KETAMINE ASSISTED PSYCHOTHERAPY (KAP) INFORMATION
What is Ketamine?
Pharmaceutically, ketamine is a dissociative anesthetic– a medication that produces a temporary sense of disconnection between mind and body, and from one’s normal reality, memory, and sense of identity. Ketamine is one of the most widely used drugs in modern medicine, and listed on the World Health Organization’s Model List of Essential Medicines - medications considered to be most effective and safe to meet the most important needs in a health system. It was developed in 1963, FDA approved in 1970. Many hospitals, surgical centers and medical offices use it because its effects are fast, safe, short-lasting, analgesic in nature, and is even safe for pediatric patients.
Ketamine has been shown to be particularly effective with chronic mood disorders, pain, and other mental health conditions which can be severe, recurring, disabling, and even life-threatening. In the last twenty years, ketamine has been used as an accessory in some severe and “treatment-resistant” conditions (not successfully treated by other modalities or drugs), including depression, severe anxiety disorders, PTSD, OCD, suicidal ideation, and other psychiatric diagnoses (Rodrigues et al., 2013). Ketamine is currently being studied with those who have substance use disorders. Many current medical treatments for these conditions simply don’t work, or they take weeks to “kick in”. In addition, medications can create side effects that are sometimes worse than the initial disorder. Although ketamine has been used as an anesthetic agent for many years, its application as an adjunct to psychotherapy and other medications is relatively new and “off label.” Based on our review of available research coupled with our own clinical experience, we have found that when used appropriately, Ketamine paired with psychotherapy, KAP, is effective, and decreases negative mental states wherein individuals have found themselves stuck, or found their conditions to be treatment-resistant.
How Ketamine Works
Ketamine works through the glutamates - powerful chemicals in the nervous system that are responsible for sending signals between nerve cells, and that play an important role in learning and memory. We know that in cases of depression, regions of the brain which help govern mood may shrink. Animal research, however, has shown that ketamine can stimulate neural growth in these regions within days (and sometimes hours), and researchers hypothesize there is similar action in humans.
Researchers also hypothesize that ketamine enables a reprieve from habitual patterns of thought that underlie mood and behavior, thereby creating an opportunity for learning new and healthier patterns of thought. In our experience, KAP not only affords a reprieve from detrimental thought patterns; the intervention can actually lead to a reprocessing of negative perceptions and thoughts that are causing or perpetuating unhealthy mental, emotional, and even physical states. Many times these thought patterns have entrenched themselves in the subconscious of the person having been learned early in life. Ketamine provides a way for these unconscious thought patterns, even painful ones, to come to the surface and be dealt with in an appropriate way.
What conditions can Ketamine help?
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Dosing Strategies and Route of Administration
Ketamine can be administered in a variety of ways. In our practice, ketamine is administered by intravenous infusion (IV). Dosage is determined by various physical factors including weight, sensitivity to medication, and history of drug use. The ketamine process is unique depending on the dosage and receptiveness of the individual. Our medical team will check your vital signs before and after the administration, and be on hand throughout the session to monitor physiological responses to the treatment.
The Ketamine Experience
The ketamine experience is marked by an easing of the patient’s typical concerns and preoccupations, all while maintaining conscious awareness. This psychological relaxation allows an alleviation of negative feelings and preoccupations. You will most likely experience a feeling of peace, devoid of stress, tension, or depression. However, psychedelic effects may also be experienced. These effects may include distorted visualization of colors, a feeling of floating, out-of-body sensations, vivid dreaming, and changes in the processing of sight, touch, and sound. These effects typically start within 5 minutes of ketamine dosing. The dissociative effect predominates for a time, usually 20 -30 minutes although this period of time seems timeless. Re-administration of ketamine midway through the session is sometimes given to maintain the effects of the medication until the end of the session.
We believe that these ‘dissociative’ experiences are instrumental in providing relief from psychological pain and tend to generate a more positive way of looking at life. We also believe that this altered state of mind and the exploration and experience of other possible states of consciousness create new neuropathways and therefore, different ways of thinking and being. Each of your ketamine sessions will be attended by a therapist who will spend time initially getting to know your concerns and mental health issues. The therapist will then act as a guide to help facilitate a growth-promoting, even life-changing experience. Each session lasts between 60 and 90 minutes depending on the individual. Even though the benefits of ketamine may be felt quickly, repeated sessions of 2-3 per week are recommended for the first few weeks for enduring benefit. Ketamine usually works to some degree immediately and can continue working days and weeks after.
Why Ketamine Assisted Psychotherapy
Both psychotherapy and ketamine are effective in helping with mood disorders and pain, but the combination of the two has been shown to be much more effective than either on its own. Our program emphasizes the potential for change and the creation of new neuropathways which can facilitate change quickly. Our experience suggests that the administration of ketamine is most effective when paired with psychotherapy. We offer a psychotherapy program which will 1) explore limiting thought patterns and conditions which may be keeping you “stuck”, 2) prepare you for your ketamine sessions including answering any questions or concerns you may have, 3) guide you through your ketamine session, and 4) assist you in exploring and integrating your experiences afterwards.
Ketamine creates an altered state of consciousness which promotes openness and vulnerability in the individual. Thus, trust between you and your provider is essential in enabling the deepest possible work to occur. Psychotherapy sessions are meant to build this sense of connection and trust between you and your providers, as well as to assist you in gaining more insights into what may be keeping you from a healthy relationship with yourself.
Your experience will be unique to you, and each of your ketamine sessions will be different. Please know there is no “right” way of being during the session. Each will be an adventure which will be enhanced by relaxing and not resisting the experience. We are confident you will feel improvement in your emotional state, and reduction in symptoms such as depression, anxiety, OCD, and PTSD. You may also notice a difference in your perceptions of your life and improved relationships.
Change may happen during treatment, soon after treatment, and/or in the days and weeks that follow. Although some experiences may be temporarilydisturbing to you, we will work to help you understand and process through these. Remember, we are working to assist you in changing thought patterns, mood, and behaviors that are causing you difficulty and distress in your life. Please also remember that repeated ketamine treatments have been shown to have a cumulative effect, extending improvements in these areas. Ketamine is an effective intervention, and is even more so when you engage with it to create positive, lasting changes in your life that can bolster your recovery.