Background: Mystical experiences during ayahuasca ceremonies are frequently associated with psychological and spiritual benefits. In contrast, challenging experiences are often viewed as negative or disruptive. However, growing evidence suggests that when these challenging experiences are well-integrated, they may contribute to meaningful personal transformation. While clinical studies on psychedelics have advanced rapidly, real-world ceremonial contexts remain underexplored. To address this gap, we conducted a latent profile analysis to identify distinct patterns of acute psychedelic experiences (i.e., mystical (MEQ), emotional breakthrough (EBI), and challenging (CEQ)) and examined how these profiles relate to enduring psychospiritual outcomes.Methods: In this longitudinal observational study, 233 participants attending ayahuasca ceremonies completed standardized measures immediately following their ayahuasca retreat to assess acute effects (MEQ, EBI, CEQ), and again at a one-month follow-up to evaluate psychological and spiritual growth (Spiritual Growth (PTGI), Meaning in Life (MLQ), and the Spiritual Well-being (SIWB)). Latent profile analysis was used to identify experiential subgroups, and one-way ANOVA tests were conducted to compare group differences across psychospiritual outcomes.Results: Three distinct profiles were identified: (1) Class 1, Steady Path Group (n=131; 56.2%): Participants in this group reported high levels of mystical (MEQ=114.0) and emotional breakthrough experiences (EBI=49.6), the lowest levels of challenging experiences (CEQ=30.4), and moderately elevated scores on psychospiritual outcomes (Spiritual Growth=5.4, Meaning in Life=5.1, Spiritual Well-being=24.0). (2) Class 2, Muted Responders (n=50; 21.5%): This group reported the lowest levels of mystical (MEQ=55.3) and emotional breakthrough scores (EBI=30.1), along with elevated challenging experiences (CEQ=37.3). They also showed the lowest scores across all psychospiritual outcomes (Spiritual Growth = 2.1, Meaning in Life=-0.1, Spiritual Well-being=18.5). (3) Class 3, Breakthrough Navigators (n=52; 22.3%): Participants in this group reported exceptionally high levels of mystical (MEQ=121.0) and emotional breakthrough experiences (EBI=54.3), accompanied by the most intense and highest levels of challenging experiences (CEQ=80.1). They also showed the highest levels of spiritual growth (6.3) and spiritual well-being (23.9), while their sense of meaning in life (4.8) was slightly lower compared to the Steady Path Group. Additionally, significant group differences were observed across all psychospiritual outcomes (ps<0.001), except for CEQ scores (p=0.160). Notably, the intense level of challenging experiences reported by the Breakthrough Navigators suggests that when paired with profound mystical and emotional breakthrough experiences, challenging experiences may play a constructive role in spiritual growth.Conclusion: These findings challenge the notion that psychedelic-induced difficulties are inherently negative. Instead, the findings point to the potential for challenging experiences to serve as catalysts for transformation, particularly when paired with profound mystical and emotional content. By focusing on ceremonial settings outside clinical frameworks, this study adds to the growing body of literature on psychedelic-assisted change by emphasizing the importance of context, meaning-making, and post-experience integration. These results underscore the importance of integration support and suggest that individuals who experience intense emotional or spiritual disruptions during ayahuasca ceremonies may benefit most from targeted therapeutic follow-up. Future research should further explore how factors such as setting, mindset, and facilitation influence whether challenging experiences lead to harm or healing.
