Little House Counseling

06/09/2025

I have been seeing a lot of press about public figures and use of Ketamine. As a provider of Ketamine Assisted Psychotherapy I would like to clear up some things about this medication and its use.

Ketamine is a powerful potentially addictive medication. Like any other medication there are risks associated with it. The protocol that we follow does not involve daily or long term use. Our prescribers limit the medication to a maximum of 8 doses, to be taken in a clinical framework, under direct supervision. It is used in conjunction with therapy, with the therapy being key to positive outcomes. Ketamine without therapy to work on changing patterns of thinking and behavior is not going to be as effective.

The current research is showing that after a limited number of doses, most people have reached the maximum level of benefit that the medication has to offer. While they may find a booster down the road helpful, our protocol is very short term. Some clients have even reported that after just 2 doses, symptoms have reduced to the point that they do not need to continue with more doses of the medication. It is important to note that research related to use of Ketamine as a mental health treatment is new, so it is ongoing and evolving and there are several different treatment approaches being studied.

Abusing Ketamine is not the same as supervised treatment. Our protocol does not support people taking Ketamine outside of a planned dosing session. They are monitored while under the influence of the medication. They are not permitted to drive until the next day. A person is not prescribed the medication unless they are also attending multiple therapy sessions before and after dosing. They must undergo an evaluation to determine if they meet criteria for the treatment.

When you hear about public figures and their abuse of Ketamine, these people are not using it as intended or prescribed. No ethical prescriber is going to support this type of abuse of a prescription drug. No ETHICAL provider is going to hand out Ketamine like candy to anyone who wants it in unlimited quantities.

I feel a responsibility as a provider to educate the public on how this medication is intended to be used. There is a big difference between being in treatment and using medication as prescribed and abusing a drug. I have personally and professionally experienced how life changing this medication can be.

I cannot speak for all companies or prescribers, but the prescribers that I work with use a protocol that makes it nearly impossible to become addicted to or abuse prescribed Ketamine as they limit the dosage and the number of doses.

It would be a shame if we make our assumptions about a highly effective treatment based only on a few high profile abuse cases, as I believe that ethical prescribers put many, many safety nets in place to prevent abuse of this medication from being the norm.

It does worry me that there may be unethical companies out there who are out to make a quick buck off of people's mental health. I can say that the company that we partner with to prescribe to our clients has been fantastic when it comes to being professional and ethical. They prioritize the safety and wellbeing of our clients. They are diligent in maintaining low risk of harm or abuse.

I am hopeful that the media stories do not skew the public from being open to learning more about this treatment. Don't take my word for it, this is my opinion based on my professional training and personal experience. As always, I encourage you to do your own research.

Feel free to comment your thoughts or experiences.

-April

04/28/2025

HEY FELLOW THERAPISTS!

Do you have a client struggling with depression, anxiety, PTSD or other mental health concern who might be a good candidate for Ketamine Assisted Psychotherapy?

We would love to collaborate with you to offer this treatment to your clients while they continue to work with you!

How it works:

We provide the preparation, referral to the prescriber, and provide live support to the client during up to 8 dosing sessions over the course of 1-6 months. Your client continues to meet with you as usual between dosing sessions. We can also meet with your client for post dose follow-up if you do not have availability that week. To get the most benefit, clients meet with either you or us within a few days of dosing. We recommend that clients attend at least one therapy session between each dosing session, but weekly therapy is highly encouraged during KAP.

We collaborate with you throughout the process. Clients complete treatment with us after a maximum of 8 doses.

Want to know more? Give us a call!

-April

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04/28/2025

Hey friends... are you interested in Ketamine Assisted Psychotherapy but already have a great therapist? You don't have to stop seeing your current therapist to receive KAP with us!

We can collaborate with your current therapist so that you can continue to work with them in therapy while doing your KAP treatment with us.

KAP involves 2 - 8 dosing sessions so it is relatively short term treatment. We do 2-3 prep sessions together to get to know you and discuss if KAP is a good fit before referring you to the prescriber, but you can continue to see your current therapist throughout the entire treatment process. Once you complete your desired number of dosing sessions you no longer need to meet with us.

