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Re: Ketamine-enhanced psychotherapy

Posted by Hugh on July 23, 2020, at 16:07:18

In reply to Ketamine-enhanced psychotherapy, posted by Hugh on July 19, 2020, at 13:22:40

Summary: Wired explores ketamine combined with therapy as a potential treatment for depression. Wired speaks to Phil Wolfson, M.D., and Julane Andries, LMFT, about their experiences administering ketamine-assisted psychotherapy to treat symptoms of depression, PTSD, and for "self-exploration and understanding." Michael, a patient who received treatment from Wolfson and Andries, discusses his experience undergoing ketamine-assisted psychotherapy. Michael's wife Lynn says "It's just been transformative," and calls Wolfson and Andries "miracle workers."

Then [Michael] discovered a psychiatrist in a small town north of San Francisco. His name was Phil Wolfson, and with his partner Julane Andries, a therapist, he'd pioneered what he called ketamine-assisted psychotherapy. The couple didn't see the drug solely as an antidepressant, but as a vehicle for self-exploration and understanding. They drew inspiration from folk-healing traditions as well as traditional psychiatry. Instead of intravenous delivery, they used ketamine lozenges or a quick injection into a shoulder. Their less medicalized, more humanistic approach appealed to Michael.

After the shot, Michael heard a buzzing noise that, as it pushed toward a crescendo, became almost intolerably loud. Then, all at once, the pressure of the noise seemed to release. He lost any sense of his body and felt completely at peace. No thoughts. No discrete sense of self. Just pure awareness. Behind the eyeshades Andries had given him, he saw a huge dome of sky, like a planetarium.

The session lasted maybe two hours. Afterward, the difference in Michael's mood was immediately apparent to Lynn. He was less irritable, more optimistic. She felt as if they'd been treading water for years in their marriage. But they started moving again -- making plans, working on problems. Long estranged from his mother, Michael called her and reestablished the relationship.

"It's just been transformative," Lynn told me. She calls Wolfson and Andries "miracle workers." Michael is not, by his own admission, cured. He still has bad days, and he still needs occasional ketamine "booster" sessions to keep his mood up. But he credits ketamine with bringing him back to life and, ultimately, with saving his relationship with his wife. "It's probably the only reason I'm still married," he says.

What impressed [Wolfson] about MDMA, which can induce feelings of deep emotional connection, was how it seemed to accelerate the therapeutic process, helping people achieve lasting transformation. (He and Andries are currently finishing up an FDA-approved trial on MDMA and anxiety in patients with life-threatening illnesses.) But after 1985, when it was classified as a "schedule I" substance, MDMA became illegal to prescribe.

It wasn't until 2015, when the couple met a Tasmanian therapist named Stephen Hyde, that they brought ketamine into their practice. Hyde introduced them to ketamine lozenges, which made the treatment cheaper for patients and obviated the need for intravenous delivery with its attendant "medical mumbo jumbo," as Wolfson puts it.

Wolfson and Andries see themselves as pioneering a new form of psychotherapy. They tend to describe ketamine not with the language of scientific articles but with more Buddhist-sounding phrasing, as giving patients a "time out from ordinary mind." They also send patients home with lozenges, something that the APA recommendations implicitly urge against. Wolfson disdains the recommendations, arguing that ketamine's safety record is far better than the APA authors imply.

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