The Indigenous origins of ayahuasca, and how a ceremony works

It’s important to respect the Indigenous people who have used plant medicines for centuries as cultural harbingers of its healing qualities. Ayahuasca is considered medicine, and should not be used recreationally or without the supervision of practiced healers. It is legal and culturally rooted in several countries with land within the Amazon Basin, where the plants originate, including Peru, Colombia, Brazil, and Ecuador. Ayahuasca ceremonies are also held openly in Costa Rica, where the brew is decriminalized, and in Mexico, where its legal status remains a gray area, though ceremonies have become widespread.

According to the Multidisciplinary Association for Psychedelic Studies (MAPS), psychoactive properties are most commonly derived from Banisteriopsis caapi, a vine containing monoamine oxidase inhibitors (MAOIs), and the leaves of Psychotria viridis, or other plants containing N,N-dimethyltryptamine (DMT). It’s believed that the DMT found in ayahuasca activates the DMT naturally found in a person’s pineal gland, often considered the third eye portal amongst the spiritual set and Indigenous healers. Many healers and shamanic practitioners believe this leads to the vision quests that ensue after ingesting the brewed version of ayahuasca, and why participating in ceremony is a way to connect deeper to your truest self. As the healers of Sacha Wasi, an ayahuasca retreat center in the Ecuadorian Amazon, explain: “Within our tradition, ayahuasca is regarded as a sacred plant teacher and a spirit of nature. We understand it as a tool for self discovery, reflection, and personal evolution.”

Ayahuasca journeys can range from one-night events to multi-day retreats, which usually require a participant to refrain from any intense physical stimulants such as sex, alcohol, and rich foods for at least a few weeks prior to and through to a few weeks after the ceremony. Silvia Polivoy, founder of the Spirit Vine ayahuasca retreat center in Bahia, Brazil, believes ayahuasca is a sentient entity, a teacher plant spirit, and emphasizes that “being clean before taking ayahuasca is essential.”

Most ceremonies are held in a maloca, a wooden ceremonial structure with a thatched roof, and begin at sunset and end the following morning before dawn, lasting around five to six hours. In my experience, a ceremony usually includes fewer than 20 participants and begins with some type of cleansing initiation through the use of tobacco snuff, such as rapé, or mapacho, a wild tobacco species native to the Amazon Basin. After ingesting the medicinal tea, most participants will experience a purging reaction, which could include vomiting or even a bowel movement. Participants drink three cups—each about the size of an espresso shot—throughout the night. Shamans and healing elders usually sing icaros (prayers) to facilitate a sense of calm and tranquility, and as the team at Sacha Wasi describes, “traditional icaros, drums, and sound elements help guide and accompany the process.” While some ceremonies observe a practice known as noble silence, many rituals encourage participants to emote as necessary: crying, screaming, and purging included.

After weeks—or even months—of anticipation, you have finally made it to your destination and are ready to enjoy a few days of sun, sand, and sangria. But wait, is that a sniffle in your nose, a scratch in your throat?

Though it is unpleasant and can even feel downright unfair, coming down with a bug during your time off isn’t uncommon. And of course, it’s certainly possible to catch a cold in the crammed quarters of a plane or eat something that makes your digestive system say, “No, thanks.” But sometimes your immune system simply decides to take a break right along with the rest of you—and that’s not necessarily a coincidence.

This phenomenon has a name: leisure sickness. Here’s what you need to know about what causes it and how to prevent it before your next vacation.

Why do we get sick on vacation?

Ad Vingerhoets, a psychologist and emeritus professor at Tilburg University in the Netherlands, coined the term leisure sickness in the early 2000s after noticing he often fell ill during his time off and decided to conduct a study on the phenomenon. His research found that high-achieving, high-stress individuals are more likely to get sick when they take a break, reporting ailments like headaches, muscle aches, fatigue, nausea, and flu-like symptoms.

Why might that be the case? Well, what you do before taking time off can influence how you feel during the trip. “Before a vacation people are already stretching themselves—working overtime, not sleeping well, not eating properly—so the body is already in a vulnerable state,” says Meena Malhotra, MD, a board-certified internal medicine physician and the founder of Heal n Cure. “Then when you finally slow down, the body kind of lets go, and that’s when symptoms show up. It’s not that the vacation caused the illness; it’s that the body was already run down and now it has the space to express it.”

