Ketamine Assisted Psychotherapy

Katrina Mondragon, MS, LPC, LMHC and Special Guest, Christina Conrad, LPC, SEP, KAP!!!

Sponsored by Katrina Mondragon, PLLC (Est. 2016)

Join us as Christina educates us on Ketamine Assisted Psychotherapy and the Oklahoma Psychedelic Collective and the upcoming Psychedelic Symposium on this week's episode of I Don't Know, streaming everywhere under the artist name katrinadragon

Transcript

SPEAKER_01 0:02

Greetings, hello humans. Katrina here, and I have Christina with me here today. So this is I don't know, and I don't know what we're going to talk about, but nothing to talk about today. Should we take it as medical, legal, or otherwise advice? This podcast is trending for education and amusement. And without any more of that disclaimer, what have you got to say for yourself? Christina, who are you?

SPEAKER_00 0:19

I'm Christina Conrad. I am a licensed therapist here in town, somatic psychotherapy. And I also offer ketamine-assisted psychotherapy and do a bunch of other fun and wild things.

SPEAKER_01 0:31

So that's one thing that I don't know about is that ketamine-assisted psychotherapy. I wanted to pick your brain on that a bit, if I could.

SPEAKER_00 0:37

Mm-hmm. Absolutely.

SPEAKER_01 0:38

For those who don't know, like what is ketamine, first of all?

SPEAKER_00 0:41

Yeah, so ketamine is actually an old school anesthetic. It was one of the anesthetics used most commonly on battlefields. It has a very high safety profile. But over the decades, they started somewhere they started recognizing that there it was actually helping relieve depression symptoms and anxiety. And so they have actually, it is a it's already FDA approved. So we were able to switch over and do this work in in therapeutic offices.

SPEAKER_01 1:12

And I'll I can tell you kind of the different types of ketamine, but I've heard that there's ketamine and the mirror neuron S-ketamine, which is more the spravato spray. Is that right? And then the other one is that sublingual, or how is that taken?

SPEAKER_00 1:25

Yeah, so the spravato, so ketamine is because it's an old school medicine, it's actually very cheap medicine. So we like that that's affordable. Spravato is what the pharmaceutical companies did to they change the formula the tiniest bit, honestly, so they that so that they could make it their own and they did research with it, but they also some of what they're trying to do is remove some of the altering effects of it. They see that as a side effect, whereas in ketamine-assisted psychotherapy, we want that so that we can do altered states of consciousness, you know, therapy and that. So spravato, the benefit of spravato is that now more and more insurance companies are covering it, and there's no insurance companies that cover ketamine assisted psychotherapy by itself, which is a major drawback. And we don't know if that's nationwide, we don't know if that's something that will change at some point. I assume it will, but hopefully the approved. Yeah, and spravado took it and made it crazy expensive, which is what happens with pharmaceutical companies. But as it continues to roll out, now that insurance companies are starting to cover it for people who can't afford the ketamine therapy on their own, they can do they can check into that. So yeah, and there's trophies, so there's the you have ketamine clinics across town that are not therapeutically based. They're just they might be there for pain management, different things. That's a medical you mentioned depression.

SPEAKER_01 3:01

Is it only treatment-resistant depression, or have they upped that to any unipolar or bipolar depression?

SPEAKER_00 3:07

Well, quite it. So now it's used, we even use it in our practice for trauma therapy. So it definitely, if there's chronic depression, that's where they first started to notice it. People who have tried a number of different meds for depression are still struggling. It helps for that population as well. And there's different protocols for each, you know, subject we might be working on. But it has that's the first thing it really got pushed through on. And now they're using it for anxiety. Now, spravado is only for depression, and you have to be on other medications to take spravato. That's part of their requirement.

SPEAKER_01 3:43

They're not gonna let you just take that and have fun. What do they call it when it's used on the street tripping?

SPEAKER_00 3:48

A special K, yeah, yeah. You're not you're not partying with it, yeah. Yeah.

SPEAKER_01 3:54

So what makes uh ketamine infusion different than ketamine assisted psychotherapy?

SPEAKER_00 3:59

Yeah, great question. So ketamine infusion is very medical. You're gonna sit there, the doctor's gonna hook you up, give you the medication, and it's there, it's treated purely like a medicine, like you're coming in to get a shot from the doctor. Ketamine assisted psychotherapy is a very different process. Different places offer either, um, there's no one nowhere locally that offers intramuscular. We've been working on that in our therapy office, but so a lot of times it's with trophies that you're taking that dissolve in your mouth, and you're sitting with a therapist, and you will have done preparation work. You you're with you're gonna be looking at what it is that you want to work on, along with so you're getting the benefit of the medicine, just as a medicine.

SPEAKER_01 4:42

Proactive therapy, okay.

SPEAKER_00 4:43

Yeah, because there's huge it's really fun to work with because there is increased neuroplasticity. There's all these, and I can give you as much info on that as you want, but use the big words.

