Welcome to Back from the Abyss. I'm Dr. Craig Hecock. Why don't some patients get better?

In my psychiatry residency, we were told that if patients didn't improve, you might have the wrong diagnosis,

or there could be a comorbid medical problem, or possibly substance abuse, or the patient

isn't following the treatment plan, or the patient has a self-destructive personality disorder,

such as borderline personality disorder. But back in the early odds, not that long ago really, what we

didn't discuss in my training was the role of early childhood trauma and neglect in our treatment

failures. It's relatively easy to assess for what has happened to someone.

It's a much more difficult process to assess what was missing.

Because it turns out that some of the most important questions in a psychiatric avow involve those first few years of life, when verbal narrative memories are hazy at best.

And these are questions like,

were you left alone for extended periods of time as a baby?

Were you cared for and loved as an infant and as a young child?

Were you wanted?

What did your first three or four years look like?

How were you soothed?

Did you feel safe? In today's story, we hear Randy describe

how he initially found sobriety, community, and healing at Alcoholics Anonymous. But as the years of

sobriety ticked by, he increasingly realized that the treatment, which was apparently working for

all his other AA friends, was not working for him. His deepest detachment circuits seemed to be faulty. He

couldn't connect and trust and love the way that others seemingly could, and he became

increasingly lonely and isolated, hopeless.

It took medicine work with ayahuasca and then with psilocybin, for him to begin to uncover how the death of his little brother and the subsequent family numbing and shutdown led to

...