Psychedelic Assisted Psychotherapy 

Is Ketamine A Psychedelic?

The classification of ketamine as a psychedelic has sparked debate among scientists and medical professionals. Ketamine in certain doses can causes altered states of consciousness, but it operates differently from traditional psychedelics in terms of how it affects the brain and the nature of its effects. Traditional psychedelics like LSD, psilocybin, and DMT primarily influence serotonin receptors to create their distinctive effects. In contrast, ketamine impacts the brain’s glutamate systems and NMDA receptors, which play a key role in synaptic plasticity and neural communication. Although whether ketamine should be considered a psychedelic is up for debate, research indicates it shares certain neurobiological and phenomenological traits with classical psychedelics. This has led some researchers to support classifying ketamine as a psychedelic medicine, highlighting its potential in psychedelic therapy.

What is Ketamine Assisted Psychotherapy (KAP)?

Ketamine-assisted psychotherapy (KAP) is an emerging therapeutic method that leverages ketamine’s dissociative properties to support psychological healing and growth. Originally developed as an anesthetic, ketamine is now used in mental health treatment, offering hope for those suffering from treatment-resistant depression, PTSD, anxiety, and other mental health issues.

Understanding Ketamine’s Impact on Mind and Body

Ketamine’s effects on the mind and body are unique and notably different from traditional psychedelics. It gently lifts existential burdens and induces a dissociative state, causing a sense of detachment from the physical body. Ketamine influences the brain differently compared to traditional psychedelics by its unique action on specific types of brain cells. Ketamine exerts its effects by calming a specific type of interneuron known as chandelier cells. These cells are responsible for inhibiting the activity of pyramidal cells in the brain. By reducing the activity of chandelier cells, ketamine decreases their inhibitory control over pyramidal cells. As the chandelier cells are calmed, the inhibitory grip they hold on pyramidal cells is loosened. This results in increased activity and interaction among the pyramidal cells. Pyramidal cells play a crucial role in various brain functions, including cognition, perception, and consciousness. This indirect method of stimulating pyramidal cells sets ketamine apart from classical psychedelics, which typically directly stimulates pyramidal cells via serotonin receptors. Ketamine’s action through the modulation of chandelier cells leads to a different set of experiential and therapeutic effects. Understanding ketamine’s mechanism of action helps explain its unique therapeutic potential. By facilitating increased activity and interaction among pyramidal cells, ketamine can help in the reprocessing of traumatic memories and altering deeply ingrained patterns of thought and behavior, making it a valuable tool in ketamine-assisted psychotherapy (KAP) for treating conditions like treatment-resistant depression, PTSD, and anxiety.

Provides Rapid Symptom Relief

1. NMDA Receptor Antagonism: Ketamine’s primary mechanism involves blocking NMDA receptors in the brain, which are involved in regulating mood and perception. By modulating these receptors, ketamine can rapidly alleviate symptoms of depression and anxiety. This is a stark contrast to traditional antidepressants, which can take weeks to become effective. This leads to rapid changes in neural communication and promotes synaptic plasticity, resulting in swift improvements in mood and cognitive function. Clients often report noticeable reductions in depressive and anxious symptoms.
2. Immediate Psychological Impact: The dissociative effects of ketamine can help clients detach from entrenched negative thought patterns and emotions. This detachment allows for a fresh perspective on their issues, often leading to immediate psychological relief and a newfound ability to engage with therapy more effectively.

Ketamine Enhances Psychotherapy

1. Increased Neuroplasticity: Ketamine promotes neuroplasticity, which is the brain’s ability to reorganize itself by forming new neural connections. This enhanced plasticity makes the brain more receptive to the therapeutic processes, allowing patients to integrate new insights and behaviors more readily during psychotherapy sessions.
2. Facilitating Emotional Processing: The altered state of consciousness induced by ketamine can enable patients to access and process repressed or difficult emotions and memories. This can be particularly beneficial for individuals with PTSD, as it allows them to confront and work through traumatic experiences in a safe and controlled environment.
3. Breaking Negative Thought Cycles: By reducing the functionality of the default mode network (DMN), ketamine helps disrupt cycles of rumination and negative self-referential thinking. This disruption allows patients to break free from maladaptive cognitive patterns, creating a more conducive mental state for psychotherapy.

