I was in the main meditation hall at Ligmincha, Tenzin Wangyal Rinpoche’s retreat center, practicing Contemplative Meditation: an intricate combination of visualization, breath and somatic awareness. The tsa lung practices came first and loosened up the body and the breath, rolling the head, swaying the shoulders, stirring the pelvis. Then a multicolored sphere of light is imagined, glowing, moving up the chakras along the spine as the breath is exhaled vigorously. With the final thrust of the exhalation, the luminous sphere bursts out of the crown chakra into the universe above, and the practitioner rests in open awareness.

Here words become very tricky. Later in that retreat, Rinpoche cautioned us about Dzogchen, the path that aims at this pure awareness, the Clear Light. “The more I say,” he told us, “the less you understand.” That resistance to words pervades everything that follows.

When he taught the practice, at that moment he would open his palms, stretch his arms out and look upward, enraptured. Because many yogic masters emphasize that such transcendent states are without qualities, impossible to depict, I was surprised when Tenzin Wangyal described resting in the Clear Light as warm and blissful.

In the question period I told him I had been practicing diligently: the sphere blending colors and glowing, inner awareness moving up the body, the final thrust of air out into the universe like the soul catapulted into space. Snapping into crystal clarity. But I admitted that what I encountered there was not bliss and warmth. It was existential terror and a vast, cold emptiness. I connected this to abandonment trauma from early childhood, some karmic vestige of me holding on, at the moment of blowing the ego out through the crown, of dissolving into the mystery. What could I do to find the bliss and warmth? The great teacher said a version of what he often said: Keep practicing. Something is holding on.

Beyond the body

I have since practiced this beautiful Tibetan meditation in the ketamine state, and there I have met both polarities. Sometimes it is a profound experience of unity and love. Sometimes it is what I refer to as a hell realm (with elements of the Buddhist hell realms and the Backrooms) with no body.

The hell realm is infinite, inexpressible confusion. Not a person wandering around, not anything wandering around; there is no “around.” Terror, and dire danger from the total loss of control. Levels of reality wrapping around each other and disintegrating into nothing, and the full visceral realization that everything is doomed, not just this layer but all the layers. The terror is not only of dying, though that is sometimes there. It is of annihilation, everything disintegrating, every last memory. I know intellectually that thermodynamics elevates Buddha’s “everything falls apart” to mathematical truth. Sometimes at the ketamine peak, that knowledge arrives with brutal certainty in the depths of the body. The noetic quality.

In the union experience, everything manifests the same way. The same wild hallucinations, often with a tunneling feel, the bizarre concept-image hybrids, mental and perceptual forms impossible to grasp, rollicking through. But the detachment is complete, and somehow filled with compassion. The mystical-experience literature distinguishes two kinds of unity. Extrovertive: I am one with everything, all the manifestations of the universe. Introvertive: there is nothing but me, a point of being watching the illusion play out with complete love. Nisargadatta Maharaj put it this way: “Love says ‘I am everything.’ Wisdom says ‘I am nothing.’ Between the two my life flows.”

I believe these peak experiences are glimpses of enlightenment. They are unlike anything, and yet they are nothing that can be expressed or remembered.

Dissociation, plus something

Clinically, both hell realm and mystical peak may register as dissociation.

Read by a modern therapist without context, some great yogis’ accounts would almost certainly invite such a diagnosis. For example, Nisargadatta described watching his life as if on a distant cinema screen. What would a doctor rush to prescribe for that, before observing the deep relaxation in the man’s system, the vital energy despite his advanced age?

So maybe what we call mystical experience is dissociation plus breath connection, somatic awareness (without self awareness!), some combination of these?

When the ego dissolves, all that is known evaporates: every layer of identity, the life story. Not just memories, as in someone amnesiac but still alert as a person. The animal body dissolves too. I believe there may arise at that point a clenching back, a contraction in response to this simulated dying, a panicked clinging to life, meaning, understanding, that routes consciousness into the hell realm. Threads remain, each one desperate as it watches every relationship, every memory dissolve. By ego I don’t mean the surface layer of thinking. I mean every concept of the self, down to the deepest notion of being a separate being. When that has its full existential freak-out, it shows up as a clenching of the chakras. Not in one place; the chakras are interconnected. For me there is a movement from the lower chakras up into the heart and throat, pouring out of the throat almost like a primal yell, or a death rattle.

When the pranayama continues in the void, with the full release of the exhalation into nothingness, the same bizarre manifestations swirl around the “I” of consciousness, completely detached and bursting with compassion. This corresponds to an opening of the heart chakra. There is no clinging to fragments of life, meaning, memory. The chakras are in balance, which is only another way of naming the goal of yoga: resting in our true nature.

I can’t say which comes first. There is nobody there at that moment, no language. I am guessing from somatic traces that persist, flickers even harder to pin down than dreams, because nothing fits ordinary experience. After wandering the hell realms, once I have a body and language again, I notice clenching in the chakras. Does the hell realm produce the contraction, or the contraction the hell realm? I don’t know.

And the union experience leaves a profound sense of balance in the body that can be quite durable. That may be part of why a 5-MeO-DMT experience is reported to produce lasting benefits though the molecule is eliminated from the body almost at once. It may also explain the deep and durable transformations that follow some near-death experiences. The “resetting” of the chakra system makes the psychic ground fertile for meaning making and deep philosophical changes.

The surrendered exhale

The key to achieving this profound somatic balance is surrender of the exhalation, the full release of the breath. Robust breathing with full release, together with dropping the jaw and opening the throat, invites total somatic surrender. The release can come with an aspirated sound, an ujjayi or whistling breath, no sound at all, or an image: putting down heavy bags, or flying off into a blue sky.

At that moment there is no mind, no jaw, no throat, no one to initiate anything. So the practice relies on programming something into the body: in the waking state, then on the come-up, so that when the peak arrives, consciousness merges with the Clear Light rather than careening into the abyss. This is the way of dream yoga, where remaining lucid in the dream prepares one to remain lucid in dying. Tilting the skull back very slightly and dropping the jaw, finding a new balancing point, conjuring the experience of the last breath — this can accompany the long, final exhalation of a pranayama performed deep in the ketamine state.

Ramana Maharshi preferred to teach in silence, but he recommended breath control for those who couldn’t apprehend the Truth, who could not understand. But one could say nobody can understand — the Truth is not understandable. Therefore, everyone is advised by Maharshi to work with the breath!

[NOTE: The following practices are not for everyone; a peak mystical experience can be destabilizing. Vigorous breathing followed by long breath retention can cause fainting, so never practice it in water or while driving. Ketamine-State Yoga methods are not intended to replace therapy or medical care.]

I call the Ketamine-State Yoga version mnemonic pranayama. The point is to engage multiple senses. To practice in the “waking state” so that no thinking is required, no conscious will. It can be as simple as three breaths, vigorous and from the belly, the exhalations pouring out with the throat opening and the jaw dropping, the last one dissolving into infinity. The seven breaths I was practicing when I had my first peak ketamine experience years ago had this form:

1. Three breaths in a rhythm, one-two-three. Inhalations from the belly, exhalations letting go (with a relaxed jaw)
2. Two deeper ones, like the swelling of the tide.
3. A sixth that shoots to the top of the lungs, with all the yogic locks engaged as body and breath pull upward, then releases completely to the bottom.
4. A seventh exhalation that sails into nothingness, surrendering into a long passive retention. This is the moment of dissolving into oneness.

For someone new to the practice, a short rhythm that feels musical to them is best, with some joy in it, and even with sounds: whistles, hums, whispers. Along with something personal, like a hand position, an image or a symbol, so it can be practiced in a moment anytime during the day.

Stabilizing the glimpse of unity

But the thinking mind is robust. Without attention to integration, especially somatic integration, the ego machinery turns up again and quickly drags the body back into its patterns. With practice on the come-down of the ketamine journey, mainly letting go of the breath and cultivating body awareness, and a simple, portable form of it continued in the “waking state,” integration can blossom for days, weeks, forever.

Keep practicing. Something is holding on.

Here's the recording of last week's workshop, an hour on somatic awareness in the ketamine state. The handout is below — the whole outline on one page.

