08/14/2026
What does psychotherapy actually look like during ketamine?
There’s a common assumption that people taking ketamine won’t want, or won’t be able, to engage in therapy.
Sometimes that’s true.
And sometimes we’re having a very active therapy session.
This is where an important distinction within ketamine-assisted psychotherapy comes in:
Psycholytic ↔ Psychedelic
At lower doses, ketamine can support a more psycholytic experience - a lighter altered state where the client remains engaged and conversational while experiencing shifts in emotional access, perspective, or their usual patterns of thinking.
In these sessions, I’m still a therapist.
I’m following a therapeutic model, using interventions intentionally… just within an altered state of consciousness.
At other doses (or even at different moments within the same session) the experience may become more inward, immersive, or nonverbal.
That’s where a more psychedelic approach may make sense.
Less talking. Less directing. More witnessing, grounding, tracking, and allowing the experience to unfold.
And here’s the important part:
KAP doesn’t have to choose between the two.
Sometimes we talk.
Sometimes we explore.
Sometimes we intervene.
Sometimes we get out of the way.
The skill isn’t simply knowing how to “do therapy on ketamine.”
It’s knowing what kind of therapeutic support is most appropriate for the client in the moment.
🎓If you’re a mental health professional interested in offering KAP, there are still a few spots left in the September cohort of Mastering Ketamine Therapy (link in bio).
