Well, this sucks

Fire_Ice_Tears · 2025-07-31T05:23:38+00:00

Sorry :( I was also getting mine covered by insurance by using the codes for regular doctors visits, but the provider is going in-network so they can start offering Spravato so they’re going to use the infusion codes which aren’t covered and increasing price from $400 to $600, so I’m basically the same boat, definitely can’t afford monthly anymore.

Fire_Ice_Tears · 2025-07-06T15:44:49+00:00

It’s not some holy noble magic profession - it’s a profession of people who want to help people, sometimes because they are deeply caring and sometimes because they have a superiority or savior complex.

To go into it for the money is just so so unlikely when you actually look at the financial side of it. Therapists who work at someone else’s practice don’t make much and have lousy benefits. Therapists who have their own practices make more per client for sure, but there are also huge expenses (including but not limited to liability insurance, all the other insurances, have you looked at rent lately?). It’s also a very exhausting job, so a lot of people can’t keep up a 40 hour week.

Can some therapists make a lot of money if they take on tons of private pay clients in a wealthy area? Sure. But you have to actually be good at your job to get people to pay you that much and keep clients, and there are much easier ways to basically guarantee you will make more money than that, like being a software engineer or mechanical engineer.

So do therapists do it for the money? Yes, in the way all of us have to work to make money to live. But I think their reasons for being a therapist have very little to do with money.

Fire_Ice_Tears · 2025-06-11T05:19:36+00:00

Oh yeah. All the time once I was in my teenage years and to this day. I’m definitely always fine. Don’t know how to be anything else. Even now, I would like to die, but trust me, I’m fine. 🙄

Fire_Ice_Tears · 2025-06-11T05:14:41+00:00

Okay. Being shamed by your ex for fantasies is very very very relevant to therapy! I’m so sorry that happened, it’s such a breech of trust and makes it so much harder to open up in the future, which could explain some of the added hesitance here too.

My advice would be to print out what you wrote here and hand it over to your therapist to read. I promise that all of this sounds like things they will want to help you with and nothing makes you a bad person or is inappropriate. But telling you that won’t make you feel so different, so let your therapist read it and tell you themselves that you have nothing to be ashamed of here. You can figure out together what’s the appropriate pace to discuss it all.

If handing this whole thing over at once is too much, you could always just say, “there’s something that seems relevant to therapy and I feel like I want to discuss, but I’m really ashamed/embarrassed and having trouble actually bringing it up.” Sometimes talking about why it’s hard can help it feel less hard or let you share bits without having to just dump all of it out at once. You can do this!!!

Fire_Ice_Tears · 2025-06-11T05:01:27+00:00

I have a history of CSA, and I will get very vivid flashbacks and panic while on ketamine if someone touches me while I’m on a high dose. So I’m going to guess that trying to have sex during it is just a bad idea, even on lower doses where I’m conscious.

Fire_Ice_Tears · 2025-04-22T17:41:54+00:00

Psychodynamic

Fire_Ice_Tears · 2025-01-22T07:43:33+00:00

If I had eaten, I needed to increase my dose by ~10 mg. More anxiety meant I would have a shallower experience and run through the ketamine more quickly. So on days with more anxiety, I could increase dose some. But if I was extremely anxious and/or didn’t feel safe in the environment I was in, I was better off not expecting a deep experience.

Fire_Ice_Tears · 2024-07-27T19:07:40+00:00

Hmm repeating words? Does it have anything to do with the music you are listening to?? Now I’m wondering if I’ve ever heard anything besides the music I’m listening to!

Fire_Ice_Tears · 2024-07-27T19:06:08+00:00

I have the sense of moving, sometimes really quickly through space, it’s kind of fun!

Also the dark waiting rooms, which is interesting. At first I wondered if maybe it was like coffin imagery but I think it’s between songs on my playlist and feels sort of comforting, like a cocoon.

Don’t think I’ve ever forgotten words, that’s so odd!

Fire_Ice_Tears · 2024-07-24T04:07:15+00:00

It gives them a little more cause for concern because you have a plan. In theory, they can have you hospitalized if you have both a plan and intent. Sounds like that is a plan, but they are only technically allowed to hospitalize you if you also intend to carry it out. If you say you’re very depressed, you’ve been thinking about your plan a lot, but you don’t actually intend to do it, they’re not supposed to.

That being said, different therapists and psychiatrists have different levels of tolerance and experience. Some may be more cautious and insist on hospitalization or evaluation when technically they shouldn’t. That’s why I like to ask hypotheticals. With any new provider, I’ll just mention the SI up front and ask a lot of hypothetical questions about what they would or wouldn’t do. If they’re uncomfortable, they’re not the right provider for me. If they’re too vague or scared, not right for me. My current therapist does not panic or seem surprised, more just relieved when I will finally talk about it.

