When Resilience Becomes a Liability: Lessons from Ketamine Assisted Psychotherapy (KAP)

Sometimes, people become too resilient.

Yes, that’s right—too resilient.

During my own ketamine assisted psychotherapy (KAP) experience, I remember telling my prescriber that I didn’t have any trauma in my history. My wife, overhearing this, laughed—gently pointing out that, from her perspective, I had navigated quite a few traumatic circumstances.

Like many in Generation X—and arguably generations before—I had become highly skilled at enduring difficulty. The “pull yourself up by your bootstraps” mentality can, of course, produce strength, grit, and adaptability. But there’s a hidden cost: we can also become conditioned to tolerate too much.

In some areas of my life, I had unknowingly embraced a kind of psychological sunk-cost fallacy—staying in situations that were clearly no longer serving me, simply because I had already invested so much.

Dan (a pseudonym) had also become too resilient.

He learned early on to absorb and internalize his mother’s frequent critical remarks. Over time, this created fertile ground for a range of self-defeating patterns:

• A strained relationship with food, alcohol, and other substances that distanced him from his physical health
• A marriage marked by criticism and control, which persisted even after divorce
• A long stretch of unhealthy romantic relationships, often with emotionally unavailable partners
• Heightened irritability toward people outside his established social circle

Like many clients I’ve worked with, Dan didn’t initially connect these patterns to the emotional abuse he experienced growing up. These weren’t conscious choices—but they were familiar ones. In many ways, they recreated the same emotional landscape he had known for much of his life.

KAP often produces the best outcomes when it’s collaborative—especially with a skilled prescriber. After a comprehensive assessment, Dan’s prescriber recommended two initial dosing sessions, followed by six more, a common and effective protocol.

Dan had been taking a GLP-1 medication to support weight loss and shift his relationship with food, alcohol, and other substances. This physiological intervention aligned powerfully with our psychotherapeutic work. As KAP helped him reconnect with his body, we focused on building structure, increasing movement, and creating healthier environmental contexts.

The changes were not just cognitive—they were embodied.

Dan began setting boundaries with his ex-wife that he would not have previously considered. In doing so, he accelerated healing related to his mother, recognizing the parallels in their patterns of criticism and control. He also became more intentional in dating—seeking reciprocal, emotionally available partnerships rather than repeating old dynamics.

Equally important, he developed a clearer understanding of what he could and could not control in his interactions with others. These distinctions didn’t just live in his thoughts—they reshaped his emotional and physiological responses in meaningful ways.

Dan continues to make steady progress.

He regularly reflects on both his internal and external experiences, helping him sustain the deeper self-connection he’s worked hard to build. He’s become more deliberate in cultivating healthy relationships. When his mother offers her usual barbs, he can now respond—or choose not to respond—in ways that preserve his emotional equilibrium.

Over the course of two years, Dan lost approximately 40% of his body weight. KAP played a meaningful role in supporting his commitment to long-term health and in helping ensure he does not return to morbid obesity.

In part, due to the neuroplasticity associated with ketamine, Dan approached integration with intention—engaging in tangible, experiential, and even joy-sustaining actions that reinforced his growth.

I often describe ketamine as a kind of neurological fertilizer.

But as any good gardener knows, fertilizer alone isn’t enough. Without proper sunlight, water, and soil—the consistent effort of both client and clinician—the potential for growth can go unrealized.

Thankfully, Dan showed up as an ideal co-gardener.

Together, we were able to cultivate something truly meaningful.