I Had Ketamine Therapy. This Is What It’s Like

The words “ket” and “therapy” couldn’t conjure up more discrete images. One might entail hedonistic fun with your mates, exquisitely escaping reality and all the fuckeries that come with living, but the other involves absolutely no fun with a stranger who forces you to confront the demons you’re trying your best to avoid. 

Obviously, ketamine-assisted therapy doesn’t involve going into a therapy room and snorting a load of K – it’s a little (lot) more scientific and high-brow than that.

Studies going back to the 90s suggest that ketamine can help treat chronic depression, if only temporarily. If you’ve ever had the misfortune of experiencing emergency surgery, like breaking a bone or dislocating a joint, you might’ve even been anaesthetised with it in hospital already. But while the psychedelic revolution is amping up, most people still tend to associate ketamine with horse tranquillisers (freaky and gross) or parties (fun but definitely not therapeutic).

@vice

this is that new wave medicine #ketty #ktok #khole #therapy

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I’ve spent the last nine years on and off antidepressants and therapy. While I got to a point of understanding my own issues and their knotty roots, I couldn’t quite unlock the key to changing my behaviour. I’ve always found it impossible to quiet the inner voice criticising everything I do – you know, the one that bullies you for basically breathing. I’ve never had unable-to-leave-the-house anxiety or life-altering depression, but I have experienced, to name a few, social anxiety, panic attacks, low self-worth and self-esteem (a surprise to many, I’m told!).

Enter Awakn, the first ketamine-assisted psychotherapy clinic in the UK. It launched in Bristol in March 2021 to provide a new approach to treating substance and behavioural addiction. While it’s not the only clinic in the UK to treat mental health disorders with ketamine, it is the only one combining the drug with a lot of psychotherapy. This programme has nothing to do with railing lines or using ket as a substitute for antidepressants. It does, however, involve undergoing an intensive four-week course of one injection a week, followed by a therapy session roughly 24 hours later. The treatment isn’t exactly accessible to everyone, given it currently costs a hefty £6,450 in London, but the goal is to make it free on the NHS one day. 

“In disorders like depression and addiction, people get locked into thought loops – maybe about being worthless people or that they’re desperate to have a drink,” says Professor David Nutt, one of the world’s leading voices in psychedelic research. “They often know they’re wrong but can’t break them, and what psychedelics do is disrupt the brain through the trip.” 

Ketamine, he explains, weakens the connections between harmful thought patterns, opening the door for a skilled therapist to intervene and help the patient develop more effective ways of responding to their negative thoughts. That’s why the therapy sessions are allocated almost exactly 24 hours later – it’s thought to be when your brain is the most malleable and open to new ideas post-injection.

“Current mainstream [antidepressant] treatments protect the brain from stress to allow it to heal, and that’s why they take weeks or months to work, and why you have to keep on taking them because the stresses are always there,” says Nutt. “But if you haven’t reframed your attitude to life, the stress will always be a stress.”

Professor Celia Morgan – a drugs researcher named one of the most influential women shaping the future of psychedelics in 2022 – puts it like this: “Ketamine is a stepping stone to help you understand that this is just one perspective on reality.”

“It’s a dissociative drug, which suggests it separates you from reality, but really, it’s kind of separating you from your preoccupation with yourself, so you can connect with the broader world around you.”

Unlike other psychedelics, which interfere with antidepressants and can cause blunted experiences, ketamine doesn’t interact with SSRIs, as a 2019 study discovered. This means there are no diminished effects for people who are on, or have been on, antidepressants. It’s also why ketamine is believed to work particularly well for addiction, PTSD and treatment-resistant depression, AKA people who’ve tried a whole host of medications to little success.

Take 23-year-old Tristan, who’s asked to leave his surname out for privacy reasons. After a decade of depressive episodes and many medications and therapies, he reached out to Awakn after his GP mentioned it offhand. 

“How I would think about it is if an average person’s mood is a five or six when they wake up, I would start off with between a three and a four,” says Tristan. “If I had a really good day, we’d be looking at five or six. But if I had a bad day, we’d be looking at the ones and twos.” 

Ketamine-assisted treatment has allowed him to drastically move that dial up. “I’m able to hold things a lot lighter, enjoy life and see more opportunities,” he explains. “Instead of getting bogged down overthinking them and all the reasons why I shouldn’t, or couldn’t, do something.”

Before the treatment, Tristan had been signed off from work and moved back in with his family so they could keep an eye on him. He’s since decided to travel the world before training as a barrister – something he could have never seen himself doing in January.

So, does it work as well as everyone claims? I was given free access to the programme given my history of antidepressant use, depression, impulsivity and negative thought patterns more than qualifies me for it. Most patients like Tristan, though, have usually tried almost every other form of treatment before giving it a go. So what is an almost £7,000 ketamine-assisted treatment actually like?

