Wayne Martin, a counselor people hired when they had insomnia, couldn’t sleep.
A practitioner in Fort Worth for three decades, Martin had long held the weight of his clients’ woes. But in the early months of the pandemic, when the unknowns pressed upon his clients like a heavy hand, his own burden felt doubled.
He found relief, more than a year later, in a small, white tablet taken alongside his own sessions with a therapist in Austin. The medicine was ketamine, an anesthetic with hallucinogenic properties that’s legal when prescribed by registered practitioners.
Martin is one of a small but growing corps of health professionals in Fort Worth espousing psychedelic-assisted therapy, a mental health practice that marries psychedelic drugs with therapy to treat conditions like depression and post-traumatic stress disorder.
The therapy is limited. Right now, ketamine is the only psychedelic legally available to patients, and while multiple studies affirm its efficacy as a treatment for depression, research is ongoing to determine whether ketamine and other psychedelics are similarly healing for other conditions.
Still, the early response has been positive, a groundswell of changed lives tempered by the cost of ketamine and each client’s willingness to process their experience. “The medicine is the catalyst,” Martin said, “but the therapy is where the work is taking place.”
The months surrounding Martin’s first “journey” brought news that psychedelics were stirring people’s interest across Texas, albeit for small and specific purposes.
Then, in December, the Center for Psychedelic Research and Therapy opened in Austin. The center, part of the University of Texas’ Dell Medical School, is currently recruiting people for its first study: Whether psilocybin or another psychedelic, 5-MeO-DMT, along with therapy, can treat prolonged grief in people whose romantic partners died during or after their service in the military.
The state’s newfound, if reserved, openness came on the heels of the first Phase 3 clinical trial conducted with psychedelic-assisted therapy. The study, published in Nature Medicine in May 2021, concluded that MDMA — the psychedelic popularly known as Ecstasy or Molly — and therapy together offered considerable relief to patients with PTSD.
In any given season, Martin had worked with one or two clients who were contemplating suicide.
But as the pandemic stretched from weeks to months, that number rose to more than a dozen. A burdened psychiatric system — hospitals at capacity, providers with lengthy waiting lists — left his patients with little recourse.
Around the same time, he came across a research proposal to help health care workers with ketamine. Curious, he enrolled in a yearlong, psychedelic-assisted therapy program through the Integrative Psychiatry Institute. Since his graduation in April, he’s guided about 10 clients through their own ketamine journeys.
Martin is hesitant to share the breakthroughs some of his clients have made. He doesn’t want anyone to think there’s something “magical” about the experience, he said.
Furthermore, psychedelic-assisted therapy doesn’t work for everyone. People with psychosis, or a family history of psychosis, aren’t good candidates, said Dr. Sandra Davis, a psychiatrist and assistant professor at the Texas College of Osteopathic Medicine.
Like other drugs, ketamine brings possible risks: allergic reactions, changes in blood pressure, interference with other medications. Mostly, Davis said, more research is needed on the longterm effects of ketamine in the body.
Still, ketamine can be especially useful for people whose other depression treatments have failed, she said. And unlike oral antidepressants, which can take weeks to work, ketamine can produce results much faster.
As for Martin, he’s seen some people gain a kind of clarity, a “remarkable insight,” about their lives and how they might live or perceive them differently. His own journey yielded a renewed pursuit of self-compassion that finally gave him respite from insomnia.
Before his clients ingest ketamine, they meet with Martin to discuss expectations, preparations and goal-setting. He outlines what they might feel: dissociation from the body, a sort of swan-dive from a cliff before a gradual return to self.
He also instructs each client to, as much as possible, minimize stress the day leading up to the journey. Ketamine, like other psychedelics, is a “nonspecific amplifier,” which means it merely intensifies the emotions a person is already feeling. “If you come in with a lot of anxiety,” he said, “you might have then a lot of anxiety in the experience.”
Finally, Martin works with each client to set a goal for the experience, which can take anywhere from 40 minutes to two hours, depending on the dose and the method of ingestion.
Martin’s clients obtain the ketamine through one of three ways: from Mindbloom, a psychedelic telehealth company; Dr. Scott Smith, a physician in South Carolina whose telemedicine practice centers ketamine; or Vigeo Wellness, a ketamine-infusion center in Fort Worth. The first two methods offer ketamine as a tablet; the third, as a liquid injected into the veins.
People who opt for the tablet can take it at home or in Martin’s office. If they choose the latter, he carves four hours for the experience: an hour to ground the client, one to two hours for the experience, and then one to two hours for “integration,” or processing together. Afterward, they’ll need transportation; Martin recommends they don’t drive that day.