The science behind why this may be happening is pretty simple, says Steven Goldberg, MD, MBA, a Kentucky-based urgent and primary care physician. It boils down to how much cortisol is in your body. This major stress hormone helps control inflammation and keep your immune system in check. “Think of it as a lid on a boiling pot,” he says. “While you’re pushing through a deadline or managing a hectic pre-trip week, cortisol is holding things together. The moment you decompress, cortisol levels begin to drop and that lid comes off.” When that happens, your immune system gets back to work. Inflammation increases, and symptoms that cortisol was keeping at bay may start to break through, Dr. Goldberg says. For example, many cold symptoms are caused by inflammation, so when that’s suppressed by high cortisol levels, you might not even realize you’re sick—that is, until you finally unwind and your cortisol drops.

People under chronic stress may be especially vulnerable. When cortisol remains consistently elevated over time, it weakens your immune system by reducing the production of certain infection-fighting cells and dampening important immune responses, both Drs. Goldberg and Guerrero-Wooley say. Pair that with other common vacation experiences, including pathogen exposure during travel, disrupted sleep, and dietary changes that can affect the gut microbiome, and you’re ripe for an illness to pop up on your trip, Dr. Goldberg says.

“The cruel irony is that your body wasn’t protecting you from illness during the stress,” Dr. Goldberg says. “It was just delaying the inevitable.”

Besides opening the door for new illnesses, pre-travel strain can also trigger underlying conditions or viruses that are sensitive to stress and immune changes, Dr. Malhotra says. One example is shingles, which is caused by the varicella-zoster virus, the same virus behind chickenpox. The virus can lie dormant in our nerves for decades after a bout of chickenpox, only to be reawakened by stress. Stress is also a common trigger for flare-ups of other conditions like autoimmune diseases, eczema, and irritable bowel syndrome.

I came to SHA because my matrescence had been the culmination of three long years of IVF—so much more than the usual nine months of hormonal, emotional, and physical changes of a pregnancy. Not only had I been subjected to thousands of needles and gallons of medications, but this roller coaster unfolded during my 40s, leaving my mind and body constantly at odds with each other. Disrupted sleep? Patchy skin? Absconding period? Unexplained anxiety? All elements of a not-so-fun game I call “Postpartum or Perimenopause?”

How do you address something you don’t fully understand? The numbers are a good place to start. “I think you’re really tired,” said Dr. Gabriela Dueñas during my functional medicine assessment. Ordinarily that’s a laughable observation to make to the mother of a newborn, but Dr. Dueñas came armed with data. Numbers and stats projected onto the wall supported her thesis: My progesterone was low, my cortisol was high, my physical stress was through the roof, but my mental stress was, mercifully, quite balanced—likely due to my saint of a husband managing as many external factors as he could. “You have to start learning how to release and relax and reconnect,” she continued. Doctor’s orders.

The regimen she prescribed included facials and massages and time at a subterranean hydrotherapy circuit overlooking the mangroves, but also an EKG, physiotherapy, and a gynecological exam—all firsts for me at a wellness retreat. Running up and down the six-story clinic between sessions was like being back in school again, only I’d swapped calculus and French for ginger therapeutic compresses, intermittent hypoxia, IV ozone therapy, and Pranayama. It was a more rigorous course load than I’d expected from a relaxing spa getaway, but I was here to do the work, after all.

No matter how excited you are for a trip, sometimes life gets in the way. You might come down with a stomach bug or the flu, develop an allergic reaction, or simply feel too under the weather to fly. If you’re not sure whether to take your upcoming flight, it’s easy to feel stuck in limbo, wondering what to do next. Consider this your step-by-step guide on deciding whether to stay put—and how to navigate the refund process if you do need to miss your flight.

Step 1: Take stock of how you’re really feeling.

You know the difference between a mild head cold and a severe case of the flu, so get real about just how sick you are. If you’re too ill to go to work, it’s probably not a smart idea to fly. Not only is that a clear sign your body needs time to recover, but that you might also get others sick if you forge ahead.

