Ketamine can open the door. What happens next matters.
Ketamine can temporarily change the way you relate to thoughts, emotions, memories, the body, and the protective patterns that normally shape what feels safe to approach. For some people, that creates access to material that has been difficult to reach through ordinary conversation alone.
At ACT, the medicine is not separate from the therapy. We prepare carefully, follow what emerges in real time, and adjust to what the work requires—sometimes going deeper, sometimes creating distance, sometimes grounding, and sometimes simply getting out of the way, while your own system does the work.
The goal is not the ketamine experience itself. The goal is what becomes possible while the door is open.
Psychotherapy
Integrated
Trauma
Informed
Individualized
Sessions
Preparation
& Integration
Sometimes you understand the problem. And still can’t reach what needs to change.
01
Depression & Hopelessness
Depression can become more than sadness. It may feel like numbness, exhaustion, disconnection, loss of meaning, or the conviction that nothing you do will make much difference. Ketamine-assisted work can create a different vantage point from which old conclusions and emotional patterns may become more accessible.
02
Trauma & C-PTSD
Trauma can make the very material that needs attention difficult to approach. Ketamine may create enough distance from memories, emotions, or bodily reactions to encounter them without being consumed by them.
03
Patterns That Won’t Move
Insight can explain a pattern without necessarily changing it. Ketamine-assisted therapy can give us another way to work with beliefs, emotional reactions, protective responses, and associations that remain remarkably persistent despite understanding them intellectually.
04
Parts, Shame & Inner Conflict
One part may want connection while another withdraws. One may carry shame while another works relentlessly to keep it buried. Altered-state work can sometimes allow these internal relationships to become more visible—and create opportunities for compassion, dialogue, or a different experience of the parts you have spent years fighting.
05
Relationship & Attachment Wounds
Fear of abandonment, rejection, betrayal, dependence, vulnerability, or losing control can shape intimacy long after the relationships that taught those lessons are over. Ketamine-assisted work may help us approach the emotional material underneath those reactions from a different perspective.
06
When Talking Has Taken You as Far as It Can
You may already know that the younger version of you was not at fault, that you deserve compassion, or that the danger is over—and still feel something entirely different inside. Experiential work creates the possibility of moving beyond explanation into an experience your system may be able to relate to differently.
Some things are difficult to change from the same state that learned to protect them.
Most of us move through ordinary life inside a familiar organization of thoughts, beliefs, emotions, expectations, and protective responses. That structure helps us function—but it can also keep recreating the very patterns we are trying to change.
You may understand exactly why you shut down, become overwhelmed, mistrust people, criticize yourself, or repeat the same relationship pattern. But understanding happens from inside the same system that learned those responses in the first place.
Ketamine can temporarily change that relationship. Thoughts may feel less fixed. Emotions, memories, parts of the self, or old assumptions may become easier to observe from a different perspective. Something that normally feels overwhelming may become more approachable; something that has always seemed unquestionably true may suddenly become available for examination.
We are not trying to bypass your defenses or force a breakthrough. We use the altered state as an opportunity to notice what becomes available—and then work with it carefully, sometimes actively and sometimes by allowing your own process to unfold.
The medicine does not decide what needs to change. It can create a different place from which change becomes possible.
Sometimes distance is what makes contact possible.
The goal isn’t always to feel more. Sometimes the first step is being able to feel without being consumed.
Distance is not the opposite of processing. Sometimes it is what makes processing possible.
01 — When More Intensity Isn’t Better
Some nervous systems do not need to be pushed deeper into the experience.
For people carrying significant trauma in the body, getting closer to painful material can sometimes mean becoming overwhelmed by it. Emotion, physical sensation, autoimmune, memory, or sensory input can become so immediate that there is very little room left to observe what is happening—much less work with it.
The same can be true for some neurodivergent people. In our clinical experience, highly immersive altered states can sometimes become physically or sensorily overwhelming rather than therapeutically useful.
