Ketamine and the Elite Athlete

I recently had the opportunity to evaluate and to treat a 24 year old NFL player. He presented with complaints of a feeling of stress, disturbed sleep, reduced appetite, and intense frustration at his circumstances for the last two seasons.

Consider his last two years:  During training camp in his third NFL season, he suffered a shoulder separation that required surgery. Although not major, during his rehabilitation, he developed mononucleosis. The combination of the two placed him on the long-term injury list. He was subsequently let go by the team.  When the next season came around, he re-applied his work ethic and found his way onto another NFL roster. However, his performance and metrics did not match up to expectations.  During game nine, after some pretty minor contact, he felt his shoulder pop out and a diagnosis of a complete dislocation was made. Surgery was immediately scheduled. Following surgical repair and long rehab, the player developed Covid. In spite of this, he maintained a very healthy state of mind and attitude, was beloved by friends and teammates alike and kept going through everything.

After hearing his history, I began to wonder how he could not be traumatized by the past two years. He had lost two playing seasons and the income that went with it, in the peak of his career. He had lost two groups of teammates that he loved, and he was constantly fighting uphill, pushing a boulder. I had an image of a damaged Sisyphus.

I did not share that with him, but did try to explore his emotional state of mind as best as I could. He was only aware of feeling frustrated and fearful about losing his career. He knows the calculus of the NFL very well. In spite of talent, and potential, you were only as good as your last play, let alone your last game or even your last season.

Concerned about his physical and mental health, I offered him the opportunity to undergo ketamine IV assisted psychotherapy. His first session was rather frightening. He felt like his body was contorting (even though it wasn’t) into a position of distress. His hand began to grasp much like the fingers of a baby grabbing for something. My nurse practitioner offered her hand. He felt a sudden warmth course through his body and thought about his stepmother. His birth mother had died at the age of nine. This was the type of maternal love that he was never aware of seeking and had lived much of his life In a big state of grief that he had funneled into his football career.

The integration session afterward provided us with access to a clear challenge he was facing but not recognizing: how so much trauma is sublimated into drive, both athletically and in connection in relationships. 

In his second session, he began to feel a familiar tightness in his chest and body and his body began to go back into the contorted position. However, this time, he was able to regulate it and not give into it. Doing so allowed him to feel his chest expanding and rising. He felt as if he was beginning to float. He began to see clouds and felt a sense of exhilaration. This was how he used to feel as a young boy before the death of his mother. It was also how he felt on the football field prior to becoming injured. He was fast, light, felt like he was floating, and felt at one with the game.

Yet, at the end of the Ketamine session, he began to feel guilty. In the integration that followed, we began to understand that each time he allowed himself to be completely himself, to feel at one in the game and exhilarated, he also began to feel guilty. Could it be, he wondered, that every time he began to feel good and exhilarated, that he began to feel guilty, to shut down the pleasure he was feeling. Could it be that he did not feel entitled to feel totally himself and  fully alive while his mother had suffered and died? I responded “you are somehow holding yourself accountable because you are feeling like you should be suffering for something that was totally beyond your control”. He broke down in tears and began the same crunching of his fists.

As luck would finally have it, someone in the NFL heard his story, and was inspired by it enough to give him another chance. He is currently fighting for another roster spot, but fighting on his terms. The joy has returned to his life and he is fully able to appreciate the joy in his body and in the game that he grew up to love.

As I have written many times, perseverance in an athlete is often born out of trauma. As this patient shows us, we are often not even aware of the traumas that we need to adapt to. Yet, ketamine has the power to open up in a safe way, that which is otherwise too painful to face. Then, in the hands of experienced and wise therapists, the ketamine experience can be used to literally begin a new life, free from all of the constraints that trauma has unconsciously placed on us.

With so much trauma fueling athletic performance, and bringing with it untold suffering and emotional struggle, I look forward to the day when pro sports not only allows, but supports, the use of Ketamine and other psychedelic treatments for its athletes.  This is sorely needed, and the time is now.