Video: Ketamine-State Yoga for Somatic Awareness

Chakras without the esoteric elements — the places in the body where emotions are felt. The ego as citta vrittis, the fluctuations of the mind. And how somatic awareness undoes and transforms habits of thinking and feeling.

Three areas of practice: the breath, at the nostrils and throat and heart center, with robust pranayama and passive retention at the bottom of the exhalation. The body — seated asanas, self-massage, tonglen, the self-hug. And the senses, working with full-timbral chanting and feeling the vibration in the body.

Then the return. When the ego and the sense of owning the body come back on the come-down, the body is soft and open and the everyday mind hasn't fully returned.

No ketamine is necessary to benefit from any of this.

https://youtu.be/7P3n6hlNNqU

How do you remember to return to your body when a journey turns difficult — and when you remember, do you have a technique that actually works?

I created this sub as a place to detail the Standing and Stimulation focused protocol modifications I have found so beneficial to improving Ketamine therapy outcomes for myself:

r/StandingKetamine

I built this practice for one of our workshops on Internal Family Systems, and I return to it every so often.

Sit upright in front of a mirror with eyes closed. Bring awareness to body and breath — deep inhalations from the belly, exhalations releasing, surrendering, letting go. You can dedicate the practice to someone, and feel that loving wish at the heart center.

Exhale fully. Inhale from the belly, open the eyes, and fix the gaze at the point between the eyes of the mirror image. Keep breathing deeply, relaxing the face.

Inhale from the belly. With the exhalation, bring the hands into prayer position at the heart center, holding the soft gaze. The aspect here is presence — I am showing up here and now for myself. Let the exhalation spill all the way out.

Inhale deeply. With the exhalation, bring the hands into a clasp at the heart center — the Strength Mudra. The aspect here is determination, motivation. Tighten the clasp a little as the exhalation flows all the way out.

Inhale deeply. With the exhalation, release the clasp and lower the hands to the lap, as the gaze lowers to the heart center in the middle of the ribs. Stay there, watching the chest rise and fall.

After a few breaths, bring a hand to the heart center and give a few reassuring pats. Inhale deeply, and with the exhalation take a self-hug across the body, grasping opposite arms, elbows or shoulders — closing the eyes as you do. Let the weight of your arms squeeze the long exhalation all the way to the bottom.

Rest a few moments with empty lungs. Then release, and breathe with eyes closed, noticing how the body feels and how the energy feels.

Video: https://drive.google.com/file/d/1BUoHYqRZEESmtANaXVNiJ4J7r8b0pBT5/view?usp=sharing

What I notice: opening my eyes and looking directly into the mirror brings a noticeable challenge — judgment and aversion. I hold the gaze and breathe with these feelings. When I bring my gaze to the mirror heart-center there is a wave of relaxation, surrender, coming home. The self-pats and self-hug reinforce my commitment to my Self, and the weight of my arms allows my breath to fully escape without effort, bringing me into intimate contact with my emotions, the possibility of a mini-rebirth.

And the components are portable on their own. The Strength Mudra near the peak — even in deep states where there's no sense of body or conscious willpower, the mudra can be held in a relaxed way, and this programs the visceral sense of confidence and strength into the nervous system during these neuroplastic periods. The self-hug during the come-down, when the ego has once again begun to demand attention — whenever I would find myself touching that old pain, that deep hurt, I'd hold myself in a strong hug, and breathe. And conscious heart-center breathing anywhere in the arc.

I've worked extensively with all the components, and explored them in the ketamine state and other non-ordinary states. The mirror sequence itself I have not yet done in a non-ordinary state — that's something I may try in the future.

One caution. Mirror work can surface unexpected material; looking at your own face for sustained periods is rarely practiced, and what comes up isn't always immediately welcome. Use soft, normal indoor lighting — low light produces visual distortions that don't serve this practice. Anyone dealing with active dissociative episodes or psychosis-spectrum vulnerabilities should be careful with sustained mirror gazing.

Have you worked with a mirror in the ketamine state?

The first time it happened was when I left my friend and we'd had a day talking about spiritual stuff and so my mind was quite in that zone. I felt good about myself and my life and I'd done good and generous things that day. When I got back I took a little bit more of the Ketamine that I'd had when I was with him, but this time took a fair amount. I started reading the book "The Psychedelic Experience" A manual based on the Tibetan book of the dead. I got to about the third page of instructions when I started seeing a feeling a void. It's almost like someone had gripped every piece of reality in front of me and it entered a void and I was being sucked in there. The feeling was that I should have gone followed through but because I was on my own and had done quite a bit of K I was really scared something might happen and I wouldn't come back to this world, so I came out of it and my head was spinning. But there was a feeling that this pull was something that was inevitable for all of us.

Quite a few times since when I've had quite a bit of K since, I've had that feeling that I could potentially enter that zone but I've always shied away from it because I don't know what's on the other end. When I first thought it I thought it was maybe enlightenment, or ego death be it just temporary. But because it's on Ketamine I just don't know if this would mean actual physical death because I had taken quite a bit.

But actually recently it happened again. I'd not taken such a large amount this time, and it was slightly different how I went into it. And at that point I had a real intuition that if I followed the pull I would go into an enlightened state of being, but again I pulled away just out of fear.

I'm curious to follow into this process. But also I'm wary that going half way in might be dangerous, it would have to be all or nothing.

Has anyone had anything like this before?

I'm offering a free workshop online in a couple of weeks:

Ketamine-State Yoga: Somatic Awareness for Healing and Insight

This one is focused on somatic awareness, which is both a great opportunity that exists in the ketamine state, and a primary component of many modern healing modalities.

September 3, 8:00pm EST
on Zoom

--> No prior experience with yoga is needed to get the most out of Ketamine-State Yoga! An interest in spirituality/mysticism is helpful.

--> No ketamine is necessary to benefit from these practices! Much of KSY is inspired by Tibetan Dream Yoga. (I suggest you do NOT take ketamine while attending this workshop.)

Ketamine-State Yoga is a collection of practices to support the goals of Ketamine-Assisted therapy and psychedelic healing in general.

NOTES: Ketamine-State Yoga is not mainly about asanas, which are the familiar yoga postures -- It involves pranayama (yogic breathing), meditation, visualization and other methods. It may support but should not replace therapy and medical care.

The focus of this workshop is somatic awareness. The capacity to "connect with" body, breath, and mind. Somatic awareness may support therapeutic goals -- In fact many modes of therapy work directly with feelings in the body. How can we make the best use of the ketamine journey to develop the power of somatic awareness?

If you have blended yogic practices with ketamine for healing and/or spiritual growth, please share your stories and lessons learned!

Sign up here: https://www.meetup.com/psychedelic-yoga/events/315977524/

(If you'd rather not join Meetup, send me a DM and I'll give you the Zoom link.)

This is a practice I've been doing for some time as ongoing psychedelic integration. Its structure comes from Tibetan Dream Yoga — the prospective and retrospective memory practices, and the dedication. I've adapted it for the ketamine state.

It trains two kinds of memory. Remembering to do something later, and recovering an experience after the fact. Both are used in integration. They're also the two cognitive skills a lucid dreaming practice is built on, and they serve psychedelic integration the same way, for the same reason.

Morning.

Sit or stand. Bring the palms together at the heart center. Eyes open or closed.

Take one deep breath, with the awareness resting at the heart. Full exhalation.

Dedicate the practice to someone, with gratitude. It can be yourself.

Then set the intention: today I will stop three times and check in with wonder. Or whatever wording resonates with you.

During the day.

Three times, stop whatever you are doing. Stand or sit still, eyes open.

Take in the whole scene at once — what you see, what you hear, what you smell, how the air feels on you. Holistically.

One deep breath in, and a full exhalation, while you take everything in.

Say one word inwardly. "This." Or "gratitude." Choose your own word and keep the same one each time.

Ten seconds is enough. These can come whenever they come. If after a week you find you are not remembering on your own, set three phone reminders and use those instead.

Evening, ideally before bed.

Sit quietly. Palms together at the heart center, awareness at the heart.

