Summary
Firsthand accounts of what ketamine assisted psychotherapy actually feels like are hard to come by. Journey Clinical's own patient materials describe it in careful, clinical terms: the effects, which most people find pleasant, last around 45 minutes, can make you feel far from your body, and often bring on a sense of expansiveness as perception shifts. Motor and verbal ability drop off during this window, which is why patients recline throughout the session.
But reading about an experience and hearing someone describe living through it are two different things. Dr. Adam Coffey, a therapist who now offers KAP to his own clients in Texas, went through the treatment himself before offering it to clients. He sat down with us to share about his first session in detail: the numbness and tingling that set in almost right away, his vision softening at the edges, time slowing until the idea of time barely made sense, the loved ones he brought to mind, a feeling of flying, an unexplained experience of light, and the slow return to his body as the medicine wore off.
Here is what he told us, in his own words.
What Happens in the First Few Minutes of a Ketamine Session?
Dr. Coffey did his first dosing session at home, with his wife present as his chaperone. "I was very relaxed," he said. "I was doing it from home and I had my wife, my chaperone, here in the home with me, so I felt secure about that."
He noticed the effects almost immediately. "It's very fast acting," he explained. "Within two to four minutes I began noticing some numbness in my mouth and some tingling going on." His visual field began to change next. "Visually things began to sort of soften for me," he said. "It was almost as if there was a wonderful sort of haze over the lighting in the room."
Time itself started to feel different too. "I began to notice certain time variations," he said. "Of course time was quite extended, and at some point the idea or construct of time didn't even really make sense."
Do You Experience Visuals During Ketamine Treatment?
One of the most common questions people ask before their first KAP session is whether ketamine produces visuals. The honest answer is that it depends on the person. Research on ketamine assisted psychotherapy, including the widely cited 2019 study by Dore and colleagues that looked at outcomes across three private practices, describes a wide range of subjective effects among patients, from numbness and altered body awareness to shifts in time perception and, for some, visual and auditory distortions. Other research on ketamine's dissociative properties has found that these effects vary significantly depending on dosage, the individual, and the setting in which the session takes place, which is part of why preparation and a trusted therapeutic relationship matter so much in KAP work.
Some patients describe seeing intricate patterns of light or color. Others report little in the way of visuals at all, and instead notice changes in body sensation, emotional access, or their sense of time. Dr. Coffey's own experience fell into the first category. Once his eye shades were on, he said the visuals that followed were shaped largely by what he chose to focus on.
"There were some interesting visuals that I was encountering, mostly based on how I was intentionally bringing people into my mind," he said. "So I would bring my wife into my mind, or my sons, or my friends."
That exercise brought up a strong emotional current. "There was a lot of warmth, a lot of love in that experience of bringing these people into my mind," he said, "and thinking about the ways in which our connections are so meaningful to me."
What Does Ketamine Feel Like In the Context of KAP?
Another common question people have as they learn about KAP treatment is simply how it feels. Experience is subjective, and if you ask different patients, you will hear different things. Firsthand accounts are helpful for understanding one possible way it can feel and be described.
Here's how Dr. Coffey described his sensations during the session.
- Sensations of Movement and an Unexplained Light Experience
Alongside the emotional warmth came physical sensations he had been warned about but did not expect to feel so vividly. "There was a lot of movement as well," he said. "So I can certainly understand how people can feel nauseous in doing this. I did not, but again, only probably because I was anticipating that." At points, he said, "I felt like I was literally flying, or that the bed was moving, or that the room was moving, even though I couldn't see the room."
He also described an unusual light experience, one he was careful to rule out as anything external. "I had a light experience even with the eye shades on," he said, "and I double, triple checked to make sure that there wasn't light coming in from the eye shades, and there wasn't. It was just sort of this existing light that was there, to almost guide the way."
- A Feeling of Expansion
If there was one word Dr. Coffey kept returning to, it was expansive. "It felt like I could breathe in more air than I had ever breathed in," he said. "The expansion was a big theme to the whole experience." He left the session, he said, with "a great deal of gratitude and appreciation about the connections I have in my life, and the people I still want to serve."
Knowing When to Come Back: How Patients Recognize the End of a KAP Journey
Patients typically recline with an eye mask during a KAP session, and the effects of the medicine usually begin to fade around the 45 minute mark. That timeline is only ever approximate, though, and not knowing exactly when to expect the shift can leave first time patients feeling uncertain. It's one of the most common questions that comes up in preparation sessions with a therapist: how will I know when it's time to take the eye mask off? At the end of a dosing session, patients have the option to talk through what came up with their therapist, or simply sit with a snack or a cup of tea before easing back into the room.
Dr. Coffey said he had wondered beforehand what it would feel like as the medicine wore off, and whether he might fall asleep during the session. He did not. Instead, he described a gradual return that he could feel happening in real time. "There was some point, as I was laying there, that my experience of holding my heart or tapping my legs had become less dissociative in nature," he said. "It seemed more, I hate to use the word normal, typical. And so I thought, well, maybe this is a sign that the big effects of the journey are sort of tapering off."
He pulled up his eye shades around that point, and noticed that another clinician in his group seemed to be coming out of her own experience at roughly the same time. "It didn't feel the same, because I think the journey left me changed," he said, "but it certainly felt familiar enough to say, okay, I think the effects of this are beginning to taper off."
Why Client Agency Matters in KAP Treatment
Dr. Coffey is careful about how he frames the experience for the clients he now treats. "I want to communicate hope, but I don't want to communicate that this is some sort of silver bullet," he said. What KAP offers, in his view, is not a guarantee but an opening, a chance for people to access perspectives or ways of processing that were harder to reach before.
That belief is tied closely to something he cares about deeply as a clinician: agency. "I'm not a big fan of this idea that ketamine might act on their brain and act on their minds, and then they can just be the recipient of the glory of ketamine," he said. "That doesn't make any sense to me. I want to help them feel like they're a part of that process."
He also wants clients to know that difficult emotions surfacing during a session are not a sign that something has gone wrong. "Even if they encounter fear or anxiety or even deep sadness within their journey or afterwards, there's nothing necessarily debilitating about that," he said. "That's going to be part of them perhaps experiencing facets of themselves, or facets of their historical experience, that they had been perhaps avoiding or not seeing in the same way."
Is Ketamine Assisted Psychotherapy Safe?
Asked directly about safety, Dr. Coffey did not hesitate. "It is safe," he said, pointing to the training and oversight involved in a properly run KAP program. "It's a very commonly used anesthesia in pediatric wards right now. It's been around since the sixties." He encourages anyone with concerns to raise them directly with their prescriber, who he says is best positioned to speak to dosing and safety for that individual.
From Patient to Provider
Dr. Coffey has since gone on to support clients through KAP treatment in Texas, and the philosophy he describes here, prioritizing client agency and holding hope without overpromising, has carried directly into that work. Having gone through the process himself before ever offering it to a client, he brings a firsthand understanding to the room that is difficult to replicate any other way.
Watch the full video above to hear Dr. Coffey describe his experience in his own words.
To learn more about ketamine assisted psychotherapy at Coffeytalk or to schedule a consultation, visit www.dradamcoffey.com or call (214) 535-6369.
Dr. Adam Coffey offers relationship counseling, professional coaching, and ketamine assisted psychotherapy to clients in Dallas and Frisco, Texas, with coaching and speaking engagements available internationally. www.dradamcoffey.com