Do I have to tell you what happened to me?

No. Our intake asks medical questions—diagnoses, medications, heart and blood pressure history, past reactions to anesthesia, and symptoms such as dissociation or nightmares. “I have a trauma history and would rather not go into it” is a complete answer. If there are things in the room that tend to set you off, you can name them without explaining why.

Is trauma-informed ketamine care the same as trauma therapy?

No. Trauma-informed describes how care is delivered: with safety, transparency, collaboration, and choice. Trauma-focused therapy, such as EMDR, cognitive processing therapy, or Internal Family Systems, is treatment delivered by a licensed therapist. We provide the medical infusion and coordinate with your therapist, with your written consent.

Can I choose whether the therapy dogs are around?

Yes. Walter White and Wilma are part of our welcome, and many patients enjoy them, but they are entirely optional. Let us know when you book or when you arrive, and you never need to explain why.

How long before I know whether ketamine is helping?

Research protocols for chronic PTSD, such as the 2021 Feder trial, measured outcomes after six infusions over two weeks, and most patients begin with a series of six infusions over two to three weeks. We review how you are doing with you as the series goes. If it is not helping, we will say so honestly and talk through next steps with you and your therapist.

Do I have to talk about what happened? What trauma-informed ketamine care looks like at MCK

Q: What if I start to feel unsafe during an infusion?

Before your first session, we agree on a stop signal and on the grounding steps you would like offered. A clinician is in the room, and Marla Peterson, CRNA, oversees every infusion with anesthesia-level monitoring throughout. If you use your signal, we respond: the infusion can be slowed or paused, the eye mask lifted, the music changed, or the lights brought up.

The short answer: you do not have to tell us your story

Many people with a trauma history arrive at a first consultation braced for a question they do not want to answer. So we will say it plainly: you do not have to describe what happened to you in order to receive ketamine infusions here. Not at the consultation, not during intake, not in the treatment room.

What we do need is medical information. We ask about diagnoses you have been given, the medications you take, your blood pressure and heart history, any past reactions to anesthesia, and whether you have experienced symptoms such as dissociation, panic, or nightmares. Those questions are about keeping your body safe and choosing a sensible dose. None of them requires a narrative. “Yes, I have a trauma history, and I would rather not go into it” is a complete answer.

Some patients choose to share a little more—a general category, or a few things that tend to set off their alarm system, such as a closed door, being touched without warning, lying flat, or a certain tone of voice. That can help us shape the room. You can tell us the trigger without telling us the reason. The story itself belongs wherever you decide it belongs, which for most people is with a therapist they trust.

What “trauma-informed” actually means

“Trauma-informed” gets used loosely, so it helps to anchor it. The most widely cited definition comes from the Substance Abuse and Mental Health Services Administration. Its 2014 guidance, SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach (HHS Publication No. SMA 14-4884), describes trauma through three E’s—the event, how the person experienced it, and its lasting effects—and asks services to realize how common trauma is, recognize its signs, respond with that knowledge, and actively resist re-traumatization.

SAMHSA then names six key principles:

Safety—physical and emotional, as the person defines it.
Trustworthiness and transparency—explaining what will happen, and then doing what we said.
Peer support—connection with others who have lived experience.
Collaboration and mutuality—decisions made with you, not about you.
Empowerment, voice, and choice—building on your strengths and your preferences.
Cultural, historical, and gender issues—recognizing that identity and history shape what feels safe.

Notice what is not on that list: telling your story. Trauma-informed care is a way of delivering any service, whether it is a dental cleaning or an IV infusion. It is not a treatment in itself. The psychiatrist Judith Herman made a related point in Trauma and Recovery (1992): in her three-stage model of recovery, establishing safety comes first. Working through the memories comes second, and that work belongs with a therapist. That is the order we try to respect.

Choice and control in the treatment room

Trauma often involves a loss of control. A medical room, with its equipment and closed doors, can echo that. We cannot make an IV infusion feel like home, but we can hand back as many decisions as possible. Before your first infusion, we walk through the options and agree on your preferences:

Music. A curated playlist, your own music, or quiet. Some people want to avoid certain genres or lyrics entirely; tell us and we will steer around them. Our piece on ketamine, music, and playlists explains why this matters.
Eye mask. On, off, or on with the option to lift it whenever you like. Some trauma survivors feel safer seeing the room.
Lighting and blankets. Dimmer or brighter; a weighted blanket or none.
Who is in the room. Your clinical team, and in some cases your therapist by advance arrangement (see can my therapist attend my session). If you have preferences about who enters or how, tell us, and we will be honest about what we can accommodate.
Touch. We will tell you before we touch you—placing the IV, adjusting the blood pressure cuff—and you can decline a reassuring hand on the shoulder altogether.
A stop signal. We agree in advance on a word or gesture that means “check on me” or “slow down.” If you use it, we respond. The infusion rate can be slowed or paused.

