Ketamine therapy in Seattle: KAP & KA-EMDR
Low-dose trauma processing (KA-EMDR) and traditional KAP for depression, emotional shutdown, and patterns that won't shift through talk therapy alone.
Practice details
When talk therapy isn't enough
Many people reach a point where traditional therapy helps, but only to a point. You've done the work. You understand the patterns. You can narrate the history. And something shifted — but not all the way. There's still a shutdown you can't break through, a layer of emotion you can't access, a numbness that hasn't lifted, or a sense of living behind glass.
What ketamine offers, in the right clinical container, is access to that layer. Not a shortcut around the work. A pharmacological assist for a nervous system that has organized too tightly to allow the work in.
“I am larger, better than I thought; I did not know I held so much goodness.”— Walt Whitman, “Song of the Open Road”
Two approaches I offer
There are two distinct protocols I'm trained in. They look different in the room, do different clinical work, and suit different presenting concerns. The choice between them — or a combination — is the first real clinical decision in this work.
KA-EMDR (Ketamine Assisted EMDR Therapy)
Low-dose sublingual ketamine combined with active EMDR processing during the session. At this dose — the psycholytic range — ketamine softens defenses and reduces emotional overwhelm enough that you can stay engaged with traumatic material that would otherwise feel too activating to approach. You remain conversational. You can follow bilateral stimulation. We work directly with memories, body sensations, and the beliefs that came out of the original event, the way standard EMDR works — but with the threshold for accessing the material lowered.
This protocol is most useful when standard EMDR has hit a wall. Common reasons: the material is pre-verbal or developmentally early; the client shuts down or dissociates the moment processing starts; the trauma is complex enough that the layered defenses prevent any single target from staying in focus. In those cases, low-dose ketamine can be the difference between processing that holds and processing that keeps recycling.
My training: Ketamine Assisted EMDR Therapy™: Enhancing Trauma Treatment with Low Dose Ketamine. More about my EMDR practice →
Traditional KAP
Higher-dose ketamine — typically sublingual, sometimes intramuscular through the prescriber's protocol — that produces a more substantial altered state. At these doses, ordinary thought patterns loosen, rigid self-narratives become temporarily more flexible, and material that has been held tightly out of awareness can surface. The session itself isn't structured around active processing the way KA-EMDR is. My role during the dosing session is presence, safety, grounding, and witnessing what arises. The processing happens in the integration sessions afterward, where we make meaning of what surfaced and translate it into something that holds in daily life.
This protocol is most useful for treatment-resistant depression, chronic shame that hasn't moved through talk therapy, emotional numbness that predates anything you can point to, rigid cognitive loops, or the kind of identity-level questions that benefit from a temporary loosening of how you usually narrate yourself. For LGBTQ+ clients in particular, traditional KAP can reach the kind of installed-shame material that ordinary therapy circles for years.
My training: Fluence Certified KAP Therapist, plus Essentials of Psychedelic Therapy (Fluence), Journey Clinical KAP Training, and EMBARK Psychedelic-assisted Therapy for Major Depression.
Many clients end up using both protocols across a treatment arc — traditional KAP to soften the defensive architecture, then KA-EMDR to do the targeted memory work that becomes possible afterward. We figure out the right sequence together.
How ketamine actually works, briefly
Ketamine is an NMDA receptor antagonist. The simpler version: it temporarily reduces the brain's normal pattern-locking, which is what makes rigidly-held trauma responses, depressive thought loops, and chronically organized defenses so hard to shift through talk alone. There's also a window of increased neuroplasticity that follows the dose — roughly 24 to 72 hours — during which the brain is more available to forming new associations than it usually is. That window is part of why integration sessions are scheduled tight, not because there's a deadline but because the brain is asking for new input during that time and the integration session is what gives it useful input rather than incidental input.
What I'd want a client to know past that: the mechanism is real, the evidence base for ketamine in treatment-resistant depression and trauma contexts is substantial, and the effects are also genuinely time-limited unless paired with therapy that uses the window. The medicine is doing something. What it's doing only becomes lasting change with the work around it.
