My first experience on ketamine was in a therapist’s office. I’d taken it to work on the depression I’d been experiencing after my older brother died suddenly of a heart attack. After I popped the ketamine lozenge, my mind ventured into a soft dreamscape of swirling colors. I felt like I was underwater, adrift and looking up at the night sky. The experience was otherworldly, so private and sweet, and in that moment, I felt a deep sense of peace with the world. When I returned from my vision, I couldn’t believe the places I’d journeyed.
How could two realities—the one I’d visited on ketamine and the one I’d been living in before—both exist at once? I wondered. Life before ketamine had been filled with debilitating bouts of low mood, insomnia, angry outbursts, and ruminating on negative thoughts. As a somatic psychotherapist who focuses on depression, anxiety, and PTSD, I knew these were the classic signs of depression. But I also knew I wanted to try something other than Big Pharma antidepressants, which I knew would take time to work—if they even worked on me at all. My brother’s death had been sudden, and mired me in sorrow. I hated thinking about how he’d been found, dead and alone, in his one-bedroom apartment. Did he know he was dying? Did he experience a lot of pain? Was he okay? Where did he go, anyway? After he died, I found myself wondering these things often.
I’d heard a little bit about ketamine before taking it. A few months earlier, I’d picked up a New York Times article that called it the “new revolution of psychotherapy.” So much hype, I thought. Could it be real? Ketamine had been used for decades, primarily as an anesthetic. Veterinarians had been using it after certain types of surgeries. Of course, it had also achieved infamy as a club drug popular in the 1980s, mostly in Europe. But now there were a handful of studies demonstrating ketamine’s antidepressant properties.
When a person goes through long periods of stress, it’s believed that certain areas of the brain become less accessible. Like a worn path on a carpet, the brain can create habitual patterns that are very difficult to change. But these ketamine studies show how the drug grows new dendrites in the brain and creates new neural pathways that allow different areas of the brain to fire—which translates to greater access to coping strategies. Ketamine also works on receptors for the neurotransmitter glutamate, which helps the brain communicate with the rest of the central nervous system. Scientists believe ketamine helps alleviate depression by turning off some glutamate receptors and increasing brain plasticity. Studies have shown it’s so effective, and works so quickly, that just one dose can snap clients out of suicidal depression.
So I decided to give it go, and found a clinic that offered ketamine-assisted psychotherapy. The clinic was so booked up that I had to wait several weeks to get an appointment. I had reservations, too, mostly about being in a medicalized space. But when I arrived, the clinic felt warm, inviting, and personal. It was filled with plants and fountains. It felt like a sacred space. A clinic employee told me that a medical doctor would administer the ketamine through an IV, and afterward, my therapist would do integration, processing the experience. The therapist and I also talked about my intention for the journey, and she offered to hold my hand during it.
Soon enough, I was basking in the sensations of being underwater, of looking at the stars, and feeling the most relaxed I’d felt in a very long time. It felt as if there was a new spaciousness in my mind, room for me to see how my thoughts had been leading me to negative territory, only now I could simply decide to stop following them, and move on. Amazing. As I came down off the ketamine, my therapist was there to help me acclimate. Then, I was told we’d have another integration session a day or so later to see how I was “landing.”
This peaceful feeling lasted for a couple weeks, and when I noticed the dark corners of my mind beckoning to me once again, I eagerly made another appointment.
This time, I requested—and was administered—a heavier dose. I was interested in a bigger experience. I wanted to see if I could perhaps encounter my brother, or somehow connect more deeply with the divine.
Once again, I found myself under the stars, looking up at the sky, deep in the flow of the dreamy, ambient music playing in the office, and my feelings. It’s okay to keep living, I heard a voice say, and I began to cry tears of relief and understanding. I hadn’t realized that so much of what I’d been feeling was guilt for having survived while my brother did not. How did I make it and he didn’t? I’d wondered. After the ketamine treatment, I didn’t have the answer, but I did now believe it was okay for me to keep living, loving, and making friends. Maybe, I thought, wherever he is, he can somehow benefit from seeing me live out my dreams. I left the clinic that day feeling filled with love, with total gratitude for my life and all of my friends and family.
I’d left the clinic with the intention of letting my pain go, understanding that it wasn’t helping me in my relationship with myself and others. Maybe if I just focus on the love I have, I can let go of the pain, I thought to myself. It seemed like a good idea, so I tried to keep it in mind for as long as I could. About three weeks later, I noticed the shadows creeping back in. The self-doubt and the fear were returning. But this time, I watched them enter my mind and realized they were just another part of me, a part of my experience, and not the whole of me. I realized that the self-critical part of myself was going into overdrive, trying to keep me safe but inadvertently making me feel sad and lonely. This time, I had enough awareness to separate myself from that critical part. I also realized it was a part of me that needed to be loved. How do I shrink the critic? I wondered. Suddenly, my heart swelled with gratitude. I felt grateful for life, for the fact that I had wonderful friends and was loved by so many. I closed my eyes and saw a vision of all my friends and family members, and sent them love. This was the antidote for the critic, I realized. I’d let myself dwell on what made me grateful.
