Ketamine Therapy in North Carolina

When Love Isn’t Enough and Old Wounds Keep Getting in the Way

You love each other deeply. You’ve built a beautiful family. You’ve worked hard, created all kinds of personal and professional success, and given your children things you never had growing up.

For years, it felt like you were living the dream. Those first several years of dating and marriage were full of joy, connection, and hope.

But now… 5, 8, maybe 10 years later, it’s different.

Old wounds you hoped were healed are back. And they aren’t just affecting you — they’re showing up in your marriage, in your health, and especially in the way you parent your kids. This is ON TOP of of managing a career, hormone changes, crazy schedules, a household, stress, and sleep disruptions.

Say What You Need, Without Losing Each Other

This is the heartbreaking cycle I see with so many couples:

• One partner is desperate to feel like a priority (but not always able to effectively communicate their needs)

• The other feels attacked, overwhelmed, inadequate, or shut down.

• Both end up feeling frustrated they haven't figured out how to break the cycle and feel more disconnected than before.

And what you actually need is the opposite. You need a safe way to own your truth without pushing each other away. To say, “I need to know I’m in your heart” without it exploding into another fight.

Why Does This Hurt So Much?

You’ve tried to outrun the pain.

• By working harder

• By starting successful businesses

• By being the “go-to” person for everyone else (all the people pleasing)

• By sending thoughtful gifts, doordashing all the right things to all the right people, proving that you are good and worthy

But deep down, it doesn’t stick.

You still feel unworthy. You catch fleeting glimpses that you are more than a parent, a partner… but you can’t hold on to it.

You’re exhausted from being exhausted all the time.

And when you want to say to your partner, “I need to know I’m in your heart. I feel unimportant. Sometimes unloved.” … instead it comes out as anger, lashing out, and shutting down.

You desperately want to be good examples for your children

Sometimes both of you get sick to your stomach thinking about how some of your interactions might impact your children’s future. You know they’re watching. You know they’re absorbing not just what you say, but how you love, how you fight and express all your emotions, and how you repair what hurts. And you’re terrified of passing down the very patterns you swore you’d never repeat. You need to protect them, and you need to figure how to do this now.

The Guilt Becomes Overwhelming

You feel crushed with guilt after your or your partner ends up losing their shit in front of the kids. Then the shame creeps in—you tell yourself you’re an awful person and a terrible parent. Sometimes you even hate yourself and just want to disappear. On top of that, you already feel so alone and unloved, even though you pour everything you have into your kids, your home, and keeping things afloat. Meanwhile, your partner seems to live a different life with working, seeing friends, enjoying freedom, while you carry the invisible weight of it all. It may sound crazy acknowledging this out loud like this, but that’s how it feels on the inside.

Sometimes in the Middle of the Escalation You Just Want to Scream: “Where are you?”

You feel so hurt. Like you’re drowning. Disappointed. Unheard. Angry. Small. Not a priority.

It doesn’t make sense — how can your partner have time to catch up with an old friend, but not check in with you about your day? Or answer your text? How else could you feel but unimportant, unseen, not worthy?

But here’s the trap. The moment you try to say it, it comes out wrong. It sounds controlling or angry. You know your partner loves you duh, but NOT in the moment when it feels like everything is falling apart and YOU are the problem. You don’t want to nag, or make them walk on eggshells around you. But you also can’t keep swallowing your truth.

So what do you do?

Hi, I’m Irina, and I Have a Solution for You That Works!

I am a seasoned ICEEFT Certified Emotionally Focused Couples Therapist (EFT) with advanced training in Ketamine-Assisted Psychotherapy. I will help you move from exhaustion, loneliness, and unworthiness into connection, intimacy, and peace.

You don’t have to keep carrying this weight alone. Together, we can create space for real healing- for yourself, for your marriage, and for your family.

What do Couples Intensives with Ketamine + EFT Look Like: A Two-Day Journey Back to Each Other

When new couples walk into my office for a two-day intensive, they often look more like business partners than lovers. They share a home, careers, bills, responsibilities, but underneath, there’s exhaustion, distance, and the quiet grief of feeling unseen and inadequate. Conversations spiral into fights or dead silence. Intimacy feels like a memory. Both wonder: “Is this all there is?”

This is where the journey begins.

Day One: Understanding the Cycle (6-hour session)

The first day is about slowing everything down. You will be hear me using this term a lot in our work because emotions travel really really fast. Together, we map out your emotional cycle, your invisible dance that keeps pulling you apart.

For one partner, that might mean desperately pushing for closeness, only to be met with walls. For the other, it might mean shutting down out of fear of failing again. Underneath, I help you uncover the raw truths: the ache to feel chosen, the fear of not being enough, the longing to rest in each other’s arms without fear of rejection.

Day One gives you the map. You begin to see clearly: “This is what’s been happening underneath the reactive behaviors. This is how we lose each other. And this is what we are scared of and really long for.”

We work hard in about 2 hour blocks of time, take some time for lunch, and then keep working. We will also break up into about an hour long individual sessions with each of you. We will spend the last hour or so recapping what we’ve just learned and discussing the preparation for the ketamine session the next day.

Day Two: The Reset (another 6-hour intensive)

Day Two is where the further shift happens.

With eyeshades, carefully curated music, and thorough preparation, we bring in Ketamine-Assisted Psychotherapy. As the medicine begins to work, something powerful unfolds:

• Your amygdala (the emotional part of your brain) calms. The constant edge of anxiety softens. You feel more at ease in your body, and with each other.

• Defenses dissolve. The rigid walls that kept you safe but alone begin to melt. You find yourself willing to listen, to reach, to risk being open and authenthic.

• The deeper corners of the psyche awaken. Memories, images, and truths you’ve held tightly guarded finally rise into awareness. The painful life narrative you’ve been “married to” loosens its grip. Instead of thinking “my partner does’t care”, you slowly start understanding that they actually deeply care, but haven’t been able to put their feelings into words because they don’t want to say the wrong thing and make things even worse.

