Photo by Aaron Farrington

Ketamine Clinic at CWC

Our Ketamine clinic provides Ketamine Assisted Psychotherapy (KAP). This is the use of ketamine in conjunction with therapeutic psychological support. Ketamine brings one into altered consciousness. This means that you understand yourself, and the world, in a way that is different from your normal way of thinking and being. Working with this information, and integrating your experience with our highly trained therapists, optimizes the therapeutic benefits of Ketamine.

 Ketamine doses are individualized. We use the same range of doses that you will find in ketamine infusion only clinics-(where there is no therapist sitting with you to process your experience).

We are with you throughout your sessions; you are never left alone. We help guide you to be open to the experience, to understand it, and integrate it into your normal conscious mind. In this way, we help you get the most out of your investment in your self care.

 We meet in our beautiful, comfortable offices. It is a safe and supportive environment for you to explore your concerns, to help you move towards increased self understanding and work towards deep personal healing.

  • The FDA approved ketamine as an anesthetic agent over 50 years ago. The mental health use of ketamine has become widespread in recent years. It has been studied and promoted by researchers at the National Institute of Mental Health. It has gained publicity as the newest antidepressant with its novel pharmacological mechanism of action.

    Ketamine has an extensive record of safety. It has been used at very high doses for surgical anesthesia, without significant side effects, and notably no respiratory depression, common in other anesthetic medicines.

    Ketamine is now a validated treatment for depression, anxiety, addiction, substance dependencies, PTSD, and other conditions. While it is being widely used for these conditions, it is considered "off label," meaning that the FDA has not explicitly approved it for these uses. However, significant research supports its effectiveness and safety when used in appropriate dosage and in a supportive, safe setting.

  • Ketamine may bring about psychedelic (altered experience of being in your mind) effects. These could be "transpersonal" (being outside of your usual sense of self), "mystical" (a heightened experience of or connection to god/spirit), or "out-of-body" (feeling separated from your physical body). These experiences may also facilitate a shift in your life perspective and your current emotional state.

    Other medicines are classified as psychedelics, meaning they take you out of your everyday and usual experience of being in your mind--how you perceive yourself and the world. Ketamine is currently the only legal psychedelic medicine in Virginia. We are firmly committed to staying within Virginia's and the United States’ legal and regulatory practices. Ketamine is the ONLY psychedelic medicine that we will be utilizing at this time.

    Throughout human history, psychedelics have been used for healing and spiritual understanding. Psychedelics came to the attention of the modern world through chemistry in the late 1930s with the discovery of LSD (lysergic acid diethylamide). There was considerable research on LSD and Psilocybin (mushrooms which alter consciousness) in the US and Europe from the 1950s into the 1970s, when widespread social use of these medications led to the termination of research. They are considered "classical psychedelics" and most analogous and equivalent to medicines used in traditional religious ceremonies since early times.

    Ketamine touches on the altered reality of classical psychedelics, but in a brief, transient way. You are in altered consciousness with classical psychedelics for 4-8 hours. With ketamine, the experience may last 30-60 minutes. How long and how deeply one is altered is dose-related. Lower doses can alter one mildly and not be psychedelic but may prove beneficial for therapy as there can be a distinct lowering of defensiveness.

    Dosing is decided collaboratively with your therapist.

  • The short answer: ketamine stimulates brain connectivity, builds new nerve pathways, and helps clear away old habitual patterns. Some experience it as a “brain wash”. It actually facilitates new nerve cell growth and enables some established nerve cells to function more flexibly. 

    The clinical understanding of how ketamine works is complex and newly understood. Read on if you want a deeper understanding.

    Ketamine is as an NMDA (N-methyl-D-aspartate) antagonist working through the glutamate neurotransmitter system. Glutamate is an excitatory neurotransmitter (NT). It is the most potent and most common NT in the brain. Glutamate plays a very large role in learning, cognition, and mood by enhancing creation of neural synapses (which are responsible for the transfer of NT) and increasing neural plasticity. 

    Glutamate is found in most synapses (points of nerve cell connection) in the central nervous system (the brain and spinal cord). Neurotransmitters are chemical messengers of the nervous system. They transmit chemical information between nerve cells or between nerve and muscle cells. Excitatory neurotransmitters encourage the movement of exchange of messages between nerve cells—also known as neurons. Other neurotransmitters inhibit this exchange, such as the main inhibitory NT, GABA.

    The excitatory glutamate and the calming GABA are deeply intertwined. Balance between the two contributes to our emotional and physical balance and well-being. Interestingly, glutamate is a major source of GABA, through biochemical conversion. Glutamate is an amino acid (building block for proteins, among other things) that was discovered in the late 1990s. This is all relatively new information. 

