Back from the Abyss: Psychiatry in Stories

I had to rebuild who I was-- Finding trust and a pathway out of psychosis Oct 25, 2024

Very few people are willing and/or able to share and describe their descent into psychosis— in part because memory formation and consolidation are so impaired during episodes of psychosis…..and also because there is often so much fear and shame tied up in the experience of losing one’s mind.
Here Dr. H's patient Corben describes his very early onset illness, how it started with years of depression, then shifted into profound alienation and increasingly frightening psychosis, and finally into stability and recovery.
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Why med management is mostly doomed to fail-- The top 10 (12!) reasons with Dr. Will Van Derveer Oct 11, 2024

The prevailing model of psychiatric care in the US is called "med management"-- this typically means a 10-15min appointment to review symptoms and choose medications. Here Dr. Will Van Derveer of the Integrative Psychiatric Institute sits down with Dr. H to deconstruct this deeply flawed model and posit a more holistic and hopeful way of thinking about psychiatric care.
Dr. Van Derveer and the Integrative Psychiatric Institute
https://psychiatryinstitute.com/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

How do you learn to do psychotherapy? An exploration with Dr. Erin Jacklin Sep 27, 2024

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.
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

BFTA Summer Special-- How to Change Your Mind About Mushrooms with Dori Lewis Jul 05, 2024

Craig sits down with Dori Lewis of Elemental Psychedelics to explore the myths and realities of working with psilocybin mushrooms, including:
•What do people not understand about psilocybin mushrooms?
•Can mushrooms treat depression? If so, which types?
•How should we think about the specific roles of mushrooms and ketamine in psychiatric and psychological treatment?
•What kinds of problems are most amenable to psilocybin?
•Why do some people have no psychedelic experience on apparently therapeutic doses of psilocybin?
•Individual vs group work with mushrooms
Elemental Psychedelics-- Ketamine and Psilocybin therapist/facilitator trainings
https://www.elementalpsychedelics.com/
Revive and Thrive retreat (with Dr. Rebecca Richey)
https://www.experientialwellnessretreats.com/beaver-run-retreat
Bringing Therapy into Med Management-- An intensive psychotherapy workshop with Dr. H
https://www.craigheacockmd.com/training/
Beyond Psilocybin-- Embracing the Power of Ketamine
https://www.reflectivehealing.com/blog/fortcollins/therapy/reflectivehealing/beyond-psilocybin-embracing-the-power-of-ketamine-in-mental-health-healing

Fishbowl 5 May 31, 2024

Chris and Craig go meta to deconstruct season 5, explore the art of storytelling and music selection, and answer listener questions.
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

When Mom is mentally ill-- A story of resilience May 16, 2024

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.
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

A Psychiatrist Goes to War May 03, 2024

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.
Dr. Russell Carr
A Psychiatrist Returns from War-- on Substack
https://russellcarr.substack.com/
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

My dog saved my life-- Understanding the story of depression Apr 19, 2024

A huge problem with current psychiatric diagnosis is that it often lumps completely unrelated things under the same vast and vague tent, such as with the diagnosis of "Major Depressive Disorder". Here Craig sits down with his patient Rebecca to try to make sense of her complex early onset depression and how it played out via addiction, anorexia, and pathological caretaking and how she was finally able find the grace and compassion to prioritize care for herself.
Bringing Therapy into Med Management-- An intensive psychotherapy training in Colorado with Dr. H
https://www.craigheacockmd.com/training/
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Psychoanalysis, Dissociation, MDMA and What Lies Beneath Apr 05, 2024

Here Dr. H sites down with Jenny, a psychoanalyst who shares her moving, then horrifying, then eventually cathartic tale of plumbing the depths of her traumatized psyche, first with years of psychoanalysis, then with five MDMA-assisted therapy sessions. This is a story of numbing and forgetting, then re-opening and remembering...of finding a way to make sense of a life of protective dissociation.
Bringing Therapy into Med Management-- An intensive psychotherapy training in Colorado with Dr. H
https://www.craigheacockmd.com/training/
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

What I'm thinking about now-- MDMA, Sleep Meds, Motivation, Bipolar vs Borderline, and more Mar 22, 2024

In this solo episode Craig shares his current thoughts on MDMA medicalization, sleep meds, ADD, motivation vs self-discipline, benzos, how long to stay on psych meds, a change and a proposed addition to his top 10 med list, borderline vs bipolar, and marriage.
Bringing Therapy into Med Management-- An intensive training with Dr. H
https://www.craigheacockmd.com/training/
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Eating Disorders, Body Image, and Building an Alliance-- A Conversation with Dr. Jennifer Gaudiani Mar 08, 2024

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/

Sex, Drugs, and Neglect-- Self-Destruction and the Repetition Compulsion Feb 23, 2024

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.
Bringing Therapy into Med Management-- An intensive training with Dr. H
https://www.craigheacockmd.com/training/
BFTA on IG @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Psychiatry in the ER Feb 09, 2024

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/

At the Crossroads of Psychiatry, Psychedelics and Spirituality--- Dr. H on the Radically Genuine Podcast Jan 26, 2024

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/

Bipolar Mania-- Superpower or Kryptonite? Jan 12, 2024

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/

Moving from the head to the heart-- The gifts and challenges of group therapy Dec 29, 2023

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/

Unhoused and Unwell-- The Nexus of Homelessness, Mental Illness, and Addiction Dec 15, 2023

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/

What does it take to fill the void? Developmental trauma and dissociation with Saj Razvi Dec 01, 2023

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/

Ketamine-- Lessons from 3000 Sessions Nov 17, 2023

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.
Bringing Therapy into Med Management-- An intensive training with Dr. H
https://www.craigheacockmd.com/training/
BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Love and Therapy-- A Conversation with Dr. Adele LaFrance Nov 03, 2023

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/

Holding on to hope-- Caring for adult children with serious mental illness, Part 2 Oct 20, 2023

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/

What will happen when we're gone? Caring for adult children with serious mental illness Oct 06, 2023

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/

Psychedelic Psychiatry-- The Swiss Model Sep 22, 2023

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/

When THC turns on you-- Cannabis, THC concentrates, and psychiatric breakdown Sep 09, 2023

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/

Healing the Wounds of Sexual and Spiritual Abuse Aug 27, 2023

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/

BFTA Summer Special at Psychedelic Science 2023 with Dr. Hillary McBride Jun 26, 2023

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/

Chris and Craig in Fishbowl #4 May 17, 2023

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/

Brothers across the divide: Treatment-resistant depression, faith, and compassion May 04, 2023

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/

The 10 Best Psychiatric Medications Apr 20, 2023

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/

A bridge between the Western and Indigenous ways— The curandera, plant medicine, and spirit Apr 06, 2023

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/

Psychedelic Assisted Therapy: Ketamine vs MDMA vs Psilocybin Mar 23, 2023

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/

What's the deal with Psychiatry? What's hopeful, what's gone amiss with Dr. Will Van Derveer Mar 09, 2023

