Integrated Interventional Psychiatry
Opening the Window, Furnishing the Room.
Why combining TMS and Ketamine with Psychotherapy creates lasting change.
At Mynd Thera, we believe that biological treatments (like TMS and Ketamine) and psychological treatments (like Therapy) are not separate paths—they are two halves of the same healing process.
Think of your brain as a house that has been locked shut by depression, anxiety, or trauma.
The Interventional Treatment (TMS/Ketamine): Acts as the key. It unlocks the door, increases neuroplasticity (the brain's ability to rewire itself), and "opens the window" of opportunity. *
The Psychotherapy: Is how we furnish the room. Once the window is open, therapy provides the tools, skills, and new learning that you need to live comfortably in that house.
We offer two ways to combine these powerful modalities: Synchronous and Asynchronous Integration.
*There is no consensus on the exact mechanism of repetitive TMS for brain function, but the explanations serve to help guide treatment decisions.
Two Modes of Integration
1. Synchronous Therapy (In-Session)
Best for: TMS, Low-Dose Ketamine, and "Psycholytic" Therapy.
In this model, a therapist is present during your medical treatment.
With TMS: Because you are fully awake and alert during Transcranial Magnetic Stimulation, this is the perfect time to engage in "Talk Therapy." The brain is being magnetically stimulated to activate specific pathways, making it highly receptive to cognitive reframing.
With Ketamine: At lower doses, Ketamine acts as a "social lubricant" and anxiety reducer, allowing you to access difficult trauma or emotions without the usual defense mechanisms blocking the way.
2. Asynchronous Integration (Between Sessions)
Best for: Spravato®, High-Dose IV Ketamine, and Deep Trauma Work.
In this model, the therapy happens shortly after the medical treatment or on the days between treatments.
The "Neuroplastic Window": Research shows that for 24–72 hours after a Ketamine infusion or Spravato® session, the brain is in a heightened state of growth (dendritic spine density increases).
The Process: We use this flexible window to do the "heavy lifting" of therapy. Insights gained during your infusion are processed, organized, and applied to your daily life while your brain is most adaptable.
Targeted Protocols: Matching Therapy to the Condition
We do not use generic "talk therapy." We pair specific biological treatments with the specific psychotherapy protocols that are proven to treat your condition.
Protocol A: The Depression & Anxiety Matrix
Medical Foundation: TMS (Left-sided high-frequency) or Ketamine/Spravato®.
Therapeutic Pairing: CBT (Cognitive Behavioral Therapy), Behavioral Activation (BA), Mindfulness.
| Therapy Type | How it works with Interventional Psychiatry |
|---|---|
| Behavioral Activation (BA) | Depression causes withdrawal. As the medication lifts your energy and mood, Behavioral Activation provides a structured schedule of positive activities to help you “re-learn” enjoyment. |
| CBT & Mindfulness | As TMS quiets the “Default Mode Network” (the part of the brain responsible for ruminating and worrying), CBT teaches you to identify and challenge negative thoughts before they return. |
Protocol B: The Trauma & PTSD Matrix
Medical Foundation: IV Ketamine (to reduce fear response) or TMS (Right-sided inhibitory).
Therapeutic Pairing: PE (Prolonged Exposure), CPT (Cognitive Processing Therapy), EMDR.
| Therapy Type | How it works with Interventional Psychiatry |
|---|---|
| Prolonged Exposure (PE) | Trauma survivors avoid triggers. Ketamine dampens the brain’s fear center (amygdala), allowing you to face these triggers in therapy without becoming overwhelmed. |
| EMDR | Eye Movement Desensitization and Reprocessing helps process traumatic memories. Doing this within the “neuroplastic window” of treatment can accelerate the processing of “stuck” memories. |
| CPT | Cognitive Processing Therapy helps re-frame “stuck points” (e.g., “It was my fault”). The biological lift from treatment makes the brain more flexible and willing to accept new, safer narratives. |
Protocol C: The OCD (Obsessive-Compulsive) Matrix
Medical Foundation: Deep TMS (dTMS) or High-Dose Ketamine.
Therapeutic Pairing: ERP (Exposure and Response Prevention).
| Therapy Type | How it works with Interventional Psychiatry |
|---|---|
| ERP (Exposure Response Prevention) | The gold standard for OCD. It involves facing the obsession without doing the compulsion. |
| The “Sticky Gear” Effect | OCD is like a gear shift that is stuck. TMS and ketamine lubricate the gears. When combined with ERP, we can manually shift the brain out of the repetitive loop more easily than with therapy alone. |
Visual Explainer: The Timeline of Integrated Care
Phase 1: Preparation (The Set)
Medical: Intake and medical clearance.
Psychological: Establishing safety, setting intentions, and identifying the "Target Symptoms" (e.g., "I want to stop washing my hands" or "I want to process the car accident").
Phase 2: The Experience (The Setting)
Synchronous: Therapist guides you during the TMS pulse or Ketamine wave to face the target symptom.
Asynchronous: Patient focuses on the internal experience (music, eye mask) during the infusion.
Phase 3: Integration (The Reset)
Timing: 24–48 hours post-treatment.
Action: "Reviewing the tape." Discussing any memories, emotions, or insights that arose.
Homework: Applying the new flexibility to the real world (e.g., "Go to the grocery store and stay for 10 minutes").
Patient FAQ: Do I need to change therapists?
"I already have a therapist. Can I still do this?"
Absolutely. We love collaborating with outside providers. You can come to Mynd Thera solely for the interventional treatment (TMS/Ketamine). We will coordinate with your current therapist to ensure they know when you are in your "neuroplastic window," allowing them to maximize the work you do together
"I don't have a therapist. Can you provide one?"
Yes. We have a network of skilled therapists trained in KAP (Ketamine-Assisted Psychotherapy) and TMS-integration who can work with you specifically during your treatment course.