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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2024-1-31 19.39.27.357

Eriach Fox

LICENSED PROFESSIONAL COUNSELOR LPC,MHS, LCADC

I am a Licensed Professional Counselor (LPC) with over twenty five years experience in the behavior health field who believes that psychedelic assisted therapies and support have the potential to support people with integrating their lived experiences to become whole again. Being able to have meaningful experiences while being supported with other therapies such as EMDR therapy or internal family systems (IFS) can lead to finding the safety and compassion needed to heal the hurt and burdened parts of yourself.

I can work with you first to identify the parts of you that need healing, their origin, and the role(s) they play in your life. Then I can support and guide you through that process to help you find a more integrated space in your life and body.

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Dr. Christopher Deussing

LICENSED CLINICAL SOCIAL WORKER (LCSW) Doctor of Social Work (DSW)

I’m a clinician who strongly believes in the power of psychedelic-assisted psychotherapy to heal the mind, body, & spirit. I’ve seen these medicines help many clients.

Currently, I focus on using Ketamine-Assisted Psychotherapy (KAP), which can catalyze the discovery of deep emotions, thoughts, & experiences. KAP sessions can create profound opportunities for growth. Sometimes KAP is like compressing years of therapy in just a few hours.

Having a therapist’s support throughout a psychedelic process is crucial. I work hard to construct a robust treatment relationship to make your journeys meaningful & safe.

I want to create an individualized plan that works for you, so let’s discuss your hopes, wants, & needs. A psychedelic experience is very personal, & I’m here to help you explore what’s possible with KAP.

I have 25+ years of clinical experience helping people cope with a wide variety of psychological challenges, such as mood disorders, trauma, grief, addiction, & personality disorders. I earned my Master’s & Doctor of Clinical Social Work from the University of Pennsylvania, & am certified in Psychedelic-Assisted Therapies through the California Institute of Integral Studies.
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Arnold B. Meshkov MD

Medical Provider

Arnold B. Meshkov MD is a Fellow of the American College of Cardiology and board certified in Internal Medicine.  He is a former Professor of Medicine at Temple University School of Medicine in Philadelphia, and trained at the University of Pennsylvania, Temple University, and Yale University. He has extensive experience and expertise in the assessment of patients prior to surgical procedures and new medication.  Dr. Meshkov has practiced at Temple University School of Medicine as a academic, and also has many years of experience in the private practice of Internal Medicine and Cardiology  He is a former Professor of Medicine at Temple University School of Medicine in Philadelphia, and trained at the University of Pennsylvania, Temple University, and Yale University. He has extensive experience and expertise in the assessment of patients prior to surgical procedures and new medicationDr. Meshkov has practiced at Temple University School of Medicine as a academic, and also has many years of experience in the private practice of Internal Medicine and Cardiology 

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Gwenn Prinbeck

Clinical Social Work/Therapist, LSW, PCC

Psychedelic-assisted psychotherapy can be a powerful tool for promoting openness and connections, especiallyfor those feeling stuck or adrift.The medicine can offer a liminal space forself-exploration, emergence, and discovery. The experiences had there can have profound and lasting impacts.

My aim as the therapist in the psychedelic space is to create a safe and supportive environmentin which your unique experience with the medicinecanunfold. I work with you throughout each step of the process and see no part as being more important than another. Before working with the medicine, our goal is to establish an attuned relationship with one anotherand to clarify the intentions for journeying. After each medicine session, we will consider the experience and look for ways to integrate what’s emerged into the rest of your life.

A contemplative and compassionate relationship with the self is a healthy fundamental instinct, but this instinct can be hampered by adverse and traumatic experiences. What’s more, when we struggle to be OK with ourselves, we often struggle relating to others. I offer support healing emotional wounds and constructing deeper and lasting connections with the self and others.

I work with adult individuals and children who are 10 years or older, I also offer family and couples therapy. I aim to be welcoming and mindful of the myriad social injustices impacting so many of us. In addition to what’s often called talk therapy, I work with experiential modalities that engage in creative, mindful, and somatic ways to help us access inherent wisdom that can lie beyond ordinary talking. I hope to help you build robust skills that ease the challenges that come with fostering acceptance and change.

I began my studies and career in science and then for almost a decade, I offered support as a certified professional life coach before attending Bryn Mawr College’s School of Social Work and Social Research to broaden my ability to support people’s resilience and potential. I am additionally trained in family systems work and provide ketamine-assisted psychotherapy.

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Sarah Lobb

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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.

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

Jennifer is an experienced mindfulness-based psychotherapist. She holds
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Psychology, and a Bachelor of Arts degree in Political Science from
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Behavior Therapy (DBT), Mindfulness Based Stress Reduction
strategies and trauma informed yoga therapy. Jennifer’s therapeutic
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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
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conflict, sexual and gender identity issues, grief, behavioral issues and
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Sophia Polin

Licensed Professional Counselor (LPC)

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.

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Stephanie Josephson

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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.
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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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