The psychedelic Ketamine is currently available for use in psychedelic assisted psychotherapy as an off-label use prescribed by medical practitioners. Yes, Ketamine, which people associate as a known horse tranquilizer, which it is, or Special K, a street drug, which it is, or what TV’s serial-killer Dexter used to incapacitate his victims, which in very high horse tranquilizer levels, it is. Medical folx know it to be a commonly used, exceedingly safe, anesthetic, with minimal side-effects, used in hospitals and clinics, with infants to the elderly, to aid in short surgical and medical procedures.

No. We aren’t in the 1960’s LSD “free your mind” revolution, or the 1980’s Ecstasy Rave universe. But we are in the third wave of US researchers focusing their attention on how we can use psychedelics in the context of psychotherapy to heal. The Federal Drug Administration (FDA), along with some of the most prestigious medical research institutions in the US, from John Hopkins Medical Center to Harvard University, have restarted the research of the ‘60’s and ‘80s exploring how psychedelics can help folx who struggle with Depression, Anxiety, Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, and even Addiction.

There are multiple psychedelics currently in late-stage trials with the Federal Drug Administration (FDA). MDMA, commonly referred to as ecstasy or molly, is slated for legal use with specially trained psychotherapist in 2023. Psilocybin, the psychedelic compound in mushrooms, will likely be ready for use with similarly trained psychotherapies by 2025. They each offer unique benefits in aiding with various psychological and emotional diagnosis and conundrums that bring folx into psychotherapy.

Many people eager to try psychedelics are hesitant to consider the currently legal option of Ketamine. While psilocybin and MDMA will offer great opportunities for healing, Ketamine is an equally exciting tool for use in psychotherapy. In fact, for some of us clinicians, myself included, it is the absolutely preferred psychedelic for psychedelic assisted psychotherapy. Ketamine offers its own unique features making it an excellent medicine to consider for use as a tool for psychotherapy.

Upsides to Ketamine

• It is currently legal and available for use in clinical settings, with the medicine itself reasonably priced, and accessible through a psychiatrist or medical provider.
• It has long been established as a particularly safe drug with minimal risks and side-effects.
• The molecule itself can help with mood disorders, much like standard anti-depressants and anti-anxieties, but operating of a different system (glutamate).
• The medicine facilitates neuroplasticity for days after each treatment, meaning it helps the mind to operate outside of our default mode functioning, creating novel opportunities for growth and change with our most entrenched thoughts and behaviors.
• The trip itself only lasts 40 to 60 minutes, which makes it ideal for first time psychedelic users, allows the trip to be focused on a handful of thoughts/feelings/experiences, making it easier to harness/capture them for processing, and also lends itself well to having a therapist present during the experience.

3 Distinct Vehicles for Transformation 

Ketamine is an exciting new application of medication for mental health and mood disorders. It provides 3 distinct vehicles for possible transformation, each uniquely potent in its own right. These can work separately and in tandem with each other.

The Molecule/Medicine

When administered 2 times a week, for 4 to 6 weeks, followed by maybe once every month to 3 months, it can help manage depression and anxiety symptoms in people who have chronic mood disorders that have never been significantly alleviated by any of the standard anti-depressants or anti-anxiety medication. While it is suspected that it will prove to be quite significant for managing mood disorders in lots of folks, the current FDA trials are specific to treatment resistant depressions. This benefit can be accessed even if the medication is taken at a low dosage that does not induce a psychedelic state.

The Trip

Another way ketamine can be helpful with a range of issues is making use of the trip itself to do pieces of therapy work. It allows for a lucid contact with unconscious materiel. If you have themes you are working on, places you feel you are stuck or confused, questions you have for your unconscious, you can prepare yourself for medicine sessions, try to give yourself some internal focus, and then do journaling and therapy integration work to unpack the material in the trip to move your issues forward. During the trip, you have novel neural pathways providing you with new, original thoughts not burdened by your default mode processing of material. To make good use of this component it is best practice to be in a active therapy process or some other super-focused activity where you work to prepare for the medicine session(s) before hand and to integrate the material you encounter after the session(s).

Some people have what they describe as mystical/spiritual experiences that give them a radically different perspective on themselves, others, and life itself. Many of us have very narrow world/self/other views that do much to dictate of experience. Psychedelic experiences can often open a totally new understanding.

Neuroplasticity

The third way ketamine can be helpful is that in the days following a session your mind has serious neuroplasticity. What this means is it is easier for new synaptic connections to be established, and less likely that your thoughts/feelings/behaviors will be forced into the same well-worn groves in your mind that have you stuck in repetition. During the days following treatments it is important to do lots of journaling, therapy, art, conversations with friends, meditation, walks in the woods, and any new behaviors/thoughts/patterns you hope to establish.

Next Steps

If you are interested in Ketemine Assisted Psychotherapy (KAP), make sure to look for a therapist who has specific training in supporting clients with psychedelic experiences. Feel free to contact us at Full Living. If you are in Pennsylvania, we can provide you with services, and otherwise, are happy to help you find a practitioner in your area.

Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the  Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on needs and issues as well as personality and style.All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing. Request an Appointment Today.

If you were interested in this blog post, check out some of these:

Psychedlic Psychotherapy: A Novel Tool for Our Stuck Places (a video blog)

Psychotherapists are like Dance Archeologists

Attending to the Unconscious in a Psychotherapy Session

Myths about Psychotherapy (a video blog)

Author Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.