Welcome to Skylight

The Client Handbook

  • Welcome to Skylight and congratulations on taking such a brave and important step on your healing journey! We are so glad to have you here and we put together this informational packet for you to have as a comprehensive resource. 

    Please note, we believe in communication and connection, and we are here  for you. If you have questions just reach out! 

    Skylight Email: human@skylightpsychedelics.com

    A little bit about us...

    Skylight was founded by board certified physicians passionate about affordable mental health, human connection, and hands on treatment, especially when it comes to psychedelics. If you are looking for more information, our complete bios can be found on our 'Team' page.

  • If you have any questions about the medication, shipping, delivery, etc…our partner pharmacies are available to answer them.  

    - If you live in any of the following states:  

    - AZ, CO, DE, FL, GA, IL, IN, ME, MD, MA, MO, NJ, NY, PA, DC, WI, VT please contact: The Art of Medicine Pharmacy at (215) 238-9055 

    - For all other states except CA:  

    - please contact: Clearspring Pharmacy at (303) 707-1500 

    -CA please contact Koshland Compounding Pharmacy 

    (415) 344-0600

    Shipping:  

    All shipping charges will be incurred by the client. Please communicate directly with the pharmacy if you need expedited shipping.

    Please Note: 

    Once the pharmacy receives your prescription, they will reach out to you directly in order to confirm shipping details. The pharmacy WILL NOT ship any medication to you unless they confirm your shipping address over the phone.

  • Ketamine is a dissociative anesthetic that has been used since the 1970’s in  many different ways. Due to its excellent safety profile and the fact that it  does not suppress breathing, ketamine was used in war times as an  anesthetic to help with trauma on the battlefield. It is used extensively in  emergency rooms, and it also has a role in veterinary medicine. Ketamine is  most often used in hospital settings by anesthesiologists during major and  minor surgical procedures as an anesthetic. Over the past decade, lower  dose (subanesthetic) ketamine has shown great promise in the treatment of  mental health conditions, most notably depression and suicidality. 

    Ketamine is one of the safest and most widely used anesthetics in the world  according to the World Health Organization. Researchers at Yale have been  studying low-dose ketamine since 2000 in controlled clinical settings for  patients with severe depression who are unresponsive to other  antidepressants. In several studies, more than half show a significant  decrease in depression symptoms in 24 hours and approximately 4 out of 5  went on to find significant improvement. 

    Ketamine is now used extensively for many chronic mental health conditions  such as depression, suicidality, anxiety, anxious bipolar depression (without  mania), post-traumatic stress disorder (PTSD), obsessive compulsive  disorder (OCD), existential distress, and more. In addition to the indications  above we use ketamine to manage the fallout of trauma, so you don’t have  to have a mental health condition to warrant treatment. Many clinicians,  including us at Skylight Psychedelics, classify ketamine as a psychedelic,  which means mind manifesting, however it is not a classic hallucinogen like  psilocybin, a compound found in psychedelic mushrooms, which also has  many promising mental health benefits. 

    Is Ketamine FDA Approved? 

    Ketamine hydrochloride, trade name Ketalar, is a Schedule III controlled  medicine that is FDA approved for general anesthesia in intravenous or  intramuscular formulations. Ketamine is a racemic mixture, made up of two  molecules that are mirror images of one another, R-ketamine and S ketamine. Ketamine does not have FDA approval for any psychiatric illness. 

    S-ketamine, derived from ketamine, called esketamine, trade name  Spravato, was approved in 2019 in nasal spray form, for treatment resistant  depression in adults with major depressive disorder with acute suicidal  ideation or behavior, in conjunction with an oral antidepressant. 

    Most ketamine being used for mental health conditions is being used legally  by healthcare professionals off-label. Sublingual ketamine used by Skylight  Psychedelics is off-label, which is legal and very safe. 

  • Ketamine is used to treat many illnesses. Notably the following: 

    Depression 

    Suicidality (Skylight Psychedelics refers all suicidal clients for IV or IM  ketamine in conjunction with therapy) 

    PTSD 

    Anxiety

    OCD 

    Substance abuse co-occurring with a primary psychiatric disorder  Addictions outside of substances 

    Relationship and existential issues such as existential distress

    Bipolar I and II depressive phases (not mania) 

    Psychological reactions to physical illness and life-threatening illnesses substance 

    Chronic pain (often requires higher doses of ketamine in a medically supervised settings such as a clinics or hospitals)

    Note: There are other indications for ketamine that are not included on this list. 

    Evidence Supporting the Use of Ketamine for Mental Health Conditions

    There are many studies supporting the use of ketamine for mental health conditions. See the following articles for more detailed information. 

    1. Huang YJ et al. New Treatment Strategies of Depression: Based on  Mechanisms Related to Neuroplasticity. Neural Plast. 2017; 2017:4605971.

    2. Hamilton et al. Depressive Rumination, the Default-Mode Network, and  the Dark Matter of Clinical Neuroscience. Biological Psychiatry. 2015 Aug  15;78(4):224-30. 

    3. Andrade, C. Ketamine for Depression, Clinical Summary of Issues  Related to Efficacy, Adverse Effects, and Mechanism of Action. J Clinical  Psychiatry 2017 Apr;78(4):e415-e419. 

    4. Gaynes BN et al. What Did STAR*D Teach Us? Results From a Large Scale, Practical, Clinical Trial for Patients With Depression. Published online  Nov 2009. https://doi.org/10.1176/ps.2009.60.11.1439.  

    5. Zarate CA, et al. A randomized trial of an N-methyl-D-aspartate  antagonist in treatment-resistant major depression.Arch Gen Psychiatry.  2006 Aug;63(8):856-64. 

    6. Aan Het Rot M et al. Ketamine for depression: where do we go from  here? Biol. Psychiatry. 2012 Oct 1;72(7):537-47. 

    7. DiazGranados N et al. Rapid resolution of suicidal ideation after a  single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major  depressive disorder. 

    J. Clin. Psychiatry. 2010 Dec;71(12):1605-11. 

    8. https://www.nimh.nih.gov/about/directors/thomas insel/blog/2014/ketamine.shtml

    9. Jennifer Dore et al. Ketamine Assisted Psychotherapy (KAP): Patient  Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy, Journal of Psychoactive Drugs,  51:2, 189-198, DOI: 10.1080/02791072.2019.1587556. 

  • The exact mechanism by which ketamine functions as an antidepressant  remains largely unknown. So far, the medical community has learned that  ketamine has an affinity for multiple receptors and it likely affects several  different types of receptors in the brain, including: 

    N-methyl-D-aspartate (NMDA) receptor, which binds glutamate, the primary  excitatory neurotransmitter in the brain as well as Alpha-amino-3-hydroxy 5-methyl-4-isoxazole propionic acid (AMPA) receptor, which is also involved  in glutamate neurotransmission. Ketamine’s antidepressant effects may be  due to activation of the AMPA receptor by the ketamine metabolite. 

