2) The subject should lie down, especially if this is his first session. In general, any kind of moving about is inadvisable.
3) Explain that there may be some pangs of concern as the substance starts to act on the system and it becomes apparent that there can be no turning back. Toward the end there may be another momentary jolt of apprehension that the mind will be unable to adjust to the exigencies of the mundane plane. This is all quite normal, and the subject should bear in mind from the start that the procedure is safer than it may seem.
4) Do not leave the subject unattended until he is thoroughly grounded again.
5) Do not touch the subject unless he specifically requests it. (This seldom happens.) In any out-of-the-body state, even if it consists only of mild anesthesia, it can be disagreeable to have to contend with physical sensations.
6) Remain quiet. It is rarely necessary to say or do much while the subject is under. Unless he wishes to communicate permit him to explore on his own.
7) Encourage the subject to rest and meditate even after he has returned to normal. Since his alpha rhythms will probably remain suppressed for some time, interesting ideas may come in the next hour or two.
8) Follow through when possible. Encourage the subject to be on the lookout for longterm insights and effects.
9) See to it that the subject arranges his schedule so that he doesn't have to drive for at least an hour after the conclusion (two hours after the beginning) of the session. Provide him with some refreshments during this time.
10) Try to avoid working with alcoholics who have been drinking or with seriously disturbed people. On the whole, samadhi therapy is for the sane, the rational and the well-adjusted.
11) Encourage the subject to broaden himself through the study of relevant literature and by associating with people interested in the fields of metaphysics and mind dynamics.
12) Keep detailed and accurate records of each subject's medical history, dosage and response. Every subject should have a standard data sheet to which further comments can be appended.
It was only after we had thoroughly established our own procedures that we began to hear of instances in which ketamine had been used in psychotherapy. Shortly before this book went to press Dr. Guenter Corssen, one of the original developers of ketamine, sent us a copy of an article entitled "The Use of Ketamine in Psychiatry" published in the June 1973 issue of the journal Psychosomatics. The authors, E. Khorramzadeh, M.D., and A.O. Lofty, M.D., state, "The present report is to the best of our knowledge the first investigation into the use of this chemical (ketamine) as an abreactive agent."
The article describes a study conducted with one hundred patients in a psychiatric unit of a university hospital in southern Iran. The patients were given 0.5 mg of atrophine intravenously with subsequent intravenous doses of ketamine ranging from 0.2 to 1.0 mg/kg body weight. Mind expanding effects of the drug were then determined in follow-up interviews. Patients were evaluated in terms of facilitation of psychotherapy and symptom relief.
Typical of the comments quoted were, "The injection took away the discomfort in my chest," "Heavy burden of sin is gone now," "I feel carefree with no worries," and "As a child I always wanted to shout but they did not let me."
Other statements categorized as psychic changes included, "I was in a different world and with flashbacks I was seeing vividly events which led to my illness," "Colors disappeared and I saw only in black and white," "I was talking to the Holy Family," "I was walking everywhere and seeing everything," "The blue sky was squeezing my chest," "I was flying and chasing my own life," and "I was facing the forgotten memories and was ashamed of them."
In conclusion, the authors state:
One hundred patients with a variety of psychiatric diagnoses have been part of our study. Three different dose schedules of ketamine were used and it was noted that a minimal anesthetic response was required for the expected abreactive effect. In all, ketamine at 0.4-6 mg/kg body weight led to minimal anesthetic effect and the abreactive response in nearly all of the subjects. The abreactive effect correlated well with the ketamine's mind expanding effects.
Ketamine was found to be a fast-acting drug with a short duration of action. It induced regression, introversion, lability of mood and perceptual disturbances. Moreover, it led to a loss of time sense and detachment from the environment. It activated the unconscious and repressed memories, while it temporarily transported the patient back into childhood with frightening reality, reviving traumatic events with intense emotional reaction. Some had recall of events leading to their illness. Interestingly, patients showed a good degree of verbosity and inhibitions were gone.
Within one year of follow up, nearly all patients had remained well, though two required a second injection. The complications were very minimal and included apprehension (two subjects), nausea (three subjects) and vomiting (two subjects). In conclusion, ketamine was found to be a safe psychotomimetic agent.
Ketamine has also been used in psychotherapy by Dr. Salvador Roquet, the founder and director of the Institute of Psychosynthesis (unrelated to the psychosynthesis of the Italian psychiatrist Roberto Assagioli) in Mexico City. Until this institute was forcibly shut down by the Mexican police early in 1975 Dr. Roquet treated over 600 patients with therapy involving hallucinogenic substances, including ketamine. Since he was using seven different psychedelics including LSD, mushrooms and morning glory seeds his work was rather different from ours. However, the essence of the therapeutic procedure was the same. That is, the patients were forced to fall apart in order to reintegrate on a higher level. As with atomic energy, fission precedes fusion and the consequent release of radioactivity.
In the last few years the use of ketamine in psychotherapy has been spreading without fanfare and it can be assumed that once this method is fully legitimized the public will become aware of how much work has already gone on in this field.
In ancient times the roles of physicians and priests were often synonymous. Evolved cultures raised magnificent temples of healing, while on the tribal level the medicine man was also the community shaman or spiritual guide. Traditionally the shaman is a person who can enter a trance state in which he apparently dies and then returns to life. He knows how to navigate the inner spaces of being and commune with higher intelligences, and can use the information thereby gained for the good of his people. The shaman's altered states of consciousness are often induced by the judicious use of psychedelic substances.
It is time now for the public to realize that shamanism is an honorable profession. With the increasing use of ketamine as a medical sacrament the demand for para-pharmaceutical personnel who can reformulate the shamanic ideal in modern terms is bound to be insistent. Much new thinking will have to be done if the leaders of humanity are to mend the splits that threaten to undermine our divisive civilization. People absolutely must be made to realize the futility of trying to alleviate bodily ills without also considering an individual's psychological, sociological and spiritual condition. Consequently, the pressure is on for a reformulation of the healing arts in holistic terms.
We believe that samadhi therapy is naturally adapted to this holistic trend inasmuch as it works simultaneously on the physical, emotional, mental and spiritual nature of man. Since ketamine is a consciousness-expanding drug it should be dispensed by a special kind of shamanically oriented therapist-one who can take an integrative view of a man and the universe because he himself has learned to see clearly. As long as qualified people are permitted to develop this shamanic vision we can hardly draw the upper limits of ketamine's regenerative potential for man and for the planet.