A Physician's Guide to Nervous System Healing: Ketamine Therapy, Stellate Ganglion Block, and Integrative Mental Health Care

Welcome

If you are reading this, there is a good chance you have already tried many things. Perhaps therapy, medications, meditation, exercise, supplements, or functional medicine. Maybe you have read the books, listened to the podcasts, and worked with thoughtful clinicians, and you still find yourself feeling stuck. You are not alone.

Over the years, I have come to believe that many of the conditions we name separately, including depression, anxiety, PTSD, burnout, chronic stress, Long COVID, dysautonomia, insomnia, and even some chronic pain, often share a common thread: an overwhelmed and dysregulated nervous system. At Soft Reboot Wellness, we focus on helping the nervous system regain its flexibility, using tools such as IV ketamine therapy, Stellate Ganglion Block, nervous system regulation, psychotherapy, integrative medicine, and lifestyle change.

This guide explains how I think about healing, who may benefit from these treatments, and why our approach differs from many traditional mental health clinics and ketamine centers. If you would like help with a specific diagnosis, you may prefer to start with our companion guide to the conditions we treat.

Why I Left the Operating Room

I spent years practicing cardiac anesthesiology after training at Stanford, Columbia, and Harvard, including a fellowship in cardiothoracic anesthesiology. In the operating room, I became fascinated by the nervous system. I watched dramatic physiologic changes happen in real time, where small adjustments could shift blood pressure, heart rate, and the body's whole stress response. I saw, again and again, how profoundly the autonomic nervous system shapes our health.

At the same time, my own practice of meditation and breathwork led me toward a different question. What if many symptoms are not signs that the body is broken? What if they are adaptive responses from a nervous system that has been overwhelmed for too long? That question led me toward integrative medicine, psychedelic-assisted therapy, Internal Family Systems, and Hakomi, and eventually to founding Soft Reboot Wellness. Today my work focuses less on helping people stay safe during surgery and more on helping people heal. You can read more about my background on our Meet Our Team and Why Choose Us pages.

Understanding the Nervous System

The autonomic nervous system regulates many functions we do not consciously control, including heart rate, blood pressure, digestion, sleep, hormone signaling, immune function, and threat detection. When it is working well, it moves fluidly between activation and recovery.

Trauma, chronic stress, illness, infection, sleep deprivation, grief, and hormonal shifts can cause that system to become stuck. Many patients describe feeling as though their body has forgotten how to relax.

Why we get stuck. The nervous system can be pushed into survival mode by many things, often more than one at once:

• Trauma and chronic stress
• Infection, including Long COVID, reactivated viruses such as EBV, and Lyme
• Hormonal shifts, including perimenopause
• Sleep deprivation
• Chronic inflammation
• Loss and grief

When the system is stuck, symptoms can include anxiety, hypervigilance, panic, insomnia, fatigue, irritability, emotional reactivity, brain fog, chronic pain, digestive issues, POTS, and persistent Long COVID symptoms. Different diagnoses often share the same underlying feature: a nervous system trapped in survival mode. This idea, different diagnoses and the same nervous system, runs through everything we do. If you would like a deeper look at the science, our Educational Ketamine Science page goes further into the neurobiology.

Why Healing Often Requires More Than One Tool

One of the most common mistakes in medicine is assuming a single intervention will solve a complex problem. In reality, healing usually happens through several pathways at once. A given person may need better sleep, psychotherapy, hormonal support, improved nutrition, nervous system regulation, ketamine therapy, Stellate Ganglion Block, meaningful relationships, and lifestyle change.

We view treatment through an integrative lens. Rather than asking only what diagnosis a patient has, we more often ask what is preventing this nervous system from feeling safe enough to heal.

IV Ketamine Therapy: What It Is and How It Works

Ketamine is a medicine with a long record of safe use in hospitals. Given as a carefully dosed IV infusion in a supportive setting, it can create a window of increased mental flexibility, an opportunity to step outside well-worn patterns of thought and feeling. It works differently from traditional antidepressants, and for many people it works more quickly. Our guide to how ketamine works in the body explains the mechanism in more detail.

