Ketamine-Assisted Psychotherapy for Treating an Index Trauma: The Client Experience

Trauma from sudden medical crises often leaves more than physical scars; it disrupts a person’s sense of safety, identity, and control. Traditional therapy can feel too slow or disconnected when your body and mind are flooded with fear. When even the memory of being in a hospital is too much to bear, how can you move forward?

One resilient woman turned to ketamine-assisted psychotherapy to process acute medical trauma. The guided sessions allowed for deep internal work — accessing and dialoguing with younger, traumatized parts of herself in a safe, altered state. Having a trusted therapist present, repeating her words and prompting her to explore further, helped anchor the experience. This inner self work, paired with a sense of physical and emotional safety, became essential for healing, especially after difficult sessions that re-triggered memories. The guest emphasizes the value of entering the sessions with an open mind and the importance of having a supportive therapeutic relationship.

In this episode of Living Medicine, Dr. Signi Goldman hears from an anonymous client about her experience with ketamine-assisted psychotherapy for acute medical trauma. Together, they explore how medical trauma affects the nervous system, tips for first-time ketamine therapy patients, and how to release tension and embrace safety during ketamine-assisted psychotherapy sessions.

This episode is brought to you by the Living Medicine Institute.

LMI is a training, resource, and membership program educating providers about the legal and safe use of psychedelic-assisted psychotherapy.

To learn more or participate, visit https://livingmedicineinstitute.com.

Intro 0:03

Welcome to the Living Medicine podcast where we talk about ethical medical use of psychedelic psychotherapy, teaching skills, examining the issues and interviewing interesting people. Now let’s start today’s show. 

Dr. Signi Goldman 0:19

Hey everyone. This is the second in a series of videos that we are starting interviewing actual clients about their experience with ketamine assisted psychotherapy. If you haven’t heard the first of these series, please check that one out. Our first one was with a client with complex trauma, and talking about Keta means usefulness for uncovering repressed trauma as well as working with somatic interventions. So please check that one out. Today’s client is talking about ketamine assisted psychotherapy for an acute index trauma. This particular client was hospitalized with a severe and sudden medical illness and almost died, was in the ICU, unconscious in a coma for quite a while, with extremely distressing symptoms before and after, and also extended medical delirium, meaning that her ability to perceive what was happening In and around her was distorted in very frightening ways, and she came to me for a series of ketamine assisted psychotherapy treatments specifically to treat this index trauma. So this is a slightly different type of trauma treatment than the one we discussed in our in our last interview series, and is also a good example of spontaneous parts work when treating trauma on ketamine. So without further ado and with much gratitude to this client for be willing, being willing to participate, let’s get her on.

Anonymous 1:57

Oh, I hear you. Yay, yay. That’s good. Oh, look at that. We mastered

Dr. Signi Goldman 2:04

a new technology, right?

Anonymous 2:07

Had to, like, go through settings and then push a bunch. It was a little complicated, but,

Dr. Signi Goldman 2:12

well, thank you for doing it. I appreciate it before we do anything formal or just chatting for a bit so I can explain what we’re doing, and also just make sure that I ask you all the things about your comfort level with what we’re doing. So one thank you is I’ve been doing a series of these, and the goal is actually kind of to let other people hear from people who’ve done it before, you know, because it would have been nice, probably for you to have had people to talk to about this who had done it before, and that includes, like, the hard parts, good parts, whatever, like, kind of like advice you would give other people that are thinking about this, and we just informally, kind of chat about it when we will blur your face, and then if you say anything identifying, like, if I I accidentally use your name, or if you say something that like, is too personally identifying, we can take that out afterwards. Okay, some people have even asked if we would change their voices. We can also do that. Most people don’t ask. That’s okay. You’re okay with your your voice sounding like your voice. Okay? And then there’s not really a lot of rules about what we talk about. So before, I mean, are there things that you are curious to talk about or you think would be important for people to hear? I

Anonymous 3:39

thought I had my notebook from the ketamine. I thought I had it with me. It was not with me. So I just had to, like, go through dresser drawers and stuff to find it. So I haven’t had a chance to I was, I was like, I’ll review it, and I’ll be, like, on top of things, I have it with me now, but I haven’t been able to find what I was looking for first. I was like, I’m going to do a good job. I’m going to be prepared for us.

Dr. Signi Goldman 4:05

That was a lot of foresight. Well, we can just go on memory even, because there’s no real rules about these conversations. But it’s cool to know that you still have those notes, even if you ever want them in the future. Exactly. Yeah, okay, so what we’re going to do is just kind of talk through your experience in your words, why or how did you end up doing ketamine assisted psychotherapy in the first place?

Anonymous 4:34

So I was had had a major medical trauma and had been hospitalized and had been delirious, and was told that I’d even been in a coma, and there was this huge chunk of time that I didn’t remember, but at the same time, I was getting really triggered, and having flooding and having memories coming back. Neck, and it was very overwhelming and sort of unable to function with it. So I started looking into trauma therapies and possibly looking into EMDR, things like that. And then it was brought up that ketamine could be used for trauma therapy. And so decided to go ahead and try ketamine. Mainly, I was like, I need to take action. I need to do something, because this is becoming unbearable. And so I was like, either this will work and be very helpful, or it won’t work, and I will find something else that will work, but it’ll at least it was taking a step and taking action and doing something, as opposed to just being overwhelmed and felt, instead of everything happening to me, I could actually make a step forward.

Dr. Signi Goldman 5:54

Yeah, I remember that. I remember you saying something like, I feel like, now is the time like, Yeah, whatever it is, I need to do something now. And, oh, really, yeah, what did did you have any expectations or imaginings of what it was going to be like, and if so, was it like that? What was it like?

