“The cat is chasing the mouse in the shed outside the house,” I mutter. These nonsensical phrases seem inexplicably significant as I recline in a massage chair, my eyes covered in eyeshades.
“Come back to your original intention—body image. Is there anything coming to you about that?” the therapist asks.
“That if I picture all my positive traits times ten, and all my negative ones divided by ten, that’s what other people see when they look at me.”
I’m at the psychedelic therapy center Field Trip Los Angeles and I’m on ketamine, an anesthetic traditionally used for surgeries, which also happens to have psychedelic properties and has recently gained attention as a mental health treatment. Research has suggested that ketamine can provide lasting relief for depression and anxiety and even other issues like chronic pain.
Field Trip isn’t the first place where I’ve done ketamine. Last year, I began my journey with the dissociative psychedelic at the Ketamine Healing Clinic of Los Angeles, hoping to reduce anxiety and lingering symptoms of chronic Lyme disease, including fatigue, irritability, and insomnia.
Back then, at Ketamine Healing Clinic, I did two ketamine sessions a week for three weeks, tapered down to once a week for a month, then came in on an as-needed basis. During each appointment, the doctor or nurse would give me the ketamine through an IV, leave me alone for an hour and a half (periodically checking in just to make sure I was okay), then come back for a brief, perhaps five-minute, chat about what happened.
Afterward, on the Uber ride back, I’d text my acupuncturist (who I was close with) all the thoughts that had come out of the journey. I don’t think she even usually responded; it was more for me to have that record of my experience and solidify it in my own mind. Often, I’d head straight to a session with her or a bodyworker afterward to talk about the journey and reinforce any physical healing it had accomplished.
Most ketamine treatment clinics are like this. You have the support of a doctor and/or nurse, but most of the integration of the experience happens on your own.
Field Trip, however, takes a different approach. They have psychotherapists on staff, who are with you while you receive the ketamine and talk to you about the experience in separate sessions. After I signed up for the program, hoping to address COVID-related anxiety and depression, I had an introductory session with the therapist assigned to me, which didn’t involve ketamine. The next week, I had a ketamine-assisted therapy session and a regular therapy session, and that same structure repeated the following week. While some patients, such as those with severe trauma, continue to go for six weeks, the team decided my treatment was complete after two weeks.
During the ketamine-assisted sessions, I’d narrate my trips, and the therapist would occasionally interject to nudge me in a useful direction—so that I, for instance, addressed the body image issues that had been plaguing me, rather than lingering on abstract images of animals and the like.
That’s the thing about ketamine—it’s really weird and abstract. A lot of the things that came up, I was never able to make sense of in therapy. But we focused on what seemed to have the most direct connection to my life. For instance, one issue that kept coming up was my difficulty distinguishing between all the competing voices in my head when I try to make decisions, so we talked about how to figure out which part of myself to listen to.
I expected that combining ketamine with psychotherapy would be the clear, more impactful way to do it, but I actually saw the pros and cons to both approaches I experienced. The pro to Field Trip’s approach was that I had a professional to help me process the ketamine in a meaningful way while I was on it. People sometimes say the best way to use psychedelics is to just surrender, but I often get more out of a trip if I can direct it a little, and that’s easier to do with the help of someone who’s not intoxicated.
Field Trip also gave me the chance to explore the trip in-depth from a psychological perspective, but I found the truncation of the therapy a bit jarring; the treatment ended just as I was starting to get to know the therapist and scratching the surface of deep-rooted issues.
I found the truncation of the therapy a bit jarring; the treatment ended just as I was starting to get to know the therapist and scratching the surface of deep-rooted issues.
At Ketamine Healing Clinic, with the simpler model, I received less attention but more freedom. Getting started was less of a process, and I was allowed to continue going for as long as I wanted and had some say in the frequency. I also developed an ongoing relationship with the doctor, though our conversations were minimal. And because I was processing my journeys with people I was already working with, like my acupuncturist, from the beginning, I had continuous support from the same people both during and after my course of treatment.
These experiences combined taught me that integration can look a lot of different ways. Psychotherapy is just one way to do it. At times, for me, integration has looked like sending love interests bold texts because of the increased confidence I was experiencing, exploring new aspects of my sexuality that came up in journeys, and writing about ideas that came to me in a book. It has not always been about looking into my psyche; sometimes it’s been about looking outward and moving forward.
My advice to others looking into different kinds of psychedelic therapy is that ultimately, no matter what format you choose, you’re the captain of your healing journey, and it’s your job to curate the integration modalities that work for you. Even if the center you’re going to provides therapy, you’ll need to think about what you’ll do afterward.
In neither course of treatment did ketamine offer me permanent changes in mood or physical health, but what it did do was give me a new, more positive perspective from which to make new choices. And it’s ultimately those choices we make after a psychedelic experience that determine how lasting and impactful it is for our lives.