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Ketamine assisted therapy: Frequently asked questions

What is ketamine?

Ketamine is a unique medication, originally developed as an anesthetic, but found at low doses to have rapid antidepressant, anti-anxiety, and trauma-lytic properties. Using specific protocols of administration within a therapeutic set and setting, ketamine can bring about profound and almost immediate relief of previously treatment resistant depression.  Ketamine works on the glutamate pathway, a different neurotransmitter pathway than all previous antidepressants. It allows the mind to become transiently more open to new possibilities. Ketamine has also been shown to enhance neuroplasticity- to actually promote regrowth of neurons in the brain. This healing process transiently enhances mental flexibility and allows one to connect with the most authentic parts of themselves. The dosages used for inner work are considerably lower than anesthetic doses. 

What are the risks and contraindications?

Contraindications to ketamine work include the following: uncontrolled high blood pressure, some pre-existing heart conditions, pregnancy, unstable mood disorders or history of psychosis or schizophrenia, severe obstructive sleep apnea, obesity (over 300 lbs), history of chronic bladder cystis, active substance abuse. 

Ketamine is safe to use in combination with most medications, including antidepressants, because it 

is working on a different pathway (glutamate rather than serotonin).

The risks to be aware of, that have been seen with prolonged, heavy and frequent use over months to years is that it can lead to habitual usage, and there is also an association with bladder damage. 

How do I prepare for my first ketamine session?

Ideally you want to come into your experience as “clean” of body and mind as possible. Minimize or avoid altogether: stimulants like caffeine, depressants like alcohol, tobacco and cannibis, and watching TV shows and movies with excessive amounts of violence. Do: focus on making healthy dietary choices like fresh fruits and vegetables, drinking lots of water, meditating, journaling, walking in nature, and doing your best to get 8 hours of quality sleep per night.

What is a session like?

You will be encouraged to recline comfortably in a semi-upright position in a chair or on a couch. You will need eyeshades and a set of headphones connected to a music source. (Ambient music is also ok, but people often find they have a deeper inner journey with headphones.) Your BP will be taken, and if it is OK and when you are ready, you will take your prescribed losenge dose and place it under your tongue to dissolve. You will begin to feel relaxed within about 10 minutes. It will reach peak effect in about 20 minutes. People tend to describe the experience as entering a euphoric, dreamlike state of relaxation, warmth, and release of anxiety. You will gradually emerge to soft but clear consciousness within 60-90 minutes. 


Should I set an intention for my first session? If so, what do you recommend?

Keep it simple... self love, acceptance, or letting go are great places to start.

Do people ever have bad trips on ketamine?

One may encounter troubling content during any psychedelic journey. This is one of the reasons for maintaining a great respect of these powerful substances, and a reason why creation of a safe container for these experiences is important. Almost universally however, people who do experience difficult journeys report retrospectively that they are grateful for the insights they received, and do not regret their experience. In part this may be related to the characteristic of psychedelics to promote a feeling of emotional warmth and compassion for self and others. Journeys into difficult terrain may allow for profound release of shame, guilt, or other issues. 


What is integration, and why is it important?

Integration refers to the process of creating a new personal wholeness in relation to an experience. In the case of ketamine journeying, this involves looking at what came up during the journey, and reflecting on what might it mean. The next step is contemplating how one might manifest or bring these insights into one’s life to bring it more into alignment with one’s true nature. In addition to processing insights with your therapist, journalling and painting are especially good tools for this.


How do I get the most benefit from a ketamine series?

The most important aspect of optimizing the benefit of ketamine work is engaging the support of a skillful therapist. If you have a history of childhood or other trauma, ideally your therapist is specifically trained in psychedelic therapy integration work and trauma informed as well. Internal Family Systems (IFS) is a form of therapy that is particularly compatible with psychedelic therapy work. It is non-pathologizing and designed to promote recognition and peace making with parts of oneself that may be in conflict or may have experienced trauma, and connection with one’s inner core self. According to IFS, the core self is characterized by the 8 C’s of confidence, calmness, creativity, clarity, curiosity, courage, compassion, and connectedness. Rediscovery of the authentic, core self, beneath one's lifetime or even multigenerational accumulation of wounds and self constructed beliefs, is what recovery and healing from trauma is all about. In the words of Pia Mellody, the ability to live life from one's core centered self is a "supreme psychological blessing. "

There is another angle to optimizing the benefits of ketamine altogether, and this relates to the neuroplastic effects of ketamine. Because of this transient effect, the days following your sessions are an ideal time to both embrace new healthy habits (like starting a meditation, yoga, or qi gong practice, eating a more healthy diet, adding any kind of exercise, and reaching out for social support), and letting go of unhealthy habits.


If it helps, how long can I continue to take ketamine?

Ketamine is best used transitionally to support working through difficult issues in therapy, like PTSD, depression and anxiety. More than one intensive series, with periodic booster doses thereafter is seldom necessary or indicated, except in cases of severe major depression. The goal of ketamine work assisted therapy is to let go and break free from old beliefs and patterns that are associated with chronic anxiety and depression. 

Is ketamine helpful for end of life transition and support?

The end of life can be an opportunity to process one's life, deepen connections to loved ones, and to find peace. Ketamine can be extremely helpful in connecting with warmth and compassion, letting go of fears, relieving anxiety and in relief of pain as one approaches the end of life. 

What does it cost to work with you?

Provided you are currently working with a therapist, I offer a package which I feel provides a balance of holistic support, safety and cost effectiveness. Please contact me for details.

During your comprehensive intake we will look at your whole health picture, including your lifestyle practices, what personal work and medications you may have explored before, and issues that may be holding you back. You will be provided with personalized recommendations relevant to your healing path on the basis of your health history. This is far beyond what you are going to get from most other ketamine providers, who are generally screening just to rule out contraindications to ketamine.

    Reach out for a free 20 minute consultation.



Recommended reading:

How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, by Michael Pollan, 2018. Also an excellent series on Netflix. 

Complex PTSD: From Surviving to Thriving, by Pete Walker, 2013. A thorough guide to understanding and recovering from childhood trauma by a therapist who has walked this path himself. 

You Are the One You've Been Waiting For: Applying Internal Family Systems to Intimate Relationships

by Dick Schwartz, 2023.

No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model

by Dick Schwartz, 2021.

Waking the Tiger, by Peter Levine, 2016.  Levine elucidates methods to connect with our inner, wild animal nature to release traumatic experiences that can become entrapped in our body. He developed the Somatic Experiencing method of therapy. 

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Bessel Van her Kolk, 


Reveal: Embody the True Self Beyond Trauma and Conditioning, by Harmony Kwiker. Extremely vulnerable relational and personal growth autobiography, by Gestalt therapist and faculty at Naropa.

Align: Living and Loving from the True Self, by Harmony Kwiker. A deeper and rich guidebook for energetic healing within, and in relationships. 

The Intimacy Factor: The Ground Rules for Overcoming the Obstacles to Truth, Respect, and Lasting Love. by Pia Melody, 2004. Provides the most lucid and nuanced overview of boundary creation (including too rigid, too porous, and healthy) as well as shedding light on the childhood origins of dysfunctional boundaries, I have yet to encounter.

Trauma and Recovery, by Judith Herman, 2022. Judith Herman is credited with proposing the concept of complex PTSD, and her framework of recovery describes three phases: security, remembering and grieving, and reconnecting.

The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, by Gabor Mate, 2022.

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