Ketamine and EMDR Therapy: An EMDR Therapist’s Perspective

In the past few years, ketamine-assisted psychotherapy (KAP) has become an increasingly discussed topic in the mental health field.  

As an EMDR psychotherapist trained through The Center for Excellence in EMDR Therapy, I’ve been particularly interested and excited in how ketamine can complement trauma-focused work and help clients - especially those with complex trauma histories - open doors that felt closed to them on their healing journeys. 

While EMDR psychotherapy on its own can be profoundly effective, some clients carry layers of traumatic experiences that are difficult to access or process fully.  

In my experience, when ketamine is thoughtfully integrated with EMDR psychotherapy, it can clear new pathways for healing. 

Why Ketamine? 

One of the reasons ketamine is generating so much interest in psychotherapy is its impact on neuroplasticity, or the brain’s ability to rewire, strengthen, and create new neural connections. 

EMDR psychotherapy also relies on the brain’s natural capacity to reprocess and integrate experiences. When a traumatic memory is successfully reprocessed, it can be stored adaptively instead of continuing to trigger distress in the present. 

Ketamine-assisted psychotherapy appears to temporarily increase the brain’s flexibility, allowing clients to step outside of rigid patterns of thinking and emotional responses.  

In some cases, this can help people access memories or emotional material that previously felt unreachable. 

How Ketamine Can Support EMDR Work 

In my practice, ketamine is used in collaboration with a prescribing psychiatrist. As the therapist, I do not prescribe or administer the medication. Instead, I focus on preparing clients for the experience and integrating the therapeutic work with EMDR psychotherapy. 

There are generally two ways ketamine can be incorporated: 

Low-dose (psycholytic) ketamine sessions 
At lower doses, ketamine can have a calming effect that lowers defenses and softens the intensity of emotional material. Clients remain present and able to engage in therapy, which can make it possible to carry out most of the 8 phases of EMDR while the medication is active. 

Higher-dose (psychedelic) ketamine sessions 
Higher doses can produce a more immersive and dissociative experience. In these cases, EMDR is typically integrated before and after the session to help clients prepare for the experience and process what emerges afterward. 

How Ketamine Is Administered 

Ketamine can be administered in several ways, depending on the medical provider and treatment model. 

Common methods include: 

• Oral lozenges (troches) that dissolve in the mouth 
• Injections or infusions administered in medical settings 

In many ketamine-assisted psychotherapy models, clients use an oral lozenge that dissolves in the mouth, allowing the medication to be absorbed through the gums and tongue. The effects typically begin within a short period of time and gradually wear off.  If the medicine is spit out after 10–20 minutes of absorption in the mouth, its effects may be shorter and less intense. Swallowing it may produce longer-lasting, more intense effects. 

What I’ve Observed in Clients 

One of the most powerful things I’ve witnessed is how ketamine can help clients move through areas where they’ve felt stuck. 

Some clients have worked on a particular treatment goal for months without much movement. After a ketamine-assisted session, they may suddenly access new adaptive information and emotions that allow movement again in the EMDR process, unlocking positive changes in the present that previously felt unreachable. 

The medication appears to lower psychological defenses and help clients approach painful experiences with more openness and less fear.   

As a clinician that uses Relational EMDR Therapy®️, I have seen how ketamine can help facilitate strengthening of the therapeutic relationship between client and therapist, so that sessions can become a more shared experience towards healing, enabling clients to not feel alone while leaning into this challenging work. 

The Client Experience 

Clients often describe the experience of using ketamine differently, depending on the dose. 

At lower doses, people frequently report: 

• Feeling calmer and less tense 
• Greater emotional openness 
• An ability to approach difficult material with less overwhelm 

At higher doses, the experience can feel more expansive or dissociative.  

• Some clients describe a sense of stepping outside their usual identity or connecting to something larger than themselves 
• For some individuals, this perspective shift can be deeply meaningful in their healing process 

Safety and Medical Oversight 

Ketamine-assisted therapy always involves medical oversight.  

The medication is prescribed by a licensed psychiatrist, and clients are carefully screened to determine whether it is appropriate for them. 

Ketamine can temporarily raise blood pressure and can produce dissociative effects, so sessions are always conducted with support present. Clients should never drive or be alone during or right after using the medication. 

Not the Right Approach for Everyone 

Like any treatment approach, ketamine-assisted therapy is not for everyone. Some clients are curious and eager to try it, while others prefer to continue with traditional EMDR work alone. 

In my experience, even when someone tries ketamine only once, the experience can still provide valuable insight that supports ongoing therapy. 

How Does a Therapist Get Trained in Ketamine-Assisted Therapy? 

As interest in ketamine-assisted psychotherapy grows, training opportunities for therapists are expanding. Programs may include: 

• Online coursework, webinars and didactic trainings 
• Experiential trainings 
• Supervised clinical practice 

Many programs also include an experiential component, so therapists can better understand what the client experience is like. 

An Evolving Area of Trauma Treatment 

The integration of ketamine and EMDR is still an emerging area within psychotherapy. However, what I’ve seen so far is promising. 

For some clients, particularly those with complex trauma, ketamine may help access areas of experience and adaptive information that previously felt out of reach. When integrated with EMDR psychotherapy, it can support meaningful and potentially transformative healing work. 

As research continues and training opportunities expand, more clinicians are beginning to explore how these approaches may work together to support lasting change. 

If you have questions about ketamine and EMDR psychotherapy, please reach out to me at schrager.sa@gmail.com 

**Please note that research on the integration of ketamine and EMDR therapy is still emerging.** 

References: 

Laliotis, D. (2010-2026) Relational EMDR Therapy. The Center for Excellence in EMDR Therapy. 

Shapiro, F. (2018). EMDR Therapy: Basic Principles, Protocols, and Procedures. 

Duman, R. S., & Aghajanian, G. K. (2012). Synaptic dysfunction in depression. Science. 

Dore, J., et al. (2019). Ketamine-assisted psychotherapy outcomes. Journal of Psychoactive Drugs. 

Kopelman, J., et al. (2023). Rapid neuroplasticity changes after ketamine. Translational Psychiatry. 

Topel, M., & Ciccone, D. (2025). Ketamine-Assisted EMDR Therapy for PTSD. European Journal of Psychotraumatology.