Humans have gravitated towards non-ordinary state (NOSC) experiences throughout history. These include communal rituals with music and dance, ingesting plants/fungi that occasion a connection with “the divine,” and other avenues of moving outside of one’s normative framework. Yoga, drumming, and fasting are some examples.

In indigenous cultures, medicine women and men, priestesses and shamans create/d ceremonial spaces to support healing and rite of passage experiences. An opening to the western world occurred in the late 50’s when Maria Sabina, a woman indigenous to the Mazatecs in Mexico, permitted Valentina and R. Gordon Wasson, both ethno-mycologists, to experience the ceremonial use of psilocybin. Their experience was published in Time magazine, a watershed moment that opened the western mind to explore the potential of psychedelics.

The 60’s are well known as a time where consciousness-changing plants and chemical compounds had an impact on the social landscape. What is less talked about is how these medicines were used for healing in hospice, addiction, outpatient therapy and mental institutions. Thousands of scientific publications established this. In addition, many prominent clinicians began using psychedelics for the “betterment of well people,” for healing, and for connecting with Spirit. This is well documented by pioneers such as Stanlasov Grof, MD, Ann Shulgin, Maria Mangini, PhD, FNP and Bill Richards, PhD.

The 1970’s began the “war on drugs,” which criminalized use and brought much of this research and treatment to a halt. The impact from that “war” runs deep, and learning more about your perception of the use of “mind manifesting” substances can be an important part of preparing for your expanded-state experience, ensuring that this history does not linger in your mind in a way that creates anxiety about doing this deep healing work.

Now another “psychedelic resurgence” is on. Major institutions such as Johns Hopkins and NYU are funding studies to scientifically prove what indigenous cultures and early consciousness explorers know. These can be – if held well – transformative experiences. While ketamine is the only consciousness-expanding medicine that is currently legal for use, it is likely that MDMA and psilocybin will become available over the next several years(Oregon, Colorado, and Oakland have either legalized or decriminalized psilocybin, and MDMA is in a final phase of FDA approval).

Ketamine has been safely used since 1970 as a dissociative anesthetic in emergency medicine contexts. Over time, there were ongoing reports of an unexpected side effect: people reported anti-depressant effects, expanded states of consciousness, and mystical experiences. These effects eventually led to research and subsequent FDA approval in 2019 for ketamine to treat resistant depression. Its use in “off-label” situations is also increasing, and research for simple depression, anxiety, and other conditions is ongoing.

Ketamine is not considered a classic psychedelic. Substances such as LSD, psilocybin, and ayahuasca work via a particular pathway in the brain (the Serotonin 5Ht2a receptors). Nonetheless, ketamine does occasionally have psychedelic effects (visual and somatosensory alterations). This means that people may experience visions, thoughts, and experiences that are a direct result of taking this medicine.

Your first session with ketamine will be a lower dose or psycholytic experience, meaning you will be able to “relate” to your therapist and have more capacity to talk about what is happening. If indicated (and you are interested), a higher dose, or psychedelic experience may be the next step. The intensity of these experiences allow clients to go “INward” and allow the experience to emerge. Talking about and integrating the experience happens when the effects have worn off.

Your treatment is collaborative, and determining your dose is done in conversation with your prescriber. There is an adage that it’s best to “start low and go slow,” a good reminder that sometimes, just a little bit of a shift in consciousness can have profound effects.

Yes, absolutely. In fact, you might have been referred by your therapist for KAP work to help you “get unstuck” or address deeper feelings or traumas that therapy alone has been unable to touch. This is very common, and speaks to the importance of accessing expanded states (and learning how to create them even without medicine) to support growth and healing.

It’s important that you let us know that you are in therapy, and we will discuss the best way to work collaboratively.

You will be given guidance on INtegration by your therapist in the Intake and Preparation sessions. It is most important that you make the time for this experience. Like spending time with a friend you haven’t seen for awhile, it makes a difference when you aren’t working up until the moment before your session, or have time pressure following the session. Your mindset will make a big difference, so taking a break from screens, stress, and the busy world is important. So is eating a simple, clean diet, and not eating for at least 4 hours prior to your ketamine session to minimize nausea.

Following your experience, we recommend against driving for the day, so thinking about how you will make your way home is an important piece for planning. Spending the rest of your day in a contemplative way allows the experience to continue to unfold via any practice you have: art-making, journaling, being with nature, qigong or yoga are all recommended and will support integrating what was revealed during your session. In what is called the “critical open period” of the next few days, your brain is open to relearning – or repatterning – the “usual state.” Michael Pollan discusses this in his book “How to Change Your Mind”.

We routinely schedule a close follow-up appointment (1-3 days after the ketamine session) to help you further integrate what you are working on, as well as a second integrate session a couple of weeks out.

You will likely feel the medicine within 10-15 minutes of taking it. The impact of the effects is variable. For some, the experience is mild, for others it is quite profound. The anti-depressant effects last for a few days to a few weeks. For some, several sessions in a series of weeks create a lasting antidepressant effect. We will work with you and your prescriber to decide the rhythm of treatment that is best for you.

As far as insights or trauma resolution, for some, the experience itself becomes a moment in time that one can reference as a marker for letting something go. Maintaining a relationship with this material brings changes over time. It’s difficult to know in advance what one’s experience will be, and treatment does not guarantee change. Integration sessions are important, as is your relationship with your healing journey outside of sessions. KAP can assist in this journey, and being ready and willing to embrace change are key components.

Some people come for booster sessions after having done a body of work – say every 3 months. Because healing rarely follows a linear course, you can expect that you will be engaged in a process with a therapist trained to work with difficult emotions and in non-ordinary states to assess your progress over time and make recommendations to tailor your treatment.

Since you will be taking a medication in your session that creates an experience of a non-ordinary state of consciousness, your intake session is an opportunity to make sure you are a good candidate. We have a framework for supporting clients and their therapist to create a collaborative treatment plan.

Intention – In this process, first and foremost, you are establishing a connection with your therapist and learning about how to work with this medicine to address your concerns. This is essential to support the deep work that is accelerated by the activation of non-ordinary states of consciousness.

Because sometimes people have a history that makes this a sensitive topic, we have an individualized treatment plan for each person that includes ensuring readiness to feel safe enough to be in a non-ordinary state and being able to ask for and receive help if you need it.

You will have a medical intake to ensure that there are not any risk factors (physical or mental) or drug interactions.

Some medical and psychiatric conditions need to be treated before you can safely work with ketamine. These include active hallucinations, psychosis, untreated mania, cardiovascular disease, uncontrolled hyperthyroidism, increased intracranial pressure, cystitis, or evidence of liver disease. Any previous “bad trips” are good to discuss, as well as any current difficult emotions or challenging conditions. There are multiple Routes of Administration (ROA) for ketamine – sublingual, intramuscular, or intravenous (IV) – and we work with clients who have been prescribed sublingual tablets. If it’s determined that you would do better with a different ROA, that recommendation would be made.

Some people have developed dependence and addiction to ketamine, particularly in contexts where ketamine is used recreationally or not in a structured, therapeutic way. Prescribed medications such as benzodiazepines and opioids (narcotics) have been used addictively. All medications have risks.

In the context of Ketamine Assisted Psychotherapy, we find that teaching a responsible relationship with this medicine leads to safe and appropriate use. Your prescription is such that you will have enough medication for a few expanded-state sessions. Ongoing access is based on what is needed for your treatment with your therapist after the initial series.

A clinician will do an intake will help determine if you are an appropriate candidate for this work, and discuss particular risks unique to you. Most people have no contraindications. Ketamine is very safe, and on the World Health Organization’s ten most valuable medications.