Components of Ketamine Assisted Psychotherapy (KAP)

Step One Intake & Assessment

Ketamine assisted Psychotherapy (KAP) at Restoring Clarity Counseling St. Louis, involves a 4-step process to maximize the therapeutic effectiveness of this form of treatment setting it apart from treatments provided in Ketamine clinics that often provide medication only treatment as “ketamine therapy” when often there is no psychotherapy taking place. Since ketamine is now also available to be compounded into a lozenge form and prescribed by a doctor to the client through a pharmacy, clients no longer need to go into a medical offices or work in person with medical staff in order to receive the medicine. Instead, client’s have the option of working with a psychotherapist with the lozenge form of the medication and doing the therapy work that is necessary to heal from past traumas, depression, anxiety, etc. Ketamine in the lozenge form gives the person all of the anti depressant effects that IV/injections do, and because it’s not too high of a dose, it can lower a person’s ego defenses which allows the person to access feelings and emotions that need to be processed from past traumas, and act as an empathogen- opening a person to feelings of love, gratitude, compassion, and forgiveness. The lozenge form of administration allows a client and therapist to work with all the benefits of the medicine (psychedelic, dissociation, bypassing the default mode network to rewire neural pathways) and more so, it allows the client and therapist to actually do therapy during the medicine treatment. The therapist can guide the client towards the areas of healing that were discussed in prep sessions and create healing opportunities for those past traumas/negative beliefs. Initial sessions involve an assessment of current problems, concerns, needs, and goals, as well as an evaluation of the patient’s overall health, as part of determining the suitability KAP treatment. Restoring Clarity Counseling, has partnerships with medical providers highly experienced and trained in Ketamine assisted therapeutic methods, prescription and assessment. After you’ve undergone an initial evaluation and received a prescription from our medical providers, Ketamine Assisted Psychotherapy can begin.

Eligibility Criteria

• KAP has been shown to be a highly effective supplement to regular therapy. Candidates must already be working with a psychiatrist or psychotherapist in addition to this treatment.
• KAP is contraindicated for individuals who are pregnant or nursing
• KAP is contraindicated for individuals who have poorly controlled or untreated hypertension, cardiovascular problems, hyperthyroidism, severe sleep apnea or respiratory disease
• KAP is contraindicated for individuals who have a BMI of >30
• KAP is contraindicated for individuals who a history or seizures / epilepsy
• KAP is contraindicated for individuals who have Parkinson’s
• KAP is contraindicated for individuals that have had a recent traumatic brain injury (TBI)
• KAP is not a good choice for individuals who have experienced an acute manic, hypomanic, psychotic episode, or have been diagnosed with schizophrenia
• KAP is not a good choice for individuals who are allergic to ketamine
• If you have been diagnosed with a dissociative disorder, personality disorder or a panic disorder: KAP may not be a helpful option for you depending on the severity of symptoms. You will be required to complete an additional assessment and close collaboration and recommendation from your therapist and psychiatrist is required.

Step Two Preparation Sessions

Preparation therapy sessions are an essential component of the Ketamine Assisted Psychotherapy therapeutic process. They help individuals mentally and emotionally prepare for the profound experiences facilitated by ketamine. This preparation is crucial for maximizing the therapeutic benefits and ensuring a safe and meaningful journey. Mental preparation involves mindfulness practices, meditation, and setting intentions. It also includes addressing any fears or anxieties about the upcoming experience.

Step Three Ketamine Assisted Sessions

Next, we’ll go through 3-6 Ketamine Assisted Sessions, each of which includes setting your hopes and intentions, guided meditations and relaxation exercises, and invocation, in addition to the guided journey. We will do some gentle integration of your experience directly after. Typically, ketamine dosing sessions last for two-three hours and are done in-office. There’s time to get settled, review intentions and calm some pre-dosing nerves, which is very normal especially for the first session. During this time, you will administer your ketamine lozenge that was prescribed and then remain in a comfortable reclined position. Ketamine Assisted Psychotherapy (KAP) treatment sessions have the potential to create a non-ordinary state of consciousness that can facilitate a profound transpersonal or mystical experience. These types of “peak experiences” have been shown to expand one’s sense of self and the understanding of one’s existence. Ketamine may also enable an individual to access their own inner healing intelligence – an intuitive inner guidance system – that can prompt specific actions or solutions based on the individual’s vast interpersonal history and the myriad of options for “moving forward.”

Essential to this method is a time-out from one’s usual day-to-day life and mental experience. The process is characterized by deep relaxation and disengagement from ordinary concerns and usual mindset, while maintaining conscious awareness. Many feel this benevolent disruption of the busy or distressed mind, along with its ruminating preoccupations and associated negative feelings, creates an open space for the exploration of new feeling states and self-observations. This process can potentially lead to significant shifts in overall well-being and understandings of oneself and others. Music  is played during the experience. Music serves to ground, support, and deepen the process. Carefully arranged music can provide a sense of forward movement and a guiding flow that can enhance the experience. I provide specially curated playlists, designed to catalyze the psychological and emotional process, and take the client on an inner journey.

Step Four Integration Sessions:

Psychedelic integration refers to taking the gained insights, emotions, or attitudes from your experience, and processing them into desired areas of your life. Integration as a general definition means “bringing parts together to make a whole.” Psychedelic integration helps to achieve a sense of “wholeness” clients seek through their set intentions for treatment. It is a crucial step for ensuring lasting therapeutic benefits. EMDR, Somatic Experiencing, and Internal Family Systems therapies may be utilized to further integrate the knowledge and wisdom you’ve gained as a result of the experience.

Reach out today to see if Ketamine Assisted Psychotherapy is the right treatment for you.