Ketamine is a potent medicine which can induce profound states of consciousness that can be deeply mystical, intellectually stimulating, and psychologically deep.

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 rapidly-acting antidepressant and mood-enhancing effects, which can begin to take effect within 1-2 hrs. after treatment and last for up to 2 weeks. 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 and boost neural circuits that regulate stress and mood. Ketamine has also been shown to enhance overall neuroplasticity for lasting symptom improvement.

What is ketamine-assisted psychotherapy?

Ketamine Assisted Psychotherapy (KAP) is a medicine assisted therapy that provides access to healing in a new and innovative way. Ketamine was approved by the FDA in 2019 for the treatment of treatment resistant depression and it is also used to treat a variety of other mental health conditions.

Ketamine can do incredible things to the brain. It is neuroprotective and allows the brain to create new pathways and receptors and it has been shown to be a rapid antidepressant, and can bring relief for pain.  There is also research showing that ketamine opens a window of increased neuroplasticity which can aid in behavioral change when used in combination with psychotherapy. 

In a psychedelic medicine framework, ketamine lifts a veil between our conscious mind and unconscious mind. The process of KAP guides you to be in touch with your own wisdsom and to trust your medicine experience to illuminate the path to healing.   Essentially, we are “making visible the soul” (the root meaning of psychedelic is “mind-manifesting” or “soul-revealing”) in order to best understand the way to work toward wholeness.  

At low doses, ketamine produces a hypnotic or dreamlike state. During normal waking life, we have barriers and defense mechanisms that serve to push away unpleasant or intolerable memories, emotions, and phobias—feelings that we repress and store in our unconscious, where we can’t readily access them. Ketamine can break down those barriers and open up a filter to the unconscious. At higher doses, ketamine can be dissociative and produce deep, meaningful transpersonal experiences. The rate at which someone can reach a breakthrough and come to terms with negative emotions is far quicker. Essentially, ketamine helps bring deep-rooted emotions to the surface, giving us a glimpse into the unconscious mind. Talk therapy will help us to examine and understand those emotions in a safe and supportive environment as well as highlight integration practices to create real and lasting change.

Ketamine therapy can be provided in different ways and in different settings. I work within a psychotherapeutic format in a peaceful home office setting, and utilize sublingual lozenges for medication delivery. I focus on the creation of an optimal set and setting through our intention setting work and the use of a ceremonial container for the medicine sessions.  

I provide KAP in my practice in partnership with an organization called Journey Clinical which has a specialized medical team that determines your eligibility for KAP, prescribes the ketamine, and supports us in monitoring outcomes. I will work to understand your particular healing needs, and focus on creating a relationship with you to create optimal healing conditions. I weave KAP into my regular psychotherapy practice as indicated. I also provide KAP as an adjunct service to clients with existing providers to help treat symptoms in a new way or move through therapeutic blockages. If you are interested in KAP, we will begin by having several regular psychotherapy sessions to get to know each other and understand your healing needs before we start working with ketamine.

“If the doors of perception were cleansed, everything would appear to man as it is, infinite”

— William Blake

FAQs

  • The effects of ketamine, which most people find pleasant, last 1-2 hours. These effects can make you feel “far from” your body, and facilitate shifts in perception that can often feel expansive in nature. Your motor and verbal abilities will be reduced, so you’ll be lying down in a comfortable position during the experience. Once these effects subsided, we’ll spend the remainder of our session giving you space to process and discuss your experience. While it may feel hard to articulate what happened during the experience, patients feel like the insights gained are none-the-less clear. Studies have shown that the benefits to mood and neurological growth can last up to two weeks after the ketamine experience.

  • 1. Initial medical consultation:

    You schedule an initial evaluation with a clinician from the Journey Clinical medical team via zoom. They will go over your medical and psychiatric history with you, provide education on the treatment and determine if you are eligible for KAP.

    If the medical team determines that you are eligible for KAP, they will develop a personalized ketamine prescription and outcome monitoring plan for you.

    The medical staff will write a ketamine prescription for you, and a small amount of oral ketamine will be sent to your home, enough for the first 2 KAP sessions. You will be taught to take your vitals and self-administer the ketamine lozenges by Journey Clinical’s medical team in advance of our KAP dosing session.

    2. Preparation sessions:

    Once you receive your ketamine lozenges, we will schedule time together for our KAP preparation, dosing and integration sessions. Preparation session(s) will be scheduled just like regular therapy sessions prior to the KAP dosing session. The goal of a preparation session(s) is to align on the process and set intentions for our KAP sessions together.

    3. KAP Dosing Session:

    A typical ketamine dosing session lasts 3 hours and will take place in-person at my office, or remotely via telehealth.

    During a dosing session, you will self-administer your ketamine lozenge. You will be in a comfortable, reclining position wearing an eye mask and listening to calming music. Although a KAP dosing session may be largely an internal experience, I will be present with you the entire time to hold space and provide support as needed.

    4. Integration Sessions:

    After our KAP dosing session, we will meet for multiple integration therapy sessions to review the memories, thoughts & insights that arose during your dosing session, and to prepare for the next dosing session.

    5. Follow-up medical consultations :

    After our first KAP session, Journey Clinical’s medical team schedules regular follow ups with you to monitor outcomes and prescribe ketamine lozenge refills, as appropriate. The frequency of follow ups depends on your unique treatment plan, at a minimum of once per quarter.

  • KAP can be used to treat anixety, PTSD, depression, bipolar disorder, substance abuse, eating disorders and others. People who are experiencing physical symptoms from chronic pain can potentially benefit from ketamine therapy because of the psychological component of this issue.

  • The ketamine dosing session is about 3 hours. You will lie down and take a prescribed dose of ketamine from Journey Clinical in the form of a lozenge that goes under the tongue; it takes around ten minutes to dissolve. At the end of those ten minutes, most people will experience a body-tingling sensation and overall relaxation. The environment in my home office is as conducive to that mental state as possible: you will be encouraged to use an eye mask, and I’ll have music playlist prepared. There is a significant amount of dissociation during the experience—feeling like you’re not present in your own body, as if it’s difficult to move. It’s akin to being in a trance state, where you may access some old memories and things will just come to mind, especially if the music correlates to some of the emotions you might be feeling while you explore your unconscious state of mind.

    The deep inner experience lasts 1-2 hours. Following that we will discuss what came up for about a half hour or so.

    Then there is the integration work. After the initial ketamine experience, we’ll meet weekly and talk about the experience—what emotions arose, what those may mean to you, what you saw, and how you felt after the experience. We explore what was seen and felt in a way that allows for personal discovery you wouldn’t otherwise get in therapy that doesn’t incorporate ketamine.

  • KAP is an “out-of-pocket” treatment and is not covered by insurance in my practice. I recommend researching other ketamine offerings to understand time and financial investment as it can differ across treatment modalities. My modality includes a psychotherapeutic component in addition to the medication delivery, which is reflected in both cost and time investment.

    Although the medical intake and medical follow-ups must be paid out of pocket, they may be eligible for out-of-network reimbursement through your insurance if you have out of network benefits. I recommend contacting your insurance company so you can be informed prior to beginning treatment. Please reach out to me direcly to discuss more about how KAP works and cost involved.

I deliver KAP in my practice in partnership with an organization called Journey Clinical which has a specialized medical team that determines your eligibility for KAP, prescribes the ketamine, and supports us in monitoring outcomes. If you would like to explore the possibility of working with me for KAP, please e-mail me at erin.vahratian@gmail.com to discuss eligibility and next steps.


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