Infusions of ketamine are an effective and rapid-acting treatment for pain, depression, anxiety, PTSD, and addiction. Ketamine is a safe medicine with few, if any, side effects when administered by licensed medical professionals who have appropriate training. And while infusions of IV ketamine have already been shown to help many, some research indicates that incorporating psychotherapy may be more likely to result in therapeutic benefits.
Among emerging medicines such as MDMA and psilocybin, Ketamine Assisted Psychotherapy or KAP is a type of psychedelic assisted therapy. By combining ketamine and psychotherapy, it is believed that the two treatments create synergy, resulting in a more powerful longer-lasting relief for challenging conditions like depression and PTSD. Today, we will discuss how KAP may be more valuable than ketamine infusions alone in some cases, despite its slightly higher cost. We will also describe how we integrate ketamine and psychotherapy into a single convenient treatment protocol at Innerbloom Ketamine Therapy.
On their own, psychotherapy and pharmacotherapy (medicine) have shown to be effective in treating psychological disorders. However, by combining the two into what the American Psychological Association refers to as combination therapy, they may be more beneficial. You or someone you know may have even been prescribed an SSRI like Prozac (fluoxetine) in conjunction with psychotherapy.
With KAP, we replace traditional antidepressants, which may be unsuitable for some people, with ketamine infusions. Like all combination therapy, psychotherapy in KAP is designed to help patients manage symptoms, while promoting personal growth that leads to lasting lifestyle improvements. Through dialogue with a therapist, patients are prompted with feedback, perspectives, and advice on investigating behaviors and interpreting past experiences.
Given the virtually unlimited approaches to psychotherapy and ketamine protocols, KAP varies widely. Below, we summarized three of the most common protocols.
The premise of this KAP method is that psychotherapy is offered during or immediately following a ketamine-induced dissociative state. This method is like therapeutic experiences with other hallucinogens such as MDMA and psilocybin. At least in theory, combining ketamine with psychotherapy at the same time could help a patient interpret thoughts and emotions as they arise. In practice, it’s much less clear whether psychotherapists can effectively work with patients who are experiencing an altered state of consciousness.
It’s also important to note that it’s widely believed that ketamine’s primary therapeutic potential lies in a phenomenon called neurogenesis. Neurogenesis refers to structural changes in the brain resulting from the repair and regrowth of neurons and begins 24-48 hours after the administration of ketamine. This has many researchers asking whether a patient’s “trip” or “journey” is consequential in alleviating mental illness.
This KAP method involves separating ketamine infusions from psychotherapy by one or two days, long after the psychoactive effects have dissipated. During this time, it is believed that the brain is more malleable and receptive to psychotherapy than otherwise. The other benefit of this approach is that the patient’s state of consciousness is restored so that a more coherent discussion can take place with less distraction from dissociation, distraction, and memory loss.
Note that in many cases, it may be beneficial to start psychotherapy before the first ketamine infusion. This allows the psychotherapist to build trust with the patient during a critical phase of ketamine therapy called preparation.
Also known as sequential therapy, this KAP method has patients complete a series (typically six) of ketamine infusions over a 2 to 3-week period. Once complete, the patient then receives psychotherapy for several weeks in order to sustain the benefits of the ketamine antidepressant.
Like a knowledgeable guide who helps you make the most from your travels, psychotherapy in conjunction with IV ketamine therapy may increase your likelihood of achieving lasting positive change. We are proud to collaborate with local licensed therapists who have experience with psychedelic-assisted therapy. Numerous studies have shown that KAP facilities rapid reduction in depression and anxiety. With regards to the treatment of alcohol and substance abuse disorder, ketamine with psychotherapy has been shown to promote abstinence initiation, improve relapse prevention, improve cravings, and increase motivations to remain abstinent. Lastly, ketamine used in conjunction with psychotherapy appears to extend the duration of relief in patients suffering from pain.
In our opinion, psychotherapy should be performed before, between, or after administering ketamine infusions but not during the same day. Ketamine is a dissociative medicine affecting perception, organized thinking, and short-term memory. Thus, to engage in psychotherapy at the time of ketamine administration may be counterproductive and limited. As previously mentioned, ketamine’s primary mechanism of action for its antidepressant and mood-altering benefits is through neurogenesis and neuroplasticity, which happen 24-48 hours after a ketamine infusion.
If you choose KAP with us, our process starts with psychotherapy during an initial session that focuses on preparation. Preparation includes education, attention to set and setting, and making use of strong support systems. Preparation also involves planning how to get the most out of these potentially transformative experiences. Why ketamine? Why now? What are we hoping to gain or improve? These are some of the few questions we feel are important to discuss long before the first ketamine therapy experience. Setting clear intentions and discussing expectations can help both the patient and clinician to achieve a shared goal.
Next, additional psychotherapy sessions take place 1-2 days between or after infusions. We make every effort to provide a place of safety, warmth, and trust. Working with a therapist after the ketamine therapy experiences can accelerate the healing during a process called integration. For our patients who have previously undergone psychotherapy, they often state feeling ‘stuck’ and unable to move past certain issues even if they have a well-established relationship with a therapist. Ketamine can have the ability to move a patient past a reoccurring and difficult issue.
In a therapeutic environment, ketamine paired with psychotherapy enables patients to let down protective barriers and begin to truly heal without concern of judgement, intrusion, or violation. KAP may result in sustained improvements in your wellbeing and healthy lifestyle. According to Jeffery Becker, functional medical doctor and psychiatrist, “The psychedelic experience produced by ketamine can be a deeply meaningful source of enduring change and personal growth… rapid realignment of self-perception away from shame, fear, and dread toward authentic self-acceptance and gratitude, offering patients opportunity for insight and the consideration of new potentialities.”
There are differences in opinions and variations in KAP administration among providers and researchers. And although it is our opinion that psychotherapy and ketamine should be separated by 1-2 days, we do agree on the following:
Schedule a free consultation or call us today to learn more. Innerbloom Ketamine Therapy works with independent licensed therapists who have experience with psychedelic assisted and ketamine assisted psychotherapy. Like us, they are located in San Luis Obispo (SLO) and see patients throughout the Central Coast stretching from the Bay Area to Los Angeles and beyond.
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