Trauma, addiction and MDMA therapy with Dr Ben Sessa

My unofficial Vital Study Zine #14 with observations from Vital Psychedelic Training and recent happenings in the space

Jimmy Cauty, ‘Riot Shield’

Dr Ben Sessa’s book The Psychedelic Renaissance acted as exactly that.

The agenda for a new Albion is effectively a ‘hypersigil’ – the gnostic term for a creative work that somehow manifests its content. These effects even included the buzz phrase the proceeding new era of research was awarded.

Debuting a decade ago, The Psychedelic Renaissance contained ideas Sessa first officially voiced in a presentation to the Royal College of Psychiatrists in 2006. LSD hadn’t been mentioned in its halls for over 30 years.

Since The Psychedelic Renaissance took psychiatry by storm Dr Sessa has hardly been flouncing around in a kaftan. He’s living the experience, conducting frontline child trauma and addiction treatment… including acting as lead psychiatrist on the Bristol Imperial MDMA for Alcoholism (BIMA) project, where patients relapsing into heavy drinking were cut to a rate of 21% from the 73% who do so despite trying medications, 12-step and conventional therapy.

BIMA research took place at leading clinic Awakn, co-founded by Sessa in Bristol, UK. It’s now listed on the NEO Toronto stock exchange and has hooked up with David Nutt’s Drug Science. The Mithoefers are on Awakn’s advisory board. Celia Morgan is head of ketamine assisted therapy, an area where Awakn just received 66% of new funding from the UK government and licensed its staggeringly successful ‘Project Kestrel’ design to US chain Revitalist.

“I resent the assumption this is all about money. My job is getting the maximum amount of psychedelics to as many people as possible”

Sessa is an avid member of the psychedelic ‘subculture’ too. In 2015 he co-founded and ran the Breaking Convention conference that showcases the space’s sharpest upcoming minds. His children are named Huxley, Jimi and Kitty.

I’ve noticed during academic presentations that after their personal intro is over it’s de rigueur for presenters to, if they’d like, admit to any horrendous biases.

Prostrate before you, I make clear: Dr Sessa is my age, lives and cheerleads for my home town, and confesses to an achingly middle class upbringing that includes winter sports and bedroom DJing… so there’s ‘similarity bias’ there. Moreover: only in the past few weeks I discovered he wrote a column for a hipster magazine I was founding editor of that’s having a bit of a moment now, and made a cameo in a Channel Four sketch show I wrote on. 

Myself and Dr Ben Sessa (right) at Breaking Convention 2022

So don’t ask me to justify statements like ‘Sessa is our generation’s admittedly unlikely Leary or McKenna’, and yes, I am calling that with this blog post. Instead ask Vital students, whose reactions to Dr Sessa ranged from “That was my favourite presentation so far” to “You’re the most interesting person to hear from in psychedelics right now” and “This has me so excited and hopeful for the future of this space!”

Whilst actually being the closest thing we do have to Timothy Leary or Terrence McKenna – closest rival Robin Carhart-Harris has recently zhuzh’d up his look just to keep up – Sessa has succeeded in ushering in a revolution where the two counterculture icons failed.

“This is the psychedelic era. Here. Now. We’re living in it,” he decrees to Vital’s class of ‘22.

“Following medicalisation the psychedelic underground is richer and freer than ever”

How has Sessa made this happen? By following his own advice in the closing pages of The Psychedelic Renaissance.

‘An unfortunate but necessary truth is that professionals working in this field must remain as boring and staid as possible,’ he solemnly advised in those very pages, ‘as well as inspirational and enthusiastic – to get the message across. I do not say all of these dull and conservative things because I lack imagination or fail to appreciate the fun, wonder and spirituality of the psychedelic experience. On the contrary, I welcome and embrace it.’ 

This trademark approach of blowing minds by stealth doesn’t stop him racking up a ton of newspaper credits, where he lays down psychedelic law (and lore) in a fashion also quite dissimilar to his predecessors. 

In fact, only this year at 2022’s Breaking Convention he decimated criticisms of corporadelia at his £6K per programme Awakn clinics with: “I resent the assumption this is all about money. My job is getting the maximum amount of psychedelics to as many people as possible, and researching that is very costly. There will still be raves, festivals, ceremonies. The psychedelic underground is richer and freer than ever post-medicalisation.”

