In depth

Ketamine-Assisted Psychotherapy (KAP)

Going beyond symptom relief to work with underlying beliefs and patterns that can keep you stuck.

In-person Ketamine-Assisted Psychotherapy

A delicate butterfly resting on a green stem in soft natural light.

Why Ketamine Works Differently

Ketamine can soften fear and reactivity while creating greater psychological and neural flexibility — making room for new perspectives, deeper self-compassion, and a different relationship to painful material.

How the Process Works

We begin with medical and psychological clearance, then meet to set intentions and clarify what to expect. Medicine sessions follow, supported by integration work — helping what emerges take root in your life.

Is KAP Right for You?

This work resonates most with people who are deeply curious about their inner lives and ready for root-level change.

What If What's Standing between You and Your Well-Being Isn't a Lack of Effort or Insight — But Old Childhood Patterns That Once Made Sense, Though No Longer Serve You Now That Your Circumstances Have Changed?

You may understand exactly why you react the way you do. You may have spent years in therapy, read the books, developed insight, and worked hard to change — yet still find yourself caught in familiar patterns.

This is where Ketamine-Assisted Psychotherapy can offer something more hopeful.

Ketamine is a dissociative medicine that has been safely used as an FDA-approved anesthetic for decades, with approximately 25 years of research into its use for mental health conditions. Although the FDA has not specifically approved ketamine for psychiatric treatment, clinicians can prescribe it for this purpose — a common medical practice known as off-label use.

Paired with skilled psychotherapy, ketamine can create more distance from ordinary ways of thinking and reacting. Fear and defenses may soften. Memories, emotions, and associations may become more accessible. And experiences that ordinarily feel overwhelming can be approached with greater curiosity and self-compassion.

Ketamine also promotes neuroplasticity — the brain's capacity for learning, flexibility, and change. Together, these effects can create a powerful opportunity to transform old patterns from a different vantage point, rather than simply understand them intellectually.

When Insight Hasn't Been Enough

Many people who come to KAP recognize themselves here:

Exhausted, burned out, or overwhelmed
A harsh inner critic that rarely lets up
Perfectionism or people-pleasing
Caring for others while neglecting their own needs
Trouble relaxing even when nothing important is happening
Staying busy — or reaching for other habits — to manage difficult thoughts, emotions, or anxiety These aren't failures of willpower.

Often, they're deeply ingrained ways of protecting yourself — adaptations that may have begun in childhood as ways of trying to feel safer, more secure, and connected with a caregiver.

KAP gives us an opportunity to approach these patterns from a different state — one that may be more open, flexible, and curious. This increased flexibility can also make it easier to question old beliefs and begin practicing more supportive ways of responding.

Rolling green fields patterned with violet flowers beneath a muted sky. — Preparation and integration provide a thoughtful container for therapeutic change.

A Different Relationship to Painful Material

One of the most useful qualities of ketamine is the psychological distance it creates.

You're not necessarily disconnected from what happened. Instead, ketamine can provide a buffering effect, making it easier to approach difficult or painful memories without becoming as overwhelmed by them. Research also suggests that ketamine can affect brain circuitry involved in fear and threat processing, including the amygdala.

That difference in the experience can be profound.

Rather than experiencing an old memory through the same familiar lens, unexpected associations, emotions, images, or perspectives can emerge.

For instance, one person spoke of a harsh, neglectful mother who insisted that he, as a 5-year-old, walk miles to school alone along a busy street, even though he protested that he felt sick.

What began as an anger-filled memory shifted during the medicine session. Self-appreciation suddenly washed over him as he recalled discovering a small animal farm along the way. He realized that this experience, and others, had helped spark a lifelong spirit of adventure and independence.

He let go of anger that no longer served him and embraced a different truth about himself.

This became a turning point: a shift from seeing himself as broken to recognizing how resilient, creative, and whole he'd always been — and still is.

This is one example, not a promise of what a ketamine experience will be. Journeys are highly individual. But it illustrates something important about KAP: sometimes a different state allows us to see an old experience through an entirely different lens.

Ketamine and Your Inner Healing Intelligence.

Ketamine Itself Doesn't Do the Healing.

Rather, it can create conditions for greater access to your own inner healing intelligence — the clear, wise part of you that can make connections, recognize what matters, and facilitate greater well-being and choice.

My role is to facilitate your connection to your inner healing intelligence.

During ketamine journeys, I'm a warm presence to accompany you, stay curious with you, help you explore what emerges, and support you in feeling safe throughout your journey.

How Are Lower-Dose and Higher-Dose KAP Sessions Different?

At lower, psycholytic doses, you generally remain conversational and aware of the room. You may feel more emotionally open, less defended, and better able to explore memories, gain clarity and greater self-compassion, helped by ketamine's buffering effect.

At higher doses, the experience is more psychedelic and inwardly immersive. There may be dreamlike imagery, self-compassion, or feelings of connectedness with others, awe, or spiritual attunement.

Neither dosage is inherently better.

What Does a Ketamine Session Feel Like?