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/

Trauma in the Transference—Repairing the therapeutic relationship Feb 23, 2023

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/

The lives I didn’t get to live- Shame, psychedelics, and owning one’s story Feb 09, 2023

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/

Thinking Through Emotions— DBT Part 2 Jan 26, 2023

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/

DBT, Self-Harm, and Suicidality with Dr. Kelly Sonnenfeld Jan 12, 2023

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/

Why psychiatric illness strikes young (and what to do about it) Dec 29, 2022

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/

Psilocybin comes to Colorado Dec 15, 2022

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/

The way out of psychosis-- Psychopharmacology as magic Dec 01, 2022

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/

Abortion in Three Acts Nov 17, 2022

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/

From Beauty Queen to Psychedelic Guide Nov 03, 2022

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/

Autism Spectrum Disorder-- A journey from alienation to attachment Oct 20, 2022

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/

Psychedelics, Psychosis, and Risk Reduction Oct 06, 2022

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/

Understanding ADD/ADHD with Dr. Jeremy Sharp Sep 21, 2022

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/

Finding a way back to each other: Addiction, a mother, and her daughter Sep 08, 2022

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/

BFTA Summer Special-- Trauma, Spirit, and Psychedelics with Laura Mae Northrup Jul 23, 2022

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/

Fishbowl 3 Jun 02, 2022

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/

Psychedelic Somatic Therapy with Saj Razvi May 19, 2022

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/

Psychotherapy Twice Told May 05, 2022

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/

MDMA, MAPS, and Cover Story's Power Trip-- Another perspective Apr 21, 2022

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/

Working with families and psychiatric illness Apr 07, 2022

Dr. H sits down with Dr. Usha Udupa, a Colorado-based child and adolescent psychiatrist, to explore the complexities of working with patients in the context of the family. They discuss topics such as:
How and when family members should be included in treatment
What if the patient refuses family involvement
When the identified patient isn't the problem
How and when to break confidentiality, especially with substance abuse
What are the hidden stories behind what people believe about meds
Why so many young men are failing to launch
What to do when one or more family members don't believe in treatment
Dr. H talks all things ADD/ADHD, meds/stimulants, treatment options
https://anchor.fm/apositivepodcast/episodes/Episode-24-Everything-ADDADHD--Medication--with-Dr--Craig-Heacock-e1fj85m
BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Attachment and Adoption Part 2– Ridghaus and the Six Word Adoption Memoir Mar 24, 2022

This is the second in our two part series on adoption and attachment wounds. Ridg and his girlfriend Rebecca got pregnant when he was 19, and they made the difficult decision to give their son up for adoption. Fast forward 16 years, and Ridg is 35, married to another woman, with their own biological children…and he’s about to have his world torn apart by a stunning revelation.
Six Word Adoption Memoirs
https://vimeo.com/161846105

https://vimeo.com/211568644

Ridghaus on IG-- @ridghaus
BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

From Seoul to Wichita-- Attachment trauma and adoption Mar 10, 2022

This is the story of Shae, who was adopted as a baby from South Korea and raised in Wichita Kansas in a family of Swedish descent. From her initial attachment wounds, subsequent heartbreak, and later a shocking revelation in late adolescence, Shae's inner light and resilience guided her to where she is today— a mother, a business owner, an adoptee voice of strength and compassion.
To reach out to Shae directly: poetseoul@gmail
Adoptee Voices-- Supporting adoptee storytelling
https://adoptee-voices.com
BFTA on Instagram. @backfromtheabysspodcast
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

The nature of gender-- A story of transitioning Feb 24, 2022

Autumn was assigned male at birth, but she sensed from a very young age that something was not right. This is her journey through denial, awakening, and then transitioning both hormonally and surgically. Autumn brings a fascinating and thoughtful perspective to this whole arena of gender and identity, and she and Dr. H explore the various ways we might think and talk about gender.
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Twenty years in psychiatry: Insights and clinical pearls Feb 10, 2022

Dr. H distills down his 20 years of clinical experience into just under an hour of musings, lessons learned, and insights.
"Sometimes the why really isn't crucial" (Essay from the NYT about addiction)
https://www.nytimes.com/2006/12/19/health/psychology/19essa.html
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

The Dark Side of Psychedelics Jan 27, 2022

Devin found out the hard way that psychedelics can have a very dark side. This is a story of discovery and of joy…of connection and dancing and jam bands….and it’s also a story of two psychotic breaks, sexual assault, and the eventual grinding realization that psychedelics demand respect. Devin speaks out so that others might avoid her mistakes and take seriously the imperative of having a safe container for psychedelic exploration and therapy.
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Treatment resistant depression: Ketamine vs ECT vs TMS with Dr. Daniel Fisher Jan 14, 2022

ECT (electroconvulsive therapy) has long been the last stop for severe and treatment resistant depression, but now there are at least two other good options for those who don't respond to meds and therapy. Dr. Dan Fisher, an ECT expert, founder of Colorado's Guerra Fisher Institute , and Craig's go-to psychiatrist for tough cases, joins BFTA to discuss how and when to think about ECT vs ketamine vs TMS (transcranial magnetic stimulation) .
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Ketamine in context-- From substance abuse to psychedelic therapy Dec 31, 2021

Expectation, set, setting, dosage, and route of administration provide the context and scaffolding for psychoactive drugs. An IV morphine drip can make unbearable pain completely manageable, while IV heroin, which is immediately converted to morphine once it crosses the blood brain barrier, destroys tens of thousands of lives a year. A benzodiazepine such as lorazepam, when taken orally at sensible doses, can stop a panic attack in its tracks, yet snorting or injecting benzodiazepines, or mixing them with alcohol, can lead to complete blackout and terrible consequences. Taking psilocybin mushrooms with friends out in nature vs at night alone in the darkened streets of an unfamiliar city vs with a trained trauma therapist in a healing setting—- the resulting risks, benefits, and experiences are mind-blowingly different.

In today’s story we hear Graham’s long and winding road with various drugs and alcohol in the context of childhood trauma and bipolar disorder, with a particular emphasis on his complicated relationship with ketamine. For years, he used and abused massive quantities of ketamine, yet now he has transitioned to using ketamine in a therapeutic context with Dr. H, and the experience of ketamine, the consequences, and the end results are just shockingly different….all because of expectation, set, setting, dosage, and manner of administration.
Audio note: Graham's emotional support dog makes some intermittent appearances on his microphone
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Conversation with an underground psilocybin therapist Dec 16, 2021

As we are now coming to realize the impressive potential of psychedelics to treat trauma and depression, we also have to face the fact that they are still illegal. This reality has led to an explosion of underground therapy, a Wild West where anyone can set up shop as a shaman or therapist or healer and the buyer must beware.

Some people are finding healing in the underground psychedelic world, while others are encountering ethically-challenged and/or naive underground practitioners who are causing more harm than good. Here Dr. H sits down with Sarah, an underground therapist who is doing this important work in a mindful and ethical way.