Dr Sessa is a boon to journalists. Here’s a few choice quotes from his week fourteen Vital lecture:

“There’s nothing more dangerous than drinking a bottle of vodka a day” 

“Then they go back on heroin, or other far, far more dangerous substances like alcohol” 

“Three quarters of a million people in the UK take ecstasy every weekend and our hospital wards are not full of casualties” 

“I’m not that spiritual a guy, but I’ll talk to patients about kundalini and chakras till the cows come home. They do also want to talk about things like how to get their children out of social services care”

Here he is on NBC with MAPS’ The Mithoefers talking about their slot on Netflix’s How to change Your Mind, showing ITV viewers around Awakn, plus watch his TEDX Talk on psychedelics as antibiotics, explain childhood trauma and MDMA therapy and more on the New Psychonaut YouTube lecture archive.

Here’s this issue’s contents arranged along Vital Psychedelic Training’s five learning themes:

Next issue: Vegetalismo author Dr Luis Eduardo Luna of Wasiwaska Research Centre

Indistinguishable from magic

Approach

Dr Ben Sessa’s greatest conversation stopper: psychedelics are a ‘psychic antibiotic’ capable of statistically curing mental diseases

Novotak, ‘Daydream Version Six’

“Psychiatry is a pretty desperate and miserable place to work.”

Dr Ben Sessa’s been at the frontline of mental health services since 1997, and deserves a rant. “Where are we going wrong? We've had modern psychiatry around for 100 years. And we’re not getting the kind of clinical outcomes we want,” he opines, “younger people get given the SSRIs, can’t work the therapy, and kill themselves.”

‘Psychic antibiotic’ is another of Sessa’s bravura catchphrases. Mental health treatment’s in a miserable state of affairs comparable to general medicine in the late 1800s, says Sessa who first presented his vision that psychedelic medicine could be revived to the Royal College of Psychiatrists in 2006.

“Doctors were losing the battle to the infectious diseases, leprosy, smallpox, tuberculosis, people dying post-operatively,” he continues, flexing his storytelling skills in a swaggering lecture, “Back then, were very good at our statistical analysis and epidemiology too. We knew that people were dying, but it wasn't clear what was going on.”

Things changed when a joint German-Japanese team discovered a cure for… syphilis in 1908, and Nobel prizes ensued.

“Where is our treatment that gets to the heart of disorders?”

‘Antibiotics’ as they were called, ‘cos they killed bacteria, include any micro-biological treatment for bacterial infection, not just other bacteria bred to fight against their microscopic kin.

Penicillin, invented by Sir Alexander Fleming in 1928, is derived from a fungus secretion… just saying. Specifically a mould, which are traditionally used for their anti-infection properties.

“Where is our antibiotic?” bellows Sessa in the general direction of the gods, “Where is our treatment that gets to the heart of disorders, and actually cures them? We write these voluminous tomes,” he continues, hitting his stride, “The ‘DSM’ and ‘ICD’. We track who gets depression, and anxiety, and eating disorders, and personality disorders, and addictions, and affective disorders,” here it comes, “…but we're not very good at treating them.”

Dr Sessa’s allowed to ham it up like this because he is legit as any clinician, researcher or spokesperson.

“The idea that healing patients would be a bad business model is sick”

It’s almost like the anthropology reports from the Amazon… where researchers are struck by the animist doctrine that you’re only allowed to talk shit about stuff you’ve actually done…

Tell us why our ailments continue to vex us so, oh unlikely shaman returned from the darkest depths of the forest with knowledge?

“Because we treat them symptomatically,” answers Dr Sessa, “We provide a whole plethora of daily maintenance drugs that mask the symptoms. Which the pharmaceutical industry queued up to provide us with.”

Yet there is hope. Way back in 2012’s breakthrough Psychedelic Renaissance, Sessa’s book which coined the phrase, he was already declaring psychedelic medicine the ‘psychic antibiotic’ that his profession and his patients crave.

In his Vital presentation during the course’s second module covering psychedelic therapy styles, Sessa beams with pride after battering his return key to reveal a graph showing MDMA-AT thrashing a combination of the best anti-addiction treatments money can buy, plus 12-step and more, by a 73% to 21% recovery rate.

“We're not going to cure everyone and therefore put ourselves out of business”

Sessa’s surging Awakn chain though, is a listed company. Like other private medical providers, doesn’t he have a duty to shareholders to drag treatment plans out too?

