Ketamine-Assisted Therapy: A Clinical and Shamanic Perspective
Educational information only. This article is for learning and awareness, not a guide for self-administration or an offering of service.
What Is Ketamine Therapy?
Ketamine-assisted therapy (KAT) is a clinically guided therapeutic process that combines the use of low-dose ketamine—a legally prescribed dissociative anesthetic—with psychotherapeutic or ceremonial support.
It is currently one of the only psychedelic medicines legally available in the United States through medical prescription.
When used in a therapeutic setting, ketamine can soften rigid mental patterns, open emotional access, and allow the body and psyche to reorganize around deeper truth and coherence.
The medicine may be administered through several methods: intravenous (IV), intramuscular (IM), nasal spray, or sublingual lozenge.
The lozenge is most often used in at-home or ceremonial settings, under medical supervision with a valid prescription and appropriate psychological or shamanic guidance.
How It Works in the Brain
Ketamine acts primarily on the glutamate system, rather than serotonin.
It blocks NMDA (N-methyl-D-aspartate) receptors and increases AMPA receptor activity, which together stimulate the growth of new neural connections (a process known as synaptogenesis).
This neuroplastic effect allows the brain to “reset” stuck pathways, which can lead to breakthroughs in treatment-resistant depression, PTSD, chronic pain, and existential distress.
Key Neurochemical Actions:
Glutamate modulation – Increases neural flexibility and communication.
BDNF (Brain-Derived Neurotrophic Factor) – Supports new growth and healing within neural networks.
Dopamine elevation – Can enhance motivation and positive affect.
Default Mode Network quieting – Reduces self-critical and repetitive thought loops, creating space for new awareness.
The result is often described as a widened field of consciousness — one where habitual defenses, judgments, and fear responses soften, and the person can access buried emotions or transpersonal states of perspective and peace.
What It Feels Like in the Body and Energy Field
Ketamine is a dissociative medicine, which means it can create a sense of detachment from the usual experience of self, body, or identity.
At therapeutic doses, clients often report:
A floating or expansive sensation
Warmth or vibration through the body
Vivid visual or intuitive imagery
Release from chronic tension or pain
Deep calm, silence, or communion with spirit
From a shamanic perspective, this state can be understood as a threshold space—a liminal zone where the ego softens and the deeper soul field becomes accessible.
It allows for soul retrieval, spiritual insight, and reorientation of life patterns through an altered lens of compassion and spaciousness.
Why This State Matters in Therapy
In everyday life, the ego tightly organizes thought, emotion, and memory to maintain a sense of safety.
Under ketamine, that structure loosens. This gives both therapist and client access to emotional truths or spiritual realizations that are often unreachable in ordinary consciousness.
Clients may encounter:
Childhood or ancestral memories
Archetypal imagery or spiritual visions
Emotional catharsis and forgiveness
Profound stillness and connection to the divine
The dissociative space of ketamine allows one to witness rather than relive trauma, providing distance without disconnection.
It often creates a sense of rebirth — clarity, emptiness, and peace where fear once lived.
How It Is Used
Ketamine-assisted therapy is always done under the supervision of a licensed prescriber (physician, psychiatrist, or nurse practitioner).
For sublingual (lozenge) use, clients receive a prescription through their provider and may then work with a trained therapist, shamanic practitioner, or ceremonial guide during the experience.
Typical Clinical Components:
Preparation Sessions – Medical intake, intention setting, and orientation to the medicine.
Ketamine Sessions – Guided journeys lasting 60–120 minutes, using the prescribed lozenge dissolved under the tongue.
Integration Sessions – Reflection, grounding, and embodiment work in the days following.
What It’s Used For
Clinically supported conditions include:
Treatment-resistant depression
PTSD
Chronic anxiety
Existential or spiritual crisis
Chronic pain syndromes
Holistically, it may also be used as part of spiritual growth, grief work, or life transition support when done with clear intention and professional guidance.
When It’s Indicated
Ketamine therapy may be indicated for individuals who:
Have not responded to conventional therapy or medication
Have established psychological support systems
Desire to address emotional or existential suffering at a deeper level
Are ready to engage both clinically and ceremonially
When It’s Not Indicated
Contraindications include:
Uncontrolled high blood pressure or cardiovascular disease
Active substance misuse
Pregnancy or breastfeeding
Psychosis or mania
Severe personality disorders without stable containment
Lack of medical oversight or psychological support
Who Can Facilitate This Work
Only a licensed medical provider can prescribe ketamine.
However, licensed therapists and trained ceremonial guides may facilitate the experience itself, provided that a prescriber oversees dosing, safety, and medical screening.
