Skip to content Skip to footer

A conversation with Revitalist CEO Kathryn Walker

Ketamine can provide relief from mental health conditions in hours. Compare that with the weeks it may take other therapies, and the allure for both providers and their patients is clear. In fact, since the FDA first approved the use of the S-enantiomer of ketamine, esketamine, for treatment-resistant depression (TRD) in 2019, more than 230 clinical trials in the U.S. are now actively recruiting patients for ketamine trials, according to clinicaltrials.gov. Many of those aim to treat major depressive disorder and other mental health conditions.

 

Even with what seems like a warmer embrace of the psychedelic space (though some may argue ketamine is described more accurately as a dissociative anesthetic), the exploration of such treatments is not without challenges, including those related to patient recruitment and enrollment.

Revitalist CEO Kathryn Walker understands firsthand what constitutes an appropriate candidate for ketamine therapies. As the founder of the mental health and wellness clinic that specializes in esketamine treatments, as well as a certified registered nurse anesthetist (CRNA) and psychiatric mental health nurse practitioner (PMHNPS), Walker has insights into which patients are well-suited for trials exploring ketamine therapies, especially those for treating mental health conditions. Walker breaks down the criteria —  and not just by diagnosis — that make the most suitable patients in the following Q&A.

In your experience treating patients at Revitalist, patients with which diagnoses are most suitable for and benefit most from ketamine therapy?
Ketamine therapies address an array of conditions that are primarily initiated in the brain. Patients with noted increased levels of inflammatory biomarkers are typically good candidates to consider ketamine therapies. Common conditions include depression, anxiety, PTSD, suicidality, fibromyalgia, complex regional pain syndrome, traumatic brain injury (TBI), insomnia, obsessive-compulsive disorder (OCD), autism, ADHD, and complex grief. Newer conditions that are being considered for ketamine therapies include neurodegeneration conditions such as ALS (Lou Gehrig’s disease), MS (multiple sclerosis), and Parkinson’s disease.

Now that we understand the suitability of particular diagnoses, let’s look more closely at the patient as a person. Are there certain demographics, backgrounds, or personality types that make someone suited for ketamine therapy?

Ketamine therapies address an array of conditions that are primarily initiated in the brain. Patients with noted increased levels of inflammatory biomarkers are typically good candidates to consider ketamine therapies. Common conditions include depression, anxiety, PTSD, suicidality, fibromyalgia, complex regional pain syndrome, traumatic brain injury (TBI), insomnia, obsessive-compulsive disorder (OCD), autism, ADHD, and complex grief. Newer conditions that are being considered for ketamine therapies include neurodegeneration conditions such as ALS (Lou Gehrig’s disease), MS (multiple sclerosis), and Parkinson’s disease.

Now that we understand the suitability of particular diagnoses, let’s look more closely at the patient as a person. Are there certain demographics, backgrounds, or personality types that make someone suited for ketamine therapy?

This is a great question that often gets overlooked. Patients who have attempted other therapies (Western or Eastern therapies) inclusive of medications, psychotherapy, acupuncture, exercise, massage, natural medicines, etc., and have not received the results they expected would then be recommended for ketamine therapies. Ketamine therapies are a medical intervention that oftentimes inhibits the inflammatory cycle that often creates the havoc that we experience in our mental health and/or physical health.

 

Ketamine therapies allow us the ability to improve our emotional intelligence (EQ) on a granular, subconscious level, giving us the ability to decrease many of our external stressors. Our goal with ketamine therapies is to identify many of the factors that may cause our mental health or physical health to negatively cycle and effectively address them, allowing our inflammatory cycles to decrease and our coping mechanisms to increase.

 

These therapies can be used across a wide age range of individuals in a variety of demographic and socioeconomic statuses. We typically recommend these therapies for qualified candidates who are 12 years or older.

Personalities that typically need greater support for ketamine therapies are those with dissociative disorders, complex trauma, and borderline personalities.

 

Individuals who typically do very well with ketamine therapies are those with strong critical thinking skills or those who serve in multi-faceted roles that demand a variety of environments and decision-making skills. If someone hasn’t been in this type of environment, prep sessions with therapists and coaches can oftentimes build these skill sets, giving the individual an optimal mindset and setting for effective integration and optimization for effective symptom reduction (or, in many cases, symptom elimination).

Do you find that the general patient population understands ketamine therapy and how it works? And if not, what level of education is needed?

Unfortunately, most community members and a large percentage of medical providers and behavioral therapists do not understand how ketamine works, and many are extremely resistant when considering learning about these therapies.

 

The level of education that someone needs is a great question. Psychedelic medicine (including ketamine) is its own specialty. It takes a mix of empathy, ethics, pharmacology (pharmacodynamics as well as pharmacokinetics), basic life support skills — an additional plus would be advanced life support skills — and expert communication skills. Unfortunately, no profession has created the gold standard — and this is inclusive of every level of specialty, from community experts to specialists with medical and philosophical doctorate degrees. I do believe that every person entering this specialty should consider didactic training, experiential sessions, and supervised residencies.