For most couples, this brings profound relief from depression, anxiety, PTSD, betrayal, infidelity and past relationship hurts that have shadowed their marriage. For others, it opens doors to psychospiritual exploration, addiction recovery, or new insights. As ketamine expands what’s possible, I weave EFT into the process by helping you put words to the experience, guiding you back to each other, creating new moments of intimacy that feel alive and safe.

The Transformation

By the end of Day Two, couples often look and feel completely different than when they arrived.

The heaviness has lifted. The silence has broken. Tears flow, laughter returns, and words that once felt impossible are finally spoken. They leave holding each other, not out of obligation, but out of relief, gratitude, and renewed love.

For many, it feels like a sacred reset. A chance to see not just their partner, but themselves, with fresh eyes.

Why It Works

Weekly therapy can take years. A two-day Ketamine + EFT intensive compresses time by offering a reset in hours, not months. It doesn’t mean every struggle disappears overnight. But it does give you something priceless: a calmer nervous system, softened defenses, and a felt memory of connection you can keep building on. Ketamine and EFT are highly effective. However, please note that most couples need 3-8 ketamine +EFT intensives (medicine session AND integration) to sustain their change.

Integration: Where the Real Work Blossoms

When couples leave a two-day intensive, they often feel lighter, softer, more open. Defenses have melted. Tears and laughter have returned. They walk out holding hands, hopeful.

But then life slams back in. The inbox is overflowing. The kids are still crazy and fighting in the backseat. The culture outside feels loud, fast, almost too much. One partner whispers, “How do we hold onto what we just found?”

This is where integration begins—and it’s the most important piece of the journey.

Anna + David’s Story

When Anna and David left their intensive, they felt closer than they had in years. David described feeling softer, gentler, less guarded. Anna noticed her jaw tension, something she’d carried for decades, was gone. She felt hopeful and seen. Both felt grateful, spacious, almost reverent.

But by the next morning, real life pressed in. Anna described it as a “return to heaviness.” The laundry, the bills, the emails, it all felt jarring after the openness of the day before. David admitted he felt culture shocked, like the world was moving too fast while he was still digesting something sacred.

And that’s exactly how integration often feels.

What Integration Looks Like

Over the next week, Anna and David began weaving the shifts into their daily life:

• They slowed down, keeping things simple.

• They picked up old joys: Anna returned to knitting (she was not a knitter at all, but realized that knitting slows her down and she wanted to hang to that feeling), David to swimming twice a week.

• They created new intentional practices: walking together after dinner, waking earlier to sip coffee in quiet, dancing in the kitchen with their kids for a minute or two.

• They noticed themselves relating differently, more transparent, less guarded.

Anna found herself connecting with a friend who came up in her journey. David said he no longer felt like he had to work so hard in social situations; he could just be himself. Both described feeling more embodied, more connected to their intuition and gifts.

Some days were heavier, even a little depressing, as they bumped into old patterns. Other days were calm and creative. That’s the rhythm of integration: expansion, digestion, and growth.

Why It Matters

The ketamine session may feel like a massive download—a rush of insight, memory, and possibility. Some couples say, “I don’t want another medicine session right away. I need to savor this. I need to digest.”

That digestion, integration, is where the real transformation takes root. It’s where new stories replace the old ones. Where softer ways of being become daily habits. Where connection deepens not just in the therapy room, but in the small, ordinary moments of life.

This is why I highly recommend for my couples to take the next day off after an intensive (I know, I know, on top of taking two days off already). But believe me, you will thank yourself. Because you will create space for the things to land. To begin weaving the sacred back into the everyday.

The Gift of Integration

Anna and David now describe themselves as more authentic, more present, more alive. They still argue sometimes, still get triggered. But instead of collapsing back into the old cycle, they return more quickly to softness. They remember the felt sense of being safe in each other’s arms.

And that’s the gift of integration: it’s not about chasing the high of the session. It’s about living the transformation, day by day, moment by moment.

Your Next Step

If you’re tired of living like roommates instead of lovers…
If you long for intimacy that feels safe, nourishing, and real…
If you’re ready to finally break the cycle and find your way back to each other and back to yourselves…

This two-day journey may be exactly what your relationship has been waiting for.

Book Your Free Consultation in Wake Forest, NC

During our call, you’ll discover how Ketamine and Emotionally Focused Therapy could help you break through the stuck places and finally feel safe, seen, and connected again.

You are worth this investment. Your marriage is worth this investment.

———-

Testimonial from google:

Working with Irina has been an incredibly meaningful experience for both my husband and me. From the very first session, her presence was undeniable — calm, steady, and completely attuned to both of us. She holds a space that feels both grounded and warmly human, striking the perfect balance between professionalism and heartfelt connection….Because of her guidance, we not only understand our patterns, but we also now have the tools to move through them — with curiosity instead of judgment, and connection instead of disconnection. Our relationship feels stronger, safer, and more open because of the work we did with her.

We are deeply grateful and would recommend Irina without hesitation to any couple looking to heal, reconnect, and grow together.

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Add testimonial:

It was my first time experiencing ketamine assisted psychotherapy (KAP) and I was nervous. I was also eager to shift some thought dynamics I was stuck in, but mostly nervous. Irina's calm grounded energy, good humor and confidence from the get-go helped me not only relax into the process, but have an amazing experience! Because I knew she was there, in charge and fully with me, I could let go and be open. Her insights, presence and laughter as we integrated my experience will mark this as one of the best experiences of my life. I can't recommend her highly enough. Especially if you are new to this modality!

Sometimes talk therapy just isn’t enough

When the pain has roots in trauma, depression, anxiety, or years of disconnection, the same old words won’t break through.

That’s where Ketamine-Assisted Psychotherapy (KAP) can help.

Ketamine-Assisted Psychotherapy allows couples and individuals to:

• Access emotions that feel out of reach in everyday life while lowering the defenses down.

• Be your powerful ally in helping you to get out of your own way

• Disrupt negative thought loops – Temporarily quiets the brain’s default mode network (DMN), reducing repetitive, self-referential thinking.

• Enhance emotional regulation – Strengthens synaptic connections in the prefrontal cortex and hippocampus, helping partners process emotions with less reactivity.

