It’s a controversial question right now in the field of psychedelic psychiatry. What is the purpose or role of subjective changes in consciousness in healing and recovery from mental illness?
There is no clear answer currently. While many studies have showed significant improvement in depression after treatment with esketamine or ketamine, one study showed that patients with depression receiving ketamine at the high doses used for anesthesia (rendering them unconscious) did not see improvement. This suggests that receiving so much ketamine that you are not able to have the subjective psychedelic experience may not be helpful, and that the “trip” may be necessary for healing. On the other hand, another study showed that patients with depression may not need to receive ketamine at all, and that simply believing that they had received ketamine, even when they had actually received a placebo, produced significant improvements in depression.
All this is to say that there is no right or wrong answer.
Our philosophy
At Amast Health, we view the wide range of psychedelic experiences that you may have while receiving psychedelic medications (such as esketamine/Spravato) during your treatment course with us as potentially important and meaningful. However, what really matters is what happens outside the clinic, in your day-to-day life.
Consider these two scenarios:
You have a subjective psychedelic experience in the clinic (for example for two hours after receiving esketamine/Spravato), with profound thoughts, revelations, breakthroughs, and you leave and in the coming days and weeks, continue living your life the same way, and feeling the same way.
You receive the medication and feel absolutely no different than normal for the few hours you are in the clinic, then leave and feel better and live better (doing the things that bring meaning to your life).
Which scenario would you prefer? The answer to that is for you to decide, not us. But the way we view it, what really matters is helping you move toward a life that feels rich, meaningful, and fulfilling in your daily life, not just in the brief hours while you are here with us.
This is why our approach, the Amast Model, emphasizes talk therapy and behavioral change over just medication alone in your recovery from depression. We do this through:
Empowering you: We emphasize the role you play in your own recovery, and empowering you. Remember that it is not the medication or the “trip” that comes with it that will change how you are living - only you can do that.
Integration: Our trained psychiatrists and therapists will talk through what you experience during the effects of the psychedelic medication and help debrief and integrate it into your life.
Neuroplasticity: Even if you don’t feel any different during the medication treatment sessions, you can still get the benefits the medication provides in helping you “re-wire” your brain.