This is what we clinically recognize as a religious or spiritual trauma, a rupture to one’s internal experience of safety, belonging, and self-definition. The trauma is not just from the strictness or rules themselves, it’s from the loss of the relational world that once provided identity, safety, belonging, and meaning. When belief dissolves or a person leaves the community, the nervous system loses its orientation point, and that rupture — the sudden absence of connection, coherence, and grounding — is what becomes the wound.

However, ketamine is not appropriate for every situation or every patient. Safe, ethical ketamine treatment requires recognizing when to prescribe, and just as importantly, when not to.

This guide explains the medical and psychiatric scenarios where I would not prescribe ketamine, and why those boundaries exist.

Ketamine-assisted therapy is widely recognized for its ability to reduce symptoms of depression, anxiety, and trauma-related distress. However, a subset of patients also report experiences that fall into the category of non-ordinary states of consciousness. These states are often characterized by a sense of interconnectedness, emotional clarity, awareness, or what many describe simply as oneness.