Philly Doctor Goes All-In On Ketamine-Assisted Psychotherapy

PHILADELPHIA (KYW Newsradio) – A woman who identified herself only as “Marie” had been struggling for years.

She had been in and out of therapy. She had tried meds. Nothing worked.

Her bouts with severe depression continued to come and go. The wounds from traumatic life events remained unhealed.

“Even though I have been relatively stable and off medications for seven years, I have found myself recently slipping hard and fast…with this impending feeling of sadness and doom,” she said in August.

Still, Marie wasn’t ready to give in.

“I have enough of a fight left in me that I don’t want to go down that road again,” Marie said.

So, at the end of the summer, she wanted to mix it up.

No more traditional therapy modalities. No more scripts that, at best, provided temporary relief for deep-rooted problems, and at worst triggered sleepless nights and extreme weight gain.

“I had a friend who had never been on medication before, and within six weeks, he killed himself,” said Marie. “I know numerous people who try [Western] medicines, and it makes them feel worse.”

That’s why, this time around, Marie decided to do something totally different: Ketamine-assisted psychotherapy.

“I’m feeling mostly excited, a little anxious, optimistic,” she said the night before her first session.

But the source of Marie’s optimism also led to some lamenting.

She couldn’t stop thinking, “What if this actually works? What if I actually get better?”

Most of all, Marie wondered if all the anguish and sorrow could have been avoided.

A potential game-changer

In the United States, ketamine is an FDA-approved controlled substance for use as a general anesthetic.

However, ketamine has not yet been approved for psychiatric treatment.

That’s because over the years, ketamine — despite its ability to reduce pain — has also become a street drug with hallucinogenic qualities.

“It really reminds me of when cannabis became legal,” said Dr. Sophia Brandstetter, who has a doctorate in psychotherapy and is certified in ketamine-assisted psychotherapy treatment.

“Everyone’s still calling ketamine a drug and then all of a sudden, it’s starting to be used as a medicine and it takes our culture and society years to be able to change the language around it. But the shift from drug to medicine creates a completely different perception of it. I think it’s going to take time for us to understand it as a medicine.”

Not Brandstetter, though. She’s sold.

She considers ketamine-assisted therapy to be a game-changer.

Brandstetter has seen the results in patients, and has also experienced them first-hand.

“I am from the position that I can’t ask my patients to do anything that I won’t do,” Brandstetter said. “I’ve taken a lot of psychedelics in my time to understand the impact the medicine can have, which is why I’m here because I know how it can change people’s lives.”

Brandstetter began practicing psychotherapy 15 years ago.

This past July, she set out on her own to open the Ko-Op, one of just a few ketamine-assisted psychotherapy centers in Philadelphia.

Brandstetter hopes the Ko-Op can distinguish itself by not only making this new-age treatment affordable and accessible for patients, but training like-minded clinicians who sign up to become members of the Ko-Op as well.

“[When] I was doing ketamine-assisted psychotherapy, I felt very alone. Where’s the community, especially in Philadelphia?” she said.

“There is tremendous support in the [Ko-Op’s] space. We’ve had patients that are in distress at times, and we have support for the therapist. There’s all these mechanisms put into place so not only the patient, but the therapist feels supported.”

The Ko-Op’s layout and setup both involved a lot of thought.

The facility is run out of a former residential brownstone in Philadelphia’s Graduate Hospital neighborhood.

“The idea is that this is your home away from home,” she said.

The homey vibe permeates throughout the Ko-Op.

There’s music playing and incense burning when patients walk in and take off their shoes; a kitchen that offers refreshments and a place to relax before sessions; and four treatment rooms, each one furnished with a chaise lounge-style sofa and different decors that give off different moods.

“This is something that people are coming to and they often don’t know what to expect,” said Brandstetter, “and so creating this ambiance is really important to what we refer to as the ‘set’ (mindset) and ‘setting’ (environment) of the experience.”

Prioritizing safety 

Inside the Ko-Op’s treatment rooms, where the ketamine is administered, holistic comfort is frequently juxtaposed with intense thoughts and emotions.

“Many of our patients are people that have tried so many different kinds of treatments, have been trying to navigate the mental health roller coaster – finding the right clinician, psychiatrist, treatments,” Brandstetter said. “These are people with treatment-resistant depression, anxiety, OCD, severe trauma, bipolar disorder. These are people that are turning towards this treatment as their last hope.”

While ketamine does not have the addictive properties of harder substances like heroin or cocaine — or even nicotine, alcohol, marijuana, or caffeine, for that matter — its ability to generate dissociative thoughts and hallucinations makes it a potential wild card of sorts.

“Let’s just take it at face value,” said Brandstetter. “You’re asking somebody to come into an office and have a psychedelic experience, to lower their protectors and to access information, content, feelings, thoughts, that feel very intimidating to them.”

That’s why Brandstetter founded the Ko-Op with a harm-reduction model in mind.

Even before patients begin ketamine-assisted psychotherapy, they must be 18 years old, meet certain psychological criteria, and participate in three preparation sessions to get their mind, body, and spirit ready.

Then, upon arriving at the Ko-Op for treatment, patients get their vital signs checked by a psychiatric nurse practitioner.

If the vitals fall within a certain range, patients proceed with treatment. If the vital signs aren’t in the right range, patients get sent home.

As for the ketamine itself, the Ko-Op gets it from the Art of Medicine, a compounding pharmacy in Philadelphia that does national business. Patients take the ketamine under their tongue in the form of a rapid dissolve tablet that disappears in about three minutes.

