What is InnerMost, and what kind of work do we do here? I am often asked these questions, and answering them has required some thought, because we really are doing a kind of work that few other places are doing, or have done before. We are a mental health clinic providing psychotherapy and psychiatric services, but we do not fit neatly into any of the existing categories that describe conventional mental healthcare clinics.
Our treatment approach has similarities with what has come to be known in the field as interventional psychiatry, but it involves a much greater focus on addressing the root cause psychological trauma underpinning mental health disorders. Thus, we have coined the phrase interventional psychotherapy to describe what we do. Let’s explore the difference between these two models in greater detail.
Interventional psychiatry is described by its pioneers as:
an emerging subspecialty that utilizes neurotechnologies to identify dysfunctional brain circuitry underlying psychiatric disorders and apply brain stimulation techniques to modulate that circuitry.
Interventional psychiatry clinics often provide, as we do, ketamine and Spravato treatments, along with other brain-focused interventions that InnerMost does not offer, such as transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT). However, it is our firm conviction that the meaning and complexity of a human life cannot be reduced to the byproducts of brain circuitry; believing otherwise is like believing that you can understand the meaning of the movie you are watching by analyzing the circuitry of your television.
The subjective meaning that people find in their suffering matters, and plays an instrumental role in how they learn to relate to their inner and outer worlds as they heal and grow. We therefore place great emphasis on psychotherapy in our treatment model, and for this reason interventional psychiatry does not adequately describe our approach.
Conversely, we are not just a psychotherapy clinic, because we are well aware of the power that neuromodulating interventions hold to enhance the brain’s capacity to revise its circuitry, which makes it easier to cultivate new ways of relating to oneself and others, and discover new avenues of meaning-making on the path to healing. We therefore combine nearly all the psychotherapy we provide with ketamine or Spravato, and will be combining it with other psychedelics such as psilocybin and MDMA when these become legal treatments, perhaps as soon as early 2027.
This potent, synergistic combination of psychotherapy with the neuromodulating effect of ketamine, Spravato and other psychedelics is what we define as interventional psychotherapy.
Perhaps most importantly, as a clinic offering psychedelic-assisted therapy, we are at the vanguard of a much needed, paradigm-disrupting sea change in the way mental health disorders are understood and treated in our society. As first movers in this nascent but rapidly developing field, we have an opportunity to set a standard that could influence other practices and practitioners for many years to come. We see this as a responsibility to act as stewards for how the practice of psychedelic-assisted therapy takes shape within the existing mental healthcare infrastructure, and we take this responsibility very seriously.
As these novel interventions increasingly enter the mainstream, the structure of economic incentives in the existing system of healthcare threatens to compromise the integrity of psychedelic-assisted therapy. These incentives could make it difficult to deliver these treatments safely and effectively, in the absence of the highly structured contexts used thus far in the FDA clinical trials.
Ensuring that we are able to achieve, in a real-world setting, a level of safety and effectiveness commensurate with the outcomes seen in these clinical trials will require a high degree of thoughtfulness, dedication, and creativity. It will be up to individual practices, like InnerMost and other likeminded clinics around the country, to safeguard the integrity and quality of this work if the great promise held by psychedelic-assisted therapies is to be fulfilled at a large scale.
What this means, practically speaking, is resisting the pressure generated by profit motive to maximize the number of patients we are seeing at the expense of the quality of care we are delivering. Our model of interventional psychotherapy resists this pressure, because it refuses to reduce a whole person to a diagnosis, and rejects the idea that adequate treatment of mental health disorders consists in merely providing life-numbing pharmaceuticals in the service of symptom suppression. Each person who chooses to work with our approach is instead undergoing a process of deep healing, transformation, and growth, engaging in an organic process that takes time and presence to unfold.
This does not mean that the healing process cannot be catalyzed and thereby expedited—this is precisely how psychedelics can assist the process of psychotherapy, and why we use them at InnerMost—but an organic process must unfold in its own time and cannot be rushed, with or without a catalyst. It also requires a substantial degree of human contact and a therapeutic container, co-created by the patient and their treatment providers, and grounded in a foundation of trust and empathetic attunement. These relational containers take time, presence, and intentionality to establish, and interventional psychiatry clinics are simply not designed or intended to create them. This kind of care is, on the other hand, exactly what InnerMost’s interventional psychotherapy model is designed and intended to provide.
If you would like to learn more about how our treatment approach might be helpful to you or someone you love, you can book a free discovery call with one of our treatment coordinators.
If something here resonated with or provoked you, I’d welcome your thoughts in the comments. And if you found this worth reading, I hope you’ll pass it on to someone who might as well.
Until next time,
Casey
InnerMost’s Chief Medical Officer, Dr. Casey Paleos, has recently launched a Substack to share his own clinical expertise, insights, and observations surrounding the evolving world of psychedelic therapy.
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