Introduction of the Client Case:
Client is a 29-year-old female with a history of diagnosed eating disorder for over 15 years. The client reports experiencing several mental health concerns such as generalized anxiety, depression, suicidal thoughts, and traumas.
Despite the various mental health challenges, the client successfully holds a postgraduate degree and a career in the sports entertainment industry. She has a limited support system due to a strained relationship with her siblings, and recently feeling supported by her parents. Her medical history and current health status fluctuate due to the eating disorders. The client is on several psychotropic medications to help reach stability. There is no reported history of mental illness in the family. The client has not reported a history of drug and alcohol, and states avoiding these substances due to increased aggravation to the stomach lining as a result of the eating disorder.
The client has experienced several life difficulties and intergenerational traumas, including sexual assault and emotional abuse, which have contributed to her unmanaged mental health concerns. She has tried a variety of treatment methods and not responded well to them, leading to the exploration of ketamine therapy in Los Angeles. Her goals for ketamine-assisted psychotherapy are to address the mental health underlying issues, improve her emotional imbalance, and establish healthier coping skills to manage her symptoms by separating her eating disorder identity from herself.
The client has been actively attempting to manage her eating disorder through enrolling into inpatient treatment centers, actively participating in traditional talk therapy for several years, and taking medications as prescribed by psychiatrists. Though these attempts and efforts have shown small improvements, the client reports them being largely unsuccessful. The client is determined, thoughtful, and intelligent in her awareness of how they desire to manage their eating disorder and steps they are willing to take with ketamine assisted psychotherapy.
The client appears to have a complex history with significant mental health concerns and trauma. Ketamine therapy are tailored to meet the client's individual needs and goals. Other healthcare professionals were involved to ensure safety, collaboration, and continuity of care, as well as to address the client's physical health and nutrition needs as part of a comprehensive treatment plan.
Case Presentation on Mental Health Symptoms:
The client presented with several mental health concerns and symptoms during the time of intake. Mental health concerns included, but are not limited, to the following:
Problems & Symptoms:
15 year old eating disorder
Generalized anxiety disorder
Major depressive disorder
Sexual assault trauma
Physical and emotional abuse,
Grief and loss
In addition, the client may experience feelings of sadness, hopelessness, and despair related to her depression, and feelings of fear, panic, and worry related to her anxiety. These mental health conditions impact her physical sensations such as rapid heartbeat, shortness of breath, and muscle tension.
The client's physical symptoms that were managed by her medical doctor included a history of malnutrition directly caused by the eating disorder and inadequate intake of nutrients. Client continues to struggle from the consequences of malnutrition through ongoing weakness, hair loss, fatigue and skin problems. The skin problems and hair loss has further exacerbated client’s mental health conditions of skin picking and hair pulling. Other physical health symptoms include digestive problems such as bloating, constipation, and stomach pain due to the eating disorder and inconsistent food intake. The client also reported struggling with imbalance hormones which impacts her confidence, self esteem, and fear for the future.
The eating disorder is being reported as taking over the client's identity. The client reports extreme fear of having the eating disorder and fear of who she may be without the eating disorder since it’s been her identify for the majority of her life.
Ketamine Therapy in Los Angeles:
Ketamine assisted psychotherapy treatment sessions in Los Angeles at Shakti Therapy & Healing Services typically involve a deeply supportive psychotherapy model integrated into a care team setting where the client is viewed as their own inner healer. The best approach to use during ketamine therapy in Los Angeles may vary depending on the individual client's needs and goals. A combination of cognitive-behavioral, humanistic, and pharmacological approaches may be effective for some clients, while others may benefit more from an integrative approach that incorporates multiple therapeutic modalities. Ultimately, the therapist works closely with the client to develop an individualized treatment plan that addresses their unique needs and goals.
Prior to the ketamine treatments, which are administered by the practice’s holistic physician, the client completed a medical assessment and completed inner work psychotherapy sessions to bring the trauma to front safely and create space for their inner healer to face it. This is done through the introduction of a variety of therapeutic models such as CBT, humanistic, motivational interviewing, strength based psychology, and inter family systems (IFS). Once the inner polarities are identified, the client was guided to set intentions and engage in the process of surrendering through a variety of somatic therapeutic practices.
The day of the ketamine treatment, the client received a dose of ketamine that is collectively discussed and administered in a controlled, therapeutic environment under the guidance of a trained physician and psychedelic therapist. At Shakti Therapy & Healing Services, the care team carefully discusses any potential risks and benefits of ketamine treatment with the client before undergoing treatment. A Shakti physician is always present during the time of the treatment to ensure the well being and safety of the client, and to ensure all side effects are monitored closely. Additionally, ongoing monitoring and follow-up care was provided as needed to ensure that the client's progress was maintained over time.
A personalized meditation was curated and facilitated to allow the client to begin to connect with her inner healer. The client was provided an eye mask and a personalized music playlist to allow the inner healer or their Shakti to expand within them during the journey. The duration of a session can vary, but is typically around 120-150 minutes in fullness. The client received a total of 4 ketamine sessions over the course of 3 weeks based on their needs and goals, with periodic maintenance sessions scheduled throughout the year.
