Ketamine has been used in medicine as anesthesia since the 1960’s. Recently, its use as a therapeutic tool has become available in many places worldwide to help treat a variety of conditions including depression, anxiety, PTSD, end-of-life distress, mood disorders and addiction. In Australia, Ketamine (and Esketamine) has been approved for the treatment of severe persisting depression.
For some clients, this therapeutic tool has been shown to have acute antidepressant effect (i.e.; lasting for several days) after each dosing session. This has been reported to have a much faster response than other antidepressant treatments. The limitation, however, is that using the current treatment modalities, these positive effects/uplift in mood tend to only last a short while after each session.
At specific doses, Ketamine Assisted Therapy (KAT) works by dissociating the mind from body and lowering the psychological defences to produce feelings of unreality, visual and sensory distortions as well as a temporary shift in thoughts and outlooks. Used correctly, this can help clients to access and resolve trauma that contributes to the persistence of their depression.
Given that set and setting have been shown to significantly impact the therapeutic outcomes with KAT, a huge limitation in the current clinical context surrounds the use of an often unhelpful (sterile) dosing session environment, as well as a lack of effective preparation and integration practices offered with the treatment (compared to e.g. psychedelic therapy; where preparation, dosing session guidance and integration are mandatory). Whilst most clients attend their dosing sessions with the intention to “feel better”, few recognise that such intentions rarely lead to lasting positive effects. It is the formulation accurate intentions, coupled with a dedication to face and work through unresolved painful experiences (particularly during the dosing sessions); that is more likely to result in healing and subsequent lasting feelings of positivity.
Drawing on over 20 years of my personal experiences with this substance, Ketamine support therapy is a specialised modality that offers prescribed users an opportunity to take greater control of their KAT and promote long-term positive outcomes. Therapeutic support is offered with preparation, goals and intentions, auditory and visual setting manipulation, trip mindset, aftercare and integration.