Ketamine is a Dissociative Anesthetic Medicine that has been used for medical purposes since the 1970's when it was approved by the FDA. Around the 2000s, medical professionals began noticing and studying Ketamine's ability to rapidly alleviate depression, anxiety, and suicidal thoughts/ideations. During 2000-2007, Ketamine studies started which ultimately showed Ketamine was effective in treating "treatment-resistant" patients and between 60-90% effective when other treatments did not work. This led to the rise of doctors going off-label and using Ketamine to treat depression, anxiety, trauma, and other mental health disorders. In addition, Ketamine has benefits in reducing chronic pain symptoms and conditions. Ketamine clinics began to open and the importance of Ketamine-Assisted Therapy was established.
According to the American Psychiatric Association, Ketamine works differently than other anti-depressants and can often be more effective than traditional SSRIs. After several clinical trials, Ketamine has been shown to produce new connections that can pave healthier pathways for healing and growth to occur. Chronic Stress and depression weaken and decrease brain neural connections over time. Ketamine works directly to restore these connections by binding NMDA receptors and releasing a surge of glutamate. This in turn releases growth factors, like BDNF (brain-derived neurotrophic factor), which help make new synaptic connections and pave healthier connections and patterns in the brain.
Ketamine-Assisted Therapy combines the power of Holistic Psychotherapy and Ketamine Medicine using Intravenous (IV), Intramuscular (IM), Intranasal or Sublingual routes of administration. You will begin your KAP journey working with a Certified KAP Practitioner in Preparation Sessions where you will learn about the medicine, what to expect, intention setting, and processing your treatment goals. Once your preparation sessions are completed you will then have your Ketamine session (s), with your therapist, who will sit with you during your ENTIRE session. Your therapist is there to hold space, support, and ensure the set/setting is safe and therapeutic. After your Ketamine session, you will then work with your therapist on integration and ways to integrate your new insights/awareness into your daily life. Working with a Trained and Certified KAP Therapist is vital to your healing and we believe necessary from a harm-reduction standpoint.
Set and Setting
Psychedelic experiences are influenced by what is called “set” and “setting”:
Set refers to the mindset of the person taking the substance. The set can be influenced by a person’s intention, their emotional state, and previous experiences with psychoactive substances.
Setting refers to the physical environment: the room, sounds, lighting, smells, other people, comfort, and safety. From a therapeutic perspective, establishing a safe physical setting and mindset for the participant requires that practitioners take an active role in creating an environment that is conducive to the therapeutic experience. This will allow the participant to fully attend to their internal process.
Create a Safe Space
The presence of a grounded, compassionate KAP therapist can go a long way in helping someone feel safe during a Ketamine experience. We approach with kindness and openness while creating an environment of acceptance and compassion. We inform the individual they are in a safe place if challenging material arises and that their experience is invited and welcome. In addition, we let individuals know that whatever is coming up for them, emotionally or mentally, is ok and we invite them to share their experiences if they would like, making no expectations.
Sitting, Not Guiding
Words can often confuse or get in the way. We use them sparingly unless the individual is desiring to engage in a dialogue about their process. Rather than analyze their experience, we listen with an open mind and heart. If there is a dialogue, we ask questions that help an individual deepen their experience. We listen from the heart and become curious about their reality allowing them to develop their own insights and conclusions. We may share perspectives on their experience, but we focus more on helping the participant come to their own insights through compassionate inquiry. We encouraged the individual to let go of their agenda and try not to get ahead of the process.
Through, Not Down
We help individuals turn TOWARD their experience rather than away from it by trusting in the process and their inner guide. We encouraged participants to lean in, get curious, and practice mantras such as, "the only way out is through." Trusting that whatever is showing up is something that the participant is being invited to learn about. We will never dismiss or invalidate someone’s perceived reality but rather we try to avoid rushing the experience, trying to fix the scenario, or finding a solution. Rather than providing answers or solutions, we encouraged individuals to remain in a place of not knowing, or a beginner's mind. If an individual is behaving in ways that are destructive, we set boundaries around the behavior while validating the emotions behind the behavior.
Difficult is Not Necessarily Bad
Difficult life experiences can be some of the most valuable learning opportunities. Strength, resilience, surrender, and deep wisdom are often forged in the fires lit in our darkest times. Trust that however challenging the situation may seem to be working with a trained KAP therapist, with a calm and grounded presence, will go a long way. If an individual starts to struggle, we will continue to remind them that their experience may be an opportunity to look at aspects of what needs to be healed. What we typically run from is what we need to work through and heal the most. We help support and guide this process. We encourage participants to invite the possibility that will emerge from the experience with new insights and understanding. Any difficult or powerful experience – whether involving an altered state or not – can be considered an opportunity for personal evolution. Not all encounters are easy, but trained KAP therapists can help individuals remain calm by reassuring them that their experience is an opportunity for growth. In this work, we honor and embrace all difficult experiences and "bad trips". After all, that's where the healing lies!