IV ketamine differs from sublingual, oral, or intramuscular ketamine, and from nasal esketamine (Spravato), in how it is absorbed, dosed, and monitored. Delivered intravenously, the dose can be adjusted in real time to your chemistry and response, which is one reason I administer and monitor treatments personally. You can learn more on our Why Ketamine page, and see a step-by-step view of a session in our walkthrough, What to Expect During Ketamine Therapy.

Research published in The American Journal of Psychiatry suggests IV ketamine is most effective as an induction series of about six infusions over a two to three week period. We loosely mirror that approach, while recognizing that six is not a magic number. Some people need fewer sessions and some need more, and we space sessions about a week apart to allow time for integration. Every patient begins with an initial consultation, available virtually or in person, so we can decide together whether ketamine is a good fit.

How much does IV ketamine therapy cost in the Bay Area?

Our initial physician consultation is $750, and ketamine journey sessions are $950 each. Current details, including what is included in a journey, are on our Pricing page. Ketamine therapy is generally not covered by insurance, though we are glad to provide documentation you can submit to your plan.

Ketamine Is a Tool, Not a Cure

One of the most important things I teach clients is that ketamine is not the treatment. Ketamine creates an opportunity. Through enhanced neuroplasticity, it may temporarily increase the brain's capacity for change, which opens a window to process trauma, soften entrenched beliefs, build new habits, and strengthen therapeutic work. The medicine itself is often the smallest part of the process. The real work happens afterward, through therapy, relationships, behavioral change, integration, and showing up for your life differently.

Neuroplasticity: Why Healing Is Possible

Most people seeking ketamine therapy are not broken. Their brains have often become highly efficient at patterns that once served a purpose and no longer do. Neuroplasticity is the brain's ability to form new connections throughout life. Trauma, depression, chronic stress, anxiety, grief, and chronic illness can create rigid patterns of thinking, feeling, and responding. Ketamine appears to temporarily increase the brain's capacity to form new connections, creating an opening for change.

This is one reason we intentionally space treatments by about a week. The goal is not simply to receive another infusion. It is to make time to integrate insights, engage in psychotherapy, strengthen relationships, improve sleep, move the body, and build new habits while the brain is in a more flexible state. Our blog posts What Does Ketamine Therapy Actually Do and the science behind ketamine therapy explore this in more depth.

Why We Encourage Therapy

We view ketamine as a catalyst rather than a cure. The medicine may open a door, but therapy helps you walk through it. Many patients arrive believing they need more insight. More often, they need support translating insight into lasting change. This is why preparation and integration matter so much in our program, and why we collaborate closely with therapists and other providers. You can read more in our introduction to ketamine-assisted psychotherapy and how we combine IV ketamine with Internal Family Systems. We are always glad to work alongside your existing care team through our partnership approach.

Stellate Ganglion Block: A Differentiated Expertise

Stellate Ganglion Block, or SGB, is one of the most promising developments in nervous system medicine, and it is something very few Bay Area clinics offer. The procedure places a small amount of local anesthetic near the cervical sympathetic chain in the neck, under real-time ultrasound guidance. At Soft Reboot Wellness, we use an ultrasound-guided dual sympathetic reset approach, designed to give the fight-or-flight system a fuller opportunity to settle.

Many patients describe feeling calmer, less reactive, more resilient, better able to sleep, and more able to access the work of therapy afterwards. For some people, SGB creates enough nervous system safety that deeper therapeutic work finally becomes possible. You can read more on our Stellate Ganglion Block Treatments page.

How much does a stellate ganglion block cost?

The SGB consultation is $600. The first treatment is $2,000, and the second treatment is $1,500, with a reduced rate for established ketamine therapy patients. Current pricing is always on our Pricing page.

Why We Combine SGB and Ketamine

Ketamine and SGB work through different but complementary mechanisms. Ketamine promotes emotional flexibility and neuroplasticity, while SGB helps calm an overactive fight-or-flight response and may also support neuroplasticity. Many clients find that receiving an SGB before ketamine allows them to feel safer, less guarded, and more able to engage in deeper emotional processing. Together, these treatments can be a powerful combination for nervous system healing and recovery.

