#18: 💤 Exploring the World of Lucid Dreaming
What it is and how you can train your brain to lucid dream
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🐎 What is Ketamine Therapy?
💤 Exploring the World of Lucid Dreaming
📚 A Court of Thorns and Roses
🐎 What is Ketamine Therapy?
Ketamine is an unusual type of psychedelic drug. It is a dissociative drug, and it does not share a similar chemical pharmacophore as the classic psychedelics. It also is an interesting chiral molecule that can exist in multiple forms, racemic Ketamine and R-ketamine and S-ketamine. More on that in Nina’s Notes #16 - How Psychedelics Work.
Originally derived from PCP, or “angel dust,” ketamine has been used in hospitals and veterinary clinics for decades.
As a horse tranquilizer, right?
That’s correct. It’s a human tranquilizer too. Ketamine is FDA-approved for use at high doses as an anesthetic to put you asleep during surgery.
Although not FDA-approved, lower doses that are “sub-anesthetic” are used “off-label” to treat depression, pain, and other mental health and substance use disorders. Particularly, it has been more widely used for treatment-resistant depression (TRD), that is severe depression that has not improved via other therapies, including people who are experiencing suicidal thoughts.
A prescription version of ketamine called esketamine (Spravato), is given as a nasal spray and approved by the FDA in 2019 for TRD. According to its guidelines, it is only to be used “under the supervision of a healthcare provider in a certified doctor’s office or clinic.”
Benefits of Ketamine
The medications currently available to treat depression, anxiety and substance abuse disorders involve daily administration of a medication which is targeted toward the correction of neurochemical imbalances of neurotransmitters in the brain such as serotonin and dopamine.
Relief from TRD with ketamine happens rapidly. Instead of waiting several weeks for an SSRI to provide relief, people suffering from TRD can start to feel the benefits of ketamine in 40 minutes.
Furthermore, in contrast to a daily SSRI, a single dose of ketamine has been shown to improve a patient's depression or anxiety scores from severe to mild, and sustain the improvement for 120 days on average after treatment.
Is ketamine therapy right for you?
This is a question for your primary care doctor, your mental health provider or other healthcare professional who knows you well. It is important to note that ketamine therapy is not a first-option treatment for depression, it is generally used when other longstanding treatments have failed.
What happens at a ketamine clinic?
Independent, outpatient ketamine clinics are popping up all over the world. Typically these are for-profit companies that are staffed by a combination of a psychiatrist or anesthesiologist (who can administer the infusion), a nurse, a social worker, and the business people who run the company.
At most ketamine clinics, patients start with a screening, and if qualified, they get a shot of ketamine and are led through a guided meditation. Afterwards they meet with a therapist.
The assisted therapy model with ketamine produces a short-lived but intense subjective experience - the mystical or peak experience- which triggers or elicits an afterglow, accompanied by subsequent positive change in affect, insight, motivation, cognition and behavior.
The clinics operate on a fee-for-service arrangement. Treatments can run from $400 to $800 a session, on average, and aren’t covered by insurance. Typically a course of 6 infusions and a clinical re-evaluation are recommended.
What are the possible side effects?
Ketamine therapy is generally considered safe, including for those who are experiencing thoughts of suicide. The main side effects are dissociation, intoxication, sedation, high blood pressure, dizziness, headache, blurred vision, anxiety, nausea and vomiting.
More detailed research needs to be done on the longer-term benefits and side effects of ketamine treatment and on its safety and effectiveness for teens and older adults, as well as for the emerging indications of ketamine therapy for PTSD, OCD, alcohol use disorder, and other mental health conditions.
Lastly, there is some concern that with repeated dosing, ketamine can start to lose its effectiveness and require larger doses to produce the same effect, which is not sustainable.
Where can you find a Ketamine Clinic?
1️⃣ Awakn Clinics - Offers ketamine-assisted therapy for addiction, anxiety disorders, depression, eating disorders and PTSD in their three clinics located in London, Bristol and Oslo. A fourth clinic in Trondheim, Norway is opening in 2023.
2️⃣ Field Trip Health immersive ketamine-assisted psychotherapy program
💤 Exploring the World of Lucid Dreaming
Have you ever found yourself in a dream, fully aware that you're dreaming and able to control the content of the dream? If so, you've experienced lucid dreaming. In fact, more than half of us have had at least one lucid dream in our lifetime, and for some, it's a regular occurrence.
But, what exactly is lucid dreaming?
The scientific community hasn't yet settled on a comprehensive definition, but lucid dreaming scientists like Paul Tholey and Stephen LaBerge have characterized it as a dream state in which the dreamer is aware of being in a dream and has the ability to make choices within the dream. German researcher Brigitte Holzinger even went so far as to coin the term "Klartraum," translated as "dream of clarity," and identified seven criteria for distinguishing a lucid dream from a non-lucid dream. Criteria 1–4 are essential for a “Klartraum,” while criteria 5–7 are optional and do not make a “Klartraum” by themselves.
