Kleshas and Root Causes of Treatment Resistance

Patanjali identifies 'kleshas'—five fundamental mental afflictions that generate all suffering: ignorance (avidya), ego-identification (asmita), attachment (raga), aversion (dvesha), and fear of death (abhinivesha). Treatment-resistant depression and complex trauma often resist conventional approaches because they're rooted in these deep structures rather than simple neurochemical imbalance. Ketamine's neuroplasticity enhancement enables access to these foundational patterns during dissociative states. A therapist trained in this framework guides patients to recognize which kleshas operate beneath their symptoms: Does depressed hopelessness stem from fundamental ignorance about consciousness itself? Does trauma-driven reactivity stem from ego-identification with harm? Does treatment resistance stem from attachment to suffering as identity? Ketamine creates space for examining and releasing these roots. This shifts treatment from medication management toward genuine psychological liberation. The dissociative properties become tools for accessing and transforming the deepest generators of suffering, creating conditions for lasting freedom rather than perpetual symptom management.