The Wednesday Effect: NOSC and IFS
I’m starting to write this on Sunday. Yesterday we held the second weekly ketamine workshop in a series of three. As our participants checked in, a pattern seemed to emerge, reinforcing past observations. People felt great after taking the medicine on Saturday, and they felt great for the beginning of the week, but on Wednesday their affliction returned with force. (Of course, it isn’t always like this, but we were seeing a trend.) So what is happening - are we just seeing the medicine’s effects wearing off?
My colleague, Sarah Levine, and I have been offering group ketamine experiences and tweaking the format each time as we learn more. Originally, the workshops followed a Holotropic Breathwork format, including sitters and mandala creation. We are finding that these aspects of HB are less relevant with the ketamine experience compared to breathwork, so we are experimenting with other formats. However, one thing that has not varied is approaching the experience through the perspective of Internal Family Systems.
From an IFS view, traditional ketamine therapy takes this approach:
A person has Protectors or Exiles that cause suffering, such as parts that hold experiences that we call depression or anxiety.
Other protective parts want to help, so they bring the person for ketamine treatment.
The doctor agrees to help eradicate, or at least dramatically suppress, the parts that cause the difficulty.
Typically it takes six treatments to beat them back enough to declare success.
It is expected that they will eventually re-emerge, at which time the patient will return for ‘boosters’.
The IFS motto is “All parts are welcome.” Certainly, this approach does not seem welcoming to parts that we associate with anxiety and depression. And who are those parts anyway? Is depression a part? If we are willing to hear from them, don’t we discover that depression isn’t “a part,” but rather a collection of different parts, such as the following?
I’m too tired.
What’s the point of anything?
I’m no good / worthless / broken.
I don’t feel like doing anything.
Nothing interests me.
I’m helpless and powerless.
It’s hopeless.
I’m irritable.
I’d rather be asleep.
We (and/or others) would be better off if we were dead.
And what we call “anxiety” can have different presentations as well, for example:
I feel scared!
Something bad might happen.
You are not prepared.
I must brace for a disaster.
Don’t let go or relax.
It isn’t safe.
They will judge or reject me.
I have a dangerous illness.
I must maintain intense vigilance.
Though it is certainly possible that one part would communicate several of these different messages, it seems unlikely that there is just one anxious or one depressed part. If there were three people with red hair in your neighborhood, and rather than learning their names, you lumped them together and described them as “the gingers,” that would be disrespectful. Perhaps describing our experience with the term “depression” is the same.
Anyway, why take ketamine if you don’t want to get rid of depression? Because depressed and anxious parts tend to be blended. In other words, they are so powerful in our system that it can be hard to have any separation from them. Without separation, there is no relationship. So we advise our participants to anticipate the Wednesday effect, and to do their best to welcome these parts when they return. When there is a little distance, we can get to know these parts better and find out what they need from us. For example, a hopeless Exile might just need to be witnessed with Self-energy. Or a worrying Protector might need us to ask it what it would like us to do to handle the situation that is concerning. Rather than being banished, when these parts are met with Self-energy, they can become valuable members of the system.
Did you ever see the Seinfeld episode in which George realizes that all of his life decisions have been bad ones and decides to do the opposite of what his instinct tells him? In general, because of the phenomenon of polarization, where actions inspire counter-actions, that is not a bad strategy. When we encounter parts that are disturbing, our instinct tells us to quiet them and turn away. But the more we ignore them, the louder they get. The IFS approach helps us to avoid this trap of polarization and learn to turn towards the parts that bring difficult feelings. Combining that strategy with the dissociating power of ketamine allows us to heal Exiles and cooperate with Protectors. Someday we may be able to study whether this approach eliminates the need for boosters. Welcoming difficult parts is the topic of Rumi’s famous poem, The Guest House, reproduced below.
Another important contribution of IFS to KAP has to do with consent. Often, someone has parts that really want to solve the “problem” of depression or anxiety. Or parts that are brave, gung ho about doing the medicine, identified with being a psychonaut, or totally committed to “healing.” These parts can blend, and therefore drown out, any parts that have concerns about entering a nonordinary state of consciousness. When someone goes there anyway, the parts that did not give consent may create a backlash, or they may sabotage whatever work was accomplished. Even if they don’t do that, they may be less likely to trust the process in the future. Bringing the IFS lens makes it clear that it is better to obtain consent from all parts before taking the medicine. We can do that by respecting their concerns and spending the time to engage with them. I’ve found that frightened parts often feel better if they are reassured that Self will be present throughout the whole experience. Ideally, the participant’s Self remains present; failing that, other people in the room can bring Self-energy to the scared parts. In 2010, I wrote about the issue of non-consenting Protectors in an article for Holotropic Breathwork facilitators, and the same principle of consent applies to medicine work. You can see that article here.
To learn more about our Group Ketamine Assisted Psychotherapy, visit www.groupkap.com.
The Guest House
by Jalaluddin Rumi
Translated by Coleman Barks
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.
Be grateful for whoever comes,
because each has been sent
as a guide from beyond.