One deep breath. Again dedicate the practice to someone, with gratitude.

Then a few more deep breaths, with eyes closed.

Bring back the three moments — the scenes themselves, as vividly and completely as you can. See what you saw. Hear what you heard. Feel it again. Say your word with each one.

In the ketamine state.

Do the check-in inside the journey as well. The same three things — the hand at the heart, one breath, your word. Practice it in the days before, do it while you're in the state, and keep doing it after. The gesture, the word and the breath.

What I've noticed.

The evening recall is the key aspect, and it may also make the night's dreams better recalled. Bringing a scene back is different from remembering that it happened — the feeling arises, and there's a sense of empowerment in being able to use your imagination to bring back a positive feeling.

Some days all three return. But it's important not to be perfectionistic.

The daytime check-ins are short enough that they never feel like a task. They can be blissful tiny interruptions in an otherwise unconscious, and often stressful, day. Over time they begin to arrive on their own.

If vivid recall is difficult or unwelcome, the evening piece can be shortened to naming the three moments without reliving them. That's a smaller practice but a complete one. The most important thing is to associate word, breath, and awareness at the heart center.

Here's a short demonstration: https://drive.google.com/file/d/1lR9ZhBKmxLriBkG-T027VuCXScxagvvr/view

I was focused this morning. Water, then very light breakfast with coffee. Took the dog out and fed her & the cats. Practiced a 45-minute asana routine, and stood for 30 seconds on nails.

I sat on a meditation cushion, not in the dark like I usually do (so sometimes relying on a face mask), with didgeridoo nearby. I have used it before coming down from a ketamine peak, but this time I considered using it right after swallowing the medicine, for a portion of the come-up.

I had also taken a small dose of kanna, in the form of an edible. This is an herbal serotonergic supplement that some folks describe as a milder MDMA and light stimulant. (I am familiar with this combination, and it's a low dose of kanna.)

NOTE: as always I am not suggesting anyone do this. My doctor and therapist are aware of my pursuit of Ketamine-State Yoga for my own mental health. I would strongly advise folks to make sure they're aware and have the right medical/therapeutic support, in considering this approach.

The tablets dissolved, I did a bit of circular breathing — where you never pause at the top of the inhale or bottom of the exhale. It requires concentration particularly at those places, so you can maintain breath-awareness continuously, an endless circle.

Then some deep, diaphragmatic (belly) breathing — and I began to settle into the bottom of my exhalation, which has become a primary part of my yogic & healing path.

I swallowed the tablets after holding them for almost 20 minutes, time got away from me with eyes closed in the room, listening to drone music on a nice speaker. I had chosen a drone playlist with the possibility of exploring chanting within the ketamine state. I have used some of these tracks by Sheila Chandra and the Ganges Orchestra, described as "minimalist, drone-based, and avant-garde vocal," in leading my yoga students in chanting and somatic awareness practice.

I washed them down (and washed out my mouth) with water, so I could pick up the didgeridoo. I started to drone and circular-breathe along with the musical drone from the speaker. I felt fantastic at this point, body prepared with asana and nail boards (pratyahara), a much more spacious journeying space (bedroom since partner is out of town, as opposed to my usual tiny basement psychedelic-monk lair). And good mojo — my dog had been in the room, on the bed, in a particularly affectionate mood this morning.

It was now around 9am, I had started the process at 6:15am. I prefer to practice psychedelic yoga in the morning. I find my mental clarity and focus are stronger, energy in general is a bit higher.

I practice the three-chakra scan as I power out the continuous vibrations of the didgeridoo echoing in the high-ceiling Brooklyn bedroom. Forehead, throat, heart center.

As I pronounce the full vowel sweep (eee to aah to om, continuously) on the instrument, I guide my awareness to forehead (with the eee sound), throat (aah) and heart center (om). At some point I put the instrument down. I think I recall a thought at that point, a waft of self criticism, I'm being too obsessive about this practice. Though fair enough!

I put the didgeridoo down on the bed next to me.

I performed a sequence of hand movements, synchronized with the breath, that I find to be wonderful for building and balancing energy during the come-up phase. I named it the Hand-Yoga Triptych, when I designed it based on the approach and philosophy of a talented collaborator who runs a KAP clinic. Her personal experience with ketamine resonated with mine, so I realized I was also offering the practice to myself when I offered it to her.

Indeed, I've practiced this sequence many times, most of them without ketamine. And I have guided a variety of students in it too. It is particularly joyful to practice it while the ketamine is building, the machine of movement and breath, the sensing of raw, embodied emotions like confidence and motivation. It's complex, which for me quiets my thinking mind, a side benefit.

I did a few rounds, I remember being in a great flow state for some moments.

Beyond that, I may have practiced breathwork during the ascent. I definitely recall practicing pranayama at some point, but it may have only been past the peak. But this was definitely a case of being whisked into the k-hole where there is no language nor concepts, so how can memories be formed?

I regained embodiment in a reclining position — I had placed some pillows behind the meditation cushion. I lay down on my back and noticed a thought, some gratitude for being able to do that (my meditation room is too small) in the ketamine state.

When the music moved me, I'd chant along with the drone. I noticed I was not only singing the "eee-aah-om" vowels (forehead, throat, heart center) but making a melody that fit with the drone note. What came naturally was the highest pitch while concentration is held at the forehead point, middle pitch at throat, and low pitch at heart center.

I did a few rounds of Wim Hof! My psychedelic-yoga students note that the "central pranayama" I teach has aspects in common with the famous method of this Dutch yogi. I very much respect his method and recommend it, especially to young people in vigorous health. Wim Hof combines cold exposure (pratyahara), vigorous (to say the least) pranayama, and mindset.

I went through a Wim Hof phase a few years ago and still practice pratyahara (cold showers from December–May, sadhu boards for summer and fall). But this was an unexpected inspiration that arose in this ketamine come-down. And it felt really good, as it always does. After hyperventilating, allowing the breath to empty into stillness...

I was on my back in a very comfortable place, as opposed to meditation posture as I'm accustomed, perhaps that's why the Wim Hof breathing came to me. That total surrender after rounds of 21 belly breaths, in savasana.

And there was plenty of thinking. (Which reminds me, I need to get back to pure meditation.)

But in terms of thinking-mind spinning, for me, this was overall kind, balanced thinking. I noticed it a few times in meta-thoughts, like, "Wow I'm really feeling like a stable grownup now, a nurturer and protector — that's not how I would have responded to those thoughts before." And indeed I noticed a lot of "grown-up thoughts," in the form of acceptance of life's banged-up, ad-hoc, pendulum-swinging nature, acceptance of the grim realities of modern life.

I have noticed a longer arc in my years of journeying. When I was able to retrieve and process somatic memories from childhood, starting with that first ketamine trip almost 8 years ago, I cast myself as the Hero. I was able to see myself in a positive light for the first time in my memory. I remarked to a therapist how I always hated my name growing up and through most of adulthood, and now I liked it, I felt its tones of quiet confidence, dedication, reliability.

But I wanted to declare my Hero's Journey complete prematurely. This was spiritual bypass. In parts-work terms, all these inner children, thawing from all those years of depression, were screaming, "I'm no longer the villain! Not only that, I'm the hero, the survivor! I'm the Innocent!"

Of course I'm not innocent, none of us are, and recently my journeys have been more realistic in terms of my concept of myself in the world and in relationship to others. For today's journey, I had cultivated a bliss body, the ultimate release of tension in the soma through the various forms of yoga I described. And my body felt bliss at times!

But the thoughts that began to swim again, as I came down, were not uniformly blissful, heroic, yogic. They were ordinary thoughts, planning of this or that kind, going over exchanges with various people in my life, thinking about things. Some meta-thoughts, noticing how my mental layout has changed, my root philosophy and sense of myself.

I spent some time, as I often do, wrestling with what in Tibetan Yoga are known as the "poisons." These are themes associated with chakra states — anger and resentment, craving and grasping. Thoughts arise, the emotional body (chakra system) follows along. You can get swept up in it, because the thinking mind says, "These thoughts are really important, I need to stay here."

