A ketamine therapy session is not simply a medication appointment. It is a carefully structured therapeutic experience spanning several days — preparation before, the dosing session itself, and integration work afterward. Each phase is essential.
Days Before: Preparation Sessions
Before any ketamine session, you will complete one or two preparation therapy sessions with Dr. Rosenbach via Zoom. These are not a formality — they are clinically essential.
Preparation covers: your intentions for the session, any fears or concerns, psychological grounding techniques, what to expect during the altered state, and how to work with difficult emotions if they arise.
You'll also receive practical instructions: fast for 4–6 hours beforehand, avoid alcohol for 24 hours, avoid cannabis for 48–72 hours, arrange a trusted adult companion to be present, and prepare your space to be comfortable and calm.
The Session Day: Arriving and Set-Up
Dr. Rosenbach comes to your home. Sessions typically run 2–2.5 hours total.
Upon arrival, Dr. Rosenbach takes your vital signs (blood pressure, heart rate, oxygen saturation). You'll have a brief check-in about your current emotional state, any concerns, and your intention for today's session.
You'll make yourself comfortable — lying on your bed or sofa, in whichever position feels most natural. Blankets, eye shades, and headphones for music are prepared. The environment is kept quiet, calm, and private.
The Dosing: Administration
For IM (intramuscular) ketamine, Dr. Rosenbach administers a precisely calculated dose by injection — typically into the deltoid muscle. The injection itself is brief and relatively painless.
Effects begin within 5–10 minutes. You'll first notice a sense of heaviness, warmth, or mild perceptual changes. Within 15–20 minutes, the full altered state develops.
Vital signs are monitored throughout. Ketamine raises heart rate and blood pressure transiently — this is expected and managed. You remain conscious throughout; this is not general anesthesia.
The Experience: The Ketamine State
The altered state typically lasts 45–90 minutes. Curated music plays through your headphones — carefully selected instrumental, ambient, or classical compositions chosen to support deep introspection.
Common experiences include: a sense of floating or weightlessness, visual patterns or abstract imagery, deep emotional processing, a sense of expanded perspective, and ego dissolution — a temporary reduction in the usual sense of 'I.'
Dr. Rosenbach or a trained companion remains present throughout. You are not left alone. While you may feel very inward and may not want to speak, you can speak at any time. If distress becomes significant, the session can be adjusted.
Not every experience is dramatic. Some people have subtle, peaceful sessions and still benefit significantly. The intensity of the experience is not the measure of its therapeutic value.
After the Session: Re-Orientation
As the ketamine wears off over 1–2 hours, you'll gradually return to ordinary awareness. Dr. Rosenbach will gently check in, help orient you, and briefly explore any initial impressions while they are still vivid.
You must not drive or make important decisions on the day of your session. Your adult companion remains with you. Most people feel a mixture of calm, emotional openness, and mild fatigue.
Rest. Hydrate. Do not consume alcohol. Write down any insights, images, or feelings while they are fresh — these become the raw material for your integration session.
Within 24–72 Hours: Integration Session
The integration session is where much of the lasting therapeutic work happens. Within 1–3 days of the ketamine session — while the experience is still accessible and the brain remains in an enhanced neuroplasticity state — you meet with Dr. Rosenbach via Zoom.
Together, you explore what emerged during the session: emotions, images, insights, or difficult material. You work to make meaning from the experience and identify concrete ways to apply insights to your daily life.
Without integration, the benefits of even a powerful session can fade within days or weeks. Integration transforms a psychedelic experience into lasting psychiatric change.
Curated music shapes the ketamine experience
The Role of Music
Music is not background noise during a KAP session — it is an active therapeutic tool. Research consistently shows that music profoundly shapes the emotional arc and quality of the ketamine experience.
Dr. Rosenbach uses carefully curated playlists — ambient, instrumental, classical, and world music — selected to support emotional opening, deep introspection, and a sense of safety and containment. Patients also have the opportunity to contribute to or create their personal session playlist.
Common Questions About the Session
Q: Will I be unconscious?
No. At therapeutic doses, ketamine does not cause unconsciousness. You are in a deeply altered, inward state — but conscious, breathing normally, and able to speak if needed.
Q: What if I have a difficult or frightening experience?
Challenging emotions can arise and are often therapeutically valuable. Dr. Rosenbach is trained to provide grounding support. Preparation sessions specifically address how to work with difficulty. The session can be adjusted if needed.
Q: How will I feel the next day?
Most patients feel a combination of emotional openness, calm, and mild fatigue. Some notice an improvement in mood beginning within hours. The full antidepressant effect typically unfolds over 24–72 hours.
Q: Can I eat or drink before the session?
Fast for 4–6 hours before your session. Light hydration (water) is fine. Avoid alcohol for 24 hours and cannabis for 48–72 hours prior.
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