Ketamine and the 12 Steps: Strange Bedfellows

How I Surrendered—First in Mind, Then in Body

There’s no hiding

The year was 2016. A circle of folding chairs was assembled under the vaulted ceiling of a church on upper Broadway. I sat in the chair closest to the door and watched the clock. My gut coiled like a steel suspension cable as the perpetual sweep of the second hand rounded the clock face. I only needed to make it through the hour. When I wasn’t fixated on the time, I fixated on the floor and the shoes of the people seated in the circle. Being Manhattan, this group had outstanding shoe game. I homed in on a two-tone loafer that I especially liked and, for a moment, was distracted from my compulsion to climb under my seat.

There is nowhere to hide in a 12-step meeting. I was expected to introduce myself without so much as a professional title. No mention of the ventures I’d led or the accolades I’d received. No list of accomplishments, not even a charming preamble. Just my first name. This was Al-Anon, the companion program for family members of alcoholics and addicts. And I didn’t want to be here because, to be clear, I wasn’t the one with the problem.

It was my therapist, Judith, who suggested that, since my husband’s recent relapse into drug use, I needed more support and Al-Anon might be a good place to get it. But right now, I wanted only to be released from this hall of mirrors. There was Tory whose twin brother died last year of an overdose, and Melanie whose husband smoked crack in the bathtub. There was Jamal whose son just got kicked out of his second school, and Stephen who’d been estranged from his mother for twelve years. Spouses, parents, children, and siblings of addicts—their stories were not mine, and yet I heard myself in every one—in the subtext of not-enough-ness running beneath their words, in the constant strain to mend the hole that was not theirs to mend.

I didn’t speak but quietly sobbed through the hour until Rafael, who looked to be in his 70s, hobbled to his feet, adjusted his waistband, and invited us to stand and grasp hands for the closing remarks. “You might not like all of us,” he said, “but you will come to love us in a very special way, the same way we already love you.” His words vexed me. I do not like you people, and how could you possibly love me?

Despite my reluctance, I kept returning to that meeting and, with encouragement from Shari from Queens, eventually mustered the courage to speak. I didn’t need the standard three-minute allotment to share my story—there was so little I could bear to say. At first, exposing myself felt like the agony of stripping naked in the open air for a skinny dip. But the people in that room had been treading water since long before I arrived, and just knowing their well-shod feet were paddling furiously beneath the surface of their placid demeanors gave me hope.

Meanwhile, my husband’s cycle of chronic relapses continued. Addiction is a cancer. It might have long periods of remission, but like all diseases, it requires ongoing treatment, monitoring, and support—and these, he’d always refused.

“AA is just not my thing,” was what he’d told me from the time we first met. At twenty-six years old, he’d already been living drug- and alcohol-free for several years. He had his own sobriety program which might be better described as drug-free addictions. Things that included fast speeds, heights, physical exertion, and high levels of risk and adrenaline—bridge climbing, skydiving, rock climbing, bungee jumping, and motorcycles. He once swam naked in a swamp teeming with alligators.

When it comes to addiction, living in remission is not the same as living in recovery. Had I understood this earlier in my life, I would have known that my husband’s relapses were inevitable.

But I was naive and I buoyed myself with hope. I hoped that our relationship was important enough to keep him sober. When that proved false, I hoped our children were important enough for him to stay sober. My last, most foolish, hope hung on his ego. He was so wrapped up in his career and professional reputation, I truly believed he wouldn’t risk losing them. Some call this living in denial. I call it living in tension because that’s what it felt like in my body. I was fully aware that the past is the best predictor of the future, but I held out hope for a different outcome. Hope is a subtle tormentor.

In Al-Anon, I finally surrendered the exhausting, hopeless illusion that I had any control over my husband. People who’ve “worked the program,” as they say of the 12 steps—be it AA, Al-Anon, or any of the others—understand, as few do, how powerless we all truly are.

