The Journey of Remembering with Ketamine

Returning to the Wisdom Within

What if healing isn't about forcing yourself to change, but creating the space to listen more deeply to yourself?

Ketamine and its History

Ketamine is classified as a Schedule III dissociative anesthetic. It is widely used in hospitals and emergency medicine today for surgery, pain control, and sedation. At higher doses, it produces anesthesia (loss of awareness and pain sensation). At lower doses, it can create a sense of mental distance from thoughts or emotions, altered perception of time or imagery, reduced intensity of depressive or traumatic symptoms, increased neuroplasticity (the brain’s ability to form new connections).

Ketamine was first synthesized in 1962 and approved as an anesthetic in 1970. Its use in psychotherapy began to be explored in the 1970s when a team of researchers was investigating its psychedelic-like properties for the potential to facilitate deep psychological work. However, formal research was limited during this time, often confined to underground settings due to the war on drugs.

Interest expanded significantly in the early 2000s. Researchers observed that patients who received ketamine for pain management reported a significant reduction in depressive symptoms. This led to a series of studies investigating the antidepressant effects of ketamine. A landmark study in the early 2000’s by researchers at Yale University showed that low-dose ketamine produced rapid antidepressant effects in patients with major depression. It works primarily by affecting the brain’s glutamate system, particularly NMDA receptors which plays a role in mood, learning, and neural flexibility. This action appears to “reset” or disrupt rigid neural patterns associated with depression, anxiety, and trauma. That finding shifted ketamine from being viewed primarily as an anesthetic to being studied seriously as a psychiatric treatment. This mechanism is fundamentally different from that of SSRIs, which can take a long time to relieve depressive symptoms and works by increasing the levels of serotonin, a different neurotransmitter, in the brain.

Over the past 15–20 years, research on Ketamine continues to grow rapidly and clinical trials are still ongoing, particularly for: Treatment-resistant depression, PTSD, Suicidal ideation, Anxiety disorders, and Substance Use Disorders. Today, Ketamine is being used as an “off-label” treatment for a variety of mental health issues.

Many clients report a significant, rapid, and sustained reduction in treatment-resistant depression, anxiety, and PTSD with improvements often lasting for months. Outcomes are enhanced when the psychedelic-like experience is paired with therapy, with studies showing 50–75% of patients achieving clinically significant improvements

Ketamine-Assisted Psychotherapy is not about “escaping” your feelings. It is about creating a supportive space where your nervous system can process trauma, your mind can become more flexible, and healing can unfold with intention and care.

