Psilocybin, or magic mushrooms as they’re more colloquially known, have been at the center of discussions on psychedelics since the first conversations happened. Psilocybin, the active ingredient in magic mushrooms, was one of the first classical psychedelics to be properly introduced to the West. This came after amateur mycologist R. Gordon Wasson’s visit to the curandera Maria Sabina in Mexico several decades ago.

The LIFE magazine article sparked conversation in many circles, with some individuals going off for their own experiences, and some starting to look into the West’s own historical and traditional use of psychedelic compounds.

In the clinical context, psilocybin has also made a name for itself through its efficacy in treating a host of conditions and ailments, as has been documented since psychedelic therapy studies first began. Psilocybin was used in the classic “Good Friday” experiment, the landmark smoking cessation study, and the mystical experience & psychedelics study. Psilocybin has a strong recreational, mystical, and clinical history behind it —and for good reason.

In this resource, we’re going to explore the subtle yet profound distinctions between ketamine and psilocybin, including the neurobiology of the compound and the phenomenological differences of the experiences.

Exploring Psilocybin

To begin, it’s worth noting that possession or use of psilocybin is currently illegal in most of the world.

As they are more commonly referred to, magic mushrooms are a Schedule 1 substance as classified by the U.S. Drug Enforcement Agency (DEA), which means they are not formally recognized or approved for medical value, among other designations. Despite its DEA classification, the U.S. Food and Drug Administration (FDA) has designated psilocybin as a “Breakthrough Therapy,” an expedited approval process, which in the case of psilocybin is evaluating treatment for major depressive disorder (MDD) and treatment-resistant depression.

Psilocybin has become a central point in the discussions around psychedelic therapy and psychedelic medicine, largely due to its ability to systematically and reliably induce a psychedelic experience in an individual. Mushrooms do have some physiological benefits to them, but the true value of the experience for individuals seeking psychedelic therapy with psilocybin is the mental and emotional healing that it seems to accommodate.

The psilocybin experience itself is longer than other medicines like ketamine or other psychedelics like MDMA, generally lasting for about six to eight hours depending on the individual and the dosing protocol. Effects typically onset at about 45 minutes to one hour after ingestion, and booster doses are rarely used in practice.

A full psilocybin experience tends to include many of the classic hallmarks of a psychedelic experience. This includes distortions of time and space, out of body experience, an ineffable quality, noetic importance, and levels of visions, visuals, or hallucinations that accompany the subjective experience. In general, though not always, psilocybin experiences tend to focus on the natural world: the body, the environment, the people, and the planet. This is more pronounced than what is reported in a DMT (N,N-Dimethyltryptamine) or LSD (lysergic acid diethylamide) experience, for example.

Psilocybin is often favored over other compounds like LSD in psychedelic therapy protocols due to the length of the experience. Whereas LSD experiences can be upwards of 10+ hours for the full experience, psilocybin/magic mushrooms tend to run about 6 hours for the complete experience. This accommodation helps the clinicians and researchers better accommodate and facilitate these experiences.

This is in juxtaposition to ketamine, where the experiences are often 60-90 minutes in length, with a rest and comedown period afterwards. While the ketamine experience does contain many similarities to the psychedelic experience, psilocybin experiences do not always provide the same level of dissociation as ketamine. This distinction can be important for the future if psilocybin becomes legally available to clients.

Psilocybin’s Effects in Comparison to Ketamine

As a classical psychedelic compound, psilocybin acts most directly on the 5HT2A serotonin receptor in the brain. This is largely responsible for the phenomenology of the experience, though there are other neurobiological mechanisms present in the psilocybin experience.

To a lesser extent, this includes increasing the presence of dopamine in the basal ganglia, while also inducing some region-dependent alterations in glutamate levels, which may contribution to the ego-dissolution experiences that are common with psilocybin and the psychedelic experience.

One of the core neurobiological correlates that happens with psilocybin is the dampening of the Default Mode Network (DMN). This also happens with ketamine. This is a significant neurobiological feature because the DMN generally creates the sense of self in the present moment. As activity here begins to quiet down, the subject-object distinction that most people live within begins to dissolve. A sense of merging with the world, or a more expansive sense of Self shines forth, and this brings in itself a level of healing and peace that is prominent in many client stories.

In some of the early psilocybin studies, participants rated the psilocybin psychedelic experience as one of the most important experiences in their entire lives, alongside their marriage, or the birth of a child.

Alongside the neurobiological effects, there are several physical effects that come from ingesting psilocybin:

• Pupil dilation
• Changes in heart rate (increase and/or decrease)
• Changes in blood pressure (increase and/or decrease)
• Nausea
• Tremors
• Increased energy levels

This presents many of the classic contraindications that would be present for individuals working with ketamine or other psychedelic medicines. A mental health screening, and a physical screening that include but are not limited to heart health and blood pressure are essential to ensure the safety of clients and efficacy of the experience.

One of the largest benefits to working with psilocybin are its low toxicity levels. Psilocybin’s LD-50 —the active dose that would be fatal to 50% of the population— is low compared to other compounds: 280 milligrams per kilogram (mg/kg). Heroin, alcohol, marijuana, caffeine all have higher LD-50s. Psilocybin is matched in its low toxicity by LSD. It also has low possibilities for dependencies to form, despite the current Schedule 1 classification from the FDA.

With low dependency potential, and given the psychedelic experience’s ability to assist individuals working through addictive behavioral patterns, psilocybin seems positioned to be net-beneficial for individuals dealing with substance use disorders. Though more research will need to be conducted to demonstrate this.

Psilocybin Phenomenology

The phenomenology of the psilocybin experience aligns very closely with the hallmarks of a classical psychedelic experience. Indeed, it was through the use and study of psilocybin experiences that the original characteristics of a psychedelic experience were able to be distilled.

As everyone’s experience and healing process is unique, these may not apply to all individuals in all circumstances. Some broad categories or types of experiences are common in the psilocybin experience are:

1. Space/Time Distortion: The individual perception of space and time may distort or become unintelligible.
2. Ego Dissolution: A calming of the ego as the center of identity. A sense of merging with the environment.
3. Visions/Visuals: Geometric patterns, color gradients, or visual illustrations may occur while eyes are closed.
4. Entity Encounters: There can be a distinct experience of interacting with entities/beings that are not the individual.
5. Ineffable: It is extremely difficult to put in words and language what happened in the experience and why it was meaningful.
6. Noetic Quality: A sense of accessing a “more true” reality, or a world/knowledge that was previously inaccessible in regular waking consciousness.
7. Cognitive Distance: A sense of distance from the individual’s thoughts, identity, and body. Taking a 3rd-person perspective or getting a “view from above.”

The combination of these characteristics is what often generates the meaning and significance of the psilocybin/psychedelic experience. Clients have a direct, embodied experience of a new way of viewing themselves and the world. They may receive insights into personal patterns or traumas, and be able to reframe their life and tell themselves a new story moving forward.

This ability to rewrite narrative views of self, others, and the world is a profound potential present in all psychedelic therapy. When paired with trained clinicians and skilled practitioners individuals are able to make significant progress on their healing journey with the support of these compounds.

Important Differences Between Psilocybin and Ketamine

There are several distinctions that can be drawn between psilocybin and ketamine as psychedelic medicines. However, it’s worth noting that both are powerful in their own right.

Both have strong scientific and clinical evidence supporting them, and both compounds have countless client stories that demonstrate the healing and supportive power of these experiences.

When drawing distinctions between psilocybin and ketamine, there are a number of key differences.

Legality

Ketamine is a Schedule 3 substance as designated by the DEA and is available for on and off-label prescription. Psilocybin is currently Schedule 1, and is not available for prescription. However, there are studies moving through FDA clinical trials right now to make psilocybin a legal and accessible medicine.

Length of Experience

Psilocybin experiences can be significantly longer than ketamine experiences. Ketamine experiences tend to last around 90 minutes including a “landing” period as the medicine slowly dissipates, while Psilocybin tends to last several hours with a comedown period. This impacts accessibility for clients, and is a more significant undertaking for clinicians and facilitators who assist in the experience.

