KEITH NEGLEY
Hello,
My name is Briana. I am 40 years old and I have suffered from bulimia since I was 13. My life now feels hopeless and I just can’t go on like this anymore. I was hoping I could be considered as a participant in any study that had to do with healing of eating disorders, in particular ayahuasca. Feel free to call me or email me anytime. Thank you.
Sincerely,
On the fumes of expired hope, she signed off, “Briana Alessi.” It was 7:51 p.m. on March 4, 2018, and sitting there alone in her home office in Charleston, South Carolina, she didn’t know what else to do.
Alessi had just completed a lengthy outpatient program that, like all the antidepressants and therapy she’d done, failed to even scratch the surface of the raging bulimia that had rotted her teeth, stunted her education, and held her hostage for 27 years and counting. Recently divorced and desperate to start a new life, she’d spent the day googling “alternative eating-disorder treatments.” When a TV clip from The Doctors popped up in her search, she wondered if that might be it. The show featured a woman named Libby who’d freed herself from the 20-year grip of anorexia—which Alessi also had bouts of—by going to the jungle and drinking something called ayahuasca. Appearing with her was a clinical psychologist named Adele Lafrance, PhD, who (google, google) was apparently a top researcher studying psychedelics and eating disorders. Alessi tracked down Lafrance’s contact info and sent the email off toward the digital horizon. She never expected to hear back.
Today, eating disorders, which are hard to treat and can often be fatal, represent one of the newest fronts in psychedelics research. Several clinical trials are in the works exploring the effects of various hallucinogens, and Lafrance is among the scientists conducting them. One awaiting publication using psilocybin-assisted therapy for subjects with anorexia looks quite promising. “There’s a good proportion of people, 60 percent, who are in remission at the three-month assessment time point,” says Lafrance’s collaborator, Robin Carhart-Harris, PhD, a prominent researcher in the field and founder of the Centre for Psychedelic Research at Imperial College London. “And these are people who are in their 30s, still chronically and dangerously underweight.” Although we don’t yet have many peer-reviewed clinical studies on this subject, researchers are predicting that these drugs’ ability to make the brain more neuroplastic and changeable for a window of time may open the gridlock of rigid thought patterns around food and appearance that get entrenched with both anorexia and bulimia.
“I’ve done ayahuasca maybe 15, 16 times now,” says Libby, the woman from the Doctors clip, a 44-year-old landscape consultant today and still fully recovered (she asked to use only her first name). “I think ayahuasca completely fractured a neural pathway highway that was anorexia, splintered it, and it’s gone—all the obsessive-compulsive stuff. But ayahuasca also gives you a chance to reframe memories that had trapped you and work from a new base.” That, hypothetically, might involve deeply embedded guilt over not protecting your sister from bullying and a new knowledge that you were just a child and vulnerable yourself. Or in the case of Libby, seeing her terrible anger that felt “so dirty and gross” appear as an old sweet lion who’d gone to battle for her but now could rest because she had other skills to cope.
She had found her way to the drug—a psychedelic tea typically made with the Amazonian plants Banisteriopsis caapi and Psychotria viridis and used for thousands of years in South America—in 2012 after seeing a documentary about how it was helping people quit drugs. She’d also read In the Realm of Hungry Ghosts, by Gabor Maté, MD, and it all clicked for her because her intractable anorexia felt like addiction, especially with its occasional episodes of bingeing and insane ultramarathon running, which she couldn’t stop. During one of the first ceremonies, she looked down at her body and saw a beautiful horse with whip marks from being abused. In a flash of recognition, she was flooded with self-empathy. To this day, she keeps crystal horses above her bed to remind her of that.
It was stories like hers that intrigued Lafrance back in 2018, when she read Alessi’s email. At the time, she’d published her first research interviewing patients with eating disorders who’d participated in ayahuasca ceremonies. In a small but provocative follow-up study, some of the participants would report that the vision-popping brew worked more powerfully than conventional treatments, and all but one said they improved significantly. But what particularly struck her was how ayahuasca went right to the roots of the anorexia or bulimia.
“I don’t know what prompted me to do it,” says Lafrance of Alessi’s email in her overflowing inbox that March evening. “But I called her.”
