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Psychology

IJTS Special Topic Section: Ketamine ● The Transformative Power of Ketamine: Psychedelic States and a Personal History of Transformation

January 1, 2014 / Ketamine, Papers, Psychology, Publications / By /

Abstract

A discussion of the nature of transformation and its relationship to psychedelic experiences— particularly ketamine experiences—is presented and discussed along with a schema for thinking about types of states that may be encountered and transformations that may occur related to psychedelic use and practice. This is followed by a longitudinal historical approach for portraying and examining personal transformation along with a proposed instrument— The Transformational Codex—for cataloging that history and the elements that compose it.

Wolfson, P. E. (2014). The Transformative Power of Ketamine: Psychedelic States and a Personal History of Transformation. International Journal of Transpersonal Studies, 33(2).
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IJTS Special Topic Section: Ketamine ● Ethnographic Accounts of Ketamine Explorations in Psychedelic Culture

January 1, 2014 / Humanities & Art, Papers, Psychology, Publications, Substance Use Disorder / By / , ,

Abstract

Off-label use of ketamine as a mind-altering substance did not begin in the laboratory, but in the psychedelic culture that grew out of the 1960s counterculture movement. Whatever the risks and limitations of such experimentation, without them the remarkable therapeutic effects of the drug might well have gone unnoticed, and unresearched. The following personal accounts—both inspiring and cautionary—offer glimpses into the cultural contexts that found ketamine to be much more than a reliable anesthetic.

Ring, K., Metzner, R., & Wolfson, P. E. (2014). Ethnographic Accounts of Ketamine Explorations in Psychedelic Culture. International Journal of Transpersonal Studies, 33(2).
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IJTS Special Topic Section: Ketamine ● Psychedelic Experiential Pharmacology: Pioneering Clinical Explorations with Salvador Roquet

January 1, 2014 / Humanities & Art, LSD, MDMA, Papers, Psychiatry & Medicine, Psychology, Publications, Substance Use Disorder / By /

Abstract

Richard Yensen was a research fellow at the Maryland Psychiatric Research Center from 1972 to 1976. He studied psychedelic psychotherapy with Stanislav Grof, M.D. and other senior staff. During this time he treated patients with substance abuse disorders, cancer, neurosis, and other health professionals seeking a training experience. Dr. Yensen did his Ph.D. dissertation on the use of MDA in psychotherapy with neurotic outpatients and conducted his research at the MPRC. Through many years of experience in governmentsanctioned psychedelic research, he has evolved a non-drug shamanistic psychotherapy called Perceptual Affective Therapy. In the 1990’s Richard was co-holder of IND 3250, an investigational new drug permit issued by the U.S. Food and Drug Administration to study LSD and psychotherapy until 2006. He is currently a licensed psychologist in California and director of the Orenda Institute in Vancouver and Cortes Island, British Columbia, Canada and president of the Salvador Roquet Psychosynthesis Association. He has served on the faculties of Harvard Medical School, Johns Hopkins University and the University of Maryland Medical School in Baltimore.

Wolfson, P. E. (2015). Psychedelic Experiential Pharmacology: Pioneering Clinical Explorations with Salvador Roquet. International Journal of Transpersonal Studies.
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IJTS Special Topic Section: Ketamine ● Regarding the Transpersonal Nature of Ketamine Therapy: An Approach to the Work

January 1, 2014 / Ketamine, Papers, Psychiatry & Medicine, Psychology, Publications / By /

Abstract

Recent evidence has shown that ketamine treatment can facilitate psychological insight and symptom resolution in various psychiatric disorders. To aid this process, psychotherapeutic support should be considered a fundamental aspect of treatment. The psychedelic experience produced by ketamine can be a deeply meaningful source of enduring change and personal growth. The author has repeatedly observed a rapid realignment of self-perception away from shame, fear, and dread toward authentic self-acceptance and gratitude, offering patients opportunity for insight and the consideration of new potentialities. The experience produced by ketamine is similar in quality to transpersonal experiences described by Jung and induced by various religious practices and near-death experiences. As such, therapists working with these patients may wish to understand and incorporate the concepts of the Psychic Life Cycle, Restitution of the ego-Self Axis, and the Encounter with the Self described within Jungian and Transpersonal Psychology. The author discusses broad themes and practical therapeutic considerations regarding the transpersonal themes identified while overseeing this treatment process. Case studies are provided for illustration.

