Explorez tous les épisodes du podcast Back from the Abyss: Psychiatry in Stories | Psychotherapy, Trauma, and Psychedelics
| Titre | Date | Durée | |
|---|---|---|---|
| How do you learn to do psychotherapy? An exploration with Dr. Erin Jacklin | 27 Sep 2024 | 01:17:05 | |
In this season 6 opener Dr. H sits down with Dr. Erin Jacklin of the Catalyst Center in Denver to explore how we learn to the deeply complex and consistently challenging work of doing good therapy. "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, Feb 4th-6th 2026 in Joshua Tree, CA https://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/ | |||
| BFTA Summer Special-- How to Change Your Mind About Mushrooms with Dori Lewis | 05 Jul 2024 | 00:59:17 | |
Craig sits down with Dori Lewis of Elemental Psychedelics to explore the myths and realities of working with psilocybin mushrooms, including: | |||
| Psychiatry in the ER | 09 Feb 2024 | 01:00:48 | |
The rising tide of psychiatric emergencies in the US most commonly ends up in the emergency room, where psychiatrists are almost never found and the brunt of the heavy lifting falls on emergency medicine physicians. Here Dr. H sits down with Dr. Treve Henwood, an emergency med physician and host of the Rural EM podcast to explore the often overwhelming challenges inherent in trying to effectively manage and treat these psychiatric crises. | |||
| Therapists in the abyss: Vicarious trauma | 20 Dec 2019 | 00:27:30 | |
This is the first of an intermittent series of therapists sharing their abyss stories. Samantha was a newly minted therapist just out of her MSW program, full of hope and excitement for her new career, when she met a client whose horrific trauma story and rapid disappearance from therapy haunted her for years. Dr. H and Samantha explore how she was able to eventually move from the grief and regret of this vicarious traumatization to a place of acceptance and self-compassion. | |||
| My desert island psych meds | 05 Dec 2019 | 00:10:26 | |
In this mini-episode Dr. H opens himself up for major audiophile shaming as he (reluctantly) reveals his three desert island albums. With this revelation complete, he then moves on to the challenge at hand-- which three psychiatric medications are at the top of the heap, combining efficacy, safety, and breadth of symptom coverage? | |||
| Healing trauma with psychedelics with Saj Razvi— Part 2 | 19 Nov 2019 | 00:36:45 | |
In this second part of Saj's story, he continues to explore the transformative healing of his MDMA session. Initially believing his therapy journey to be complete, his mother later develops terminal cancer and his attachment wounds reactivate. This impending loss leads him to seek even more advanced and difficult work with psilocybin and the support of two experienced guides in the Netherlands. | |||
| Healing trauma with psychedelics with Saj Razvi— Part 1 | 05 Nov 2019 | 01:05:47 | |
This is the first of a two part very special interview with Saj Razvi, the Director of Education at Innate Path in Denver, CO. Saj weaves together his three fascinating perspectives— that of a nationally recognized trauma expert, his own personal story of early childhood neglect and how this shaped everything else to come, and finally his long journey of healing the deepest wound a person can have, eventually coming to MDMA and then psilocybin at the latter part of his therapy journey. | |||
| How to think about anxiety | 23 Oct 2019 | 00:07:04 | |
Anxiety and pain are the primary drivers of medical visits, as well as two of the more complicated symptoms to break down in a meaningful way. In this mini-episode, Dr. H presents the metaphor of "below the neck" vs "above the neck" anxiety to help us think about anxiety in a way that might better guide diagnosis and treatment. "Above the neck" anxiety emanates from the ruminating/imagining/obsessing/spin-cycle brain, while "below the neck" anxiety is the body's fight/flight response, with adrenaline coursing through the body to send the blaring smoke alarm signal of impending danger...even where there is no apparent immediate threat. | |||
| The Delta Flight Attendant-- BPD and psychotherapy | 06 Oct 2019 | 00:51:39 | |
In psychotherapy, it’s the relationship itself that heals. In this episode of BFTA, Dr. H and his patient Jasmine explore their always complicated, often humorous, and at times very painful journey through the minefield of borderline personality disorder. | |||
