Medication Assisted Psychotherapy FAQs
Is this the same as psychedelic therapy?
Many terms are used for this type of therapy—ketamine-assisted or facilitated psychotherapy, cannabis-assisted psychotherapy, etc. In the United States, we are limited to utilizing only medications that are FDA-approved. (Though their use in psychotherapy is not FDA approved and therefore done “off label”). Ketamine is an FDA-approved medication for anesthesia, and ketamine (Spravato) is FDA-approved for treatment-resistant depression. Ketamine can be used in an off-label manner either as a sublingual lozenge or “troche,” intramuscular injection, or sometimes at a higher dose with IV infusions. Ketamine is considered a dissociative agent and not a “psychedelic,” though it has been lumped in this category. Some therapists offer “psychedelic integration” of people’s psychedelic experience from drugs not used during the therapy session, which is very different than medication-assisted psychotherapy done in a controlled setting with evidence-based psychotherapy.
How long will this therapy take?
There are no quick fixes for complex trauma. Simple traumatic experiences may be resolved in a relatively short period of time. Complex trauma and chronic PTSD take much longer to resolve, especially if there are also childhood and attachment issues connected to the trauma. That being said, medication-assisted therapy is a more effective and efficient way to resolve these issues than what we have seen with other therapeutic modalities.
If I do this kind of therapy and quickly tap into my trauma issues, will I fall apart?
As Jon Kabat Zinn, the godfather of Westernized mindfulness meditation therapy, once said, “Meditation is not for the faint of heart.” The same can be said of trauma therapy and, more specifically, medication-assisted psychotherapy. Centers around the country working with various techniques and research protocols for medication-assisted psychotherapy have noted that this type of therapy can create a level of “destabilization” (worsening of symptoms) in the early part of therapy. The reason for this is that symptoms of PTSD, such as dissociation (shutting down) and compartmentalization, are your body, mind, and brain’s way of coping and protecting you from the trauma. Although you may not experience the trauma overtly, it does manifest in other ways, such as mood disorders, anxiety, physical symptoms, and relational problems. These coping mechanisms, which have been in place for years, begin to break down during treatment as these “workarounds” are no longer needed to protect you (hang onto or bury the trauma without resolution). The doors to your psyche begin to open in this therapy, and through these doors come the experiences, events, and “programming” that are frequently responsible for the symptoms you have experienced for so long. This traumatic material emerges with the support of medication-assisted therapy, and it is not an easy, blissful journey. Though not easy, it is a path towards wellness and peace of mind which you may never have experienced before. The journey is supported by our expert therapists, and it is an intelligent experience that will make sense to you. For improvement to be made in trauma/PTSD, which is lasting and fulfilling, this is a necessary part of treatment, leading to people feeling more associated but also more symptomatic and less functional in the early part of the work. For many people, the destabilization that occurs is significant, but they can function at an acceptable level at work and with family, though it may not be on their “A game.” Others may require more intensive support to help them through these early, difficult experiences.