Ketamine therapy in Seattle: KAP & KA-EMDR

No. I am not a medical provider. Prescribing, medical evaluation, and safety screening are handled by a separate licensed medical provider — I connect you with one. I provide the therapeutic support: preparation, presence during dosing sessions, and integration therapy afterward.

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.

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.

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.

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.

The therapy sessions — preparation, dosing, and integration — are billed at my standard rates; see my Rates page or ask me directly. The medical provider I connect you with bills separately for their services, and the prescription itself is a separate cost. I'm happy to walk through the full picture in a consultation.

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.

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 the medical provider I connect you with.

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.

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 a separate licensed medical provider I connect you with. I provide the psychotherapy component—preparation, therapeutic support during sessions, and integration.

Yes, if you're a Washington State resident. KAP is offered both in-person at my Capitol Hill office (226 Summit Ave E, Office B-03) and via telehealth anywhere in Washington State. Dosing sessions can happen over telehealth, or independently with a chaperone present — which option is available depends on what your prescriber agrees to. Telehealth dosing carries added safety requirements: a chaperone must be physically present, you'll need your own blood pressure monitor, and we'll confirm your exact location at the start of each session. If you need a higher level of medical care than this therapy-centered model provides, I can refer you to a ketamine infusion clinic. 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.

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.

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.

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 the medical provider I connect you with; 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.

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.

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.

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.

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.