🫠 Psychonaut POV

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As a board-certified anesthesiologist, Sara Herman had been working with ketamine for years before she started, well, working with ketamine. Since making that pivot, she’s co-created a whole new way of experiencing the medicine—ketamine-assisted group horse therapy. (That’s our mouthful, not hers.)

We asked Sara about her evolving relationship with ketamine, developing a new modality of psychedelic healing, and what makes horses such therapeutic companions for humans.

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What sparked your transition from cardiothoracic anesthesia to ketamine-assisted psychotherapy?

I've been a psychonaut since the early nineties. But the real spark came during the pandemic. As an anesthesiologist, I was still working in person, dealing with a lot of stress and political BS at the hospital. Our group had been bought by a private equity company who was trying to cut our salaries by 50 percent. It was making me an angry person.

To cope, I started deepening my practice of meditation, yoga, and breathwork. Prior to 2020, I had a very traditional, by-the-book, allopathic medical mindset. But some of those breathwork experiences opened me up in ways I hadn’t anticipated. It was during one of those sessions that I received this message about ketamine therapy. Ironically, I had never personally used ketamine, though I was known as the "ketamine queen" in the hospital for how often I used it perioperatively.

Curious, I booked myself a ketamine infusion at a local clinic. It was… terrible. There was no music, no eye mask—just me sitting there, watching the practitioner to make sure nothing sketchy happened. I walked away from that thinking, "I could do this so much better."

So, I started slowly, subletting space from a psychiatry office and intuitively holding space for people the way I would want if I were in an altered state. I knew the basics—set and setting—but quickly realized how much more there was to learn. That’s when I dove into training, determined to expand my understanding of the therapy side.

What I found was that ketamine therapy really works. People responded well to it, and I found it rewarding. It’s very different from the operating room, but I love the challenge. It lets me tap into my creativity in ways I couldn’t in a clinical OR setting.

Your project with Alison Hunter, Soul Strides, combines KAP with equine coaching. How did you two discover this pairing, and how do the two modalities work together?

It's actually a three-pillared approach: ketamine-assisted psychotherapy, equine-assisted therapy, and group process. It all came together through a bit of synchronicity. I was trying to market my practice and ended up connecting with Alison Hunter, an LMFT specializing in equine-assisted therapy. Being a horseback rider since I was eight, I was intrigued. We exchanged sessions—she facilitated an equus session for me, and I facilitated a ketamine journey for her. That’s when it clicked: There’s a way to combine these. And Soul Strides was born.

What we’ve created is a unique therapeutic model where ketamine journeys are enhanced through equine interaction and group dynamics. Ketamine opens up profound inner exploration. Following that, we work with horses to solidify those insights by practicing authentic communication and presence. The group aspect adds another dimension—witnessing each other’s journeys allows for shared learning and connection.

What’s so powerful about horses is that they respond to energy and authenticity. They’re non-judgmental, living fully in the present, and they mirror back what’s happening inside of us. As an example, a client was struggling with a conflict with her boss. We encouraged her to think of the horse as her boss and practice the conversation. At first, the horse ignored her, but by the end, it was following her around without any lead. Just a shift in her energy changed the dynamic.

The real magic happens in how these elements—ketamine, horses, and group work—interact. Ketamine helps people explore new internal landscapes, and horses provide a mirror to test those changes externally. The group process reinforces these transformations through social support and reflection.

Riding a horse on ketamine sounds like a recipe for disaster. How do you ensure the safety of your guests?

Well, no one is riding the horses under the influence of ketamine! All horse interactions happen on the ground, and only after the effects of the ketamine have worn off. There's a solid three-hour gap between the ketamine journey and the equine work, and all interactions are done with professional facilitation.

We partner with horses that are experienced with people. They spend time with kids, adults, and different kinds of energy every day. On the medicine side, we administer ketamine intramuscularly at psycholytic doses, so there is more room for engaging with one another while not being too altered.

How does integration fit in your program? How do you help participants carry their insights from these experiences into their daily lives?

Integration, in my opinion, starts with preparation. Before our retreats, we have Zoom calls to help participants feel comfortable with each other and create a safe, supportive set and setting. We explain that this isn't magic; there's actual work involved.

On the day of the retreat, we debrief individually and in groups to help participants process their ketamine journeys. We also weave nature and movement into the experience, making it personalized for each individual.

At the end of the retreat, we ask participants to write a letter to the horse about what they learned. They then read the letter again, replacing the horse's name with their own. It's a powerful moment when they realize, "I thought the horse did this, but really it was me."

We then focus on how to incorporate these lessons into daily life. We offer journal prompts and send them home with a kintsugi-inspired activity. They take a picture of themselves, cut it up, and glue it back onto gold paper, writing the day's lessons into the cuts. At the follow-up integration call, everyone shares their artwork.

For multi-day retreats, we do other integration activities like making transformation boards with imagery. We're really encouraging people to tap into their intuition or inner healing intelligence, and figure out how to take that forward with them.

For our readers with pets at home, do you think any of the work you do with horses applies to dogs, cats, or other animals?

Some of it might apply, but there's a key difference with horses. They're prey and herd animals, so they have to be extra aware and in tune to survive in the wild and their level of sensitivity to different animals—humans included—is higher than, say, a cat. The size of a horse also matters. Because they're so big, they're able to co-regulate the human nervous system in a way that smaller animals may not be able to. Their size also activates our nervous system, which means we need to practice regulating our own energy and staying grounded in the present moment.

That said, I'm an animal fan. I think there's definitely therapeutic value to having an animal and all the unconditional love and affection they bring. The natural world in general has a lot we don't appreciate or give credit for. Humans are very self-centered; we think we're so exceptional. But animals probably have a lot more capacity for thoughts and feelings than they can express in ways we understand.

There's definitely something to be said for being open to the natural world. I'm reading a book called Your Brain on Art. The chapter I just finished talks about the neuroplastic effects of nature exposure. If we can really give ourselves permission to lean into what the natural world has to offer, I think we can learn a lot from animals. They're special creatures, and there's so much more going on there than we realize.

Want more from Sara?

Learn more about SoulStrides' herd experiences, or donate to The Warrior Women project to provide ketamine-assisted and equine therapy to mothers of children who struggle with substance use disorders.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.