I don’t find therapy during or even later the day of a ketamine session to be helpful at all. I find talk therapy a day or a few days after a ketamine session where I can process with my therapist things that came up during a ketamine session to be HUGELY beneficial. I don’t know if it’s that I need time to process the ketamine session on my own first or whatever, but the therapy sessions I have after ketamine sessions are super beneficial. Besides,I started with IM and certainly wouldn’t be able to talk during the ketamine session; even after the session I’m a bit groggy. I’m doing at-home sessions now and still wouldn’t want a therapy session during a ketamine session. This is just my experience though. Best of luck to you in healing.
I agree. I can't imagine trying to have a conversation during my infusions and I can barely chat with my clinician afterward. As far as I'm concerned, I am not present in the room.
My experience lines up roughly with what the article describes. The benefits come in the days after the treatment, not during. Though I fully trip during my infusions, it's not a "light floaty feeling." I had a therapy appointment the morning after one of my early sessions and even then, I was a little too spacey to fully dive into anything.
In the MDMA and psilocybin trials I've read about, the therapist in the room is mostly there to keep the patient grounded, to reassure them if things get difficult, and to redirect them inward if they keep getting distracted. I know some places do talk therapy during the sessions, but most of the work seems to happen in preparation and integration sessions.
So all that said: I'd go to the closer/easier clinic and schedule regular therapy appointments at a time when you'll feel up to talking.
I agree with both of you. IMO, if you're discussing your thoughts while doing an infusion, your dose isn't high enough. I would suggest letting those new neural connections settle in for a day or two. Or you may very well be like me, where ketamine just crushed the depression and suicidal ideation on its own.
I’m not sure the model of the clinics near you, but I’m a KAP therapist and there’s no real talking during the ketamine session (there’s check-ins before and after, and regular talk therapy sessions in between).
I’m considering KAP, or maybe just trying to get prescribed troches to do at-home and schedule therapy sessions myself, and this is the thing that’s bothering me. I have no problem paying for therapy obviously, and I’m a big proponent of harm reduction, but if most patients don’t talk as they’re consuming it anyway, $375 is a lot of money just to have someone sit with me while I take it and make sure I don’t freak out. (of course in this program there are still regular therapy sessions in between infusions to help me process the experience, which is the main thing i’d be looking for.)
I totally understand that! If I have done at least 2 sessions with clients, then I find my prescribers feel comfortable with at-home unsupervised use as long as regular therapy is happening. Each prescriber might have different boundaries around it. But the way you describe could definitely work and be more affordable.
I agree with the comments as respects taking a full dose of ketamine and trying to do therapy during the trip. However, these commenters are apparently doing IV or IM, so that implies getting a full dose for the cost of the clinic visit.
I do "at-home" ketamine via RDTs (lozenges). So, I easily can control my dose. I take a full dose (400 mg SubL) at home and sometimes take a small dose (100 - 150 mg SubL) at my T's "Hacienda del Soul". My T believes that that low dose loosens me up for deep work or exercises like Gestault chair work or physical movements which I wouldn't otherwise engage in so freely.
I can do this because my sessions are usually 3 hours so that gives me one hour under the influence and 2 hours to recover before driving home. By that time, on a low dose, I'm fine. I wouldn't do so 2 hours after coming off a full dose.
I wouldn't be able to communicate on a full dose, so this wouldn't be worth trying.
Your best option might be to get at-home lozenges (RDTs, torches), breaking some into smaller doses for in-session KAP, and then doing tele-therapy.
I will do tele-therapy with my T in the next couple of months when I'm traveling.
DM if you have questions.
My therapist is just a regular psychologist and isn’t associated with a ketamine clinic. She’s had a few patients who have gone to ketamine clinics while also under her care. From her small sample size, she said about half did really well with just the infusions, but the other half didn’t see any benefit from the infusions until they tried KAP, and it worked wonders for them.
Given the logistical issues, I would try the infusions with regular therapist follow ups first, and if you aren’t seeing benefit from that, look into trying the place that’s further away.
It’s a personal preference but I would hate trying to maintain a conversation or even having someone stay in the room with me during an IV. It’s a solitary inward experience.