In the hours and days following the journey, he encourages clients to be especially kind to themselves: Avoid alcohol, eat healthy, exercise gently.
“You’ve got this wonderful neuroplasticity that’s been activated,” he said. “And so, without being too harsh and too much of a taskmaster, gently guiding yourself in new and healthy practices.”
Vigeo Wellness sits on the ground floor of a boxy, white-bricked building near Fort Worth’s medical district.
Inside, plants and paintings of plants adorn sage accent walls. Brown leather recliners in private rooms offer customers both heating and massage. The space is, by all appearances except the infusion pumps, a spa. In Latin, “vigeo” means “I thrive.”
“In psychedelic therapy, there’s a lot of talk about set and setting. Set is your mindset when you come in for the infusion,” said Megan Holland, a nurse anesthetist who opened the center in May. “And then setting is this — creating an environment where you feel safe, secure, relaxed.”
The center has performed close to 400 infusions, including a few for Martin’s clients.
As with ketamine in tablet form, most people receive six infusions over the course of two or three weeks. At first, the relief from symptoms lasts two weeks to a month, Holland said. Then, people return monthly for a “booster,” with the long-term goal to receive an infusion once every few months.
Like Martin, Holland is careful to qualify ketamine’s potential. Recovery requires work, she said: integration, processing, adoption of new and healthy habits. “I tell patients it’s not a magic bullet. It’s a tool,” she said. “It’s a very effective tool, but it is a tool.”
In the center’s opening months, she’s seen people who are dulled from depression return for a third or fourth session smiling, laughing and making eye contact. “It’s amazing,” she said. “You know, we’ve had people tell us that we saved their life.”
Amid the victories comes struggle. Most insurances don’t cover ketamine infusions, and one 40-minute infusion session costs $400. For Martin’s clients who pursue ketamine through Mindbloom, six treatments cost close to $1,200. The cheapest option is through the physician in South Carolina, though the dosage is smaller; clients can receive 10 or more treatments for just a few hundred dollars per month.
To lessen the burden, Holland offers discounts for veterans and first-responders. She also works with health savings accounts and flexible spending accounts, as well as a group that provides financing options for her clients.
“I want people to feel good,” she said. “I want them to get their life back.”
When Mayor Mattie Parker took questions at a gathering of Fort Worth business owners this spring, Faith Geiger came prepared: Was the city aware of the movement toward the legalization of psychedelic-assisted therapy?
The mayor seemed curious, Geiger remembers, and afterward, other attendees approached Geiger with their own stories about psychedelics. One person had tried ayahuasca, a psychedelic made from Amazonian plants. Another had microdosed, or ingested small amounts of a psychedelic, to try to help their anxiety.
As an executive coach and therapist-in-training, Geiger educates her clients about treatments that don’t involve medicine, like mindfulness and meditation. She’s also enrolled in the same psychedelic-assisted therapy program from which Martin graduated.
The business owners’ stories only affirmed the platform she considers her calling: the workplace.
“This isn’t something that we need to demonize. Let’s learn about it,” she said. “And if you can, as an employer, please begin to consider adding psychedelic-assisted psychotherapy to your health insurance plans. So if your employees are eligible for the medicine and the therapy, gosh, let’s really help people heal.”
Geiger plans to meet with local employers to discuss the risks and benefits of psychedelic-assisted therapy. She knows insurance coverage options aren’t likely to expand until federal regulators approve other psychedelics as mental health treatments.
Still, she’s hopeful: A now-public letter from the U.S. Department of Health and Human Services suggests the FDA could approve psilocybin and MDMA to treat depression and PTSD in the next two years.
Geiger wants Fort Worth employers educated and open when that day comes.
“I’m very convicted in the belief that these medicines should and can be available to people who need it,” she said.
These days, Martin falls asleep.
He credits his first ketamine journey — and the integration work that succeeded it — in November 2021. The insight came to him with searing clarity: As a therapist, he knew what he needed to do to create space for sleep. He’d been pursuing those habits rigidly, not from a place of self-care.
“Part of what came in that first experience was the epiphany that I could actively love myself by practicing these things that would help me sleep better,” he said. “So the motivations shifted from frustration and rigid adherence to the principle into this — this was imbued with warmth and love and care for myself.”
In the nearly year since, he’s taken roughly a dozen journeys. Each time, the feeling is like suspension in outer space.
Cocooned in warmth and black, he disconnects from the internal voice that, all day, offers a critical commentary on his experiences. Chattering, always chattering and then —
This part, the deepest of the experience, lasts anywhere from a few to 15 minutes. Then, he emerges, reconnecting gradually to an awareness of self amid fractals of color.
Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at firstname.lastname@example.org or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.