Back from the Abyss: Psychiatry in Stories | Psychotherapy, Trauma, and Psychedelics

After seven years and so many powerful stories, Craig announces a tectonic shift in the BFTA plates. Support the show! https://www.buzzsprout.com/396871/support Closing song-- "Come and go" by Timber Choir Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collins https://www.craigheacockmd.com/bringing-therapy-into-med-management/ "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transferenc...

Published: 15 May 2026

Amidst a long catalog of previous BFTA stories featuring complex or developmental PTSD, today’s story is one of classic DSM-style PTSD, it’s a story of both medical and parenting trauma, of facing the fear of annihilation and death. In this three part story, first we hear Tracy tell of the increasingly severe medical challenges of her children, then Tracy flashes back to describe her own terrifying emergency hospitalization as a 5 year old, then finally we trace Tracy’s treatment ...

Transcribed - Published: 1 May 2026

In this solo episode Dr. H shares his thoughts on the unexpected risks of feeling too much positive energy and/or identification with a patient. This talk is also a sneak preview into the workshop that Dr. H teaches with Dr. Hillary McBride called "I Love You I Hate You...Are You My Mom?' Support the show! https://www.buzzsprout.com/396871/support Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collins https://www.craigheacoc...

Transcribed - Published: 17 April 2026

Today’s story is one of genetic predisposition, environmental triggers, and finally a psychiatric flame thrower. Whitney’s uncle had a particularly severe form of bipolar disorder and she too began to develop mood instability and depression as an adolescent. When we think of environmental triggers for mania, we tend to think of sleep deprivation, substances, and the postpartum period. And through her 20s and 30s, Whitney began to have more serious bouts of hypomania during times of slee...

Transcribed - Published: 3 April 2026

The US has a major suicide problem, around 50,000 people every year, and 60% of these suicides are gun suicides. The number one risk factor for completed suicide is not depression or anxiety or addiction….it’s access to means, and it turns out that it’s actually not that easy to impulsively kill yourself, unless you have ready access to a gun. We are finally starting to talk about ways to keep guns out of the hands of potentially suicidal people, and a concrete step in that direction is...

Transcribed - Published: 20 March 2026

Today’s story explores how we love, how we grieve, and how we eventually find some sort of equilibrium thereafter. This episode is a heartbreaking, yet beautiful story by Colorado-based somatic therapist Darci Meyers about her journey through multiple losses, grief, and ongoing recovery. Support the show! https://www.buzzsprout.com/396871/support Darci Meyers http://www.darcimeyers.com/ Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in ...

Transcribed - Published: 6 March 2026

Kari reconnected with her birth mother in her 40s and finally began to understand the suffering for which she had no words. This is a story of adoption and reunification, of forgetting and remembering, of finding a truth without words in the wisdom of the body. Kari’s birth mother was able to see something deep in Kari that she had never had words for….and thus began her path toward healing. Support the show! https://www.buzzsprout.com/396871/support Bringing Therapy into Med Mana...

Transcribed - Published: 20 February 2026

Kate started her addiction journey at a young age, using substances as a salve for her terrible grief. Later, drugs and alcohol helped her to cope with the transition to nursing and the unending demands of a hospital setting. But as with all addicts, this strategy worked until it didn’t….Kate eventually had to find a new way to cope if she was going to survive past her 30s. Support the show! https://www.buzzsprout.com/396871/support Kate Gibson (The Coleman Institute) Kate@thecole...

Transcribed - Published: 6 February 2026

Dr. H dives deep into a patient's scary, confusing, and ill-advised list of psych meds to illustrate some deeper truths and lessons about psychopharmacology and the med management model of psychiatry. Support the show! https://www.buzzsprout.com/396871/support Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collins https://www.craigheacockmd.com/bringing-therapy-into-med-management/ Explore the podcast through themes, domains, form...

Transcribed - Published: 23 January 2026

Dr. H sits down with Dr. Elizabeth Fenstermacher, Medical Director of the TMS Clinic at the University of Colorado- Anschutz to explore the growing role of TMS and neuromodulation in psychiatry. They explore questions such as: •How should we think about TMS vs ketamine in the treatment of depression? Trauma? OCD? •Who are the best candidates for TMS? •What are the relative merits of intensive TMS (SAINT) vs standard protocols? •How might TMS and ketamine work together to promote p...