Ketamine FAQ

Ketamine is described as having psychedelic-like properties because it can alter perception and awareness and induce altered states of consciousness. However, it is pharmacologically different from classic psychedelics like psilocybin or LSD. Its mechanism of action and subjective effects are distinct.
When used therapeutically, ketamine is provided in a controlled, supervised environment at much lower doses than in surgery. It may be administered in forms such as Intramuscular injection (IM), Intravenous infusion (IV), Nasal spray (such as Spravato, the FDA-approved form of esketamine for treatment-resistant depression), or Oral Lozenges. This practice only uses oral Lozenges, prescribed by our Provider, Angela Brown.
When prescribed appropriately, controlled, and monitored by qualified medical professionals, ketamine has a strong safety record. However, the safety of ketamine therapy is heavily dependent on professional supervision. The FDA has warned that at-home or unsupervised use of compounded ketamine poses serious risks, including potential for abuse, misuse, or dangerous side effects like severe sedation. It is not appropriate for everyone, and careful screening is essential to determine candidacy.
While generally well-tolerated, side effects can occur, most of which subside shortly after the session such as dissociation (feeling detached from the body), dizziness, nausea, headaches, blurred vision, flushing of the skin, confusion, and high blood pressure. Rare/Serious side effects can include: Respiratory depression (slowed breathing) and hallucinations. Studies have shown potential for bladder or liver problems with long term/repeated use.
Ketamine-Assisted Psychotherapy may be helpful for individuals experiencing:
- Treatment-resistant depression
- Trauma or PTSD
- Anxiety disorders
- Existential distress
- Persistent negative thought patterns
Ketamine-Assisted Psychotherapy (KAP) is not appropriate for everyone. Careful medical and psychological screening is required.
You may not be a good candidate if you have:
- Active psychosis (hallucinations, delusions, schizophrenia-spectrum disorders)
- Unstable or untreated bipolar disorder, especially recent mania
- Uncontrolled high blood pressure or serious heart conditions
- Current pregnancy or breastfeeding
- Active, untreated substance use disorder
- Certain significant medical conditions (e.g., kidney or liver dysfunction, high blood pressure, cardiac problems)
Some individuals may require additional preparation or medical collaboration before proceeding.
The effects of ketamine changes with the dosage and the dosage is decided based on overall treatment goals and treatment plan. There are some physiological effects that you will experience during ketamine sessions as changes in perception and sensitivity to light and sound.
Effects of ketamine can be described in seven categories: Mindfulness, Empathogenic effect, Out of Body experience, Near Death Experience, Archetypal/Mythological Experience, Ego – Dissolving Experience, and Mystical Experience.
Empathogenic effect in lower doses may result in increased awareness of the body, feelings of comfort and relaxation, reduction of ego defenses, increased empathy, compassion, and warmth. This is considered a sub-psychedelic dose and best supports talk therapy as there is more openness and relaxation of defenses.
Out of Body Experiences (OBE) involve complete separation from one’s body; significantly diminished ego defenses but with continued awareness of the self. OBEs may also include mythological/archetypal imagery, visiting non-physical realities, possible encounters with spiritual entities and non-terrestrial beings, vivid dreams of past and future lives and incarnations, and re-experiencing aspects of the birth process.
Near Death Experiences (NDE) involve the experience of complete departure from one’s corporeal and biographical existence, complete ego dissolution/loss of identity, (perceived) death of physical body and identity, reliving/reviewing one’s own life, and merging into the field of collective consciousness.
Ego – Dissolving Experience (EDE) is an ecstatic state that can involve: the dissolution of boundaries between the self and external reality; complete dissolution of one’s body and sense of self; transcendence of time and space and the five senses, connection to collective consciousness; unity with Nature/Universe; sacredness; feelings of becoming one with God; immersion into an ocean of brilliant white light; deep feelings of love, peace, serenity, joy and bliss; and, a sense of ineffability of the experience.
Following NDEs and EDEs, clients can gain perspective on long-standing psychological and existential issues and begin engaging in their lives and relationships in new, more compassionate and fulfilling ways.
Ketamine has a rapid onset and is a short acting powerful psychedelic with the potential of transformative experiences.
Regarding the acute effects of ketamine, with sublingual administration, it generally takes about 10 – 15 minutes to begin feeling the effects, which then subside in about 60 – 90 minutes. With intramuscular administration, it generally takes 3 – 5 minutes to begin feeling the effects, which then subside in about 45 – 60 minutes.
This onset of anti-depressant effects typically occur within 24 hours and has been known to last up to 2 weeks. Ketamine administration has been shown to effectively interrupt acute suicidal ideation in some patients. Repeated administrations over a short amount of time tend to result in more durable and clinically significant effects.
KAP is a non-linear process and relief from symptoms may wax and wane before stabilization of gains is achieved. Effectiveness of treatment can typically be assessed within a few sessions, although with some clients with more complicated psychological conditions, a longer course of treatment may be needed.
The amount of sessions is individual depending on overall treatment goals and responsiveness to the treatment. Some patients benefit from only one session, while many benefits from a series of 3-6 sessions, and some come for more ongoing “booster sessions” intermittently over months or years.
Current research on ketamine infusion treatment shows that 70% of patients with treatment resistant depression respond positively to 1-3 administrations, and 30-60% report some remission of their depression symptom for varying length of times. With repeated sessions, there is a cumulative beneficial effect.
Ketamine is a controlled substance and is subject to Schedule III rules under the Controlled Substance Act of 1970. Medical evidence regarding the issue of drug abuse and dependence suggests that ketamine does have some abuse potential. Ketamine can have effects on mood (feelings), cognition (thinking), and perception (imagery) that may make some people want to use it repeatedly. Ketamine has been known to be a drug of abuse in recreational settings. However, in clinical practice, given the limited access, psychoeducation of responsible use, and close monitoring, problems with the abuse and diversion of ketamine are rarely seen.
Because of its potential for abuse or psychological addiction, ketamine should never be used except under the direct supervision of a licensed physician.
Participation in ketamine psychotherapy can result in a number of benefits, but there is no guarantee that this will occur.
The ketamine experience is designed to enable your own inner healing intelligence to be accessed and guide your process. The psychotherapy relationship will provide safety, support, dialogue, and containment through the course of treatment.
Potential benefits of KAP may include: Improved mood, reduced anxiety, improved stress-management, enhanced self-esteem and resilience, reduced hypervigilance and fearfulness, resolution of trauma, increased engagement with life and interpersonal relationships, reduced existential distress, increased mindfulness, decreased compulsive and addictive behaviors, increased self-compassion, and a wider-angle lens perspective on one’s history, identity, and future.
Ketamine therapy is a new and experimental psychiatric treatment, though there are now many studies demonstrating its efficacy. Improvement generally occurs with more than one administration and is most robust when part of an overall treatment program. It may not permanently relieve your condition. If your symptoms respond to ketamine, you may still elect to be treated with medications and ongoing psychotherapy to reduce the possibility of relapse. Over time, you may also need additional ketamine booster treatments or other therapies to sustain benefits.
The literature indicates a 70% initial response rate to ketamine, as well as a remission rate (return of symptoms) for patients with treatment-resistant depression of 40-50%. If you respond with mood improvements after 6 treatments, you may go on to receive additional booster treatments periodically to be determined by your treatment team.
Music is an essential component of the KAP experience. We use special, curated music playlists that are designed to synergize with medicine effects and support the therapeutic process. Ambient, atmospheric tracks are carefully selected to help patients to deepen into the meditative state of mind and surrender to the experience.
Ketamine can temporarily increase neuroplasticity — opening a window where the brain is more receptive to new patterns of thought, emotion, and behavior. Psychotherapy is what allows you to step into that window with intention, process what emerges, and carry meaningful change back into your daily life.
Without psychotherapeutic support, experiences may feel significant in the moment but remain difficult to understand or sustain over time. With a dedicated psychotherapist guiding you through preparation, dosing, and integration, insights can become lived change.
Ketamine works differently than traditional antidepressants. Rather than targeting serotonin or dopamine, ketamine acts on the glutamate system and promotes neuroplasticity—the brain's ability to form new neural connections. This can help break rigid patterns of thinking and behavior associated with depression, anxiety, and trauma. Research shows that when ketamine is combined with therapy, patients are better able to access and process difficult emotions, leading to more lasting change than ketamine alone. The therapeutic relationship and integration work are what help translate these neurological shifts into real-life improvements.