• Reduce fear responses – Lowers amygdala hyperactivity, creating a sense of safety for deeper emotional conversations.

• Increase emotional fluidity – Softens ingrained coping mechanisms like avoidance or defensiveness, making honest communication easier.

• Facilitate emotional release – Allows suppressed emotions like grief or shame to surface and be processed safely.

• Create space to let go of what no longer serves you and identify specific behavioral changes with your therapist, so that you don’t end up in the old place again

What Makes Irina’s Work Different

I run a boutique-style private practice, which means I work with a very small number of clients at a time (because no one wants to be client #23). This allows me to show up fully: rested, inspired, and aligned, so you’re not getting a burned-out therapist just checking boxes.

Most years, I fly all over the country and the world to attend advanced trainings in mental health, psychiatry, and cutting-edge therapeutic approaches. Even after 14+ years in the field, I still invest heavily in high-level coaching and bi-weekly clinical consultation with multiple leaders in the field, because I believe my clients deserve the best and most up-to-date care available.

I also take intentional time off to be with myself, my kids, and to nurture my own relationship. I’ve lived in three different countries, started over multiple times, navigated heartbreaks, divorce, big moves, parenting small children, and building a business. In other words—I get it. Life is messy, relationships are complicated, and healing takes balls.

Here’s what that means for you:

• You get a therapist who keeps things real. I swear in sessions (and a lot outside of it).

• You get someone who is not afraid of going deep and sitting with the hard stuff.

• With your consent, I will collaborate with advanced practitioners to get a second or third pair of eyes on your case, making sure you’re receiving the highest standard of care.

• You get someone who doesn’t just teach balance and connection but actually lives it, and brings that embodied wisdom into the room with you.

I LOVE deep work. I don’t waste your time. And I won’t sugarcoat things. I’ll meet you exactly where you are, and help you find your way forward.

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add this quote some where here

“I’m a licensed marriage and family therapist (LMFT) with a doctorate in counseling education and supervision, and I’ve worked as a couple’s therapist for over 20 years in Virginia, Maryland, and California,” she says. “I’ve exclusively seen couples for all of that time. There is nothing close to ketamine-assisted therapy and its unique ability to address unresolved trauma and expedite healing.”  (dr Dr. Kathryn Rheem)

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How Ketamine Therapy in North Carolina Works With Couples

This isn’t about “tripping” or escaping. It’s about carefully guided experiences, with me as your therapist, that open a window into the deeper layers of your heart and history.

• Preparation: We begin by understanding your story, your relationship patterns, and what you’re carrying.

• Medicine Sessions: In a safe, supportive environment, ketamine helps you access parts of yourself and your connection that have been blocked.

• Integration: This is where change happens — weaving the insights and emotions from your session back into your daily life and relationship.

Research shows that Ketamine therapy can reduce symptoms of depression, anxiety, and trauma, the very things that keep couples stuck in cycles of disconnection.

This Is For You If…

• You still love each other, but feel stuck in the same painful loops.

• You want to protect your children from inherited patterns of hurt.

• You’re tired of proving your worth through busyness and success.

• You long to feel truly seen, held, and loved by your partner.

• You’re ready to stop fighting for love and finally rest in it.

• You are sick on traditional psychotropic meds (and their side effects) that you HAVE to take for the rest of your life while feeling numb and not even like yourself

• You have tried traditional talk therapy and it didn’t quite help to rewire your old ways of thinking, provide moments of relief, and open your heart for expressing genuine emotions to heal old wounds and unprocessed pain.

This is not for couples who have already checked out or decided to separate. It’s for those who still have hope, even if it feels faint, and want to lean in.

———-

testimonial from google review

I attended a training for Ketamine Assisted Therapy (KAP) with Irina. We were placed together in a small group to help learn and prepare for our own medicine journeys. I felt an immediate connection with Irina. Her calm, intuitive and caring presence helped immeasurably in the positive outcome of my experience. I would highly recommend her as a therapist or KAP practitioner or both! Thank you for your presence, Irina.

Irina’s care and presence is felt in every interaction. She really just seems to get “it”. Truly feel so grateful to have had the opportunity to work with her.

Irina is a down to earth and authentic person who is the biggest encouragement when you need it. Her zest for life allows her to earnestly encourage the fun in relationships while her authenticity helps her excellently empathize with hardships that come with interpersonal growth. She has been a delight to know and work with and I highly recommend her. Flexible yet realistic and I love this about her!

Ketamine-Assisted Psychotherapy (KAP) – Frequently Asked Questions

What is ketamine?

Ketamine is an FDA-designated Schedule III dissociative anesthetic agent widely used since the 1970s for sedation and pain reduction. In recent years, sub-anesthetic doses to treat pain, depression, or other psychiatric diagnoses is a newer, off-label use of ketamine. While not FDA-approved for these uses, scientific studies support its efficacy. Intranasal esketamine (SPRAVATO) has received FDA approval for drug-resistant depression.

You may have heard that ketamine is mostly used in the clubs, hence the “club drug” name. However, ketamine was used as a medical anesthetic for many years, long before it became known as a ‘club drug.’ Psychiatric use of ketamine has become relatively widespread in recent years, has been studied and promoted by researchers at the National Institute of Mental Health, and has had front-page publicity as an effective antidepressant with a novel pharmacological mechanism of action. Ketamine can be administered by intravenous, intramuscular (IM), sublingual, oral, and intranasal routes. Often, it is used after other treatment approaches have been unsuccessful.

Ketamine is now an “off-label” treatment for various chronic “treatment-resistant” mental health conditions. Ketamine is a Schedule III medication that has long been used safely as an anesthetic and analgesic agent and in recent years is being used as an effective treatment of depression, alcoholism and other substance dependencies, PTSD and other psychiatric diagnoses.

Ketamine is classified as a dissociative anesthetic, dissociation meaning a sense of disconnection from one’s ordinary reality and usual self. At the dosage level administered to you, you will most likely experience mild anesthetic, anxiolytic, antidepressant and, potentially, psychedelic effects.

