Integration

I’ve read much here about “integrating” the ket experience, with some people stating that if you don’t go through an integration process that you’re just “getting high” or “tripping”. While I don’t doubt there is at least some truth to that perspective (I think it ignores the neuroplasticity aspect of treatment), I wonder how those of us with less-than-optimal access to care are to set about that integration process. I rarely see anything during my treatments that I could describe as recognizable - pretty much just slowly flowing fractals; sometimes I experience movement. During my last infusion, I had the experience of being pulled backwards, rotated 90 degrees to the left so I was viewing an enormous field of stars , then being propelled like I had been shot out of a cannon into that star field. While profound, I have no idea how to integrate that experience.

The infusions do help me, no question, but I’ve been doing this now for coming up on two years, and I still feel like I’m struggling pretty frequently. I do see a therapist twice a month and that helps, but frankly it’s not enough. I find myself sinking into pretty serious SI at times, and sometimes (rarely) it goes beyond that.

I’d be open to suggestions, but please keep it constructive. I get plenty of “Just suck it up! from my own inner Critic.

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Oh my goodness! I would never tell anyone to suck it up. I’ll bet we’ve all gotten that way too much in our lives, huh? I can’t speak to everyone’s experience. Integration might be different for everyone or someone else here might know more definitively. I find that even though I have struggled from a very young age with depression, anxiety and PTSD, I am pretty clueless when it comes to self awareness, really knowing myself or connecting the dots, so to speak. I guess I am very reluctant to look inside at all the ugliness and damage. Now ketamine is blowing open the long hidden layers of trauma and depression. For me, I find it best to have an appointment with my therapist the day or two after my infusions. I like to journal right after and for the next day or two to really put down to paper what I experienced, what I’m feeling, my thoughts. I think this is integration as well. Then I see my therapist and she has the distance and perspective (and the degree!) to help me connect it to my overall history and healing. Then a lot more writing. This helps reinforce and deeply absorb it all. It’s like ketamine blows it up and integration helps me put the pieces together in a new and healthy order, and maybe throw away a whole mess of crap I no longer need to hold onto too. That’s what integration is to me. I have to also say though that my therapist is as new to ketamine as I am. So, this might not ring true for those receiving therapy with someone more experienced or receiving therapy during the infusion. I’m interested to see what others say. You sound very knowledgeable and self aware though, Sojourner. You probably already integrate your experiences a whole lot better than I do! Clueless here! Best with everything. Sending love to you.

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Sojourner- I’m sure you’ve been fighting as hard as you can for a very long time. My experience is much the same as yours with regards to treatment. There’s no control and I don’t have an ability to recount much afterwards.
If there’s SI involved, maybe some medication is in order. I don’t pretend to know what works, but, I do know that I still use Cymbalta. Even with the infusions I can’t maintain stability without it.
I also have a light for seasonal affective disorder. At first it seemed a little hokey, then it really seemed to help. I got it on Amazon. It’s very bright and you sit close to it for an hour or longer. It feels like you’ve been outside in the sun.
My clinic tells me that if I get into a very dark place, it may take a few infusions close together to get that gain that ground back.
My thoughts are with you and I will keep you in my prayers that you get relief in some way.

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Thanks, @gingersmom and @littlevoice. I think that I may be a little SADD as well.

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:blue_heart:

@gingersmom, there’s a piece that I wrote about 20+ years ago (at a time that I was a fairly prolific poet) that I’ve been considering sharing with the forum. I think I’ve decided that the benefits of sharing it probably outweigh the risk to my ego. Watch for a post entitled “Maelstrom”.

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My clinic doesn’t do any therapy other than the ketamine injections, so I have wondered about integration as well.

They do give prescriptions for troches for home use. I have asked here, and the providers at the clinic about them, since I have discovered that in terms of scheduling, taking them when I go to bed works pretty good. Both the providers here and at the clinic tell me “No problem.” They say that whether or not I am conscious, the drug does what it does.

I have not had any accusations (other than from myself) about recreational tripping. I have decided that (a), there isn’t much about the experience that I would consider recreational. And (b), tripping, well, yes. That is kind of the point. Let it take me to a different viewpoint of whatever it is, so that I am seeing it all in a different way, from a different place.

As the old joke had it, I’m not really hallucinating, I just think I am.

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There’s an online integration coaching company that I’ve been using called Being True To You (beingtruetoyou.com). They’re pretty good and reasonably priced. Check them out.