02 — A Different Kind of Access
Ketamine can create space between you and what hurts.
Its dissociative effects may change the relationship to the body, emotion, memory, or story. The material can still be present, but sometimes with enough distance that you can look at it rather than be completely inside it.
We do not automatically interpret that distance as avoidance. Sometimes distance is precisely what makes something approachable for the first time.
03 — Regulating the Distance
We are not trying to get you as far away from yourself—or as deep into yourself—as possible.
We follow what is happening in real time. Sometimes the work calls for staying with a thread. Sometimes we create more grounding through the therapist’s voice, the room, bilateral tappers, music, or other sensory anchors. Sometimes there is already enough movement happening and the best intervention is simply to let your system continue.
The aim is to find the amount of distance from which the material becomes workable rather than overwhelming.
our approach
We do not decide in advance what your ketamine session is supposed to become.
We begin with the larger therapeutic picture—what you are struggling with, what we already understand about your history and protective patterns, what you want from the work, and what might need particular care if it emerges.
Then the medicine changes the conditions.
What happens next can be highly individual. A memory may surface. A younger part may appear. Something you have understood intellectually for years may suddenly feel different. You may encounter grief, shame, imagery, bodily sensations, relationship material, or a completely unexpected thread that becomes important.
Our job is to stay close enough to recognize what the moment needs without taking the experience away from you.
Prepare the Ground
The session begins before the medicine does. Preparation helps us understand what you are bringing into the room, what your system tends to protect against, what you hope might change, and how we can create enough safety for meaningful work to happen.
Follow What Emerges
We follow the work rather than forcing the session into a protocol. Sometimes we ask a question, follow an image, work with a part, explore a younger self, or stay with an emotional thread as it unfolds. Sometimes music, sound, or carefully chosen frequencies help shape the environment or support where the experience is moving. What matters is not whether the session looks a particular way. It is whether what is happening is useful.
Know When to Intervene — and When Not To
More therapy is not always better therapy. At times, a precise question or intervention can open something important. At other times, the client’s own process is already moving beautifully and the best thing we can do is get out of its way. We may also use bilateral tappers, the therapist’s voice, or other grounding cues when someone needs more connection to the room or more support processing what is emerging.
The medicine creates the state. The therapy helps us use what the state makes available.
The psychological work can be fluid. The medical safeguards are not.
01 — SCREEN BEFORE WE TREAT
Medical review + same-day drug screening
02 — READY BEFORE WE BEGIN
IV access + emergency equipment in place
03 — PHYSICIAN NEARBY
Medical support on standby throughout treatment
Ketamine-assisted therapy can take you into an unusual psychological state, but the medicine still has real physiological effects. Injectable ketamine can affect blood pressure, heart rate, breathing, and level of consciousness, which is why appropriate monitoring and readiness to respond matter.
At ACT, a physician is nearby throughout treatment. Before the injection, we complete medical screening and a urine drug screen. If something is present that could make treatment unsafe that day, we do not proceed.
We also establish IV access before administering ketamine by intramuscular injection. The IV is there as a precaution—so medication or fluids can be given quickly if they are ever needed. Emergency equipment, including a crash cart, is immediately available.
We would rather postpone a session than take a risk that does not need to be taken.
Sometimes knowing something is true isn’t the same as being able to feel it.
01
Parts & Protectors
Protective parts may shut down, become anxious, control, avoid, criticize, numb, or push other parts of you away. In ordinary life, those responses can happen so quickly that there is little room to understand them differently. During ketamine-assisted work, they may become easier to notice, approach, or relate to without immediately getting pulled into the pattern.
The goal is not to defeat the protector. It is to understand what it has been trying to do—and whether it still needs to work quite so hard.
02
Younger Selves
You may understand intellectually that a younger version of you was frightened, abandoned, blamed, abused, or simply doing the best they could. And yet some part of you may still reject them, feel ashamed of them, or wish they had been different.
