Ainlay Dixon, her husband, and three of their four children were in a town in central Ecuador, midway through a South American tour, when a guide approached and offered to take them on a four-day jungle excursion to see the “authentic” Amazon: an indigenous village led by a real shaman. To get there, the family took a 4x4 as far as they could down a rutted road, which soon dwindled to a trail; they made the rest of the way on foot. Eventually, they arrived at a small village where they were introduced to the village chief, a well-known shaman who’d had tourists flocking to his remote village ever since he’d been featured on a news show in Ecuador. That night, the shaman held a welcome ceremony for the new guests. They sat in a thatched roof hut while he blew pungent tobacco smoke on them, invoking a charm of protection. The novelty of the experience was tempered by the presence of another American — a strawberry-blonde Harvard Divinity School student named Lily Ross, who had been living in the village for the past few weeks, working for a grassroots nonprofit and researching shamanic practices.

Over the next few days, the Dixons’ children played soccer with the village kids. The family went on walks in the jungle with the shaman’s son, who rattled off the names and medicinal uses of the plants they came across. The day before the Dixons were set to depart, Ross asked Ainlay if they could speak privately. The two women found a space to sit in a guest hut, and Ross said that she and the shaman were in love. Something immediately struck Ainlay as off. “She would say that it was meant to be, and she would say that it was forever — but she was in a daze, talking almost in a monotone,” Ainlay said. Her concern piqued, Ainlay gently suggested that Ross was so isolated in this village, and so immersed in a culture that wasn’t her own, that perhaps she had lost her bearings a little bit. “That’s when she told me that they were bonded through this — I forget the name of the drink that they do. You know, the medicine. Through the medicine, they were bonded. And that he was really powerful.”

The “medicine” Ross took with the shaman was ayahuasca, a bitter, sludgy liquid, made from the labor-intensive combination of two plants native to South America, that has been used in the Amazon as a holistic medicinal treatment for centuries. More recently, it has become the center of a rapidly growing shaman-tourism industry. There’s no official count, but some experts estimate that there are now hundreds of spiritual centers offering ayahuasca ceremonies throughout South and Central America, many of which are booked months in advance. “Tourism went from something that was very sporadic, very low-key backpacker tourism, to a flourishing industry with a lot of competing lodges,” anthropologist Daniela Peluso told me. Ayahuasca rituals have become an expected part of the South American itinerary for a certain type of traveler: today, river rafting; tomorrow, a transcendent drug experience.

The tourism is fueled by the personal testimonials of people who say the drug changed their lives — helping them to recover from trauma, quit drinking, or finally get over their childhood sexual abuse. “It’s been incredibly healing for me,” an American woman who went on an ayahuasca retreat last year told me. “It enables you to understand what can only be described in hymns or poems by Rumi. It was one of the crowning experiences of my life.”

This reputation for healing is one reason ayahuasca is a drug that you’re not supposed to call a drug. In a YouTube parody video, a vague-eyed, long-haired man sporting a lacy, turquoise headband underlines this point: “You can refer to ayahuasca as plant medicine, medicine, a sacred plant, a sacrament — but it is not a drug,” he says primly. “What makes a plant sacred?” an off-camera questioner asks. The man replies, “Its ability to get you high.”

An ayahuasca trip can also be an extremely erotic experience. “You can have a lot of really sexual visions and feelings while you’re tripping on ayahuasca,” the American woman had said. “A lot of us were really surprised by that — we’re rolling around, seeing all this weird sexy stuff and feeling all this weird sexy stuff. It was really unexpected.” It’s common to abstain from sex — as well as alcohol, other drugs, and red meat — for several days before and during an ayahuasca ceremony. “I realized afterward that one of the reasons they prohibit sex is because you could make some really bad decisions while on the drug,” the woman added. “Just some really hasty emotional decisions. You could get in way over your head.”

