Ketamine-Assisted Psychotherapy for Trauma: Some Healthy Debates

02/27/25 • 63 min

Dr. Signi Goldman, MD, is a board-certified psychiatrist and the Co-founder and Medical Director of Living Medicine Institute, which offers psychedelic-assisted psychotherapy training programs. As a certified provider for psychedelic-assisted therapy and research, she has practiced in various clinical settings, including hospital systems and alternative treatment settings. Dr. Goldman also serves as a Psychiatrist and Psychotherapist for Concierge Medicine and Psychiatry’s Ketamine-Assisted Psychotherapy Program for Mental Health.

Dr. Sandra (Sandy) Newes, PhD, is a licensed psychiatrist and the Co-founder and Programming Director of Living Medicine Institute. With over 25 years of clinical experience as a psychedelic-assisted psychotherapist, she specializes in anxiety, chronic stress, trauma, and recovery. Dr. Newes has provided ketamine-assisted psychotherapy through Concierge Medicine and Psychiatry since 2019. She is also an educator and speaker offering workshops, events, and education on psychedelic-assisted psychotherapy and the intersection of nature connection, trauma, and mental health.

In this episode...

Trauma therapy is a complex and often debated field, with professionals holding differing views on the best approaches. Some therapists prioritize exposure, helping clients directly engage with painful memories, while others focus on resourcing to build a sense of safety and well-being. When ketamine is introduced into trauma work, how does it shape the healing process, and what approach leads to the most effective outcomes?

Psychedelic therapy training professionals Dr. Signi Goldman and Dr. Sandy Newes and training students Barbara Connold, Barrie Bondurant, and Amy (Maiima) Nicholson explain that ketamine-assisted psychotherapy facilitates a balance between exposure and resourcing. Clients often toggle between processing traumatic material and deepening into states of well-being without direct therapist intervention. During ketamine-assisted therapy sessions, therapists should practice tethering to ensure clients feel supported, manage disassociation as a therapeutic tool rather than a barrier, and assess a client’s readiness for deeper trauma work. Dr. Goldman, Dr. Sandy, Barbara, Barrie, and Amy also underscore the importance of preparation and integration, ensuring clients develop resilience and maintain stability between sessions.

In this episode of Living Medicine, Dr. Signi Goldman and Dr. Sandy Newes interview Barbara Connold, PMHNP, of Ketamine Psychotherapy Associates, Barrie Bondurant, PhD, LC, and Amy (Maiima) Nicholson, about the intersection of ketamine and trauma therapy. Together, they share insights on managing client dysregulation, the relational aspects of ketamine-assisted therapy, and strategies for balancing exposure with resourcing.

In this episode...

Previous Episode

Ketamine-Assisted Psychotherapy and Physician Burnout

Mel Herbert is the Founder and CEO of EM: RAP (Emergency Medicine: Reviews and Perspectives), which provides engaging, high-quality educational content for emergency care providers. As a renowned emergency medicine physician, he established the nonprofit EM: RAP GO to extend emergency medical training to underserved communities. Mel is also the author of The Extraordinary Power of Being Average.

In this episode...

As the demands of emergency medicine take a heavy toll on clinicians, many struggle with depression and anxiety, often finding little relief in traditional treatments. For medical professionals seeking solutions, could ketamine therapy provide a breakthrough in combating burnout and restoring mental well-being?

After struggling with severe depression and suicidal ideation and failing to find relief with conventional medications, emergency medicine physician Mel Herbert turned to ketamine-assisted psychotherapy, which he describes as life-changing. Ketamine lifted his depression and reshaped his brain’s neural pathways, allowing him to experience joy and gratitude in ways he hadn’t for decades. However, Mel warns against the dangers of unregulated ketamine use, stressing the importance of controlled administration with a professional therapist, proper dosing, and integration therapy.

In this episode of Living Medicine, Dr. Sandy Newes interviews Mel Herbert, the Founder and CEO of EM: RAP (Emergency Medicine: Reviews and Perspectives), about his experience with ketamine therapy for professional burnout. Together, they discuss training considerations for professionals entering the ketamine-assisted psychotherapy field, how providers customize treatment to patient needs, and the ideal candidates for ketamine-assisted psychotherapy.

Next Episode

Michael Mithoefer: The Non-Directive Approach Takes Actual Work

Michael Mithoefer, MD, is a clinical psychologist and the Senior Medical Director for Medical Affairs, Training, and Supervision at the Multidisciplinary Association for Psychedelic Studies (MAPS). He specializes in treating PTSD with experimental psychotherapy through clinical research and outpatient clinical practice. Between 2004 and 2018, Michael and his wife Annie completed two of the six MAPS-sponsored Phase II clinical trials testing MDMA-assisted psychotherapy for PTSD.

In this episode...

Therapists new to the psychedelic psychotherapy space are often uncertain about how to support clients effectively during altered states. Should they remain silent and allow the medicine to do the work, or should they actively guide the session with interventions? Misconceptions about the "non-directive approach" often leave practitioners unsure of their role, leading to either over-involvement or complete disengagement. How can therapists balance presence and intervention?

As a psychiatrist and researcher specializing in psychedelic-assisted psychotherapy, Michael Mithoefer explains that the therapist’s role is not to impose structure but to follow the client’s inner healing intelligence. He outlines three key principles: only intervene when necessary, provide time for natural processing, and always frame suggestions as invitations rather than directives. Additionally, he highlights the importance of relational safety, regular check-ins, and the integration of somatic interventions to help clients navigate difficult emotional and physical manifestations of trauma during their sessions.

In this week’s episode of Living Medicine, Michael Mithoefer, the Senior Medical Director for Medical Affairs, Training, and Supervision at the Multidisciplinary Association for Psychedelic Studies (MAPS), returns to talk with Dr. Signi Goldman about guiding internal-directed healing during psychedelic therapy sessions. Michael discusses the importance of checking in with clients regularly during sessions, how therapist training and personal psychedelic experiences influence psychedelic therapy facilitation, and when to intervene during MDMA sessions.