4)
In applying these techniques it may be important to consider whether the experience is deficiency or growth motivated. That is, does the subject have a particular problem to solve or is he basically concerned with the exploration of alternate realities. Both reasons may be cited or he may go from one to the other.
Within the general therapeutic situation the following factors are to be considered:
1) Potency of the dose.
2) Frequency of the dose.
3) The subject's personality and expectations.
4) The therapist's personality and expectations.
5) The influence of companions present.
6) Setting.
7) The purpose of the experiment.
No one should presume to be a guide who has not personally undergone the ketamine experience. It is important for the therapist to have a general background in metaphysics and to be a sensitive, caring, insightful human being. The fact that he is serving mainly as a mirror makes it all the more important that his character should be pure and undistorted by personal biases. He should also be cognizant of the following general rules:
Practical Considerations
1) Food and alcohol should be avoided for at least four hours before taking ketamine. The subject should know beforehand that it is important to take the medicine on an empty stomach and that fasting maximizes its effects.
2) The subject should lie down, especially if this is his first session. In general, any kind of moving about is inadvisable.
3) Explain that there may be some pangs of concern as the substance starts to act on the system and it becomes apparent that there can be no turning back. Toward the end there may be another momentary jolt of apprehension that the mind will be unable to adjust to the exigencies of the mundane plane. This is all quite normal, and the subject should bear in mind from the start that the procedure is safer than it may seem.
4) Do not leave the subject unattended until he is thoroughly grounded again.
5) Do not touch the subject unless he specifically requests it. (This seldom happens.) In any out-of-the-body state, even if it consists only of mild anesthesia, it can be disagreeable to have to contend with physical sensations.
6) Remain quiet. It is rarely necessary to say or do much while the subject is under. Unless he wishes to communicate permit him to explore on his own.
7) Encourage the subject to rest and meditate even after he has returned to normal. Since his alpha rhythms will probably remain suppressed for some time, interesting ideas may come in the next hour or two.
8) Follow through when possible. Encourage the subject to be on the lookout for longterm insights and effects.
9) See to it that the subject arranges his schedule so that he doesn't have to drive for at least an hour after the conclusion (two hours after the beginning) of the session. Provide him with some refreshments during this time.
10) Try to avoid working with alcoholics who have been drinking or with seriously disturbed people. On the whole, samadhi therapy is for the sane, the rational and the well-adjusted.
11) Encourage the subject to broaden himself through the study of relevant literature and by associating with people interested in the fields of metaphysics and mind dynamics.
12) Keep detailed and accurate records of each subject's medical history, dosage and response. Every subject should have a standard data sheet to which further comments can be appended.
It was only after we had thoroughly established our own procedures that we began to hear of instances in which ketamine had been used in psychotherapy. Shortly before this book went to press Dr. Guenter Corssen, one of the original developers of ketamine, sent us a copy of an article entitled "The Use of Ketamine in Psychiatry" published in the June 1973 issue of the journal