Ketamine-Assisted Psychodynamic Psychotherapy.
John G Cottone
Psychodynamic psychiatry December 1, 2023 DOI: 10.1521/pdps.2023.51.4.467 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 54-year-old woman with multiple traumas, sexual assault, life-threatening physical injuries, and primary lateral sclerosis (PLS) |
| Intervention | Ketamine-assisted psychotherapy (KAP) |
| Topics | Psychedelic-assisted therapy Esketamine Ketamine |
| Keywords | Ketamine-assisted psychotherapy Psychodynamic psychotherapy |
| Key findings | After a KAP session, the patient discovered unconscious idealizing tendencies and secondary gain from physical symptoms, leading to reduced idealization and fewer symptom exacerbations. |
Abstract
This case report details the treatment of a longtime psychodynamic psychotherapy patient, with a particular focus on a ketamine-assisted psychotherapy (KAP) session, and how the progress achieved during this session compares with the literature on KAP. The patient is a 54-year-old woman with a history of multiple traumas, including sexual assault and life-threatening physical injuries, as well as a recent diagnosis of primary lateral sclerosis (PLS). For most of her life, she relied on extreme idealization of important people in her life as her primary defense mechanism, helping her to maintain physical and psychological survival. However, after a KAP session in January 2023 she discovered the consequences of her extreme idealizing tendencies. Among these was the creation of troubling double binds for the people she idealized, as well as the fomentation of conflict between these individuals with each other. Also unconscious was the secondary gain offered by her escalating physical symptoms and pain-that is, the ability to resolve conflicts between those she idealized-and how this secondary gain increased the likelihood of symptom exacerbations during periods of conflict. After the discovery of these unconscious tendencies during her KAP session, the patient has since been able to avoid extreme idealization of important people in her life and has subsequently experienced fewer episodes of exacerbation of her physical symptoms. Consistent with the opinions of clinicians and researchers published in the literature, the achievement of a psychedelic trance state appeared necessary for the success of the patient's KAP treatment.
Comparable studies
Other case reports and case series on ketamine and psychedelic-assisted therapy, most cited first.