Why Ketamine?
Researchers at Yale have been studying low dose ketamine since 2000 in controlled clinical settings for patients with severe depression who are unresponsive to other antidepressants. In several studies more than half have shown a significant decrease in depression symptoms in 24 hours and approximately 4 out of 5 went on to find significant improvement.
In an article of Journal of Psychoactive Drugs, Dore (2019) stated, "Our patients experienced a clinically significant decrease in anxiety and depression with our treatment as compared to baseline at intake. We also found that patients with more severe symptoms, including current suicidality, higher depression scores on Beck's Depression Inventory, and higher Adverse Childhood Experiences scores, tend to show the most significant benefit."
More evidence based research on the benefits of ketamine and psychedelic medicine can be found on my resources page and link to a resource document that I compiled of research that I have used to present to other professionals with.
Ketamine Assisted Psychotherapy (KAP)
Ketamine assisted Psychotherapy (KAP) is the only current legal psychedelic therapy available in the U.S. DEA Schedule 3 drug that has medical value: at high doses it is a well-tolerated and very safe dissociative anesthetic known not to interfere with breathing. In psychedelic therapy at low doses, it creates a relatively short acting psychedelic experience that can support therapeutic goals. Using it in a therapeutic way is considered an “off label” approach. In general, KAP is a treatment and not a cure for symptoms of Depression, Anxiety, and PTSD. I have engaged in extensive training through Polaris Insight Center and Skylight Psychedelics and have over 400 hours+ working with a variety of clients using KAP ( about 2 years of experience).
Ketamine Administration in Various Settings
Ketamine is being administered in a variety of settings including in hospitals, infusion centers, at individual’s homes, and in psychotherapy settings. Ketamine requires a prescription from a psychiatrist or doctor. This occurs after a medical and psychiatric screening to assess for safety and suitability of clients. It can be administered intravenously, intramuscularly, nasally, or sublingually, which all have different approaches, dosing protocols, and treatment plans depending on who and what is being treated. Vital signs are commonly monitored by a licensed medical professional (MD, NP/PA, RN) during session.
KAP as a Therapeutic Tool in My Practice
KAP involves a long-term commitment of multiple sessions and at least two specially trained practitioners: therapist and medical prescriber. Initial therapy sessions with me are geared towards building a relationship, collaborating about therapeutic goals and intentions, preparation before medicine sessions, and integration practices following medicine sessions. An intake with a medical prescriber addresses medical history and other factors to determine the appropriateness of taking this medicine. Individualized dosing and specific instructions for oral ketamine (and sometimes intramuscular ketamine) are provided by the prescriber. Then, I sit with you and support you for the duration of the 3-hour medicine session. Integration sessions with me to create meaning of the experience occur within 24-72 hours the medicine journey.
Preparation and Integration Tools I Use
My approaches to therapy engages the limbic system of the brain, which is involved in processing memories and emotions, and brings the whole body into the experience (head, heart, and gut). By creating awareness about what is being experienced in the body in real-time while accessing memories, thoughts, and emotions, there is ample research and evidence to support this process creating powerful, long lasting results. This method of engaging the felt sense of the body and our emotions as a primary state of being and then moving into the analytical parts of our mind, is known as "bottom-up" processing. This is in contrast to our day-to-day way of taking in information, known as "top-down" process, in which we start with our logical minds and often disconnect from our emotions and sensations. By understanding how the nervous system works, how your early social relationships and environment inform your current relationships, and assessing and challenging your conditioned limiting beliefs, you create possibilities for change in alignment with your values and desires. Using embodiment therapy approaches and practices during the preparation and integration stages of KAP may create greater shifts in your healing process.
I use the following modalities to support the preparation and integration process of KAP:
Somatic Based Therapy Interventions
EMDR
Brainspotting
Nature Connection
Embodiment Practices Learned from KAP training with Polaris Insight Center and Skylight Psychedelics
Step 2:
Reach out via contact form
Wait 1-2 business days for a response. Can schedule a free 15 min consultation call upon request.
Step 3:
Complete Intake Paperwork, Screening Questionairre, and ROI sent by me
Wait up to 5 business days for me to review. Will either schedule a time for an 50 minute assessment or make other recommendations
Step 4:
Meet with therapist for 50 minutes intake assessment.
Appropriate referral to medical provider will be provided if indicated that KAP is appropriate.
Step 5:
Coordinate to meet with psychiatrist for KAP screening
Medical provider must also determine appropriateness of treatment. Either you will be cleared to go and they will write a prescription or other recommendations will be made.
Step 6:
We collaborate about how many 50 minute preparation sessions we need; I require at least 1
Establishing a good therapeutic relationship is important for our work together and to determine when you feel safe and comfortable to start KAP medicine sessions.
Step 7:
3 hour KAP Session
I am present for 3 hour medicine sessions. Typically we start with 4-6 sessions over 2-6 weeks and additional sessions after that can be discussed after completing protocol.
Step 8:
50 min integration session 24-72 hours post medicine session
We will process the medicine session as it relates to your goals. After completing protocol, we can explore continuing to work together, recommendations will be made, and/or I will connect with your outpatient therapist if you would like.
Process for KAP
Who is not appropriate for KAP?
Individuals with the following conditions:
Uncontrolled hypertension
Untreated hyperthyroidism
Epilepsy Aneurysm
Severe breathing problems
Kidney disease
Advanced liver disease
Interstitial cystitis (bladder wall inflammation)
Glaucoma (unless cleared by an ophthalmologist)
Arrhythmia
Pregnancy
Active Psychosis or Recent History of Active Psychosis
Active diagnosis of Schizophrenia
Active addiction
Active mania
You may be asked by a physician to tapper off of the following medications if you're taking them: Theophylline or Aminophylline, Benzodiazepines, opioid analgesics, or other CNS depressants, Lamotrigine, Sleeping aids and sedatives such as Ambien, Benadryl, Remeron
Individuals who feel motivated to engage in immersive, experiential therapeutic experiences.
Individuals who are open to the idea of processing in a "non-traditional" way. AKA: are open to exploring the idea that abstract imagery and sensations, experiencing and witnessing sensations in the body, and being patient with meaning and answers to surfacing questions over time are all a valuable way to approach greater self-awareness and/ or healing. Versus analyzing and problem-solving like what is typically done in talk therapy.
Individuals who are willing to experiment with or continue practicing self-care, taking action in alignment with values, and fostering a sense of trust and patience with self-compassion.
Individuals who are open to approaching experiences with curiosity rather than judgement and may be seeking greater connection with themselves or a higher power as they define that to be.
Individuals who have support systems in place such as friends, family members, professionals, and/or guides that are available to lean on for communal support.
*Individuals who can arrange a safe ride from a trusted friend or family members after medicine sessions