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Back from the Abyss: Psychiatry in Stories
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Back from the Abyss: Psychiatry in Stories

Author: Craig Heacock MD

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How do we find a way out of the darkest depths of despair? Psychiatrist Dr. Craig Heacock hosts a deep dive into powerfully moving stories of hope and healing, as well as topical explorations of psychopharmacology, psychotherapy, and psychedelics.

113 Episodes
Fishbowl 5

Fishbowl 5


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 Dr. H
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. We 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…...
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 CarrA Psychiatrist Returns from War-- on Substackht...
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 Me...
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.&nb...
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 on IG @backfromtheabysspodcast Dr. Hhttps://www.craigheacock...
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/respe...
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 rep...
Psychiatry in the ER

Psychiatry in the ER


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
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 mis...
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 tak...
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 on IG @backfromtheaby...
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 t...
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 Dr. H
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 experi...
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 Projecthttps:/...
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 on Instagram. @backfromtheabysspodcast Dr. H
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 ...
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!
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 Dr. H
Comments (2)

Rebecca Boyd

Wow, thank you for sharing your experience strength and hope. I struggled with drugs and alcohol but I relate to 95 % of what you shared. Thank you so much

Jan 1st

Leah Marie

I am so excited to listen to these!

Oct 6th