Back from the Abyss: Psychiatry in Stories

Dr. H sits down with Dr. Jennifer Gaudiani, a nationally recognized expert on eating disorders to explore a wide range of topics including:

• etiology and the relative influence of temperament, culture, and concomitant psychiatric illness
•anorexia as a qualitatively different kind of treatment challenge
•treatment ambivalence, building the alliance, respecting protectors
•anosognosia and its relationship with severity of illness
•how to talk about weight, body image, and eating with mindful/respectful language
•thin privilege and fatphobia
•involuntary treatment
•orthorexia and food rules as a cultural disease
•GLP-1 agonists and bariatric surgery

Dr. G
https://www.gaudianiclinic.com/team

Sick Enough-- A Guide to the Medical Complications of Eating Disorders
https://www.gaudianiclinic.com/sick-enough

Bringing Therapy into Med Management-- An intensive training with Dr.  H
https://www.craigheacockmd.com/training/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

The driving force of so many of our self-destructive tendencies is not conscious, it’s an unconscious drive called the repetition compulsion, where we try to reenact early child traumas or deficits, often consciously hoping for a different result but unconsciously walking directly and knowingly into the flames.  One of the central tasks of therapy is often helping people identify their repetition compulsions and doing the deeply uncomfortable work of making different choices. For the repetition compulsion feels right, at the deepest levels of being, because it was wired into us during early childhood. Self-destructive decisions smell like home cooking, they are the blue light that draws in the unsuspecting moths over and over and over, even when they see what’s about to happen.

Here Dr. H's patient  Katey describes how early emotional neglect and toxic parental modeling led her down a path of almost two decades of self-destruction, with an ongoing battle between her healthier and more resilient parts and her wounded repetition-seeking masochistic parts. Who would choose superficially “sweet” boys with good drugs and little emotional connection….why Katey would, and did, and this is her story of why she did that for so long and how she eventually broke free.

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Radically Genuine Podcast
https://www.drmcfillin.com/

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Here Craig sits down with Louise Barnett, host of the Together S.O.B.E.R. podcast, as she shares her harrowing journey through years of cyclical mania, eventually finding a way to not just make peace with bipolar disorder, but to use it to her advantage.

Louise Barnett
https://www.instagram.com/louisedbarnett/?hl=en

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Carrie Haynes/The Art of Groups
https://www.artofgroups.com/

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Why is this happening? What can we do to help our most vulnerable citizens? Here Dr.  H sits down with Dr. Dave Iverson, a Colorado psychiatrist, advocate, and policy expert who has devoted his entire career to caring for the most ill patients with the least resources.  We get to hear what it's like to work in the psychiatric trenches-- the deep sense of urgency and purpose, along with the constant losses and ever growing numbers of people to serve. 

BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Saj Razvi and the Psychedelic Somatic Institute
https://www.psychedelicsomatic.org/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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?

Here Dr. H synthesizes and summarizes his experience over the last 6 years doing over 3000 IV and IM ketamine treatments and addresses each of these critical treatment dilemmas.

Ketamine-assisted therapy training in CO in 2024
https://www.elementalpsychedelics.com/ketaminetraining

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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?

Dr. Adele LaFrance, a Colorado-based psychologist, the co-creator of Emotion Focused Family Therapy, and now the principal investigator of a fascinating study called "The Love Project" shares her stories and wisdom on all things love.

The Love Project
https://dradelelafrance.com/the-love-project

Dr. Adele LaFrance
https://dradelelafrance.com/

Dr. H/BFTA
https://www.craigheacockmd.com/podcast-page/

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.


NAMI Family to Family support
https://www.nami.org/Support-Education/Mental-Health-Education/NAMI-Family-to-Family

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

NAMI Family to Family support
https://www.nami.org/Support-Education/Mental-Health-Education/NAMI-Family-to-Family

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.


BFTA among the Top 15 Psychedelic Podcasts of 2023!
https://podcasts.feedspot.com/psychedelic_podcasts/?_src=alsoin

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

Shelly Winemiller
http://www.oasisforhealing.com/meet-shelly

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Craig sits down with  Dr. Hillary McBride, a psychologist, researcher, author, and podcast host (Other People's Problems) to explore all things psychedelic.


Dr. Hillary McBride
https://hillarylmcbride.com/

Roots to Thrive-- a model of ketamine group therapy used by Hillary at Katalyst
https://rootstothrive.com/

Hillary's ketamine groups at Katalyst
https://www.katalystmentalhealth.com/

Psychedelic Ceremony and the Art of Groups with Dori Lewis
https://www.elementalpsychedelics.com/psychedelictraining

Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.


BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Can you treat >95% of all patients with mood, anxiety, and psychotic disorders with just ten meds? Dr. H says YES.
Here he posits his top ten, based on efficacy, safety, tolerability, and cost.


BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

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.

The Revolution Will Not Be Psychologized (The Emerald podcast)
https://www.buzzsprout.com/317042/12293967-the-revolution-will-not-be-psychologized

BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/

BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/