Ketamine-Assisted Psychotherapy and Complex Trauma: The Client Experience

Dr. Signi Goldman 14:58

And some deep part of you. A knew it, and B had a lot of rage about that. And that was your sort of introduction to the fact that all that content was in there. Yeah, showing up on ketamine. And I guess we should name this as after many years of you engaging in therapy, yes, yeah, good, and bad and off types, right? What was your journey with that content afterwards? Because I know that we did other ketamine, more facilitated ketamine sessions, but I also know that you did a lot of work with that in other ways yourself too. Yeah, it’s an important thing to say, because just because some challenging content comes up on ketamine, doesn’t mean you can only process it on ketamine. Oh yeah, you can certainly start working with it in your life. That’s what we call in the biz integration, yeah, is figuring out what it means for you, and then what was that like for you, and if you did dip back into ketamine. Work with that. Work, did you do that or not? And if so, what was that like? Yeah. So

Anonymous 16:07

I remember, like, if I remember the progression of the year, I, like, did that, I did the that series of infusions, and started to feel the rage. And it took me, I don’t remember exactly how long, but it took me a little bit of time to make the connection even between, like, the anger and the fact that it was like treatment. And then that was the period of time in which in which you Lisa, my mother and I spent a lot of time deciding whether or not I was gonna go back to residential. I remember we, like, interviewed a few program directors, and we ultimately decided that just due to the degree of like institutional trauma that I had, that that was not a suitable situation for me, because I just wasn’t going to be able to feel safe in like a removed home environment where people had control, like I just couldn’t, I couldn’t let go of that and so, and I know that was like, you know, we were all concerned about my level of safety and things like that, And I had immense amount of have and had immense amount of gratitude for both you and Lisa in being able to find a way to hold space for me in an outpatient setting to do the work. And so I started working with Lisa twice a week on an outpatient basis, and I spent that year, to be completely honest, I actually don’t have a lot of recollection of it was the true nitty gritty, yeah, like, what was the true nitty gritty therapy that happened? Other than, like, I survived that year by the skin of my teeth and, like, I literally, I mean, Lisa can attest this. I went and sat in her office and started every single session now by saying I don’t want to be here.

Dr. Signi Goldman 17:43

Yeah, I think it was incredibly hard. And it’s, you know, this is something that’s interesting. I think for people who may listen to this, to hear is like you’re describing, maybe a cautionary note about ketamine, which is, it can open up stuff, right? And you can’t necessarily just go back to your life and put it back in the box after that. Yeah. And so this might be an argument for, you know, having a more access to preparing ahead, or just knowing, like you need a lot of support around you during the integration process that can happen afterwards. And even though it’s not that explosively set like it doesn’t do that for everyone, it does for a lot of people, right? And especially people with trauma history, which is so many of us, yes, that things will show up on ketamine that we weren’t prepared for or hadn’t really even consciously registered, was a thing for us, yeah, now, now it’s there. Now, all of a sudden, it’s at the surface. So it’s an argument for why you need a therapist, yeah, or somewhere safe to land. There’s some way it’s someone to process all of that with, because that, yeah, that was, I was really hard what I saw you, I just the par So I saw you go through,

Anonymous 19:07

I It’s crazy, like it’s I look back at, like, pictures that I took of myself during that I have camera roll of selfies that I took of sitting At my house in Black Mountain, just sobbing, because I literally was, like, trying to, like, make sense of, like, my life and what had happened to me, that being said though, like looking back on it now and experiencing what I experienced this past year with my mom and Greg and everything like, I know, hands down, I would not have been able to handle this past year of my life, this grave magnitude of trauma that was literally happening at every single moment of my life for the past year plus. Because even after the hurricane, like I would not have survived. This period of my life, had I not done that work and had such a great understanding of myself like that literally saved my life going forward, and I would do it seven times over because of how much relief and understanding it brought me within myself, just overall, from doing all of that work like it was incredibly hard and during it, would I have agreed to do it again, I don’t know, but in retrospect, it was beyond worth it.

Dr. Signi Goldman 20:25

Yeah, you almost got thrown into it, in a way, right, without even knowing all it was going to be that intense, of

Anonymous 20:30

course, because we, yeah, we did the depression protocol, like, my understanding was, it was a, it was to help with my symptoms, right? But it actually exacerbated them, but in a way that was like necessary. It just didn’t obviously feel that way at the time.

