What to Expect from Ketamine-Assisted Psychotherapy?

The therapy scene has widely used psychotherapy, also known as talk therapy, to address thoughts, emotions, and behaviors due to underlying mental health conditions.

It serves a great purpose for many people and has excellent benefits when it does work. For some people, though, solely talking through issues does not provide the full support they need. We need additional methods to alleviate symptoms. Ketamine is one of those options.

Despite the binary nature of drugs, there are situations where they blur the lines. They aren’t always good or bad. When it comes to ketamine, it can fit both. Mental health issues are rising, and expanding the toolbox to address them gives people more opportunities to shed their symptoms.

What Is Ketamine?

So what even is ketamine? It is a drug that has historically been used for pain relief and has psychedelic properties. Hence the bad reputation for misuse in non-medical settings.

Ketamine can create a hypnotic state, decrease pain sensitivity, and potentially elicit a dissociative trance-like state. It can be administered intravenously, as a lozenge, a nasal spray, or through a series of injections.

Beginning a Ketamine-Assisted Psychotherapy Session

The first session will be an evaluation and assessment with a professional. This entails psychoeducation on the process to familiarize you with what to expect. We will review your treatment plan and give you the chance to ask any questions you may have.

The goal is to be comfortable with the process before it begins. Your understanding of this experience is key to the process. Your provider will want to discuss coping strategies with you during the pre-work. If this is an area where you struggle, you and your provider can address it.

Identifying who is part of your support system is also crucial. This isn’t a solo journey, so having people in your corner is also a large help in the process.

Ketamine Sessions

To start your session, your provider will get you situated and check your blood pressure to ensure you’re in the desired range. If so, you'll be instructed to lay back and get comfortable. There may be comforting music, soft lighting, or even an eye mask option.

You will receive your ketamine lozenge (or method of administration) at your prescribed dose. Generally, it will take about ten minutes to kick in and take effect. Your provider will be present the entire time. If this occurs, they can help you with grounding or coping techniques.

Ketamine creates a trance-like state that guides you to focus inward. It helps you break down your "walls" so that you can process painful emotions that you protect yourself from. The dissociative journey will typically take an average of 45 minutes.

The typical time block for these sessions is three hours, allowing time before and after the peak of the ketamine's effect. Once the ketamine wears off, you may not feel prepared to get up and leave. Time for mindfulness and regrouping is provided before ending your session.

Integration Sessions

This part of the process is to help you integrate your ketamine journey with the rest of your day-to-day life. You went through a dissociative experience, so there may be after-effects on your thought processes. It is hard to be vulnerable.

Working with your provider, you can talk through any remaining loose ends of the experience for the day. There is no specific guideline, so it is a personal experience.

How does ketamine-assisted psychotherapy help?

1987 was a big year for depression treatment with the approval of Prozac. Almost 36 years later, depression has grown to be the leading cause of disability across the world. While medication as a therapeutic intervention has been extremely helpful for managing symptoms, it is often a bandage over a wound that still needs to heal.

A psychedelic wave may be the next big revolution in mental health treatment. Ketamine comes with a reputation of its own but has proven to have positive impacts when used in clinics and medical settings.

Understanding Ketamine

At this time, ketamine is the only psychedelic able to be used legally in the clinic. In conjunction with talk therapy, it has had positive results in treating depression, PTSD, and anxiety. Ketamine itself works differently than an SSRI (anti-depressant) would. SSRIs require gradual accumulation in your system and consistent use to achieve their full effectiveness. With ketamine, however, it hits your system immediately. The medication targets neurotransmitters in your brain and can provide instant relief. It also creates new learning opportunities by altering glutamine mechanisms. With this medication, there are no long-term side effects or addiction risks. Administering it in a controlled environment ensures the safety of the entire process.

The Effect on the Brain

During ketamine-assisted psychotherapy treatment, there are two states that you can enter. A lower dosage offers a trance-like state, while a higher dosage allows you to enter a transformative state. With both, you enter the state rapidly, and the work you do while on ketamine can be integrated into your daily life long after the effect wears off.

The trance-like state is brought on by a lower dosage of ketamine, typically in lozenge form. While in this state, you can access parts of your subconscious mind with less fear and hesitation. With some caution, you can challenge your way of thinking. Coming out of the trance-like state, you should feel like a new person with improved awareness about yourself and your healing. But, most importantly, you should feel some relief.

In the transformative state, it is brought on by a higher dosage, usually through intramuscular injection. During this time, you can feel a full-body experience. It hits your senses a little more strongly and allows you to reduce your ego.

The Experience

The brain is a tricky thing to overcome on your own. Dealing with painful or negative emotions is hard. Once you receive your dosage with a therapist guiding the session, you will quickly feel some dissociative effects.

It forces your walls to come down and gives you a clearer path to tackle your emotions. It strips you of your innate human instinct to constantly defend. Dealing with previously repressed or avoided things is now much easier.

After you finish your round of treatment, you will continue to discuss what came up during that time. The work doesn’t end when the medication does. Continued processing is required to work through the challenges uncovered or cut open.

Is it for you?

Despite not being a novel drug, researchers are revisiting it to address new concerns and conducting further research. Studies have shown effectiveness with depression and trauma, but also with alcohol and substance dependence and pain management.

If you have been struggling with depression with little (or less than desired) success through other methods, you may want to explore ketamine-assisted psychotherapy. It has its pros and cons, just like anything else, but it can give you a much-needed open door into your mind to better approach healing.

Ketamine-assisted psychotherapy is a vulnerable and personal experience. If you think this may be a good approach for you, schedule a consultation today for in person or online therapy. We serve the Boulder, Longmont and Denver area.

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