This is so helpful. I wish the drug were available and licensed in this way in the UK, though I imagine there would need to be a long and difficult fight to get the NHS to use it. Sadly care for mental health in the UK is very primitive and not yet trauma informed. (It's basically the antidepressant roulette wheel, outdated CBT or nonexistent. )
Thanks for your note Allyson! I once sat in on an Oxford webinar about ketamine for treatment resistant depression. I asked the researcher & presenter whether he consider therapy an important part of medicinal ketamine, and if there is any data on the efficacy of ketamine alone vs. a "ketamine + therapy" combination. He snorted and said that by the time patients get to him, "they've had enough CBT," implying that therapy has lost its usefulness for this group of severely depressed people. His condescension was palpable but his answer spoke volumes about his ignorance. Cognitive Behavioral Therapy (CBT) is not the only type of therapy, and therapists trained in psychedelics don't generally combine it with ketamine. They're not well suited for each other. Instead they use less cerebral, gentler approaches like Internal Family Systems (IFS). He saw ketamine as merely a chemical, similar to any SSDI, and had no appreciation for the value of personalized therapy before, during, and after ketamine treatments. It was really disheartening that this preeminent researcher was so clueless about how to help his patients.
Wow, this is so revealing--and if this attitude is prevalent at the 'top', it's no wonder it trickles down to the GP level. It is a mechanised approach, as if we are machines needing the right chemical tweak to 'function.' The self-paced CBT I was using was old and triggering, created before being 'trauma aware' was even a thing. It was like a website multiple choice thing. I was shocked that I was asked to use it as it made me worse. When the doctor told me to stop using it, she offered no other alternative. I can see that even the process of ketamine therapy would be so disruptive to the assumptions underpinning mental health in the NHS that it would have to happen in the private sector, somehow. Thanks for offering this perspective.
This is so helpful. I wish the drug were available and licensed in this way in the UK, though I imagine there would need to be a long and difficult fight to get the NHS to use it. Sadly care for mental health in the UK is very primitive and not yet trauma informed. (It's basically the antidepressant roulette wheel, outdated CBT or nonexistent. )
Thanks for your note Allyson! I once sat in on an Oxford webinar about ketamine for treatment resistant depression. I asked the researcher & presenter whether he consider therapy an important part of medicinal ketamine, and if there is any data on the efficacy of ketamine alone vs. a "ketamine + therapy" combination. He snorted and said that by the time patients get to him, "they've had enough CBT," implying that therapy has lost its usefulness for this group of severely depressed people. His condescension was palpable but his answer spoke volumes about his ignorance. Cognitive Behavioral Therapy (CBT) is not the only type of therapy, and therapists trained in psychedelics don't generally combine it with ketamine. They're not well suited for each other. Instead they use less cerebral, gentler approaches like Internal Family Systems (IFS). He saw ketamine as merely a chemical, similar to any SSDI, and had no appreciation for the value of personalized therapy before, during, and after ketamine treatments. It was really disheartening that this preeminent researcher was so clueless about how to help his patients.
Wow, this is so revealing--and if this attitude is prevalent at the 'top', it's no wonder it trickles down to the GP level. It is a mechanised approach, as if we are machines needing the right chemical tweak to 'function.' The self-paced CBT I was using was old and triggering, created before being 'trauma aware' was even a thing. It was like a website multiple choice thing. I was shocked that I was asked to use it as it made me worse. When the doctor told me to stop using it, she offered no other alternative. I can see that even the process of ketamine therapy would be so disruptive to the assumptions underpinning mental health in the NHS that it would have to happen in the private sector, somehow. Thanks for offering this perspective.