What Is Ketamine-Assisted Psychotherapy (KAP)? How it Works, Benefits and Common Concerns
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Ketamine-Assisted Psychotherapy (KAP) is both cutting-edge, while also being informed by and rooted in indigenous wisdom from various plant medicines and subsequent journeying throughout the ages. Ketamine Assisted Psychotherapy is an approach to mental health that combines the clinical benefits of ketamine with the supportive guidance of psychotherapy. Unlike traditional western psychological treatments that often focus solely on symptom management, KAP works by fostering deep psychological exploration, emotional release, and neuroplasticity—the brain’s ability to form new pathways and connections, which makes it a great partner to the depth oriented work we do at Reverie. During KAP, ketamine is self administered in the therapeutic setting while your trained therapist supports your experience, helping you process insights, memories, or emotions that arise. We also guide you through the integration process once the medicine journey is complete. Many people turn to KAP when other treatments have felt insufficient, seeking a holistic, integrative approach that addresses mind, body, and soul.
Why is Ketamine-Assisted Psychotherapy Becoming So Popular?
In recent years, mental health care has expanded beyond standard antidepressants and talk therapy. More people are exploring alternative pathways that honor both biology and psychology. Ketamine, originally developed as an anesthetic, emerged in the 1970s as a potential tool for treating depression. Over the decades, research has shown its rapid and powerful effects on mood disorders, PTSD, and anxiety. Today, KAP combines these clinical benefits with psychotherapy, offering a guided, conscious experience that feels different from conventional medication approaches. The rise of KAP reflects a larger cultural shift toward personalized, experiential mental health care—where healing is not just about symptom relief, but self-discovery and empowerment.
Potential Benefits of Ketamine-Assisted Therapy
Rapid relief from depression and anxiety symptoms
Enhanced emotional processing and trauma release
Increased neuroplasticity and flexibility of thought
Potential to address treatment-resistant conditions
Deepened insight and connection during psychotherapy
The Facts: How Ketamine Works in the Brain
Ketamine acts on the brain’s glutamate system, particularly the NMDA receptors. By modulating these pathways, ketamine can reduce rigid thought patterns, quiet negative self-talk, and enhance neural flexibility. Unlike traditional antidepressants, which may take weeks to show results, ketamine can have rapid effects on mood and cognition. Clinically, it is often paired with psychotherapy to ensure insights and shifts are integrated into daily life. At Reverie, we believe you possess an innate ability to heal yourself. The main way ketamine works is by giving you access to this innate ability and to your unconscious, to help you connect with your inner knowing, which facilitates healing.
What Happens to Consciousness During KAP
During KAP, your consciousness may feel altered but not lost. Some people describe a sense of spaciousness, detachment from rigid thoughts, and/or vivid imagery. This state allows for exploration of emotions, memories, and beliefs in a supportive, therapeutic context. It is guided rather than recreational, and your therapist helps you navigate the experiences that arise. Great care and attention are placed on your mindset and intentions as well as the physical and emotional setting for the journey.
What Makes KAP Different from Psychedelic “Trips”
Unlike some psychedelics, ketamine’s effects are typically shorter and more controllable. KAP is focused on therapeutic exploration rather than recreational experience. The goal is insight, healing, and emotional processing—not entertainment or escapism.
How Does a Ketamine-Assisted Psychotherapy Session Work?
Preparing for KAP: Safety, Intention, and Grounding
Preparation is essential for a safe and meaningful KAP experience. Building trust with your provider and setting intentions can greatly enhance the session’s benefits. Key steps include:
Developing trust and safety in the therapeutic relationship and setting
Discussing medical history and potential contraindications
Setting clear personal intentions for the session
Practicing grounding or mindfulness techniques beforehand
Planning a comfortable, safe space for recovery post-session
The Ketamine Dosing Session
In our KAP sessions at Reverie, ketamine is self administered via oral/sublingual lozenge which is prescribed after a medical screening with our partners at Skylight Psychedelics. Effects may begin within minutes and last up to an hour, depending on dosage. Common sensations include lightness, floating, visual or emotional imagery, and a sense of mental clarity - and this varies from person to person. We work with you to provide guidance and ensure your comfort throughout.