How sessions actually work
The full structure has four phases. Each one is doing different work, and skipping any of them is the most common way KAP fails clients.
1. Medical evaluation — with a Journey Clinical prescriber, not with me. They determine whether ketamine is medically appropriate for you, screen for contraindications, set the dose and route, and handle all prescribing. I am not a medical provider. I do not prescribe ketamine. All medical decisions sit with the prescriber. This separation is structural to how legitimate KAP is delivered, not a workaround.
2. Preparation — with me, before any medicine session. We work through your intentions, your history, what tends to shut you down, what safety actually looks like for you, what the practical experience of a session involves. We also decide together — based on what surfaced in preparation — whether KA-EMDR, traditional KAP, or a combination is the right place to start.
3. Dosing — with me, in the office. The shape of this session depends on which protocol. For KA-EMDR, we work actively with EMDR targets while the medicine softens your defenses. For traditional KAP, I provide presence and grounding while you explore your inner experience; we are not trying to talk through what's happening as it happens. In both, I'm tracking your state continuously and adjusting pacing.
4. Integration — with me, in the days following. This is where the work consolidates. What surfaced gets named, connected to the rest of your life, and translated into something that holds outside the session. People who do KAP without integration get the experience but lose the work; the integration sessions aren't optional, they're the protocol.
The reason all four phases matter, and the reason coordinated care with a separate prescriber works better than a one-stop clinic doing everything: medical and psychological care are different specialties. The prescriber handles the medical layer with their full attention. I handle the therapeutic layer with mine. When both are tracking, your work is safer and goes further than either alone could take it.
Who this is right for, and who it isn't
KAP tends to fit when standard trauma therapy has reached a real limit — not at the start of treatment, but after the work has done what it can do on its own. The clearest indications I see: treatment-resistant depression, chronic shame that hasn't shifted through any of the usual approaches, emotional numbness with no clear cognitive entry point, complex trauma where standard EMDR keeps getting walled off, and the kind of long-running rigid defenses that often show up in men, in LGBTQ+ clients carrying installed shame, and in high-insight clients who've already done a lot of cognitive work and need something that reaches what cognition can't.
It isn't the right starting point for everyone. Active substance use that puts the medicine session at risk, severe psychiatric instability, active suicidal crisis, certain medical contraindications the prescriber screens for — these all rule it out, sometimes temporarily, sometimes longer-term. Equally important: KAP isn't the right tool for someone hoping for a pharmacological intervention without the therapy. People who want ketamine without integration would be better served by an infusion clinic, where the relationship is upfront about being medical rather than therapeutic.
If you're not sure where you fall, that's what the consultation is for. Part of preparation is honestly working out whether KAP is the right tool, or whether standard trauma therapy first is.
KAP vs. infusion clinics, and what people search for
If you search for ketamine therapy in Seattle, most of what comes up is infusion clinics: medical facilities that administer IV ketamine, usually without a therapist in the room. That's a different service for a different need. For someone whose primary concern is the neurochemical effect on depression and who doesn't want the therapeutic relationship to be part of the treatment, an infusion clinic is what they're describing. Places like SeattleNTC or Northwest Ketamine Clinics do that well.
What I offer is the other thing. Ketamine-assisted psychotherapy is therapy-centered: the medicine is one tool inside a treatment relationship rather than the treatment itself. The same medicine, used differently, doing different work. If you've tried infusions and they helped during but the effect didn't hold, the integration layer is usually what was missing.
The phrases people search for when they're trying to find this service are mostly condition-specific. Ketamine for depression in Seattle — traditional KAP is supported by a real evidence base in treatment-resistant depression, and the integration sessions are what make the lifted mood translate into the kind of structural shift that holds past the dosing window. Ketamine for PTSD and trauma — KA-EMDR is the relevant protocol here, especially for material that shuts down standard EMDR. Ketamine for anxiety — when anxiety is rooted in trauma or chronic hypervigilance, KAP can help by reducing the defensive layer that keeps the underlying material inaccessible; if anxiety is the only presenting concern, though, trauma processing or EMDR is usually the better first move. Ketamine for emotional shutdown and numbness — traditional KAP can reach the kind of dampening that has come from years of suppression, chronic dissociation, or early attachment disruption, where talk therapy alone hits the wall and stays there.
