Ketamine Therapy Glossary
Making the decision to embark on a ketamine therapy program is exciting, it’s a major decision for yourself and everyone you interact with. As you explore the world of ketamine therapy further, you may come across some terms and phrases you may not have encountered before — this can lead to some confusion, anxiety, and uncertainty if you’re have to make decisions for your health and wellbeing without a deeper sense of what you’re working with or how the process unfolds for you.
That is what this Glossary resource will take care of for you. It is a glossary of the common terms that may arise throughout the course of a ketamine therapy protocol, and what they mean in context and for you specifically. This is an evolving resource, it will continue to be updated as new terms arise or through the questions we receive from clients at Mindbloom®. With that being said, this is not an exhaustive list, some clinicians or other contexts may use language that is not universally shared by the community.
It’s important to ask for clarification if you need any, to investigate deeply the programs and protocols you will be working with so that you can make informed decisions for yourself and for your overall health and wellbeing.
If you have a term to suggest for this list, or would like clarification on anything listed below, feel free to reach out to our team. If you’d like to work with experts in this field familiar with the protocols, phrasing, and process of ketamine therapy, you can sign up here to start the process.
BDNF stands for brain-derived neurotrophic factor, is a protein found in the brain and body that helps regulate, heal, and promote growth of new cells and synapses.
It has important functions in the role of synapse health and healing, assisting long-term memory, and emotional regulation. BDNF is colloquially referred to at times as "fertilizer for the brain" as it helps the brain develop new connections, repair failing brain cells, and protect healthy brain cells. Part of the reason psychedelic experiences provide a sense of increased mental flexibility is due to the impact of increasing BDNF levels in the brain.
Body load is the specific physical or tactile sensations brought on by psychoactive drugs, especially psychedelics.
Body load can often be a challenging or uncomfortable feeling or sensation brought on by these experiences, but it can also refer to the overall strain or stress that the compounds put on the physical/mental systems. There are some medicines that can bring on feelings of nausea, while others increase the heart rate or blood pressure, others still can have neurotoxic effects at higher dosages.
When someone is working with their care team on a specific dosing protocol, the body load of the medicine is often considered, to ensure client safety and a comfortable, but powerful experience in the sessions.
“Classical” psychedelics are a set of compounds all have similar mechanisms of action in the mind and body, and were the first group of psychedelics actively studied and researched in clinical settings.
As a result, they are commonly referred to as the “classical psychedelics.” These are: LSD (lysergic acid diethyl amine), psilocybin (mushrooms), and N,N-DMT (DMT).
They work on the serotonergic system in the brain, binding to the 5HT2A/B receptors. The phenomenology of the experience is unique between the three of them, but they all reliably induce the classic hallmarks of a psychedelic experience such as: dissolution of the ego, warped sense of space/time, novel insights/feelings/experiences, distance from the body, etc.
Container / Therapeutic Container
A container is a metaphor, used to help allude to the safe, secure structure that supports you and your transformation throughout the experience.
Given the sensitive nature of the experiences and the content of your program, a secure and safe support system is essential to a safe and effective experience.
The container includes things like the protocols and processes, recommendations and regulations, and the overall arc of the experience. Although transformation and healing is beautiful, it can also be sensitive or challenging, having a firm structure and container supporting this process is vital and essential, which is why clinicians and practitioners may refer to a safe or therapeutic container before your experience.
Contemplative practices are supportive techniques and modalities that facilitate the act of self-contemplation, of looking and examining yourself, your emotions, and your mental processes.
There are a number of contemplative practices that may be discussed as tools for you to use within sessions, or as part of the preparation/integration process before and afterwards, these can include: meditation, mindfulness, yoga, journalling, walking, movement, and others.
Whether it’s within a session to help you stay present or work through challenging experiences, or afterwards to help you embody new states or glean insight into your experiences, contemplative practices are valuable augments to psychedelic therapy programs.
Contemplative practices are supportive techniques and modalities that facilitate the act of self-contemplation, of looking and examining yourself, your emotions, and your mental processes.
These experiences are meant to be healing and helpful, not harmful to individuals. Given the impact on the body and the effects on the psyche, there are some individuals for whom psychedelic therapy is not recommended as it could be more harmful, leading to injury, suffering, or in some cases death.
We have released a much more comprehensive overview of contraindications and specific contraindication lists for psychedelic therapy and ketamine treatment.
Default Mode Network (DMN)
The Default Mode Network (DMN) is a system in the brain responsible for the sense of self in space, and maintains the boundaries and "normal functioning" of the psyche when not engaged in other tasks, or in a state of "wakeful rest.”
The DMN is prominent in the psychedelic therapy world as it appears to play a central role in facilitating the psychedelic and/or mystical experiences that are commonly associated with these medicines. Specifically, these medicines appear to reduce the activity (by reducing blood flow) of the DMN, and this reduction in activity leads to a changing sense of Self, through dissolving boundaries and functions that normally keep the sense of the body-mind stable.