Sarah has been doing underground psilocybin work for seven years and comes from a place of her own severe childhood trauma, a journey where she found healing with psilocybin and was then compelled to offer this path to others. Sarah and Dr. H explore whom she works with and why, how she thinks about psilocybin in the therapeutic toolkit, how other underground therapists get themselves into trouble, and finally she offers wisdom about how one might enter into underground therapy in a thoughtful way.
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA on Facebook
@Back From The Abyss Podcast
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Body dysmorphia, disordered eating, and embodiment Dec 02, 2021

Body dysmorphia is the disorder of imagined ugliness, a type of delusional OCD that can lead to severe depression, eating disorders, compulsive body alterations, and suicidality. As a young child, Georgina was a "cute kid", not particularly self-conscious, and able to move through her world without undue pain. With the onset of adolescence, however, her self-image changed completely-- she suddenly found her face horribly ugly, she felt helpless and hopeless, and she frantically tried to find ways to cope.
Here Georgina shares her story of recovery from body dysmorphia and an eating disorder, a long and winding path from Health and Wellness Instagram fame while compulsively exercising and restricting to the hard work of showing up in therapy to rediscovering her non-judgmental inner child during a psilocybin journey. Georgina and Dr. H also explore orthorexia, atypical anorexia, intuitive eating, and the concept of healing through embodiment.
Georgina Berbari is a writer and photographer living in NYC
https://www.georginaberbari.com
Dr. Hillary McBride's new book "The Wisdom of Your Body"
https://hillarylmcbride.com/the-wisdom-of-your-body/
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA on Facebook
@Back From The Abyss Podcast
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Hold on to memories-- The aftermath of suicide with Doug Friedman Nov 18, 2021

Doug Friedman, the co-host and producer of the podcast Your Mental Breakdown, contacted Craig last spring and said that he was ready and wanting to tell his abyss story-- that of his wife’s death and his journey of recovery thereafter. Doug has mentioned a number of times on his podcast that his wife passed away the same week in 2018 that he was diagnosed with MS… but the details of his loss are actually much more profound and heartbreaking. That’s because Doug’s beloved wife Kim, who was also a psychotherapist, died by suicide when her bipolar disorder overtook her.

After Kim’s death, Doug plunged into a process of painful reckoning that finally culminated in a move to the Colorado mountains to plumb his emotional depths through songwriting and music. The result of his inner process, of his working through the paralyzing grief and the overwhelming emotions… is the music you will hear throughout this story.
Doug Friedman
https://www.clearmindfullheart.com
Your Mental Breakdown podcast
https://www.yourmentalbreakdown.com
BFTA on Instagram
https://www.instagram.com/backfromtheabysspodcast/
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Doing the loving thing-- An exploration of marriage with Jeff Pincus Nov 04, 2021

Here Craig sits down with Jeff Pincus, a nationally recognized couples therapist and trainer from Boulder, they explore why it’s so challenging to be an effective marriage therapist, why we are all destined to marry the wrong person (hint….our partners eventually become a mirror for us and our issues), and how marriage can be the most nourishing yet also the most difficult and painful relationship of our lives.
Jeff's work is informed by cognitive neuroscience, somatic psychotherapy, systems thinking, and Tibetan Buddhism. He is an expert in PACT (Psychobiological Approach to Couple Therapy) and was one of the original core faculty for the PACT Institute. He currently offers transformational three-day intensives for couples interested in healing, growing and loving.
https://jeffpincus.com
BFTA is now on Instagram
@backfromtheabysspodcast
https://www.instagram.com/p/CVf2XzhlTZ5/?utm_medium=share_sheet
BFTA on Facebook
@Back From The Abyss Podcast
BFTA/Dr. H
https://www.craigheacockmd.com/podcast-page/

When meds don't work: Diagnostic confusion, trauma, sleep, hormones, and mistaken expectations Oct 21, 2021

When psychiatric meds work well, it can be nothing short of miraculous. Yet so often, patients accumulate a long list of med failures, leading to a sense of deep frustration and even hopelessness.
Here Dr. H explores five central reasons why psych meds fail:
1. Misdiagnosis, largely due to overlapping and confusing diagnostic categories and the general lack of a coherent nosology in psychiatry
2. The role of trauma as the great imitator
3. Sleep issues
4. Hormonal status
5. Confused and/or unreasonable expectations
BFTA/Dr. H
https://www.craigheacockmd.com/podcast-page/

The Secret Sauce-- Treating PTSD with MDMA Oct 07, 2021

An amazing healing journey deserves a detailed post-game analysis and deconstruction. Here Elizabeth, a participant in the MAPS MDMA study, sits down with Craig and co-therapist Karen Cooper to look back at what were the crux moves and essential ingredients that shifted Elizabeth's PTSD into remission.
BFTA/Dr. H
https://www.craigheacockmd.com/podcast-page/

Craig and Antonio Sacre talk shop Sep 23, 2021

Craig sits down with LA-based Cuban American storyteller, author, BFTA super-advisor, and longtime dear friend Antonio Sacre to explore the art and power of storytelling, their personal abyss moments, friendship and vulnerability, and their shared love of air conditioning.
Antonio Sacre
https://www.antoniosacre.com
BFTA
https://www.craigheacockmd.com/podcast-page/

I felt the world too much-- On being a highly sensitive person Sep 09, 2021

Life would be so much easier if we each came with an individual instruction manual, to both guide us and also warn us of how our inherited temperament and predilections might cause us great suffering.
The first page of Emily's manual would have started with a capitalized bold face warning:
"You are a highly sensitive soul, you will feel others' hurt and anger and sadness as if it were your own....you will experience the world as if you had no protective skin, no shield....you will need to find people who see you and understand who you are, who can help nurture the beautiful flower that you can and will become."
Emily eventually found her healthy place in the world, but in the process the darkness almost took her.
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Where did our son go? A family faces schizophrenia Aug 24, 2021

Just after starting his career, Dr. H met Matthew, a middle school student in the midst of a horrifying psychotic break. Here Dr. H sits down with Meg and Phil, Matthew's parents, to explore their 15 year journey of grief, acceptance, recovery, and eventually becoming a source of support, connection, and wisdom for other families on this brutal and often deeply isolating journey.
NAMI Family to Family classes
https://www.nami.org/Support-Education/Mental-Health-Education/NAMI-Family-to-Family
NAMI support groups
https://www.nami.org/Support-Education/Support-Groups
BFTA/Dr. H
https://www.craigheacockmd.com/podcast-page/

The Quickening-- A healing journey through AA, Psilocybin, and Ayahuasca Aug 08, 2021

12 step programs have helped millions of people, but they can't address everything. Randy got clean and sober and found a supportive community in AA....yet something was missing. He couldn't find peace, he couldn't connect in intimate relationships, he felt deeply broken and spiritually empty. It turns out that when Randy's little brother drowned when Randy was just 4 years old, his family became a numbed archipelago of grief, leaving him to grow up without the mirroring and attachments that he desperately needed. Enter ayahuasca, followed by psilocybin....Randy was finally able to reach the parts of his unconscious where his childhood trauma was blocking his attachment and safety circuitry.
BFTA/ Dr. H
https://www.craigheacockmd.com/podcast-page/

