Dosing Preparation
Prepare the mind and body for ketamine dosing session
The following information is for psychoeducational purposes and will give the client proper preparation and support for the upcoming journey.
Ketamine Effects
Ketamine is a dissociative psychedelic
It often feels like your mind is separate from your body
Typically the medicine takes effect within 3-5 minutes
Effects will last from 30 minutes - 1 hour
The sensation is is often described as dreamlike
Experiences vary from person to person and each journey will have its own unique sensations and outcomes
The body feels relaxed, can feel heavy or light, and a warmth may spread through the body
There may be unusual visual effects, physical sensations, amplified emotions
Some experience visual elements while others do not
Mystical experiences can occur or even “ego dissolution” which is a temporary loss of a sense of self or identity, feeling a deep connection to everything around them which can be enlightening or frightening to some
Both pleasant and unpleasant feelings can occur and often within the same experience
Occasionally, there may be some nausea
Focusing on your breath and grounding yourself to relax and allow the experience to flow can help
Overcoming Challenging Infusions
Difficult or challenging experiences are not necessarily bad as they will often provide insight. Challenging is a more helpful way of reframing the insight it can provide.
Psychedelics are considered “non-specific amplifiers” meaning it may enhance or intensify a person's existing thoughts, emotions, and perceptions
With the right support, any challenging experiences can result in deeper healing which can help to process what may have previously been suppressed
As your therapist, I am here to provide additional support should any difficult experiences emerge
It is encouraged to bring a neutral witnessing presence to these moments as they arise during your experience
You may use the music to anchor yourself or ride the waves of relaxation or intensity to help you through your journey
Remember to use your breath to help through these moments as well to ground yourself
Have you had a challenging experience during any previous psychedelic or other type of transcendent experience? If so, what helped you through that moment?
Resourcing is helpful to assist in grounding. What types do you normally use? Would you like to practice some? (i.e. breath work, body scan, tapping, muscle relaxation, etc.)
Music
A music playlist will be played throughout the entire session to help facilitate movement of emotions, energy, thoughts
Music does not have lyrics and will range in styles
Some clients will want to choose a playlist they most connect with (nature, classical, cinematic, etc.)
Often wearing noise cancelling headphones can help immerse you in the experience or I may choose to play the music in the room in order to be able to speak with you during the session
If the music becomes agitating, you are invited to allow the agitation to guide you through your emotions or we can turn off the music
You may also listen to silence but it is important to be able to allow for outside noises to not distract you from your inner process
Comfort
Explore the physical comfort of the client to ensure nothing will interfere with the experience
Offer pillows, blanket, reclining, lighting adjustments, temperature
Ask if there is anything that could increase comfort?
Remind client to use the restroom prior to ketamine administration as it can often create feelings of needing to use facilities during journey
Eyemask
An eyemask or eyeshades will be provided which you can wear or not to help facilitate an inner journey
Having eyes open during the treatment can cause nausea and often the brightness of a room may be intensified causing discomfort
If no eye mask is the preference, it is recommended to close eyes or look downward for the session
Therapeutic Touch
It is important to receive verbal consent for therapeutic touch and review personal boundaries before the client begins the dosing
How is this distance of where I am sitting now in proximity to you? Would you like me closer, further away, next to you?
Urgent Assistance - If at any time you are in danger or at risk of physical safety (falling, bodily movement that would cause physical harm) I need your permission to help keep you safe. That may involve touch for safety. May I get your permission for this type of touch?
Therapeutic Touch - Oftentimes, clients ask for physical touch to help during times of distress or openness or gratitude for connection which at times can be helpful for healing and support. It can remind you that you are not alone. This could include holding your hand, a hand on your shoulder, arm, foot, or top of your head. Is this something you might want? If so, what would be the touch you would prefer?
Would you prefer that you ask for it and I will then provide that or would you like me to provide that touch if it seems you are in need?
Please note: It is best to allow the patient to lean into emotional moments and oftentimes working through this can feel empowering. However, if client has attachment issues it can help. Therefore, if touch is requested in advance to be used at your discretion you may find that it pulls the client from their experience and into their head with questions like, Was I being too loud? Am I taking too long and I should wrap this up? etc. So use touch if it feels necessary.
If you prefer no touch, but during your ketamine session you change your mind, would you like me to provide touch or continue to follow your current request for no touch?
It is never appropriate for any sexual or intimate touch so I will never engage in that at any time.
You may also prefer a pillow or blanket to hold or push against to feel the weight which could also provide comforting supportive touch, so I could get that for you now if you would like.
Explore
Client History
One of the most healing aspects of ketamine therapy can often be the therapeutic relationship. The more you explore about your clients history and discuss what they may feel comfortable sharing with you the more your client will feel comfortable enough to trust in the ketamine process. Creating the most inviting setting in which they can feel seen and validated and supported can expand their mindset and allow for greater insight.
Gathering Information
Exploring these questions with your client can help build rapport and allow for them to provide background and information that can increase safety and proper support for their dosing session.
Past Experiences and Present Situation
What is your past experience with psychedelics or ketamine?
If you have a history with them, would you like to share what your previous experience(s) were like?
Are there any current events that are impacting your daily functioning that you would like to discuss? (career or relationship transitions, moves, etc.)
Any traumas or major life events that may be impacting your emotional functioning you would like to share?
As your therapist, what would you like to work on together in therapy?
Is there anything about me that you would like to know that might help you feel more safe or comfortable as we work together?
Cultural/Social Context
Is there anything about your identity seen or unseen that would be helpful for me to know during our work together? (gender, race, neurodiversity, sexual orientation, age, disability, etc.)
Have you experienced any trauma or distress due to discrimination or microaggressions? (Spend time exploring)
Is there anything you would like to explore regarding you and I working together such as differences in cultural or social background or potential power dynamics?
I want you to feel safe with me so might there be something I can do to ensure that for you?
Managing Expectations
It is normal to have an idea or an expectation for your ketamine experience whether through your own research, past experiences with psychedelics, social media, or societal messages.
Approaching this experience with a “beginner’s mind” can help allow for you to be open to your own unique journey ahead as each dosing session will be unique to the person and the session as no two are the same.
Do you have any expectations for this ketamine sessions and if so what might those be?
Oftentimes, there is an urge to judge the experience as good or bad, right or wrong, which can bring more disappointment. If you can approach this session with curiosity that can help open your mind to unexpected insights and progress.
Intention Setting or Goals
Do you have any goals for this session or long term goals for your ketamine experiences?
What is your intention for this session?
It is important to begin with that intention, hold on to it loosely, then to let it go. It can help to remember to Trust, Let go, and be open. Trust you are in a safe environment, let go of needing a specific outcome, and be open to what your journey may show you.
It may help to think of your intention like a direction and not an address.
Allow yourself to be open and curious to what may be ahead because while you may not get what you want from your journey, you may get what you need.