Looking for advice that’s a little more specific? You should probably bag a trip if you have a fever above 100 degrees Fahrenheit and symptoms such as coughing or sneezing, says William Schaffner, MD, a professor of infectious diseases at Vanderbilt University Medical Center. “Coughing and sneezing give exhalations more energy, which means you’re more likely to spread germs or viruses over a larger distance than if you simply had the sniffles,” he explains.

If you absolutely must fly, you should at least test yourself for COVID-19 to ensure you don’t expose others. Ideally, though, you should see a doctor to make sure whatever you have isn’t contagious. And masking up is always a good idea to avoid spreading the germs that are plaguing you.

Rashes and skin conditions that suddenly crop up should give you pause, as some of them are contagious. For instance, shingles—an illness caused by the same virus that triggers chickenpox—can spread to others when its telltale rash first makes an appearance. “When fluid is draining from the bumps, that fluid is chock-full of virus,” says Ankush Bansal, MD, an internal medicine physician and hospitalist in South Florida. “So if the pustules haven’t crusted over like a scab, you are contagious.” If you’re not sure what’s going on with your skin, Dr. Bansal suggests seeing a healthcare provider. “A lot of rashes look similar, and yours may be contagious or not. A doctor can figure it out,” he says.

Additionally, the CDC warns against flying if you’ve recently had surgery, a heart attack, or a stroke—these can increase your risk of blood clots and heart-related issues. In any of these instances, you have a plausible reason to plead your case for a travel refund.

Step 2: Know the rules.

Today in the U.S. airlines essentially across the board (minus some low-cost carriers) have permanently gotten rid of change fees for tickets beyond the basic economy level, says Scott Keyes, founder of the flight-deal app Going. This means that, usually, if you booked a main cabin fare or higher, you can change your travel dates later and only pay for any fare differences—at least on flights that originate in the U.S. (This can be hit or miss with flights originating abroad.) Though rebooking for another time isn’t the same as a refund, it is often an option if you’re too sick to fly right now.

It’s also worth noting some key policy updates in the world of flying and flexibility. For instance, United now lets passengers who booked in basic economy to upgrade to main economy, something that wasn’t always allowed, thereby giving them the option to switch a flight without paying a penalty. “It’s a little convoluted,” says Keyes. “But it’s one way that folks will be able to have flexibility if they are not able to travel for some reason.”

As the pool hoist lowered me into the water, I noticed how it bubbled up from thousands of feet underground. These thermal baths in Palm Springs, stewarded by the Agua Caliente Band of Cahuilla Indians for more than five millennia and long considered a portal to the spiritual underworld and a place of healing, welcomed my paralyzed body. I began to float weightlessly as the surrounding San Jacinto Mountains turned pink in the evening desert light. I felt the strangest sensation of being received by something both ancient and entirely new.

I was in the California desert landscape of Palm Springs in search of wellness—an experience that, more often than not, evades people like me. Around the world, spas are often physically inaccessible, retreats off-limits by design, and practitioners limited in their ability and training to see disabled bodies as deserving of the restoration everyone so desperately needs.

The city lies roughly 130 miles east of Los Angeles, a distance that by any American metric is barely a blip on the map. It is easily reached by a highway that cuts cleanly through the Sonoran Desert, past wind turbines spinning in their hundreds. Arriving in the Coachella Valley, with its impossibly blue skies and neighboring Joshua Tree wilderness, one’s sense of scale and perspective soon recalibrates; a prerequisite, perhaps, for experiencing a city that has long served as refuge.

A view from the Museum Trail above Palm Springs

Daniel Seung Lee

From the 1930s, when Hollywood stars fled here to escape studio contracts that controlled their public images, finding sanctuary in midcentury modern villas hidden behind bougainvillea; to today, where the LGBTQ+ community has built a haven when few other places offered acceptance: Palm Springs has always known how to welcome the marginalized. Over a third of its residents now identify as queer. The question I had was whether that welcome extended to disabled travelers too.

“For families like mine, travel has always meant planning around what might go wrong,” Josh Heinz, a local father of a son with autism, tells me over coffee one morning. “I wanted to flip that—to make sure people traveling to Palm Springs can plan around what might go right for once.”