Two Approaches. Different Pathways to Exploration.

Ketamine-Assisted Psychotherapy (KAP) & Psychedelic Somatic Interactional Psychotherapy (PSIP)

Ketamine-Assisted Psychotherapy (KAP) and Psychedelic Somatic Interactional Psychotherapy (PSIP) both incorporate altered states into therapeutic work, but they differ in where attention is directed and how the experience is approached.

KAP creates a supportive space to explore thoughts, emotions, imagery, meaning, and new perspectives. The focus is on meaning-making, emotional exploration, parts work, and integration.

PSIP is a body-oriented, relational approach that emphasizes present-moment sensations, protective responses, and what unfolds within the therapeutic relationship. The focus is on somatic awareness, dissociation, protective patterns, and relational experience.

Ketamine-Assisted Psychotherapy Sessions

KAP incorporates prescribed ketamine into a broader psychotherapeutic process. The experience may offer a different perspective on familiar thoughts, emotions, or patterns, which can then be explored and integrated through therapy.

Psychedelic Somatic Interactional Psychotherapy (PSIP) Sessions

Rather than focusing only on thoughts, memories, or the story of what happened, PSIP helps you gently connect with the deeper experiences held within your body and nervous system. With the support of a safe therapeutic relationship, psychedelic medicine, and body-based awareness, we create space for protective patterns, unresolved emotions, and old wounds to emerge and be processed in a new way.

PSIP can be especially meaningful for people who have gained insight through traditional therapy but still feel stuck in certain patterns, symptoms, or emotional responses. Sometimes we can understand why we feel the way we do and still find that our body continues to respond as though the past is happening in the present.

The goal is not to force difficult memories or relive trauma. Instead, we follow the wisdom of your nervous system at a pace that allows your experiences to be felt, understood, and integrated—with compassion, curiosity, and support

PSIP offers an opportunity to move beyond simply understanding your experiences and begin developing a deeper, more compassionate relationship with the parts of yourself that have been carrying them.

What a PSIP session may look like:

Psychoeducation and Prep sessions including non-medicine PSIP work
Beginning with cleansing, grounding, safety, and connection
Sitting comfortably upright with eye covers, no music
Establishing awareness of your body's sensations and responses
Entering an altered state with the support of prescribed ketamine when medically appropriate (lozenge dissolves under tongue for 10-15min). Sessions usually last 90-120 min.
Gently noticing sensations, emotions, impulses, protective responses, or relational patterns/positive or negative transference as they arise
Slowing down and staying curious about what your body may be communicating
Allowing emotions or experiences to unfold without forcing or analyzing them
Using the therapeutic relationship as part of the process
Integrating what emerged after the experience

PSIP sessions focus completely on the body rather than cognition with less emphasis on retelling trauma stories/analyzing the experience and more emphasis on safely staying present with what your body and nervous system are experiencing. It targets dissociation directly and works with survival energy.

