Takiwasi: addiction treatment in the "Singing House"

An addiction treatment center in Peru, Takiwasi, combines Amazonian plant medicine (including ayahuasca) with Western psychotherapy and medicine. A reappraised biopsychosocial model, grounded in critical pragmatism, was used to study the center. Results from ethnographic fieldwork, psychological testing, and salivary cortisol measurement of patients undergoing treatment show no harm and clinically positive change for the majority. Profound but poorly understood biological and psychological mechanisms likely contribute, though some healing mechanisms exceed Western medical rationality. Contextualizing these results within a critical biopsychosocial model challenges the biomedical brain disease paradigm and demonstrates the deficiency of asocial, ahistorical addiction theories. Addiction is also considered via classical critical theory, with Takiwasi representing a potentially resistive process against a dangerous tendency in modernity.

Study at a glance

Abstract

Takiwasi is an addiction treatment centre located in Peru that fuses traditional Amazonian medicine (including the use of psychoactive plants, such as ayahuasca) with Western medicine and psychotherapeutic techniques. Anecdotal and indirect evidence suggests that the treatment could be highly effective for certain individuals, yet rigorous studies have been rare. Given the centre's medical pluralism, I develop and utilize a research approach based on a reappraisal of George Engel's biopsychosocial model; that is, a biopsychosocial model founded on critical pragmatism. The basic relationship between stress, addiction, and the environment is represented in a new model of addiction, which is then elaborated upon in terms of critical psychosocial theory. Such an approach draws on biology, psychology, anthropology, and sociology in an attempt to understand not only Takiwasi, but the phenomenon of addiction itself in relation to the modern world. Results from the study of Takiwasi patients undergoing treatment (with methods including ethnographic fieldwork, psychological testing, and salivary cortisol measurement) indicate not only an absence of harm, but also the presence of clinically positive change for the majority of patients. Within the treatment context, it seems likely that profound (yet poorly understood) biological and psychological mechanisms are associated with these changes, although the nature of the treatment also leads to discussion of alternate healing mechanisms which exceed current Western medical rationality. Contextualizing these results within a critical biopsychosocial model of addiction challenges the adequacy of the biomedical brain disease paradigm, and also demonstrates the logical deficiency (and potential danger) of asocial and ahistorical theories of addiction. Finally, addiction is considered from the perspective of classical critical theory, with Takiwasi demonstrating a potentially resistive process against a dangerous tendency embedded in the project of modernity.