How is ketamine different from traditional psychotropic medications?

Ketamine is sometimes called the “medicine of perspective.” It helps people shift their lens—whether zooming out to see the big picture, or zooming in to connect with what’s happening inside. That shift often sparks movement where clients have long felt stuck.

Psycodelics help us move from numbing (symptoms) to evoking (possibilities):

Unlike traditional psychotropic medications (like zoloft, xanax, adderral, prozac, lithium, effexor, or sertraline), which can numb emotions, dull clarity, and sometimes leave you with withdrawal symptoms, ketamine has the opposite effect. It “awakens” the brain, increasing neuroplasticity and helping new connections form.

• Works up to 70% of the time, often within hours or days (vs. 40% with antidepressants, which take weeks).

• Used as a catalyst or short-term treatment, not an ongoing daily medication.

• Can ease depression, anxiety, PTSD, OCD, eating disorders, and more.

• Helps people reconnect with themselves, with others, and with a greater sense of possibility.

What is Ketamine-Assisted Psychotherapy (KAP)?

KAP blends the biological effects of ketamine with the emotional holding of psychotherapy. The medicine may quiet the brain’s defenses, soften resistance, and dissolve rigid narratives. The therapy provides safety, meaning-making, and gentle guidance so insights become lasting change.

The purpose of the intramuscular and sublingual ketamine experience is to create a non-ordinary (“altered”) state of consciousness in order to facilitate profound transpersonal (“transcendental”, “mystical”, “spiritual”, “religious”) peak experiences. These may prove to be auspicious in resolving your existential problems, accelerating your psychospiritual growth, and leading to a deep personal transformation and optimization of your lifestyle. Such change is best facilitated within a structured, supportive environment in connection with experienced KAP therapists who collaborate with you in working towards your treatment goals and hold a view of your issues, hopes, desires, and struggles.

 As a byproduct of your experience you may feel improvement in your emotional state and reduction in problematic symptoms such as depression, anxiety, and post-traumatic manifestations. You may well notice that you are a bit different after a ketamine experience, and that difference may be liberating and allow for greater access to presence of mind, increased awareness of emotional and cognitive patterns and perspectives, and enhanced ability to make positive behavioral changes.

For best effects from this treatment, new clients are asked to make a commitment to at least 3 sublingual KAP sessions—with the possibility to pursue the full course of treatment as prescribed. This requested commitment is based on both research and clinical practice observations that suggest a cumulative benefit to repeated treatments. Please understand you are able to withdraw from treatment at any time. Your experience will be unique to you, and your KAP therapist will assist you in exploring the possible benefits and challenges that may arise during treatment. It is helpful to keep in mind that each ketamine experience may be different, with possibilities ranging from profound insights to a perceived lack of subjective effects. It is my perspective that each experience contains value to be explored in psychotherapy and integration. The degree of intentionality, curiosity, and openness you bring to this treatment is likely to provide you a greater depth of benefit as the series of experiences unfold.

How does KAP work exactly?

Ketamine primarily acts as an NMDA antagonist within the glutamate system. This is very different from SSRIs or benzodiazepines. Research shows it:

• Boosts BDNF (brain-derived neurotrophic factor), which improves learning and healing.

• Creates a 36–72 hour “window” of enhanced neuroplasticity where new habits and insights can be anchored.

• May reopen “critical learning periods”—almost like hitting the brain’s reset button.

Some traditions see ketamine (and other psychedelic medicines) as a master key, unlocking flexibility, loosening old constraints, and allowing the psyche to reorganize in healthier ways.

In simpler terms, ketamine floods our brain with glutamate and glutamate is considered the work horse or the master switch to the brain. Glutamate has roles in pain, anxiety, inflammation, memory, and lots of mental health symptoms.

How Long Will It Take Before I Might See Beneficial Effects?

You may experience important changes in personality, mood and cognition during treatment, in the aftermath, and in the days and weeks that follow. Some experiences may be temporarily disruptive or challenging for you. The ketamine experience itself is designed to enable your own healing wisdom to be accessed and support your integration of these experience to gain psychotherapeutic benefits in alignment with your treatment plan and goals. The psychotherapy support you will receive will aid you in making your experience(s) valuable and understandable to you. I will endeavor to assist you in changing patterns of mind and behavior that are of concern and cause you difficulty.

Benefits of KAP

Expected response rates to ketamine treatment for chronic (treatment-resistant) depression are 60-75%, based on available literature exploring a series of treatments using either IV or sublingual routes of administration. While some people do not see a notable remission of their symptoms, most will at least report gaining some valuable insights or improvements. Relapses can occur and may require periodic additional sessions. Over time, a certain number of clients may become unresponsive to further ketamine sessions.

Other benefits include:

• Calms the amygdala (less anxiety, more ease).

• Softens resistance and dissolves rigid ego defenses.

• Helps access deeper corners of the psyche.

• Supports transformation in depression, anxiety, PTSD, OCD, eating disorders.

• Encourages psychospiritual exploration, addiction recovery, and couples/group work.

• Promotes insight and new flexibility after traumatic brain injury.

• Can help people move beyond being “married” to a painful or limiting life narrative.

What routes of administration are available?

In my outpatient office my marriage counseling office in Wake Forest , I offer:

• Sublingual/oral (20–30% bioavailability)

• Intramuscular / IM (95% bioavailability)

I do not offer IV administration.

How will I take the medicine?

Ketamine creates an unusual experience of formlessness and a dissolving of boundaries and has novel effects on the mind. Therefore, it is much better to have an initial learning experience using a lower dose. The oral ketamine (either in a lozenge or tablet form) will dissolve slowly, and I wll ask you not to swallow your saliva for at least ten minutes and “swish” the saliva around in your mouth in that time to ensure absorption. Ketamine will penetrate the oral mucosa—lining of your mouth—and will be absorbed rapidly in that manner.. Some clients like to bring orange juice to help with the taste (I can’t provide it for compounding reasons, but you’re welcome to bring your own).

Is ketamine safe?