Spiritual gaslighting Jul 23, 2021

We're back!!
Sometimes it's irresistible, necessary even, to lose ourselves into the greater collective, to become a honeybee buzzing with the ecstatic singular purpose of the hive.
In this season 3 opener, Jamie tells Dr. H her story of trying to save herself by losing herself, then finally coming to face the fact that she had to plumb the depths of her trauma alone, culminating in a high dose DIY psilocybin session and the rediscovery of herself.
A heads up-- this episode contains a description of a sexual assault.
BFTA/Dr. H
https://www.craigheacockmd.com/podcast-page/

Fishbowl #2-- Chris and Craig talk shop May 16, 2021

In this final episode of season 2, Chris and Craig explore the highs and lows of the last year and plans for season 3.
Craig discussing the psychedelic revolution in psychiatry on the Modern Therapist Survival Guide podcast
https://therapyreimagined.com/modern-therapist-podcast/psychedelic-assisted-therapy/
BFTA
https://www.craigheacockmd.com/podcast-page/

(Almost) Everything about psych meds... in under 16 minutes Apr 27, 2021

Antidepressants, mood stabilizers, antipsychotics, benzodiazepines, stimulants.....READY SET GO!
Med cheat sheet
SSRIs (selective serotonin reuptake inhibitors)-- Prozac, Lexapro, Paxil, Celexa, Zoloft, Luvox, Trintellix, Viibryd-- They are generally NOT antidepressants
Mainly helpful for OCD, body dysmorphia, panic (if not from trauma), depression if postpartum or fueled by neuroticism or ruminative anxiety
SNRIs (serotonin norepinephrine reuptake inhibitors)-- Effexor/venlafaxine, Cymbalta/duloxetine
Mostly helpful for combined depression/anxiety, especially with insomnia
Wellbutrin/bupropion-- very stimulating (prison crack!), true antidepressant; can trigger/worsen anxiety
MAO (monoamine oxidase) inhibitors-- powerful antidepressants, lots of side effects and med interactions
Lamictal/lamotrigine-- definitely ALL THAT and a bag of chips (see My Desert Island Meds in Season 1)
Atypical antipsychotics- Abilify/aripiprazole, Latuda/lurasidone, Seroquel/quetiapine, Saphris/asenapine, Vraylar/cariprazine, Risperdal/risperidone, Zyprexa/olanzapine, Geodon/ziprasidone, Invega/paliperidone
Generally good mood stabilizers (in contrast to the putative "mood stabilizers" below); typically more helpful for severe depression and bipolar disorder than true psychosis (Zyprexa and Risperdal excepted)
"Mood stabilizers"- (big misnomer, most effective for mania/agitation, not depression)-- Depakote/valproic acid, Trileptal/oxcarbazepine, Tegretol/carbamazepine
Lithium- it's not clozapine, but gets the silver medal as a true mood stabilizer (see My Desert Island Meds in Season 1)
Clozapine- the winner of the psychiatric med decathlon in most every event; needs weekly blood monitoring and has a few very serious potential side effects
Benzodiazepines- Xanax/alprazolam; Klonopin/clonazepam, Librium/chlordiazepoxide, Ativan/lorazepam, Valium/diazepam
Stimulants- Adderall/amphetamine; Vyvanse; Ritalin/Concerta/Focalin/methylphenidate
Amphetamines are more euphoria-inducing, thus more abused and addictive and also tend to have more side effects; both amphetamines and methylphenidate are roughly equally effective for ADD/ADHD
BFTA
https://www.craigheacockmd.com/podcast-page/

All we have is now-- A psychotherapist faces mortality Apr 13, 2021

How do you show up for others when you are facing the loss of everything you have ever known and loved?
Here Leah Barrett, a Colorado-based psychotherapist, opens her heart and shares her story of managing the careful dance of witnessing her clients' pain and trauma while she faces her own unfolding medical nightmare. Leah and Craig explore this immediacy and the implications for doing the sacred work of psychotherapy.
Leah Barrett's podcast --Precarious
https://www.leahbarrett.com/precarious-podcast
BFTA
https://www.craigheacockmd.com/podcast-page/

How healing happens with Dr. Hillary McBride-- Eating disorders and body dysmorphia Mar 29, 2021

What's the special sauce of psychological and psychiatric treatment? How do we change, particularly in relationship with others? Here Dr. Hillary McBride, a psychotherapist, researcher, author, and podcast host (Other People's Problems) opens up about the details of her years of psychiatric treatment, what worked (often surprising!), what did not, and how she had to leave home to find a home in herself.
Dr. Hillary McBride
https://hillarylmcbride.com
Hillary's new book-- The Wisdom of Your Body
https://www.amazon.com/Wisdom-Your-Body-Wholeness-Connection/dp/1587435527/ref=sr_1_2?dchild=1&keywords=hillary+mcbride&qid=1617029987&sr=8-2
BFTA
https://www.craigheacockmd.com

Addiction treatment-- What works, what definitely doesn't with Dr. Jeremy Dubin Mar 13, 2021

How can we stop the heartbreaking and horrific spiral of addiction?
Dr. Jeremy Dubin, the Medical Director of Colorado's Front Range Clinic, sits down with Dr. H to discuss their top five things that actually work....and the five factors which most predict jails, institutions, and death.
Dr. H and BFTA
https://www.craigheacockmd.com

A superhero at night-- Lucid dreaming, opioids, and ibogaine Mar 01, 2021

BFTA takes a wild ride with Colorado based artist, writer, and video producer Ian Jaydid as he tells his double abyss story of lucid dreaming, out of body experiences, REM deprivation and transient psychosis....which then led to the blissful but ultimately destructive salve of opioids and a life changing encounter with the African psychedelic Iboga (ibogaine).
Ian Jaydid
https://ianjaydid.com
Ian's novel Tripping the Field
https://www.amazon.com/Tripping-Field-Existential-Ungodly-Proportions/dp/0991193199
Ian's first lucid dreaming experience
https://www.youtube.com/watch?v=j-WaA3SGl9M&t=26s
Dr. H/ BFTA
https://www.craigheacockmd.com/podcast-page/

Why is it so hard to find a good psychiatrist? Feb 09, 2021

In the context of an increasingly severe shortage of psychiatrists, Dr. H discusses some uncomfortable truths about why finding a good outpatient psychiatrist is even more difficult than ever.
Psychedelics and Psychiatry-- Dr. H on The Third Wave Podcast
https://thethirdwave.co/podcast/episode-112-craig-heacock/
BFTA and Dr. H
https://www.craigheacockmd.com

