Terminated for too much secondary. trauma

please be kind in any responses. Thank you.I had one ketamine session during which I successfully processed a secondary /vicarious trauma—it no longer haunts me. But my principle concern is my treatment resistant depression and suicidal ideation triggered by almost any sort of rejection.
When I returned for my second treatment, i was told that I was inappropriate for ketamine therapy b/c as a social worker I had too much secondary trauma, that the first treatment indicated that the first ketamine had damaged me. I tried to explain that in fact it had freed me, but they did not believe me. They considered a second dose but decided against it because I I mentioned how the first dose had helped me understand evil better, and referenced the archetypal Trickster . I tried to explain that for me these were positive things, but was told that my mindset was too negative and I was not a suitable candidate for this type of therapy.

This confused me for 3 reasons: 1. The V.A. Uses ketamine to treat PTSD in vets—how can I be more traumatized than they are? 2. This is is a treatment for depression. Usually depressed people have some kind of depressive thought process going on. Right? Can you really have too much “negative energy” to be treated? 3. How do they know what my experience was and how can I not know? They would not entertain the possibility at all that i found it was incredibly positiveI do understand that I looked distress. while I was processing the trauma. But I was not. I was.detached from the narrative.

Obviously not the treatment program for me. Few alternatives where I live. 1. There is psychiatrist who will do infusions with or w/o therapy. The intake is another $1000, and the chances of me fitting into the paradigm of a male psychiatrist are slim. So I am hesitant. 2. There is the home program—obvious safety concerns. Anyone tried that? 3. Non-medical model. Dissociative drug with a “guide”. Same obvious concerns. Anyone tried.that?

I honestly don’t know what to do now. I don’t know now who I can trust, can I even be treated? I am in a negative spiral right now.
Any suggestions or thoughts?

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It sounds to me like you need to find a clinic with some compassion that is truly wanting to help people. Did they at least give you any recommendations?

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No, they just told me I’m untreatable and to call my ride to come get me early. There is almost nothing else available in my area.in terms of ketamine therapy. Anyway they couldnt refer me even if there were a place to refer me to because they think I cannot be helped. I’ve tried so much else and worked hard , and I function with work, friends, community service etc.but still the continuous suicidal ideation. This was kind of the last house on the block. Im not non-functional enough to qualify for the brain implant.

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I’m so sorry to see that you are having such a difficult time. Please reach out to any of the moderators or look on the FAQ section on this site for resources. You deserve compassion and support. Please don’t give up. I wish you comfort and peace.

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Thank you for your kind words.

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Also know that this community is full of support. I get on here quite a bit and just read when I feel myself spiraling. I’m sorry the “professionals” aren’t there for you right now. Keep fighting, it’s so worth it. I’m here for you, I know others are as well. 🫀⚡️

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Okay, but right now I don’t know what to do. They told me ketamine therapy is not appropriate for me but they didn’t tell me what is. I really don’t want to do ECT. It causes memory loss and my short term memory is already not great. I am too functional to qualify for the brain implant. Just thinking outloud. I just can’t wrap my head around what happened this week. It’s like a solar plexus punch and a concussion at the same time. And I know you can’t give me answers. But I do appreciate your encouragement.

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I agree with @gingersmom. There has to be someone on here that can point you in the right direction.

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@Kara I’m so sorry to hear about your situation. Hang in there - hopefully a solution can be found. Their denial of treatment makes no sense to me at all given all the life stories of everyone here - we’re all broken and struggling to heal or we wouldn’t be here. We’re all here for you - and hopefully help will be found!

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@Kara, Do you care on elaborating what exactly happened during your first infusion that made them decided that Ketamine was contraindicated for your condition? What kind of behavior did you exhibit?

@Kara I am not trying to be negative but I do know from the research Ketamine is not a positive treatment for everyone. I had to go through an interview before it was determined Ketamine may be a helpful treatment for me. The interview process is reviewed periodically to ensure progress is being made. I experience CPTSD. My Ketamine treatments have definitely helped however, it has been a real process. Checking in to ensure the Ketamine is working was explained to me in part as an ethical requirement of the clinic. If I was not a good candidate for the Ketamine, if improvement was not being made, they felt it unethical for the clinic to continue such expensive treatments.
Have you researched other psychedelics in your state? MDMA is now legal in Oregon and in the final phases of clinical trails to be legal in Washington. Some studies argue MDMA is actually more effective for people experiencing PTSD. The research suggest as more psychedelics become legal there may be a distinction in diagnosis and prescribed psychedelic treatments.
Again I don’t know your history however, I have also read studies where multiple modality treatments have been helpful for people e.g. EMDR and Spravato or EMDR and Emotional Freedom Technique (EFT) or tapping. There is a website called the Tapping Solution by founder Nick Ortner that can give you more information and even lead you through tapping exercises.
I wish you the best.