    It has been demonstrated that people who suffer from chronic depression  and anxiety experience atrophy of neuronal connections in the frontal part of the brain. Ketamine enhances neuroplasticity, the brain cell’s ability to form new connections with one another via expression of brain-derived neurotrophic factor. Not only has ketamine demonstrated the ability to repair neurons that were atrophied from chronic depression, but it also promotes the growth of new neuronal connections! 

    Furthermore, animal studies have suggested that neuronal vascular endothelial growth factor signaling in the prefrontal cortex region of the brain mediates the rapid antidepressant actions of ketamine. It is also referred to as a “psychoplastogen” which refers to small molecule neurotherapeutics that induce swift changes in plasticity following a single administration. These changes are thought to promote lasting changes in behavior patterns. Ketamine also activates at the level of the anterior cingulate cortex and by increasing connectivity between the insula and default mode network. We believe one of ketamine’s main roles in healing is promoting connection with your inner healing intelligence, or inner healer, as well as disrupting thought loops. 

    Note: It remains unclear if the effect ketamine has on the opioid receptors plays a role in its antidepressant effects. Ketamine’s effect on these receptors demonstrates how this medicine also functions as an analgesic (pain medicine) for those with chronic pain. 

    Ketamine Doesn’t Help Everyone 

    A small percentage of clients will not respond to ketamine, even at higher  doses. Additionally, some clients with rigid personality structures, including  those with severe OCD or personality disorders and possibly those with  profound PTSD, won’t be able to go into a trance-like state on the medicine  and may find it challenging to maintain the benefits of the treatment  experience, if they find any relief with the experience at all. We don’t yet  know enough about who won’t benefit and recommend attempting this  treatment if no contraindications exist, as the medicine is incredibly safe and  well-tolerated. There is data to support that the elderly may respond less  well to ketamine treatment.  

  • There are medical and psychiatric conditions that render people unable to receive ketamine therapy. These include: 

    Untreated hyperthyroidism (overactive thyroid)  

    Untreated hypertension (high blood pressure)  

    Epilepsy (seizure disorder) 

    Aneurysm or dissection (serious problems with the blood vessels)

    Heart disease, including heart failure, heart valve disease, heart attacks or abnormal heart rhythm) 

    Severe breathing problems 

    Kidney disease  

    Advanced liver disease 

    Interstitial cystitis (bladder wall inflammation)  

    Glaucoma (elevated pressure inside the eye)  

    Active illicit substance abuse 

    Pregnancy (exceptions may apply) 

    Note: All of these conditions will be evaluated by our medical team and  there may be other conditions not on this list 

    Psychiatric Contraindications 

    Schizophrenia

    Psychosis

    Acute Mania 

    As an added safety measure, we recommend our clients reach out to their primary care physician to ensure they do not have any contraindications to treatment. Additionally, if you have a psychiatrist, we recommend you  contact her/him/them to ensure you have no contraindications to treatment  and to let them know you are seeking ketamine therapy. 


  • Ketamine Administration Setting

    Ketamine has traditionally been given in a hospital setting or doctor’s office.  Ketamine clinics are surfacing all over the United States. Many clinics offer  ketamine to clients left alone in a treatment room. More recently ketamine  has been provided in home via at home ketamine kits. This can be traumatic  for some clients, and many prefer being supported while in a non-ordinary  state of consciousness. There are ketamine-assisted therapy clinics that  provide support to clients while in non-ordinary states of consciousness, but  practices like these are hard to find, are expensive and often not covered by  insurance. 

    Route of Administration (formulation) 

    The optimal method of administering ketamine for depression and other  forms of mental health issues has not been fully established and protocols  are therefore lacking. Although most studies have given ketamine  intravenously, it can also be administered via many routes, including:  intramuscular (IM), intranasal (in the nose), oral (P.O.), subcutaneous (SQ,  under the skin), and sublingual (SL, under the tongue), and is also available  in rectal (PR) formulations. 

    The route of administration can have several impacts on the client. Notably,  comfort, convenience, as well as bioavailability (see below), serum  concentrations, and duration of the medicine’s effect. Minimal evidence  exists comparing different routes of administration. 

    Bioavailability refers to the proportion of a medicine that enters the  circulation when introduced into the body. 

    Sublingual and Intranasal Ketamine and Skylight Psychedelics  Protocol 

    Skylight Psychedelics uses specialized sublingual and intranasal formulations  of ketamine with an onset typically in 5 - 30 mins. Rarely the medicine can  have a delayed onset, even several hours. Our protocol was formulated by a  multidisciplinary team of physicians who are board certified in internal  medicine, anesthesia, and psychiatry in conjunction with doctors of  pharmacy. Our protocol was developed with client safety and the medicine’s efficacy as top priorities. We provide our clients with client specific dosing based on many factors including level of anxiety about non-ordinary states of consciousness, prior psychedelic experience, suicidal thinking or addiction and more.  

    We chose to work with sublingual and intranasal ketamine as they are safe, and reliably promote communication between client and therapist while the client is in a trance-like state. They also allow people to tap into difficult  states of mind with decreased fear. Further, they afford clients the ability to  integrate healing after the acute phase of medicine starts to wear off. Our  team at Skylight Psychedelics believes that the trance-like state is an ideal  state of mind to allow the client to tap into previously locked away thoughts  and feelings. We find that most often the peak experience on the medicine  lasts approximately 15-60 mins and the medicine becomes much less  intense after this initial wave. 

    What Should the Client Expect to Experience in the Ketamine Session  with Sublingual or Intranasal Ketamine? 

    Many people in a trance-like state from sublingual ketamine often report  positive feelings. This has been described as euphoria, empathy,  forgiveness, calmness, total relaxation and reduced “mind chatter”. 

    Some clients more often report dissociative effects and can experience the feeling of falling, flying, feeling out of their body, they can  relive a past events, they can feel paralyzed, they often cry, laugh, smile,  breathe very deeply and quickly, moan, and rarely, some can kick and  scream, but this is rare. 

    Each ketamine session is completely different from the one prior, and also  differs significantly from client to client. There is no way to predict what a  session will be like for someone. 

    Experiences with ketamine can often lead to any one of the following  and more:  

    Feelings of gratefulness, calmness, acceptance, connection Feeling of flying Feeling of falling Seeing God 

    Feeling out of body - looking down on oneself  

    Feeling of being reborn 

    Re-experiencing past events, including traumas 

    Ego dissolution/Ego loss - a complete loss of one’s sense of self or self identity (less likely to occur with sublingual ketamine) 

    Falling asleep 

    Feeling of paralysis is a rare occurrence, but possible. 

    What are the Effects of Long-Term Ketamine Use? 

    Ketamine-induced cystitis, a bladder pain syndrome due to chronic ketamine  use is associated with ulceration of the bladder lining and chronic  inflammation. This condition is typically found in people who abuse street  ketamine. Studies have demonstrated that certain concentrations of  ketamine were toxic to the cells of the bladder wall, causing damage to the  urinary barrier. 

    Further there is data to suggest that some factor in urine (rather than  something affecting the whole body) is responsible for the ulceration–most  likely ketamine itself or its metabolites.  