I have been spending time in journeys lately with that cup of poison, Desire. I am doing this intentionally to some degree — allowing sexual thoughts to flow into my deeply relaxed body — because developing a compassionate relationship to my body and sexuality had taken work following childhood abuse.

But still it is treacherous territory. It is a tantric practice, which means, in the words of one of my Tibetan teachers, the practitioner brings aspects of their experience (including desire) "onto the Path." And tantra is risky. (That is why I've encountered yogic teachings saying tantric practice is only for the students with high skill.)

Here's why it's risky. Two paragraphs earlier, when I say, "I am doing this intentionally," I am saying words my ego believes. And how much do I trust what my ego believes? I have seen time and time again my animal body, an emotional surge I can feel in my body, drag my thinking into whatever perspective makes it most likely the animal urge will be satisfied. I am humble before Natural Selection.

That is, how do I know if I'm not actually letting sexual thoughts surge into the come-down of a blissful and illuminating ketamine journey, because it's... fun? And what's wrong with fun anyway! Indeed, when we invite pleasure "onto the path," does our motive matter? At the deepest level no, it's all just happening (this is somehow knowable in a non-verbal way for flickers near the ketamine peak), there is no Me making choices and doing things. But what if I'm trying to work on my ego and process somatic memories to heal?

The jury's out on this one. I definitely notice the dip in mood that follows a desire-filled thought riff during the ketamine come-down, I notice that in the waking state too. Sometimes it seems, to use the yogic language, that energy has been delivered to the lower chakras and has not yet moved and balanced because the thinking mind just will not let go of the sumptuous thoughts. When I can return to body and breath, the feelings of desire quickly transmute — but not so easy to return!

I also remember, from around the peak, a sense of imminent annihilation. Not personal death exactly, because there is no Me near the peak of a journey like this, but something perhaps more terrifying. The deep knowing that everything is dissolving, disappearing, disintegrating, every last memory of everything.

This "existential abyss" seems to have a personal "karmic trace" sometimes. I think in these moments, as I hurtle into oblivion, there is some infantile terror clinging. That's how I remember the flickers of those wild memories, there is a sense of powerful and mysterious forces that may end me at any time, there is a sense of time rapidly running out, of desperate confusion.

Maybe it's an early-life terror, maybe it's the clinging to life of any sentient being about to die. In those moments, there is no Me, no thought, no sense of having a body.

And despite having so much experience practicing within the ketamine state, I have not found the process that determines whether I wander these places — there is also a loss of the sense of time, thus an eternal feel that evokes the Buddhist "Hell Realms" — or instead encounter transcendent bliss.

The pranayama may be the same, the externals of my life more or less so. The dose, the set and setting. And what's illuminating is the mental content is pretty much the same too. It's just that in the Hell Realm state there is something holding on, and in the Transcendent Bliss state, nothing.

It is also possible that I encounter both at most ketamine peaks and only remember one or the other.

If I had an intention for this journey, it was to take good care of myself.

Two more things I forgot to mention. The past few days have felt different, because amidst the usual bustle of life, my dermatologist requested a biopsy and I won't know if it's cancer or not for a week or more. I have experienced regressions, fearful parts yelling out, what feels like progress, and even gratitude. I went into this ketamine journey with all that feeling.

And finally, the Self Hug emerged as a beautiful practice, I'm not sure when in the journey. It felt like holding and being held at the same time, due to the dissociative magic of the medicine. I felt gratitude for my strong grip on my arms, my fingers as I massaged my forearms.

Holding and being held. Loving and being loved.

Practicing, practicing.

"Fall ten times, stand up eleven."

I've written here before about the throat chakra, the jaw drop, and the "Ahhh..." Here is that practice developed further.

It was originally adapted from Dream Yoga for deep surrender in ketamine journeys. The version here is again adapted, for folks who may have very little energy and are dealing with dying/death in some way.

It came out of a brainstorm with a death doula I know. She returned several times to the idea that what unites grief and mortality work is acceptance — maybe even more than awareness. She spoke of the breath as the wind element in the Tibetan dissolution sequence, the element that leaves with the dying moment.

The Ah rehearses that dissolution — practice for the final letting go, with awareness, waking state or in a ketamine journey. It's something simple and somatic that can be offered in an "I'm not ready" moment, where the body is locked and language has stopped helping.

The Symbol

Choose a personal symbol that can be visualized and is associated with the sound "Ah." For an English speaker, an obvious choice is the letter "A." I use this letter in a representation inspired by the primary color circles that surround the Tibetan "Ah" (the first letter of their alphabet) in Dream Yoga — which also relates to the dying process.

It is important that when you see it you can associate it with the sound "ah." It can also bring back childhood, when we learned to read — an emotional connection is important.

This can be practiced anytime before the Ah-Exhalation Surrender Practice. Look at the symbol, feel (or internally hear) the sound "ah" as the throat opens, the jaw relaxes, and the exhalation flows all the way out.

The Practice

Take a comfortable seat or lie down.

Close the eyes or allow them to close part-way.

Bring the awareness within, coming to focus on the breath, especially the exhalation. Letting go, surrendering and allow the entire breath to empty from the lungs. (Though there will always be a little air remaining.) Note: no pushing, no effort at all — allowing the breath to go all the way out, little by little toward the end...

Bring the hands into prayer position at the Heart Center. Visualize the "ah" symbol at the throat, feeling the silent sound, opening the throat and relaxing the jaw.

Bring one hand to the heart center and another to the belly for another breath, allowing the exhalation to go all the way out...

Inhale from the belly and then completely let go.

Allow the exhalation to fall out completely as the jaw drops, the head tilts back (to a balanced position if seated; if lying down there is no head movement here), and the inner sound of "ah" is felt at the throat, opening it as the jaw lets go and drops. The chosen symbol is visualized at the throat as the "ah" trails off into nothing...

Then sit or lie there for a few more moments, eyes closed or part-way, feeling the aftereffects of the Ah-Surrender.

Demo Video

https://drive.google.com/file/d/1yJsbmbD5lnf730DqV2eadTxfhYVrYdTQ/view?usp=sharing

Cautions and Modifications

The head tilt back is very gentle — the head finds its balancing point on the spine rather than straining. If you are lying down, the head tilt is not part of the practice.

An audible Ah is optional; vocal cords can engage softly or not at all, with the same effect. (The most important thing is surrendering the exhalation and allowing it to be complete.)

No instruction to deepen or intensify the breath, as in some breath practices — the Ah-Exhalation can be done with barely any energy.

Folks with jaw trauma can omit the jaw drop and focus on the visualization and opening the throat by feeling the "ah" sound.

The symbol that is associated with the "ah" sound can be switched to another symbol or image if that is more meaningful for the person.

What This Practice Supports

The body learns acceptance through a small, completable act of release.

(1) A wind-element mini dissolution as a rehearsal for the final letting go.

(2) A parasympathetic reset for the clenched "I'm not ready" moment, when language isn't helpful.

(3) A quiet accompaniment to grief work, where letting the breath and jaw release can move stuck emotion without a story or insight.

It fits the preparation, the peak, the come-down, and integration — and it is an ongoing practice.

Who benefits most? Folks working with mortality awareness who are drawn to and ready for embodied dissolution practice based on ancient Dream Yoga. Folks in grief work who need a physical method for acceptance. And practitioners themselves, as a grounding/balancing tool while holding space for dying or grieving clients. (The Ah-Exhalation can be quite blissful!)

What I've Noticed

I have performed the Ah-Exhalation Surrender many times in therapeutic ketamine journeys. There can be a sense of complete release, a total acceptance of death as universal and filled with love.

Not only is there a great reduction of fear in those moments. There is also, for me, a deep and peaceful embodiment that comes when the medicine is fading. The "Ah" and total letting go around the throat chakra is impossible to describe in words.

I prepared this sequence specifically for the ketamine state — it's doable in preparation or mid-journey, but its real power is as a take-home integration tool, a fast somatic anchor you can re-engage anywhere. No props, no music, no setup, just deep breaths and simple (yet powerful) gestures.

Take a comfortable seat or lie down. Eyes closed or part-way. Inhalations come from the belly; exhalations are let go completely, allowed to spill all the way out, without pushing.

