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The Department of San Martín was until recently one of the main areas of production of cocaine paste, and Tarapoto one of the three cities with the highest consumption of drugs in Peru. At the same time this area of the high Amazon has a high biodiversity that serves as the basis for many autochthonous medical practices that are still very alive and dynamic, capable of being true therapeutic alternatives to major contemporary challenges in the public health
While the official conventional medicine offers poor results to the treatment of addictive pathologies, scientific observation has proved that traditional ancestral treatments are very efficient to treat toxic substances dependencies. Since the 60’s, Peruvian neuropsychiatry has been worldwide recognized for its study of autochthonous medicines (C-A. Seguin, M. Lemlij, O. Ríos, F. Cabieses, M. Chiappe, etc.). In 1978 Dr. Mario Chiappe reported to the WHO the high percentage of alcoholism cases that were cured with empiric traditional methods used by North Andean Peruvian healers (shamans).
Since 1986 our preliminary research centered in the active observation of the work of Amazonian healers (shamans), especially regarding the ritualized use of medicinal plants for the treatment of coca paste, cannabis, cocaine and alcohol consumers.
On this basis, in 1992 Takiwasi opened its doors to offer a treatment protocol for consumers of legal or illegal drugs.
Following this objective an adequate infrastructure was built for the residence and cohabitation of the patients, and a multidisciplinary team was constituted, conformed by doctors, psychologists, educators, traditional healers (shamans) and various therapeutic assistants.
Since its beginning Takiwasi receives treatment requests coming both individually and as referred by public institutions or NGOs, and welcomes local, national and foreign patients.
Takiwasi has legal recognition to operate as a Health Centre, issued by the Regional Health Department of San Martín 039-DG-DIRES/SM-96 Directorial Resolution. In that way it becomes one of the few therapeutic communities in Peru to have legal recognition
*All the treatment activities are in Spanish, so applicants must have and adequate level of spoken Spanish. This is a basic requirement to be accepted in our program.
*The residential program is for male patients only because under Peruvian law men and women cannot live together in the same therapeutic community.
The therapeutic model that is applied in the TAKIWASI Center is innovative and unique in its genre. It is characterized by the combination of the resources of psychological and medical conventional therapies with the ones of the Amazonian traditional medicines. Therefore, a curative tripod is conformed, comprising three complementary therapeutic workspaces, which provide mutual feedback:
It follows the general model of therapeutic communities, offering an instance of self-observation and restructuring through the daily life and domestic chores.
It takes into account a diversity of instruments for the individual or collective approach to the issues that arise with the cohabitation and as a consequence of the use of traditional medicine plants
They closely accompany the patients in each stage of the treatment, for both the initial detoxification and for the exploration of their own inner world. There is a special emphasis in the ritual and controlled use of medicinal plants with psychosomatic effects, in accordance with the Amazonian tradition. These practices require, for a good result, the strict observation of certain rules: special diets, sexual abstinence (including masturbation), absence of stimulators, quiet life and concentration, proper sleep rhythms, physical activity and rest, baths and sauna, etc. Thus, a specific diet is part of the treatment: fritters and excess of sweet and salt are avoided; condiments and coffee are prohibited; and few milk products are permitted. Smoking is not allowed during the treatment
The therapeutic team is trained in the use of medicinal plants. It is a tradition in the Center that every therapist goes through a process of initiation and self-exploration with Amazonian traditional medicine. This ensures a true therapeutic relationship and empathic accompaniment in the patient’s personal healing process
The therapeutic activities are always led by professionals. Patients are not ranked by seniority. No patient is responsible for other patient’s care or for directing therapeutic activities.
Takiwasi is an open therapeutic community, i.e. the doors of the Center are always open, physically and symbolically. No patient is interned or held against its will. Those who decide to enter and stay are obliged to respect the basic rules of operation outlined in the Treatment Commitment letter that must be signed on admission.
The use of allopathic medication is only restricted to urgent cases. Psychotropic medications are not used in any stage of the treatment.
Takiwasi does not recur to pressure, manipulation, coercion or violence (either psychological or physical) during the treatment. Reciprocally, a patient that dares to recur to any of these methods towards his companions or the Center personnel is exposed to his immediate expulsion. Thus, the patient that enters the Center must be really motivated to heal himself. The fundamental criterion for admission will be the patient’s own level of motivation
Human rights and the medical ethics code are respected, as well as the freedom of religious cult.
The planned activities for the residents are not optional since they constitute an integral part of the whole treatment. However, the spiritual or religious activities are never compulsory. Each patient will be free to participate or not according to its faith, belief or philosophy of life.
During the day residents are organized in working groups by areas in order to accomplish the everyday community tasks. The work areas in the mornings are cooking, cleaning, gardens, maintenance of facilities, seeding of fruits and vegetables, and bakery, among other ergo therapy activities. Everything that is produced is exclusively for domestic consumption. Participation in these work activities not only orders the environment, but structures internally as well. It is also a form of personal retribution to the dynamics of the Center.
In this way each patient learns how to cook, make bread, wash their clothes, i.e. address itself in elementary aspects of life.
The Center brings together people of much contrasted origins and social or cultural backgrounds, from the local indigenous peasant to an academic from Lima or Europe. This encourages the development of mental flexibility, adaptation to others, and awareness of individual characteristics in a healing differentiation process.
In the evenings, occupational workshops are carried such as craftwork, carpentry and others, or artistic activities as a means of expression of feelings (painting, music, masks, clowns, etc.). At the end of the evening psychotherapeutic, psychoeducational, general culture or capacitation meetings are held. Their goal is to manage interpersonal conflicts, learn tolerance to frustration, develop a true communication and open the patient’s horizons.
Sportive activities are organized, from a classic soccer match, to martial arts, athletic disciplines and Ping-Pong.
Playful activities are also held (games, bonfires, walks, tournaments, etc.), and spaces are left for rest and relaxation both in everyday living as well as during the weekend. Takiwasi does not propose a permanent hyperactivity that would divert the patient’s attention from its problematic. Even though it is considered necessary not to remain in constant mental debates, the treatment seeks to be a moment of self-observation, reflection and meditation.
Freed from external concerns, the patient can focus all his energy towards the knowledge of himself. Following that purpose, there are no departures out of the Center until reinsertion time (approximately after the sixth month of treatment). However, the therapeutic team plans one-day rides every two weeks and regular visits to the botanical reserve (1 hour walking distance from the Center into the jungle) where the patients work, ingest plants, participate in ayahuasca sessions or in "diets" (retreats of eight days) that break the daily confinement at the housing center.
It is worth emphasizing that the group a maximum of 15 patients has 2.5 hectares to spread, with the doors open to the street, simple fences made of plants and trees, and the river Shilcayo bordering one of the sides of the land, where one can bathe. This way the context does not evoke an atmosphere of forced incarceration, like the one that exists in hospitals or prisons.
Everyday life in the Center is marked and accompanied by diverse social celebrations (such as birthdays, commitments or vows of abandonment of drugs, or departure celebrations), by a therapeutic process (essentially with ritualized plant sessions and diet retreats) and by spiritual life (meditation, mass for religious practitioners, reparation rituals, etc.).