Dr. Signi Goldman 20:46

Yeah, I think, and you and I have talked about this, but what we believe goes on with this is that prior to that, you were carrying all of that trauma already, so you were feeling symptoms related to it, and you are struggling from it. It’s just that your brain didn’t connect it to that. So you saying that you’ve coped with this past year, which has been a year of immense loss for you and grief and transition better than you would have then makes sense in the sense that, like you are going through that as someone who’s not also carrying around a whole bunch of subconscious, unacknowledged trauma that’s living in your nervous system. And go ahead and

Anonymous 21:34

it’s just, it’s the it’s the true like, bodily autonomy, awareness, because the other element of like the ketamine work that we haven’t even talked about that’s like, huge for me personally is like the the work that we did in relation to, like the physical sensations in my body, and just like, not only becoming so emotionally, like intimately aware of Like my subconscious self, to the best that you can, as being like the conscious being or the conscious side of it, but also being able to shift as somebody who, like could not identify more with the body keep score, like being able to shift some of those body sensations and some of those like deep, traumatically held, like energy aspects in the body and like that work that we did where, like you would put pressure on my chest, and like you can ask more questions, you can elaborate on that, but that between not only, like being more aware of myself, emotionally and truthfully, understanding myself more in that way, but also being able to not physically hold on to those things in the same way that I had in the past. I think really, like, made this year that much more tolerable. Like all like, there’s not only like being able to, like, let go of that trauma, but also just like, in real time, knowing myself better and being more aware of that was really impactful.

Dr. Signi Goldman 22:58

That’s so interesting. Can you, like, how would you explain to a friend what you’re talking about with the body stuff, right? Yeah, so, like, in

Anonymous 23:08

the most simplistic way I can describe it as like all so I’ve always had a good awareness that I feel things like in my chest, in my body, and it always centered on my chest. I feel everything in my chest, but at different sensations in different places and different like, textures and things like that. And I also, like, have really bad, like, I get really, like, locked into positions. Like, I joke with my chiropractor all the time, like every other session, I always say, like, I literally am the living embodiment of the body. Keep score, and he cracks up and laughs, because it’s true, like the way that my body locks up, it’ll be like clockwork in the same position, even if he adjusted it, you know, like the week prior, and when we were doing a ketamine session. Sorry, I needed tissue one sec. Okay, so with all that awareness, when we, we were doing Academy, an IV ketamine session, it wasn’t this past year, I think it was the year prior. I think it was literally the year before this all happened in a while. Yeah, yeah, it was the year prior. And things were kind of like somewhat even in my, you know what I mean, things were kind of somewhat even in my life, and we were in, you know, I’m like, in the process, and I mentioned, like, the chest pressure, or like, something to do with the chest, or whatever. And you were like, you know, are you okay if I try and, like, hold it for you? And I was like, Okay, and so, I mean, I had been describing this sensation in my body, up in, you know, at this point, what, like, two years ago, for like, 25 years of my life, I’ve been experiencing this, the sensation describing in great detail, and never felt it shift in my body like it always was, just like, this uncomfortable thing. Right? And you came over and held pressure my chest, and I felt it release for the first time in my entire existence. That makes me never and I never thought that would change. Like it was so crazy to feel like my body truthfully understood, you know what I mean, like there was a deep body understanding that it did not have to hold that in that same way. And it was a progression, right? Like that was the first, this was another great, you know, example of the integration of this, because it was that work that I then took and started working with that trauma, informed yoga instructor about and all of the sudden in the months after that, repeatedly, week after week, I was able to get that sensation to shift in a sober state in a yoga practice. And it was like it was totally life changing. I needed less adjustments from the chiropractor, like, you know, I was able to get more movement on that stuff with myself, like, I didn’t know that I could feel like kind of less sick in my own body, right? So that was a huge element to me.

Dr. Signi Goldman 26:15

That’s a beautiful way to describe it. So you felt in that moment, the shift, like, it’s almost like your body did a did something, yes,

Anonymous 26:26

absolutely, it was like, I’m trying to think, because, I mean, I remember it vividly, like I remember that whole session very vividly, and it’s like, I guess so, like, I would always feel It kind of like constricting. It was like so much energy and pressure, like constricting inward, right? Like, it’s almost like I couldn’t breathe or whatever. And then when you put the pressure in my chest, it wasn’t like the energy entirely dissipated, right? Like, that’s not necessarily what it was. It was like it and then it just kind of felt like it radiated outwards instead of inwards, right? Like, it wasn’t like the energy was like, trapped within me, per se, like, had more room, you know what? I mean, it was like, Oh, we don’t have to stay, I guess, just within you. Like, I think it was kind of like, oh, like, there’s places in other spaces and people that can, like, hold this too. I guess, in the most simplistic way,

