What is the concept “set and setting”? Why should you care? You’re busy thinking about or already starting your ketamine clinic. The last thing you need is another thing to worry about when providing ketamine infusion treatments. In this blog, we’re going to answer these questions plus give you a starting point to help you in addressing “set and setting” with your ketamine infusion patients.

4 small pebbles stacked on top of each other on a wooden surface — Set and setting each have a role to play during ketamine infusions.

What Does “set and setting” Mean?

These are the patient’s mindset (set) and the environment (setting) where the infusion will occur. Mindset is shortened to “set” and refers to the mental state a person brings to the clinic. This also includes their motives, intention, beliefs, along with the physical, emotional, & cognitive state before the infusion.

Setting refers to the physical and social environment where the ketamine experience will occur. This includes the physical environment (both inside & outside), the healthcare team in the room, as well as the person who brought you to the clinic.

Two white candles, one wooden candle holder with two smaller candles and incense in the background — Ketamine is merely a chemical key in the transformative experience of a patient. What truly matters is set and setting.

Why should you care about “set and setting”?

If you are not convinced of the importance of this concept and practice, here is where we are going to persuade you to change your mind.

“Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key — it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting. Set denotes the preparation of the individual, including his personality structure and his mood at the time. Setting is physical — the weather, the room's atmosphere; social — feelings of persons present towards one another; and cultural — prevailing views as to what is real. It is for this reason that manuals or guide-books are necessary. Their purpose is to enable a person to understand the new realities of the expanded consciousness, to serve as road maps for new interior territories which modern science has made accessible.”

— Timothy Leary, The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead

The set and setting creates the experience. The biochemical properties of ketamine and the experience (since ketamine is a psychedelic) is where the improvement in your patient’s symptoms come from.

The “better” the experience, the “better” the transformation and healing

Take it from the quote above by Timothy Leary, and take it from us! We have seen patients who went to ketamine clinics where they were not mindful of set and setting, and then came to us. They reported their ketamine infusion experience was so more impactful and meaningful with us, as compared to a clinic that didn’t care about music, physical comfort, and creating intentions. We have noticed that for many of our patients, knowing they are in a safe supportive space with people who care about them can be as healing as the medicine. Wouldn’t you personally prefer to go to a clinic that you knew truly cared not only about your physical well-being during a treatment but also your comfort and emotional state?

The “better” the experience, the “better” it is for all of you

If you’re personally not sold on the above argument, and you’re more of a logical practical type of individual not fully convinced about psychedelics...well why are you even opening a ketamine clinic? But in all seriousness, here is a different way of looking at it. By being mindful and intentional about creating a healing set and setting, you are increasing the odds of a “smoother” ketamine experience for your patient. If your patient is mentally and emotionally prepared for challenges with an intention (set) and they are comfortable knowing you or your staff is there if they encounter issues (setting), the smoother their experience. And the smoother the experience, the better it is for you as the ketamine specialist working with this patient. Not only that, but it’s better for business as well! Great experiences at your clinic inevitably leads to more patients coming to you.

Opened empty notebook with a pen in the center, on top of a wooden surface — Creating the right mindset for ketamine infusions just involves a few simple, small steps.

Ways To Address The Mindset aka “Set”

There are several ways by which you can help your patient prepare their mindset. These don’t have to be so complicated and in fact, are just small habits that your patients can incorporate into their daily lives before the infusion. But despite how small these are, they significantly improve your patient’s ketamine experience:

Ask your patients to prepare and bring an intention with them.
- Preparatory detox or fast/diet:
  - Detox from substances, activities, and items which can affect both the mind and mood.
  - Avoid stimulants and depressants as this could alter the experience only under the guidance of a medical doctor).
  - Avoid watching TV shows and movies with excessive amounts of violence.
  - Be cognizant of what they drink, eat, watch, and read.
- Meditation
- Journal and reflect before the infusion
  - While simple, but not easy, meditation can help prepare to quiet the mind and be open to what they will be experiencing during the ketamine infusion.
  - The skills cultivated in a meditation practice, such as grounding and keeping calm when thoughts race, can be very useful during the infusion.
The emotional state of the patient entering the clinic can affect the infusion tremendously. This means it's important to bring a positive mindset, especially the day of the infusion.
Encourage patients to reflect, journal, and discuss with a friend, psychotherapist, and/or psychiatrist to have a clear goal or outcome for the infusion.
Examples of intentions:
- “I want to let go of the past.”
- “more peace and mobility.”

Why else should your patients set an intention before the infusion? Read our blog post here to learn more!

Pair of hands holding a book and another book beside it. In front is a cup of tea and 2 bouquet of flowers. — *The environment of your ketamine clinic also plays a huge role in the ketamine infusions.*

Ways To Create An Optimal Setting

As we mentioned earlier, ketamine is only a catalyst in your patient’s treatment. Both you and your patient each have a unique role to play in this ketamine journey. Your role as the doctor is to prepare the space aka “the setting.” Here are some steps to prepare your space for the infusion:

Have comfortable seating
Have headphones, eyeshades, music, and aromatherapy inside of the clinic to target all senses to make the ideal environment
Trained healthcare professionals are with you throughout the entire infusion, along with continuous oxygen, pulse, & cardiac rhythm monitoring.
Be fully present and available for the patient. Be mindful to leave your own personal issues or concerns outside of the infusion room. You have the honor to hold space and create a safe environment for an individual trusting you in their own journey of healing.

Hand with palms facing up to the sky with green mountains in the background — *You and your patient have the opportunity to establish the right “set and setting” to create a truly transformative ketamine journey.*

Final Thoughts: Do the right thing with “set and setting”

Ketamine infusions truly are a remarkable treatment for your patients. And you as their doctor are very lucky to witness these life-changing transformations. By establishing the right “set & setting,” you will be able to impact even more people’s lives. Just remember that both you and your patient get to play an active role in this transformative journey. We hope that you have a clearer understanding of why “set and setting” are important and how you can create an environment that your patients will feel safe in!