Ketamine Experience Guide

I get a lot of questions about how to approach a ketamine session, especially what to do within the experience itself. While ketamine is becoming more accessible, experienced guidance for navigating these sessions is harder to find. Having guided hundreds of individuals through thousands of ketamine sessions, I've developed specific approaches to help you work with your session skillfully. Setting intentions, surrendering, working with memories and dissociation, exploring internal dialogue, and imagining corrective experiences can all support healing and transformation. I also discuss how to handle situations where it seems like "nothing is happening."

Get settled: connect with your heart and intention

Whether your session is at home or in a clinic, the logistics of preparation can pull your mind away from your core reasons for working with the medicine. At the beginning of your session, take time to settle and refocus: reconnect with your heart, offer yourself some empathy, and bring to mind your intention. Remind yourself why you chose this approach and what you hope to see or heal. Your intention acts as a lens, focusing the insights and information that come up throughout the session.

Surrendering, opening, letting be

Surrendering is central to ketamine therapy. It's like passing through a gateway into the experience. How readily you can surrender depends on several factors: your mindset going into the session, the depth of your preparation, and the dosage and protocol used.

Releasing control and letting go of resistance or expectations can open the door to what ketamine has to offer. But surrendering often takes effort and courage, especially when the medicine experience or the contents of your psyche are unfamiliar terrain. With the right mindset and support, you can develop trust, relaxing into each moment as it unfolds and letting the medicine's effects bring insight and healing.

Surrendering may not come easily, and there's no formula. Be gentle with yourself as you practice letting go of preconceptions and opening to whatever is arising. Each small release of resistance builds your capacity for deeper surrender in future sessions. This develops over time, with practice.

The middle way between letting be and doing

As you move through your session, work toward a middle way between letting the experience unfold naturally and actively engaging with it. The balance takes a few sessions to get a feel for, and it's dynamic; constantly changing. Within a session, and across multiple sessions, you may need to shift when to be passive and when to actively participate.

You may not always be able to actively engage the content of your session. Dosage and your state of mind and body affect your capacity to do so. If you feel the balance is off in one direction or the other, it's worth speaking with your prescriber about dosage.

Letting it come to you and appreciating

During your session, you might find that your experience unfolds effortlessly. You may see shapes and colors, often dark and moving. You might witness scenes, environments, memories, or dream-like experiences. Typically, you'll "see" these in the same place you dream: in your "mind's eye."

When a session is unfolding this way, with information coming up from your psyche, practice letting go and letting the experience come to you. As thoughts, emotions, or sensations arise, observe them from the vantage of your higher self, your inner advisor, or pure awareness, and appreciate their presence. Letting the experience flow naturally creates the conditions for insight to surface. Each moment may carry valuable information, even when it's not immediately apparent.

Focusing on parts of your experience

To deepen your engagement, focus on the specific details of what's arising. You might focus on a particular emotion, thought, or sensation, exploring it more closely. Or you could direct your attention to your breath or other bodily sensations to anchor yourself in the present moment. Focusing this way can reveal connections between different parts of your experience and surface new information and insights. Try to stay curious and open as you explore what's coming up.

Working with dissociation to get closer to your experience

Ketamine-induced dissociation (a detachment or distance from your body and surroundings) can be a useful tool for exploring your experience. As you enter the dissociative state, your usual defenses and filters often relax or fade, letting you reach deeper parts of yourself directly. To make the most of this, try to stay curious about, and accepting of, whatever arises. You might notice thoughts, emotions, or previously inaccessible memories, bringing fresh insights. The dissociative state can be a window into your inner world. Try to use it to deepen self-understanding.

Replaying and exploring memories

During your session, memories from your past may resurface. With non-judgment and openness, let yourself replay them in your mind. Let your mind's eye recollect and display the details: the people, places, emotions, and sensations the memory evokes. As you experience it, see if it's more like a movie, where you're watching it unfold as an observer, or more like a lucid dream, where you can explore and even participate. Either way, try to stay open to what this might reveal about your current situation or where you're headed. Working with memories this way can yield insights that support healing and integration.