| One phone call changed everything: EMDR Part 2 | 22 Sep 2019 | 00:44:47 | |
As her father descended into years of meth-induced rages and psychosis, Kate and her family repeatedly tried to flee...but there was no place to hide. And when at last, after finishing college and starting a new life with her husband, she thought she had escaped the demons of her past, a phone call lit her world on fire. Kate eventually found a way to heal through a six year treatment journey with the help of a deeply caring and skilled therapist and the tool of EMDR. | |||
| When the past haunts the present: An EMDR story | 04 Sep 2019 | 00:36:44 | |
Sometimes trauma settles deeply in the mind and body and wreaks a kind of clandestine subterranean warfare, turning the body against itself and manifesting strange, frightening, disabling, and even life-threatening symptoms. Sophie's trauma simmered for 16 years, making her life difficult but still mostly manageable. Suddenly, however, she was waylaid as her trauma metastasized into something infinitely more dangerous. A long torturous course through emergency rooms and various specialists eventually ended up on a therapist's couch, holding an oscillating paddle in each hand, walking directly into the mindscape of her mother's death. | |||
| Can marijuana be medicine? A psychiatric perspective | 21 Aug 2019 | 00:08:57 | |
Is marijuana a medicine or a coping strategy? Is it safer than alcohol, or in some people, much more risky? Does it help anxiety or does it trigger panic symptoms? This mini-episode explores the complex landscape of "medical" marijuana and what this looks like in Colorado. | |||
| Desperately NOT seeking meth: A harm reduction story | 07 Aug 2019 | 00:21:45 | |
Sobriety can sometimes be a bridge too far. In a last ditch attempt to escape his methamphetamine-drenched life, Larry moved 1000 miles away to live with his father, he threw away his cell phone, gave up all drugs and alcohol, started running, got a good job...and found himself increasingly overwhelmed by the need to put a needle in his arm. | |||
| At the Crossroads of Psychiatry, Psychedelics and Spirituality--- Dr. H on the Radically Genuine Podcast | 26 Jan 2024 | 01:23:18 | |
This is an interview Dr. H did a few months ago on the Radically Genuine podcast. Although we posted about this interview on our Instagram feed back in August, we thought this was worth re-releasing on the main BFTA feed. Of all the podcast interviews Dr. H has done, this one might be the most interesting and relevant for our listeners. Here Dr. H discusses the deep structural problems with current psychiatry, the confusion around psychiatric diagnoses and nosology, controversies and mistaken beliefs about psychiatric meds, problems with informed consent and involuntary treatment, why med management is doomed to fail, psychedelics as a portal into psychospiritual and trauma healing, pearls about ketamine treatment, and other topics. | |||
| Ketamine treatment for depression: Seven questions | 24 Jul 2019 | 00:16:00 | |
This mini-episode explores some of the most frequently asked questions about ketamine: | |||
| A power wash of the brain-- Ketamine, depression, and suicidality | 09 Jul 2019 | 00:50:37 | |
Chris successfully hid his increasingly severe depression throughout middle and high school, but by his first year of college he could no longer ignore the horrifying signs that his brain was losing touch with reality. Inanimate objects began to radiate into his thoughts, and suicide seemed the only way to escape. Fortunately Chris took the scariest leap of all and began to open up to a therapist about what was happening in his mind, leading to an exploration of shame, a reformulation of the self, and finally the unexpectedly powerful healing of ketamine. | |||
| Why it's so hard to find (or be) a good therapist | 25 Jun 2019 | 00:08:12 | |
A wise psychotherapy supervisor once said: "There are only two things a therapist can do...hold...or poke...lots of therapists are good at holding...not so many are confident enough to poke...the good therapist has mastered the art of both." | |||
| One foot in the darkness— A path through treatment resistant depression and eating disorder | 24 Jun 2019 | 00:55:21 | |
