The Ketamine Solution
(Part 4 of the story of my psychedelic-enhanced journey to mental health)
I met David, my therapist, at the ketamine clinic. Because of COVID, it was the first time I had met him in person. All of our prior therapy sessions had been via tele-health. I had feared that meeting in person might be awkward, but it wasn’t. He looked and sounded the same as on the computer screen, and I was immediately comfortable with him.
We were at the ketamine clinic to try to find my childhood trauma — assuming there had been one. David believed that my sense of shame and obsessive personality suggest that there probably is an underlying trauma, but I could not recall any. As a child, I had had very little interaction with my father, so if there was a parental-caused trauma, it was probably with my mother, but I had never come even close to identifying it. I was beginning to think that perhaps I was a psychological outlier, and despite David’s belief, hadn’t experienced any childhood trauma.
The ketamine clinic was in a typical medical office building, clean and sterile but not forbidding. The nurse brought David and me back to a small, windowless “examining room,” except that instead of the usual padded table to lie on, there was a very comfortable, vinyl reclining chair. I sat in the recliner, and David sat in a stackable-type chair against the opposite wall, about six feet in front of me.
The clinic doctor came in to give us a short explanation of the ketamine infusion procedure, and then the nurse returned and inserted a transparent intravenous line into my arm. She started up the small pump on a side table next to me, and I watched the first drops of ketamine enter my bloodstream,
I closed my eyes and relaxed, surprised that I wasn’t more nervous. To focus on my trauma, I thought about myself as a little boy. No more than a minute later, revelation struck! It seemed incredible. The ketamine had been dripping into my arm for no more than a minute or so, and suddenly the source of my trauma and the pattern of events that caused it just seemed clear and obvious.
I sat up straight and announced to David, “I know my trauma. It wasn’t my mother. It was my father.” I fell silent for a moment, my mind replaying the now-clear pattern of events that hadn’t even occurred to me before. “What happened?” David asked, prompting me.
“It wasn’t any one thing,” I replied. “It was a series of disappointments.” Not only was I remembering small, minor incidents from sixty-some years ago, but I clearly understood their similarity, the pattern they created and their effect on very-young me.
Although my father was a metallurgist with a chemistry degree from UCLA, what he really liked was to work with his hands. He loved gardening, woodworking and tinkering with car engines. In an effort to engage with me when I was very young, he had tried to teach me these skills and interest me in these hobbies.
But they weren’t for me. I had no talent and even less interest in these kinds of activities. I liked numbers and patterns and strategies, not working with my hands. When I declared my lack of interest in these endeavors with a typical five year-old’s certainty and disgust, I could see the disappointment in his face. And with my ketamine-enhanced memory, I re-lived my youthful reactions to his disappointment: I felt like a failure, inadequate, unmasculine and shameful.
Let me pause the story for a moment to explain how recollections worked (at least for me) under the influence of ketamine. My 65 year-old brain was present and observing what was happening, but the rest of me not only remembered — but truly re-lived — these childhood incidents. I observed them in what seemed like high-definition video, and I heard all the words and other sounds as if they were occurring all over again.
More importantly, right there in the examining room, I re-experienced the same emotions that I had felt at the time as if they were happening to me at that moment. That was what confirmed to me the authenticity of these ketamine-induced memories. I not only saw what I clearly understood to be disappointment on my father’s face, but I felt and re-experienced my younger self’s internal shame with a sinking feeling in the pit in my stomach — even as I knew that I was sitting on the examining room recliner.
With the wisdom of my 65 year-old brain, I was able to understand what I didn’t realize sixty-some years ago. To my young self, my father was the paragon of masculinity, and I had concluded that I was an unworthy boy because I lacked the masculine skills and interests that he was trying to teach me. It seems trivial — even silly — in retrospect, but my five year-old self had concluded and made an integral part of his personality the assumption that he was a shameful person and a disappointment to his father.
And that was my trauma. David had prepared me for the possibility that a trauma can be a gradual erosion of self-esteem rather than some kind of “explosion” that creates comparable mental illness. That’s what this was. The ketamine helped me not only remember a series of relatively minor individual incidents in which my reactions had disappointed my father, but it enabled me instantly to perceive the pattern that they represented and how they had fundamentally altered my self-concept.
The ketamine also helped me to recall a related incident from when I was six years old. Trying to connect with me on my own terms, my father taught me how to play chess. Together we learned how the pieces moved and what the object of the game was. This I liked! It felt like something that I was meant to do. We sat down and played a game. He won, but I instinctively knew that there ought to be interim objectives and reasons that I didn’t yet understand for why a piece should move from one square to another, and I wanted to learn and master them.
The next day in my school library, I found a book on chess for beginners and quickly absorbed it. When my father and I next sat down to play, I beat him very quickly — in just four moves. And it was clear that I knew what I was doing. I proudly explained to him what I had learned from the chess book and what he should do differently next time to prevent losing.
My young self expected him to praise me and be proud of me for learning the game so well — and I was surprised when he reacted differently. He was disappointed, not in me, but in the fact that I had taken what he had hoped would be a fun activity for us and turned it into a competitive endeavor that he could no longer enjoy.
But my six year-old self could only understand that I had “ruined it.” I had already incorporated as an axiom of my young personality that I was unmasculine and shame-worthy and blamed myself for again disappointing my father.
Of course, my 65 year-old brain which was observing the interaction could see that my younger self had done nothing wrong and deserved praise for having the initiative and talent to figure out such a complicated game. It was my father whose personality shied away from competitive endeavors and who probably had his own sense of shame or inadequacy triggered by losing in chess to a little boy who had been playing the game for less than a week.
Overall, the ketamine experience was very positive: useful and even enjoyable. In a sense it was like watching old family videos except that instead of passively watching images on a screen, I felt that I was re-living the events in question. And I felt secure and grounded throughout the session because my adult self was observing everything that I was reliving and interpreting with my adult perspective. I later learned that this is the essence of successful trauma therapy: re-living and re-interpreting the trauma through a lens that has a current-day perspective distant from the pain of the trauma.
Something very strange happened in the middle of the ketamine session that was later mirrored in my subsequent psychedelic trip. I could have sworn that my 65 year-old brain was awake and alert during the entire ketamine experience and that I remembered all of it. But an important event happened that I was completely unaware of until David told me about it after the ketamine had run out and I had emerged from the trip.
When David and I were talking immediately afterwards, I told him that I thought that I had gotten “a handle” on the origins of my shame and knew that it was based on my younger self’s false and unwarranted assumption about his worthiness.
“Don’t you remember?” David asked me.
“Remember what?” I queried in response.
“Toward the end of your experience,” he said, “shortly before you emerged, you held your arms out at full extension and slowly raised your hands to the sky and said: ‘It is lifted.’”
My mouth opened in surprise and shock. I most certainly did not remember raising my hands to the sky or saying, “It is lifted.” But I instinctively and immediately knew what it would have meant had I done so and said those words. It would have meant that the burden of the shame had been lifted from my shoulders and that it was no longer “weighing on me.”
In later chapters, I’ll explore whether the shame was truly gone. But first, there was one more crucial recollection from the ketamine session of an event that ended up changing my life.