“The idea that healing patients would be a bad business model is sick,” and he doesn’t mean in the same way he dryly describes my wannabe-hipster home town of Bristol as ‘extremely sick’ in his introduction, “sustaining poor treatments with poor outcomes in order to maintain a customer base is absurd.”

Accident wards don’t keep your leg held up in traction forever. “There's plenty of work out there for orthopaedic surgeons mending broken legs,” explains Sessa to an enquiring Vital student in the Q&A, “plus there are plenty of people out there who could do with their mental disorders being completely cured. We're not going to cure everyone and therefore put ourselves out of business.” 

Behind the mask

Therapy

MDMA provides lasting respite for the traumatised

Stefanie Schneider, Boy with Silver Mask (Stay) Photograph

MDMA’s ideal for therapy because it can “rebrand your sense of self.”

Shame and trauma dance a ghostly tango. An ostracised alcoholic is merely the grown-up version of the abused child we clutch our perals over. Or so says child psychiatrist and leading psychedelic researcher Dr Ben Sessa, presenting to Vital students.

“Abused children generate tremendous sympathy,” says Sessa alluding to many high-profile court cases in the UK during lockdown and beyond, “but once the same abused child turns to addiction, they’re written off as a filthy smackhead, or an alcoholic.” Reported child abuse cases rose a staggering 1493% at one point during the C-19 lockdowns.

Dr Sessa has worked as a child psychiatrist since 1997. But not just with under-16s. He’s taken his knowledge of childhood trauma and applied it across the all-too-adult issues it causes later.

“Existing drugs are not treating the base disorder – trauma”

Like alcohol use disorder (AUD) for example. 

“I naturally take a very developmental approach to mental disorder,” he says, “I think that every adult psychiatrist should spend some time as a child and adolescent psychiatrist, because we really do grow up to become our parents. And those things that we learned in those early years – ‘Even my parents can’t love me, I’m useless, I’m a failure, I can’t achieve’ – become a blueprint for the rest of our lives.”

Childhood trauma operates on a scale ranging from forced labour and sustained sexual abuse, to simply growing up in a rigid suburban household where neurotic parents act out their frustrations with a shaming communication style featuring ‘too many shoulds’. 

“I deliberately lump together childhood trauma, post traumatic stress disorder, complex post traumatic stress disorder, and addictions,” explains Sessa, “it's very difficult to treat these, and there’s no single approach.”

The trajectory from trauma to addiction draws on John Bowlby’s attachment theory and research from the past decade or more connecting PTSD to substance abuse. Attachment theory suggests that maladaptive adult behaviour is more likely to be caused by issues between a baby and its mother and other environmental factors including poverty. This contradicts established psychoanalytic narrative, which says it’s all about… the oedipus complex, and other aspects of thanatos, the Freudian ‘drive’ to act according to one’s most selfish, basest urges.

Despite being head of The Tavistock Clinic’s child psychology department from the mid-1940s, Bowlby’s ideas were still being rubbished by the establishment in the 1990s.

“If you’ve had an insecure attachment to your parents, you develop these neuro-protective narratives: ‘I'm bad, I can't achieve, I'm unlovable, the world is dangerous’,” explains sessa, “By the time you've been thinking like this for ten, twenty, thirty years you truly believe it. This is why mental disorders become chronic, lifelong unremitting problems. Faced with it, the safest and simplest way of dealing with it is to numb yourself, block out the world with sedating dangerous substances like heroin. And far more dangerous ones… like alcohol.”

Like in the USA, there’s currently no pharmacological prescription for PTSD available in the UK. Nor alcohol use disorder; in the United States only 4% of AUD sufferers are given a medication.

“We have what we call ‘polypharmacy’,” explains Sessa, “If the patient's depressed, we'll give them an antidepressant. If they can't sleep, we'll give them a hypnotic. If they're constantly anxious, we'll give them an anxiolytic. If their mood goes up and down, we'll give them a mood stabiliser. If they are hyper-vigilant, one of the core features of PTSD, if this spills over into paranoia will give them an anti-psychotic. And of course, you have to keep taking these drugs day-in, day-out as maintenance medications for the rest of your life. None of these different classes of drugs are curing the patient. They're not treating the base disorder – which is trauma.”

