Ketamine is unique from the known and loved phenethylamines, tryptamines, and ergolines (all Schedule 1 drugs in the U.S. and highly controlled), which tend exert their effects by interacting with serotonin, dopamine, and/or norepinephrine receptors. Ketamine is classified as a dissociative anesthetic and is listed as a Schedule III drug in the United States. It has a novel mechanism of action as a N-methyl-D-aspartate (NMDA) receptor antagonist. In addition, its effects can be quite different from the more typical hallucinogens/psychedelics/entheogens (I think I prefer to use entheogen). Due to the dissociation occasioned by ketamine, we believe this supports non-ordinary states of consciousness (NOSC) that are quite unique from NOSC’s produced by other entheogens and this is an important piece of ketamine’s unique healing potential.
Ketamine was discovered in the 1960’s and was primarily used in surgical anesthesia, but soon after its use by surgeons and anesthesiologists declined due to “emergence phenomena”, described as an “unwanted” side effect of the medicine. As anesthesia wore off, patients often reported travels through a wide range of realities and alternate realms – extraterrestrial civilizations and parallel universes, astrophysical worlds and the animal, botanical, and mineral kingdoms, other countries and historical periods. These reports sometimes alarmed post-surgery teams, but psychedelic therapists and researchers became very interested in this “side effect”. Famed Mexican psychiatrist Salvador Roquet, described it as the principal fascinating effect of ketamine rather than an unwanted side effect. The emergence phenomena is a non-ordinary state of consciousness (NOSC). We believe that healing and transformation can happen through NOSC and we are interested in the relationship of the phenomenological experience of ketamine-induced NOSC to the healing of mental health challenges.
Interest in the use of ketamine for the treatment of depression has grown steadily since Zarate and team published their article in 2006. In March 2019, Janssen received FDA approval for esketamine (brand name Spravato) for treatment of depression, which is bringing more interest to the field and greater acceptance of this extraordinary medicine.
We will discuss the phenomenology of ketamine experiences when used in the context of a therapeutic set and setting. This presentation will include literature review but will focus on classification and description of reports of subjective experiences of Ketamine-Assisted Psychotherapy clients. It is my belief that healing and transformation happens through direct experience and I will highlight the unique qualities of experiential learning under the influence of ketamine. I will also consider whether there may be a direct link between the type of phenomena in the ketamine experience and the depth of psychological healing and the subsequent discovery of meaning and life direction.