Dissociation and ketamine treatment: A case study with heather

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Athena Phillips
 

Portland State University, USA

: Int J Ment Health Psychiatry

Abstract

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Patients with complex trauma and dissociative symptoms often present with significant and stratified complexity. The treatment trajectory is lengthy, arduous, and milestones typically occur in scarce intervals. While research has contributed to notable strides in treatment outcomes for dissociative patients, the length and severity of suffering remains a feature of the clinical picture. Interventions that combine traditional psychotherapy with novel approaches have the potential to decrease the overarching length and cost of treatment to the patient. Ketamine and psilocybin may have potential to significantly shift the treatment trajectory given the research that is emerging for those with treatment resistant depression. While there may be a great deal of promise in these interventions, of equal concern is the risk potential with their use being applied to those with complex trauma and structural dissociation. Heather’s experience with and response to ketamine as an intervention may offer insight to both the risks and possibilities in the application of ketamine to this population. Learning Objectives: Participants will be able to: 1. Discuss the potential treatment outcomes in the use of Ketamine treatment with dissociative patients. 2. Identify potential risks in the use of ketamine treatment with dissociative patients. 3. Discuss the importance of pursuing additional research in utilizing ketamine as an intervention with dissociative patients. 4. Discuss the cultural denial of dissociation as a contributing factor in research gaps with novel interventions, such as ketamine. 5. Discuss possibilities for the use of ketamine in adjunct with psychotherapy in patients with dissociative disorders. Potential for Distress The potential for distress in this presentation is limited to conversations surrounding the severity of self-harm in Heather’s presentation as well as nearly lethal engagement with eating disorder behaviours. Her trauma history will only be vaguely referenced in the context of establishing the foundation for her dissociative symptoms. Specifics of her history will be excluded.

Biography

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With a career spanning over two decades, she has devoted herself to the field of behavioural health since 1995. Beginning with work alongside developmentally disabled children and adults, her journey led her to pursue a bachelor’s degree in social work at Pacific University, where she graduated Magna Cum Laude in 2000. Interning at the Sexual Assault Resource Centre sparked her interest in trauma treatment, propelling her to earn a master’s in social work from Portland State University. As a medical social worker in various settings, she cultivated expertise in trauma and dissociative disorders, eventually founding Integrative Trauma Treatment Centre (ITTC) in 2012. Recognizing the need for holistic trauma approaches, she established ITTC as an outpatient clinic in Portland, OR, accompanied by KALOS for specialized trainings. Her global impact expanded with the launch of an online Trauma Coach Certification course and The Orenda Project, offering resources and community for trauma providers worldwide. She has also contributed to local capacity building, including the development of mHub Rwanda, a mental health clinic run by Rwandans. Her dedication continues as a trauma consultant, volunteering within the mHub community and beyond.