Here in the UK psychiatrists (doctors prescribing drugs), clinical psychologists (NHS trained psychoanalysts who have lots to do) and psychotherapists (talk therapists of wildly varying quality, without medical training) have long existed seemingly independently of each other.

Personal and financial resources are required to tackle one’s mental health with impact.

“Pharmaceutical MDMA is 99.8% pure and very expensive”

I’d recommend medication, psychoanalysis and psychotherapy. But as a customer myself I know it doesn’t come cheap. The experience can be arbitrary too.

“After 30 years in psychiatry, my opinion is that psychotherapy boils down to a relationship between the patient and the therapist, and an ability for the patient to talk about their pain,” claims Sessa with authority, “that's fine for around 50% of people with trauma based disorders.” 

But not nearly for all.

“A significant half, they cannot go there to talk about their pain… they will do anything but talk about that night when they were ten years old, and their grandfather came into their bedroom,” says Dr Sessa.

Many therapists are understandably not fully prepared to deal with angry, impenetrable PTSD cases with substance use disorders and co-morbidities like ADHD.

“Trauma victims drop out of therapy. We have high rates of self harm and suicide, and very high rates of addictions. There's a 50% treatment resistance in PTSD. After detox, 70 to 90% of addicts are back on the substance again.”

Combining psychiatry and psychotherapy sounds like common sense. But it’s practically unheard of. “The therapy alongside the MDMA makes the difference,” says Sessa pointing out that his clinic Awakn doesn’t offer its current ketamine programme without accompanying talk sessions.

Awakn conducted its BIMA – Bristol Imperial MDMA for Alcoholism – project under research trial conditions, so while the process mirrored a regular treatment programme with genuine sufferers they didn’t pay and regulations were fiercely adhered to. Pharmaceutical MDMA was used, “it’s 99.8% pure and very expensive,” says Sessa. 

MDMA’s cocktail of positive therapeutic effects include a melodic duet between the amygdala and frontal cortex, where the amygdala ‘fear response’ shrinks while activity in the advanced brain grows, providing an ‘optimal window of arousal’. MDMA’s empathy-increasing properties, generated by production of the hormone oxytocin, strengthen the bond between therapist and patent.

“Elements of transpersonal psychotherapy were used during the drug sessions”

The ‘peak experience’ though remains key for softening the calloused neural pathways that dictate repeated cycles of dysfunctional behaviour, like addiction in particular. 

“You can't just tell someone ‘stop thinking like that’. Chronic unremitting mental disorder is all about ‘stuckness’. It becomes your version of yourself.” Decades on from the original trauma, “Something otherwise relatively benign happens in the queue at the post office and you have a panic attack,” illustrates Sessa. 

BIMA’s eight-week course Sessa describes with characteristic honesty as, “‘MDMA assisted psychotherapy for the treatment of alcohol use disorder’, which is perfectly accurate. It's never been done before; we were making it up as we went along.”

For MAPS-trained Sessa and his prodigal collaborator Dr Celia Morgan (named by Business Insider as one of the ‘Women Shaping the Future of Psychedelics’) this meant drawing on their wealth of experience carving out the Psychedelic Renaissance over the past 20 years, rather than riffing.

“Of course it was more nuanced than that. We had elements of transpersonal psychotherapy we used during the drug sessions; we used a lot taken from the maps manual for PTSD.” 

All the subjects were daily heavy drinkers who had been through detox. Talk therapy in the ‘non drug’ sessions, a total of 15 around three MDMA ‘trips’ drew from their experience at the forefront of addiction treatment: “We used elements of Acceptance and Commitment Therapy, Motivational Enhancement Therapy, and CBT [Cognitive Behavioural Therapy], which were typical for addiction studies. We are of course writing the manual for this, and will be using it as we move into Phase 2B.”

Ravers score rare victory over Mondays

Medical

The Awakn formula to avoid notorious MDMA comedowns: peak early and don’t skimp on quality

Scott Houston, ‘Party Kids at Dawn’

In 40 years there’s been no single serious reaction to MDMA in clinical setting.

Doses taken are 125mg and up, about half the size of a respectable ecstasy pill. But “It’s 99.8% pure, and very expensive,” says Dr Sessa of his MDMA stash.

