9: Cautionary Notes
It was the distinct impression of the observer that most of the patients who had received ketamine experienced a sense of well-being which supplemented the analgesic effect of the drug in such a way as to give increased relief from postoperative pain. This observation, coupled with the comments of the volunteers that they had experienced a pleasant psychic experience, tends to suggest that this drug has a definite potential for being abused, and that clinicians should be aware of this possibility.
Several of our comrades were incredulous. "Why do it?" Why blow this beautiful set-up for all of us by provoking unnecessary opposition? Here you are, married to a successful physician, able to relax and enjoy the reputation you've already earned. If you want you can spend the rest of your days taking ketamine with no hassle, and write about it as well. But if you bring your therapy sessions out in the open you'll be jeopardizing his career and your own peace of mind."
Why indeed? Perhaps the answer is that anyone who dabbles more than a toe in the ocean of truth can no longer go on living for himself alone. One of the first effects of most psychedelic agents is the obliteration of the differences between what is inside and outside one's own head, with the result that the cosmos is experienced as a matrix of interpenetrating forces. We are here as co-creators of the world in which we live, and that means that we can serve ourselves only by serving others. Intellectually, most of us admit the truth of this golden rule, just as we know that it is desirable to express love and enjoy the grandeur of nature's continual striving for perfection. But in the higher dimensions of meaning, where samadhi is the soul's native element, it is as natural for an illumined individual to want to spread the light as for the sun to shine.
To me, the issue of what other people think of me personally has long been a matter of relative indifference, except insofar as it would endanger Howard's job. On the negative side criticism was inevitable, but on the positive side a ground swell of support could release us to pursue fulltime research into the psychotherapeutic application of ketamine. It was a big gamble but one we would have to take. If the cosmos is indeed ruled by divine justice then our story would have to have a happy ending, despite the stresses of the immediate necessity to fight for what we believed.
Far more serious was the issue of the possible dangers that might await the over-zealous explorer of ketamine's yet uncharted kingdom. In all our research the most difficult fact for me to confront has been the increasingly inescapable conviction that my beloved samadhi medicine cannot, and should not, be given out to all people indiscriminately. I so much wanted to open the gates of our bright world to others and to share our insights. There was even a time when I had visions of groups of yoga students inhaling ketamine vapors while meditating and chanting in unison. I would have liked to have seen it made available to prisoners, psychopaths, bored housewives and jaded businessmen. Now I am not so sure.
For one thing, I have found out that the average person simply isn't interested in experiencing altered states of consciousness. Even among our fellow spiritual students the majority insisted that they were quite content with their present state of mind and had no desire to experiment with any other. The situation was analogous to that encountered in our reincarnation research. Seemingly most of the dwellers on planet Earth still find the question of immortality to be of minor importance compared to the everyday concerns of making a living and cultivating normal human relationships. There are few indeed who really care about discovering the nature and purpose of their own beings.
It must also be confessed that not everyone who has undertaken our samadhi therapy has welcomed it as ecstatically as I did. Several were disappointed or indifferent, averring that they did not achieve any insights; it was just another kind of psychedelic high. Remembering my own first trip I could understand this reaction. It takes a while to discover how to maximize the beneficial effects of this medicine-in much the same way it may take a while to enjoy sex. And of course some never do. Even though the majority of our test subjects found the experience to be extremely pleasurable, a few were disconcerted to feel so "different" from their ordinary selves.
One of the most important lessons we had to learn was how little ketamine is required to lift an individual into the scenic highlands of consciousness. Hence, as we proceeded, we changed our initial injection from fifty to twenty-five milligrams and found the results greatly improved. Once the subject had an idea of where the medicine would take him he could give us an informed opinion as to how much he should have. Even if he did wish to intensify the experience twenty-five milligrams followed by a booster shot of twenty-five seemed to serve our purposes better than fifty milligrams all at once.
From a psychotherapeutic standpoint our best results were achieved with doses ranging from twenty-five to thirty-five milligrams (depending on the subject's weight) with conversations being carried on throughout the process. Virtually all the people with whom we have worked have become extremely communicative and have really wanted to describe what was going on in their psyches. We have taken people on many a beautiful "flight" working this way. In general the results have been sufficiently beneficial to convince us that this will be a valuable adjunct to the psychotherapy of the future. Since the patient is able to commune with his own higher self it doesn't greatly matter what school of thought the therapist represents. It is enough that the guide should be an understanding person who will leave the patient to his own devices.
When the aim of the ketamine trip is to explore higher realms of consciousness larger doses may be in order. But these should be given only to seasoned travelers who also know when to apply the brakes to their enthusiasm. Such people will have to proceed at their own risk, taking full responsibility for their own safety and welfare. Their position is analogous to that of pilots who fly private airplanes. The government should not have to regulate every detail of what they can and cannot do. If they choose to take foolish risks and crash that is their problem. In any field there is a limit to the extent to which safety can be legislated and it is up to intelligent self-governing individuals to realize that this leeway must be allowed if they are to retain their basic freedoms.
Our considered opinion is that most of the liabilities associated with ketamine are those inherent in the use of any mind-expanding agent. Nevertheless, it is important to emphasize that ketamine is qualitatively different from the others and should not be regarded as just one more way of getting high. Most of its negative aspects are reverse sides of its positive benefits-as inevitable as the shadows produced on a sunny day.
Ketamine indisputably does enhance sensitivity, and this revving up of the nervous system can be a mixed blessing. Being more responsive to beauty can also mean being more responsive to ugliness. We can regret being able to absorb the disagreeable emanations of others, especially when these negative-thinking people are close associates. It becomes all too easy to spot the phoniness of a pose that has hitherto held us beglamored and to reject the polite shams which convention demands as the price for dubious rewards.