Many people don't realize that Ketamine Infusion Therapy lasts only about 45 minutes to one hour. And you only feel the effects of ketamine during the infusion, afterwards, it fades quickly. But how you go into the treatment - your mental state - likely can affect your experience and possibly even the effectiveness of the treatment. These are some techniques that I've felt helpful especially for anyone who is anxious about undergoing the treatment.
We tell our patients to focus on 3 core principles:
Before each infusion, and especially before the very first infusion, if you can try to engage in the practice of curiosity. We start out slowly, encouraging you to practice short bursts of curiosity about everyday objects, experiences or observations. It could be just pausing a moment in the morning to stare out the window at a leaf in the wind, or perhaps taking a minute to watch the steam rise off of a pot of boiling water. The idea is to practice observing without judging, and to cultivate a tiny moment of awe. If you find that you are curious, I invite you to explore more. Perhaps the leaf in the window inspires a desire to walk outside and stare up at the trees. Or perhaps you find yourself drawing the shape of a leaf or looking at pictures of leaves under a microscope. The idea is to learn to be curious and to harness that curiosity. Start small and to try to practice curiosity for a few moments each day in preparation for their journey during the infusion. This way, on the day of their infusion, you have the tools to enter the Ketamine state with a curious mind. We want you to be able to let go and explore your inner self while in a dissociative state. Curiosity helps to frame the patient's role in the experience as a passive observer. In this way of thinking, the patient is not trying to "fix" themself or endure a procedure, but rather should think of yourself as a curious passenger on a short and fascinating journey.
We encourage each patient to try to spend a few moments the night before each infusion thinking of an intention for their journey. This should be something very limited. Examples of intentions; to "write more," to "have better connections with my loved ones," to "drink less"... Each intention should be something low key and achievable. For example, if you wanted to "write more," I would encourage you to engage with writing for just a few minutes on the day prior to and the day after their infusion. The idea is not to focus on writing your novel or your screenplay, or even to focus on writing everyday, but rather to just set aside a few hallowed minutes to write anything; it could be some thoughts on the back of a napkin, or a thank you note to your aunt... We want you to realize a small intention to focus on in preparation for the journey, and one that you can practice after the journey. If it's to "drink less" then I would ask you to refrain from drinking on the night before and the day after their infusion, maybe swap a cup of tea for their usual glass of wine.
We encourage patients to link their intention, which they set before the infusion with an action that they can take after the infusion. The idea is to help set the new neurons and guide the synaptogenesis in a direction that is helpful and purposeful. Much like practicing an instrument, it helps to DO something after the infusion. An example might be that if your intention were to "write more" then we would encourage you to write a single paragraph or maybe a poem after your infusion. If your intention is to have more self confidence, then we might encourage you to stand in front of a mirror for 5 minutes and recite some self affirming sentences while you play your favorite song. Like the intention, the praxis should be short and achievable, a small task that affirms the intention. For some patients, who want to lose weight, or eat healthier or exercise more, I tell them to simply go for a short walk on the following day. There is actually some fascinating research on this intention/praxis approach, see this study as an example.
Patients often find that the images and feelings that you experience on your journey are connected to your intentions in unexpected ways. We encourage you to be flexible and allow the journey to shape your praxis afterwards. As an example, one patient wanted to have better "connections" with people, because she felt so dissociated and detached from other human beings, a defense mechanism she had developed over the years following a childhood sexual assault. She set this as her intention, and during her first infusion, she saw herself from the perspective of her long dead dog, bounding up to herself and licking her own face. In this visceral way, she knew she was lovable in a way she never had before. This realization allowed her to drop her guard and reach out to her son the day after her first infusion. She managed to have a deep and meaningful conversation with him that she had wanted to have for a long time, but never could. In this unexpected way, she was able to connect her intention with a task, though it manifested in a way she hadn't planned.
What you bring into the session is just as important as the session itself. By fostering curiosity, setting an intention and then approaching your life anew, you can undergo deep and meaningful change.