Mechanism of Action

There are neurobiological differences between the compounds and how they act. Psilocybin is largely active on the serotonin 5HT2 receptors, while Ketamine is most active in the glutamate system.

Matching Individual Needs

Depending on the condition and the individual, sometimes a more dissociative experience is needed, in contrast with a more mystical experience.

Ketamine has the distinction of providing a dissociative experience, whereas psilocybin does not as reliably induce this state. In the future if psilocybin becomes clinically available, matching the medicine to the individual’s needs will become more and more central in the discussions.

While there are several core distinctions to be made, at the time of this writing ketamine remains the only legal and accessible option for individuals seeking psychedelic therapy immediately.

There are several promising studies underway at various stages of the approval process for psilocybin, but this requires more time before it becomes clear what conditions psilocybin can be used for and whether it becomes a legal medicine.

Conclusion

There is hope that psilocybin can become a legal and available psychedelic medicine for individuals in the near future. Several studies addressing depression, eating disorders, smoking cessation, and other conditions have been conducted or are currently happening —and the early results have been promising.

There are several major institutions and organizations currently working on standardizing treatment care plans for psilocybin therapy, and the future looks bright for this medicine and treatment option.

Psychedelic therapy is gaining momentum, it is building legitimacy and proving its efficacy with each new client that works with it. The introduction of additional medicines like psilocybin, LSD, DMT, or MDMA can help expand the options available to clients while helping address the exact conditions and concerns each client has.

You’ve made the decision to move forward with a ketamine therapy treatment. You may have explored the importance of set and setting, and have a sense that you’d like to have your experiences in an environment that is conducive and welcoming, with trained practitioners and clinicians present. The job now is to find a ketamine clinic that is safe, accessible, and can provide the style and quality of treatment that you want.

Where do you begin? How do you identify the clinics and the practitioners that are best suited to help you on your journey? It’s not always straightforward, and finding the solutions that fit best for you is an important part of this process.

This article will explore the process of vetting ketamine clinics and ketamine practitioners, to help ensure your personal safety, program efficacy, and strength of the experiences.

Deciding on IV/IM Clinic or At-Home Ketamine Treatment Methods

The first step is to ensure and confirm that you have selected the correct style of treatment for you. Sometimes decisions are made simply because you don’t know that other options are available. It’s important to have a complete sense of the landscape and all of the available options before choosing something to move forward with.

We have covered the types of ketamine treatments currently available in great detail, including IV (intravenous) infusions, IM (intramuscular) injections, tablets, and nasal sprays. We suggest reviewing that resource to ensure that you are selecting the option that best fits your lifestyle, available price range, and has the level of support, care, and integration guidance that you require or expect to have.

The next choice is whether you’d prefer to receive treatment in a clinic or in the comfort of your own home. Platforms like Mindbloom offer the ability to receive treatment anywhere virtually, provided you’re in a qualifying U.S. state. You can determine if you’re a Mindbloom candidate by taking our free assessment.

Regardless of your decision to receive treatment at home, or head into an in-person clinic, the next step in this process is identifying quality practitioners and quality clinics to provide this treatment.

Identifying Quality Ketamine Practitioners

Throughout your experience you will be working directly with a licensed, trained, and experienced practitioner/clinician. If you’re unsure of the qualifications of your care team, we recommend confirming this before taking any further treatment steps.

How do you understand these qualifications, areas of specialization, and the scope at which the care team is available for assistance before, during, and after your individual dosing sessions?

There are a few factors that go into determining the quality and appropriateness of the practitioner for you.

Education or training

First, you want to ensure that they have an adequate level of education and training in ketamine treatment or therapy to be helpful.

You will want to look at education and depth of study, such as with Psychiatric Nurse Practitioners (PNP’s) or Certified Physician Assistant (PA-C), that are currently licensed and able to provide therapeutic ketamine administration.

Experience with medicine

Second, you want to ensure that they have experience with ketamine treatment. They should have experience providing ketamine treatment for others in order to adequately hold space and provide support in times of need.

Given the nature of the ketamine experience, knowing that your provider has gone through this experience is essential to build trust and rapport in the client-clinician relationship.

Compatible frameworks

It’s highly beneficial that you both share compatible mental frameworks and understandings of how this treatment works, what is important about it, or how the healing process works.

It can be challenging and confronting and erode trust and safety if you find out that you differ greatly on ideology and principles half way through treatment. Asking to learn more about why they do this work and how they approach their work is not something to overlook in this exploratory research process.

Available support level

You must personally determine or decide on the level of available support that you would like from your clinician throughout the treatment process. Does the clinician work with a team that will help you integrate and process your experiences?

Do you expect the opportunity for integration conversations, ability to contact them after dosing sessions for conversation, or otherwise? While this type of support is available with Mindbloom, this is not a service that always comes included in ketamine treatment at in-person clinics. You should know what you expect/want from your clinician during your treatment program, and ensure that they have the capacity and willingness to be able to provide this for you.

The client-clinician relationship is the bedrock of ketamine treatment, and ensuring that you have found a clinician that you are happy with, have trust and rapport with, is an essential component of this process.

Identifying Quality Ketamine Clinics or Online Treatment Platforms

While at-home treatment options like Mindbloom give you control over your own mindset and physical setting (Set & Setting), if you’ve chosen to visit an in-person ketamine clinic, it’s helpful to investigate the clinic they work at and the space that you will be having your sessions in.

Different in-person clinics may have different standards. They may have different resources available to and for you, and so exploring this in further detail will help cement the trust you have going into this process. With Mindbloom, your Guide can help answer any questions about available resources or the process, and lend extra support if needed.

Some factors to look for in ketamine treatment via telemedicine or in-person ketamine clinics:

Following Regulations

First things first, always ensure that they follow regulations. This includes patient-doctor confidentiality agreements, payment protocols, or if you’re seeking in-person treatment, cleanliness and sanitation. These may seem minor, but friction or confusion or distrust leading up to your dosing sessions can have a significant impact on your experience and quality of care. Attention to detail matters.

Welcoming Space

If you’re considering an in-person ketamine clinic, is the space welcoming for you? Does it have the atmosphere and the resources that you would prefer? Knowing where you will have your sessions, what the space is like, and what is included are all important factors that go into establishing your Set & Setting for the dosing sessions.

If you’re choosing at-home treatment with Mindbloom, your Guide can make recommendations on how to make your space and ambiance as comfortable as possible.

Integration Areas

After your in-person treatment concludes, is there a space that you can stay within after your dosing sessions for rest and recovery? Being asked to leave quickly after the sessions while partially under the influence of the medicine can be disorienting, unappealing, and even dangerous. Ensure that there is space and breathing room for you after the dosing session to allow yourself to acclimatize to your environment.

Dosing Methodologies

What are the specific dosing methodologies that the telemedicine platform or clinic uses and follows? How do they determine your dose amounts? Do they refer to your previous historical treatment and medical data to determine this? Where do they receive their medicine from? These questions are part of good due diligence, helping you feel confident in your decision.

These two critical components — quality clinicians working within quality clinical settings — are absolutely fundamental to the safety, quality, and efficacy of the ketamine treatment you will receive. If you can be confident and feel secure with these decisions, you are in good hands for powerful healing experiences

What to Ask

If you’d like to go through this vetting process before starting your own ketamine treatment program or protocol, there are some questions that you can and should be asking before starting:

• Where did you receive your training and education?
• How many treatments have you administered and facilitated before?
• How do you determine dosages?
• What does the treatment protocol look like?
• Is there preparation or integration support included with this?
• Why do you do this work? How do you approach the healing process?
• Can this treatment work with my existing medical insurance policy?
• What are the costs associated with this treatment?
• Do you personally have any concerns with my medical history or any aspect of working directly with me?
• How could I best assist this process to ensure safe, effective, and powerful experiences?

These questions are good starting points to conversations that you will have with your telemedicine platforms or clinics, and their clinicians, while starting the client intake process. These should help you cover the significant bases covered in the earlier sections.

A reminder: If there is anything in particular that is confusing or concerning to you, raise this as soon as possible. The more information that all parties have, the better. This allows you and your care team to make the best possible decisions for your treatment plans and program protocols.