At first, letting go felt reckless. Like stepping away from the wheel of a car that was skidding on ice—with my children in the backseat! I thought if I stopped monitoring, managing, helping, fixing, he’d spiral even further. But eventually, I realized his descent wasn’t mine to stop. I began to loosen my grip. And in that loosening, I felt the tiniest bit of space open up. Just enough for a breath. Just enough to realize I hadn’t exhaled in years. That was surrender—not giving up, but giving back what was never mine to carry. No amount of love or fury or carefully worded ultimatums would change him. I couldn’t save him. All I could do was choose myself.

Embodying Surrender: My First Ketamine-Assisted Therapy Session

The little exhale that began in the church on upper Broadway was a hint of what was to come years later when I was introduced to ketamine-assisted therapy and learned what it feels like to embody surrender.

In the 1980s, when I first heard about ketamine, referred to as “K,” I was told it was a horse tranquilizer that people took to get high. I was so naive about addiction (and drugs in general) that my bewildered response was something like, How is that fun? Because, to my mind, what’s the purpose of taking drugs if not to have fun?

Thirty years later, I found myself climbing a weather-beaten staircase to a second-floor office in the town of San Anselmo for the first in a series of ketamine treatments. I didn’t expect it to be fun. I expected it to be otherworldly. I’d done my research.

For the curious, here are some reputable online sources to find information about psychedelics:

• The Microdose, a research-backed newsletter from UC Berkeley’s Center for the Science of Psychedelics

• Erowid, the mothership of drug knowledge, with its dial-up-era interface and encyclopedic information on everything from drug composition, dosing, risks, and user stories.

• DoubleBlind, a designerly online magazine dedicated to harm reduction by providing rigorous reporting and accessible information about psychedelics

First Developed in 1962 as an anesthetic for medical use, ketamine is not a classic psychedelic but has hallucinogenic properties and is noted for its dissociative effects. The drug's abuse potential led to its classification as a Schedule III controlled substance in the United States in 1999. But more recently, research has focused on its rapid-acting antidepressant effects, leading to the FDA approval of esketamine, a ketamine derivative, for depression treatment in 2019. Multiple studies report significant mood improvement and restored emotional resilience following ketamine treatment.

Being a synthetic chemical compound, you don’t find ketamine referred to in the same reverential tones that you do plant medicines like ayahuasca, psilocybin mushrooms, and peyote, which carry spiritual and cultural significance beyond their chemical properties alone. Some might go so far as to say ketamine lacks spirit—that it’s more “Breaking Bad” than “Avatar.” Like any mind-altering substance, it can be abused.

It was perhaps a strange choice of drug to initiate my psychedelic healing journey, but it was the only one legal where I lived. If given a choice, I preferred not to break the law—at least not right out of the gate. I also liked that ketamine had a short duration. One hour, maybe ninety minutes—unlike other psychedelics that can alter an entire day.

I chose the practice in San Anselmo because the therapist worked in conjunction with a psychiatrist to provide ketamine-assisted psychotherapy (KAP)—making it distinct from providers who offer ketamine infusions absent any kind of therapeutic component or container, as they say.

In psychedelic work, “the container” refers to more than just the walls of the room in which the medicine is taken. It’s the presence of someone trained, someone calm, someone you trust. It’s the music, the lighting, the intention-setting conversation before the journey, and the integration that happens afterward. It’s the sense that if you find yourself floating in a black hole or battling your inner demons, someone will be there. Not to steer the ship—but to anchor it. A single appointment in this practice is three hours long.

In my preparatory session with Julane, my KAP therapist, I’d told her I felt overwhelmed by despair. I described a recurring fantasy: the earth’s crust cracking open and swallowing me whole.

Now, a week later, I arrived at Julane’s cozy office, where we reviewed the themes of our earlier conversation and discussed my intentions for the session. Julane explained that setting intentions was a key part of psychedelic-assisted therapy. Intentions help focus your session on areas in which you want to grow or heal and the insights you hope to uncover.

“I'm ready to stop circling the same questions,” I told Julane. “I’m tired of feeling stuck.”

“You crave movement,” she affirmed, her voice even. Then she explained the role of music, how it guides the experience. “Your body’s sensations will rise and fall with the sound,” she said, cueing a special playlist she’d curated. “It’s not unusual to feel like you’re not just moving with the music—but that you are the music.”