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Alessi grew up on a small family farm in Ohio, the eldest of five siblings raised by a single mom working as a bartender. “Today I decided to become bulimic,” she wrote in her journal when she was 13, and in some ways it seemed the perfect solution to the shambles of her life. Starting around age 7, she says she was repeatedly sexually assaulted by a teenage boy, who would later be convicted of raping another child (a trauma that increases the risk of developing bulimia by five times, according to a 2008 study in JAMA, which isn’t true for anorexia). The abuse Alessi pretty much could block from her mind. What detonated her small world at age 12 was its exposure after she told a friend in confidence. “I could never talk about it. I was just so embarrassed,” she says. “Mortified.” Her parents had separated when she was 4, and now she was especially worried about her father, whose new wife was dying of cancer.
Bulimia let her hide in its furtive binges and behind bathroom doors, converting the shame she couldn’t bear into a shame she could. But the pain pounded her over and over. “I remember when I was in college making boiling pots of potatoes to eat with ketchup and throwing them up, just to get that feeling of hurt followed by relief,” she says. “And every single time, I’d get up from the toilet, crying and feeling disgusting, promising myself this is the last time, only to be doing it an hour later.” As with Libby, there was an addictive quality because after purging, Alessi would feel shaky and need to eat something, and just a cracker could send her into another frenzy of gorging until she couldn’t stand up. “Once your stomach is stretched out that much, you can put away, like, 10,000 calories, two whole pizzas,” she says, “and you have to walk to the bathroom crunched over.” Becoming an aesthetician with her own spa and working in an industry of impossible beauty standards made it all worse. By the time she got the call from Lafrance, she was bingeing and purging three or four times a day.
“At the core,” says Lafrance of bulimia, “is loneliness. And feeling like they can’t handle it. And what I really appreciate about psychedelic medicines is that they help increase self-trust, which is your compass for trusting others.” Lafrance didn’t have an appropriate study going on, but she connected Alessi to a colleague. That therapist helped her get her symptoms under control so she could be ready for an ayahuasca retreat in Peru.
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About four months later, Alessi made it down to the jungle for her treatment—a monthlong retreat with a small group where she’d do four ceremonies a week. The irony of taking a drug that makes you throw up was not lost on her. She embraced it and named her vomit bucket Ralph. But traditionally with ayahuasca, it’s seen as purging your trauma or cleansing the spirit, and it did feel that way to her. After meeting with the shaman to confess what had brought them there, the participants gathered on their mats, buckets in tow, for the first ceremony, where each went up to receive their cup of medicine with a blessing. During that journey, Alessi swayed to the music as the shamans sang and chanted. “Some of the songs feel like they’re doing surgery on you,” she says, “as if someone’s pulling things out of you.” But afterward, when others shared their wild visions, she wondered why she hadn’t had any. The same thing happened the next two times. Maybe this medicine wouldn’t work for her, either.
Before her fourth journey, she went to the shaman to ask if he could help. “He looked at me and goes, ‘Have you had an abortion?’” she says. “I don’t know how to explain that, because I’d never told anyone, but he said it was blocking me.” After their talk, he did a special prayer blessing over the ayahuasca, and the visions came. This time it took her through the traumas of her past, which is where she needed to go. First she saw her beloved pet, Cecil—a rat she’d rescued as a newborn when she was married and carried with her everywhere, despairing when he died. She told him how much she loved him, and he said, “I know you do.” He stayed with her, like a guide, as she saw her ex-husband walking off with his arm around his new wife and wished him the best. Her estranged mother flashed by next. She was in a mental prison, screaming in panic and terror. Alessi asked how she could help and was suddenly filled with sympathy. Her father followed. She told him, too, how much she loved him, and knew she’d hurt him, making amends with all the guilt she’d been carrying about that. Finally, her abuser showed up, and she was able to say, “I forgive you. You also went through a lot of trauma, and you were just passing it along. I know you did not mean to harm me.” But the medicine wasn’t done. Soon she saw a little girl petting Cecil and smiling. “He was staring right at me, and I could read his energy,” she says, “and I knew this little girl was the daughter I aborted at 17. She was smiling at me, holding Cecil. And then they walked off into the distance, finally at rest and where they were supposed to be, and not in my head surrounded by guilt, sadness, and loss.”
When she came out of that trip, her bulimia was gone. “That was the first time in my entire life since age 13 that I ever had relief from this disease,” she says. It lasted for the whole retreat, and she left elated, thinking she was healed.
