"Euphoric Nothingness:" The Dichotomy of Dissociation & Healing

Here, we examine the paradoxical healing potential of ketamine and other dissociative drugs, and how to approach them as the double-edged sword they are.

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Jul 21, 2023

Ketamine therapy is all the rage these days. It’s one of the fastest-growing segments of psychedelic-assisted therapy and one of the biggest innovations in the way we treat depression in over 50 years.

Ketamine is classified as a dissociative drug — which means it has the ability to “disconnect” or “dissociate” you from yourself and from the world around you.

There are 2 main aspects of the dissociative state:

Depersonalization — This involves feeling as though one is an outside observer of their own thoughts, feelings, body, or actions. People often feel as though they’re in a dream.
Derealization — This involves experiencing the world around you as unreal. Surroundings may seem blurry, colorless, two-dimensional, artificial, or surreal. Perception of time, distance, and the size of objects may change or feel disproportionate.

Explaining the dissociative state is no easy task. Language itself often proves insufficient for describing these kinds of experiences.

Here are a few examples of people’s reports involving dissociative drug experiences:

“Everything is close and far at the same time”
“My body died, but my mind lived on”
“I was caught in an endless time loop”
“I visited a place outside of time”
“I was teleported to another location or dimension”
“I forgot who I was or that I ever existed in the first place”
“My body was dissolving into the fabric of time and space”
“I lost emotional connection to objects, people, or locations I'm familiar with”

In states of complete dissociation — like the ones IV ketamine can induce in a clinical setting — users attain a profound “zen-like” state of consciousness.

This zen experience is similar to ego death, but the drug’s detachment effect removes uncomfortable feelings of fear and grief that present themselves as the ego struggles to retain its hold on the conscious mind.

All the shame, worry, anger, and discontent someone might feel in waking consciousness is washed away. They enter a meditative, almost thoughtless state of consciousness.

Within this state of consciousness, one has a unique opportunity to identify “undesirable” traits and suppressed “truths” about themselves.

It’s also common to feel a deep sense of insignificance and loneliness within the cosmos. Normally, this kind of realization results in fear, panic, and grief — but this isn’t the case with dissociatives.

More often than not, dissociative users feel blissful and whole rather than scared and alone.

This is the state of “euphoric nothingness” — a state outside of time and space, completely alone and isolated, but free from emotions like grief or sadness.

It’s through states like this that dissociative drugs such as ketamine provide a profound capacity for healing. They give people the opportunity to peer into their own minds and take an unbiased look at who they truly are without judgment or emotion.

This is a valuable tool in helping people identify suppressed unconscious behavior (Carl Jung refers to this process as shadow work) — all without experiencing the pain and discomfort that accompany these realizations in the moment.

Profound realizations like this serve as a catalyst for patients to shift their worldview in a positive way.

The underlying, unconscious thoughts and urges dragging them through the ups and downs of depression have been identified, and the arduous process of clearing them out can finally commence.

"There’s no coming to consciousness without pain." — Carl Jung

I need to note that none of these benefits are permanent without significant (non-drug-related) effort.

This is what the process of “psychedelic integration” refers to.

It’s critically important for long-term success that someone who’s attained insights from dissociative drugs (like ketamine) take the time to work out what to do with this new information and how to implement it into their daily lives.

Integration is complicated, which is why psychedelic integration coaches are such a valuable part of this process. They’re trained in techniques that can help patients make sense of the insights gained during the experience. They also help connect the dots and find ways these insights can be applied to improve one’s sense of well-being and happiness.

Here are some of the most popular techniques used to integrate psychedelics (and dissociatives):

Journalling — Writing down one’s ideas helps to unpack and reconsolidate complicated emotional thoughts stirred up during the session.
Talk therapy — Engaging in conversations with a trained professional provides a safe space to explore and interpret the experiences and emotions triggered during the session.
Meditation — Meditation improves the organization of thoughts and processing of new neural pathways opened up during the psychedelic session.
Painting & art therapy — Expressing thoughts and feelings through art can offer a non-verbal, creative outlet to make sense of the complex emotions and insights unearthed during a psychedelic experience.
Self-care practices — Everything from massages, weekend getaways, or purging of items you no longer need can contribute significantly to the enhancement of mental clarity and personal growth.
Writing letters to friends/family — Letters can be written to a friend, family member, or abuser to provide closure. They can remain private or be delivered to the recipient.
Writing letters to oneself — Apology letters, gratitude letters, or letters to the inner child that are directed at oneself can also be used.
Nature walks — Nature promotes feelings of relaxation and well-being. It tends to improve one’s general outlook on life, even if only momentarily.
Embrace the power of ritual — In the context of integration, a ritual is a powerful tool for connecting with the self and processing emotions. There’s no right or wrong way to approach this. Prayer, yoga, and meditation are common elements, but a simple walk in the woods, a cup of tea, or lighting a candle all work too. The key to developing a good ritual is to make it your own and to practice it often.

High Hopes & Hard Limits: A Reality Check on Dissociative Healing

The dissociative state offers impressive healing potential — but there can certainly be too much of a good thing.