For support after psilocybin, MDMA, or ayahuasca experiences, I also offer psychedelic integration as a separate service.
Common Questions
Do you prescribe ketamine?
No. I am not a medical provider. All prescribing, medical evaluation, and safety screening are handled by licensed prescribers through Journey Clinical. I provide the therapeutic support: preparation, presence during dosing sessions, and integration therapy afterward.
What's the difference between KA-EMDR and traditional KAP?
KA-EMDR uses low-dose ketamine combined with active EMDR trauma processing—you remain alert and engaged while we work directly with memories and emotions. Traditional KAP uses higher doses that create a deeper, more dissociative experience where I provide presence and safety while you explore your inner world. Integration happens afterward. We'll determine together which approach fits your needs.
Will the ketamine session be psychedelic?
It depends on the dose and protocol. KA-EMDR uses lower doses where you remain conversational and able to do active processing—it's not typically "psychedelic" in the classic sense. Traditional KAP at higher doses can produce more profound altered states. We discuss what to expect during preparation.
What if I get overwhelmed during the session?
I'm with you the entire time, tracking your state and providing grounding as needed. Ketamine's effects are relatively short-lived, and we can adjust pacing, offer reassurance, or simply sit together until you feel settled. You're never alone with difficult material.
Does ketamine replace therapy?
No. Ketamine creates a window of increased neuroplasticity and reduced defenses—but lasting change happens through the therapeutic relationship, the preparation, and especially the integration work afterward. KAP without integration is a missed opportunity.
How much does KAP cost?
Preparation sessions (55 min): $175. Dosing sessions (2–3 hours): $500 (not covered by insurance). Integration sessions (55 min): $175. You also pay Journey Clinical separately for medical services—initial evaluation is $250, follow-up medication management is $150. These costs don't include the prescription itself.
What is the difference between ketamine-assisted psychotherapy and a ketamine infusion clinic?
Ketamine infusion clinics typically administer IV ketamine in a medical setting, often without a therapist present during the session. KAP is psychotherapy-centered: I provide preparation before each session, therapeutic support during the ketamine experience, and integration therapy afterward. The medicine creates a window; the therapy is what makes it count. If you are looking for IV infusions without a therapy component, a dedicated ketamine clinic may be a better fit.
Can ketamine therapy help with PTSD?
Yes. KA-EMDR (ketamine-assisted EMDR) combines low-dose ketamine with active trauma processing, which can be especially effective for PTSD that has not responded to standard EMDR or talk therapy alone. The ketamine softens rigid defenses and reduces emotional overwhelm, allowing traumatic material to be processed more safely. This approach requires medical clearance through a Journey Clinical prescriber.
Can ketamine therapy help with depression?
Yes. Traditional KAP at higher doses can be effective for treatment-resistant depression—depression that has not responded adequately to medication or talk therapy. Ketamine increases neuroplasticity and can temporarily lift rigid thought patterns, creating a window for therapeutic work. Integration therapy afterward helps translate that temporary relief into lasting change.
Is ketamine therapy legal in Washington state?
Yes. Ketamine is a legal, FDA-approved medication. Licensed medical providers can prescribe it off-label for psychiatric conditions including depression, anxiety, and PTSD. In my practice, all prescribing is handled by licensed providers through Journey Clinical. I provide the psychotherapy component—preparation, therapeutic support during sessions, and integration.
I'm not in Seattle — can I still work with you?
Yes, if you're a Washington State resident. KAP is offered both in-person at my Capitol Hill office (226 Summit Ave E) and via telehealth to anyone elsewhere in Washington State. Telehealth dosing sessions carry additional requirements: a chaperone must be physically present, you'll need your own blood pressure monitor, and we'll confirm your exact address at the start of each session. Out-of-state residents cannot do KAP with me — Washington licensure requires that you be physically located in Washington at the time of every session.