    Glutamate exerts its effects through binding to different types of neuron receptor cells, one of which is NMDA. Ketamine acts as an NMDA antagonist by blocking the effects of glutamate at NMDA receptors. The inhibition of the glutamate system at the NMDA receptors by ketamine influences the broader NT system and seems to be the basis of its therapeutic effects. 

    If you have the wherewithal and want to do a deep dive into this subject, please click this link to view—> this video of a talk by Rakesh Jain MD on the Glutamate system, ketamine and the exciting future of psychopharmacology.

  • Ketamine along with psychotherapy has been shown to be helpful in treating the following conditions:

    • Depression

    • Anxiety

    • PTSD

    • End of life/terminal illness anxiety

    • Addiction

    • Eating Disorders

    Ketamine isn't a one-time treatment that "cures" mental health conditions in a single session. Rather, ketamine can offer a different understanding of how you perceive yourself in the world. You have a 40-60 minute “journey” into a different understanding of yourself and the world. Then you return to normal consciousness and process or integrate that experience with your ketamine provider. Both in the journey and in the integration a deeper understanding of one’s life can emerge and solidify.

    Ketamine also stimulates beneficial brain changes such as enhancement of neuroplasticity—brain nerve cell flexibility and neurogenesis—creation of new brain cells (neurons). These changes may lead to significant symptom relief.

    What has shown to be most beneficial is a series of six ketamine sessions spaced out over the course of three to six weeks. This initial treatment cycle is followed by a long-term maintenance phase that may include occasional booster sessions.

  • KAP combines psychotherapy with the neurological and psychedelic benefits of ketamine to maximize the positive benefits.

    The addition of psychotherapeutic support helps guide clients toward deeper insight, connection, and growth. Ketamine can lower anxiety and provide some distance from the emotional flooding that can occur when exploring difficult issues. When exploring uncomfortable thoughts, feelings, and body sensations in our normal conscious state, we can become defensive and/or tense which can get in the way of openness and healing. During a KAP session, this defensive wall typically falls away opening one’s curiosity and allowing exploration of the inner landscape.

    During the peak effect of ketamine, most people are fully turned inward and not interested or particularly able to talk with another. However, after the peak effect, there is an opportunity to explore your issues while in an altered state. Further, there is an opportunity to integrate your experience with your usual conscious understanding as you return from your journey. The entire experience is supported by a therapist being there with you.

    Your KAP therapists are here to support you as needed. You will never be alone during your session. There will be a clinician with you who understands how the medicine works and is looking after your needs.

    While we are your therapists during your KAP program, your outside therapist is welcome to come to some sessions. This can help them understand the KAP process and how you are working with it. We will need to speak with them before they attend your KAP session.

    The powerful shifts realized in your KAP therapy can be supported and enhanced by sessions with your outside therapist or integration sessions with us.

  • Initially, you will have an intake appointment lasting approximately 1 1/2 hours. This will include a detailed history of both psychological and physical health.

    A second meeting (about 50 minutes) allows you to prepare for how to work with ketamine, explore your intentions for the therapy, and help you decide in what form you wish to take your ketamine; IM, or IV.

    The total number of dosing sessions may vary by the individual. We recommend a minimum of three dosing sessions. However, we encourage six sessions, ideally over three to six weeks. This dosing frequency is considered optimal to affect flexibility and shifting in the patterned thinking that often causes us distress with mental health difficulties. The six ketamine sessions are followed by at least one “integration” session.

    Integration refers to the discussion and emotional "digestion" of your ketamine experience(s). This helps you integrate the altered consciousness of the KAP session with your ordinary consciousness. Integration will occur during the dosing sessions and there is at least one integration session following the last KAP session. Additional therapy/integration sessions can be scheduled throughout treatment as needed or requested

    Please visit the "Who can-not receive Ketamine Therapy?" section to ensure that you are eligible for KAP therapy with CWC.

  • The first ketamine dosing session can provide significant symptom reduction lasting a few days to weeks. For some, It may take several sessions to start noticing an impact. Subsequent sessions will then tend to result in longer-lasting beneficial changes. Some people may not experience significant treatment-related benefits from this therapy.

    After an initial series of treatments, clients may go many months between treatments with sustained, significant symptom reduction.

    Effectiveness increases with multiple sessions and when accompanied by integration sessions. It is alo recommended that KAP is part of an overall treatment program that includes ongoing work with a therapist and attention to self-care. If your symptoms respond to Ketamine Assisted Psychotherapy, you may still elect to continue (or begin) treatment with medications and psychotherapy to reduce the possibility of relapse. Over time, you may also need additional ketamine treatments or other therapies to maintain your remission.

  • You may be administered ketamine via one of two methods: intramuscular injection (IM), or IV infusion. These methods are reviewed below.