Becker, J. (2014). Regarding the Transpersonal Nature of Ketamine Therapy: An Approach to the Work. International Journal of Transpersonal Studies, 33(2).
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IJTS Special Topic Section: Ketamine ● Making Ketamine Work in the Long Run

January 1, 2014 / Depressive Disorders, Humanities & Art, Ketamine, Papers, Psychiatry & Medicine, Psychology, Publications / By /

Abstract

Treatments such as ketamine psychotherapy face substantial financial and regulatory obstacles to dissemination into widespread use. Newly patented medications are able to generate enough capital to pay for studies required for FDA approval, personnel to apply for coverage on insurance plans, and marketing to establish a successful launch. Ketamine is an older drug with considerable evidence of efficacy for treatment resistant depression, and almost 50 years of data concerning safety as an anesthetic agent. However, it can no longer be patented, so there is no incentive for pharmaceutical companies to help get it into widespread use. In this paper we discuss some of the complex issues surrounding use of ketamine in the outpatient setting and share information and practice pearls that have been gathered through communication with other practitioners and through direct experience with over 1000 treatments involving 120 patients in the last eight years. The safety and appropriateness of intramuscular ketamine treatment in the outpatient psychiatric office is discussed. We hope to help proponents of effective mental health interventions navigate the actual and potential challenges involved in safe application of this treatment option outside of hospital-based programs.

Early, T. S. (2014). Making Ketamine Work in the Long Run. International Journal of Transpersonal Studies, 33(2).
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IJTS Special Topic Section: Ketamine ● Ketamine Psychedelic Psychotherapy: Focus on its Pharmacology, Phenomenology, and Clinical Applications

January 1, 2014 / Ketamine, Papers, Psychiatry & Medicine, Psychology, Publications / By / , , , , , ,

Abstract

Meant to be an authoritative guide for psychiatrists and others interested in understanding and applying ketamine psychedelic psychotherapy (KPP), this paper focuses on its pharmacology, phenomenology, and clinical applications. Ketamine is a dissociative anesthetic widely used by physicians and veterinarians in the United States. In addition to its anesthetic and dissociative properties, ketamine also has a multitude of other psychological and pharmacological properties, which include analgesic, sedative, neuroprotective, anxiolytic, antidepressant, stimulant, euphoriant, and hallucinogenic effects. The literature on the clinical application of KPP is comprehensively reviewed, practical advice for using KPP is given, and the pharmacology and phenomenology of ketamine-induced psychedelic experiences are explored, including in relationship to transpersonal healing and possible iatrogenic consequences of misuse of KPP.

Kolp, E., Krupitsky, E., Sylvester, M., Kolp, A., Friedman, H. L., Jansen, K., & Young, M. S. (2014). Ketamine Psychedelic Psychotherapy: Focus on its Pharmacology, Phenomenology, and Clinical Applications. International Journal of Transpersonal Studies, 33(2).
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IJTS Special Topic Section: Ketamine ● Ketamine for Depression: A Mixed-Methods Study

January 1, 2014 / Depressive Disorders, Ketamine, Papers, Psychiatry & Medicine, Psychology, Publications / By /

Abstract

Prior studies have reported variously on the presence or absence of dissociative effects at subanesthtetic doses of ketamine administered for treatment-resistant depression. This mixedmethods study emulated the protocol used for the studies in question, with IV administration of 0.5mg/kg over 40 minutes with eight experienced ketamine users. Quantitative measures were generally insignificant since this was not a population reporting depression; blood pressure increased as expected by 20-30mm systolic and 6-20mm diastolic, falling rapidly by 20 minutes after completion of the infusion. Individual qualitative reports reports of relaxation, pleasant sensation, decreased cognitive function, and some disabling of ordinary capacities. As experienced users, subjects commented freely on what was characterized as the triviality of the experience, and typically expressed skepticism that ketamine could have antidepressant properties when administered at this dose or in this manner, as well as disbelief that it could be beneficial except perhaps as a period of relaxation, or as a partial break from ordinary states of mind in naïve subjects. Group discussion produced a consensus recommendation in favor of threshold- and higher-dosage transformative work beginning with a 40-50mg IM bolus, potentially in a series of sessions with higher dosages if indicated, with the number of sessions to be determined by clinical practice; such work should occur in a closely monitored psychotherapeutic setting.