No one believed me-- Complex PTSD and BPD Jan 26, 2021

The therapeutic relationship is built on trust, we come to therapy expecting that we are going to be heard and believed.
Jeanine wasn't believed-- about her childhood sexual assaults, or the emerging psychotic symptoms, or her intractable suicidality....even after many near fatal attempts and over 40 inpatient stays.
This episode looks at how and why we believe some people and discount others. It turns out that the way people tell us their stories matters just as much as the actual words they choose. And, unfortunately, certain clinical presentations make patients/clients much less likely to be heard and believed.
A heads up-- this episode includes descriptions of childhood sexual abuse, self-harm, and suicide attempts.
Dopamine, saliency, and the onset of paranoia
https://www.nature.com/articles/s41398-020-00912-4
Borderline personality diagnosis leads to demedicalization and poor treatment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870819/
Inappropriate affect
https://www.betterhelp.com/advice/personality-disorders/inappropriate-affect-symptoms-and-signs/
Dr. H/BFTA
https://www.craigheacockmd.com

Psychedelic mushrooms and the magic of life Jan 11, 2021

Some things in life defy explanation...like tripping on mushrooms and arresting the plunge into alcoholism.
Here Stella shares her story of childhood abuse and neglect, her reenactment of the abuse through toxic relationships with men, and then her life-changing sessions with both psilocybin and MDMA. Stella and Dr. H explore how she was able to first bring her dissociated and numbed self back to life with the help of psilocybin and later heal her attachment wounds and trauma with MDMA-assisted psychotherapy.
BFTA and Dr. H
http://craigheacockmd.com

The clinical moment in psychotherapy-- A conversation with Dr. David Puder Dec 22, 2020

Dr. H sits down with Dr. David Puder, a psychiatrist and host of the Psychiatry and Psychotherapy podcast, to explore the beauty and challenge and mystery of psychotherapy.
What are Chris and Craig wanting for Christmas...??? How about writing us a review!
Dr. Puder and the Psychiatry and Psychotherapy podcast
https://www.psychiatrypodcast.com
Dr. H essay on psychedelic healing for CNN.com
https://www.cnn.com/2020/12/20/opinions/psychedelics-trauma-healing-this-is-life-heacock/index.html
BFTA and Dr. H
https://www.craigheacockmd.com

Diagnosis guides treatment....except when it doesn't Dec 08, 2020

In most specialties of medicine, the dictum "Diagnosis guides treatment" is the law of the land. In psychiatry, however, most of what we treat are often overlapping syndromes, not actual diseases, and these syndromes involve hugely varying dimensions of symptoms with a vast array of potential causes and exacerbating factors.
Maggie came to Dr. H with a challenging clinical presentation: likely genetic loading for a mood and/or anxiety disorder, childhood emotional neglect, years of school problems, hormone irregularities and progesterone hypersensitivity, all leading to steadily worsening mood instability, depression, and hopelessness. Over the course of the last 12 years, Maggie and Dr. H were eventually able to co-create both a successful treatment course and a shame-free narrative, without a clear diagnosis to guide them.
Comments, suggestions, questions? We'd love to hear them! Email us via https://www.craigheacockmd.com or message us on Twitter @bftapod
If you haven’t already, please write us a review!

Craig Plays Goalie-- The Psychedelics Today interview Nov 24, 2020

The podcast Psychedelics Today recently released a two part interview with Will Hall, an author, podcaster, therapist, and voice of the anti-psychiatry community. This BFTA episode came about after Dr. H reached out to the hosts of PT and asked for a counterpoint to Will's complete dismissal of psychiatry as a meaningful part of the mental health treatment community.
Here Dr. H presents a more nuanced, balanced, and hopeful perspective, one that recognizes the harm that psychiatrists and other physicians have caused in the past and continue to cause today, while also asking that we try to lean into the positive, to identify and celebrate what works for people, to reject the black/white thinking that calls for tearing down systems which are, by their very nature, messy and imperfect, just as we humans are messy and imperfect.

Psychedelics Today
https://psychedelicstoday.com
Dr. H and BFTA
https://www.craigheacockmd.com

Steering into the hard stuff-- A father and husband's story Nov 10, 2020

Dr. H sits down with his friend Brian, who watched his daughter, and then his wife, plunge into the depressive abyss. This is the journey of a father and husband, of a "we can fix this" engineer trying to find a path through the ambiguity and uncertainty of psychiatric treatment.
This is the second in an intermittent series of family members describing their journey of trying to support their loved ones through their darkest times.
Grief and loss raft trips (mentioned by Brian)
https://www.pathfindersforyou.org
Dr. H/Back from the Abyss
https://www.craigheacockmd.com

Touching the edges of life-- Healing from divorce Oct 20, 2020

In this third of an intermittent series about therapists in the abyss, Dr. H sits down with his colleague Dr. Elena Estanol, a Colorado-based psychologist, to explore Elena's "fourth dark night of the soul". Her story serves as a springboard for exploring how to cope with the randomness of life, learning to go inward to heal relational wounds, differentiating pain vs suffering, and finding peace with who shows up for us and who doesn't.
Dr. Elena Estanol
https://www.synapsewellness.com/
Dr. H and BFTA
https://www.craigheacockmd.com

Craig's letters from the past: Mistakes made, lessons learned Oct 06, 2020

Dr. H finds a trove of patient letters from the last 15 years and shares three of the most poignant, using each as a springboard for lessons learned.
Dr. H and BFTA
https://www.craigheacockmd.com

A mother's story-- When your child can't see what's wrong Sep 22, 2020

After a difficult final year of high school, Tessa hoped and prayed that her youngest son would make the transition to college and find a way to thrive. He would be only an hour away, he wanted to go, and she was hopeful that getting a new start there could reverse whatever was happening to him. Yet just two months into his freshman year, it was apparent that he was sinking fast into a maelstrom of panic, body dysmorphia, delusions, and hopelessness.
This is Tessa's story of trying to find the strength, and eventually, the self-compassion, to both find help for her son as well as work through her own guilt and shame.
Book recommendation (from Tessa)
The Stressed Years of Their Lives: Helping Your Kid Survive and Thrive During Their College Years
BFTA and Dr. H
https://www.craigheacockmd.com

Trauma, yoga, and spiritual recovery Sep 01, 2020

Trauma embeds in the complex zone between body and spirit, deep within the realm of primary consciousness. The typical psychiatric approaches of meds and talk therapy rarely access these unconscious realms. In prior episodes of BFTA, we have heard accounts of healing these deep wells of trauma with EMDR, psilocybin, and MDMA-- this episode highlights the unexpected power of a loving teacher and a guided spiritual practice.
Jeff Finlin, a Colorado-based singer/songwriter and recovery coach, shares his story of recovery after recovery, accessing his embodied trauma and deeper self years into sobriety, through a practice of the breath and self-compassion.
Jeff Finlin
https://www.jefffinlin.com
Back from the Abyss and Dr. H
https://www.craigheacockmd.com
On Twitter @bftapod

Psychiatry in one question + When ketamine therapy gets difficult Aug 18, 2020

In the first half of this two part mini-episode, Dr. H explores the four stages where fully dissociative doses of ketamine can get a little rocky:
*reaching escape velocity
*re-entry
*dissociative shatter
*post-session processing
What if a psychiatrist were allowed to ask only one question at a session....what might that be? In the second part of this episode, Dr. H ties together sleep, mood, hormone cycling, friendships, work, circadian rhythm, addiction, and dogs vs cats into just one question.
Comments, suggestions, questions? We'd love to hear them! Email us via https://www.craigheacockmd.com or message us on Twitter @bftapod
If you haven’t already, please do write us a review!

