Reset Your Nervous System

What is Ketamine-Assisted Psychotherapy (KAP)?

Ketamine-Assised Psychotherapy combines the effectiveness of therapy with the efficacy of Ketamine, a promising new drug to treat trauma, anxiety, depression, suicidal ideation, addiction, and more. Ketamine has been combined with therapy since the 1970s to help provide healing and relief to clients who are suffering.

Clients report that KAP improves their confidence, increases curiosity, and fosters a sense of aliveness and inner safety.

A typical KAP session is 2.5 hrs long. You will only be “under the influence” of the medicine for about an hour.

Ketamine is best considered a catalyst and not a “cure.”

History of KAP

Ketamine was synthesized in the 1960s and approved by the FDA in 1970 as a surgical anesthetic used in medical procedures. High doses provided an amnesic state that would relieve pain and sedate the patient. While it was safer than other anesthetics in use, it had an unusual side effect: patients would report a “trance-like” state where they revisited painful memories and emotions from the past.

Shortly after its approval, therapists from all around the world began combining ketamine with psychotherapy. In Mexico, Salvador Roquet saw benefits in combining therapy with ketamine in addition to psychedelics (Yensen, 1973). Physicians in Iran observed that ketamine helped to recall and process trauma which relieved many symptoms (Khorramzadeh and Lotfy, 1973). In the Soviet Union, Evgeny Krupitsky used Ketamine to successfully treat alcohol abuse (Krupitsky et al., 1992).

Back in the US, the National Institute of Mental Health (NIMH) began exploring Ketamine in the late 1990s. Frustrated with the limited benefits of traditional anti-depressants, a landmark study was conducted in 2000 (Berman et al.) which cemeted that Ketmine as a powerful alternative.

Today, over 22,000 scientific papers have been published on Ketamine for mental health.

Science of Ketamine

Without the addition of therapy, Ketamine alone is very powerful:

  • Increases neuroplasticity and reactivates the reward system, making it easier to learn new skills and habits.

  • Increases BDNF (“brain fertilizer”) and Glutamate which help create new brain cells and create more connections between cells

  • Rapidly improves mood and memory

  • Calms the “Default Mode Network,” reducing inner criticism, rumination, and self-defeating patterns.

  • Reduces activity in the right amygdala in the brain, reducing feelings of anxiety

  • Fosters an inner sense of pleasure, aliveness, and safety

  • Calms the nervous system by reversing the effects of stress (Duman & Aghajanian, 2012)

Science of Ketamine with Therapy

While there are many ways to use Ketamine legally, research has shown that Ketamine is safest and most effective when combined with psychotherapy:

A 2019 study reviewed data from 235 clients cross 3 practices from 2013-2018. Individuals had a wide range of diagnoses. The study suggests that adding ketamine to therapy significantly reduced symptoms for patients. In fact, those with a history of childhood trauma (CPTSD) showed the greatest improvements.

A 2022 paper did a systematic review of 17 studies spanning 603 participants. The results suggest that adding ketamine to psychotherapy can start and prolong “clinically significant reductions in pain, anxiety, depressive symptoms, while encouraging rapport and treatment engagement, and promoting abstinence in patients addicted to other substances….these findings suggest that psychotherapy provided befefore, during, and following ketamine sessions, can maximize and prolong benefits.”

The Steps of KAP

  1. Exploring KAP — we will discuss what KAP is and if it could be the right fit for you. If we both agree, I will refer you to Journey Clinical.

  2. Medical Assessment — a healthcare professional will assess you and prescribe the medicine if appropriate.

  3. Preparation sessions — we will extensively review the process, address concerns, and rehearse the experience.

  4. KAP Session — this 2-3 hour session involves prep work, taking the medicine, and doing integration work. You’ll feel under the influence for about 40 minutes.

  5. Integration sessions — the next sessions are focused on processing the experience, exploring the challenging aspects, and sustaining the gains made from it.

Your Costs

Traditional IV Ketamine is very expensive, but I have partnered with Journey Clinical to help reduce costs. Here is the breakdown:

My Time — the equivalent of 3 sessions (2.5 hrs). We can discuss payment plans or scholarships as needed.

