KA-EMDR® Therapy in the DC Metro Area
Ketamine-assisted psychotherapy to help you heal from trauma. Find relief from the memories that hold you back and build a kinder relationship with yourself.
What is KA-EMDR®?
Ketamine-Assisted Eye Movement Desensitization and Reprocessing (KA-EMDR®) pairs standard EMDR therapy with a low dose of ketamine prescribed by a medical provider. During KA-EMDR, you self-administer a low dose of ketamine (by mouth) while receiving EMDR, a type of talk therapy designed to help you process trauma. This is a very specific type of psychotherapy treatment with an established protocol and structured approach.
KA-EMDR may help you: (1) work through distressing memories, (2) develop a more compassionate understanding of yourself and your experiences, and (3) lessen the impact of trauma-related symptoms on your daily life. In this model, EMDR is the main intervention, and ketamine enhances it.
Why Get KA-EMDR® Therapy In DC?
KA-EMDR can help when a memory carries so much fear or distress that approaching it feels like too much. It pairs EMDR with a low dose of sublingual (under the tongue) ketamine to provide added support as you approach what has previously been hard to face. For example, you may want to work through an early experience related to sex or relationships but notice yourself going numb or mentally drifting away whenever you get too close to it. Or perhaps painful memories come up during therapy, but you find yourself circling them without ever quite touching them. Ketamine may help ease the fear and anxiety attached to these memories so you can stay present while processing them and carry less of their weight into your relationships and everyday life.
Here’s How KA-EMDR can benefit you:
Supporting openness
Fear and shame can make it hard to look directly at a painful experience. A low dose of ketamine can make that distress feel more manageable, so you stay present with memories or beliefs that you have kept at a distance.
Processing trauma
KA-EMDR can help you reprocess traumatic experiences that still shape how you see yourself and how you connect with others. That might be a sexual boundary violation, a betrayal in a relationship, or an early experience that taught you something untrue about your body or your worth.
Reducing emotional distress
As memories get reprocessed, the emotions attached to them tend to become less intense. Reminders of the experience may also begin to feel less overwhelming.
Deepening intimacy
KA-EMDR can help you work through negative beliefs about sex and intimacy and develop healthier ones. As those beliefs shift, it gets easier to feel safe in your body and present with a partner. This can create more room for emotional and physical connection without past experiences getting in the way.
Who is KA-EMDR® therapy for?
KA-EMDR is for people carrying experiences that still affect how they see themselves and how safe they feel in their bodies and relationships. It may be a good fit whether you have tried EMDR before and want more support or you are new to it and certain memories have always felt out of reach. Early research suggests that KA-EMDR can be effective in treating PTSD. KA-EMDR can be integrated into individual therapy, couples therapy, or sex therapy.
KA-EMDR may be helpful if you:
Have a history of trauma. This might be an acute event such as assault or violence. It may also be developmental trauma caused by abuse or unmet needs during childhood.
Experience symptoms of PTSD (post-traumatic stress disorder). This might include flashbacks or nightmares. You may also feel constantly on guard or experience intense anxiety when something reminds you of the past. EMDR was developed specifically for PTSD, and KA-EMDR builds on that foundation.
Feel stuck in talk therapy. You can understand what happened and how it still affects you, but feel unable to move past it.
Shut down when approaching painful memories. You go numb or mentally leave when difficult experiences come up. This can make it hard to stay with a memory long enough to process it.
Struggle with shame or persistent negative beliefs. Past experiences continue to shape how you see yourself. You may carry beliefs such as “I’m not safe” or “Something is wrong with me.”
What can you expect in KA-EMDR® therapy?
You’ll begin with a thorough assessment, like any other therapeutic process. If your therapist thinks that KA-EMDR would be helpful, they will refer you to a licensed medical provider who determines whether ketamine is medically appropriate for you. Our approach is to introduce KA-EMDR at the right time as a tool within an ongoing therapeutic relationship.
With KA-EMDR, you can expect:
Initial assessment: Your therapist will take time to understand your history, current challenges, and goals for therapy.
Medical evaluation: Before beginning KA-EMDR, you will meet with a licensed medical provider to discuss your health history and determine whether a ketamine prescription is appropriate for you. Your therapist will help coordinate this with prescribers we know and trust.
Safe environment: Sessions provide a supportive, judgment-free space to discuss sensitive topics.
Preparation sessions: Over several 50-minute sessions, you and your therapist will decide which memories or beliefs to focus on and build the skills needed to approach difficult material safely.
KA-EMDR processing session: At the beginning of the two-hour session, you’ll self-administer a low dose of sublingual ketamine according to your medical provider’s instructions. Your therapist will then guide you through EMDR reprocessing, using bilateral stimulation as you notice the thoughts, emotions, and sensations that arise. Bilateral stimulation simply means activating the left and right sides of your brain through headphones (beeping sounds), buzzers in your hands, or similar methods.
