What to Think About During Ketamine Therapy: A Patient’s Guide

Ketamine therapy is emerging as one of the most promising treatment options for people struggling with conditions such as treatment-resistant depression, post-traumatic stress disorder (PTSD), anxiety, and suicidal ideation. The medical side of treatment, including dosing, monitoring, and safety protocols, is carefully managed by trained professionals. Still, many patients find themselves wondering about their own role in the process. A common and very natural question is: what should I think about during ketamine therapy?

What you bring into a session, both mentally and emotionally, can strongly influence your experience and even shape the outcome. Your mindset, expectations, and willingness to engage all play an important part in how beneficial the therapy will be.

This guide explores three key areas: how to prepare yourself before treatment, what to focus on while the session is taking place, and how to reflect afterward so that the insights from ketamine therapy become lasting tools for healing and growth.

1. The Role of Mindset in Ketamine Therapy

Clinical research shows that the effects of ketamine are not purely based on its chemistry. A patient’s mindset, expectations, and surrounding environment all play a major role in shaping how the therapy unfolds (Dakwar et al., 2014). This is why many psychiatrists and therapists emphasize preparation and encourage patients to approach treatment with a thoughtful frame of mind.

When you enter a session with openness and curiosity, you increase the likelihood of experiencing meaningful insights and emotional release. These breakthroughs can create space for long-term recovery and growth. In contrast, approaching therapy with fear, resistance, or rigid expectations may make the session more difficult and limit its benefits.

Your mindset does not need to be perfect, but a willingness to trust the process and remain receptive often makes the difference between a challenging experience and a healing one.

2. Setting Intentions Before Treatment

One of the most powerful ways to prepare for ketamine therapy is by setting a clear intention before the session begins. An intention helps focus your thoughts and provides a sense of direction, giving the experience personal meaning beyond the medical process itself.

Examples of intentions might include:

• Exploring the roots of depressive or anxious thought patterns.

• Releasing painful memories or unresolved trauma.

• Cultivating greater compassion and patience toward yourself.

• Strengthening your motivation to stay committed to recovery.

Intentions should be seen as anchors, not strict instructions. They guide you, but they do not lock you into a fixed outcome. The therapeutic process often brings forward unexpected images, emotions, or realizations. When this happens, your intention can help you feel grounded while still allowing new insights to unfold naturally (Dore et al., 2019).

Some patients find it helpful to write down their intention or share it with their therapist beforehand. This simple practice can reinforce focus and make it easier to return to that guiding thought if the session feels overwhelming. Over time, revisiting intentions across multiple treatments can also help track progress and deepen your healing journey.

3. Embracing the Experience in Session

Once a ketamine session begins, it is common to notice shifts in perception, changes in memory recall, or heightened emotional intensity. These effects are part of how ketamine works in the brain, and they can feel unfamiliar at first. Rather than trying to steer your mind in a specific direction, it is more helpful to simply observe what arises and allow the experience to unfold without judgment.

You may find yourself revisiting past events, feeling emotions you have avoided, or looking at challenges in your life from a completely new angle. Some patients describe this as stepping outside of their usual patterns of thought, creating space to see themselves and their struggles with fresh perspective.

When this happens, a useful reminder is to “stay curious.” Approaching the experience with curiosity instead of fear helps reduce the sense of being overwhelmed. It also increases the likelihood of breakthroughs, as openness has been linked to more effective processing of trauma and longer-lasting symptom relief (Feder et al., 2021).

Even if difficult material surfaces, remember that it does not need to be solved in that moment. Simply noticing, acknowledging, and allowing the experience is often enough to begin the process of healing.

4. What to Think About During Ketamine Therapy

A common question patients have is whether they should focus on specific memories, positive thoughts, or particular goals during their sessions. The truth is that there is no single “right” way to direct your thoughts. What often works best is finding a balance between gentle focus and letting the mind move where it needs to.

• Let go of control
  Trying to force the experience in one direction can create tension. Instead, allow your mind to bring forward what it naturally wants to. Often, the most important themes are the ones that rise on their own.

• Notice patterns
  Pay attention if certain images, emotions, or memories repeat or feel especially vivid. These patterns may point to areas of your life that need healing or greater attention. Simply acknowledging them without judgment can be a powerful step.

• Return to intention
  If you feel unsettled or lost, gently come back to the intention you set before the session. That guiding thought can serve as a grounding tool, reminding you of why you are there and what you hope to learn.

• Trust the process
  Remind yourself that you are in a safe therapeutic setting with a team that is trained to support you. Placing trust in the process allows you to relax into the experience rather than resist it, making it easier to gain insight and relief.

What you think about during ketamine therapy matters less than how you relate to your thoughts. Approaching them with openness, curiosity, and trust often leads to the most meaningful breakthroughs.

5. The Importance of Trust and Safety

When considering what to think about during ketamine therapy, it is important to remember that the process is not only about your internal mindset but also about the relationships and environment that surround you. Trust in your psychiatrist, therapist, or clinical team plays a central role in shaping how secure and supported you feel throughout treatment. Research shows that a safe and supportive setting improves both patient comfort and therapeutic outcomes (Krystal et al., 2019).

Knowing that you are being carefully monitored gives you permission to let go of the need to control every detail of the experience. This trust allows you to lean into the process and observe what arises rather than resisting it. If difficult or unsettling thoughts come forward, grounding yourself in the awareness that you are safe and supported can help make those experiences easier to process. Over time, this sense of trust becomes part of the healing itself, reinforcing the idea that recovery is not something you face alone but with guidance and care from your treatment team.