Yes. Ketamine is considered a very safe and forgiving medicine when prescribed and used responsibly.

For more than 50 years, ketamine has been widely recognized and safely used in operating rooms, emergency departments, and pain clinics. At the doses typically employed in psychiatry (0.5–1.5 mg/kg), it has demonstrated a strong track record of safety and reliability. In fact, the Ketamine Treatment Centers have reported administering over 20,000 psychiatric treatments without a single serious adverse event. Globally, ketamine is valued not only as a dissociative anesthetic but also as a versatile medicine. For these reasons, the World Health Organization has included ketamine on its list of Essential Medicines.

Who is not a good candidate for Ketamine Therapy?

• Medical exclusions: uncontrolled high blood pressure, significant heart disease, aneurysm, stroke history, pregnancy and breasfeeding, severe liver disease, untreated thyroid disease, acute angle closure glaucoma, severe/recurrent bladder problems (cystitis)

• Psychiatric exclusions: schizophrenia, active psychosis, recent mania/hypomania, severe substance use disorder

Additionally, a thorough medication review is essential as certain medications and substances may negatively interact with ketamine.

Am I a good candidate for KAP?

Before participating in ketamine treatment, you will be carefully assessed by a medical professional/prescriber to determine if you are eligible for ketamine-assisted psychotherapy. This may include the following: medical history, a physical exam (if deemed necessary), review of your medical/psychiatric records, a psychiatric history, and administration of brief psychological tests to assess your state of mind.

What are possible side effects?

You will be asked to lie still during the ketamine administration because your sense of balance and coordination will be adversely affected until the drug’s effect has worn off (generally within two hours). It is possible you may fall asleep during the drug effects due to being in a relaxed state.

 Some possibilities for adverse effects include blurred and uncomfortable vision (you are advised to keep your eyes closed until the main effects have worn off), slurred speech, mental confusion, excitability, diminished ability to see things that are actually present, diminished ability to hear or to feel objects accurately including one’s own body, anxiety, nausea and vomiting. Visual, tactile and auditory processing are affected by the drug. Synesthesia—a mingling of the senses may occur. Ordinary sense of time may morph into time dilation.

Because of the risk of nausea and vomiting, please refrain from eating and drinking for at least the 4 hours preceding the session. And eat lightly when you do. Ketamine generally causes an increase in blood pressure (equivalent to moderate exercise) but does not usually affect pulse rate. If you have a history of high blood pressure, it is essential you follow all requirements of your prescribing physician to be in compliance with your prescribed use of ketamine. If blood pressure monitoring is required, you must bring in your own blood pressure cuff and take a reading prior to drug administration. Your KAP therapist reserves the right to cancel a session if blood pressure levels are too high, or any other aspect of the prescription protocol is not met.

Agitation may occur during the course of a ketamine session. The administration of ketamine may also cause the following adverse reactions: tachycardia (elevation of pulse), diplopia (double vision), nystagmus (rapid eye movements), elevation of intraocular pressure (feeling of pressure in the eyes) and anorexia (loss of appetite). However, with low dose oral ketamine, these agitations are less likely.

Driving an automobile or engaging in hazardous activities should not be undertaken after your ketamine-assisted psychotherapy session until the following day. You should have someone who knows your general state of mind drive you home from your first treatment. You will be assessed for safety prior to leaving the office premises. In terms of psychological risk, ketamine has been shown to worsen certain psychotic symptoms in people who suffer from schizophrenia or other serious mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders.

During the experience itself, some people have reported frightening and unusual experiences. These frightening experiences, however, may be of paramount value to your transition to recovery from the suffering that brought you to your KAP work. They will stop! You will receive psychotherapeutic help and ongoing guidance from your therapist.

Other side effects may include:

• Nausea or dizziness

• Mild increase in blood pressure

• Headaches or migraines

• Vertigo, fatigue, sensory sensitivity

• Temporary insomnia or tinnitus

• Emotional or “transformational” intensity

Please keep in mind that you may not experinece any of these at at all (and many people don’t).

How can I best prepare for a KAP Session

Preparation for a ketamine session requires assessment by your therapist of your readiness and a sense of trust, safety, and rapport between you and your therapist. We are engaging in a therapeutic endeavor to benefit you and those who are affected by you. Together, we are creating a supportive “set” (state of mind) and “setting” (environment) to maximize the benefits of this treatment.

• Practice grounding: box breathing, meditation.

• Plan for aftercare: arrange childcare, meals, rest—think of it like a “birth plan” (it won’t go perfectly, but preparation matters).

• Support your body: some clients like acupuncture, sauna, or massage beforehand.

• Set an intention: intentions might be big (“Help me connect with myself again”) or simple (“Show me calm”). And sometimes the medicine answers directly; other times, it takes you on a winding backroad. Both are valid.

• Spiritual or cultural support: if your faith, cultural background, or ancestral traditions are important, bring them into our conversation so the space is tailored for you. Some rooted in indigenous traditions even choose to “pray with their medicine,” holding it for a moment before beginning.

• Allow yourself to quiet your mind and acknowledge your journey as being a

  time for you to be with yourself. Minimize distractions such as your phone,

  social media, or news. Make a list of anything that you might need to do in the

  future or that is on your mind from the past. Bring your awareness to the fact

  that there will be a time to address these items later. This is your time to

  receive, to allow, to accept what is.

• Avoid alcohol, cannabis and benzodiazepines (e.g., clonazepam, lorazepam,

  alprazolam) for 24 hours prior to the treatment. The day of treatment, please

  follow your prescriber’s instructions regarding psychiatric medications.

• Fast from food for 4 hours prior to your treatment. Reduce intake of liquids for 2

  hours prior.

• Secure a safe ride home (you are not allowed to drive for the rest of the day)

What should I bring?

o Comfortable clothing

o Eyeshades, pillow, and blanket

(I recommend Mindfold eyeshades, as these allow you to open/close

your eyes freely during your session, while maintaining total darkness)

o Any other items that may increase your sense of comfort and safety during your

session

o Photograph of loved ones or pets, favorite blanket or stuffed animal, rock,

candle, or other objects of comfort

o Water bottle

o Bluetooth headphones (optional)

o Snack (salty can be a good option)

o Sunglasses (optional) – light sensitivity is possible for a short time post-

ketamine treatment.