She handed me noise-canceling headphones and a sleep mask unlike anything I’d seen: the space inside hollowed so I could open my eyes within the dark. Then she reclined my armchair and tucked a blanket around me. I felt like an astronaut pre-launch—secured in my capsule, bracing for a journey to the stars.

I felt the injection go into my shoulder as the delicate sound of a piano solo played in my head. Murky, morphing patterns and colors appeared to respond to each note, as if they were precisely fitted to a corresponding cell in my body, like lock and key.

And then the rocket boosters fell away from my capsule and I left the room. Ketamine is a dissociative drug, which means at higher doses, you feel disconnected from your body and surroundings, leading to a state often described as a detachment from reality. Indeed my whole self dissolved like a sugar cube in hot tea—if hot tea were the cosmos itself.

Sometime later, as I began to reenter Earth’s atmosphere, I reached for my lips—tapping and pressing around the edges of my mouth. Am I all here? Am I real? What just happened? Wow.

Le Taureau by Pablo Picasso

The room came back in pieces. Julane’s voice filtered in through the murk. She spoke gently, as if coaxing me across a great distance through an underwater, transatlantic pipe. It took time for language to reassemble, for memory to reboot. In a stammered attempt to speak, I explained that the shared first letters of our names—the J-U-L—had become threads woven into a common tapestry. I spoke calmly and felt immense gratitude. Not for something specific—just for being.

What, you might ask, is the value of an experience you can barely remember and scarcely articulate? The value isn’t in the narrative, as we’re trained to believe about talk therapy. In ketamine work, especially at higher doses, it’s not about what you “figure out” while you’re under the medicine. It’s about the felt experience of letting go. And in that sense, it teaches surrender in a way nothing else ever has for me.

You might initially try to cling to some approximation of reality but it quickly recedes like a mirror in infinite regress. When you have no name and no body and indeed all known constructs fall away, you have no choice but to surrender. Control is simply out of reach. So while I can’t recall the experience of being under the ketamine, the act of surrender it entailed was an empowering and enduring result.

“I don’t know how all this works, but I feel energized,” I told Julane during our post-treatment integration call.

“That makes sense,” she said. “Trauma is not just a psychological phenomenon, it lives in the body.” Her use of the word trauma gave me pause. Trauma, in my mind, was experienced by people who'd endured catastrophic events. Trauma shattered lives and left visible scars. My own experiences seemed, by comparison, more mundane. Who doesn’t have an addict in the family these days? Half of all marriages end in divorce. These are not exceptional problems. But Julane believed otherwise.

At her suggestion, I read Bessel van der Kolk’s book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. I came to understand how the constant stress of living with a relapsing addict meant the ground beneath my feet was quicksand. Trauma, for me, was an ongoing presence that shaped how I related to myself, others, and the world around me. The emotional volatility, unpredictability, and subtle manipulations of my dysfunctional marriage meant my nervous system was in survival mode for many years. No wonder I was so depleted.

* * *

In the days following my treatment, I slept more deeply and woke refreshed. I looked into my eyes in the bathroom mirror and decided I was looking less haggard. What had happened?

The surrender that began in my mind—when the 12 steps altered those looping thoughts and self-deceptions—had not yet rewritten the language of my body. The mind could only take me so far. Because the body truly does keep the score. It holds the fear, stores the shame. You can’t outthink it. You have to feel your way through it. As trauma expert and somatic experiencing founder Peter Levine said, “The story is in the biology, not the biography.”

It might seem paradoxical that a dissociative—ketamine—would bring me closer to embodiment. But in disconnecting from the ordinary patterns of thought and perception, I could finally access what had been buried beneath them. In stepping outside my body, I found a way back to it.

I love you.

Juliette

PS. Five questions for the Expert. Next week’s post will introduce you to Julane Andries, a pioneer in the field of ketamine-assisted therapy. She’ll be the first in a periodic Q&A series called Five Questions for the Expert.

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