Keep in mind, the therapy is the MOST important part of this treatment. Ketamine is just the tool that supercharges the therapy. Therapy is where the real lasting benefits happen. We know how much it matters to have a therapist that gets you and who you already do great work with! You don't have to give them up to do this treatment with us.

Have more questions? Feel free to call!

-April

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04/04/2025

Wondering if Ketamine-Assisted Psychotherapy (KAP) is right for you?

Join us on Tuesday, April 15th at 8pm ET for our next live virtual info session on KAP and Journey Clinical’s Psychiatric Medication Management program. This event will cover key information such as the science and safety behind KAP, collaborative care, modality options, cost and insurance details, and more.

You can RSVP at journey.click/liveinfosession Can't make it? Simply RSVP to receive a recording after the session.

04/02/2025

I read something very disturbing about s*x today and I need to complain about it for a minute so I can go back to dishing out heaps of sunshine and rainbows and teddy bears to all. Hush, haters, let me believe what I want for a moment.

I was reading a post about a couple. The man was upset because his wife's libido had tanked and things were not lining up in the bedroom. He was frustrated and needing intimacy with his wife. They were in their late 40s. He was looking for advice. He sounded kind, he loved his wife, they were struggling, he wanted help from other men about how to handle it. He sounded like a good, kind, loving husband. That is not the disturbing part.

The disturbing part was the advice that was given and the tone of that advice. One advice giver told him he needed to sit her ass down and make her get her head on straight. Tell her she needs to figure out how to meet his needs or that he will find somebody that will and divorce her. This was the worst, but other's dogpiled on to say similar things. Most were less harsh, but the majority of the comments involved him giving her ultimatums to give him what he needs or divorce.

It made me so sad and angry. For him, for her, for society, that this is what people think the best move is.

This is a very complicated situation with no easy solution. But not one person considered that at nearly 50 she may be having issues with her libido due to the hormone changes that happen to women due to menopause. Not one person suggested that they to talk to a professional about what might be affecting them. Not one person asked him if he had talked to her about what she might be going through. Not one suggested she may have some unmet needs here too, be it emotional or medical, that could be explored.

What the hell.

Soooo, let me make a suggestion. Do with it whatever you will. First of all, men, I hear you and your needs for s*x and intimacy are just as valid as ours. You need things too. You are not wrong or bad for wanting and needing to have s*x with the person you are with. You are human, and s*x is important. But please please please do not be a person who says things like "tell her to put out or get out". please. Why not? Because that never works. Like Ever.

When a person is struggling with their libido there is often a tremendous amount of anxiety and shame involved. Pressure doesn't ease that, it magnifies it. It shuts down the person's desire even more. Trying to have s*x with someone when you don't feel it is horrible. It destroys people in ways they have a hard time coming back from. There are many reasons why a person may not be interested in s*x, and news flash, it might not even be about you. Darling, I KNOW you are s*xy AF... I know you deserve to be pounced on, lets see if we can find a better way to make some magic happen.

The key is to take pressure off of your partner, not put more on them. The key is to communicate and find out what the challenges are together. The key is exploring it with empathy. Is that all it takes? No. But it works a hell of a lot better than criticism and demands.

I am a woman in menopause. It sucks. Nobody tells us anything about what is going on with our bodies. We hear vague things about it when we are younger, but most of us are pretty clueless to many of the symptoms we face. We just know that we wake up one day and suddenly nothing does what it used to do. We are blindsided and unprepared. We are told to get over it, that nothing can be done, that we just have to deal with it. Some of us feel an incredible amount of shame and grief over losing parts of who we used to be. It physically and emotionally hard and we need reassurance and compassion while we figure it out. There are options including mental health treatments and Hormone therapy that help. Most of us do not know that options exist for us and that information is sometimes hard to find.

