Interested in learning about ketamine and ketamine-assisted psychotherapy?
Below, you'll find many answers to your questions about what ketamine is, what it feels like, how it can help you, the process ofthe sessions and the costs.
What is Ketamine?
Ketamine is a legal, safe, and effective medicine used to treat a variety of mental health conditions, including depression, anxiety, and PTSD. Ketamine has a long history of safe use as ananesthetic in a medical setting, due to its lack of respiratory suppressing effects. Ongoing research shows ketamine produces rapidly acting antidepressant and mood-enhancing effects, which can beginto take effect within 1-2 hrs. after treatment. It works by blocking the brain’s NMDA receptors as well as by stimulating AMPA receptors, which are thought to help form new synaptic connections andboost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for more sustained symptom improvement.Ketaminecan be administered in a variety of ways, including IV infusion, intramuscular (IM) injection, via nasal spray and using sublingual/oral lozenges - sometimes referred to as troches. For yoursessions, we will use sublingual/oral lozenges, prescribed to you by a psychiatrist or MD.
How does ketamine feel?
The effects of ketamine, which most patients find pleasant, last for approximately 45 to 90 minutes. These effects can facilitate shifts in perception that can often feel expansive innature.Ketamine often softens defenses, allowing for gentle,deeper access to traumas and subconscious material in need of healing. People report a variety of insights and experiences, such as feeling outside of the self, seeing things from a differentperspective, or feeling a sense of oneness--what would be termed a “mystical” or spiritual experience. We are trusting the medicine and your inner healing wisdom to bring up what you need in themoment - what needs to arise will arise.
Ketamine’s antidepressant effects are cumulative, so you may find that you achieve the most benefits with 4-8 session
Why use ketamine lozenges in the context of therapy, instead of going to an IM or IV clinic?
Taking ketamine in a therapy session makes sense because the material and insights that emerge may be related to relationships, spirituality, traumatic memories, symptoms of anxiety, depression andptsd. Your therapist can help you understand, integrate and process that information during and after your ketamine journey. KAP sessions are typically far less expensive than IM or IV treatments,and so are more accessible. And although IM and IV treatments can be beneficial for alleviating symptoms, these treatments often do not include the emotionally supportive environment of a therapyoffice, or the ability to process a sometimes intense or confusing experience safely, with a psychotherapist.
Who Should not Take Ketamine? Peoplewith:
- Untreated high bloodpressure
- Untreatedhyperthyroidism
- Epilepsy or seizuredisorder
- Heart disease
- Addiction to ketamine
- Untreated mania
- Schizophrenia, psychosis
- Active suicidality
Common Experiences During a Ketamine Treatment Session:
Dissociation:A sense of detachment from one’s body, emotions, or surroundings. Some people may experience a feeling of floating, or an altered perception of time and space.
Altered perceptions:Colors may appear more vibrant or muted, sounds may be amplified or muffled, and physical sensations may feel more intense or muted.
Visual and auditory hallucinations:Ketamine can cause vivid and sometimes intense hallucinations, such as seeing geometric patterns, or hearing messages.
Emotional experiences:Ketamine can evoke a range of emotions, including euphoria, tranquility, compassion, sadness, fear and grief. Some people may feel like they have gained a new perspective on their emotions orexperiences, or they may experience a sense of connection with others or the universe. You may also feel confused or intrigued by some of your experiences, which is where the importance ofintegration comes in.
The Roadmap of Your Ketamine-Assisted Psychotherapy (KAP) Sessions:
I partner with an organization called Journey Clinical (JC), who provides medical support and the ketamine lozenge prescription, while I take on the therapy piece of your treatment. You also have theoption to ask your own psychiatrist to prescribe ketamine lozenges for your KAP sessions.
After you have been approved for a ketamine prescription through JC or your own psychiatrist and complete a psychotherapy intake with me (if you are a new client), at least 2-3 preparation sessionsare held before your 3-hour ketamine session. In these sessions we will discuss your hopes, fears, and expectations for your ketamine session. We will also discuss set and setting for yourexperience, talk about your intentions, develop affirmations, discuss challenging emotions, build grounding and calming skills, and plan for integration.
During the ketamine session itself, you will take your own vitals with my blood pressure cuff so we can make sure your blood pressure is within a normal range. You’ll settle into my reclining couchwith a cozy blanket as we talk about your goals and intentions, and you will then take the ketamine lozenge, swishing it in your mouth for 10-12 minutes without swallowing your saliva. The taste isbitter and your mouth will feel numb, and during this time I'll play soothing music for you, read you your favorite poetry, lead you through a relaxing guided meditation, and remind you of youraffirmations and intentions. You may notice that the effects of the ketamine come on quickly, with a sensation of light-headedness or dizziness.
After the swishing, you’ll spit out the ketamine and relax on the couch with eye shades on, listening to carefully chosen music as you sink into the experience. Many people are silent during theirjourney, while some people choose to talk about what they are experiencing--both are completely fine! While you are on your journey, my role is to hold space for you, providing an emotionallysupportive presence as I sit in silence with you and/or listen to you.
Once the effects of ketamine subside, we’ll spend the remainder of our appointment giving you space to integrate, process, and discuss your experience. The integration portion of the session isimportant because it gives us a chance to pull together the insights and themes of your experience and talk about how you can use them in your daily life. Together we will work to understand yourexperience on a deep level so that you can continue to work towards developing healthier habits and beliefs about yourself and others.
After your session, you may be hungry and thirsty, and I’ll have some snacks and water/tea/hot cocoa for you. By the end of the session, you should feel back to your usual self, though you may feelsomewhat spacey and tired. For these reasons, it’s important to have a trusted person pick you up to bring you home, and you shouldn’t drive for at least 6 hours after ingesting the ketamine. We willhave a chance for further processing in your next integration/ketamine preparation session.
What’s the Cost of KAP?
I charge a low, flat rate of 150.00/hour, so the 2.5-3 hr. KAP sessions are typically 375.00-450.00, while the 1 hr. intake, preparation and integration sessions are typically 150.00 (or less, ifyou'd like to use your insurance).
You’ll also need to pay the co-pay or out-of-pocket fee for your psychiatrist, as well as the fee for the ketamine itself.
Can I use my Insurance?
You may be able to use your insurance to partially cover your dosing session and your intake, preparation and integration sessions. Besureto ask if I can accept your insurance.
How many sessions should I have?
Since ketamine has a cumulative effect, it’s recommended (though not required) that you have a total of around 4-8 sessions for maximum benefit. Your psychiatrist will help you determine how to spaceyour sessions and which dosage will be best for you. If you are a new client without another therapist, we'll meet for at least 3, 55-min. sessions before your ketamine session (for intake, rapportbuilding, preparation, psycho-education and resourcing). If you'd like to see me in addition to your regular therapist, we can meet for 2 sessions before your ketamine session. I ask that you committo at least 3 ketamine sessions, however you are always free to stop at any time.
So to summarize, the process might look something like this:
1. In-person or virtual free consultation with me to chat about your goals and make sure I'm a good fit for you.
2. Intake session with me. I'll refer you to psychiatrist if you don't already have one.
3. Virtual or in-person intake session with psychiatrist, ketamine prescription sent to you or you pick it up.
4. Preparation sessions with me (2 or 3).
5. Ketamine session with me.
6. Integration session/prep for next katamine session.
7. Ketamine session.
8. Integration session/prep for next ketamine session.
9. Etc.
Contact me for a complementary, in-person or virtual consultation to determine if KAP may be a good fit for you at m.young@creativejourneyscounseling.com.