    1) Intramuscular injection (IM): Intramuscular injections are administered by a syringe injected into a muscle (usually the shoulder or thigh). This method's onset is rapid, typically taking 2-5 minutes. Due to rapid onset and a shorter course of action, the total dose is usually given in two (2) half doses about 10 to 15 minutes apart. Its entire duration, when given in this fashion, will last from 40 minutes to an hour.

    2) Intravenous (IV); When administered by IV infusion, ketamine is taken directly into the bloodstream. The onset of effect is less rapid than the IM dosing due to the controlled intake of the solution. The duration of IV sessions is about the same as IM, typically lasting 40 minutes to an hour.   You are connected to the IV through-out this time. This method has the advantage of being able to turn it off at any point if desired, and within 10 minutes, you are back to fairly normal consciousness.

  • Before participating in ketamine treatment, you will be carefully interviewed to determine if you are eligible for ketamine therapy. This will include a medical and mental health evaluation and history. This may include a review of your medical/mental health records. You will also be given brief psychological written testing to assess your state of mind.

    • There are some conditions that may make you not eligible to participate in this treatment, as follows:

    • Pregnant women are not eligible because of potential effects on the fetus. The effects of ketamine on pregnancy and the fetus are undetermined. Therefore, it is advisable to protect against pregnancy while exposing yourself to ketamine or, in the immediate aftermath of its use—your current menstrual cycle.

    • On a case-by-case basis, a nursing mother with significant postpartum depression will be given consideration, with the agreement that their milk will be pumped and discarded for 4 hours after the dosing sessions. In the absence of acute mental health issues, we recommend waiting until weaning for this therapy.

    • Untreated hypertension is a contra-indication to ketamine use as it can cause a rise in blood pressure. Similarly, a history of heart disease may make you ineligible to participate.

    • Your medications will be reviewed to make sure that you are not taking any medicine that interacts negatively with ketamine.

    • Ketamine is not taken if you have untreated or unstable hyperthyroidism.

    • If you have a significantly weakened immune system, you may not be eligible for ketamine treatment as there have been reports of some decrease in immune function in patients receiving surgical doses of ketamine.

    • Ketamine has been shown to worsen certain psychotic symptoms in people who have schizophrenia or other severe mental disorders. It may also worsen underlying psychological problems in people with severe personality disorders. If you have been or are presently diagnosed with a similar, severe mental disorder, you may not be a candidate for KAP.

  • You can call us at: 434 202-8612, email us at: info@wellnessandchange.com or, fill out an appointment request form online.

    You will then be scheduled for a free consultation with one of our therapists. During this consultation, we will discuss your needs and how ketamine-assisted psychotherapy (KAP) could help you.

    After this free consultation, you will be scheduled for an intake appointment. This is a 1 ½ hour meeting with one of our therapists to discuss your mental health and medical history. This helps us get to know you more deeply which is essential in this psychotherapy-based ketamine treatment.

  • Our prices include the presence of a highly trained therapist who is with you throughout each session. The thorough initial screening and preparation sessions provide an important foundation for entering into work with this medicine.

    • Initial Phone Consult (30 min)
      Free

    • Mental Health/Medical Evaluation (90min)
      $200.00

    • KAP Preparation session (50 min) $150.00

    • Ketamine-Assisted Psychotherapy Pre-paid Package:

      - Initial series of six 2 hour dosing sessions: $ 2,550.00 *

    • Ketamine dosing sessions paid individually: (120 min)
      $475.00

    • Integration Sessions: (50 min)
      $150.00

      * The total cost including the Psychiatric Evaluation, Prep Session and six (6) Ketamine-Assisted Psychotherapy sessions (with pre-paid discount) is:
      $ 2,900.00.

      Total cost without the discounted pre-paid is:

      $ 3,200.00

  • Relevant Ketamine Articles

    An Interesting Way to Understand Psychedelic Consciousness.

    The link below is a 2 part talk lead by Tara Brach—a meditation teacher, healer and writer. She speaks with Dan Siegel MD who is a psychiatrist, therapist, researcher, and writer. In this talk he explores how we typically view ourselves as individual beings and how this view can be expanded. His previous work has explored what he calls Interconnection—how we humans connect with each other. His recent work expanded to Intraconnection. How we can connect with each other and the natural world. His exploration of Intraconnection is very consistent with what many experience as psychedelic consciousness, however, he comes to this understanding through science and meditative practices. It is a very interesting talk.

    Agencies Supportive of Psychedelic Therapy

    • Multidisciplinary Association for Psychedelic Studies (MAPS) is an American nonprofit organization working to raise awareness and understanding of psychedelic substances.

      https://maps.org

    Podcasts About Therapeutic Ketamine

“The only way to ease our fear and be truly happy is to acknowledge our fear and look deeply at its source.”
— Thich Nhat Hanh
“The natural healing force within each one of us is the greatest force in getting well. ”
— HIPPOCRATES