A Therapist’s Year with Ketamine: Reflections on Healing

When I began ketamine-assisted therapy in 2023, I was following a pull of intuition. Other treatments had revealed their limits, and I was drawn to the increasing availability of at-home dosing for a different approach to my mental health. My curiosity was rooted in ketamine’s demonstrated benefits for depression. As someone whose symptoms had become treatment-resistant, I was seeking relief from this darker season with its lingering fatigue and negative thought patterns, which made life difficult.

I found a well-regarded psychiatrist who worked with me to start an appropriate dose and dosing frequency, and a psychedelic-trained therapist who helped me create a nurturing set and setting for each trip. As with any promising treatment, I longed for the ketamine to work, but I had to see through trial and experimentation to determine its efficacy for my brain and body. I continued taking other medications as well after determining there were no known contraindications.

Looking back on my year of ketamine treatment, I can say wholeheartedly that it was a gift. Through it, I discovered fresh insights made possible by synaptic renewal, regained memory of what nervous system regulation could feel like, felt the loosening of the negative internal monologue, and uncovered a drive to make much-needed lifestyle changes. Now I’m eager to share about this restorative experience with any who might be longing for a similar change.

Ketamine’s Potential

Depression can cause chronic, whole-body stress, including inflammation of the brain and withering of central nervous system cells [2]. I experienced this over the years, alongside rigid thinking patterns, rejection sensitivity, and difficulty envisioning a brighter future. 

I learned that ketamine’s mechanism involves rebalancing glutamate, which in turn supports the flourishing of BDNF (Brain-Derived Neurotrophic Factor), a protein that safeguards nerve cell health [3]. BDNF levels guide neurogenesis, mood regulation, and capacity for learning. This is the remarkable path by which ketamine can address neural atrophy and executive functioning challenges. For depression specifically, research has found ties between ketamine-assisted therapy and rapidly decreased symptoms, including suicidality [4].

I was intrigued by ketamine’s psychoactive effects and ties to non-ordinary states of consciousness as well. As a psychotherapist, I’m passionate about Jungian depth psychology and about experiencing more of the transpersonal. Whether through practices like dream work or active imagination, I’d already had illuminating encounters with my unconscious mind that helped me tap into authentic Selfhood. This new opportunity to access more unconscious material, and perhaps even process trauma from a place of essential emotional distance, seemed like therapeutic gold.

Prioritizing Integration

But I knew I was the one setting out to do the work, not the substance. The heart of ketamine-assisted therapy is to partner with a trained therapist to navigate the psychedelic process. Together, by taking advantage of the window of neuroplasticity following dosing, you can articulate ineffable ketamine journeys and incorporate major takeaways into your life [5].

For those battling depression, this treatment can make established wellness practices easier to achieve. It includes releasing unhelpful beliefs by practicing flexible thinking, building healthy routines of nature immersion or creative self-expression, and connecting with community in more open-hearted ways. As an initiate, I automatically set these intentions, but soon discovered the profound ways they could actually be realized in my life.

The Dosing Process

I started my dosing sessions with an intention-setting practice where I’d jot down a theme or challenge to hold in mind. I’d also ask, “What am I ready to release, or what am I open to receiving?” I held both answers loosely, knowing my unconscious would bring up what needed to be explored. I aimed to stay present to the unfolding experience – to let go and drop in.

“It wasn’t that my traumatic memories changed; it was how I grieved them anew with a greater ability to see them from a calmer, compassionate place.”

— Marian Ting, LMFT

Once the medicine began to metabolize, my perceptual field would be the first to change. Time felt slower and less urgent, and I’d settle into a much-welcomed state of rest. My awareness of the room took on a softer quality, and I could breathe the cool air more deeply. The chronic ache of sadness sitting in my chest would subside, helping me feel safer to inhabit my body fully. The calming of my nervous system felt effortless.

Mentally, I was ushered into a dream-like state with thoughts both serene and sometimes troublingly familiar. As I’d hoped, I had more freedom with ketamine’s dissociative qualities to flow across old memories and their accompanying emotional blocks. Familiar pain somehow felt easier to hold. Without the nagging of the inner critic in the way, I could access the compassionate, confident voice of my inner Self guiding me toward greater acceptance of what arose.

Integration Sessions

After the psychoactive effects faded, I’d start integrating their meaning. Therapy sessions helped me to express the ineffable sensations creatively, begin to grieve the loss of what depression had taken, and test out long-desired lifestyle changes.

Outside of sessions, I’d reflect on the notes taken during the trips. It was as if my unconscious mind consistently imparted small gifts of insight that needed to be saved. Meditation helped process these discoveries and the emotional closure they offered. It wasn’t that my traumatic memories changed; it was how I grieved them anew with a greater ability to see them from a calmer, compassionate place.

Certainly, the medicine’s empathogenic effect played a large part in the process. It also enlarged my awareness of how much love and connection were possible, once I could separate myself from depressive distortions and lean into relationships with greater openness and authenticity.

My ability to trust in my intuition also grew. There were some confounding situations in my life when I simply knew what to do, and I felt free to take action with less inner resistance. With the chronic self-doubt temporarily lifted, fear receded too. My unconscious wisdom had more space to come to the fore, and I had the energy to act on its prompting.   

Sometimes organic action looked like sending a long-delayed text to someone whose rejection I’d been fearing. Other times I’d feel inspired to step outside for a nourishing walk or have the creative energy needed to cook an elaborate, satisfying meal.  