People often describe ketamine as spacious, dreamlike, reflective, or uplifting.

A quiet wooden dock extending into still water beneath a pink sky. — Integration helps meaningful insight become part of everyday life.

Both high and low doses create a non-ordinary state of consciousness. At low doses this is mild and builds as the dosage increases.

Images, sensations, memories, emotions, and unexpected associations may unfold without a need to organize or control them.

Not every journey is blissful. A session may feel peaceful, joyful, poignant, confusing, challenging, spiritual — or some combination of these.

It is helpful to greet whatever emerges in a KAP session with openness. And I'm present throughout, as a journey companion and guide who encourages curiosity, asks questions to stimulate reflection, and ensures you feel safe and your needs are attended to.

What to Expect from the KAP Process

The process generally includes four stages:

1. Screening

Before we begin, a medical provider and psychiatric professional determine whether ketamine treatment is appropriate and safe for you.

2. Preparation

We usually meet for 1–3 sessions before your first medicine journey.

We build trust, discuss any relevant history, clarify your intentions, and talk through what to expect and how you'd like me to support you.

3. Medicine Session

Medicine sessions generally last 2.5–3 hours.

You take your prescribed sublingual ketamine and settle in with an eye mask and instrumental music curated to follow the arc of the experience.

The setting is calm and comfortable, and I'm nearby as an attuned presence throughout.

There is nothing you need to perform or accomplish. Just be curious and engage with what arises.

You'll need to arrange transportation home, as you cannot drive for the remainder of the day.

4. Integration

We meet within 48–72 hours and usually again the following week to explore what emerged and how you might integrate your experience into daily life.

We may also use EMDR, somatic work, or parts work to deepen what emerged during your low-dose journey, or in integration sessions.

Integration asks:

How Might Your Experience Change the Way You Relate to Yourself and Live a Better Life?

Who Might Benefit from KAP?

KAP may be worth exploring if you're struggling with:

Anxiety
Depression
Burnout
Perfectionism and people-pleasing
Trauma (PTSD) or complex trauma (cPTSD)
Persistent patterns that haven't shifted despite considerable insight
Questions of meaning, purpose, identity, or connection You don't need to be in acute distress.

Some people seek KAP because they feel stuck. Others are functioning quite well but sense there is something more to explore than talk therapy alone has been able to reach.

KAP isn't right for everyone, and outcomes vary.

But if you're curious about your inner life and interested in deeper change, I'd be happy to talk with you about whether KAP might be a good fit.

Schedule a free consultation →

Bay Area in-person sessions · California psychotherapy

Questions

Frequently Asked Questions

What is Ketamine-Assisted Psychotherapy?

Ketamine is an FDA-approved medicine with over 50 years of use as an anesthetic and about 25 years of use in supporting mental health. Paired with skilled psychotherapy, ketamine isn't the treatment itself — it's a facilitator, creating a buffered, expanded state where healing and insight can happen more readily. The goal isn't just symptom relief; it's reconnecting with who you truly are and supporting how you want to live your life.

What is the arc of a KAP process — what should I expect from beginning to end?

Screening. A physician and a psychiatric professional assess if KAP is a good fit. Common medical exclusions include uncontrolled hypertension, serious cardiovascular disease, and pregnancy. Psychiatric exclusions include active psychosis, certain bipolar conditions, and some substance use disorders.

Preparation (1–3 sessions). We build trust, understand your history, clarify your intentions, and address questions, concerns, and logistics, so you have a clear idea of what to expect, and how you'll be supported throughout.

Medicine session (2.5–3 hours). You take your sublingual lozenge in an environment that is warm, calm, and comfortable. You'll hear music that is synced to the arc of the medicine journey. The effects of ketamine often begin within 15–20 minutes and peak around 40 minutes.

We begin with grounding — perhaps a poem, and selecting an oracle card — to help shift from overthinking to connecting more with the subconscious. I'm near you throughout the session as a warm, grounded presence. I encourage you to welcome everything that arises, stay curious, and allow your own inner healing intelligence to show you the way. Where helpful, I ask brief questions like, "What are you noticing now?" or "Can you be curious about that?"

You will need someone to drive you home — it is not safe to drive that day.

Integration. It's best if we meet for a session within 48–72 hours, and again in about a week. This helps you integrate new associations and release old patterns, so you can transform your life. This may be a good time for EMDR, somatic work, and parts work, so what emerged can take root in your life.

How is this different from IV ketamine clinics?

IV clinics typically administer ketamine without a therapist present, relying on the medicine's biological effects alone. This work differs, as KAP pairs the medicine with psychotherapy before, during, and after each session — and much of the change happens in that surrounding work, not just the session itself.

What does a ketamine session actually feel like?

Most people describe it as dreamlike, spacious, and reflective — often gentler than they expected. At lower doses, you may feel relaxed and emotionally open with mild distance from everyday worries. At higher doses, it is usually psychedelic and more inwardly focused, with imagery and a sense of deep peace. It can also be challenging, but these sessions can provide the most transformational material as well. Whatever arises, you're not alone — I'm present with you throughout.