Yes, Ketamine is safe when used with Certified and Licensed practitioners in a therapeutic set and setting. Ketamine is a dissociative anesthetic medicine therefore it is important the patient is medically screened and works with a Certified Ketamine Provider at all times. However, when used as an illegal drug off the streets, Ketamine is not safe and can cause harm because of its disassociative qualities. The street names for Ketamine include Special K, Kit Kat, and Vitamin K, and it can be laced with other drugs such as amphetamine, fentanyl, or other opiates causing serious harm or death. We do not advocate for the illegal use of Ketamine or any other medicine.
"After having personally conducted over the last fifty years more than four thousand psychedelic sessions, I have developed great awe and respect for these compounds and their enormous potential, both positive and negative. They are powerful tools and, like any tool, they can be used skillfully, ineptly, or destructively. The result will be critically dependent on the set and setting.”
Non-ordinary states of consciousness, notably psychedelic, can be multidimensional, and psychospiritual in content. This complexity can be intimidating to our rational minds, thereby discouraging us from searching for the transcendental meaning of the contents. As the name implies, psychospiritual contents have “psychological” and/or “spiritual” relevance and offer the most life-promoting value. Psychospiritual contents emerging during psychedelic experience can have healing potential, and with proper integration, lead to major personal and spiritual transformations. I argue that these healing potentials are mainly due to their transcendental quality, and direct access to the numinous during the experience. In other words, it is not the psychedelic nor altered state that can be healing, but rather what they facilitate, which is a deeper connection to spiritual essence of an individual.
In contrast, we can find many practical insights in the psychospiritual contents of a psychedelic experience. This is mainly due to their personal and spiritual relevance. For example, one can relive a traumatic life event for healing or closure, connect to spirits of departed loved ones for reconciliation, or experience “ego death” to come to terms with thanatophobia (death anxiety). The term “ego death” (or ego loss) has different interpretations in psychology, mythology, and mysticism, but we can describe it as a transformation from ego consciousness, i.e., “who we think we are”, to a state of consciousness that transcends all personal and subjective identities. In mysticism, ego death is viewed as self-surrender which is necessary for spiritual growth and enlightenment.
Ultimately, the true value of psychospiritual contents is only unlocked when individuals experiencing them can relate to their psychological and spiritual contents at a deeply personal and intimate level. Focusing on one without the other rarely results in full integration or healing, especially if we underestimate the value of transcendental and spiritual contents. Psychospiritual content emerging in psychedelic experience usually has a spiritual essence in its core. This spiritual essence can present itself as a higher “Self”, in numinous symbolic images (e.g. Mother Earth, Heavenly Father, Buddha, Christ, Archangels, etc.). It can also emerge as a connection to formless energy (e.g. Pure Love, Pure Light, Godhead, Source, etc.). Honoring the connection to this spiritual essence is the key to unlock the healing and transformative potential of psychospiritual contents.
We can also observe the healing potentials of this spiritual essence in individuals who had deeply meaningful transcendental experience, e.g. Near Death Experience (NDE). These individuals tend to become highly spiritual afterward, and make significant adjustments to their belief systems, world view, and guiding principles in life. All such transformations originated from a single transcendental experience, and psychospiritual integration that followed it.
Improper use of psychedelics can diminish their known healing and transformative potentials and undermine their sacred and life-promoting history and place in the world, which has been honored through indigenous shamanism and ancient wisdom traditions. Lastly, as important as it is to honor one’s inner calling for transcendence and spiritual growth, so too is one’s psychological readiness and supervision of a shaman elder or an experienced practitioner in the process.
We offer preparation work before any psychedelic medicine journey to promote wellness and healing. Although MDMA, Psilocybin, Ibogaine, and other psychedelics are illegal in the U.S., we understand the importance of preparation work to decrease harm. We do not advocate for use of illegal substances, however, from a harm reduction viewpoint we believe an individual should be prepared for any non-ordinary states of consciousness.
We also offer integration after a psychedelic experience. Many times individuals can have a "bad trip" or see something scary, challenging, and negative in their experience. We help an individual process and integrate the information so they can see the positive message in their challenging experience. We understand how important integration is you your healing and growth! Again, we do not advocate for use of illegal substances but understand from a harm reduction viewpoint how important integration is after a psychedelic experience.
Psychedelic experiences are influenced by what is called “set” and “setting”: Set refers to the mindset of the person taking the substance. The set can be influenced by a person’s intention, their emotional state, and previous experiences with psychoactive substances. Setting refers to the physical environment: the room, sounds, lighting, smells, other people, comfort, and safety. From a therapeutic perspective, establishing a safe physical setting and mindset for the participant requires that practitioners take an active role in creating an environment that is conducive to the therapeutic experience. This will allow the participant to fully attend to their internal process.
If you are interested in starting a Ketamine-Assisted Therapy Practice or incorporating Ketamine-Assisted Therapy into your clinic, contact us today to see how we can help! We understand the importance of Preparation, Set, Setting, and Integration in using Ketamine for Therapeutic purposes. With over 20 years of experience, our knowledgeable therapists are trained and certified in Psychedelic-Assisted Therapy from the Integrative Psychiatry Institute (IPI) in collaboration with the Multidisciplinary Association for Psychedelic Studies (MAPS).