Integration: You’ll have space to reflect on what came up and connect the work to your relationships and everyday life.
Throughout this process, you’ll have the support of a compassionate, experienced therapist trained in this approach.
The first step is contacting us for a free consultation call. You’ll be matched with a therapist on our team for a 15- to 30-minute video call to see if you are a good fit.
Can KA-EMDR® be used for couples therapy or sex therapy?
Yes, it can be used for both.
KA-EMDR in Couples Therapy
Often, in couples therapy, we identify barriers to intimacy and the root of anxiety, withdrawal, or tuning out during sex. This might be internalized negative beliefs, such as “I’m not good enough,” or traumatic memories. These can be addressed in individual sessions with either standard EMDR or KA‑EMDR. If the therapist recommends EMDR for one or both partners, the partner or partners will meet individually with the therapist for one to three sessions before returning to couples sessions.
KA-EMDR in Sex Therapy
KA‑EMDR can also be used to work on sexual intimacy. In the context of sex therapy, it may be helpful if you experience:
Difficulty or discomfort talking to your partner about intimacy
Withdrawing or tuning out during intimate moments
A sense of disconnection from your body or your partner
Anxiety during sex, including tension in the body or sweating
Feeling held back from the kind of sex life you want
Both standard EMDR and KA‑EMDR can be effective tools in sex therapy. Negative experiences throughout life can affect how you show up during intimacy. For example, being told that sex and pleasure are bad can lead to an internalized belief that you are bad if you want these things. This, in turn, creates a stress response during intimacy, perhaps leading you to pull away from sex and refuse it altogether, feel panic during a sexual moment, or have sex while numbed out. EMDR can help you process these experiences and give you back your ability to make choices from a grounded place, so that you have the sex life that you want, on your own terms. Of course, EMDR can also help process experiences of sexual abuse or boundary violations.
Is KA-EMDR® safe and legal?
Yes, when used as prescribed and under the guidance of a qualified prescriber, it is generally considered safe. When mixed with other medications, drugs, or alcohol, or when it’s obtained from an illegal source, ketamine can be very dangerous. It’s important to be honest with your prescriber about your medical history and use of substances. Every drug has risks and benefits, and just like all medications, there is no guarantee of safety or efficacy.
Ketamine is an anesthetic drug that has been around since the 1960s. It’s important to note that ketamine can be administered in a wide range of doses and methods, from high-dose IV administration in a hospital setting to low-dose sublingual (by mouth) administration at home. Your experience of ketamine will greatly depend on the dosage, route of administration, and intent of the treatment.
Ketamine is legal in the United States when used as prescribed. It is a controlled substance that is only available by prescription. Your prescriber will determine if it is safe for you. Tell your provider if you are pregnant or have a history of psychosis, substance abuse, bipolar disorder, or dissociative identity disorder.
In recent years, ketamine has become more widely used “off-label” for some psychiatric treatments. This means the FDA hasn’t approved the drug for that specific purpose, but it is still allowed to be prescribed. If you have any concerns or questions about this, consult your prescriber.
How does KA‑EMDR® differ from other ketamine treatments?
KA-EMDR
Uses a psycholytic dose (not a psychedelic dose), self-administered by mouth in a therapist’s office. During the treatment, you will be cognizant and able to participate in talk therapy. It is intended to gently boost the EMDR psychotherapy treatment.
Nasal Ketamine
Is a spray administered in the nose in a medical provider’s office, using esketamine (similar to ketamine). This is a higher psychedelic dose that requires a medical setting for safety. The effects can be strong, and you will be too altered to participate in talk therapy during the treatment (although talk therapy afterward or in the days afterward may be offered). This is often used for treatment-resistant depression or PTSD when other options haven’t worked.
Intravenous (IV) ketamine infusion
Is a higher psychedelic dose administered through a needle in a medical provider's office. The effects can be dissociative and intense. This is used most commonly for treatment-resistant depression.
Ketamine-assisted psychotherapy (KAP)
Usually uses a psychedelic dose, self-administered by mouth in a therapist’s office. During the treatment, you might become very altered and may feel like turning inward silently, perhaps using an eye mask or listening to music. Psychotherapy may happen during the ketamine experience, as you are coming down from it, or shortly afterward.
Unlike these other treatments, the KA-EMDR protocol specifically uses a psycholytic dose, not a psychedelic dose. There are no needles, and the ketamine can be self-administered safely under the guidance of a prescriber.
By the end of your two-hour KA-EMDR session, you will be back to a normal mental state and able to go about your day. We recommend taking it easy and practicing self-care after a ketamine session, so that you get the full therapeutic benefits.
How much does KA-EMDR® cost?
KA-EMDR is billed like any other psychotherapy. The preparation sessions are priced the same as any other therapy session. The two-hour KA-EMDR session itself is priced separately. As with all of our services, you may request a superbill for out-of-network insurance reimbursement for psychotherapy sessions, whether with ketamine or not. Click here for our fees.
