ketamine-assisted psychotherapy

How does it work?

 
Ketamine has been used therapeutically since the 1970s, and is classified as a dissociative anesthetic. Initially, ketamine was used by anesthesiologists to ease pain and keep patients asleep during surgery. Through its use as an anesthetic, researchers found that ketamine improved symptoms for patients experiencing depression and further research on ketamine’s impact led to supporting its use in treatments.
Where ketamine becomes emotionally therapeutic is at doses that allow for notable or complete absence of anxiety and depressive symptoms. This ‘state’ shift is largely located in the default mode network of our brain where our psychological guards and defenses reside. This creates a trance-like state in which our conscious mind is allowed to traverse our memories and emotions without the weight of fear or anxiety of doing so. 
At higher doses, ketamine can allow for lowered anxiety and some psychedelic effects, often described as a disembodied or trance-like state. The term ‘psychedelic’ has various connotations in today’s world, but ultimately refers to something that is ‘mind manifesting’. Psychiatrist Humphry Osmond defined psychedelics as “producing expanded consciousness through heightened awareness and feeling”. At these dosages, people can have deeply meaningful  experiences, connecting us to our memories and emotions in a way that transcends one’s normal- potentially constrictive boundaries of identity, limitations, fears or anxieties. These states are often referred to as ‘transpersonal’ experiences.  In a time frame of 30-40 minutes the effects of ketamine dissipate and metabolize at which point clients have access to further integrate with one of our therapists, allowing for deeper understanding and catalyzing change.
Generally, the goal of psychotherapy is to improve how you respond to life & it’s changes - past, present, and future. Throughout our lives, for various reasons & circumstances, we can develop structures, defenses, behaviors, and beliefs that help protect us, allowing for some equilibrium. While these coping mechanisms serve a purpose for us, they can be maladaptive in that they keep us stuck in cycles of re-creating or re-experiencing elements of our past that we want to move on from.  Moving beyond these coping strategies can be extremely difficult to do under normal circumstances -as they are actually an aspect of how our brain becomes wired.  This is one way psychedelic-assisted therapy can help by actually supporting new neural connections, a process which has been described by neurologists as “a reset button for our brain”. 
 

Ketamine & Psychotherapy

how ketamine can change our brains

 
Ketamine, specifically, impacts the parts of our brains that are related to memory and synaptic plasticity in the moment. This can allow people to process previously held feelings, experience emotions and memories in new ways, and to once again feel a sense of pleasure, relief or understanding. By prolonging the reconsolidation window, these new perspectives can be stored in a more emotionally resourced context, allowing for a relearning or rewiring to begin. This work can lead clients to deeper emotional experiences and open up to more connection, memory, and meaning in their lives.  
KAP is a modality that allows clients to access their ‘felt sense’ of emotions and open a doorway to their difficult or unconscious material. This way of accessing and working with whatever challenges we face allows for us to move through what is keeping us struck in a more rapid and powerful way.  
Initially, our prescribing partner does a medical and physiological evaluation. This includes exploring history, concerns, and goals, and is followed by an assessment of if/what form of Ketamine would best support you. Ketamine prescriptions can be in any of the following forms: oral lozenge (self- administered),  intramuscular injection, or intravenously through our licensed medical staff.  
In addition to your medical intake, you will have a mental health intake and 2-4 prep sessions prior to beginning KAP. Our intake sessions are 60-90 min, but in some cases, this may be split into multiple sessions. In these sessions, we will explore your history, goals, intentions, and answer any questions you may have.
While goals and intentions can act as somewhat of a guide, these sessions are best experienced through allowing ‘what is’  in the present moment. We will discuss and help clients practice important concepts of witnessing & staying curious as primary tools to support their own wisdom throughout the experience.  
Once clients are in a comfortable space - often in a reclined position and with an eye mask on and music (via headphones when desired) - the therapeutic dose of ketamine is taken or given (by oral lozenge, intramuscular injection or IV) and the experience unfolds.
While clients are in the deeper parts of the experience they may feel moved to relate some of their experience or not as emotions, memories, and sometimes images may come to them in this state. Once the deeper ketamine state resolves, clients can begin to talk and further integration of the experience can begin. Whether clients  explore experiences brought up during, after or in following sessions, we support the natural weaving in of body-oriented experiences and use other free forms of expression depending on the clients process to help further integrate the session. 
 

What is a kap session like?

lozenge v. IM & IV

 
Clients allow for the lozenge to dissolve without swallowing (when possible) over 10-15 minutes. In this form, the deeper ketamine state generally lasts 20 min. 
Both intramuscular(IM) and IV can allow for a more intense experience. In these forms, it generally brings clients into the experience more quickly and more deeply. While lozenge and oral solution methods are more gradual in their effects both as they increase and decrees and can be as or more impactful--every journey is different. Psychedelic effects for most methods resolve after about 45-60 minutes, often with a maintained sense of deep relaxation for several hours afterwards (and possibly with some mild soreness at the injection site).
Clients may choose with their therapist to have their integration sessions be separate from the KAP sessions or they may choose to extend their KAP session in the beginning to include some integration from the previous session. Integration sessions can be held inside or outside in a private setting if desired and are a vital element of deepening and integrating KAP sessions. 
There is an initial requirement of 3 KAP sessions and 3 integration sessions in addition to medical and therapeutic intake sessions which can be scheduled concurrently. Efficacy studies have shown that 6 KAP sessions have the greatest benefit.
 

integration sessions

is it safe & Effective?

 
Despite an aspect of its reputation as a street drug, ketamine has been used for decades safely in the medical community with a high success rate. While many people can benefit from ketamine assisted psychotherapy, it has shown immense improvement perhaps most notably researched for those experiencing PTSD, suicidality, and treatment-resistant depression.
Ketamine is a non-toxic anesthetic. A thorough medical history is taken prior to any prescription. Additionally, we keep your general response to ketamine into account during any increase in dose.