Institute of Anatomy, Faculty of Medicine, University of Zurich, Zurich, Switzerland; Department of Psychology, University of Fribourg, Fribourg, Switzerland.
Department of Psychology, University of California, Berkeley, United States.
J Ethnopharmacol. 2022 Mar 25;286:114910. doi: 10.1016/j.jep.2021.114910. Epub 2021 Dec 20.
Indigenous groups of the Amazon have developed intricate methods for the application of psychoactives, among which particularly the dieta or diet method of Peruvian-Amazonian traditional medicine stands out. It is a retreat-like intervention involving lengthy periods of social, behavioural, and alimentary restrictions, while ingesting specially prepared plant substances. The interplay of the dietary conditions and plants ingested sensitizes the dieter to receive healing, strength, guidance, and knowledge. From a clinical scientific point of view, the method has remained largely underexplored, but seems more pertinent than ever given the increasing interest in Amazonian psychoactive preparations including ayahuasca (Banisteriopsis caapi) and the burgeoning field of psychedelic-assisted therapies in general.
This study offers a descriptive account and emic interpretation of the Peruvian-Amazonian dieta. More specifically we document in detail the procedure, its context and purpose of application, effects, modes of action, adverse effects, and risks, from the perspectives of a sample of Peruvian traditional healers. The Peruvian-Amazonian dieta is a multi-purpose method for making use of medicinal plants, many of which (but not all), are psychoactive; the current work especially focuses on its therapeutic applications in conjunction with psychoactives.
We interviewed 16 healers working in the Ucayali, San Martín, and Loreto provinces of Peru using a semi-structured interview approach. Interviews were audio-recorded and transcribed verbatim. The extensive data derived from these interviews were analysed by means of computer-assisted manifest qualitative content analysis using a theory-advancing approach. Over 500 coded text segments were categorized, resulting in 7 main theme clusters and corresponding sub-themes.
The interviewed healers described a complex intervention with multifaceted applications (treatment, prevention, training) and effects in various domains (body, mind, spirit, energy). The process was portrayed as transformative, with benefits attributed to the effects of the so-called teacher plants in conjunction with the diet's conditions, along with the skill of the healer guiding the intervention. Further, a detailed risk assessment revealed sophisticated safety measures and tools designed to address adverse responses. The importance of adequate training of the healer that administers the diet was particularly highlighted in this context.
The dieta is a central therapeutic concept and tool in Peruvian-Amazonian traditional medicine and a unique method for using psychoactive plants. Multidisciplinary health research that includes traditional treatment methods from Indigenous cultures, Amazonian and other, should not be neglected in the current global interest in psychedelic therapies; such research may in the long-term contribute to a more inclusive psychedelic research paradigm as well as healthcare practice in countries where rich traditional healing systems exist, and perhaps beyond. It may also contribute to the recognition of the Indigenous healers as not only historical forerunners, but also current leading experts in psychedelic medicine.
亚马逊地区的土著群体已经开发出了复杂的应用精神活性物质的方法，其中秘鲁-亚马逊传统医学中的“饮食疗法”尤为突出。这是一种类似静修的干预方式，包括长时间的社交、行为和饮食限制，同时摄入特别准备的植物物质。饮食条件和摄入的植物之间的相互作用使节食者能够接受治疗、获得力量、指导和知识。从临床科学的角度来看，这种方法在很大程度上仍未得到充分探索，但考虑到人们对包括死藤水（Banisteriopsis caapi）在内的亚马逊精神活性制剂以及整体迷幻辅助治疗领域的兴趣日益浓厚，它似乎比以往任何时候都更加相关。
本研究对秘鲁-亚马逊的饮食疗法进行了描述性说明和本土解释。更具体地说，我们从秘鲁 16 名传统治疗师的角度详细记录了该方法的程序、背景和应用目的、效果、作用模式、不良反应和风险。秘鲁-亚马逊的饮食疗法是一种多用途的药用植物使用方法，其中许多（但不是全部）植物具有精神活性；目前的工作特别侧重于其与精神活性物质联合应用的治疗用途。
我们使用半结构化访谈方法对秘鲁乌卡亚利、圣马丁和洛雷托省的 16 名治疗师进行了访谈。访谈进行了录音，并逐字记录。从这些访谈中获得的大量数据通过计算机辅助的显性定性内容分析进行了分析，采用了一种推进理论的方法。经过 500 多个编码文本段的分类，得出了 7 个主要主题集群和相应的子主题。
接受访谈的治疗师描述了一种具有多方面应用（治疗、预防、培训）和多种效果（身体、心理、精神、能量）的复杂干预措施。该过程被描绘为具有变革性的，其益处归因于所谓的“教师植物”与饮食条件的结合，以及治疗师指导干预的技能。此外，详细的风险评估揭示了复杂的安全措施和工具，旨在应对不良反应。在这种情况下，特别强调了对进行饮食疗法的治疗师进行充分培训的重要性。
饮食疗法是秘鲁-亚马逊传统医学中的一个核心治疗概念和工具，也是使用精神活性植物的独特方法。在当前对迷幻疗法的全球兴趣中，不应忽视包括来自土著文化、亚马逊和其他地区的传统治疗方法在内的多学科健康研究；从长远来看，这种研究可能有助于形成更具包容性的迷幻研究范式以及在存在丰富传统治疗系统的国家的医疗保健实践，也许还会超越这些国家。它还可能有助于承认土著治疗师不仅是历史上的先驱，而且是当前迷幻医学的领先专家。