How to Get Started

Armed with this information and the appropriate questions, you can begin finding telemedicine solutions or ketamine clinics near you, or clinics/clinicians that you would like to work with.

There are several resources to find these options, and many of the questions above are usually addressed directly on the website or with an introductory phone call.

If you are looking for an at-home ketamine treatment solution or ketamine clinic near you, consider these steps:

• Direct Referrals: A great place to start is a referral from somebody you know and trust who has gone through treatment at that location. This helps you ensure a level of care and quality directly, from a trusted source.
• Local Online Searches: If you don’t choose an at-home ketamine treatment experience, searching for ‘ketamine clinics in X’ —where X is your particular region, will surface a list of nearby clinics. As always, just because a clinic is close does not guarantee that it will be the best fit for you. This is where your screening questions and due diligence steps will be important.
• Online Directories: Ketamine treatment is an established practice, fortunately there are many available telemedicine options and clinics providing this treatment, and a number of online directories exist to help create single sources of trusted resources for you. Some of the directories include: Ketamine Clinics Directory, Ketamine Directory, ASKP, Ketamine Academy, and Ketamine Therapy USA.
• Personal Clinicians: Another opportunity you have is to speak directly with your personal clinician. Let them know that ketamine treatment is something you are interested in pursuing, and ask them if they have any recommendations or resources they can share with you.

The challenge and opportunity of working with ketamine platforms or providers isn’t the lack of available options, it’s simply finding the one that will work best for you and your specific circumstances. Using the information and questions above, paired with the online directories or resources from trusted parties gives you both the resources and the skills needed to find and vet the best option for you.

Conclusion

The decision to move forward with ketamine treatment is a beautiful step and act of self-love. Because ketamine treatment can be so powerful, it deserves a level of respect and due diligence on the part of the client.

Doing your homework, determining your needs and wants, and working alongside the clinics and clinicians to arrange this will help ensure your personal safety, your program efficacy, and help to facilitate powerful healing experiences for you. Enjoy the process, and here’s to your healing.

‍Disclaimer: This article explores a highly sensitive topic involving the tapering off of or weaning down certain mental health medications with the assistance of ketamine treatment and psychedelic therapy. Never make decisions like this without first consulting your clinical team that manages your mental health medications like: a primary care provider, psychiatric clinician, and psychedelic/ketamine therapy care team.

At Mindbloom, there are many clients who throughout their healing process in ketamine therapy state that they are feeling very good —sometimes better than ever before— and are curious about the possibility of tapering down, or discontinuing, the existing prescribed psychiatric medications they’re actively taking alongside the treatment.

With increased and adequate support, through the responsible use of psychiatric best practices and supportive techniques, it is possible to taper off of medications. This can result in either lowered dosages of existing medications, or the complete cessation of certain prescriptions. Though this is in the realm of possibility, it is a highly individual process and may not be appropriate for everyone.

This resource explores when tapering or cessation may be appropriate, and what the specifics of this process may look like. As always, if this seems resonant with your own interests, the first step is always consulting your current care team and bringing this topic into your healing discussion.

Tapering vs. Discontinuing Medications

It is seldom appropriate to immediately stop using any or all of your existing psychiatric medications —known as going “cold turkey”, particularly if you are feeling calm, strong, and happy. If a change needs to be made, the process of slowly tapering down or off of existing medications, guided by your care team, is the more appropriate route.

The process of tapering down medications can be challenging. Anti-depression or anxiety medications like selective serotonin reuptake inhibitors (SSRI’s) have a significant impact on your neurochemistry. Altering the specific balance of these neurotransmitters can instigate or bring back many of the symptoms you’ve been working to address, such as depressive tendencies, feelings of anxiety, mental fog, and potentially more serious symptoms such as suicidal ideation.

That said, some medications can also bring along side-effects such as drowsiness, lethargy, mental fog, depression, lack of appetite, or other effects that are generally undesirable —yet tolerated— because the net benefit of taking the medications outweighs the accompanying side effects. However, if an individual experiences deep healing and is feeling significantly better, it is understandable that the desire to taper off of some medications and find relief from the side effects that may arise.

Due to the complex nature of tapering off of psychiatric medications, this is a long process, and it is not always linear in nature. There can be significant periods of time staying and adjusting to a lowered dose before then continuing to taper the dose down. This should be known and expected when entering into this process.

Fortunately, when working alongside a care team, if you do notice the resurgence of any adverse effects, you can also address this by slowly returning to a suitable dose that addresses these issues. There are steps you can take to reverse any effects, which can help build trust and confidence in the process, knowing that you can simply return to where you started if anything comes up.

Utility & Durability of Ketamine Experience While Evaluating Medications

There are many reasons why ketamine treatment in particular is useful in the process of tapering or discontinuing psychiatric medications. It has to do with the phenomenological and neurobiological effects of ketamine treatment and the durability of the experience even after the dosing session has passed.

Neurobiological effects

There are many resources that explore the beneficial neurobiological (physical) effects of ketamine in more detail, but the primary area of focus is that ketamine can have positive effects on the brain itself: increasing the overall health, growth, and resiliency of the brain.

Ketamine can facilitate this process through a few mechanisms:

• Upregulating Neuronal Production: Ketamine increases the production of new neurons, supplying the brain with healthy and vital neurons, the basis for more effective and harmonious connections in the brain.
• Upregulating Release of BDNF (brain-derived neurotrophic factor): BNDF, colloquially referred to as ‘fertilizer for the brain’ helps promote neuron growth, overall health, and ongoing maintenance. Providing both short and long-term benefits.
• Stimulating mTOR: mTOR regulates many processes involved in cell growth and healing worn out synaptic connections, and also stimulates activity/growth in the prefrontal cortex and hippocampus, essential areas for emotional regulation.

This means that over time, ketamine can help increase the overall health and resiliency of the individual brain — helping an individual regulate their emotions, create new behavioral patterns, and maintain this new baseline health in the long-term.

Phenomenological effects

Alongside the neurobiological benefits, ketamine also presents immediate and long-term phenomenological effects, or mental / emotional effects.

Some of the phenomenological benefits include:

• Novel Insights: With dissociation comes a sense of being separate from yourself. With this perspective individuals can spot certain behavioral patterns, environmental triggers, or see how they act in a new way. These insights can catalyze short-term respite or long-term positive behavior/mood change.
• Embodied Feelings: The ketamine experience can induce a number of embodied emotions/feelings. For those with depression, having an embodied experience of calm, joy, contentment, or elation can be a powerful reminder or positive reinforcement that these states are possible for them. This can change long term outlooks and actions.
• Cognitive Distancing: Both during and for a brief window after a ketamine session, it’s possible that individuals may notice more ‘space’ between an external stimulus and their internal reaction to it. This space can provide the room to change behavior, remove automatic self-sabotaging habits, all of which are valuable in managing depression.

This combination of neurobiological benefits and significant phenomenological experiences creates a favorable context for individuals to feel better and move closer towards healing and wholeness. This experience in clients often creates the circumstances that lead them to begin questioning whether or not its possible to taper off of or discontinue their psychiatric medications.

This is paired with what is called the “durability” of the ketamine experience, in which these benefits are not only experienced within the dosing session, but can last for upwards of 7-10 days after a single dosing session.

If a comprehensive tapering schedule is paired with a ketamine therapy protocol, the positive benefits of ketamine treatment can help equip an individual to better handle the direct and side effects of tapering off of psychiatric medications.

Building Self-Support Skills and Resiliency

One of the important points in this process is that all of this work must be paired with the intentional act of building the skills and personal resiliency that can carry on and support the individual beyond any use of medication.

One of the most important components to a successful tapering program will be in actively building the skills and resiliency to support individuals in times of challenge, unexpected events, or when setbacks occur.

Some of the skills that can be helpful to cultivate are:

• Contemplative/reflective habits and rituals for continued growth and insight
• Emotional regulation techniques
• Somatic, body-based techniques for stress reduction
• Cultivating deeper relationships and communities of support
• Creating a welcoming and warm living environment
• Working to overcome any addictions or self-sabotaging behavior
• Asking for support when challenged
• Understanding the integration process for psychedelic therapy
• Moving towards meaningful work, authentic connection, and rediscovering joy and play in their day-to-day life

If the individual can build these skill sets, alongside the positive effects of ketamine treatment (like reduction in anxiety and depression symptoms), they are in good shape to begin the process of tapering. The ketamine treatment can give the support needed to help the process, while the increased confidence and skills ensure that the individual has what they need to better handle what life throws at them in the future.