Alongside a 9:30am start time, measured hydration, and overnight stays in the chic surrounds of an Awakn clinic, the integrity of the substance is one of the many reasons why Dr Ben Sessa reckons MDMA comedowns don’t exist. Just like your mate, ‘Hardcore Mandy’.

Sessa didn’t exactly say ‘Comedowns don’t exist’ in his December 2021 report Debunking the myth of ‘Blue Mondays: No evidence of affect drop after taking clinical MDMA.

“Take it during the day”

In fact, like he does say in the proceeding war of words on the letters pages of The International Journal of Psychiatry (which is a pretty cool thing to be having anyway) after the article appeared:

‘We were not stating that ‘Blue Mondays’ do not exist in recreational user populations. Quite the contrary, they do. In respect of power: across 26 clinical MDMA sessions, we did not elicit one single report of acute comedowns. All participants reported no negative disturbance to affect at the end of the day after taking MDMA as the drug wore off. No comedowns. This is a highly significant outcome over 26 separate sessions with clinical MDMA.’

The notorious ecstasy ‘comedown’ where ravers feel considerably less clever on the morning commute than they did atop a riser earlier in the weekend, is likely due to sleep deprivation, over-exertion and dehydration.

“People often ask, what about comedowns?”

Plus combining recreational MDMA with whatever ravers can get their hands on at 7am, Dr Sessa told Vital students. 

“Every weekend, three quarters of a million doses of ecstasy are taken in the UK, yet our wards and clinics and outpatient departments are not full of ecstasy casualties. That is a data driven,” he explains, “People often ask, ‘What about comedowns? Recreational ecstasy users describe all kinds of flowery terms to describe this: blue Monday, black Tuesday [usually the worst I find], suicide Wednesday. We saw no evidence of this effect drop after taking clinical MDMA.”

“Not too quick on ‘Debunking the myth of ‘Blue Mondays’,” responded a team of Dutch psychologists in masterful pidgin english before going all n=17 on everyone and spreading a really heavy vibe over the whole session. 

‘For instance, were there multiple raters, and can the authors report inter-rater reliability?’ They wrote to the editor in the August 2022 issue of the IJP, ‘These questions also apply to the “list of representative questions and responses” included in Table 3. What does representative mean in this case, and how was representativeness assessed?’

The urbane Sessa parried, ‘We feel our recent Blue Mondays article contributes positively to the field by providing a clear report of the relative lack of adverse effects seen with clinical MDMA administration in contrast with the widely reported negative anecdotes seen with recreational use… This is especially relevant given the fact that we were studying potentially vulnerable patients with significant mental and physical illness. We appreciate the criticisms about the article’s hard-hitting title, which has certainly resulted in considerable debate.’

Dr Sessa’s valuable advice to recreational users?

“Take it during the day,” he told readers of hoary hedonism journal Vice, “I realise that is a bit unrealistic.” The rave scene adapts nonetheless: next-gen London nightclub Printworks is built in a former newspaper printing press for total soundproofing within a central north London location. DJs play all afternoon and evening to three generations of ravers, mostly on the younger end. Closing time on the Tube hasn’t been the same since it opened in 2017. While Printworks will be demolished to make way for… commercial offices, a successor has been announced.

Where social services are the new gods

Integration

Atheists need answers from their insights too. So do jedis. And children in care

OMA studio for Prada

How do you explain a mystical psychedelic vision to a devotee of science?

“There’s no magic to being a good humanist,” says Psychedelic Renaissance author Dr Ben Sessa who’s likely to have doled out some unconditional love in his time working as an addiction specialist, “kindness and compassion straddle all religions.”

Though “I'm not a particularly spiritual person” he says, like most other Brits – hundreds of thousands of whom answer ‘Jedi’, referring to the mystic order from the Star Wars movies, when asked if they are religious in national census forms. Others enter ‘heavy metal’.

But the religious-style ‘peak experience’ is considered so key to treating addicts that ‘giving yourself over to a higher power’ has a whole step (number four if I remember rightly) in the 12-step program. Alcoholics Anonymous (AA) founder Bill ‘W’ Wilson was apparently thinking of exactly the non-denominational spirit of psychedelics when he coined the non-denominational ‘higher power’.

“The psychedelic community puts itself out there as open and free, but they’re dogmatic about some things”

Wilson’s inspiration, the philosopher William James thought that only religion was powerful enough to wrest a mind away from the demon drink. But so could LSD, which Wilson was treated with and espoused until AA pharisees put the kibosh on it.

