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

Are GLP-1s the best thing to come along in psychiatry in years…. or are they going to turn out to have a dark side,  by triggering eating disorders, causing undernutrition, and narrowing what’s an acceptable body type? Dr. H sits down with nationally known eating disorder specialist and the author of Sick Enough, Dr. Jennifer Gaudiani, to explore both the hopeful upside of these meds as well as their hidden risks.

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Dr. Jennifer Gaudiani

https://www.gaudianiclinic.com/#welcome2

Elemental Psychedelics

https://www.elementalpsychedelics.com/<...

Dr. H sits down with psychotherapist and Enneagram expert Joy Gribble (Reflective Healing; Elemental Psychedelics) to explore the fascinating nexus between psychedelic-assisted therapy and the Enneagram.

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Joy Gribble

https://www.reflectivehealing.com/about-joy-gribble-fort-collins

Elemental Psychedelics

https://www.elementalpsychedelics.com/

Explore every episode through themes, domains, formats, and speakers.
The BFTA CODEX is a listener-built and curated field guide to the podcast.
https://bfta-codex.org

BFTA episode recommendations/Podcast page

https://www.craigheacockmd.com/podcast-page/

This is the story of Milena, starting with her early years in a Bulgarian orphanage, then the hope and promise of being adopted by an American family, and finally the emerging and increasingly ominous consequences of early attachment trauma and institutionalization. Adoption is complicated and multi-layered….and the unforeseen consequences of adoption can play out over a lifetime.  Milena thought she had won the golden ticket out of the orphanage and into a new life in America, but after the initial honeymoon period, the deeper reality of what it means to spend the first 5 years of life in an ins...

In this season 8 opener Rosy shares both her experience recovering from bipolar disorder and the heartbreak of watching her beloved son begin to show signs of an even more extreme form of bipolar disorder called schizoaffective disorder. This is a story in parallel, two lives deeply intertwined, yet also slowly tearing apart as her son’s illness became increasingly severe.

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Elemental Psychedelics

https://www.elementalpsychedelics.com/

Explore every episode through themes, domains, formats, and speakers.
The BFTA CODEX is a listener-built and curated field gu...

In this second of two parts, Laura Mae Northrup shares stories of how she found a healing path through connection, therapy, and psychedelics. 

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Laura Mae Northrup

https://www.lauramaenorthrup.com/

Elemental Psychedelics

https://www.elementalpsychedelics.com/

Explore every episode through themes, domains, formats, and speakers.
The BFTA CODEX is a listener-built and curated field guide to the podcast.
https://bfta-codex.org

BFTA episode recommendations/Podcast page

https://www.craigheacockmd.com/podcast-page/

BFTA on IG @backfromtheabysspodcast
h...

This is the first of a two part summer special with Laura Mae Northrup, who was first featured in the original BFTA summer special back in 2022. In this first episode, in an excerpt from her wonderful podcast called Inside Eyes, we hear Laura describe her long and grueling battle with suicidality, which emerged as a result of childhood sexual abuse. In the second episode in two weeks, Laura and Dr. H dive deep into her personal healing journey— what worked, what didn’t, and how she was able to finally put her chronic suicidality to rest. 

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After seven years and so many powerful stories, Craig announces a tectonic shift in the BFTA plates.

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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 transference and countertransference with Dr. H and Dr. Hillary McBride, June 18-20 2026 in Vancouver/Chilliwack BC

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 journey through traditional psychotherapy and eventual MDMA-assisted therapy as she tries to find a way to calm her...

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?'

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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/

"I Love You, I...

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 sleep deprivation or in her postpartum periods. But it took an increasingly severe weed habit to bring her to the horrors of ma...

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 something called Donna’s Law— a program where people can volunta...

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.

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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 Ft Collins

https://www.craigheacockmd.com/bringing-therapy-into-med-management/

"I Love You, I Hat...

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.

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https://www.buzzsprout.com/396871/support

Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3...

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.

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https://www.buzzsprout.com/396871/support

Kate Gibson (The Coleman Institute)

[email protected]; [email protected]

B...

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.

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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, formats, and speakers.

The BFTA CODEX is a listener-built and curated field guide to every episode.

https://b...

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 psychiatric stability?

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https://www.buzzsprout.com/396871...

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 parts of the basal ganglia of the brain had exterior cell proteins which were very similar to those of the strep bacteria, and as the imm...

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. 

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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 expe...

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 then talk shop about DID and Jade challenges some of Dr. H's long held beliefs.

Jade Miller

htt...

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 and structure and patience and compassion adequately compensate for profound early ch...

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 her when her body carried out its ultimate rebellion in the context of havi...

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 1 disorder, formerly known as manic-depression. Both tried all the meds, did all the things, then eventually re...

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 the autistic spectrum are so often masters of masking, which means imit...

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 others…with the guidance of his two devoted therapists and the assi...

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.

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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-are-you-my-mom/

BFTA episode recommendations/Podcast page

https://www.craigheacockmd.com/podcast-page/

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/

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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.craigheacockmd.com/podcast-page/

"I Love You, I Hate You, Are You My Mom?"  An intensive ex...

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. 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.in...

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 story that looks at the question of whether people need meds for life….and it turns out, surprise surprise, that what’s causi...

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 for you to hear this.

Koelle Simpson

https://koellesimpson.com/

<...

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.craigheacockmd.com/podcast-page/

Support the show

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-you-i-hate-you-are-you-my-mom/

"Bringing Therapy i...

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/

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

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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 based psychologist and OCD expert, who then took over the exposure therapy. "A...

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, by Daniel’s chronic and worsening depression, by Mindy’s frustration and anger and shame. Teetering on the edge, they decide...

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, including a hierarchy of safety in terms of potential med interactions.

"I Love You, I...

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 session was THC— Saj has spoken extensively in past BFTA episodes why he considers vaped THC a particularly potent...

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.instagram.com/backfromtheabysspodcast/

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

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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 survived, how she coped,  and how this helps her to help others.


BFTA on IG @backfromtheabysspodcast
https://ww...

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