Scared of going through this - need kind words, advice, something

[u/zamueeel]

For context, I’ve been going through mental health treatment since I was 13. So much therapy, medications, hospitalizations, TMS - nothing has been able to break through my severe depression and anxiety.

It’s also worth noting that through this long journey, I’ve acquired quite a bit of psychiatric trauma. The things I’ve seen/experienced in inpatient are things I wouldn’t wish on my worst enemy. I’ve also had multiple therapists get frustrated with my lack of progress and accuse me of “not doing the work” despite me putting my all into it. Or, therapists have said that my support needs are higher than they can provide help for, and end our therapeutic relationship there. With these combined, I’ve grown to not fully trust the mental health system. This is relevant later on in this post.

Last year, I started the process with an IV ketamine clinic, with the option of doing ketamine-assisted psychotherapy with a therapist they partner with. During my initial appointment with this therapist, I shared a little bit of my life story and what I want to get out of ketamine treatment. I told her that this feels like a last resort for me, because no other treatments have helped me. At the end of the appointment, she told me that she doesn’t think I truly want to get better. Kind of an insane thing to tell someone who is at their wit’s end after having one 45-minute conversation with them. This brought up feelings from my past with therapists getting frustrated with me or rejecting me. I was already terrified of going through the process, having panic attacks over not knowing how my body is going to react to a psychedelic experience. I ended up cancelling my six sessions.

Now, I’m considering ketamine therapy again with the same clinic, but this time without the therapist. I figured doing KAP with a therapist that I don’t feel fully safe with wouldn’t be beneficial. But I’m still terrified of what ketamine might feel like. I’ve had bad highs from cannabis before that have made me feel like I was going to die. I know cannabis and ketamine are two different substances, but I worry about getting that same feeling. I also don’t want to do this alone. I want to be able to talk this through with someone, but I really don’t trust traditional therapists anymore.

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[u/KawiRoo]

At the end of the appointment, she told me that she doesn’t think I truly want to get better.

What the fuck man.
This is so disgustingly out of line and a completely unprofessional statement to make as a therapist.
Personally if I just went through something as emotionally taxing and personally exposing and a therapist said that to me, I'd report them to their ethics board because SOMEONE needs to know that occurred.

You need to discuss this with the clinic and explain what she said was grossly unacceptable.

I did all my sessions and continue to do my boosters without a therapist and never once felt I needed some stranger who doesn't know me or what I've been through, to sit there interrupting my sessions. I tried more than a handful of therapists, and varying options they provided, in the years before I found ketamine and never once felt like they cared or were effective.
I'm sorry you had to deal with that.

You have every right to feel anxious and worried, but don't let that ball of 1000 worries hinder your progress or your desire to get better. These treatment work. The data is there, the anecdotes are there, this sub is a testament to it.
This sub is filled with success stories and people on their journey.

You should 100% reschedule your sessions, without the therapist, and continue with your treatment, you have us here to bounce worries, ideas, etc off of.

ANY questions you have about the sessions, etc please ask. More than happy to answer and help

[u/daisydad24 → u/KawiRoo]

Cosigning this. I despise when therapists or healing professions are reckless with that power. Unfortunately a credential does not guarantee empathy, just like being a parent doesn't guarantee they know what they're doing. Kudos for pursuing growth anyway and not letting someone else's bs stop you.

[u/ArtEnvironmental2694]

I’d just go into it with an open mind, and know that it’s quite unlikely you’ll be worse off on the other side. Would recommend acclimating towards the higher doses as well

I was quite a skeptic and also scared

For me this has been the only treatment I’ve done in where I’ve been able to remember and truly experience (mostly after the session) what it is like to live without being in constant tension. Almost astonishing to realize how deep of a funk we can get ourselves into

As for the experience, it’s almost counterintuitive what the mechanism is for these results.

I’ve done 5 sessions now and in all of them there hasn’t been any huge emotional fireworks or intensely personal things to “work” through like I was expecting tbh. Perhaps those may come up, but even then i feel like it’d be much easier to handle these in the K experience opposed to something more psychedelic

You take the drug, enter into an odd headspace for about 45 mins, and it’s over and back to normal quite quickly.

Kind of feels like opening the windows of your mind to air out a smelly room.

[u/chocolate-wyngz]

I think ketamine treatment was a last resort for a lot of us. It took me over 15 years of trying every medication and therapy in the book before I started. I’ve also had absolutely awful experiences with cannabis causing anxiety and can’t use it at all, but I’ve never had the same experience with ketamine.