Transcribed - Published: 9 January 2026

There is a growing awareness in psychiatry that not all psychiatric illness is psychiatric— some percentage of what presents in psychiatric settings is actually triggered by autoimmune responses to various pathogens and insults. In the late '90s a syndrome called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with strep) came on the scene with cases of sudden onset OCD and tics that appeared in conjunction with strep infections. The theory behind PANDAS was that part...

Transcribed - Published: 26 December 2025

Psychotherapy can often get stuck in a there and then storytelling mode....how do we shift the therapeutic encounter into the immediacy of the Here and Now? Here Dr. H shares 10 questions which shine a spotlight on what's happening (and not happening!) between therapist and patient. Support the show! https://www.buzzsprout.com/396871/support Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collins https://www.craigheacoc...

Transcribed - Published: 12 December 2025

Dr. H sits down with Jade Miller, a peer support specialist and advocate for public education about DID (Dissociative Identity Disorder). In the first part of this episode, Jade shares her story and how she came to understand that the puzzling gaps and often frightening incongruities in her life were caused by her rotating through a number of dissociated identities or alters, initially protecting her… but eventually leaving her powerless to stop repeated traumatization. Jade and Dr. H t...

Transcribed - Published: 28 November 2025

BFTA storyteller Frank shares the joy, confusion, chaos, utter fear, and deepest gratitude when he and his partner Brad adopted and raised two boys, ages 4 and 2, from the foster care system. Twenty years ago, when Frank adopted the boys, trauma was not in the public awareness as it is today, and he was told that these little boys, who had spent some time in a meth house, might well have some challenges…..but he never could have expected what awaited. Can love overcome trauma? Can stability a...

Transcribed - Published: 14 November 2025

Rachael, a trauma therapist and today's storyteller, describes how her early childhood abuse was buried by the protective mechanism of dissociative amnesia. As Rachael wrote to Dr. H, “The only way I could continue to live, with no way out, with no one to tell, with no words even to describe what was happening to me, was to forget what was happening to me….when our minds forget, our bodies remember.” Rachael saved herself by forgetting, then was forced to finally face what happened to h...

Transcribed - Published: 31 October 2025

This story is a mirror to Elizabeth’s story from season 1 episode 1. Today’s storyteller Sarah was so moved by Elizabeth’s story that it helped her to trust Dr. H's recommendation to take a pretty scary medication, the extremely powerful antipsychotic and mood stabilizer called clozapine. So why tell this story again? As they say, history doesn’t repeat itself, but it does often rhyme, and Sarah’s story rhymes beautifully with Elizabeth’s. Both had severe and treatment resistant bipolar...

Transcribed - Published: 17 October 2025

In today’s story we explore what it’s like to be on the autistic spectrum, and more specifically, how a later life diagnosis can totally change the way you view the world and yourself. Aurelie, our storyteller today, was an autism expert, a clinical psychologist who had trained with some of the premier autism experts in the country…yet she didn’t discover her own autism until she was 40 years old. This episode explores why women on the spectrum are so often missed, how women on th...

Transcribed - Published: 3 October 2025

How do you rebuild trust amidst the ashes of trauma? This is the story of Sean, an up and coming star tennis player whose coach carefully selected him and then groomed him for years of sexual assault. His trust destroyed, Sean had to find a way to try to trust again…..and after many years of hiding and pretending and near self-destruction, Sean finally was able to share the details of what happened to him. Thus began his therapeutic journey of finding compassion for himself and trust toward o...

Transcribed - Published: 19 September 2025

In this fourth annual summer psychedelic special, Dr. H sits down to hear some hard-earned wisdom from a therapist colleague who has been doing underground MDMA and psilocybin work for years. Support the show! https://www.buzzsprout.com/396871/support "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, Feb 4th-6th 2026 in Joshua Tree, CA https://www.craigheacockmd.com/i-love-you-i-hate-you-ar...