Nurse Visit + Medication Fees

  • Your first appointment is $330. This covers the intake with the prescriber ($250) and two doses ($85).

  • Follow-up sessions are $295. These cover a meeting with the prescriber again ($150) and 6 more doses ($145).

Note: Journey Clinical now accepts Aetna and Cigna insurance, so the meetings with the prescriber (not the meds) may be covered.

What will my experience be like?

Unlike Tylenol or blood pressure medicine, Ketamine’s effects are highly dependent on the client’s mindset, setting of the experience, dose, intention, and relationship with the therapist.

The first two sessions of ketamine are lower doses and designed to get to know the medicine. It is common to feel:

  • Sense of calm and positive mood

  • Tingling sensations and a slightly elevated heart rate

  • Altered sense of time and space

  • Observer mind — seeing yourself more objectively.

If we both agree that a larger and more intense experience would be beneficial, future sessions, involving higher doses and different dosing protocols, could lead to other experiences:

  • Remembering key memories from the past

  • Releasing suppressed pain and emotions

  • Mystical states of consciousness

Note: Ketamine is not a traditional psychedelic and does not always lead to a psychedelic experience. All clients are started with lower doses / dosing protocols to ensure the experience is pleasant and familiar. Unlike popular psychedelics, Ketamine’s effects last under an hour.

Ketamine’s physical side effects are mild and typically last only for a few hours.

Why I love Ketamine for my clients:

  • You’re not high for hours. Unlike other similar drugs, ketamine’s high only lasts around an hour.

  • It provides benefits quickly.

  • Ketamine will likely make your life less triggering. Being constantly triggered is a sign of an upregulated amygdala. The Amygdala is the "smoke detector" that alerts your brain to danger and is a key part of your brain responsible for triggers. Ketamine calms down the amygdala on its own and reactivates parts of your brain that can naturally keep it calm.

  • Ketamine is better than substances to calm down your system. If a major goal is stability and calm, Ketamine can help with that. Ketamine is great for the nervous system and can provide a lot of relief.

  • We still get to do therapy. It’s common to do therapy while clients are either under the influence of Ketamine or just coming off of the influence. This therapy is often more effective.

FAQ

  • While some have reported large, life-altering changes, Ketamine is best thought of as a tool or catalyst, reducing the amount of work needed to heal. Dr. Ingmar Gorman states, “Ketamine may make change easier, but it does not do the work for you."

  • Ketamine is approved by the FDA and is very safe. To ensure continued safety, you will only be under the influence while under my care and you will be at home for the rest of the day.

  • While Ketamine was widely abused in the 1980s as a popular street drug, the potential of developing an addiction to ketamine is very low for our work. Ketamine addiction has rarely resulted from a clinical prescription. This is because:

    1) Ketamine isn't inherently addictive. People who abuse it use high, frequent doses through injecting or snorting.

    2) Our work uses low and infrequent doses.

    3) Our work uses sublingual tablets, which means that your system only absorbs ~20% of the medication.

    Overall, the experience of the drug ends up being about 1/10th of what an "abusive" dose is.

  • Unlike common medications like antibiotics or painkillers, psychedelics are not inherently healing. Many people abuse ketamine and find that it actually helps them escape or ignore their pain. This is because Ketamine (and psychedelics) only lead to healing if the right factors are in place For example, if you don’t have the intention of facing your pain, the psychedelic will be limited to help you face it.

    Psychedelics can be difficult to research because they don’t work like traditional drugs.

  • If you do have a psychedelic trip, it is possible that you will have an experience that involves suppressed and painful memories. This can be very challenging.

    The possibility of being re-traumatized is low. This is because:

    • You’re doing it in the therapy office

    • We’ll do prep work, including inner work.

    • We focus on having the right set and setting

    • I am a trained guide and can help you get unstuck or find calm if overwhelmed.

    • We’ll do integration work to ensure we maximize the benefits of the experience.

Jennifer Dore, MD

Palo Alto Weekly, July 26, 2019 / Conversation with Jennifer Dore, MD

“It would be inhumane,” Dore said, to not offer ketamine to people in intractable mental anguish. “We need things that are transformative, that aren’t putting a Band-Aid on a problem.”