Clarity that one is dreaming.
Clarity about the freedom of choice.
Clarity of consciousness.
Clarity about the waking life.
Clarity of perception.
Clarity about the meaning of the dream.
Clarity recollecting the dream.
Why are scientists so interested in studying lucid dreaming?
For one, it has the potential to provide valuable insights into the nature of consciousness. But it also holds great promise as a therapy for those who suffer from chronic nightmares and PTSD. By becoming lucid during recurring nightmares, sufferers may be able to realize that the dream isn't real and change the direction of the dream to a more positive or neutral outcome.
How can you train your brain to have lucid dreams?
Three techniques have been found to induce lucid dreaming most successfully, reality testing, Mnemonic Induction Lucid Dreaming and Wake-Back-to-Bed.
The reality testing method involves asking your waking self whether you’re dreaming, and performing an action that helps you to find out. In the movie Inception, Leonardo DiCaprio’s character, Dom Cobb, uses a spinning top, which would eventually stop rotating but continues eternally when dreaming. The idea here is that the repeated checks throughout the day make you more likely to do the same checks while dreaming, and thus become lucid to the dreamworld.
In the Mnemonic Induction Lucid Dream (MILD) technique, you rehearse a dream and visualize becoming lucid while repeating a mantra expressing the same intention, such as “next time I’m dreaming I want to remember that I am dreaming.”
For best results, this should be combined with the Wake-Back-To-Bed (WBTB) technique, where you set your alarm clock to one or two hours before your normal waking time, get up for a few minutes, and then go back to sleep.
The brief awakening is thought to increase activation of the key brain areas involved in lucid dreaming when one slips back into rapid eye movement (REM) sleep, the stage during which vivid dreaming occurs.
Various wearable technology companies have developed wearables in an effort to alert the dreamer that they are dreaming. These wearables flash light, vibrate or play sounds during REM sleep. However, these external stimuli need to be handled with care or designed for a particular intensity tailored to each individual, as some people are lighter sleepers than others.
Besides these three techniques, it may be possible to chemically induce lucid dreaming.
A controlled, double-blind study found that taking a certain medication called galantamine, which is an inhibitor of an enzyme called acetylcholinesterase, can increase the frequency of lucid dreams when taken at a specific time during the sleep cycle and combined with training in techniques for inducing lucid dreams. This effect was seen in a dose-dependent manner, meaning that the higher the dose, the more frequently lucid dreams were reported.
Are lucid dreamer’s brains different from non-lucid dreamers?
Researchers at the University of Wisconsin-Madison looked at a group of frequent lucid dreamers and compared them to a control group of people who were similar in age, gender and how often they remembered their dreams. They identified eight brain regions that showed increased activity during lucid dreaming.
The frequent lucid dreamers had increased connectivity between several brain regions, and specifically heightened activity and connectivity in the left anterior prefrontal cortex. The anterior prefrontal cortex has been linked in the scientific literature to metacognitive functions, including the evaluation of one’s thoughts and feelings and variance in the capacity to make accurate metacognitive judgements.
Despite differences in brain connections between lucid dreamers and non-lucid dreamers, lucid dreaming does not affect the brain structure, or the way the brain works in other aspects of memory, focus or mindfulness.
Is it possible to communicate with a lucid dreamer or share a dream?
Scientists have not yet studied or proven the existence of shared dreams among a group of people, but in a report published in February 2021, scientists claimed they were able to share a two-way conversation with a person in the midst of a lucid dream. The sleeper would hear audio cues from the lab, and then respond with specific eye movements, even solving simple math sums. This echoes the use of musical cues to signal incoming wake-up kicks in the science fiction film Inception.
As brain imaging technology continues to improve, scans can currently tell which cortex is active during sleep, offering some clues as to what the subject might be dreaming about.
Our understanding of sleep and dreaming has advanced significantly in the last decade. It’s not inconceivable that several more decades in the future that this brain and dream imaging tech could become more accurate in revealing the contents of a person's dream.
📚 Book of the Week
A Court of Thorns and Roses #1 by Sarah J. Maas
Its fantasy. Its sexy. It is consuming.
Nobody told me that this book…is CRACK
⚡️ Check This Out
In Nina’s Notes #5, I talked about Life’s Powerful Moments, and gave a shout out to Priya Parker, author of one of my all-time favorite books, The Art of Gathering. In it she gives many examples and exciting real-world ideas to help you create meaningful, memorable gatherings, large and small, for work and play.
She just launched a digital course “The Art of Gathering Digital Course” which is now open for enrollment! Description below:
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Gatherings play a large role in our lives. How we spend our time with our friends, family, and co-workers has the potential to change the way we connect, the way we understand one another, and the way we live. It’s about time we start practicing how we intentionally plan them so that our time together better serves our needs, whatever those needs might be for you at work and in your communities.”
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