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Ketamine-Assisted Intensive Short-Term Dynamic Psychotherapy

Allen Kalpin

Psychoanalytic Inquiry September 8, 2026 DOI: 10.1080/07351690.2026.2721956 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 2
Population Two patients receiving intravenous ketamine treatment
Interventions Ketamine Intensive Short-Term Dynamic Psychotherapy (ISTDP)
Dose low to moderate doses of ketamine; a higher dose of ketamine
Topics Esketamine Ketamine Psychedelic-assisted therapy
Key findings The author argues that psychodynamic approaches, specifically ISTDP, can add value to ketamine therapy and that ISTDP clinicians can learn from incorporating ketamine-assisted and psychedelic-assisted psychotherapy. Two cases illustrate a "psycholytic" approach with low to moderate ketamine doses and therapy during infusions, and a "psychedelic" approach with a higher dose whose experience was discussed in subsequent therapy and provided therapeutic value.

Abstract

In recent years, researchers have demonstrated that the dissociative anesthetic ketamine provides therapeutic benefits for depression and other mental health problems, and when combined with psychotherapy, it is considered a type of psychedelic-assisted psychotherapy. In this article, I first review the main issues surrounding ketamine-assisted psychotherapy and then describe the psychodynamic therapy model known as Intensive Short-Term Dynamic Psychotherapy (ISTDP), highlighting key features and comparing them to elements of psychedelic-assisted psychotherapy. I then present two clinical cases in which an ISTDP-style approach accompanies intravenous ketamine treatment. In the first case, the patient was administered low to moderate doses of ketamine, and I conducted therapy sessions during the infusions, illustrating a “psycholytic” psychotherapy approach. In the second case a higher dose of ketamine was used, precipitating a “psychedelic” experience that, when discussed in subsequent therapy, provided therapeutic value and exemplified “psychedelic” psychotherapy. Throughout, I emphasize how psychodynamic approaches can add value to ketamine therapy and explore what ISTDP and other psychodynamic clinicians can learn by incorporating ketamine-assisted and psychedelic-assisted psychotherapy into their practices.

Comparable studies

Other case reports and case series on ketamine, most cited first.

Study Year Design Participants
The destruction of the lower urinary tract by ketamine abuse: a new syndrome? Young recreational abusers of street-ketamine in Hong Kong referred to urology units 2008 Retrospective case series n = 59
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions Chronic and treatment-resistant eating disorder patients 1998 Case series n = 15
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4

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Esketamine Ketamine Psychedelic-assisted therapy Depression