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Optimize Your Ketamine Therapy With Mindfulness Exercises

Hello again. It is Susan from

I am a blogger that suffers with Treatment Resistant Depression (TRD), Anxiety, and Obsessive Compulsive Disorder (OCD). I was introduced to Ketamine for TRD in January 2015.  I am forever grateful that I was. I spent the first two years focused on my recovery. I now have an excellent treatment plan in place, but that does not clear me from obstacles or pitfalls.  I journal regularly. I educate and advocate for Ketamine Therapy to help treat chronic depression.

I have written for several Ketamine websites, entirely based on my experience with Ketamine therapy over the past 3.5 plus years in treatment.  I am now adding the Ketamine Academy to my list of platforms I am grateful to use, in order to educate and advocate for this cutting edge therapy for treatment resistant depression.

In this blog, I really want to discuss what I have found incredibly helpful for me, a sufferer of suicidal depression, anxiety and obsessive compulsive disorder for decades, in conjunction with Ketamine therapy.  As I have stated multiple times in past articles, Ketamine treatments are an aid, a nontraditional antidepressant, and it is not a cure for depression but a bandage of sorts. Ketamine, for me, lifts the symptoms of depression unlike any other medication has before it, and there have been numerous ones that I have tried with no benefit.  The relief I experience using Ketamine is real, but it does not necessarily change underlying thought patterns and habits that years of depression have instilled. Thus, in my opinion, there is also a strong need for assistance from a cognitive behavioral specialist.

Many of us with Treatment Resistant Depression have been plagued for years with distorted thoughts and perceptions of the world around us and once the Ketamine grabs hold of the illness and relief is at hand, a new type of confusion permeates our minds.  

In the beginning, these new emotions can be quite overwhelming for a person that has been exposed to the world through tainted glasses and a heaviness similar to quicksand, or worse, concrete.  This was definitely my experience when I originally began my Ketamine maintenance program. I encountered feelings I didn’t understand or know how to handle. It created a new struggle for me.

I have known the definitions of words like happiness, glee, joy, relief, peace, contentment, amazement, calm, surprise, trust, acceptance, kindness, serenity and so on.  What I didn’t understand was how these emotional words would actually feel for me; as my acquaintance with them was minimal and typically found only in novels and storybooks.  I was unaware that my logical mind couldn’t comprehend the depths of their meanings. However, I had a masters in such words as unhappiness, despair, fear, shame, sadness, anger, helplessness, disdain, contempt, disgust, guilt, indignation, depression, anxiety, sulkiness, hopelessness, terror, evil, self loathing, heavy heartedness, distress, and misery.  These types of expressions or terms I was intimately familiar with, and I had decades of resisting and struggling with unwanted relationships with them.

When the Ketamine freed me of the petulant and persistent hold my depression had over me, I figured I would gain new associations and friendships with the meanings of this foreign language of sought-after emotions.  I believed I was totally ready to no longer feel the crushing weight of my demons. I was unbelievably willing to engage in a world that knew words like jubilation and the sensations that came along with these feelings.

Depression is debilitating.  

It paralyzed me.

Imagine a young child locked in one room for more than thirty five plus years and the only friends that child had truly known over that time were masked; life-sucking demons portraying as her companions.  She was stuck, chained in that lonely one-room house full of darkness and shadows. No light. They terrorized that vulnerable child. They were unsympathetic to her needs. They taunted her. They teased her.  Repeatedly beating down her excitement and curiosity year after year. They engaged in games that only played off her fears. They taught her that the world was an unsafe place. They told her of no escape. They would convince this child, as she grew, that the only true way to leave that room was death.


There were cracks in the walls, and she would seek glimpses of the outside world.  Her imagination was vast in spite of the horrors surrounding her. This child wanted desperately to be one with the light and warmth of the sun and all the pretty colors.  She wanted to believe that there was more to life besides the hideous and barbaric existence she was trapped in. There had to be more. She dreamed of fields of sunflowers, music, and dancing . . .  but her reality and enemies stole away all faith of being more than just a broken skeleton shattered on the floor. Her inner world diminished. Died. Her existence was full of hateful beings that were cunning and undeniably believable.  Her room was plagued with misery, panic, agony and torturous nightmares that would eventually spread evil like spackle along the walls closing her off from hope.

