If you're considering ketamine-assisted psychotherapy, you've probably read some about the science — how it works in the brain, what the research says about depression, anxiety, trauma, and human potential. What's harder to find is a simple answer to the question I hear most often before someone's first session:
"What actually happens in the room? How do you help?"
First, I'm not the one who determines your dose or prescribes your medication — that's the role of your prescribing clinician. My job is different, and in some ways more personal: I'm the person sitting with you while the medicine does its work. Here's what that actually looks like.
Before We Ever Get to the Dosing Session
The first step is preparing for the journey (dosing session). In our preparation sessions, we talk about what's bringing you here, what you're hoping might shift, what you're anxious about, what questions you have, and how best to prepare for the journey. We talk about what it might feel like to lose your usual sense of control for an hour or two, what it could be like to enter a non-ordinary state of consciousness, and how going inward is, in itself, a practice that can be powerful. We build a plan together for what you want from me if things get intense — more talking, less talking, a hand to hold, just a quiet presence.
This matters more than people expect. The research on psychedelic medicines is pretty consistent on this point: set and setting — your mindset going in, and the environment, or setting, you're in — shape the experience as much as anything else. So we spend time on both.
being in the Room
By the time you arrive for a dosing session, the room (my office) is already doing some of the work. Low light. A comfortable place to lie down. A blanket, an eye mask, headphones, or a speaker, with a playlist that supports your experience.
I check in with you before we start — how you're feeling that day, whether anything's changed since we last spoke. Doing some mindfulness, grounding, or art activity to begin shifting from being external (getting to the office, talking with others, etc) to going inward (noticing your thoughts, body sensations, emotions). Your emotional state when walking in genuinely affects the experience, so I want an honest read before anything begins. Also, you can come as you are. You don’t have to put pressure on yourself to arrive perfectly grounded or at peace. In fact, most people arrive with some anxiety, hesitation, or excitement. That is totally normal.
While experiencing the medicine
Once you take the medicine, I'm not explicitly directing the experience — I'm holding space for it, while keeping a close eye on how you are doing. I do not leave the room.
If you reach for my hand, I'm there. If you want to talk through something that's surfacing, I'll listen and reflect gently, without steering. If you want silence, I give you silence. A lot of what I do in that hour is not talking — it's staying attuned to you so that if you need something, I'm already paying attention.
Afterward
As the effects wear off, we don't rush straight into conversation. I let you come back at your own pace, offer water, a snack, and give you time to just be in your body again before we do anything else.
When you're ready, we usually talk a little about what came up — not to analyze it to death, but to start letting it settle into language. I take notes on what you say and later send them to you, because you are still in the medicine, and it is nice to have a reference point. The real integration work, where we make sense of the experience and connect it to your life outside the room, happens in the sessions that follow.
What I Want You to Know
People often worry that a ketamine session means losing control in a scary way, or that they'll be alone with something overwhelming. That it will be a ‘bad trip’. In my experience, most people find it's the opposite — because someone steady is in the room the entire time, paying attention, ready to help if needed, and not going anywhere.
That's really the heart of what I do: I'm not driving the experience. I'm making sure you don't have to go through it alone, while also having the important training on what to say when, how to support you, and why certain things are happening.
If you have questions about what a session with our practice might look like for you specifically, I'd love to talk it through before you decide anything. Feel free to contact me to learn more.