Ketamine Assisted Psychotherapy
KAP is a cutting edge treatment for trauma and depression. Clients take prescribed ketamine at the beginning of our psychotherapy session, and I facilitate the client’s journey into themselves, helping them stay with and explore their experience.
One of the exciting aspects of ketamine, as is true of most psychedelic medicines is how it can disrupt the Default Mode Network of the brain. The Default Mode Network (DMN) is the background standard operating stance of our brains and it dictates much of how we perceive ourselves and the world. Each of ours is different and they occur on a spectrum from highly rigid to very loose. According to the work of Robin Carhart Harris people with clinical depression, anxiety, and trauma all have DMN’s that run on the rigid end of the spectrum. Ketamine and other psychedelic medicines are useful tools in helping create more flexible and fluid DMN’s. As this is paired with psychotherapy it offers the chance to build our new neural connections and stabilize that flexibility.
However, new neural connections are very weak and must be developed by repeated access. As renowned psychiatrist Daniel Siegel says, “neurons that fire together wire together.” Most new neural connections fail to replace a deeply entrenched pattern of thinking or behaving— simply because the entrenched pattern is more like a neural superhighway, compared to a new connection’s footpath. By doing repeated sessions over a period of months, we give your brain and nervous system the absolute best chance to integrate, sustain, and build upon those new insights to make deep, fundamental shifts in your being toward health.
Clients participate in repeated sessions over a period of a few months. The new connections, realizations, and ways of being clients uncover in their lives have a chance to stabilize and develop into more permanent changes, instead of temporary insights or shifts in their DMN. The healing of trauma and attachment wounds, mixed with the power of new insights as experienced on ketamine, creates a powerful container for healing and transformation.
In my experience, KAP is useful in helping people assess core material that can be difficult to contact otherwise. It creates a window of time where clients can assess, experience, and relate to their character structure and issues, from outside their deeply conditioned and personalized ways of doing so. And it is a sensitive window in which to begin rewiring attachment and bonding patterns.
In traditional talk therapy, you might get a few minutes of deep access to the inner workings of your being or personality in each session, if you’re lucky. In KAP you get a much longer window of time. For many, a KAP series can address issues in 3-4 months that can otherwise take years to address.
How I Differ From Traditional Ketamine Therapy
Originally intended as a surgical tranquilizer at very high doses, ketamine has lately been gaining traction as a treatment for depression. It is often administered in a clinic setting where clients are hooked up to an IV drip and left in a dark room for the duration of their treatment. According to a growing body of research, many get relief from their depression symptoms for a period of time, be it a week, two weeks, a month, or longer. And then the symptoms of depression return. Basically this allows people to trade in their antidepressant dependence for a ketamine dependence. Treatment of this quality does not interest me.
However, when ketamine is paired with psychotherapy, clients are able to access very deep psychological material and are guided through it in a way that allows people to heal and rework the underlying issues that are creating their depression in the first place. This kind of treatment can produce a very different outcome than simply eliminating the symptoms for a period of time. It has the potential to heal the depression, creating what is known as a durable remission.
How it Works
While the rate of metabolization is different for everyone, often the period of active influence of the ketamine is roughly 60-120 minutes. Some people are ready to be done after a 2 hour session, for others a 3 hour session is more supportive, as it allows more time for integration immediately following the experience.
Often in cases of severe depression, clients will come in two times per week for the first few weeks, and then go down to once a week or every other week, with integration sessions mixed in. After people complete a full series of KAP they stay on for further integration with weekly hour long sessions of psychotherapy. Some decide after KAP that they are ready to stop for a period of time and may decide to come back for an integration session every once in a while. In short, how you move through treatment is both personal and tailored to your needs.
Eligibility for KAP will ultimately be decided by the psychiatric nurse practitioner who I collaborate with. At no point do I prescribe, handle, or administer the ketamine. The correct dosing and mitigating health concerns are all issues you can discuss with her.