When Ketamine Treatment Surfaces Hard Feelings — And What You Can Do
Ketamine therapy and Spravato treatment don’t always feel light or easy. For some patients, the dosing sessions bring up images, emotions, or sensations that can be difficult to sit with. While this can feel alarming in the moment, it often carries therapeutic potential. Below are some of the most common themes we see at Lumin Health in clinical practice.
Fear of death during ketamine sessions and what it might mean
A subset of patients describe moments during treatment when they feel like their sense of self is dissolving. Lumin Health’s Chief Medical Officer Dr. Ben Yudkoff notes that patients sometimes worry this could be like “a little death” — an ego-dissolution experience that feels like vanishing. While unsettling, many later find that touching this experience gives them new appreciation for life, or a softened relationship with mortality.
Self-judgment and shame
Old patterns of inner criticism can surface during ketamine sessions. Patients may recall moments of being judged or may turn that judgment inward. These experiences can feel harsh, but the medicine sometimes loosens the automatic link between memory and meaning — allowing space to reinterpret shame as history, not destiny.
Unfinished grief
Ketamine and Spravato can open the door to feelings of loss that were long suppressed. Memories of loved ones or unresolved endings can surface. While painful, this release often allows people to name and carry their grief in a new, more compassionate way.
Making Meaning out of Ketamine Sessions, Not Myths
Curiosity over certainty
One of the risks in ketamine therapy is trying to make immediate and rigid sense of everything. Instead, Lumin Health’s clinicians encourage curiosity: What might this feeling be showing me? At Lumin Health, we strongly believe that dissociations and imagery are experiences to explore, not conclusions to lock down.
Bringing insights from ketamine into support sessions
The neuroplasticity window after ketamine treatment and Spravato treatment makes it an ideal time to explore these themes with a therapist. Shame, death imagery, grief, or difficult but important ideas can be gently unpacked in conversation, helping the patient integrate rather than avoid the experience altogether.
Small commitments after big emotions
Patients often ask: What should I do with what I felt during ketamine? The answer is usually simple. Choose one small action that honors the insight — journaling, a conversation with a loved one, or practicing self-kindness. These small commitments help translate the emotional weight into lived change.
When to Pause, Adjust, or Stop
Red flags and green lights
Not all difficult experiences are productive. If sessions repeatedly lead to overwhelming panic, unrelenting despair, or extraordinary vulnerability, that’s a moment to pause and see if the treamtent is right for you. But moments of fear that give way to reflection, or grief that feels contained, are often green lights that the process is working within safe limits.
Collaborative decision-making
At Lumin Health, we never ask anyone to “push through” suffering alone. Patients are active partners in deciding whether to continue, adjust dosage, or take a break. This collaborative approach helps keep the treatment aligned with safety, meaning, and the goal of improving mental health outcomes.
Alternatives within the ketamine toolkit
Sometimes the answer isn’t to stop, but to change the route or formulation. For example, Spravato nasal spray offers a slower onset and structured insurance coverage, while intramuscular ketamine injections may allow more flexibility in dosing. These alternatives can reduce anxiety and give patients a better fit for their needs.
How Hard Feelings can be Integral to Getting the Most Out Of Ketamine Treatments
Ketamine and Spravato treatment can surface hard feelings: fears of death, waves of shame, or unresolved grief. These moments are not failures of treatment — they are part of the terrain. With safety, curiosity, and support, even difficult experiences can become teachers. And when they feel too heavy, adjustments or alternatives are always possible.
At Lumin Health, we don’t glorify suffering. We honor the reality that healing often includes both comfort and challenge — and we walk with you through both.
