Ketamine is an older prescription drug that has undergone a renaissance in the pharmaceutical marketplace, specifically for treatment resistant depression and psychedelic therapies. This paper ethnographically presents a case study of a patient undergoing ketamine treatment through “neuropsychotherapy” – a relatively new area of expertise. Brief interviews and focused ethnography with psychiatrists, ketamine prescribers, and a licensed ‘trip guide’ are presented along with the narrative of the ketamine user to probe and understand how the drug is transforming care in the marketplace. One outcome is that we can come to understand that the efficacy of ketamine has displaced the role of professionals engaged in psychodynamic practices and psychiatric practices (e.g., deprescribing) in peculiar ways; abreaction is now pharmaceutically-mediated. Ketamine itself is neither fully accepted psychedelic nor fully embraced psychotropic – a liminal pharmakon. Nevertheless, its use (and cost) continue to increase due to entrepreneurial uses and defining the multiple efficacies of ketamine requires ethnographic elaboration of subjective experiences of the user as well as the larger cultural and corporate forces at work.
Dr. Michael Oldani