Altered-state work can sometimes create an opportunity to encounter that younger self from a different place—with protection, tenderness, grief, forgiveness, or something they were never able to receive when the experience first happened.
03
Core Beliefs & Identity
I am unsafe. I am too much. No one is coming. I have to earn love. I cannot trust myself. If I lose control, everything falls apart.
Beliefs like these can organize an enormous amount of life without feeling like beliefs at all. They simply feel like reality. A different state can sometimes create enough perspective to notice the assumption itself—and begin asking whether it still deserves that much authority.
04
Corrective Experiences
A person may know they are safe now and still brace for danger. Know they are loved and still expect abandonment. Know an assault was not their fault and still carry shame.
In ketamine-assisted therapy, there may be opportunities to experience something different while the old expectation is present: safety instead of threat, compassion instead of rejection, connection instead of abandonment, or acceptance where shame has lived for years.
Not because we pretend the past was different.
Because the present can become different.
Two different doorways. One continuous piece of work.
Different states can reveal different parts of the same story.
Ketamine and hypnotherapy are not interchangeable. They create different kinds of access, and sometimes that difference is exactly what the work needs.
Ketamine can make something available. A protector may become visible. A younger self may emerge. An old belief can suddenly be experienced rather than merely understood. Something that has remained inaccessible in ordinary conversation may finally have enough space around it to be approached.
Hypnotherapy gives us another way to return to that material intentionally. We can slow down, communicate with parts, revisit an experience from a different perspective, reinforce something that shifted, or help integrate material that continued unfolding after the ketamine session ended.
Sometimes the sequence goes the other direction. Work in hypnosis may reveal a pattern that later becomes useful to approach during ketamine. Ordinary therapy, altered-state work, and integration can continue informing one another rather than existing as separate treatments.
We do not use either modality simply because we can. The question is always what kind of access would be most useful now—and whether changing the state would actually help us reach something that ordinary therapy cannot yet reach.
The medicine wears off.
The work may not.
A ketamine session can end long before everything it opened has finished moving.
An insight may feel obvious in the room and less certain the next morning. A part may become louder. Grief can arrive later. A relationship may suddenly look different. Something that felt resolved may reveal another layer.
Integration is where we become curious about what followed you home—what changed, what persisted, what became clearer, and what still needs attention.
Sometimes that means ordinary therapy. Sometimes parts work or hypnotherapy. Sometimes it means allowing an experience time to settle before doing anything with it at all.
Ketamine is not a separate track. It belongs to the whole case.
The medicine may change the state. The larger story is still yours.
A ketamine session does not happen in isolation from the rest of your life. What emerges may involve trauma, attachment, sexuality, grief, neurodivergence, family conditioning, identity, relationships, protective parts, or questions about who you are and what you want your life to become.
That is why we do not treat ketamine as a stand-alone experience.
When we already understand the larger therapeutic picture, something that appears in the ketamine room has context. A reaction may connect to work we have been doing for months. A relationship pattern may suddenly become clearer. A part we have talked about may finally become accessible in a different way. Something entirely unexpected may emerge and give us a new direction.
The work can then move where it needs to move. What begins during ketamine may continue in ordinary psychotherapy, hypnotherapy, parts work, couples therapy, sex therapy, or another altered-state session when appropriate.
The modality can change without requiring you to start over.
That is the advantage of treating the person rather than treating the ketamine session.
We don’t just want to know that something helped.
We want to understand why—and whether it can help again.
Some of the most interesting moments in altered-state therapy raise questions that clinical intuition alone cannot answer. Why did one intervention create movement when months of insight had not? Which elements mattered? Was it the altered state, the timing, the therapeutic relationship, the specific technique—or some interaction between them? We are interested in turning those questions into better clinical practice.
Clinical intuition can show us where to look. Research helps us determine what is actually there.
01
Marc Geronimo is pursuing a PhD in Psychology at the California Institute for Human Science, specializing in Psychedelics, Consciousness, and Transformation.
