The setting was idyllic—a secluded haven, a beautiful 30 foot yurt, all meticulously chosen to foster the perfect set and setting for communion with the sacredness of ayahuasca. But even with the perfect set and setting things can go awry. 

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Ascension into the Mystical

The most powerful evening was the second night. As the evening unfolded, the intensity of the ceremony escalated.

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Consuming the potent brew initiated a profound metamorphosis. I transformed into a condor, soaring effortlessly above the Andean landscapes, the cold, crisp air beneath my expansive wings. Below me, a vivid tableau of cosmic struggle played out, with luminous beings of light clashing against dark, malevolent energies—an allegory of eternal battles waged beyond human sight.

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Simultaneously, I encountered an array of serpentine entities. These snakes, both awe-inspiring and unsettling, wove around and through me, embodying primal earth forces and inducing a deep visceral reaction that was difficult to articulate. This encounter, while intensely vivid, was overwhelming yet left me without the profound insights typically associated with such visions.

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Throughout that evening I was able to “hold my seat” and just stay with the experience. I even managed to play didgeridoo as part of the ceremonial music. Although I had to stop playing the didgeridoo due to the fact that so many snakes were pouring out of the didgeridoo. My concern was they may be overwhelming for other participants. 

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The Return and Subsequent Descent

The ceremony concluded with no immediate revelations. I felt oddly untouched, with a lingering sense of anticipation, as if waiting for a delayed reaction. This reaction came not in the form of enlightenment, but as a creeping, unsettling shift in my reality that began a week later.

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While engaged in the simple act of raking some Autumn leaves, a moderate surge of anxiety washed over me, reminiscent of the initial onset of the ayahuasca’s effects. This fleeting visit from the past was an unsettling reminder of the ceremony, suggesting that the journey was not yet complete.

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Later, while speaking with a friend, this feeling intensified dramatically, spiraling into a disorienting resurgence of the ayahuasca’s power. Words from my friend turned into unintelligible sounds, and my own speech failed me. I retreated, overwhelmed and confused, to my bedroom.

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Night of Torment

That night marked the beginning of a year-long ordeal. My body began convulsing and shaking uncontrollably, a terrifying physical manifestation of an internal rupture. As I clutched the rail at the end of my bed for stability, I felt an excruciating sensation of being torn in two, my body and consciousness splitting.

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The physical pain was unbearable, matched only by the panic that surged through me. Teri, my partner at that time, found me in this state, but I was beyond the reach of comfort, writhing in agony and fear, unable to communicate the depth of my distress. It was incredibly terrifying and I had no idea what was happening or why. 

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Months of Despair

This episode was the first of many. Over the next nine plus months, I endured frequent and unpredictable attacks.

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The episodes varied in duration—some lasted just a few minutes, while others stretched into hours of relentless intensity. The common theme was that I was being ripped in two, part of me being pulled in one direction and the other part in the opposite direction. The pain was unbearable and then the panic from the pain would increase the terror to a point of feeling like I was going insane.

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Throughout this period, I grappled with very unsettling symptoms of depersonalization and derealization. I recognized my identity as Steve and understood that I was on Earth, but these facts felt hollow, stripped of their inherent meaning and reality.

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One of the most severe episodes occurred unexpectedly while I was showering. The familiar sensation of being torn apart returned with overwhelming force, driving me to the brink of despair and prompting suicidal thoughts. The pain and isolation became so intense that I contemplated ending my suffering permanently. I also had this ongoing fear that this would be my permanent state.

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Seeking Guidance in Vain

Desperate for answers, I sought the expertise of leading psychedelic specialists, hoping for an explanation or remedy. Despite their knowledge, no clear solutions were offered.

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Dennis McKenna’s perspective of the ordeal as a “shamanic initiation” implied a hidden purpose or lesson, yet it provided little consolation during the relentless assaults of these mysterious episodes. It did spark a small glimmer of hope though. 

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The unanimous advice from the experts was clear: “Avoid psychedelics in the future.” Despite this, I felt a compelling need to revisit this place eventually, to either resolve these experiences or allow them to naturally diminish over time.

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A Brush with Death and Subsequent Rebirth

By the nine-month mark, the episodes had intensified significantly in both frequency and severity.

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During one particularly distressing episode that lasted several hours, the experience was so horrifying that I was convinced I would not survive if it happened again. This fear drove me to seek medical assistance, where I disclosed my panic attacks to a physician.