Wolfson, P. E. (2014). Ketamine for Depression: A Mixed-Methods Study. International Journal of Transpersonal Studies, 33(2).
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Flashbacks and HPPD: A Clinical-oriented Concise Review.

January 1, 2014 / LSD, Papers, Psychology, Publications / By / , ,

Abstract

A unique characteristic of LSD, LSD-like and substances with hallucinogenic properties is the recurrence of some or all the hallucinogenic symptoms which had appeared during the intoxication after the immediate effects of the substance had worn off. This recurring syndrome, mainly visual, is not clearly understood. The terms Flashback and Hallucinogen Persisting Perception Disorder (HPPD) have been used interchangeably in the professional literature. We have observed at least two different recurrent syndromes, the first Flashback Type we refer to as HPPD I, a generally short-term, non-distressing, benign and reversible state accompanied by a pleasant affect. In contrast, the second HPPD Type we refer to as HPPD II, a generally long-term, distressing, pervasive, either slowly reversible or irreversible, non-benign state accompanied by an unpleasant affect. HPPD I and II appear to be part of a broad spectrum of non-psychopathological and psychopathological states reported by hallucinogen users. HPPD I and II may be clinically characterized by prodromal symptoms, onset, content of visual imagery, precipitators, frequency, duration and intensity of perceptual recurrences, severity, course, differential diagnosis, accompanying mood and affect, insight and remission. Pharmacological therapy with or without preceding or following co-occurring psychiatric disorders have been shown to ameliorate this syndrome. A large variety of medications may be utilized to alleviate this condition, but with differential results suggesting several subtypes. The purpose of this manuscript is to provide a clinical-oriented, comprehensive and concise review to treating psychiatrists.

Rudinski, D., Bor, O., & Goodman, C. (2013). Flashbacks and HPPD: A Clinical-oriented Concise Review. The Israel journal of psychiatry and related sciences, 51(4), 296-301.
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IJTS Special Topic Section: Ketamine ● Ketamine and Depression: A Review

January 1, 2014 / Depressive Disorders, Ketamine, Papers, Psychiatry & Medicine, Psychology, Publications / By / , ,

Abstract

Ketamine, via intravenous infusions, has emerged as a novel therapy for treatment-resistant depression, given rapid onset and demonstrable efficacy in both unipolar and bipolar depression. Duration of benefit, on the order of days, varies between these subtypes, but appears longer in unipolar depression. A unique property is reduction in suicidality although data are more limited. Strategies to extend duration, via multiple doses, maintenance treatment, or subsequent augmenting medications have yielded mixed results. There is a relative paucity of data regarding alternate methods of administration such as intramuscular, intranasal, and oral routes, though preliminary results are promising. Adverse effects most reliably include dissociative and sympathomimetic effects, both transient and mild, and suggest good tolerability. Ketamine’s unique effects may represent an opportunity for a paradigm shift in the pharmacologic treatment of depression.

Ryan, W. C., Marta, C. J., & Koek, R. J. (2014). Ketamine and depression: A review. International Journal of Transpersonal Studies, 33(2), 40-74.
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IJTS Special Topic Section: Ketamine ● Ketamine—Its History, Uses, Pharmacology, Therapeutic Practice, and an Exploration of its Potential as a Novel Treatment for Depression

January 1, 2014 / Depressive Disorders, Humanities & Art, Ketamine, Papers, Psychology, Publications / By /

Introduction

The origins of this special section on ketamine and ketamine assisted psychotherapy and an overview and deliberately controversial discussion of depression and ketamine’s putative efficacy as an antidepressant arise from two sources. The first is a fairly widespread and historical appreciation of ketamine’s power as a transformative agent, especially when embedded in a psychotherapeutic context. Ketamine is after all the only legal psychedelic in use—as a Schedule III substance with an indication as a dissociative anesthetic and a long history of safe and effective use for anesthesia and analgesia, this without significant respiratory depression. Other uses have occurred, for example in the control of agitated, suicidal, and aggressively psychotic individuals in the ER setting, and as a transformational, psychedelic experience at low to moderate dosages—pre-anesthetic levels — inspired by the work of Roquet, Jansen, Krupitsky, and others [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][…]

Wolfson, P.E. (2014). Introduction to the Special Topic Section: Ketamine–Its History, Uses, Pharmacology, Therapeutic Practice, and an Exploration of its Potential as a Novel Treatment for Depression. The International Journal of Transpersonal Studies, 33(2), 33-39.
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