Some people, especially inexperienced users, can also feel immobilized, both physically and mentally; participants describe periods of intense physical weakness where they are unable to control their bodies. They also report becoming highly suggestible. This openness — the surrender to the will of the plant mind, as initiates put it — is precisely the point, and for many people it’s a transcendent experience. It also means that when things go wrong, they can go very wrong. Panicked participants may find themselves isolated in a rural setting, unfamiliar with the local language or culture, away from resources and support systems — and, of course, quite high.

When Lily Kay Ross arrived in Ecuador in June 2012, she was planning to stay in the village for about ten weeks, working on a project for a nonprofit that equipped indigenous villages with media equipment and training. By that point, Ross had had a research interest in ayahuasca for four years, and she knew that the trip wasn’t entirely without risk. “It’s a lot of power in these people’s hands,” said Ross, whose research partly concerned itself with that power dynamic. “How does one handle this power with integrity when there’s no governing body, no network of accountability?” Ross’s concerns are echoed by the U.S. Department of State. “There is no way to vet ayahuasca tourism operators,” the department’s page for students studying abroad in Peru warns. But an American friend who had worked with this shaman for two years had reassured her — this guy, he said, was one of the good ones. “And maybe I thought that because I was aware, I was immune,” said Ross.

As she tells it now, her first encounter with the shaman was inauspicious. Ross is fluent in Spanish, but when he picked her up at the bus station, the shaman and a protégé spoke to each other only in Shuar, their indigenous language, ignoring Ross for most of the long trek — via another bus, and then that long walk through the jungle — to the village. The second surprise was the village itself — just a handful of huts, which seemed to be occupied by only the shaman and a few family members. During her first days there, Ross quickly discovered that there wasn’t much for her to do. She tried to pick up some Shuar words and hung out in the kitchen, offering to help the women prepare meals. Each time something seemed strange or off, she repeated a mantra to herself, like a good student of anthropology: “Do not let your Western-morals framework impinge on the practices of other people.”

On one of those first nights, the shaman gave two tourists, both men, a plant bath, which entailed his spreading a specially prepared mixture of medicinal plants directly on their skin. After the men’s treatment, the shaman told Ross to do as they had: go into the hut and strip down to her undergarments. “I knew in the back of my mind that you’re not supposed to take your clothes off and go into the private place with the shaman for the healing — that’s how creepy things happen,” she told me later. “But then having seen him do these baths with these men, I was like, All right, I think I can actually trust this.” The shaman covered her in a fragrant concoction of plants. He instructed her to put her clothes back on and left.

The world quickly went sideways. Ross tried to stumble out of the hut. As she did, the shaman saw her and led her over to the bed to lie down. He started telling Ross that he’d had visions of her before her arrival, that he’d known what clothes she’d be wearing, that they had a higher purpose together. He had so much to teach her, he said. Then he climbed on the bed and wrapped his arms around her; she could feel his sweat against her skin as he began professing his love. Ross felt unable to move. “My grip on reality — I was watching it kind of slip away,” she said. The shaman began writhing against her. She eventually mustered the strength to turn away from him, and he left. The next morning, he returned: “He motioned me to the bed and told me to take my clothes off. That was the point at which it was like I had no will,” she said. They had sex. “He could have told me to do anything and, like an automaton, I would have just done it. I would watch my body perform these things, and it was like I wasn’t there to control it.”

The rest of the day felt dreamlike and fuzzy. The shaman told her she wasn’t allowed to eat anything in preparation for the next ceremony. She called a friend back home and told him she and the shaman were in love. “I remember just listening to the words come out, totally numb, like my mouth wasn’t part of me, like my body was a machine and my mind wasn’t in control,” she said. That night, the shaman gave Ross ayahuasca. She saw visions of furniture and stairs that weren’t there and lost the ability to walk. The shaman tried to take her to her own bed, but Ross refused; instead, she slept outside for hours, shivering alone in the dark. “The memory of that night sky is still with me,” she said. “And the feeling of being so high I couldn’t walk. My body shook in tremors.”

