When you swallow a vitamin C tab, it doesn’t matter what’s on your mind. You can
believe vitamin C is a waste of time, but your immune system will still benefit.
Whereas other experiences are more dependent on your state of mind.
Suppose you are trying to sit down and eat, but you’re aware your partner is upset at
you. The stress may upset your stomach and cause indigestion. Italian and other
cultures are wise to protect time for meals and pair them with uplifting conversation.
The Italian way of turning meals into a slow ritual helps support digestion. Likewise, in
some sports such as baseball or golf, players go through complex rituals before a pitch
or a swing. The mindset is a necessary ingredient to success.
Finally there are some things that hinge almost entirely on one’s state of mind.
Silence is one of those things. If a friend ignores your text message for two days, what
thoughts come to mind? It is like a Rorschach ink blot. How you respond to silence is
colored first by what’s already in your mind. Prolonged eye contact is another example
of this, and so are psychedelics.
Ketamine is so much like this, that some people report that every session is like an
entirely new experience.
Excessive worry and doubt won’t ruin your ketamine experience. Most people still get
tremendous benefit even in those circumstances. However, you will get the most bang
for you buck if you attempt to trust, let go, and surrender. This is especially true if you
are the sort of person who is prone to worrying you screw things up. I occasionally have
patients who ask the staff every five minutes ,“Am I doing it right?” or who may tell us
“I feel like I’m doing it all wrong.” This sort of person is full of doubt, worry, and thinks
that in order to heal, they have to do something.
Instead, they should approach the experience in a passive state. Like drifting down a
river on an inner tube. “Relax, kick back, and float downstream” is good advice.
If you are one of those worried people, this handout will be very helpful.
We have found the following points to be most helpful:
- Have faith in the medicine.
- Have faith in us.
- Have faith in yourself and your capacity to heal.
- Let go.
- Make your mind a sacred place.
I will discuss each of these below.
1. Have faith in the medicine.
Faith does not contradict Reason, and works with it. However, it goes beyond Reason,
as it often required by necessity. To have faith in the medicine, for most people this can
be accomplished by asking Dr. Cook as many questions as you like, or reading about
ketamine’s effectiveness and safety profile.
There is another, more important way to having faith in this medicine. To heal from
depression many of us must overcome excessive skepticism and doubt.
We can get a mild placebo (i.e. a feel-good) effect from a brand name drug, merely from
its catchy and slick advertising. This is a little gullible, but very common, and it’s a form
of having faith in a drug. But because of the saturated corporate advertising culture we
live in, many of us swing the other direction, and we struggle with skepticism. We also
have a tremendous fear of addiction in our American culture, and we are suspicious of
loving a drug too much.
Skepticism can at times be rooted in trauma, and because of childhood trauma, some
people cannot place much faith in any drug, because a medicine is associated with
trusting a bad parental figure. Such people are prone to nocebo responses… “nocebo” is
a term which means an automatic anticipation of harm. It’s important for such people to
realize that in their healing journey, they are alone, and they and no one else is
ultimately responsible for their healing. Solitude can, for them, help clear away
unhealthy attachments and can free them up from second guessing any trust they might
place in the treatment.
Do not be afraid of ketamine. I have worked with it for many years and it is among the
safest psychoactive drugs. It does not lead to addiction and the side effects it produces
(temporary motion sickness, dissociation) are temporary.
2. Second, have faith in us.
You are safe, and you are in good hands. We will think about your safety more than
you. So you don’t have to.
We know what we are doing, otherwise we wouldn’t be doing it. We are like ground
control at the airport. We take care of everything so that your mind can drift, relax, let
go, and give itself permission to surrender. If you have doubt about us, or our clinic,
express it. Ask us questions.
3. Have faith in yourself.
You possess an inner healing intelligence. Whatever comes up during your session is
exactly what needs to come up. That is to say, you already know the changes you need
to make to heal from depression. You may not be aware of this, but the healing capacity
is inside you already.
It is very common for people to have epiphanies, or shining realizations, right after
ketamine treatments. These epiphanies are a sort of natural wisdom. They feel like
“remembering” something forgotten long ago. It feels like a lost memory because it was
already in you.
Some people expect their healing to have always an upward trajectory, and when it
doesn’t they lose confidence in themselves. But psychedelics have a way of removing
layers and layers from the personality, and there are positive and negative layers there,
and sometimes people get a worse mood after some treatments. However, what I have
seen is that even though the mood may worsen, the mood tends to change (or recover)
more quickly than it did before. The person becomes more flexible, expressive, less
numb, and, although sad, more resilient, which is how we all were originally as
children. Instead of becoming depressed, children tend to suffer, cry it out, and then
adapt and recalibrate towards happiness.
This original state of mind is naturally happy, curious, and spontaneous.
For those that experienced a lot of trauma during childhood, ketamine may cause a
feeling of vulnerability which is difficult to tolerate. It is helpful to re-learn to tolerate
the feelings of extreme vulnerability. This, in itself, can be quite healing. We have a
guide to help you through that.
If you are tortured with hopeless ideas, e.g. that you can’t do it right, that you are
cursed, or that you are a hopeless case, consider the following: depressed people often
feel as if their sufferings are so rare, so special, or so unique that healing is impossible.
