Prof K
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Audio Recording by George Hahn
I experienced ketamine therapy a few weeks ago and, after discussing it on Pivot and Prof G pods, I’ve received a great deal of inquiries from friends, strangers, and media. I wanted to let the experience settle as my perception continues to evolve/mature/unfurl (couldn’t find the right word), and to take advantage of Daniel Kahneman’s advice to employ our “slow thinking.” I was also inspired to do some research on the background and technology of the craft I traveled on, and the drug an increasing number of people are using … in a variety of settings. Anyway, here goes.
Anesthetic
Ketamine was developed as a surgical anesthetic. It replaced PCP — yes, that PCP — which was effective, but patients frequently emerged from unconsciousness confused and sometimes hallucinating, a state known as “emergence delirium.” Scientists modified the compound until they hit on a variation that had similar anesthetic properties but with less risk of psychedelic side effects. First synthesized in 1962 and tested on Michigan state prisoners in 1964, ketamine remains in widespread use as an anesthetic today.
Ketamine produces less emergence delirium than PCP, but it does have that effect, and in the 2000s, researchers started looking more closely at the unusual phenomenon. The “dissociative state” is characterized by a sense of detachment from reality and one’s physical self, or even consciousness. Dissociation can occur without drugs — psychotic hallucination is a type of dissociation — but the particular sense of detachment from the self that ketamine produces (and other psychedelics such as psilocybin and LSD can produce) turns out to be a potentially powerful tool. It can enable personal growth as well as enhance artistic and intellectual expression. Research interest in this phenomenon opened the door to a broader insight: While the mechanism is not yet fully understood, there is growing evidence that at sub-anesthetic doses, ketamine can help resolve serious mental health conditions, including anxiety, bipolar disorder, PTSD, and depression.
Depression
The most thoroughly studied and accepted therapeutic use of ketamine is for treating depression and, in particular, treatment-resistant depression. Depression is a modern scourge. It afflicts an estimated 280 million people worldwide, and nearly 18% of U.S. adults report they are currently in treatment for depression — up from just 10% a decade ago. Depression factors into two-thirds of suicides, killing over 30,000 Americans per year. Antidepressants are effective for many but are ineffective or bring major side effects for others — around a third of patients suffer from treatment-resistant depression. Over the last decade, dozens of studies have shown ketamine to be particularly effective for this cohort.
Similar to other antidepressants like Prozac, ketamine works by altering our brain chemistry — it increases the availability of substances the brain uses for internal communication. But beyond its direct chemical impact, ketamine (and other psychedelics) offers an additional dimension to treatment: the dissociative state and the greatly enhanced neuroplasticity that follows it. Depression and other disorders are so difficult to escape in part because they change not just our brains but also our minds. They influence how we see the world and ourselves, and directly interfere with our ability to change. The dissociative state induced by psychedelics allows us to see ourselves from a distance, to disentangle our disorders from our identities. Patients report being able to face deeply buried traumas without suffering and to acknowledge unhelpful patterns of behavior without defensiveness.
Over the past 15 years, interest in psychedelic-assisted therapy has renewed and accelerated. Michael Pollan’s 2018 book, How to Change Your Mind, catalyzed popular interest, but general awareness was just catching up with the science. Because ketamine can be more effective when combined with therapy, some doctors have opened specialized clinics where ketamine experiences are integrated with therapy and other treatments. A few weeks ago, I visited one.
Prof K
I’d been considering ketamine therapy for a while. I struggle with anger and depression, and thought it might help. Also, I was curious. Similar to Burning Man, ketamine therapy is something I’ve planned on doing for several years but I always find an excuse not to go “there.” I was wary that something unwelcome would surface. Whatever trauma or demons lie in my subconscious, I’ve managed to (mostly) suppress them. And I’m down with that — let sleeping dogs lie. But here we go.
At Kuya Wellness in Austin, the first step was a detailed interview about my medical history. The onboarding process was both comforting — they take this seriously — and a bit disconcerting (see above: This is serious). I was approaching the experience as a more cerebral form of the Space Mountain ride. Except, at Disney World, the screening is only that you be at least 3 feet 8 inches tall. If you had to meet with a doctor and go over your medical history at the beginning of the line, you’d be more pensive while you waited your turn to ride.