It’s hard to reconstruct what happened over the next few weeks, in part because it involves a version of herself Ross doesn’t quite recognize — someone who’s passive and floaty and disconnected, where Ross usually thinks of herself as decisive and in control. She was exhausted and sleep-deprived; the shaman called her Yumi, a Shuar name he’d given her. He told her that she had an indigenous spirit, and that she was meant to study ayahuasca as his apprentice for five years. “I remember a constant state of numbness,” she said. The shaman’s words about love and destiny echoed in her head; stranger still, she somehow believed him. A few days after Ross met Ainlay Dixon and made her flat-voiced confession of being in love, Ross recalls that she and the shaman drank ayahuasca together once more; during the ceremony, she had a vision of looking down at her own corpse.

After Dixon left the village, she continued to feel troubled by Ross’s story of love and destiny and powerful medicine. Finally, on July 9, 2012, she reached out to Ross. “I’ve been wondering about sending this email for a while and finally decided to do it,” she wrote. She told Ross that while in town, she’d met some local Shuar who knew the shaman. “They seem to have a very different impression of [him], and not a good one at that.” Dixon had heard that the shaman had been involved with a number of white women who came to the village as tourists. She also included links to an Ecuadoran newspaper report that the shaman had been investigated — and, ultimately not charged — with a murder relating to illegal shrunken-head dealing.

When Ross checked her email on the shaman’s laptop during one of her rare trips into town, Dixon’s message struck her at first as ridiculous. But here, outside the village, connected to the wider world, she began to question the shaman. Whether Dixon’s reports were true or not, whatever spell Ross had been under had been broken. The next day, she secretly boarded a bus for the ten-hour ride out of the Amazon. By 4 a.m. the following morning, she was on a plane. “I remember sitting in the airport and feeling like I was sitting on the top of a mountain, looking into this crazy jungle,” she said. “I knew I had to walk through it to get wherever I was going. I knew that the coming years of my life, that the process of recovering from this, was going to fundamentally change everything.”

Despite the advice to abstain from it, sex has become a common part of the ayahuasca experience. “Many young men and women show up at ceremonies in a highly open, receptive, compliant state,” wrote Chris Kilham, self-described ayahuasca thought leader, in The Ayahuasca Test Pilots Handbook, his 2014 guide for curious psychonauts. “They are open to experience, and some shamans want to be part of a more intimate experience than those who come to them might expect.”

While some tourists have had what they describe as consensual sexual relationships with shamans or other ayahuasca guides — or as consensual as they can be when one or both participants are hallucinating — Ross isn’t alone in having a sexual encounter that she believes was not consensual. In January 2015, an anonymous open letter reported 15 women’s “horrific and unsafe” experiences at a shamanic center in Peru, where the women alleged various forms of groping and inappropriate touch by shamanic apprentices: “Touching of breasts, pulling down panties, kissing heads, kissing hands, laying and cuddling while kissing head, neck, etc.” A leader in the Santo Daime church, a syncretic form of Catholicism that treats drinking ayahuasca as a sacrament, was accused of making sexual advances on multiple women who had gone to him for healing. “There are now many recorded cases of shamans who intentionally seek out sexual relations with participants,” Peluso, the anthropologist, wrote in a 2014 academic paper on ayahuasca, sexual seduction, and shamanism, “showing that, for these particular men, sex with participants is premeditated and part of a routine.”

In that paper, Peluso points out that indigenous women can also become targets of predatory shamans. One Peruvian woman told her that a shaman said, “If you want to ‘see,’ then you need to drink with me alone.” But most indigenous women won’t drink ayahuasca with a shaman they don’t know unless they’re accompanied by a family member or friends. Peluso told me that she has also heard an increasing number of reports of shamans adding other plants, like brugmansia, to their concoctions — ostensibly to intensify the ayahuasca experience to better align with tourist expectations. But these other plants can also be used to increase women’s sexual receptivity. Also known as toé or floripondio, brugmansia is described in The Ayahuasca Test Pilots Handbook as “an intensely powerful and dangerous psychoactive agent” that is “employed as a sedative and calming agent and is known to lower inhibition.”