Anonymous 6:18

Yeah, so it was doing guided or supported sessions. And so what it was is going into the office and had like a combo medical team, and then my psychiatrist, who was doing therapy with me, was there, and so would get the IV hooked up, and had a blindfold, and got like to lay back in a chair, and they had nice heavy blanket, and it was really posh, and then the medicine would start and And it was kind of like sinking back into myself, or going down this deeper spot, like it was, like going down into, like a canyon, but then going through we had, we had talked in advance about some of the parts of myself that were affected, or that had, like, were trying to that were activated, and we’re trying to process experiences and so able to, like, go on this journey. And it did. It did feel very much like a journey with these parts of myself, certain encountering different things that, like symbolized the trauma itself. Or sometimes it was just very pleasant. Sometimes it was just scrolling imagery, or like, yeah, sometimes it was like, kind of fractally or kind of being in this deeper space of darkness, but it was like it was a texture darkness. I don’t really know how to a lot of it doesn’t translate literally.

Dr. Signi Goldman 8:12

That’s true. You’re doing great, considering this is a really hard thing to put into words. A lot of what you just said, is interesting, this thing about going falling back into a canyon? Was that a consistent thing, or was that the first time? Or I’m always interested in how people describe the kind of onset of the balance or state

Anonymous 8:34

that was pretty much almost every session. It was just like sinking into this experience this stuff began, can I say your name? Would you rather anything

Dr. Signi Goldman 8:47

you want? And then there’s no rules on these for sure.

Anonymous 8:50

Okay, so as I was going through, I was talking which, the first time I did it, I didn’t realize I was like, not sure exactly what I was supposed to do, and if I was supposed to be talking and describing things, or if I was just supposed to be having the experience, but when I when I was articulating things, you Signi, would be repeating things Back To Me, which helped to clarify some of the experiences I was having, or some of helped things resonate.

Dr. Signi Goldman 9:28

Can you say more about that that’s kind of interesting, like, how does having your words echoed back to you? What was your experience of that?

Anonymous 9:39

I’m curious. So it was kind of put things, not necessarily on a on a loop, but able to, like, go and stay with the thought longer, acknowledging that this could be significant. It, or this was opening something further to kind of keep on track. I guess I do. I do feel like the sessions were not, were kind of guided, but someone so they were supported. You know, definitely, you definitely played an active role in it. I I’ve talked to some people that have done ketamine treatments at other places, and they were just like, given a dose and left in a room with, like, a nature documentary on and low lights and stuff.

Dr. Signi Goldman 10:35

I’ll stop you say you’re describing actually the difference between ketamine treatment and what we call ketamine assisted psychotherapy, which is a therapy session facilitated, you know, and enhanced with the person being on ketamine. And that is the difference. Is, yes, I had, there was a more active role of myself as the therapist. And one of a lot of what we are doing is just tracking along with you and mirroring things back, which is exactly what you said, but it’s it’s interesting to hear you say that that sort of helped land you in it more or highlight it more, because often what I’m doing there is just repeating your exact words back, right? So it’s stuff that’s already happening for you, but there’s something about knowing that the other person is witnessing it, or dialoguing with it, that helps you almost notice it more. That is the words, too.

Anonymous 11:33

Words are definitely complicated on ketamine, yeah, yeah. It’s a non ordinary

Dr. Signi Goldman 11:39

experience. So it is art. It’s like we’re talking about a dream state or something, for sure, it’s hard to name you also mentioned a minute ago, when you were describing your journey, I think you called it this idea of parts, and this happens a lot with people on ketamine, like, What was your experience of that?

Anonymous 12:00

So we had identified like a younger self, or a hyper vigilant self, or things parts of myself that have been very, very heavily impacted and traumatized by what everything had happened, and so being able to acknowledge them directly, having that experience of meeting and working with these parts and and sometimes it was like literally could see like a younger version of myself, or could tell that there was humanized or there was like a visual connection there, which was really intense. I think, I think one of the biggest takeaways I had from the first session was that I felt safe like I had. I could interact with these parts and acknowledge that right now, in this moment, we are safe. And that was huge. I had not felt you, even when I was like, logically, knew that this was not happening. This is over now. This is but still, the things had still felt in the body and and in the in the mind that things were still, I was still in danger. This was still happening, or was going to happen again, or was, you know, being flooded and being able to have a moment where I did feel like I that I would say that and could acknowledge that To my younger selves or things like that, that we are safe right now. We do not have to be panicking. We do not have to be overwhelmed or upset or, you know, we do not need to be actively traumatized or actively in the trauma right now, because right now is okay. That’s

Dr. Signi Goldman 14:25

a beautiful description. I remember that too. My memory is that you had not done parts work in regular therapy. So this idea of having parts kind of came up on ketamine very much. And it’s not uncommon at all, and it’s it’s something that kind of surprises people to know that they have parts young, younger parts that not only are scared, but also developmentally, are too young to understand everything that our adult self understands. And so there’s this myth. Mismatch, and I remember you saying something along these lines in the very beginning. Often when we’re traumatized, there’s this mismatch, because consciously, we know that we’re not in danger anymore, but yet our nervous system is basically still freaking out on us, because some these younger parts don’t know that you said something like that in a minute ago, like there’s a parts of you that don’t actually know that you’re safe, and so something about actually being able to communicate that to the younger parts sounds like you’re saying that created a shift that you remember. I think that that was a beautiful description of that also said a few minutes ago that you experienced these parts as real, like you. It wasn’t just an idea. It was kind of like you. You met them on some So was that a sense, or was that a you said something about visual Can you say a little more about what you actually experienced and understanding that it’s hard to put into

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