Unfortunately, this child would begin to listen to the voices in the corners of her deary dungeon.  She would become a shell of her former self. Lost. Her world was damp and scary. Void of all light and escape.  The floors were puddles of tears that never ceased. Drowning. She would surmise that the only way out of this pit of despair was taking herself out; ending the struggle and sinking beneath the floor.  Gone.

The child would undoubtedly grow into a middle aged woman that would constantly attempt to survive and battle the trolls promising her with relief if she only let go and stopped waging war on them.  She would grow tired. It was exhausting fighting objects she could no longer see but felt wholeheartedly. Their presence the only one she knew to be true now. She wanted death. Only death. It was the only option that she was told for tearing down the walls that kept her a prisoner for decades.

Clawing at the walls, the woman discovers a door that wasn’t there previously.  Shocked and petrified by what this could mean for her she stands still. How could she have not found this opening sooner?  She would blindly hunt for a handle or a mechanism to operate the door. It would take her time to find the lock. The dying woman would uncover many objects she thought would unlock or damage the lock, to no avail.  In her follies, she would unearth a key. She suppressed her excitement as she had previously encountered similar tools and nothing successfully allowed her an exit from her hell hole. Remarkably, this key would fit perfectly into the latch and unfasten the entire wall and free her.

Let us call that key, Ketamine.

Stumbling out into the light would not be easy.  In the mind of that woman she was certain that all she would need was to escape her prison to find a better world.  A world full of all the things she once longed for and needed to feel whole. That grown child would no longer be trapped in that one room house.  

Let us call that room, depression.

It is a puzzling world outside of the house of horrors.  It isn’t as easy to navigate as that child believed it would be.  There are so many stimuluses and it is overwhelming. Engaging in a new world full of colors, sounds, people, smells, textures and light is crushing in a new way.  Hope is there. It is present. It is seems absurd to think that leaving that house would not be enough. It seems unfair in a twisted way that child could never have known or predicted.  

How baffling.

How unfair and ludicrous!

Oh, the anger.

The confusion.

Lost in an avalanche of unknown emotions.

How is a grown woman to learn to live in this strange world without knowledge on how to do so?  How, I ask you, without tools to maneuver through the obstacles? How is a stunted child supposed to manage through the lessons and challenges of life outside of the pure darkness that was once her unwanted home?

Help is needed.  Assistance from those that have the skills and methods to make sense out of the craziness.  It may be exhilarating to be on the other side of those abominable walls, but it is still alien and unsettling.

I can relate.

I was that child forced to live a lifetime in that one room pit that eagerly ran into the sunshine, only to discover that outside the four walls of hell it still occasionally got cloudy and rained.

Intellectually,  I understood that an adjustment period would be necessary.  I mean, if you are in a dark cave and someone turns on a flashlight, the eyes need to acclimate to the stream of light.  What may be overlooked is how that cave will appear with the help of light. You can see the formations, the colors and textures.  Once you adapted to the sights the beauty would prompt thoughts and feelings about the caverns that you didn’t have when still in darkness.  

I now comprehend that just escaping that horrific room would not be enough.  I was filled with rage and confusion. Will I never be healed and free of flashbacks of hell?  Will this just be another pathetic attempt at living in a more colorful and fanciful world handicapped by my lack of experiences and misconceptions of what life could be if not trapped inside that warped room?

After all, I was now sensing new emotions and these feelings were no longer being filtered through heavy fog and torment.  Yet, I felt an equal amount of terror and uncertainty. I had a childlike belief that once the depression wasn’t keeping me detained, I would miraculously be a part of the living and would find happiness.  I was in the fields of wildflowers and laughter and life should be…… grand.

