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Category: Anxiety

Resources and Literature about Ketamine Assisted Psychotherapy and Psychedelics

Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207256/

The New Yorker: Ketamine therapy is going mainstream. Are we ready? https://www.newyorker.com/culture/annals-of-inquiry/ketamine-therapy-is-going-mainstream-are-we-ready

The New York Times Podcast: “The Veterans Fighting to Legalize Psychedelics” https://www.nytimes.com/2023/02/22/podcasts/the-daily/veterans-psychedelics-legalization.html

The Harvard Gazette: “Ketamine found effective in treating severe depression” https://news.harvard.edu/gazette/story/2023/05/ketamine-found-effective-in-treatment-resistant-depression/

Johns Hopkins Psychedelic Research https://www.hopkinsmedicine.org/psychiatry/research/psychedelics-research

Michael Pollan “How to Change Your Mind” ( book and Netflix Series) https://michaelpollan.com/books/how-to-change-your-mind/

https://www.netflix.com/title/80229847

Gabor Mate “Psychedelics in the Treatment of Trauma” https://www.youtube.com/watch?v=SOGTqVt0dlQ

“The Myth of Normal” https://www.amazon.com/Myth-Normal-Illness-Healing-Culture/dp/1785042726/ref=asc_df_1785042726/?tag=hyprod-20&linkCode=df0&hvadid=622500525054&hvpos=&hvnetw=g&hvrand=13225712727406116208&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9028298&hvtargid=pla-1296869923417&psc=1&mcid=e0096839455a38888cad99362de55928&gclid=CjwKCAiAiP2tBhBXEiwACslfnrnhWT0XpXjlBVuVba-oQ5VIdklWj0qp-LaXK1jK-CCuEtpUxwuq0xoCDwEQAvD_BwE

Bessel van der Kolk “Childhood Trauma, Psychedelics & EMDR”  https://www.youtube.com/watch?v=XIH5taudtH0

Penn Medicine News “Penn Medicine Study Gives Peek of How Ketamine Acts as ‘Switch’ in the Brain” https://www.pennmedicine.org/news/news-releases/2022/december/a-peek-of-how-ketamine-acts-as-switch-in-the-brain

CNN “ How psilocybin, the psychedelic in mushrooms, may rewire the brain to ease depression, anxiety and more” https://www.cnn.com/2022/06/11/health/psilocybin-brain-changes-life-itself-wellness-scn/index.html

Stanford Medical School “Psychedelics” https://med.stanford.edu/spsg/about.html

Ketamine Research Institute “5 amazing things you need to know about ketamine infusion therapy” (anti-inflamatory, autoimmune treatment, reduce stress response and increase immune function, brain regeneration, Long haul COVID, addiction recovery)  https://ketamineinstitute.com/ketamine-blog-news-and-recent-developments/5-amazing-things-you-need-to-know-about-ketamine-infusion-therapy/

Ketamine as a treatment for PTSD (Research article) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457782/

MDMA for Couples Therapy (research article) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631777/

Time Magazine “MDMA could Revolutionize Couples Therapy” https://time.com/6262291/psychedelics-mdma-couples-therapy/

Vice: “Couples Are Doing MDMA and Ketamine Therapy To Save Their Relationships”

https://www.vice.com/en/article/5d9yg5/ketamine-mdma-couples-therapy

Austin Concierge Therapy offers Ketamine Assisted Therapy with Texas Direct Medical

Austin Concierge Therapy and Texas Direct Medical Care are working together now to provide ketamine assisted therapy to our clients. Ketamine is a drug that was previously approved by the FDA as an anesthetic to treat soldiers on the battlefields in Vietnam in 1970.  So, it’s been around a long time.  Over the years, ketamine has become routinely used as a sedative in emergency rooms worldwide, and has more recently been found to aid in helping alleviate suicidality when combined with psychotherapy.

The shift to using ketamine in psychedelic assisted therapy began in 1999, following a study done by the Yale School of Medicine.  This landmark study showed unequivocally ketamine’s ability to shift one’s mood towards more positive thinking following its administration.  A number of subsequent studies followed that confirmed ketamine’s tremendous ability to treat depression, suicidality, and PTSD.  Ketamine has also been shown to improve addiction, chronic pain, OCD, and bipolar.