As well as being an invested parent, Heinz is also the community engagement manager for Visit Greater Palm Springs. Last spring, he spearheaded an initiative that led to Greater Palm Springs becoming the first destination in Southern California, and only the fifth worldwide, to achieve Certified Autism Destination status. Hotels, restaurants, and attractions across the valley have now completed specialized training to accommodate guests with sensory sensitivities: learning, for example, that a meltdown is not a tantrum, that fluorescent lighting can overwhelm, or that sometimes a quiet corner matters more than a view.

Mid-flight exhaustion is a special kind of torture—the unintentional head nods, the restless legs, the feeling of dread that almost makes you want to ask the flight attendant, “Are we there yet?” Whether you’re halfway through a long-haul flight or on the last leg of a journey with multiple connections, running on no sleep, Biscoff cookies, and in-flight entertainment really makes you question if packing your suitcase and hitting the road was even worth it to begin with.

The key is not to let yourself get to that stage to begin with. And let’s be clear: Getting a few hours of quality sleep doesn’t require splurging on an upgrade to business class. It’s very possible to set yourself up for a good night’s sleep in economy with a bit of planning. As long as you’re willing to make a little extra room in your carry-on for in-flight comfort, sleeping on an airplane (yep, even in the middle seat) isn’t just feasible, it’s actually pretty simple. Here’s how to do it.

Consider the time zone you’re flying into

The first question to ask: Should you actually be sleeping at all? “If you haven’t started to adjust your schedule before your flight to align with the time zone of your destination, you can start to shift your schedule on the plane,” says Jeff Kahn, co-founder CEO of Rise Science. “Set your watch to the time in your destination’s time zone when boarding the plane, and try to sleep (or not), eat, and get sunlight accordingly.”

“You might also want to avoid eating on the plane if it’s nighttime in your new time zone,” Kahn says. A 2017 study found that eating according to your new time zone while in-flight can speed up the adjustment. If you land at night, or if you find yourself awake during the night, try to resist eating until breakfast time in your new location. Further research shows what you eat may also have an impact: Studies suggest that high-calorie diets may prevent adaptation to your new time zone.

Create your own sleep hygiene amenity kit

Putting in a little extra effort to elevate your in-flight experience will pay off big time once you’re strapped in for a long flight. I love creating my own business class–inspired amenity kit to keep all my sleep essentials easily accessible while also making an economy class seat more comfortable.

“​​The first things I would advise travelers to pack in their amenity kit are earplugs (or noise-canceling headphones), and an eye mask,” says certified sleep science coach Alex Savy. “It’s crucial to limit the stimuli on the plane since they can easily interrupt sleep.” I like to opt for EarPlanes earplugs which help regulate the cabin pressure and lessen the potential for ear pain. Pop on a pair of noise-canceling headphones, like the ones below from Bowers and Wilkins or JBL, and you’ll be whisked to a relaxing world all of your own, whether you’re listening to white noise or soothing music.

Intermittent fasting. Cryotherapy. Pleasure-dampening GLP-1 drugs. Silent retreats. Dark retreats. But in our obsessive, high-tech pursuit of longevity, we’re also craving a bit of lo-fi, sensory-igniting fun, especially on vacation. Wellness tourism is one of the fastest-growing segments of travel, predicted to reach over $1.4 trillion by 2027. Longevity clinics and biohack clubs aren’t going away. In fact, they’ll be more ubiquitous than ever, but next year they’ll be the mainstay of business or bleisure travelers looking to maintain their health goals on the road and combat jet-lag. The leisure traveler is tired of optimizing every inch of their life and just wants to let loose a little. Wellness-minded hotels and retreats have taken note and are offering more opportunities to dance to DJ beats, star gaze under dark skies, sweat to sauna performances, and most of all, socialize.

We’re going back-to-basics, looking to centuries-old healing practices and tapping into a bit of mysticism with modalities like soundbaths and astrology. Star gazing will be the preferred way to meditate and desert landscapes are where we’ll go to find our zen. Cultivating purpose is key to longevity and we’ll hone new passions and seek out a new breed of wellness adventures. And at the gym, we’ll skip burpees in favor of brain exercises.This will be the year of women’s health, but also family-focused wellness, with more spas offering multi-gen retreats.

Prioritizing your health on holiday has never been easier. Bring the kids. Go solo. Socialize with strangers in the sauna. Have a glass of green juice, or champagne. Wellness your way is the new mantra. Here are the trends, resorts, retreats, and destinations that promise to make wellness travel less like a doctor’s visit, and more like a vacation in 2026.

