The K-Hole Theory: Spravato, Ketamine, and the Psychiatric Reset

In this deep-dive episode, Dr. Faisal Rafiq explores the clinical science, supervision nuances, and lived experience surrounding Spravato® (esketamine) and IV ketamine as tools for treatment-resistant depression (TRD), suicidality, and trauma-linked shutdown. Through the story of Emily, a 32-year-old nurse whose depression was unresponsive to conventional treatments, we see how structured ketamine therapy provided more than symptom relief—it offered a psychological reset.