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Ketamine-Assisted Psychotherapy: A Path to Transformation

Updated: Jun 3

In recent years, there has been a growing need and interest in so-called “alternative" (more on this later) forms of therapy for mental health conditions. Among these emerging modalities is ketamine-assisted psychotherapy. Ketamine has garnered attention for its potential to offer rapid relief to those struggling with treatment-resistant depression, PTSD, anxiety, substance use disorders, and other psychological disorders.

In truth, ketamine is not alternative at all. First FDA-approved as a sedative and pain reliever in 1970, ketamine has a stellar safety profile and is incredibly easy to use for medical providers and lay people alike. In fact, it is so safe and effective as a pain reliever that soldiers would administer it to one another on the field in the Vietnam War. In fact, military personnel called ketamine the “Buddy drug.”

It wasn’t until 30 years later in 2000 that researchers discovered that ketamine was also a rapid acting antidepressant. Working on glutamate receptors in the brain, ketamine’s mechanism of action is completely different from other antidepressants on the market (think Prozac, Lexapro, and Wellbutrin). Because of its unique activity in the brain, it is effective for people who don’t reposed to other antidepressants. To boot, ketamine is not meant to be taken daily and has very few side effects, a feature that some people find preferable to traditional medications.

Ketamine-assisted psychotherapy combines the use of ketamine with psychotherapeutic techniques. Unlike traditional antidepressants, which can take weeks or even months to produce effects, ketamine often acts rapidly, providing relief from symptoms in a matter of hours. Using a consciousness-shifting medicine is what some refer to as “alternative.” However, this method has deep roots in both psychotherapy traditions and indigenous communities. Combining the neurological effects with therapy can produce deep insights that leads to lasting change. 

During a ketamine-assisted therapy session, a trained therapist guides a client through their experience with ketamine in a controlled setting. The psychedelic properties of ketamine can induce a deeply introspective state, allowing patients to explore their thoughts, emotions, and memories with heightened clarity and insight. Many discuss this state as being ego-dissolving, or at least ego-inhibiting. This altered state of consciousness can facilitate breakthroughs in therapy, enabling individuals to confront and process traumatic experiences or deeply ingrained patterns of thinking without feeling overwhelmed or defensive.

The inherent assumption here is that consciousness, not just the chemical, is playing a role in healing. It’s my belief (formed through decades of experience and research) that ketamine is a tool, a catalyst which allows us access to parts of ourselves we cannot access in ordinary mind. This non-ordinary state of consciousness (NOSC) seems to hold innate wisdom we need to heal. The beauty is each person is healing within themselves, we are just a guide, a support, a hand to hold. 

As for my anecdotal experience, over the past eight years working with this medicine I have seen people break the chains of decades-long depression in single session. I have witnessed clients reclaim their voice, their joy, literally their life. It’s like the ketamine gave them the space or permission, or both, to reconnect with parts of them that had been lost. Indeed, a depressed brain is a disconnected brain (really, the neurons in people with depression are less likely communicate on fMRI scans).

While the literature on ketamine as an antidepressant is indisputable (showing a 60-70% response rate in treatment-resistant depressive, a number unheard of in psychiatry), research into the efficacy of ketamine-assisted psychotherapy is still in its early stages. Preliminary studies have shown promising results. For instance, my instructors, Drs. Jenn Dore and Phil Wolfson, co-authored a paper published in 2019 which demonstrated efficacy of ketamine plus psychotherapy for depression and anxiety. A 2018 study published in the American Journal of Psychiatry found that ketamine significantly reduced symptoms of depression in patients with treatment-resistant depression within 24 hours of administration, however the majority of participants relapses within a month. Our hypothesis is that coupling psychotherapy with the medicine will improve and prolong these outcomes.

One of the key advantages of ketamine-assisted therapy is its potential to offer relief to individuals who have not responded to traditional treatments. For those who have struggled with debilitating depression or PTSD for years, the rapid relief provided by ketamine can be life-changing.

However, it's important to note that ketamine-assisted psychotherapy is not without risks. Ketamine can be a drug of abuse and cause mental changes that, without proper preparation, may cause discomfort. That’s why it's crucial for therapy sessions to be conducted by trained professionals in a safe and supportive environment.

As the field of psychedelic-assisted therapy continues to evolve, I look forward to seeing advancements in patient selection (figuring out who it’s more likely to work for) and techniques to prolong remission. 

In my practice, I am committed to using what works at the service of my clientele. I integrate evidence-based care and ancient wisdom (in this case, psychedelic medicine) while prioritizing the safety and empowerment of my clients.

While it may not be the right approach for everyone, for some individuals, ketamine-assisted therapy could offer a new path to healing and transformation where other therapies and methods fall short.

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