This is where ketamine treatment and effective integration of the psychedelic experience from the dosing sessions become a very powerful asset for the individual. They are creating an adaptable, healthy brain, putting themselves in a neuroplastic state to adopt new patterns of behavior, and building skill sets for resiliency and growth for the long-term future.

Sensitivity & Working With Care Team

It is easy to read this and make the assumption that this is a straightforward and simple process. In some individuals that may be the case, but it’s not an assumption that can be granted as a natural part of the process. This is highly sensitive work, and must be done while working alongside a seasoned, well-trained, and compassionate care team.

Investigating resources for mood regulation, stress management, and psychedelic integration are assets to the process. Also, working with a licensed therapist to help process the experiences that are happening is also helpful for individuals making this change.

Despite the sensitive nature of this work, it feels important to say that although challenging, it is possible for some individuals to successfully taper down their psychiatric medications, or discontinue some of them entirely. It is always a unique process, and no result is guaranteed, but it is possible.

If individuals are prescribed psychiatric medications to help them cope with symptoms of anxiety or depression, and the individual is able to reduce these symptoms, and build the skill sets to help them manage their health moving forward, it stands to reason that they are then in a position where the psychiatric medications may no longer be necessary. They have served their purpose as a critical support in a sensitive and challenging time, and the individual can now embark on the process of slowly and intentionally weaning off of these medications.

Taking Control of Your Health

This work can also be an empowering step for many, as it is deeply rewarding to take full control and ownership of your mental health and your engagement with life.

This perception of renewed empowerment and possibility can also be a significant healing force for many individuals going through this process —reconnecting with their own innate power and possibilities in life.

And as responsible care providers, this is what should be desired for clients: making progress towards their own healing and return to wholeness. A return to their happiness, their power, their meaning, and their deep engagement with life.

If medications are required to assist that process, wonderful. It’s amazing that modern science has come to a point where that service can be provided. And if the next step on their journey towards wholeness is now an attempt to move away from the support that they once had, to stand once again on their own two feet, this decision requires and warrants serious care, consideration, and conversation. With the guidance, wisdom, and expertise available of course, but also honoring the individual’s request to take full control of their health once again.

Conclusion

As mentioned, this is highly sensitive work. Never make a decision on these topics without first consulting your medical care teams and practitioners so that you have the support and guidance necessary. It is a reality that this process may not be possible for everyone, and it may not be a positive move towards others.

This is why it must be done with attention, with full awareness of the positive and negative potentials, and with the support and care of experienced practitioners.

With this said, ketamine treatment can present an opportunity for some individuals to attempt to taper off of existing medications, and for many reasons creates a favorable environment to do this sensitive work within. Whatever you choose, may it be for your health, healing, and wholeness.

Ketamine therapy is coming to the forefront of the psychedelic medicine conversation, over other classical psychedelics and compounds.

While it’s increasingly becoming recognized in the mainstream over other options, ketamine therapy has a number of factors that are putting it at center stage in the world of psychedelic medicine. Kristin Arden, psychiatric nurse practitioner and Lead Clinician at Mindbloom, helps explain some of the components that make this treatment option so promising.

It’s Already Being Used in Medical Practices

For decades, ketamine has been used in a clinical setting for anesthesia and to help treat pain. As a result, there’s plenty of science that validates the safety of its use in a medical context.

“In thinking about treating off-label, for things like depression and anxiety, we have a medication that’s scientifically validated as being safe,” Arden says. ”We have a large body of research that has validated its safety for treatment indications that often require higher doses than we typically use in a mental health setting.”

Medications face a lot of barriers before they can be accessed for general use. They go through an extensive review process by the FDA and are scheduled by the DEA. Ketamine is scheduled by the DEA as a Schedule III controlled substance, which is defined as “drugs with a moderate to low potential for physical and psychological dependence.” Some examples of Schedule III substances are anabolic steroids, supplemented testosterone, and pain-relief products containing less than 90mg of codeine.

At this time, other psychedelics such as psilocybin (mushrooms) and MDMA are classified by the DEA as Schedule I, which by definition means drugs with no currently accepted medical use and high potential for abuse. This is despite the fact that those compounds are currently in various phases of FDA trials for their medicinal applications.

“The regulatory barriers for utilizing ketamine in the treatment of mental illness aren’t there as they would be with other substances at this time,” Arden says.

The FDA already has indications for the use of ketamine for treatment of conditions like treatment-resistant depression and depression with suicidality.

Ketamine has a Relatively Short Half-Life, Which Means Quick Recovery

When you are treated with ketamine, the acute, disassociating effects wear off quickly, and the side effects dissipate rapidly as well. When comparing ketamine to other psychedelics available, the more acute phase of the ketamine treatment generally lasts about an hour. Generally, it takes about three hours after someone who has done the treatment to return to their baseline mental status and physical status.

This is significantly shorter compared to treatments with other psychedelic compounds, which can last anywhere from four to eight hours during the acute effects of the medicine, followed by a much longer recovery time.

“When we think of ongoing maintenance treatment, or a course of several treatments for conditions like depression and anxiety, ketamine is really on the up side of that, just based on sheer time commitment or time burden for the individual,” Arden says.

It also doesn’t have lingering effects, so you won’t need to take time off to recover from the treatment process.

It Doesn’t Interfere with Traditional Treatments for Depression / Anxiety

Another promising aspect of ketamine, especially those using it for depression and anxiety, is the way it works neurobiologically.

Unlike SSRIs and SSNIs, which are active in the serotonin pathways, ketamine works through different brain receptor pathways, known as the NMDA (N-Methyl-D-aspartic acid). Other substances like LSD, psilocybin, MDMA/ecstacy have a very high serotonin burden. This means there’s more potential for drug to drug interactions.

For example, if someone on Prozac wanted to try psilocybin to help treat their depression, they would have to taper off their antidepressant treatment, as there would be risk of serotonin syndrome. This is a life threatening condition that can lead to extreme nerve activity and dangerous symptoms like confusion, agitation, and heart arrhythmias. With ketamine, there isn’t that risk, since it works on a different neurotransmitter and pathway of the brain.

“For people who are on antidepressants, they may feel 50 percent better,” says Arden. “Ketamine works really great as an adjunct, to add on, to treat that other 50 percent.”

It has the Potential to be Affordable

While it’s not clear how accessible ketamine will be in the future from a regulatory standpoint, there’s a good chance that it will be a more affordable option than other psychedelic medications. Arden suspects that once synthetic versions of psilocybin hit the market, they will have the potential to be pricey.

However, while there is a relatively expensive ketamine product currently on the market —ketamine-derived nasal spray Spravato for treatment-resistant depression— generic ketamine is already being used in many practices, such as through Mindbloom.

“We have generic ketamine that we can use, and that significantly reduces the price point in that it’s already in that generic group of medications, as far as classifications go,” says Arden.

It has Fewer Barriers to Treatment

There’s a lot of steps to follow when prescribing a drug like Spravato. It’s logged into the drug safety program, Risk Evaluation and Mitigation Strategy (REMS), which the FDA requires for many medications with safety concerns. This is to help make sure the benefits outweigh the risks.

Once it’s prescribed, a doctor has to follow very specific steps to ensure the patient’s safety. With generic ketamine, there are less barriers to allow access.

“Ketamine is in a special place in that we’re using it off-label in its generic form, and it removes step-by-step legislations where you have to go through all these [measures] to prescribe it safely,” says Arden.

Currently, clinical studies involving psilocybin and MDMA have a very high clinical burden. Patients are monitored for eight hours and must have two clinicians with them, which adds up in terms of time and expenses.  With generic ketamine, there are less clinical burdens.

Throughout the course of your psychedelic therapy protocols, you may hear about or experience yourself a session that feels underwhelming, as if “nothing” happened in your conscious experience.

