What to Expect
Answers to your frequently asked questions
Many people have questions about psychedelic treatment such as what the process looks like, how long it will take, what they will experience and more. The following is based on our experience with many clients and we attempt to answer the most frequently asked questions. There are, of course, too many variables to know precisely what path your treatment will take. What we describe here is the common arc of therapy for many of our clients.
We do not use cognitive behavioral therapy (CBT) at our clinic, and our modality is much more of a body-based, autonomic nervous system approach than it is a standard talk therapy model. We do this for two reasons. First, we find that many mental health symptoms such as anxiety, panic, depression, bipolar symptoms and addiction do not improve with more insight or understanding. Understanding the cause of something or changing a belief in most cases does not change the bottom-up reactivity that clients experience. We find that people don’t think their way out of anxiety and depression so much as they feel their way out of anxiety and depression.The other reason we don’t primarily use a talk therapy approach is because it does not pair as well with psychedelic medicine as more experience focused, body-based approaches do. It is certainly possible to talk one’s way through a psychedelic therapy session and gain more insight. We find that deeper shifts are accomplished when the much more robust pathway of the body is used to help process the difficult revelations, memories, and emotions that typically arise with psychedelic therapy.
How long are the sessions?
Our drug assisted sessions are always two hours in length. In the case of ketamine, the active effects of the drug typically last between an hour and thirty minutes all the way up to two hours. The cannabis assisted sessions are more controllable in terms of how long they last. Your clinician is with you the entire time helping you navigate the emotions, memories, deep seated beliefs and non-verbal programing that arises during the session.The final portion of the session is used to discuss and integrate what took place. We have a quiet recovery room that you can stay in for as long as you need before leaving. You are welcome to schedule additional integration sessions but many of our clients do not feel the need given there is usually time for that in the two hour drug session and also because we have other support and integration group options at no cost. (See "Integration & support groups" below)
How many sessions will I need?
The answer depends on what you are bringing to the table. Here is the rule of thumb: if a client has a securely bonded, stable childhood filled with attuned parenting and connection, and if they went through a stressful or traumatic period as an adult; we are typically talking about a shorter course of treatment. This can potentially mean two to four treatment sessions for a significant single event trauma. This person’s internal system is typically trusting and resource filled (aware of the goodness of their world and relationships) such that the psychedelic therapy can provide a lot of movement and resolution in a short period of time. Alternatively, there is the client who has had stressful, chaotic, traumatic or neglectful experiences particularly in the developmentally sensitive window of childhood. This is a far more complex situation and is referred to as complex PTSD (C-PTSD). It typically leads to people being in therapy for years or to treatment resistance. Many of the people we see come to us with this background. We see roughly a third of this type of client complete at around twelve sessions, and another third needing to go beyond that and wrap up between eighteen and twenty one sessions.
Unfortunately, stressful and traumatic events are frequently cloaked in dissociation. This is especially true of events that took place in childhood. Because of this, neither we nor you can fully know what to expect before actually going in. Dissociation is what frequently leads to treatment resistance and fortunately, this is the area that psychedelic therapy can be very effective. See our blog article on this subject.
What is your rate?
Our rate is $185 per hour. This is true if you are receiving ketamine assisted psychotherapy, cannabis assisted psychotherapy or non-drug assisted psychotherapy. The only exceptions to this rule are the medical psychiatric visit (in the case you will be working with ketamine), and the various support, integration groups which are no cost to our clients (see the "Integration & support groups" section below).
Frequency of sessions
We recommend maintaining a regular frequency of sessions as you are moving through your treatment. Clients sometimes inquire, ‘can I do this once every other week’? Our recommendation is to hold off and not begin treatment until you can have a regular weekly frequency of sessions. The idea here is that weekly sessions are helpful for gaining traction and for continuing the momentum once we have it. Four treatments over two months does not yield the same outcomes as four treatments over one month. You are welcome to double up on sessions if you are visiting from out of state or if you are in the middle of a particularly difficult piece of work and want to move through it more quickly. Some clients are not able to emotionally tolerate more than one session per week.
What we have seen in the MDMA clinical trials is very similar to what we see in our clinic every day which is that psychedelic psychotherapy creates destabilization in the short run. Essentially, the compartmentalization, the dissociation, the coping mechanisms that have been in place for years begin to break down with treatment (these work arounds are no longer needed by your system). The doors in the psyche begin to open and through those doors come the experiences, the events and programing that are frequently responsible for generating symptoms. As trauma emerges with the support of psychedelic therapy, it is not an easy, blissful journey but it is a supported, intelligent experience that will make sense to you. This is a necessary part of treatment and it leads to people being more associated, but also more symptomatic and less functional in the early part of their work.
For many people, the destabilization that occurs is significant but they are able to be functional for work and family. They are not on their A game. For others, they need added levels of support to help them through this period.
Integration & support groups
As noted above, some clients will feel more raw during the initial phase of treatment but will remain functional for work, family and commitments. Other clients will need added support to help them through this period. We have created five different groups facilitated by our staff that are designed to provide integration and support. We do not charge a fee for these groups to ensure there are as few barriers as possible for our clients seeking stability between their sessions. These groups include: art therapy integration, Dialectical Behavior Therapy (DBT), restorative yoga, women’s movement, and peer support discussion groups. We are aware of the depth of work psychedelic therapy invites and these resources allow us to provide an intensive outpatient level of support that is simply not possible in a private practice setting. Additionally, these groups convey a sense of community and a shared experience since you will be around other clients going through a similar process.