Rapid Relief of Complicated Grief State in a Marital Dyad By Application of Ketamine-facilitated Couples Psychotherapy

This work was sponsored by Project Vida Health Clinic (FQHC) Objective: Report of relief of Complicated Grief State via Ketamine-facilitated Couples Psychotherapy. Methods: Case Report Results: On 3 Dec 2021, a couple experiencing acute grief enrolled in couple’s therapy for grief work. They shared the devastating death of their 5-year-old son due to the negligent actions of the birth mother. The male partner of the dyad (birth father) had psychiatric comorbidities of Adult Persistent ADD, Acute Stress Disorder, Social Communication Disorder, and Insomnia Disorder. His baseline PHQ-9/GAD-7 scores were 10/9. The female (stepmother) of the dyad had preexisting Adult Persistent ADD, GAD, MDD- moderate, Insomnia Disorder, and Chronic PTSD (the result of resuscitating a co-worker in the emergency department where she worked). Her baseline PHQ-9/GAD-7 scores were 21/19. The male declined all psychopharmacologic interventions other than low-dose benzodiazepine for insomnia. The female had Bupropion XL, and Guanfacine ER added to her chronic Adderall. After 20-weeks of conventional couple’s therapy, they remained out of sync in their grieving; in particular, the male perseverated over the legal minutiae involved with ‘getting justice’ for his son’s death; continuously re-traumatizing himself. The female’s patience with this behavior became exhausted, and weekly sessions reached a bottleneck where the couple was not progressing in their mutual grief work. The therapist suggested Ketamine-facilitation of their therapy. After the second mutual Ketamine-experience, they entered the transpersonal therapy space, and their post-session PHQ-9/GAD-7 scores were 0/0. They remain 0/0 one year later. Conclusion: Rigorous clinical trials need to establish the generalizability of this novel therapy approach to couples therapy.