If this occurs, it’s easy to quickly jump to conclusions, such as: “this isn’t for me,” “it didn’t do anything,” or “I did something wrong”. Though this isn’t the case, and there’s often a lot more going on under the surface than you may anticipate.

This piece explores the mechanics of milder experiences, potential meanings as to why they happen, the biological mechanics, and how to integrate/work with these experiences throughout the rest of your healing journey.

Defining “Nothing Happened” Experiences

By “nothing happened” experiences, individuals tend to mean that there didn’t appear to be any active effect/change in their physical bodily sensations and/or their conscious waking state.

In other words, they were “lucid” or “normal” the entire time during the session. And as mentioned, at this point it’s easy to make the jump to assuming that it didn’t work, that nothing happened, or that the individual made some form of mistake before or during the session. Though none of these are true, and “nothing happened” experiences can and likely will happen to anybody throughout a psychedelic therapy program with multiple sessions.

Given the amount of stories you may hear from others and their journeys, and given the classic hallmarks of a psychedelic experience — it is common to have some assumptions, or hard as you may try not to, have expectations about the nature of the experience. This includes what your session will be like, and more importantly, what you think you need to experience in any given session.

For the purposes of this resource, “nothing happened” experiences will be defined as no detectable change in the physical sensations or the conscious landscape during the dosing session, or while under the influence of the medicine.

Biological Mechanisms/Healing

Let’s return for a moment to a topic we have explored before in a number of pieces — which is that there are often two apparent sides to the psychedelic experience: the biological and the phenomenological.

These are differentiated by what happens to the brain and body, and what happens in your subjective experience and your conscious awareness.

It’s important to remember that when going through psychedelic therapy with any psychedelic compound, you will have ingested a compound that has a neurobiological effect. These effects are dose-dependent and will happen regardless of whether or not there are any associated phenomenological sensations/experiences that accompany them.

Psychedelic therapy compounds such as ketamine, psilocybin, MDMA, and others have powerful neurobiological effects. They help to repair, maintain, or promote healthy neural connections and pathways in the brain. These healing effects are always present whenever you ingest the compound.

No matter what the experience is like for you, rest assured in knowing that you are receiving a dose of medicine tailored to your needs, that is working on your mind and body regardless of the experience.

Just like a plant, if you give your brain and body the right conditions it needs to thrive, healthy growth is a natural byproduct. The positive neurobiological effects of psychedelics medicines help create and maintain the environment for your mind and body to heal, grow, and move towards health and wholeness.

What Does The “Nothing Happened” Experience Mean?

With the neurobiological benefits covered, there are many ways that you can interpret the “nothing happened” experience to help you continue on your healing journey.

A few framings and potential drivers of nothing experiences may include:

It may be unconscious priming

Some individuals are working through very challenging circumstances, and seek psychedelic therapy to resolve intense emotional pain or challenges. Always remember that the medicine and the experience is on your side, it is helping to heal and avoid further harm.

The experience may be working to prime or prepare a foundation of safety and healing, even before beginning to present the material being healed in your conscious awareness. Surfacing highly traumatic material before the individual has the resources, safety, strength, and trust in the experience to handle it can lead to re-traumatization, and does more harm than good. For this reason, the medicine may keep the healing and processing at an unconscious level to set the stage for further experiences.

It may be related to intentions

Though it is possible, the psychedelic experience does not always address intentions through the format of linear, languaged responses. You may ask a question in your intention, but the answer doesn’t always come in the form of a single-sentence response to you.

The medicine may present visions or images, re-surface childhood memories, generate physical sensations in the body, or many other forms of “communicating” the lesson and insight to be learned. It is not always straightforward or immediate to understand. This is also why continued integration and unpacking is essential in psychedelic therapy.

One of the ways the experience can address your intentions is in stating “you don’t need anything else/new,” or “the work you need to do is here in the world”. Instead of saying that in language, it answers you by not responding.

By keeping your awareness in the here-and-now of conscious experience, in the world. If you experience “nothing,” consider how a non-response or a suggestion of “there’s nothing you need to see right now in the psychedelic space” might be the answer or insight you need.

You may need rest

The healing process itself is a long-game. It’s a marathon, not a sprint. It’s possible to exhaust yourself with healing, to feel like you’re not doing enough, not moving quickly enough, haven’t “gotten there” just yet. Notice how these are the same feelings/patterns many people often seek to heal! With these attitudes, it’s easy to push yourself too far, too hard, too fast.

As always, your inner healing intelligence and the psychedelic experience recognize this, and will accommodate and match the experience to your energy levels, both physical and psycho-spiritual energy.

If you are tired, have a habit of overworking yourself or of pushing too far too fast, the medicine may bring you a restful experience. No grand insights, no visuals, no physical discomfort, just a period of time to relax, to be in relationship with yourself, and to directly see what self-care and self-love look and feel like. It’s not glamorous or fancy, and that’s the point. It’s taking intentional time to rest and recover.

Other Reasons

Now of course, these are merely potential reasons as to why the experience unfolded as it did. They are different lenses that you can view your experience through, to see if anything clicks, if that feels correct, or to glean any insights from.

Though it’s important to also take the time to continue connecting with this experience, and to journal and reflect upon it.

Ask yourself: What did this mean to me? How did I react to this experience? What is this giving me the opportunity to learn?

It’s About the Healing Process

First and foremost, individuals come to psychedelic therapy for healing. To become more whole, to cultivate a deeper relationship with themselves and with life. The healing is paramount.

How the medicine and the experience chooses to facilitate that healing should come later. This is where the timeless mantra of Trust, Let Go, and Be Open comes back up.

Trust that the medicine and the experience is working for your benefit and for your healing. Let go of the preconceived notions you have of what the experience will be like and what it needs to do for you, when. And finally, Be open to the possibility that this is all working exactly as it needs to, when it needs to, how it needs to.

Sometimes these “nothing happened” experiences can be delivering you exactly what you need. This may be an opportunity to work with your disappointment, and an understanding of how to accept reality as it is. Maybe there aren’t any visions or visuals, strange sensations or distortions of time, but it helps to get the job done regardless. It helps facilitate your healing process, and that’s what matters most.

Integration and the Space Between

If you are moving through a psychedelic therapy protocol, it’s likely that you still have some additional sessions as part of the program. It is helpful to return to viewing these experiences as part of a much larger story, where the success of the program is not determined by the “success”’ of one individual session. This is a long game, and there are many steps involved.

In a way, having these ’nothing’ experiences can be extremely valuable. They help you address the balance of wanting a fancy experience vs. true healing. They help you come into direct contact with reality and accept things as they are. And they help you take the integration process more seriously and focus on the time outside of sessions, an often neglected area in psychedelic therapy protocols.

If you would like to be an ally on your own healing journey and continue the integration process after an experience like this, you might try:

• Continued Reflection: Dedicate time in the following days to continue reflecting on the experience —and in particular your reaction/emotions related to it— and see if you can dig deeper into why this experience happened as it did.
• Assist the Neurobiological Benefits: You will always have the neurobiological healing benefits, and the neuroplastic integration window, after any dosing session. Help this process by dealing in your physical health and wellness practices and routines.
• Continue Integrating: Whether it’s outstanding integration activities from previous sessions, or establishing new behaviors, honor your integration window by continuing the best integration practices you have available to you.

Conclusion

“Nothing happened” experiences can be challenging and highly confronting. It’s easy to get swept up in an emotional response to them afterwards, either blaming yourself or believing that this just isn’t the fit for you.

As you’ve seen, there are a number of ways that “nothing happened” experiences can be just as significant as any other session you may have throughout your psychedelic therapy program.

By taking advantage of the neurobiological healing benefits, and in working to continue processing and reframe the meaning of the subjective experience, you have a valuable opportunity to continue exploring who you are. This includes how you think or act, and where you want to go next.

If you ever have any questions about this, reach out to your Guide, to your Care Team, or others who have done this work for additional support and guidance. With that, enjoy the rest of the journey towards healing and wholeness!

Ketamine treatment may be a welcomed option for patients who’ve struggled with finding effective relief for various mental health conditions.

For those choosing ketamine treatment while also using other psychiatric medicines, a common question arises: Is it safe to combine ketamine treatment with anxiety or depression medications, amongst others?

