What is Ketamine Assisted Psychotherapy?
If you had asked me while I was in graduate school if I thought that psychotropic medicine was important in psychological healing, I would have scoffed. In my young mind, I believed that with psychotherapy, clients could create the change with their own efforts and that symptoms would remit. While I still believe this is the case for many people, I have frequently reached the point where I recommend a client to try a psychotropic medicine. The old CBT research I would espouse went something like this: If we separated people into 3 groups, one who did psychotherapy alone, one that did medication alone and a third that combined both, all the participants would show improvement but in different ways. The psychotherapy alone group showed improvement but it took longer (it takes time for insights, behavior change and emotional healing to take hold). The medicine alone group got better and quicker but many people stopped taking it for various reasons and the depression or anxiety returned. Of course, the third group did the best- they showed faster improvements and the therapy assisted them in making changes in their lives that were long lasting. I still believe this is true for many people.
However, I have been a psychologist for 20 years and have seen too many folks do everything they were supposed to and continue to struggle with a life that they did not want. They worked hard, they took the medicine and sometimes, the wounds were just too deep. Year after year, I would encounter folks whose pain was chronic and unremitting. These experiences are what lead me to pursue extensive Psychedelic Assisted Therapy training through the Integrative Psychiatric Institute in Boulder, Colorado .
While combining therapy and medication has been done for many years informally, it has not been combined in quite the same way as is being done with psychedelic assisted psychotherapy. With these medicines, the effectiveness of the dosing experience is amplified by psychotherapy and/or integration that promotes your ability to move beyond your stuck points. At Inner Journey, we join a large community of indigenous healers, medical providers, and other psychotherapists in the belief that healing needs to occur within community, within relationship.
How does Ketamine work in the brain?
Ketamine is primarily known as an NMDA receptor antagonist. NMDA receptors are involved in the transmission of signals in the brain that are related to learning, memory, and neuroplasticity. We know from imaging studies that individuals with depression or significant stressors have a reduced amount of synapsis in their brain. The chemical reaction occasioned by Ketamine seems to produce structural changes in the brain itself by way of increasing NMDA which almost immediately increases the amount of synapses (thus supporting the rapidity in which it works).
This suggests that ketamine promotes neuroplasticity—the brain's ability to form and reorganize synaptic connections in response to experience or injury. This is especially important in the context of mental health because conditions like depression and PTSD are associated with a reduction in brain plasticity. By encouraging the growth of new connections and strengthening existing ones, ketamine may help restore brain function and improve emotional regulation.
How does Ketamine work in the mind?
The Default Mode Network (DMN) was first discovered when researchers were trying to learn the various functions of the brain with an fMRI. In early research studies, researchers tried to map what parts of the brain 'lit up’ when participants were asked to perform mental tasks such as problem solving, thinking of riding a bike or focusing on an early childhood memory. During these studies, the researchers stumbled onto a curious process. They found that between tasks, the brain would light up just while the participant was waiting and not focused on a particular task. They began asking the participants about their thought patterns leading them to coin the term Default Mode Network. As its name implies, the DMN is the default of where our minds go when we do not have a task to complete or we’re not working on a problem. It includes our self-memories and habits of thinking. It is sometimes referred to as our personality or ego and those with anxiety or depression, the thought content tends to be self focused and negative and it becomes the ‘default way of thinking’.
The DMN is a network of brain regions that is typically active when we are at rest or self-reflecting. In people who have depression, the DMN is often overactive and can contribute to rumination and negative thought patterns. When someone with social anxiety encounters someone they may have a complicated relationship with, their DMN will activate more strongly than someone without that struggle. We notice that when someone has a strong and rigid DMN, Ketamine helps to interrupt cycles of negative thinking and promote more adaptive cognitive and emotional states.
KAP at Inner Journey Healthcare
At Inner Journey Healthcare, we offer Ketamine Intramuscular (IM) injections and Spravato® which chemical structure is the mirror image of Ketamine and is delivered intranasally (more on Spravato in another post). When Ketamine is combined with the intentional behavior change of the client, they can access the thoughts/feelings/behaviors that were previously unavailable to them. We believe that Ketamine itself acts as a catalyst and your intentional actions through preparation and integration create the change you need!
We recommend IM Ketamine for people who are stuck in patterns of thoughts or behaviors that are preventing them from moving forward in their lives. Instead of speaking about disorders, at Inner Journey Healthcare, we prefer to speak in terms of patterns, habits, and processes. With depression, anxiety, trauma and other psychological struggles, the common factor is that people cannot break out of their stuck patterns. We believe that psychological flexibility (rather than rigidity) is extremely important in living a fully life and we have seen Ketamine become the key to unlocking the new way of being.
If you decide to try Ketamine, the process is simple. Call us (406) 541-4222 and we would be happy to share the process with you. We look forward to working with you!