Dr. Signi Goldman 27:18

that’s super interesting. I’ve never asked you about, like, your really inner experience of that, yeah. I remember it obviously, yeah, yeah, yeah. I remember you and I having some conversations and integration afterwards about ways to work with that physically in your body. And I think that working with someone like trauma informed yoga. That was like one of the ideas you had. Like, I think I remember us talking about how the body is working through this, yeah, and honoring that. And, like, make creating some sort of space for that to show up in a way that’s safe and work with it. And you did that, you sort of found that that route on your own as part of your integration process. Yeah,

Anonymous 28:02

yeah, I don’t know. I really, I truthfully, between, like, the ketamine slash therapy work that we did, you know, kind of prior to that, and then the, like, trauma informed yoga and like, really being able to learn how to shift like energy in my own body, and that way, those are literally the two things that I credit with saving the past year in my life. I have absolutely no doubt that I would have been in and out of the mental hospital while dealing with my dying mother and my dying cat, which would have been absolute fucking nightmare. It would have been nightmare. And I’m I’m so i There will never, ever, ever be a day in my life that I don’t have great gratitude and everything for the people that helped me do the work that I was able to do, to like, not be destroyed, yeah, by the past year of my life, because I watched many people, you know, really, really, really struggle in it. And I struggle too. It’s not to say that, like, obviously you don’t struggle anymore. It’s just you have a different relationship with the amount of emotional suffering and the like, emotional magnitude of things that happen to you. Like, I remember saying to both you and Lisa on a multitude of occasions, like this time last year, right? Like, even just to talk about it now, like I was pro, I was, think I was probably up, I mean, my mom was probably getting your second round of chemo around this time or something, right? And, you know, like, even the midst of it, like, I would call you guys, and I would tell you all about, like, the shit that was going on, and I was like, Oh, this is so terrible and so horrible, but I’m okay.

Dr. Signi Goldman 29:42

I do remember that. I remember us having some really authentic we talked from the hospital even a couple times, like, about you feeling like you were able to show up in a good way for your family. Um. Which takes a lot of resilience in those moments well. And

Anonymous 30:04

it came down to my weird like, it came down to like, the fact that I understood I’m going to I’m going to physically feel these ways. I’m going to mentally feel these ways. I can anticipate how I’m going to react to these situations, and I can acknowledge those experiences, not fully feel them, acknowledge them to the extent that I can, and then continue to show up in the moment. And the way that I feel is appropriate, and the way that I feel is like an alignment with my values and morals as I want to act. I don’t think there’s anything else you can ask for in that type of situation like

Dr. Signi Goldman 30:42

and that’s something you feel you would not have been able to do if you had not done this particular kind of therapy work. Yeah, absolutely. There’s no question.

Anonymous 30:51

There’s no question in my mind, I

Dr. Signi Goldman 30:53

love the one I love. Everything you just said. And there’s you use the phrase like being in a different relationship with your suffering. Yeah, I think it’s just a really kind of perfect way of describing, well, trauma treatment, effective trauma treatment, period. But a lot of what we do on ketamine work, and in your journey, it was a lot of trauma work that came up with your ketamine work, which is exactly what you said. It’s not that your wounds go away, but you live in a different relationship with them. They don’t. Maybe, I don’t know if this feels right to you, but I sometimes like they don’t have their claws in you to the extent that they’re controlling your lived experience moment to moment. Yeah, but so you have more, a little more agency in your relationship with it. But it’s not like those things disappear, and of course, so I just like that you said that because it was realistic. It’s real. It’s not like our trauma just evaporates and, you know, it’s like it’s always part of you.

Anonymous 32:00

Oh, for sure, and well, and I wouldn’t have it any other way, right? Like, because ultimately, all these things that have happened to me, like, make me this very unique person that attracts so many people, and I’m able to have these really incredible fruit pro relationships with people, because I’m able to show up so authentically. And I like, I am one of the very few people in my life that I can say, like, almost definitively, like when when push like when I leave everyone else behind, like my relationship with myself, my own internal experiences, like I am so fine. There’s nothing that I have at the end of the day that comes to bother me and like, in terms of my relationships too, not only can I stiff arm them, but also, like, I don’t have many relational problems with people anymore, because I have so much awareness surrounding like, what is their trauma and what is my trauma, and just like, kind of being able to discern in that. So I feel like it also transferred, just because of how well I guess I understood myself, that it helped me relate better, or, you know, like, helped my relationships with others too.