There are a number of things to consider when it comes to concurrent use of ketamine therapy and other pharmaceutical medications. Dr. Leonard Vando, a New York-based board certified psychiatrist and the Medical Director at Mindbloom, helps break it down.

Ketamine and SSRIs

Selective serotonin reuptake inhibitors (SSRI) are a common class of drugs that are typically used as antidepressants to treat conditions like major depressive disorder and anxiety disorders. Some brands of SSRIs include: Sertraline (Zoloft), Fluoxetine (Prozac), Escitalopram (Lexapro), Citalopram (Celexa), and Paroxetine (Paxil, Pexeva).

When it comes to combining SSRIs and ketamine treatment, the good news is that it’s considered to be safe.

“Ketamine works with the NMDA receptors, the glutamate receptor,” says Dr. Vando. “You can use it in addition to most SSRIs, and almost every antidepressant on the market. As a blanket statement, that’s the truth.”

Ketamine and SNRIs

Serotonin–norepinephrine reuptake inhibitors  (SNRIs) are a category of antidepressant drugs used to treat a host of conditions like: major depressive disorder, anxiety disorders, obsessive compulsive disorder, social phobia, attention-deficit hyperactivity disorder, chronic neuropathic pain, fibromyalgia syndrome, and menopausal symptoms.

Brands of SNRIs include: Venlafaxine (Effexor XR), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq), and Levomilnacipran (Fetzima). For the most part, SNRIs are safe to take during ketamine treatment.

However, some SNRIs tend to increase blood pressure in some patients, though it’s usually minimal and self limiting. Blood pressure and heart rate increases for many during ketamine treatment. Dr. Vando notes that’s why blood pressure is monitored before and after each session.

“If the blood pressure is too high, treatment won’t be administered,” he says.

Ketamine and MAOIs

Monoamine oxidase inhibitors (MAOI) are a class of antidepressants first introduced in the 1950s, which are also used to treat panic disorder and social phobia.

MAOIs are less commonly used compared to other classes of antidepressants, as they have a host of side effects. Patients on MAOIs often have a team of professionals to help administer the treatment, as well as a special diet they must follow. MAOI are often prescribed as a last resort, as they are shown to be highly effective.

Some brands of MAOI include: isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), phenelzine (Nardil), and selegiline (Eldepryl, Zelapar).

Dr. Vando says he has not heard of any adverse effects from ketamine treatment and patients who are on MAOI. However, they should proceed carefully with the treatment.

“Anyone using ketamine therapy while on MAOIs has to do it with caution, and only if the benefits clearly outweigh the risk,” he says.

Ketamine and Wellbutrin or ADHD medications

Wellbutrin is the brand name for Bupropion, which is an antidepressant mostly used to treat major depressive disorder (MDD), seasonal affective disorder (SAD), and to support smoking cessation. It’s also used as an off-label treatment for Attention Deficit Hyperactivity Disorder (ADHD).

Medications used to treat ADHD directly include: Adderall (amphetamine), Ritalin (methylphenidate), Concerta (methylphenidate), Dexedrine (amphetamine), Evekeo (amphetamine), Focalin XR (dexmethylphenidate), Quillivant XR (methylphenidate), and Strattera (atomoxetine hydrochloride).

Dr. Vando says this category of medication should be closely monitored while ketamine therapy is being administered.

“Blood pressure may be mildly elevated upon initiation of treatment, and while monitoring it is not routinely done for patients receiving these medications, it is worth noting that ketamine also may mildly increase blood pressure,” he explains. “This does not necessarily mean an added burden, as blood pressure monitoring is routinely done when receiving ketamine. So it really confers no additional risk.”

Medications and Other Psychedelic Therapies

Many patients who resort to ketamine therapy do so because traditional psychiatric medication doesn’t seem to be enough.

While ketamine can be used in combination with almost every antidepressant on the market, that’s not the case for all forms of psychedelic therapy.

That’s because other psychedelics work on similar pathways as antidepressants medications – like serotonin. Dr. Vando explains that if a patient decides to try ayahuasca, psilocybin, or DMT, it shouldn’t be mixed with their medication and they should consider getting off with the help of a professional.

Doing so without professional guidance may not be a good idea, and in some cases may cause more harm and risk in the long run.

“While alternative therapeutic treatment is known to help with depression and anxiety, most people who deal with depression and anxiety are on some type of antidepressant, so that’s an obstacle.”

Other Important Considerations

Be honest about legal and illegal drug use

It’s crucial to be upfront with your care team about your history of prescribed medications, as well as any illegal drug use, as it helps the care team make an informed decision for your overall health and safety.

“It’s good to reveal what you’re on to the person you’re working with,” says Dr. Vando.

Consider timing if combining with other drugs

Some medications that are prescribed, like Xanax, can be sedating —a physical effect which isn’t optimal when taken along with ketamine. So, for example, if you take sedating medication at night, it’s best to schedule the ketamine treatment in the morning so the two medications don’t overlap.

Listen to your body and mind, report anything awry

If something doesn’t feel right, speak up. Listen to your body and don’t dismiss anything that feels off, no matter how minor it might be. This treatment is for you, and your comfort and wellbeing is of the utmost importance.

Trust your clinical provider to determine how to approach treatment with multiple medications

Your provider will know the best course to take when it comes to ketamine treatment. Be upfront and honest about all other medications you are using, including the dosage and time of day taken.

Throughout your psychedelic therapy protocol, particularly within an individual psychedelic experience, you may come to have what is known as an “out-of-body experience.”

If you’ve spent any time reading through individual stories online or on forums, or in speaking with others who have had a psychedelic experience before, you may hear familiar themes along this line, such as “I left my body,” or “I was looking back on myself.”

Without having had this experience before, these reports can seem like exaggerations, overly fantastical, or downright baffling.

Whether you have recently had an experience like this that you would like to understand further, or you are interested in exploring this topic more, we’ll cover the definitions, characteristics, and the process of integrating out-of-body experiences.

Defining Out-Of-Body Experience

As with any sensation within the psychedelic experience, due to the often indescribable quality of the experience, it is challenging to effectively put these experiences into words.

With that disclaimer in place, an out-of-body experience (OBE), can be likened to a dissociative episode. Dissociation is the direct experience of separating consciousness from the body, of a felt distinction or separation between the mind of the body.

This is pointing towards what an out-of-body experience is: the direct felt experience of an individual’s consciousness being outside, above, or somewhere that is not contained within their body.

During waking or regular consciousness, most individuals would say that their sense of self is located within their body. What can make OBEs so powerful, challenging, or interesting is the direct experience of having one’s center of identity no longer be within the body. Rather, it’s perceived as outside of the body, either close by or far away, or felt to exist outside of material reality altogether.

Of course, these phenomena are dependent on the nature of the experience, the intensity of the sensations, how the individual assimilates this information, and many other facts.

For the purposes of this resource: OBEs are the direct experiences of having your sense of Self be located outside of your body.

Hallmarks of Out-Of-Body Experiences

There are a few classic hallmarks that can be used to identify an OBE, though the most simple heuristic is the lived experience of the individual who experienced it.

One of the factors that can make these experiences so significant is that it is quite apparent whether it has happened to you, particularly if this is the first time an experience like this has ever happened.

There are a few hallmarks, or defining phenomenological characteristics, that you can look to when trying to define or discover whether you had an OBE or what it meant:

1. Disembodiment: The location of the individuals Self (Ego) distinctly outside of the confines of the physical body.
2. Elevated perception: The sense of seeing and experiencing the world from an elevated level of perception, or a distanced visio-spacial location. This remains ego-centric (the sense of self is still what is viewing the world), but from an extra-corporeal perspective (outside/above/beside the physical body).
3. Autoscopy: The sense or direct experience of being able to look from this new elevated perspective back down at your own body. To see your body from a third person or dislocated perspective.
4. Noetic Quality: Similar to the classic hallmarks of a psychedelic experience, there is the strong internal sense that what is occurring is real and significant.

At this time, there is little research around physical bio-markers of OBEs, as they seem to be highly phenomenological, rather than strictly biological experiences.

This makes sense as OBEs deal with the individual’s sense of Self and locus of identity, however this is also a ripe area for continued research and study. Some studies have been done to explore this, and further exploration of these experiences seems warranted, given their significance for those who experience them.