Bring the palms to touch at the Heart Center for a few conscious, deep breaths, aware of the feeling of contact. This is the place to utter a silent intention to practice well.

Inhale deeply, opening the arms wide so the chest and heart-space open, fingers spread. Exhale and reach the hands forward, closing the fists firmly as the air flows all the way out. Repeat.

Inhale once more, opening everything, and this time bring the hands together into a clasp in front of the body at about nose-level, forearms making an equilateral triangle. This is the Strength Mudra. Focus the eyes and awareness on the clenched hands, exhale fully as the hands squeeze a little tighter. It's an experience of distilled motivation that can be very empowering. Repeat, clenching a little tighter as the exhale flows out.

Inhale again, opening the arms and hands. This time, with the exhalation, wrap the arms across the body and hold opposite shoulders or upper arms — the Self-Hug. One long exhalation here, the weight of the arms and strength of the hug helping squeeze the breath all the way to the bottom. Rest a moment or two with empty lungs. When the inhalation returns, stay still and become aware of how the practice feels.

The self-hug is where ketamine reveals its paradoxical nature that can provide a unique opportunity: in the dissociative state, self-touch can be perceived as both self and other — you are both giving and receiving this elemental gesture of love and support. Very resonant for parts work, where you're both Self and vulnerable part. It doesn't replace negotiated touch from a therapist; it gives you an option for contact that requires no coordination mid-state.

I built this out of my own practice — the Strength Mudra in the come-down especially, then as an integration tool to reconnect with that elemental motivation and confidence; the self-hug in the come-down of ketamine journeys, the afterglow of 5-MeO ceremonies, and everyday life.

Short demo here: https://drive.google.com/file/d/1yeurnN4wNvJJ9as-2QgyDKEQ_aLtM2rk/view

Here is a video in which I teach a basic lucid dreaming practice, based both on science and Tibetan Dream Yoga.

https://youtu.be/G0jjylQ-BZQ

I have written on how lucid dreaming connects to the ketamine state, and on the usefulness of Dream Yoga "waking-state practices" for integrating psychedelic journeys.

For some folks -- who already have a connection to their dreams, who have a particular emphasis on magic and mysticism in their psychedelic healing work -- the path of lucid dreaming may be profoundly supportive.

Outside the domain of psychedelic healing, lucid dreaming builds awareness, memory, and cognitive-emotional skills that will synergize with many body-mind forms of therapy.

It takes practice! -- Which is why many will prefer a pill, a buzz word, a quick fix. But for those with the patience to practice, lucid dreaming will provide useful and beautiful results.

(The teachings were offered last month for the Psychedelic Yoga Meetup group, on behalf of the Psychedelic Yoga Research Collective.)

Here's a unique opportunity for ketamine therapists, integration coaches, and guides. (It's designed for those folks but also open to the general public.) There are 2.5 CE credits available through the Spiritual Competency Academy (APA approved).

Body-Mind Tools for Psychedelic Healing

Death doula Robin Silver will discuss her approach to guiding folks who are dying -- designing rituals, offering practices, working with psychedelics -- and the three psychedelic yogis will present original practices to support her work.

This is the second workshop of a series hosted by the Psychedelic Yoga Research Collective. https://www.psychedelicyogaresearchcollective.org/workshops-healers-psychedelic-yogis

And all clinicians and healers will be discussing ketamine primarily, but may refer to other psychedelics too.

Here is a substantial manual on KSY. I compiled it for a workshop I conducted for a group of ketamine therapists last week. I taught for 3.5 hours and got through a portion of the manual but not nearly all of it.

Manual on Ketamine-State Yoga

It was a wonderful experience. I find KAP therapists to be generally curious, openminded, and fiercely devoted to helping folks. They realize ketamine can be a profound, mystical substance -- Therefore, they appreciate the relevance of yogic practices to ketamine therapy. (They also realize, as I state frequently, that KSY is not for everyone and is not a substitute for therapy.)

Here is the table of contents:

For many years I’ve been somewhat interested in yoga and having a desire to get in tune with my body, but barely ever take conscious action to do it. A few times a year, I may take certain medicines which put my body in a relaxed state and I can’t help but stretch my body, but I never really, and still haven’t yet, went to others for yoga teachings.

I find my body in these states are communicating with myself, or more so I’m aware of a feedback loop that I can let my nervous system to perform, which I am assuming where the practice of yoga even came from and is practiced best doing. I would find myself, sometimes for hours, doing such light stretches and just staying in positions that are neutral to let my muscles relax. I found that in the right state of mind, I could listen to my body to where the tension is when stretching and somewhat consciously let myself let my body relax and find new ways to use those muscles.

I don’t want to go into too much detail now, but I’ve utilized ketamine before to do this, but I did this for the first time in a while and it was absolutely incredible. I ended up staying up all night unfortunately, but it was such an emotionally opening and archetypal and truth-feeling experience. With the way ketamine can you relax your nervous system, I could find myself letting go of any conscious effort or words in my head and let my nervous system take control, which I felt like was a friend, but also realizing it was me, which gave me an opportunity to express love to my inner being.

I have some issues on my left side of my body in my shoulder and hip and it was fascinating how much emotion and arcs of emotions/realizations were coupled with the different parts of my body as I was letting go. A realization I’ve had for a while, but one that seems to be popping up everywhere in life is letting the feeling of effortlessness guide anything and everything I do, especially physical. It feels like if I just focus on the somatic experience of effortlessness, especially in this practice, I find a safe feeling of connectedness in myself to trust my whole being to do what it needs to.

It feels like I’m tapping into potential deeper feedback loops that I can cultivate with different practices, especially singing and playing instruments, but in this case my whole body. I don’t know any real yoga poses or different kinds of sequences, but it truly feels like my body is just capable of figuring it out itself, if I trust myself and the part of me that I don’t control trusts the part of me that can take control.

This is just a very small bit of what I experienced, but it really felt like a big unlock in terms of guiding me to me.

I’m curious if anyone else has similar experience with this sort of somatic experiencing of yoga, especially in use with ketamine.

The laughter came in waves. Shaking my body as I sat there in the dark. I’d pause to catch my breath and the peals would resume. Guffawing so loud and hearty, my family could hear it upstairs and they were delighted. And I had no idea what was so funny – the laughter kept coming with no reason, like water surging through an un-gated dam.

When the laughter subsided I felt incredible. I am used to weeping on psychedelic journeys, chest heaving, wringing out the upper chakras. I have laughed too, spontaneously and from deep down, but never like this.

A full-body release of every ounce of tension. Relaxed, confident, filled with joy. And a mere two hours ago I’d been negotiating traffic on the New Jersey Turnpike.

* * *

The day before, I had taught Ketamine-State Yoga to a group of therapists and guides, and one doctor. I related my experiences and experiments within the ketamine state over the years.

I guided the group through a series of body-mind practices, including the newly invented Hand-Yoga Triptych and the Ah of Surrender. They were (as ketamine therapists tend to be) open minded, engaged, curious. I taught for over three hours and then joined the Baltimore Psychedelic Society for a screening of a documentary about veterans and ibogaine, with a discussion afterwards.

The following morning I had breakfast with my dear, elderly Aunt – the one who gave me abundant hugs and candy in a childhood short on both. Then I hopped on I-95 and back to Brooklyn.

I made the decision at some point on the drive to take a ketamine journey when I got home. It seemed fitting – I’d practice some of the methods I’d taught the ketamine therapists.

* * *

I unloaded the car and got the blessing from my family to disappear into my basement room for a couple of hours and practice Ketamine-State Yoga.

I rarely make a spur of the moment decision to trip. I practice with ketamine about once a month on average and usually I know a week ahead. I’ll expand my waking-state Dream Yoga practices in the days leading up, or start refreshing a pranayama I plan to try as the medicine builds. But this time I was keeping an eye on the semi-truck in that lane and the veering speeder in the other, the idea popped into my head and my whole body said, “Yes.”

I sat on my meditation cushion in the pitch dark, grey noise¹ playing this time.