Dr. Signi Goldman 33:09

I love that. It’s almost, I mean, if I had to put that in my lens, you might use this words for yourself, but I saw you go through a lot of suffering and a lot of having to look at your hardest things and your scariest things. And I think that changes a person. I think it’s a kind of initiation experience. It’s not one in life is compelled or forced to do that. And so a lot of people never do do that. And you, I think you come out the other side of that with a kind of wisdom that that’s maybe, maybe what you’re speaking to. You’re using different language for it, where you are in a kind of a shift in perspective.

Anonymous 33:50

Yeah, you know all of that, like, once I got away from all of those incredibly traumatic and stressful and draining and just like, frankly, like soul crushing, like environments and experiences. I did not know that life was so enjoyable, or even to a lesser degree, that life had neutrality, like I know that it could just be neutral, and that’s what I just can’t emphasize enough to people like people that were in shoes like mine, is that there is truthfully, a whole life ahead of you, and it doesn’t ever feel that way when you’re in those times and places. And I just can’t it’s so funny because as somebody who spent so much of their life so suicidal and really never expecting it to make it to my age. I I cannot emphasize enough. Just hold on until you have some more self. You know, work towards your own autonomy, because it really does change your reality. That needs to be heard. I think. Yeah, I think there’s a lot of people that need to hear that. I’m very glad that you spoke it.

Dr. Signi Goldman 35:07

One thing that I think is compelling about your journey, but also just useful for people to know, is that, like, you’ve named these key points where ketamine was like, played a crucial role or shift at a certain lever or something, right? Yeah. But this was not something where you got on Kennedy multiple times and got to this place of recovery that you’re describing now. It was also a lot of hard work that you were doing on all kinds of ways, with therapy support, also with other kinds of within that you engaged in. And so I actually like that you are saying that because one of the misunderstandings of psychedelic assisted psychotherapy out there is that, oh, I’ll go and I’ll do this psychedelic experience, and my pain and trauma will go away. And what you’ve said is more accurate, sometimes you actually just get thrown more into your pain and trauma, because now you’re seeing it even more, and now you’ve got to do a lot of therapy work outside of the psychedelic experience to process that out. We call that integration, or to integrate it, right? And that can be a big journey, right? So, and then you want a support team. You want to, you know, support with it, but also the person that actually has to live that challenging experience day in, day out. It’s you, yeah. So it’s almost like going into, I think it’s important sometimes for people to hear going into any kind of psychedelic work is, you might be setting you may, and there’s huge amounts of difference with people. Some people, this is, I kind of mean it’s work is very, very different. But what you’re describing is not uncommon. And people, it’s sometimes you’re stepping into opening up things that you now are going to have to like, I sometimes use, I don’t know if I ever said this to you, but sometimes I’ll tell people it’s like fighting your dragon, like you’re going to meet your dragon. What I don’t know, like it is going to be scary and hard, and nobody at the end of the day can do it except you, like your team can support you in that process, but you have to feel and walk through all of that and and I think the value of the psychedelic aspect is showing you things that you don’t see, which is, I think, what you’ve named, but it’s important to know that that can happen and to be and to have preparation, and then the shifting things in the body, which I think is a really you’ve described, a powerful example of the like you named the book The Body Keeps the Score right. But this idea that a lot of trauma work happens on the level of the body itself. So it may not even be something you’re thinking about as a memory or a particular story. It may be that the body has to actually release something. And this is another thing that tends to happen more on psychedelic assisted psychotherapy, if it’s facilitated, has that has to be facilitated. I know that you I’ll just say, for the sake of the interview, that that involved me, like using physical contact in certain ways, it probably wouldn’t have happened without that. So there is a facilitation piece, but it’s a very powerful way of working with psychedelic altered states. So one, seeing things that you didn’t see before happens on psychedelics. And two, letting the body being able to shift, having some sort of ability to shift when it couldn’t before. Those are two things that are definitely true and that I see a lot. And the third thing is what you have named, and I also saw you walk that journey of which is you’re still going to have to hold a lot of work and do a lot of you know what I mean? There’s just so much. Those things are parts of the process, but you are the one that has to do all the work through the process, right? So in other words, that’s a lot of language, because I like to make sure that people know that it’s not a quick fix. It’s not like you do a psychedelic session and now you’re just better forever. Is not that. And so I’m trying to counter that narrative a little bit, educating people,

Anonymous 39:18

yeah, and that’s the thing, is that I think like, so that’s the thing, right? It’s, it’s, it’s there, whether we want to acknowledge it or appreciate it, it will exist, regardless of whether or not you ever address it and like, it’s funny, because as somebody who has been very fortunate that I’ve always had like, a very strong work ethic as it pertains to, like, therapy and like pursuing, like, my own mental health, I sometimes find myself, like, kind of scratching my head looking at people that are like, I don’t want to face this, you know, because I’m kind of like, I get that, but I’m also like, there’s so much value in it, right?