Ellie grew up in small town Montana and found a highly effective way to cope with the terrible pain of adolescence, family chaos, and depression. Unfortunately, her eating disorder took on a life of its own and almost destroyed her. This is her hero's journey, not of "recovery" per se, but rather of courage, grit, and fierce intention to construct a new self, and ultimately, find a path into the light. | |||
| Strawberries-- A story of bipolar disorder | 18 Jun 2019 | 01:14:21 | |
In this very first episode of BFTA we explore one of the most frightening parts of the abyss, coming face to face with the desperate need to die. Elizabeth woke up five days after her near fatal suicide attempt and found herself with another chance-- this is her story of finding a new way to live and be in this world. | |||
| Bipolar Mania-- Superpower or Kryptonite? | 12 Jan 2024 | 01:12:53 | |
What does it feel like to be manic? It can be very difficult for people to accurately recall manic episodes— they aren’t stored like typical narrative memories, but rather they often feel like confusing and out of control reveries that seem to have happened to a different version of themselves. Then comes the guilt and the shame that often follows manic episodes, as a result of the loss of normal social inhibition, the lack of fear, and the surging dopamine levels… leading people to take risks and do things they would never normally do, typically within the big three “Ss”- Spending, speeding, and sex. | |||
| Moving from the head to the heart-- The gifts and challenges of group therapy | 29 Dec 2023 | 00:59:45 | |
Craig sits down with Carrie Haynes, a colleague and Colorado-based group therapist and host of the podcast The Art of Groups. They explore their shared love of group process, the unique benefits and risks of working with groups, specific challenges for the group therapist or leader, and finally how and why Carrie is moving away from traditional group therapy to a more heart-focused transpersonal group model. | |||
| Unhoused and Unwell-- The Nexus of Homelessness, Mental Illness, and Addiction | 15 Dec 2023 | 01:02:18 | |
In the streets and sidewalks of every American city, a slow motion disaster is unfolding, with ever increasing numbers of people suffering from serious mental illness and/or addiction. | |||
| What does it take to fill the void? Developmental trauma and dissociation with Saj Razvi | 01 Dec 2023 | 00:32:32 | |
Saj Razvi returns to BFTA to discuss a listener letter, which leads to an exploration of treatment resistance, developmental trauma, the absence of experience ("the void") vs dissociation as experience. Saj and Craig also explore attachment vs love, whether trauma healing has to be difficult, and the common elements of successful trauma treatment. | |||
| Ketamine-- Lessons from 3000 Sessions | 17 Nov 2023 | 00:20:43 | |
Some of the most basic questions about ketamine are still under investigation— Which patients are ideal responders? What is the therapeutic dose range? Is there a meaningful dose/response curve? Are fully dissociative treatments necessary for optimal efficacy? How important is psychotherapy after a higher dose IV or IM session? And how should we think about frequency of initial treatments and then ongoing maintenance treatments, if needed? | |||
| Love and Therapy-- A Conversation with Dr. Adele LaFrance | 03 Nov 2023 | 00:49:35 | |
Is there a role for love in therapy, whether in the traditional psychotherapeutic context and/or in the psychedelic space? And if we were to more consciously invite love into therapy, how could we do this in a safe and boundaried way? | |||
| Holding on to hope-- Caring for adult children with serious mental illness, Part 2 | 20 Oct 2023 | 00:54:12 | |
Dave and Laurie sit down with Dr. H to share their journey through the denial, fear, grief, and eventual acceptance of their son’s life-altering psychiatric illness. BFTA on Instagram. @backfromtheabysspodcast | |||
| What will happen when we're gone? Caring for adult children with serious mental illness | 06 Oct 2023 | 00:38:14 | |