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I am not sure about the integration process. I do the infusions alone and troches/nasal spray at home. HOWEVER, I found that, during my infusions, a lot of the themes from my therapy sessions (CBT based) come through in some very fascinating ways. I share these with my therapist and she has been amazed at the breakthroughs that have come on my own during the sessions while “tripping”. In short, I think most of us are doing the work outside the infusions and that will probably play out during the infusion experience. Just my opinion, but I feel that the barrier between my subconscious/conscious mind breaks down during the infusions and allows real healing.
For example, during one infusion, I was shown two rooms, one a place of safety and one a place of innocence. Both with specific visual and emotional qualities. These were safe spaces created by myself for when I feel pain or guilt. That’s a pretty incredible thing for the brain to do on its own when you think about it. Thirteen years of therapy alone couldn’t break down those walls and provide that coping strategy for me. But I don’t think I would’ve gotten there without doing the therapy as well.
I also still take antidepressants. I’m not sure what would happen if I stopped but I would like to get to a place where I could. Any thoughts on this??

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Keeping in mind that my depression isn’t severe, just damned persistent, I have been able to get off the SSRI that I was taking. I talked with my therapist (not my ketamine doc) first and he was OK with it.

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@salty I think mine was moderate but is also persistent, however I have TRD so how much do the meds help anyway is my question.
My psychiatrist is pretty insistent on the antidepressants and I have to stay with her for my anxiety meds so :woman_shrugging:t2:.
I mean I guess I could just try quitting them on my own and not telling her. I basically did the ketamine on my own. She provided no assistance with that. SMH.
We have to do so much advocating for ourselves!!!

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@Scoobie76 re: antidepressants. That’s really a question for yourself and your doctor. I weaned myself off for what I hope will be the last time about five years ago. I have been on and off for about 20 years. Most had terrible side effects, and made me feel like a zombie. Coping, but not living. So I decided I’d rather deal with the depression and anxiety symptoms rather than the SSRI symptoms, and weaned myself off over several months. I have not regretted it.

Actually, the anti-depressant that helped the most was Trazadone, which is pretty old. I was prescribed it for occasional use for my raging insomnia (especially while traveling for work) and then when the S@#$ hit the fan in 2020 I started taking it every night rather than just occasionally. But it has some well known side effects like brain fog that I did feel it was causing, so in early 2021 I quit taking it. But it did help me get through 2020.

Obviously I still have challenges there or I would not have gone through ketamine therapy. Ketamine has without a doubt been the most effective, without any real (lasting more than a day or so) side effects - apart from the emotional upheaval it creates as your brain rewires itself. So grateful for this therapy.

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However much I may question the ‘business’ of medicine, I wouldn’t quit without some discussion with a doc. I have done that, both deliberately and inadvertently, and I wouldn’t wish the results on my worstest enemy. I have done some Seriously Stoopid Shit in the absence of my head meds. I have joked in the past that the only reason I ain’t dead is that I am too stupid to know I should have been dead a long time ago.

Maybe consult with a different doc for a second opinion. Coming off some of those unguided can truly be Hell on Earth. Maybe Hell on Earth would be an improvement over some of what I experienced that way.

I’ll admit that I am lucky for having providers that are supportive of the ketamine therapy. Neither my regular doc nor my therapist are against it, and neither of them have any connection to where I go for it. But I am honest with them, and they tell me that if it works, go with it, and don’t hesitate to call if there are any problems. My ketamine clinic has also been very good about telling me to call if there are any problems.

Ketamine might be as close to anything I might (in my un-religious/irreligious state) consider to believe in as a miracle.

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@salty @Shepherdess I have changed meds so many times trying to find an effective treatment that I have experienced the withdrawal and weaning process too much. I would certainly wean myself off the meds slowly. Not sure if you are experiencing this in your area but where I live they treat benzos like opioids. I am on a very low dose after being over prescribed for years and enduring a painful weaning process. I endured extreme anxiety and was told by my previous doc that she would NOT provide any meds for anxiety attacks if I did not completely come off benzos and would have to rely on the really low dose I was on that barely managed my daily anxiety levels.
All other docs consider me an addict and will not take me as a patient bc I am taking benzos. I can’t even imagine discussing ketamine treatment with them. This is the ONLY reason I would consider staying with my current doc and weaning myself off the antidepressants. It’s not ideal but I think you both know that the system is broken and we are often treated as drug abusers for simply requiring meds to operate normally on a daily basis.
I agree that ketamine has been a miracle treatment for me. Would be amazing if this were covered by insurance and offered earlier for people rather than suffering with the awful side effects of multiple meds and feeling like a guinea pig.

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You know you best,just be careful.

You gotta love the system that gets you hooked and then blames you for it. I used to work with a former addict. He had several surgeries as a kid to correct scoliosis, which made it physically impossible for him to go through withdrawals. He had a hell of a time finding a doc that would prescribe methadone.

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@Scoobie76, you speak for me as well. My doctor retired about 3 years ago because his practice clinic got taken over by big health care, and my one attempt at a new doctor was a disaster. Three years later, I still don’t have a primary care provider.

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I didn’t read everything in this thread but I just remembered something my psychiatrist told me when I told him all I want is to be by the ocean. He said there is evidence that sunlight in conjunction with the water somehow raises mood. Without a doubt when I’m at the beach and walking in the sun and my feet in the water, I am better. Maybe now my name makes sense :grinning::beach_umbrella::sunny:

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