How can I best navigate my ketamine journey

• Prepare for any potential discomfort; as you will experience a non-ordinary state of

consciousness, your normal perception of reality will be altered. Whenever you feel

discomfort, allow yourself to let go and embrace the challenge as a learning

experience rather than reacting to it.

• “Trust, Let Go, Be Open” is a commonly used mantra in psychedelic therapy.

o Trust your clinician to prepare and guide you through this experience, as

well as your own Inner Healing Intelligence: your inherent capacity for

resilience and ability to obtain wholeness and well-being.

o Let go of any expectations about what should or should not come up during

your experience; open yourself up to whatever may be unfolding during your

journey – positive, enlightening, difficult, or scary. Know that whatever is

happening is okay, and that the experience will end.

o Be open to wherever the medicine takes you. Your journey may be centered

on your intentions, or not, and that is okay! You may not be able to make

sense of what is occurring during your journey at the time. You may have a

mystical experience and gain deep insights into yourself or your way of life,

or you may not. Do not be disappointed with wherever your journey leads

you – you will see benefits as you progress through treatment, and your

therapist is there to help you make sense of the experience.

Setting an Intention

• Gives way to increased clarity and depth in your experience while

supporting your strength and ability to persevere through your journey.

• It may be helpful to ask yourself:

§ What am I grateful for?§ What are my fears? My worries?

§ Who is an ally or support person(s) I can call on (internally) during

my journey?

§ What might I let go of? Who might I let go of?

§ Who might I forgive?

§ What dreams do I have for my life?

§ What are my desires, intentions, or expectations for the

experience?

§ What parts of myself do I wish to know more?

o You may practice setting intent by placing your hands at your navel area,

breathing deeply, and imagining that you are receiving the medicine in a

way that is healing for you.

During a KAP Session

During the ketamine administration session, you will be asked to make the following agreements with the therapist(s) to ensure your safety and wellbeing:

1.     You agree to follow any direct instructions given to you by the therapist(s) until it is determined that the session is over;

2.     You agree to remain at the location of the session until the therapist(s) decides you are ready to leave; and

3.     You agree you will secure return transportation following your ketamine treatment and will not drive for the remainder of the treatment day.

What will happen?

• You’ll settle into a cozy “nest,” often with weighted blankets (especially helpful if you experience vertigo).

• You’ll wear an eye mask and headphones, journeying inward while I support from the outside.

• Every session is unique—like weather passing through. No two journeys are the same.

What will you do while I have my eye mask on?

• Take notes on what I observe.

• Write down the music track names.

• Gently remind you of your intention or mantra if you drift.

• Step in only if necessary for safety, containment, or grounding.

What if I need the bathroom?

We’ll review touch consent ahead of time. If you need to go, we’ll use a signal, and you’ll place your hands on my shoulders as I carefully walk you there and back. Please don’t lock the door.

How long does a session last?

The length of ketamine sessions varies from person-to-person and from experience-to-experience. You are likely to be mostly internally focused for the first 45 minutes to one-hour-and-a-half following oral absorption of ketamine. You can expect to continue to feel the effects of ketamine at a lesser level for an hour or more beyond this time.

How will I know it’s over?

• A rosewater spray gently signals when we are nearing the end.

• A soft shoulder tap after ~100 minutes lets you know it’s time to begin reorienting.

Integrating Your Experience

• Integration is the act of processing and reflecting on any material that arose during

your journey in a non-ordinary state of consciousness (insights, feelings, body

sensations, etc.) through self-care activities (journaling, art, yoga, conversations

with your therapist or other trusted person, etc.) once you have returned to your

ordinary state of mind. These steps will help you increase your understanding of the

experience and support your ability to use this material to create lasting, positive

change in your life. Ideally, the integration process should begin immediately after

your journey to maximize your ability to positively integrate the experience.

• Most individuals find journaling or sharing about the experience with a close friend

or loved one to be a good way to do this.

• As you integrate and spend time reflecting on your experience, consider journaling

or making art that explores the following prompts:

o What did I feel emotionally and physically during the session?

o What did I see during the session? What did I hear?

o Do I need to talk this through with someone or ask for support?

o What is one thing that I feel gratitude for after this session?

o How do I feel now after the session?

o What messages am I continuing to receive from my body d and emotions?

o Which parts of myself did I become more aware of? Did these parts share any

messages with me?

o What do I hope to explore in future sessions?• One of the best ways to promote lasting benefits and healing from your experience

is through behavioral change. This may include the following:

o Starting a daily practice of mindfulness (meditating, listening to music, yoga,

prayer, spending time in nature)

o Committing to a daily practice of creative expansion (drawing, painting,

dancing, journaling)

o Making time to process insights (talk with a trusted friend or family member,

schedule non-medicine therapy sessions)

o Committing to dietary changes (eat healthy meals, cut down on sugar

processed foods, reduce alcohol/drug use)

Please remember that integration is where the real work happens. Medicine can open doors, but integration helps you walk through them.

After Your Ketamine Treatment

• You may take any daily prescribed medications and resume normal food/liquid

intake after your session.

• DO NOT drive for the rest of the day following your treatment. Please plan to have a

family member or close friend provide you with transportation home. You may take

a taxi/Lyft/Uber if needed, however I encourage you to avoid doing so after your

first KAP session.

• If possible, it is recommended to take the rest of the day off after your ketamine

treatment to allow you time to engage in resting, self-care, and integration. During

this time, suggested activities include taking a bath, going for a nature walk,

listening to music, journaling/writing about your experience, making art, or getting

a massage.

• Feel free to go back to your normal work/activity schedule the day following your

session.

Avoid big legal, or financial decisions for at least 1-3 months post your ketamine session

Avoid alcohol, cannabis, kratom, or kava for at least 48 hours before and after.

What if I feel disappointed?