One of the tragic truths of psychiatry is that the sickest patients more often than not either don’t realize they are ill, or are convinced that treatment will do nothing. No group of patients better exemplifies this than those with schizophrenia and other psychotic illnesses. A common presentation in Dr. H's office is an older adolescent or young adult, often male, who is descending into psychosis and also completely unaware of the illness or need for treatment. Meanwhile, the parents are telling of frightening threats, explosive outbursts, bizarre behaviors, profound social isolation, and/or paranoid beliefs. This episode today is the first of two parts— in part 1, Karen, the mother of Sam, describes the progression of his illness and how she has grieved and coped and parented him. In part 2 in two weeks, we’ll hear from Laurie and Dave, who also have a son with severe mental illness. The two stories are both the same and also different in some key ways. One thing they both share is that their sons, after some very scary times, both finally agreed to engage with treatment. BFTA on Instagram. @backfromtheabysspodcast | |||
| Fishbowl 5 | 31 May 2024 | 01:00:39 | |
Chris and Craig go meta to deconstruct season 5, explore the art of storytelling and music selection, and answer listener questions. | |||
| Psychedelic Psychiatry-- The Swiss Model | 22 Sep 2023 | 01:04:37 | |
Dr. H sits down with Dr. Julia King Olivier, a Swiss psychiatrist and co-founder of the Compassionate Care Center in Geneva, Switzerland, to explore the fascinating landscape of psychedelic-assisted therapy there. Julia is one of a small group of physicians in Switzerland who has permission to work with LSD, psilocybin, MDMA, and ketamine, and she shares her clinical experience and wisdom in this emerging realm. | |||
| When THC turns on you-- Cannabis, THC concentrates, and psychiatric breakdown | 09 Sep 2023 | 00:47:36 | |
Dr. H's patient Lindsey shares her story of self-medicating her anxiety and depression with cannabis, then steadily building tolerance and moving on to THC concentrates. This led to full-blown dependence and a spiral downward into daily bouts of terrible nausea, near constant panic, and emerging hopelessness. | |||
| Healing the Wounds of Sexual and Spiritual Abuse | 27 Aug 2023 | 01:17:50 | |
In this season 5 opener, Craig sits down with Shelly Winemiller, a Colorado-based trauma therapist, to witness her powerful story of reclaiming her body and spirit from the nightmare of clergy sexual abuse. | |||
| BFTA Summer Special at Psychedelic Science 2023 with Dr. Hillary McBride | 26 Jun 2023 | 00:56:10 | |
Craig sits down with Dr. Hillary McBride, a psychologist, researcher, author, and podcast host (Other People's Problems) to explore all things psychedelic. | |||
| Chris and Craig in Fishbowl #4 | 17 May 2023 | 00:57:16 | |
BFTA's co-conspirators explore what they learned this season, their favorite episodes, ideas/plans for season 5, whether BFTA has become too psychedelic-heavy, and what they most value in each other. | |||
| Brothers across the divide: Treatment-resistant depression, faith, and compassion | 04 May 2023 | 00:51:50 | |
In this final story of season 4, Craig speaks with Wayne, a longtime patient of his who has battled treatment resistant depression and crippling anxiety for many years. Wayne's story highlights a few crucial things— the fact that sometimes you can do everything right, do all the self-care things, yet still be waylaid by the crushing dark force of depression…this story also illustrates the power of the therapeutic relationship, and the fact that two people can deeply respect and care for each other, even when they land on opposite ends of the religious and political divide. | |||
| The 10 Best Psychiatric Medications | 20 Apr 2023 | 00:41:57 | |
Can you treat >95% of all patients with mood, anxiety, and psychotic disorders with just ten meds? Dr. H says YES. | |||
| A bridge between the Western and Indigenous ways— The curandera, plant medicine, and spirit | 06 Apr 2023 | 01:20:23 | |
Craig sits down with Ana, a Mexican medicine woman, or curandera. Ana shares a unique perspective and an earned wisdom that is particularly relevant today as we enter a veritable renaissance of plant medicines and psychedelics, while also trying to avoid the rampant mistakes and misuses of the past. Ana works with various medicines, including one that was mentioned in the “The Dark Side of Psychedelics” episode— that would be Bufo, also known as 5-MeO, or 5-methoxy-DMT. In contrast with that episode, Ana describes much more mindful and careful use of this powerful compound. | |||
