What is ketamine?
Ketamine is a medication that has long been used safely as an anesthetic and analgesic agent. It is classified as a dissociative anesthetic. Ketamine has been used in surgical settings and pain management since its approval by FDA in 1970. It is now increasingly applied clinically as an off-label treatment for various chronic treatment-resistant mental health conditions, such as depression, anxiety disorders, alcoholism and other substance dependencies, PTSD, OCD, and other psychiatric diagnoses. It is a blocker of the cellular NMDA receptor, a neural receptor for glutamate that has proved to play a significant role in major depression, chronic pain syndromes, fibromyalgia, and other ailments. It is also known to have potent anti-inflammatory properties and is known to stimulate neuronal growth, synaptogenesis, and neuroplasticity.
How does ketamine work?
Ketamine works by allowing people to take a break from their everyday ordinary waking consciousness. People tend to have a more relaxed mind with a reduction in negative thinking that allows people to process their thoughts, beliefs, behaviors, emotions and past memories. This increase in flexible thinking is what can lead to new insights and understandings that allow personal transformation and change to occur.
Some feel that over time ketamine helps to retrain the mind, brain, and personality system to become more relaxed, flexible, creative, and self-compassionate. Psychedelic induced and enhanced neuroplasticity effects in the brain may play a part in the types of positive cognitive, personality and behavior shift that ketamine and KAP foster. Verbal, emotional and relational processing/integration during and after ketamine sessions seek to maximize the beneficial effects of neuroplasticity.
What is Ketamine-Assisted Psychotherapy?
KAP is medical treatment with Ketamine Assisted by Psychotherapy. Some people benefit more from ketamine sessions when it is paired with psychotherapy. The treatment protocol includes sessions that will prepare you for your ketamine sessions followed by assisting you in integrating your experiences afterwards. The potential for change is greater when your ketamine sessions are facilitated within a structured, supportive psychotherapeutic environment with a therapist who is aware of your issues, desires, and goals for change.
A ketamine treatment session has the potential to create a non-ordinary state of consciousness and facilitate a profound transpersonal or mystical process. These sort of peak experiences have been shown to expand one’s sense of self and understanding of existence. Ketamine may also enable you to access your own inner healing intelligence in a manner that is valuable to you. Your therapist serves as a guide, and assists in processing the experience and its impact. Ketamine assisted psychotherapy varies depending on the particular problems being treated, every session can look different depending on your intentions and goals that you bring into each session.
Initial sessions will involve an evaluation of your current problems, concerns, and needs, evaluation of your overall health, as well as evaluation of suitability of this treatment for you. It is important that we both consider if we are the best provider of these services to you and if Ketamine Assisted Psychotherapy is the best approach for your situation. The goals of therapy are arrived at by mutual collaboration. These goals will be reviewed during the course of our work together in order to assess and/or modify the treatment according to your needs. Participation in this treatment may result in a number of benefits but there is no guarantee that this will occur.
What is integration?
Integration is how you can maximize the benefits of KAP by starting to implement new ways of thinking and behaving into your life. It is a time to notice shifts in your life that can lead to transformation and change. Integration is about connecting the dots between past experiences and creating new meaning in your life. Integration is an ongoing process. Common practices of integration include meditation, journaling, spending time in nature, creating art, and other practices that allow you to reflect on and remember the important insights of your ketamine experience. The healing process should naturally unfold over the subsequent days, weeks, and months after completion of the treatment, or after the treatment has entered a maintenance phase. Sometimes, it is only through later self-reflection, spontaneously-emerging insight and/or meaningful dreams that important perspectives resulting from this work may emerge and can be integrated.
How many sessions will I need?
The amount of sessions is individual depending on overall treatment goals and responsiveness to the treatment. Some patients benefit from only one session, while many benefit from a series of 3-6 sessions, and some will come for more ongoing treatment sessions over months or years.
Current research shows that 70% of patients with treatment resistant depression respond positively to 1-3 administrations, and 30-60% report having a remission of their depression for a varying length of time, some patients then receive “booster” sessions. With repeated sessions there is a cumulative effect and in combination with psychotherapy it becomes a treatment.
What are the side effects of KAP?
Ketamine has an extensive record of safety and has been used at much higher doses for surgical anesthesia, without respiratory depression. As with any medication, there are also some potential risks and side effects to be informed of and to consider.
Our setting is intended to minimize ketamine’s side effects as much as possible. You will be asked to lie still during the ketamine administration and we will invite you to use an eye mask during your treatment.
Effects of ketamine may include distorted visualization of colors, feeling suspended in space or floating, falling sensations, experiencing out-of-body sensations, vivid dreaming and changes in visual, tactile and and auditory processing. Music that may be familiar may not be recognizable. Synesthesia (a mingling of the senses) may occur. Ordinary sense of time will morph into time dilation.
Other possibilities for adverse effects include dizziness/lightheadedness, sedation, slurred speech, mental confusion, excitability, diminished ability to see things that are actually present, diminished ability to hear or to feel objects accurately including one’s own body, diminished awareness of physical functions such as respiration, headache, anxiety, nausea, and vomiting (although rare).