It does not function that way. In my experience the preparation and the integration are often more important than the session itself, and when someone tells me a previous course did nothing for them, this is usually where the conversation ends up.
What preparation is for
Usually one or two sessions, and the last of them is where we set an intention.
Intention gets talked about loosely, so let me be plain about what I mean. It is not a wish and it is not a goal to achieve during the session. It is a question you are bringing, or a direction of attention. The difference matters, because a rigid expectation about what should happen tends to produce disappointment, whereas a question tends to produce something usable.
Preparation is also where the practical things get settled. What the session will actually be like. What happens if it becomes uncomfortable. What we do afterward, who is taking you home, what the rest of your day looks like. People underestimate how much steadier the experience is when none of that is unresolved.
And it is where I get a clearer read on your nervous system than an evaluation alone gives me. Sometimes preparation is where I conclude that the timing is wrong, or that something else should come first. That is a legitimate outcome, not a failed process.
What happens in the session
A ketamine-assisted session with me runs about two hours and is supervised throughout. My role is not to direct it. It is to be a steady presence so that you are not doing it alone.
I do not have much to say about what you should experience, because that varies enormously and expectations tend to get in the way. Some sessions are quiet. Some are emotional. Some are unremarkable, and that is not a wasted appointment.
Why integration is where it lands
We meet again within two or three days at the most. I am firm about that window because it is when the material is still available and still workable.
After that, usually one or two integration sessions, and then it depends. Integration is not a fixed course you complete. It can go on for months, and for some things it is genuinely lifelong, in the sense that you keep returning to an insight and finding another layer of it.
The work is ordinary. What came up. What it seems to be about. What is different since, and what is not different that you expected would be. Then one small change specific enough to survive a difficult week.
Without that, an experience becomes a story you tell rather than something that altered how you live. I have seen a great many powerful sessions dissolve for exactly this reason, and it is avoidable.
What change actually looks like
Not dramatic, mostly. Subtle, and compounding over time.
What people describe is being kinder to themselves in a moment that would previously have been harsh. A pause appearing before a reaction that used to be automatic. Loosening a grip on perfectionism or on the habit of managing everyone else's comfort first. Individually those sound minor. Accumulated over months they are not minor at all.
I want to be careful here, because this is exactly the point where marketing copy usually overpromises. I cannot tell you what this will do for you. What I can tell you is that the people who get the most from it are almost always the ones who took the preparation and the integration seriously, rather than the ones who had the most vivid session.
And when it is not the right tool
Ketamine-assisted work is one option among several and it is not a starting point. It is not right for everyone, some histories and some medications call for a different sequence, and part of my job is saying so.
If you have never had a thorough psychiatric evaluation, that is where I would start. It costs less, it is usually covered, and it frequently surfaces something nobody had checked.
I see adults across Oregon by telehealth. Ketamine-assisted psychotherapy is self-pay; psychiatric care and therapy are in network with Aetna, Cigna, and UnitedHealthcare.