Many shamanic or integrative therapists collaborate with prescribers — the medical professional handles dosing and monitoring, while the therapist or ceremonialist provides the container of care, ritual, and integration.
Typical Protocol and Dosage
Lozenge dosing is determined by the prescriber, but generally follows these guidelines:
Low-dose (50–100 mg): gentle, inward relaxation and emotional processing.
Moderate-dose (100–200 mg): mild dissociation, expanded consciousness, vivid imagery.
High-dose (200–300 mg): full immersion, deep symbolic or spiritual experience.
Sessions may occur every 1–2 weeks for a series of 4–6 sessions, followed by integration and maintenance sessions as needed.
The Shamanic-Integrative Perspective
Within a ceremonial framework, ketamine is seen as a sacred mirror — a spirit ally that opens gateways between consciousness and soul.
The work is not about escaping the body, but about returning through the body, remembering connection to the larger field of being.
Adjunctive supports may include:
Flower Essences – Star of Bethlehem, Angelica, or Walnut for protection and integration.
Herbal Allies – Tulsi, rose, and lemon balm for grounding the nervous system.
Bodywork or Energy Healing – To help integrate and release stored somatic memory.
Ritual & Prayer – Creating sacred context, invoking guides, setting intention for insight and repair.
The Process: From Intake to Integration
Medical and Psychological Intake
Health history, medications, blood pressure, and psychological screening.
Review of contraindications and prescription approval.
Preparation & Intention Setting
Therapist and client co-create clear intention: emotional, psychological, or spiritual focus.
Create ritual container: altar, music, breathwork, energetic grounding.
Ketamine Ceremony (1–2 hours)
Lozenge is placed under the tongue, dissolving slowly over 10–15 minutes.
Client reclines with eyeshades and music; therapist or shamanic guide holds presence.
Journey unfolds through visions, emotions, stillness, or release.
Therapist may offer grounding touch (if pre-consented) or speak minimal guidance.
The experience naturally subsides within 60–90 minutes.
Closing & Re-Entry
Soft landing with breathwork, gentle sound, or energy clearing.
Offer warm tea, light nourishment, or grounding herbs.
Reflect on insights or sensations, noting symbols or themes for integration.
Integration & Aftercare
Follow-up within 24–48 hours.
Grounding practices: salt baths, journaling, gentle movement.
Supportive therapies: somatic therapy, massage, Reiki, bodywork, nature immersion.
Continued integration sessions over the following weeks to translate insights into daily life.
Ketamine Therapy for Couples
Some clinicians and ceremonial practitioners facilitate ketamine-assisted couples sessions, using low-dose lozenges to foster openness and communication.
Purpose
To reduce defensiveness and anxiety during difficult conversations.
To restore emotional connection, compassion, and forgiveness.
To facilitate shared healing from relational or family trauma.
Structure
Both partners receive their own medical clearance and lozenge prescription.
Sessions are guided by a trained therapist or ceremonial facilitator.
The focus is on shared experience and listening, not argument resolution.
Integration includes individual and joint follow-ups.
Boundaries
No physical intimacy during or immediately after the session.
All touch remains consensual and grounded.
Emotional honesty and mutual respect are the center of the work.
Boundaries and Etiquette
Sessions are non-sexual, confidential, and ceremonial.
Consent is required for any physical or energetic touch.
Client remains sovereign and may pause or end the session at any time.
Facilitator maintains a clear, grounded, and sober presence.
No recordings, phones, or distractions; the space remains sacred and contained.
Integration: The True Medicine
The power of ketamine therapy lies not only in the experience but in what follows.
The real healing occurs through integration — when insight becomes embodiment.
Supportive Tools:
Grounding herbs, essences, or flower baths
Bodywork or somatic therapy
Prayer, altar tending, or meditation
Journaling, art, or movement
Continued connection with trusted community and guides
Summary of Key Principles
Clinical Model:
Ketamine is a legally prescribed dissociative anesthetic used therapeutically to support neuroplasticity, emotional release, and trauma resolution. The environment is clinically safe and medically monitored.
Shamanic Model:
The medicine is approached as a sacred ally that opens perception, softens ego structures, and reconnects the soul with divine awareness. The space is held as ceremony — a sacred threshold between worlds.
Disclaimer
This article is for educational and informational purposes only.
Ketamine is a prescription medication that can only be provided legally through a licensed prescriber.
Nothing here constitutes medical advice or endorsement of unsupervised use.
If you are considering ketamine therapy, consult with a licensed medical provider and ensure the work is done safely, legally, and in alignment with your physical, psychological, and spiritual wellbeing.
