Medication Assisted Psychotherapy FAQs
Many terms are used for this type of therapy. Ketamine assisted or facilitated psychotherapy, cannabis assisted psychotherapy etc. In the United States, we are limited to utilizing only medications which are FDA approved. (Though their use in psychotherapy is not FDA approved and therefore done “off label”).
Ketamine is an FDA approved medication for anesthesia and esKetamine (Spravato) is FDA approved for treatment resistant depression.
Ketamine can be used in an off label manner either as a sublingual lozenge or “troche”, intramuscular injection or sometimes at higher dose with IV infusions.
Ketamine is actually considered a dissociative agent and not a “psychedelic” though it has been lumped in this category.
Some therapists are offering “psychedelic integration” of people’s psychedelic experience from drugs not used during the therapy session, which is very different than medication assisted psychotherapy done in a controlled setting with evidenced based psychotherapy.
Ketamine has been misused on the street in very high doses for its dissociative effects. In medication assisted psychotherapy, we are using ketamine at much lower and safer doses. The drug is truly a facilitator and not the main player in getting you better. It provides much more rapid and effective access to the traumatic issues allowing faster resolution which is long lasting.
There are no quick fixes for complex trauma. Simple traumatic experiences may be resolved in a relatively short period of time. Complex trauma and chronic PTSD take much longer to resolve, especially if there are also childhood and attachment issues connected to the trauma. That being said, medication assisted therapy is a more effective and efficient way to resolve these issues than what we have seen with other therapeutic modalities.
As Jon Kabat Zinn, the godfather of westernized mindfulness meditation therapy once said, “meditation is not for the faint of heart”. The same can be said of trauma therapy and more specifically, medication assisted psychotherapy.
Centers around the country working with various techniques and research protocols for medication assisted psychotherapy have noted that this type of therapy can create a level of “destabilization” (worsening of symptoms) in the early part of therapy. The reason for this is that symptoms of PTSD such as dissociation (shutting down) and compartmentalization are your body, mind and brains way of coping and protecting you from the trauma.
Although you may not experience the trauma overtly, it does manifest in other ways such as mood disorders, anxiety, physical symptoms and relational problems. These coping mechanisms, which have been in place for years, begin to break down during the course of treatment as these “work arounds” are no longer needed to protect you (hang onto or bury the trauma without resolution). The doors to your psyche begin to open up in this therapy and through these doors come the experiences, events and “programming” that are frequently responsible for the symptoms you have experienced for so long.
This traumatic material emerges with the support of medication assisted therapy and it is not an easy, blissful journey. Though not easy, it is a path towards wellness and peace of mind which you may never have experienced before. The journey is supported by our expert therapists and it is an intelligent experience that will make sense to you. For improvement to be made in trauma/PTSD which is lasting and fulfilling, this is a necessary part of treatment leading to people feeling more associated, but also more symptomatic and less functional in the early part of the work. For many people, the destabilization that occurs is significant but they are able to function at an acceptable level at work and with family, though may not be on their “A game”. Others may require more intensive support to help them through these early difficult experiences.