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@Kara, I definitively agreed with @Deb, recommending anything for your particular situation, because it seems almost impossible to do so without having a clear picture of your mental condition. Who knows what the staff at the clinic witnessed when you were under that made them think Ketamine would create more harm than good in your particular case. Also the comments you made to them about Evil and the archetype trickster. They probably though -like you said- you were experiencing psychotic ideation versus just plain and simple depression. The trickster comment is considered a text book sign of schizophrenia and Ketamine is contraindicated for patients with schizophrenia. I am not saying you are schizophrenic. I am not trying to diagnose you or anything like that but you need to get further psychiatric assessment to determine if your treatment choices are going to be effective or not, how can you be treated appropriately unless you really know what is wrong with your mind.
I truly hope you take my comment as coming from a good place, I want you to get better and find a solution to your problem but it truly gets my attention that a clinic that could benefit from the revenue the ketamine treatments bring would turn you away just like that. Either they don’t know what they are doing or they know more than anyone out there, and they do have your best interest at heart but expressed them very poorly.
There is a liability line as well, ketamine is definitively a tool to improve the person’s ability to better manage depression but I don’t think it is considered a cure by any means. It works differently for every person and its long term effects can not yet been predicted. Doesn’t get your attention why some people need boosters and more frequent maintenance treatments? Depression is a chronic condition, it might get alleviated and manageable with the available medical resources but without treatment it returns once something triggers it, it is a recurrent mental disorder, and it carries a very heavy stigma and no ones is comfortable being open about it.
These are my opinions, and they way I deal with my depression. Acknowledging it and accepting it, is as important to its treatment as any prescribed medication.
Please forgive me if I aggravated you with what I said, this community here is wonderful and we helped each other by being objective when we can not discriminate right from left. Thanks to the advise of many people here I feel safe talking with you like that. Love.

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Hi, Deb. I appreciate your comments. I’m in the field so I know about and have tried a lot of methods and techniques . Maybe other psychedelics is the way to go, although I recently such benefits from my one ketamine treatment—but it seems to be attached to a medicalized/pathologizing type of treatment model, which Im obviously not finding compatible. I went through three assessments for this one program; the first brief phone conversation was free, the other two in more depth and cost about $1000.
I think I am done with private mental health providers which is sad, b/c I am one.

Hi Rafael, thanks for your comments. I think Im more Jungian than schizophrenic. Mention of archetypal material is really considered a sign of schizophrenia by the private practice mental health world? Wow. Not what I hear my schizophrenic street people talking about—but then, Im a social worker so maybe I just look at the world differently. Through a less refined lens.

Or maybe Trickster references are just for schizophrenics who have been to graduate school.:smile:. Or are Into the Tarot. Or maybe both graduate school and the Tarot are indicators of psychosis? Now that could be.

Clearly, they had a bad experience of what was for me an incredibly helpful experience. This is hippie-dippie No Calif. I thought everyone talked about archetypes and was trauma-informed. I was wrong.
I do think it’s unethical just to tell someone they are being terminated and not give any referrals, recommendations, alternatives. I do think it is unethical not to at least try to leave the client with some hope , something to pursue… But maybe that’s just a social worker thing.
I’m a bad patient. No more MDs. No more PsyDs. Going off grid now.

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Where R u located. I’m in Houston and am able to go to any ketamine clinic. No referrals or anything needed. I’ve gotten Ket infusions for 2 years at two different clinics. The doctors ask questions and get my history and info from my current psychiatrist but the ultimate decision to do the treatments or not is in my hands. I’m having a really hard time understanding how the people at the clinic you went to feel that they are entitled to make this decision for you??? Sorry if this is sounding harsh or anything…. But I’m angry on your behalf for the way you have been treated.

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Wow. I feel that something shady is going on there and they didn’t want you to see it. I am retired from your same profession. Nothing about this sounds right. Trust yourself. You know you need help and it is at least unethical to send a suicidal ideation patient home without appropriate referrals and follow up on their part. I did 6, 2hour infusions as a last ditch effort for several problems. I was vegetative for a year and a half. No way would I have ECT. Each infusion was terrible and horrible in experience but at the end the next day or so I felt a huge relief from all symptoms. The only reason I hung in there was that I new I was out of options. So glad I did. I did not have to tell them I am a LCSW so I didn’t and usually don’t because at times I need to be the patient and not treated like I have knowledge that I don’t when I comes to my own pain and problems. My doc of many many years gave me the choice of this or some new ECT with magnets. I chose the ketamine. He made the referral. Who was your referral source? Sounds like you have at least Depression. It is not a requirement to have trauma directly or any other way. There is something else that is going on. Seek out a referral source to refer you to a reputable clinic that they know to be sound because they have seen the results for patients they treat. And you know what I have to say — get help for that SI immediately. Gather your support team. We don’t want to lose you. And stay in touch. It is worth driving somewhere else if you have to even for anonymity sake. Please take care. And allow yourself to be the patient of someone trustworthy. Let us know and hang in there. You are worth it.

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@Booker, you’ve raised a good point here, that clinic might need to be investigated because if Kara’s report is accurate, there is a bigger ethical issue here that risk Kara’s well being.

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It really doesn’t sound right. Treatment 101: if someone tells you they have SI, you are not allowed to say in effect “go away”. It is on them to ensure her safety and they added to her stressors. They must at least make referrals and follow up with her and the referral source to ensure she gets there.

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