| Psychedelic Assisted Therapy: Ketamine vs MDMA vs Psilocybin | 23 Mar 2023 | 01:22:21 | |
Dr. H explores how to think about psychedelic assisted therapy with ketamine, MDMA, and psilocybin in terms of patient selection, ideal indications, psychiatric diagnosis, trauma history, medical comorbidities, medication interactions, cautions, and contraindications. | |||
| What's the deal with Psychiatry? What's hopeful, what's gone amiss with Dr. Will Van Derveer | 09 Mar 2023 | 01:24:11 | |
Dr. H sits down with Dr. Will Van Derveer of the Integrative Psychiatry Institute and Higher Practice podcast in a wide-ranging exploration of what's good (and not so good) in current psychiatric practice. | |||
| When Mom is mentally ill-- A story of resilience | 16 May 2024 | 00:54:02 | |
Christina grew up with a tumultuous and mentally ill mother, an older brother who decompensated into psychosis and frightening aggression, and just one healthy family member, her father. Dr. H and Christina explore both the wounding of having a desperately ill parent, as well as the profound gift of having another parent able to provide love and support. Christina suffered terribly from these maternal wounds, but she was also able to finally emerge as a healthy, grateful, wise, and deeply caring adult….initially drawn to nursing, she eventually transitioned into working as a psychiatric nurse practitioner. This story is in two parts— first Christina shares her moving story, then she and Dr. H go meta and explore the behind the scenes preparation for this episode. Two of the themes that emerge in this latter part are storytelling as integration, and vulnerability as part of healing. Christina beautifully describes how the process of pulling her story together and unearthing these often brutal memories allowed her to find a deeper sense of peace, acceptance, and self-affirmation. | |||
| Trauma in the Transference—Repairing the therapeutic relationship | 23 Feb 2023 | 01:12:17 | |
The magic of psychotherapy is that it brings forth transference— the patient’s most important and formative relationships, typically with early caregivers, are unconsciously re-enacted in the therapy room. And this transference necessarily creates countertransference, the therapist’s unconscious reactions to the transference. Alexandria came to Dr. H originally due to her severe harm OCD. But over time, it became clear to him, and eventually to her, that she was increasingly, and unconsciously, trying to put him in the role of the abandoner, the critic, the emotional abuser. This process is called projective identification, and as you will hear, it played out very dramatically between them, and was a major factor in her plans to die.
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| The lives I didn’t get to live- Shame, psychedelics, and owning one’s story | 09 Feb 2023 | 00:43:48 | |
Thirty years ago, a 10 year old boy was found stabbed to death in a park…the same park where 18 year old Stephanie and three young men were seen riding bikes the night before. Stephanie and the others were repeatedly questioned, they became the prime suspects…..yet they, nor anyone, was ever charged for the murder. It remains unsolved to this day. This is the story how how one event can alter the course of your life, how so many possibilities for the future can disappear overnight….this is a story of how after years of unhelpful psychotherapy and medications, Stephanie was finally able to uncover what lay beneath-- with the help of an unusually perceptive therapist, as well as ketamine and MDMA- assisted psychotherapy. | |||
| Thinking Through Emotions— DBT Part 2 | 26 Jan 2023 | 01:01:38 | |
After years of crippling anxiety, substance abuse, mood instability, and loss, Daniel had finally found the path to impending fame and success beyond his dreams. Then everything fell apart, and he was forced to face the fact that he lacked the skills to face life on life's terms. Enter DBT, and Daniel began to piece his life back together with increasing confidence and competence. | |||
| DBT, Self-Harm, and Suicidality with Dr. Kelly Sonnenfeld | 12 Jan 2023 | 01:08:16 | |