    Symptoms include pelvic pain, frequent urination, urgency, hematuria (blood  in urine), nocturia (frequent urination during the night) and urinary incontinence. This condition is often reversible once the medicine is stopped.  For clients who develop this condition complete ketamine cessation is  recommended but will be discussed in consultation with a urologist. This  condition is exceedingly rare. If you develop this condition please contact  Skylight Psychedelics.  

    Ketamine tolerance can also develop. Concerns arise over addiction but  when used at low doses and with infrequent dosing models, as used in  mental health, this is less likely to occur. 

    Neurotoxicity has been identified in ketamine abusers and rodents impacting  brain structure and function and reports of liver toxicity have also been  found in the literature. 

    How Long Will the Benefits of Ketamine Last? 

    The duration of benefits is variable and depends a lot on why the client  sought out ketamine to begin with. Many clients will return for further  courses of treatment, especially those with long standing depression, who  have previously failed multiple medications. If you feel like your symptoms  are returning and you would like to be evaluated for another course of  treatment, please email us at human@skylightpsychedelics.com. Please  remember, more medicine is not always the answer.  

    What is the Role of Adjunctive Psychotherapy When Using Ketamine  for Mental Health Conditions? 

    Ketamine is routinely given in sterile clinical settings for various mental  health indications. Oftentimes, there is no therapy provided with this service  and clients are left trying to make sense of the experience and to navigate  challenging experiences on their own. The lack of therapy short-changes  people seeking ketamine treatment as they are less likely to be able to  integrate the experience into their everyday life. 

    In 2015, Stephen Hyde published a paper titled, “Ketamine for Depression”,  demonstrating ketamine’s ability to be used successfully via routes other  than IV and IM, promoting easier use outside of a clinical setting.  Incorporating psychotherapy into ketamine treatment sessions was first  described by Wolfson and Hartelius in 2016. By the mid-2000s many clinicians were using ketamine in conjunction with therapy. It has become increasingly more apparent that prescribers aren’t required at the bedside, but someone should be there to hold space for clients on ketamine and that’s your trusted therapist. Many ketamine companies make clients use their own therapists. Skylight knows that most people seeking this therapy have an established relationship with a therapist, and we don’t want you to have to find a new therapist and start over. This is why we have developed our model that trains your therapist to provide this modality of treatment. 

    How are Ketamine Sessions Scheduled? 

    When used for mental health, ketamine is typically given 6-12 times over a  2-12 week period. When this schedule isn’t possible we ask clients to do the  best they can. Clients may reach out to Skylight Psychedelics for further  ketamine treatment courses, if they had further trauma or other setbacks. We do not have patients on a standing autopilot schedule without checking  in with them first to ensure they need further treatment after the initial  course of medicine. This is a very client specific medicine and the need for  further courses of treatment should be determined on a case-by-case basis  by our prescribing medical providers, with input from the client and their  therapist. 

    Telehealth Visit with Our Healthcare Providers 

    One of our prescribers will meet with you via telehealth to review your medical intake form and answer any questions you may have about the process. Please make sure you have watched our 'Client Video' below prior to this call.

    Managing Expectations

    Ketamine does not work for everyone, and sometimes, although very rarely, clients can get worse before they feel better. Infrequently, a client can  become worse after treatment including new or worsening suicidality. If this  occurs, we recommend you discuss these feelings with your therapist and  activate any safety plan that you have. Each medicine session will be  different and there is no way to predict what will come up for people. We  recommend clients come in with an open heart and open mind. Please  understand that the initial doses of medicine are low. We do not blast people  out to the moon, certainly not on the first dose. Our sublingual doses  increase as you move through the protocol and some doses will be duplicate  (in the 10+ dose course of treatment).  

    Scheduling Medicine Sessions 

    It is the responsibility of the client and the therapist to schedule all  treatment and integration sessions. Scheduling of the first session should take place once you receive the medicine. 

    What to Wear to a Ketamine Session 

    Clients should wear loose fitting comfortable clothing. Scarves should be  removed. Apple watches and phones should be silenced. We want you to  have an uninterrupted experience. 

    Eating and Drinking Before Sessions 

    We prefer to err on the side of caution and recommend avoiding eating and  drinking 3-4 hours prior to taking the medicine. This will likely limit the  amount of food in your stomach and minimize the likelihood of vomiting and  decrease the risk of any complications. Diabetic patients may have some  exceptions. This will be determined during intake. 

    Bathroom Use Before Sessions 

    Clients should always use the restroom immediately prior to the medication  session to avoid having to ambulate in a non-ordinary state of  consciousness. 

    Intention Setting

    Skylight Psychedelics has a specialized framework that provides suggested  intentions for their ketamine sessions that directly correlate with our  psychedelic yoga integration offerings. We don’t force you to have an  intention; if it isn't resonating with you that’s ok. If you prefer to choose  your own intention, we recommend the intention be broad. Examples are:  “Be open” and “go with the flow.” 

    Skylight Intentions: 

    Session 1- Show Me How to Trust  

    Session 2- Be Open 

    Session 3- Unity and Connection  

    Session 4- Forgiveness 

    Session 5- Acceptance  

    Session 6- Heal My Heart 

    Sessions 7-10 Go Deeper  

    Nausea/Vomiting 

    Rarely, a client can feel nauseous or vomit. Your therapist will be prepared  for this rare complication by having a bucket, emesis basin, or trash can  nearby. Because this is a rare phenomenon we do not routinely pretreat with  anti-emetics (anti-nausea medicines). If you experience nausea, we can  prescribe an antiemetic to be used prior to the remaining sessions. This can  be called into your local pharmacy after you discuss this with your  prescriber. We do not believe in giving people medicine they may not need.  Of note, many in the psychedelic community, including us at Skylight  Psychedelics, encourage the client to sit with the nausea should it come up.  This can be considered a part of the journey, it will pass, and it is not  something we need to immediately extinguish, unless it renders the client  unable to complete the treatment.  

    Preparing Calming and Grounding Techniques 

    Prior to the medicine session, think of images that will bring you a sense of  calmness when described by your therapist and discuss these with your  therapist prior to the journey. This image can be a person (alive or deceased), pet, place, spirit animal or guide, etc. When reminded of these  images it can bring peace when in a time of severe distress, should that ever  occur. If you have a mantra, bring this into the session and repeat it when  needed to ground and calm yourself. An example of a Skylight mantra is: “I  am love, I am light”. 

    Another helpful tool that can be used is to identify the parts of you that may  get in the way of your journey. Politely, ask these parts to sit on an  imaginary bench or in a peace corner while you explore your non-ordinary  state. These parts may be fearful, controlling, anxious and so forth. You may  be pleasantly surprised how well they listen. Be sure to thank them.  

    Set and Setting 

    Set refers to the client's mindset and setting refers to the environment  provided by the therapist. Music is an integral part of the setting and can  make or break a journey for some clients. 

    Carefully curated music playlists are provided by Skylight Psychedelics and  are strongly encouraged. These can be found on Spotify, labeled Skylight  Psychedelics 1, 2, and so forth. We do not recommend using music that is  familiar to you. We are trying to foster new connections. The music on our  playlists is selected to coincide with our intention framework and is inspired  by our prescribers own psychedelic healing journeys. Additionally, our music  playlists are also reintroduced to our clients in virtual psychedelic yoga  integration experience to further imprint the experience. 