Birkenstock Austin
The clinic felt like the Austin regional office of Birkenstock or the HQ of a successful scented candle manufacturer — groovy but well funded. The first thing you encounter is a purposefully distressed shoe cubby that sets the tone, as everyone is barefoot. My guide, John, was out of central casting to lead a yoga retreat, or an angry professor’s ketamine trip. He was about as chill as one could be while still maintaining an air of competence. I had an additional intake with the medical director, an attractive woman in her 60s. I had trouble focusing for the first few minutes as she had a Tammy Wynette–like wig. It looked good, but she could have been the offspring of Sophia Loren and Beyoncé. I immediately summed her up as a rich housewife who, after the kids left, got bored/depressed, decided to get a degree, and convinced some rich investors to fund her adventures in ketamine.
But here’s the thing, I was wrong. Dr. Sheila Newsom was the captain of the baseball team at West Point, served her country for four years as a paratrooper, got a medical degree from the University of Texas, and built a hospital in Africa. At 63, Dr. Newsom underwent gender transformation and answered a call to help people suffering from suicidal ideation via ketamine therapy. Jesus Christ, an amazing athlete who served her country and later in life felt a calling to be her true self while helping others. So, the first “unlocks” from ketamine were before the ketamine: I am judgmental, and there are so many remarkable Americans. Just as grit is a combination of resilience and forgiveness, I’d like to think “American” is a mix of opportunity and acceptance. The two are force multipliers for one another. I worry that America, for the first time in our history, is becoming less accepting. Less American. But that’s another post.
The trip room was what you would expect to find in the home of a Gen-Xer who, after his kids are asleep, takes an edible and retreats to a room with an oversize sectional, a flat-screen, and no sharp edges (speaking for a friend). Dr. Newsom joined John and me in the opium den, grasped our hands, and prayed … which I found oddly comforting. For some reason I requested a weighted blanket. I’d never used one, nor really knew what it was … but it just felt right. John and I did some breath work and then Dr. Newsom injected me with 87 milligrams of ketamine.
Elevator Up
Shit got real, or unreal, pretty fast. I felt heavy but not uncomfortable. Wary but not anxious. With the blindfold on I was in the Sphere (Vegas immersive theater), only this was to the Sphere what the Sphere is to a black-and-white television. Walls of red numbers and symbols bumping into, and absorbing, each other as the sheets of imagery expanded and contracted as if they were breathing. The visuals took on a sentient feel and turned to emotion and experiences that then liquified and poured over my consciousness. I immediately felt a sense of wonder for a drug that could inspire this depth of hallucination, this fast, without the feeling of being out of control. Then things got weird.
Imagine your brain is a tightly wound knot of experiences, emotions, visuals, and neural pathways (your consciousness). Ketamine loosens the knot and unfurls everything, including material that’s there but not previously visible. The strands of the knot then separate from your physical self and all things. People have described it as floating through space. For me, it felt like a different dimension where there was nothing physical, just my being. My thoughts and perceptions were untethered from any organic or inorganic material. A friend who several years ago urged me to try K therapy described it best: It’s as if your life is an ocean. And you can see some stuff below the surface, but it’s not clear. K drains the ocean so you can walk along the floor and see everything in sharp relief.
Recognizing that my senses and emotions (i.e., perception) were the only “real” thing was overwhelming, and for a few moments unsettling. How was my perception formed? Jesus, this is me … and what does “me” really mean? Similar to when I was a kid on a long road trip with my mom, I’d ask myself over and over, “Who am I? Who am I?” and then feel faint. I’d tell my mom; she’d tell me to not think about that kind of thing. Ketamine doesn’t care what your mom says. Trying to wrap my conscience around itself and understand my being, my soul felt overwhelmed. Never panicked, like being too high (been there), just overwhelmed.
Bahne
A couple images kept resurfacing. First and foremost, I have specific pictures of my boys that I’m fond of and they appeared square in front of me. Except, they were in 4K, high def. I, similar to most parents, think my boys are the most beautiful things ever created. The depth of commitment and love I feel for them felt impossible. Impossible in a good way, as if it was a secret that would only be revealed to them when they had kids. The images were just so illuminant, and the emotion so strong.
