Trauma vs. Ketamine-Induced Dissociation: What’s the Difference and Why It Matters

It is a word we hear often in the therapy room: dissociation. For some, it is a clinical term used in textbooks or treatment notes. For others, it is an intimate, lived experience. And when ketamine enters the conversation, the word can start to feel even more confusing. Clients sometimes ask, “If I dissociate during a ketamine session, does that mean I’m dissociating the way I do when I feel triggered or shut down?” It is a very fair question, and an important one. The answer is no. The dissociation that can arise during a ketamine session is a completely different experience from the kind of dissociation caused by trauma. They may share the same word, but they are not the same thing. In fact, trying to compare them is a little like comparing apples and oranges. Let me explain why.

Dissociation from trauma is protective in nature. It often comes in response to overwhelming fear, helplessness, or prolonged distress. Imagine a child growing up in a chaotic home where emotional or physical safety is unreliable. That child may learn, unconsciously, to “check out” when the world becomes too much. It is not a choice. It is a built-in survival mechanism. Over time, this kind of dissociation may show up in adulthood as a sudden emotional numbing, memory gaps, or feeling disconnected from one’s body. Clients often describe it as going blank, floating away, or watching their life happen from far away. It can be frightening. It can feel like losing control. And it rarely happens in a safe or contained environment. It happens because the nervous system is doing its best to survive.

One of the most challenging aspects of trauma-induced dissociation is the way it can interrupt memory. Entire stretches of time may be missing. People often say they remember certain events only in fragments, or not at all. This is not forgetfulness. It is a psychological defense. The mind, in trying to protect itself, places certain memories out of reach. But those memories are not gone. They often remain in the body and the subconscious, where they can later be triggered without warning.

For example, imagine someone walking into a crowded store around the holidays. Everything seems fine, but then a particular smell from a candle display hits them — something faintly familiar but hard to place. Suddenly, their heart races. They feel dizzy. They go numb. They cannot remember why they walked in. What just happened is not about the store or the candles. It is about a buried memory that got stirred without conscious awareness. The dissociation is the mind’s way of shielding that person from something it still considers too much to handle.

Now, let us look at dissociation during a ketamine session. Here, we are talking about a temporary, time-limited alteration in perception caused by the medicine itself. Ketamine affects certain receptors in the brain that shift how we experience time, space, and even the sense of self. In the right setting, under the care of a trained professional, this kind of experience can allow clients to step outside their usual thought patterns and view things from a different angle. The body is supported. The mind is allowed to explore without the usual noise. While the experience can be disorienting, it is often accompanied by a sense of spaciousness or emotional release. Many clients describe it as stepping into a place where their inner critic is quiet, where they can see a painful memory with more compassion or curiosity than fear.

So yes, ketamine can produce dissociation. But this dissociation is not rooted in fear or survival. It is not a reaction to danger. It is a shift in consciousness that allows for emotional insight and cognitive flexibility. It is supported, intentional, and temporary. And when done within a therapeutic container, it can open doors that have long felt closed.

Of course, each person’s history matters. For clients with complex trauma, it is especially important to approach this work slowly, thoughtfully, and collaboratively. This is why integration therapy is essential. It is not enough to have an experience. What matters most is how that experience is made sense of, how it is woven into your story in a way that promotes healing rather than more fragmentation.

In short, trauma-based dissociation pulls us away from the moment to protect us. Ketamine-induced dissociation can invite us into the moment from a new perspective. One is a reflex. The other can be a resource.

If this conversation resonates with you or someone you care about, there is space here to explore it further. We are always here to walk the path with you, gently and at your pace.