What is Ketamine Assisted Therapy? 

You may have heard a lot of buzz in the media about psychedelic assisted therapy, a type of therapy where psychedelics are used to alter consciousness and potentially allow deep changes to be made in the way we think. Ketamine assisted psychotherapy (KAP) is the use of ketamine in conjunction with talk therapy to help treat depression, anxiety, trauma, PTSD, and potentially more. Ketamine is currently the only substance that is legal to use for psychedelic assisted therapy across the U.S., but other substances are being studied. 

Often KAP is done with an infusion, the person receiving the therapy is hooked up to an IV to receive the ketamine. KAP can also be done with ketamine administered orally,, which allows for more flexibility in the type of setting where the therapy is done. For the best results, research shows that important aspects of this type of therapy are preparation (multiple therapy sessions before the ketamine experience) and integration (multiple therapy sessions after the ketamine experience). 

I recently had the opportunity to participate in a group therapy process that involved a ketamine experience (administered orally), and I hope through this blog to share some valuable things I learned, details about the process, and what you might expect if you were to seek out an experience like this. Throughout the group we read the book Conscious Medicine by Francoise Bourzat, so a lot of the concepts discussed come from this book. (I want to acknowledge that there have been allegations of abuse against Francoise Bourzat, and while I do not want to promote someone who has caused harm, her book is where I learned many important ideas and concepts. I encourage you to do your own research to decide what resources you want to engage with).

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Group Therapy: Why use Ketamine in this Setting?   

KAP is often administered as a one-on-one treatment, much like traditional talk therapy. However, looking back at the history of how certain psychedelics have been used in intentional and healing ways, it becomes clear that community, collaboration, and shared experience has often been an important aspect of this type of work. Research shows that an individual receiving KAP with a trained therapist can have benefits, but I am specifically interested in looking at what the unique benefits may be of a group process. 

In group therapy one of the benefits is people are able to feel less alone, they hear about others’ perspectives and often learn that they are not alone in a certain feeling or experience. Another major benefit of group therapy is that  people have the opportunity to work through group dynamics (which often emulates family dynamics and other significant relationship patterns) in real time. I was curious going into this experience if it might be similar with KAP, if working in a group would allow us to work through interpersonal relationship patterns and dynamics. Ketamine is sometimes said to ‘soften’ our rigid walls and defenses, and this may be an ideal time to work through these challenges. 

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Cultural Appropriation and Colonization 

I want to acknowledge that cultural appropriation and colonization have been an issue within psychedelic assisted therapy. Colonization has criminalized many of the traditional practices that have historically been used to heal, and has forced people to adopt European ideas of health and psychology. The fact that traditional western medicine is now making a profit off of these practices through psychedelic assisted therapy is hypocritical and problematic. 

I encourage you to research practices from your own culture to learn the types of rituals and altered consciousness that were historically used. For example, my ancestors are largely Irish, and there is a history of the Celtic Druids using psychedelic mushrooms in rituals and ceremonies. I have tried to learn what I can about how this was used and what these ceremonies looked like, as opposed to trying to copy practices from other cultures. If you belong to a culture that has had its practices appropriated and criminalized by colonization, it may be important to spend some time acknowledging that pain and grief. 

There is also the issue of resources; with an increase in people wanting to try these rituals and ceremonies, some types of psychedelics have been overharvested. Specifically, ayahuasca and peyote have been overused in a way that has hurt not only the people that make use of these substances, but also the ecology and health of the environment. It is important before participating in any type of psychedelic ritual to understand where the resources are coming from, and what impact your participation may have on the wider community. 

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Preparation   

Preparation included four group therapy sessions where we spoke about the logistics, the book we were reading, and what we hoped to gain from the experience. Outside of group meetings, preparation included reading, journaling, meditating, and adjusting our habits as much as possible to optimize the experience (cutting down things like alcohol and media that is agitating or overstimulating). We spoke about our desires for the experience in terms of ‘weeds and seeds.’ Weeds were things we wanted to remove and let go of. Seeds were new things we wanted to plant. 

We also discussed our connection to spirituality or a higher power. It is definitely not necessary to be religious in any sense of the word in order to participate in this type of therapy, but having some connection to something bigger than ourselves (like nature) was an important aspect. We also spoke about things that bring us comfort and support, which for many included pets, friends, family members, books, scents, and reminders of nature. We came up with altar items to bring with us for the day of the ketamine experience; we each brought items that represented our own ideas around spirituality and comforts and placed them around the room.