Marc’s doctoral research is supervised by Glenn Hartelius, PhD, Co-Director of Psychology Programs at CIHS, whose research includes transpersonal psychology, attention, somatic experience, and states of consciousness.
That academic work complements what is happening clinically at ACT: examining altered states, consciousness, trauma, psychological change, and the conditions that may make transformation more likely.
02
The ketamine clinic is becoming a place where therapeutic approaches can be refined—not by treating clients as experiments, but by paying unusually close attention to what creates meaningful movement.
That includes the integration of ketamine-assisted therapy with hypnotherapy, parts work, trauma treatment, bilateral stimulation, experiential interventions, and other techniques that may help people access material differently.
When something appears especially promising, the question becomes: can we understand it well enough to test it?
03
As part of Marc’s doctoral work at California Institute for Human Science, ACT is preparing for future doctoral research conducted through our ketamine clinic, examining techniques used alongside ketamine-assisted psychotherapy, including approaches relevant to trauma and PTSD.
The larger goal is not to create methods that only work in our treatment rooms. It is to identify approaches that can be studied responsibly, refined when necessary, and—if the evidence supports them—eventually taught to other clinicians.
meet our team
Therapeutic depth, medical oversight, and the flexibility to bring in the right kind of work as the process unfolds.
Marc Geronimo
LMFT-A, CHT
Ketamine-Assisted Therapy • Trauma • Hypnotherapy • Altered States • Integration
Sara Sloan
LMFT, CST, IRT
Ketamine-Assisted Therapy • Sexuality • Neurodivergence • Attachment • Integration
common questions
The experience varies from person to person and from session to session. You may notice changes in your sense of time, space, the body, emotion, memory, or perspective. Some people feel deeply inward; others experience imagery, unexpected memories, parts of themselves, or a sense of distance from things that normally feel overwhelming.
We are less interested in whether your experience looks a particular way than in what becomes available because of it. Ketamine is a dissociative anesthetic and can produce dream-like states, altered perception, and changes in the experience of the body and environment.
No. Some sessions involve considerable interaction; others become very quiet.
We may ask a question, follow an image or emotional thread, work with a part, help you orient to the room, or invite you to stay with something that seems important. At other times, your process is already moving and the most useful thing we can do is not interrupt it.
The goal is not to keep you talking. It is to recognize what the moment needs.
At ACT, ketamine is administered by intramuscular injection within a medically supervised setting. Before treatment, we complete medical screening and a same-day urine drug screen. IV access is established as a precaution, emergency equipment is immediately available, and a physician remains nearby throughout treatment.
Ketamine can affect blood pressure, heart rate, breathing, and level of consciousness, which is why monitoring and readiness to respond matter.
If something makes treatment medically inappropriate that day, we do not proceed.
The medicine may wear off before the psychological work has finished unfolding. We pay attention to what follows you home—insights, emotions, memories, parts, relationship material, or changes that become clearer over the following days—and decide together what deserves further attention.
You will need transportation home. The current FDA prescribing information for ketamine injection advises avoiding driving, hazardous machinery, and other hazardous activities for 24 hours after receiving ketamine.
There is no number that makes sense for everyone.
Some people may benefit from a defined series of sessions; others may use ketamine selectively within longer-term psychotherapy. What matters is what we are treating, how you respond, what changes outside the treatment room, and whether another session is actually likely to move the work forward.
We do not want the protocol making decisions that should belong to the case.
They are different.
Ketamine injection is FDA-approved as an anesthetic; its use for psychiatric treatment is off-label. FDA has specifically noted that ketamine itself is not approved for treatment of psychiatric disorders.
Spravato is esketamine, a related medication delivered as a nasal spray. It has FDA approval for treatment-resistant depression in adults, either alone or with an oral antidepressant, and for depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behavior when used with an oral antidepressant.
ACT’s work described on this page is intramuscular ketamine-assisted psychotherapy, not Spravato treatment.