Dissociation involves a sense of disconnecting from one's immediate experience, bringing about a felt separation between one's awareness and their body, mind, emotions, sensations, etc.
Ketamine is a dissociative medicine, an exogenous compound that induces a dissociated state. Other psychedelic medicines have this property as well, and the psychedelic experience can invoke a sense of dissociation. This "psychic breathing room" can allow for novel insights to emerge.
Dosing protocols refer to the specific cadence, dosage, and frequency that you will take the medication or have a session throughout the program.
Depending on your biological makeup, your experience with psychedelics, your intentions for the programs, and the discretion of your clinical team — each individual will have a unique dosing protocol.
It’s important for your safety and experience throughout the program to stick with the dosing protocols as prescribed by your clinician and care team. These are prescribed for a reason, and with a number of factors taken into consideration. If you are working with a specific dosing protocol, it is best to honor this and keep it going.
Embodiment refers to the act of coming back to, and staying grounded in, your body and your physical sensations.
There is a tendency to over-conceptualize these practices, or to be disconnected from one's body, which creates an inherent sense of separation or distance from your immediate experience. Embodiment is the process of coming back to the very direct sensations occurring in the body.
It helps you stay present with sensations as they arise in a session, it helps you to communicate how you’re feeling to a clinician or Guide, and it is also a process and a practice that allows you to turn the abstract ideas and experiences from sessions into practical, real-world change and positive movement in your life.
Endogenous / Exogenous
Endogenous and exogenous refer to the location of origin of certain experiences or compounds. Endogenous means generated internally, while exogenous means it was generated outside of the organism.
In psychedelic medicine, the medicines themselves are exogenous compounds, they are something outside of yourself that you ingest to trigger a set of physiological and phenomenological responses. Exercise on the other hand, is an example of an activity that triggers the release of endogenous compounds, such as endorphins, that originate entirely within the organism of your body.
Felt Experience / Lived Experience
Your lived experience is the direct reality of what you are experiencing. These include the emotions, physical sensations, mental associations, beliefs, and ideas that make up the present moment for you.
You may be asked about your lived experience from the clinician or your Guide, or your lived, direct experience may be different during the sessions or throughout the program than what you have read about or heard from others.
Everyone’s lived experience is different, and everyone’s lived experience is valid. It is important to stay in touch with your direct experience throughout the sessions and throughout your program to help glean insights and support your communication with your care team.
Guide / Care Team
There are a number of roles you may find within the team structure working with you in your care team.
No psychedelic therapy protocol is done in isolation, you are always working with a care team alongside you. Of course, there is the clinician or practitioner, the individual doing your intake process, landing on a diagnosis and a dosing protocol, and helping work through it.
Throughout the process, you may receive help from other individuals, such as Guides or Coaches, individuals familiar with the experiences who help you create a safe environment, who help you unpack the experience, and can provide support throughout the integration process. In total, all of the individuals that you work with comprise your clinical care team.
Harm reduction is an emerging field within the psychedelic space at large, directly relating to the intentional efforts of individuals and organizations to help to provide safe access and experiences to individuals across recreational, intentional, and therapeutic psychedelic experiences.
These initiatives include providing safe material and equipment for dosing, giving information and support where needed, and providing safe containers for individuals to process difficult emotions or work through challenging experiences. Some harm reduction initiatives are informative websites, organizations present at music or transformational festivals, or guides/clinicians offering full overviews of the risks and benefits of different compounds and experiences.
The complimentary second half to intentions, integration is the process of taking the lessons and experience you have within sessions and throughout the therapeutic program and bringing them into your everyday life.
To integrate something means to bring it into wholeness, which is a nice framing for the work done in psychedelic therapy —to bring the best parts of yourself, the forgotten or rejected parts of yourself, back into your entire being, and move towards healing and wholeness.
It is easy to assume that the experiences themselves are the only important part of this process. However, psychedelic medicines are not panaceas, they are not magic pills. There is additional integration work that comes after the experiences in order to help these lessons settle in deeply and become fully embodied in your day-to-day life.
An intention is an orienting mechanism, something that you consciously would like to focus on or work through during each individual session.
Intentions are a foundational principle in psychedelic therapy. They help the preparation process, navigate the experiences, and provide content and experiences to help support the healing process. These are not specific expectations or requirements of the experience, but simply a suggestion from you to the medicine on what you would like to experience or the material that you would like to work through.
You can have an intention for the entire healing protocol you are embarking on, and also a new, more specific intention for each individual session. Intentions are foundational because they are how you get involved with the process, how you help support your own healing journey throughout the process.
The mind-body connection points to the deep and inseparable link between the function and health of the mind, and the function and health of the body.
