By Greg Ferenstein
On the surface, Emily* had a blessed life: a supportive husband, a loving son, and a solid career as a frontline therapist. She had all the professional training and social support to manage her mental health, yet she was plagued by debilitating panic attacks.
Even when nothing was wrong, she couldn’t escape intrusive, catastrophic daydreaming of how she was likely to wreck her family and community. She knew the thoughts were purely imaginary, yet the uncontrollable episodes of sobbing that accompanied these ruminations took a toll on both her family and office administrators.
As an example, Emily recalls being mildly afraid that she might cheat on her husband. That same day, she went through a grocery checkout line with a male cashier and was bombarded with thoughts of cheating on her husband.
“I immediately just lost it,” she says. “I cheated on my husband because I went through this line that had a male cashier.”
She burst into her home, began crying, and apologized to a very confused partner. She remembers thinking that “I just can't, I can't live like this.”
As a working mental health professional and current master’s degree student, Emily was surrounded by treatments and strategies to help her deal with her panic attacks.
And she did on occasion find them helpful.
Yoga, for example, helped give her space to contemplate quietly. “I was able to lay there and relieve some of my self-loathing and self-hatred and difficulty in accepting myself as a human.”
Unfortunately, nothing seemed to stick, partly because Emily was terrified to let her mind wander. “I get a little skittish around trying to create images in my mind because I don't trust my brain; any moment, this self-compassion exercise could be totally taken over by myself.”
As bad as the attacks were, Emily could still function as a loving mother and run a therapy practice while going to grad school.
But COVID tipped the scale; intrusive fears became too intense. Shopping at Target was a panic-inducing experience. “What if the girl that is spraying the carts right now doesn't believe in COVID? And so she actually just put water in the spray bottle …. And now I'm going to take it home, and we're all going to die?”
The constant fear became too much. She needed new solutions.
The ketamine experience
At this point, Emily was open to anything that could help. She heard about a clinical pilot for frontline healthcare workers offered by Novamind, a mental health startup specializing in ketamine-assisted psychotherapy.
Ketamine, a dissociative anesthesia, was showing promise for a range of mental health issues, including suicidal ideation and depression.
Novamind’s clinic pioneered a method of pairing ketamine sessions with intensive psychotherapy.
Growing up in a religious community, Emily felt uncomfortable with psychedelics. But she was desperate for solutions and decided to sign up.
Emily was placed in a trial with other frontline healthcare workers exploring how ketamine-assisted therapy could help them overcome their mental health challenges.
In preparation for the treatment, they were given worksheets and instructions on how to mentally navigate the psychedelic experience. In between treatments, the group would come together for discussions and integration.
Emily recalls one particularly powerful psychedelic episode that rooted out the source of her panic attacks.
As she began to feel the effects of the ketamine, she remembers seeing a visualization of a black hole and asking the overseeing physician how she should interact with the bizarre object.
“The doctor encouraged me to go toward it and that he would be there if I needed. I asked to hold his hand.”
Images morphed, and she recalled herself a young religious missionary in South America. As an adult, she was no longer a member of her same church, and since leaving, maintained intense shame around trying to force religious beliefs on the local residents.
During the psychedelic experience, Emily felt the people of the town forgive her. They told her that her missionary work did not harm the community and that they were grateful to have known her.
Then, with that same compassion, Emily turned to speak to her childhood self, “I told her these thoughts that you have are called ‘obsessive compulsive disorder’, and you don't have to repent for them.”
Emily and her younger self openly discussed all the complex feelings around moral purity and guilt they would experience in their life. She forgave herself. And, in that moment, Emily acknowledged it as a significant source of panic attacks.
“It was a closure I didn't even know I needed.”
Better at managing attacks
Emily still experiences episodes of shame, but now, they don’t spiral out of control.
She recalls one recent example of an incident that would have triggered a panic attack prior to her ketamine treatment.
One day, she had thrown away a bunch of plastic. Normally this slight moral transgression would trigger intense feelings of guilt about how she was wrecking the planet.
“Yes, I will have the thought of like, ‘Oh my gosh, what am I doing to the earth’, but within moments, I'm able to go to a place of ‘Emily’, this is so hard for you, I'm so sorry that you struggle with this—everything's going to be okay.”
Emily estimates that before, she would have a debilitating episode about once every three weeks, and then more minor attacks in between.
Since her treatment, she has experienced just one triggering episode, but it was not as severe, and she was able to adopt new coping mechanisms.
In addition to a more stable family life, Emily believes she’s become a more empathetic and present therapist. “I'm able to be fully present in their story, instead of letting my mind wander off into my own story.”
Emily is a therapist in a community with a lot of mental health distress around religion. Her clients have become curious about her personal transformation and the role of psychedelic-assisted therapy. Emily says that she would recommend Novamind.
“Dr. Reid Robison and Dr. Stephen Thayer were really great at setting us up for success,” she exclaims. “I can't imagine doing this with any other people.”
*Emily is a pseudonym. Some quotes edited for clarity.
About the author
Greg Ferenstein is the founder of Frederick Research, a mental health innovation consulting firm. His research has been widely covered in leading publications, including the New York Times, The Brookings Institute and The Washington Post.
His field investigations in mental health have been supported by respected technology companies, from Google.org to Lyft and his public policy papers have influenced bills at the U.S. federal and state level.
Prior to founding Frederick Research, he taught statistics for journalists at the University of Texas and received a Masters in Mathematical Behavioral Sciences.