Some clients don’t have the “big” experience they were hoping for. This is completely normal. Every journey is different, and there is always something to learn. We can also talk with your prescriber about dosage adjustments. Remember: you didn’t do it wrong.

POTENTIAL FOR KETAMINE ABUSE AND PHYSICAL DEPENDENCE

Ketamine belongs to the same group of chemicals as Phencyclidine (Sernyl, PCP, “Angel dust”). This group of chemical compounds is known chemically as Arylcyclohexylamines and is classified as Hallucinogens (“Psychedelics”). Ketamine is a controlled substance and is subject to Schedule III rules under the Controlled Substance Act of 1970. Medical evidence regarding the issue of drug abuse and dependence suggests that ketamine’s abuse potential is equivalent to that of phencyclidine and other hallucinogenic substances. Phencyclidine and other hallucinogenic compounds do not meet criteria for chemical dependence, since they do not cause tolerance and withdrawal symptoms. However, “cravings” have been reported by individuals with the history of heavy use of “psychedelic” drugs. In addition, ketamine can have effects on mood (feelings), cognition (thinking), and perception (imagery) that may make some people want to use it repeatedly. Therefore, ketamine should never be used except under the direct prescription or supervision of a licensed physician. Repeated, high dose, chronic use of ketamine has caused urinary tract symptoms and even permanent bladder dysfunction is individuals abusing the drug. This has not been reported to occur within the framework of our proposed treatment paradigm. You will be provided only the amount of ketamine necessary for your treatment as prescribed. If concerns arise that you may be misusing or distributing your prescription, your KAP therapist and prescriber may assess this and require you to bring in all doses at each session to monitor for compliant use.

Where will I get ketamine?

I work with trusted medical prescribers who will provide a one-time medical evaluation and, if appropriate, prescribe your medicine. It is shipped directly to your home from a compounding pharmacy, and you’ll bring it with you to your session.

Why is a preparation session important?

Preparation creates safety. We’ll discuss:

• Consent and boundaries

• Types of touch (necessary vs. supportive)

• The bathroom plan

• What to expect before, during, and after

• Answering all your questions

If anyone tells you they can predict exactly what your ketamine experience will be like, that’s a red flag. Every journey is unique. My role is not to script your path but to be the custodian of the space, the midwife of the process, your timekeeper and caretaker.

I trust the medicine, the music, and your own inner wisdom. You are safe, supported, and never alone in this journey.

How is KAP different from just getting ketamine at a clinic without therapy?

Very different. Ketamine on its own can open doors in the mind and heart, but walking through those doors without support often feels confusing, overwhelming, or even traumatizing. At a medical clinic, you might receive the medicine and then be sent home — left to make sense of a powerful experience by yourself.

In Ketamine-Assisted Psychotherapy (KAP), the medicine is paired with the presence of a trained therapist who stays with you before, during, and after the session. I help you feel safe enough to let go, and I guide you in making meaning from what arises. Together, we explore how to bring the insights, emotions, and breakthroughs into your daily life and your relationship.

Without this integration, it’s easy for the experience to fade or feel unfinished. With therapy, the medicine becomes a catalyst for lasting healing, deeper connection, and real change.

Can we do KAP sessions together as a couple, or is it only individual?

You can do Ketamine-Assisted Psychotherapy (KAP) either individually or together as a couple.

• Individual KAP is often where people start, especially if one partner wants to focus on their own healing, processing trauma, or shifting out of patterns like depression, anxiety, or emotional numbing. Having space that’s just yours can help you go deeper into your inner experience. Some couples like to take turns as well.

• Couples KAP can be very powerful when both partners want to experience the medicine together in a safe, guided setting. Instead of being alone with the experience, you move through it alongside your partner, with the therapist holding space for both of you. This can help open emotional doors that may feel shut in everyday life—making it easier to reconnect, soften defenses, and share more vulnerably. Many couples find it deepens empathy, compassion, and intimacy.

Some clients choose a hybrid approach—doing one or two individual sessions first to orient themselves, and then moving into couple sessions when they feel ready.

How might ketamine help us break out of our negative conflict cycles?

1. Quieting the inner guardrails.
In the heat of conflict, old defense, like shutting down or pushing away, often take over. Ketamine can help soften that inner critic, giving you the emotional breath space to speak and listen from a more open, vulnerable place.

2. Reclaiming emotional connection and perspective.
Life gets busy with work, kids, schedules, and the connection that used to be effortless feels slow and distant. Ketamine can offer a “zoom‑out” moment, helping you glimpse past everyday overwhelm and reconnect with what truly matters: each other’s hearts.

3. Inviting empathy where only patterns remain.
When your relationship drifts into roommate territory, it’s easy to lose sight of your partner. Ketamine can gently guide you back to empathy by helping you see the person behind the frustration or exhaustion and feel compassion, even in the midst of tension.

4. Shifting from “just getting by” to “love partners.”
You’re not looking for just functional love—you want that soul-to-soul, special‑something connection. With the support of KAP and Emotionally Focused Therapy (EFT), you can start to break free from the automatic conflict relay and create new, secure patterns of reaching, responding, and reconnecting.

Will we be able to talk to each other during the ketamine session, or is it a private inner experience?

During a ketamine session, you’ll wear eyeshades and headphones with carefully chosen music. This helps you turn inward and have a more personal, reflective experience. For most of the session, you won’t be talking to each other—this quiet space allows the medicine to do its work without distractions.

That said, you’re never cut off. You can always remove the eyeshades and speak with me if something comes up that needs support. Some clients come out of their experience sooner and want to talk, but that’s not common and I will direct you to going back inward. After the medicine wears off, we set aside time to talk together, share your experiences, and integrate what came up. That’s often where the most powerful moments happen—when partners bring their inner journeys back into connection with each other.

How do we integrate what happens in a ketamine session into our everyday relationship?

Great question, and honestly, this is where the real magic of KAP happens. The ketamine experience itself can open doors, soften defenses, and bring new insights to the surface, but if those insights stay in the therapy room, they won’t create lasting change. Integration is about weaving what you discovered into the fabric of your daily relationship. Together, we will come up with step by step behavioral changes that will get you unstuck and reconnected,

How will this fit with the work we’re already doing in couples therapy?