Experience Observing  

My ketamine experience happened over a weekend; Saturday half of the group took the ketamine, and the other half (including me) observed/ held space; Sunday we switched roles. Everyone had a comfortable place to lay down for the experience, and something to cover their eyes (light sensitivity is a side effect). The first thing I learned about the experience from observing was that the ketamine lozenges taste bad! The recommended way to take it is to hold it under your tongue for 20 minutes, and then swallow, so the unpleasant taste was definitely an issue for some, but everyone managed. After swallowing, and beginning to feel the effects, everyone was very peaceful, it looked a lot like they were taking a nap. There really wasn’t much to do except stay present, and assist if anyone needed water or help getting up to go to the bathroom. 

One of the benefits of ketamine is that the experience is relatively short, after a little over 2 hours people started coming out of the experience. People slowly sat up, switched from eye coverings to sun glasses, and we shared some food together (fasting or eating very lightly beforehand is recommended to avoid nausea, so eating right after can feel good). People shared their experiences in bits and pieces, choosing what felt most comfortable or relevant to share. Even though I hadn’t had to do much as an observer, I felt exhausted and took a long nap when I got home, and began preparing for my own journey. 

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Experience Journeying 

The morning of I did decide to have a few crackers as I don’t do well on an empty stomach, and even though I am a regular coffee drinker it felt fine to skip the caffeine for the day. I did feel some anxiety, but it was a manageable amount. I set up my altar items and my area to lay down (I brought my own blanket and pillows so I knew I would be comfortable). I appreciated the preparation for the bad taste (it was bad!) and the need to wait 20 minutes before swallowing. After that, my experience was very different from the one I observed. 

While the folks I observed had very quiet individual experiences, I immediately started talking, reaching out for support, and trying to articulate what I was feeling and going through. I needed a lot of support and a lot of reassurance. I also heard others in the room expressing things and asking for support. I was very affected by what I heard and what I sensed happening in the room, and the group aspect of the experience became much more relevant and intense. I feel that my experience was definitely enhanced by having people holding space to be with me and help reassure me when things felt challenging, and my connection to other people journeying felt like a reminder that we are not alone, and I will talk more in the next section about some of the connections we found. 

One of the most interesting aspects of the journey for me was that sense of self that I felt. In Internal Family Systems (IFS), we talk about ‘self energy,’ an aspect of ourselves that is compassionate, calm, untouched by trauma. I felt this ‘self’ stronger than I ever had in any talk therapy session. I was able to look at trauma and painful things that had happened in my life with a distance and a safety. This was a very powerful experience, and the memory of what this felt like is something I have continued to take into my own therapy and work. 

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Integration  

After the ketamine experience, we had two group therapy sessions to discuss our experiences and work on integration. Outside of the group we also had our own work to do journaling, meditating, continuing reading, and reflecting on the meaning of our experiences. One of the main pieces of integration for me was reflecting on what the group experience meant. For me, it felt like an experience of learning to trust others to be caretakers, and learning to trust that it is ok to ask for reassurance and for support. 

We spoke about the group experience in our integration sessions, and it seems that there are many benefits from awareness of others who were journeying at the same time. Hearing others have big emotions gave us permission to have them ourselves. Some of us also had a feeling of deep connection during the experience and the integration. There was a sense of feeling that there are shared human experiences and connection to fellow humans even if we do not know each other well or have anything specific in common. It felt like a softening and relief from any feelings of isolation- feeling that there is a connection and common experience between many human beings, whether or not we’re aware of it most of the time. 

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Conclusion 

Ketamine assisted therapy can be a different and enlightening way of approaching therapy, and can benefit people who have felt stuck and struggle with traditional talk therapy. This therapy is definitely not for everyone, and specific health concerns should be taken into consideration as there are some contraindications. I hope that by explaining the process it is also clear that I do not think of KAP as any kind of magic bullet; like talk therapy it takes a lot of effort, work, and being intentional with the experience. I personally am interested in learning more about the potential benefits of this type of therapy in a group setting, and how this may uniquely serve people looking to work through relational issues, family dynamics, and feelings of isolation. 

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Further Reading/ Listening 

• Ketamine Research Foundation 
• Consciousness Medicine by Francoise Bourzat
• KAP and IFS
• Ayafusion Ketamine Clinic