I am no longer plagued constantly with the demons that I lived with consistently for close to half of a century, but I have had to relearn an emotional language, one that the definitions of I proudly had claimed I knew.  I would undoubtedly have a vocabulary of emotions and their meanings, but I would have absolutely no experience of what those feelings exactly felt like. The best way I can explain this phenomenon is to say it is like a scholar that has book smarts but lacks common knowledge or street smarts.

I was a grown child with only education and no actual experiences.  I knew the definition of joy and I wanted it, but I had no knowledge of what or how that word, joy, would stir things in me.  My heart has felt despair and misery. I am familiar with those sensations and have no problem identifying them. They are the friends I am better off without in my life.  In a disturbing and sick way, oftentimes unhealthy were my coping mechanisms, but I still knew how to manage or navigate the darkness. However, the opposite could not be said about my abilities to handle life without that filter clouding or numbing the good.

How strange.

I no longer feel the intense depression or suicidal thoughts, but yet I still felt anxious and overwhelmed with living.

I am no stranger to cognitive behavioral therapists.  I have been in therapy for years trying to learn to manage a life I wanted only to end.  I was also told about breathing exercises and meditation. These practices seemed impossible for me, a person that has spent a lifetime holding my breath, because I physically didn’t feel I was capable of taking a full healing breath.  It is difficult to explain. I truly didn’t know what filling my lungs on an inhale felt like because the depression constricted my muscles to the point it literally hurt to try. There was always a massive knot blocking my ability. I would try, but once again I would feel like a failure.  The depression keeping me captive. I stopped trying and turned my mind off to suggestions involving controlling my breathing. If it wasn’t the depression, it was the panic attacks and anxiety refusing to allow me to relax the diaphragm to train myself to breathe properly.

After my first Ketamine infusion, it was my breath that I noticed.  I could inhale. I am not kidding. It was like, Wow! That was intense.  I filled my lungs and exhaled loudly. That was new and refreshing. It was the first sign that maybe Ketamine could work for me.  I looked for the subtle differences, as I needed hope.

I can still remember the first time I met with my current doctor and he asked me if I knew what centering was. I did, and I told him it always hurt for me to do that until I started Ketamine.  When I was describing to him what I saw when looking inward, it was as if I saw was a ball of colorful rubber bands blocking my ability to relax and focus on my breathing.  I was a ball of tension and full of knots. This would be the first lesson he would teach me. He was hoping this would reduce my anxieties. He would have me practicing dozens of times each day.  It was not any easy task for me and oftentimes seemed silly and pointless. I can honestly say that it was the beginning of my wanting to learn more about mindfulness techniques. It would take me a couple of years to truly be converted to accepting the benefits of mindfulness in my life.  

It appeared too simple.

It wasn’t.

It is incredibly difficult.

It is, however, the therapy that has aided me most in so many crucial ways.  It has freed me. I can’t even express how mindfulness has become a huge facet of my life and my recovery.

It is challenging but incredibly healing.  

Mindfulness training allows me to take back control of my mind.  

Recently, I have been blessed to be introduced to Robin, a therapist who teaches mindfulness and radical acceptance techniques.  It has revolutionized my life.

I want to suggest it to others that are being helped with Ketamine therapy as an avenue to explore.  You don’t have to be getting Ketamine treatments to utilize mindfulness exercises. However, for me, I needed  relief of my depressive symptoms in order to feel comfortable enough to properly train my breath.  

I would get too discouraged prior to Ketamine to keep at it religiously.  

It wasn’t an easy task in the beginning, as I have spent my life holding my breath for extended periods of time, and letting out an exhale -  only to return to holding my breath. I had to break that habit, and that took time. A lot of time. So, don’t give up if you don’t notice any benefits right away.  What does a long time look like to me? A couple years. Yikes. I had a long road back to the basics. I can attest to the benefits now, so trust me when I say don’t lose hope it pays off in the end.

It has been through my practice with centering and breathing that I was open to learning more about how using mindfulness could aid me in coping with my emotions and stresses.

My new therapist, whose main practice focuses on mindfulness and radical acceptance,  has been a wealth of information and help to me. I have been seeing her for less than three months and the changes in my anxieties, panic attacks, and daily living have been innumerable.

