I had my first ketamine experience two weeks ago. In a serene plant-filled room equipped with a zero gravity massage chair, weighted blanket, silk eyeshades, noise-canceling headphones, and lavender aromatherapy. Couldn’t ask for a better psychedelic therapy setting but I’m a little biased, it was at our new LA center. My intent was two-fold. To go through the Field Trip program, just as our patients do, to gain a deeper empathy for the journeys I’m designing technology to support. And two, to experience a psychedelic dose of ketamine.
While ketamine hasn’t gotten as much attention as the classic psychedelics like psilocybin-producing mushrooms, LSD, or DMT, it’s important we change that. Ketamine is the only federally legal psychedelic today and as such, will play a key role in paving the way for psychedelic therapy. It’s currently being used throughout the country for off-label use in treating depression, anxiety, PTSD and other mental health issues. Classic psychedelics have rightly received credibility and attention after millennia of use, and will have their legal glory (round two) one day but if we want these medicines to help people sooner than later, we need to invite ketamine to the party and understand that it holds its own power in mental health. And that it very much has psychedelic qualities…after two experiences I can tell you that’s more true than I anticipated, but we’ll get to that.
I’ve been around ketamine plenty—a party drug that’s becoming near as common as alcohol in some places. Categorized as an anesthetic, it was originally developed in the 60s for use during surgeries. It was approved for medical use in 1970, found its way to the streets around that time, and has since grown in popularity for recreational use due to its dissociative, hallucinogenic effects at certain doses. Though, since joining Field Trip and being at the forefront of the newest psychedelic research and learning the power in set and setting—via a purpose-built environment with trained therapists—snorting an ambiguous dose of questionably-sourced powder amidst dancing strangers seemed like a fun setting but maybe one that should come later, after working with the medicine in a way that could derive the most benefits.
The journey began with a virtual psychiatrist consult to get a medical history and personalize my program (a set of prep appointments, ketamine sessions, and integration therapy). Then came my first therapy sessions with one of our CIIS-trained therapists who’d be along with me throughout the program. In these, we got to know one another more deeply, discussed what to expect and how to prepare (fasting, meditating, writing, no other psychedelics or alcohol, etc), and my intention for the experience.
I arrive at the clinic for my first ketamine session nervous but ready. I started the day as calmly and mindfully as I could on a Friday after a busy week. My therapist shows me to my dosing room, I get comfy on the reclining chair, curl under weighted blanket, and queue the music. The medical director comes in to discuss dosing, they ask me things like my weight and tolerance for other psychedelics, allergies, etc. They decide on 75 mg, enough for a psychedelic experience, not enough for K-hole—the state of paralysis between a semi-conscious and tranquilized state that can be more traumatizing than therapeutic.
My therapist and I reflect on my intention, meditate, and cultivate a space between the day and this experience. Then the nurse practitioner injects my shoulder with the intramuscular ketamine. Eyeshades down, headphones on. Off I go.
It came on slow then quick. There’s a certain point easing into a psychedelic experience when you meet a threshold of will I let go or will I cling. It’s a familiar place for me. I used to grip, hold on to normal consciousness, recoil from the vast unknownness in that space beyond the wall that sits between everyday reality and psychedelic reality. Now I know the beauty that lies behind it. That the whole point lies behind it. Now I gratefully, eagerly let go. I met that wall here like an old friend, breezed over and past it. Left body and room, surrendered into the abyss.
That’d be the best way to describe this one. An abyss. A spacious swirling abyss I was simultaneously observing and plunging into. I remember trying to mentally drop in personal content—relationships, memories, goals, etc. Life stuff for which the wise unconscious mind might provide answers or insight. Nothin. Almost comically nothing. The experience was a blatant contrast to any life content that if I was cognizant enough at that moment I would’ve laughed at how small they seemed there. They didn’t belong. As if they were all just a strange little dream within a far greater world. An unfamiliar world, a non-world. An edgeless expanse of nothing and everything. The only content that lived there was space and experience, experience that was both observed and felt without form or judgment. Continuous, boundless, timeless, flowing experience. One I wasn’t separate from, but merged with. There was no separateness, no form or distinctions, just one expanse where everything that ever was and ever will be somehow meshed together, all at once.