“There's no magic lost in psychedelics by just being a good humanist. Kindness and compassion straddle all religions”

My Vital colleague Christine Caldwell of Diaspora retreat centre in Treasure Beach, Jamaica spoke about her scientific framing of peak experience in our study group. “Quantum mechanics teaches us that what we think of as our physical bodies and brains is just a slower frequency or vibration of the energy from which all the universe is made,” she posits. “And entanglement, created through the explosion of the Big Bang from which all energy in our universe was born, dictates there can be no separation within that field. Not only does entanglement dictate we exist as an evolution of the primordial soup in our connectedness, it also means what affects one can instantaneously affect another in an eternal dance.”

That’s some solid ammo for the committed atheists. Mirroring the patient’s own beliefs is the goal in MDMA-AT though, and they could range from ‘lapsed high elf’ to devout Neo-Satanist.

“Patients are equally likely to talk about Social Services as they are chakras”

Normalising the peak experience on the patient’s own terms, like Dr Sessa avoided by not imparting his neurological frame on his patient who asked ‘Is this what love feels like?’ is key to its comprehensive integration.

“I use universal language, meeting the patient where they are,” explains Sessa, “It comes down to: ‘What are your relationships with others? How are you getting on with people? Do your children like you? Have you got a job? Does your girlfriend like you? Are you a law abiding citizen that spreads love and kindness?’”

The ebullient Sessa says therapists must be happy to go down a rabbit hole of any choosing: “If my patient wants to talk about Kundalini and chakras, I'll do that till the cows come home. But they’re equally likely to speak about getting their kids out of Social Services care.”

We must be careful not to weave a new narrative of disapproval, insisting our own prejudices take the place of those we hold in contempt, insists the man who literally wrote the book on the Psychedelic Renaissance. “The psychedelic community puts itself out there as being so open and free, but they’re so dogmatic about some things” he says in response to evangelical mysticism on behalf of the space.

Ketamine Assisted Therapy with Veronika Gold

My unofficial Vital Study Zine #13 with observations from Vital Psychedelic Training and recent happenings in the space

Noëlle Matip ‘Therapy’

San Francisco’s Veronika Gold set up the Ketamine Training Centre ‘emphasising the skills unique and germane to ketamine assisted psychotherapy.’

The MAPS co-therapist has written K treatment programs already in use across the USA. Her impressive CV includes somatic experiencing and EMDR expertise on top of academic psychology credentials. She works as an independent psychotherapist, and at stand-out San Francisco clinic Polaris Insights. Veronika has even curated a specialist ketamine therapy playlist.

Her overview of the high street K revolution: “People get a series of sessions over to to three weeks which is usually what it takes to get the anti-depressant effect. Then they will come for what are called booster sessions: maybe every two weeks, or every three weeks, for somebody it might be four to six weeks.”

Veronika plainly admits this is “Almost like an indefinite treatment,” but points out “for many people it’s still a preferable treatment compared to being a a daily SSRI.”

We all love to rag on K clinics. But for the sake of successfully treating depression and alcoholism, please put snobbery to one side. Plus set-ups are likely to eventually incoporate MDMA and psilocybin treatments. So what’s happening now is a fascinating precursor to the future. There’ll be DMT on the go eventually.

Precise therapy alongside ketamine (KAP) catalyses long term results, summarises Veronica: “The psychological paradigm has an emphasis is on processing the underlying issues and challenges that are causing the symptoms. We actually see healing and change that the booster sessions are eventually no longer needed.”

Shamanic-style trauma processing with its ‘the only way out is through’ ethos can hit flabby westerners hard though. Not only during the experience itself but afterwards: “They have to face all the losses that were connected to being depressed after it suddenly lifts… perhaps not being able to enjoy relationships, or having relationships that are no longer working for them when they are not depressed.” If that’s anything like my own revelations after going on ADHD medication, it feels like someone else has been living in your body all this time.

Veronika talks about her training program here, and see her on Psychedelics Today’s up to the minute ketamine therapy panel from earlier this summer plus more on the New Psychonaut YouTube Lecture channel.

These five items I pulled from the week’s research are themed along Vital’s natural element-themed structure.

Next issue: Psychedelic Reanissance authour and top-flight global expert Dr Ben Sessa

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.”