Wellness seekers want to be social

We are social beings and amidst a global loneliness epidemic, travelers are craving connection. In response, spas and hotels are creating more communal spaces and ways for travelers to engage. Earlier this year, the Retreat, a veteran spa hotel in Costa Rica, unveiled Santosha Wellness Club. Set just below the main hotel, the new open-air clubhouse includes 10 luxury lofts, a gym and yoga studio, plus a chic lounge area with an infinity pool, tapas bar, and a restaurant steered by a Michelin-decorated chef. Famed Mykonos beachclub Scorpios blurs the lines between spa and nightclub at its new line of hotels. At its first outpost, Scorpios Bodrum in Türkiye, guests attend group sound baths and yoga sessions by day and at night, they dance to DJ beats. The same formula will roll out at forthcoming properties in Dubai and Aspen. Ahãma Living, another newcomer on the Turkish coast, is also a mish mash of spa offerings and nightlife. And longevity clubs are the new social club, with the hottest memberships being at spots like Remedy Place in NYC, LA, and Boston and the forthcoming Six Senses Place London and the Estate in LA.

Saunas will double as entertainment venues

Saunas have long been social hubs in Nordic countries—gathering places where friends and strangers would sweat it out and reconnect. The concept has swept across North America and Europe, but now we’re catching on to a wacky sauna group ritual known as aufguss. Meaning “infusion” in German, these 15-minute performances are hosted by a trained Aufgussmeister in a large communal sauna. The sauna master prances around the room to a soundtrack of music smashing ice balls infused with essential oils on hot rocks and using towels and fans to waft aromatic steam over half-naked bathers. Priedlhof, a resort in Naturno Italy, has an entire team of Aufgussmeisters who put on theatrical performances in its four-story sauna tower. An aufguss show is included in your entry fee to BASIN Glacial Waters, a new modern-day bathhouse at the Fairmont Chateau Lake Louise in Canada. Bathhouse Flatiron in New York hosts aufguss ceremonies and Othership, a spa with locations in Toronto and New York, takes a fresh approach with sauna parties featuring breath work, live music, and dancing for up to 90 people.

Women’s needs (menopause + more) are a top priority

After years of neglect, the health industry is finally waking up to the unique needs of women through their full life cycles. A group of doctors known as the “MenoPosse” are the latest stars on mainstream podcasts, speaking openly about once taboo topics, like vaginal dryness and hot flashes. Everyone from Naomi Watts to Michelle Obama have shared menopause experiences and celebrities like Kate Hudson and Halle Berry are talking about testosterone. After seeing an explosion of well-received menopause-focused retreats, spas are now taking a more 360-degree approach to what women need at various stages of their life. At Shou Sugi Ban House in the Hamptons, women can sign up for female-specific nutritional counseling to improve hormone health and support menstruation and fertility. Mothers-to-be can sign up for solo babymoon trips with Mom’z, a retreat group supported by a network of expert doulas, midwives, and wellness professionals. Four-night itineraries around Spain and Portugal include daily prenatal movement, journaling and visualization, and loads of pampering. Canyon Ranch, the OG of American wellness destinations, is making a statement with its next location in Lake Plato, Texas, just outside of Austin. When the resort debuts in September 2026 it will have a dedicated Women’s Collective that will address the needs of women in their 30s, 40s, 50s, and 60s and beyond.

“Contiiiiinue…” Giuseppe guides in a hushed, musical tone as I channel all of my efforts into slackening my spine, unclenching my jaw, and unfurling my fists. Responding to his gentle instructions, I inhale deeply from my stomach, hold for three seconds, and exhale through my nose, repeating for several cycles. This is followed by a shorter interval of chest breathing, which feels much more shallow and uncomfortable but also, strangely, more familiar to me.

A therapeutic floating treatment at the spa

Lefay Resort & SPA Lago di Garda

Living as an undiagnosed autistic ADHDer for 34 years has trapped me in perpetual fight or flight, placing an invisible vise around my lungs. “The stomach and chest are home to the diaphragm, which allows the lungs to empty completely and thus renew their oxygen supply,” Giuseppe tells me afterwards. “According to Chinese medicine, the proper movement of breathing ensures communication between the upper and lower parts of the body, allowing energy to flow freely without blockages.” As I eventually surrender to the exercise, incorporating both the stomach and the chest in a final series of conscious breaths that draw in air with my whole being, the phantom grip loosens, and I taste a hint of that sweet, free-flowing energy.

