From Knowing to Healing: How Ketamine-Assisted Psychotherapy Helps Break Old Cycles

Finding peace after trauma: Ketamine-Assisted Psychotherapy can help bridge the gap between knowing your patterns and truly healing, opening the door to lasting change.

Shannon’s Story
Shannon sits across from me in session, her voice caught between anger and exhaustion. “Why am I like this? I know Joe isn’t good for me. I tell myself every time that I need to put myself first and stop going back. But I can’t seem to stop.”

Shannon is not a beginner in therapy. She shows up. She journals. She keeps good sleep habits. She has read the books and can explain her patterns. Yet she is stuck. She knows Joe is unhealthy for her, but the knowing doesn’t translate into change. “It’s like I can explain it, but I can’t feel it,” she says.

Her history helps explain this. Shannon grew up in a home marked by abuse, neglect, and instability. Her father drank heavily and was violent. Her mother, though present, did not protect her. Later, she lived with her grandmother, but the wounds were already embedded: love felt unsafe, betrayal felt familiar. As an adult, she entered relationships that replayed those same dynamics.

And yet, Shannon can barely remember much of her childhood. She is a poor historian of her past. What she does remember are the echoes, feeling invisible, being unsafe, carrying the burden of survival. Research shows that trauma often fragments memory, leaving people unable to recall details while their bodies carry the imprint (Bessel van der Kolk, The Body Keeps the Score). Shannon’s adult life tells the story her memory cannot.

The Gap Between Knowing and Doing
Clients like Shannon live in what I call the knowing phase. They can describe their trauma, understand the patterns, and even teach others what unhealthy dynamics look like. But they cannot shift from insight to action. This is not because they are weak. It is because trauma is stored not just in thoughts, but in the nervous system. Healing requires more than understanding; it requires embodied change.

This is where Ketamine-Assisted Psychotherapy (KAP) offers something unique.

What is Ketamine?
Ketamine has been used safely in hospitals for over 50 years as an anesthetic. At lower doses, researchers discovered, it can rapidly relieve symptoms of depression, anxiety, and trauma. Unlike psilocybin or LSD, its effects are shorter (45–90 minutes) and gentler, yet powerful in shifting perception.

Studies at Yale and the National Institute of Mental Health show ketamine’s rapid antidepressant effects, sometimes within hours. For trauma survivors, this window can allow access to emotions and memories long locked away.

What is Ketamine-Assisted Psychotherapy (KAP)?
KAP combines carefully prescribed ketamine with the support of a therapist. The medicine opens the mind and body, softening defenses and creating space for buried emotions to rise. Therapy then helps process those emotions and transform insights into lasting change.

For Shannon, this could mean moving from “I know Joe isn’t good for me” to actually feeling in her body why she deserves to let go, and being able to act on it.

What to Expect in a KAP Session

Preparation
Before your first full session, you and your therapist will take time to set intentions, review safety, and clarify your goals. To begin, you’ll start with a practice dose of ketamine at home. This helps you and your therapist understand how your body responds in a safe, supported way before moving into deeper work.

Medicine Experience
During a session, ketamine is usually taken as a lozenge that dissolves slowly under the tongue. Within about 10–15 minutes, you’ll enter a dreamlike, spacious state. Most people describe feeling calm, deeply relaxed, or gently detached from everyday concerns. Each session is scheduled for about 2.5–3 hours, giving you time to settle in, experience the medicine fully, and then transition smoothly into integration. Your therapist will remain with you the entire time, virtually, through secure video, holding space, and offering guidance if needed.

Integration
After the medicine experience, the real work of KAP begins. With your therapist’s support, you’ll process what came up, connect insights to your life, and begin rehearsing new ways of being. For someone like Shannon, integration is key, the medicine may open the door, but therapy is what helps her walk through it and truly embody change.

Who is a Good Candidate?
KAP can be especially helpful for people who:

• Are already in therapy but feel stuck in the same cycles.

• Struggle with depression, anxiety, or PTSD that hasn’t fully improved.

• Know their patterns, but cannot change them.

• Have limited access to childhood memory but clear signs of trauma in adult life.

• Have established healthy routines and good sleep hygiene.

• Want to move from numbness and survival into openness, embodiment, and presence.

When KAP May Not Be the Best Fit
KAP is not for everyone. It may not be recommended for those with uncontrolled blood pressure or heart conditions, a history of psychosis, or current/recent substance use struggles. It is also not designed for people seeking ketamine without the therapy component. People with poor sleep hygiene or ongoing sleep issues may also not benefit fully from KAP. KAP works best when medicine and therapy come together, and when the body already has a foundation of rest and regulation.

Research and Evidence

• Memory and Trauma: Van der Kolk’s work shows trauma disrupts memory recall but imprints deeply in the body.

• Ketamine and Depression: Yale research demonstrates rapid improvement in treatment-resistant depression with ketamine.

• Integration Matters: Studies from Johns Hopkins and MAPS emphasize that psychedelic medicine only creates lasting change when paired with therapeutic integration.

From Stuck to Free
Shannon’s story is not about weakness. It is about the natural outcome of a lifetime of survival. She has insight but remains tethered to old wounds. KAP offers her a bridge, from knowing to feeling, from stuckness to change.

KAP doesn’t erase the past, but it helps release its hold, allowing the future to unfold with greater clarity and strength.