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He prescribed alprazolam (“Xanax”)—a medication commonly used to treat anxiety and panic disorders—to be used as necessary to curtail the episodes, along with an SSRI (selective serotonin reuptake inhibitor)—a medication commonly prescribed to treat depression and anxiety disorders by increasing levels of serotonin in the brain. 

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Although the Xanax offered some relief, the SSRI seemed to intensify my depersonalization symptoms, leading me to request a different medication. My doctor then prescribed an SNRI (serotonin-norepinephrine reuptake inhibitor), which unfortunately led to serotonin syndrome—a severe and dangerous reaction due to improper medication management.

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Experiencing serotonin syndrome was profoundly alarming. I believed I was dying, marked by uncontrollable spasms and twitches, unlike anything I had previously encountered. At the time, I did not realize I was experiencing serotonin syndrome; I thought it was a new, even more frightening condition.

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The ordeal reached a climax where it felt as though thousands of shards of glass were multiplying inside my brain, piercing through it and my skull. The pain escalated beyond the worst conceivable headache, culminating in a blinding flash of agony. I lost consciousness, convinced at that moment that I had died.

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When I regained consciousness, disoriented and unsure if I was still alive, I hesitantly reached out to touch my face. To my amazement, I confirmed it was indeed my face—I was alive.

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Ironically, this life-threatening setback was also the turning point towards recovery. It seemed to have created a “reset” in my brain. Gradually, the episodes lessened, paving the way for a slow and cautious return to normalcy over the next three months

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Lingering Shadows, Unfinished Business and Resolution

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Despite the diminished intensity of the episodes, a sense of unresolved issues persisted. I felt a compelling need to revisit a psychedelic experience, believing it essential for resolving the turmoil and completing the spiritual journey that had started tumultuously. I was convinced that there was something unresolved within me needing to work itself out.

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It would be another nine months before my next session with psychedelic medicine. I was determined to return, but this time, within a safe and professional framework.

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This quest eventually led me to participate in a Phase 1 FDA pharmacokinetics study examining the effects and adverse reactions to high doses of psilocybin—a narrative deserving of a more detailed exploration in another article. In brief, the study involved three escalating doses administered over three months, culminating in the largest dose of psilocybin ever reported in an FDA study. Each session was profoundly challenging.

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During this period, I also uncovered severe birth trauma. I was a breech baby, manually repositioned by three men while my mother was under heavy medication, and extracted with forceps. Additionally, I was born with the umbilical cord wrapped around my neck and required resuscitation. Learning this between the first and second doses provided a moment of clarity, helping me understand the origins of the torment during my year-long ordeal with ayahuasca, which manifested as sensations of being torn apart—echoing the physical trauma of my birth.

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My body was attempting to process these traumas, but my mind struggled to comprehend or cope with the events. In retrospect, I was experiencing a form of psychedelic-induced structural dissociation, creating a schism between my infant self and my current self at 50, leading to intense feelings of depersonalization and derealization.

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It would take several more years to find a resolution to the birth trauma. This breakthrough came through a psychedelic somatic approach using cannabis. After numerous sessions addressing the dissociation from infancy, I finally re-experienced the moment of being pulled out by the forceps. Ironically, the excruciating pain and terror of that moment, which had trapped me for nearly a year, lasted only about seven seconds.

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Final Thoughts

Psychedelic substances are potent tools that can offer profound insights and healing. However, they can also lead to severe and challenging long-term reactions.

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There is a critical need within our community for a deeper understanding of how to manage these adverse reactions following psychedelic sessions. Tragically, the consequences can be dire, as illustrated by the loss of a close personal friend to suicide following his first ayahuasca ceremony in Peru. Another individual, a friend of a friend, also took their own life after returning destabilized from an ayahuasca experience.

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I believe that many of these challenging post-session experiences are linked to unresolved early childhood trauma. This pre-verbal trauma can surface during a psychedelic session, where pain that was previously contained under layers of protective dissociation may be released—and, regrettably, amplified by the psychedelic effects.

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The mind struggles to make sense of this primal fear, which lacks words or coherent understanding. The resultant mental landscape is one of indescribable terror, akin to a young child overwhelmed by the fear of death. This can be one of the most horrifying experiences imaginable, and tragically, for some, suicide seems like the only escape.

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There is an urgent need for better education and support mechanisms to aid those grappling with these issues. This topic warrants further discussion, which I plan to address in a subsequent article.

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Please, stay safe and seek support when exploring these profound but potentially perilous experiences.