    MUSIC: The Skylight Psychedelics Spotify Playlists 

    A specific playlist was created to accompany ten ketamine  sessions. Playlists can be found by searching Skylight Psychedelics on  Spotify. 

    Blood Pressure Monitoring 

    This is a responsibility of the client and NOT the therapist. Clients will take  their own blood pressure with a blood pressure cuff they purchase on their  own, unless the therapist has a cuff for you to use. We recommend digital  upper arm cuffs and not wrist cuffs due to a concern regarding accuracy with the latter. Blood pressure cuffs can be found at pharmacies and online on  Amazon. They range in price, however many are in the $20-$40 range. It is important to take your blood pressure before and after ketamine  treatment. Prior to the ketamine session if the blood pressure is 150/90 or  above you should remember to relax, meditate and find your breath. After  5-15 mins of relaxing the blood pressure can be repeated. If it continues to  be elevated above 150/90 after 15-20 mins of relaxing, we recommend not  proceeding with the medicine and contacting your primary care doctor for  blood pressure optimization. Ketamine can increase the blood pressure and  that is why this is required. 

    Besides breathing and meditating other ways to quiet the mind include:  Listening to calming music, smelling essential oils, guided deep breathing  exercises which your therapist may be able to help you with. Once the blood pressure is less than 150/90 we recommend you lie down on  a bed, couch or yoga mat provided by your therapist, with a blanket and  pillow. This is the time to take the medicine. We expect the blood pressure  to be elevated after the journey.  

    We recommend taking your blood pressure after the journey. If your blood  pressure is over 180/120 and you have a headache, are confused, have  chest pain, shortness of breath, nausea/vomiting or vision changes we recommend seeking emergency medical attention. Should this occur please also call Skylight once stabilized. 

    Taking the Medicine 

    The sublingual formulation of the medicine should be placed under the  tongue, and it will quickly dissolve. Do not spit. It will take effect typically  within 10-30 minutes. You do not need to hold or swish the medicine in your  mouth for any particular period of time. Swallow as needed once dissolved.  The intranasal formulation will be 5 sprays in each nostril per session. You  can also boost yourself in the session. Your prescriber will discuss boosting  during your appointment. 

    Eye Mask

    We recommend clients wear a black out eye mask during psychedelic journeys. The purpose of the eye mask is to promote an internal experience.  Put the eye mask on immediately after taking the medicine. We recommend using the masks designed by psychonaut and artist Alex Grey, called  MindFold. These can be found on Amazon. Ideally the eye mask is worn for the entire time the medicine is working, approximately 40-60 mins. When the hour-long playlist is over, we suggest taking off the mask. You will know when the journey is coming to an end when the instrumental version of the song “Where is My Mind'' by Matt White plays., if you’re using Skylight’s playlists. 

    Note: Some clients will not want to wear an eye mask, this is ok, but we recommend closing the eyes for the session to promote an internal experience. 

    Safe Ride Home and Other Precautions 

    Clients must have a safe ride home following ketamine sessions and should  not drive for the remainder of the day. It is not the responsibility of the  therapist to confirm the client has a ride home. Please avoid rideshares  (Uber and Lyft, etc). Please also avoid public transportation. It is also  important to avoid swimming, bathing and being the sole childcare provider  to small children on days of ketamine sessions. Very rarely the medicine can  reactivate after you have left the therapist’s office. This is the reason why  we ask you to take all precautions.  

    Ketamine in the Time of COVID 

    We do not support the use of masks for clients in non-ordinary states of  consciousness. If there is a mask mandate, the therapist should wear a  mask and not the client. 

    Journey Space Rules 

    Clients must adhere to the journey space rules provided by Skylight  Psychedelics. These rules are to keep clients safe. Please read the following very carefully.

    1. The client will remain free from illicit drugs and alcohol both during the course of ketamine treatment (to the best of their ability) and will not come to the appointment acutely intoxicated or under the influence of illegal substances.  

    2. The client will call 911 and activate their individual safety plan with  any plans to hurt themselves or others before or after the session. 3. The client will check and record their blood pressure before and after  sessions and will not take the medicine if their blood pressure is 150/90 or  above. 

    4. The client will avoid food and drink for 3-4 hours prior to the medicine  session. 

    5. The client will not hurt themselves or the therapist during the session. 6. The client will not damage any property in the therapist's space during  the session. 

    7. The client will not leave the office unless it is safe to do so as deemed  by the therapist and it has been an hour since the medicine has worn off,  typically 2 hours since the medicine was taken. 

    8. The client understands there will be no sexual touch whatsoever and  there will only be appropriate touch with the permission of the client. 9. The client will not drive home following the treatment session or later  that same day, take a ride share, or public transportation, nor will they  bathe, swim or be the sole provider of childcare to small children. 10. The client will come to all integration appointments with their therapist  to the best of their ability. 

    The therapist will agree to the following: 

    1. The therapist confirms there will be no sexual touch and agrees to  discuss this with the client at the beginning of each ketamine session. 2. The therapist confirms that any bodywork done during the session has  been discussed thoroughly prior to the session and the therapist will never  touch the client during a medicine session without the permission of the  client and never inappropriately. Only therapists who are licensed to provide  physical contact (massage therapy, somatic therapy, craniosacral, OT, etc…)  should practice that modality if agreed upon with the client prior. 3. The therapist agrees that he/she will call 911 in the event of a medical  emergency and will contact Skylight Psychedelics to report any  complications.

    4. The therapist agrees that if there is a formal complaint filed against them from a client of Skylight Psychedelics that Skylight Psychedelics will be notified within 24 hours of the filing.  

    5. The therapist agrees to never leave a client alone while on ketamine.

    Therapist Preparation Visit 

    Prior to the medicine session it is important to schedule at least one visit to  sit with your therapist to discuss the upcoming treatment session. During  this visit it is important to discuss your answers to the following questions: 

    1. What was your past experience with psychedelics, if any?

    2. Have you taken ketamine before and if so, what was your experience?

    3. What is important for your therapist to know about what you would  like to work on in these ketamine sessions? 

    4. Why are you coming to the medicine?  

    5. What are you looking to gain from this medicine experience?  

    Reminder: If you have any questions about the medicine itself you can  always reach out to us or our partner pharmacy. 

    The Day of the Treatment Session 

    Once you arrive at your therapist’s office, you can proceed with treatment  after checking off all the boxes on the checklist provided in the Skylight  Psychedelics Flight Instructions. Make sure you have a blood pressure cuff  and an eye mask for the journey unless your therapist has this on site. If  you are feeling anxious or nervous, sit and relax, meditate or do some  gentle yoga stretching to calming music, if possible. If you have an  intention, consider sharing it with your therapist. 

    What Should You Expect During Treatment? 