But once she got home, the stress piled up, and after a month, the symptoms started creeping back, although they were a little more manageable. Knowing there was hope, she decided to return for a few more ayahuasca sessions, which she did over the next few years. “She always progressed,” recalls Lafrance, who stayed in touch and became like a sister. “But then she’d have a relapse. And then she’d progress a little further, with a less intense relapse, and that kept going until, boom!”
The finale was a powerful ceremony with three shamans praying over Alessi. The medicine showed her a huge black bowling ball in her stomach that was trying to get out—but her skin was gripping tight. “And then the ball just lifted off and went out into space, and a voice told me, ‘That was the last of it,’” Alessi says. “And since then, I have never had an episode.” She was 43. This time, she walked away from a 30-year sentence.
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Reveling in her new freedom, Alessi decided in November 2021 that she finally had to end a relationship with the love of her life, who she says had turned toxic. She rented a U-Haul and planned to move out while he was at work—but he came home before she left, making it all the more difficult. By the time she’d extricated herself and made it to the storage unit, it was 11 at night. Exhausted both physically and emotionally, she opened the rear door of the truck only to be toppled to the ground by the torrent of haphazardly loaded belongings. “I’m lying on the pavement, with things falling—and then I hear tink, tink, tink, the last little thing coming down,” she says. “And it’s a box of tampons that just explodes all over the parking lot. I’m like, Of course!”
Just when she thought it couldn’t get any worse, weeks later, on January 3, 2022, she was diagnosed with breast cancer—aggressive ductal carcinoma. She’d left a bad relationship, and let go of the horrible eating disorder. And now this. After soldiering through two surgeries, which left her thin and weak, she decided to do another ayahuasca ceremony. She hoped it would help her deal with growing fears of cancer cells continuing to replicate in her body, especially since she’d opted out of chemo and radiation and was starting to doubt her decision.
Her fears went through the roof four days after she arrived at the retreat and got the phone call from her cancer doctor that they didn’t get it all. “I just was like, I can’t believe it,” says Alessi. “Not again.”
Psychedelics have been found to make people more at ease about dying. The drugs are famous for helping participants tap into a mystical or spiritual realm that is far more significant than an individual life. On the clinical side, a long-term study on 16 patients facing life-threatening cancer showed that psilocybin markedly reduced their anxiety and depression and helped them accept death—a finding supported by other research.
But the ayahuasca told Alessi something different. As she lay on her mat, raglike and heaving into her bucket, she recalls feeling that there was nothing left to her. For three ceremonies, Alessi could barely move. No visions came to her. On the last night, she almost didn’t go through with it. Once she decided to give it one last shot and the medicine took hold, she couldn’t stop throwing up. She stared into her bucket, trying to call for help. A young lady came to hold her hand but eventually left. “And then I felt a presence, and all I could do was lift my head up to look to see who it was,” says Alessi. “And when I did, I was six inches from a tiger. His teeth were gnarled, and his eyes were looking at me. I could feel his breath. I’m thinking. This thing’s gonna eat me, and I’m gonna die. And I decided to just lean into it.”
She put her head back down, moving her body closer to the tiger. But nothing happened. And when she looked up, so did her predator. This time, though, his face was a lot calmer, and he was just staring at her with intent. Maybe he wasn’t hungry, she thought. And maybe if she hid back in her bucket, he’d just go away. But when she looked up again, he was still there. She blinked for a moment. And the tiger did, too. “And then I blinked again, and the tiger blinked again,” she says, “and then it hit me. I was the tiger.”
As many a seasoned psychedelic-journey woman will tell you, the medicine doesn’t always deliver what you want or think you’re looking for. But it usually gives you exactly what you need. She’d never felt more alive in her life. She stood up and felt like she could run a marathon. “For me, the medicine has chipped away at all the traumas that formed my eating disorder as a way to release all this hatred I had and anger at myself. It allowed me to forgive myself and others, and helped retrain me to where I didn’t need that type of release anymore,” she says. “It also allowed me to come out of hiding and open myself up to be seen.”
That last ceremony was a year and a half ago. Alessi quit working in the beauty industry and had another surgery, and at 46 is figuring out her next career move. So far she is cancer-free, and her bulimia is out of her life. And if either comes back, she’s not worried.
“I’m a fucking tiger.”
If you are struggling with an eating disorder, you should consult a healthcare professional. For those considering participation in a study on psychedelics, Lafrance suggests trying clinicaltrials.gov for a list of open studies or applying through special access programs in your jurisdiction.
This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. It should not be regarded as a substitute for professional guidance from your healthcare provider.
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