Wednesday, November 30, 2022

Comments by outof

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  • There are two other issues.

    Intravenous ketamine brings very short-lived effects. The effects described above are very brief and the patient is kept safe during that time. About twenty minutes to half an hour in total. This is the antithesis of being drugged around the clock.

    The other thing is that brief periods involving just a few sessions do not cause the damaging effects that regular, long-term applications of the patented products do. When actual Ketamine was found to be beneficial for some people experiencing long-term and intractable despair, there came a plethora of attempts to create a patentable, commercial product. Ketamine itself has been off-patent for decades.

    In order to patent an off-patent drug, it needs to be altered in some way. It seems likely that the ‘need’ for a commercial product may mean the resulting commodity is less effective. It may also, potentially, be dangerous.

    Off-patent Ketamine has been safely studied and used in controlled settings and for a variety of conditions, for a very long time.

  • What is described as researched is not the protocol for Ketamine.

    It is strange to suggest that a single dose of anything making a major difference in serious, long-lasting despair. It entails the assumption that it is the treatment experience itself that lifts mood. This was not what I found.

    I agree about the danger of esketamine. In this I’m assuming you are talking about multiple treatments, otherwise the bladder damage makes little sense – it is not a sequelae of a single dose. This is a problem arising from too much for too long.

    As one who found profound benefit – not at the time of taking it but in the time outside of the actual treatment – (I found the actual treatment horrible not euphoric) – I’d like to hear about research findings of a few doses of Ketamine within a few weeks followed where necessary by widely spaced maintenance -as is the usual treatment protocol.

  • Thank you for this moving and beautifully written piece.

    I will have to return to it because after a point I found it too gruelling. It just hurt me too much.

    I’m so glad that there those like you who come through such torment, and go on to shine a light for others, in your case, through your gift for expression.

    But what a terrible, gut-wrenching way to hone beauty. And how many others? How long must this continue? How many words and tears, lost decades, lost lives, is it going to take?

  • Richard,
    The assumptions in this are dangerous.

    I’ve been left-wing all my life. I’ve been an activist for most of my adult life – fighting against neoliberalism.

    My objections are not about limitations of the research but its underlying assumptions.

    Such as that government interventions were in the actual best interests of the people; that interventions would not lead to greater suffering and death across time; that disagreeing with particular interventions can be assumed to correlate to neo-liberal ideology; that anti-government feelings and lower satisfaction relate to neo-liberal hostility at government intervention rather than being about, say, enforced, unjustified authoritarianism that made matters worse for the people, and\or tribalism, division, group-think, and extreme censorship shutting down debate and\or and turning frightened pro-interventionists into state-sponsored scapegoaters of those who disagreed.

    And this on top of the dire consequences for the poorest, and that the interventions caused a massive transfer of wealth to the richest.

  • My argument was not about anything other than the right for people to access something that might release them from extreme anguish – it was not about the experience of Ketamine – but about life outside of it. My argument is founded in my own experience of the outcome, not about the experience of Ketamine.

    To say the experience is spiritual and that there are other routes to spiritual experience is moot for me. I did not experience anything ‘spiritual’ but no matter what the brief experience consists of, and how it is conceptualised, what I am saying is this an important human right.

    I was not talking about informed consent and the safety of the proctocols surrounding administration, nor about price, or who or what body should be permitted to administer such treatment and under what conditions. Obviously these are important but my only comment in relation to them was about frequency of administration and to emphasise what to me is most important – our lives.

    There is a world of discussion to be had about the danger of treatments that don’t actually restore health turning into the central pillar of our lives, and the resulting thought-mess for all concerned.

    And I want to emphasise that I’m talking about health not as some kind of guarantee about life but as just one freedom that might allow it to be broadly explored. (Beyond relentless and life-limiting suffering.)

    It feels to me that the arguments are circular – Ketamine treatment is medical, and it is spiritual, ie about accessing spiritual experiences that can be accessed by safer, (morally acceptable) means. If not one then the other and round and round. There have been other moral or moralised issues caught in the same loop. Science or spirituality or science……..

    Spiritual experiences, if they are truly spiritual cannot be accessed at will. By definition. No matter the faith or belief, practices may make such experiences more likely, but they are ultimately not amenable to the will of the small person.

    My own pre-existing spiritual practice of several years did not provide release.

    I hope you know that I say all of this this with the greatest of respect for you Steve.

  • I don’t know about this particular formulation Ketamine, but I feel an obligation to say that I found Ketamine extremely beneficial. I found the short-lived experiences themselves frightening but the result was life-changing.

    What I find worrying from this article is the weekly treatments that this particular formulation of Ketamine requires. Once depression has lifted and not feeling like hell has stabilised, – for me within a few weeks – maintenance, if needed, can be widely spaced. What people need is to focus on their lives, because this is about life, not about 25 minutes of (IM ketamine – in my situation) drug experience.

