Understanding Ketamine-Assisted Psychotherapy: A New Path to Healing
Ketamine-Assisted Psychotherapy, often called KAP, has received growing attention in recent years as an option for people who feel stuck despite sincere efforts to heal. For many individuals living with depression, anxiety, trauma, or persistent emotional pain, traditional therapy and medication have helped only partially or not at all. KAP offers a different kind of doorway into the healing process, one that works not by forcing change, but by softening the inner defenses that often keep people locked into familiar patterns.
At its core, ketamine-assisted psychotherapy is not about escaping discomfort or chasing a peak experience. It is about creating the conditions where meaningful psychological and emotional shifts can occur safely, intentionally, and with support.
What makes ketamine-assisted psychotherapy different
Ketamine has been used safely in medical settings for decades. In therapeutic doses, it can temporarily reduce the grip of rigid thinking, quiet habitual self-criticism, and allow emotional material to surface with less resistance. Many people describe feeling more open, less defended, and more connected to their inner experience during a ketamine session.
What makes KAP distinct from medication-only approaches is the role of psychotherapy before, during, and after the ketamine experience. The medicine alone does not create lasting change. It is the integration of insight, emotional processing, and deliberate practice that allows healing to take root.
In this sense, KAP is best understood as a process rather than a single event.
Healing often requires letting go of control
One of the central challenges in healing anxiety, trauma, and depression is the nervous system’s relationship to control. Many people develop strong protective strategies early in life. These strategies may include overthinking, emotional numbing, perfectionism, avoidance, or constant vigilance. While these defenses once served a purpose, over time they can limit emotional flexibility and reinforce suffering.
In KAP, the therapeutic aim is not to dismantle defenses aggressively, but to gently reduce their intensity so that new perspectives can emerge. When the mind loosens its grip just enough, people often experience themselves, their relationships, and their lives in a broader and more compassionate way.
This shift in cognitive and emotional flexibility can open doors that were previously inaccessible, creating opportunities for healing, creativity, and growth in the weeks that follow.
The fear of losing control is real and valid
It is common for clients to feel anxious before a ketamine session. Even individuals with prior psychedelic or altered-state experiences often report a moment of apprehension just before the medicine is administered. This anxiety is not a sign of weakness or resistance. It is a healthy response to stepping into the unknown.
A central responsibility of ethical ketamine-assisted psychotherapy is minimizing the risk of overwhelm. A frightening or destabilizing experience can reinforce symptoms rather than relieve them. For this reason, careful preparation and skilled therapeutic guidance are essential.
As Brian Shiers describes in his work on KAP preparation and safety, the goal is not to eliminate fear, but to give clients tools to navigate altered states of consciousness with grounding, awareness, and choice .
The role of preparation in KAP
Preparation sessions are a critical part of ketamine-assisted psychotherapy. These sessions help clients understand what to expect, clarify intentions, and build skills that support emotional safety during the experience.
Preparation also helps establish trust. When clients feel supported and informed, their nervous systems are less likely to interpret the experience as threatening.
Two mindfulness-based practices drawn from Buddhist psychology are especially useful in this context: Three-Sense Immersion and Choiceless Awareness. These practices are not about controlling the experience, but about developing familiarity with one’s inner landscape.
Three-Sense Immersion: grounding in the present moment
Three-Sense Immersion is a structured mindfulness practice designed to anchor awareness in direct sensory experience. It develops concentration, reduces reactivity, and strengthens the capacity to return to the present moment when anxiety arises.
The practice unfolds in stages. Clients begin by closing their eyes and attending to breath and body sensations. When the mind wanders, attention is gently redirected back to physical experience. This trains the ability to notice distraction without judgment.
Next, clients open their eyes and soften their gaze, allowing the entire visual field to be taken in without fixating on specific objects. This wide-field awareness reduces mental narrowing and supports a sense of safety.
The practice then shifts to listening. Clients attend to ambient sounds without labeling or interpreting them, allowing sound to come and go naturally.
