Dr. Joan Obiols shares his more than 50 years in psychiatry, marked by a transcultural perspective, his father’s legacy, and his experience with innovative therapies such as ketamine-assisted psychotherapy. It’s a journey through a person-centered approach to mental health, open to new perspectives.
This blog explores what a psychedelic experience might feel like through a symbolic fable. Using metaphors and imaginary characters, it tells a story that invites reflection on what is truly important in the psychedelic journey.
New therapies and treatments for depression and other mental health disorders are constantly being researched and developed. One of the most promising avenues currently under investigation is psychotherapy with 5-MeO-DMT, a short-acting psychoactive substance.
In this engaging interview conducted by Dr. Joan Obiols, Phil Wolfson, founder of the Ketamine Research Foundation, speaks passionately about the pivotal events in his life and what led him to become a world-renowned expert in ketamine-assisted psychotherapy.
Ketamine’s clinical journey spans more than six decades, evolving from a battlefield anesthetic to a groundbreaking therapeutic tool in mental health. Its history reflects a convergence of neurobiological discovery, clinical intuition, and unmet therapeutic needs, leading to its current role in the treatment of depression, addiction, and treatment-resistant conditions. This article explores the key milestones that have shaped ketamine’s evolution and its relevance in contemporary psychiatric practice.
Anxiety disorders are increasingly prevalent and often respond poorly to standard treatments such as SSRIs or benzodiazepines. Growing evidence suggests ketamine-assisted psychotherapy may offer rapid relief, particularly in treatment-resistant anxiety. By modulating glutamate via NMDA and AMPA receptors, ketamine enhances neuroplasticity and may reduce pathological worry within hours or days. Clinical trials show benefits in social and generalized anxiety, and real-world studies report sustained symptom reduction and decreased suicidal ideation. When combined with psychotherapy and integration, ketamine may help consolidate meaningful and lasting change.
Recent research suggests ayahuasca-assisted psychotherapy may support people facing acute grief. In a structured therapeutic setting, ayahuasca was associated with reduced grief severity, fewer prolonged-grief symptoms, and greater post-traumatic growth. The study compared ayahuasca-assisted therapy, psychotherapy alone, and no intervention, finding the strongest improvements when ritual, psychotherapy, and community support were combined. Results indicate ayahuasca may help integrate loss by easing pain while preserving emotional connection to the deceased, offering a humane complement to existing grief care within ethically guided clinical frameworks.
Ketamine therapy can be delivered intravenously or intramuscularly, each offering distinct therapeutic experiences. IV administration provides gradual delivery, precise titration and close monitoring, often preferred in acute settings. IM administration offers rapid onset, high bioavailability and a more immersive experience, with simpler logistics and greater comfort for many patients. Research shows both routes are similarly safe and effective for depression, anxiety, PTSD and pain, especially when combined with psychotherapy and structured integration. Patient preference, clinical goals and context should guide route selection.
Depression, anxiety and chronic stress are associated with the loss and retraction of dendritic spines, disrupting communication between key brain regions involved in emotion, memory and decision-making. This disconnection reduces cognitive flexibility and promotes rumination and rigid negative patterns. Ketamine and other psychedelics have been shown to rapidly enhance neuroplasticity by increasing the formation and stabilization of dendritic spines, reopening critical learning periods. When combined with psychotherapy and supportive habits, this window of plasticity can facilitate lasting emotional and behavioral change.
Treatment-resistant depression affects up to one third of patients with major depressive disorder and is linked to severe impairment and suicide risk. Real-world clinical data show that ketamine offers rapid antidepressant effects, with meaningful symptom reduction in nearly half of treated patients and remission in around one third. Benefits often appear within hours or days and can be maintained over time with follow-up treatment. Evidence also indicates good tolerability, low risk of symptom worsening and effectiveness in both unipolar and bipolar depression.
This article explains the key differences and similarities between ketamine and esketamine in the treatment of resistant depression. It reviews their shared glutamatergic mechanisms, distinct stereoisomeric forms, routes of administration and side effect profiles. Evidence from preclinical and clinical studies suggests racemic ketamine and R-ketamine may offer longer lasting antidepressant effects and fewer adverse reactions than S-ketamine. The text also addresses subjective experiences, dissociative effects, cost, regulatory issues and why many clinics prioritize racemic ketamine in personalized, evidence based care.
Ketamine-assisted psychotherapy can use several routes of administration, each with different pharmacokinetic profiles. This article explains bioavailability and half-life, and compares intramuscular, intranasal and oral ketamine. Intramuscular administration offers very high bioavailability, rapid onset and longer half-life, while intranasal delivery has moderate bioavailability and shorter duration, and oral use shows slower onset and lower absorption. Based on these factors, the clinic prioritizes intramuscular injection as a balanced option combining efficacy, predictability, patient comfort and clinical safety in routine ketamine-assisted psychotherapy settings.
