Ketamine-assisted psychotherapy in San Francisco

Ketamine is a consciousness-altering medicine. It can change your state of mind in a way that may make feelings, memories, and new perspectives easier to reach. In ketamine-assisted psychotherapy, ketamine prescribed by a medical provider becomes one part of a longer course of therapy. For me, the therapy around it is the center of the work.

Maybe you have come a long way in therapy, and still feel that some layers are hard to reach. You may feel caught in low mood, numbness, or stress reactions and patterns that seem to be held in the body, and that regular therapy has not resolved. It can feel as though part of you is ready to approach this work in a different way.

Ketamine may open a window where the brain is more receptive to change.

In therapy, we use that window to work on what matters most to you.

This work may suit you if you want to go deeper, and to work with long-standing patterns that have been hard to change through regular therapy alone. Many people begin simply with curiosity and a sense that something in them may be ready for change.

Who this work may be for

Ketamine is not right for everyone. For some people, more preparation first, a different approach, or simply continuing regular therapy is the better choice.

What the process looks like

Ketamine-assisted psychotherapy is usually part of an ongoing therapy process. Before any ketamine session, we work together in regular therapy sessions, online or in person, to build a solid foundation for the work. We talk about your history, what brings you here, what you hope for, and any questions you have. It can help to go in with a gentle intention rather than a fixed goal.

I offer ketamine sessions in person in downtown San Francisco.

In the sessions that follow, online or in person, we talk about what came up and how it can be carried into your everyday life.

Preparation

Ketamine sessions

Integration

Ketamine is usually offered as a series of sessions rather than a single one, often around six, and change tends to build over time.

Experiences vary a great deal, both between people and from one session to the next. Some sessions are vivid and emotional, some are quiet, and some can feel as if very little happened. There is nothing you need to make happen. You do not need a dramatic experience for the work to be meaningful, and its value often becomes clearer later.

What a ketamine session
can be like

Working with your medical provider

I do not prescribe ketamine. A licensed medical provider assesses whether it is medically suitable for you, prescribes it, and oversees the medical side of your treatment. If you already have a provider, I can work with them with your permission. If you do not, we can talk about how to find one. If you are having ketamine sessions elsewhere, for example at a clinic, I can also offer preparation and integration therapy around them.

Whether ketamine is right for you is something we think through carefully over time, together with your provider.

Frequently asked questions

Do I need to already be in therapy with you?

Ketamine-assisted psychotherapy usually grows out of ongoing therapy. If we have not worked together before, we begin with regular therapy sessions. How much therapy is helpful before a first ketamine session differs from person to person. There is no one-size-fits-all, and it is something we work out together, along with whether ketamine might be a helpful next step.

Can I have ketamine sessions online?

I do not recommend being alone during your ketamine-assisted therapy session. Ketamine sessions take place in person in downtown San Francisco, with someone present to guide you through the process and help with anything that comes up. Preparation and integration sessions can be in person or online across California.

What can ketamine help with?

Is ketamine safe?

People come to ketamine-assisted psychotherapy for many different reasons. Research is strongest for depression, including depression that has not improved with other treatments, and ketamine can bring relief more quickly than most antidepressants. It is also showing promise for post-traumatic stress, obsessive-compulsive difficulties, anxiety, and problematic drinking.

Ketamine has been used in medicine for more than 50 years, especially for anesthesia and pain relief, and it is on the World Health Organization's list of essential medicines. Even so, ketamine for mental health is a serious medical treatment. Common side effects, such as feeling disconnected or dreamlike, nausea, dizziness, or a rise in blood pressure, usually pass within a few hours. It may not be suitable for people with, for example, high blood pressure that is not well controlled, some heart conditions, a history of psychosis, or some substance use concerns. Your medical provider goes through the risks with you and assesses whether it is safe for you before any treatment begins.

How is ketamine different from esketamine (Spravato)?

Is this the same as psychedelic therapy?

Esketamine, sold as Spravato, is a form of ketamine given as a nasal spray in a certified medical setting. It is approved by the FDA for some forms of depression, including depression that has not improved with other treatments. Ketamine itself is approved as an anesthetic, and using it for mental health is off-label. Which form of ketamine is right for you is a question for your medical provider.

Not quite. Like psychedelics, ketamine alters your state of consciousness, and some of what comes up can feel similar. But ketamine is not a classic psychedelic. It is an FDA-approved medicine, which a medical provider can legally prescribe for mental health, and here it is used as part of therapy. If you are thinking about, or have had, a psychedelic experience in another setting, my page on psychedelic preparation and integration therapy describes that work.

Get in touch

If you are interested in ketamine-assisted psychotherapy, you are welcome to book a first session. You can reach me through the form, by email, or by leaving a voicemail.

Email: drirismsteine@gmail.com

Phone: +1 510-545-3111

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Dr. Iris M. Steine
Registered Psychological Associate, registration 94029954
Supervised by Dr. Cheryl Tien, licensed clinical psychologist, PSY 36121

Insurance is not accepted.
If you are in crisis, call or text 988, or call 911 in an emergency.

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