The assessment

Naturally, I’m apprehensive as I press the buzzer for the first time at the unassuming London clinic, which lies behind the ivy-clad iron gate of a pretty four-storey period building just five minutes from Euston station. I’m here for my in-person assessment, where I’ll spend the next three hours laying out my darkest moments and deepest hang-ups to a psychiatrist I’ve only just met. After I fill out several questionnaires and submit proof of the various medications and therapies I’ve tried over the years, the team will decide if I’m suitable for the treatment.

Once through the cobbled courtyard, I enter the clinic through big glass doors and step into what feels almost like a spa retreat. Soothing, meditative music plays on the sound system. The walls are styled with Scandi wood panelling and leafy plants burst out of minimal, concrete-block pots. It’s clear this is no regular clinic – it’s a “cool clinic” – and TBH, they had me at the exposed brick wall. I’m greeted warmly by the receptionist, who offers me a fancy machine coffee (they even have almond milk) as she leads me to the waiting area.

Despite all this, my palms start sweating the second I’m taken into a side room for the actual assessment. The psychiatrist asks me uncomfortable questions about my mental health history, along with the ways I’d like my life and behaviours to change. There were tears (I’m a big cryer) and it was pretty draining, but the team were lovely and genuinely likeable – they made me feel as comfortable as possible under the circumstances. 

After filling me in on the general process, the doctor warns that I need to seriously cut down on alcohol and stop all recreational drug use completely for the treatment to work properly. As someone who’s never attempted a dry Jan and has a lifelong problem with being able to say no, this was daunting, to say the least – but I felt ready to try. A week or so later, I receive a phone call telling me I was fucked up enough – my words, not theirs – to join the programme. Success!

Prep therapy sessions

Before the actual ket part begins, I have two sessions with my allocated therapist, Fardijah Treacher-Morley, for the first time. She’d read my assessment notes, but I had to go back into it all again and the waterworks were extensive as I opened up to someone new. 

The second session feels a lot calmer (no tears!), and we spend most of it talking through the practicalities of next week’s ketamine session. Fardijah explains that there’s no way to control what I see, and whatever thoughts, memories or visuals come up during the trip are the issues my subconscious wants to draw my attention to and fix. I’m told that, unlike the psilocybin and MDMA-assisted therapies I’d seen on the Netflix documentary How to Open Your Mind, it’d likely be less visual and classically trippy.

For homework, she sets me a task to think about what I want my life to look and feel like. Instead of the “I don’t”s which flow more easily for me (like: “I don’t want to doubt my every move and conversation”), I decide I wanted to “feel secure”, “feel peace” and  – as cringe as these next ones sound – “be kind to myself” and “love myself”. We create an intention for my trip – basically, a sentence that encompasses my main goal for the therapy. Given that my issues ultimately stem from self-worth, mine is “find self-acceptance through being kind to myself” (vom).

The ketamine sessions

On the day of my first dose, I finally feel my first twinge of nerves. Previously, I’d been very blasé and relaxed in the knowledge that this was going to be much safer and more controlled than any other drug experience I’d ever had – but it finally dawns on me that I had no real idea what it was going to literally feel like.

For my first session, I’d be injected with 0.6mg for every kilo of my body weight. Over the four weeks, this would steadily increase to 1.1mg per kilo. For the final session, I’d be injected with 73mg – roughly a quarter of the amount I’d be put to sleep with in a hospital, according to a doctor friend. The idea was to keep upping my dose to the point I fully dissociate, but not to the point where I pass out. 

I lie down on the sofa with my head on a pillow and pull the weighted blanket up to my shoulders – a gorgeously cosy way to start a Monday afternoon, really. Fardijah places my finger in a heart monitor peg and dimmed the lights. As I slip the headphones over my ears and the sleep mask over my eyes, a nurse injects my upper arm with liquid ketamine.

As music plays – a range of ambiguous rhythmic sounds, from calming waves to darker melodies, one of which gave big Succession theme tune vibes – my body slowly begins to feel like lead, and I half-drift out of consciousness.

Then a rush of energy and endorphins hits me: I’m off on a dark and dream-like journey, twisting and turning like I’m a particle spinning through the universe. At the start, I try to hold onto reality a little too tightly, chanting my intention and constantly trying to remember what I “should” be doing. Then I’m falling, suddenly landing in a black room of nothingness with throbbing green grids on the walls – a bit like the glowing green code in The Matrix. This is the moment I well and truly tap out, losing all grip on reality. 

I unexpectedly start reliving memories of times I’ve been taken advantage of by men – times I let things happen or did things I didn’t really want to do, because I was never asked or just couldn’t bring myself to say no. I’m pretty sure this is the point I start crying, but I only realise this when I slowly started to gain feeling in my body again – a sign my experience is coming to a close. 

