If you’re considering ketamine therapy or supporting a loved one through it, you may be wondering:
“What actually happens during a ketamine session?”
Understanding the process can greatly reduce anxiety and enhance the therapeutic outcome.

In this article, we walk you through a typical ketamine-assisted therapy (KAP) session — from preparation to post-session integration — based on ethical practice guidelines and current clinical protocols.

🧑‍⚕️ Step 1: Pre-Treatment Evaluation

Before your first session, a comprehensive evaluation is conducted. This includes:

• Clinical history review (diagnosis, past treatment response)

• Medical fitness assessment (vitals, cardiac risks, medication use)

• Psychological readiness (trauma history, mood state, coping style)

• Consent and education about the effects, risks, and goals of therapy

This step ensures you’re a suitable and safe candidate for ketamine therapy.

🧘 Step 2: Set and Setting

“Ketamine doesn’t just work pharmacologically; it works experientially.”

🔑 Two key concepts matter:

• Set = your mindset going in (mood, expectations, openness)

• Setting = the physical and emotional environment

Your therapist helps create a calm, safe space — often with:

• Reclining chair or therapy couch

• Eye mask (optional)

• Calming music

• Reduced interruptions

A trusting relationship with your therapist is central to this process.

💉 Step 3: Administration of Ketamine

Depending on the protocol and route of administration:

During the session, vital signs are monitored, and a clinician or assistant remains nearby.

🌌 Step 4: The Ketamine Experience

Each person’s experience is unique, but common phenomena include:

• Visual imagery or dream-like scenes

• Detachment from body or self (dissociation)

• Shifts in perception of time and space

• Emotional breakthroughs or clarity

• Floating or expansive states of consciousness

Some describe it as “seeing their problems from above”, while others feel deep peace or catharsis.

It’s not always pleasant — some people experience confusion, fear, or revisit traumatic content — but that’s where therapeutic support matters.

📝 Step 5: Integration and Reflection

Once the effects wear off (usually within 1–2 hours), the therapist may facilitate a short debrief:

• What did you experience?

• Were there insights or emotional shifts?

• What does this mean for your healing journey?

Within the next 24–48 hours, a full integration session may occur, using:

• Psychotherapy (CBT, ACT, Internal Family Systems)

• Journaling or guided reflection

• Creative techniques (art, music, drawing emotions)

“The medicine opens the door — but integration walks you through it.”

🔁 Step 6: Follow-Up and Treatment Planning

Patients are usually advised to:

• Avoid driving or major decisions for 12–24 hours

• Maintain hydration and rest

• Note changes in mood, clarity, sleep, or emotional reactivity

Subsequent sessions are planned depending on response. Some patients require:

• 2–3 sessions/week for 2 weeks (induction)

• Once every 2–4 weeks (maintenance)

Psychotherapy continues throughout for consolidation of gains.

💬 What People Commonly Say After a Session

“I felt like I had 6 months of therapy in one session.”
“The fog lifted. I didn’t feel stuck anymore.”
“I saw something I had been running from — and I was okay.”

These experiences are not due to the drug alone, but to the interplay between mindset, environment, and support.

⚖️ Safety and Monitoring

All sessions should occur under:

• Supervised clinical protocols

• Real-time monitoring (pulse, BP, mental state)

• Emergency preparedness (though adverse reactions are rare)

Ethical practitioners also screen for dependency risk, and discourage long-term unsupervised use.

🧘 Is It Like a Trip? Or Therapy?

Both — and neither. While some describe it as a psychedelic or altered state, the purpose is therapeutic.

Ketamine allows you to:

• Step outside habitual thinking

• Observe inner narratives with less emotional charge

• Access repressed or defended material

• Feel safe enough to release old pain

When combined with therapy, this can lead to lasting psychological change.

📘 Final Thoughts

A ketamine session is not a chemical shortcut, but a powerful doorway to insight and healing — when used responsibly.

Preparation, setting, emotional safety, and structured follow-up are essential. With proper guidance, ketamine can help individuals break through emotional walls, reconnect with purpose, and move toward integration and recovery.

Written by:
Dr. Srinivas Rajkumar T, MBBS, MD (Psychiatry)
Consultant Psychiatrist
Apollo Clinic, Velachery, Chennai
📧 srinivasaiims@gmail.com
📱 +91 85951 55808
🌐 www.srinivasaiims.com

Curious about whether ketamine therapy might help you? Reach out for a structured evaluation and discuss whether this path is right for you.