Another common thread in psychedelic experiences is a reveling conviction that this is true, this is real. It’d be difficult to explain or convince to those who haven’t been there so trust me when I say it’s a somatic intuition that rests deep, that when you let the formed reality go and meet the egoless state, something internal lights up and revels at the obviousness in it. Whatever form my awareness took in this experience felt that conviction. I remember feeling awestruck at the simultaneous senses of extreme anomaly, with immediate acceptance.
The ease out an hour later was like the ease in—slow then not. I felt sad, sad to leave my strange new world. As I returned to the room and body, my mind felt like it was getting smaller. The vast boundless space shrunk to a small little existence that I realized is just my normal reality. I returned to my body, felt my hands resting on lap, my head against pillow, fuzzy blanket over skin. I became aware of the sounds in the room, of my therapist sitting next to me, and spent moments reveling behind eyelids before I was ready to form words around the experience.
An experience that was a glaring contrast to my 5-gram mushroom dose a few months ago. One where I cried, laughed, released in a way I never have. One where it seemed every emotion ever bottled or ignored throughout my life burst forth, expressed, let itself be known, then let go. There was none of that here, my therapist tells me I simply rested silently, motionlessly, as my mind did quite the opposite. Even as I write this I feel bored for who’ll read it. I write best when I feel emotion behind it—deep powerful emotions like love, thrill, loss, grief. There was no emotion, just neutral, yet somehow still ineffably powerful, experience.
One explanation is simple biology. Psilocybin (the psychoactive molecule in the mushrooms) is serotonergic. Ketamine, alternatively, is an NMDA blocker which responds to glutamate, so has no direct effect on serotonin. Ergo, as serotonin is much more directly involved in mood regulation than glutamate, this can lead to a more neutral, dissociative journey.
In both I felt a letting go of self, both were psychedelic. Which was more therapeutic? I spoke with our director of research, Marshall Tyler, a few days later, trying to get more clarity:
“If you destroy the ego, there’s nothing, really. I’ve seen people go to places on psychedelics where there’s nothing. No happiness, no sadness, nothing. I think that’s what there is, nothing. Society and instinct push people to attach a negative emotion to that nothingness. But why? It simply is. That feeling, that “isness”, can be profoundly liberating. The most trivial things—an ant crawling across a keyboard, leaves in the wind, a crack in the sidewalk—are as blissfully filled with meaning as you want them to be. There’s no inherent meaning to anything—pain, love, life, death—none of it is inherently good nor bad. We make it good or bad. That’s cool. I like that. That imparts so much psychological power.”
I spent the next few days wondering how to integrate an experience that had no inherent goodness or badness to it. One that left me as blank and detached as I felt in the experience itself. The integration session was an important step in this, she helped me accept and understand that the insights more often flow in time, subtly weaving into life as you move through it vs. presenting themselves as bullet-point takeaways right after lifting the eyeshades.
I intuitively knew this…but my left-brained mind loves its bullet points and takeaways. I started telling myself that perhaps I’m just a plant medicine posterchild. That the serotonin-activating mechanism in mushrooms and ayahuasca offers more healing power for my structured, emotionally-walled mind than the glutamate-activating ketamine.
Writing this two weeks later, I realize that thinking was limited. That neutral and dissociative can have its own power. That it can help you get outside of yourself, view life and the way it’s being lived from a new, unbiased perspective detached from ego and conscious identity. It wasn’t bullet-point insights that told me this, but a new, higher level of thinking and awareness to which I now have access. As if new neuronal connections were made, the mind literally expanded, to form paths I can now mentally venture down in meditation or moments of mindfulness. I have, and find a lot of solace in doing so. In moments of charge or anxiety, it’s been easier to pause, step back, and observe the feelings and situation. As if looking out a window from within that spacious non-world I was introduced to two weeks ago, peering over this strange little dream we call reality.
Does every psychedelic trip need to teach you something? To that I’d ask, does every novel life event teach you something? Any experience that’s drastically unfamiliar can internalize in the form of new connections—that’s how we learn and grow. Psychedelics just happen to be a more quick and powerful method. Whether those connections persist and translate into new narratives and behaviors is up to you.