Ketamine, when taken in a psychotherapy session, can be very beneficial. The medication can stabilize patients with severe depression swiftly. Scientists from the University of Texas (UT) have identified the key protein that helps activate the rapid antidepressant effects of ketamine in the brain. Their study, published in the science journal, Nature, revealed that the medication blocks the N-methyl-D-aspartate (NMDA) receptor, an ion channel protein and glutamate receptor found in nerve cells. Inhibiting NMDA produces an initial antidepressant reaction. A metabolite found in ketamine is responsible for prolonging the effect’s duration.

Stabilization is not the only effect of Ketamine Assisted Psychotherapy (KAP) therapy. The blocking of the NMDA receptor also induces the hallucinogenic responses of ketamine. These responses lead to” journeys,” where deepening and broadening our inner and outer view occurs. When taken with proper care, the drug may help severely suicidal, depressed, or anxious patients get effective, fast, and lasting treatment.

What does KAP feel like?

This is one of the questions I'm asked most often — and it's a good one. Ketamine is unlike anything most people have experienced, and knowing what to expect can help you arrive with a little less anxiety and a little more openness.

The honest answer is that no two experiences are exactly alike. Ketamine is what's called a dissociative medicine, which means it temporarily loosens the brain's ordinary grip on self, time, and space. What happens within that loosening is personal — shaped by your nervous system, your history, your intentions, and the moment itself.

That said, there are qualities that appear again and again across sessions, and describing them can offer a sense of the territory.

One of the most striking features for many people is a complete release of body awareness. The physical self — its weight, its limits, its familiar sensations — simply recedes. You may have no sense of having a body at all until you begin to return. This is not alarming once you’re in it; most people experience it as a kind of freedom.

Movement is a consistent quality of the ketamine state — but it is less often a feeling of traveling through open air than of being in and on the earth itself. People find themselves in the sea, in a river, on the ground — moving through elemental terrain with a felt sense of being held by it. There is a quality of groundedness here that surprises many people: not floating away, but moving through something real and present. The world unfolds in front of you, or you find yourself unfolding with it, always in passage.

For some, the journey opens into something vast and cosmic — stars and planets, enormous geometric forms, deep color and light, a sense of moving through space itself. These experiences carry their own particular quality: not frightening, but humbling, as though one has been granted a view from somewhere far outside the ordinary human frame. The body is gone, the personal self is gone, and what remains is something witnessing on a scale that has no name.

Others encounter places that feel known, intimate even, though they may be nowhere recognizable from waking life. Faces sometimes appear — luminous, arriving and receding — but rarely with others present in the scene. The experience is solitary in a way that is not loneliness. What is encountered in that aloneness is often one’s own spirit, one’s own depth — or something that can only be described as the sacred itself. For many people, this quality of solitude, unaccompanied by demand or the needs of others, is part of what heals.

“Many people encounter something that can only be called numinous — a sense of vast significance, of touching something beyond ordinary understanding. It arrives not as a belief but as a direct experience, often wordless, often accompanied by awe.”

This quality — what depth psychology calls the numinous, what mystics across traditions have pointed toward — is one of the most consistently reported and least expected aspects of the ketamine journey. People who did not consider themselves spiritual often describe encounters with something that feels sacred. The medicine does not create this. It seems, rather, to remove what ordinarily stands in the way of it.

Many people describe the experience as something that happened not just in the mind, but through the whole being — a knowing that arrived from somewhere other than thought. What we encounter in the ketamine state often feels more real, not less, than ordinary awareness.

You are not alone during the session. I remain present with you throughout — a steady, grounded witness. The music, the setting, the intentional preparation we do together — all of this shapes the container that makes depth possible.

There is nothing you need to do or achieve. The work is to be present with whatever arises, and to trust that your own psyche knows what it needs.

How is Ketamine Administered?

People undergoing KAP therapy can take the drug in various ways. A medical professional can inject the medication into their vein or muscle or have the patient ingest it; some use a nasal spray route. At Transformational Psychotherapy, we provide ketamine to patients in the form of a low-dose, sublingual lozenge and Intra-muscular injection.

When we conduct lozenge sessions during ketamine psychotherapy, we make sure that the patient reaps the benefits of the medication along with psychotherapy. Our team begins by evaluating the individual’s responsiveness to the lozenge. This allows us to adjust the dose and evaluate the ongoing effectiveness of the medication. Along with our assessment, we may prescribe lozenges that enable patients to do their ketamine sessions at home. The oral lozenge sessions, together with more profound in-office sessions and the accompanying psychotherapy, could be their successful strategy with ketamine.

What Is The Eligibility for Ketamine Treatment

Before you undergo KAP therapy at one of our centers in Marin County, California, we first interview you carefully to find out if you’re eligible and safe to receive this medication. We have you go through the following procedures:

• Assessment and review of Your Medical and Psychiatric History

• Short Psychological Tests to Evaluate Your Current State of Mind

Apart from these procedures, we look for specific criteria that would make you ineligible for KAP therapy. You may not undergo the treatment if you belong to one (or more) of these categories:

• Pregnancy – While ketamine may be safe for nursing mothers using a strict protocol, it has not yet been shown safe for pregnant women. 

• Untreated Cardiovascular Problem–Hypertension, if untreated, is a contraindication to the use of ketamine. The drug causes a transient rise in blood pressure and heart rate; some Individuals with a history of cardiac issues, therefore, may not be eligible to take this treatment.

• Untreated Hyperthyroidism – People with this condition should not take ketamine. The drug increases the risk of tachycardia and hypertension.

• Those individuals with untreated Bipolar Disorder, Schizophrenia or other psychosis would not be candidates for KAP

We Value Your Privacy

If you are eligible and will be undergoing our KAP therapy, you can be at ease knowing that we will keep your records confidential. A signed release form is required to allow others, such as medical professionals, to access your files.

A Disclaimer on Ketamine-Assisted Psychotherapy

KAP is considered an “off-label” treatment for mood disorders. Ketamine itself is FDA- approved as an anysthetic. The use of racemic ketamine for depression, ptsd, anxiety and other psychiatric conditions is considered off-label. Esketamine nasal spray (Spravato) is FDA approved for treatment resistant depression and other depressive conditions.

We encourage you to ask us questions during the intake process.