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In the current psychedelic renaissance, I hears lots of excitement about the not yet-legal-for-use psilocybin, the psychedelic component of mushrooms.  Currently under FDA trials, mushrooms will likely be legal for use by specially trained psychotherapists as early as 2025. While this is fabulously exciting, there is already another psychedelic legal and safe for use that is additionally a far superior medicine for psychic work, in my not particularly humble opinion.

My informed opinion is based on my work as a psychedelic assisted psychotherapist. I have been an analytically oriented psychotherapist for over 30 years, informed by Freudian, Object Relations and Relational Theory. Two years ago I decided to pursue learning how to use the tool of psychedelic medicines to help clients who felt stuck in their work.

I assumed the medicines I would want to work with were ones I had tried in my early 20’s, including LSD, mushrooms and MDMA (commonly referred to as ecstasy). All had provided experiences of revelation, that helped shape my understanding of myself, my world, and my relationships as profoundly impacted by the flexibility of my perception.

A few months into my training I decided to give ketamine a try, given primarily its legal status and medical safety. There were other of its features which also intrigued me, and seemed particularly well suited for use in a psychotherapy model. Now, I am an absolute believer.

Besides being a delightful psychedelic experience, complete with visuals, audio, and somatic element, and the expansive experiences of flying/floating/traveling/journeying, it has multiple features that make it ideal for focused psychic work.

Length of Medicine Session

  • The ketamine medicine session, or trip, only lasts about 40 to 60 minutes.
      • The shortness of this experience allows for a very focused intention for each session, as opposed to some psychedelics, which last hours and therefore usually cover a lot of internal territory.
      • The brevity of the medicine session makes it financially reasonable to have a therapist present during the session itself.

Controlled Dosing

  • There are multiple versions of a medicine experience a client can use to do their psychotherapy work.
      • The medicine itself, at a low dose, at a twice a week protocol over 4 to 6 weeks, provides an antidepressant effect that last months, in 2/3rds of people with treatment resistant depression, with booster sessions once every 1 to 3 months.
      • At a slightly higher dose, clients have a psychelytic effect, which produces psyche flexibility, allowing clients to have a talk therapy session free of default mode processing, easier access to associative and unconscious material, allowing them to discuss old topics with new impressions.
      • At a medium dose, clients can have a psychedelic experience. This can provide them with new material, symbolic exploration, about their most stuck places, and embodied experiences of some of their truths. It is an opportunity for new perspectives.
      • At high doses, many clients have experiences of mystical revelation and ego dissolution. While hardly a place to start, for some clients, these experiences will be some of the most meaningful of their lives.

Dissociative Anesthetic

  • Ketamine is used as a dissociative anesthetic for surgeries and outpatient procedures. But that does little to describe the ways this psychedelic offers such a unique experience.
      • One of the anesthetic effects of the medicine is that is muffles external sensory input. Sounds in the space around the person on the journey are muted. The sounds may weave their way into their unconscious, and if desired, they can tune into them, but they can also easily tune them out. This allows clients a uniquely integral focus perfect for work on ourselves.
      • The dissociative experience plays out like having two selves during the medicine session…the tripper and an observing ego. One is having a wild experience, while the other is quite self-aware, and able to offer direction, reassurance, and containment to the tripping self.
      • While ketamine offers the mental mind bend characteristics of classic psychedelics, it does so in an affective, emotionally rich environment. During the medicine session clients are not just having interesting thoughts, but are having them in an embodied learning experience.


I did not add the tool of psychedelics assisted psychotherapy to my work because of my love of psychedelics. It is my love of the work of therapy. I have changed my own life, over and over again, with the tool of therapy, and have walked the journey with countless clients and they set out to craft a better life for themselves. Psychedelics is a psychic change lubricant that can aid clients in accessing a safe world for exploration, new symbolic material as clues, and the flexibility of mind to explore their predicaments with new eyes.

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:

Ketamine for Psychotherapy? Yes!

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.

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