Psilocybin is a naturally occurring psychedelic found in certain mushrooms with a long history of ritual use. Research shows it can alter perception, mood and sense of self, often producing meaningful or mystical experiences. Recent studies highlight potential benefits for depression, anxiety, addiction and grief, linked to temporary increases in brain connectivity and neuroplasticity. Evidence supports structured, high-dose sessions combined with psychotherapy, while microdosing lacks solid support. Despite advanced clinical trials in the US and Europe, psilocybin remains illegal in Spain and is not offered clinically.
Following the success of the first edition, this second Ketamine-Assisted Psychotherapy training expands theoretical and experiential learning for health professionals. Level 1 in Barcelona offers five days covering neuroscience, clinical applications, preparation, integration and best practice. Level 2 adds an immersive experiential retreat in Montnegre Natural Park, inspired by long-running US programs. Led by international experts, the training equips participants with practical, ethical and clinical tools to personalize treatments, enhance safety and deepen therapeutic effectiveness in mental health and chronic pain settings worldwide today contexts.
Aquest article presenta els ponents de la formació en Psicoteràpia Assistida amb Ketamina que tindrà lloc a Barcelona el 2025. El programa reuneix professionals de referència internacional en psiquiatria, psicologia, neurociència i teràpies psicodèliques. Els formadors aporten dècades d’experiència clínica, recerca científica i desenvolupament de models terapèutics innovadors. Conèixer els seus perfils permet entendre la solidesa acadèmica, clínica i humana de la formació, així com la diversitat d’enfocaments que conflueixen en aquesta proposta educativa única.
Microdosing psychedelics involves taking sub-perceptual doses of substances such as psilocybin or LSD with the aim of improving mood, cognition and emotional wellbeing. This article reviews current scientific evidence on microdosing, including proposed neurobiological mechanisms, potential benefits for depression and anxiety, cognitive and motivational effects, safety considerations and the role of placebo. While observational studies suggest possible benefits, controlled trials show mixed results, highlighting important limitations and the need for further rigorous research before clear clinical recommendations can be made.
This article compares ketamine and psilocybin-assisted therapies, outlining differences in legality, mechanisms of action, therapeutic uses, safety profiles and patient experience. Ketamine is legally available and offers rapid symptom relief through glutamatergic modulation, making it useful in acute depression and suicidality. Psilocybin, currently illegal outside trials in Spain, acts via serotonin receptors and is associated with longer-lasting psychological change. The article highlights clinical considerations to help patients and professionals choose the most appropriate treatment based on current research and clinical practice.
Group psychotherapy is a therapeutic approach in which individuals meet regularly with trained therapists to explore emotional challenges through shared experience and interaction. This article explains how group therapy works, the role of the therapist, and the unique benefits of peer support, feedback, and social learning. It also highlights the value of group therapy for integrating psychedelic experiences, offering a safe space to process insights that are often difficult to verbalize, and describes the group therapy format offered at Clínica Synaptica in Barcelona.
Holotropic Breathwork is an experiential method developed by Stanislav and Christina Grof that uses accelerated breathing, music, bodywork, art and group integration to access expanded states of consciousness. The article explains its origins in psychedelic research, its development after LSD prohibition, and the therapeutic principles behind it. It describes the emotional, physical and transpersonal benefits reported by participants, clarifies that it complements but does not replace psychotherapy, and outlines how Holotropic Breathwork workshops are structured and offered at Clínica Synaptica in Barcelona.
The Ketamine Research Foundation, led by Dr. Phil Wolfson, has published a comprehensive guide for the safe and ethical use of ketamine. The document addresses responsible personal use, clinical application within ketamine-assisted psychotherapy, and a professional ethical code developed by the Ketamine Psychotherapy Associates. It offers practical guidance for preparation, accompaniment, and integration, aiming to minimize risks and maximize therapeutic benefit. The guide reinforces KRF’s leadership in setting high ethical, clinical, and educational standards for ketamine-assisted therapy worldwide.
Grief after the death of a loved one is a universal experience, yet for some people it becomes prolonged, intense, and deeply disabling. Prolonged grief is associated with persistent yearning, emotional pain, and functional impairment, and often does not respond adequately to antidepressants or conventional psychotherapy alone. Emerging research suggests that psychedelic-assisted therapies may offer new therapeutic possibilities. In this context, ketamine-assisted psychotherapy stands out as a legally available option that can foster emotional processing, cognitive flexibility, and meaning reconstruction in individuals suffering from prolonged grief.