‘Letting Go’ was created to rebuild healthier relationships between overstimulated individuals and their present. Over the course of three nights, participants benefit from a combination of treatments and therapies aimed at grounding them in the here-and-now, including cooking classes, massages, and guided excursions. “We want our guests to break away from burnout, to reconnect with their senses and self,” says Roberta Rovelli, the Senior SPA Receptionist. And reconnecting is what I do over the next few days: an exquisite anti-aging lavender facial feels as if its scrubbing away years of camouflaging; a morning walk among olive groves and shaded woodland engages more than my under-worked calves; and even sipping a cup of floral tea becomes a meditative ritual. One afternoon, I forage for herbs that grow wild in the resort grounds, later using them to flavor a dish of hand-rolled cavatelli in Chef Mariano Melluso’s holistic cooking class. With contagious nonchalance, he describes the three stages of pasta-making—stress, rest, shape—and challenges me, in the kindest of ways, to embrace imperfection.

It’s a reminder to stop glamorizing exhaustion and control, and to start prioritizing restoration and renewal. Whether neurodivergent or not, it’s a relatable concept, and Lefay’s ‘Letting Go’ program signifies a shift towards wellness travel experiences that champion our sacred selves. The ‘Rebalancing Bliss’ program at Sri Lanka’s Santani Wellness claims to cleanse anyone addled by stress or zapped of energy, while the ‘Burnout Recovery Retreat’ at Zulal Wellness Resort by Chiva-Som in Qatar promises deeper links to one’s inner purpose. Recently, FUEGO hosted ‘From Autopilot to Authenticity’ in Mallorca, a retreat that seeks to reset participants’ nervous systems and reignite intention.

We had been in Rome a few nights, and a piece of lamb was making me laugh. It doesn’t happen often, but it’s a totally involuntary reaction—and my highest possible praise. There was nothing funny about our abbacchio alla romana, Roman-style roast suckling lamb, which is a springtime delicacy; I was more dumbstruck. It was our first trip back to Rome since my wife, Lauren, had been diagnosed with celiac disease, and we were eating as well as ever.

It may seem counterintuitive, but Rome is one of the world’s great gluten-free travel destinations. And although I don’t have celiac disease, Lauren and I like to share when we go out to eat—and you can’t Lady and the Tramp bucatini by yourself. For this trip I challenged myself not to be tempted by the pizza slices and crusty sandwiches that were now off-limits to Lauren, and it wasn’t that hard.

Italy is at the forefront of celiac disease research and screening, so gluten-free diets are taken very seriously nationwide. At many restaurants, not just dedicated gluten-free establishments, celiac-disease-level precautions are the baseline for gluten-free dishes rather than the exception. Servers in the US often ask, “Is cross-contamination an issue?” In Rome, by contrast, one server informed us as we sat down that because of the note I’d left on our reservation, the kitchen had already started boiling a separate pot of water in case we wanted to order gluten-free pasta. (Of course we did!)

Celiac disease is but one of many reasons travelers may need to avoid gluten. Since unwittingly joining this community last year, Lauren and I have learned more about other autoimmune conditions that sometimes lead folks to go gluten-free, including Hashimoto’s thyroiditis and inflammatory bowel diseases like ulcerative colitis. We’ve also learned the nuances that differentiate celiac disease from non-celiac gluten sensitivity, gluten intolerance, and wheat allergies. Planning this trip we were concerned that Lauren’s diagnosis might alter our dining experience in one of our favorite cities, and it did—but only for the better.

Local flavors

Roman cuisine is rich in alluring seasonal vegetable dishes and satisfying secondi (main courses, which are generally protein-focused) that are often naturally free of gluten. And since the city’s four canonical pasta dishes—cacio e pepe, amatriciana, carbonara, and gricia—typically call for dry rather than fresh shapes, many restaurants can easily make them using high-quality gluten-free offerings. At those that can’t there’s always laughter-inducing lamb.