Since 2010, doctors have been prescribing ketamine in low doses to people with treatment resistant depression, but it may only be administered in the presence of a licensed physician.

The most recent research is showing that intravenous or intramuscular administration provides the best outcome, when using ketamine in psychedelic assisted therapy. The way ketamine works is similar to what we’ve learned about MDMA and psilocybin; Ketamine administration “rapidly increases the number, complexity, and strength of connections between neurons, and this effect appears to be directly correlated with its antidepressant benefit,” said Dr. Kelley O’Donnell, a psychiatrist who studies and provides psychedelic-assisted psychotherapy at New York University’s Langone Center for Psychedelic Medicine.

The belief is that ketamine, similar to studies on psilocybin, helps generate new connections between neurons that have been lost over time as a result of depression. We do know that ketamine causes a boost in the neurotransmitter, glutamate. Glutamate is known to stimulate new communication between brain cells that might have been damaged by stress and depression.

Ketamine used for depression is administered twice a week for three weeks, then once a month or as needed after that.  Ketamine, like other psychedelics, also gives clients the ability to look at and examine trauma that may be too painful to bring up initially in talk therapy.  In the same way that ketamine can anesthetize the body, it can do the same for the mind, which makes it much easier to re-process trauma with your therapist in order to get to the root of the depression.

Working with Intergenerational Trauma and Epigenetics in Therapy

Sara Sloan, LMFT, CST, IRT contributed to Zocdoc’s article, “What is Intergenerational Trauma,” originally published on October 20th, 2024. Below is Sloan’s new content and article summary.

Intergenerational Trauma is something you’ve probably heard about recently in the news.  There have been more studies in the last year, that show directly how parents’ trauma is able to leave biological traces in their children. In particular, research has shown how the father’s trauma is passed on to the child through the sperm.  Meanwhile, scientists have found that a mother’s trauma is associated with changes in mitochondrial bioenergetics.

This is important in therapy, because there are rare occasions where you’ll find a classic trauma response in a client with no past trauma or memory attached, as well as nothing medically to explain it.  It could show up as anxiety or unexplained fear, or it might look like depression, or re-occuring nightmares. This can happen in lineages of those who have had parents, grandparents, or even great-grandparents that survived a war or genocide.

If we think back to the original rat study, female rats were given the smell of roses, before receiving an electric shock.  This happened a number of times, until the smell of roses elicited a fear response in the rats, even without the electric shock.  These same rat’s children and grand children continued to show physiological signs of fear and anxiety with the smell of roses, even though none of the following generations had experienced the smell of roses paired with an electric shock.

We see heightened anxiety and a direct link to changes in cortisol for children with one or both parents who had experienced the Holocaust.  You can see the same thing happening in those with Native Lineages that experienced the Indian Boarding Schools.  These changes in epigenetics affect following generations mental and physical health due to events that happened before they were born.

New research shows that psychedelics may be one way to help reverse epigenetic trauma.  One study completed on ayahuasca, found it works directly on the Sigma-1 receptor (SIGMAR1), which helps regulate traumatic memories and cellular stress associated with PTSD.  Ayahuasca showed notable results by providing a decrease in the methylation of SIGMAR1, which translates to higher gene expression.  These changes improve PTSD and anxiety by strengthening cellular stress resilience, reducing neuroinflammation, and stabilizing fear circuitry, while enhancing the neuroplasticity needed for trauma reconstruction.

Other ways we’ve leaned to work with lineage trauma that doesn’t have a core memory attached is through hypnotherapy, ketamine assisted therapy, EMDR, and somatic experiencing.  In therapy, you can focus on the feelings to help process them, even if you’re unsure where they’d originated.

epigenetic trama

Interested In BDSM? Here’s How To Protect Your Mental Health…

Adventurous sex is no longer taboo or uncommon—on the contrary, it’s actually a perfectly healthy way to explore one’s sexuality, as long as you’re being safe about it.