Their mother appeared as well, and she produced entirely different emotions. At first, a surprise … who is this? Then a sense of relief and joy. When I was 10 my only hobby was skateboarding. I bought a skateboard at Big 5 for $3. It was a piece of pressed balsa wood with steel wheels. We had to check our skateboards in at the beginning of school to the principal’s office and then retrieve them when school was over. Anthony Fadale and friends would mock me and my board when he and his crew picked up their Dogtown and Zephyr boards.
My mom’s boyfriend, Terry, was leaving on Sunday and left a UPS box on the dining table. In the box was a new Bahne skateboard with AC500 trucks and KONA wheels. This board cost $45, which might have well meant $45 million for my mom and me. The feeling of surprise and joy when I realized this was mine was similar to the emotion that registered when the image of my wife came into view. This relationship is mine … really?
I also had some anxiety around things that were on my mind, bothering me. I don’t think K is good at sorting, and these things were only there as they were present at that moment. I’d said something stupid at a conference earlier in the week onstage and had been an asshole to someone the same week. They both kept coming up and confronting me.
No Free Lunch
There is an increasing body of research showing that ketamine therapy can do wonderful things for people suffering from trauma, depression, and addictions. However, I would not recommend doing this recreationally or outside a therapeutic environment. It is intense. What has struck me is the benefits of the session have mostly occurred well after the session as I process the experience and what to take from it. This is why several sessions done in a licensed clinic in conjunction with a therapist is a best practice. Recreational use is spiking, and while it will be a light diversion for most users, ketamine can be addictive and, when abused, can cause serious physical harm, including bladder infections and renal failure. Ketamine purchased from mail-order pharmacies or bought on the street is of uncertain provenance, and when sold in powdered form, is often cut with other substances including fentanyl.
Clarifying
During my trip, there was nothing new. No discovery, just clarification and illumination. I know I love my boys, and that their mom is impressive. But this was a chance to bask in those emotions and register real reward. Also, in the two weeks since the therapy I haven’t had a drink — first time I’ve gone this long since college. It’s not that I had a revelation that I drink too much (again, I knew that), I have just sort of lost the taste for it. We’ll see. Again, the majority of the benefit has been post-therapy processing the experience, what I take from it and how it will change my behavior and perspective moving forward. Some thoughts:
- Feeling the depth of emotion for my boys gives me a sense of purpose. I love the notion of “surplus” value, that you become a man when you add more than you take. Sort of a spiritual profitability if you will. My purpose is to love my boys, and others, more than I’ve been loved. I’m almost there, and it gives me a sense of peace about aging and dying (note: not planning to do this anytime soon). I used to be terrified of death, and feeling purpose take shape — and that it’s within reach — provides comforting permission to leave. As they say in the Navy, “Fair winds and following seas, we have the watch.”
- I’ve also come to the conclusion that the quality of your relationships isn’t a function of that person but of you. Specifically, your willingness to lean into the relationship and not keep score. For most of my life, relationships have been transactional. And I was either on the right side of the ledger — getting more than I receive — or dissatisfied. I realize that my role is, among those close to me, to provide witness to their life. For them to know that I notice. To rescue them from any doubt that they matter, that when good or bad things happen to them … that I notice. Their life happens, and registers, as a decent man who loves them provides witness.
My son has a ring on a necklace inscribed with a quote from one of my favorite childhood movies, The Little Prince: “What is essential is invisible to the eye.” When I called my wife after the therapy and told her she was a skateboard, and why, there was a long silence on the other end. However, I knew what she was feeling. We didn’t need to hear or see each other. It didn’t matter, as the essential is invisible.
Life is so rich,
P.S. If this email was forwarded to you, you can receive No Mercy / No Malice in your inbox every Friday by subscribing here.
P.P.S. Missed my AMA on building wealth yesterday? We tackled real estate, retirement savings, raising kids, quitting toxic jobs, and what to do with $100,000 – watch the recording here.
Scott, thank you for sharing your experience and understanding the care that is needed around servicing ketamine treatment.
On a previous episode of your podcast, you interviewed Ronan Levy about the psychedelic industry. You read a question of mine on that episode, around the time that we were beginning a two-year inquiry into the intersections of psychedelics and corporate capitalism. We just published the findings of that study.
