Going through a painful event is draining and devastating. You may find yourself playing the drama over and over in your mind. The emotional ruminating on the deep sense of remorse or loss hijacks your attention and makes it challenging to focus on anything else. In this state, you may find it hard to experience joy in other activities because you feel so dragged down by your thoughts.
Whether it is the passing away of a loved one, ending a romantic relationship, making a terrible mistake that you regret, realizing that you hurt someone or have been hurt by another, or have been disappointed by an outcome that failed your expectations, the episode will not let go of you. It would be nice if you could simply pick yourself up, brush the dirt off and move on.
The mind keeps you stuck in the pain, replaying memories, fantasizing on a different outcome that should have happened, and looking back at how you took things for granted. You can’t sleep or concentrate. Others around you see you as a shadow of your former self.
You wonder if you are depressed because the memory carves such a piece out of you, or if your underlying depression is exaggerating these feelings. The same can be said about anxiety, where you question if you are doomed to encounter this event again in the future or does your anxiety make you obsess that this is what you will constantly encounter in life moving forward.
The loss, the remorse, the trauma creates a metaphorical and psychological hole in your being. It is more than just feeling, but a relentless pit of hurting.
It is important to heal and find a pathway forward through these feelings.
Acceptance commitment therapy (ACT), combined with psychedelic medicine offers a powerful set of coping tools to handle these profoundly unsettling events, and helps make space from your emotions.
ACT is a psychological approach that provides a series of tools to promote psychological flexibility that helps you become unstuck from these emotions. The sooner you use these tools, the easier they work as the longer that these automatic negative thoughts and emotions linger. The more they get imprinted in the brain, but in certain cases like the passing of a loved one, it is healthy to allow a grieving period.
When it is time to move on, the ACT framework can guide your emotional processing to a greater state of healthy mindedness. The problems do not go away, and the memories remain, but a space is created, allowing you to focus on the general direction that you want to move in your life.
ACT does not delve into the root of the problem. It does not ask questions and analyze why you feel so hurt or determine the meaning of the pain or devise a series of logical or emotional conclusions of what gives rise to these feelings. That introspective route is usually taken by psychoanalysis guided by a specialized therapist. Instead, ACT promotes acceptance of these feelings.
These thoughts and emotions are a part of you, and it is futile to struggle and try to unthink or un-feel them. The goal of this approach is to cultivate acceptance and to struggle with them less.
ACT provides the framework of de-fusion. This is a compelling process that presents your thoughts and emotions not as an absolute fact or truth or unbreakable laws of nature, but as a series of pictures or words that the Self becomes fused to. Space and separation are possible from these thoughts and emotions because the Self has context. Your identity is not rigid and stuck in place and there is the power to separate Self from these thoughts, and work on a process of diffusion to displace them out of the center of your attention.
With acceptance, you are not burying and forgetting, however through de-fusion, you are compartmentalizing the thoughts and memories, emphasizing a widening of distance from Self and the psychodrama. It is okay to visit them from time to time, but the creation of emotional space is liberating.
Various practices help forge a path forward and develop this psychological space. ACT promotes mindfulness or being present in the moment, to turn your thinking Self into an observing Self. It encourages you to pay attention to the flow state of your consciousness, the immediate experience of life in front of you, rather than the endless cycling of painful thoughts. Meditation is a powerful tool in empowering the mind for this exercise.
ACT describes a process of internally reflecting and genuinely defining your deeply held Values. It creates exercises that encourage you to step away from psychological pain and identify and describe what you stand for and define the big picture goals that you want to achieve in life and then identify obstacles that are in your way of these goals.
Clearly, the state of being stuck in your pain is a profound hurdle, but stepping away and focusing on the greater direction of your life is a useful strategy to create psychological space.
While there is more to this approach than what is summarized in the above brief sketch, at an intellectual level, the ACT framework is sound and coherent. However, the real-world application of these tools and techniques to create a wedge between the Self and the emotions is challenging. The brain just at times does not want to let go.
Using ketamine or psychedelic therapy as a force multiplier to help you through this process can be profound accompaniment to the ACT process. In the psychedelic space, the activated state of the brain, that stimulates new neural pathways can shape new perspectives, promote being intently present in the moment, allow you to experience your thoughts as pictures that you can stare at from a distance rather than have them fused to your identity, and discover Self as context.
Then when you return from the journey, and more rational thoughts ensue, in the afterglow of the emotionally elevated state, you can more clearly evaluate Values, Goals and Obstacles.
Psychedelics can serve as a useful catalyst to enact the ACT blueprint when struggling to develop acceptance and diffusion that is needed to move forward. The thoughts, the emotions do not go away, but they seem distant, and do not drain or suffocate you. A brighter path forward becomes clearer. Many patients report a feeling that a weight is lifted after a ketamine treatment session, and it is my opinion that this reflects the creation of that psychological space.
Ketamine therapy is not an escape from your reality. It is a training ground where these skills can play out, like a dojo of the mind. Having your coping skills improve in this setting requires intention setting and following through in these practices when not in an altered state of consciousness for them to stick.
At Genesis Ketamine Centers, we will start providing all patients with a journal that has a series of reflection assignments, founded on ACT principles to help you move forward and work on becoming unstuck through the series of treatments. If you would like extra support from a health coach to work through these ACT journaling processes, let us know and we will be able to provide additional services.