What if a session feels difficult?

Not every session will necessarily feel peaceful, and that's alright. Difficult material is often exactly what's ready to be worked with — and having me a trained therapist present means you're supported through it, both in the moment and in integration afterward.

I'm nervous about the idea of using a psychedelic.

That's an understandable reaction, given how ketamine and psychedelics are often mis-portrayed in the media. This isn't a recreational experience — it's a carefully supported therapeutic one. At lower, psycholytic doses especially, it's closer to a very relaxed, reflective state where you remain conversational throughout. We always start low and adjust gradually, so the experience matches what's right for you.

Is ketamine safe?

Ketamine has a long, well-established safety record in medical settings. With proper screening and a trained therapist present, it's considered low-risk for most people, though it isn't appropriate for everyone.

Common contraindications include uncontrolled high blood pressure, certain cardiovascular or psychiatric conditions, and pregnancy — a physician and psychiatric provider screen for these before we begin. Mild side effects like dizziness or nausea during a session typically resolve as it wears off. For safety, clients need to arrange another way home rather than driving themselves.

Most people begin with a series of around 6 sessions, spaced roughly one to two weeks apart, with integration woven throughout. Some find that's enough; others continue, and many return occasionally for a booster session — there's no fixed endpoint, and we assess together as we go.

Why is KAP helpful? How does ketamine support healing?

A dissociative psychological buffer — reduced fear, more perspective. Ketamine softens the brain's threat-detection center, the amygdala, reducing fear and reactivity and making it easier to approach emotionally charged material without flooding or avoidance.

At the same time, flexibility in the prefrontal cortex — the part of the brain involved in reflection and meaning-making — increases, so you can observe your experience with more curiosity, compassion, and perspective, rather than being pulled in and overwhelmed by it.

How does change begin to take root following KAP?

Over time, early wounds and long-standing emotional, mental, and physical patterns can potentially begin to shift. You may feel more at ease in your body and more compassionate toward yourself and others. Old traumas tend to become memories of the past, not relived activations. You may notice:

More ease in your body
Less reactivity, more choice
Greater self-compassion
A stronger sense of alignment with your more authentic self — and a greater capacity to thrive These shifts can create the conditions for meaningful, enduring change.

How are low-dose and high-dose KAP sessions different?

Different doses of sublingual ketamine create different therapeutic experiences, ranging from reflective and conversational to deeply inward and psychedelic.

Psycholytic (roughly 50 to 150 mg): Present, reflective, and relational. Many people remain partially present — able to speak and reflect with the therapist. They often feel mildly dissociated, relaxed, and more emotionally open. Therapeutic modalities like EMDR, somatic work, and parts dialogue can be used at this time.

Moderate (roughly 150 to 250 mg): More inward, more imagery. This dosage increases non-ordinary states of consciousness, which can feel more dreamlike, with visual imagery, especially at the outset. As the medicine wears off, people often become more externally focused and want to engage more with the therapist.

Higher/Psychedelic (roughly 250 mg and above): Deeply immersive, inward, and expansive, initially psychedelic and inwardly focused. More spiritual or mystical states are possible with this level of non-ordinary states of consciousness. Verbal interaction with the therapist is initially minimal, but increases later in the session.

Is ketamine safe? What are the risks?

Ketamine has a long and well-established safety record — it has been used as an anesthetic since the 1960s, and in mental health treatment for about twenty-five years. In a therapeutic context, with proper screening and a trained therapist present, it is considered low-risk for most people.

That said, it is not appropriate for everyone. Common side effects during a session can include dizziness, nausea, and temporary disorientation — these typically resolve as the medicine wears off. It is not safe to drive for the remainder of that day. The medical screening process is designed to identify any contraindications before beginning, such as uncontrolled high blood pressure.

What is neuroplasticity, and how does it work with inner healing intelligence?

Ketamine grows new neural networks during the medicine session, which makes the brain more flexible — a state called neuroplasticity. This flexibility begins tapering within 48–72 hours and continues declining over several weeks.

During this 48–72 hour window, usual defenses, habitual thoughts, and emotional patterns quiet down, creating more room for self-compassion, self-supportive habits, and the emotional resilience needed for more enduring change.

This same flexibility is also what makes it easier to access your inner healing intelligence — your own innate capacity to see the big picture and get a felt sense of your own worth and goodness. Since the mind is less bound by old patterns, it can be more open, and lean into wholeness.

What is memory reconsolidation?

A hallmark of trauma is feeling like you're reliving an old experience, rather than remembering it — as if it's still happening, not something that's over. KAP, along with other trauma-informed treatments, can help shift that: painful memories can be reconsolidated, losing their emotional charge, so they can be filed away as something that occurred in the past instead of being relived as traumatic reactivation.

Is KAP covered by insurance?

Insurance typically reimburses for one hour of therapy during a medicine journey. It also reimburses for pre- and post-therapy sessions. The medicine itself is prescribed by a collaborating physician and is relatively affordable. I'm happy to talk through fees during your consultation.