Integration
Integration is the phase after the ketamine session, where insights and emotional experiences are processed both with your therapist in session, as well as for the next few days following a journey. I like to encourage you to reflect on imagery and any felt experiences of the journey before trying to make meaning of what came through. Journaling, reflection, time in nature, and psychotherapy can support you in translating session experiences into lasting changes in thought patterns, behaviors, and emotional resilience.
Meaning-Making Without Pathologizing
One of the defining aspects of KAP is that experiences do not need to be analyzed or explained away. Sensations, images, or emotions are treated as meaningful, even when they are non-linear or symbolic.
This can be especially healing for people whose experiences have historically been dismissed, medicalized, or misunderstood. Instead of asking, “What’s wrong with me?” KAP often invites the question, “What happened, and what does my body need now?”
Integration work helps translate these inner experiences into daily life - supporting self-trust, emotional resilience, and a more compassionate relationship with your identity and nervous system.
The Inner Experience of Ketamine-Assisted Psychotherapy
While ketamine’s effects are often described in clinical terms, many people find that the most meaningful aspects of KAP happen on the inside—at the level of the nervous system, identity, and felt sense of self. Rather than “fixing” something that is broken, KAP often creates conditions where the body and mind can finally exhale.
Nervous System Shifts: From Survival to Safety
For people living with chronic stress or trauma, the nervous system may be stuck in patterns of hypervigilance, shutdown, or overwhelm. During KAP, many clients notice subtle but profound shifts in these patterns.
Common nervous system cues during a session may include:
A sense of spaciousness or slowing, as if the body is no longer bracing for impact
Reduced muscle tension or jaw clenching
A feeling of warmth, heaviness, or gentle floating
Decreased inner urgency or self-criticism
Easier access to emotions without becoming flooded
Ketamine can temporarily soften the brain’s threat-detection circuits, allowing the nervous system to experience safety without effort. This is especially meaningful for people who have spent years in survival mode and rarely feel at rest. In this state, insight doesn’t have to be forced, it arises naturally, through sensation, imagery, and emotional truth.
Ketamine is used to treat various conditions, including:
Depression and suicidality
PTSD
Anxiety
OCD
Eating disorders
Substance abuse co-occurring with a primary psychiatric disorder
Relationship and existential issues such as existential distress.
Bipolar I and II depressive phases (not mania)
Psychological reactions to physical illness and life threatening illnesses
Ketamine Therapy for PTSD
KAP can reduce the intensity of trauma memories, promote emotional release, and help reframe challenging experiences in a safe, guided setting.
Ketamine-Assisted Psychotherapy for Depression and Anxiety
Rapid mood improvement, reduced rumination, and increased cognitive flexibility are commonly reported outcomes, especially for treatment-resistant cases.
Identity-Based Trauma and the Experience of Being “Othered”
For queer, trans, nonbinary, BIPOC, and otherwise marginalized individuals, trauma is often not a single event—it is cumulative. It lives in the body as repeated moments of invisibility, misattunement, or having to explain yourself in order to be safe.
In KAP, many people experience a temporary loosening of internalized narratives shaped by oppression, such as:
“I have to perform to be accepted.”
“My body is unsafe or wrong.”
“I am too much or not enough.”
With the support of an affirming therapist, ketamine can create enough distance from these narratives to observe them with compassion rather than identification. Some clients describe encountering a version of themselves untouched by shame—an internal sense of worth that existed before harm or conditioning. This can be deeply reparative for those whose identities have been pathologized or dismissed in traditional healthcare settings.
LGBTQ+ Affirming Care: Being Seen Without Translation
An LGBTQ+ affirming KAP container is about resonance and having a therapist with shared lived experience of being in the community. When you do not have to educate, defend, or censor parts of yourself, your nervous system can relax more fully into the experience.
