Ketamine Assisted Psychotherapy & Obsessive Compulsive Disorder

If you have OCD and have sought treatment for it, you probably know that the frontline treatments are E/RP (Exposure/ Response Prevention) therapy and antidepressants. The antidepressants typically used for treatment of OCD are called Selective Serotonin Reuptake Inhibitors, or SSRIs. Some SSRIs commonly used for treatment of OCD are Prozac and Zoloft. These medications work by increasing the availability of the neurotransmitter serotonin– which is associated with mood, learning, and memory– in the brain. SSRIs at higher doses can be effective in treating OCD. However, more and more research is emerging suggesting that OCD symptomology is related to the an excitatory neurotransmitter called Glutamate.

Glutamate is also a key neurotransmitter involved in the psychoactive mechanism of Ketamine. There’s some evidence that high absorption of Glutamate in the brain can contribute to chronic depression, and ketamine can be affective in blocking glutamine receptors. This may be why ketamine has been so effective in treating depression, and why some studies have shown that it is highly effective in reducing the symptoms of OCD. Old overactive receptors are blocked, and new neuronal pathways are rapidly formed. This process is called neuroplasticity. It is the essential element in the therapeutic effects of ketamine.

Everyone’s personal experience with ketamine is different. Some of my clients report complete dissociation—feeling completely disconnected from their bodies, unsure of the boundaries between self and others, unsure of the limits of reality. This dissociative reaction, which typically comes from a higher “psychedelic” dose of ketamine, may be accompanied by visual effects. Some of my clients report seeing elements of the same visuals repeatedly, every time they journey. This type of journey is more likely to incorporate transpersonal experience. Transpersonal experience, sometimes called ego death in common parlance, is the feeling of a dissolution of self and a connection to a greater whole. It’s a state of mind that necessitates full surrender to the medicine, to the experience as it comes. The ketamine itself can help initiate the surrender, but willing participation on the part of the individual is also integral.

Logically, it’s clear why such an experience may help with the treatment of OCD. OCD is desperate for control at all times and has a firm grasp on the psyche of its sufferers. Even if the concept of surrender or letting go sounds relieving to many OCD sufferers, there is little precedent in the brain for the individual to work with. Working with an ERP therapist helps create that precedent—the ability to “embrace uncertainty” is the core skill taught in OCD treatment—but what if it isn’t enough?

Dr. Jonathan Grayson, a leader in OCD treatment and internationally recognized author, states that OCD is both a learned and a biological disorder. The biological predisposition exists, and an individual learns their rituals (and reinforces their symptoms) in an effort to neutralize anxiety. ERP can be very effective in helping with the learned aspect of OCD. Dr. Grayson adds, though, that in severe cases, medication is also needed to treat the biological aspect of the disorder.

Could this be where ketamine treatment emerges as a standard for OCD treatment in the future? Rather than SSRIs, which a client takes everyday and which can take weeks or months to take effect, will OCD sufferers treat their severe symptoms with Ketamine Assisted Psychotherapy? With the help of their KAP therapist, OCD sufferers can practice the same acceptance of uncertainty standard in all ERP while the medicine’s neuroplastic effects are underway.

The client and the KAP therapist work together in determining the correct dose for the client, depending on their symptoms and their goals. Most KAP clients who present for treatment of OCD opt for a lower dose at first, to ease into the process of letting go that KAP (and OCD) requires. Too high a dose at first can be jarring, and may invite an individual’s typical attempts to control the uncontrollable. This can lead to an unpleasant (but perhaps informative) ketamine experience.

 On a lower dose, called a “psycholitic” dose, a patient is typically verbal, aware of the boundaries of self, and focused on deep processing of biographical material. It can look like a typical therapy session, but one in which the patient is free of their usual defenses. Many patients report feeling very relaxed in this state. My clients have reported being able to make deep connections about themselves, their patterns of functioning, and their relationships while processing on a psycholitic dose of ketamine. I believe there is real potential for gaining insight into the etiology and function of OCD, as well as an opportunity to see the broader patterns an individual’s symptoms form over time.

In the days following KAP sessions, client’s should practice their ERP skills and pay close attention to their mood and symptomology. In this window, the “psychedelic glow”, lasting changes can form. As the treatment continues, a patient and their KAP therapist will adjust the dosage of ketamine based on the patient’s reaction so far, their symptoms, and their hopes for treatment.

Research about the efficacy of KAP in OCD treatment is still new, but there is promising evidence that ketamine, especially intravenous injections, can have a strong, immediate effect on OCD symptoms, which can last clients several weeks. As we learn more about the connection between the glutamate pathway, ketamine, and OCD, we will undoubtedly hear more stories of successful treatment.

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Sarah Lobb

Sarah Lobb

LICENSED SOCIAL WORKER (LSW)

Psychedelic assisted psychotherapy is a modality that is particularly good at helping develop our awareness by allowing us to encounter ourselves and our experiences in unique and poignant ways. Inviting and working with expanded consciousness in therapy often begets sessions full of rich content, permitting a more authentic self to emerge in therapy and beyond. As a psychotherapist whose practice is rooted in psychodynamic and relational theories, I’m attentive to how past experiences inform present circumstances, and this helps me provide attuned support throughout the ordinary and extraordinary experiences of psychedelic assisted psychotherapy.