Depressed individuals will cherish these thoughts as if they are the only thing that is
true. But notice that no children talk this way. This kind of unique or “I’m an extreme
case” talk is a maladaptive response that comes from being wounded. No happy person
thinks their happiness is unique but almost every seriously depressed person does think
this… To heal, you must eventually let go of that idea. Your sufferings are not as unique
as they seem. “Uniqueness” always isolates people. This is part of the isolation of
depression. As you heal you must find a way to stop believing this. I cannot tell a
patient when or how to stop believing this, but as soon as they do, I can tell a difference.
There is less gravity to the personality, and the mood improves drastically.
“Angels fly because they can take themselves lightly.” – G.K. Chesterton
4. Let go.
The word “surrender” isn’t used today very positively.
To “lay down your guns” may be a better way of putting it. The guns are the critical and
harsh negative self-talk that you may be dishing out to yourself, perhaps all day long.
Letting go of this causes an immediate improvement in mood.
Ketamine puts people into a hypnosis, or trance state, in which the mind’s control
valves are released. Most people are able to let go, and do just fine at this.
This is not an achievement you must work at. In fact, the more we think of relaxation as
an achievement the harder it is to relax. “Whatever you do, do not think of a pink elephant.”
It is impossible… so long as it is put in those terms.
Again, you are not here to “do” anything during your treatment, but merely let go,
trust, and follow the experience.
When some people try too hard to meditate, they are not actually meditating. They are
only thinking about themselves meditating. This gets in the way of actual meditation.
We live in a culture of hyper-reflection. It is one of the reasons we have so much
depression. We have a compulsive need to think, and to think about ourselves thinking,
and to think about that… and so on. Like being stuck in a hall of mirrors. When we are
confronted by anything that draws us out of that hyper-reflective whirlpool, like a
beautiful cathedral, or a ride at Disneyland, our first impulse is to reach for a camera,
rather than to simply live in the moment. A photograph will usually diminish the
Luckily, dreams cannot be photographed, and it is difficult to analyze a dream. This is
perhaps one of the purposes of dreaming: to relieve prolonged sadness by leading us
out of the control aspect of the wakeful conscious mind. In dreams, we relinquish
control, but it is this vulnerability which makes sleep restorative. Again, to fall asleep is
to let go, and ketamine is no different than that. Except that with ketamine, you are still
very much awake.
5. Make your mind a sacred place.
“Sacred” is a difficult word today because our society is a religious melting pot.
But most people would agree that life is sacred, or that something about their existence
is mysterious or sacred. This can be thought of as a very practical and down to earth
Perhaps we can get at its meaning by saying what it is not. People would not store
diamonds and pearls or other precious jewelry together in a drawer with paperclips and
scotch tape. We all instinctively feel a need to set apart things of great worth, so they
aren’t mixed with objects that are replaceable.
Consider that your mind and soul are things of great worth, like a priceless diamond.
Yet your mind is assaulted everyday by garbage info, advertising, social media, and
other worthless stuff. Sooner or later there is no room for anything else. You may begin
to feel like you are the sum of that garbage, i.e., of low worth.
To restore your mind as a sacred place, consider that most thoughts are socially
contagious, (just as despair and suicide can be socially contagious) but once certain
thoughts are inside of us, they seem to have originated in us. They do not come from us,
and they devalue us, but we grab onto them like a hoarder who lives in a mountain of
garbage and never throws anything away. If we identify with every negative thought,
we become like the person who feels empty after watching TV advertisements, because
they agreed with every advertisement.
Your mind is like a living room, and your thoughts are like furniture. Make your mind a
comfortable place to live in.
Who would put an horsehair couch, or a bed of nails, in their living room? Some
thoughts are disturbing to our self esteem, but we still entertain them. Thoughts can be
like rude, unwelcome visitors. For example, “I can’t make any friends” is a rude thought,
like a friend who waltzes into your mind and tosses himself, all sweaty, on your favorite
recliner. Later he invites the thought “it’s no use, I made a big mistake and ruined my life” to
come over, who eats out of your fridge. Finally “my life is just not worthwhile” comes in,
and stamps muddy shoes all over your rug.
In depressed people there is a tendency to give high value to these rude thoughts. And
to be overly attached to them. Even when they harm us. That is the essence of
depression. To be overly invested in, and identify with thoughts that demean ourselves.
Pardon me for saying it, but the best perspective towards most of our thoughts, is to
think of them as burps or farts. Like a burp or a fart, they aren’t important, don’t need
to be taken seriously, and make no sense. Like a burp or a fart many of them are useless,
unwelcome, and unannounced. I have time and again seen psychedelics help depressed
people get rid of the over-investment in their thoughts, to detach from thoughts, to see
them as not necessarily an intrinsic part of what is YOU… and I have seen psychedelics
teach people to be more playful and less serious in the way that they think.
Any perverse sense of pride and private personal attachment to our own thoughts, is
often something that needs to be done away with.
I have given a lot of advice here. If it is useful, remember it. If not, forget about it.
Remember, finally, that we are there for you, and we have great confidence in your
ability to heal.