TRUST IN THE PROCESS: ketamine therapy and the inner healing intelligence

Abstract (English)

This paper draws from ethnographic fieldwork conducted at ketamine retreats in California, USA. These are ceremonial, ritualised group experiences using psychedelic doses of the dissociative anaesthetic drug ketamine that induce spiritual experiences in participants. Ketamine treatments are a growing mental health intervention in the USA, with several clinical trials establishing its rapid efficacy in alleviating symptoms of depression (Murrough et al., 2013; DeWilde et al., 2015) and suicidal ideation (Wilkinson et al. 2018). Ketamine is understood neurobiologically to be an anti-depressant potentially capable of enhancing 'neuroplasticity' (Kopelman et al., 2023). It is also harnessed as a tool for psychotherapy, healing trauma and as a catalyst for psychospiritual transformation (Wolfson & Vaid, 2024), due to its intense psychedelic effects at higher doses. In my research I worked with several patients who told me that ketamine therapy saved their life. In non-clinical contexts, ketamine may be a drug of chronic abuse.

After the initial hype around the so-called "psychedelic renaissance", more recent literature is beginning to reckon with the potential dangers of psychedelic use (Evans et al., 2023). This paper analyses how facilitators at ketamine retreats create a safe environment for participants to experience the potentially terrifying but also transformative, healing effects of high-dose ketamine. Facilitators cultivate trust in participants via an unshakeable faith in what they call the "inner healing intelligence", understood to be the mind's innate capacity to heal that is activated by the "medicine" or ketamine and analogous to the body's ability to heal itself under the right conditions. This framing posits that all intentional psychedelic experience, positive or negative, is ultimately in the service of healing. Participants are encouraged to "trust in the process" or "trust in the medicine", and facilitators make participants feel safe by their own "trust in the process" communicated via their confidence in the practice of psychedelic therapy. This confidence is the product of well-cultivated spiritual beliefs around being protected by spiritual forces, entities and connection to "Spirit", understood to be the ultimate nature of reality synonymous with universal love. In a secular society where not all participants share in the spiritual beliefs of the facilitators, spirituality is here presented as non-prescriptive, playful and multicultural, rooted in the perennial philosophy and New Age belief that posits a single transcendent reality to which all mystical traditions point towards (Huxley, 1945).

I draw from my experiences of both assisting at ketamine retreats and participating in them to show how faith in unseen forces - as both an injunction and a product of spiritual experience - becomes a practical necessity to ensure safety and minimise risk in a potentially dangerous enterprise, where the line between spiritual revelation and psychosis may be thin.