    The effects of the medication typically appear a few minutes after you put  the tablet into your mouth or spray the intranasal ketamine. Peak effects  can last up to 60 minutes. Clients will typically lay still in a moderately  dissociated (trance-like) state. Some clients laugh, cry, mumble, moan, make loud noises, or move their bodies in unusual ways sometimes that may look like punching and kicking. Some people experience fatigue, nausea, dizziness, lightheadedness, drowsiness, or headaches. Side effects, such as sedation or feeling “out of it”, can extend another 60-90 minutes after peak effects wear off, sometimes longer.  

    Goals of Psychedelic Therapy Sessions 

    Connection with Self, your inner healer or inner knowing or inner healing  intelligence. Connection with the universe. Connection with the deeper  meaning of life and life's purpose. See things through a different lens, from a  different perspective. Be an observer. We like to think of psychedelic  experiences as scuba dives into deep waters where we gear up, entering  only when prepared, with trust in the preparation and process, trust in the  medicine, and trust in the healing container created by your therapist. Once  we dive in, we search around and explore and avoid trying to make sense of  the experience while in it, and when we resurface, we have a trove to  unpack. We unpack this during integration sessions. 

    Inner Healing Intelligence 

    It is essential for clients to work towards trusting and connecting with their  inner healing intelligence, which is a person’s innate capacity to heal wounds  from traumatic experiences. It’s important to be aware that each person has  the potential to heal via contact with their inner healing intelligence. The  ketamine and the therapist are likely to facilitate access to a deep healing  process, but they are not the source of this healing process, the client is.  The body knows how to heal itself but oftentimes needs help. 

    The Role of Your Therapist 

    Your therapist’s role is to be a source of support and comfort. They will hold  space for you throughout your journey with an empathic presence and will  likely not be very talkative. It is your journey and your time. They will  encourage you to get in touch with your inner healing intelligence and  encourage you to allow the music to guide you.  

    Therapists will remind you that you are safe, and they are instructed to  never leave you alone while you are on the medicine. If and when you face a  challenging experience, they are trained to encourage you to go toward it  and be curious instead of running away... because the only way out is through. This is the time to explore your subconscious. You are safe.  Therapists may invite you at times to find your breath. They may offer to  burn sage or palo santo (sacred plant medicines) to move the energy around  you. 

    If you don’t like a particular song they are playing, we have trained your  therapist to encourage you to explore what’s bothering you about the song  and see if you can stay with it. They will remind you that all parts of you are  welcome in the journey space and you should feel free to get in touch with  any of your parts that come up.Your challenging experiences are welcome.  We believe that with appropriate therapeutic support these experiences  often lead to a deepening of the healing experience and can foster successful  integration. 

    Remember: “Bad trips” are unlikely to occur in supported spaces where you  are safe. Difficult experiences can occur, and these are areas for potential  growth and deep insight. 

    Emergency Situations 

    911 should be called by your therapist if any of the following unlikely events  were to occur: 

    - Lack of breathing 

    - Lack of a detectable pulse 

    - Severe headache 

    - Unresponsiveness following the cessation of a session 

    - Active suicidal or homicidal intent, such as threats of imminent  violence to oneself or another person. 

    - Acute behavioral disturbance which if untreated may lead to harm,  either to the individual or to others in the environment. 

    Therapeutic Touch in Altered States of Consciousness 

    Therapeutic touch can be very beneficial to clients when in non-ordinary  states of consciousness, however it is critical that your therapist goes over  the rules around appropriate touch prior to any medicine session. There will  be NO sexual touch whatsoever. Clients should not be touched unless they  have consented to touch and are asking to be appropriately touched in the  session. We also recommend appropriate touch only, a hand on the shoulder, hand holding, a head on the head. If your therapist is specifically  trained in somatic work, it is important to discuss what type of touch will be  performed during the session prior to taking the medicine. 

    When is the Journey Over? 

    The journey is over when the music ends and the song “Where is My Mind”,  Instrumental Version by Matt White, is played if you are using the Skylight  Psychedelics Spotify Playlists. This is to signify to the client and therapist  that the session is coming to an end. The client can then remove their eye  mask. Some people are ready to get up and ambulate and some want to lie  down a little longer, even with the mask on. Rarely, ketamine can stick  around longer than expected. This should be noted by your therapist and  appropriate time should be allotted for the next session. The client should  check their blood pressure at the end of the session and record this in a  journal. Ketamine can raise and lower the blood pressure (typically raise). 

    What Can Clients Expect to Feel After the Session? 

    Some clients may experience blurred vision immediately following the  session, this resolves quickly. Some people may experience headaches.  People can feel vulnerable following a ketamine session and should surround  themselves with people who are supportive and loving, ideally not someone  who may trigger them. Following psychedelic sessions, you may feel very  compelled to make a life altering decision. We recommend clients sit with  these feelings and not make any “big decisions” for at least 30 days from the  medicine experience and after extensive discussions with your therapist. 

    What Should Clients Do Following a Ketamine Treatment Session? 

    After the session clients are encouraged to go home, spend time listening to  gentle music (ideally the music from the session) and journal about the  experience. If a client has a therapy session immediately following the  ketamine session, then they can also write things down during this time. Art  therapy can also be very useful following a journey. Clients are encouraged  to either be alone or be with people who love and support them. We  recommend immersion in nature following every session and the more the  better. Mother Nature is free and our greatest teacher. 

    Rarely, a person can have increased thoughts of harming themself or others following ketamine. Typically, the opposite occurs. If you have thoughts of suicide or homicide, please notify your therapist immediately, activate your care plan should you have one and call 911.  

    Many clients report feeling better shortly after the session. Some clients may  have experiences during a medicine journey that leave them confused and  difficult to describe, otherwise known as ineffable. Don’t feel pressured to  make sense of the journey immediately. Things will soon come together  especially during integration sessions. Integration sessions can follow the  medicine session immediately or days later. We suggest integration sessions  be scheduled either immediately after the medicine session or within two  days when possible. Skylight Psychedelics clients are also encouraged to do  the virtual psychedelic integration yoga for further integration. Please also  consider joining our group integration Zoom call with other clients  using ketamine for healing, led by one of our Skylight therapists.  

    Group Integration Zoom Link: https://us02web.zoom.us/j/82622818852Skylight Psychedelics Integration Yoga Framework 

    The founders of Skylight Psychedelics are yogis and understand the power of  yoga and its inherent psychedelic nature. We have developed the first of its  kind psychedelic integration yoga series and are excited to share this with  our clients. With the help of spiritual yogi guide Jackie Smith, we have  created six sessions to follow each of your ketamine journeys and the same  music will be played from your medicine session. The intentions are also  brought into this sacred healing space. Following the six hours of yoga we  have also put together a two-hour experience that incorporates both yoga  and meditation that we know you’re going to love. The music chosen for this  extended session is heavily influenced by Ayahuasca journeys experienced  by one of our prescribing physicians. 

    More of Jackie Smith’s Yoga Classes can be found here:  

    https://www.livekick.com/en/c/jaquelynsmith

    Client Progress Tracking

    We recommend your therapist track your response to treatment with the PHQ9 and DASS21 scoring. Ideally this is done before the first session and the day after each session. If they don’t mention it, please remember to ask! 

