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GUIDED KETAMINE
THERAPY

The most progressive type of treatment available for depression, PTSD, or other issues

  • Have you found it impossible to face trauma history or seek help for PTSD?                                                                                                                                                                                                  

  • Have you made progress with therapy for trauma or problematic emotional patterns, but feel ready for the next step in healing?                                                                                                             

  • Are you motivated to maximize your psychological and emotional growth in a safe, legal, controlled, and supportive setting?​

  • Do you struggle with unrelenting depression that has failed to respond to multiple forms of medication or other treatment?

What is ketamine? How is it safe?

Ketamine is an FDA approved substance that's historically been used as an operative anesthetic, but has also been demonstrated as safe across a wide range of applications. Unlike opioid-based anesthetics, it does not suppress the respiratory system. Although it can be contraindicated for certain existing medical conditions such as uncontrolled hypertension, it poses virtually no overdose risk. Ketamine is now being used as a medication that alleviates depression and some types of chronic pain for extended periods with cumulative use, as well as a vehicle for an altered state of consciousness that facilitates psychotherapy for trauma and other issues. The Center for HBH is thrilled to now offer preparation, guided ketamine therapy, and integration services through Wellward Medical

 

Ketamine's ability to change consciousness occurs through its mechanism as a dissociative anesthetic, meaning that it creates some degree of detachment from one's usual sense of self.  Like other psychedelics, at high enough doses, this can range from a near-death experience to temporary but complete detachment from identity, also known as ego dissolution. While research shows that reaching this state often has enduring benefit to well-being afterward, it can be terrifying at the time. In contrast, Wellward Medical physicians are neither using high doses that would create a very frightening experience, nor a sedated dosing approach (common to many ketamine treatment facilities) that treats depression pharmacologically, but allows no therapeutic work. Using an individualized, therapeutic dose administered either through  IV infusion or intramuscular injection--both with vital sign monitoring--the result is a dissociative effect that is mild to moderate, and one that can typically be managed by opening your eyes and re-connecting with the reality of the room. 

How does guided ketamine therapy work? What does it feel like?

Although dissociation may sound unpleasant at any level, the ketamine effect at this dose is enjoyable for most people. Although ketamine is a synthetic substance developed in a lab, it can have an entheogenic effect like many plant-based medicines, creating feelings of self-compassion and even spiritual connection. The key benefit of a dissociative effect lies in its impact on brain structures collectively known as the Default Mode Network (DMN), or the source of our beliefs, thought patterns, and resulting sense of self.  In psychological terms, the DMN is the seat of our ego constructs or parts, which develop through upbringing and social conditioning and collectively create our personality. Although the ego and its sense of ''I'' is necessary to create independence from the primary caregiver, it also holds our emotional wounds, insults, and conflicted feelings. It then expresses them or tries to keep them in check through symptoms or personality traits. The DMN causes many people to over-identify with their emotions, and others to overidentify with their ability to repress them, leading to fixed identities and worldviews over time. The DMN is of course also that which makes us feel separate from others.

Since ketamine impacts the fixed nature of ego parts, it allows new connections to be made about trauma, identity, and emotional and behavioral patterns. Interestingly, the connections aren't always totally clear during the session, as the psychological content may feel disjointed or slightly dream-like; instead, they may become evident over the ensuing days and weeks. For this reason, combining the treatment with a more comprehensive therapeutic approach such as Internal Family Systems (which fundamentally works with ego parts, or the DMN), crafting an intention for each session, and doing follow-up integration sessions makes ketamine treatment maximally effective. During the ketamine treatment itself, the presence of a therapist familiar with your story and goals creates an optimally supportive setting for addressing what comes up, and for noticing if connections are already developing. 

As stated above, the dosing in this case will not cause a frightening level of disruption to the cohesive ego state. You are unlikely to have a very difficult experience, especially if you have identified a strong intention in advance. Read more about this under the heading below.

The ketamine experience feels and plays out differently for everyone, but generally, you're likely to feel slightly less psychologically and emotionally burdened with each treatment session, and significantly less burdened after several. 

 

Will this be as effective as a plant-based medicine? 

 

You may wonder how a synthetic treatment could be as effective for healing as a plant-based substances like psilocybin or ayahuascua, but what all the psychedelics have in common is the impact to the DMN. Also, experiences and observations suggest that the ''Self'' proposed within the Internal Family Systems therapeutic model--a compelling force that drives us toward wholeness-guides the effect through the vehicle of intention regardless of psychedelic type, with perhaps even greater impact through preparation and integration. Depending on your personal orientation, the Self can be conceptualized as your ''Higher Self,'' or simply your highest potential--that which is greater than the sum of your limited ego parts. Although the Self, or individual will, is always there to respond using the tools of intentions we set and actions we take, ketamine and the other psychedelics act as power tools for intention:  The Self is assisted by their ability to loosen ego parts (e.g. depression, fear of failure, etc.) that are getting in the way.

 

Can I use ketamine while taking other mental health medications? Is it recommended for any disorder?

 

Because ketamine acts on NMDA (glutamate) receptors rather than serotonin receptors, it has the distinct advantage over some other psychedelics (such as psilocybin and MDMA) of being safe to use if you already take an SSRI or SNRI medication for depression, anxiety, or other symptoms. This avoids the dilemma of having to taper off these prescribed medications beforehand, which can result in potential ''discontinuation syndrome'' effects that have been known to continue affecting people even after a positive psychedelic macrodosing experience. GABA receptor agonists such as Lamictal or the benzodiazepines can also be used safely along with ketamine if the dose is adjusted accordingly. 

Guided ketamine therapy can be useful for most mental health disorders, but it is not recommended if you have schizophrenia or or unstabilized bipolar disorder. Even if you feel stable on bipolar medication, you should discuss potential risks, and the cost-benefit ratio of treatment, with your prescriber.

 

If you have an active substance use disorder, it's important to seek formal comprehensive treatment and develop a recovery lifestyle first, as ketamine is not a magic bullet. Although the effects at this dose are likely to be more than you could achieve on your own, they tend to be incremental, and will be most impactful if you already have clarity about the issues masked by the addiction. Although many people feel resistance to 12 Step programs for reasons such as religious dogma or program orthodoxy, it may be helpful to know that the Internal Family Systems approach to psychedelic treatment could be conceptualized as a parallel to step work. ''Character defects'' are ego parts, and the Self is the higher power of one's understanding. This is why most people familiar with 12 Step work often say it would benefit anyone.

 

As noted above, certain physical health conditions are contraindicated, and this would be discussed with a Wellward Medical healthcare provider first. Trying guided ketamine treatment may seem overwhelming or intimidating, but you'll receive support from start to finish, with assistance from the Wellward Medical Patient Navigator (to discuss an overall plan, including cost), establishment of a safe relationship in therapy sessions prior to actual ketamine treatment, and a physician's oversight of all the medical aspects. 

As the therapist in the process, I would be honored to hear your story and facilitate your change.

     Guided ketamine therapy in Lexington, KY