Trauma-Informed Care: Our Clinical Framework

For us, trauma-informed care is clinical, not only philosophical. It shapes how we screen, how we prepare patients, and how we are present during treatment. Our care is informed by Internal Family Systems and Hakomi alongside psychedelic medicine. Every treatment plan begins with a thorough intake that reviews your medical history, psychiatric history, current medications, and cardiac safety, followed by a consultation with a physician.

Repair is part of healing. We believe healing happens in relationships, and relationships are imperfect. We are human, and misunderstandings can happen. When they do, we encourage patients to talk with us because repair, honest communication, and working through challenges together can be important parts of healing. Our commitment is not to be perfect, but to meet concerns with openness and humility. You can see how we describe this on our FAQs page.

Why Safety Matters

Safety is the foundation of everything we do at Soft Reboot Wellness. We believe that feeling safe is not only important medically, it is often a prerequisite for healing.

Every IV ketamine treatment is physician-supervised and monitored, and every Stellate Ganglion Block is performed under real-time ultrasound guidance. As a board-certified anesthesiologist with advanced training from Stanford, Columbia, and Harvard-affiliated Brigham and Women's Hospital, I bring extensive experience in patient monitoring, airway management, ultrasound-guided procedures, and the administration of ketamine in both hospital and outpatient settings.

Ketamine has been used safely in medicine for decades and is included on the World Health Organization's Essential Medicines List. It was even used during the rescue of the Thai soccer team trapped in a flooded cave because of its unique safety profile under challenging conditions. I share this not to dramatize the medicine, but to highlight an important principle: when patients feel physically and emotionally safe, they are often better able to relax, let go of protective defenses, and engage more fully in the healing process.

Safety is not separate from the work. Safety makes the work possible.

You can read more about our standards on the Why Choose Us page, and in our article on the safety of ketamine therapy beyond the headlines.

Is ketamine therapy safe, and what are the risks?

In a monitored medical setting, serious complications are uncommon. Common, temporary effects during a session can include dissociation, changes in blood pressure or heart rate, nausea, vomiting, and dizziness. These are expected, monitored, and managed in real time, which is exactly why physician supervision matters. Candidacy is assessed individually, and some medical and psychiatric conditions mean ketamine is not the right choice.

The Soft Reboot Difference

What sets Soft Reboot Wellness apart can be summarized simply:

• Physician-led care, with Dr. Sara Herman personally administering and monitoring every treatment
• Training from Harvard, Columbia, and Stanford
• Board-certified anesthesiologist
• Board-certified integrative medicine (ABOIM)
• MAPS trained, IFS-informed, and Hakomi-informed
• Ketamine and Stellate Ganglion Block under one roof
• Whole-person care across body, mind, and spirit, including labs, lifestyle, and relationships
• Trauma-informed and integration-focused throughout

The Integrated Toolkit

Ketamine and SGB sit within a broader set of supports. For some patients, we add NAD+ infusions or IV vitamin support such as B-Complex or Glutathione during recovery, alongside attention to sleep, nutrition, and integration. You can see options on our Vitamin Infusions page, and read about how ketamine and NAD+ work together. The goal is never to collect more interventions, but to create the conditions in which healing can happen.

Serving Menlo Park and the Bay Area

Soft Reboot Wellness is located at 825 Oak Grove Avenue, Suite A101, in Menlo Park, on the San Francisco Peninsula. Patients travel to us from across the region, including San Francisco, Redwood City, Palo Alto, Mountain View, Los Gatos, San Jose, and the broader South Bay, and we also see some out-of-state patients. Every patient begins with an initial consultation, which can be virtual or in person, so distance need not be a barrier to a first conversation. Visit our Contact page for directions and details.

A Closing Thought

I do not believe healing happens through a single procedure, medication, supplement, or insight. I believe it happens when the body, mind, nervous system, relationships, and environment align in support of growth. Ketamine is a tool. Stellate Ganglion Block is a tool. Therapy is a tool. The goal is not to collect more tools. The goal is to create a life that no longer requires constant survival.

If that resonates, the first step is a conversation. You can start your journey here or contact our team.

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This guide is for informational purposes only and is not a substitute for individualized medical advice. Reviewed by Dr. Sara Herman, MD, ABOIM.