Ketamine Assisted Therapy, Trauma Informed Therapy

Frequently Asked Questions

How do you choose your dose for clients undergoing ketamine therapy?

The Art of ketamine dosing in Ketamine Assisted Therapy

Dosing is more of an art than science in the world of ketamine assisted therapy. Traditional medical model studies using IV ketamine without incorporating the set (mindset), setting, preparation, and integration of the experience used a value based on body weight. This number is often cited as 0.2mg-0.5mg/kg of body weight delivered in sustained IV over the course of approximately 45 minutes.

‍

The reality of the ketamine assisted therapy experience paints a much more layered, nuanced picture. One's ability to access the mystical-dissociated state that is well accepted as necessary to reap the benefits of a psychedelic experience relies on many factors. Our years of experience working with ketamine assisted therapy clients has allowed us to provide experiences for people based on their individual readiness , their mindset and their ability to let go of control into the experience.

‍

We help someone reach readiness through preparation sessions which are designed to cultivate relational safety, curiosity and the readiness to let go of control. We provide the space that allows someone to feel comfortable, safe and relaxed. We always have our therapists in the room, holding space and attuned to the client at all time. This relational safety is key for one to be able to feel comfortable enough to let go. We integrate the experience afterwards and stay in relationship with our client through further integration work between sessions. All of this refers to what is commonly known as set and setting in the ketamine therapy space.

‍

With that said the dose becomes nothing to do with weight but a factor based on the above. We use lower doses for more psycholytic ( loosening of psychological defenses and ego) which provides a time of more interactive work. We then follow with a higher dose for a psychedelic (mind-manifesting and shifts in how we perceive reality.) This is a more introspective experience.

‍

Each session may have a different dose based on where someone is at in their healing process that given day. Needless to say we treat this as a blend of art and science and each person will have a unique dose.

Is Ketamine therapy helpful and safe for people with Dissociation?

The safety of Ketamine Therapy in clients with dissociative disorders

A common question that arises is the confusion over the dissociative effects of Ketamine and how that relates to the symptoms of dissociation in a patient with mental health symptoms. The two words are the same but mean completely different things!

‍

In short one can look at it this way:

‍

On a very simple level trauma-based dissociation, which is a form of hyper compartmentalization of different aspects of a traumatic experience (for the sake of psychological or physical survival after overwhelm and endangerment or various forms of traumatic injury and intrusion, threat etc.) is very different from the benevolent, kind of pharmaceutically or biologically mediated dissociation, which helps people separate from at lower doses, their ruminative calculative, obsessive, thinking, and constricted consciousness and at a higher dose, helps people separate from their biographies, and their sense of being limited by time, space, and identity, and so that type of dissociation lubricates the therapeutic process. Whereas the first type of traumatic dissociation , protects peoples’ sanity, and sense of self from further re-traumatization or protects from further disintegration under the pressure of trauma or post traumatic navigation of life.

‍

See full blog post for more information on ketamine therapy and the safety and efficacy in patients with dissociation

‍

Trauma Dissociation vs. Ketamine dissociation

Trauma induced dissociation vs. Ketamine therapy induced dissociation

Trauma-driven dissociation is usually adefensive disconnection from experience because experience has becomeintolerable. Ketamine-induced dissociation is a temporary pharmacologicloosening of the brain's ordinary integration of self, body, perception,memory, and salience.

Ketamine through its neuropharmacologicalmechanisms create capacity and re-connection/integration ofcortical-subcortical circuits that are usually offline in PTSD and Trauma.Allowing integration and flow of communication potentially allows forintegration of experiences that otherwise are difficult to integrate

Inwell-held relational KAP, that loosening may allow a person who chronicallydisconnects from experience to encounter previously intolerable experiencewhile remaining connected enough to another human being, the present moment,and an observing self.

When a traumatizedperson dissociates, the nervous system may be saying: “I cannot remain here andexperience this.” Ketamine can also create distance from ordinary experience,but through a different biological pathway. In a carefully held therapeutic relationship,a person may sometimes discover: “I can be far enough away from this experiencenot to be consumed by it, yet close enough to encounter it. I can remainconnected to my body, another human being, and the knowledge that I am herenow.”

‍

If this occurs during a period of increased neural flexibility, the clinicallyimportant possibility is not simply remembering differently, but learning adifferent way of being with the memory and the felt sense of the experience.

‍

Reach Out

We are here to support your healing journey with safe and compassionate care through trauma informed psychiatry and ketamine assisted therapy, helping you unlock new possibilities for growth and wellness.

Email Us

Rocky mountain cliffs illuminated by warm sunlight with green pine trees in the foreground under a clear sky.