What Causes Out-Of-Body Experiences?

There are a number of factors that can lead to OBEs. They are not strictly within the domain of the psychedelic experience, and can be induced through a number of other techniques that alter consciousness.

It is important to note that OBEs are not something that are consciously willed by the individual. A defining trait of OBEs is that they are largely involuntary, something that happens to the individual rather than something the individual plans for and then executes.

There are alternative techniques (such as astral projection or shamanic visualization journeying) that can bring about this disembodied identity, however they are not what we are discussing when looking at OBEs.

Some experiences that can bring about OBEs include:

• Acute Stress: Highly acute and severe stressors (car accidents, childbirth, etc.) have been reported to bring about OBEs. These are not reliable mechanisms to induce OBEs, and individual experiences may vary significantly.
• Medical Conditions: Some medical conditions, such as epilepsy, dissociative disorders, and brain injuries have also been reported to include OBEs or similar phenomena. These are not reliable mechanisms, but these experiences can happen or be brought about by individual medical conditions.
• Psychedelic/Dissociative Compounds: OBEs are never guaranteed in any psychedelic experience. Psychedelic and dissociative compounds, such as ketamine, LSD, psilocybin, DMT, ayahuasca, and others are all able to induce OBEs and are often associated with high-dose or phenomenologically-intense experiences from individuals.
• Near-Death Experiences (NDE’s): OBEs have a strong history in surfacing during near-death experiences, where they are often most notable. There are many reports of individuals feeling like they had left their body, moving through tunnels of light, or similar experiences. These experiences are reported during major car accidents, or during cardiac arrest before resuscitation.
• Hypnosis/Trance: Using techniques such as hypnosis or trance-states through rhythmic drumming can bring about OBEs or similarly adjacent experiences. The locus of identity travels, or is experienced as somewhere outside of the physical body.
• Breathwork/Yogic Techniques: Similarly to the hypnotic and trance states, there are breathwork practices like holotropic breathing or some pranayama techniques in yoga that can induce OBEs or similar identity-altering experiences.
• Sensory Deprivation: Sensory deprivation, such as the use of flotation tanks, or dark meditation retreats, also have the potential to induce or trigger out-of-body experiences.

There are no reliable triggers to induce out-of-body experiences, though some techniques have been reported to, and continue, to bring about OBE in some percentage of those who undergo the experiences.

As OBEs are phenomenologically similar to dissociative experiences in some ways, ketamine or other dissociative experiences can get individuals close to, if not fully within, an out-of-body experience.

What to Do If You Have an Out-Of-Body Experience

These suggestions are particularly relevant if someone has just had an OBE for the first time, or experienced quite a significant OBE.

If you are still in your experience, using whatever method and technique brought about this state, it’s important to remember to remain calm, to know that you are safe, to trust in the experience and the wisdom and healing that it can provide.

OBEs can be very significant for individuals, particularly if one has never experienced a shift in identity-center before. They can be highly alarming, such as feeling the individual has died or something wrong has occurred. There may be fear that you will never return back to normal, or that something with the experience has gone wrong.

Above all, remind yourself that you are safe, that you can trust in the experience. This opens up the opportunity to become curious, to explore this newfound psychological state you find yourself in. This shift from fear, to curiosity, to wonder is a powerful mechanism all individuals have access to, and can be a driver of very significant experiences.

If you are coming off of an experience, and returning to this world, simply take things slowly. You’re returning to your sense of self and to your body. You can still be a bit loose, fuzzy, groggy, or similar after an experience like this. There may be a great deal of excitement and positive energy, or there may be a lot of confusion, hesitation, or doubt within you. All of these feelings are okay, and you can honor fully whatever emotional state is present after this.

It’s important not to make any major decisions after experiences like this, a good rule of thumb is simply to “sleep on it” for a day or two. Let the experience settle in, and to allow your system to calm down. Journaling, or other integration work like meditation or yoga can assist with this process.

If this was a significant experience for you, why was it so significant? What did it show you? What did you learn? What did you experience? Reflecting on this will help things settle in and help provide a firm foundation for the rest of your integration process.

How to Process/Integrate an Out-Of-Body Experience

Processing and integrating an out-of-body experience isn’t always a straightforward process. For some individuals, these can be highly confronting and invite major questions around the nature of reality, the truth of individual/collective consciousness, and similar themes surrounding metaphysics and ontology —the nature of being. For others, there may be significant themes surrounding the personal relationship to death, to spirituality, or to the rest of their life coming up.

If anything like this is occurring for you, it’s helpful to honor this process in yourself, to show up as best you can for it, and to really explore with open-minded curiosity what this experience was trying to show you, what it wants to teach you, and how you can utilize it on your path to healing and wholeness.

Here are some ideas on how to integrate and process an OBE.

Journal

Journaling is a powerful integration technique, as mentioned above. Continuing to reflect on this, to create the space to put into language what you experienced and what that means for you, is powerful and will help provide clarity and comfort throughout the process.

Consult other teachings

Though an out-of-body experience may have been new for you, these experiences have been the focus and excitement of many cultures and teachings for thousands of years. It can be helpful to look at other teachings and ideas surrounding OBEs to help process and make sense of your own experience.

There are teachings across the various major world religions, Native and mystic traditions, and the psychedelic/psychonautic communities. Knowing you are not alone in your experience, and hearing the stories of others, can help you be more comfortable with your own.

Discuss your experience

You always have support throughout this process. Joining a community to discuss this, working with your care team, your Guide, or joining integration groups can all help. This was an individual experience, but you can find refuge and support in a community of individuals who are there to help you.

Go slowly

There isn’t a deadline on your healing. There’s no test at the end of processing experiences like OBEs. Going slowly, not rushing to conclusions, not forcing yourself into quick answers is very helpful throughout this process.

Giving yourself mental and conceptual space to explore what this experience means for you can allow you to come to deeper and deeper understandings of yourself, and your role in this world.

Ground into your body

Significant OBEs have the potential to be slightly destabilizing. It can be hard to return to work on Monday while you’re questioning the nature of Self. This is real and possible.

Whenever you are getting lost in mental conceptualizations and rationalizations of the experience, ground back into your body. Take a walk in nature, do a yoga or meditation practice, come back to the direct experience of you and your body in the world. Get some sunlight, breathe fresh air, do a project with your hands. These practices can help manage any overwhelm that may arise, and give you the breathing room to continue your integration process.

Conclusion

Out-of-body experiences are unique to each individual. They can be extremely beautiful, life-altering, or existentially challenging. As always, just because you are embarking on an experience that has the potential to induce OBEs, does not mean you will experience one.

What comes up in these experiences and throughout your path in life comes up for your own healing and personal development. If you have an OBE, there’s a reason it came up for you at that time. Taking the time to process and explore this, and working with your practices and community support to unpack and integrate it, can be very powerful catalysts for growth and development.

As always, after any significant experience, we must return to the world, and to ourselves, our relationships, and our role in the web of humanity. Hopefully, after these experiences, we come back more whole, more healed, with more love to give.

The dissociative and psychedelic experience brought on by ketamine can be hard to put into words. Everyone has their own unique experience while working with ketamine. A common question that comes up surrounds the classical psychedelic motif of experiencing visions or visuals.

Some clients ask this question because they would like to have this experience. Others ask this question because they would like to avoid it if possible, as it’s something they may not be comfortable with at the time or have heard things from others about their experiences that lowered their interest in this type of experience.

The simple answer to this is, yes, it is possible that you may experience some visions and/or visual imagery while working with ketamine, and with other psychedelic medicines.

Each experience is unique

As always, there is far more nuance to this answer than simply accepting it as a guaranteed fact. Every individual has their own unique experience with psychedelic compounds, and each session for each individual is unique. Some may be visually pronounced, while others may be highly somatic or felt in the body, while others still may be dominated by emotions.

Just because you have or have not experienced visions before does not guarantee that they will come again. There’s also no guarantee that they will be the same as previous times, or that they will share similarities with any stories you have heard from friends or read online.

All individuals have unique personalities and life circumstances, and this too will impact the prominence of visuals in the experience, as well as the role they are playing in the healing process.