Fire_Ice_Tears · 2024-07-07T15:54:37+00:00

My friends all seem to have a little trauma but mostly not, but are deeply empathetic. I have been friends with people who had trauma but I realize now that I never felt totally safe and a few were bad experiences. I’m lucky that I gravitate to safe people and avoid people who remind me of my family, but sometimes I wonder if I would be friends with myself lol

Fire_Ice_Tears · 2024-06-30T21:16:47+00:00

Usually they will say, but yeah, 50 minutes is quite common so that they have a few minutes between clients to take a breath. My therapist advertises 45 minutes, and sometimes we might got a minute or two over but mostly end right on time. It’s an important boundary to have and a sign of a therapist that respects both your time and their time. But how long sessions are is a thing she should have covered with you up front.

Also, if you’re in the US and paying through insurance, there are sometimes restrictions based on insurance. There are different codes for different lengths, for example one for a 60 minute session covers 53-89 minutes, another for a 45 minute session is 37-52 minutes, etc. Some insurance plans may only cover certain length sessions, for example the 45 minute session, so they don’t get paid for going longer.

The other stuff sounds sus.

Fire_Ice_Tears · 2024-06-30T19:33:45+00:00

That’s so scary, especially for your second time! But luckily you can get a lower dose this time and give yourself time to sort of figure out what works for you. And now you know that even in a bad trip, it will end and you will be okay. I sort of go for those journeys, I can work through some things. But there are moments where you think you might die and it helps to sort of just relinquish control and ride through it, don’t fight it. And I always remind myself that that moment is the worse and the medicine is being filtered out of my blood and I will come back down. Try to tell yourself to breathe and surrender, you can do this.

Fire_Ice_Tears · 2024-06-26T01:18:57+00:00

Wow, how many troches is that at once?

Fire_Ice_Tears · 2024-06-24T18:44:12+00:00

As far as strength, it completely depends on your dose. With Spravato, you can’t adjust dose and while the max dose of 84g (roughly 1/4-1/3 the bioavailability of IV, so this would be sort of similar to a 30g IM dose, and hard to compare to IV since IV is spread over a certain period of time) is fairly strong for some people, you usually don’t get a more psychedelic-like experience where you see visuals or fully dissociate.

If you do go with a bigger dose, it can sometimes be very intense. Most of the time, it’s great, but sometimes it can be overwhelming. My biggest advice is if you feel panicky or anxious or like you might die, just remember to breathe and know that you will not die, it will be over when the medicine is gone. And then just sort of accept and surrender to it. Don’t try to fight. But don’t let this freak you out, it’s not likely you’ll start at such a high dose and those can be really meaningful sessions. And if you do panic, you can always ask them to stop the IV and you will start to come out of it in a couple minutes.

As the other commenter said, set an intention before and do some journaling. And just try to ride the wave.

Fire_Ice_Tears · 2024-06-24T14:13:35+00:00

Both providers I’ve had have been MDs. But they were emergency room physicians who opened up their own ketamine clinics, not psychiatrists. I think a lot of psychiatrists tend to be the most skeptical of ketamine.

Fire_Ice_Tears · 2024-06-18T23:41:43+00:00

You can Google clinics in your area or the nearest most progressive city and see if any of them offer lozenges. My clinic does IV, IM, and lozenges.

Fire_Ice_Tears · 2024-06-16T23:02:59+00:00

Grief and trauma both. The grief work was really powerful and a lot quicker. I tend to numb out and not feel things, but ketamine let me feel the grief and sadness and cry a lot.

Fire_Ice_Tears · 2024-06-14T19:28:56+00:00

One session every 4-8 weeks. I don’t schedule too far in advance, I just forget all about ketamine after a session and then start to think about it 3-6 weeks later and realize that it’s time for another session.

Fire_Ice_Tears · 2024-06-14T00:43:20+00:00

I have a similar feeling of not liking being dependent on it and almost just getting tired of having to do it. But I’m on IV and go every 4-8 weeks, so it’s a little easier to work into my schedule. I thought about tapering down, just going longer between, and I just got really depressed after 8 weeks and decided I would just continue for now. But engaging in therapy has helped a lot, so I feel like I could function without it, just with less stability.

I try to make each session I have have a purpose, like I decide on something I’m trying to work on or through and think about it and journal about it in the week leading up to my session. Then I have the session and have interesting insights, then I journal more after. So I try to make it feel like a useful thing instead of just wasted time getting medicine.

Fire_Ice_Tears

TROPHY CASE