Can Ketamine Really Heal Trauma? Richmond Therapists Share Their Insights

A guy with CPTSD walks into an Airbnb full of therapists. Humorous as it may seem, that was my Saturday one chilly November afternoon. I ventured out to Jackson Ward to attend a mixer and livestream event hosted by Journey Clinical, a purveyor of Ketamine-Assisted Psychotherapy.

On the way, I drove across the 1st Street bridge. There was a barefoot homeless man lying on the bridge—either asleep or dead—and it was one of the first truly cold days of winter. I stopped because I’ve been in that same position in life: without shelter, cold, retreating to the realm of sleep to escape the indifference of waking life while the world around me kept moving.

Honestly, I stopped because I thought he was dead. I prayed he wasn’t, though I remembered how much I had once wished for that same end as the bitter cold crept through every flaw in my clothing. Back then, I cursed the God who created a world filled with so much hurt.

I gently tapped him. At first, he didn’t move, and I feared the worst. But after a moment, he came to and asked me for money. I’ve never been more relieved in my life to be asked for change. I told him I was just making sure he was still with us. A man walking by with his dog told me I had a good heart. I hoped he was right.

After that interaction, I got back in my vehicle and drove the few hundred yards into the gentrified and fashionable Jackson Ward. I was looking for an address that was either 2A or 2B. It turned out to be 2B.

Once inside, I was welcomed by an employee of Journey Clinical. We were in the “RVA All Day” Airbnb for their conference and livestream. The topic of the day was Ketamine-Assisted Psychotherapy.

I mingled a little with the mental health professionals who were there. Having never attended a professional mixer outside of the restaurant world, I was curious to see how these events worked without alcohol. Apparently, the move is premium pastries that hardly anyone touches and Spindrifts.

I did my best to interact, having done a bit of research on KAP the night before, but I was mostly preoccupied with the rolodex of trauma spinning inside my mind. I thought about homelessness, foster care, being estranged from my adopted family, and the paywall standing between my problems and the services of the people around me. I wondered how relevant the plethora of hallucinogens I’d done in my life was to this psychedelic soiree. I made sure to mention it, lest I come across as unsociable or gauche.

I smiled politely as some of the therapists bragged about being from Alexandria, one of the wealthiest places in America—or as they put it, “one of the best cities in America.” I glanced at the fake greenery and the neon sign that said “RVA ALL DAY” and thought about the homeless man just hundreds of yards away. I felt I had more in common with him than with the people in front of me. A bitter twinge of resentment surfaced as I considered how the goal of treatment for someone like me—or for that man—would be to function within their idea of normal.

Still, it’s clear that homelessness and debilitating CPTSD aren’t lives anyone would willingly choose. And in that moment, I reminded myself that the room was filled with the helpers Mr. Rogers always told me to look for. Rather than focus on the particulars of the conference’s livestream or the promises of Ketamine-Assisted Psychotherapy, I decided to speak with the therapists I felt a connection with. I knew how hard it can be to find the right guide on the journey to thriving in a room full of Alexandrians.

ed. note: Yesterday, the FDA announced the expanded approval of Spravato, a ketamine-derived nasal spray, as a standalone treatment for severe depression. This groundbreaking decision underscores the growing recognition of ketamine’s potential to provide rapid and transformative relief for millions of individuals struggling with mental health challenges across the United States.

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GW: Alright, so tell me your name…
CM: Crystal Myers

GW: And you practice where?
CM: Ruckersville, Virginia. It’s 20 miles north of Charlottesville.

GW: And the type of therapy you do?
CM: I work with adult survivors of childhood trauma and abuse. Complex PTSD is not an official diagnosis—it would be called Chronic PTSD—but most of my clients would meet the criteria for that. I like to use the word complex.

GW: So, if you would, what is Ketamine?
CM: Ketamine is a psychoactive substance. It’s actually called a dissociative anesthetic, so they use it in hospital settings for people who need minor procedures. It’s also used in veterinary medicine. Some of my clients have had a strong reaction to the idea of using a horse tranquilizer because that’s how people have mostly heard about it.

GW: Right. So how effective is Ketamine in treating CPTSD?
CM: Very effective. I’ve had clients that I’ve been seeing for years—that’s the model of therapy that I practice, because we’re talking about brain changes that need to happen in a safe relationship, and that takes a long time.

Ketamine accelerates that timeline. I’ve seen two of my clients make significant progress in just the couple of months they’ve done Ketamine therapy. They’ll probably discharge from therapy soon and just do maintenance sessions.

