Rewiring Shame: How Ketamine-Assisted Psychotherapy Supports LGBTQIA+ and Queer Healing
What does it mean to truly come home to yourself in a world that’s told you not to exist as you are?
As a therapist working closely with LGBTQIA+ and queer community, I’ve witnessed how the weight of systemic oppression, internalized shame, and deep-rooted trauma can shape a person’s inner world and the trajectory of their life.
These aren’t just passing experiences—they’re patterns that get wired into our nervous systems over time. And while traditional therapy offers invaluable support, for some, it doesn’t quite reach the core of these entrenched beliefs.
Furthermore, as a queer therapist myself, I have also experienced deep healing thanks to psychedelic-assisted therapies. I was unable to tend to the internalized, intergenerational pain I was carrying through talk therapy alone.
There came a point when I realized (as I have repeatedly learned on the psychedelic path) that “logic-ing” my way out of my own narratives was not enough to separate myself from the entrenched beliefs I was carrying.
I felt swallowed whole by ingrained thoughts that I didn’t even truly believe. I remember thinking, “Whose are these, and why do I keep coming back to them?”
Then along came ketamine…
To be clear, ketamine alone did not save me from my repetitive thoughts or intergenerational trauma. With the support of my trusted long term therapist, the queer community, and my own commitment to healing, I could open up to the therapeutic power of this medicine.
Below, I explore how combining transpersonal therapy with ketamine-assisted psychotherapy (KAP) can play a powerful role in this reclamation of self.
Cecily Kreager LPCC, article author, transpersonal therapist, and psychedelic-assisted therapist
Neuroplasticity and Ketamine
At the heart of psychedelic healing is neuroplasticity—the brain’s ability to form new neural connections and pathways, helping us step away from the familiar feelings of stuckness. Research shows that ketamine can rapidly enhance neuroplasticity, offering a unique window for transformation (Kopelman, 2023).
When administered in a safe and trusted therapeutic setting, ketamine can help loosen the grip of fixed, negative beliefs about the self. These beliefs often stem from years of navigating a world that invalidates or marginalizes queer and trans identities.
Messages like “I’m not enough,” “I don’t belong,” or “I’m broken” can become deeply ingrained, not just emotionally, but neurologically.
Thanks to ketamine's ability to disrupt rigid neural loops, individuals often experience new perspectives, a softening of inner criticism, and increased emotional flexibility. This mental spaciousness is where healing begins.
Additionally, a therapeutic session with ketamine is often softer and more manageable for folks than with other psychedelics. Guided sessions typically last around three hours, and you feel the effects of the ketamine strongly for around an hour––though it can vary from person to person.
This spacious amount of time allows you to “drop in” with your therapist, ingest your medicine, have an inward experience in a safe and familiar container, and then begin the integration process directly afterward.
Therapy as a Sacred Container
It’s important to remember that ketamine isn’t magic on its own. Its true power lies in the therapeutic relationship and commitment to integration, which is how the experience is processed and woven into a client’s narrative with the help of a trained therapist. For queer and trans folks, this work is sacred. It’s about reclaiming parts of the self that have been buried under shame, trauma, or rejection.
As a therapist, my role is to create a container of safety and trust first and foremost so that clients can feel not only comfortable to be their full selves, but also to engage in the deep healing that we all yearn for. When ketamine is introduced into this space with integration work, clients often find they can access breakthroughs that felt unreachable before.
Integration of ketamine assisted psychotherapy in a thoughtful therapeutic relationship can provide:
Access to repressed emotions: Many queer individuals have had to suppress emotions for survival. KAP helps bring these to the surface in a safe and supported way.
Interruptions of shame cycles: Ketamine’s effect on the default mode network (Zacharias, 2019) can reduce overactive self-criticism, making room for self-compassion and curiosity.
Embodied experiences of safety: Dissociation in KAP (unlike trauma-induced dissociation) can allow individuals to feel safe in their bodies, sometimes for the first time in years.
Increased openness to change: With reduced psychological defenses, clients may feel more empowered to explore gender, identity, and relational dynamics in affirming ways.
It is important to note again that while many people find moments of clarity and shifts in perception during medicine sessions, the breakthroughs I am referencing most often show up in folks’ lives in the integration period.
This process of integration involves exploring the experience and narrative of your journeys alongside skillful therapeutic interventions to help you solidify your new insights over time. Remember, it took your whole life to root into the beliefs we want to shift––it will take commitment and time to begin to choose differently.
Cecily with their local queer community builders
A Path Toward Liberation
Ultimately, healing is a process of returning to our authentic selves. For LGBTQ+ and queer individuals, this often means untangling years of conditioning, rejection, and internalized narratives that tell us we’re not worthy of love, joy, or safety.
I have spent years working with queer clients and even longer in community with folks who have been stuck in a narrative that they are “bad”, “wrong”, or “broken”. Ketamine-assisted psychotherapy is a proven option that is grounded in science and, when supported by trauma-informed, affirming care, offers a powerful tool in this journey. It helps not by “fixing” anyone, but by reminding them that they were never broken in the first place.
I am inspired by folks who are willing to step out of the boxes they have found themselves in, and I am deeply committed to creating safe and affirming spaces for healing for those on this brave journey.
If you are interested in exploring this work with me, I offer a holistic approach that honors the unique experiences of queer individuals and supports a path toward true liberation and healing sovereignty (your right to heal). Together, we can work towards dismantling internalized shame and embracing the fullness of your authentic self.
If this resonates with you, reach out to me via email at cecily.k@doriglewis.com to schedule a free consultation call.
References
Kopelman, J., Keller, T.A., Panny, B. et al. Rapid neuroplasticity changes and response to intravenous ketamine: a randomized controlled trial in treatment-resistant depression.Transl Psychiatry 13, 159 (2023).
Zacharias, N., Musso, F., Müller, F., Lammers, F., Saleh, A., London, M., de Boer, P., & Winterer, G. (2020). Ketamine effects on default mode network activity and vigilance: A randomized, placebo-controlled crossover simultaneous fMRI/EEG study. Human brain mapping, 41(1), 107–119.