Robin introduced me to Alfred James’s Pocket Mindfulness exercises.  I will include the six exercises and acknowledge and thank Alfred James for this magnificent blog and for the mindfulness directions and doable exercises.  I practice these daily, and it has made life more manageable for me.  

The following are the six mindfulness exercise my therapist handed me only a couple months ago, and I highly recommend them to anyone and especially to those battling with treatment resistant depression.  If you are being treated with Ketamine therapy, being symptom free from your depression will only enhance your recovery and help you gain back control of your life. That has been my experience anyway…..

1.Mindful Breathing

This exercise can be done standing up or sitting down, and pretty much anywhere at any time. If you can sit down in the meditation (lotus) position, that's great, if not, no worries.

Either way, all you have to do is be still and focus on your breath for just one minute.

Start by breathing in and out slowly. One breath cycle should last for approximately 6 seconds.

Breathe in through your nose and out through your mouth, letting your breath flow effortlessly in and out of your body.

Let go of your thoughts. Let go of things you have to do later today or pending projects that need your attention. Simply let thoughts rise and fall of their own accord and be at one with your breath.

Purposefully watch your breath, focusing your sense of awareness on its pathway as it enters your body and fills you with life.

Then watch with your awareness as it works work its way up and out of your mouth and its energy dissipates into the world.

If you are someone who thought they’d never be able to meditate, guess what? You are halfway there already!

If you enjoyed one minute of this mind-calming exercise, why not try two or three?

2. Mindful Observation

This exercise is simple but incredibly powerful because it helps you notice and appreciate seemingly simple elements of your environment in a more profound way.

The exercise is designed to connect us with the beauty of the natural environment, something that is easily missed when we are rushing around in the car or hopping on and off trains on the way to work.

Choose a natural object from within your immediate environment and focus on watching it for a minute or two. This could be a flower or an insect, or even the clouds or the moon.

Don’t do anything except notice the thing you are looking at. Simply relax into watching for as long as your concentration allows.

Look at this object as if you are seeing it for the first time.Visually explore every aspect of its formation, and allow yourself to be consumed by its presence.

Allow yourself to connect with its energy and its purpose within the natural world.

3. Mindful Awareness

This exercise is designed to cultivate a heightened awareness and appreciation of simple daily tasks and the results they achieve.

Think of something that happens every day more than once; something you take for granted, like opening a door, for example.

At the very moment you touch the doorknob to open the door, stop for a moment and be mindful of where you are, how you feel in that moment and where the door will lead you.

Similarly, the moment you open your computer to start work, take a moment to appreciate the hands that enable this process and the brain that facilitates your understanding of how to use the computer.

These ‘touch point' cues don’t have to be physical ones.

For example: Each time you think a negative thought, you might choose to take a moment to stop, label the thought as unhelpful and release the negativity.

Or, perhaps each time you smell food, you take a moment to stop and appreciate how lucky you are to have good food to eat and share with your family and friends.

Choose a touch point that resonates with you today and, instead of going through your daily motions on autopilot, take occasional moments to stop and cultivate purposeful awareness of what you are doing and the blessings these actions brings to your life.

4. Mindful Listening

This exercise is designed to open your ears to sound in a non-judgmental way, and indeed to train your mind to be less swayed by the influence of past experiences and preconceptions.

So much of what we “feel” is influenced by past experience. For example, we may dislike a song because it reminds of us of a breakup or another period of life when things felt negative.

So the idea of this exercise is to listen to some music from a neutral standpoint, with a present awareness that is unhindered by preconception.

Select a piece of music you have never heard before. You may have something in your own collection that you have never listened to, or you might choose to turn the radio dial until something catches your ear.

Close your eyes and put on your headphones.

Try not to get drawn into judging the music by its genre, title or artist name before it has begun. Instead, ignore any labels and neutrally allow yourself to get lost in the journey of sound for the duration of the song.

Allow yourself to explore every aspect of the track. Even if the music isn’t to your liking at first, let go of your dislike and give your awareness full permission to climb inside the track and dance among the sound waves.

