Ketamine therapy at a retreat combines medical screening, a supervised ketamine session, trauma-informed counseling and ongoing integration afterward. That is how the founders of Transcendelic Retreats describe their program in this conversation with Jeremy Van Wert. A nurse practitioner, a critical care physician and a Zen master explain why they built it and how they approach safety, trauma and aftercare.
ᛉKey takeaways
- Dr. Amy Milroy says she built the retreat because the medical model often manages symptoms without reaching the roots of suffering.
- Dr. Sal Kalra describes screening, medication, close vital sign monitoring and on-site emergency equipment as the core of safety in ketamine therapy.
- Amy says the main medical risk with ketamine is severe chronic heart disease, and that a proper screening is essential.
- The team uses trauma-informed methods such as EMDR, internal family systems and somatic experiencing, which Amy sums up as: I see you and I believe you.
- JPC says care at a retreat has three parts: preparation, support during and support after, with integration circles continuing as long as people want them.
ᛃ Moments in this one
ᚠWhat ketamine therapy looks like at a retreat
Jeremy talks with the founders of Transcendelic Retreats, a Southern California program for ketamine-assisted therapy. Dr. Amy Milroy is a psychiatric and family nurse practitioner and the CEO. Dr. Sal Kalra is a physician in internal medicine, pulmonary and critical care and the chief medical officer. JPC is a Zen master and Buddhist monk who leads meditation and peer support.
Amy describes the model as preparation sessions, ketamine journeys and integration sessions, set inside a retreat in a large home. Guests also have yoga, massage, sound healing, nature walks and meals together. The conversation was recorded in February 2024, so the legal details below reflect that moment.
ᚢWhy Amy turned to ketamine therapy for depression
About five years before the interview, Amy received esketamine, a prescribed form of ketamine, for treatment-resistant depression and PTSD. She says other clinicians had run out of ideas, and that she began to wonder whether she was the problem. At first it was treated as a molecule to take and go home, and only later did she learn ketamine is a psychedelic.
Amy says the experience taught her self-love as something lived, not just understood. She also found that much of the pain she carried for others was not hers. In her view, the effectiveness of psychedelics is not just the molecule but the journey and the way a person changes their life afterward.
ᚦTrauma-informed care instead of symptom suppression
Amy criticizes a medical model that tells patients to take a pill and correct a chemical imbalance. In her telling, people keep returning with the same problems because their history of trauma is rarely asked about. She describes trauma as what happens inside a person when their ability to cope is overwhelmed, whether by one event or by years without safety.
She says complex PTSD, which comes from chronic experiences like a dysfunctional or abusive parent, is still underrecognized in the official diagnostic manual. At the retreats, the team uses internal family systems, EMDR and somatic experiencing. Amy says the common core is validation: I see you and I believe you.
Jeremy adds that the Western model can feel like a freeway paved over old pain. Anyone who wants support working through the roots of trauma can explore individual therapy with Jeremy.
ᚨIs ketamine therapy safe? Screening, side effects and monitoring
Sal says that before anyone arrives, the team collects an extensive physical and psychological health history, with attention to cardiovascular problems and high blood pressure. During a session he administers the medication and monitors blood pressure, heart rate and oxygen. He says they treat side effects such as nausea or headaches, keep equipment on site for a serious cardiac event and would call an ambulance if needed.
Amy says ketamine is very safe overall when someone is properly screened. She names the main risk as severe chronic heart disease, because ketamine raises heart rate and blood pressure. Sal adds that the dose they use is subanesthetic, far below what is used for surgery. These are the team's statements, and this is not medical advice.
On addiction, Sal says psychedelics including ketamine carry a very low risk, and he describes ketamine as prompting changes that may help the brain form new pathways alongside therapy. The team also discusses media coverage after Matthew Perry's death. Amy's understanding is that it involved several factors, including a heart condition and a very large amount that did not come from a prescription.
ᚱIs ketamine therapy legal?
Amy explains that ketamine is federally legal and has been since it was created in the 1960s. It is a Schedule III controlled substance, so a prescriber needs a DEA license. Many uses, such as depression, anxiety and PTSD, are off label, and the only FDA-approved form she names is the esketamine nasal spray.
She adds that the team works only with what is federally legal, and that at the time of recording she described ketamine as the only federally legal psychedelic. MDMA and psilocybin were discussed as still in clinical trials. Those details may have changed since, so check current laws and speak with a licensed provider.
ᚲMoral injury, burnout and mindfulness
Sal explains why he left conventional care behind. In the ICU he saw patients as young as 18 and as old as 100 die, and during COVID he watched people suffer alone. He also describes working under constant pressure to see 20 to 30 patients a day, and says it felt like being a cog in the wheel.
He says that experience, along with his own mental health, led him to psychedelics and to seeing his own worth. JPC, who says he lives with bipolar depression and has worked as a police officer, teaches what he calls micro mindfulness moments. A shower or a cup of coffee, he says, can become a daily practice that supports what people learned on the retreat.
ᚷWhat happens during and after the retreat
Amy says the retreat setting helps because many people carry medical trauma from rushed appointments. She describes it as a fresh start, with people eating together and sharing as peers. JPC adds that making schedules and meals easy lets guests focus on themselves.
On integration, Amy explains that it means bringing insights from the journeys together into daily life. The team offers an online circle one week after the retreat and ongoing circles after that for anyone who has attended. JPC sums it up this way: we have not left you.
Jeremy offers Light in the Mountains, a three-day small-group psychedelic-assisted psychotherapy retreat in the Sierra Nevada, for people ready for deeper work.
ᚹAccess, support and what comes next
Amy says retreat costs can be a barrier, and that Transcendelic has a sponsorship program for people with marginalized identities, disabilities, trauma or financial hardship. She also says she and Sal do not take a profit from the work at this point and want money not to be the reason someone cannot access it.
The team leaves listeners with a simple message, that you are not broken and that being seen without judgment is where healing can begin. For more conversations about healing and community, Thriving Spirits, the Mindful Mutiny community, offers real conversation, live Fireside Chats and a course library.
Psychedelics and plant medicines may be illegal where you live and aren't right for everyone. Nothing here is a recommendation to use any substance. Ketamine therapy requires medical screening and supervision. This is not medical advice. This episode also mentions mental health struggles. If you are struggling, please reach out to a licensed mental health professional or your local emergency services.
ᚨ Questions people ask
What is ketamine-assisted therapy?
In this episode, Amy describes it as preparation sessions, ketamine journeys and integration sessions, delivered under medical supervision. The team pairs the medication with trauma-informed therapy and mindfulness.
Is ketamine therapy safe?
Amy and Sal say it is very safe when someone is properly screened and monitored, and they name severe chronic heart disease as the main risk. These are their views. A licensed provider can tell you whether it is appropriate for you.
Is ketamine therapy legal?
Amy says ketamine is federally legal with a prescription from a DEA-licensed provider. She described MDMA and psilocybin as not yet legal for therapy in early 2024, so laws may have changed since.
What happens in trauma therapy at a retreat like this?
Amy says the team uses internal family systems, EMDR and somatic experiencing, with validation at the center. The goal, she says, is to let people feel pain safely rather than stuff it down.
What is integration after ketamine therapy?
Amy defines integration as bringing together the insights from different journeys and letting them unfold in daily life. Transcendelic offers online integration circles for as long as people want them.