Prolonged or complicated grief affects around 10% of bereaved people and is marked by persistent longing, intense emotional distress, and functional impairment. Current evidence shows only moderate benefits from psychotherapy and no proven efficacy of medication alone. Recent research highlights psychedelic-assisted therapies as promising alternatives. Ketamine-assisted therapy may support grief treatment through two complementary mechanisms: a neurobiological window of enhanced neuroplasticity that increases psychological flexibility, and meaningful altered-state experiences that facilitate acceptance, emotional processing, and the reconstruction of personal narratives around loss.
Psilocybin-assisted therapy is emerging as a promising approach for depression, particularly treatment-resistant cases where standard antidepressants show limited efficacy and burdensome side effects. Research suggests psilocybin can produce rapid and sustained reductions in depressive symptoms, partly by enhancing neuroplasticity and facilitating meaningful psychological experiences. When embedded in a structured therapeutic model with preparation, dosing, and integration sessions, psilocybin may foster emotional openness, cognitive flexibility, and long-term positive change, highlighting a potential paradigm shift in how depression is treated within modern clinical research frameworks.
Music has played a central role in psychedelic practices for centuries and is now recognized as a key therapeutic component in psychedelic-assisted therapy. Research shows that psychedelics heighten emotional responsiveness to music, transforming it into an active guide for inner exploration. Carefully selected music can evoke deep emotions, access unconscious material, and support transformative or mystical experiences. By amplifying emotional processing and reducing psychological defenses, music helps patients surrender to the experience, facilitating insight, emotional release, and therapeutic change that is difficult to reach through verbal therapy alone.
Chronic neuropathic pain is often severe, persistent, and poorly responsive to conventional treatments such as anti-inflammatories or opioids. Ketamine has emerged as a promising option by modulating NMDA receptors involved in pain perception and memory. Clinical studies show that ketamine can significantly reduce pain for weeks, particularly in complex neuropathic conditions. Beyond analgesia, ketamine may also improve comorbid depression and PTSD, which frequently accompany chronic pain. When combined with psychotherapy, ketamine offers an integrative approach addressing both physical suffering and psychological distress.
José Carlos Bouso, psychologist and PhD in Pharmacology, reflects on the present and future of psychedelic therapy in an interview recorded during a ketamine-assisted psychotherapy training in Barcelona. He reviews the historical importance of psychedelic research in psychiatry, addresses current regulatory and sociopolitical challenges, and discusses the influence of the pharmaceutical industry. Bouso also highlights his long-standing interest in schizophrenia and its potential responsiveness to psychedelic-assisted approaches, expressing strong optimism that we are entering a uniquely promising era for psychedelic medicine.
Fear is a fundamental emotion that protects us, but when it becomes chronic it can lead to disorders such as phobias and post-traumatic stress disorder (PTSD). Conventional treatments often show limited efficacy, prompting new approaches like MDMA-assisted psychotherapy. Research promoted by Multidisciplinary Association for Psychedelic Studies (MAPS) and led by figures such as Rick Doblin suggests that MDMA can reduce fear responses, enhance emotional processing, and strengthen the therapeutic alliance. These effects may allow patients to revisit traumatic memories with less avoidance, fostering recovery and improved quality of life.
During our recent Ketamine-Assisted Psychotherapy training, we had the privilege of welcoming Vladislav Matrenitsky, founder of Expio Clinic in Kyiv. A medical doctor and transpersonal psychotherapist, Dr. Matrenitsky integrates psychedelic medicine with non-Western traditions such as Qigong and Sufism. Since 2018, he has worked therapeutically with ketamine, with a special focus on soldiers suffering from PTSD, contributing both to clinical care and to the growing body of research on ketamine-assisted therapy.
Phil Wolfson, creator of Ketamine-Assisted Psychotherapy (KAP) and director of the Ketamine Research Foundation, shares an in-depth reflection on his life, clinical work, and the future of psychedelic medicine. In this interview, recorded during the 2024 KAP training in Barcelona, Wolfson discusses ketamine’s unique therapeutic flexibility, the risks of over-medicalization, and the importance of integrating psychotherapy with psychedelic treatments. He also offers a critical perspective on regulation, corporatization, and access in Europe.
Depression, or major depressive disorder, is a common and complex condition marked by persistent low mood, loss of interest, cognitive difficulties and physical symptoms. Diagnosis is usually based on manuals such as the DSM-V by the American Psychiatric Association and the ICD by the World Health Organization, yet many people suffer without fitting rigid criteria. The text explores symptoms, stigma, limits of diagnostic labels and the need for a more holistic, humane approach to mental health care.
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