When you get the chance, I would invite you to read the abstract of this essay and consider bringing this research to your students or audiences.
https://corporate.substack.com/p/consequences-of-the-psychedelic-renaissance
Consequences of the Psychedelic Renaissance
A critical study at the intersections of psychedelics, corporate capitalism, and this moment in history
Cheers,
Mike
Thank you for sharing this. As a father, I can deeply relate to your conclusions.
I have taken just about every hallucinatory drug in my lifetime and I am now 84 and of perfectly sound mind and body. From Thai sticks to peyote and mescalin to magic mushrooms and ketamine to angel dust and ecstasy to LSD and Opium. In my view the effect depends completely on the state of mind of the user at the time of using.
It is vital to be receptive and enquiring mentally and to be in a fit state of mind and body if possible. If you take these drugs as a replacement or as a staff to lean on they are dangerous and must only be used occasionally for enquiry and for fun.
Many psychedelic drugs have the same effect of starving the body of sugar as the fasting of 40 days and nights of biblical prophets
It is essential not to eat or drink any substance with sugar while taking.
I have experienced some of the best moments of my life taking psychedelics, particulary in sharing with loved ones mentally and physically.
I have no doubt whatever that it opens far broader new dimensions of the mind of than humans use normally and one of my heroes Dr Francis Krick the discoverer of DNA claimed in his biography that taking LSD revealed the secret of DNA to him.
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Para 5 beginning “Similar to other antidepressants” and ending “acknowledge unhelpful patterns of behavior without defensiveness” runs like an exact description of what a sensitive reader experiences while reading fictional classics–the Victorian, American and the American greats. As English majors (first half of Seventies) arriving at experiential correspondences and encountering parts of oneself submerged till then while reading them was an experience prevalent and shared. It was therapy enough for quite a few of us. But the merciless march of relativism propelled by ever mushrooming new fangled theories termed such works as exercises to uphold Eurocentricism and imperialism. They are now treated by quite a number of people as somethings that the cat brought in. The Departments of English prefer to keep mum on this as speaking favorably of canonical works is heresy now. Just wondering whether we jettisoned something that was working after all in order to appear more hip.
K-therapy can’t solve the world’s problems. Why do we think that our problems can be solved without taking into account the loveless systems that grind us to pieces? We cannot.
K-therapy only serves the interests of those making money from it, and those seeking redemption. To hell with the rest of the world.
87 millilitres (ml) would drop an elephant. I know the metric system is a struggle, but try.
I listened to this, the written version is accurate I believe.
Andrew Huberman, PhD, (hubermanlab.com) has an excellent podcast episode in which he discusses Ketamine at length. Says he, “In this episode, I explain how ketamine causes rewiring of brain circuits and dissociative states to relieve symptoms of depression and post-traumatic stress disorder (PTSD). I explain how ketamine impacts both the brain’s glutamate and its endogenous opioid pathways, which together regulate mood and well-being. I discuss how ketamine therapy is used clinically to treat major depression, bipolar depression, obsessive-compulsive disorder (OCD), suicidality and other psychiatric challenges. I also describe how ketamine causes the subjective effects of dissociation and euphoria and, at higher doses, is an anesthetic. I compare the different routes of ketamine administration, dosages and forms of ketamine, and if micro-dosing ketamine is effective. I also highlight the potential risks of recreational ketamine use (and the colloquial term ‘K-holes’). This episode should interest anyone interested in ketamine, treatments for depression, neuroplasticity mechanisms, psychiatry and mental health.”
Thanks for this. I think it could be really useful to have updated reflections in six months or so. Also, I didn’t pick up whether you had much therapeutic intervention
Interesting experience and given the noterity and air of mystery that Elon has given it quite informative. Oddly you seem to be improving and Elon becoming more cartoonishly mad scientist crossed with Ming the merciless. The warning that your mileage may vary clearly applies.
Hey, I’m a rich old white dude, I did class 1 narcotics that would get anyone else arrested, but this was in a “therapeutic setting” so it’s all cool.
WTF?
As someone who has to get a DEA license just to administer ketamine to laboratory mice, fuck this privileged shit!
What a weird take. Did you read any of this? K is prescribed for all kinds of things, and these clinics are all over. Arrested? It’s not even a Schedule 1 drug, it’s schedule 3, same as Tylenol with codeine.
