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I will briefly go over the forms of dissociation to help understand its causes and effects. I will mainly focus on dissociative anesthesa, which is used to help control pain for medical reasons such as emergency injuries. This has also been abused to produce a trance like state or an out of body experience (hallucination) that’s been noted to be like a pleasant dream like state. I will go over Timothy Leary’s thoughts about hallucinogen drugs such as dissociative drugs. Also documented experiences from users of the dissociative drugs. I will tell about medical risks that go along with this and how it can be diagnosed and treated.
There has been a huge amount of information on posttraumatic and dissociative disorders resulting from childhood abuse. There is no easy way to treat survivors and their families. Understanding dissociation and its relationship to trauma is basic to understanding the posttraumatic and dissociative disorders. Dissociation is the disconnection from full awareness of self, time, and/or external circumstances. It is a complex neuropsychological process. Dissociation exists along a continuum from normal everyday experiences of disorders that interfere with everyday functioning. Common examples of normal dissociation are highway hypnosis (a trance-like feeling that develops as the miles go by), “getting lost” in a book or movie so that one loses a sense of passing time and surroundings, and daydreaming. Researchers and clinicians believe that dissociation is a common, naturally occurring defense against childhood trauma. Children tend to dissociate more readily than adults faced with overwhelming abuse, it is not surprising that children would psychologically flee (dissociate) from full awareness of their experience. Dissociation may become a defensive pattern that persists into adulthood and can result in a full-fledged dissociative disorder.
There has been made a dissociative spectrum that shows all the possible forms of dissociation. The dissociative spectrum extends from normal dissociation to poly-fragmented DID. All of the disorders are trauma-based, and symptoms result from traumatic memories. Braun Bask made this spectrum in 1988.
The Dissociative Spectrum
Normal Dissociative PTSD DDNOS DID Poly-fragmented
Dissociation Amnesia/Fugue DID
I will briefly go over each disorder. If the disturbance mainly occurs in memory, it’s a Dissociative Amnesia or Fugue disorder. Posttraumatic Stress Disorder (PTSD) is recalling or a re-experiencing of the trauma (flashbacks) which alternates with numbing (detachment or dissociation), and avoidance. Atypical dissociative disorders are classified as Dissociative Disorders Not Otherwise Specified (DDNOS). If the disturbance occurs primarily in identity Disorder (DID), formerly called Multiple Personality Disorder.
Although DID is a common disorder (perhaps as common as one in 100), the combination of PTSD-DDNOS is the most frequent diagnosis in survivors of childhood abuse. These survivors experience the flashbacks and intrusion of trauma memories, sometimes not until years after the childhood abuse, with dissociative experiences of distancing, “trancing out”, feeling unreal, the ability to ignore pain, and feeling as if they were looking at the world through a fog.
Symptom profile of adults who were abuse as children includes posttraumatic and dissociative disorders combined with depression, anxiety syndromes, and addictions. Here are some of the several symptoms of dissociation disorders. (1) Recurrent depression; (2) anxiety, panic, and phobias; (3) anger and rage; (4) low self-esteem, and feeling damaged and/or worthless; (5) shame; (6) somatic pain syndromes (7) self-destructive thoughts and/or behavior; (8) substance abuse and (9) alternative states of consciousness or personalities.
The diagnosis of dissociative disorders starts with an awareness of the prevalence of childhood abuse and its relation to these clinical disorders with their complex symptomatology. In the past, individuals with dissociative disorders were often in the mental health system for years before receiving an accurate diagnosis and appropriate treatment. As clinicians become more skilled in the identification and treatment dissociative disorders, there should no longer be such delay.
The heart of the treatment of dissociative disorders is long-term psychodynamic/cognitive psychotherapy facilitated by hypnotherapy. It is not uncommon for survivors to need three to five years of intensive therapy work. Setting the frame for the trauma work is the most important part of therapy. One cannot do trauma work without some destabilization, so the therapy starts with assessment and stabilization before any abreactive work (revisiting the trauma). The journey is long and painful, but the reward is great for a survivor’s life.
