Ketamine-Assisted Couple Therapy

A pathway to deeper connection and healing…

In relationships, we often find ourselves trapped in the same patterns. We try to communicate our needs, but defensiveness arises. We long to feel connected, but old wounds keep us distant. Traditional couples therapy offers tools to work through these issues – yet sometimes, despite our best efforts, we remain stuck.

This is where ketamine-assisted couple therapy (KACT) offers a unique and powerful pathway.

What is ketamine?

Ketamine is a legal (if medically prescribed), fast-acting psychedelic medicine used off-label for mental health treatment under clinical guidance. Ketamine is a dissociative anaesthetic with unique psychological properties. It fosters neuroplasticity—the brain’s ability to reorganise and form new neural connections—while also reducing emotional rigidity and avoidance behaviours.

Ketamine’s precise mechanisms are still being fully explored, but research shows that beyond acting on NMDA receptors in a brain – which are critical in neuroplasticity, it also increases dopamine, and serotonin, altering brain connectivity. All of which promote more flexible thinking, greater perspective taking, empathy, openness to experience and reduced avoidance.

What is ketamine-assisted couple therapy?
These cognitive, emotional, and behavioural shifts are important for moving through relationship pain, creating new patterns, and building healthy connections. Indeed, across different couple therapy approaches, the primary goals typically include identifying harmful patterns, increasing understanding and empathy, and improving communication in order to build closer and more fulfilling intimate connections.

Considering ketamine’s psychological and neurophysiological properties, in couples therapy, ketamine is used intentionally to:

• Increasing emotional accessibility: Partners become less emotionally defensive, making space for vulnerability and connection.
• Enhancing cognitive flexibility: Ketamine disrupts rigid thought patterns and negative attributions, allowing for new ways of perceiving relationship dynamics.
• Encouraging behavioural change: By reducing avoidance and emotional reactivity, ketamine helps couples break dysfunctional cycles and develop healthier interaction patterns.

What do KACT sessions look like?

KACT is a carefully-curated experience with thorough preparation and integration sessions on each side of the ketamine journey(s).

The overall structure includes an assessment session, preparation, ketamine session(s), and integration. Depending on the goal of therapy, couples engage in one to six ketamine sessions. Each medicine session is followed by at least four integration sessions.

Preparation: You and your partner meet with the therapist to clarify intentions, expectations, fears or ambivalence about the medicine session, relational patterns, and boundaries for the journey.

Medicine session: Sessions are guided by the therapists in a safe, supportive environment. The dose can vary depending on the need and therapeutic goal, but a typical psychedelic session will involve the couple taking ketamine simultaneously in a form of lozenges, lying comfortably beside one another. The session lasts about three hours in total. This experience is mostly internally-focused, with patients wearing eye masks and guided by evocative, instrumental music. The intentions you set before the session, related to your couple’s relational pattern, typically guide the experience. Some gentle integration can take place toward the end of your medicine session, with deeper integration during follow-up sessions.

Integration: In the days following, integration sessions help you embody insights by looking at any shifts in how you are thinking and feeling about your relationship and your partner, as well as changes in how you see yourself and how you want to show up in your relationship, implementing those shifts in daily life (e.g. by practicing different way of communicating) to sustain those changes long term.

Is KACT right for your relationship?

Ketamine is not for everyone, and careful screening is necessary to ensure safety.

Moreover, ketamine is a prescription medication that should only be used under the care and supervision of a licensed provider. Although ketamine is generally safe to use, like all prescription medications, ketamine can have potential side effects and risks that are important to be aware of. Before engaging in ketamine-assisted couple therapy, it’s important for couples to review all the medical contraindications and risks with a prescriber, obtain the ketamine prescription only from a licensed doctor and/or pharmacy, and take the medication only as directed. Couples are encouraged to discuss the dosing approaches with their prescriber to help create the best treatment plan for them.

Considering the above, KACT may be particularly supportive if you and your partner:

• Feel stuck in entrenched relational dynamics
• Desire to rebuild trust or intimacy after rupture
• Struggle to communicate vulnerably despite traditional therapy
• Long for deeper spiritual or emotional connection

Final reflections

At its core, KACT is not about “fixing what is wrong” with your relationship. It is about opening to what is true, alive, and possible between you when the protective layers soften. In these moments of expanded awareness, couples are able to see/feel each other differently, with compassion and an open/loving heart – and from there, begin creating a new chapter of their love story which often is stronger and more intimate than what they experienced before.

Agnieszka Religa offers KACT in collaboration with the well-established Ketamine Clinic in London. She works from our Richmond centre. Find out more here: info@connect-therapy.org / connect-therapy.org