What is Ketamine?
Ketamine is a psychoactive drug classified as a dissociative anesthetic. It has been used in the United States as an anesthetic in medical settings since 1970, and is on the World Health Organization’s List of Essential Medicines. It has been used off label in sub-anesthetic doses to treat chronic pain, treatment-resistant depression, and other mental health issues for the past 20 years.
For people suffering from treatment-resistant depression or suicidal ideation, it can often times provide immediate relief. While the antidepressant effects tend to be temporary, multiple treatments and treatments in conjunction with psychotherapy have proven to have an enduring effect, successfully alleviating symptoms in approximately 30 - 60% of individuals with treatment-resistant depression.
Another characteristic of ketamine is that it creates novel states of mind. These mind states vary from individual to individual, but offer an opportunity to surrender habitual destructive states, explore underlying psychodynamics, and open to new perspectives.
Ketamine-Assisted Psychotherapy (KAP)
Ketamine-assisted psychotherapy (KAP) uses low doses of ketamine to enhance and deepen psychotherapy, to loosen the grip of habituated patterns and coping mechanisms, and to amplify and prolong the curative effects of ketamine.
The literature suggests that ketamine sessions are 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 you with your issues, hopes, desires and struggles.
KAP provides an opportunity for the temporary softening of psychological defenses, allowing for deeper self-reflection and psychotherapeutic processing. The process is characterized by the relaxation of ordinary concerns and usual mindset, all while maintaining conscious awareness. This can lead to a disruption of negative feelings and obsessional preoccupations. Many clients find that this interruption can produce significant shifts in overall well-being. KAP can lead to greater clarity and insight into inner psychodynamics, a new capacity for handling life's challenges, increased ability to surrender into interconnectedness, as well as facilitating a sense of meaning.
KAP includes sessions that will prepare you for your ketamine sessions and assist you in integrating your experiences after and in between medicine sessions.
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 with you, and and will 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 has the potential to create a non-ordinary state of consciousness and to facilitate transpersonal or mystical experiences. These kinds of experiences have been shown to expand one’s sense of self and one’s understanding of existence. Ketamine may also enable you to access your own inner healing intelligence in a manner that is valuable. Our Temenos clinicians serve as guides to assist you in processing the experience and its impact.
We encourage you to explore additional information about ketamine. We offer some useful links here.
What to Expect in KAP Treatment
Your inquiry about KAP begins with a complimentary 15-minute phone consultation in which we discuss your symptoms and determine 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 Intake, Informed Consent, and Client Information forms and schedule a Medical/Psychosocial Assessment session with one of our psychotherapists and our physician. A fifty-minute in-person initial consultation is also available, if desired. We ask that you complete and return the forms to us prior to your initial Medical/Psychosocial Assessment appointment.
During the Medical/Psychosocial Assessment Session, you will meet with one of our psychotherapists and our physician. In this session, we will review your medical and psychosocial history, further discuss the use of KAP to address your concerns and issues, 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.
Ketamine Medicine Sessions typically last from 2 ½ to 3 hours. The psychotherapist with whom you met at your Assessment appointment will be with you during the entire session; and each session is overseen by our physician. Sublingual lozenges will typically be utilized during your first Medicine Session, most often 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 time the effects will dissipate over the next 1-2 hours.
Positive impacts on mood have been shown to last over the following days and sometimes weeks.
After your first Medicine Session, you will meet with your psychotherapist for an Integration/Psychotherapy Session during which time we will discuss how you responded to the medicine, address any questions or concerns you may have, and review the balance of your treatment plan. These Integration/Psychotherapy Sessions are further addressed in the “Integration” section below.
Generally, multiple ketamine medicine sessions are required in order to experience lasting effects. After your initial Ketamine (lozenge) Medicine Session, ketamine is generally administered in an intramuscular injection administered by our physician.
Information about our fees is here.