A particularly popular form of kink is BDSM, which refers to bondage, discipline, sadism, and masochism. Over one-third of women and men in America have explored BDSM, and there is now scientific evidence that proves BDSM can be a healthy part of any relationship. In a recent study, BDSM practitioners were found to be less neurotic, more extroverted, more open to new experiences, more conscientious, and less sensitive to rejection, and they had a higher subjective well-being.

While this is good news, it’s still important to keep in mind some key factors for maintaining your physical and mental health when incorporating BDSM into your sex life, especially if you’re experimenting with it for the first time.

The neurobiology of BDSM.

The practice of BDSM physiologically triggers many of the same hormones that sky diving and other extreme sports may invoke. In particular, the stress hormone cortisol is often released, particularly by the receiver of the sensations, which helps to turn off the executive functioning area of the brain leading to feelings of euphoria and increased partner connection.

Heather McPherson, certified sex therapist and CEO of the Sexual Health Alliance (as well as my professional mentor), describes this state as “subspace.” “Subspace is a state that some players attempt to accomplish, where you can tolerate more pain and sensation than usual,” she explains. “Experienced players often call it, ‘flying.'” These are the feelings that often tend to make couples feel more bonded following a session.

Unfortunately, the flip side of this euphoria is all too common in the hours and days following an intense experience, especially for those on the receiving end. For those new to BDSM with a history of anxiety and depression, this is an important fact to keep in mind. In addition to the increase in cortisol, participants have also had an increase in endorphins, which bind to the opiate receptors. The steep drop-off in these chemicals can create a state referred to as the “sub drop.”

Sex therapist and erotica writer Dr. Donna Jennings explains that sub drop follows the “endorphin release after a BDSM scene, where the body works to move back to a normal chemical state.” She says that chemical drop can create both a physical and emotional reaction. Physically, a person can feel fatigue, aches, and pains. Emotionally, McPherson adds, a person can experience a range of emotions including “sadness, numbness, disconnection, guilt, or shame.”

Unfortunately, for those new to BDSM, sub drop can often get misinterpreted and misattributed to other aspects of the participant’s life and relationship.

How to prevent the drop.

By understanding what happens in the mind and body during a BDSM session, you can better prepare for the intense psychological ups and downs.

According to certified sex coach Ginger Hart, it’s best to mentally prepare ahead of time. Hart says there are two distinct phases people go through when they first begin exploring BDSM: the curious state and the adventurous state.

“The curious state is all about watching, learning, and gathering information to figure out what you’d like to explore, which builds confidence and excitement,” Hart explains. “This state is fragile, and [people] should consider adopting the mantra, ‘I would like to watch. I’m not ready to play.'”

She says that those new to BDSM shouldn’t move from the curious phase to the adventurous state until “they feel secure in their desires and are able to articulate and define personal boundaries.”

Once you’ve engaged in a session, you and your partner should participate in what’s referred to as “aftercare” to help prevent and subvert negative feelings associated with sub drops. In aftercare, usually the dominant partner takes care of the sub by participating in caretaking activities. These might include one partner holding and caressing the other, falling asleep in each other’s arms, giving a massage, running a bubble bath, or cooking their favorite meal following an intense scene. Participants can also plan to have self-care activities after they play to lessen the effects of sub drop (or top drop, which can also happen). Aftercare following a BDSM session should also help to increase the bond between partners.

If for some reason your partner is not offering you this type of care after your play session, you can still practice self-care on your own, including eating your favorite foods and indulging in your favorite Netflix shows—especially those that make you laugh.

Reaping the psychological rewards.

While BDSM might not be for everyone, McPherson explains, “This area of practice does contain great risks and rewards.” Counter to what you might expect, “for those with sexual anxiety, they can feel relief and comfort in BDSM play because it requires in-depth communication about what might happen as well as negotiation about what will happen and what they do not want to happen, which can calm nerves.”

Once you’ve decided to try out BDSM for yourself, it’s important to properly educate yourself and to listen to your partner.

“The key to safely expanding and exploring new areas of sexuality such as BDSM is to be aware of your own needs and desires, as well as those of your partner,” Hart says, “and to know when to push forward and when to remain curious.”

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