Know that we understand the basis of dissociation and dissociation disorders and what happens such as “trancing out”, feeling unreal, and the ability to ignore pain (in the complex forms of the dissociative spectrum) we can see the related affect of the abuse of dissociative drugs such as dissociative anesthesia. First I will go over what dissociative anesthesia is and what it is used for. Dissociative anesthesia is a unique method of pain control. It reduces anxiety and produces a trancelike state. The person is not asleep, but rather feels separated from his or her body. Dissociative anesthesia is useful in emergency situations, such as an injury. It can also be used for short procedures that are painful, such as changing bandages. This method is safe and lasts only a short time. Because a person does not usually recall the procedure, this method is useful in children.
The medications used for dissociative anesthesia are given through a shot into a muscle or through an intravenous line, or IV. An IV is a thin tube that is usually placed into one of the veins of the forearm or hand. The medication quickly takes effect. The primary medication used is called ketamine, (which I will go into further detail later). A sedative is often given before ketamine to reduce anxiety.
A single dose of ketamine produces a trancelike state for about 10 to 30 minutes and pain control for about 30 to 45 minutes. A pinprick is often used to make sure the person doesn’t feel pain. The procedure is then performed. Additional doses of medication can be given if the procedure takes longer than expected. The individual’s eyes stay open during the procedure, but he or she is in a daze and feels no pain.
A person who has had dissociative anesthesia usually does not remember the procedure, especially if a sedative has been given along with the pain medication. Most people feel back to normal within a few hours. As the medication wears off, an individual may have intense dreams and even hallucinations. If the procedure corrects the problem and a hospital stay is not needed, the person can go home. Someone else must drive the person home, because the medications can impair coordination and reflexes for several hours. Once at home, a person may have effects as a result of the procedure or injury, but usually not as a result of the medication used for dissociative anesthesia.
When the medication is wearing off, a person may have frightening dreams or hallucinations. Dissociative anesthesia is generally avoided in a person with a psychosis because it can cause severe anxiety. Other problems are rare, although allergic reactions to the anesthesia are possible. The American Society of Anesthesiologists recently issued a warning about the potential side effects and interactions of herbal remedies with medications used before, during, and after surgery. The group recommends discontinuing all herbal remedies and supplements at least two weeks before planned surgery.
Ketamine is psychedelic anesthetic classified medically as a dissociative anesthetic, discovered by Dr. Cal Stevens of Wayne State University in 1961. Heavily used on the battlefields of Vietnam, it is used today for short-term surgical procedures in both animals and humans. For human consumption, it is marketed as Ketalar by Parke-Davis. It is sold legitimately only to hospitals and physicians. Since it does not depress critical body vitals as much as other anesthetics, it is often used in procedures with burn victims, for example. It produces a dissociative state in the central nervous system in which amnesia and profound analgesia (loss of pain) are induced, though the patient does not appear to be asleep.
Abuse of ketamine goes hand in hand with drugs like gamma hydroxy butyrate (GHB) and MDMA (Ecstasy). Where you find one, you will likely find the others. All three are very popular with the RAVE party crowd. Ketamine may produce pleasant dream-like states, vivid imagery, hallucinations and possibly extreme delirium. This usually lasts only a few hours. Ketamine is essentially a less-potent version of PCP. While ketamine and GHB and MDMA provide out of body experiences, it is still a bit below the level of PCP trips, but that varies with the amount taken and other drugs combined with it. Flashbacks from ketamine are common. Ketamine is also used in sexual assault on occasion since it puts the victim in a frozen state for at least a brief period of time. The ability to induce a lack of awareness to the environment is the effect abusers crave. It was big in the 70’s with New Age types like Dr. John Lilly and Timothy Leary, but its been coming back by having a steady increase since the 1990’s.
Ketamine comes in injectable form, liquid, for legitimate use. It is most commonly dried. The crusty residue is ground to a fine powder is inhaled. The liquid form may be applied to smokable material or consumed in drinks. Powdered K has been encountered in one-inch ziplock baggies, paper folds or capsules. In order for a vial of ketamine to be in an abuser’s hand, someone has already smuggled it in from Mexico or robbed or burglarized a vet clinic or pharmacy, or in some other manner diverted the product for illicit use.