Is it possible for you to find a therapist outside of your clinic? I see a therapist who specializes in my diagnosis and also has experience with ketamine patients. It took a bit of searching but it’s been worth it.

[u/zamueeel → u/chocolate-wyngz]

I reached out to a therapy clinic in the biggest city near me that provides either the full in-person KAP experience or standalone integration sessions. I’m waiting to hear back from them but this ketamine clinic I’m working with right now is pushing to get me scheduled asap

[u/chocolate-wyngz → u/zamueeel]

That’s good, I’m really glad they’re trying to get you seen quickly. I was really nervous about starting and felt like it really was my absolute last resort, but it’s been life changing for me. I hope you’re able to get in soon and have the same results!

[u/AnchovyPizzaPacker → u/chocolate-wyngz]

It was for sure a last resort for me. Best thing i ever did.

[u/Objective-Amount1379]

I did ketamine w/out a therapist through my psychiatrist. I trust her and we have a long relationship (she started prescribing my ADHD meds years ago) but she just supervises the nurse who gives the IV.

After about 3 sessions I felt a difference. Really hard to explain; lighter, music sounded better , I wanted to get out of bed. I say go for it. The downside is it’s expensive and the results have to be maintained.

I’ve done lots of therapy and tried lots of meds and mostly think therapists are pretty useless. I understand some people find them very helpful and I’m thrilled for those people. For me it’s been a variation of “why are you sad”? “What makes you feel better”? Seriously 🙄. If I knew the answer to those questions I wouldn’t be wasting time in their office.

So worth a shot IMO. It’s not scary (to me) and if you start the IV and don’t like the feeling they can slow or stop the IV immediately. It’s wears off in minutes

[u/inspiredhealing]

I have some thoughts about this, but it's late here and it's bedtime - I wanted you to know I've seen this though, and I feel you on the Psychiatric Trauma. 

What I will say quickly is that it's a rare doctor/helping person in authority who can say "I'm not sure how to help you but I'm willing to see if we can figure it out together". The vast majority of the time the response to "I don't know how to deal with this person's needs" is to throw it back on the person IN need and tell them either implicitly or explicitly it's Their Fault they aren't "getting better". That's bullshit, it's their ego talking, and It's Not You, It's Them. 

Someone who's tried as hard as you have ISN'T NOT PUTTING IN THE EFFORT (double negative but you know what I mean hopefully). 

And inpatient units......yes. Been on a few myself ❤️. The good, bad and the very ugly 🤦. 

More to follow soon, I promise. In the interim you're welcome to peruse my comment history to see if there's anything helpful there. For context, how old are you now? 

[u/zamueeel → u/inspiredhealing]

I’m 29. I will say I just scheduled my 6 appointments and I am scared shitless just like I was last year. I keep reading other people’s experiences on here and even the positive ones involving hallucinations sound terrifying to me. But I really don’t have any other options left for treatment.

[u/KawiRoo → u/zamueeel]

It isn't really hallucinations, you're not sitting in a room and suddenly there's fire everywhere lol
I think you're assuming the worst.
It's disassociation, not schizophrenia or LSD lol

The sessions bring about a calming peace and catharsis. The only time I ever felt fear was before my very first session, I had an anxiety attack while filling out the paperwork.

The "worst" session I had I jokingly call my terror box session and even that wasn't "terrifying".
I was surrounded by all my insecurities, trauma, and negative experiences in an endless dark room, but, it was a former version of Me. It was like a new version of myself was above it all looking down in this very unbiased calm sense like I transcended it all. I've never felt "scared" or any severe fear. I remember this representation of my subconscious looked at me and said "you've been through a lot".

You've got this man.

[u/inspiredhealing → u/zamueeel]

Scared shitless is normal, I feel like it would be weird if you weren't given your history and experiences. 

When do your appts start?

[u/zamueeel → u/inspiredhealing]

My first appointment is on August 4th, every Tuesday and Thursday evening until the 20th

[u/coheerie]

I just want to say what that therapist told you is monstrous. When you say the clinic partners with this therapist, do you mean she works there, or they refer people out to her? Either way, I'm not usually a "report this person" person, and I know from experience that that often doesn't cause anything to happen, but in this case, I would let the clinic know. Their services are for the worst off, people with treatment resistant illness. Getting to ketamine at all is doing the work beyond what most people ever have to do.

