I hope it is okay that I am answering your questions from your PM in the spirit of getting as much as I can explain out there for educational purposes.

I go to a dedicated ketamine clinic.

I don't know if any hospitals offer it, but I would be wary. Reading posts on the TherapeuticKetamine subreddit has been eye-opening. There are a lot of bad clinics out there. In my first post here I mentioned some things to look for, if it wasn't all that clear please ask and I will try again.

Hospital settings are probably not ideal, but I am sure there are exceptions.

Describing what I feel is difficult but I will try. As it gets more intense my feelings can be unpredictable. Yesterday I had a session, and I dove into the deep end almost immediately, which was different. The session is always different in multiple ways, but there are similarities.

It starts out peaceful. The staff are very kind and keep things calm when setting everything up. The first song in the playlist I linked to above helps the beginning to be gentle. The first thing I feel is that my teeth go numb, and then my thoughts go fuzzy. Sometimes I feel overwhelming sadness. It is actually a safe space to do that, it is like there is a buffer between the feeling created by ketamine and yourself. Other times, I feel uncomfortably happy. It is a weird feeling for me.

Two feelings always happen. One is that I feel that I am very close physically to someone - I don't know who it is. The other is when she vanishes, I feel extremely lonely. My therapist claims that my mind is trying to tell me to start talking to people again.

Other than that, it is a lot of thoughts about my daily issues and working through them. The feelings are typically neutral here. Sometimes, my mind goes blank which is a weird thing also since my mind is typically very chaotic.

I have learned that there is nothing to fear. I breathe better during ketamine than I do any other time. Even when I feel like I just died, I can notice myself breathing.

One skill I have learned to do is to always have a thin tether to reality. So when I feel overwhelmed I can mentally grab it and reorient myself to the room. Most times, the room changes its look and size, so if I can briefly get the room to normal, my mind kind of resets. Other times, I can recognize that my thoughts are going dark and I can steer away from it. It took at least 15 sessions to be able to do this. Before that, I was just floating wherever it took me.

I don't think it is a good thing to keep control of the entire session. Let your mind wander but it is also good to re-orient yourself when needed.