What is psychodynamic psychotherapy?
Ever wondered - Why do I become more like my mom or dad even though I am doing everything I can to avoid it?  Why am I attracted to partners with the same problems? According to psychodynamic theory, early life experiences in relationships shape the way that we interact with others for the rest of our lives. The familiar is comforting to us, so we unknowingly repeat the past. Avoidance of the past can paradoxically lead to repeating it. Until we break the cycle, the past may continue repeating itself.  Psychodynamic psychotherapy (also called psychoanalysis) looks for patterns from the past (for example early family relationships) that persist into our present. 


You and your therapist examine present relationships and how they compare to past relationships. The therapist’s job is to understand the relational dynamics happening in session and help change the dynamic which can help break the cycle. Clients learn to stop avoiding distressing thoughts, feelings, and sensations and learn to sit in discomfort, something that psychodynamic therapy has in common with mindfulness based therapies like Acceptance and Commitment Therapy (ACT). The theory is that when we learn to recognize internal conflicts, we can also learn to deal with them in healthy ways, which will lessen symptoms. 


What does psychodynamic theory look for? 
Psychodynamic theory looks for uncomfortable feelings and thoughts that lead to avoidance. According to psychodynamic theory, uncomfortable thoughts and feelings are pushed down and can lead to symptoms in our bodies. Our bodies struggle to bring these conflicts to the surface and thus into our awareness. Examples of possible bodily symptoms are muscle aches, headaches, stomach pain, and loss of feeling in arms and legs or less commonly in other body parts. 


What makes psychodynamic theory different from other theories in treatment?
What makes psychodynamic therapy special is that it focuses on deep-seated issues in order to alleviate symptoms rather than focusing only on the symptoms themselves. This makes psychodynamic therapy more typically long-term. The theory focuses on creating greater, long-term change rather than what are perceived as short-term and surface-level changes via cognitive, behavioral, or solution-focused therapies. 


What can I expect and who benefits from psychodynamic psychotherapy?
Some favorite interventions utilizing psychodynamic therapy involve dream work, art therapy, describing fantasies, and exploring themes and symbols. These types of activities are thought to awaken unconscious content and bring forth important information about inner conflicts and family dynamics. If you enjoy abstract thinking, fantasies, and being creative, you may feel drawn to psychodynamic therapy. 


Psychodynamic therapy has been shown to be helpful in managing depression, anxiety including panic disorder, somatoform disorder, eating disorders, personality disorders including borderline personality disorder, and substance-related disorders

Ketamine has been in use as an anesthetic and sedative in operating and emergency rooms for the last 40+ years. More recently, studies have demonstrated its effectiveness in mental health, most notably in patients with chronic, treatment-resistant conditions like anxiety, depression, PTSD, and chronic pain. Ketamine Assisted Psychotherapy (KAP) is an emerging treatment in psychiatry and psychotherapy.  It combines the medicinal effects of ketamine with therapy in a state that better allows you to access difficult emotions and memories.  

Ketamine is the only current psychedelic substance approved by the Federal Drug Administration (FDA). The effects of Ketamine can lead to relief of everyday distressing emotional, physical, and mental states. Ketamine is thought to be helpful therapeutically as the psychedelic effects lead to non-ordinary state of consciousness where fear of difficult feelings, thoughts, and sensations are lessened.  This can allow for more advanced therapy to occur.

Ketamine shows promise in clinical studies for rapid symptom reduction for individuals with treatment-resistant depression including a reduction in suicidal thoughts.  The rapid reduction of symptoms stands out against common psychiatric medications that require weeks for full effect and traditional talk therapy, which can take months for significant symptom reduction.  Ketamine is considered a NMDA receptor antagonist, but some theorize that ketamine works by encouraging neuroplasticity (neuronal growth). 

Ketamine assisted psychotherapy takes place in the office under the care of dedicated, trained staff. Psychiatrists analyze patient fitness for ketamine: individuals with chronic heart issues, hyperthyroidism, uncontrolled hypertension, among others, should not take ketamine. It is important to disclose all over-the-counter and prescription medications to staff to avoid interactions. Studies that focus on ketamine often utilize a treatment plan that begins with approximately six sessions in the first 2-4 weeks and then tapered maintenance sessions.  Treatment that involves therapy will typically include being in the clinic for 2-3 hours.

The optimal dosage and modality (oral, intramuscular) are determined based on the ketamine experience by the patient and assessment by the psychiatrist. Therapists working with clients will reassure, validate, and deeply listen to each patient while anchoring the KAP session. In this safe environment, the patient is able to engage with the effects of ketamine and begin the journey to long term change.

While some clinics focus on providing ketamine intravenously in a medical setting, we believe long term change better occurs when combining ketamine with counseling in a more relaxed setting.  Accessing and addressing our trauma, frustrations, and emotions that hold us back can better allow for change to occur.

Common side effects are: out of body experience, increased heart rate and blood pressure, dizziness, nausea, and sedation. These side effects typically dissipate within a few hours. Patients in ketamine treatment are not safe to drive for approximately 12 hours, thus must leave the office with a designated driver. 

Ketamine treatment is for patients who have tried psychiatric medications or are looking for another option for treatment-resistant depression and other disorders. Ketamine, however, is not the only alternative. Other options for treatment-resistant depression include transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). Symptom alleviation may not be permanent, and may require further ketamine treatments. 

If you believe you may be a candidate for Houston ketamine assisted psychotherapy, contact our office at 281-849-4080 for a psychiatric consultation.