In addition, you will pay the prescriber directly for your medical evaluation. If you already have a psychiatric prescriber, you are welcome to use them or anyone you choose. Our recommended prescribing partner accepts some insurance plans, so you may only have to pay a copay. Out-of-pocket costs for the prescriber range from $200–$300. The ketamine itself is not covered by insurance; it costs about $5–$10 per dose out of pocket.
Meet your KA-EMDR®-trained therapist
Camille Espinoza, LICSW, specializes in sex therapy for people ages 25-45, of all orientations, genders, and backgrounds. Camille has completed training directly from the founders of this protocol at the Ketamine Assisted EMDR Therapy Institute. Camille is also trained in several methods of couples therapy, including Gottman Method, Emotionally Focused Therapy, and Collaborative Couples Counseling. She is an AASECT Certified Sex Therapist Supervisor.
Camille Espinoza LICSW, CST-S
Why choose the Center for Intimacy and Relationships?
We specialize in relationships and sex therapy using a variety of modalities, so you get the most out of your therapy. Here, we weave together individual therapy, couples therapy, and sex therapy with KA-EMDR therapy, among many other tools.
At the Center for Intimacy and Relationships, we have:
Specialized Training: Camille is trained in both KA-EMDR and sex therapy, allowing us to provide a comprehensive approach to your concerns.
Holistic Perspective: We incorporate the emotional, psychological, and relational aspects of sexual health, ensuring a well-rounded therapeutic experience.
Compassionate Support: We prioritize your comfort and safety, guiding you through sensitive issues with empathy and respect.
We are a boutique psychotherapy practice offering customized therapy services tailored to you and your goals, including sex therapy for couples. Here, you’ll receive care from a warm and welcoming team of clinicians committed to the therapeutic process, helping you harness your healing and growth.
Offering both in-person and online therapy for busy DC professionals, we can meet you where you are on your schedule. Contact us now to schedule a free video consultation.
KA-EMDR® Therapy FAQs
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KA-EMDR follows the same EMDR process, with one addition: a small, prescribed dose of ketamine taken before moving into the reprocessing part of the session. This may help difficult material feel more manageable to approach while you remain engaged in the EMDR process. EMDR remains the central therapeutic approach. However, because medication is involved, KA-EMDR also requires a separate evaluation and prescription from a licensed medical provider.
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Ketamine-assisted psychotherapy, or KAP, typically uses a higher dose of ketamine that may create a more psychedelic experience. The session is not structured around EMDR. Instead, the therapeutic work focuses on the experience that comes up while taking ketamine and the insights that follow.
KA-EMDR uses a smaller dose and follows the standard EMDR process. You and your therapist work with a specific memory or belief using bilateral stimulation.
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If your therapist believes KA-EMDR may be a good fit, they will refer you to a licensed medical provider. The provider will complete a medical evaluation, determine whether ketamine is appropriate for you, and provide a prescription if you are eligible.
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You (the client) self-administer the medication during the session, as prescribed. Therapists do not administer or provide medication. The therapy takes place while you are experiencing the effects of ketamine. There are additional sessions before and after without ketamine.
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Most people start with one experience, then decide whether to have more. This is a decision for you, your therapist, and your prescriber. Some people choose several ketamine sessions spread out over weeks or months. It’s up to you.
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This protocol calls for a small dose of 37–75 mg of sublingual ketamine in a troche, which is a dissolvable lozenge. Your medical provider will determine the dose that is appropriate for you based on your individual needs and medical history.
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In this particular protocol, the dose is low. Most people feel relaxed, sleepy, and dreamlike. This dose is not intended to induce hallucinations. Your experience will be unique to you. If you have any concerns or worries about the ketamine, please bring them up with your therapist beforehand.
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KA-EMDR isn't right for everyone, and screening happens on two fronts. Your therapist will assess whether EMDR is a good fit and whether you're ready for it. If symptoms are very active, it may take weeks or months of preparation first, and that's normal. Separately, your prescriber will review your health history and medications to determine whether ketamine is safe for you.
If KA-EMDR isn't the right fit, that doesn't mean therapy isn't. We'll help you find another path.
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To get started, fill out our contact form. We’ll be in touch within 48 business hours. We start all potential clients with a free 15- to 30-minute video consultation to see if we’re a good fit to work together. And we are happy to refer you to one of our trusted colleagues if it’s not a good match.
Important Considerations
KA-EMDR is a newer approach. Early results are encouraging, but larger studies are still needed.
You will need both a therapeutic assessment and medical screening before beginning.
Ketamine is prescribed by a licensed medical provider and taken as directed. Your therapist does not supply or administer it.
Side effects at low doses are usually mild and short-lived. The most common are nausea, dizziness, headache, and heightened emotional sensitivity.
Results vary, and symptom relief cannot be guaranteed.