GW: Is there anyone you could share a story about? With their permission, obviously.
CM: Yes, so Sarah has been coming to see me for therapy since about 2016. She had gotten to a place where therapy didn’t work out for her, so she would drop out and come back. She’s done about a year of Ketamine therapy, and her life has transformed.

She has had a lot of trauma triggers associated with relationships and places. She lives in the same area where the abuse occurred, so she’s had a lot of trouble actually engaging in social settings and being able to regulate herself.

GW: Is this the person that you spoke of who came from a childhood of parents in jail and parents that were doing drugs?
CM: Yes.

GW: It must be difficult for a person in that setting to even feel that they can relate to the people around them.
CM: Yes.

GW: When that may not even be true.
CM: Exactly.

GW: And I imagine that Ketamine is starting to abate these symptoms.
CM: It is, yeah.

GW: Awesome, awesome! So how long-lasting are the effects of Ketamine treatment?
CM: That can vary per person. After the first session, typically, people have an improved mood, and if they’ve had suicidal ideations, that symptom typically abates. It is different for every person. However, if you do the integration work, the changes that are made in your brain can be long-lasting.

And that’s one thing that Sarah will talk about. You still have to do the hard work. It’s not a placebo or a magic bullet. You must do the deep work. And she’s recently made a shift from focusing on trying to do the trauma work to saying, “This is my future, and I feel positive and hopeful about it.” That’s significant for someone who has experienced trauma and abuse.

GW: What are some of the ways to ensure that the benefits of KAP carry on long after the treatment?
CM: Engaging in a psychotherapy relationship. Every client that comes into our office gets a workbook so they can focus on different learning styles to process the things that happened to them and actually dig into that and do it. Talking to people about it, whether it’s your therapist or the supportive people in your life.

Sarah has a couple of family members who provide high levels of support for her, and as she’s changed—setting new expectations in relationships—they’re actually being more supportive. And they may have been supportive in the past, but now she’s noticing, and that just does so much to make her feel validated and cared for.

GW: Right. She’s broken down the fourth wall. In a lot of ways, that helps you to be able to perceive the help where before you may not have necessarily seen it. And that just makes you more pleasant to be around and starts that positivity loop that you were looking for in the first place.
CM: Right.

GW: So, are there any personal habits that you think, outside of psychotherapy, will help ensure the longevity of Ketamine treatment? Exercise, time in nature, mindfulness—is it as easy as that? Would you recommend all those things?
CM: You got it—letting yourself be in your body and being safe with that, as much as you can tolerate.

GW: (Laughs) I really appreciate you talking to me.

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GW: Share your name.
LW: My name is Lynn Wolf.

GW: And share your practice…
LW: I am with Women’s Mental Health Specialists.

GW: Okay, cool. And where are y’all based out of?
LW: We are a telehealth practice, and we have a couple of practitioners in our group. I am the only one based in Virginia for now. We’ve got a couple in Tennessee, we also see patients in Florida and Kentucky, and we are rapidly expanding to other states.

GW: Alright, and you have a practice primarily for women.
LW: Primarily we see women, but we will also see partners of those that come through our practice. So, for example, if someone comes in with postpartum depression and their partner is affected, we will also see them.

GW: So, your practice does not do Ketamine therapy, correct?
LW: We do not do any Ketamine therapy.

GW: And you’re still seeing great results with your patients, I’m sure.
LW: Absolutely! We have a really holistic approach. All of us in the practice are certified nurse midwives first.

GW: That’s super interesting.
LW: Yeah, we take care of women across their lifespan. We’ve all worked generally in hospital or clinic settings—throughout pregnancies, taking care of women through menopause, all of the above. And we recognize the gap in care with psychiatry as it applies to women.

GW: Could you expand on that a little bit?
LW: Yeah, absolutely. I’ll give you an example from my own personal story. I suffered with really severe postpartum depression after all three of my pregnancies.

And with my last child, who is now seven, I was already a nurse working on labor and delivery, I was in midwifery school, and I suffered so badly. I really struggled to get the care I needed. Really struggled. And I was really dialed into the community.

And that, to me, was really alarming. If I, as someone who works in this industry, can’t get the help that I need, what is the rest of the world doing?

GW: Absolutely.

LW: I recognized that gap, and I decided to pursue the post-graduate certificate in psychiatry so that I could combine the two. The people that come through our practice benefit from our knowledge of the hormonal changes throughout menopause, the medications that are safe during pregnancy and breastfeeding, and also the psychiatric knowledge. So it’s a blend.

