Back from the Abyss: Psychiatry in Stories

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.

This episode comes from a recent interview that Dr. H did on the podcast The Testing Psychologist.


"The Unwell Doctor" episode on the podcast The Nocturnists
https://www.thenocturnists-shame.org/episodes/9-the-unwell-doctor

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

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

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.

They explore topics including:
 •Problems with diagnostic nosology
•Depression as a spiritual problem or a symptom of disconnection
•Integrative psychiatry and how this differs from standard psychiatry
•Getting at root causes of psychiatric illness
•The role of psychotherapy in good psychiatry practice
•Diagnosing and treating ADD
•Ketamine-- Dosing, route,  how and when to include adjunctive psychotherapy
•Ketamine via tele-health....Expanding access or increasing risk?
•What other psychiatric and non-psychiatric clinicians are missing
•Vicarious trauma and grief in psychiatry
•Hopes and concerns with recent psychedelic decriminalization

Psychedelic Practitioner Immersive
https://www.enduringlovetherapy.com/events-1/psychedelic-practitioner-immersive-psychedelic-space-holding-integration

Dr. Will Van Derveer and the Integrative Psychiatry Institute
https://psychiatrycenters.com/team-members/will-van-derveer-md/

Higher Practice podcast
https://psychiatryinstitute.com/podcast/

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

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

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.

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

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

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.

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

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

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.

To contact Daniel about Peer-led DBT groups or Dual Diagnosis 12 step meetings:
dualrecoveryresource@gmail.com

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

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

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.

Psychedelic therapy training in CO with Dr. H
https://www.enduringlovetherapy.com/events-1/psychedelic-practitioner-immersives-psychedelic-space-holding-integration-2

Dr. Kelly Sonnenfeld
https://drkellysonnenfeld.com/

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

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

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.

These factors include:
•Leaving the tribe
•Contagion and heightened peer influence
•Early existential life crises
•Developmental brain changes
•Sleep deprivation and sleep cycle derangement
•Cannabis and alcohol


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

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

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.

Chris Johnson/Whooz Larry--  "Have My Heart"
 https://open.spotify.com/track/7CoXPcTsQGjIU3mEbeTMQX?si=dc6f5f06a4394b2c

Dr. Shannon Hughes
https://www.drshannonhughes.com/

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

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.

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

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

Three women. Three stories.
One must listen.

Act 1- Sarah
Music by Dori Lewis

Act 2- Karen
Music-- Karen and Craig,  "Waterfall of Wisdom" by Fia

Act 3- Elizabeth



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

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.

Micah Stover
http://www.micahstoverconsulting.com/


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

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

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.

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

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

This is a talk that Dr. H gave in Denver at the Nowak Society in Aug. 2022.

Medicalization and/or legalization of psilocybin is likely coming to Colorado soon, with other psychedelics soon to follow. This will foster both a new era of psychiatric treatments and psychospiritual exploration, as well as a significant increase in adverse psychiatric events, including psychotic breaks. Dr. H explores the various classes of psychedelics (cannabinoids, tryptamines, phenethylamines, ketamine, e.g.) and assesses their relative risk of triggering psychosis, how and why polypharmacy (particularly with THC) greatly magnifies risk of developing psychosis, and the complex interplay between genetic vulnerability for psychosis/schizophrenia and the use of various psychoactive drugs.

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

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

Dr. H sits down with Dr. Jeremy Sharp, Director of the Colorado Center for Assessment and Counseling and host of The Testing Psychologist podcast,  for an exploration of  the psychological and psychiatric aspects of ADD/ADHD.

Dr. Jeremy Sharp
https://www.coloradocac.com/about/dr-jeremy-sharp/

The Testing Psychologist podcast
https://www.thetestingpsychologist.com

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

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

In this season 4 opener, we hear the unforgettable story of a mother and daughter torn apart by addiction, then slowly finding the path of compassion, acceptance, and grace.