I appreciate helping people through transitions such as navigating grief and loss, adjusting to major life changes, and addressing shifts in motivation and focus. I have extensive experience supporting people who are tackling addiction and recovery, either for themselves or within their families and communities. For many, compulsive behavior, or addiction, begins as a way of enduring but over time the behavior can end up inhibiting our ability to relate to others and ourselves. I offer a place to build resilience and rediscover the self.

Jennifer O’Donnell

Jennifer O’Donnell

M.A., Counseling Psychology, Certified Psychedelic Facilitator through Soundmind in Phila.

Jennifer is an experienced mindfulness-based psychotherapist. She holds
a Master’s degree from Delaware Valley University in Counseling
Psychology, and a Bachelor of Arts degree in Political Science from
Temple University. Jennifer is a certified sexual assault counselor, an
experienced certified yoga therapist, and a certified yoga and Pilates
instructor. Jennifer has completed post graduate training with
Soundmind Institute in Philadelphia as a certified Psychedelic
Facilitator. She offers an array of therapeutic techniques which include:
Trauma Focused – Cognitive Behavioral Therapy (TF-CBT), Dialectical
Behavior Therapy (DBT), Mindfulness Based Stress Reduction
strategies and trauma informed yoga therapy. Jennifer’s therapeutic
approach encompasses the integration of therapy, yoga, breath work and
mindfulness and includes a blend of therapeutic modalities such as
somatic experiencing, attachment theory, psychodynamic, and Hakomi.

“ I see counseling as a safe and therapeutic relationship. My approach
is a blend of both clinical and alternative therapies designed to meet the
needs of each individual. The goal is for you to gain insight and clarity
into your thoughts and feelings in a supportive and encouraging
relationship as we uncover new paths to your personal healing and
transformation. I believe we all carry inner wisdom, and when we start
quieting our minds and listening to our bodies the wisdom can then be
heard.”
Jennifer has experience in treating trauma, PTSD, anxiety, depression, bipolar
disorder, obsessive compulsive disorder, women’s issues, family
conflict, sexual and gender identity issues, grief, behavioral issues and
life transitions. Jennifer has a deep understanding of how trauma shows
up in the body, and continues her personal practices to deepen her own
understanding of self, consciousness, and collective healing.

Sophia Polin

Sophia Polin

MASTER OF SCIENCE MS: MENTAL HEALTH COUNSELING

I am an integrative therapist whose practice combines relational theory with elements of Cognitive Behavioral Therapy. In my standard practice I work with adults and adolescents with histories of trauma, who are facing major life transitions, struggling with anxiety and depression, who are dealing with relationship discord, or who want to explore their full potential. I have substantial experience working with Post-Traumatic Stress Disorder as well as Obsessive Compulsive Disorder. I practice Exposure and Response Prevention (E/RP) for OCD, and take expert care in helping my clients face and overcome what they fear most.

In session, I emphasize attuning to the mind-body connection, habituating to feelings of vulnerability, and integrating disparate “parts” of the psyche in order to guide clients towards conscious, intentional lives and relationships. I consider early life and relationships to be integral in the formation of the personality and of patterns of behavior later in life.

I have recently expanded my practice to include psychedelic therapy. The use of psychedelics in a therapeutic setting gives clients the unique opportunity to distance from ingrained ways of thinking, connect with their own healing intuition, and dissolve the boundaries of self that are no longer serving them. The transformative shifts we are seeing in Ketamine treatments are the result of— the creation and reorganization of pathways in the brain (neurogenesis and neuroplasticity). These are the same processes therapists have been using traditionally to support their client’s growth and healing. I like to think of it as automating what has traditionally only been achievable manually.

Occupying altered states can be scary at first. My role as a psychedelic therapist is to lay the grounds for a safe and revelatory journey. In our preparation sessions we will build essential trust, explore your history, and collaboratively set your intention for your psychedelic experience. We will use our integration sessions post- treatments to synthesize and apply the wisdom gleaned from your journey to affect lasting, meaningful change. Whether you are experienced with psychedelics or exploring psychedelia for the first time, I am with you every step of the way.