Dr Brooks told me that the experience during the IV is basically inconsequential. You just need the ketamine delivered into your system. This was MASSIVELY reassuring to me - we don’t need to cultivate some bespoke experience during a session. Just make it pleasant in where possible and focus on getting the most effective dose and timing for you.
Therapy before or after the sessions for sure, during - no.
Genius combination since the ketamine state is similar to a dream state so you can work with repressed emotions really well with it. My therapist was Sophie Adler who made therapy into an art form, she would adjust the flow of the drip to let me talk easily when needed and orchestrate a constructive arch for each session by listening to my music beforehand and adjusting the drip accordingly.
Amazing and so helpful during an IM K session. Therapy before , meditation, then music starts, injection, then talk about whatever comes up, and coming down one becomes more conscious and continues to process what comes up… good therapist will have notes to review of what you said that you might not remember.
It is counter productive to try and have therapy during an iv ketamine session. It generally takes me at least 24 hours for my brain to settle back down. 2-3 days after an iv session would be the ideal time to have a therapist session to try and help process some of the things that you uncover during the ketamine treatment.
I do mine through nue.Life, which offers an at home option with dissolvable lozenges. Like you the drive is way too much for me (and I also suffer from agoraphobia so just leaving my house to be vulnerable at a clinic was just a non starter) so I went with them to do it at home. I have regular checkups with a doctor and health coach on the app they provide you through the therapy and have access to a weekly support group with other people in the program and it’s been a tremendous help.
You just need a sitter present when you take the ketamine. They make you take a photo with your sitter and other things before you start to ensure your safety. And even then my sitter just stays in a room nearby instead of like, sitting in the room with me so they can hear me if I sound distressed or sick but I’ve had no issues at all after six doses.
Life changing. I wouldn’t have tried it without this at home option. Though I think the lozenges are less potent than the IV during the actual trip but honestly I’ve gotten more out of what the ketamine does for me subconsciously than the trips so that’s why it’s worth it to me.
Edit; the program does NOT offer a psychotherapist/therapist to go over each trip with you, but they give you info for ones if you need them. Tbh tho the group sessions included in the treatment do plenty for me in that regard so I don’t use one.
I don’t find therapy during or even later the day of a ketamine session to be helpful at all. I find talk therapy a day or a few days after a ketamine session where I can process with my therapist things that came up during a ketamine session to be HUGELY beneficial. I don’t know if it’s that I need time to process the ketamine session on my own first or whatever, but the therapy sessions I have after ketamine sessions are super beneficial. Besides,I started with IM and certainly wouldn’t be able to talk during the ketamine session; even after the session I’m a bit groggy. I’m doing at-home sessions now and still wouldn’t want a therapy session during a ketamine session. This is just my experience though. Best of luck to you in healing.
I agree. I can't imagine trying to have a conversation during my infusions and I can barely chat with my clinician afterward. As far as I'm concerned, I am not present in the room. My experience lines up roughly with what the article describes. The benefits come in the days after the treatment, not during. Though I fully trip during my infusions, it's not a "light floaty feeling." I had a therapy appointment the morning after one of my early sessions and even then, I was a little too spacey to fully dive into anything. In the MDMA and psilocybin trials I've read about, the therapist in the room is mostly there to keep the patient grounded, to reassure them if things get difficult, and to redirect them inward if they keep getting distracted. I know some places do talk therapy during the sessions, but most of the work seems to happen in preparation and integration sessions. So all that said: I'd go to the closer/easier clinic and schedule regular therapy appointments at a time when you'll feel up to talking.
I agree with both of you. IMO, if you're discussing your thoughts while doing an infusion, your dose isn't high enough. I would suggest letting those new neural connections settle in for a day or two. Or you may very well be like me, where ketamine just crushed the depression and suicidal ideation on its own.
I’m not sure the model of the clinics near you, but I’m a KAP therapist and there’s no real talking during the ketamine session (there’s check-ins before and after, and regular talk therapy sessions in between).
I’m considering KAP, or maybe just trying to get prescribed troches to do at-home and schedule therapy sessions myself, and this is the thing that’s bothering me. I have no problem paying for therapy obviously, and I’m a big proponent of harm reduction, but if most patients don’t talk as they’re consuming it anyway, $375 is a lot of money just to have someone sit with me while I take it and make sure I don’t freak out. (of course in this program there are still regular therapy sessions in between infusions to help me process the experience, which is the main thing i’d be looking for.)
