Ayahuasca has gained international attention for its healing potential—opening inner doors, dissolving defenses, and reconnecting people with their deeper sense of purpose. Scientific studies point to benefits such as reduction in depression, trauma symptoms, and addictive patterns. Yet, beyond the headlines lies a more delicate and rarely discussed question: what happens when ayahuasca is given to someone with a fragile or unstructured sense of self? A fragile self is also understood as someone with a confused sense of identity also known as low self steem.
The Fragile Self and Ayahuasca
I am going to mention IFS (Internal Family Systems) as each is one of the therapeutic frameworks I use the most and is the one that easily explains what a fragile self is. I have mentioned IFS various times on this blog, for first timers it is a therapy framework that works with an inner parts models as sub-personalities developed on top of the self. In IFS, psychological suffering is understood as a complex interplay between protective parts, wounded exiles, and the Self—the inner core that is compassionate, calm, and centered . When the ego is fragile or underdeveloped, protective parts often dominate, leaving little room for Self-leadership. In other words people with low self-steem have a disconnection from their self energy and their outer parts take over leadership.
From a transpersonal perspective, Stanislav Grof and others have long warned that deep non-ordinary states can overwhelm those whose ego structure is not yet consolidated. Instead of expanding into wholeness, they may collapse into fragmentation, psychosis-like fear, or retraumatization. Non-ordinary states promoted by entheogens, like ayahuasca, bufo alvarius, mushrooms, etc. So in these cases outer parts, can become amplified and overwhelm the person, diminishing more the self.
What We See in Retreats
In facilitation contexts, participants with fragile identity structures often show acute risks:
- Reinforced Defenses: Protector parts can double down, building thicker walls instead of opening.
- Firefighter Reactions: Panic attacks, paranoia, and intense fear can emerge suddenly, overwhelming the person’s capacity to regulate.
For example, a protective part that has been living in a distrust strategy, can become amplified during a medicine session and take over the person, by producing paranoid thoughts, amplifying fear and making the person feel in danger. In these cases the person if not attended can end up leaving or escaping from the retreat unannounced. This interruption of the process can end up being detrimental since the paranoia wont allow facilitators to approach the person and be able to integrate the process. - Re-traumatization: Old traumatic scenes may surface in full force, without the ego strength or Self-energy needed for integration. The person can experience vivid traumatic memories that can disregulate her during the session or integration.
- Spiritual Bypassing: For participants with fragile or unstructured identities, the temptation to interpret terrifying or confusing experiences as “spiritual signs” can serve as a defense against unbearable vulnerability. Protective parts may seize on grandiose mystical narratives (“I am chosen,” “I am enlightened,” “My suffering is proof of my special destiny”) to shield the person from the raw pain of exile parts that have surfaced.
Rather than leading to catharsis and healing, these experiences can leave participants more destabilized, distant from their Self, and struggling to integrate after the retreat. Since entheogen produce non-specific reactions it is very difficult to predict the outcome and it is like playing the lottery many times where the result could be absolutely transformative or completely traumatic.
The most important thing is to be very aware of the psychological state of the person. Have a clear understanding of the self energy of the person. Define the guidelines to be able to asses this on the person, their mental state and their relationship with their inner parts. It is a tremendous responsibility to provide medicine to someone knowing that this could be as transformative as detrimental to their mental health.
Why This Matters
Therapists and facilitators have a responsibility to discern who is ready for the intensity of ayahuasca or any other psychedelic substance. A fragile self does not mean a person is forever “unsuitable,” but it does call for caution, careful screening, and alternative preparatory work (such as body-centered therapy, IFS, or Somatic Experiencing ) before exposing them to such overwhelming states.
As Peter Levine’s trauma research reminds us, trauma is not the event itself but the nervous system’s inability to process overwhelming experience . For fragile selves, ayahuasca risks pushing them further into dysregulation rather than helping them out.
Toward Safer Practice
Ayahuasca is neither inherently safe nor inherently dangerous—it is profoundly powerful. To work responsibly with it, facilitators must:
- Identify fragile participants early through thorough screening.
- Provide clear psychoeducation about potential risks.
- Offer alternative preparatory or therapeutic pathways.
- Maintain strong post-retreat integration support, especially for those showing signs of destabilization.
A Question for facilitators
As ayahuasca continues to enter psychotherapeutic and personal growth contexts, the key question is: are we ready to hold the risks of fragile selves with the same seriousness as we celebrate ayahuasca’s benefits?
The answer to this question will shape the ethical and therapeutic integrity of the psychedelic field in years to come and it will something for you as a facilitator to consider in your path to personal growth.