Craig and Saj Razvi talk shop— Dissociation, the unconscious, countertransference sadism, and psychedelics Aug 04, 2020

Saj Razvi (of Innate Path and Psychedelic Somatic Institute) returns to BFTA to help Craig do a deep dive into listener questions.
Have questions you want us to address in a future episode? Email them via craigheacockmd.com
Psychedelic Somatic Institute
psychedelicsomatic.org
Video showing somatic/primary consciousness trauma work catalyzed by THC
https://vimeo.com/442544334

A special place in my drug addict heart-- Finding safety with Suboxone Jul 21, 2020

We typically think of addiction as a symptom of a deeper issue, such as trauma or a psychiatric disorder. Sometimes, however, addiction is the main event, and powerlessness is the starting point, not some ambiguous distant stop on the substance abuse train.
Lena fell hard into addiction by sixth grade and by all rights should have been dead or imprisoned long ago. Yet today she is fully alive, deeply grateful, and six years clean and sober.
Dr. H and Lena explore her journey out of darkness and the varied and often surprising roles that jail, a caring probation officer, Suboxone, and a seemingly random visit by two near strangers all combined to help her change the course of her life.
Dr. H and Back from the Abyss
https://www.craigheacockmd.com
On Twitter @bftapod

Losing patients, one after another--Craig's meditation on loss and life Jun 23, 2020

Season 2 is here!
We kick off our new season with Dr. H going deep into the immediate aftermath of losing four patients and his eventual path back into the light. Save this one for when you are in the right headspace.
Dr. H and Back from the Abyss
http://craigheacockmd.com
On Twitter @bftapod

Bonus episode-- Inside Eyes: Ayahuasca and sexual trauma Jun 09, 2020

Can a podcast have an identical twin separated at birth? If so, then "Inside Eyes" might possibly be that long lost twin of BFTA.
Laura Mae Northrup is the creator of Inside Eyes and a trauma therapist in the Oakland area. She put a ton of work into these moving stories of healing from childhood sexual trauma with entheogens and psychedelics. She is planning to soon feature a favorite BFTA episode on her show, while Dr. H picked this one as a favorite.
This episode is the story of Shan, an NYC tattoo artist who found unexpected healing from her sexual abuse and rheumatoid arthritis through ayahuasca. It's truly a mind-blowing and moving memoir.
Website: www.InsideEyesPodcast.com

Instagram: @lauramaenorthrup

Twitter: @inside__eyes

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

Bonus Episode-- Conversations with a Wounded Healer (Interview with Dr. Hillary McBride) May 26, 2020

Self-described podcast junkie Dr. H reached out to Sarah Buino, host of the excellent podcast Conversations with a Wounded Healer, and they agreed to do this super nifty episode swap, in which Sarah will feature a favorite BFTA episode on her show, and Dr. H chose a favorite episode to feature here.
In this episode Sarah interviews one of the more thoughtful and compelling people in the podcast universe, Dr. Hillary McBride (of both The Liturgists and Other People's Problems). They explore Hillary's journey of healing and how this informs her current work as a therapist and researcher.
Dr. H interviewed on Conversations with a Wounded Healer
https://headhearttherapy.com/114-craig-heacock-back-from-the-abyss-with-psychedelic-assisted-psychotherapy/
Subscribe to Conversations with a Wounded Healer!
https://podcasts.apple.com/us/podcast/conversations-with-a-wounded-healer/id1356225272
Conversations with a Wounded Healer home page
https://headhearttherapy.com/podcast/
IG: @headhearttherapy

FB: @woundedhealr and @headhearttherapy

Twitter: @woundedhealr and @HeadHeart_Chi

Chris and Craig in the Fishbowl May 12, 2020

BFTA's two co-conspirators sit down together for a look back at the first year-- the origin story, highlights, points of gratitude, mistakes made, Craig's most poignant/painful moment, the Enneagram, and Chris' desert island albums (no Meat Loaf!)
Back from the Abyss
https://www.craigheacockmd.com

Adventures in Exposure Therapy Apr 28, 2020

In this second of a two part exploration of OCD, Dr. H and Dr. Amy Indermuehle, a Colorado-based OCD expert, deconstruct Erin's treatment. Dr. Amy is a big fan of in vivo exposures, whether that be watching stomach-churning Youtube videos, touching forbidden items at Target, or riding out the anxiety wave in a public bathroom. Dr. Amy highlights how OCD treatment is so different from typical psychotherapy for anxiety and why so many therapists default to the much more comfortable (but counterproductive) option of trying to help patients soothe their nervous systems.
OCD is arguably the most-missed psychiatric diagnosis, for reasons that Dr. H and Dr. Amy explore. OCD is often mistaken for generalized anxiety or for bipolar disorder, with the unceasing obsessions being mislabeled as racing thoughts, and the frantic compulsions as mania.
Dr. Amy Indermuehle
http://facemyanxiety.com
Exposure and response prevention
https://www.theatlantic.com/health/archive/2016/10/exposure-response-prevention-for-ocd/505538/
Meds for OCD
https://iocdf.org/about-ocd/ocd-treatment/meds/
Exposure therapy and OCD-related disorders
http://jonabram.web.unc.edu/files/2012/07/Abramowitz-Jacoby-2014-misuse-of-exposure.pdf
Dr. H and Back from the Abyss
https://www.craigheacockmd.com
On Twitter @bftapod

OCD in the Time of Corona Apr 14, 2020

The postpartum period is by far the most psychiatrically vulnerable time in a woman's life. Erin had always some some mildly annoying obsessive-compulsive tendencies, but they were never a major factor in her life, until just after her daughter was born. Almost immediately she was flooded with horrific violent images and urges, these then morphed into a paralyzing dread of viral contamination.
This is the first of two parts. This episode is Erin's story of learning to lean directly into her fears, the next episode will be Dr. H and Dr. Amy Indermuehle, an OCD expert and Erin's therapist, deconstructing Erin's treatment and how exposure therapy helped her to reclaim her life.
Postpartum OCD
https://iocdf.org/expert-opinions/postpartum-ocd/
https://www.postpartumdepression.org/postpartum-depression/types/ocd/
Exposure and response prevention
https://iocdf.org/about-ocd/ocd-treatment/erp/
Dr. H
https://www.craigheacockmd.com
On Twitter @bftapod

