The Three Levels of Ketamine Treatment

Farid Alsabeh
6 min readJun 30, 2023

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Ketamine is one of the newest and most exciting medicines in mental healthcare. Since the turn of the 21st century, it has been used as a powerful and rapid-acting treatment for depression, providing relief for thousands of patients who haven’t responded to typical antidepressants and psychotherapy.

We know that ketamine works — but there are still questions about how it works. The treatment causes a number of well-studied changes in the brain, which are thought to underlie its healing effects. In addition, the experience itself involves deep and transformative moments that can play an equally important role.

How can we sort out the many factors involved in ketamine’s healing effects? We can separate them into three levels: psychedelic, psycholytic, and pharmacological. In this article, we’ll read about these Three P’s of ketamine treatment, and conclude with a real clinical example that shows how they come up in a patient’s experience.

The psychedelic level

As its name suggests, the psychedelic level of ketamine treatment involves the effects that we typically associate with psychedelic drugs. These include powerful confrontations with mystical, transcendent, and cosmic experiences, which transform our typical understandings of basic concepts like mind, reality, and selfhood.

The psychedelic level of treatment happens beyond the self. The term ‘transpersonal’ points to this aspect of the experience, suggesting that it puts us in contact with a reality beyond the limits of our individual selves. This can lead to enhanced feelings of connectedness with others and the universe at large.

The psychedelic treatment heals by giving us experiences of non-ordinary consciousness that radically shift our everyday perspective. By stepping out of our everyday awareness, we return deeply changed: with an new understanding that helps us manage stress and embrace new existential values. The role of ketamine is to catalyze these transformative experience.