Ketamine helped me get here. Thanks to ketamine, I now see the beauty around me in a much more present way. I see colors and hear music in a new way. The afterglow after the ketamine wore off lasted a few weeks. But afterward, I had a new appreciation for things, especially in nature. That has remained, and has helped me be more present and grateful. Ketamine directed me to pay attention to the beauty in my life—the small garden in my backyard, the way the trees sound when the wind blows through the leaves, the lavender color of the sky at dusk. My heart feels so very grateful for life.
After this experience, I knew I needed to share what I’d learned with my clients, and soon afterward decided to get training to become a ketamine-assisted psychotherapist. To be clear, many companies offer ketamine without the psychotherapy component, but I don’t believe that real, enduring progress is possible without someone like a therapist present to support you in changing your life. Many people who take ketamine will have experiences under its influence that need to be explored and integrated. Ketamine can bring up old traumas and the unfinished business of our past, so therapy is an excellent way to help transform it. Integrating imagery, feelings, and overall experience into talk therapy is another very important aspect of recovery. I know that for myself, having a counselor present during the ketamine intervention was extremely helpful. She’d remind me of the information I’d received during the experience and helped me stick to the positive changes I was making in my life. The mind is a creature of habit, and if you don’t have someone helping you see your life differently, changing is going to be very difficult.
Today, I work in a clinic specifically devoted to ketamine-assisted psychotherapy, and I’ve watched the old habits that depression loves—like spending hours in bed, avoiding tasks, and self-isolating—suddenly loosen their grip. Clients who take ketamine no longer find these coping strategies compelling and try different behaviors instead. One of my clients once had a habit of going to bed whenever he felt overwhelmed. After about three ketamine treatments, he reported feeling better, but also said it brought up some scary thoughts. What if this isn’t real? he wondered. What if it doesn’t last? Then what will I do? He told me that after treatment, he went to bed feeling despondent, but just ten minutes later thought, This is boring, got out of bed, and did some gardening. For more than 20 years he’d been unable to resist retreating to bed whenever he felt sad, but this time, he could. I hear these kinds of stories often from my clients. Many report sudden breakthroughs, a shift from feeling stuck to action.
Unlike in somatic psychotherapy—which was very helpful in assisting my clients in releasing trauma from their bodies but could be slow-going—ketamine-assisted psychotherapy has helped my clients free their minds from getting trapped in certain thinking patterns. It’s helped them approach their issues from a more neutral and compassionate place. In therapy without ketamine, my clients were able to give themselves a softer, more loving perspective, but when they were back out in the world, they’d often lose that frame and revert to old behaviors and patterns.
I had a similar experience. Before ketamine, when I’d try to recall my therapist’s voice when I encountered the judgmental voices inside my head, it was very hard to feel different. The whole fake-it-till-you-make-it approach wasn’t working for me. Yes, I was more aware of the negative beliefs guiding my thoughts and actions, but I still couldn’t manifest a more loving voice for myself.
Ketamine helped me find it.
Of course, results vary from person to person. About a third of people won’t experience any big changes from ketamine-assisted therapy, although almost everyone I’ve worked with finds it to be deeply relaxing. Some clients who take ketamine speak with ancestors, or see a traumatic event replayed but from a distance that suspends the fear and allows them to more consciously process it. One of my clients saw his father who’d passed a decade ago. In the vision, his dad looked into his eyes and my client said, “I love you, dad. It’s not perfect.” Then, he saw a vision of his son, who he’d been having a hard time connecting with. My client said, “I love you, son. It’s not perfect.” He called it a deeply profound experience—a message, he said, that love is what it is and you can access deeper love by simply accepting where you are with someone. Once a perfectionist, my client has now learned to live with imperfections much more easily, and his relationships have improved as a result.
It’s been an incredibly rewarding experience seeing my clients make changes they’ve wanted for a long, long time in a relatively short period of time. I’m grateful that ketamine has given me a different tool to help my clients access their own wisdom. My personal experience with ketamine has left me feeling closer to my true self. I carry a sense of peace now that I didn’t have before, and it’s made all the difference during these exceptionally difficult times. If you’re interested in learning more about ketamine-assisted psychotherapy, I encourage you to do so. We owe it to our clients, and to ourselves, to explore new pathways to healing.
Moksha Donohue, LMFT, is a somatic and ketamine-assisted psychotherapist in private practice at the Evolve Mind Wellness center, located in Sebastopol, California. Learn more at sebastopolmft.com
Photo Credit: iStock/George Peters