None of these requests needs a justification. Having a say in small things is part of how the nervous system learns that this room is different.

How we handle dissociation for trauma survivors

Ketamine is a dissociative anesthetic, and a dreamlike, floaty sense of distance from the body is an expected part of an infusion. For many trauma survivors, though, dissociation is not a neutral word. It may be something the mind learned to do in order to survive. So we talk about it before the first session, not during it. Our explainer on dissociation during ketamine covers what it feels like and how it differs from trauma-related dissociation, and can ketamine cause flashbacks? addresses the most common fear directly.

A few practical choices follow from that conversation. For trauma-sensitive patients, we generally start with a lower dose and titrate more slowly. We agree on grounding steps you would like offered if the experience becomes too much: lifting the eye mask, a steady voice saying your name and where you are, feet on the floor, a change of music. Research also offers some reassurance here. A 2024 exploratory analysis in the International Journal of Neuropsychopharmacology (Sajid and colleagues), involving 40 participants who received ketamine for depression with suicidal thoughts, found no association between the intensity of acute dissociation and the antidepressant response. That was one study in a different population, but it supports what we tell patients: you do not have to “go deep” for the medicine to work.

Marla Peterson, CRNA, oversees every infusion, with anesthesia-level monitoring throughout—continuous pulse oximetry, blood pressure, and heart rate. A clinician is in the room, and the team is on-site throughout, so if you use your stop signal, someone responds. If you want to know more about the role, see what a CRNA is.

Walter White and Wilma: part of the welcome, and your choice

Our clinic has two Old English Sheepdogs, Walter White and Wilma. They are part of how we welcome people, and many patients tell us that a large, calm, shaggy dog lowers the temperature of the waiting area. They do not provide medical care, and we do not make clinical claims about them.

We also know that not everyone wants a dog nearby. Some people are allergic, some are afraid of dogs, and for some a dog is connected to something painful. You can choose whether the dogs are around during your visits, and you never need to explain why. Just let us know when you book or when you arrive.

Your therapist holds the story; we coordinate

Music City Ketamine is a medical clinic, not a psychotherapy practice. We provide the infusion, the monitoring, and the medical judgment. The trauma work itself—EMDR, cognitive processing therapy, prolonged exposure, Internal Family Systems, somatic approaches—happens with a licensed therapist. For trauma presentations, we generally recommend having a therapist in place before starting infusions, and our article on ketamine for complex PTSD explains why.

With your written consent, we can coordinate with your therapist: timing infusions so an integration session falls within a few days, sharing what we observed medically, and hearing what they think we should know. Your therapist does not have to share your history with us, and we will not ask them to. If you do not have a therapist yet, our guide to finding an integration therapist in Tennessee is a practical place to start, and if you work with a parts-based therapist, ketamine and IFS therapy covers how that pairing is usually structured.

What the evidence says, and what it does not

Ketamine is FDA-approved as an anesthetic; its use for PTSD and other trauma-related conditions is off-label. The evidence is still smaller than for depression, but its direction is encouraging.

A 2014 randomized trial in JAMA Psychiatry by Feder and colleagues gave 41 people with chronic PTSD a single infusion of ketamine or midazolam. The ketamine group showed a significant reduction in PTSD symptoms at 24 hours, and the authors reported that ketamine was generally well tolerated without clinically significant persistent dissociative symptoms. A 2021 follow-up by the same group in the American Journal of Psychiatry tested six infusions over two weeks in 30 patients. At week two, CAPS-5 scores were 11.88 points lower in the ketamine group, and 67% met the response threshold compared with 20% on midazolam.

What the research does not tell us is whether a trauma-informed setting improves those outcomes. No trial has compared a trauma-informed infusion to a standard one. We follow SAMHSA’s principles because they are the recognized standard for treating people with trauma histories respectfully, not because we can promise a better result. Ketamine does not cure PTSD, it does not replace trauma-focused therapy, and some people do not respond. Sessions are $475 each, and insurance generally does not cover off-label use.

If you want the broader picture, our trauma and PTSD pages bring the relevant articles together, including ketamine for PTSD and combat PTSD versus military sexual trauma. Whatever you decide, you set the pace, and you decide what you share.