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

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

Craig sits down with Inside Eyes creator Laura Northrup for a wide-ranging discussion where they explore topics including:

•Trauma as a spiritual wound
•How psychedelics can help reach the realm of trauma
•Why psychedelic trauma therapy can be so profoundly painful
•The uniquely damaging sequelae of sexual trauma
•What it means for a therapist to have adequate trauma training
•How and why therapists hurt their clients/patients, particularly in the psychedelic space
•The crucial nature of preparation
•Therapist burnout and spiritual practice
•Coming to terms with our conscious and unconscious beliefs and biases around money


 Laura's Website: www.InsideEyesPodcast.com

Instagram: @lauramaenorthrup 

Twitter: @inside__eyes

Facebook: https://www.facebook.com/LauraMaeNorthrup

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

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

Chris and Craig celebrate season 3,  discuss the results of the listeners poll (with a surprising reveal of their unconscious motivation for producing BFTA), offer their curated episode sampler plates, and then settle into a detailed deconstruction of the Psychedelic Somatic Therapy episode.


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

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

Saj Razvi returns to BFTA to share and discuss a mind-blowing audio recording of a ketamine-facilitated somatic therapy session. This session was from a recent training workshop with experienced trauma therapists, and Saj uses a somatic exercise-- staring into the client/participant's eyes- as a way to elicit a rapid and powerful transference reaction, with the psycholytic catalysts of ketamine and oxytocin already on board.  We hear Saj handle the mounting fear and dread of the emerging traumatic transference, then work through this with the therapist in training to find nervous system resolution and safety on the other side.  In the latter part of the episode Saj and Craig explore the challenges of recognizing and working with transference.

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

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

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

One of Craig's heroes is Dr.  Irvin Yalom, a psychiatrist and writer— Yalom's books inspired him in the early years of learning to become a psychiatrist. Today’s story concept was sparked by Yalom's book “Every day gets a little closer—A twice told therapy.” To create this book,  Yalom asked one of his long-term patients to keep a weekly diary of their therapy sessions, and he did the same. He wove their two very different but fascinating perspectives together to write the book. 

Craig just loved this idea and thought it would be really cool to do the BFTA version of this. In this story, Dr. Erin Jacklin, a psychologist in Denver, and her 15 year client Sherlock tell their shared story…..with Erin first meeting Sherlock at the very beginning of her doctoral training, and Sherlock coming to Erin at a pivotal point in his life.  To create this episode, Craig asked Erin and Sherlock to not discuss their treatment history or what they might say during the recording, then he recorded Erin and Sherlock separately, asking them each the same questions, and then the magic unfolded.

Dr. Erin Jacklin
https://catalystcenterllc.com/our-team/erin-jacklin/

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

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

The podcast Cover Story just released a series called Power Trip, an expose of the dark side of the psychedelic treatment world. The series highlights the stories of a few women, including the co-host, who were sexually assaulted in psychedelic treatment spaces….mostly in the underground, but also one woman who was abused by her therapist both during and after her participation in the MAPS PTSD study.

Later in the series, Cover Story shifted to a double barrel assault on MAPS as an organization and its Phase 3 PTSD study. Cover Story questioned the integrity and competence of the people working in the study and tried to paint the study as some kind of amoral juggernaut which, in its desperate desire to bring MDMA to full medicalization, is willing and able to squash any vulnerable participants or opposition in its way. 

Dr. H couldn’t disagree more, and felt the imperative to share a different view.  He was a study physician and therapist in the Phase 3 MDMA trial, and his experience with participants, with colleagues both at his study site and other sites, and with numerous MAPS staff at all levels of the organization was unrecognizable in Cover Story’s sensationalized account.

In this episode, Dr. H sit down with Hope, a former participant in MAPS' PTSD study.  First Hope shares her moving story, then she and Dr. H discuss the critiques from Power Trip. Hope's story is neither a home run cure nor a story of wanton abuse, but rather one of two steps forward, one step back....which is how the healing journey most commonly unfolds.

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

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