Annie Oak, a former science journalist who has used psychedelics for decades, founded the Women’s Visionary Congress, an organization that hosts conferences and events for women interested in “non-ordinary forms of consciousness,” in 2007; almost immediately, she began hearing from people who had either experienced or witnessed various forms of sexual assault during or after ayahuasca ceremonies. “The reports we heard were really diverse, from people who were inappropriately touched by the ceremonial organizers or their apprentices, to others who were coerced into inappropriate relationships after ceremonies, when they were in a very vulnerable state,” Oak told me. “But what was common was the sense of betrayal.”

Supporters of ayahuasca’s healing effects are quick to point out that sexual misconduct isn’t an intrinsic part of the experience; it’s fueled more by the power imbalance between spiritual seekers and their guides than by any property of the drug itself. “I’ve taught yoga for 45 years. Yoga teachers can get laid any day of the week,” Kilham said, bringing up another potent student-teacher dynamic. He believes that the influx of outsiders also gives those with an impulse to behave badly a greater opportunity. “All of a sudden, these shamans find themselves in the position where there are zillions of American and European women falling all over them. Some of them are hard-liners, it’s just a definitive no. Others are like, zip-a-dee-doo-dah! Why would I pass this up?”

Kilham and I were talking by phone. As we were finishing up, his wife, Zoe Helene, said she has something to add. She took the phone out onto the porch so we could talk privately. We proceeded to have one of those frank conversations that happen with depressing regularity among women, swapping stories of scary situations and near-misses, of friends and family members who are still coping with the aftermath of sexual trauma unrelated to ayahuasca. “I’ve been drinking ayahuasca for nearly a decade,” Helene told me. “I cannot imagine being raped while in the medicine space. There would be such a deep betrayal there — your mind is opened up in this particular way, and that wound is going to be really deep.”

It wasn’t until months after Ross returned from the Amazon that she first sought counseling at the Boston Area Rape Crisis Center; it took even longer for her to begin to describe what had happened to her as rape. “It was really tentative at first — ‘I think it’s rape,’” she said. The more distance she had from her time in Ecuador, the more troubled she was — the question of why she hadn’t left the village earlier gnawed at her. But she watched a documentary about brugmansia in which people described their experiences with the substance in terms that felt familiar to her: a loss of will, a feeling of paralysis. Ultimately, she concluded that she had been drugged, brainwashed, and raped by the shaman. “I spent the next several months wrapping my head around what that meant.”

Afraid of retaliation, Ross doesn’t want to name the shaman publicly. But she did provide me with his information. When reached by phone, the shaman said, in Spanish, that Ross drank only a small dose of ayahuasca, just once during her stay, and that the other plants he gave her — including brugmansia — are commonly used in a medicinal context by men, women, and children in the village: “Never, ever, was she drugged. She drank and I drank; she ate, I ate.” He also denied raping her: “In the Shuar culture, it’s natural and not a problem to have [relationships with] two, three, four, ten women, only if it’s agreed upon by both men and women. Nothing by force. We are very respectful in that sense.”

Peluso, the anthropologist, told me that having sex with someone who is incapacitated is not acceptable in a local context, and that it was also “not normal” for the shaman to tell Ross to take off her clothes for the plant bath: “No indigenous woman would ever let a man do that.” Tourists tend to romanticize shamans, she said. Combine that idealization with a lack of understanding of local customs and the particularities of gender relations, and trouble can result. “Sexual assault is not acceptable [in Amazonian cultures]. But there’s a kind of sexual harassment that is considered — I don’t want to call it normal, but in the range of possibility,” she told me. “Local women see shamans as men, as humans, as flawed beings. Western women go down there and they don’t understand this, and on top of it, a lot of them think these shamans are like gods. But these are egalitarian societies. Healing is a shaman’s vocation. He’s not your car repairman, but he’s not so different from that.” Ross, who had a much more sophisticated understanding of Amazonian culture than the typical tourist, told me that she thought the shaman was nonetheless able to manipulate her own willingness to suspend judgment to his advantage. “He was acutely aware of the romanticization of native people,” she said. “And also the nature of idealists and activists who want to believe the best of people, to look respectfully at native people. He really used his indigenous identity to establish a kind of de facto credibility and to foster trust.”