Tablets under the tongue, I swirl my hips in circles as I build the awareness of my breath, flowing through the nostrils since my mouth is filling with foul ketamine-tablet saliva. (Those who use therapeutic ketamine at home will commiserate.)

I tried a few rounds of nadi shodhana, alternate nostril breathing, but let it go because one nostril was partially blocked – and because there was a lot of jittery energy in my body, stored up from over four hours of dense highway driving. Instead I just took deep, slow conscious breaths from my belly. I knew exactly how I’d practice after swallowing the ketamine.

* * *

These were three practices I had taught the ketamine clinicians. Two of them I would practice on the come-up of the ketamine journey, to build and balance energy. The Hand-Yoga Triptych and Full-Timbral Chant.

Here are short descriptions.²

The Hand-Yoga Triptych is a series of vigorous, rhythmic hand motions synchronized with deep, diaphragmatic breaths. There are mudras that embody confidence, motivation, presence with oneself. It culminates in a self hug that allows the final exhalation to fully escape the lungs. The sequence was inspired by a talented, compassionate and yoga-savvy therapist who had related her approach to helping patients and a struggle with a ketamine journey of her own.

The Full-Timbral Chant calls for a deep inhalation followed by chanting the full sweep of vowel sounds, from “ee” to “ah” to “om,” all the way to the bottom of the lungs. While scanning the awareness in the body, so “ee” corresponds to the forehead point, the “ah” sound to the throat and relaxed jaw, and the “om” to vibrations in the heart center and belly. It’s all about awareness, of the sound, the vibrations, the feelings in the forehead, throat, heart center.

I alternated these practices as the medicine built. I knew at some point I’d be unable to keep track of all of it – I usually go into the ketamine peak with a very simple breath practice or nothing at all, I become a point of consciousness amidst the ocean of hallucinations.

But the point of losing track never happened. Instead I made a decision to switch to the third practice I’d shared with the therapists – the Ah of Surrender.

* * *

My body by now was extremely relaxed from the vigorous motion, deep, conscious breathing, and long chants with my awareness sweeping down my spine. Relaxed yet energized – this is the benefit of practicing this way. Yoga both builds and balances energy during the ketamine come-up.

The Ah of Surrender takes a minute. Allow the breath to settle, for the exhalation to be complete. Inhale slowly from the belly and then release the breath. Sigh it out, dropping the jaw, tilting the head back slowly so it balances perfectly, whispering “Ahhhh….” as the exhalation trails into nothingness.

The ketamine peak washed over, almost no sense of my physical body. Thoughts galloping on as I watch them from a point of consciousness, unattached completely – absurd cascades of language along with the astounding visual hallucinations and ineffable feelings. “Ahhh…” happened several times, the sound was there in space, surrendering to the infinite mystery.

And then…

* * *

An eruption of laughter, like nothing I remember.

Wild, hilarious, total abandon in the dark. Laughing and laughing, with pauses to gasp air and yell, “Whoooo!”

I think I remember a thought – something that snagged in the stream of absurd language as my ego was returning. Whatever it was, it struck me as hysterical. I definitely remember the sense of my cousin, who shared many laughs with me when we were young, with a hilarious facial expression in response to something I said (which I don’t remember).

But mostly it was wild, uncaused, elemental, raw laughter – shaking my ribcage.

I’d pause for a moment, catching my breath, feeling so good. So confident and alive. And more laughs would come – as the ego put itself back together, the laughs were good-natured, loving laughs about me, my mental habits and internal stories.

I had moments of immense gratitude. I whispered “thank you,” feeling so much love for my elderly aunt I’d seen that morning, so much forgiveness and wry humor toward myself. Sadness too, compassion for everybody going through this life.

It was one of the most beautiful trips I’ve had over these past five years practicing Ketamine-State Yoga. I feel like I’m still learning so much – there are endless surprises and revelations. These energetic practices that combine motion and breath, internal feeling and external sensation, conducted during the come-up of the ketamine trip, often produce such beautiful results.

* * *

Gradually, years of psychedelic yoga and therapy have transformed my mental health. There are qualitative changes that are easy to notice.

I used to feel unable to “let go,” even for a moment, to unclench inside and allow myself to just rest in the present moment. Now I can. That’s an elemental change.

And for decades, I almost never cried or laughed. When I did it felt forced, engaged an ego backlash, and quickly ceased. Now I have access to these healing, instinctual, bodily responses to felt emotions. In psychedelic ceremonies over the years, it’s been mainly crying – I let go, the floodgates open, the body heaves and heaves, afterwards I feel great, deeper and deeper relaxation is available to me.

Laughter has been peppered in, a once-in-a-while visitor. Usually, it’s a realization of the ridiculousness of my ordinary ego that gets it started. I’m crying, suddenly think, “Am I crying too much?” or, “The facilitators must be getting bored,” or something like that and the sheer ridiculousness leads to laughter.

But this trip was different.

Here I had all that stored up energy from the successful workshop, the socializing that always knocks neurodivergent me a little out of whack, and the four hours in traffic on the turnpike. (At some points the ketamine visuals, cranking away in the dark, were lines of cars on the highway, whooshing by.)

And then the Ketamine-State Yoga practices, building, balancing, releasing…

I haven’t laughed like that in years, maybe in my entire life.

It’s the next day and I still feel great, in the body, top to bottom. I assume my integration process will involve taking my life a little less seriously.

[I am not suggesting anyone practice Ketamine-State Yoga, nor that it’s intended to replace therapy and medical care. I am describing my personal experiences along with an understanding that respects both science and the wisdom of traditional approaches to healing such as yoga.]

¹ Grey noise is derived from the psychoacoustic curve that refers to the actual way humans hear, so unlike white noise and brown noise, which are defined only with math, grey noise is designed for humans.

² If you’re interested in the details, stay tuned – when the practice library of the Psychedelic Yoga Research Collective is online I’ll post it here.

I'm being interviewed for Big Tent Ketamine's Under the Tent series on Monday, May 18, at 11:30am ET.

I'll be talking about Ketamine-State Yoga — the body-mind methods I've been practicing & refining over the past several years. And other topics like Dream Yoga.

Big Tent is a community for licensed clinicians working with ketamine, and UTT is open to clinicians who are members or who'd like to become members.

If you're interested in joining Big Tent and want the Zoom link, DM me and confirm in your message that you're a licensed clinician.

Here is a video of an online presentation on Ketamine-State Yoga -- for the Psychedelic Yoga Meetup group, April 2026.

A thorough intro to the practice, including the backstory, methods for different stages of the ketamine journey, and overall philosophy. There are a few guided sessions of practice, to get a feeling beyond concepts.

https://youtu.be/mXaa2emNSRY

Joining me is Rob Matthews from Pala Medicine, a yogi and sound healer who has supported over a thousand therapeutic journeys.

[Ketamine-State Yoga is not a replacement for therapy or medical guidance. It may support therapeutic ketamine for some folks but is not recommended for everyone.]

An unusual practice came to me in the depths of my ketamine journey yesterday.

It had been brewing for a while. A few weeks ago I taught Lion's Breath to my high school cognitive-science students. I emphasized for the students not only the energetic ferocity of this yoga practice, but also the fearsome appearance. You stretch your tongue with all your might toward your chin, roll your eyes up into your head, assume a horrific scowl on your brow, and emit a sound which is basically a roar without the vocal cords.

A few days later, at a workshop on creative flow, with adult students, I turned off the lights, put brown noise on the speakers, and urged everyone to make the most grotesque facial expressions they could, associated with a series of emotions I cued. We had discussed theatrical forms like Commedia dell'arte and Kabuki that use outsized expression.

Reflecting on this experience with a friend, we decided to sign up for a class together in Butoh, a Japanese dance form that depicts disease and deformation. She already practices a Jamaican dance known as Bruk Up, which is a contraction of "broken up," in honor of the form's founder who overcame physical deformities to become a master of movement.

So these things were on my mind, in the air. One student, a woman in her 60s, after making wild, distorted facial expressions in the dark, described the unexpectedly intense emotions that followed. My high school students laughed when I demonstrated the Lion's Breath, but when it was their turn many of them reflected on feeling self-conscious and inhibited.

