Ketamine Assisted Psychotherapy was completely new to me. I’ve had numerous IV ketamine infusions and I’ve been in therapy for years, but I’ve never merged the two in the same setting. The first goal was to find a dose of ketamine that caused me to dissociate enough to let my defenses down, but not so much that I was incapable of answering coherently. I was nervous beforehand; the unknowns of it were stressful. Once we got started, though, that anxiety faded.
My doctor asked me to tell him when I started to feel the effects of the ketamine, and when I didn’t, he asked me again a few minutes later. “It’s hard to tell with my eyes closed,” I said, “but yes, I think so.”
“Why is it harder to tell with your eyes closed?” My therapist asked. I paused to think.
“I guess because I don’t have any reference points. When my eyes are open, I can see that things are getting fuzzy or moving slightly, but with my eyes closed, all of that is gone.”
This is where my memory of the infusion gets a little foggy. I remember talking about particular topics, and I remember it being easier to answer quickly. In my normal therapy sessions, I take time to think about my answers, which leaves lots of space between our talking points. During ketamine assisted psychotherapy, I found myself answering with less deliberation. The majority of what we talked about flowed fairly well, but then we’d hit a tricky topic and my defenses went up. I’d stop talking, trying to decide if I should speak or not, and if my therapist pushed a little, I’d open my eyes. Opening my eyes seemed to be an indicator of my resistance to an especially uncomfortable topic. I must have been trying to exert some control over the situation, although I wasn’t fully aware of what made me open my eyes.
I had been worried that ketamine would make me incapable of holding back or deciding what I would or wouldn’t speak on. It turns out that the brick wall of lucidity also exists under the influence of ketamine. The presence of that brick wall usually makes me anxious; I worry about it. Why can’t I just talk about this stuff? There’s nothing behind it that’s secret or an enormous revelation. I feel like I’m wasting everyone’s time by being so silent, but I just can’t seem to break through it. Ketamine made me too relaxed to care much about what my therapist and my doctor thought of my silences.
For a few weeks now, Friday has been “Yes Day”. On Yes Day, I make a deliberate effort to say “yes” to opportunities that come my way. It’s a step towards becoming more spontaneous and a way for me to push myself to get out of the house. This ketamine appointment was, of course, on Friday. At some point during the infusion, my therapist mused that we could have No Nap Day in an attempt to combat my excessive sleeping. When asked if I was on board with Mondays being No Nap Day, I jokingly accused my therapist of exploiting Yes Day in order to create No Nap Day. In the end, I said “ok,” which I think counts as “yes”.
Unlike my usual trippy IV ketamine experience, I didn’t “see” anything this time. I think focusing on the conversation kept me from getting sucked into any kind of creative extensions of whatever random thoughts usually pass through my mind. All I saw was the darkness behind my eyelids, although it did seem somehow more dark than what I see when I simply close my eyes. It was deeper than that, as if I were farther away from access to my eyelids. I felt as if I had to swim upwards to reach them.
With my eyes closed, I sort of forgot that there was a person attached to the voice I was hearing. Not entirely – I knew somewhere that I was talking to my therapist, but it was easier to just focus on the disembodied voice without any of my usual curiosities. In our normal sessions, I often wonder what she’s thinking about my answers, but during KAP, all I could think about was responding to the question immediately at hand. It was an interesting change.
Being able to remember only parts of the infusion is odd. The gaps in my memory that I notice after an infusion usually feel like how dreams disappear when you wake up. I’m often left with the impression that I’m forgetting something rather inconsequential. This time, however, the knowledge that we were talking about real things has left me feeling slightly raw. I feel sort of scrubbed at in a nonspecific way, and it’s mildly uncomfortable.
I also feel like this ketamine infusion consisted of a lot of work. Usually, they’re relaxing and somewhat meditative; I just float along and let whatever comes into my mind pass by. This time, the effort of speaking and of thinking in sentences made it feel a lot less restful, but a lot more purposeful.
If you’re thinking about ketamine assisted psychotherapy, remember that this post is only my experience, and only of my very first one. Apparently, I’m tenacious in my resistance to open up; it may be easier for you to let your defenses down. While parts of it were uncomfortable, it was never scary.
I now have to think about how I want to proceed. Choices, choices!