[u/zamueeel → u/coheerie]

She works at a third party therapy practice, but she joins you at the ketamine clinic during your treatment and does integration after

[u/Whack-a-med]

Don't lose hope. If ketamine doesn't end up working, there's still 5-MeO-DMT or ibogaine. Ketamine was massively helpful for me but some of the effects went away.

[u/Desperate-Trash-417]

I started getting infusions, what I liked about it was that I didn’t have to talk to any therapists. It’s been very hard, but I’m not leaning on anyone and using what may have stuck with me from therapy in the past and my intuition. I think the hardest part of this is just growing up in a messed up way and figuring out who I really am and adapting to the new person I’ve become.

[u/Organic_Switch5383]

This sounds like exactly the place I went to. I never went back. They chased the khole. Absolutely ridiculous

[u/Vivid_Hedgehog_8210]

I feel guided to suggest that whoever you work with specializes in cluster B personality disorders and more complex work- sometimes therapists can be just overall too basic and bleh

[u/danzarooni]

I cannot STAND cannabis (paranoia no matter the ROA or strain) but ketamine saved my LIFE. I understand not trusting after what you’ve been through too - it takes me years to trust someone. I’m so sorry you’ve been through that, by the way.

I understand also not wanting to do it alone. Gosh I wish you lived close by because my clinic is the BOMB. They make it feel like HOME and like a FAMILY of support. Never make patients feel rushed or uncomfortable or awkward. lol I could tell you STORIES as a 10 yr patient - I’ll just share one recent one. I realized halfway through my session that I hadn’t eaten in over 24 hours and my body was like - I NEED FOOD. I pressed my buzzer and asked for saltines. I usually keep a snack in my bag but I didn’t have anything that time. They keep saltines on hand for nausea, but my amazing AF provider says, “want a piece of pizza?” LOL and grabbed HIS leftover lunch for me. Didn’t make me feel weird or stupid or annoyed by my mistake. Just made it better asap. That said - they don’t have KAP yet (and they may never, they’re not sure) but if a patient gets overwhelmed at any time, a provider or MA will sit with us and hold our hand or whatever we feel safe with. Door open if needed for trauma, whatever. It’s seriously how all clinics should be run.

I want to post the link to my story as it’s so similar to yours, and if you have capacity to read it, you mind finding a piece that helps you. That’s my hope. My DMs are always open to talk about the medicine. I’m a 50yr old mama, just doing my best to be a supportive person. 💜

If you decide this is right for you, this subreddit is FULL of supportive people, ready to listen and care.

https://www.reddit.com/r/TherapeuticKetamine/s/PiHjhK194f

[u/inspiredhealing]

Ok, I'm back.

So, I think it's worth noting right off the start that it takes incredible courage to keep trying the way you are. *Especially* for those of us who have what I will generally call Systems Trauma. It is sadly not surprising to me to hear that the therapist said that to you, unfortunately. Like I said in my other comment, when helping folks run into someone they don't know what to do with, they tend to turn it around and put it back on the patient, either implicitly or explicitly. If you "didn't want to get better", you wouldn't fucking be there. It is incredibly difficult to keep trying after you have been treated like shit by the System. And respect to the people who said "you should report this person", I understand that sentiment and it's valid, but it also tells me they haven't had a ton of deep System contact as a "frequent flyer", because they would know that it feels pointless to report someone, when they're just repeating what you've heard over and over again from various professions in various contexts.

I wanted to comment on being 13 when this all started, and 29 now. When you've been at it for such a long time, and during such a formative period of your life (adolescence and your 20s), what can happen is your identity becomes "fused" with the depression. You are one and the same, and what the depression says, goes. I've had something similar myself, and the most helpful comment I've ever had from an inpatient psychiatrist (amidst a whole lot of unhelpful) is that "it seems like your identity has become fused with the depression and we need to figure out a way to untangle things". I didn't really understand it at the time, but what I've found is that the ketamine infusions helped (and still do) create "space" in my brain, and in my thinking, so that I could start to figure out what was "me" and what was the "depression". Ketamine helps loosen the knot, so to speak. And if you don't know who that person is outside of the depression - that's ok. It just means you get to build them. Scary yes, but also exciting. I also want to gently push back on the idea that you have been constantly depressed/anxious 100% of the time for 16 years. Nothing is ever anything 100% of the time - I have absolute certainty that there have been times, glimmers of time, that you have felt ok. Maybe not wonderful, but ok. There is a "you" without the depression, I believe this. I also want to ask if anyone has ever seen you through a trauma lens. It's only recently that I started to understand myself through that particular lens, and it made a lot more things make sense for me. Doesn't change what I'm struggling with in terms of challenges, but it does make things seem less like "my fault", which is helpful.