In this model, ketamine is not the treatment by itself. It is a catalyst that helps the body connect to and access our inner healing intelligence to release deeply held protective patterns and allow the nervous system to complete what was interrupted — while the therapeutic relationship provides safety, guidance, and containment throughout the process.

The goal is not to relive trauma, but to allow the nervous system to complete what was interrupted.

If you are not familiar with PSIP, you might find it useful to review these educational resources. The last one in particular is a map of the autonomic nervous system (ANS). These resources will give you a better feel for the orientation of the work, the kind of clinical territory PSIP addresses, and whether this approach resonates with you.

01| Preparation

One or more preparatory sessions to build rapport, discuss safety, establish intentions, and prepare for the experience.

02| The medicine session

A comfortable, supported setting with an eye covering, pillows, blankets, and an individually selected playlist. The therapist remains present throughout the session.

03| Integration

A follow-up session to reflect on the experience, explore its meaning, and consider how insights may relate to everyday life.

PSIP may be helpful if you experienced

Early developmental or relational trauma
Emotional numbness, shutdown, or disconnection
Dissociative experiences
Persistent protective patterns despite previous therapy
Difficulty translating psychological insight into lasting change
A desire to explore body-based approaches to trauma

PSIP Resources

Watch a longer clinical discussion or demonstration

“In a survey of participant's assessment of how helpful the PSIP model was to them:

57% rated as "very helpful"

29% rated as "quite helpful"

=86% found the model helpful

PSIP Research | Psychedelic Somatic Institute

PSIP FAQ

No, you definitely do not need to already understand the model before booking an appointment. However, familiarity with it will tend to make our time together more efficient. There are a lot of educational materials available on the PSIP model but a curated collection of resources can be found here: https://www.psychedelicsomatic.org/resources
No, you definitely do not need to already understand the model before booking an appointment. However, familiarity with it will tend to make our time together more efficient. There are a lot of educational materials available on the PSIP model but a curated collection of resources can be found here: https://www.psychedelicsomatic.org/resources
Not at all, the relational and autonomic pathways PSIP focuses on are quite different from the transpersonal or insight-oriented work, which is usually the focus of most psychedelic experiences. PSIP will feel new even to those with significant psychedelic experience.
This is either a 60- or 90-minute meeting that can be used to review your personal therapeutic or psychedelic work. We can focus on patterns or symptoms that do not resolve or that keep recurring, as well as places that remain inaccessible because of dissociation.
If you are interested in receiving PSIP sessions, we can use this time to review your history, process, goals and see if there is a good clinical fit for PSIP work.
There are three options for people seeking PSIP work:
1) You are a good fit for the modality
2) There are no overt rule-outs but there are some foundational pieces that are not in place which we would work on developing before beginning the psychedelic processing component of the model. This might mean we don’t reach the psychedelic processing phase for some time until the foundation is set.
3) You’ve met one of the rule-out criteria which would make PSIP contraindicated for you.
There are many variables that can influence readiness for PSIP therapy and we can make further recommendations based on the consultation.
Length of treatment depends on what you are bringing to the table. People who have had a secure, stable, relatively safe early childhood will have a short course of work (3 to 5 sessions). The vast majority of people seeking PSIP have complex, developmental trauma that took place in childhood, typically in their family of origin. These clients should expect a solid year of work which would likely include periodic intensives.
No, PSIP is significantly different from all of these. The main process, or agent of transformation, in PSIP is the bottom-up shift accomplished by the autonomic nervous system that takes place in the actual psychedelic session. The type of work that takes place in a psychedelic integration session will typically yield secondary benefits.
This describes the type of client that frequently seeks out PSIP work, and also the experience that motivates many mental health professionals who train at PSI. While there are no guarantees about how well any individual will respond to PSIP work, we frequently see movement with clients dealing with chronically stuck mental health patterns they have struggled with for years.
This is not a rule-out, but it is a reason to gather more information about what didn’t work and ultimately run some experiments altering different variables. The primary interventions in PSIP involve therapeutic levers meaning we focus on the relationship, the container, the level of internalized solution, the condition of the client’s autonomic nervous system, dissociation and other variables. Rarely is the solution to a stuck system, “take more medicine."