GW: That’s really awesome. I’ve seen in my own family how deeply you can be affected by postpartum depression. It’s a strange thing, from the non-personal perspective, to watch that happen because you see this thing that is obviously bringing them so much joy, but they’re dealing with all of these complicated issues. As a male, I had no real way to empathize in a way that helped. I’m glad there are people out there who study the process, fill in the gap, and give women that help.

LW: Thank you, and it’s not just postpartum depression. We’re seeing and treating anxiety, mood disorders, OCD, ADHD—a broad range of issues. It’s a telehealth practice, so it’s not super acute. If someone comes to us and we suspect they’re in psychosis, we refer them to the appropriate next level of care.

GW: Beyond therapy itself, what was one thing that you, as a new mother, had or did that really helped abate the symptoms of postpartum depression?

LW: I preach this to all of my patients because this is what I think ultimately worked for me. Mental health is a multifaceted approach—it’s not just medication. What is your diet like? What kind of nutrients are you or are you not putting into your body? Are you moving your body, or are you sitting around all day?

Yes, motherhood is hard. We don’t always have the energy to get out there and move our bodies, but that is so important.

GW: It is very true. Just myself personally, I’ve always dealt with anxiety and had shaky hands via CPTSD, and I started exercising and taking magnesium, and my anxiety is almost completely gone. Other than dealing with dumbasses at work, right? Also, my hands stopped shaking as badly. It is interesting that it’s not always just one singular thing within your mental health, because your brain is part of your body. There are so many things that you need to address to make sure you’re running in tip-top shape, as good as you can.

LW: 100 percent. We look at the whole picture. I will test people for iron deficiencies, thyroid issues, nutrient and mineral deficiencies, and recommend supplementation. Magnesium is something that is huge. I recommend almost everybody take magnesium. And it goes a little deeper too.

The other practitioners that I work with—we go to conferences and work with other professionals on more integrative approaches and holistic therapy as well. A lot of people that come to us recognize the benefit of medication but maybe don’t always want to take that step. So, we’re looking at what else we can do and seeing if we can avoid medication.

But medication also has its time and place, and we frequently use it. It’s always about meeting the patient where they are.

GW: That’s awesome. I really appreciate you speaking to me.

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GW: So, what’s your name?
LC: Luisi Cano.

GW: And you practice here in downtown Richmond?
LC: Yep. I’m a licensed professional counselor and drug abuse treatment practitioner. My office is really close to VCU.

GW: Very cool. Do you do Ketamine-Assisted Therapy?
LC: I do. I started with Journey Clinical earlier this year, and I’ve also worked with people who have “graduated,” essentially, from the IV ketamine clinics.

GW: What are some of the issues that you run into a lot working with people here in the inner city?
LC: Probably accessibility is the toughest thing. In Virginia, we don’t accept insurance for Ketamine-Assisted Psychotherapy yet through Journey Clinical, so a lot of people I would want to offer this service to are in a place where it’s too expensive. I take Medicaid, so there are components that I can bill the insurance for, but a lot of the expenses are still out of pocket. That’s probably the toughest thing.

GW: Do you see people from all levels of income?
LC: I do. I have people who are private-pay, I see those who have commercial insurance, people with Medicaid, and I see some patients on a sliding scale as well.

GW: How would you say the process of gentrification has affected your patients?
LC: Hmm. That’s interesting. I think in terms of accessibility, it’s really pushed people out of the city. Folks who in the past had an easier time getting to their appointments through the bus or walking are not able to do that as much anymore.

GW: Because they just can’t afford to live here.
LC: Yeah, and some folks have Medicaid transportation, so they can try to use that, but it’s not always very reliable.

GW: Right.

LC: I try to be flexible with people, but sometimes the Medicaid transportation can’t get them to the appointment until 30 minutes to an hour after the appointment. Really, it’s taking a lot of time out of people’s day because these people will tell their transport that the appointment is an hour earlier just to get there on time.

GW: It’s almost comical, were this not to be about therapy, the amount of work you have to do just to work on yourself.

LC: Absolutely. Knowing where to look is tough also.

GW: Right. Would you say that the people from our area are a little more open to Ketamine-Assisted Therapy, or are they a little more closed off to the idea?

LC: I would say my clients who are people of color—because their community has been hurt by the war on drugs, and drugs have been used against them in the past—there is some apprehension. Like, what are you giving me? Is this safe?