Your mind and body are deeply connected, both influencing each other heavily. When discussing long-term positive behaviour change, both of these systems need to be addressed, and treated as a larger whole working in harmony throughout your entire being. For example: increasing time spent outside and in sunlight (body), can often make individuals feel better (mind). Alternatively, long periods of depression (mind), can leave an individual feeling more depressed or anxious (body).
When working within psychedelic experiences, the mind-body system is addressed as a whole, and the necessary steps or insights for change may relate to one or both of these systems.
Neurobiological is a combination of the prefix neuro-, relating to mind, and biology, the study of living organisms. The definition of neurobiology is the study of the nervous system and brain.
Neurobiological impacts refer to the physical alterations or impacts that certain compounds or experiences have on your overall nervous system and the downstream effects they then have on the body as a whole. Psychedelics affect the brain and nervous system (changing neurochemical levels) which then has downstream effects on the body (increasing heart rate, sweating, etc). It is this series of effects that are referred to when using neurobiological effects.
Phenomenology refers to the sciences of direct experiences and consciousness, of the phenomena you are experiencing.
This refers directly to the sensations or emotions experienced in your mind, your psyche. Within the context of psychedelic therapy, phenomenological experiences can relate to your sense of time, space, self, emotions, thoughts, ideas, beliefs, and more.
As psychedelic medicines interact powerfully with your mind, as opposed to the separate neurobiological effects they have on the body, and so it is helpful when understanding your own experience, or when communicating it with your care team, to draw the distinction between the neurobiological (physical) effects and the phenomenological effects (mental).
Processing / Unpacking
Processing is the act of working with your clinician to explore the experience you had and begin to make sense of the messages, experiences, or symbolism that may have arisen throughout your sessions.
Processing is a technical term that involves the assistance of a trained clinician or therapist to help process fully.
Unpacking is a useful metaphor that does not have a technical grounds in the clinical field, but simply refers to the act of separating out experiences or ideas that arose throughout the sessions. Noting any distinct experiences or ideas that arose in the session can help break the experience down into more manageable chunks that allow you to process and integrate them more successfully than trying to manage the experience in its entirety.
Psychedelic / Mystical Experience
Psychedelic medicines commonly bring about a psychedelic experience, which has similar overlapping with a mystical experience.
Though there is no universally agreed-upon definition of what constitutes a psychedelic or mystical experience, there are common hallmarks across both of these, including: distorted sense of space/time, dissolution of the ego, novel states of thinking/feeling/experiencing, ineffable quality, and a new perspective on self, others, and world.
Serotonin is a key hormone and neurotransmitter of the human mind and body, and the serotonergic system is the sum total of the pathways and biological avenues that distribute and interact with serotonin in your system.
Many of the classical psychedelics work on this serotonin system as their primary mechanism of action (binding with the 5HT2 receptor sites, found within the serotonin system). There are other psychedelic medicines (such as ketamine) that do not have the serotonergic system as their primary mechanism of action, but you may come across this term through continued exposure in this space, or in reading clinical studies.
A side effect is any effect that occurs that is not directly stipulated or intended from the medication or procedure.
These can be both positive and negative effects. In ketamine for example, the ability to help decrease symptoms of anxiety and depression is a side effect, as the original intended use was to induce dissociative anesthesia. Adverse side effects would include things like nausea, heart rate increase, dizziness, etc.
When embarking on any healing journey, particularly with psychedelic therapy, it’s important to have a complete picture of the side effects of particular medicines so that you can make a safe, informed, and effective decision for your personal process and your individual healing.
Set & Setting
Set & Setting refer to your individual mindset and your physical setting/environment when going into and within a psychedelic experience.
They are timeless and time-tested principles to help individuals have safe, effective, and powerful experiences throughout psychedelic therapy programs.
Although you can’t control the experience, adequately preparing your set and setting and creating the most conducive environment for your experience can help ensure your safety, a powerful experience, and one that works with your intentions to help provide the healing and wholeness you are looking for.
Activities such as journaling, meditation, relaxing before a session are all examples of how you can prepare a conducive mindset for the experience. Creating a calm, welcoming environment, getting comfortable, and ensuring no distractions will come into the room are ways that you can prepare your setting for a powerful experience.
Trust. Let Go. Be Open. (TLO) is a time-tested mantra given to clients by practitioners in the field of psychedelic therapy.
It was originally coined during the initial wave of psychedelic therapy trials as a universal guide to help clients orient themselves to their upcoming experience, and also as a tool that clients can use within the experience itself to navigate and understand the content of the experience.
As everyone’s journeys are unique to them, and each session is a unique experience itself, it can be difficult (and sometimes unwise) to give highly generalized advice when approaching the psychedelic experience. Through countless individual sessions and research protocols ,the clinicians and practitioners of universities and personal practices eventually landed on T.L.O. as a tried and true mantra that each person can use to prepare and help navigate an experience should it ever become disorientating or challenging.