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Simon Ruffell was living the dream as a London psychiatrist, until he realized conventional treatments weren't working. A chance encounter with a would-be shaman in South America led him down the rabbit hole of ayahuasca research, where he's spent the last six years bridging two worlds that rarely speak the same language.

We asked Simon what compelled him to reconcile psychiatry with curanderismo, how he translates spiritual concepts for skeptical colleagues, and what dangers lurk when we try to blend indigenous wisdom with modern science.

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What compelled you to try to bridge Western psychiatry with Amazonian plant medicine rather than picking just one path?

I started my career as a psychiatrist because I was completely fascinated with the human mind, especially things like psychosis. When I got into psychiatry, I absolutely loved most aspects of it—the patients, the staff, the work itself. But there was one pretty big issue: a lot of our treatments, especially the medications, didn't seem to work that well. Many psychiatrists have been talking about a crisis in psychiatry for a long time, and that really weighed on my mind.

I got so concerned about it that I decided to take a break and go around the world to see if I might encounter other ways we could be approaching mental health. One of the places I traveled to was South America, where I met someone training in Shipibo shamanism. He basically said that a lot of the things you're struggling to treat in psychiatry, we often treat successfully, though mostly through spirits and plant medicines.

After my own experience, I came out blown away by how incomparable the Shipibo worldview seemed to our approach with antidepressants and other psychiatric drugs. Ayahuasca was an unusual and even controversial area of research at the time, at least in the UK, so we ended up just doing our first study without external funding or academic affiliations.

None of it has really felt like a choice. As a scientist, when you come across something potentially significant, there is a responsibility to at least consider it, along with the ethical implications associated with the decision to research it. I couldn’t not explore it. I've been a student of curanderismo (shamanism) with the Shipibo in parallel to doing this research over the last decade, and of course I’ve had conversations with ayahuasca where I've asked, “should I just fully commit to being a curandero over and above Western medicine?”. But the intuition I always get is “no, you need to remain a psychiatrist.” I strongly believe we can advance science and humanity by listening to other paradigms and connecting different worlds.

What's been most eye-opening from your research on ayahuasca so far? Any findings that surprised even you?

The foundational research isn't particularly surprising, certainly not to Indigenous people. We've seen ayahuasca decrease depression and anxiety immediately after retreats, and interestingly, it decreases further six months later as people continue processing. We've seen improvements in life satisfaction and less negative associations with memories, as well as changes in personality and evidence of feeling more connected with nature.

The epigenetics study, though, was quite surprising to me. We found increased methylation in the Sigma-1 gene, associated with traumatic memory and neuroplasticity. I thought, "this looks like ayahuasca could actually be changing DNA expression." But when I told my maestro Don Rono, he just said, "Yeah, of course it is. We've known that for thousands of years. We just call it cleaning ancestral lines." Apparently I was the only one in the jungle who was surprised.

We're now doing larger studies with military veterans in collaboration with Heroic Hearts Project, conducting genome-wide methylation analyses. We're also studying the gut microbiome for the first time with any psychedelic, which I couldn't believe hadn't been done before. This year, we’re expanding our scope, looking at athletes engaging with ayahuasca to treat traumatic brain injury (TBI). We have an Indigenous Advisory Board where we develop research ideas and interpret results together, making sure we disseminate findings to communities in accessible ways.

When your Shipibo teachers talk about plant spirits and energetic healing, how do you translate those concepts for your skeptical medical colleagues?

Metaphysics is an excellent tool to build the bridge. For entities and spirits—and I include myself ten years ago in this camp—metaphysics allows otherwise skeptical people to understand what Indigenous groups are saying without immediately thinking it's nonsense. (I definitely used to eye roll when anyone said "it's just the energy"!)

The Shipibo hold what we in the West would call an animistic worldview, in which all things—plants, rivers, animals, even stones—are understood to have consciousness or spirit. They speak of powerful, god-like beings who guard different realms or dimensions, and of healing as something that occurs across physical, energetic, and spiritual planes. There’s a Shipibo concept called Nete Ibo, which can be loosely understood in Western terms as the idea that all things are alive, interconnected, and part of a greater unified awareness.

The same can apply when we take up biological language. A good example is "cleaning ancestral lines" and epigenetics. If you say "cleaning ancestral lines" to scientists, they might dismiss it. But if you describe it through epigenetics—how trauma passes down through generations and how you can reverse gene expression changes from stress and trauma—suddenly you have an explanation scientists can relate to. Unfortunately, there aren't many examples like that yet, but I fully believe we'll get there.

Indigenous healers credit spirits, icaros, and dietas for healing, while Western science looks for neurobiological mechanisms. How do you personally hold both these different explanations in your mind?

I used to wear two different hats. I would have my Western psychiatric hat when I was in London working in psychiatric hospitals, and when I was in the jungle, I would convert back to Shipibo. Otherwise I felt like I'd go insane. But my approach has changed because I've become concerned about safety in this so-called psychedelic renaissance.

My viewpoint now is: Are spirits real? Do we remove energetic blockages? Can we communicate with plant spirits and ask them to heal patients? Totally, I 100% believe that we can. But is ayahuasca also a serotonin agonist that induces neuroplasticity, changes the gut microbiome, and downregulates the default mode network? Also 100% true.

Both worldviews can work together. I don't see Western science and traditional medicine as clashing. Maybe thousands of years from now, if humanity lasts that long, science and spirituality will be the same. We'll be able to explain why spirits exist and what shamans mean by other dimensions. I see traditional medicine as science itself because it's based on trial and error over hundreds if not thousands of years. We're just far from understanding the convergence right now.

What dangers should we watch out for when trying to merge Indigenous wisdom with modern medicine? How do we avoid the pitfalls?

There are a thousand ways to merge paradigms badly. Indigenous peoples are skeptical of the Western world because of what’s happened historically—extraction, genocide, slavery, and everything colonial regimes have been associated with. Every psychedelic organization claims to "bridge worlds," but usually you get an Indigenous person at a conference who says "watch out for spirits," everyone says thank you, and that's the bridging done. It’s much more difficult to actually do it.

Ontological shock is huge. I get people emailing me constantly. They go on retreats wanting insights about their business or marriage, end up meeting entities like Ganesh, then return to their London banking job wondering what just happened. They can't tell friends without seeming insane or therapists without seeming delusional.

Ego inflation is another big issue, especially with ayahuasca. People drink a few times and think they have unique insights or that they’re the chosen one. If you've been to Iquitos in Peru, it's a city with a lot of seeking. There are so many people looking for meaning who've clearly been there a very long time.

In Indigenous communities, everyone understands this paradigm. If somebody begins to get a bit egotistical, everyone just checks them and brings them down a few pegs. But in the West, we live much more individualistically, and most people don't understand these frameworks. So there can be real isolation.

It's easy to say you're bridging without actually doing it. Real bridging requires building trust, ongoing relationships, and taking concepts like spirits seriously, which essentially requires expanding the remit of science itself.

Want more from Simon?

Watch his TedX Talk, and check out Onaya’s research and continuing education programs. Cyclists can take 10% off the Psychedelic Mentorship Training with code TRICYCLE10.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.