    Psychedelics and The Inner Healing Intelligence 

    Ketamine, like other medicines, including MDMA, psilocybin, mescaline, DMT,  LSD, ayahuasca and ibogaine, provides clients with access to their own inner  healing intelligence, inner knowing or inner healer. This “knowing” is based  on the belief we all have an intrinsic wisdom honed by our life experiences.  While we are all born with an inner healer, many of us have difficulties  accessing this innate tool. Psychedelics can be the key to unlocking this  healer and ketamine is no exception. We believe that our client’s inner  healers should set the pace for psychedelic sessions. 

    The Default Mode Network 

    The default mode network (DMN), is a group of regions of the brain that  connect to one another. These regions of the central nervous system are  associated with functions such as self-reflection, self-criticism, and internally  directed thought. The DMN is considered critical to our consciousness on a  daily basis. When a person is resting and not distracted the DMN is most  active. These connections comprising the DMN develop in childhood, around  the time of ego development, and continue to develop into adulthood. As we  develop into adults, we develop patterns of behavior and communications  between brain regions, including those of the DMN. Communication between  regions of the DMN becomes rigid and our brains' communication pathways  become more restricted as we age.  

    These restricted pathways develop into our default mode of operating in the  world and in turn our survival. The activity of the DMN has been studied with  functional MRI imaging modalities. In certain mental health conditions, such  as depression, anxiety, and OCD, the DMN has been found to be overactive.  Some experts have equated the overactive DMN with rigid thought patterns  and negative thought loops. 

    Psychedelics Dissolution of the Default Mode Network

    When people ingest a psychedelic medicine the DMN’s activity decreases significantly. At the same time connectivity in the rest of the brain outside of the DMN increases. This finding has been demonstrated in brain imaging studies. When the activity of the DMN decreases the sense of self seems to shut down and self-criticism and negative thought loops may decrease.  Studies have demonstrated similarities to deep meditative states. In these states increased activity occurs in pathways that typically don’t communicate. After these new pathways are formed it appears that the DMN becomes more connected. It has been suggested that this may be one of the explanations for reduced depression and anxiety following psychedelic journeys. Since psychedelics can alter the DMN, by turning it off, they have the potential to greatly impact negative thought patterns and increase psychological flexibility. 

    Psycholytic vs. Psychedelic Experiences 

    Psycholytic therapeutic experiences are ones in which the client is in a  trance-like state but is able to maintain dialogue and effectively  communicate. These are typically achieved with lower doses of psychedelics,  including ketamine. This is typically achieved with either sublingual or  intranasal routes. The goal of a psycholytic medicine experience is not ego  dissolution or self-transcendence as in a psychedelic therapeutic session.  The goal in the psycholytic session is for clients to experience altered states  of consciousness while at the same time being in the present with the here  and now. When clients are in a trance-like state they can more readily  access thoughts and feelings at a conscious level. The psycholytic experience  affords the client and therapist the ability to work with material that could  otherwise be challenging to access. 

    Skilled therapists can engage the client while in a trance-like state and offer  questions to deepen the client’s experience. Higher dose ketamine treatment  via intravenous or intramuscular routes often results in clients having a  psychedelic experience, one in which they become dissociated and can often  have an ego dissolution, losing sense of Self and attachment to their  identity. The term psychedelic means “mind manifesting.” According to  many in the field, including Skylight Psychedelics, ketamine is a psychedelic  medicine. 

    Integration

    Integration is the process by which a client takes the information gained during a journey and incorporates it into their daily life. Integration is an integral part of psychedelic work. Without this, clients can be left with an  

    obscure recollection of a strange experience which is not optimal. Integration  sessions are where the experience is processed and integrated. It’s the time  to take the knowledge gained from the ketamine experience and integrate it  thoroughly into the client’s everyday life. Once experiences are integrated,  clients can then move forward. They can also continue to work with the  messages as they move forward.  

    Unprocessed trauma and grief can also surface during someone’s journey.  Following a psychedelic session, it can be helpful to make sense of the  material. There’s no one way to integrate the experience. It is important to  remember that integration does not mean interpretation, and the goal is for  the client to put things together - not the therapist. Integration can be done  in groups, by guides or trained practitioners, with therapists or coaches  (ideally known to the client), trusted friends or mentors, or on one’s own.  We encourage clients to journal after sessions and to bring the journal to the  therapy session. 

    What is Psychedelic Integration Therapy? 

    Psychedelic integration therapy involves working with a trained therapist to  unpack prior psychedelic experience(s) and bring the wisdom of the  experience into one’s present reality. Therapists can work with people for  the short term or on an ongoing basis. They may utilize a variety of  therapeutic techniques from the domain of internal family systems, cognitive-behavioral therapy, somatic therapy, and even modalities like eye  movement desensitization and reprocessing to help clients fully absorb and  integrate the content from the psychedelic experience. Integration is viewed  as an essential and ongoing process as the inner experiences catalyzed by  ketamine-assisted sessions continue to unfold. Follow-up contact with the  therapist by phone and during scheduled integration visits is necessary to  support successful integration. During these visits the therapist's aim is to address any difficulties that may have arisen following ketamine-assisted sessions and to anchor the lessons gained in a non-ordinary state of consciousness so they can be integrated into daily life.

    With the support of the therapeutic relationship, the client can incorporate new thought, behavioral, and central nervous system patterns. Since the material that arises in a psychedelic trip can be incredibly personal, complex, and is often related to past trauma, doing integration work with a licensed therapist can facilitate the healing process. 

    Skylight’s Integration Guide - Integrating Psychedelic Experiences Reflection 

    We encourage journaling. Write down everything experienced on your  journey. Include thoughts that surfaced, things you saw, what you felt, and  where you felt this and what other senses were triggered. Try to be as  detailed as possible. These journal entries can include artwork and poems as  well. 

    Journey Reflection Questions: 

    These questions can be applied to each journey. 

    1. List three words (feelings, things you saw, things you have learned)  that best summarize your journey? 

    2. What sensations are most alive in your body as you reflect on your  journey? 

    3. Where in your body do you feel these feelings most? 

    4. Did you identify parts of you that wanted to be heard? If so, how did it  feel to give those parts attention? 

    5. Did you experience death or rebirth? If so, what was that like? 6. What felt like the most challenging part of the experience? Was this  expected? 

    7. Was there something that came up for you that was unexpected? If so,  what was it and how do you feel about it surfacing during your journey? 8. What felt most rewarding? 

    9. What are some of the key insights you have had since the experience? 10. Did the experience stir up any questions or new curiosities? What feels  most salient as you look through the questions above? 

    Different Ways Psychedelic Experiences Can be Integrated: Somatic or Bodily Integration

    Bessel Van Der Kolk, MD authored the book “The Body Keeps the Score”.  The premise of which is that when we experience a trauma, we are typically unable to process it in the moment it occurs. When this happens, our body remembers (keeps score). Psychedelics, such as ketamine allow us to release repressed emotions. It also allows us to disconnect the emotional reaction of trauma from the memories of what occurred. When we release these emotions, we become lighter, softer, and gentler versions of ourselves, and we become way less likely to manifest dysregulated mood reactions in the face of emotional triggers. We become more connected and centered. 