How many sessions does KAP involve?
A typical arc is six to eight dosing sessions, but the full structure includes more than that. New clients begin with three 90-minute preparation sessions before the first dose — covering clinical intake, KAP-specific education, intention setting, and resourcing skills. Existing therapy clients who add KAP need only one preparation session. Each dosing session runs two to three hours and is followed by multiple integration sessions before the next dose. Integration is where the lasting change happens; the dosing creates the opening. The pace is set by your nervous system, not a protocol.
What do I need to do on the day of a dosing session?
Fast for four hours before (clear liquids OK up to two hours before). Skip alcohol for 24 hours prior and cannabis for 48 hours prior. Wear loose, comfortable clothing. Arrange a chaperone to pick you up and drive you home — you cannot drive for the rest of the day, and the medicine often continues working into the evening. Plan a quiet evening with nothing demanding scheduled. Bring a comfort object if it helps; eye mask, blanket, water, and tissues are provided. The session itself runs two to three hours.
Who is KAP not a good fit for?
KAP isn't right for everyone. Medical contraindications include uncontrolled hypertension, personal or family history of psychosis, active mania, pregnancy, and certain medications (benzodiazepines, MAOIs, stimulants, lamotrigine). Beyond the medical screen, KAP also isn't appropriate during active crisis, recent psychiatric hospitalization, or acute grief that hasn't yet stabilized. The medical screen is handled by your Journey Clinical prescriber; the clinical fit is something we evaluate together during preparation sessions. There's no rush — if you're not ready, we wait or pursue other therapeutic work first.
Can KAP help with anxiety?
Sometimes — but anxiety is not the first thing I'd consider KAP for. When anxiety is rooted in trauma, chronic hypervigilance, or attachment patterns that talk therapy hasn't reached, KAP can temporarily soften the defenses keeping that material inaccessible. For more recent or situational anxiety, EMDR, Brainspotting, or standard psychotherapy usually does the work without needing a medicine assist. We'd talk through your specific history before considering whether KAP fits.
I don't feel depressed — I feel nothing. Can KAP help?
Often, yes. Years of suppressing emotions, chronic dissociation, or early attachment disruption can create a shutdown pattern that talk therapy alone can't penetrate. People in this state often describe themselves as numb, flat, going through the motions, watching their own life from a distance. KAP — particularly higher-dose traditional KAP — can soften that wall enough to begin accessing what's underneath. The work afterward in integration is where the shutdown actually starts to lift; the medicine just opens the door.
What's expected of me between dosing sessions?
Active integration. Each dosing session is followed by one or more integration sessions where we process what surfaced — not by interpreting it, but by connecting it to your history, your patterns, and your life. Between sessions you'll be asked to journal, take voice memos, or capture images of what stays with you. Most clients also benefit from time in nature, gentle movement, or creative practice — not as homework, but as containers for what the medicine has stirred. Major life decisions get postponed for 48 hours after each dose, and conversations with family or friends about the experience often need to wait until you've made meaning of it for yourself.
Is KAP the same as psychedelic therapy?
They overlap. Ketamine is pharmacologically a dissociative anesthetic, not a classic serotonergic psychedelic like psilocybin or LSD — but at psychedelic doses the subjective experience can feel similar (dissolution of self, time dilation, sometimes visual content). The therapeutic structure is the same: preparation, dosing, integration. Ketamine is currently the only legally prescribable psychoactive medicine for this kind of work in Washington State. Psilocybin remains in research and in state-program contexts (Oregon, Colorado); MDMA is in further clinical research after its 2024 FDA application was returned.
Certification covers KAP-specific clinical methodology — preparation, presence during dosing sessions, and integration work.
How I think about this work → Approach
If you are experiencing a difficult psychedelic or ketamine experience and need immediate support, contact the Fireside Project at 623-473-7433 (62-FIRESIDE). For all crisis resources, see our FAQ page.