Is that what the issue is for this couple? I don't know. Maybe not. Maybe she finds him repulsive and they need to split up. Maybe she feels overwhelmed and needs some help so that she can feel s*xy again. Maybe she needs to feel closer to him to want that. Maybe her hormones are out of balance. The point is that we don't know, and neither do they. HMMMMM, IF ONLY THERE WERE SOME WAY TO FIND OUT. HOW MIGHT WE DO THAT. Maybe, just maybe, we could try this thing where we ask each other questions and then listen really carefully to the answers! OMG THAT SOUNDS GENIUS!!!!!!
I know. I'm pretty good at this stuff most of the time. But I digress...
Ok all jokes aside, the path to s*xual glory land involves empathy and communication and teamwork, exploration and sometimes professional help, not ultimatums and threats. The reality is that It may not work out. but if you love someone it is worth a shot.

The s*xiest thing my husband ever said to me was "This isn't a you thing, this is an us thing, and we do things together."

You got this,

-April

04/01/2025

My ketamine treatment update:

So I am a week out following my 2nd dosing session. Given that I am also a provider of this treatment, I am aware that I could be skewed in my optimism. But I will try to point out the negatives too.

First the good:

Dare I say this treatment has been life changing???
I mean I WORK on myself. A lot. Like constantly. To the point that I should probably chill and float around on the surface a little instead of constantly diving into the emotional depths of why I am how I am. I feel things super big and I over analyze to a fault most days. My point is I've been fumbling in the depths for years looking at my monsters and now I don't really feel any need to do that and its super weird. The depths are clear. The monsters that were swimming down there decided they were done being terrifying and morphed into tidbits of wisdom. Yay. The depths are no longer a place where its hard to breathe. Its fun down there now that I know I'm not going to get emotionally ripped to shreds by one of my monsters. Now they are happy to provide me with helpful bits of wisdom and meaning that I can use to walk through life instead of biting off one of my legs.

Ketamine has shifted something in a very big way, and it did it VERY quickly. This is really hard to explain. I just sort of feel really clear. The things that used to cause me big emotions just aren't that overwhelming anymore, or aren't what really matters to me anymore. I can focus on the things that I want to focus on because my mind is not cluttered with anxious or depressed thoughts. My mind feels peaceful. I feel like I have a lot of clarity. It doesn't mean I don't feel things, it means I feel the things I need to feel at the level I am meant to feel them.

Ketamine creates this sense that all is as it should be, even when its not ideal, and everything feels interconnected and one with nature. sounds so woo woo, I know. Its the kind of thing that once you experience it you know exactly what I am talking about. Here is an example of what I mean:

During my dosing I had this overwhelming physical and emotional comfort and peace. I remember thinking that if this is what death feels like it is absolutely incredible. I was no longer just a physical being, I didn't feel any need for my body anymore, I was being absorbed into the things I was seeing and becoming part of the landscape. It felt right somehow, it felt like where I was supposed to be. Like I was part of something much bigger and more meaningful than myself. It felt amazing. I didn't really want to come back to my body and its limitations. There was no stress, no pain, only peace. It made me think if I had a terminal illness, I would want this experience because I would no longer be afraid to die.

Regardless of your spiritual beliefs, if this is what it feels like to leave your body or this life, its a very comforting and peaceful experience. I though a lot about my dad and his passing. I felt a lot of peace in the idea that maybe this is what death was like for him. Now when I think of him I am comforted by this.

Obviously that sensation ends once the medicine wears off, but there is a part that stuck with me. An existential peace. An evaporation of anxious thoughts. An inner acceptance of whatever will be. The little things don't matter as much. No matter what happens I can and will be ok. Even death feels like something that isn't scary anymore. Everything will happen the way that it happens and I can be ok with whatever that turns out to be. I don't just think this, I FEEL this in my bones. All is right with my universe even when all is not exactly right with my universe. Zen is the word that comes to mind, and I was not previously a very Zen person. I was a person who bounces around like a ping pong ball reacting to every surface that I hit.

I still have stressors, I just roll through them with less overwhelm and more clarity.

