Dr. Michael Alpert and Peter Alberding - ALS, Existential Distress, and Ketamine Therapy

Ketamine-assisted psychotherapy is presented as a structured way to help an ALS patient process fear, grief, loss of function, and the reality of death. Peter Alberding, diagnosed with ALS in late 2023, describes seeking a clinical, not recreational, approach and working with psychiatrist Dr. Michael Alpert after several preparatory sessions. The conversation emphasizes that ketamine sessions can vary widely: some were intense or difficult, while others felt peaceful, joyful, or restful. Even temporary emotional relief is framed as therapeutically meaningful in a time-sensitive medical crisis. Alpert explains that the work depends heavily on preparation, informed consent, music, therapeutic setting, and post-session integration, not just the drug. The discussion also notes dose strategy, intramuscular administration, and the need for clear consent and precision around any supportive touch. Ketamine is discussed as helping Alberding move through phases of terror, bodily loss, and eventually less fear of dying, while highlighting limits of generalizing from one experience.