What is a 'K Hole,' and Why it is Part of Therapeutic Ketamine Use

I vividly recall attending a party in Los Angeles in my early 20s, where I found a young man lying motionless on the lawn. His gaze was fixed on the tree branches above, and though this wasn’t entirely unusual at a party, the scene felt disconcerting.

"Is he okay?" I asked.

"He’s in a k-hole," came the reply.

Though I’d heard the term before, seeing it firsthand was disturbing.

While experiencing a k-hole through recreational drug use is dangerous, research has shown that ketamine’s dissociative effects, when used in a controlled, therapeutic setting, can be beneficial for mental health treatment.

What is a K-Hole?

A “k-hole” refers to the dissociative state induced by ketamine, an anesthetic and psychoactive drug. In this state, users may feel detached from their body and reality, with sensory distortions and a sense of time suspension. Some describe the experience as feeling outside their body or suspended in space.

How Can a K-Hole Be Therapeutic?

While dissociation might seem unsettling, it’s believed to have therapeutic potential, particularly for treatment-resistant depression and PTSD. In a controlled setting, ketamine therapy allows clients to break free from entrenched thought patterns, offering a "fresh perspective" on trauma or current struggles. This altered state can promote emotional release, new neural connections, and psychological reset.

Dissociation in this context provides distance from overwhelming pain, enabling individuals to process difficult emotions and gain insights that traditional talk therapy may not facilitate. Importantly, therapeutic ketamine use is always closely monitored by professionals for safety and efficacy.

Later that evening, I saw the young man who had been in the k-hole, wandering around the party, disoriented. Only decades later did I realize that he could’ve benefitted from processing the encounter with a professional. Without the support and guidance of a trained therapist, the experience lacked therapeutic benefit. This highlights a key difference between IV ketamine treatment and ketamine-assisted therapy (KAT).

Why Ketamine-Assisted Therapy is Superior to IV Ketamine

One individual reached out to me, and shared their experience with IV ketamine treatment:
“Essentially, I go in, they put in the IV, the doctor tells me to think positive thoughts and walks out of the room. I don’t like that as soon as I’m done, I basically get in my car and leave. I’m left to go home, alone with racing thoughts and flashbacks."

Though this may not be the typical experience, it underscores a critical issue: the lack of integration. Many clients undergo a dissociative experience, then leave without support to process what they’ve gone through, which can feel isolating and unsettling.

In contrast, during KAT, the therapist is present throughout the session, offering real-time support, monitoring both physical and emotional responses. As the effects of the ketamine wear off, clients are encouraged to process their experience, ensuring a smoother transition back to reality. I’ve found that healing happens not only through the medicine but also through the therapeutic relationship.

If you're interested in exploring whether ketamine-assisted therapy is right for you, reach out today.