Dr. Signi Goldman 39:57

Anything that we haven’t talked about that you think you’re. Of be important to say, like, if you were just talking out there to people who may be interested in this, what do you think they

Anonymous 40:05

need to hear? Um, like, not only ketamine, ketamine work, but just, you know, any types of new therapies that, like come about and that type of thing, I would say to people that I think the best thing you can do is keep an open mind and find a professional that you really trust and put your faith in those around you that make you feel seen and supported and and trust in those around you when you are in, like, those really, really, really intense periods of struggle, because that was ultimately what led me to the decision to do the ketamine I had been seeing you for several years. And, you know, my symptoms kind of reached to another breaking point, and I really felt like I had nowhere else to go, and my mom and I were sitting around, you know, what do we do? And that’s when we reached out to you, and that’s when this was suggested. And, you know, we really were at our wits end, and just kind of took a blind leap of faith. And that’s not the only blind leap of faith that I took, but, and ultimately, I guess maybe the other story that I’ll share that I know this has impacted many people I’ve spoken with over the years, and it gives me troubles thinking about this now, but when I was leaving to go to the woods the second time around, when I was 16 or 15 years old, and I was leaving, like my in my outpatient therapist back in the DMV area, and like this was like when I had no one. I had nothing. I had no relationships. My life was a complete mess. And the only person I had any relationship with was this therapist that I was about to leave. And they let me call her from the mental hospital, from the acute before I left to go to the woods, and I remember sitting like I can see the tile in the, you know, hospital, like hallway where I’m taking this phone call on this desk, you know, like landline, and I call Jean, and I just start sobbing. I’m just like, Jean, you don’t understand. I can’t leave you. I have no one. If I leave you, I will have nothing. I will never find enough. You know, like just I am completely beside myself. And she said to me, if you believe that this relationship is real and that the work that we have done is real and that the benefit that you have experienced from a relationship is real, you cannot believe that I am the only person out there like this, and it allowed me to continue to keep an open mind like throughout my and I’ve told that story to many people over the years, and I was 15 years old when that was first told to me, and that is a huge part of what helped me keep the faith when I really felt like there was nowhere to turn there was nowhere to go, was I was like, I have these people in my life that I trust, and I just have to lean on them in blind moments of support, like you really just have to take a blind leap of faith, and this is a huge blind leap of faith. But if you’re really interested in trying to reach a different place within yourself and have a different relationship with yourself and the things that have happened to you, it’s absolutely worth to try,

Dr. Signi Goldman 43:29

so take the leap of faith, but not until you have a foundation of trust. Yeah, person you’re working with for sure. Think that’s absolutely true, because that’s what creates safety. Yeah? Well, thank you for saying that. Thank you for taking the time today. I just want to say that even like while we’re still recording, that we really whoever listens to this in the future, we are super grateful for you just being willing to help educate and put information out there. You know you’re not being compensated for this. You’ve taken your time and your energy and your resources to kind of share in this conversation, and so just want to pass my gratitude sincerely and just on behalf of anybody who listens to this in the future, that for you, that’s a gift. So I just appreciate that. Of

Anonymous 44:20

course, if one person, if it helps shift one person’s mind or something, it’s well beyond the time. So I’m just, I’m I cannot. Thank you enough as well. You know what I mean, like I you and your husband and Concierge Medicine and all it has done for me, it has absolutely saved my life. There’s absolutely no question in my mind. And I, I’m more than happy to help support your guys’ endeavors. So

Dr. Signi Goldman 44:43

Well, thank you. It is kind of a crazy privilege to be doing this work. Every so often I look and I’m like, How is this my job? And you know, you and I have talked about that a little So, alright, well, I am super grateful. I’m gonna, I’m gonna send this to. You. Once we know what we’re going to do with this, I will, like, I’ll send it to you so you can share it with anyone you want, or you can just know it’s out there. Yeah,

Anonymous 45:07

yeah, no, I love to see the results, but yeah. Thank you so much. Dr. Goldman, talk to you later.

Dr. Signi Goldman 45:14

Thanks for listening to Living Medicine. We’ll see you again next time. Be sure to click Subscribe to get future episodes