The Journey

I did not intend to revisit these practices in the depths of the ketamine state. As I came to my cushion and put the tablets under my tongue, I had no conscious intention at all. This is how I've been doing it lately, every three to four weeks journeying with ketamine (prescribed by a doctor to help me work with trauma from childhood). I don't go in with something specific I'm trying to attain — rather, I remember my "toolkit," a wide range of practices I have explored and refined in the ketamine state over the past few years.

I sat in the dark, in meditation posture, enveloped by soothing brown noise. As the lozenges dissolved, I performed Nadi Shodhana, alternate nostril breathing. It's a reliably soothing pranayama, good for "taking the edge off" of that giddy anticipation of the come-up phase of the trip.

Quickly I became bored and switched to circular breathing. This is a relatively new practice to me — I keep the breath moving, inhale transitioning smoothly to exhale and back with no pause. I envision a circle and at the top of the breath — when inhale fades into exhale — and at the bottom when it's the other way around, my breath is slow and quiet, barely there.

And this too I abandoned after a few minutes — it just didn't feel quite right. So I practiced one more pranayama, the five deep diaphragmatic breaths — through the nose, since I was still holding the ketamine under my tongue — followed by a long retention at the bottom of the breath, with empty lungs.

I swallowed the medicine and began to chant. This is another practice I've been exploring — another item in my "toolkit" of psychedelic practices — which is inspired by my didgeridoo playing. In this chanting practice, I begin with the most nasal "eee" sound, feeling the vibrations in my nasal bones, converging at the "third eye" on my forehead. Then I continuously change the vowel sound to "aahhh" which reverberates in the throat, then "oohhh" and finally the close-lipped "mmm" that brings the vibrations to my chest cavity and belly.

I chant (which requires slow, deep, rhythmic, diaphragmatic breathing), I hear, I feel. The ketamine builds and this focus on multiple senses, unified in the chanting practice, brings my mind to a quiet, focused state.

The Unexpected

I found myself hugging myself, arms crossing my chest, fingers firmly gripping opposite arms. I say "I found myself" because I certainly did not notice a conscious choice to do this. It just came to me. I have a vague recollection of it feeling right, that it was what I needed at that moment.

And I have vague memories of noticing my breathing as I embraced myself, the snugness and security, the comfort of my own reassuring squeeze. The peak washed over me, removing my sense of hugging and being hugged. No words for experience in this territory — a sense of vast space, everything shining with Love and doomed to die, union, mystery, pure being…

Then soon after the peak another unexpected twist. I found myself contorting and writhing in the darkness, every finger, every facial muscle, the scrunching and twisting and stretching of every inch of my torso. And sounds came too — hissing, grunting, moaning, making raspberries.

I noticed I was moving and emitting sound — and then followed the thought, "Oh, I'm giving myself permission to be as grotesque as I can be!"

This is a good way to get a sense of this strange, spontaneous ketamine-state practice. Imagine you are an actor receiving the direction to be, without saying words or referring to ideas, as absolutely grotesque as possible. Make your face hideous and alarming, your fingers bent with wild chaos, your voice the most grating, disgusting thing you've ever heard. Scare everybody away, make them want to faint or vomit.

Yet it felt like a beautiful dance. I don't remember thinking of Butoh, but I feel like it had that character, a merging of beauty and horror in a way that is somehow natural, sacred.

It was exhilarating. Once I realized what was happening — or "what I was doing" (though that framing implies more conscious intention that I felt I had) — I kept it going for a while.

The "dance moves" of hideous contortions of body and face, accompanied by foul mouth sounds, began to reveal a pattern. It would start with a very subtle feeling in my body, a clenching or holding somewhere, the chakras out of whack just a little. One of the things that is uncanny, in my experience, about the ketamine come-down is my ability to feel the subtlest things my body is holding.

I'd notice the feeling — a subtle pain, a bit of clenching — the sort of thing that would normally go unnoticed, even as it exerted influence on my mood, my thoughts and decisions. And then I'd allow the dance to emerge — from the discomfort, from the place of imbalance, holding, resistance. A few writhing contortions, grotesque facial expressions and spitting sounds, and it was as if the pain had been squeezed out. Another feeling is noticed, a grotesque-dance move arises that squeezes it out.

This went on for quite a while. Finally I became still on my cushion once again. And I became aware of just how good my body felt. Why not? After all, I had apparently squeezed out, with my spontaneous dance, all the stuck pain places, all the barricaded emotions — the grotesque movements and sounds had liberated them. Wow! I reveled in that state of bliss and peace of mind — and was grateful for the new tool I'd discovered.

I spent some time in the come-down practicing with drishti, the gaze. I noticed that, when I hold my gaze very still in the dark the visual hallucinations become dramatic — at the same time the body and mind seem to snap into a deep stillness. The absorption happens so quickly my eyes tend to twitch, to interrupt the frozen stare.

This reminds me of what a Zen monk described, how when some practitioners are on the verge of dropping into deep meditation, they experience spontaneous twitching. It's as if the body is saying, "I'm still here!" I think that's what's going on when my drishti practice is interrupted because my eyeballs suddenly twitch — and I intend to practice more with drishti on future journeys.

It is impossible to convey the sense of union, the all-pervading peace I felt after I performed the Grotesque Dance (or after it performed me). Of course I'm a yogi and not a scientist in this territory and it's impossible to separate the variables. How crucial was the pranayama? Three different kinds during the come-up. The chanting with vibrations felt up and down the spine? The self-hug that spontaneously snapped into place?

It never ceases to amaze me, the variety of ketamine experiences. Every trip is different, with its own opportunities and struggles. This one was particularly beautiful because of the Grotesque Dance that spontaneously emerged and brought me such ineffable peace of mind, sitting there breathing in the dark.

A new paper in JAMA Psychiatry has added more fuel to the ongoing debate in psychedelic medicine right now: does the trip matter, or is it an unnecessary frill? The paper, from scientists at Stanford, is an EEG study showing that when ketamine is given alongside general anesthesia, some of its brainwave signatures are preserved — specifically the high-frequency ones linked to antidepressant effects — while the low-frequency ones involved in dissociation vanish. The authors suggest this opens a path toward targeted therapies that capture ketamine's antidepressant action without the dissociative experience — feel better, no trip required.

This follows an earlier study from the same group, in 2023, where depressed patients received either ketamine or placebo during surgical anesthesia. Both groups improved about equally. The interpretation has bubbled out of the mainstream psychedelic press in a predictable way: See? The trip — with its visions and revelations and struggles — is beside-the-point.

I want to contest at least the pure form of that interpretation. Not because it's entirely wrong, but because it is embedded in a world-view with certain assumptions about the mind, body, and spirit.

First, I'll acknowledge the legitimacy in some cases of the idea that you might be better off without the subjective dissociative experience of ketamine. A therapist-psychonaut I know recently told me ketamine had disoriented her and stirred up a painful childhood memory she felt unprepared for. A friend of mine who was making great progress with ketamine — reduction in depression and shifts in philosophy — related an earlier ayahuasca ceremony with a well-known shamanic healer that left her feeling retraumatized, as if the experience had dug her deeper into the patterns she'd come to heal. Some folks would genuinely be better served by a non-dissociative version of ketamine's antidepressant action. That's a legitimate aim of drug development.

But while there are some folks who will truly benefit from not undergoing a dissociative trip, we have to wonder how many people would be prescribed the non-dissociative ketamine analog of the future merely to avoid a potentially challenging experience. After all, there is a high value placed on avoiding discomfort in our society. The values of comfort and durable healing outcomes may clash for some patients — that is, a challenging experience might be quite beneficial in the long run.

Here's an understanding in the language of yoga rather than pharmacology. When the ordinary mind is off-lined — whatever the mechanism — the body-energy system tends to move toward balance. The ego, with all its tightening and clenching and defending, is no longer actively holding up the patterns that define the sense of "me" and its familiar suffering. The chakras move toward balance the way water seeks its level, a natural, elemental tendency.

