Chapter 6

Wednesday, April 3

Elaine is the last of the seven in the group to arrive for her one-on-one debrief with Holly, a day after their dual MDMA and ketamine session.

Before Elaine even reaches the chair, Holly can tell that her client has had a vastly different response to dual therapy than the rest of the group. To start with, there is no light in her eyes. The others have all described the experience in glowing terms such as “life-altering,” “transformative,” and even “a brush with God.” Holly might have predicted such enthusiastic responses from perpetual optimists like Simon or JJ. But it was Reese, the lawyer and most businesslike member, who likened the experience to the divine.

The feedback only validated Holly’s decision to use dual psychedelics for the first time in her practice. But her excitement is now tempered by the sight of Elaine. Her color is slightly off. And her bloodshot eyes hold a haunted look, reminiscent of a victim of domestic assault or other recent trauma.

“You went through a lot yesterday,” Holly says, after Elaine sits down across from her. “I’m sorry for that.”

“Me, too,” Elaine mutters, avoiding eye contact.

“No question, the experience can be overwhelming. Not at all easy to process. Particularly after such a traumatic trip.”

Elaine shrugs but still refuses to look up.

“Can we talk about it?”

Her shoulders twitch again. “I don’t remember much.”

“That must be the midazolam.”

“The sedative?”

“Yes. You were having a severe dysphoric reaction. A bad trip. You dropped into the ‘hell realm,’ as some people call it. When the hallucinations turn nightmarish. I had no choice but to sedate you. And midazolam often causes amnesia for part or all of its duration.”

“Oh.”

“You don’t remember anything from the experience?”

“I remember a meadow. Lots of flowers. Vivid colors…”

Holly nods. “That’s a good start. You did cry out, though. It sounded as if someone else was with you in the vision. You were screaming at him to go away.”

“I… I don’t remember that.”

Holly waits a few seconds before asking, “Was it the wolf?”

Elaine buries her face in her hands and begins to rock in her chair.

Holly knows better than to push too hard, but she also can’t ignore it. Elaine has arguably made the most progress of anyone in the group. Early on, she confided to Holly that despite being a leading voice in the fight against the opioid crisis, she was still abusing prescription painkillers such as Vicodin and Percocet. She just hid it better than most. But a month into therapy with ketamine, Elaine found sobriety. A fact Holly has confirmed every week since, with Elaine’s permission, through urine drug screening.

Elaine’s abstinence coincided with one of her earliest ketamine trips. In the subsequent debrief, she recounted to Holly her powerful hallucination about being chased through a forest by a hungry wolf. By the next session, Elaine had recognized the wolf for what he was: the anthropomorphic representation of her uncle.

From the age of six to nine, Elaine and her little brother had gone on an annual summer fishing trip with their paternal uncle. She hated those excursions and came to despise her uncle, refusing to go back by the time she turned ten. But it wasn’t until she began working with Holly that the suppressed memories of those nights spent alone in her uncle’s cramped cabin, while her brother slept next door, flooded back to her. Elaine remembered the encounters in harrowing detail: the claustrophobic sense of being swallowed in her uncle’s arms, the stale beer on his breath, the way his whiskers scratched her face, and the panicky, gut-churning sensation of his pudgy fingers probing between her legs.

It was hard for Holly to stomach the details, but she recognized that Elaine’s devastating molestation had contributed to, or likely caused, her severe anxiety, her inability to sustain romantic relationships, and ultimately her opioid addiction. Holly is convinced that for Elaine to heal from her PTSD and remain sober, she needs to confront those horrific memories.

“After yesterday’s session, Elaine, did you… relapse?”

“No!” Elaine snaps, her face still covered by her fingers. “Want me to pee in a cup right now to prove it?”

“No. It’s just that you seem so shaken.”

Elaine pulls her hands from her face. “Because I am!”

Holly reaches for her wrist, but Elaine recoils from her touch.

I moved too fast. I pushed too hard.

Holly had predicted Elaine would be the most vulnerable member to compounding doses of psychedelics. And she silently berates herself for not listening to the inner voice that told her to slow down, to begin with smaller doses. But what was done was done. “Aside from the flowers, Elaine, do you remember anything else from yesterday’s session?”

“No.” She pauses. “Except…”

“Except what?”

Elaine’s eyes narrow. “When I woke up. Or came to. Or whatever. I was in your… arms.”

“Yes. Right after I injected the midazolam, you reached out and clung to me. And you asked me—pleaded with me—to keep holding you.”

Elaine’s chin drops, and her gaze falls to the floor.

Holly suppresses a sigh. She has no idea how far yesterday’s experience might have set her client back.

Though there are twenty minutes still left in their session, Elaine rises abruptly to her feet. Turning away, she murmurs something Holly can’t decipher.

“I didn’t catch that,” Holly says.

Elaine looks back over her shoulder. “I said it didn’t feel right.”

“What didn’t?”

“That hug. The way you touched me. It didn’t feel right at all.”