Transcribed - Published: 14 August 2025

Chris and Craig invite Antonio Sacre, an LA-based professional storyteller, author, and BFTA super-advisor into the Fishbowl to deconstruct season 6. BFTA episode recommendations/Podcast page https://www.craigheacockmd.com/podcast-page/ "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, Feb 4th-6th 2026 in Joshua Tree, CA https://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/ Suppo...

Transcribed - Published: 6 June 2025

Craig sits down with his mentee and colleague Mandy Bliss, a psychiatric NP in Louisville KY, to explore the compelling and complex challenges of meeting the ever-expanding need for psychiatric care. Unlike in psychiatric residencies, much of the current training of psychiatric NPs is done online. Does this constitute adequate training? And what of psychotherapy? Mandy Bliss MSN, APRN, FNP-BC, PMHNP-BC https://blisspsych.com/ BFTA episode recommendations/Podcast page https://www.craig...

Transcribed - Published: 23 May 2025

Craig sits down with Colorado-based psychotherapist and Enneagram expert Joy Gribble (Elemental Psychedelics; Reflective Healing) to explore how the Enneagram can predict the strengths, fears, and blind spots of both the therapist and the client/patient in the complex dynamics of therapy. Joy Gribble https://www.reflectivehealing.com/about-joy-gribble-fort-collins "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr....

Transcribed - Published: 9 May 2025

Here Dr. H sits down with Lisa, a pediatric nurse practitioner, to witness her story of developmental trauma, concomitant chronic depression, and eventually her path of healing and rebuilding trust and connection, largely through psychotherapy. During her years of intermittently crippling and suicidal depression, she was put on various psych meds, which might have helped at the time, but later became shockingly difficult to try to taper and stop. This is a story of overcoming shame, a s...

Transcribed - Published: 25 April 2025

Craig sits down with Colorado-based equine and somatic therapist Koelle Simpson to witness her harrowing and moving story of healing from repeated sexual assaults through a deep psychospiritual connection with horses, then learning how to trust her male psychotherapist, and finally coming to face the darkness and shame head on through the use of psilocybin mushrooms. A heads up-- this episode contains graphic descriptions of sexual assault, please be mindful of whether this is the right time ...

Transcribed - Published: 11 April 2025

Dr. H breaks down the complex task of deprescribing into six clear steps, starting with the most important and challenging question of all: Who is the patient and why are they suffering? "Bringing Therapy into Med Management"-- a psychotherapy training intensive with Dr. H for psych NPs and PAs this October in Ft Collins https://www.craigheacockmd.com/training/ BFTA on IG @backfromtheabysspodcast https://www.instagram.com/backfromtheabysspodcast/ BFTA/ Dr. H https://www.craigh...

Transcribed - Published: 28 March 2025

This is an interview that Dr. H recently did on a podcast called "The Web: Weaving Psychology and Soul in Circle" where he goes deep into his own journey learning how to work with transference and countertransference. Carrie Haynes and "The Web" https://carriehayneslpc.com/ "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, Feb 4th-6th 2026 in Joshua Tree, CA https://www.craigheacockmd.com/i-love-yo...

Transcribed - Published: 14 March 2025

Dr. H sits down with Dr. Neill Epperson, chair of the University of Colorado Department of Psychiatry, to talk all things hormonal. "I Love You, I Hate You, Are You My Mom?" A intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, May 28-30 in Victoria BC https://www.eventbrite.com/e/i-love-you-i-hate-you-are-you-my-mom-tickets-1112117516429?aff=ebdssbdestsearch BFTA on IG @backfromtheabysspodcast https://www.instagram.com/backfromtheabysspodcast/ ...

Transcribed - Published: 28 February 2025

This is a re-release of an episode called "Adventures in Exposure Therapy" which first published in 2020. That episode was the second of a two part exploration of OCD, the first episode was called "OCD in the Time of Corona." In brief, "OCD in the Time of Corona" was the story of Dr. H's patient Erin, who suffered from disabling OCD that focused on a catastrophizing fear of cold sores and the herpes virus. Dr. H initially treated Erin, then referred her to Dr. Amy Indermuehle, a CO base...