Powerful story and thanks for sharing your experience.
I heard you recount your K experience on “Pivot”. The written word is so powerful. Thanks for giving me and others the opportunity to share in your experience
“Think my boys are the most beautiful things ever created. The depth of commitment and love I feel for them felt impossible.”
The visceral love that you have for your sons is so beautiful and yet, completely at odds with your stance on the Israel/Gaza conflict. How can you not feel tremendous outrage and sorrow at the loss of 13,000+ Palestinian children, thousands more maimed and starving, and probably hundreds more buried under the rubble…and not grasp the incredible grief every Palestinian parent is feeling (if they themselves actually survived)?
And if you can acknowledge that, how can you not call for a permanent ceasefire AND a return of the hostages? What Israel is doing is criminal and the US government is enabling it. Having this view is not anti-semitic, it is not anti-American…which is what you have said. It’s pro-humanity. In recent months, I have heard your thoughts on this topic on various podcasts and a recent Bill Maher show, and I have become so disappointed with you, Professor Galloway.
I have read your columns since Day One and understand that you are someone who has gained a lot more empathy as you have gotten older. But it seems that your empathy is quite selective.
The whole time I’m reading this I thought it was an April fools joke. I guess if you keep filling your cup w illusions ( edibles, alcohol, ketamine ,etc ) your bound to experience something
*you’re
Love the shares and the honesty! Thanks! K
The journey of a thousand miles starts with the first step. Excellent post, Professor G! : – )
Wonderful insights into a subject of which I know very little…emotional and very thoughtful.
Just a few months ago you were having a lot of fun ripping on Elon Musk for his ketamine use. Remember the “Ketamine heart” comment? Kind of messed up to mock someone for the prescribed drug he uses to treat his depression… but that’s the kind of cruel and messed up behavior we have all come to expect from you.
Now just a few months later and you’re a big fan of the drug and jumped on the ketamine bandwagon to treat your depression.
Don’t you feel the need to apologize for your previous comments?
Even just a quick 1 line public shout out. “Musk, sorry I was mocking you for this. I was wrong. Peace”
See how easy that was?
You wrote an entire post talking about how much you dig this drug and it never even occurred to you that maybe you should apologize for mocking people that were using this exact same drug just a few months ago?
There’s something seriously wrong with you, Galloway.
Elon Musk: “Put ‘Never Went to Therapy’ on my gravestone.” If Elon Musk is not using this in a therapeutic setting with a therapist, he’s not using ketamine therapeutically. Self-treatment with ketamine (i.e., without a therapist) is not treatment, particularly in the case of a man who does, in fact, have access to the finest medical care money can buy, and can definitely afford to have a therapist administer the treatment properly. If you’re looking for apologies, maybe ask Musk to apologize for demonizing SSRI’s as “zombifying” when they have helped give millions of people relief from anxiety and depression (and as someone who has taken them, I have not a clue what he means about “zombifying” – maybe he hasn’t tried them either.). No one needs to apologize for mocking Musk’s recreational drug use.
Thx for sharing..but did you really need K to tell you to “give more than you receive?” Hope not. My dad taught me that when I was 11 years old.
We’re all told a million things during our lives but we truly understand almost none of it. When true understanding comes, whether thru K, thru a near death experience, from a profound author or in losing or finding a loved one…it can be a life-changer. Sometimes we can use help from the outside.
Thank you, Scott, for baring your soul. A very interesting and stimulating post. Just a note of caution to any ‘DIYers’ out there: there is something wrong with the stated quantity that was injected: “87 milliliters of ketamine” makes no sense (there is no unit of weight in the term): please do some serious research before deciding on the dose!
Just when I feel we share an inbox connection you move the needle to challenge me, again….
“I love the notion of “surplus” value, that you become a man when you add more than you take.”
Interested to know more about this notion of surplus value. Google just gave me a bunch links on Marx….
Great piece Scott , like a lot of people our age I am open to trying new things especially K and cybin although yet to action the urge , one thing about which I am sceptical is my own ability to not “keep a ledger” on ones relationships as I think this maybe the most challenging undertakings in mankind’s history , K or no K ,
peace
The Fat Gladiator
Such deep wisdom and insight.. Thank you , once again Scott Galloway for this piece on your experience with Ketamine. It was enlightening and moving.. not surprising that you had such a positive experience, Full of love and worthwhile insights.. You are a remarkable man.