Explore the song by listening to the dynamics of each instrument. Separate each sound in your mind and analyze each one by one.

Hone in on the vocals: the sound of the voice, its range and tones. If there is more than one voice, separate them out as you did in the last step.

The idea is to listen intently, to become fully entwined with the composition without preconception or judgment of the genre, artist, lyrics or instrumentation. Don't think, hear.

5. Mindful Immersion

The intention of this exercise is to cultivate contentment in the moment and escape the persistent striving we find ourselves caught up in on a daily basis.

Rather than anxiously wanting to finish an everyday routine task in order to get on with doing something else, take that regular routine and fully experience it like never before.

For example: if you are cleaning your house, pay attention to every detail of the activity.

Rather than treat this as a regular chore, create an entirely new experience by noticing every aspect of your actions:

Feel and become the motion when sweeping the floor, sense the muscles you use when scrubbing the dishes, develop a more efficient way of wiping the windows clean.

The idea is to get creative and discover new experiences within a familiar routine task.

Instead of labouring through and constantly thinking about finishing the task, become aware of every step and fully immerse yourself in the progress. Take the activity beyond a routine by aligning yourself with it physically, mentally and spiritually.

Who knows, you might even enjoy the cleaning for once!

6. Mindful Appreciation

In this last exercise, all you have to do is notice 5 things in your day that usually go unappreciated.

These things can be objects or people; it’s up to you. Use a notepad to check off five by the end of the day.

The point of this exercise is to simply give thanks and appreciate the seemingly insignificant things in life, the things that support our existence but rarely get a second thought amidst our desire for bigger and better things.

For example: electricity powers your kettle, the postman delivers your mail, your clothes provide you warmth, your nose lets you smell the flowers in the park, your ears let you hear the birds in the tree by the bus stop, but…

Do you know how these things/processes came to exist, or how they really work?

Have you ever properly acknowledged how these things benefit your life and the lives of others?

Have you ever thought about what life might be like without these things?

Have you ever stopped to notice their finer, more intricate details?

Have you ever sat down and thought about the relationships between these things and how together they play an interconnected role in the functioning of the earth?

Once you have identified your five things, make it your duty to find out everything you can about their creation and purpose to truly appreciate the way in which they support your life.

I thank you, Alfred James, for giving me direction and the ability to stay in the here and now! My deepest appreciation. My favorite exercise is definitely Alfred James’s mindful immersion. I feel such freedom and peace when I am able to fully immerse myself in one activity at a time.  I am in training, but finding the comfort and well-being monumental.

I will also mention here that Passage Meditation by Eknath Easwaran, which I practice every morning and evening, has been a part of my recovery for over nine months now, and I can’t imagine going another day without practicing at least once a day.    

It is because of reading Pocket Mindfulness that I sought out other teachers and led me straight to Thich Nhat Hanh, The Miracle of Mindfulness and I am excited to make my long term goal in 2019 to practice being mindful for a day.  Thich Nhat Hanh describes this practice in chapter three. I may need to start with an hour at a time and work up to a full day, but I currently know through practicing immersion mindfulness just how profound this therapy is for me.

I hope I was able to inspire those using Ketamine therapy as their antidepressant, as well as other depression sufferers, to optimize their recovery by sharing a few of the mindfulness techniques I have been using daily. I am finding them beneficial for my overall health and happiness.  These exercises limit my struggles with feeling overwhelmed and living outside that one-room house of horrors.

Until next time, feel free to comment or shoot me an email. Better yet, if you are a healthcare provider, why not sign up for the Ketamine training course today through The Ketamine Academy.  Be a force of positive change.  Be an option. Be a place for those suffering with Treatment Resistant Depression or Post Traumatic Stress Disorder to turn when all other avenues have been exhausted.  

Ketamine is hope.

I hope this personal blog from a patient that suffered for over four decades inside that one room house, until she found the key, will be helpful in convincing you why Ketamine could help you or someone you love.  Just know the road to recovery will take time and other forms of therapies will be needed to assist you or them in their journey through life.


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