Ketamine therapy update + Listener questions Mar 31, 2020

Listeners ask: "Can I tell my story on Back from the Abyss?"
"Can you heal trauma that you cannot remember?
Dr. H then looks back at 3 years of 800+ ketamine sessions and further explores the question of intramuscular (IM) vs intravenous (IV) treatment, as well as whether reaching full dissociation is necessary for optimal efficacy.
Dissociation improves ketamine response
https://www.psychiatryadvisor.com/home/depression-advisor/ketamine-induced-dissociative-symptoms-predict-antidepressant-response/
Dr. H
https://www.craigheacockmd.com
On Twitter @bftapod

The two loves of her life-- Alcohol, self harm, and the path of recovery Mar 17, 2020

If only swimming or meditation were as good as vodka. Unfortunately, the most powerful and rapid-acting coping strategies also tend to be the most damaging and addictive.
Annie learned this the hard way. After her father's death when she just 9 years old, she eventually found two of the most alluring and effective coping strategies, and they made day to day life possible, even manageable. They worked fantastically well, until they didn't. Annie found healing through 12 step groups and also through DBT (Dialectical Behavior Therapy) and now works as a clinical psychologist, sharing her hard-earned wisdom and relentless hope with others.
Dialectical behavior therapy
https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
Effectiveness of Alcoholics Anonymous vs other modalities
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012880.pub2/full
Dr. H
https://www.craigheacockmd.com

MDMA and the Inner Healer Mar 01, 2020

After a nightmarish sexual assault at age 15, Mitch's life felt over. Wracked by daily dread, panic, and a desperate longing to die, he eventually found his way 22 years later to the MAPS trial of MDMA-assisted psychotherapy for severe PTSD.
In this astonishing account, Mitch describes how MDMA was able to reactivate his innate healing intelligence to allow him to go directly into the hottest fires of his trauma with a powerful shield of openness, safety, self-compassion, and trust. Mitch describes the actual "how" behind MDMA-assisted therapy and why it shows such promise for the future of trauma treatment.
MAPS (Multidisciplinary Association for Psychedelic Studies)
https://maps.org
Dr. H interview on Therapy Chat podcast about working with MDMA
https://baltimoreannapolispsychotherapypodcast.libsyn.com/218-understanding-the-research-on-psychedelics-with-trauma-survivors-with-dr-craig-heacock
BFTA in the top psychedelic podcasts of 2020!!
https://blog.feedspot.com/psychedelic_podcasts/
MDMA and inner healing intelligence
https://maps.org/news/bulletin/articles/383-bulletin-winter-2014/5427-a-conversation-with-mdma-assisted-psychotherapy-researchers-winter-2014
https://maps.org/news/bulletin/articles/435-maps-bulletin-winter-2018-vol-28-no-3/7515-cultivating-inner-growth-the-inner-healing-intelligence-in-mdma-assisted-psychotherapy-winter-2018
Dr. H
https://www.craigheacockmd.com

When a tree falls twice-- OCD, emotional neglect, and resilience Feb 17, 2020

The root system of a tree is its hidden protection against the harsh realities of wind and drought and disease. For people, loving and healthy childhood attachments are our central hidden protection against the inevitable losses and tragedies of life. But what happens when these early attachments aren't safe and secure?
Jami's childhood emotional neglect and abuse and profound loneliness left her attachment roots shallow and damaged, yet her inner fire and natural resilience helped her to grow up strong and healthy despite the childhood challenges. When the winds of loss and grief started to blow, she came toppling down, twice. This led to a long list of failed treatments, benzodiazepine dependence and its horrors, and even a brief course of ECT (electroconvulsive therapy) when seemingly all other options had failed.
And today, she again stands strong and tall, a testament to her refusal to give up and to relationships that have helped to scaffold her and compensate for those early traumas.
Adverse childhood experiences and effects on long-term resilience and risk of chronic illness
https://www.acesconnection.com/blog/got-your-ace-resilience-scores
Major depressive episode vs "nervous breakdown"
https://www.psychologytoday.com/us/blog/how-everyone-became-depressed/201309/bring-back-the-nervous-breakdown
Ketamine vs ECT
https://www.psychiatryadvisor.com/home/topics/mood-disorders/depressive-disorder/short-term-treatments-for-depression-ketamine-vs-ect/
Dr. H
https://www.craigheacockmd.com

Bright and Shiny and Exciting: An Adderall story Jan 31, 2020

Life is much better on Adderall, until it's not.
In this episode, Dr. H and Dan Ronken, a Boulder-based psychotherapist and addiction specialist, explore the double edged sword of stimulants. Using Dan's ADHD and addiction story as a launching point, they explore questions including: Do stimulants make us smarter and more productive? What is the saliency circuit and why is it so relevant here? Are some stimulants safer than others? Can they safely be used by people in active addiction or in recovery? What behavioral strategies are helpful with ADD? Can you ever get that same dopamine rush without drugs? They then transition to the question of whether ketamine therapy is safe for people in recovery.
Dan Ronken
https://www.inclusionrecovery.com
Dan's Youtube channel
https://www.youtube.com/user/danronken
Dr. H
https://www.craigheacockmd.com

Understanding Depression Jan 17, 2020

In this mini-episode Dr. H explores the critical implications of thinking about Depression as a syndrome rather than as a meaningful clinical diagnosis. The diagnosis of Depression is but the first tiny step in the journey of exploring biological, psychological, and interpersonal causes and factors which might then point toward effective treatment.
Dr. H
https://www.craigheacockmd.com

Can you take someone where you haven't gone yourself? Jan 03, 2020

In this second installment of therapists in the abyss, Dr. H sits down with Jungian analyst and master therapist Dr. Michael Daine to explore how facing death catalyzed an exploration of the unconscious and the eventual rebirth both of his career and sense of purpose in the world. This then leads to a discussion of whether one can be a capable and resilient therapist without having successfully passed through periods of darkness and despair.
Dr. Michael Daine
http://www.dainepsychservices.com
Dr. H
https://www.craigheacockmd.com

Therapists in the abyss: Vicarious trauma Dec 20, 2019

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.
A heads up— this story contains a description of a sexual assault.
Dr. H / Back from the Abyss
https://www.craigheacockmd.com

My desert island psych meds Dec 05, 2019

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?
A hint-- they all start with the same letter. And they are all generic. And psychiatry would be greatly hamstrung without them.
Guesses??
Dr. H
https://www.craigheacockmd.com

Healing trauma with psychedelics with Saj Razvi— Part 2 Nov 19, 2019

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.
Saj further develops the idea that while psilocybin may well have major therapeutic potential, it is definitely not a starter psychedelic medicine, but rather one that requires significant psychological preparation and scaffolding in order to harness its power.
Saj Razvi and the Psychedelic Somatic Institute
https://www.psychedelicsomatic.org/
Dr. H
https://www.craigheacockmd.com

Healing trauma with psychedelics with Saj Razvi— Part 1 Nov 05, 2019

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.
The episode starts with some foundational concepts in understanding trauma and its long term effects, then shifts to compare and contrast psychotherapy vs somatic therapies vs psychedelic assisted therapies (cannabis vs ketamine vs MDMA vs psilocybin). Part 1 ends with Saj's life-changing MDMA therapy session and beautifully describes how MDMA might help people break through the dissociative legacy of complex PTSD and attachment trauma.
Saj Razvi and the Psychedelic Somatic Institute
https://www.psychedelicsomatic.org/
Dr. H
https://www.craigheacockmd.com