6. Post-Session Reflection and Integration

What you think about during a ketamine session is only the starting point. The deeper work often happens afterward, when you take time to reflect on the experience and begin weaving its lessons into your daily life. Clinicians refer to this stage as integration — the process of making sense of the emotions, memories, and insights that surfaced and turning them into practical steps for healing.

Effective integration helps ensure that the benefits of ketamine do not remain as fleeting moments of clarity but instead become lasting tools for recovery. Without reflection, even powerful breakthroughs can fade or feel disconnected from everyday challenges.

Some practical ways to support integration include:

• Journaling: Write down your impressions and emotions as soon as possible after the session. Capturing these details early makes it easier to revisit them later and track progress across treatments.

• Therapy sessions: Talking through what you experienced with a therapist provides structure and helps connect the session to your broader treatment goals.

• Mindfulness practices: Meditation, breathwork, or grounding exercises help you stay connected to the calm and clarity you experienced, while also giving you tools to manage difficult feelings that may arise later.

Studies suggest that patients who engage in structured integration work are more likely to turn ketamine’s rapid symptom relief into long-term improvements in mood, resilience, and behavior (Dore et al., 2019). In this way, reflection and integration serve as the bridge between short-term therapeutic effects and lasting recovery.

. Practical Tips for Patients

Along with medical preparation, the way you care for yourself before and during ketamine therapy can make a meaningful difference in how the sessions feel and what you take away from them. A few simple practices can help set the stage for a smoother and more rewarding experience:

• Arrive well rested
  A good night’s sleep helps your mind stay balanced and your body feel steady. Fatigue can make the dissociative effects of ketamine harder to manage, while being rested allows you to enter treatment with greater calm and focus.

• Limit caffeine or stimulants
  On treatment days, reducing caffeine or other stimulants prevents unnecessary restlessness or spikes in anxiety. A calmer baseline makes it easier to lean into the therapy without physical tension or racing thoughts.

• Use a calming phrase or anchor
  Some patients benefit from creating a simple phrase or mantra to repeat if anxiety arises during the session. A reminder such as “I am safe” or “This will pass” can provide grounding when the experience feels intense.

• Release the need to force insights
  Ketamine often brings clarity and new perspectives, but these cannot be demanded on the spot. Remind yourself that allowing the process to unfold naturally is more effective than trying to control the experience. Many patients report that the most meaningful insights come later, during reflection and integration.

These practical steps may seem small, but together they help create a mindset of openness, stability, and trust — qualities that allow ketamine therapy to reach its full potential.

Prescription Basics

Ketamine is classified as a Schedule III controlled substance in the United States. This means it has recognized medical uses but also requires careful regulation because of its potential for misuse. Only certain licensed medical professionals can prescribe it, and the process depends on the type of treatment being considered.

• Psychiatrists (MD/DO): Psychiatrists are medical doctors with full prescribing authority. They can prescribe both FDA-approved esketamine (Spravato®) and off-label ketamine treatments such as IV infusions, IM injections, or oral lozenges.

• Certified Clinics: Esketamine nasal spray is only available in clinics that are part of the FDA’s REMS program, which requires in-person administration and monitoring for safety.

• Other Prescribers: In some states, other physicians (such as anesthesiologists or primary care doctors) may prescribe or oversee ketamine for pain or mental health conditions, though this is less common. Nurse practitioners (NPs) and physician assistants (PAs) may also prescribe ketamine in certain states if they work under a supervising physician with DEA authorization.

Regardless of who prescribes it, ketamine is never given as a take-home medication for depression. It must be administered in a structured, supervised setting to ensure safety and proper monitoring. Patients should always confirm that their prescriber has experience with ketamine therapy and follows established safety protocols.

Conclusion

When reflecting on what to think about during ketamine therapy, the key is not to manage or control every thought. Instead, focus on preparing with a clear intention, staying open and curious as the session unfolds, and engaging in thoughtful integration afterward. These steps create a foundation where insights can emerge naturally and be carried into everyday life.

With the right mindset, combined with professional guidance and a safe therapeutic environment, ketamine therapy becomes more than a medical procedure. It transforms into a meaningful opportunity for growth, self-discovery, and long-term healing.

Solace Health Group conducts thorough research, includes trusted citations, and ensures all content is reviewed for accuracy. However, this article is not medical advice and should not replace professional evaluation or treatment. Always consult a licensed healthcare provider before making any medical or treatment decisions.

References

• Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., ... & Wolfson, P. (2019). Ketamine-assisted psychotherapy (KAP): Patient demographics, clinical data and outcomes in three large practices administering ketamine with psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198.

• Dakwar, E., Anerella, C., Hart, C. L., Levin, F. R., Mathew, S. J., & Nunes, E. V. (2014). Therapeutic infusions of ketamine: Do the psychoactive effects matter? Drug and Alcohol Dependence, 136, 153–157.

• Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., ... & Charney, D. S. (2021). Efficacy of repeated ketamine infusions in treatment-resistant depression. American Journal of Psychiatry, 178(3), 193–202.

• Krystal, J. H., Abdallah, C. G., Sanacora, G., Charney, D. S., & Duman, R. S. (2019). Ketamine: A paradigm shift for depression research and treatment. Neuron, 101(6), 774–778.