Transcribed - Published: 14 February 2025

Today’s story is the story of so many marriages— starting off with hope and excitement, then settling into careers and kids and unforeseen challenges, then facing emerging disenchantment and mounting frustrations, then maybe even reaching a breaking point, where the marriage seems unable to withstand all the stuff life is throwing in its path. For Daniel and Mindy, their initial years of love and hope and adventure were slowly buried by layers of physical and emotional pain...

Transcribed - Published: 31 January 2025

One of the more interesting and difficult challenges of integrating psychedelics into psychiatry is how to deal with the fact that so many of the folks who will seek out care for their treatment-resistant depression or OCD or body dysmorphia or PTSD or attachment trauma are on psychiatric meds, many of which can have very significant and even dangerous interactions with certain psychedelics. Here Dr. H explores some of the key issues around med tapering with ketamine, psilocybin, and MDMA, i...

Transcribed - Published: 17 January 2025

Saj Razvi and Hillary McBride return to BFTA, this time together, for one of the most compelling and fascinating episodes we have featured on the podcast-- an in depth, in the room exploration of the moment to moment unfolding of a psychedelic-assisted trauma session. During her training to work with Saj’’s psychedelic somatic model, called PSIP, Hillary did a profound session with Saj that led to some very unexpected gifts for Hillary. Interestingly, the psychedelic used for this sessi...

Transcribed - Published: 3 January 2025

In this solo episode, Craig synthesizes the most salient aspects of identifying and treating OCD, with some cool musical interludes to boot-- in just over 20 minutes! "I Love You, I Hate You, Are You My Mom?" A intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, May 28-30 in Victoria BC https://www.eventbrite.com/e/i-love-you-i-hate-you-are-you-my-mom-tickets-1112117516429?aff=ebdssbdestsearch BFTA on IG @backfromtheabysspodcast https://www.insta...

Transcribed - Published: 20 December 2024

You don't end up working in psychiatry/mental health by accident-- therapists and psychiatrists almost always come from their own place of emotional pain. Here Dr. H sits down with his colleague Kristen, a well-respected Colorado psychotherapist who always appeared to have it all together, while battling her own inner demons of feeling like a fraud-- broken, unworthy, irredeemable. This is Kristen's story of finding a way through her double life, of coming to peace with what she survive...

Transcribed - Published: 6 December 2024

In this solo episode Dr. H shares his current thoughts on working in the here and now; polypharmacy; the root causes of suicidality; diagnostic parsimony ; ketamine microdosing; and online psych NP training programs. BFTA on IG @backfromtheabysspodcast https://www.instagram.com/backfromtheabysspodcast/ BFTA/ Dr. H https://www.craigheacockmd.com/podcast-page/ Support the show

Transcribed - Published: 22 November 2024

Kate lived for many years in a hazy and numbing dialectic, thinking that her life was “perfect”, but also having a vague and gnawing sense that just under the surface something was terribly wrong. This is a story of forgetting and remembering, a story of finding a therapist who was willing and able to sit through years of hateful negative transference and let Kate work through her parent-child wounds. And finally this is a story of MDMA and psilocybin helping someone move forward ...

Transcribed - Published: 8 November 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...

Transcribed - Published: 25 October 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:...

Transcribed - Published: 11 October 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. "I Love You, I Hate You, Are You My Mom?" An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, Feb 4th-6th 2026 in Joshua Tree, CA https://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/ BFTA on IG @backfromtheabysspodcast https://www.i...

Transcribed - Published: 27 September 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 the...

Transcribed - Published: 5 July 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/ Support the show

Transcribed - Published: 31 May 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 dee...

Transcribed - Published: 16 May 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 Substac...

Transcribed - Published: 3 May 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 ...

Transcribed - Published: 19 April 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.&...

Transcribed - Published: 5 April 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.cra...

Transcribed - Published: 22 March 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...

Transcribed - Published: 8 March 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 rep...

Transcribed - Published: 23 February 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...

Transcribed - Published: 9 February 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 mi...

Transcribed - Published: 26 January 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 tak...

Transcribed - Published: 12 January 2024