Integrating Ketamine-Assisted Psychotherapy and EMDR: A Relational, Trauma-Informed Approach to Deep Healing

by | Ketamine Assisted Psychotherapy

In recent years, interest in psychedelic-assisted therapies has grown rapidly — especially for individuals who feel they have “tried everything” yet still struggle with depression, trauma, or anxiety. One of the most promising developments is the integration of Ketamine-Assisted Psychotherapy (KAP) with Eye Movement Desensitization and Reprocessing (EMDR).

At our practice, Soma Psychotherapy, we approach this work thoughtfully, relationally, and with deep respect for the nervous system’s innate capacity to heal.

What Is Ketamine-Assisted Psychotherapy (KAP)?

“Psychedelic” comes from the Greek roots psyche (mind or soul) and delos (to reveal) — often translated as “soul-revealing.” Ketamine, currently the only legally available psychedelic medicine widely used in healthcare settings across the U.S., can induce an altered state of consciousness that allows clients to access emotions, memories, and perspectives in new ways.

 

Unlike traditional antidepressants, ketamine works on the glutamate system rather than serotonin. Research suggests it:

  • Promotes neuroplasticity and synaptogenesis
  • Increases Brain-Derived Neurotrophic Factor (BDNF)
  • Temporarily quiets the Default Mode Network (associated with rumination and self-criticism)
  • Reduces limbic activation (fear and hyperarousal)

While ketamine may reduce symptoms of depression or anxiety, the goal of KAP is not simply symptom relief — it is deeper healing, particularly of developmental and complex trauma.
The medicine is a tool. The therapy is the transformation.

What Is EMDR?

EMDR is a trauma-focused therapy based on the Adaptive Information Processing (AIP) model. It proposes that the brain naturally moves toward healing — unless traumatic experiences become “stuck” in the nervous system.

Through bilateral stimulation (eye movements, tapping, or tones), EMDR helps:

  • Activate traumatic memories safely
  • Introduce new, adaptive information
  • Reconsolidate memories in a less distressing form

Over time, memories lose their emotional intensity. The nervous system reorganizes. Clients often report cognitive shifts such as, “It wasn’t my fault,” or “I’m safe now.”

Why Combine Ketamine and EMDR?

 

Emerging research suggests ketamine increases glutamate transmission and enhances neuroplasticity — the same mechanisms that support memory reconsolidation in EMDR (Abdallah & Krystal, 2020; Kang et al., 2022; Murrough, 2017).

When thoughtfully combined:

  • Ketamine may widen the “window of tolerance,” reducing overwhelm (Feder et al., 2021)
  • Fear responses may soften, allowing safer engagement with trauma material
  • Cognitive flexibility increases, making integration more accessible
  • Old neural pathways loosen while new ones form

In lower (“psycholytic”) doses, clients remain oriented and able to engage in dialogue, making it possible to integrate EMDR reprocessing during the medicine session (Passie et al., 2022).

In higher (“psychedelic”) doses, clients may experience expansive or dissociative states. In these cases, EMDR is often used during post-session integration (24–72 hours later), when the brain may be especially receptive to adaptive learning.

Healing Happens in Relationship

 

One of the most powerful aspects of this work is relational.

Ketamine can temporarily soften protective defenses. When this occurs in a safe therapeutic relationship, clients often experience:

  • Increased trust
  • Heightened awareness of attachment patterns
  • Greater compassion toward themselves and others
  • Relief from long-held shame or blame

As with all psychotherapy, the relationship itself is the primary vehicle of healing. Medicine does not replace that — it amplifies the conditions that make healing possible.

What Does a KAP + EMDR Process Look Like?

Though every treatment plan is individualized, the process often includes:

1. Careful Assessment & Preparation

  • Comprehensive history-taking
  • Clarifying goals and intentions
  • Education about risks, benefits, and alternatives
  • EMDR preparation skills (resourcing, stabilization)
  • Medical screening and informed consent

2. Medicine Sessions

  • Comfortable, calming environment
  • Clear safety protocols
  • Structured check-in and intention setting
  • Therapist present throughout
  • Supportive, non-directive approach

3. Integration

  • Integration is essential for long-term benefit (Dore et al., 2019). This may include:
  • EMDR reprocessing sessions
  • Journaling or creative expression
  • Somatic practices
  • Mindfulness
  • Group integration support

The days following a session are often reflective and tender. Rest, low stimulation, and supportive connection are encouraged.

