What is Ketamine?
Ketamine is in a category of medications called dissociative anesthetics. It has been used since 1970 by anesthesiologists to help keep patients, usually children, asleep and free of pain in surgery. More recently, however, it was discovered that depressed patients who were given ketamine during surgery would find their depression symptoms rapidly improved. This prompted a series of scientific studies supporting the use of ketamine for rapid treatment of severe depression, especially those with suicidal urges. In doses used to treat depression, it is neither dissociative nor anesthetic.
At slightly higher doses, ketamine produces a light trance-like state where anxiety is lowered. Our defenses, the protective character armor that we have developed over our lives, can be slipped off for a while, allowing us to feel connected to emotions and memories for 30 to 40 minutes. For many patients, this experience can act as a rapid and powerful catalyst for change and insight that might otherwise take months or years to access and work through.
At higher doses, but still much lower than those used commonly in anesthesia, ketamine can bring psychedelic effects. Psychedelic literally means “mind manifesting”; or, as psychiatrist and pioneer in psychedelic psychotherapy Stanislav Grof stated it, as a “nonspecific amplifier of the unconscious process.” At these slightly higher doses people can have deep, meaningful experiences beyond the boundaries of one’s personal identity (often referred to as “transpersonal” experiences).
Ketamine is very safe and has been used for decades with medically fragile patients, soldiers in the battle field, and children.
We use ketamine in several ways: as an oral lozenge, an intramuscular injection, and sometimes intranasal. We do not use it intravenously but that does not seem to be necessary for effects.
What is Ketamine Assisted Psychotherapy?
Ketamine-Assisted Psychotherapy is a practice that allows participants to gain access to the “felt-sense” of emotional content and difficult unconscious material in a rapid and powerful way, allowing the participant to open up a doorway to allow that content to be accessed, worked with, and processed with the assistance of a highly-trained therapist. Ketamine is a powerful catalyst to allow inner access to difficult and often “stuck” material and emotions, and the psychotherapy allows the participant to actively examine, work with, and effectively process that material for long-lasting change, often far more quickly than traditional talk-oriented psychotherapies. It may have additional roles in the treatment of addictions, where stuck memories can be softened and replaced.
How it Works
Ketamine's proposed mechanism of action, targets NMDA glutamate receptors, which are crucial to memory and synaptic plasticity. One set of actions may deactivate the anti-reward center, and restore the connections between the default mode network and the lower brain structures active in processing feelings. People once again feel a capacity for pleasure, and are able to experience emotions and associated memories without the constraining habits from a lifetime of trauma and other painful experiences.