Think of ketamine not as replacing the work you’re already doing, but as an incredible tool that can deepen it. In other words, the medicine opens the door, and therapy helps you walk through it together. Traditional couples therapy (like Emotionally Focused Therapy, or EFT) helps you slow down conflict patterns, share emotions more vulnerably, and build new ways of reaching for each other. Sometimes, though, defenses or old wounds can make it hard to access those deeper feelings in the therapy room.

That’s where ketamine can help. It softens the protective walls, quiets the inner critic, and creates a sense of openness that makes it easier to feel and share what’s really going on inside. After a KAP session, many couples find themselves more present, more compassionate, and more willing to try something new with their partner.

Will ketamine bring up old wounds, like infidelity or past trauma, and how do we handle that together?

Sometimes ketamine brings forward past hurts, like old betrayals, unfinished grief, or painful moments you thought were long buried. Other times, the experience is gentler, focused more on perspective, release, or even a sense of peace. There isn’t one “right” way it unfolds, and not every session stirs up the past.

Either way, what surfaces is always useful. If an old wound comes up, it means there’s still healing needed, and we can work with it together in a safe, guided way. If the session is quieter, it can still open doors to more connection, empathy, and presence with your partner.

The beauty of combining ketamine with Emotionally Focused Therapy (EFT) is that you’re NEVER left alone with whatever arises. We’ll make space afterward to talk, share, and integrate the experience, so even painful memories become stepping stones toward deeper trust and closeness.

Use this quote here: “Ketamine has a way of bringing to the forefront what and who we

care most about and underscores the importance of these

themes and relationships in our lives. As a result, it can be quite

powerful to manifest a practical connection with this material” (Jayson Jason Sienknecht, LPC, CAC, co-founder of PRATI (Psychodelic Research and Training Institute), had over 700 Ketamine sessions with clients )

Can ketamine help us reconnect emotionally if we feel like “roommates”?

Yes, ketamine-assisted psychotherapy (KAP) can sometimes be a powerful catalyst for helping couples reconnect emotionally, especially when a relationship feels more like a “roommate” arrangement than a partnership.

Here’s how:

1. Breaking Through Emotional Numbing

When couples feel stuck in a roommate-like dynamic, it often comes from years of emotional numbing. Life feels like checklists and logistics rather than intimacy. Ketamine can temporarily quiet the parts of the brain that keep us stuck in rigid patterns and overthinking. This allows space for softer emotions (longing, sadness, love) to come to the surface, emotions that may have been buried for a long time.

2. Creating Perspective & Insight

Many clients describe ketamine as a “medicine of perspective.” It can help partners zoom out and see their relationship from a new angle. Instead of being caught in the day-to-day grind, you may gain clarity about what truly matters to you as a couple. That sense of perspective can reignite motivation to nurture closeness.

3. Deepening Connection Afterward

During the medicine experience itself, you’ll be in your own inner process (with eyeshades and music), but the integration work afterward is where the real relationship healing happens. Together, you can share insights, talk about what came up, and explore new ways of showing up for each other. Many couples find themselves speaking more vulnerably and with less defensiveness after sessions.

4. Not a Magic Fix, but a Doorway

KAP won’t instantly solve every issue in your marriage, but it can open doors that have felt locked shut. Think of it as softening the emotional walls so that the therapy you’re already doing has more room to land and stick. I hear couples often tell their therapist after KAP sessions: “I remembered why I chose you in the first place,” or “I felt love again instead of just obligation.”

How much does Ketamine Therapy Cost?

The overall investment in ketamine-assisted treatment depends on each person’s unique needs and goals. To help you estimate the cost, here are the standard service fees:

• Initial Medical Intake & Screening Consultation
  Conducted by the collaborating medical provider
  Approximately $400 for 75 minutes (paid directly to the prescriber)

• Preparation Sessions
  At least one day long intensive session is required before beginning ketamine treatment
  $3000 for 6 hours

• Medicine Session and Integration Session
  Held after ketamine administration to process and integrate your experience
  $3000 for a 6 hour private intensive (about 3 hours for the medicine session and 3 hours for the integration)

• Medicine itself ($40-80 per package to use for 4 sessions)

Additional resources and articles to explore

Drozdz, Sandra et al; KAP a systematic review: Hyde, Steven Ketamine for Depression, 2015

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207256/pdf/jpr-15-

1691.pdf

Krystal, J.H., Kavalali, E.T. & Monteggia, L.M. Ketamine and rapid antidepressant action: new treatments and novel synaptic

signaling mechanisms. Neuropsychopharmacol. 49, 41–50 (2024). https://doi.org/10.1038/s41386-023-01629-w

Marguilho, Miriam, et al. “A Unified Model of Ketamine’s Dissociative and Psychedelic Properties.” Journal of

Psychopharmacology, vol. 37, no. 1, 17 Dec. 2022, pp. 14–32, https://doi.org/10.1177/02698811221140011.

Multidisciplinary Association for Psychedelic Studies (MAPS): http://www.maps.org/

Sessa, Ben Psychedelic Renaissance, 2012

Walsh, Zach et al; Ketamine in mental health systematic review- https://pubmed.ncbi.nlm.nih.gov/35040425/

Tupper, Ken “Psychedelic Medicine”, CMAJ 2015. DOI:10.1503 /cmaj.141124

Wolfson and Hartelius The Ketamine Papers, 2016

Matthews Vu Medical Group. (April, 2022). Dr. Rachel Wilkenson – Neuroinflammatory model [Video]. YouTube.

https://youtu.be/wJZIqDrOumw

Are you ready for:

Ketamine experiential sessions can produce:

• Strong feelings of freedom, expansiveness,

and empowerment

• Strong feelings of love for Self, others, and

the Universe

• Renewed faith in oneself to start moving in

the direction of self-actualization

• Increased willingness to engage in life and to

hurdle the barriers that had previously

deterred progress towards goals

Schedule your free consult today button

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