    Questions for Somatic Integration: 

    Describe ways in which you could involve mindful movements in your healing journey. 

    - List some therapeutic somatic modalities you would be willing to try.  

    Examples are: holotropic breathwork, rolfing, reiki, somatic experiencing,  massage 

    - List some things you would like to change in your external world.  

    This can be your actual physical space, do you need to add more plants to  your environment, change your blinds or shades to let more natural light in?  What about your phone? Consider deleting social media and any applications  that don’t serve you. How do you feel about candles, incense or diffusers  with scented oils? What about cleaning out and debulking your wallet or  purse? 

    Spiritual Integration 

    Working with psychedelics allows us to tap into a universal consciousness.  We are able to connect with our highest self and spirit. 

    Questions for Spiritual Integration:

    What are your core beliefs you have about yourself? What is important to you in your life? Have you learned anything new about yourself? If so, what? What kind of person did you see yourself as and do you want to continue to be this person moving forward? How would you like your relationships to change following this experience? 

    Emotional Integration 

    Many different emotions can surface during a psychedelic experience. For  many people emotions have been repressed for most of their lives.  Psychedelics help us to bring these repressed emotions to the surface and  once at the surface we can more easily work with them. During and  following a psychedelic experience we often find that our emotions are more  intense. It is important to establish emotional plasticity so that we can  ensure we are not overtaken by the experience. 

    Emotional Integration Questions: 

    Describe the array of emotions you encountered during your medicine  experience. Were there any surprises? 

    How do you process your emotions? 

    Do you have a support system in which you can reach out to to help you  process your emotions? 

    Additional Integration/ Journey Reflection Questions: 

    What significant things have transpired as a result of this journey? What might change as a result of what I have learned from this experience? When do I feel most connected to my heart and how am I choosing and  committing to bringing more of this connection into my daily life? How can we center ourselves daily so we can align with love? 

    Integration Writing Assignment: 

    Following the sixth ketamine session write yourself a letter. Remind yourself  of the journey you were on and the insights you gained. 

    Skylight Psychedelics Integration Ritual Practice

    Go outside, immerse yourself in Mother Nature as often as possible. Journal away! The more you write about your experience the more likely it is to stick around and impact your life. 

    Draw, paint, sculpt.  

    Meditate 

    Do yoga 

    Float therapy 

    Holotropic breathwork 

    Dance! Seek out intuitive dance.  

    Integration Yoga 

    *Consider IFS or ACT therapy and Somatic Experiencing 

    The ACE Therapy Model 

    Psychedelic researcher, Rosalind Watts, developed a psychotherapeutic  model called the ACE therapy model (Acceptance, Connection and  Embodiment) after analyzing data collected during psilocybin research at the  Imperial College of London. This model was formulated based on integral  components of people’s healing journeys and the intention is to provide  support to the preparation and integration of these profound psychedelic  experiences. The main focus of the ACE model is to maximize a client's  psychological flexibility. Psychological flexibility refers to one’s ability to cope  with, accept, and adjust to difficult situations. By helping patients increase  psychological flexibility, the ACE model of therapy aims to maximize the  benefits psychedelic drugs offer during psychedelic therapy sessions. 

    In therapy, psychological flexibility is centered on six principles, on which  the ACE therapy model is based.  

    These principles are: 

    Being in the present moment Accepting unwanted feelings 

    Cognitive diffusion – realizing that one’s thoughts aren’t inherently true  Accepting the dynamic nature of self.  

    Being able to clarify meaningful values. 

    Conscious action – action and behavior which is consistent with one’s values.

    The Three Areas of Focus for The ACE Model 

    Acceptance 

    Acceptance is the first part of the ACE model which encourages clients to acknowledge, accept and navigate through uncomfortable and challenging experiences, instead of repressing them. Clients are encouraged to explore  deeper aspects of themselves during the psychedelic journey and invite  whatever emotions that arise to be fully experienced. It’s important for  clients to be able to sit with the discomfort that may arise. 

    Connection 

    The next part of the model centers around Connection. Oftentimes  psychedelics enhance a deep feeling of unity with the natural world.  Psychedelic medicines can oftentimes help people move from a feeling of  disconnectedness to connectedness. 

    Embodiment 

    Embodiment is the third part of the model. Clients are encouraged to explore  sensations in their bodies. Clients are invited to get in touch with the  feelings in their body as they arise and prepare them for the psychedelic  experience so they can embrace and feel these emotions deeply to help  break negative thought patterns. 

    Terms and Concepts in Psychedelic Therapy 

    Spiritual Bypassing 

    Spiritual bypassing is a defense mechanism that protects us from things that  appear too difficult to manage. It’s a way of hiding behind spirituality or  spiritual practices that prevents people from acknowledging what they are  feeling. 

    Spiritual Narcissism

    Spiritual narcissism refers to the belief in which some people feel more special than others due to their spiritual wisdom. This belief is often used to impress others and enhance one’s self esteem. It can also be used as a  weapon to tear people down. 

    Shadow Work 

    The term shadow work refers to the work involved when we start to examine  things inside ourselves that are typically hidden. These hidden parts of  ourselves usually elicit feelings of discomfort. If your psychedelic medicine  experiences or meditative/mindful practices bring negative or unexpected things to your attention they need to be witnessed and processed, not ignored and repressed. Ignoring them will not make  them go away. 

    Therapeutic Bends 

    Some clients experience a period of difficulty adjusting to changes following  psychedelic experiences. This response is referred to as the “therapeutic  bends” which can occur when someone comes up too fast from extreme lows  seen in some clients with severe depression responding to ketamine. 

    Noetic Quality 

    Religious, spiritual, and mystical experiences are often described as having a  noetic quality, or the compelling sense that the experience feels “real”. 

    Therapy Models that Complement Psychedelic Work 

    Consider seeking a therapist who specializes in any of the below modalities  that work very closely with psychedelic medicine. These can be adjuncts to  the therapy you are already receiving. 

    Acceptance and Commitment Therapy  

    Internal Family Systems Therapy 

    Art Therapy Ecotherapy 

    Does My Insurance Cover Me for Ketamine?

    We recommend clients reach out to their provider to determine if they can get reimbursed for treatment. At this time, we do not accept insurance. If you need a superbill please email human@skylightpsychedelics.com

    Flight Instructions for Clients 

    1- Prior to arriving at your therapist’s office please ensure you have a safe ride  home with someone that you know who will wait for you after the medicine experience. 

    2- Plan for a day free from distractions and work on medicine session days.

    3- Consider thinking of an intention for your medicine session. 

    4- Bring an eye mask, blood pressure cuff and journal to the medicine session. 5- Remember to bring your medicine to your session. 

    6- Dress comfortably with nothing tight around your neck. 

    7- Avoid food and water for 3-4 hours prior to the ketamine experience.

    8- Use the bathroom and power down your devices prior to the session.

    9- Invite a mantra or spirit guide into your session if that is something that speaks  to you. 

