The Role of the Sitter: Why You Need a Sitter and What They Should Expect

April 19, 2022

Nue Life

Nue Life

Top points

  • A ketamine therapy sitter is a friend or loved one who ensures your emotional and physical safety during the ketamine experience.
  • The sitter provides a caring presence, maintains the physical environment, and assists as needed so you can achieve optimal results.
  • Witnessing the changes in thought patterns and emotions that occur during the ketamine journey can be very rewarding for the sitter.

“Life’s better with company. Everybody needs a co-pilot.” – Ryan Bingham (George Clooney), Up In The Air (2009) by Jason Reitman

When you sign up for a Nue Life program, you agree to have a friend or loved one with you during your ketamine treatments, known as a “sitter.” A sitter is simply a trustworthy person who will ensure your emotional and physical safety during the ketamine experience.

It may be tempting to think having a sitter isn’t an important part of the ketamine therapy process, but they are essential to providing the best environment, or setting, to achieve the most positive long-lasting results.

Whether you’re a client preparing for your journey, or a loved one who has agreed to serve as a sitter, read more to learn what the sitter should expect and how rewarding the experience will be.

What is a Ketamine Therapy Sitter?

“I’ve had a beautiful run of experiences with patients being a sitter, and it’s so rewarding,” says Alicia Hugh-Fisher, a Nue Life team member and who has sat in-person with numerous clients undergoing psychedelic integration therapy.

“Safety, trust, comfort, and integrity. Those are the four pillars we should strive for as sitters,” she says. “Make sure they can trust you, give them space to speak if they wish, and don’t cut them off. Ensure the setting is comfortable for them to release and surrender, and maintain the integrity of confidentiality.”

The role of the sitter has a rich and complex history, spanning from traditional guides and spiritual leaders, to the recreational “trip sitters” of the 60s, to what we have today – an aid in a therapeutic setting.

Sitters or guides were often the shamans and spiritual leaders within ancient communities such as the Siberian shamans from the 1600s who used the mushroom Amanita muscaria (known for its red-and-white spotted cap). Native American tribes also participated in peyote rituals, led by the tribe’s spiritual leader. They were responsible for administering psychedelic substances in the desired dosages, and also leading healing and spiritual ceremonies.

But don’t worry, if you are serving as a sitter for a loved one undergoing ketamine treatment, you will not be expected to act as a guide or shaman. You are not there to pilot the plane but rather to serve as a co-pilot, ready to step in if your sittee has any needs or challenging moments. The sitter is there to hold space, maintain the physical environment, and ensure that everything is as it should be.

Before the Ketamine Experience

Set and setting are key elements in achieving a positive psychedelic experience. “Set” refers to the patient’s mindset entering into the experience. “Setting” encompasses everything about the physical space including temperature, sound, and lighting. The sitter is there to make sure the setting remains positive, calm, and free of distractions.

Communication is key in preparing for the ketamine experience. As a sitter, you will want to discuss a plan that includes anything your loved one may need during the experience such as tea or water, the music that will provide the best environment, and ways to provide support should any intense feelings or thoughts arise.  

“Vulnerability is powerful and having a sitter there is important,” says Hugh-Fisher. “For many, this is the first psychedelic experience they’ve ever had, and it’s coming at a point where they truly need healing. For many, it’s the last straw.”

Depending on how much they are willing to share regarding their specific reasons for choosing ketamine therapy, it is also helpful to remind them of their intention. “Intention is everything,” Hugh-Fisher stresses. Reminding them of their intention will be useful before and during the experience, especially if they encounter any challenging thoughts or emotions.

During the Experience

After the client has taken the medicine as directed, it is recommended that they lie down comfortably, put on the blindfold provided in their Welcome Kit, and listen to any music they have chosen for the experience. Nue Life provides curated playlists designed for specific intentions and struggles.

“The less they have to do, the better,” Hugh-Fisher says. “The last thing I want them to do is to be choosing music or walking around during the experience.”

You will remain present and available throughout the experience. They may ask for a change to the environment and you are there to accommodate these requests as fully as possible. If they have to get up to use the restroom, you will guide them for their safety, as motor function may be impaired.

It is best to avoid asking your loved one unprompted questions about how they are doing or what they are feeling during the experience. This could serve as a distraction from the experience and from their intention. Simply remain a present and caring presence. Often, this stable presence is all that is required to provide the safety and comfort needed to move into a deeper experience.

As the patient moves into higher doses of ketamine, the experiences may become more intense or challenging. Hugh-Fisher stresses that it’s important to remain present and calm. She calls it maintaining a “hollow space” without judgment or pushing. “Remember this is not about you, you’re not a guide or psychotherapist.”

If the patient is having a hard time, she recommends that the sitter remind them of their intention and to focus on their breath, and remind them that they are safe.

“After one treatment, a woman shared that she had forgotten what a carefree child she had once been. She said that she had forgotten she was a little girl that loved the color purple and loved to get dirty. She had forgotten how free she was as a child,” Hugh-Fisher remembers.

It was two sessions later and this woman began feeling some anxiety during the treatment. Hugh-Fisher reminded her of the previous memory of being a carefree child. “Reminding her of that brought her back to that space,” she says.

After the Experience

“When we end the experience, I like to tell them that we’re back,” Hugh-Fisher says. “It’s great to listen and also hold the energy and trust that what lands will land. I recommend they drink a lot of water and take their time.”

Check in with your loved one and see if they need anything like hot tea or water. Encourage them to eat a nourishing meal, something that will be grounding. Hugh-Fisher suggests something rooted in the ground such as a sweet potato or spinach.

Reassure them about any challenging emotions or thoughts that may have come up during the experience. Remember that the most important healing work takes place after the ketamine experience during the integration process. Discuss ways to achieve integration, through journaling, discussion through an integration group (which comes with every Nue Life program), or work with a therapist. This is also an ideal time to begin a mindfulness practice, which may be beneficial for the sitter as well.

The Sitter’s Reward

While individuals respond to ketamine treatment in their own individual ways, it is often very rewarding to witness the changes in thought patterns and emotions that occur from treatment to treatment.

“I had a teacher whose anxiety was through the roof and felt that she was going to have to quit her job if this didn’t work,” Hugh-Fisher remembers. “She was very nervous, very anxious. By the fifth session, she noticed that she wasn’t feeling as anxious in parent/teacher conferences. She has noticed herself speaking up and creating boundaries.”

“She’s feeling empowered, taking space, and giving herself that space to be empowered,” she says. “It’s beautiful, seeing them improve.”  

And remember how she said that intention is everything? The same holds true for the sitter as well. Hugh-Fisher recommends that the sitter have as clear an intention for the experience as their loved one. For example, “I intend to help my friend/loved one with their anxiety by embodying compassion, focusing on their breath, staying present, and bringing them back to their intention.”

If you’re someone who is considering or has agreed to serve as a sitter for a loved one undergoing ketamine therapy, we hope you have a better idea of what to expect, what not to do, and how integral you are to the healing process. You are also welcome to participate in a Preparation Group session where any other questions can be asked and answered.


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