At our Boulder Mind Care and Transcendent Ketamine of Colorado offices, we encourage and endorse our patients to maintain an ongoing relationship with a psychotherapist. Multiple studies have demonstrated that psychotherapy prolongs the improvement achieved by Ketamine therapy, as well as the degree of symptom reduction in patients with mood disorders. Our clinical experience agrees with these studies, which is why we encourage our patients to continue, resume, or start ongoing psychotherapy. We also endorse Ketamine-Assisted Psychotherapy or KAP, which is explained below. Please note, however, that although we endorse psychotherapy and/or KAP, we do not require or insist on them as a condition to receiving Ketamine infusion therapy.
Psychotherapy is especially synergistic with Ketamine Infusion Therapy (“KIT”). Ketamine reduces brain inflammation, promotes the healing of damaged nerve connections in the brain, and causes positive changes in brain chemistry. As a result, Ketamine brings about a therapeutic window of opportunity, wherein patients experience dramatic breakthroughs and epiphanies in their therapy. For example, a KIT session on a Monday may result in a particularly positive psychotherapy session the following Wednesday. This is even more likely to occur if the therapy appointment is on the day after the Ketamine infusion (Tuesday); and indeed the most amazing synergism is seen when the two are conducted simultaneously, also known as Ketamine-Assisted Psychotherapy.
Ketamine-Assisted Psychotherapy
Ketamine-Assisted Psychotherapy or KAP, consists of combining a talk therapy session (with one’s usual therapist, usually in-person, but also by telephone or video chat) with Ketamine.
KAP is especially helpful in breaking through the PTSD “avoidance” symptoms which can prevent meaningful progress with talk therapy. When dosed properly, Ketamine allows the patient to face his/her traumatic material head-on, without feeling fearful or distressed. This allows the patient, under the guidance of his/her therapist, to process and move past these traumatic blockages, resolving many if not all of their PTSD symptoms. One therapist, after a KAP session with one of her patients at our office, described it as “equivalent to 5 years of therapy alone”.
At both of our Boulder and Fort Collins offices, we have designed our infusion rooms to facilitate KAP in-person, with a patient’s own therapist, or one of the therapists we work with regularly. We also conduct KAP by phone or videochat as well.
For KAP, the Ketamine can be given sublingually, intramuscularly, or by IV intravenous infusion. The IV route is preferable for many reasons, especially in the context of KAP. It allows for very precise adjustments in the rate of infusion in order to maximize the effectiveness of therapy.
Some clinics do KAP with sublingual Ketamine. However, when given as a lozenge sublingually, it takes approximately 30 minutes to take effect, and if the dose is not enough, it will take another 30 minutes or so for additional sublingual Ketamine to take effect. Some clinics do not have the personnel or inclination to start an IV line, so they take the easy route and give the entire Ketamine dose upfront, at once, as an intramuscular injection. When given by this route, IM or intramuscular Ketamine has the opposite effect of the sublingual route, meaning the onset to peak effect is within a few minutes, and if the dose was too high, can cause severe anxiety and agitation. When this happens, the unfortunate patient has to just “wait it out” until the anxiety and agitation subside. When given intravenously, we deliver the Ketamine at precisely the right dose, and can quickly adjust the dose if needed. We use a microcomputer-controlled syringe pump, and fine-tune the rate at which the medication reaches the brain. With feedback from both the patient and his/her KAP therapist, we dial in to the “sweet spot” wherein the dose rate is high enough to allow the patient to face his or her traumatic material painlessly and fearlessly, as well as gain fresh perspectives and insights. This therapeutic “sweet spot” is also low enough so that the patient is not overly sedated, can participate in the dialog with his/her therapist utilizing all of her/his faculties, process, and retain or remember the insights achieved in the process. KAP will help you gain a fresh perspective on your belief systems and mental patterns, allowing you to see these stuck patterns more clearly.
If you are interested in giving KAP a try, discuss it with your therapist, and give us a call at (303) 823-4882. We have seen some truly inspiring transformations in our patients as a result of KAP. One of our patients, a professor of mathematics at CU Boulder, had this to say about KAP:
“Later, at Dr Grindle’s recommendation, I tried “Ketamine Assisted Psychotherapy” wherein I did therapy with my therapist while receiving Ketamine at the same time. Ketamine by itself was incredible; Ketamine and therapy simultaneously was miraculous. The Ketamine enabled my therapist to walk with me through and process traumatic memories; in a way that was not painful or difficult. As a result, I had my most productive sessions ever!”