    10- Avoid using headphones in your session, this will allow you to connect deeper  with the therapist and for 

    you to hear them if they are speaking with you. 

    11- Choose the Skylight Psychedelics Spotify playlist that correlates with your  journey number. 

    12- Check your blood pressure. Do not proceed if the blood pressure is above  150/90. If your blood pressure 

    is elevated above 150/90, you can try to relax and meditate and retake it. If it  remains elevated, we 

    recommend you reschedule your ketamine session for when your blood pressure is  optimized after you 

    see your healthcare provider. 

    13- When ready to take the medicine place the tablet(s) under your tongue. Do  not spit. Allow the medicine 

    to dissolve. Most often, it will start working within 10-20 minutes. 14- Place your eye mask on and lie down in the comfortable space provided by  your therapist. 

    15- Avoid using any sucking candies during the medicine experience. 16- During the experience on the medicine remember to try to surrender, be open,  go with the flow. Talk to 

    your therapist if you desire but remember it’s also completely ok to have a silent  internally focused 

    journey as well. 

    17- The journey should last approximately one hour. Once an hour is up your  therapist will shut off the music 

    and invite you to open your eyes. 

    18- Check your blood pressure and make note for your records.

    38 

    19- You should not leave your therapist’s office unless you are alert and oriented  to person, place and time 

    AND it has been an hour since your medicine session has ended. Very rarely a  person can come out of the 

    medicine experience and go back in. 

    20- Ensure you leave your therapist’s office with a safe ride, someone who is  known to you. We discourage 

    people from using ride shares or public transportation for safety reasons. 21- Avoid driving, operating heavy machinery, swimming, bathing, taking public  transportation, and being the 

    sole provider of childcare for the remainder of the day of your ketamine session. 22- Ensure you have an integration session booked either immediately following  the journey or shortly 

    afterwards in the coming days. 

    23- Proceed with the next medicine session if you are feeling ready to do so. If  you are having big experiences, 

    and it is overwhelming, you can pause the medicine sessions and use that time for  integration. If you are 

    unsure of what to do, please discuss this with your therapist and you can also  reach out to Skylight as 

    needed for additional advice. 

    24- If during your journey you struggled with nausea or vomiting or any other side  effect that you need help 

    with, please reach out to Skylight. 

    25- Please remember to journal about your experience and bring this material  with you to integration 

    sessions. 

    26- Try to spend as much time in nature as you can. 

    27- Join our community of clients on a similar journey bi-weekly via Zoom with Dr.  Elizabeth Wolfson. Link 

    here: https://us02web.zoom.us/j/82622818852

    28- If you are having thoughts of harming yourself or anyone else, please activate  your care plan accordingly. 

    If you do not have a care-plan, please call 911 or 988 immediately. The Skylight Psychedelics Lifestyle 

    We believe that healing requires a holistic approach which includes therapy, diet, exercise, nature and community in addition to exploring non-ordinary states of consciousness. Find the time for yourself. As we better ourselves, we better one another. 

    Recommended Daily Practice by Skylight Psychedelics

    Nature: Spend 15-30+ mins outside doing anything, walking the dog, having your morning tea, etc. 

    Yoga: This can be an in-person class, guided virtually or on your own. We recommend yoga with Jacqueline Smith @  

    https://www.livekick.com/en/c/jaquelynsmith

    Affirmations: Look in the mirror and say something nice to yourself.  Breakfast: Decaf tea, small bowl of fruit 

    Afternoon 

    Journal: Journal your thoughts, draw or paint if that speaks to you. Dinner:  Salad, light piece of fish or eggs, small bowl of fruit, water to drink Consider  bathing in the moonlight. 

    Meditation: Insight Timer app - best done right before bed! Gets your  meditation time in and allows you to quiet the mind to promote a restful  night's sleep. 

    Dietary Suggestions  

    Sugar: We recommend minimal sugar intake. 

    Caffeine: We don’t need caffeine. Our society has trained us to think we do.  Your body can easily regulate itself when you start cutting down with the  ultimate goal of using this as a medicine for when you have a killer  headache. 

    Alcohol: Just because it’s legal doesn’t mean it’s safe. Alcohol suppresses  emotions. It’s also very rough on your body. Try cutting down. Try removing  it completely and just see how you feel. 

    Meat/Fish/Poultry: We recommend limiting eating/avoiding eating our big-brained animal friends. Limiting your consumption of animal creatures to seafood and poultry is bound to make you feel better and decrease your risk of heart disease and other medical problems. Please remember to give a moment of gratitude to our food before eating. Thank you to Mother Earth for the sustenance she provides and thank you to the animals who have sacrificed their lives for us. 

    Tobacco: We discourage smoking tobacco.  

    Recommended Readings 

    “The Body Keeps The Score”, by Bessel van der Kolk, MD No Bad Parts by  Richard Schwartz, PhD 

    “How to Change Your Mind”, by Michael Pollan This is Your Mind on Plants by  Michael Pollan 

    “The Psychedelic Explorer’s Guide Safe, Therapeutic and Sacred Journeys”  by James Fadiman, PhD 

    One of our favorite poems: 

    The Guest House by Rumi 

    This being human is a guest house. Every morning a new arrival. A joy, a depression, a meanness, 

    some momentary awareness comes as an unexpected visitor. 

    Welcome and entertain them all! Even if they’re a crowd of sorrows, who  violently sweep your house empty of its furniture, 

    still, treat each guest honorably. 

    He may be clearing you out for some new delight. 

    The dark thought, the shame, the malice, meet them at the door laughing, and invite them in. 

    Be grateful for whoever comes, because each has been sent as a guide from  beyond. 

    Please know you are never alone. 

    Team Skylight

  • What are the Physical Side Effects of Ketamine? 

    Note: Side effects from ketamine are rare and when they occur, they are  most often mild. The most common side effects from ketamine include: 

    Headache Blurry vision Nausea Vomiting Anxiety 

    Diminished ability to see/hear/feel Dry mouth 

    Lip tingling and/or heaviness 

    Elevated blood pressure Elevated heart rate 

    Elevated intraocular or intracranial pressure Excitability 

    Loss of appetite Confusion 

    Nystagmus (rapid eye movements) 

    Restlessness 

    Slurred speech 

    Synesthesia (overlapping of the senses, for example seeing sounds)

    Dissociation (feeling out of body) 

    Dizziness 

    Tinnitus (ringing in the ears) 

    Hypoesthesia (partial or total lack of sensation in a body part) Lethargy (fatigue) 

    Sedation (somnolence) 

    Vertigo (room spinning) 

    Feeling “drunk” 

    Rarely a client can experience a feeling of paralysis 

    Note: There have been no cases of persistent neuropsychiatric sequelae, medical effects, nor increased substance abuse in clinical practice. 

    Note: Skylight Psychedelics firmly believes that the dissociative and/or psychedelic effects of ketamine treatment are a critical piece of the therapeutic process and should not be avoided. We believe this part of the experience can be extremely beneficial to our clients when supported in a trusted healing container. 

Skylight Music Playlists

We have curated six Skylight Psychedelics Spotify playlists to be paired with each of the six ketamine treatment sessions.