Lasting Changes

Not all the shifts were internal. Over the ensuing months, I grew in certainty that I wanted to leave what had been an emotionally manipulative relationship. Clarity here was hard-won, and I credit it largely to the steady process of psychedelic integration.

Something more subtle yet pervasive was how I came to embody the peaceful sensations of dosing trips, which felt like refreshing dips into an oasis of calm. It rewired my system differently – by helping me remember how life felt without chronic stress and strain, and inspiring me to do what it took to achieve that for myself without a substance.

There were also areas of gentle unfolding I’m integrating to this day, including the spiritual connections I’d made and how they grew my ties to common humanity. I’d known of Jung’s theories on the collective unconscious and how archetypal wisdom manifests in every individual. I’d also anticipated the warm, empathogenic effects ketamine consistently offered.

But I hadn’t realized how I’d come to know in an embodied way that we are all connected. My trips echoed the impact of entheogens used since ancient times, opening my heart to new levels of existential mysteries and also answers. After a year of ketamine-assisted therapy, I now carry these connections with me. When I wake up in the morning, I have a deeper trust in the meaning that comes from loving well.

No Magic Bullet

Ketamine-assisted therapy is an established presence alongside other evidence-based approaches to mental health, but expectations for how the process unfolds must be realistic. Ultimately, I found it to be an effective adjunct treatment to my existing medications, which I still take to this day.

The spontaneous insights ketamine brings are also not to be received passively. What Stanislav Grof described as our Inner Healing Intelligence needs to be embodied, with hearts committed to living out the clarity that ketamine helps us access. Just like with any therapeutic approach, our own life force is the true mechanism for lasting transformation. 

The Psychedelic Harm Reduction and Integration (PHRI) model also emphasizes how psychedelics aren’t a magic bullet for overcoming pain and suffering [6]. This places the popularity of the purely medical model in a sobering light, as ketamine treatment in a clinic doesn’t typically include ongoing integration therapy.

I believe that for the ketamine experience to be most effective, individuals must be proactive about self-reflection and personal growth. The substance is an entryway – a powerful one to be sure, but only a companion on our own journey toward a more hopeful future.

On a practical level, translating new somatic and mental states into lasting personality traits takes time. Ketamine-assisted therapy comes with ample opportunities to practice, particularly when powerful emotions such as grief, anger, or anxiety rise to the surface. Lingering traumatic experiences that live in our bodies have the opportunity to be processed with more gentleness and clarity. I found complementary therapy approaches such as Acceptance and Commitment Therapy and Internal Family Systems to be powerful amplifiers of this inner growth. 

Following the Pull

For anyone who is considering ketamine-assisted therapy for their mental health, I’d encourage you to locate psychiatric and therapeutic care that’s committed to understanding your situation and needs. Whether via at-home dosing or clinic protocols, you deserve attuned support throughout your journey.

After my transformative year with ketamine, I’ve become passionate about widening access to psychedelic medicines, particularly for those living with treatment-resistant conditions or burdened by existential questions that traditional therapy hasn’t quite reached.

What brought me to ketamine was my intuition. What kept me going with the process was something I hadn’t expected – not a cure, but a steady homecoming. The medicine didn’t offer an escape from depression; instead, it cleared just enough space for me to remember what had always been waiting underneath: my capacity for aliveness, discernment, and profound hope.

For those who’ve spent years managing symptoms rather than fully inhabiting their lives, this remembering can mean everything.

References 

1. Yin, Y., Ju, T., Zeng, D., Duan, F., Zhu, Y., Liu, J., Li, Y., & Lu, W. (2024). “Inflamed” Depression: A Review of the Interactions Between Depression and Inflammation and Current Anti-Inflammatory Strategies for Depression. Pharmacological Research, 207, 107322. https://doi.org/10.1016/j.phrs.2024.107322
   
2. Ribeiro-Davis, A., Saeedy, D. Y. A., Jahr, F. M., Hawkins, E., McClay, J. L., & Deshpande, L. S. (2023). Ketamine Produces Antidepressant Effects by Inhibiting Histone Deacetylases and Upregulating Hippocampal Brain-Derived Neurotrophic Factor Levels in a Diisopropyl Fluorophosphate–Based Rat Model of Gulf War Illness. Journal of Pharmacology and Experimental Therapeutics, 388(2), 647-654. https://doi.org/10.1124/jpet.123.001824
   
3. Jawad, M. Y., Qasim, S., Ni, M., Guo, Z., Di Vincenzo, J. D., D’Andrea, G., Tabassum, A., Mckenzie, A., Badulescu, S., Grande, I., & McIntyre, R. S. (2023). The Role of Ketamine in the Treatment of Bipolar Depression: A Scoping Review. Brain Sciences, 13(6), 909. https://doi.org/10.3390/brainsci13060909
   
4. Duek, O., Korem, N., Li, Y., Kelmendi, B., Amen, S., Gordon, C., Milne, M., Krystal, J. H., Levy, I., & Harpaz-Rotem, I. (2023). Long Term Structural and Functional Neural Changes Following a Single Infusion of Ketamine in PTSD. Neuropsychopharmacology, 48(11), 1648-1658. https://doi.org/10.1038/s41386-023-01606-3
   
5. Gorman, I., Nielson, E. M., Molinar, A., Cassidy, K., & Sabbagh, J. (2021). Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice. Frontiers in Psychology, 12, 645246. https://doi.org/10.3389/fpsyg.2021.645246