Imagining corrective experiences

During your session, you can use your imagination to create corrective experiences. Start by bringing to mind a painful or challenging memory, then imagine meeting your younger self there. Give that child what you needed (and may not have received) in that moment: protection, love, recognition. By re-experiencing and rewriting the narrative this way, you can shift your relationship to past events and experience actual emotional healing.

IFS-style internal dialogue

The Internal Family Systems (IFS) approach holds that everyone has a "family" of inner parts, each with its own role and perspective. During your session, you may get the chance to meet and converse with these parts. To start, identify the different parts that may be present and notice any emotions or sensations associated with them. Greet each part with curiosity, compassion, and openness, and invite them to share their perspectives, fears, and desires. Working through this process can generate new insights and improve communication between parts of yourself. The effects of ketamine can intensify your capacity for this kind of internal dialogue. If you find the approach helpful, consider seeking out a guide or therapist who specializes in “parts work.”

What if "nothing's happening"?

Sometimes nothing seems to be happening in your experience. This is common, has many causes, and isn't necessarily a sign of a problem. My recommendation is to be as kind and gentle with yourself as possible, and to stay curious about why your experience might be unfolding the way it is.

Sometimes, especially toward the end of the day, your mind gets pulled into thinking or ruminating on any number of topics. A wandering, ruminating mind can feel like a spinning merry-go-round, making it hard to step into the experience of the session. In that case, try mindful or deep breathing, letting your thinking mind run in the background while you tune in to what's happening in the present moment. You can also repeat a short phrase. Giving the thinking mind something else to do can help it settle.

Resisting or struggling with letting go is another common case that often produces an experience of nothing happening. Relaxing your need for control can be difficult, especially in your first few sessions. The urge to control can make it hard to be present with what's actually happening. Here, it helps to recollect and trust in your preparation, your intentions, your support system, and the fact that many others have safely gone through similar experiences. That trust can give you the confidence to surrender into the moment.

It's possible you have a particular expectation of how your experience should be. You might be hoping for an extraordinary psychedelic display, a life-changing experience, or "five years of therapy in an hour," as psychedelic marketing spiel sometimes promises. Even trying too hard to let go can produce a session where it seems like the medicine isn't working. Try not to fixate on what the experience should be like, and instead let go of any preconceived notions.

There's a chance that a specific issue from your subconscious is ready to be addressed in the session. When you resist what's arising in favor of what you think "should" happen, you can cut yourself off from what the medicine actually has to offer. Letting go of the preconceived notion often lets the real experience arise naturally.

Sometimes your intention for the session needs to align more closely with the actual phase of your transformational journey. I guide my clients through a phased approach to healing I call Settling, Seeing, Growing, and Integrating. An intention that isn't attuned to the right phase can also produce an experience where it seems "nothing's happening." For example, if you're still working on calming your nervous system and building resilience, you may not be ready to gain clear insights or replace old habits and beliefs. Similarly, if you're near the start of the Growing phase, you may not yet have the skills to integrate those changes into your life. In these cases, it can be tremendously helpful to work with a guide or experienced therapist who can help you adapt your intention more appropriately to your current phase of healing.

So when nothing seems to be happening, try to expand your view, let go of judging the experience as positive or negative, and stay open to meeting each moment as it comes. What's coming will come in its own time. Your system may be working below the surface in ways that aren't yet apparent.

Seek support and guidance

Be patient with yourself as you explore these practices and find what works for you. Actively engaging with these techniques during your ketamine-assisted therapy sessions can give you access to more information and deeper insight. Getting the most from ketamine takes effort and engagement. Consider working with an experienced guide and coach who can help you clarify intentions, get more from your sessions, and integrate what you learn.

I've had the privilege of helping hundreds of people navigate thousands of sessions and the integration that follows. It's been a true joy to be part of the healing and transformation that is possible through well-guided psychedelic experiences. If you'd like to discuss how to get more out of your ketamine sessions, or how to take a more active role in your healing, the option to schedule a conversation will be available soon. I'd love to hear about your experience.

Schedule a conversation (coming soon)