Ayahuasca purge and pre-purge: what to expect

Many people purge on ayahuasca, usually by vomiting, sometimes with diarrhea, tears or shaking. Nausea and vomiting are among the most common physical effects of the brew, and in the Amazonian tradition, as at our church, the vomiting is called purging and treated as a normal part of ceremony.

Many people also find that something like a purge starts weeks earlier, as soon as they decide to come. We call that the pre-purge. This post covers both: what to expect from the purge on the night, and what tends to come up before it.

Why people purge on ayahuasca

Ayahuasca is a brew of two Amazonian plants: the Banisteriopsis caapi vine and the leaves of the Psychotria viridis shrub. It is hard on the stomach. A 2022 review of placebo-controlled trials found that nausea, vomiting and headaches were among the most common side effects (Rossi and colleagues, Expert Opinion on Drug Safety). Not everyone vomits, and researchers haven’t settled exactly why some people do.

We don’t treat the purge as a detox or a cure. We see ayahuasca as a mirror that shows you what you’ve been avoiding, and the body often reacts as that comes up. Release can come as vomiting, tears, laughter or stillness. All of these are welcome, and none of them means you are doing it right or wrong.

What to expect on the night

• You have your own mat, blanket, pillow, bucket and tissues. The room is dark and quiet, so the only sounds are the music and people releasing.
• If you need the bathroom, a facilitator walks you there and back.
• The first cup is a light dose, and you can ask for a half or a quarter cup. A second or third cup is optional, offered only if you have shown you can sit with the first.
• Bring plenty of extra clothes in case you vomit or have diarrhea. We have laundry facilities.
• No one is left alone. A facilitator stays with anyone who isn’t stable.

What you eat helps. The ceremony diet is a gentle two-week clean-up, and eating lighter gives your body less to deal with during ceremony. On the day, eat breakfast and a light lunch. Coming in starving doesn’t help anyone.

The purge is also a good place to watch yourself. Notice if you fight the nausea, feel embarrassed that others can hear you, or try to hold it together so you look okay. Those reactions are part of what you came to see. Breathe, let it happen, and it passes.

Some sickness is not a purge. Ayahuasca contains MAO inhibitors, and with SSRIs and other antidepressants it can cause serotonin syndrome, which can be life-threatening. That is why every medication goes through our screening. Never stop a medication on your own, and talk to your doctor before you plan a ceremony.

What is a pre-purge?

Sitting with ayahuasca is a big event in a person’s life, and the lead-up to it matters. Think of it this way: you just got the promotion you’ve been waiting for, and it means moving to another country in three weeks. The moment you say yes, there’s a long list of things to deal with, starting right then.

A pre-purge doesn’t mean running to the bathroom all the time. It means that once you decide to come, you start noticing things you usually keep out of view. Feelings stir, old memories come back, habits feel heavier and relationships come into sharper focus. Each of these is a chance to see a pattern and choose again, before you ever drink.

It can show up as fear, anxiety, a lot of crying, or even the start of a personal crisis. Part of us doesn’t like change and would rather stay where it’s comfortable. If what comes up gets worse or won’t lift, see a doctor or therapist, and let us know. If a medication was changed for ceremony, these feelings may be withdrawal or your symptoms coming back. Tell your prescriber.

What tends to come up

Your relationships

With your family: do you feel free to be yourself, or are you still pulled by the strings of your childhood self? With your friends, it may become clear who you feel good around and who leaves you drained. With a partner, you may see the role each of you plays and how you really feel about it. Insecurity, past relationships, abandonment and grief can come up. Let yourself feel them, and notice your own part.

Your body and diet

As you set aside some of the foods and habits you lean on, you may notice what they were helping you avoid feeling, like a need for control, anxiety or stress. Better to meet those now than push them back down. They tend to come up in ceremony anyway.

The things that really matter for safety are alcohol, recreational drugs and some medications. We never tell anyone to stop a medication. Our preparation course walks you through the diet and what to do about medications, so start there.

Your home and your time

You might notice you’re surrounded by too much of your past: clothes, furniture, the color of the walls. If something no longer feels like you, it’s a good time to clear it out or repaint a room. You might also want more time on your own, and see how much of your time goes to other people. If you’ve been giving more to others than to yourself, practice saying no.

Coincidences

Coincidences and patterns may start to seem meaningful. We read that as a sign you are paying closer attention, which is the point of preparing.

How to move through it

You can clench your fists and jaw through the whole pre-purge, but whatever you refuse to face in preparation will probably show up in ceremony. The resistance often gets louder as the date gets close. Now is not the right time. Did I choose the right church? Should I really spend money on this? When thoughts like these pop up, you’re pre-purging. Name the feeling under them: “I feel restless.” “I’m scared.” Naming it is where letting go starts.

If a doubt is about your health or your medications, that is not resistance. Read our preparation course and talk to us before you come.

Breathe through what comes up

Three-step breathing is a simple practice to keep on hand. Breathe:

1. into the belly,
2. then the chest,
3. then up into your upper body and shoulders.

Use your right hand to help your mind follow the movement. Touch your belly and feel it expand. Touch your ribs and feel them move sideways, then bring your hand to your shoulder to feel the upward movement. The same breath helps with nausea on the night.

Get outside and move

City or countryside, find trees. You don’t have to change your life to do this: take a new route to work or get off the bus one stop early. Stretching, yoga, walking or dancing alone at home all let you feel what words can’t reach yet, and you don’t need to be flexible for any of it.

Try meditation

If you’ve heard of it but never tried it, this is a good time to start. Our Sunday Service in Anna is one place to try it with us.

Journal

In the words of one of our participants: “It’s not until I journal, that I can understand and become capable of sharing what I truly feel. It’s like, I need to untangle it first, take it out of my mind on paper, and see it outside the mind to feel at ease.”

Writing pulls one thread out of everything running through your mind, so you can look at one thing at a time.

Therapy

If you have a therapist, bring what’s coming up to your sessions. If you don’t, this is a good time to find one. A licensed mental health professional can help you work through fears and old patterns as they surface, before ceremony and after it.

Go easy on yourself

You don’t have to arrive perfect or “fully cleansed.” The point is to show up honest and willing. If you stumble, resist or feel afraid, that’s all right. Try these suggestions with curiosity and a sense of play, and laugh at yourself when you’re clumsy at dancing or yoga.

For what comes after ceremony, read our posts on facing your triggers in ceremony and integration after ayahuasca.

If you’d like to start with us, take the free Welcome course or come to Sunday Service, 3 to 6pm in Anna. Our ayahuasca ceremonies are by invitation only.

Ayahuasca ceremonies at Two Birds Church in Anna, Texas →