I am struggling to figure out what I need to work on now that I resolved the reasons I wanted to do this treatment in the first place. I feel healed.

The cool thing is that I am not alone in this shift. It is still very early in the process for us, but some of my KAP clients are saying the same thing. Even though life stress has not really changed, the perception of ones own role in life has shifted, which allows for more acceptance, more clarity, less emotional reactivity and at the end of the day, more ability to roll with challenges. And this is happening after just 2 doses.

So what is the bad?
Cost. This treatment is fairly expensive. It is an investment of time and money. Insurance companies are not covering the actual dosing sessions which can be between $300 - $500 per 3 hour dosing session depending on the provider and protocol. Multiply that by 8 for a full course of treatment plus therapy copays etc. While therapists are advocating hard for insurance companies to cover this they currently are not. It is a big investment for most, and it has no guarantee that it will work. Like any treatment, it does not help everyone and it is quite the investment if it does not work for someone.

With that said, the current research says that it has a much higher efficacy rate than traditional SSRIs and SNRIs that are currently prescribed for reducing anxiety and depression symptoms. Do not take my word for it, do your own research to see the current data, but I believe it is around 65% efficacy rate for SSRIs (like prozac, Zoloft, etc) for folks and 85% efficacy rate for folks taking Ketamine. Thats huge. However, there is currently very limited data on how effective Ketamine is over time as it is so new as a treatment for mental health.

It works really well for 85% of people who have participated, but do the benefits last over time? One thing to point out is that once you stop taking traditional meds for depression and anxiety, your symptoms may return as those medications do not fundamentally change your neuroplasticity. Ketamine can be short term because it actually improves the neuroplasticity in your brain. Its a short term treatment because it isn't necessary to take it long term like other medications to benefit from it. Once you reach maximum neuroplasticity you no longer need the medication. This has been my experience so far, after 2 doses I am not sure why I would need to take any more because I am no longer having symptoms.

So what about addiction? Ketamine is a narcotic. That needs to be considered. We do not want to create a bunch of people addicted to Ketamine. remember the opioid crisis that started with Oxycontin being prescribed as a miracle pain med? I think we need to be very aware that Ketamine should not be prescribed long term or in high doses. The good news is, it doesn't need to be prescribed long term. While science is still figuring out the best course of treatment, once you reach the benefits, you no longer need to keep taking it. For me that was 2 doses. For others it may be up to 8. But after that, if it hasn't helped, it may not be a treatment that is effective for that person. The research is ongoing.

Therapists have also reported that clients with substance abuse concerns have reported a reduction in their substance use after participating in Ketamine treatment. Clients are reporting that they just don't feel the need to use their drug of choice as much or at all. This is also very promising information, but also the research is very new.

So my verdict so far is this:

As a result of my own experiences with Ketamine, I am optimistic that this medication will change our approach to mental healthcare. For me it has been a game changer and worth the investment of time and money. In my opinion the up front cost is probably less than the cost of traditional medication over the years. I personally like the idea of healing myself rather than masking my symptoms with traditional medication for the rest of my life. I would recommend it a thousand times over.

The caveat is this - It is not a miracle cure. It is a big commitment in time, effort and money. I hope insurance gets on board with offsetting the financial burden and I hope that happens soon, because I think this can change people's lives. It is not the right treatment for everyone, and it does not work without doing the work. My own treatment and the effects of treatment for my clients was absolutely contingent on their willingness to work on themselves outside of the medication. Ketamine is the start, you have to take what calm and clarity it gives you and use that to make the changes in your life. It gives you the boost, but you have to use that boost to your advantage to get the full benefit.

If you want to talk more or are thinking about trying your own Ketamine experience and want to chat, you know where to find me.

Happy travels,
April

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03/25/2025

Update on my personal KAP journey:

If you recall I am not only offering Ketamine Assisted Psychotherapy, I am also receiving the therapy myself. I had my second dosing session last Friday. Here is how it went:

I have been working with a new therapist since Jane, my previous therapist had completed KAP. I have been meeting with my new therapist, Camilla, and we have spent several sessions working on some personal triggers that I have as a result of past trauma.