Even if patients are informed when it comes to ketamine therapy, hesitation to participate may still exist. What additional preparations or assurances must be made when it comes to treating a patient with ketamine?

Hesitation is something to accept when trying something new, especially when it comes to your mental or physical health conditions. Risks and benefits should always be considered before trying anything new in life.

 

Before starting with psychedelic therapies, a great recommendation would be to work with someone who has been trained in psychedelic medicine and understands the many variations of presentations that may become evident during the therapy. Each person discovers their ground truths with ketamine and psychedelic therapies, allowing an expansion of effective integration and coping mechanisms leading to comprehensive alignment (mental, spiritual, emotional, and even physical) to oneself. It’s a view that is very foreign for most as we are not encouraged to trust what we feel (though we may disagree with those feelings) — instead, in today’s society we view ourselves as “sick” or “ill.”

 

The insight from a professional coach, therapist, or provider who looks at the brain as a data center with circuits that are firing incorrectly instead of viewing it as an illness or a sickness allows the patient an empowered view when entering ketamine therapies.

 

When working with clients in this specialty, emphasis must be placed on preparing the patient on multiple levels including consideration of their physical, mental, emotional, and spiritual health. Many of these concepts are traditionally foreign in clinical studies, but they must be considered and structured to be inclusive of a study that is considerate of multi-faceted healing aspects. Professionals working in preparatory sessions with clients are intended to build rapport, support, trust and safety to patients entering the clinical trial.   If one enters the space with a mindset of curiosity to identify complex patterns that lead to clarity then you will begin a journey of discovery of yourself and why imbalances exist, why overreactions occur, and why isolation patterns feel safe.

 

Ketamine therapies work on a variety of levels with consideration to improvement of anatomy, physiology, and psychology enmeshed with immune modulation, anti-inflammation, neuroregeneration, autoregulation, and integration. Recognizing the proper preparation of patients receiving effective support and integrative therapies is of great importance in this sector.  One aspect to consider is the many ways neuroscience is evolving and unleashing many theories that are disrupting the way neuroscience has traditionally been viewed. One common concept is considering that the brain does not know right from wrong; it is all based on the way it was trained (in a subconscious, not conscious mindset). If we are trained in an abusive environment, the brain will be trained to expect abuse and ways to protect itself. If we are trained in an overly critical environment, our brain will learn to become overly critical, making us feel that we are never good enough. While examples like these seem routine and often overlooked or viewed as PTSD or OCD, these are subconsciously learned patterns that we must break in order to heal. Ketamine therapies allow this to occur.

 

So, my six top things I encourage patients to consider is:

 
  1. Do you feel safe? How do you communicate safety to others?

  2. Do you feel loved? What is your love language to others?

  3. Can you trust the environment you are in? How can others trust you?

  4. What are your core values?

  5. What are your core virtues?

  6. What are your core ethics?

 

If you can discover these personal language styles and personal pillars, you will begin to build a base that allows patients to grow in the direction of psychological evolution that they are seeking ultimately improving their emotional intelligence (EQ) and allowing for effective integration with their intelligence quotient (IQ).

Once a patient is enrolled in a study, what efforts must be made to ensure the patient remains enrolled? Are there any accommodation needs that are especially different than those for trials not studying psychedelics?

Patients enrolled in a psychedelic medicine trial have to feel comfortable with the practitioners and the environment where the study is taking place. Ketamine and psychedelics act as catalysts, placing the patient in a present state of mind. During this state of mind, mental health symptoms or pain symptoms are nonexistent, leading to a truly vulnerable state. This state of mind is where the patient truly begins to heal.

 

Patients must be supported physically, emotionally, spiritually, and mentally with sound ethical standards while also empathetically connecting with the patient using communication styles that are most applicable to that individual. Patients oftentimes need assistance to restrooms during the sessions —  a sound understanding of walking assistance with a psychologically altered individual and understanding potential triggers of touch should be part of the entire process. Physical accommodation recommendations include soft lighting, comfortable oversized furniture, journaling tools, fluid music, and the option of wearing eye masks and/or earplugs.

 

Kathryn Walker

We use cookies to personalise content and ads, to provide social media features and to analyse our traffic. We also share information about your use of our site with our social media, advertising and analytics partners. View more
Cookies settings
Accept
Privacy & Cookie policy
Privacy & Cookies policy
Cookie name Active

Privacy Policy

What information do we collect?

We collect information from you when you register on our site or place an order. When ordering or registering on our site, as appropriate, you may be asked to enter your: name, e-mail address or mailing address.

What do we use your information for?