SPEAKER_01 4:54

So I know that neurons that fire together wire together, but that's all I know about neuroplasticity.

SPEAKER_00 4:58

Yeah, well, neuroplasticity is the brain's ability to change, so to create new ways of being being and new goals that you want to do. Ketamine opens up for two weeks afterwards, increased neuroplasticity windows. So it's kind of like how I describe it as you get like a superhero powers for changing some behaviors. So when you're working with a CAP therapist, you are also looking at that. Like, what are the things we want to work on? How do we want to implement that at home to specifically use that window?

SPEAKER_01 5:31

You mentioned the duration of two weeks. Is that how often the treatments are? How frequently do people on average go? I know every individual is different.

SPEAKER_00 5:39

If they're doing the depression protocol, the depression protocol is typically twice a week for four weeks. Bravado follows that as well. And then after that, it's going to be based really individually per client on what they're needing. With our offices and with clients who see CAP therapists, it's going to be like a trauma protocol. We do three or four sessions, but we do one session and then do integration for a while and pull out as much as we can from that session. And then we do ah, good question. So integration is the process of integrating what came up in the journey. And we are doing preparation ahead of time to and kind of look at what we want to work on. We're tickling the psyche, getting it all kind of woken up so that when we go into the journey, sometimes exactly what we're working on comes up, and sometimes something completely different comes up. But either way, we we the integration sessions are there to really look at any content that comes up and see how we want to integrate it in. Because just like psychedelic journeys, they can be profound and amazing, but it's the integration, which is actually the juiciest part to create lasting change. Cause otherwise, over time, like any new habit we get, it'll fade. Right. So, yeah, so that integration is really important.

SPEAKER_01 6:57

Mention psychedelics, is that something that has been studied as far as like being used more commonly for medical?

SPEAKER_00 7:05

Absolutely. We are hosting our third annual psychedelics symposium on June 27th in Tulsa. And we are having doctors and researchers and therapists and a variety of people speak. So CEUs are available for those therapists who need them, but it's a community event to simply learn about all the different ways psychedelics are helpful. And actually, Oklahoma just passed Ibogaine legislation, which is a whole different thing.

SPEAKER_01 7:30

I've heard about that in Texas. I didn't know that about in Oklahoma.

SPEAKER_00 7:33

Yeah, it just happened. We've been working on all of this stuff, and then ibogaine suddenly just passed. So that just happened in the last couple months, and that's really exciting. There, we're we're learning how they're gonna roll that out. But ibogaine is great for opiate addiction, which is one of the number one reasons it's getting pushed through. Is that the same or different than ayahuasca?

SPEAKER_01 7:52

I've heard that word before.

SPEAKER_00 7:53

Yeah, ayahuasca is very different, but they're both kind of ancient tribal medicines, and those are big journeys.

SPEAKER_01 8:03

Ketamine ritualistic in any way like the psychedelics.

SPEAKER_00 8:06

Yeah, so a ketamine assisted psychotherapist is actually when you're in that with a therapist, with the medical offices or spravato, that's not there. But when you're with a therapist, everyone kind of does it a little differently. But it's very much seen as a form of ceremony. We go in with much intention, we prepare through diet, we we're looking at under extraction beforehand can assess can assist with the side effect of nausea. Yeah, and actually for ketamine, you do we do ask people to fast a number of hours ahead of time just because for some people it can cause nausea. And even absorption-wise, it lets the stomach be empty so it can absorb more.

SPEAKER_01 8:46

And not to TMI, but I've heard it can increase urination. Is that something that you have people restrict as water beforehand, or do you say drink normally? You do know some things, by the way.

SPEAKER_00 8:55

It it for like if somebody is struggling, has bladder issues of any kind, ketamine can inflame that. So it does, there is a relationship ketamine has with the bladder, but for most people, it does not affect. Although occasionally we have somebody who is might be thick in their journey, but they need to get up and go to the bathroom because it kind of does act like a diuretic. It's not really a big issue.

SPEAKER_01 9:18

Or is somebody able to walk themselves in the midst of a treatment?

SPEAKER_00 9:21

Yeah. So obviously in a medical facility, you would have a nurse that could help you. In our sessions, that is all discussed ahead of time around touch consent, the type of touch that's okay. And that would literally be like safety touch just to make sure they don't fall over. And we actually practice it ahead of time so they know exactly what that will be like and make sure it feels comfortable. But it kind of has the feeling if you have to get up in the middle of your journey, you'll feel it feels similar to being really drunk, not the nauseated part, but like your legs feel funny, you'll kind of walk a little bottomly. Yeah.

SPEAKER_01 9:54

Yeah. Okay. Mm-hmm.

SPEAKER_00 9:57

Yeah. So it's um, but most people, I would say only about 10% of people need to get up and go to the bathroom during it.

SPEAKER_01 10:04

That's a small percentage. Well, tune in next week for the rest of the conversation with Christina as we talk more about her psychedelic symposium and ketamine assisted psychotherapy.