Introducing Ketamine Assisted Psychotherapy

Talk therapy has been an excellent–sometimes life-saving–process for many struggling with mental health.  But for others, no matter how long they spend on the therapist’s couch, they struggle to find relief for their symptoms. In those cases, nontraditional therapy tools might be more effective—tools like ketamine.

Ketamine is a dissociative anesthetic that is best known for both its pain relief and its psychedelic properties.  Ketamine can decrease sensitivity to pain, and depending on dosage, route of administration, etc., it can create hypnotic, dream-like, or even fully dissociative trance states for a person.

Thanks to these effects, ketamine has had many uses in the medical field over multiple decades. It is often used as a part of general anesthesia to control pain during and after surgery. Ketamine is beginning to gain traction in quite a different context: psychotherapy.

Ketamine-Assisted Psychotherapy (KAP) is a mental health treatment method that involves using ketamine’s trance-inducing and pain-relieving properties to help individuals work through various mental and emotional challenges.  As a certified KAP provider in California, I hope to address the most common questions I get through this blog post.

For a few decades, researchers have looked into the uses of psychedelic substances like psilocybin (commonly associated with magic mushrooms) and MDMA (commonly associated with ecstasy) as an alternative and/or supplement to traditional talk therapy.

All this research has proved promising, but ketamine has pulled a bit ahead of the pack in many ways. The first reports of using ketamine in psychiatric treatment came in 1973.   Since then, research and personal anecdotes have painted a successful picture of ketamine in treating anything from depression to addiction to PTSD.   In 2019, ketamine became the first psychedelic drug to be approved by the FDA for use in treatment-resistant depression.

Today, KAP is most often used in treating major depressive disorder (MDD) and PTSD but has made appearances working with issues like substance use disorders and OCD, among others.

What is it about ketamine that makes it such a promising therapeutic tool?

Treating mental illness is not often as simple as weekly talk therapy or daily medication. Sometimes, it can be difficult, maybe even seemingly impossible, for a person to manage their symptoms.

Let’s face it—our minds can be scary sometimes. Unpleasant thoughts, painful memories, stubborn beliefs about ourselves and the world? These are not always easy things to sit with, let alone long enough to deal with.  Because our brains are wired to try to protect us, the root of these issues can often be shoved down out of our reach, leaving us to deal with the aftermath.

So, someone living with MDD might be battling a constant wave of hopeless thoughts and negative beliefs about their self-worth, while someone with PTSD is trying to manage debilitating fear and uncontrollable flashbacks.

This is where KAP comes in. During a typical KAP session—prefaced by thorough evaluation and discussions with the provider—a patient will usually lie down in a quiet room and take the prescribed dose of ketamine. Providers might put on soft music or have patients wear an eye mask to keep the environment as relaxed as possible.

In many cases, the medication will be in the form of a lozenge that dissolves under the tongue and takes about 10 minutes to kick in. Other methods include a nasal spray, IV or a series of injections, depending on the patient, the therapist, and the treatment setting.

Shortly after, patients will start to feel the dissociative effects. For the next 45 minutes or so, with the therapist monitoring, patients explore whatever arises.  According to both providers and patients, these trance-like states that ketamine can produce relax the walls that often come up when trying to address painful emotions. With these walls down, patients can access these things in a controlled environment without fighting against the mind’s natural defenses.

After the experience, the patient and provider sit together and discuss what came up. Patients can continue to work through their challenges in the weeks following, ketamine included or not.  Notably, patients tend to report few side effects from KAP, aside from those typically expected from psychedelic substances—dizziness, nausea, vomiting, and increased heart rate being the most common.

As with any practice that involves bringing up painful feelings and experiences, things can feel a lot worse before they start to feel better. Anyone looking into KAP should keep this in mind and discuss a potential plan with their therapist if necessary.

Many have found that the experience of KAP led to therapeutic breakthroughs at an exponentially faster rate than traditional talk therapy. They’ve resolved past trauma, faced previously unbearable emotions, and even found the purpose and peace they have been searching for.

Research is, of course, still ongoing for KAP and other psychedelic psychotherapies. While this doesn’t mean KAP will be a guaranteed fix, it opens a much-needed door for people struggling to progress with more traditional forms of therapy.  If you are interested in finding out more, schedule a free 15 minute consultation with me to ask any questions you may have.