Peluso said that while nothing justifies sexual assault, it is unrealistic for women to expect to encounter the same attitudes toward what is appropriate behavior that they would back home. “There’s a certain arrogance in expecting that things in South America are going to be the same as at the Esalen center in California. To go there and expect people to have this mutual sense of what healing is, what a healing setting is, what a code of conduct is, what a doctor-patient relationship should be like is just not realistic. I don’t believe in blaming the victim. I’m a hard-core feminist. But seeing these New Age people who have no sense of what local gender relations are like coming together with these shamans who are navigating new worlds — it’s an intersection where a lot of things can happen.”

When Ross first started telling friends in the ayahuasca community about her experience, she ran into more resistance than she expected. “Victim blaming in New Age–y culture is essentially the same bullshit,” Ross said. “Not that this happened because you wore a short skirt, but that somehow you, like, manifested it.” Still, she kept hoping she’d be able to transform her own violation into something that might help other people. In 2014, two years after she returned from the Amazon, she gave a lecture about her experience at a psychedelic symposium in Amherst. In it, she discussed some of the difficulties of addressing sexual assault in fringe or underground communities, where there aren’t clear structures in place for how to handle misconduct. “Sexual abuse is happening often, and it’s not a secret. People are talking about it, but they talk about it in private for the most part,” she told a room of young psychedelic enthusiasts. “Our enemy here is silence.”

But as Ross contemplated sharing her story with a wider audience, she grew more cautious. Many of the respected academics and experts in the psychedelic scene she contacted discouraged her from coming forward. “The message was basically: Shut up and move on with your life,” she said. Ross recalls one man, a key figure in organizing medical research in psychedelics, saying that if she told her story in the media, she’d be undermining decades of work, perhaps even reinvigorating the drug war. After that, she cut ties with the psychedelic community. “I’d gone from wanting to be an active researcher and a member of the psychedelic field to wanting to have nothing to do with it.” She is now in a Ph.D. program, researching in part how institutions respond to victims of sexual violence.

Everyone I spoke with in the ayahuasca community — researchers, advocates, activists, enthusiasts — acknowledged that sexual misconduct was a growing problem. What they didn’t agree on was what to do about it. There has been one serious attempt to address the issue broadly: In 2013, an international nonprofit consultant and newly converted ayahuasca enthusiast named Joshua Wickerham founded an organization called the Ethnobotanical Stewardship Council, which crowdfunded more than $20,000 to create a list of approved ceremonial centers that voluntarily abided by designated safety principles — particularly with regard to sexual assault. But nearly as soon as it launched, the ESC, whose promotional materials featured a blend of New Age lingo and the bureaucratic language of international development (“holding space,” “multi-stakeholder consensus,” “ayahuasca value chain”) faced a backlash. A letter signed by a number of academics and Amazonian specialists claimed that “the ESC’s lack of on-the-ground experience is apparent, the ethnocentricity of the project is alarming, and the assumption that they know better than the locals how to manage ayahuasca is unfounded.” The ESC soon disbanded.

Since then, the best solution anyone has come up with seems to be that it’s women’s responsibility to keep themselves safe. Zoe Helene counsels women who reach out to her through Facebook to do their research, only visit reputable centers, and bring a friend, preferably a man, to watch their backs. And Oak’s Women’s Visionary Council has issued 20 safety tips for participants in ceremonies using psychoactive substances, including setting boundaries in advance and securing safe lodging. Like Kilham, Oak thinks that problems of shamanic sexual assault are not the fault of psychoactive substances: “This happens in all spiritual traditions, and it’s probably been happening ever since there were spiritual traditions,” she said. “This is a much older, larger problem about the abuse of power.”