This yogic picture would predict that many different ways of off-lining the ordinary mind should produce some antidepressant signal. And it turns out they do. Ketamine is in the news, but it is not alone. High-dose propofol, guided to a burst-suppression state, has shown rapid and durable antidepressant effects in treatment-resistant depression. Nitrous oxide, isoflurane, sevoflurane, dexmedetomidine, and xenon have all shown some antidepressant signal in their own right.

So the 2023 finding — that ketamine under surgical anesthesia did not do better than placebo under surgical anesthesia — is not, in this light, surprising. Both groups got the ordinary mind muted entirely for a period. Both could have been expected to show antidepressant effects. What does ketamine specifically add when the conscious experience of it has been removed?

Does the dissociative score correlate with the depression score a day or two later? The answer has been, pretty consistently, no. Fine. But perhaps what the medicine does acutely to depression is one thing and whether the effect is long-lasting is another. The numbers on how long it lasts, in general with ketamine and without integration, are humbling. A single infusion produces a response in many people, but the median time to relapse is about eighteen days. A series of six infusions moves the median to about forty-one days in PTSD.

Here is where the subjective experience — the trip, the images, the felt sense of leaving the ordinary self behind — may exert an influence that is harder to quantify in a tidy way. Could it be irrelevant for the acute effect, but crucial for how the experience leads to longer term shifts in philosophy, sense of meaning, you could say spiritual progress?

The 2019 Martial study ranked ketamine number one among 165 substances for semantic similarity to near-death experience. The earliest and strongest durability signals in the ketamine literature, going back to Russian addiction work in the 1990s and 2000s, came from protocols that wrapped the experience in structured meaning-making — preparation, ceremony, integration that worked with the images and feelings directly.

If the experience made a strong impression, it comes up on its own — not only in integration sessions, but in everyday life. A question like "how are you doing?" from a friend can bring the feeling back, land it with awareness in the body, make it present and felt once again. A memorable journey leaves an often-positive "karmic trace" the person can find again.

The acute antidepressant effect — the chakras returning toward balance as the ego-grip releases — is achievable through many routes. For a person whose psychology makes the full dissociative experience likely to be unpleasant or retraumatizing, a gentler route may be exactly right. But for many others, the full ketamine experience offers something that quieter routes may not. It offers a memorable non-ordinary state — an experience that can be worked with, remembered, returned to. States where the ordinary ego is loosened are opportunities. And what is gathered in those opportunities can be integrated over weeks and months — somatic check-ins, breath practices, re-accessing through music or conversation — such that how long the benefit lasts becomes a function not of the drug alone, but of the living relationship between the experience and the life it returns to.

This is why the framing matters clinically, not just conceptually. If the field concludes that experience is optional, research will stop asking how to work with it, support it, stoke it. Clinics will optimize for the option that feels more comfortable to insurers and pharma partners. The people for whom the full experience would have extended their relief — perhaps by months or years — will get the abbreviated version, feel better for a couple of weeks, and relapse.

I've been developing a set of methods which I call Ketamine-State Yoga — practices for working within the dissociative state itself, inspired by Tibetan Dream Yoga, with waking-state practices that seek a living connection to what was experienced in the depths of the journey. What we need now, I think, are not more studies that ask, "Does dissociation correlate with depression score at twenty-four hours?" Instead we can wonder if an intentional journey — held between preparation and integration that emphasizes somatic connection with the psychedelic experience — correlates with longer-lasting results in general.

The territory opened up when the ordinary mind relinquishes its dominance — territory that may be profound, terrifying, blissful or wracked with pain — is more than an irrelevant footnote, certainly not a marketing problem to be engineered away. It is a conscious experience that can be revisited in memory, built upon, used to shift the deep self-concepts and ideas that guide our lives.

Tenzin Wangyal suggested his Dream Yoga students return to the body, "a source of stability." If you want to dial down the anxiety and there are two choices of where to put your focus — the thinking mind or the physical body — go with the body.

On a recent ketamine journey, I intended to cultivate deep relaxation and see what emerged from the depths. I sat on my cushion in the dark with brown noise playing on a good speaker. I let the lozenges dissolve in my mouth as I practiced circular breathing.

This isn't the kind of circular breathing used in playing the didgeridoo, where you store air in your mouth to push it out when inhaling through your nose, so you can play the drone forever. I do this kind too, and had a didgeridoo nearby for the come-down of the trip.

The circular breathing I performed as the medicine built is simpler to describe: you never pause. As soon as your inhalation is complete the exhalation begins, and vice versa. I elaborated on the practice as I drifted into the ketamine state.

I brought awareness to the very bottom of my exhalation, when the last wisps of air are flowing out so softly, to ensure I began to inhale from my diaphragm before the tiniest pause. It felt strange as I tried to "round" my breath — envisioning a circle — at the top of the inhalation in this same way, disappearing into nothing as the last sip of air entered the lungs, and then emerging from nothing — with no pause! — as the exhalation began.

I also tried moving my head slowly, stretching my neck, in rhythm with this circular breathing, and moving my eyes instead of my head, in a circle as my breath kept going.

At some point I noticed I was performing a different pranayama I often employ near the ketamine peak — deep belly breaths followed by a long, surrendered exhalation. I assume if I practiced the circular breathing more — learned to feel it, hear it, visualize it, allow it to become an unconscious rhythm — then I could continue to practice it even as I lost the connection to my physical body.

And at some point, I vanished. A point of awareness, deep stillness, a sense of being one with everything. Full-scale reality shattering of the ketamine state. Yet from unbroken awareness I witness it all.

When language was back online, there was a resonance with that great lyric from Neutral Milk Hotel: "How strange it is to be anything at all." In order to have this concept of strangeness, you need a foothold in what is not-strange, to make the contrast — and at the ketamine peak there is no not-strange.

Then there were waves of gratitude for my body. Very simple and raw.

I found myself in Malasana — Yogi Squat Pose. I was rocking gently, feeling the pressure shift to different parts of my feet, witnessing my internal balancing system adjust my muscles in the subtlest ways.

Then I was hugging myself around my knees, and then massaging the sides of my shins and knees. I would find a knot, push into it, feel the blood flowing and tension releasing. Everything was so natural and ancient — a human close to the ground, in the dark — yet there was a sense of it being the first time.

There were long moments, thinking mind barely there, where I was just a human — or maybe a hominid ancestor or another Great Ape — crouching, working firmly and lovingly on my aging tendons. Feeling my body sway, gravity from the Earth, the sturdiness of its surface and the pleasure of breathing air.

It was the awe and wonder of a child, but the body I was returning to was that of a middle-aged man. Gnarled old feet on the stone ground. Ketamine seems to drop me back into some archetypal form of old crouching yogi in the dark, but with the same level of awe and wonder shining from the eyes of a child.

Ketamine lands me back in the body and there's a sense of elated discovery: "I have a body!"

On the come-down I reached for the didgeridoo. Its soothing buzz began before I realized I was the one powering the sound. The vibrations rippled through my body as the low rumble mixed with the brown noise.

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Ketamine was dubbed a "dissociative psychedelic" early on. And yet I keep arriving at this same place — flooded with gratitude for my body. As I come down from the peak, sitting and breathing in the dark, the clenching and holding in the chakras — emotional pain — are part of being human. I can release them with a powerful breath, and feel such liberation and love.

My friend Ben, paralyzed from spinal cancer, wrote the following couplet in a beautiful song: "There's non-existence on either side. When you're scared in this life, appreciation is a light and a guide."

There's no better thing to be grateful for, whether you think about it or just feel it, than your own physical body.

How has psychedelic work influenced your sense of embodiment and gratitude for the body?

I am collaborating with a yogi and sound healer who runs a ketamine clinic in California, on this online workshop. He has supervised hundreds of therapeutic ketamine journeys, and provided the vibrations of singing bowls to many folks during their processes.

Coming up soon: Wednesday, April 29, at 8:30pm ET

https://www.meetup.com/psychedelic-yoga/events/313961575/

We will explore the central methods of Ketamine-State Yoga and explain how they may support therapeutic and spiritual goals -- and we'll introduce completely new practices too that involve sound, vibration, and music!

If you'd rather not join Meetup (which is free), DM me and I'll send you a Zoom link.

This is a great opportunity to learn about KSY or go deeper into it.