Ketamine Assisted Psychotherapy: Hope for Treating Depression

Ketamine Assisted Psychotherapy: Hope for Treating Depression

By Guili Zavaschi, LPC


Participating as a therapist in the Ketamine Assisted Psychotherapy (KAP) project at the Integrative Psychiatric Healing Center in Boulder, Colorado has been a fascinating and encouraging journey. In a short amount of time I have seen clients having profound insights and relief from harsh depressive symptomology. In this small article I will address four themes that I have noticed and observed in my work with clients during the process of KAP.

Accessing traumatic states with support

It is a rare and valuable opportunity to work psychotherapeutically with the support of a medication that accelerates the healing process. In working with clients undergoing KAP I have witnessed and facilitated people accessing traumatic memories and repressed feelings. Clients become more easily aware of traumatic material without being as triggered or activated as they are when touching into those states without KAP. This allows for the integration of past experiences associated with their current states of anxiety and depression.

Flexibility of mind

During KAP clients tend to enter into a state that I call “mind flexibility.” Stubborn mindsets and introjected beliefs about themselves and their experience of life that create great suffering and sometimes feel involuntary and irrational can be experienced with a sense of ease and softness. Clients often begin to access a certain gentleness in which they hold their beliefs. This process can also allow them to access the memories of traumatic life events that shaped those foundational internalized messages. With KAP the pressure or threat that solidified those mind states is temporarily alleviated or eased, allowing the individual to let go and soften the grip on those beliefs. As the mind and body access a sense of ease while touching those core inner messages and traumatic feeling states, clients can find a new template for being. There can be a shift not only around how clients think about themselves, but also around how they feel about themselves and their lives in a more embodied manner.

Attachment/Relationship repair

With the help of an emotionally available, attuned and attachment informed psychotherapist, clients undergoing KAP can potentially reshape their sense of safety and capacity to be in relationship with others. While under the effects of Ketamine, clients’ brains are in a malleable state that can more easily open to a sense of “right relationship.” Clients become capable of finding empowerment through relaxation, and access the emotional availability necessary to relate to others and claim relational boundaries when appropriate. While in KAP the role of the therapist is to support the client to find a natural sense of connection, safety and access to emotion that is often disrupted in the face of relational trauma and that attachment psychology claims is every human’s birthright/natural state while in relationship.

Embodiment/Temporary ego dissolution

Another theme I have witnessed facilitating KAP sessions is that there is an experience of temporary ego dissolution. When medical professionals use Ketamine for anesthetic purposes, such as medical surgeries, the result is a complete yet temporary dissociation from the body in order to not feel the pain of the surgery. In KAP, however, the clinical dose is a fraction of the medical anesthetic dose, which allows clients to track a mild dissociation from the body that actually has the unique and paradoxical effect of intensifying an awareness of the body and invites a new kind of presence into the client’s lived experience. In this process the coping strategy of dissociation, often linked to severe depression and anxiety, starts to unwind and clients can experience their bodies in a more vital and present way. While under the influence of Ketamine the experience of being in a body changes, thoughts and feelings can seem suspended, having a personality and the way one perceives time and space become temporarily altered and there is often a total shift in ones sense of self location. Although experiences like these can be frightening, strange and confusing, with the anesthetic effects of Ketamine combined with a skillful psychotherapeutic facilitation those states can have a profound reorganizing and relieving effect. Clients can potentially have what Abraham Maslow called “peak experiences,” experiences that challenge our usual lived perceptual reality. Peak experiences can support clients to renew and expand their sense of self and connect to a sense of wholeness. Those experiences can be perceived as being spiritual or transpersonal and have the potential to be profoundly liberating.