Why Ketamine Continues to Fascinate Me
- Richard Clark, CRNA, APRN
- 5 days ago
- 4 min read
Updated: 5 days ago
One of the questions I'm asked most often is, "Why ketamine?"
With the growing interest in psychedelic-assisted psychotherapy, it's a fair question. Psilocybin and MDMA often capture the spotlight, yet ketamine remains the only widely available legal psychedelic medicine that can be integrated into everyday clinical practice.
My answer isn't based solely on research papers or clinical trials. It's shaped by more than two decades of administering ketamine in operating rooms, emergency situations, and now in Ketamine-Assisted Psychotherapy (KAP). Over those years, I've come to appreciate ketamine not only as a remarkably safe anesthetic, but as one of the most versatile medicines I've ever encountered.
My First Lesson
I still remember one of my earliest experiences with ketamine.
I was on call the week between Christmas and New Year's in 1999. The world was consumed by fears surrounding the Y2K computer bug. Every news channel was talking about computers crashing, banks failing, and the uncertainty of what midnight on January 1st might bring.
That evening I used ketamine to induce anesthesia for an emergency Cesarean section. The surgery went beautifully. Mother and baby were healthy.
But as Momma emerged from anesthesia, she looked around the room with complete sincerity and announced that she had given birth to a laptop computer. Fortunately, the confusion passed quickly, and we all had a good laugh afterward.
What stayed with me, however, wasn't the humor.
It was the realization that suggestion matters. Altered states of consciousness don't begin with the medicine—they begin with the mind. The conversations we have, the expectations we carry, and the environment we create all become part of the experience.
Years later, that lesson would become foundational to how I approach Ketamine-Assisted Psychotherapy.
The Same Medicine Can Act in Extraordinary Ways
One of the most fascinating aspects of ketamine is that it can wear many different hats.
At one dose, it's a reliable anesthetic that allows surgeons to perform life-saving procedures. At another, it provides sedation for painful procedures. At still lower doses, it becomes an effective treatment for chronic pain and suicidal thinking. And at KAP doses, it creates an altered state that allows people to step outside their usual patterns of thinking and experience themselves in entirely new ways.
Psycholytic. Psychedelic. Sedative. Anesthetic.
Very few medications can legitimately claim all four.
Over the years I've seen ketamine used safely with infants, toddlers, pregnant women, trauma patients, older adults, military personnel, and individuals with complex medical conditions. It's used in operating rooms, emergency departments, combat medicine, surgery centers, and now psychotherapy offices.
Can you name another medication with this level of versatility and this kind of safety profile? I honestly struggle to.
More Isn't Always Better
One of the biggest misconceptions I encounter in KAP is the belief that deeper healing requires higher doses.
In my experience, that's simply not true.
Some of the most profound sessions I've witnessed have occurred at lower doses.
Sometimes healing whispers. It doesn't always shout.
Finding that therapeutic sweet spot is one of the reasons I love working with ketamine. I've come to think of ketamine as a medicine that meets the nervous system where it is.
Why I Believe Ketamine Is Different
Ketamine helps pause our default way of thinking and our default way of being. In that pause, curiosity becomes possible. People begin exploring themselves with openness instead of judgment.
I've watched individuals reconnect with grief they had buried for years. I've watched others rediscover joy, awe, gratitude, and wonder. I've watched people experience a profound sense that they are connected to something larger than themselves.
Those moments never stop amazing me.
What I Wish Every Therapist Knew
Ketamine is appropriate for far more clients than many clinicians realize.
Because of its remarkable safety profile, compatibility with many psychiatric medications—including SSRIs—and relatively short duration of action, ketamine removes barriers that often prevent people from accessing psychedelic-assisted psychotherapy.
Trust Every Part of the Journey
Ketamine doesn't simply reveal the parts of ourselves we enjoy meeting.
It illuminates everything.
The loving parts.The frightened parts.The protective parts.The wounded parts.
The journeys that feel uncomfortable in the moment frequently become the ones that produce the deepest healing later.
Why I Still Love This Work
After thousands of ketamine administrations, what continues to excite me isn't the medicine itself.
It's what happens when someone returns from the experience and quietly says something they never expected to discover.
Just recently, during an integration session, one therapist reflected on their very first KAP experience by saying:
"I have never felt more peaceful and present with myself in the presence of another person before."
Those moments remind me why I continue doing this work.
I've come to realize that I'm not fascinated by ketamine because it's a powerful medicine.
I'm fascinated by human consciousness.
Ketamine simply happens to be one of the most extraordinary lenses I've found through which to explore it.
It blends my years in anesthesia with what I've learned sitting beside people as they rediscover parts of themselves. It's deeply clinical, yet profoundly human.
And after all these years, it still fills me with a sense of curiosity and wonder.
Richard Clark is a Board Certified Registered Nurse Anesthetist (CRNA) and APRN; Certified in Psychedelic Assisted Psychotherapy through the Integrative Psychiatry Institute, and is the founder and clinical director of Ayafusion Wellness Clinic and Ayafusion Ketamine Clinic. Rick also partners with Autumn Starks, LCSW at Starks Therapy Group in Oak Park, IL to provide ketamine-assisted psychotherapy and together they host the Ketamine Collective for therapists.
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