How to think about anxiety Oct 22, 2019

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.
It matters greatly whether anxiety initially sparks from above or below, and the failure to pinpoint the source can lead to treatment failure and prolonged suffering. Obsessional/ruminative anxiety responds best to mindfulness meditation, cognitive therapy, and SSRIs; somatic/adrenaline anxiety requires interventions such as biofeedback, (intensive) aerobic exercise, meditation, beta blockers, and the various somatic trauma therapies (EMDR, somatic experiencing, Hakomi). Benzodiazepines address both types, but at significant potential cost.
Dr. H
https://www.craigheacockmd.com

The Delta Flight Attendant-- BPD and psychotherapy Oct 06, 2019

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.
A heads up on this episode— Jasmine and Dr. H discuss self-harm/cutting and suicidality in a very frank and perhaps unsettling manner.
BPD overview
https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview
Lifetime course of BPD
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/
Dr. H
https://www.craigheacockmd.com

One phone call changed everything: EMDR Part 2 Sep 22, 2019

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.
This episode is the second in a two part exploration of healing through EMDR.
Links
Complex PTSD and EMDR
https://www.goodtherapy.org/blog/complex-trauma-emdr-can-help-but-its-no-quick-fix-0425165
http://www.coping.us/images/Korn_2009_EMDR_with_PTSD.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904704/
Dr. H
https://www.craigheacockmd.com

When the past haunts the present: An EMDR story Sep 04, 2019

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.
Links
EMDR (Eye movement desensitization and reprocessing)
https://www.emdr.com/what-is-emdr/
https://www.scientificamerican.com/article/emdr-taking-a-closer-look/
Video explaining fight/flight (sympathetic nervous system) vs freeze (parasympathetic nervous system) and their roles in PTSD
https://www.youtube.com/watch?v=q6M1FumqeyM
The parasympathetic (freeze) response is tied to allergic and asthmatic reactions
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039300/
Dr. H
https://www.craigheacockmd.com

Can marijuana be medicine? A psychiatric perspective Aug 21, 2019

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.
Links
MJ and psychosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033190/
MJ as mania trigger
https://www.ncbi.nlm.nih.gov/pubmed/25285897
Adolescents and MJ-- increasing risk of developing psychosis
https://www.ncbi.nlm.nih.gov/pubmed/25774457
https://www.psychiatryadvisor.com/home/topics/addiction/cannabis-use-disorder/cannabis-induced-psychosis-in-teenagers-and-young-adults-risk-factors-detection-management/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931552/
CBD
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
Dr. H
https://www.craigheacockmd.com

Desperately NOT seeking meth: A harm reduction story Aug 07, 2019

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.
His eventual solution wasn't perfect, but it may have saved his life.
Links
Harm reduction
https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-6-35
Marijuana and cognition
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037578/
Suboxone/buprenorphine
https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
https://www.vox.com/science-and-health/2017/7/20/15937896/medication-assisted-treatment-methadone-buprenorphine-naltrexone

Ketamine treatment for depression: Seven questions Jul 24, 2019

This mini-episode explores some of the most frequently asked questions about ketamine:
•What is ketamine?
•How does it work?
•Who responds best to ketamine?
•What is the ketamine experience like?
•What is the best way to do ketamine treatments?
•What are the side effects/risks?
•Who definitely shouldn't do ketamine?
Interview with Dr. H about ketamine on Rural Emergency Medicine podcast
https://www.ruralem.org/2019/03/07/episode-17-ketamine-revisited/
Dr. H and Back from the Abyss
https://www.craigheacockmd.com

A power wash of the brain-- Ketamine, depression, and suicidality Jul 09, 2019

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.
Dr. H interview-- "Recognizing psychosis", on Rural Emergency Med podcast
https://www.ruralem.org/2019/03/31/episode-18-recognizing-psychosis/
Ketamine resources/information
https://www.kriyainstitute.com
Links-- Delaying treatment leads to worsening and more difficult to treat depressive, bipolar, and psychotic illness
https://www.nature.com/articles/mp201233
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608308/
https://eurekalert.org/pub_releases/2018-02/cfaa-oyd022318.php
https://www.nationalelfservice.net/treatment/systems/early-intervention-in-psychosis/outcomes-in-first-episode-manic-psychosis/
https://www.sciencedirect.com/science/article/abs/pii/S0920996412004987
Dr. H and Back from the Abyss
https://www.craigheacockmd.com

Why it's so hard to find (or be) a good therapist Jun 25, 2019

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."
Actually, there are at LEAST 4-5 other crucial mental processes that an effective therapist should be doing more or less simultaneously...and that's no easy task.
This mini-episode explores the hold vs poke dilemma, why this matters so much to anyone who has come to a therapist for meaningful change, and some tangible markers for whether your therapist is up for the challenge of you.
Dr. H
https://www.craigheacockmd.com

One foot in the darkness— A path through treatment resistant depression and eating disorder Jun 24, 2019

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.
Resources on eating disorders
Books
Eating in the Light of the Moon by Anita Johnson
Life without ED by Jenni Schaefer
Sick Enough by Jennifer Gaudani
https://www.nationaleatingdisorders.org
For ketamine resources see episode 1 (Strawberries)
Dr. Craig Heacock is an adolescent/adult psychiatrist and addiction specialist in Colorado. He was a co-therapist in the Phase 3 trial of MDMA-Assisted Psychotherapy for PTSD and has particular interest in the use of ketamine and other psychedelics to treat severe mood disorders and PTSD. He is a graduate of the University of New Mexico School of Medicine and did his psychiatry training at Brown University.
Dr. H
https://www.craigheacockmd.com

Strawberries-- A story of bipolar disorder Jun 17, 2019

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.
Helpful websites on:
Bipolar disorder
https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
Clozapine
https://www.ncbi.nlm.nih.gov/pubmed/25346322
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30081-5/fulltext
https://www.ncbi.nlm.nih.gov/pubmed/7883728
Ketamine
https://www.knowablemagazine.org/article/mind/2019/listening-ketamine
https://www.scientificamerican.com/article/getting-the-inside-dope-on-ketamine-rsquo-s-mysterious-ability-to-rapidly-relieve-depression/
https://www.ncbi.nlm.nih.gov/pubmed/28749092
Dr. H and Back from the Abyss
https://www.craigheacockmd.com
Dr. Craig Heacock is an adolescent/adult psychiatrist and addiction specialist in Colorado. He was a co-therapist in the Phase 3 trial of MDMA-Assisted Psychotherapy for PTSD and has particular interest in the use of ketamine and other psychedelics to treat severe mood disorders and PTSD. He is a graduate of the University of New Mexico School of Medicine and did his psychiatry training at Brown University.

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