We planned my dosing session for last Friday. I decided that this time I was going to take my full dose, as last time I had taken the lower dose option to see how it felt. Since all went well, I had the option to take the full dose this time.

We spent 30 mins talking about my hopes for the session and the goals I am working on. Then I took the dose. My friend Christine was there to assist incase I needed her, and Camilla monitored me via video.

It was a great experience that lasted about 50 minutes. As the medicine kicked in I felt myself flowing through space and time, each time the music changed the scene changed. I was again well aware of my surroundings but the higher dose allowed me to be more emersed in the scenes in my own mind. The entire experience is hard to explain, but its like I am floating through scenes in the most relaxed state of wonder that I have ever felt. All feels right, time flows by, I am one with everything. I feel amazing. I am disappointed when the experience starts to fade and I am back in my body. I enjoy every moment of it.

It takes about 15 mins for the wobbly feeling to fade away. I have a very mild headache, like I am dehydrated, and I am hungry. Christine and I bs for a bit. We go for a ride to run some errands. I am not allowed to drive for 12 hrs to be safe but I go along for the ride with her. After I drink some water and eat the headache is gone. I spend the rest of the night just chilling and watching some TV. I feel totally normal.

I wake up the next morning and feel fine. I am mildly disappointed that I don't feel the same bounce of extra good mood that I felt after my first dosing session, but I feel good and motivated to do some chores around the house. The next 2 days I don't really feel anything special or different. I don't feel bad, I just feel normal. I start to wonder if I got any benefit from it.

And then something happens. I am intentionally pushing myself to work on my triggers while my brain neuroplasticity is boosted by the Ketamine. I test my reaction to one of my triggers. I have zero anxiety. The trigger has no impact. I am able to feel totally like myself when exposed to the trigger. I not only ride it out, I am able to feel none of the usual anxiety or shame at all. The trigger no longer triggers me. WHAT JUST HAPPENED???? I am amazed. I have fought with this trigger for YEARS and its suddenly no big deal. I test the trigger again the next day and same response. I am good. This particular trigger is no longer an issue for me. I don't know that it will stay this way. I want to keep testing to see if the effects last.

I am not sure I even need to keep going with the KAP treatment. I am not sure I need any more. I feel like I may have healed the final bits I was trying to heal. I may keep going with the last few dosing sessions just to see if there is any additional benefit to be gained, but I feel great. I can do up to 6 more doses before I am done with the full course of treatment.

I will keep you posted in the upcoming weeks as to if the changes stick. I need to do the work to make sure that the changes stick, but the Ketamine sure did make the work easier, and the dosing experience was a pleasant and fun cherry on top. I do think this treatment needs to stay short term due to the addictive nature of this medication. I like this protocol of max of 8 doses.

I will update soon!

02/15/2025

People suck, and I would rather talk to my cat, my pillow, or a blank wall than another s**tty human.

Can you relate???

Let's talk about the suckiest of suckery that people do to mess with you and how to shut it down without landing yourself in jail.

I'm talking about manipulation, the weapon of choice for the suckmeisters of the world. Have you been the target? I have, and I bet you have too. Maybe you didn't even see that you were being beat with a big stick until it was too late, maybe you saw it and couldn't get away, maybe you didn't see it at all. I'm about to change that for you, my fine fellow beatdown takers. You are about to be untouchable.

The bad news is you didn't see it coming and you got played. The good news is once you see it, its realllly hard to unsee it. Like one of those magic optical illusion pictures...once you know you know and you can't unknow after you know, but you don't know until you know, and most people don't know. Well, my friends, grab a snack and let me serve you up a big ole dollop of knowing sauce to dip into.

So what do these masters of illusion do, why do they do it, and why do we fall for it so easily?????

