Ketamine-Assisted Psychotherapy (KAP)

A Body-Centered Approach to Psychotherapy

The National Institute of Health started investigating Ketamine as an alternative to antidepressants in the late 1990s.  Since the sixties, it has been used as an anesthesia for outpatient surgeries for children and adults.  Most recently,  it has been used in much lower doses as a mental health intervention, with the intention for self-exploration and healing.  It is now being used around the world. 


What is Ketamine Assisted Psychotherapy?

Ketamine Assisted Psychotherapy (KAP) is a new type of psychotherapy. Lower dose sublingual lozenge of Ketamine is ingested prior to a psychotherapy session to support more openness and less defenses.  The medicine works to facilitate the processing of difficult material from ones’ past.   The non-ordinary consciousness states of the ketamine experience provide for more material to work with in therapy, especially in the context of a psychotherapeutic relationship.


Why administer Ketamine within a therapy session?

Ketamine is considered a dissociative anesthetic, due to its ability to help people disengage from their usual ways of feeling and thinking.   At low doses, this effect produces shifts in awareness, perspectives, tremendous feelings of joy, pleasure, and openness towards oneself, and their life situation.  Worries and anxieties which usually accompany ordinary mind, shift and sometimes lift.  Psychotherapy helps people take actionable steps to cement the changes they realize are necessary and offers support through the integration process. 

At higher doses, Ketamine may, at times, promote psychedelic experiences such as expanded awareness and mystical or spiritual connection. These characteristics are like other psychedelic drugs that have been used successfully in psychotherapy sessions to reduce pain and distress. However, ketamine is currently the only legally available medication that may produce a psychedelic effect that can be used in psychotherapy

Issues that may respond to KAP include but are not limited to:  Obsessive-compulsive disorder (OCD), treatment resistant depression, depression associated with pain, bipolar depression, ruminative suicidality.

How does ketamine work in the brain?

Ketamine enhances healing in the brain through multiple pathways. A main action path for Ketamine is on the NDMA receptor site, increasing activity of the neurotransmitter glutamate. This may enhance mood, decrease anxiety, and decrease the cravings found in addiction. Neurogenesis or growth of neuronal connections can occur, along with a decrease in the inflammatory response in the brain and body. Ketamine may ultimately allow for novel connections to be made (neuroplasticity) across areas of the brain that allow for change and healing to take place. This may translate into enhanced enjoyment of life, renewed sense of connections in relationships, and elevation of positive mood.

Why is KAP effective? 

“In essence, we use the experiential component of the medicine to bring new perspective and the direct experience of seeing ourselves in a new way— for sufferers…  who cannot achieve this critical reframing by other means.”(p. 193, Dore, et al., Journal of Psychoactive drugs, 2019.)   It is suggested that ketamine aids the brain in making new synapses, causing a window of neuroplasticity in the brain where new connections and ideas can be formed.

“KAP’s effectiveness lies in several factors. Depending upon dose, ketamine promotes a time-out from ordinary, usual mind, relief from negativity, and an openness to the expansiveness of mind with access to self in the larger sense. These effects enhance a patient’s ability to engage in meaningful psychotherapy during and after administration. Ketamine is potent for respite, analysis, and meditative presence, and potent for recovery from depression and the lingering effects of trauma. (P. 191 Dore, et al, Journal of Psychoactive drugs, 2019)

Does ketamine have any side effects? 

Side effects are generally limited to the timespan directly after session and usually resolve quickly. These include mild nausea, dizziness, derealization, possible headache, and drowsiness. Ketamine has a low risk of abuse and tolerance; however,  escalated use comes with adverse outcomes. It generally has low reinforcement properties (I.e., stimulants) and no physiological withdrawal syndrome (i.e., opiates, benzodiazepines, ). Therefore, it is atypical for patients to crave use and demonstrate behaviors to obtain it. Some patients exhibit tolerance (needing higher doses for the same effect).

Unlike other psychedelics (mostly illegal), Ketamine can be used while a patient is on antidepressants. 

How long do treatments last? 

KAP sessions last approximately 2 to 3 hours. The varying length of time depends on dose, response to the medicine, recovery time, and what you are working on.  Frequency of KAP depends upon your treatment goals.  Some patients may want only a single KAP session, while others will need multiple sessions.  

Does my insurance cover KAP?  

Psychotherapy is covered by most insurance plans.  Insurance does not cover more than one hour session in one day.

How do I get started? 

You must be a client of Dr. Haessig for at least 2 to 3 months before she determines whether you are an appropriate candidate for KAP.  If she sees that KAP may be beneficial, she will refer you to Journey Clinic, informing them of the reasons she thinks you are a good candidate.  You will then meet with their on-line prescriber to undergo a medical evaluation and be given a prescription enough for 1 or 2 guided sessions.