Here Dr. H sits down with Dr. Kelly Sonnenfeld, a psychologist and DBT expert, in this first of a two part look at dialectical behavior therapy, or DBT. This episode is a primer on DBT-- what DBT is, how it works, and how it fits into the landscape of therapy options. Part Two explores Daniel’s story of how DBT helped him recover from a terrible period of psychiatric suffering. DBT is best known for successfully treating self-harm and suicidality, particularly in the context of complex PTSD and borderline personality disorders, primarily through building skills to cope with emotional dysregulation. | |||
| Why psychiatric illness strikes young (and what to do about it) | 29 Dec 2022 | 00:16:34 | |
Most medical illnesses appear later in life, as organ systems fail and the decades of wear and tear eventually erode the body's innate homeostatic mechanisms. Psychiatric illness, however, is profoundly different. Here Dr. H explores six central reasons why serious psychiatric illness tends to appear in mid to late adolescence. | |||
| Psilocybin comes to Colorado | 15 Dec 2022 | 01:11:00 | |
Last month marked a fairly momentous occasion in Colorado, the statewide passage of Proposition 122, the Natural Medicines Health Act. Coloradoans voted, by a tally of 53 to 47%, to approve both the decriminalization of psilocybin, DMT, ibogaine, and mescaline, along with the medicalization of psilocybin, with the possibility of a medicalization pathway for the others in 2026. This is a landmark, tipping point kind of social change, and one that triggers a huge number of hopes, concerns, and questions. Here Craig sits down with Shannon Hughes, a CSU Professor of Social Work who specializes in issues of drugs, meds and society; she is also a co-founder of the Nowak Society, Colorado’s preeminent force for psychedelic education and community. Together Craig and Shannon explore the wide-ranging implications of decriminalization and medicalization of psilocybin and other psychedelics. | |||
| The way out of psychosis-- Psychopharmacology as magic | 01 Dec 2022 | 01:04:47 | |
Psychiatric meds so often get demonized in the media, including the podcast world, and while psych meds are far from perfect and often cause problematic side effects, they also literally save people’s lives every single day. Steve grew up as the youngest of four, a happy boy in a happy family, a “golden” childhood as he describes it….until everything fell apart. Within a period of just a few years, he lost his father and both his beloved older brothers, all while still a young teenager, leaving him with his Mom and an older sister. His family had been cut in half, yet his most frightening and overwhelming challenges were still to come. | |||
| Abortion in Three Acts | 17 Nov 2022 | 01:10:47 | |
Three women. Three stories. | |||
| From Beauty Queen to Psychedelic Guide | 03 Nov 2022 | 01:12:31 | |
Raised in an abusive misogynistic home amidst deep shame and the purity culture of her parents' faith, Micah's journey carried her though Southern pageant culture, anorexia, estrangement, birth trauma, and, eventually, connection and acceptance and grace. | |||
| Autism Spectrum Disorder-- A journey from alienation to attachment | 20 Oct 2022 | 00:55:54 | |
Anne grew up always feeling on the outside-- outside her family, her peers, her species. She knew something was "wrong", but a diagnosis would not arrive until she was well into adulthood. Meanwhile she became an expert in studying the ways of people, of "operating in manual", consciously and methodically using the lessons she had learned to know what to do in social situations and how to pass as "normal". Unlike so many others with ASD, Anne was able to marry and have two children and even develop a secure loving attachment to her children-- something she herself never got to experience as a child growing up amidst severe neglect. Yet her years of careful observation and mimicry didn't fully insulate her from the emotional pain and alienation of ASD, which she shares in her story today. | |||
| A Psychiatrist Goes to War | 03 May 2024 | 00:49:06 | |
Dr. Russell Carr was a career Navy psychiatrist for 20 years and served in Iraq, where today’s story begins. This is a story of a healer, then a terrible wounding, then the healer trying to find his way amidst the chaos of war. This story is about a rite of passage, one that not every psychiatrist faces, but most do at some point-- that of losing the first patient to suicide, then trying to find the strength to move forward. | |||