I do not come from an easy life. I will spare you the details, but I have been struggling with trauma for my entire life. I vividly remember the exact moment I learned what trauma was. I was in a psychopathology class learning about PTSD. As we went through the symptoms for diagnosis-intrusive symptoms like flashbacks and dissociation, avoidance of memories and people, persistent altered mood like dissociative amnesia, distorted beliefs about myself and the world, inability to feel happiness and love and persistent irritability- I gained overwhelming clarity of “oh, this is me.” I was depressed, I was traumatized, I was isolated. I was miserable.
Throughout the years, I had tried everything. Being a therapist, I knew the importance of therapy. And while therapy has helped in deep and meaningful ways, especially my latest (and present) stint in relational therapy, it wasn’t enough.
I got on medication, which made a huge difference. Being properly medicated makes things a little easier. I felt better. I didn’t sob every morning and every evening. I didn’t throw up when I was anxious. I could get through the day without a nap. But it wasn’t enough.
I joined a 12 step program for those who struggle with the effects of childhood trauma. I got a sponsor. I worked the steps. I found connection and people who understood. It helped tremendously, but it wasn’t enough.
I was still chronically afraid of people. I was still crying consistently. I still felt unloveable. And I couldn’t spend another moment feeling the way I was feeling. My therapist calls this the gift of desperation. I needed something radical. And I needed something fast.
So, I tried ketamine assisted psychotherapy, and it changed my life. Saved my life is actually more accurate. I did a few sessions, working with a trained guide, and each time, things profoundly shifted. The fear left my body. Over a few sessions, the depression went away. I felt more open to connection. In time, I was able to get off medication. While I still felt (feel, this is ongoing) pain, it wasn’t all of me anymore. It was no longer all consuming. It was parts of me aching to be heard and grieved, and eventually, let go of. The pain was moving through me. I feel more free than I have ever felt in my life.
I have tears in my eyes as I write this as I think about the pain that I felt and what is possible for people struggling.
But what is ketamine?
You may know it from its street name “special k”, or as a horse tranquilizer. Ketamine was popularized in the early 60’s and used as a dissociative anesthetic during the Vietnam War. It has also been used successfully in pediatrics and veterinary medicine. As it gained popularity medically, it also gained popularity as a party drug. But using ketamine recreationally is a lot different than using it medicinally. The healing powers of ketamine are strong. It has shown great success for treatment resistant depression and Post-Traumatic Stress Disorder.
Researchers are still learning exactly how ketamine works on the brain. From what they understand, and from what I understand of what they understand, ketamine works on the glutamate receptors in the brain. Glutamate is used in the neurons in the brain to communicate with other neurons. At low doses, glutamate production is enhanced, and more activity in the brain occurs. It is believed that ketamine may help regenerate new neuronal connections. When people are under stress or depressed for a long time, neurons can start to lose the connections. There’s a saying in the therapy community, what fires together wires together. By new firing and wiring happening, new things are possible.
Stress, especially persistent stress, induces structural changes in the brain. Ketamine counterbalances these changes by promoting synaptic growth in affected areas of depressed brains such as the prefrontal cortex and the hippocampus, which regulate behavior, mood, personality development, and memory. When ketamine is administered, some of those effects seem to start to reverse. In this way, the brain is healing. While the brain may not heal into the brain it was pre-trauma, perhaps it can get close.
One of the appeals of ketamine is the rapid onset of action and results versus other antidepressants or talk therapy. As many as 4 million adults in the US have treatment resistant depression, making this fast-acting option even more appealing. Dr. Andre Atoian states “Ketamine is the agent that works when most others have failed. It is something that really allows us to give patients a new hope. They’re in this situation where nothing’s really working and they’re suffering, they’re miserable.” (Cue back to me saying I was miserable.)
In most studies, more than 50% of the participants exhibited a decrease in their depression symptoms just 24 hours after ketamine treatment. These results are statistically significant, and the results increase with number of sessions.
What can I expect? Different places do it different ways, but generally speaking, you will first meet with your guide for one or many preparation sessions to discuss what your presenting issues are and your intention for the work. Preparation sessions and integration sessions are an integral part of the work, as unconscious and repressed material will likely show itself during your journey, or piece of work, while under the ketamine.
Your day of treatment, you will go into a room and get comfortable and have your medicine administered. Administration of medicine can happen with sublingual lozenges (through your mouth) or intramuscular injection. As the medicine makes its way into your system, you will find yourself in an expanded state of consciousness. Many report feeling one with the world, and overwhelming feelings of love and serenity. The ketamine session itself typically lasts 3 hours or so. Coming out of the journey, you may feel groggy, and likely with an improved mood. Within the following weeks, you will engage in integration sessions with work with what material came up in your journey. Many practitioners recommend multiple ketamine sessions for a more successful outcome.
I believe in this work not only as a client, but as a clinician who has dedicated their life to the pursuit of healing trauma.
But while ketamine assisted psychotherapy is fruitful work, it’s not a cure all. Your problems will still be there. Your wounds will still hurt. But you may be in a different headspace to take things on, to purge the pain, and to finally move forward. I know it has done that for me.