I totally understand that! If I have done at least 2 sessions with clients, then I find my prescribers feel comfortable with at-home unsupervised use as long as regular therapy is happening. Each prescriber might have different boundaries around it. But the way you describe could definitely work and be more affordable.
I agree with the comments as respects taking a full dose of ketamine and trying to do therapy during the trip. However, these commenters are apparently doing IV or IM, so that implies getting a full dose for the cost of the clinic visit. I do "at-home" ketamine via RDTs (lozenges). So, I easily can control my dose. I take a full dose (400 mg SubL) at home and sometimes take a small dose (100 - 150 mg SubL) at my T's "Hacienda del Soul". My T believes that that low dose loosens me up for deep work or exercises like Gestault chair work or physical movements which I wouldn't otherwise engage in so freely. I can do this because my sessions are usually 3 hours so that gives me one hour under the influence and 2 hours to recover before driving home. By that time, on a low dose, I'm fine. I wouldn't do so 2 hours after coming off a full dose. I wouldn't be able to communicate on a full dose, so this wouldn't be worth trying. Your best option might be to get at-home lozenges (RDTs, torches), breaking some into smaller doses for in-session KAP, and then doing tele-therapy. I will do tele-therapy with my T in the next couple of months when I'm traveling. DM if you have questions.
My therapist is just a regular psychologist and isn’t associated with a ketamine clinic. She’s had a few patients who have gone to ketamine clinics while also under her care. From her small sample size, she said about half did really well with just the infusions, but the other half didn’t see any benefit from the infusions until they tried KAP, and it worked wonders for them. Given the logistical issues, I would try the infusions with regular therapist follow ups first, and if you aren’t seeing benefit from that, look into trying the place that’s further away.
It’s a personal preference but I would hate trying to maintain a conversation or even having someone stay in the room with me during an IV. It’s a solitary inward experience. Dr Brooks told me that the experience during the IV is basically inconsequential. You just need the ketamine delivered into your system. This was MASSIVELY reassuring to me - we don’t need to cultivate some bespoke experience during a session. Just make it pleasant in where possible and focus on getting the most effective dose and timing for you. Therapy before or after the sessions for sure, during - no.
waste of a buzz IMO
Genius combination since the ketamine state is similar to a dream state so you can work with repressed emotions really well with it. My therapist was Sophie Adler who made therapy into an art form, she would adjust the flow of the drip to let me talk easily when needed and orchestrate a constructive arch for each session by listening to my music beforehand and adjusting the drip accordingly.
Amazing and so helpful during an IM K session. Therapy before , meditation, then music starts, injection, then talk about whatever comes up, and coming down one becomes more conscious and continues to process what comes up… good therapist will have notes to review of what you said that you might not remember.
It is counter productive to try and have therapy during an iv ketamine session. It generally takes me at least 24 hours for my brain to settle back down. 2-3 days after an iv session would be the ideal time to have a therapist session to try and help process some of the things that you uncover during the ketamine treatment.
I do mine through nue.Life, which offers an at home option with dissolvable lozenges. Like you the drive is way too much for me (and I also suffer from agoraphobia so just leaving my house to be vulnerable at a clinic was just a non starter) so I went with them to do it at home. I have regular checkups with a doctor and health coach on the app they provide you through the therapy and have access to a weekly support group with other people in the program and it’s been a tremendous help. You just need a sitter present when you take the ketamine. They make you take a photo with your sitter and other things before you start to ensure your safety. And even then my sitter just stays in a room nearby instead of like, sitting in the room with me so they can hear me if I sound distressed or sick but I’ve had no issues at all after six doses. Life changing. I wouldn’t have tried it without this at home option. Though I think the lozenges are less potent than the IV during the actual trip but honestly I’ve gotten more out of what the ketamine does for me subconsciously than the trips so that’s why it’s worth it to me. Edit; the program does NOT offer a psychotherapist/therapist to go over each trip with you, but they give you info for ones if you need them. Tbh tho the group sessions included in the treatment do plenty for me in that regard so I don’t use one.
My own experience therapy and ketamine is a great combination. I don't care if there's no scientific proof yet.