Ketamine-Assisted Psychotherapy

“Ketamine, unlike conventional psychiatric medications, provides a gateway to states of awareness that are relatively free from normative defensive inhibitions and rigidly patterned behaviors. It acts as both a time-out from our ordinary mind, and its obsessive and negative patterns, and an opportunity for transcendent views of the Self and one’s context. Often it serves as a relief from depression and can offer a pleasant expansiveness in which other opportunities for being emerge”
—The Ketamine Training Center

Research over the last two decades has established ketamine as a safe, effective, fast-acting, and sustained antidepressant that significantly reduces adverse symptoms associated with anxiety and depression.1 Besides being the only legally-available psychedelic medicine, ketamine is increasingly being prescribed because it has a short duration of 45-90 minutes and, unlike traditional SSRIs, works quickly and without unwanted side-effects.

In addition to its antidepressant and anxiolytic (anxiety-reducing) benefits, the use of ketamine has been found to increase neuroplasticity in the brain. Therapy seeks to utilize the increased neuroplasticity that ketamine fosters, enabling the disintegration of old negative patterns and the neural re-wiring of healthy ones.

As a psychedelic agent, ketamine provides a sense of disconnection from everyday reality and produces an out of body experience that is rich in unconscious content, meaning and insight. Ketamine temporarily turns off the brain’s Default Mode Network (our ego/everyday sense of ourselves) and dissolves the boundary between self and other, generating a sense of interconnectedness and oneness with the universe that is often referred to as a state of non-duality.

Depending upon dosage, a ketamine journey may include audio-visual imagery and other sensory effects, such as a feeling of floating and weightlessness. Generally ketamine experiences are known to be positive, spiritual and profound. Regardless of the quality of the experience, a ketamine journey’s peak is usually over within 30-45 minutes, and for those who would like to reap the benefits of ketamine without its psychedelic effects, it can also be administered at lower doses.

While many people associate ketamine treatment with IV infusions or intramuscular injections in a medical or clinical setting, ketamine is also available in the form of dissolvable lozenges that are placed under the tongue and held for ten to fifteen minutes as well as in the form of an intra-nasal spray, which facilitates at-home use with a designated sitter (a partner, friend or family member) or in-office with a therapist rather than in a medical setting.

Ketamine-Assisted Psychotherapy with Ian

First we will use talk-therapy to thoroughly understand the work you want to undertake and if/how ketamine may be applied to help you process, reflect and reach your goals. This initial phase of talk-therapy may take 2-3 sessions, with the use of ketamine emerging organically from our conversations.

In terms of a psychiatric evaluation and medical assessment, Ian has partnered with Dr. Meera Garcia MD of Lantern Medical, who will ensure that you’re a suitable candidate for ketamine therapy and will prescribe accordingly. Once approved, you will receive your lozenges and/or intranasal spray via FedEx from a licensed compounding pharmacy.

Leading up to your first ketamine session, we will decide if it makes sense for your sessions to happen in Ian’s office or at home with a designated sitter. If the latter, Ian and your designated “sitter” will meet together to go over rules for a safe, comfortable experience (referred to as the “setting”) and mutually agreed upon goals and intentions (the “set”). We will also have brief check-ins via Zoom before and after your actual ketamine session. If an at-home model is desired, often it makes sense to begin with a session or two in-office before transitioning to an at-home model. Ian is also able to offer in-office sessions throughout the entirety of treatment.

If you are not doing the dosing in-office with Ian, then follow-up Integration sessions (within two days) are an important part of your ketamine treatment. During these sessions, we will work together to process your experience, translate insight into action and calibrate the treatment plan as needed.

Generally, patients receiving ketamine treatment will need six to eight consecutive sessions over a period of two months, with the possibility of occasional boosters afterwards to maintain its benefits.

In addition to benefiting individual therapy, ketamine treatment also provides a sense of open-mindedness, vulnerability and emotional safety that can be very meaningful in couples therapy, as well as a deep sense of body-awareness that can be impactful in sex therapy. For an interesting article on ketamine and couples therapy, please check out this article in Vice.

Ian has trained at the highly-esteemed Ketamine Training Center, with faculty members including Phillip Wolfson MD, Bessel Van der Kolk MD and Gita Vaid MD amongst others. He is also a member of Ketamine Psychotherapy Associates where he benefits from peer support amongst a community of multi-disciplinary practitioners as well as the latest research from the Ketamine Research Foundation.

1. Muscat, S. A., Hartelius, G., Crouch, C. R., & Morin, K. W. (2021). An integrative approach to ketamine therapy may enhance multiple dimensions of efficacy: Improving therapeutic outcomes with treatment resistant depression. Frontiers in Psychiatry, 12.