Then some folks of the younger generation are like, “Yeah, let’s do this!” They see it as an interesting way to get through some things they may not have been able to get through with talk therapy.

GW: After ketamine treatment, have you seen people cease treatment itself, or do they usually stick around for a little bit but at a greater level of understanding of self?

LC: Yeah. I would say what ketamine has been helpful in doing for a lot of my folks is unlocking things or opening more avenues to explore. So, say someone comes to therapy because they’re having panic attacks and they don’t know where they’re coming from. Maybe through our ketamine treatments, they are able to access some information and process their issues a little more deeply rather than just wondering why they have trouble being around people in crowded spaces.

GW: Well, that’s really cool. I appreciate you taking the time to speak with me.

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GW: Let’s start with your name.
SC: My name is Seth Criner.

GW: And where do you practice?
SC: I practice here in the Richmond area. I’m the owner of White Stone Counseling Center, and my office is located in North Chesterfield.

GW: And you do Ketamine-Assisted Therapy?
SC: I do. My specialization really is in EMDR therapy.

GW: Do you want to explain to the readers what EMDR is?
SC: EMDR stands for Eye Movement Desensitization and Reprocessing. It was originally discovered as a trauma treatment. It’s a non-traditional therapy in the sense that it’s not talk therapy. The talking in EMDR is fairly minimal once you start getting into the reprocessing work. So much of it is done internally and is a client-centered process.

GW: I know you do faith-based therapy. I imagine that some Christians have a little bit of an issue using ketamine, would you agree?
SC: Yeah, for sure. I think in the Christian community, thankfully, it’s becoming a lot more normalized and encouraged to seek mental health treatment, specifically treatment that is outside of the church.

I find that with most Christians, they really want to be able to trust that the person they are seeing—if they don’t have the same worldview—they are at least open to them having theirs.

GW: Right.

SC: Because your faith is something that’s so precious to you. I think I saw this a lot working with adolescents. Parents want to take care of their children and shepherd them throughout their life. They want to make sure that whoever their child is seeing is really aligned with them ideologically in a lot of ways.

But within the church, I’ve been surprised to see people being open to the idea of Ketamine-Assisted Therapy. I’ve talked with a few pastors and told them that this is something I’m integrating into my practice and asked what they think about it.

A lot of times, they might not know much about it, but they let me explain it to them. By the end of the conversation, many of them can see the sense that it makes and don’t have problems with it. That’s not an exclusive opinion of every pastor or every Christian. Certainly, there are those who, whether they’re Christian or not, can have reservations about it—and therapy in general—but I’ve been pleased to see people be pretty receptive.

GW: I imagine that once you’re done with Ketamine therapy—at least your first session—and you’re trying to process everything that went on and integrate it into your own understanding and life, if you were a Christian, you are preset with symbols you can attach to the ideas that come up. Have you seen that happen?

SC: Oh, absolutely. Something in my practice that I really enjoy is metaphor, analogy, and symbolism—things like that. That’s pretty heavy in the work with ketamine. So that symbolism with folks in treatment can be very faith-based.

GW: You actually said something earlier that hit me like a ton of bricks: “A boat big enough for the fish that you want to catch.” I was like, “This guy’s writing it for me.” (Laughs)

SC: Yeah, I think there’s this idea of going too deep too fast. You don’t want to throw someone into something they’re not ready for, and you don’t want to try to tackle something that you’re not ready for as a therapist.

GW: Right.

SC: Getting trained in KAP or EMDR—those are not things that, in and of themselves, broaden your scope. Meaning, if I don’t have any training in treating CPTSD and dissociation, learning EMDR or Ketamine-Assisted Therapy doesn’t suddenly bring those issues within my scope. There’s always additional training that has to happen with those things.

You want to know pretty confidently what your client is equipped to handle and how prepared they are. You also want to make sure they aren’t overemphasizing the role of KAP or EMDR in their own healing.

GW: Right. Like, “Ketamine saved my life.” Because YOU saved your life.

SC: Exactly. You’re the person that’s going to do it. Not me, not ketamine, not EMDR. You spend a lot more time with yourself than I do, so it’s going to be on you to maximize and utilize all the time you need to. To equip yourself. To do the integration work in KAP or EMDR, and then go and apply those things and see if it actually makes a difference for you.

GW: Well, from what you’re saying, it sounds like it does, and I’m glad that we have people like you around.

SC: Thanks, bud.

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