Ketamine in Groups: The Potential for Exponential Gains
Community-based ketamine groups have been gaining momentum- but is this just about reducing cost and increasing access? Or is there something uniquely powerful about healing together? While it’s true that group work is often more time-efficient and resource-conscious, stopping there misses a deeper truth: group ketamine offers an opportunity to alter ourselves in a truly transformative way that simply cannot be replicated in solo sessions. In today’s post, I explore how internal narratives about self and other shape our perceptions and behavior. I explain how critical social reward periods explain the biological basis for rigid internal working models and how ketamine has the potential to tap into this same biology to create lasting alterations in our sense of self in relationships. And finally, I’ll close with an unabashed plug for a small group experience I am organizing this summer to help participants increase their sense of resilience by tapping into this wisdom.
Humans are inherently social beings, dependent upon their caregivers and social system for survival. Negative events in early life strongly influence how we relate to ourselves and others. We develop internal narratives— like “I’m unlovable” or “others can’t be trusted”— that profoundly shape our day-to-day experience of the world. Often these views are outside of conscious awareness- that is, something in the environment occurs and rather than seeing the event objectively, the internal narrative colors the meaning-making that we attribute to the event. For example, a young man who was bullied in his youth sees a group of men talking amongst themselves and glancing his way; he immediately senses this situation as a threat and he turns his gaze and gait away from the group. In contrast, another person in this same circumstance but without his history might keep firm eye contact and assess the situation closer, only to be invited to play a pick-up basketball game. In this manner, we can see how past negative experiences can both influence present perceptions and impede the ability to embrace new experiences that might challenge our internal narratives.
Group therapy has long been utilized to help shift internal narratives, or internal working models, by creating a safe place for individuals to express genuine thoughts and emotions, gain new perspective by listening to others’ shared experiences, and receive feedback that fosters a more compassionate view of self and others. Groups that help shift internal working models are often ongoing, taking place weekly or biweekly for six months or more. There is a strong argument that adding psychedelics to group therapy can enhance these positive effects and there is growing evidence to support this (eg., A case series of group-based ketamine-assisted psychotherapy). Furthermore, groups members may not need weeks and months to make these gains given psychedelics’ ability to accelerate group bonding and cohesion.
One intriguing mechanism by which psychedelics, including ketamine, may be especially beneficial in groups is their potential to reopen “critical periods” for social reward learning. Social reward critical periods are times in human development when the brain is especially attuned to "social rewards" (such as smiling, affection, and feelings of acceptance). Formative experiences during these times essentially create inner models for how we understand ourselves and others. These windows of development are deemed ‘critical periods’ because after these distinct times in childhood and early adolescence pass, the brain's plasticity in this domain diminishes, making it challenging to alter established internal models. Given this information, it’s easy to understand why self narratives are so hard to shift in psychotherapy- they’re literally neuronally wired during youth!
But here is where ketamine may help. By re-creating the natural malleability that the brain has during social reward critical periods, ketamine facilitates an opportunity to re-experience and re-wire our expectations of self and other in the social setting. When combined with a carefully facilitated group experience, ketamine can help individuals come back to their natural state as social beings— where others are sought out for comfort and support when the individual is in distress. Shifting our bodies’ expectation of what it feels like to be vulnerable with others often has far-reaching effects following such a group experience, especially when special attention is given to follow-up care and integration activities.
As someone who has personally experienced the healing power of ketamine in a group context, I’m super excited to tell you about the therapeutic ketamine group my colleague and I have developed for this summer. Rediscovering Resilience is a 6-week program designed to help participants reconnect with their inherent capacity to navigate life’s challenges with ease and clarity. Grounded in positive psychology, we utilize practices in mindfulness, self-compassion, and creative self-expression to deepen participants’ connection to self and others within the group dynamic. We pay special attention to cohesion and a felt sense of safety among group members to promote vulnerability and authentic connection. The group includes three in-person ketamine experiences, and is structured with three preparatory and four integration meetings to ensure that participants are fully supported throughout the process. To honor depth of connection and personalized attention, space is limited to just six participants. Click here to learn more about Rediscovering Resilience and to apply!