I’ve been waiting to hear about your experience for weeks and it did not disappoint. I’m 50 and have dealt with depression since high school. Nothing severe, I simply attributed the occasional funk to genes as well as something that creatives must endure to be, well, creative. A few years back I encountered some severe emotional trauma, which exacerbated my depression to levels I had never before experienced as well as creating some lovely PTSD.
I started therapy for the first time in my life and it was wonderful, but tough — so wish I had done this sooner in life. Unpacking one’s life can feel like receiving a gift that you thought you had already regifted. I did the work but sometimes the wiring becomes so hardwired that drugs need to get involved — I’ve tried just about all of them. Unfortunately, antidepressants and I didn’t mesh well; the side effects were overwhelming, ranging from anxiety to a loss of libido. As a result, I ended my relationship with them.
Recently, I’ve been researching psilocybin and ketamine treatments, and both seem promising. I believe this could be the next step in my healing journey.
Thank you for sharing the details of your personal experience, Scott. The more we discuss mental health the less stigma we allow it.
Just WOW. Thank you for sharing your experience. Will pack away your last clarifying thoughts. 💭
Scott it’s a great one! Your honesty is inspiring and helps me ;spurs me on to be a better man and dad. Thx brother !
The unlocks, the revelations.
You’d find all of that as the norm in an Amish community. Even “normal” Americans have this already, but I’d say most of them are cemented in a traditional life.
It’s almost like you’re taking medicine to reverse the changes humanity has gone through in the last 50 years, because a lot of changes don’t make you happy.
I tend to agree.
Thanks so much for writing about your experience. I had the same aha moment when I tried psilocybin mushrooms for the first time. “What has struck me is the benefits of the session have mostly occurred well after the session as I process the experience and what to take from it.”
💯
After just one trip, I experienced closure that decades of therapy never produced. On my second trip, I realized shrooms are not something at risk of becoming a habit – you take them until you have all of your questions answered. And the speed at which that can happen is mind blowing. I actually feel angry that my boyfriend and parents, and even myself just a few months ago – are taught to only think of them as illegal, recreational drugs. These treatments COULD help so many people. Ugh.
I read the Pollan book and told my wife that before I’m gone, I want to have some of these managed experiences. On one hand, I’ve got too many responsibilities now to risk a profound change, if that makes sense. On the other hand, I just hope I have enough resources to be able to take the trip before the final destination. Keep trying to be a better asshole. We appreciate it.
Love it!
This: “What is essential is invisible to the eye.”
Thanks, Scott!
As a “ devout “ Scout Galloway fan… this report on your “k” journey is so informative and insightful… I will certainly share with my friends
Your writings and podcasts continue to be so interesting… your emotional and psychological condition(s) keep inspiring me to “ do better and be better” in my work and personal relationships
With gratitude
One of your best, Scott. Some of your takeaways came right into my heart as your work highlighted how much in relationships is up to me. So Dawg – I’m going to act like a dog with more unconditional love and noticing. Although I dont plan to follow anyone into the bathroom.
Thank you for this open sharing. I’m in Austin and your deception was so spot on. Thanks, too, for the laugh.
I worked in biology research and nursing. Ketamine is classified as a hypnotic, not an anesthetic although, as you wrote, it may be used in that way. It is also referred to as a tranquilizer. It is commonly used with animals and I once saw an ER doctor order it to help a young child who had a fishing hook through a finger. The drooling, hypnotic state of her child caused the mother to cry. One place used it on monkeys to keep them from getting wild when they were handled for a health check. I don’t know if putting yourself in a trance helps with emotional issues, but like I told patients in mental health, if what you are doing doesn’t work, try something else.
Exactly. I think there are MANY people out there who think they have “tried everything” and they need to read stuff like this.
So, the first “unlocks” from ketamine were before the ketamine: I am judgmental, and there are so many remarkable Americans. Just as grit is a combination of resilience and forgiveness, I’d like to think “American” is a mix of opportunity and acceptance.
What a line, Scott! Your willingness to expose your full self – warts & wings – continues to make you so worth tuning into.
Professor psycho – do some gardening and stop taking drugs you nutter
Go touch grass mate.