    Anguish extended is pure hell. I wasn’t able to overcome it by any other means.

    I strongly object to an implicit argument that anyone should accept hell over an extended period, or even for the rest of their lives as their fate. We are entitled to at least find out if a few brief ‘trips’ can return us to life outside of hell, (with all of its inevitable sorrows and pains).

    The experience of hellish pain is often a part of life’s mix for all of us. But if it does not ease back down to manageable pain, and finally, relent, we have a right, (and, I suggest a moral imperative) to seek a new solution unfettered by moral policing about how we should get over, or accept it.

    Unrelenting hell kills many people, and Ketamine is able to lift some people out. I have huge respect for those who through great struggle, deliver themselves. I wasn’t able to, but not for want of trying.

  • Thank you Alishia,

    This is beautiful and profound.

    There is so much in what you have written, but there is one sentence that is really important to me:

    ”Even if they’re conscious of my reality, their inability to receive and feel my words disconnects us.”

    So eloquently put.

    Connection is so delicate. In the best of relationships there are so many moments of loss. Yet I don’t think most therapists are even aware. It requires self-awareness to be even capable of feeling this relentless tide. Yet this is the ‘us’ that heals, not knowledge. As you say, receiving and feeling. And to achieve it, constant small gestures of repair from both sides into that common pool.

  • I also disagree with the link to covid. And also, with some of your premises and conclusions.

    Psychedelics require safe surroundings, sitters who are authentic, who understand themselves, who practice genuine self-reflection, and interact with humaneness, trust and integrity.

    There are plenty of arseholes around. Such people are dangerous and should always be avoided. Most vitally in any situation where one is vulnerable. There needs to be a safe and accessible reporting mechanism and a deep understanding of what constitutes psychological safety.

    As for the appalling commodification and exploitation of these agents – (and in a way this whole piece can be seen as being about these dangers – psychedelics, people, nature etc.). I agree, this is much of the problem, and can never be a part of a solution.

    I differ with you in regard to excessive personal restriction.

  • My conclusion now is that most of psychiatry could easily be changed to the title ‘don’t know’. This is a problem that few mention.

    I read a neurologist a few years ago saying that much of her work was about not knowing and working within that space. Sometimes a known organic cause proves to be correct for the suffering person. Or further down the line some new information becomes available.

    The problem is that in the uncomfortable place of not knowing, claiming to know feels better but is a huge barrier to learning.

  • What you went through was horrendous and I wish I could express the sorrow I feel that your trust had been shattered and in a state of such vulnerability it was shattered again.

    Psychedelic therapy is like where the ‘rubber hits the road’ for the trustworthiness empathy and emotional maturity of therapists. And the repeated reports of nightmares of untrustworthiness need to tell us something that can be less clear in more mundane settings. Where trauma is concerned it’s like the first rule of fight club. But for therapy it is ‘be trustworthy’. Second rule is ‘be trustworthy’ and so on.

    To be a therapist and to not even know what trustworthiness is and therefore, how to create necessary safety, in relationship. To be so lacking in true empathy and in maturity….. These failings in a therapist are a recipe for causing further harm, yet without even the empathy and maturity to know it.

    To me this is the message. It saddens me that you feel that psychedelic therapy should not be used to help those whose trust in other people has been badly broken because therapists can’t be trusted with the basics. This is tragedy.

    This is not rocket surgery, but the basics: trustworthiness, being safe and creating a safe space for another. These qualities are also the bedrock for creating any authentic relationship in any context. These non-healers failed at the entry-level.

    This is not an argument about psychedelics, for me that is a separate issue. What you are describing about their behaviour says a great deal about the dangerousness of psychotherapy in the wrong hands. These reports of untrustworthiness where such exquisite vulnerability is concerned need to be a lesson about character and trustworthiness in members of the ‘healing professions’ more generally.

    We keep seeking fault in the injured when ‘help’ doesn’t help while ignoring the humanity-health of the ‘helpers’. Trauma and psychological pain are about being human, so helping is intrinsically bound up in the quality of being human in response.

    This is like seeking medical treatment for a broken leg and the so-called professionals jumping on the injury.

    I’m so sorry.

  • If your gut feeling is located in your body and your sense of reason is located in your intellect then it is the tearing apart of these, en mass, as intellect stretches away from its obligation to “have a heart”

    Outstanding.

    The certitude of rationalism is false anyway, though we kid ourselves that the ‘tearing apart’ allows us to understand complexity more clearly. It just the bolsters the illusion of understanding and allows us to stand apart. This standing apart is dangerous. We understand less while imagining the opposite, and can enact cruelty while patting ourselves on the back.

    We need the wisdom of the heart.

  • Dogworld, Diaphonous Weeping, Steve, and Joshua.

    I feel what you are saying are aspects of my own feelings. All of them. Struggling to explain here. I hope you know what I mean.

