“There is a wealth of information built into us … tucked away in the genetic material in every one of our cells … without some means of access, there is no way even to begin to guess at the extent and quality of what is there. Psychedelics allow exploration of this interior world and insights into its nature.”
Alexander "Sasha" Shulgin
What is Ketamine?
Ketamine is a psychoactive drug classified as a dissociative anesthetic. It has been used in the United States as an especially safe anesthetic in medical settings since 1970. It has been used off-label in sub-anesthetic doses to treat chronic pain, treatment-resistant depression, and other mental health issues for over 20 years.
For people suffering from treatment-resistant depression or suicidal ideation, ketamine can oftentimes provide immediate relief. While the antidepressant effects tend to be temporary, multiple treatments, especially those in conjunction with psychotherapy, have proven to successfully reduce symptoms in individuals with depression and other disorders.
Another characteristic of ketamine is that it creates novel states of mind which facilitate psychotherapy in general. Ketamine at low doses creates enhanced awareness of underlying psychodynamics, habitual mental states, and unconscious coping strategies. Familiarity with ketamine states can teach resilience, openness, and equanimity.
What is Ketamine-Assisted Psychotherapy (KAP)?
Ketamine-assisted psychotherapy (KAP) uses low and moderate-dose ketamine to enhance and deepen psychotherapy. While ketamine alone can often have an immediate antidepressant effect, the literature suggests that ketamine is most effective when paired with psychotherapy. Change is best facilitated within a structured, supportive psychotherapeutic environment with trained and skilled clinicians who are focused on assisting clients with their issues, hopes, desires, and struggles (set, setting, and integration).
Is KAP right for you?
Ketamine is used off-label to address a variety of mental health disorders, including depression, chronic pain, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, and addiction.
Some medical and psychiatric conditions need to be treated before you can safely work with ketamine. These conditions include hallucinations, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease.
We strongly encourage our KAP clients to be in ongoing psychotherapy in conjunction with and after their KAP treatment. We will further discuss this in the intake process and make appropriate referrals to local resources as needed.
Ketamine as a Psychedelic Medicine
In moderate doses, ketamine has psychedelic effects, which have been shown to facilitate profound transpersonal experiences. A ketamine medicine session creates a non-ordinary state of consciousness and may facilitate transpersonal or mystical experiences. These kinds of experiences often expand one’s sense of self and shift one’s understanding of existence. Ketamine may also enable individuals to access their own inner healing intelligence in a manner that is valuable.
Our Temenos clinicians assist clients in processing the experience and its impact.
We encourage you to explore additional information about ketamine. We offer some useful resources here.
What to Expect in KAP Treatment
Your inquiry begins with a 30-minute phone consultation in which we discuss your symptoms to begin assessing whether ketamine-assisted psychotherapy might be of benefit to you.
If it seems likely that KAP could benefit you and you are interested in proceeding, you can fill out our preliminary forms, and schedule a Medical/Psychosocial Assessment session with one of our psychotherapists and our physician. Oftentimes clients desire a more in-depth discussion with a therapist to determine whether ketamine is likely to be helpful for them. These sessions can be scheduled with a Temenos psychotherapist or physician for a fee.
During the Medical/Psychosocial Assessment Session, clients meet with one of our psychotherapists and our physician. We will review your medical and psychosocial history, further discuss the use of KAP, answer any questions you have, and prepare you for your first medicine session. Our physician will also provide you with a prescription for the sublingual ketamine lozenges which you will bring with you to your first Medicine Session.
We may suggest additional preparatory sessions prior to your first Medicine Session, depending on what arises in the Assessment Session.
Initial Medicine Sessions last 3 hours. A psychotherapist will be with you during the entire session, and our physician oversees each session. Sublingual lozenges will typically be utilized during your first Medicine Session, beginning with one 100 mg lozenge. After approximately 20 minutes, you may be offered additional lozenges depending on how you respond to the medicine. You will begin to feel the effects of the medicine within 15-20 minutes and feel its full effect for approximately 40 minutes, after which the effects will dissipate over the next 1-2 hours.
After your first Medicine Session, you will meet with your psychotherapist for an Integration/Psychotherapy Session. During that time, we will discuss how to integrate your experience, address any questions or concerns you may have, and review the balance of your treatment plan.
Generally, multiple ketamine medicine sessions are required to experience lasting effects. After your initial Ketamine (lozenge) Medicine Session, ketamine is generally administered by an intramuscular injection by our physician.
Contact us to schedule your initial consultation if you’re interested in pursuing ketamine-assisted psychotherapy in the Bay Area. Information about our fees is here.