Over the next weeks, the rest of my sessions are thankfully more positive, with heart-in-my-mouth moments of utter bliss. On my second and fourth trips, I feel a constant soaring upwards to euphoric climaxes, interlaid with the blissful and overwhelming openness you feel on shrooms. It’s as if my senses of sight, sound and touch combine to create a single mega-sense. At many points it feels so good I can’t actually believe I’m allowed to experience it. 

“You feel a sort of bigness of everything, what I would describe as a positive insignificance,” Tristan remembers. “You no longer feel worried or think everything’s all about you, because you feel positively small.” 

He found his trips to be more “content-rich”, even mystical. “It was sort of like the best Baz Luhrmann film you can think of,” he says. “I definitely felt a connection with nature. In those more positive moments, you get that real sense of awe and elation.”

Both of us also experienced darker moments during the trip: “My therapist told me these are actually, clinically, some of the most important times,” Tristan counsels. “These are the crucial messages and moments you need to work through in the therapy afterwards.”

We were warned of potential side effects like vomiting, but neither Tristen nor I had that or anything else negative. The most noticeably abnormal feeling is a nostalgic, festival-like stagger to the toilet after just coming back to reality in the therapy room, before I’m chaperoned to the chill-out area to sober up and get picked up by a pal. 

The post-ket therapy sessions

The day after my first ket session, I feel noticeably more connected and relaxed with Fardijah. It was like we’d gone through something big together, sort of like that closeness you feel to your pals on your way home from a mangled night at Sankeys (RIP) or the first festival you dropped at. When discussing my teary trip, I come to interpret the uncomfortable memories as a sign of wanting to get better at setting boundaries and learning to treat myself with more respect and care. There are a few of the usual therapy tricks, too – like awkwardly talking to my younger self – but, for the first time ever, they actually seem to sink in. 

I start to understand that each trip tells a story, from learning to treasure my female friendships to appreciating and even loving my inner self. In my fourth and final trip, I actually felt like I met my conscience and gave it a hug, thanking it for everything it’d done and promising that I wouldn’t let my old ways consume me once I floated back up into my body.

“It’s very value-driven,” says Tristan of the therapy sessions. “It’s very much: Who are you? What are your values? And what do you need to do to move towards those values? It makes you able to hold onto thoughts lighter by encouraging the really simple question of: Does this move me towards my values?”

A huge thing for me was feeling more present in my body and life during the process, as I spent days then weeks away from any kind of intoxication. I’ve never had so much clarity without my weekly hangovers or comedowns and, like most people, I’ve certainly never spent four weeks with such intense focus on understanding and bettering myself.

There have been noticeable changes, too: I’m able to disregard the automatic thought that I’m embarrassing myself in conversations. I seem to be truly respecting and valuing myself, and my desires, more. Then there’s the tangible life changes: I’ve stopped wearing super long fake nails for the first time in a decade (a kind of compliment crutch for me); I’ve started regularly meditating; I’m making more time for old hobbies like dancing; I’ve finally stopped vaping. I feel sort of spiritual, in a very loose way: I’m not so closed off to the idea and have been able to get into yoga a little more, something I always used to shoot down as a waste of time that simply wasn’t me. I’ve been Googling reiki for god’s sake.

If injecting ket sounds a bit extreme, just think about it this way: It’s actually an incredibly short intervention compared to other forms of therapy and medication. And when compared to some of the side effects of antidepressants, too – whether that’s suicidal thoughts or drowsiness, nightmares and an inescapable unhinged feeling, as I experienced on fluoxetine – it might just be a lot kinder on the mind. 

“In the two years we’ve been running, we’ve been gathering data with the hope that we’ll have enough, by the end of 2023, to convince the NHS that what we’re doing is a lot more cost-effective than what they’re doing,” says Nutt. “Particularly in terms of alcoholism, where it costs roughly £50,000 to send someone to a private residential treatment centre. We can potentially treat ten people for the same price and probably get better outcomes.”

Obviously, I’m not saying this is some kind of quick fix holy grail, especially at its current price point – though it’s worth nothing that a year’s worth of private therapy can cost as much as £7,800 right. For some, therapy and antidepressants work just fine. But am I behind Awakn’s programme and making this available on the NHS? Hell yeah. Surely another string to our mental health bow can only be positive.

Oh, and one other thing: If you’re thinking you might try a DIY jobby of this at home, just don’t. “It’s about the intention around it, with clinicians who understand the experience to guide you and hold you safely, emotionally speaking,” says Morgan. “It’s partly that feeling of safety that allows you to explore these alternative realms and realities… It’s qualitatively not the same as just doing it in your living room and then going to your therapist the next day.” Shame, I know.

@beckyburgum