Ketamine is most commonly called Ket, K or Special K; it may also be referred to as Green. Other names include 1980 Acid, Super C, Vitamin K, Super Acid, Special LA Coke, Baby Food and God (because users often are convinced they have met their maker), Jet, Honey Oil, Blast, and Gas. A dose is called a “bump.” The K-hole is where you go when on it and K-head is a name of a user.
While ketamine is approved for commercial use as a veterinary product in cats and monkeys for short-duration surgery or immobilization, it is also used in human medicine. Ketamine was also used for battlefield injuries for rapid induction. Ketamine has been used for repeated procedures such as radiation therapy. Tolerance and psychological dependence can develop with daily exposure. Chronic users may have short-term memory loss; impaired vision or attentions span limitations. A number of Ketamine-related deaths have been recorded across the nation. For RAVE users excitement and visual disturbances can recur days or weeks after exposure to ketamine. The problem with “flashbacks” may be greater with ketamine than with other hallucinogens. It also produces ataxia, slurring of speech, dizziness, confusion, blurred vision, anxiety and insomnia. It can also cause cessation of breathing, cardiac arrest, brain damage and death.
Timothy Leary, a Harvard Professor during the mid1960’s had researched hallucinogen drugs. Although he mainly studied L.S.D. he recognized that dissociative anesthesia affects appear to selectively interrupt association pathways to the brain before producing somesthetic sensor blockage. He identified a genetic type whose future circuits have begun to be activated and coined them FUTANTS. Futants are naturally selected to facilitate survival by being better adapted to explore the future and take risks through their genetic characteristics. Timothy Leary did not discourage this kind of drug use. He felt drugs should be studied because we can learn from them.
I found a website about a man named Erowid who recorded what he saw while on drugs (a trip) and described his views about drugs such as dissociative anesthetics. The opening paragraph is as follows. “I have read many articles and other literature on and by Timothy Leary, Albert Hoffman, William Burrougs, and Hunter S. Thompson. I have also researched the realms of mythology and the use of dissociatives in discovering ones self and mind. I have never really understood human behaviors; in fact it strikes me as rather odd and ritualistic. From the beginning I have doubted that we have found the full extent of our minds. Since then I have desperately trying to find some ‘gate way’ so to speak which would allow me to discover these regions of the mind. Thus I found dissociative anesthetics.” He also documented his trip while on a combination of drugs including a hallucinogen drug Ketamine. I won’t write down his entire journal entry, but I will still sum up what he believed to see and what he comprehends them to mean. He started by popping two dots, smoking a joint and then he took a shot of Ket. (He doesn’t describe what dots are) He almost immediately felt familiar sensations of dissociative anesthesia. His perception of time was altered and felt like he was swimming in space. Then snorted a cap of meth and went outside to lie down. He felt acid creeping up his spine. A feeling of warmth and coziness along with an array of colors consumed him. Then he felt as if he was on the worst place of the earth. He was looking for answers and was looking all around him. When he looked down he saw his feet but no floor. Then he was talking to one of his favorite author and he said to him once he found what he was looking for the answers would become clear. Then he was in a bar looking at different colored people and found himself talking to a women who held what he as looking for the answers he seeked it was in a box. He can’t remember their conversation or what was in the box but believed he found his answers and his mind wont let him remember it. This story tells us how devastating hallucinogen drugs such as dissociative anesthesia can be on our brains.
Related fields in the studying human behavior and how the brain works would be psychology. Also a drug attic consoler would be related to my subject. Having knowledge of drugs physical and mental affects on the body would be able to assess a person’s addiction and be able to treat it. Psychiatric institute worker to treat people of dissociative disorders. Therapists related jobs. There are many jobs that could relate to my topic.
Abusing ketamine easily can go along with using other drugs since ketamine can be found at the RAVE scene. There are usually many drugs that go around at RAVES such as ecstasy. Tobacco use could easily be used in this environment where hard drugs are being used. Smoking before or after ketamine is probably not uncommon.