    DW, I too believe we are equal, all human, and, from my own understanding of your previous comment, that the words that live inside us are truly only words, neutral in themselves as mere words, empowered or not inside us according to our own beliefs and feelings. And there is a real need to take responsibility for that. And also to see through a broad lens to not get bogged down in taking things personally. I thought about what you said then, and also after.

    Dogworld, I also agree, but want to add that humanity is between as well as within us. Sharing our stories, or just a few words of commonality can break down the barriers that can imprison us from our common humanity. At the same time, we can build internal fences from them, or grasp hold of them when we are lost and what we really need is to find own own compass and follow it even when our own path seems impenetrable.

    Humanity is our birthright, denial of it causes suffering and damage.

  • Max, I find this sad. All health professionals are also health consumers.

    I feel you feel forced to stand in two places at the same time, here. Yet if a professional has a hernia fixed, for example, there is no major conflict in being a patient, or in later returning to work as a health professional.

    Both professionals and patients know that physical health professionals access services for their bodies. And there is no whispering or derision, no changed boundaries at work. They can mention their own experience of surgery, or whatever, to patients when relevant, and feel that their practice and understanding are enhanced as a result of it. Many live with chronic conditions and have to alter work schedules as a result.

    What I’m trying to say is that there is no need to find a middle ground, and nor is there a special title, because every one of them knows they occupy this ground. At different times they are professional and patient, and the middle is simply any enhancement that one role might possibly offer the other.

    What I’m hearing, and I could be wrong.
    The patient-prejudice you experience hurts and undermines you, and it would be a relief to be able to lose it;
    And also there is guilt and artificial distance in the prejudice that those you work with suffer, and a sense of a need to bridge a vast gulf that secrecy seems to be a part of?

    You are the same person with the same set of experiences regardless of your previous patient status being known or not. It seems to me that what you are talking about is the effect of severe, wide-reaching and damaging bigotry.

  • Daiphanous Weeping,
    There is something that troubles me.

    I read Karin as saying she was oppressed by psychiatry and that in internalising its words, she unwittingly colluded in this.

    If I read you correctly, you are saying that it is not the words that oppress, but people, and that you have not felt oppressed by such words, that they have no inherent capacity to harm.

    Yet there can be no words without people. They are not neutral, people define and categorise with words. In this case the words are chosen and expressed by people considered to be authorities on human distress, and who society has invested with great deal of legal authority to coerce, and with moral authority to explain and treat such distress. Such words are not neutral to that authority, it is based in words.

    At the same time I felt a judgement in the idea that she was worrying about mere words while there is ‘real’ tragedy and oppression in the world. For example this line: ”The world has more than enough to deal with, what with needing to be feeding starving babies in Somalia than bothering about personally stigmatizing little ol me.”

    It seems to me the ”world” is quite capable of both.

    Most of medicine is concerned with far less critical problems than babies starving to death. Most of our everyday care and compassion is freely given to others with lesser claims and many of us would never be entitled to compassion if our pain and need of others had to meet such a high bar of importance.

    This was a personal account of overcoming suffering in which psychiatric words were personalised, not a narcissistic over-inflation and imagined personalisation. Words were used to define her. She wrote of the detrimental effects they had.

    I appreciate that you have not felt oppressed by your diagnosis, but there is a way that both of these approaches seem to express a negation of Karin’s experiences. An argument against her suffering and of her understanding of it.

    I don’t question your compassion and I value your perspective. It made me think. Most of all of how I use words and how I’m affected by others’ words. And about the nature of blame.

  • Thankyou for this well written piece.

    I have experienced this kind of therapy.

    I believe such therapies have enormous potential and equally great danger. I suspect this duality will always arise where the deep psyche is opened. It is time the sitter danger was addressed openly.

    My experience has simplified for me, a major problem in psychotherapy abuse. It is also a key ingredient in all psychological abuse imho. Its not an original idea, but here is what I’ve come to understand. It is the problem in which too many choose to Play Dolls with other humans. Can the therapist, (friend, lover, whatever) be a free space for another to unfold – or do they need that person to act out a scenario for their own benefit. It feels kind of simple to me now.

    There are roles in some situations to effect particular, and mutually agreed outcomes – like a haircut, and there are always boundaries, including in therapy.

    But can this person be human with another -authentically – or do they need to cast the other in a drama to allow themselves to be or do something they want for their own gratification.

    Psychedelic therapy can be a powerful ‘tell’ about the humanity-health of the sitter because the participant is often wide-open. The perfect candidate as a cast member in an unhealthy psychodrama, but also, for lovers of humanity, a unique unfoldment. A special time in which the sitter can be a safe experience of human with vulnerable, open, human.

    It is almost unbearably sad to me that so many people cannot be with another in joy and faith, are unable to be trustworthy. They can’t put aside their own agendas about themselves and their personal desires and fantasies, but instead need to direct a script in which they can act out their own fantasies with a human doll.