Aloha Mā - Self-reflective Love

Hello and welcome to The Enlightened Tripper.

First things first... I don't know that I am really "enlightened" but that is the goal. And truly, enlightenment is much more of a journey than a goal, so you could say this blog is more about the journey to enlightenment than the state of being enlightened. It is a journey to self-reflective love.

Secondly, I guess that "tripper" could mean several things as well. It could be the person who stumbled and fell as he walked past a crowded sidewalk cafe. Or it could be someone who travels frequently. Or it could be someone who seems to have lost touch with reality: "You're tripping, bro." And though I have been all of the above, the trip (me being the tripper) I am referring to is a spiritual journey.

For most of my life, I have lived with depression and complex post traumatic stress disorder. I've lived with it for so long, I don't know if, or when, conventional psychiatric medicines ever worked for me, but what I do know is that at some point they stopped working and my depression became "treatment resistant." I have tried so many psych meds that I have to keep a running list in the Notes application on my phone. It has been frustrating and debilitating.

Enter psychedelics. 

A couple of thoughts about "psychedelics:" After being demonized in the 1960's, psychedelics pretty much disappeared from public discourse until recently. I remember growing up in the 1970's and 1980's when apparently the most dangerous thing you could do was drop acid or eat 'shrooms. I myself was terrified of them, convinced that in my already depressed condition, I would have a "bad" trip and try to fly off a house, or try to dig my brains out through my eye sockets, or suffer some other psychedelic induced nightmare. Even in my late 20's and early 30's, when I was game to try just about any drug that would "take me out of it," I steered clear of psychedelics, so ingrained in me was the fear of losing my mind.

And just as an interesting aside, I did way more damage to myself with alcohol and non-hallucinogenic drugs than I probably ever could have with psychedelics.

These days when people talk of psychedelics, at least in terms of their benefits to people with mental health issues, the term is used pretty loosely. For instance, two medicines that are getting a lot of attention and airplay right now in mental health circles are Ketamine and MDMA, and strictly speaking, neither of these is a hallucinogen.

So what is this blog about? Depression and C-PTSD? Psychedelics? Spirituality? Yeah, pretty much all of those things. Confusing? I know, try living it! Bear with me, I'm making this up as I go along.

My journey with mental health is one of spirituality, and while psyhedelics have been shown to have a positive effect on brain chemistry and neuroplasticity, they have helped me most by helping me to connect with a deeper level of spirituality and understanding. So that is what this blog is about, my spiritual journey.

First Experience with Ketamine

My first healing experience with ketamine was many years ago, on the dance-floor of a night club in New York City. 

At the time, I was miserable at my job. The person I was working for was a complete nightmare to work with every day. I remember going home after the first day I worked with this person, my roommate met me at the door and asked me how my first day was, and I just broke down in tears. 

For the next few weeks, I was miserable. Every morning, I woke up dreading the coming day and having to deal with this person. It would be one thing if I just had to go to work and do my job. But my boss insisted that I go above and beyond my normal duties. Every day, I was responsible for feeding this person, who was probably the most finicky person I've ever met. I was asked to feng shui this person's office, paying special attention to the "relationship" corner because this person was single and looking for a relationship. This person's neurotic impulses became my problems to deal with, and I was forced to walk on eggshells every day. One time, on a Sunday, I was asked to come in to the office and turn on the computers for this person, because, after weeks of doing it themself, they could not remember where the power switch was. As time went on, I became more and more depressed and anxious, and going in to work made me feel physically ill.

Then, one weekend, my roommate suggested we just cut loose and go out to the opening of a new club. I agreed that I needed to just let go and have a good time, and before long, we were dancing and enjoying the music. Ketamine, aka Special-K, was a popular party drug at the time, and someone we met there had a bullet of Special-K. It wasn't long before I was high as a kite.

Ketamine, which was mostly used as an animal tranquilizer, is a dissociative drug. If you take too much of it, you can end up in a K-hole, which was described to me as a condition where your body is no longer accepting instructions from your brain, so your body continues to dance while your mind goes elsewhere.

I must have slipped into a K-hole that night because in my mind, I left the dance floor and was transported to another place in outer space. I remember meeting my horrible boss there and being free to let out all of my frustration and anger at this person. On the dance floor, my body was dancing robotically, while in my mind, I was light-years away screaming at my boss.

The ketamine wore off, and I returned to my body.

That Monday morning, I woke up and the first thing I noticed was that my usual nausea at the thought of facing my boss was gone. I went to the office and was surprised to find  that I was able to cope with my boss's personal demands without it bothering me or seeming like a big deal. Those neurotic requests that had so tormented me, were now amusing idiosyncrasies, and what before seemed like life-threatening challenges, now seemed benign. My boss was no longer a tyrant, but someone that I felt compassion for. I was able to stand up for myself. And my boss and I began to be friends. We would even laugh when I would point out to my boss how unreasonable their demands were.

My boss hadn't changed, but I had. I credited that "trip" on ketamine with fixing my relationship with my boss. I was not surprised, thirty years later, to find out that ketamine was being discovered as an almost miracle treatment for depression. And I was anxious to try it therapeutically.

First Therapeutic Experience with Ketamine - Set and Setting

Okay, my first therapeutic experience with ketamine was not a good one... But let me explain.