During the session, the client experienced a range of sensations and emotions, including altered perceptions, dissociation, and a sense of euphoria and relaxation. The first session was the most challenging for the client; the client’s ego was actively involved and caused the client to feel confused and pull off the eye mask and headphones several times in effort to stabilize and come back to “reality.” This is the ego’s defense mechanism and attempt to control the journey. The ego’s attempt to take over was the beginning of a profound integration session that took place the next day. The client was able to actively participate in engaging with her ego and see how their eating disorder is part of the ego as per IFS parts work.
Difficulties encountered by the client during treatment included feelings of discomfort and extreme anxiety related to the altered state of consciousness induced by ketamine and the attempt of the ego to take control. What started off as the most difficult session for the client, became the foundation of profound healing that the client had never experienced before; the realization that:
“I am not my eating disorder. I am so much more!”
The therapist used various techniques to guide the client through these experiences, such as breathing exercises, pranic healing, and crystal healing.
Shakti Therapy & Healing Services combines both ancient Eastern and the most up to date scientific modalities. This work stems from a basis of connection - mind to body, human to nature, individual to community, physical to spiritual, past to present to future.
Ketamine Treatment Follow-up at Shakti Therapy:
The effectiveness of ketamine treatment can vary from person to person, and the client’s response demonstrated improvements in their symptoms of depression and anxiety, as well as an increase in feelings of well-being and emotional regulation, with an understanding of a separation between the eating disorder and self. A reduction in symptoms of depression and anxiety as measured by GAD and PHQ-9 data collections were observed. The client reported experiencing an increase in feelings of well-being and emotional regulation, as well as an understanding of their separation from their eating disorder.
There were minimal side effects associated with ketamine treatment with this client. The side effects included feelings of discomfort and anxiety related to the altered state of consciousness induced by ketamine.
The therapist worked with the client to develop and anchor coping skills and strategies to help maintain these gains over time, and also connected with the client’s long-term therapist for continued support post ketamine treatments and for effective coordination of care.
Conclusion: A Testimonial From the Client:
"I’ve been struggling with my eating disorder since I was a teenager. I’ve tried everything from therapy to the best inpatient eating disorder programs. And they really help and keep me feeling somewhat hopeful. Each time I have therapy or go through a program, I have hope to keep going. But that’s what it’s been - just hope. I really need more than hope at this point in my life. Dating is hard, working is hard, being around myself is so difficult. I don’t feel good about who I am and am so scared of who I will become if I don’t do anything to get rid of my eating disorder. It’s consumed my identity and I no longer know who I really am. My therapist and I have been working together to figure out what could be a saving grace, and she told me about Shakti Therapy & Healing Services and their holistic ketamine assisted psychotherapy practice.
When I first reached out for ketamine assisted psychotherapy in Los Angeles, I was feeling really hopeless and defeated. I didn’t think it would really work, but I needed to try. My eating disorder has been weighing me down and quite literally eaten the joy out of my life. I felt like I had tried everything, and nothing was working.
During the ketamine treatment sessions, I felt weirdly held and safe in a way I haven’t felt even in my own body. The support I got for my emotions was different. I wasn’t told to ignore them, change them, or cope with them. I was actually told to explore them, hear them out, and hold space for them. This is different from my traditional therapy experience. I believe they called this parts work.
With ketamine assisted psychotherapy, it really helped me learn that maybe I can love myself through a different part of me.
I haven’t done psychedelics before so I was scared but I got through the altered state of mind. The therapist’s hand and helping me breathe when I was scared made me feel like I was not alone. The therapist did these other things with crystals that I haven’t worked with before, and it weirdly helped me ground and hold when I was scared.
The ketamine helped to break down some of the barriers that I had put up, or the barriers my eating disorder put up against my will. I was able to confront my fears and anxieties in a way that felt safe.
I have seen a big difference in my anxiety and the control my eating disorder has over me. I can now ask myself “Is this my choice or is the eating disorder deciding for me?” I am starting to feel a separation from my eating disorder. This is kind of cool because it’s like I am rediscovering who I really am - this part feels exciting. I hope I can learn to love myself through this experience. For the first time I feel like it can be possible.
Looking back, I can see how far I've come since starting ketamine treatment. Honestly, it’s a work in progress and I have made such substantial progress, more than ever before. Thank you so much Shakti Therapy for showing me my eating disorder and not hating it anymore. I'm so grateful for the support and hope helpful ketamine has been with Shakti Therapy."
Ektha Aggarwal is an experienced licensed clinical social worker (LCSW) and Founder of Shakti Therapy and Healing Services.
Shakti Therapy offers a holistic and psychotherapeutic approach to help clients realize that we are an integral part of the vast and complex web of life - that the health of the whole is intimately connected with the health of the individual. Shakti Therapy combines both ancient Eastern and the most up to date scientific modalities, to create a basis of connection - mind to body, human to nature, individual to community, physical to spiritual, past to present to future.