Defining “Visions/Visuals”

To begin, there are three distinctions to draw in this discussion. Though these are commonly grouped together under the umbrella term “visions,” there are a few nuances that can be drawn to gain deeper insight into what happens within the psychedelic state.

Visual distortions

The first experience that may occur are visual distortions. These are slight alterations to your normal sight and vision. Things like tracers —a blur pattern after moving objects— or “movement” in solid objects can start to occur. These are simply alterations to normal sight as the effects of the medicine begin to come on, and throughout the peak of the experience.

However, in most psychedelic therapy protocols, clients are given a blindfold to use to aid the process of turning inward for self-reflection and contemplation. As a result, visual distortions are not as relevant in this discussion as they would be in recreational or intentional containers. They may arise on the spontaneous trip to the washroom, which is why having a peer monitor or trip sitter with you is always a smart decision.

Visuals

Visuals, or closed-eye visuals, are novel or unique patterns/perceptions that arise in the normally dark space behind closed eyes.

For most individuals, the space behind closed eyes often just looks black, or like old TV static. However, while within the psychedelic experience, an individual may experience a variety of visuals such as complex, undulating geometric patterns, or soft, transforming color gradient patterns. There can be the perception of “moving forward” or moving inside an area, rather than the static “lying down” position common to psychedelic therapy.

Other examples of visuals might include seeing words, seeing soundtracks, or synesthetic experiences such as visualizing sound, or seeing the taste of something.

Individual characters, letters, or objects may also appear in the closed-eye visual field, and all of these fit under the moniker of psychedelic visuals.

Visions

Visions are often the most pronounced, or apparent, form of psychedelic-induced visual change that arises. Visions can range from photographic imprints of places, people, things, or old memories, to full on moving, animated scenes unfolding in your mind’s eye.

Visions can range from intensely beautiful to downright scary. They can make complete sense, such as the face of a family member waving back to you, or the exact meaning can be harder to decipher, like something out of a dream.

Visions may be very clear, full of color and animation, and the events unfold in a logical progression. They may also be very faint, lacking definition, leaving you guessing as to what that was and what it meant.

Over and above everything else, all of these visual experiences on psychedelics are okay. None is better or worse than the other. All of them are possible, even in the range of a single experience, and it’s equally possible that you may not experience any of them. What’s important is how these relate to your healing and your journey to wholeness, this is what is covered next.

The Purpose or Role of Visions and Visuals

As mentioned earlier, what’s important is the overall role that the visions and experiences you have contribute and assist your healing process.

There is a tendency sometimes in the psychedelic space to attach too heavily on the specifics of the visuals, with individuals comparing stories of what they saw. Always bring the experiences back to your healing. How did these help? What made the visions important or significant for you?

As for why visions and visuals happen at all, there are a number of potential reasons why the psychedelic experience may include a series of visions or visuals.

Information management

When you dream, your brain and subconscious are processing and managing your memories and information. It may be similar here, where your subconscious is working to heal. The process of this is reorganizing memories or visual information which brings it up to your conscious awareness.

Delivering messages

Humans are highly visual creatures. We dedicate major processing power from our brains to our visual systems, we often dream in imagery, and it’s incredibly powerful on our waking consciousness. When your inner healing intelligence is working and trying to communicate with you, one of the ways it may choose to deliver the healing you need is through visual messages/imagery. So it is using a powerful delivery mechanism to complete this process.

Neurobiological triggers

Psychedelic medicine compounds can activate the visual cortex, or areas of the brain associated with sight. So even though you are lying down with a blindfold, certain medicines can activate the visual cortex, spurring the instances of visual distortions, closed-eye visuals, or full-on visions.

Overall, this is still an area deserving of more rigorous study, as the exact mechanisms of psychedelic visuals and the role they play in the healing process is still unclear — though for those who have had the experience of visions/visuals on psychedelics will know that the experience can be a powerful one, and be a significant catalyst for healing.

Vision Motifs, Themes, and Archetypes

This section must be prefaced that everyone’s experience is unique. Each session is unique in itself, and although a certain vision with a certain meaning may have arisen for someone else, that does not mean it will happen for you and it does not imply the same meaning either.

This is another reason why choosing to work with experienced and licensed professionals can significantly aid this process. They can help you tease out the meaning and importance of the experience, such as visuals and visions, and use them as aids in your healing process.

With that said, there are a few common motifs that can arise throughout psychedelic experiences, and that can possibly arise in your own sessions.

Complex or sacred geometry

Highly complex geometric patterns are a common visual motif that arises in the psychedelic experience. Building off the mystical experience hallmark of the noetic quality, or higher-order truth, these complex geometric patterns —sometimes called sacred geometry, seem to imply a higher-order operating system for reality.

They are considered to be the pattern that life is generated from, and found throughout the inner and outer worlds.

Archetypes or entities

Archetypes, which are classic personality forms, or specific entities may also appear as allies, enemies, obstacles, or opportunities in psychedelic visuals.

Visions of the King, the Jester, the Innocent Child, the Divine Mother, the Dragon of Chaos, or aliens, can appear and deliver messages to the individual.

The specific form or archetype can often represent an aspirational state —something the individual would like to embody further. They can also represent the way that they see themselves, such as a comedian, a lazy person, or courageous. Another take is that these appearances relate to events in their life, such as a dragon in front of their parents home.

In sitting with these experiences, insights or lessons can often be drawn out.

Tunnels or pathways

With psychedelic visions/visuals, there is often a progressive sense to them, that you are moving through space and time, walking or moving forward, often  in a tunnel, or on a pathway.

Visions of these may include walkways through the forest, seeing familiar places like homes, schools, or parks.

Episodic or future memory

A final type of visual experience that may arise is episodic memories or “memories of the future.” Individuals may, from a third-person perspective, see events from their lives. These may be significant moments, include an important individual, or simply provide a new vantage point for the individual to see themselves.

These can be powerful catalysts for healing and self-reflection.

There can also be visions which appear as memories of potential future scenarios, such as what may happen if an individual stays addicted to a substance, or continues being angry toward their family. These can be highly cathartic and influential experiences, showing individuals where they may end up unless they make behavioral changes.

This is not an exhaustive list of visions, these are simply broad categories or themes of visual experiences that may occur during a psychedelic experience. Some of these are very clear and powerful, some of them are fleeting and hard to navigate through.

What’s important is to stay present to what is arising, know that it is coming up for healing, and do the work to integrate them if that is called for after the experience.

Understanding and Integrating Visions or Visuals

Psychedelic visions or visuals can feel like little movies playing in your mind. They can be romantic storylines, thriller storylines, maybe comedic, heroic, or mind-expanding.

However, if all you’re doing in the experience is watching movies, you’re probably better off saving your time and energy to go to the movie theatre. Psychedelic therapy is a catalyst for healing, and always trying to ground your visual experiences back into your healing process is an important part of the process.

Why integration of psychedelic visions or visuals is important

Journaling and reflecting on your experiences afterwards is helpful and important. Taking note of what your original intention for the session was can also be helpful. You’re simply looking for ways to tie the visuals back into your life.

Sometimes the connection is obvious, like having a vision of a recently-departed family member and having some time to speak with them. Other times, the meaning and utility of a vision is not obvious at all, but there may be a way it relates.

For example, if you had an intention to practice your mental calmness, or to remain grounded, it’s possible you might be presented with some challenging imagery. This isn’t because the visuals are telling you something, but because they’re giving you a chance to practice staying grounded.

Taking the time to reflect, and work with your care team on navigating these visuals and visions, can help your psyche to process important memories. It can also help unlock important realizations about behavioral patterns, and help make each session an asset on your healing journey.

Conclusion

Visions can be a powerful part of the healing process, but they’re not everything. A powerful emotional release can be just as significant as any vision. Trust in the fact that what is coming up —or not coming up— for you is for your own healing and wholeness, and is playing the role it needs to play on your journey.

Visions and visual experiences are always possible with any psychedelic medicine, but they are not guaranteed, nor are they necessary. Always return to your own inner intelligence, find the meaning that these experiences hold for you. When it feels like additional support would be helpful, reach out to your care team and work with them to explore your visions.