Brandstetter says patients typically feel the effects of ketamine for about 20 to 60 minutes, depending on how fast they metabolize it.

“Ketamine is short active, which is really unique to be able to offer a psychedelic medicine that doesn’t have to be on a journey for 15 hours.”

The Ko-Op’s ketamine-assisted psychotherapy program lasts six weeks. Sessions are three hours long from start to finish, and can be spread out week-by-week, or done at the preferred pace of patients.

“I think the simplest form to put it in is that in my own experience — and I often hear this with patients as well — is that when the [ketamine] journey starts to settle in, oftentimes we can see us sort of zooming out,” Brandstetter said. “We’re actually getting a bird’s eye view of the Earth, and you’re in the stars.

“What’s really interesting about that is this sort of immediate shift around perspective. We’re so zoomed in on our own lives, obviously, that we just can’t see it and it’s really hard to change. But when you zoom out, and you have a completely different perspective, not only of you but as we all relate to each other in this world, changes can happen.”

Perhaps a patient with agoraphobia (a fear of being in places that can lead to anxiety and panic attacks) starts going for walks outside. Maybe someone else finds a way to muster up enough strength to get out of bed and take a shower, after being bedridden by depression.

The turning points, Brandstetter says, tend to happen around the third session.

“We are seeing people be able to live a life that feels much closer to the life that they feel they were meant to live,” Brandstetter said.

Springboarding into a new mindset

How did things go for Marie, the patient who started her ketamine-assisted psychotherapy sessions in August after grueling bouts with depression and PTSD?

Really well by all accounts, except for the taste.

“It was like Tang mixed with metal shavings,” she said with a few chuckles.

But for Marie, it was worth it.

Sure enough, around the time of her third ketamine-assisted therapy session, she started to notice changes.

‘A lot of triggers that normally would have put me in a real bad space and taken me a while to get out of, or gotten me just in a funk, did not have the same effect,” she said. “The emotion…didn’t linger.”

During her fourth session, Marie had what she called a “breakthrough” journey.

“I had this vision. I was seeing myself standing on a balcony overlooking a green jungle and it was raining and I was drinking a cup of tea,” Marie described.

“There was this beautiful feeling, this beautiful version of me seeing the back of my silhouette. It felt like…this was like a rite of passage, a state of mind that I had accomplished. This was solidified, and I saw a beautiful version of myself in this moment. It was just gorgeous and simple. The depression I have experienced in my life has always blocked me from seeing the best of me.”

Finally, Marie saw it.

Dr. Sophia Brandstetter didn’t work with Marie directly. Marie picked another therapist who belongs to the Ko-Op.

But Brandstetter has been in enough treatment rooms to know how powerful these breakthrough moments can be.

“The lights are off, the candles are burning, the music is going, [a patient] is lying on your couch, and you’re up face-to-face with them as they are describing a scene of something that might have happened to them,” said Brandstetter.

“You are in it with them – you are in that long hallway, you are in that room…and their experience is happening with you. You are in it in ways that you cannot even imagine. I get the chills [thinking about it] because it brings me back to something so humbling: To sit in the room with somebody that’s having a journey like that.”

As fall began to arrive in September, Marie gained more and more momentum.

In the past, seasonal change was hard for her. Not this year.

By the time she finished her six weeks of ketamine-assisted psychotherapy, she felt transformed. She was actually looking forward to winter.

“It definitely feels easier to let go when something isn’t vibing in my life and to appreciate more the things that are going well,” Marie said, “and I didn’t gain 100 pounds with antidepressants, so that’s pretty lovely.”

After patients like Marie complete treatment, many of them go back to traditional modes of therapy.

Marie isn’t naive, though. She realizes that at some point down the road, some of the demons she squashed with the help of ketamine could bubble back up to the surface.

If they do, she’s open to returning to the Ko-Op for a follow-up.

“This has definitely springboarded me,” she said, “into putting a better netting in my life for my mental health.”

 

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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.

Jeffrey Shralow

Jeffrey Shralow

Not available for booking
Support Staff
HARM REDUCTION SPECIALIST
MSN, CRNP, PMHNP-BC, MA

I am a licensed and certified Psychiatric Mental-Health Nurse Practitioner, with a M.S.N. from University of Pennsylvania.  I have a Master of Arts in Buddhist Studies from The Naropa University.  My clinical work is integrative and holistic, with a harm reduction ethical framework. I am trauma-informed and person-centered; these are the foundations for my practice.  I am committed to informed decision making as well as providing clear and understandable educated answers to any question that might arise.  I am committed to the highest levels of professionalism and to ensuring a safe and therapeutic experience.  I am trained and experienced in providing psychedelic integration therapy and Ketamine Assisted Psychotherapy (KAP).  I consider access and inclusion within diverse populations and expressions of the highest priority.

I have been studying and practicing healing and growth processes within the intersection of psychiatry, neuroscience, trauma theory, psychology, and spirituality for several decades.  I have focused on actualizing treatment approaches at the cutting edge of the rapidly expanding and evolving paradigms within psychiatry and consciousness studies. I am particularly excited to be expanding into the field of psychedelic-assisted therapies

My clinical work includes psychotherapy, coaching, and education within a wellness orientation.  Therapeutic specialties include mood dysregulation, anxiety, trauma, psychiatric symptom management, spiritual emergencies, global climate crisis related dysregulation, as well as insight and growth aspirations and psychedelic integration. Integrative elements of psychodynamic/Jungian/Gestalt and transpersonal psychologies, eco-psychology, Buddhist psychology and the mindfulness sciences, as well as Eastern/Asian medicine theory and energy psychology are the foundations of my clinical work.

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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