“Angry at the Wrong Thing:” Queering Ketamine Assisted Psychotherapy for Clients Experiencing Body Image and Eating Distress

ABSTRACT

Unlike classic serotonergic psychedelics, whose psychoactive shifts are recognized as having therapeutic value, ketamine’s perceptual effects are often overshadowed by its rapid antidepressant properties. However, within a ketamine assisted psychotherapeutic (KAP) context, ketamine’s distinct anxiolytic and dissociative features can cocreate a safe setting for client-directed psycho-spiritual exploration, including around body image and feeding disturbances. Eating disorders affect approximately 9% of Americans, and present a significant concern for LGBTQ2SIA+ community. This paper outlines a KAP framework, for further study, that is foundationally queer and grounded in postcolonial and intersectional feminist theories. This paper introduces societal body dysphoria, as a tool for clinicians to recontextualize how unrealistic ideals, identified as a societal distortion rooted in white supremacy, are individually internalized and collectively enforced through self-policing, with the belief that adherence will yield access to power and resources. Within this framework, a case report presents an example of how KAP can facilitate the deconstruction of societal constructs and alleviate distress.

KEYWORDS:

• Ketamine
• radical social work
• eating disorders
• body image
• postcolonial knowledges
• anti-fat bias

Acknowledgments

I would like to express my gratitude to Denise Rue, LCSW, for her mentorship, guidance, and continual inspiration, as well as to Lilly Kaplan, LMSW, and Jenna Hollenstein, MS, RD, CDN, for their invaluable editing, insights, and support. The author received no funding.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data

No data associated with this article.

Consent

Written informed consent for publication of client’s clinical details was obtained from the client.

Notes

1. In this article, the pronouns “she” and “they” are used alternately to respect Charlie’s identity exploration journey as it unfolded in therapy. Initially, Charlie indicated “she/they” pronouns on the intake form. Through therapy, it became evident that Charlie resonated with the use of “they,” yet there was no explicit request to use this pronoun exclusively. With Charlie’s consent, a practice of “rolling pronouns” – alternating between “she” and “they” – was employed to acknowledge all facets of Charlie’s emerging identity. This narrative choice reflects the therapeutic process and underscores that neither “she/her” nor “they/them” pronouns are privileged over the other in the text, aligning with the inclusive and validating approach of the therapy sessions themselves.