Blog post written by Brian Danziger, MA, LPC — Psychotherapist
For most people considering Ketamine-Assisted Psychotherapy, the dosing session is the part they are most curious about, and often the part they are most uncertain about. This post is a careful look at what a dosing session actually involves, what people commonly experience during one, and what the research and our clinical experience suggest KAP can offer.
The Setting
A dosing session at our practice takes place in a private therapy room. The lights are dimmed. There is a reclining chair or a low couch with pillows and a blanket. You come dressed in whatever is comfortable. A driver has already dropped you off, and someone is scheduled to pick you up when the session ends.
Once you settle in, you and your therapist take a few minutes to talk. Your therapist may ask you to name your intention for the session, to check in about your body and your emotional state, or simply to breathe together before you begin. When you are ready, you take the prescribed medication, put on a pair of eye shades, and lie back. Music begins to play through headphones.
The eye shades and music are not decorative. They serve a specific purpose. Closing off external visual input helps the internal experience come forward. Music, chosen from playlists designed for psychedelic-assisted therapy, provides a kind of scaffolding that the mind can rest on. Both elements are grounded in decades of psychedelic research and practice.
Your therapist stays with you throughout, seated close, quiet, and attentive. A Ketamine-Assisted Psychotherapy dosing session is typically two and a half to three hours from arrival to departure. The medication itself has an active window of roughly forty-five to sixty minutes. Nothing about the arc is rushed.
What It Feels Like
Every person’s experience is different, and no single description will be accurate for everyone. That said, there are some common features clients report.
The onset is gentle. The world softens rather than jolts. Many people describe a sense of the body becoming lighter, or of thoughts slowing down, or of ordinary preoccupations receding into the background. Some experience visual imagery, either abstract or narrative. Some experience a felt sense of distance from their usual self, as ketamine temporarily softens the default mode network, where old stories and beliefs live. Some feel emotions arise with unusual clarity, ranging from grief to tenderness to a quiet joy. Most people remain conscious and aware throughout, though the quality of awareness is different from ordinary waking consciousness. You are not asleep. You are in an altered state, but one most people find navigable rather than overwhelming.
The character of dosing sessions varies, and while some are quiet and open, others can bring up more tender material. Your therapist is with you through both, helping you stay present with whatever arises. Meaningful shifts often happen in the moments that ask a little more of us.
The work happens inside. There is no expectation that you talk your way through it. Your role, if it can be called a role, is to stay with whatever is arising in you, to let it move, and to trust that your therapist is nearby. The medication is not asking you to be productive. It is offering an opening, and your role is to be present for what arises inside it.
What Ketamine-Assisted Psychotherapy Can Offer
Research on Ketamine-Assisted Psychotherapy is early relative to more established therapies, but it is meaningful. Multiple studies have found that ketamine paired with structured psychotherapy can produce rapid reductions in depression, including in clients who have not responded to prior medication trials (Dore et al., 2019; Wilkinson et al., 2018). Research on KAP for PTSD and complex trauma is growing (Feder et al., 2021). There is also a well-documented window of enhanced neuroplasticity in the days following a dosing session, which is one reason why integration sessions are scheduled so soon after.
Beyond the research, what clients tend to describe is something harder to measure. A softening of patterns that had been rigid. Access to feelings that had been walled off. A different relationship with pain, grief, or fear. A sense of possibility where there had been a feeling of stuckness. These are not universal outcomes, and KAP is not a guarantee of anything. But for many clients, it offers a deeper experience than talk therapy itself can provide.
After the Session
When the medication’s effects have receded, your therapist helps you re-orient. You have some water. You may talk briefly about what came up. Your driver arrives. You go home and rest. You do not drive, work, or make major decisions for the rest of the day.
Within seventy-two hours, you return for an integration session with the same therapist. This is not an add-on. It is where much of the lasting change happens. The dosing session opens something. The integration is where it becomes durable.
A Careful Beginning
Ketamine-Assisted Psychotherapy is not something you begin without preparation. Every client is medically screened. Every client has preparation sessions before the first dose. Every client is walked through what to expect in detail, so that arriving at the dosing session feels like the next step in a considered process rather than a leap into the unknown.
Consultations for our KAP program open soon. We are keeping a waitlist of prospective clients to contact when intake begins. To ask a question or to request a spot on the waitlist, reach out to Brian Danziger at brian@evolveinnature.com.
When you're ready, we'd love to hear from you:
References
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., Monnette, C., Huidekoper, A., Strauss, N.,
& Wolfson, P. (2019). Ketamine assisted psychotherapy (KAP): Patient demographics, clinical data and outcomes in
three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189-198.
Feder, A., Costi, S., Rutter, S. B., et al. (2021). A randomized controlled trial of repeated ketamine administration
for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193-202.
Wilkinson, S. T., Ballard, E. D., Bloch, M. H., Mathew, S. J., Murrough, J. W., Feder, A., Sos, P., Wang, G., Zarate, C.
A., & Sanacora, G. (2018). The effect of a single dose of intravenous ketamine on suicidal ideation: A systematic
review and individual participant data meta-analysis. American Journal of Psychiatry, 175(2), 150-158.