A Guide to Successful At-Home Therapy with Ketamine

As a Founding Therapist with Innerwell, I frequently work with individuals who have started or completed several at-home doses of Ketamine as part of a prescribed treatment protocol. Many of these patients book therapy sessions to troubleshoot their experience or seek advice on optimizing their treatment success. From this experience, I have distilled three key principles to help you create a well-structured at-home Ketamine treatment protocol.

Before we get started, I'd like to emphasize the immense value of integrating therapy into your at-home Ketamine treatment program. I understand that cost can be a barrier (Innerwell now accepts major insurance carriers for therapy integration!), so this guide is designed for those unable to incorporate therapeutic integration.

In this post, I will keep it concise and address aspects often overlooked by prescribers. You may already be familiar with fasting periods, substances to avoid on the day of, and the significance of your mental set and physical setting during Ketamine doses, as well as the importance of music. If not, here are some resources to get familiar with:

• Set and Setting
• Video Resource 

Now, let's focus on other aspects not widely discussed:

Before Treatment

Principle 1: Intention Setting

Setting an intention is like guiding your Inner Healer—the part of you that takes the lead during dosing sessions. Instead of "I Am" or "I Will" statements, which can lead to attempts to control the session, try verb-based intentions such as "Help me to…", "Show me…", "Teach me…", or "Let me be…". These phrases help you become a third-person observer, ideal for the Ketamine experience.

Your intention should be specific enough to guide your integration work but broad enough to apply to several areas of life. For instance, instead of saying "Teach me to be happy," try "Help me understand why I am afraid in social situations." This approach addresses a specific issue without being overly narrow.

Action Step: Write your intention down in your journal. Engage in a mantra with your intention for a minute or two at the outset of your dosing. This helps make your intention clear and present in your mind as you begin your psychedelic journey.

Principle 2: Be the Observer

Ketamine and other psychedelics have a remarkable ability to place us in the "Self"—a part of us that can detach from inner critics, protectors, and traumatized parts to observe and learn. Internal Family Systems (IFS) is a great resource for understanding this further.

Think of yourself as a curious scientist or a reporter gathering data. Observe your inner world with openness and willingness. If you experience vivid, dream-like metaphors, explore them with wonder. If unrelated thoughts or emotions arise, simply observe them without judgment.

Action Step: Do not journal until after your inward journey. Trust that what you need will come back to you. Once you return to relative baseline, typically between 45 and 75 minutes after a sublingual dose, start reflecting and writing down your thoughts. Gardening or coloring can also help you process your experience mindfully before journaling.

Principle 3: Get Moving!

Neuroplasticity is one of the most amazing aspects of psychedelic care. In VERY BASIC terms, the increase in neuroplasticity means that our brain has new connections both during and after the psychedelic treatment. We can leverage these new connections for lasting behavior change and create new patterns that our brains will follow when the window of neuroplasticity closes after we stop psychedelic care.

Post-treatment, engage in behaviors that help create the neural connections you seek. Avoid falling back into the same routines that led you to treatment. Connect your behavior to your intention. For example, if your intention was to improve social functioning, plan social activities within 48 hours of your treatment. Go out with friends, attend a group fitness class, or have a meal with someone you've been meaning to see. Challenge yourself to be the change you want to see.

Action Step: Engage in activities that align with your value goals and intentions to reinforce the positive changes you're seeking.

Conclusion

This guide is not exhaustive, but by following these three foundational principles, you'll set yourself up for meaningful change through your Ketamine therapy. Remember, successful and safe Ketamine journeys involve more than just these guidelines, so continue to educate yourself and seek support when needed.

If you have any questions or need further guidance, contact Dr. Cirigliano in the Pre Psychedelic Program.

Happy healing!