Back from the Abyss: Psychiatry in Stories

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 voluntarily be put on a no-sell list during times of psychological crisis or instability.  Donna’s Law is named after Donna Nathan, who impulsively bought a handgun in 2018 in New Orleans and shot herself during a period of psychiatric crisis.  There were no barriers in place, no waiting period or no-sell list...Donna found easy access to means and paid the ultimate price.We first hear the voice of Katrina Brees, Donna’s daughter. Katrina tells us more about who Donna was, how she lived and how she died. After we hear from Katrina, Dr. H leads a discussion with two prominent Colorado voices for both Donna’s law in particular and suicide prevention in general— Dr. Dave Iverson is a Denver-based psychiatrist, a board member of Colorado Ceasefire, and lifelong advocate for society’s most vulnerable folks, including those on the streets or in the justice system… also Ginny Mack joins the conversation, she is a Ft Collins-based psychiatric nurse practitioner, a Navy Veteran, and a longtime advocate for suicide prevention efforts on the state and local level. Support the show! https://www.buzzsprout.com/396871/supportDonna's Law for Suicide Preventionhttps://www.donnaslaw.com/Donna's Law for Coloradohttps://www.donnaslawforco.com/Colorado listeners who would like to get involved in the awareness campaign for Donna's Law, please email:donnaslawforco@gmail.comGolden Gate suicide studyhttps://www.goldengate.org/assets/1/6/suicide-deterrent-seiden-study.pdfBringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://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 BChttps://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/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.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

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/supportDarci Meyershttp://www.darcimeyers.com/Bringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://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 BChttps://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/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.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

Carrie, an adopted nurse practitioner who reconnected with her birth mother, shares a healing journey from childhood sexual trauma. She talks about reunification, somatic therapy and body mapping, ketamine and MDMA-assisted sessions, and confronting family truth. Short, moving moments highlight embodiment, shame, and rebuilding self-compassion.

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/supportKate Gibson (The Coleman Institute)Kate@thecolemaninstitute.com; Kate.gibson.dnp@gmail.comBringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://www.craigheacockmd.com/bringing-therapy-into-med-management/BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/Explore the podcast through themes, domains, formats, and speakers.The BFTA CODEX is a listener-built and curated field guide to every episode.https://bfta-codex.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

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/supportBringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://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://bfta-codex.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

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?Support the show! https://www.buzzsprout.com/396871/supportDr. Elizabeth Fenstermacherhttps://som.cuanschutz.edu/Profiles/Faculty/Profile/33013Patient selection for TMS- Case report with Dr. Fenstermacherhttps://journals.lww.com/hrpjournal/fulltext/2025/11000/case_report__personalizing_transcranial_magnetic.3.aspxBringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://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 BCExplore the podcast through themes, domains, formats, and speakers.The BFTA CODEX is a listener-built and curated field guide to every episode.https://bfta-codex.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

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 immune system began to attack the strep bacteria, it also began an autoimmune assault on parts of the midbrain, including the basal ganglia, thus producing a sudden onset of OCD or tics.In recent years PANDAS has evolved into a broader concept called PANS— pediatric acute onset neuropsychiatric syndrome— which includes a vast array of neurological and psychiatric symptoms and syndromes that can potentially be triggered by autoimmune reactions. It can be tricky to diagnose PANS….this is probably why it is still a somewhat controversial diagnosis in some arenas. We don’t have a clear and consistent set of labs or biomarkers to positively determine PANS, and because the syndrome is so broad in how it can present, clinicians struggle to come up with a modal or average presentation that they can put in their pattern recognition systems. One feature that seems fairly classic for PANS is that the symptoms tend to increase during and/or right after a concomitant infectious illness, presumably because the immune system activation is reigniting the autoimmune attack on the central nervous system.Today’s story features a mom, Kari, and her daughter, Zoe. Zoe had lots of illness and immune system issues as a young child, first fatigue and then GI symptoms, then profound mood instability, and then she eventually developed horrific treatment resistant anorexia which did not respond to the best treatments psychiatry had to offer.Support the show! https://www.buzzsprout.com/396871/supportExplore the podcast through themes, domains, formats, and speakers.The BFTA CODEX is a listener-built and curated field guide to every episode.https://bfta-codex.org"I Love You, I Hate You, Are You My Mom?"  An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, June 18-20 2026 in Vancouver BChttps://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/BFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

Discover how therapy can break free from the confines of past narratives. Dr. H presents ten probing questions that invite patients to engage with their current feelings and interactions. Topics include the challenges of building trust, exploring fears about the therapeutic relationship, and addressing unresolved issues. The discussion highlights the importance of acknowledging emotions like regret and judgment in real-time. Dive into the dynamics of transference and learn how these questions can transform therapy into a more immediate experience.

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 Millerhttps://payhip.com/peersupportformultiplesSupport the show! https://www.buzzsprout.com/396871/supportExplore the podcast through themes, domains, formats, and speakers.The BFTA CODEX is a listener-built and curated field guide to every episode.https://bfta-codex.org"I Love You, I Hate You, Are You My Mom?"  An intensive experiential workshop exploring transference with Dr. H and Dr. Hillary McBride, June 18-20 2026 in Vancouver BChttps://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/BFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show

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 childhood neglect and abuse?  Frank’s story is just one example, but it’s a beautiful one, these two dads trying to find a way to heal deep attachment wounds without a roadmap. Support the show! https://www.buzzsprout.com/396871/supportBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/Support the show