Who Might Benefit?

This approach may be considered for individuals who:

  • Struggle with chronic or treatment-resistant depression
  • Live with PTSD or complex trauma
  • Experience persistent anxiety
  • Have not found sufficient relief through traditional medications or talk therapy

It is not appropriate for everyone. Contraindications may include uncontrolled high blood pressure, certain cardiac conditions, psychotic disorders, unmanaged bipolar disorder, active substance misuse, or pregnancy (Walker-Journey, 2021; Wesley & Bennett, 2020). Careful screening and collaboration with medical providers are essential.

A Final Thought

Both EMDR and psychedelic-assisted psychotherapy share a core belief:

The mind and body have an innate capacity to heal.

Ketamine may temporarily quiet the noise of fear and rumination. EMDR may help reorganize traumatic memory networks through reconsolidation processes (Ecker & Bridges, 2020; Elsey & Kindt, 2017). But what ultimately transforms is not the medicine alone — it is the integration of insight, safety, and relational repair.

If you are curious whether Ketamine-Assisted Psychotherapy with EMDR integration might be a good fit for you, we invite you to reach out for a consultation. Together, we can explore whether this path aligns with your goals and readiness for deeper healing.

See Kate Kincaid and Amy Davis’ new book on this subject available now on Amazon:
https://www.amazon.com/Ketamine-Assisted-Psychotherapy-Treatment-Companion-Optimize/dp/1648487785

Contact Us

References

Abdallah, C. G., & Krystal, J. H. (2020). Ketamine and rapid acting antidepressants: Are we ready to cure, rather than treat depression? Behavioural Brain Research, 390, 112628. https://doi.org/10.1016/j.bbr.2020.112628

Campbell, J. (2014). The Hero’s Journey. New World Library.

Chen, J. (2022, March 9). How ketamine drug helps with depression. Yale Medicine. Retrieved from https://www.yalemedicine.org/news/ketamine-depression

Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., … Wolfson, P. (2019). Ketamine-assisted psychotherapy (KAP): Patient demographics, clinical data, and outcomes in three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198. https://doi.org/10.1080/02791072.2019.1587556

Ecker, B., & Bridges, M. (2020). The transformative power of memory reconsolidation in psychotherapy. APA Psychotherapy Networker.

Elsey, J. W. B., & Kindt, M. (2017). Tackling maladaptive memories through reconsolidation: From neural to clinical science. Neurobiology of Learning and Memory, 142(Pt A), 108–117. https://doi.org/10.1016/j.nlm.2017.03.007

Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., et al. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. The American Journal of Psychiatry, 178(2), 103–206.

Kang, M. J. Y., Hawken, E., & Vazquez, G. H. (2022). The mechanisms behind rapid antidepressant effects of ketamine: A systematic review with a focus on molecular neuroplasticity. Frontiers in Psychiatry, 13, 860882. https://doi.org/10.3389/fpsyt.2022.860882

McElvery, R. (2022, May 24). The past, present, and future of using ketamine to treat depression. Smithsonian Magazine. Retrieved from https://www.smithsonianmag.com/science-nature/a-brief-history-of-ketamines-use-to-treat-depression-180980106/

Murrough, J. W. (2017). Targeting glutamate signaling in depression: Progress and prospects. Nature Reviews Drug Discovery, 17, 472–486.

Passie, T., Guss, J., & Krähenmann, R. (2022). Lower-dose psycholytic therapy: A neglected approach. Frontiers in Psychiatry, 13, 1020505. https://doi.org/10.3389/fpsyt.2022.1020505

Shapiro, F. (2001, 2018). EMDR therapy: Phases 1–8, targeting, RDI, three-pronged protocol.

Walker-Journey, J. (2021, March 29). New Guidance Released for Ketamine, Esketamine Therapy Use. Psychedelic Spotlight.

Wesley, R., & Bennett, R. (2020). Ethical guidelines for ketamine clinicians. The Journal of Psychedelic Psychiatry, 2(4).