Finally, awareness expands to include sights, sounds, and bodily sensations together, creating a broad, open field of experience grounded in the here and now.
This practice is particularly helpful for settling anxiety before a ketamine session and for reorienting clients afterward as they prepare to leave the office.
Choiceless Awareness: learning what letting go really means
Choiceless Awareness is a complementary practice that helps clients explore the experience of letting go without losing agency. Rather than focusing on a single anchor like the breath, clients rest in open awareness, allowing sensations, emotions, and thoughts to arise and pass without preference or effort.
In practice, people often move back and forth between reactivity and observation. This oscillation is not a failure. It is how the mind learns that it can witness experience without being consumed by it.
Over time, clients develop a subtle but important skill: the ability to influence the intensity and flow of inner experience without trying to control it outright. This capacity is especially valuable during non-ordinary states of consciousness, where rigid control often increases fear rather than reduces it.
Together, Three-Sense Immersion and Choiceless Awareness help clients feel more prepared, resourced, and oriented when entering a ketamine session.
Integration: where healing becomes lasting change
While the ketamine experience itself can be meaningful, integration is where insights become embodied. Integration sessions provide space to explore what arose during the experience and how it connects to daily life.
During integration, clients may reflect on emotional themes, images, memories, or shifts in perspective. Therapists help translate these experiences into concrete understanding and practical steps.
Integration may include:
Making sense of emotional insights
Identifying new ways of relating to oneself and others
Recognizing outdated patterns that no longer serve
Developing practices that reinforce flexibility and compassion
This phase is essential. Without integration, powerful experiences can fade without producing lasting change.
What ketamine-assisted psychotherapy can help with
KAP may be helpful for individuals experiencing:
Treatment-resistant depression
PTSD and trauma-related symptoms
Chronic anxiety
Persistent negative self-beliefs
Emotional numbing or disconnection
Existential distress
Feeling stuck despite insight-oriented therapy
Ketamine does not erase pain or bypass difficult work. Instead, it creates a window of opportunity where new learning and healing can occur more readily.
A thoughtful and ethical approach to KAP
At Aligned Mind Therapy, ketamine-assisted psychotherapy is offered with careful attention to medical safety, psychological support, and ethical responsibility. Ketamine sessions are conducted in person in a supportive, monitored environment. Preparation and integration sessions ensure that clients are not navigating the experience alone.
This approach reflects the understanding that non-ordinary states of consciousness require respect, skill, and humility. When supported properly, they can become powerful catalysts for growth rather than sources of harm.
About the Clinical Perspective Behind This Work
The approach to ketamine-assisted psychotherapy described above is informed by decades of clinical practice and long-term training in mindfulness-based and contemplative traditions. The preparation and integration practices used in KAP draw from Buddhist psychology, modern psychotherapy, and evidence-based third-wave modalities that emphasize awareness, emotional regulation, and psychological flexibility.
Brian Shiers, MA, CMF, LMFT has studied Buddhist meditation with respected teachers for over thirty years and is a senior teacher with UCLA Mindful. He provides mindfulness-based intervention training through UC San Francisco’s Enhanced Stress Resilience Training program for surgical residents at the UCLA Geffen School of Medicine.
As Clinical Director of Aligned Mind Psychotherapy, Brian integrates these contemplative practices with trauma-informed psychotherapy to support clients navigating non-ordinary states of consciousness safely and intentionally. Ketamine-assisted psychotherapy is offered in person at the Studio City office, with preparation and integration sessions designed to support lasting psychological growth.
Moving forward with clarity and support
Ketamine-assisted psychotherapy is not a shortcut, but it can be a meaningful path forward for those who feel they have reached the limits of traditional approaches. With proper preparation, guidance, and integration, KAP can help clients experience themselves and their lives in new ways that support healing and resilience.
If you are curious about whether ketamine-assisted psychotherapy may be right for you, learning more and asking thoughtful questions is a valuable first step.
You can explore the Ketamine Therapy services offered at Aligned Mind Therapy here:
https://www.alignedmindtherapy.com/ketamine