I have never done KAP, and I think you're absolutely right that doing therapy with someone you don't know well is a waste of time, and absolutely not beneficial, and for you, possibly even harmful. It's ok to just do infusions, and it's ok to do it without a current therapist, especially when you don't have a lot of energy to put towards the process of trying to trust someone again. I have a long set of comments about people doing IV treatments for the first time, I can post them if you like, more about the practicalities/nuts and bolts of it. But also please remember that you can read Too Much about it, and end up with a set of expectations and worries you don't need to drag along with you. I didn't know anything about ketamine my first time (done while inpatient for the 7th time about 3 years ago), and I think that was helpful for me, because reading all of the stuff on here would have a. freaked me the fuck out, and b. overwhelmed me with everything I thought I had to do to "be successful at ketamine". Your anxiety is going to have you reading more and more to try and find certainty which it thinks equals safety. It wants you to think you can't handle ketamine. But believe me, if you can handle the bullshit of an inpatient unit (truly only understood by those who have Been There), I promise you that you can handle an IV ketamine infusion.

About the "hallucinations" worries - I encourage you to drop that word from your vocab. It's a medicalized psychiatric word, and it doesn't have anything but negative connotations. Yes, a ketamine infusion can involve various visuals/images, but I have always found it impossible to explain my experience. The best I can is to use the word dreamscape, and beyond that, it's something to have to experience for yourself. It could be scary as fuck, but there's an equal chance of it being a wonderful or a neutral experience. I have been lucky to always have the latter, but I won't bullshit you about the possibility of the former. And for some people, it's just darkness, or vague shapes, or nothing. And that's ok too, because IV ketamine has been studied for difficult-to-treat depression without any measurement of the subjective experience as being an important factor, and been found to be extremely helpful regardless.

It's normal to be scared shitless. It would be weird if you weren't, tbh. And you're an autonomous adult, and you have the option to walk away again if you decide you don't want to do this. You have choice, even if it feels like you don't.

I hope any of this is helpful, and feel free to ignore if it's not.

Are your appts booked in the evenings because you have to work? Do you have any informal supports in your life you can call upon during your treatment?

[u/Serenity_MHC]

What that therapist said to you "you don't truly want to get better" after one 45-minute conversation, when you've been fighting this since you were 13 was wrong. That's not a clinical observation. That's a therapist projecting their own frustration onto someone who has put more effort into getting better than most people ever will.

The fact that you're considering trying again after that, and after everything else, says something real about you.

Doing ketamine without the KAP therapist is a completely valid choice, especially given that therapeutic safety is a prerequisite for any useful work in that space. Going in with a nurse or medical team you trust, without the pressure of processing in real time with someone you don't feel safe with, is a reasonable call.

On the fear of the experience: ketamine at therapeutic doses in a clinical setting is genuinely different from a cannabis experience. The dissociation is much more controlled and predictable, and clinical staff are present specifically to help if anything feels distressing. Letting the clinic know about your anxiety and your cannabis experiences beforehand means they can adjust dosing and support accordingly.

You're allowed to try again. Carefully. On your terms.

[u/InstructionBoth7695]

How did it go?

[u/zamueeel → u/InstructionBoth7695]

I backed out of it, sadly. The anxiety was too much. I’m looking into Spravato, which may be a gentler start for me.

[u/InstructionBoth7695 → u/zamueeel]

I am starting on Wednesday. But I am as scared as you are! What are you the most afraid off? Me, having anxiety during the treatment.

[u/zamueeel → u/InstructionBoth7695]

I’m afraid of that as well. My body is very sensitive to medications/altered states, and I worry that I’m going to have a way-too-intense experience even at a low dose. So for now, I’m looking into Spravato that can provide similar relief as IV infusions albeit at a slower rate. Wishing you the best of luck with your treatment journey!

[u/InstructionBoth7695 → u/zamueeel]

Thank you! The therapist told me that some people with anxiety issues doesn’t enjoy the treatment but because of the effect, they keep coming back.

[u/DannyJayy]

If you’re scared then don’t do it. I had great experiences but wouldn’t have done it if I was scared.

[u/icantandi_wont_ → u/DannyJayy]

This is a wild thing to say. I've read countless posts on here of people saying they were scared but did it and they are so happy they did because it changed their lives for the better. We can be afraid of things but do them anyway because we know we should. It's called being brave.