When talking about psychedelics, the concept of "set and setting" is probably the key to having a successful experience. "Set" refers to your mindset, your intention for the "trip" and the story that you are telling yourself about what it will be like. You want to be comfortable with the experience you are about to have, if you don't feel safe about taking the medicine, it can impact your experience of it. "Setting" refers to where you are taking the medicine, who is administering it, and the environment that you will be in. If you don't feel like you are in a safe place or you don't feel supported by the people that are administering the medicine, this can also affect your experience.

There are a few different ways to take ketamine therapeutically. One is to take it intravenously: you are hooked up to an IV and the ketamine dose is slowly dripped into your system. From what I understand about ketamine treatments, it is recommended that you go four to six times over two to four weeks. I should also mention that these ketamine treatments are not cheap, and they are not covered by insurance, or they weren't at the time. 

I made three appointments right off the bat. The place I went to for my first ketamine treatments was a joke. It was a group of anesthesiologists who saw a way to make some easy cash, rented an examination room, and set up shop. It was impersonal and borderline inappropriate, like seriously these people should not have been allowed to practice. I just didn't know any better.

I went to my first appointment. The examination room was very sterile and cold, the only ambience was provided by the muzak playing outside in the hall. 

As the doctor was preparing the IV, she advised me that ketamine works in conjunction with anti-depressants, and warned me that if I was not taking a selective serotonin reuptake inhibitor (SSRI) that it was likely that the treatment would not work as well for me. 

As I have mentioned before, I have treatment resistant depression, anti-depressants do not work for me. Because most anti-depressants come with negative side effects, it would not have made sense for me to be taking them. 

It also didn't make sense that a drug that was being touted as a breakthrough for people with treatment resistant depression, would require that the patient be taking a treatment that doesn't work for the medicine to be able to work.

Nevertheless, the IV was already in my arm and it was too late to stop it, so I let her continue. The experience was vaguely reminiscent of my partying days, the dissociation, the feeling of being somewhere else. I remember being annoyingly tuned in to the muzak from the hallway. 

I left there feeling worse than before I started. But, not to be discouraged, I went back the next day for treatment number two. My mood continued to plummet. Because this was over the Christmas/New Year holidays, I assumed that my worsened mood was being brought on by the holidays and I went back a week later for a third treatment. After three appointments ($1500), I was feeling worse than when I started. So I decided not to continue with any more treatments.

When I declined to continue the treatments with them, citing my worsening mood, the woman had the nerve to blame me, claiming "I told you it wouldn't work if you were not on anti-depressants." (Apparently, she had no problem taking my money for a treatment she believed would not work for me.)

But she was WRONG, WRONG, WRONG! This group that I went to was not trustworthy, had no idea about how the medicine worked, and did not care whether the treatment was helpful or not. It just goes to further my point that set and setting are the key to a successful experience. 

Hindsight is 20/20, but at the time, the only conclusion I could come to was that ketamine was another treatment that didn't work for me.

Second Therapeutic Experience with Ketamine - Set and Setting

**If you are experiencing thoughts of suicide or thinking about hurting yourself, please get help right away. The new national suicide helpline is 988. You are important in this world and this world needs you!**

After that first experience with ketamine treatments, I had all but given up on it as an avenue of healing for me. Every time my therapist would bring up trying it again, I would refuse. That is, until my depression got so bad that I was seriously considering checking myself into a mental hospital again because I was thinking of hurting myself and I was scared.

My therapist, after making sure that I was not in imminent danger of hurting myself, suggested that before I take the step of entering a mental hospital, that I give ketamine another try. There was another facility near where I lived that offered ketamine treatments and my therapist had heard good things about them. At this point, I felt like I had nothing to lose. So I went home from my session that day and went online to look this place up. I was fortunate that they had an open appointment the next day.

The next morning, a friend drove me to my next ketamine experience. There was a different feel immediately. Instead of being in a sterile medical building, this was in a lovely older house. I walked into the clinic and immediately felt very calm - and safe. To be honest, this was a few years ago, so I can't remember the details of the waiting room that spoke to me. I remember there were some books on the bookshelf that I was familiar with, the waiting room was very serene, there was just a peaceful feeling about it. The nurse practitioner who operated the clinic came out of his office and welcomed me. After introducing himself, he took me into his office and sat me down to talk about the treatment. He explained that the treatments were administered via intramuscular injection. He explained the process: that there were two injections, the second one being done about 45 minutes after the first one. 

He took the time to get to know me and my story and talked a little about his own experience. He took the time to make sure all my questions were answered and to let me know what to expect during the trip. He stressed the importance of having an intention for the trip and helped me set one. Then he led me to a comfortable reclining chair and set me up with an eye mask and headphones. After checking my blood pressure and pulse, he gave me the first injection, telling me that it would take a few minutes for it take effect.

It didn't take long before the medicine started to take effect. That familiar sense of being separated from my body came over me and the soothing music through the headphones started to drive my experience. It was night time and I was floating on a river through the canyons of the southwest. It was dark, so the sandstone formations rose in silhouettes against the purple night sky. Above me soared an owl, drifting in the air above me in time with the river. I wasn't afraid. Released from my body, I no longer felt distinctly separated from the universe. Instead, I felt like I was a part of the greater whole. It was so comforting. I remember that I had other revelations: I finally understood the creation of the universe and how it all worked and where I fit into it. I forgot the specifics of these things immediately, but I came back from the trip with this knowing that everything was as it should be and that my place in all of it was secure. Most importantly, I came back not feeling like I needed to check myself into a hospital and not feeling like I was a danger to myself any longer.

It was such an amazing experience and so different from my first experience with the muzak and the people that just didn't care... Set and setting. Set and setting. Let me say it one more time: SET AND SETTING.