Do the public care about therapy with their infusion? They do when trips get intense

Veronika Gold has a front row seat at the new psychedelic healthcare reality.

The family psychologist worked on ketamine treatments at Cleveland’s New Pathways before heading to SF, training with MAPS and co-founding Polaris Insights.

Unsurprisingly, when psychedelics hit the general public it can get quite messy. Never mind your neighbours falling down the K-hole – can you explain that it’s only ego death and it’ll be alright soon? (Encounters with Anne Shulgin’s (RiP) ‘death door’ may be more complex).

“Even if you don’t agree with areas of psychedelic therapy, like the re-living the birth process and perinatal matrices, they can come up in patients. We’ve had girls go through that process,” says Veronica, who’s KAP program has been honed by what she sees in her treatment rooms each working day.

Accompanying psychotherapy for ketamine treatment is not covered by US insurance policies, as things stand. Over here in the UK its benefits aren’t exactly stressed by, for example, London’s Safe Minds. Besides haven’t we all gone round in circles with our psychotherapists enough by now?

“Patients might struggle with things coming up that conflict with their established beliefs”

Compass Pathways exec, psychiatrist and ketamine veteran Dr Steve Levine, who’s treated over 6,000 people with 60,000 infusions, urges caution over ketamine’s efficiency without therapy, and shakes his head over standards on the off-label scene. One Vital student who tried out their local K-clinic said he was very much left to his own devices. “It didn't necessarily engage in what I would consider best practices, preparation and integration, stuff like that,” he tells Veronika in her Vital lecture Q&A, “During the higher doses, I would get lost. I wouldn't know where it was, what was going on, or I just didn't have any sort of focal point, even with the music.”

A study group fellow on a series of ketamine treatments tells me anecdotally, “You get what you pay for.” Veronika is of course appalled at rookies being left alone in drab treatment rooms. Attention is important for first-timers especially, she says. 

Most of all Veronica’s own Ketamine Assisted Therapy (KAP) program stresses flexibility. “The medicine may be too much for psychedelic therapy where they process internally, so you lower the dose and try a psycolitic approach with talk therapy while they are under a lighter influence. Or the patient could pull back from a shamanic experience where they confront the trauma, to discuss insights on a transpersonal level. They might struggle with that as things are coming up that conflict with their established beliefs.”

It seems clinic staff need to stay light on their feet.

“It was exciting to see that for some people, home treatment worked better”

And, prepared.

“We have a long intake questionnaire, we as well ask about trans-generation trauma, we ask about their birth process, we ask about you know relationships in their life, we're asking about religious and spiritual history, discuss how they may want to be held,” says Veronika. Screening patients is key to unproductively disturbing scenes. “We have though, had referrals asking for the medicinal treatment alone who’ve had a difficult time and needed attention,” she warns. 

“We see people moving a lot, kicking, pushing, shaking off trauma physically,” says Veronika, “patients subconsciously feel more able to do this when they‘re not connected to the IV, so switching administrations can be useful too.”

If the unwashed masses crashing down main street on K wasn’t concerning enough, moral guardians gasped when the pandemic struck and ketamine therapy was offered… via Zoom.

“We weren't sure how it's how it's going to work,” says Veronika, “it was really exciting to see that for some people it worked better. They didn't have to end the session at the three hour mark, get everything together to leave the clinic, have somebody pick them up or take a ride home. They were able to stay in their space.” Sounds groovy.

Vital student and first responder Kelli Ann Dumas, who talks about her own ketamine treatment experience elsewhere in this issue of the unofficial Vital Student Zine took her later lozenges accompanied only by her two terriers, snug in her beloved RV surrounded by Louisiana woodland. She thinks it wouldn’t have been as effective without applying her own self-healing skills, which range from to participation in ayahuasca ceremonies to frontline trauma counselling work and a transpersonal psychology qualification. 

“Pulling into the observing ego was my benefit,” says Kelli, “I’ve learned how to access an observing space, but that’s through years of yoga, meditation and eastern studies. Plus from my career I have advanced skills in narrative therapy. I don’t think someone without access to those would have as effective an experience.”