Unfolding States of Mind: A Dissociative-Psychedelic Model of Ketamine-Assisted Psychotherapy in Palliative Care
Preprints.org August 29, 2025 Alessandro Gonçalves Campolina, Marco Aurélio Tuena de Oliveira 1 citation preprint
A narrative review synthesizes evidence on ketamine-assisted psychotherapy (KAP) for palliative care patients, who often suffer existential distress, loss of meaning, and emotional pain beyond physical symptoms. The authors present a novel, time-limited KAP model tailored to end-of-life settings, integrating neurobiological, psychological, and experiential effects. The model includes preparatory and integrative psychotherapy, two ketamine dosing sessions (one low-dose and one moderate-dose), concurrent psychotherapy, goals of care discussion, and optional pharmacological optimization. It leverages ketamine's effects on self-processing networks—the Salience Network (embodied self-awareness) and Default Mode Network (narrative self-construction)—to address bodily and narrative dimensions of distress. The approach emphasizes psychological safety, meaning-making, and patient-centered care to enhance quality of life at the end of life.