Working with Ketamine
Introducing Ketamine
Like every psychedelic medicine, ketamine has its own unique character and set of gifts. Its chemical makeup is that of an anesthetic and anti-depressant, and so it offers deep relaxation to the body and an abrupt release from negative and self-critical thought patterns, even at lower doses. As we increase the dose, ketamine enables a kind of “dissociation” of mind from body - not the kind of shutting down that happens with trauma, but rather a remarkable freeing of the mind from the fixed and rigid aspects of living in a physical body that can only know reality through five senses. Experiences vary, but consistently include the following possibilities (Wolfson & Hartelius, 2016):
-Deep feelings of peace and joy
-Feelings of ego-dissolution
-Sense of transcending normal time and space
-Reliving of important life experiences, trauma reprocessing
-Feelings of unity with all, interconnectedness with all people and nature
-Sense of sacredness or transcendence
-Out of body experience
-Emotionally intense and meaningful visions
-Encounters with archetypal/spiritual/mythological places and beings
-Death and rebirth experiences
Another rather unique feature of ketamine is its short duration. Our bodies metabolize ketamine very quickly, meaning that the dissociative effects generally last only up to 1 hour. By 2 hours after dosing, you are fully back in your body and your cognitive faculties are back to normal operation. This makes journeying with ketamine much easier to fit in to a full life and less costly than other medicine experiences.
The process
Your ketamine journey begins with a free consultation call with me. We’ll talk about what’s going on in your life that’s leading you here, your interest and experience with psychedelic work and psychotherapy, and any initial questions or concerns you have about the process. Together we will make a determination about whether ketamine therapy is the right choice for you at this time.
Next, we will plan our first preparation session. This will be a 50 minute session at our journey space (or over Zoom if you have constraints on time and travel). In most cases it is best to subsequently have one or two more preparation sessions, and we will make this decision together.
After the first preparation session, I will put you in touch with out prescribing partner. You will set up a virtual or phone-based intake appointment with the prescriber. The prescriber will make sure you are good candidate for ketamine work from a physiological perspective. Following their determination, they will write you a prescription for the full amount of oral ketamine tablets you will need for your ketamine experience. The tablets will be sent directly to your home, or may be picked up from the compounding pharmacy, and you will bring them with you to your ketamine sessions.
Once we have have completed our preparation sessions, we will schedule your ketamine sessions. These sessions are 3 hours long, allowing us enough time to settle in, connect, create intentional space, have an unhurried trip 1-2 hour trip, and then do some debrief and integration before you go. The number of ketamine sessions will vary depending on your healing needs and individual preferences, and can range in frequency from one to six. But there is no hard and fast rule about when they have to occur. If your trips will be spread out over time, we can easily plan virtual or in-person integration sessions in between them to keep in contact and process how the medicine is working in your life.
Following your ketamine session, we will schedule an integration session (also considered psychotherapy for insurance purposes). At this session we will process how the work has gone so far and make a plan for your ongoing journey. This may mean scheduling a few more integration sessions, connecting with a psychotherapist, or joining a psychedelic integration group or other supportive context. The important thing is that you have some kind of support in place to allow your your journey process to keep unfolding over at least a few months, as psychedelic work is often the beginning, rather than the end, of a period of healing and change.
Looking to the future, once you get a feel for psychedelic work, it may become something you want to come back to on a seasonal or annual basis. Once our rapport has been established, I will be glad welcome you back for ketamine work for as long as the medicine serves you.