TACTIC 1 - The BULLY
Manipulators love to make you feel small. Why?? Confident people set limits and do not put up with their s**t. If they can bully you into doing what they want, you will do it to avoid the wrath. They will call you names, tell you how awful you are, basically try to cut you down at the kneecaps so that you can't stand up to them. They will hit below the belt because they do not care about your pesky little feelings and they don't care about peace or compromise. They care about getting their way, and if you are in the way they will hit you with the big stick and step right over you and not think twice about it. Oh, and they also believe its all your fault for being in the way.

TACTIC 2 - The VICTIM
The VICTIM loves to guilt you into doing what they want. They pull at your heart strings and make you feel like a s**tty human for not giving in to their demands. "How could you do this to me?!" "If you loved/cared/were a decent human being you would do (fill in the blank) for me!!". Poor me! I am the innocent victim! Its all your fault! Now do what I want!

But this one can be very tricky because not all people who have been victimized are manipulators. So how do you know the difference?? People who are victimized tend to not want to stay a victim because it is actually super PAINFUL. They want more than anything to feel better and they are willing to try things to get there. The manipulator is hell bent on making you the problem and playing the role of victim to control you. Their guilt trips are always followed by some sort of demand, and if you say no, prepare for one of the other tactics to come up almost instantly.

TACTIC 3 - the LOVE BOMBER
This is the most difficult of the tactics to detect because it involves making you feel realllly good. The love bomber finds out what you need the most, makes you feel amazing, and butters you up like a biscuit. You are the most amazing, attractive, important person that ever existed. You are the only person that can do what they need, the only one who matters, the best, the most capable, the most amazing, and they NEEEEEED you and ONLY you. The bomber hits all of your feels.

So how is this different than someone who genuinely sees how awesome you are? Genuine compliments don't include a demand or request. You feel good, the person dishing out the compliment feels good, you move on with your day.

The bomber isn't satisfied with it ending there, they want something more. There is an expectation. The bomber made you feel good and now you owe them something. What that something is will usually become apparent pretty quickly. The bomber's compliments are followed by a demand for your time, energy, attention, or some action they want you to do.

Want to test it out? Thank them for making you feel good then say no to something. Watch how fast the bully or the victim jump up and shove you off the pedestal. It won't take long. They are waiting in the wings for their cue.

Ok, April, I get it, so what now?
If some person in your life tends to spark some bad feeling in you (even if they also spark good feelings) pay attention to it. Are there demands that make you feel uncomfortable? Do your needs matter? Do any of these tactics get thrown at you if you say no to something? Do they make you feel small or bad about yourself if you don't do things their way?

Everybody has bad days and we all have had moments or times in our lives where we may slip into one of these tactics. Even good people do bad things from time to time. The difference is that true toxic manipulators have patterns that show up more often than not and they have no desire to change it. It works for them and they don't really care about how it affects you. So why would they change something that is working for them? They don't tend to veer much from these tactics and they will use them every time they suspect they may not get their way. Their goal is not peace, it is power.

So what do you do about it? Here is the super simple version:
First you have to see it for what it is. Then you have to decide that it is no longer ok with you. The next step is drawing your lines in the sand and backing up from people who stomp right over them. You can't change the manipulator, not because you are not good enough or don't have the skills, but because you cannot change someone who does not want to change. You can only change you.

We all have to say no to things. You are not an unlimited supply of energy and attention. You have needs and limits. Your job is to decide what your lines in the sand are and deliver them in a respectful way. It is not your job to make people agree with you. It is not your job to make them like it. That is up to them to sort out how to cope with someone else's "no". Healthy people can accept that they do not always get their own way, even if they don't always like it.

This stuff can be hard because most of you have big hearts and you care. And at the end of the day manipulators are just people who are choosing a s**tty way to get what they need. But that does not mean they get to give you a beat down when they need something. Sometimes you have to care about people from a distance if they are swinging a big stick around, because you are going to take a hit if you get too close. And sometimes you just have to walk away from them.

Have you ever dealt with a manipulator? what did you do about it? Or maybe you see some of these patterns popping up in yourself and want to change it.

As always, if you need me you know where to find me.

Stay real out there,

April

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