In affirming KAP spaces, clients often report:
Feeling safe to explore gender, sexuality, and identity fluidity without interpretation or correction
Greater freedom in imagery, emotion, and self-expression
Relief from the constant background effort of “being legible”
A sense of being witnessed as whole rather than segmented
Ketamine’s dissociative properties can sometimes allow clients to step outside rigid identity roles long enough to reconnect with something more essential—without erasing or minimizing who you are. For many queer and trans clients, this can feel like reclaiming an inner truth that predates societal expectations.
Risks, Side Effects, and When KAP Is Not the Right Fit
According to the World Health Organization, ketamine is one of the safest and most widely used anesthetics in the world. Researchers at Yale have been studying low-dose ketamine since 2000 in controlled clinical settings for patients with severe depression who are unresponsive to other antidepressants.
While generally safe under clinical supervision, ketamine can cause temporary side effects such as nausea, dizziness, or mild dissociation. It may not be suitable for individuals with certain cardiovascular conditions, uncontrolled hypertension, or a history of psychosis.
Is Ketamine-Assisted Psychotherapy Safe?
When conducted by trained professionals, KAP is considered safe and well-tolerated, with serious adverse effects being rare.
Why Some People Are Afraid of Ketamine Therapy
Fear may arise from concerns about altered consciousness, stigma, or uncertainty about the therapeutic process. Education, preparation, and your team of both a skilled prescriber and therapist can help alleviate anxiety.
Ketamine-Assisted Psychotherapy Compared to Other Treatments
KAP differs from standard medications by combining pharmacological effects with psychotherapeutic guidance. It is faster-acting than many antidepressants and can complement other therapies rather than replace them.
Still Unsure? KAP Frequently Asked Questions
Is Ketamine-Assisted Therapy Legal?
Ketamine is legally prescribed for medical use in the United States and many countries. KAP conducted in licensed settings is fully legal and regulated.
Can I try ketamine therapy at home?
Home use without supervision is not recommended due to safety concerns. Clinical guidance is essential.
What Does Ketamine Feel Like?
Experiences vary: from calm detachment to vivid imagery or emotional release. It is generally controllable and guided.
How long does ketamine-assisted therapy last?
The ketamine experience typically lasts 45–90 minutes, with integration continuing for days or weeks afterward.
How Much Does Ketamine-Assisted Psychotherapy Cost?
Costs vary based on provider, location, and session format. At Reverie the cost is based on our hourly rate - $185 per hour and most KAP sessions are typically two hours in length. There is an additional charge for the ketamine itself which will be prescribed by our partners at Skylight Psychedelics.
Is KAP Covered By Insurance?
Insurance coverage is limited but growing, particularly when combined with mental health therapy. As always, you will need to check with your individual provider to assess for coverage.
Is This the Same as Recreational Ketamine Use?
No. KAP is structured, guided, and therapeutic—focused on healing, insight, and emotional processing.
Will I Lose Control?
You remain conscious and supported throughout. The therapist ensures safety and helps you navigate any intensity.
Exploring KAP on Your Healing Journey
KAP does not create insight out of nothing. It reveals what is already there—often beneath layers of survival, shame, or adaptation. For people carrying identity-based trauma, this revelation can feel less like a breakthrough and more like a homecoming. Ketamine-Assisted Psychotherapy offers a unique intersection of spirituality, science and consciousness. For many, it opens doors to emotional release, insight, and new ways of relating to self and others.
If you are curious about exploring KAP as part of your healing journey, this integrative approach can be a powerful tool on your path to self understanding and growth. You deserve care that sees you fully—without explanation, correction, or translation. Reverie offers ketamine-assisted psychotherapy in a space that honors identity, complexity, and self-trust. If you’re wondering whether KAP might support your healing, we’re here to explore that question with you to help you discern whether this path feels aligned for you.