Any of the information we collect from you may be used in one of the following ways: To personalize your experience (your information helps us to better respond to your individual needs) To improve our website (we continually strive to improve our website offerings based on the information and feedback we receive from you) To improve customer service (your information helps us to more effectively respond to your customer service requests and support needs) To process transactions Your information, whether public or private, will not be sold, exchanged, transferred, or given to any other company for any reason whatsoever, without your consent, other than for the express purpose of delivering the purchased product or service requested. To administer a contest, promotion, survey or other site feature To send periodic emails The email address you provide for order processing, will only be used to send you information and updates pertaining to your order.

How do we protect your information?

We implement a variety of security measures to maintain the safety of your personal information when you place an order or enter, submit, or access your personal information. We offer the use of a secure server. All supplied sensitive/credit information is transmitted via Secure Socket Layer (SSL) technology and then encrypted into our Payment gateway providers database only to be accessible by those authorized with special access rights to such systems, and are required to?keep the information confidential. After a transaction, your private information (credit cards, social security numbers, financials, etc.) will not be kept on file for more than 60 days.

Do we use cookies?

Yes (Cookies are small files that a site or its service provider transfers to your computers hard drive through your Web browser (if you allow) that enables the sites or service providers systems to recognize your browser and capture and remember certain information We use cookies to help us remember and process the items in your shopping cart, understand and save your preferences for future visits, keep track of advertisements and compile aggregate data about site traffic and site interaction so that we can offer better site experiences and tools in the future. We may contract with third-party service providers to assist us in better understanding our site visitors. These service providers are not permitted to use the information collected on our behalf except to help us conduct and improve our business. If you prefer, you can choose to have your computer warn you each time a cookie is being sent, or you can choose to turn off all cookies via your browser settings. Like most websites, if you turn your cookies off, some of our services may not function properly. However, you can still place orders by contacting customer service. Google Analytics We use Google Analytics on our sites for anonymous reporting of site usage and for advertising on the site. If you would like to opt-out of Google Analytics monitoring your behaviour on our sites please use this link (https://tools.google.com/dlpage/gaoptout/)

Do we disclose any information to outside parties?

We do not sell, trade, or otherwise transfer to outside parties your personally identifiable information. This does not include trusted third parties who assist us in operating our website, conducting our business, or servicing you, so long as those parties agree to keep this information confidential. We may also release your information when we believe release is appropriate to comply with the law, enforce our site policies, or protect ours or others rights, property, or safety. However, non-personally identifiable visitor information may be provided to other parties for marketing, advertising, or other uses.

Registration

The minimum information we need to register you is your name, email address and a password. We will ask you more questions for different services, including sales promotions. Unless we say otherwise, you have to answer all the registration questions. We may also ask some other, voluntary questions during registration for certain services (for example, professional networks) so we can gain a clearer understanding of who you are. This also allows us to personalise services for you. To assist us in our marketing, in addition to the data that you provide to us if you register, we may also obtain data from trusted third parties to help us understand what you might be interested in. This ‘profiling’ information is produced from a variety of sources, including publicly available data (such as the electoral roll) or from sources such as surveys and polls where you have given your permission for your data to be shared. You can choose not to have such data shared with the Guardian from these sources by logging into your account and changing the settings in the privacy section. After you have registered, and with your permission, we may send you emails we think may interest you. Newsletters may be personalised based on what you have been reading on theguardian.com. At any time you can decide not to receive these emails and will be able to ‘unsubscribe’. Logging in using social networking credentials If you log-in to our sites using a Facebook log-in, you are granting permission to Facebook to share your user details with us. This will include your name, email address, date of birth and location which will then be used to form a Guardian identity. You can also use your picture from Facebook as part of your profile. This will also allow us and Facebook to share your, networks, user ID and any other information you choose to share according to your Facebook account settings. If you remove the Guardian app from your Facebook settings, we will no longer have access to this information. If you log-in to our sites using a Google log-in, you grant permission to Google to share your user details with us. This will include your name, email address, date of birth, sex and location which we will then use to form a Guardian identity. You may use your picture from Google as part of your profile. This also allows us to share your networks, user ID and any other information you choose to share according to your Google account settings. If you remove the Guardian from your Google settings, we will no longer have access to this information. If you log-in to our sites using a twitter log-in, we receive your avatar (the small picture that appears next to your tweets) and twitter username.

Children’s Online Privacy Protection Act Compliance

We are in compliance with the requirements of COPPA (Childrens Online Privacy Protection Act), we do not collect any information from anyone under 13 years of age. Our website, products and services are all directed to people who are at least 13 years old or older.

Updating your personal information

We offer a ‘My details’ page (also known as Dashboard), where you can update your personal information at any time, and change your marketing preferences. You can get to this page from most pages on the site – simply click on the ‘My details’ link at the top of the screen when you are signed in.

Online Privacy Policy Only

This online privacy policy applies only to information collected through our website and not to information collected offline.

Your Consent

By using our site, you consent to our privacy policy.

Changes to our Privacy Policy

If we decide to change our privacy policy, we will post those changes on this page.
Save settings
Cookies settings