Seth Criner, LPC, is a Journey Clinical Ketamine-Assisted Psychotherapy (KAP) provider based in Richmond, Virginia. He is the owner of White Stone Counseling Center and specializes in EMDR and Christian Counseling. We sat down with Seth to ask him about how he has incorporated KAP in his practice since joining Journey Clinical in February 2024.
What is EMDR?
“EMDR is eye movement desensitization and reprocessing. I always describe it to people as a sort of non-traditional therapy, but it’s becoming much more mainstream and a lot of therapists are incorporating it in their work.
Essentially, folks are utilizing bilateral movements (such as eye movements) and making good use of the brain’s natural storage of memory and the way that those are connected to identify root traumatic experiences where someone started to form faulty narratives about themself. With EMDR, they can reprocess these narratives; they’re not being launched into that traumatic experience again, but rather [the therapist] is helping them keep a foot in the past, another foot in the present, and help them observe what they’re experiencing in the moment.”
How does EMDR work with KAP?
“EMDR and KAP just fit together beautifully. Something that sticks out to me is how well the language around the structure of EMDR fits with the language and structure of KAP. The reason why they work so well together is because of the down regulation of the default mode network. The effects of ketamine go in tandem with the effects of those bilateral movements of EMDR – the processes look so similar. The default mode network houses all of those faulty narratives, and a client is able to refine and edit those stories, separating themselves from their past trauma. When someone successfully reprocesses a memory with EMDR, they’ll tell me that the moment feels much smaller and farther away. For someone who is wrestling with PTSD, they’re able to view these traumatic experiences from a different point-of-view. The ability to combine these two things so seamlessly and see how KAP can complement what clients do when developing their EMDR treatment plan just makes a lot of sense to me.”
Can you walk through what it looks like to combine KAP with EMDR?
“My specialization is treating C-PTSD, grief, and substance use with EMDR. When a client is interested in doing KAP, we first have a long discussion about what KAP looks like. I want to field any questions and concerns that they may have and just help them feel comfortable.
When doing EMDR, the preparation process is huge – you cannot move forward into any kind of trauma reprocessing without being adequately prepared and making sure that you have a boat big enough to catch the fish you’re looking for. It’s important to create an EMDR treatment plan and start reprocessing before we do a KAP dosing session in order to get a baseline for how much the client is handling reprocessing in the absence of ketamine. We go back to the primary issue that they’re hoping to address and use that to guide their intention setting to make sure everything falls in line with what they initially set out to do in their EMDR treatment plan.
I just focus on constant communication with the client and really being with them through every step of the dosing session. During the first hour, we review intentions and make sure that the set and setting is right for them to confidently step into that psychedelic experience during the second hour. We then do an initial integration and debriefing of what happened during the third hour, taking notes on some key symbols or concepts that came up during the experience. At the end of the dosing session, I make sure that they know how they’re going to maximize the work that they’ve just done in the dosing session – that could include journaling, going on walks, or having helpful conversations with people in their lives as examples.
During the integration session, we do EMDR again to capitalize on any insights that may have come up and turn them into resources within EMDR reprocessing. We’ll also start working on the target they had set during preparation while they have the added neuroplastic benefit to maximize their time with reprocessing.”
Who is an ideal candidate for this type of work?
“My ideal client is someone who’s been in therapy for years or decades. I see a lot of clients with C-PTSD and treatment-resistant depression and I’m down for being creative with experiential kinds of therapies to try and get them out of the cycle of being in therapy forever. A recent client shared that it really helped them to push the boundary of the talk therapy that they have been doing for the past few years and step into this new experience. Patients have told me that KAP also makes their EMDR reprocessing feel a bit more tolerable and their targets a bit more approachable. Watching someone begin to distinguish between a normal sadness and deep depression and recognize that they would’ve fallen into that depression in the past is incredible. Clients will start doing well outside of the 3-day window [after a dosing session] and continue to see beneficial change – it just adds so much to the other work that we’re doing together.
Christian counseling is a big focus of mine. I went back and forth, tirelessly trying to figure out if I was going to be like a biblical counselor or clinical counselor. I feel like I was able to strike a good balance in the clinical setting. I get to talk to a lot of Christians about EMDR and KAP and being able to calm some of their particular concerns around it is really helpful.”
How has Journey Clinical supported you in your practice?
It would be interesting to calculate the added value of a Journey Clinical membership with all of the additional consultations and resources that you can get. When I first joined, I looked for peer consultation groups focusing on EMDR and saw that there already were multiple. I feel like Journey Clinical is really receptive to the needs of their growing base of therapists. There’s so many training programs, consultation groups, and opportunities for networking or help with marketing. They’re very helpful in providing things top to bottom to help you feel comfortable and prepared.
What are you hoping to offer in your KAP practice in the future?
“I’m excited about being able to expand and maybe offer some group sessions. There’s always new group protocols coming out, and I think group sessions are probably the most underrated thing within the therapy world. It’s something that a lot of therapists and clients might not know enough about or the benefits associated with it. You can really maximize the amount of direct content that you’re getting with people and add this communal aspect to it. With KAP, it’s really no different, so I’m excited to see how that can fit in with some EMDR groups.
I currently do EMDR intensives as well. People can do as much as 6 hours of EMDR in a day, and I’m excited to see how KAP can help with that – whether that be in cyclitic dosing or doing those EMDR intensives within the KAP integration window. The sky’s the limit, and having the freedom and ability to be creative with the therapeutic work that we’ve been doing and collaborate with other professionals in this space is great.”