Stephanie Josephson

Stephanie Josephson

LCSW

I am a Licensed Clinical Social Worker with 20+ years of experience working with people in Philadelphia, New York City and San Francisco.  I am certified in Psychedelic Assisted Therapy and practicing Ketamine Assisted Psychotherapy at the Ko-op.  My client may be a person who currently feels stuck in their life, dealing with chronic health issues, issues related to being queer, trans or non-binary,  concerns about use or mis-use of substances, or dealing with depression or anxiety.  My focus is to work collaboratively with clients to foster growth and personal development in a supportive, judgement-free environment. We can develop skills to deal more effectively with overwhelming feelings, identify your strengths, and work together to overcome challenges in your life.
Psychedelic Assisted PsychoTherapy is a tool to help feel unstuck, expand your perspective and deal with events in your life that, in the past, you have been unable to fully address.  I offer Preparation sessions where we build rapport, gain an understanding of what to expect during a medicine session, and set intentions for what you would like to achieve. I also offer Integration Sessions, weaving the insights gained during your psychedelic journey into your conscious living.
I look forward to speaking with you, and discussing how we can work interactively so that you can better navigate your way forward
Megan Remsen

Megan Remsen

Licensed Social Worker (LSW)

I am a psychodynamic therapist trained in the analytic tradition with specialization in integrated trauma treatment. My practice is grounded in using psychedelic psychotherapy to promote relational and internal acceptance and stimulate growth in spaces that previously seemed stagnant. My kaleidoscopic background and diverse trainings in social work, anthropology, native plant medicine and community healing support my practice. I value and feel curious about the use of dreams, mythology, and intangible heritage as insights into our construction of Self. I embrace the use of non-ordinary states to support the work of engaging with these inner realms.

Psychedelic journeying provides expansive opportunities to engage with and feel curious about the events and beliefs that have shaped our experiences. Our sessions will prioritize interpreting and integrating the insights from your journey into your conscious experience, in support of your relationship with new ways of being. The elasticity of journeying benefits from a secure and stable holding relationship, I will provide collaboration and witnessing through every step, and I recognize and will respond to the vulnerabilities of these new states.

Much of my work centers on supporting the effects of transitions and change on the mind, spirit and body. In our sessions, we will examine the systems, early childhood experiences and deeply internalized messaging that continues to constrain the expansiveness of who we are. Together, we will move towards illuminating those spaces and undoing their harm.

I recognize the oppressive impact of contemporary conditions on the human experience, and I strive to hold the complexity of the treatment I offer and meet clients where they are. I collaborate on a course of treatment that fosters a sense of physiological, emotional, and relational security, while addressing economic realities. I offer a sliding scale and I am happy to consult on a course of treatment to meet unique needs. I center social justice in my work, welcome all sexual and gender identities and make an LGBTQ+ affirming space a priority. Whether you are new to Ketamine Assisted Psychotherapy or returning to continue your insights, I offer a constructive space to work through the subconscious to foster connectedness and curiosity in support of relief from severe depression, attachment injuries, PTSD and anxiety.

Dr. Sophia Brandstetter

Dr. Sophia Brandstetter

LCSW, PSYD CLINICAL DIRECTOR

I am a licensed psychotherapist who is rooted in psychoanalysis and psychodynamic and relational theories. In recent years, as a compliment to my psychotherapeutic approaches, I’ve shifted my training to include psychedelic medicines as a method for integrating the mind, body, and soul. In many ways we are rediscovering verifiable facts about the impact of psychedelic medicines on our neurochemistry, physiology, and psychology. I have witnessed plant medicine as a power catalyst for change for my patients.

At this time our work must center around Ketamine Assisted Psychotherapy. Ketamine is renowned for uncovering our intrinsic healing capacity while transporting us to a place of higher consciousness. The ketamine psychotherapy experience can bring attention to deep-rooted emotions, patterns, narratives, and/or experiences that could be unconscious sticking points or barriers to our growth. Ketamine sessions often access an abundance of material that might take months or years to uncover in traditional psychotherapy. Previous patients have stated, I have felt in a couple of hours, I have learned more about myself than I have in several years of psychoanalysis. Confirmations like this are common and the insight the ketamine sessions impart can remain long after the effects of the ketamine have dissipated.

At higher dosages, psychedelic medicines have the capacity to allow for significant disruptions of self‑consciousness, a phenomenon known as medicine-induced ego dissolution. Using your experience with the medicine as a guide, we can collaborate in understanding the experience of dissolution to create opportunities for regeneration and integration.

As you can see, I believe providing therapeutic support to be a vital part of the curative mechanism of the psychedelic experience. Together we will work on building a therapeutic relationship founded on trust, safety, and mutual respect for the sacred work the medicine can help facilitate. The approach we co-create can enhance the experience and make way for relief and change.

If you’re entering treatment to address trauma or if you’ve experienced trauma, it’s important to understand the healing significance of the therapist as a witness. Research on treating trauma explores how the witnessing (experiencing the presence of another) is considered an essential prerequisite for our capacity to narrate our experiences. One of the crucial impacts of a trauma is the damaging effect caused by the absence of a witness: without a witness we may have lost touch with how to make sense of what has happened, but when we gain a witness, the experience becomes more possible to know and understand, and healing can begin. As your witness in your psychedelic journey my role is to be visible in all the necessary ways to offer support.

My intention is to design a program that meets your expectations. I’m open to the many possibilities of what may work for you and want to invite you to imagine and share your hopes and needs for the journey. A psychedelic experience is a personal process and I welcome the opportunity to meet for a free consultation to answer all your questions and provide you with a comprehensive understanding of the possibilities

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