Ketamine Assisted Psychotherapy: What Can I Expect?

You’ve heard the buzz about ketamine assisted psychotherapy (KAP), but what actually happens during this form of therapy? Taking a mind-altering substance can be intimidating to some, and not knowing what to expect can serve as a hindrance to folks who may really benefit from this treatment. In this guide, I will walk you through the whole KAP process using sublingual ketamine- from the first consultation to maximizing the benefits after treatment. Let’s demystify ketamine assisted psychotherapy!

Initial Consultation

The first step in seeking KAP is speaking with a trained provider to determine if this treatment is right for you. During the initial consultation, a KAP therapist will ask about your mental health symptoms, previous treatments, and other pertinent factors such as your current stressors and your support network. They will screen for psychosocial factors that could make ketamine a risky treatment decision for you, and also assess whether their therapeutic style suits your needs. Although feeling comfortable with a provider is an important factor in all therapies, this is especially important when the therapy uses altered states. Be thoughtful in choosing your KAP provider; explore what they share about themselves online and be sure to ask questions that help you determine if they are a good fit for you.

Medical Clearance

If your KAP therapist isn’t a medical provider, they will refer you to someone who can assess your physical health to make sure it is medically safe for you to ingest ketamine. The medical provider will ask you a variety of questions regarding your current and historical health status. This appointment is an opportunity for you to ask questions about potential side effects and any medical concerns you may have for your KAP treatment. If medically cleared, you will receive a ketamine prescription to bring to your KAP sessions. Don’t forget to take note of the suggested starting dose for your KAP sessions as you will be self-administering the ketamine in the therapist’s office.

Preparation

Before your first medicine session, you’ll have a series of preparation sessions with your therapist. These sessions help you gain a sense of the therapist’s style of working and allows the therapist to better understand your goals for treatment. The therapist will lay out what you might expect from the treatment, help prepare you for any emotional challenges, and will explore your hopes and fears for the treatment. Together, you’ll discuss your intentions for each session—whether you're seeking insight, healing, or wanting to cultivate an attitude of openness or surrender. Some preparation sessions may involve rehearsing the medicine session to help you feel more at ease on the day of your first experience.

Medicine Sessions

KAP sessions can last up to three hours and your therapist will remain in the room with you the entire time. The first 30- 45 minutes of a medicine session are spent checking in, reviewing your intention, and engaging in a guided meditation or other ritual activity. You will then administer the ketamine sublingually by swishing it in your mouth for 15 minutes before spitting it out. At this point the ketamine should be taking effect; you put on an eye mask and headphones, lay back and relax into the experience as you listen to music. Most people are internally focused for 30-60 minutes while under the acute effects of the ketamine.

While under the influence, many feel like they are in a dreamlike state or in a deep meditation, often experiencing imagery, varied bodily sensations, or expanded emotional states. You might visit memories of past events or gain knowledge through a felt sense or inner awareness. After the acute effects fade and you have returned your attention back to the room, your therapist will support you in recollecting the experience and any associated insights. Your therapist will take notes throughout the KAP session to help you hold onto anything that came up during the experience as ketamine can cause mild memory loss. You may not drive following a KAP session so you will leave when the major effects of the medicine have worn off and your arranged ride has arrived to the office.

Integration

Integration sessions, scheduled in the days after each medicine session, are an important part of the KAP process. Integration refers to reflecting upon the insights gleaned from the medicine sessions and using them to inform how you understand yourself, your relationships, your past, and how you want to relate to these things in the present. Ketamine increases neural plasticity which makes the days following the medicine session a prime time for interventions aimed at making small changes in your thoughts and behaviors as related to your treatment goals. This period of increased openness is an ideal time to work on making changes that can have lasting implications for your life. Integration activities that focus on developing healthier patterns of behavior (e.g., increasing social engagement, establishing self-care routines, picking up an old hobby) are an important part of relapse prevention. Using this time to build up habits that support mental health in the long-run are key to finding your way to recovery.

In Closing

I hope this guide gives you a clearer picture of what you can expect from ketamine assisted psychotherapy. Although the effects of the medicine can vary widely from person to person, your therapist will help you navigate this unique therapeutic opportunity. Please keep in mind that this is just one model of KAP, and different practitioners may offered varied approaches to support you. Want to learn more? Don’t hesitate to reach out with any questions. Contact me today for a free 20-minute phone consultation.