On the couch 2.0

Approach

Psychedelic snobs like me sniff at ketamine treatment. But patients with lived experience say it works

‘Infused Vocabulary’ by False Negative Art

There are now hundreds of clinics in the USA dispensing psychedelic-style treatment using what we used to call ‘regretamine’ (as in “I regret having that ketamine”) and ‘ROFLcopter’.

Depression, PTSD and addiction, including for cocaine use disorder, are the conditions treated. Novamind’s six clinics in Utah expect a more than 200% rise in patient numbers next year, up to 65,000. Waiting lists are already two weeks long for a single infusion. While Spravato’s inhalers have become synonymous, lozengers are used too and an adjustable IV drip is considered the most workable method overall.

In her lecture covering the K-clinic phenomenon, specialist ketamine therapist Veronika Gold told Vital students that a raft of approaches are required to suit patient needs. Treatment modes range from the purely medicinal, including Mindbloom’s at-home service, to a psycholytic take where therapy takes place during the trip, to the psychedelic approach nailed down by Stan Grof where discussion occurs between guided, internal drug experiences (this is Awakn’s method used in the UK).

However, US insurance codes cover the substance but do not currently include accompanying psychotherapy. Patients’ strong reactions to emerging trauma on early trips have encouraged many dispensers to provide a sitter for inaugural unaccompanied voyages nonetheless.

I’m a complete snob about ketamine masquerading as a ‘psychedelic’. I can’t help but feel gaslighted by the assumption. LSD has given birth to its own rich culture of art and ideology. Even MDMA (also not a psychedelic) gave birth to rave. Where, I ask, are ketamine’s contributions to the collective imagination?

“I was able to go into the outside world without a sense of impending doom”

Moreover. I for one, given my own history with this particular ‘medicine’, have been less than compassionately curious as to ketamine’s therapeutic worth, in comparison to what we now have to call ‘classical psychedelics’ and indeed MDMA. Reports are varied but most are positive compared to existing treatments. Many are euphoric; others a disappointment. I’m heading off for the sharp end of guide training in a month and it feels incongruous not be getting first-hand know-how of ketamine therapy too.

Close-up of the IV bag used in ‘Infused Vocabulary’ by False Negative Art

Thankfully, trustworthy circle buddies have, both microdosing and the full clinical shebang. Know what? Their verdict is… thumbs-up. 

Kelli Ann Dumas is a psychotherapist in my Vital study group. She received ketamine treatment after two decades working as a first responder in disaster zones, and with the US military abroad. While first responders do not require a PTSD diagnosis to obtain treatment in the USA, Kelli’s career has included the ‘direct threat to life’ instances this usually requires.

“In the completing treatments rose joy. A positive, giving dynamic. Love and fire”

She says of her symptoms, “My intrusive thoughts were of… being killed. I would live in fear of it. All the time.” 

After the first dose, “I was able to go into the outside world without a sense of impending doom. The intrusive thinking went away. Anger was still there though. And so were panic attacks.”

The mental room she free’d up made for a beach head to assault these deeper issues, and Kelli got to work. “Before with PTSD I felt uncommon; only tight and damaged space inside,” she reports, “As my journey went on I was able to claim more of that space internally. When I did feel anger or fear come up, I could back into myself and feel safe.”

Powerful senses of grief and loss followed as Kelli went deeper, taking lozengers alone amongst Louisiana countryside in her beloved RV with a therapist available remotely. 

“Love would arise instead and I saw myself journeying like I had in my earlier life – my energy crossing the land. In the completing treatments rose joy: a positive, giving dynamic… love and fire. This became solid inside of myself, instead of the fear.”

Costly top-ups (weekly blasts add up) haven’t been necessary so far says Kelli: “When the tremble of the trauma comes I remember the call home, and am able to ride over it with my true self of dynamic proportions,” she says. “I don't inward as much: integration with family is getting better, my exterior boundaries are getting better when faced with negativity.”