The first few breakthrough experiences on dissociative drugs like ketamine are often very productive — but it becomes exceedingly rare for dissociatives to induce the insightful “zen state” they once delivered.

Over time, these drugs start degrading the mind and ultimately cause the user to become more disconnected, more isolated, more depressed, and less aware of their unconscious patterns than ever before.

In fact, all the things that make dissociatives useful as medicine also make them attractive as drug-based escapism.

Many people use drug-induced escapism as a coping mechanism. It’s a way to deal with feelings of hopelessness, grief, or other negative emotions.

Dissociatives and strong analgesics such as opiates are often the drugs of choice for this effect because of their capacity to temporarily induce a state of bliss and mute one’s painful inner dialog.

Others use dissociative drugs for experimental escapism.

K-hole or breakthrough- experiences are not hard to achieve with certain dissociatives (ketamine included), and these states are some of the trippiest experiences one can achieve from any drug.

In either case, escapism is not a healthy reason for using any substance — especially dissociatives. These drugs have a glow in the beginning, but their positive effects can take a turn in the opposite direction if you’re not paying attention.

Dissociative drugs “feel” enlightening at first (and perhaps they are to some degree), but long-term or repetitive use is antithetical to the process of self-improvement.

Not All Ketamine Clinics Are Created Equal

There are hundreds of ketamine clinics in the United States, Canada, Europe, Australia, and around the world offering IV injections of ketamine.

While many clinics are well-staffed with skilled psychotherapists and nurses, a few will simply hook you up to intravenous ketamine, sit you behind a curtain, wait until your time is up and send you on your way to await the next treatment.

Avoid clinics like this at all costs. Ketamine therapy should not be treated like fast food.

Effective ketamine therapy requires multiple sessions, both with and without ketamine, and there should always be a strong focus on integration after the session.

Ketamine and other dissociative drugs give you a chance to reframe the way you view yourself and your life — but it’s up to you (with the help of a skilled therapist) to make sense of this insight and integrate it into your daily habits.

It’s critically important that clinics take this seriously and don’t fall victim to the same mistakes that plague other areas of public health.

Issues with the regulation process and lack of altruistic goals for clinic owners are rampant and sure to worsen as ketamine therapy becomes more widespread.

Here are a few traits we consider red flags for ketamine clinics:

No intake consultation & evaluation process
Lack of information about therapeutic approach
Lack of clear, informed consent process
Lack of clear credentials for physicians or therapists administering ketamine
Poor clinic design (curtains, dingy rooms, etc.)

There are so many great ketamine clinics popping up these days you shouldn’t settle for anything sub-par. This treatment is powerful, but only when done properly — if you get a bad vibe or something doesn’t seem right, it’s best to trust your instincts and look for another clinic.

A (Brief) Primer on Dissociative Drugs

Dissociative drugs (AKA ‘dissos’) are substances that decouple one’s first-person experience from reality. They dismantle the idea of “self” and alter one’s perception of reality.

Dissociative drugs have paradoxical effects — they’re stimulating and sedating, neuroprotective and neurotoxic, and have both addictive and anti-addictive qualities.

The differences come down to which drug is being used, how often, and at what dose.

Here’s a brief list of dissociative drug classes:

Arylcyclohexylamines like ketamine, PCP, MXE, DCK, & others
Inhalants like xenon and nitrous oxide (laughing gas)
Opiates like dextromethorphan
Diarylethylamines (diphenidine & ephenidine)
Other NMDA antagonists like MK-801 (Dizocilpine)
Ibogaine
Salvinorin A (Salvia divinorum)

Many deliriant drugs also feature dissociative effects — but none possess the same benefits of the “euphoric nothingness” state of being.

Some examples include:

Chemical deliriants like orphenadrine and diphenhydramine
Natural deliriants like Amanita muscaria, datura, nutmeg, brugmansia, & mandrake root

How Do Dissociative Drugs Work?

Most dissociatives work by blocking the NMDA receptors. Some also work by activating the kappa-opioid receptors (such as ibogaine or salvinorin A).

However, by and large, it’s NMDA antagonism that provides the primary mechanism of action for drugs like PCP, ketamine, nitrous oxide, MXE, xenon gas, and many others in this class.

The NMDA receptors are critically involved in higher brain functions, such as:

Memory and learning
Neurodevelopment
Synaptic plasticity
Pain perception
Attention and focus
Consciousness

NMDA also acts like a "molecular coincidence detector." It only allows the transfer of information when two conditions are met — glutamate is bound, and the neuron is already depolarized. This unique feature allows NMDA receptors to control excitability in the brain.

Unsurprisingly, due to the importance of NMDARs in higher executive functioning and consciousness, problems with these receptors have been linked to a variety of neurological and psychiatric conditions as well — including Alzheimer's disease, Parkinson’s disease, epilepsy, and schizophrenia.

Very high doses of classical psychedelics, including LSD, 2C-X compounds, 5-MeO-DMT, and psilocybin, can also cause dissociation, but it works through an entirely different system (5HT2A receptors), and the experience feels distinctly different from NMDA-regulated dissociation.

→ Learn more about dissociatives & how they work at Tripsitter.com

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Credits & Shoutouts:

Article by Justin Cooke
Artwork by Dikigiyat