Forming Intentions in Psychedelic Therapy

When I first learned about healing trauma with psychedelic medicines,  I loved  the widely held notion that setting an intention for psychedelic therapy was like creating a hinge, that makes it possible for the door of healing to swing open into a new space.  But as I have gained more experience doing psychedelic therapy with clients, I have found that in real life, it doesn’t always prove to be quite so simple.  Intention setting can be a challenging task, and intentions frequently change, as multiple KAP sessions occur. At the first visit, as I begin to understand a new client, I find myself wondering, “will this person be able to form an intention?” Not everyone is. And quite honestly, forming an intention was a learned skill for me too, when I first experienced psychedelic therapy.

The Symptoms of Trauma

In trauma related mental health, unpleasant symptoms are the rule.  Many of us struggle with disrupted sleep, or even nightmares.  Sometimes we have so much ‘hyperarousal’ that it is difficult to even initiate sleep at the beginning of the night.  It is also common for trauma to leave us with a sense of uneasiness or anxiety in our normal daily life. Sometimes we can even be paralyzed by moments of panic.  It is also natural for us to try to medicate our anxiety, sadness,  fear, or even anger with substances like tobacco or alcohol, or ‘recreational drugs, or even with food, work,  or sex.  Medicating our feelings inevitably creates a second set of symptoms that interferes with our life even more.  Sometimes we are surprised by flashbacks of traumatic events, which make it difficult for us to function.  I often will ask the question, “why do you want to do ketamine assisted psychotherapy (KAP)?”  It is normal for clients to reply by describing their mood, their anxiety, or their panic, or even their addictions as possible targets for KAP.

Quiet reflection is an important part of KAP

The actual cause of the symptoms

While these negative symptoms might motivate us to consider therapy (including KAP), there is a notion among therapists that mere symptom relief might not be our real intention.  This is because with exploration,  it is usually possible to link our negative symptoms to the actual trauma, and the effect that the trauma had on our inner life.  For those of us who have lived through trauma, there were huge societal and cultural pressures on us to not be honest about our traumatic experience.  We were usually not encouraged to report sexual, verbal, emotional or physical abuse, especially when we are young.  Often there is societal or family pressure for us to ‘keep quiet about it’, or (even worse), we may be encouraged to normalize the thing that injured us.  For this reason, I think KAP is a kind of therapy that  works better when we have developed the capacity to name our trauma.  Naming is extremely hard to do, and sometimes it takes years to get used to putting these things into words.

It is common to uncover hidden linkage between the symptom we are having, and the actual injury that occurred in the past.  An intention  can really open the inner self to healing, if we can put it into words. Trauma and abuse can shape what we tell ourselves about who we are as a person. I might ask, “is there something that you learned from the trauma you went throughl?”  It is also very common for trauma to affect our belief systems.  Trauma can tell us to expect negative or dangerous things from the world we live in. Trauma affects us deeply, right down to our spiritual beliefs.  But if  our intention cuts down to this deep level of healing our inner beliefs, then we are preparing to glimpse a new way of understanding ourselves.

Set and Setting: Preparation for KAP

In preparation sessions, before KAP actually takes place, I explore the idea of what kind of intention a client might want to hold for their psychedelic experience.  In the realm of psychedelic healing, there is an  expression: “Set and Setting”, which is used to describe a kind of preparation for psychedelic work. “Setting”  means of the circumstances that we might want to create for our KAP ceremony, like eyeshades, or headphones for music, for example.   The “Set” part of preparation is our mindset. Set is about our feelings and beliefs, and our hopes we hold for doing KAP.  The mindset is imagined to be like a rudder that guides the ship of the psychedelic experience.  When we are talking about intentions, I encourage clients to think of a a small object that could symbolize their intention. This is an object that they might bring to the office to help create a personalized healing space.  I actually create a little makeshift altar on my desk, with a candle for the KAP experience.  Sometimes, clients will bring a stone, a crystal, or a figurine that symbolizes their intention.  Sometimes they bring a picture of a family member or pet, and often times, they will bring a picture of their younger self from when the trauma occurred.

Journaling for intentions

Finding Meaning

While it is true that ketamine can relieve mental health symptoms (depression and anxiety) or even neurogenic pain, this is not why ketamine is used for KAP.  Ketamine is used in KAP to create an experience  where healing can take place.  It is said that it takes an experience to heal an experience. For me, KAP is less of a medical procedure, and is more like a ceremony for the repair of trauma.  Sometimes, healing takes the form of a new sense of meaning.  I would be the last to suggest that this is an expectation for psychedelic work, and I would never tell someone to find meaning inside of a tragedy.  Yet, surprisingly, this is exactly what happens sometimes, and it has even happened to me.  This is not a kind of meaning that we can search for. Instead, it is a sense of meaning that dawns on us, as we experience ourselves in the context of  the greater universe.  I like to think that the formation of an intention might be a way to prepare our souls for recognizing this meaning, when it emerges.

Healing trauma is a journey, not a destination. It’s filled with ups and downs, and also moments of clarity and growth. Treatment experiences like KAP are like stars that guide us through the night - sometimes faint, sometimes bright, but always giving light to help us find our way.

If you’re curious about innovative options, I encourage you to explore resources like those offered by Gregory Loewen in Buffalo, who is pioneering Ketamine Assisted Psychotherapy. This approach is opening new doors for healing and transformation in mental health care.