How to think about anxiety
Back from the Abyss: Psychiatry in Stories | Psychotherapy, Trauma, and Psychedelics
10/23/19
•7m
About
Comments
Featured In
Anxiety and pain are the primary drivers of medical visits, as well as two of the more complicated symptoms to break down in a meaningful way. In this mini-episode, Dr. H presents the metaphor of "below the neck" vs "above the neck" anxiety to help us think about anxiety in a way that might better guide diagnosis and treatment. "Above the neck" anxiety emanates from the ruminating/imagining/obsessing/spin-cycle brain, while "below the neck" anxiety is the body's fight/flight response, with adrenaline coursing through the body to send the blaring smoke alarm signal of impending danger...even where there is no apparent immediate threat.
It matters greatly whether anxiety initially sparks from above or below, and the failure to pinpoint the source can lead to treatment failure and prolonged suffering. Obsessional/ruminative anxiety responds best to mindfulness meditation, cognitive therapy, and SSRIs; somatic/adrenaline anxiety requires interventions such as biofeedback, (intensive) aerobic exercise, meditation, beta blockers, and the various somatic trauma therapies (EMDR, somatic experiencing, Hakomi). Benzodiazepines address both types, but at significant potential cost.
Dr. H
https://www.craigheacockmd.com
Previous Episode
In psychotherapy, it’s the relationship itself that heals. In this episode of BFTA, Dr. H and his patient Jasmine explore their always complicated, often humorous, and at times very painful journey through the minefield of borderline personality disorder.
A heads up on this episode— Jasmine and Dr. H discuss self-harm/cutting and suicidality in a very frank and perhaps unsettling manner.
BPD overview
https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview
Lifetime course of BPD
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/
Dr. H
https://www.craigheacockmd.com
Next Episode
Healing trauma with psychedelics with Saj Razvi— Part 1
November 5, 2019
•65m
This is the first of a two part very special interview with Saj Razvi, the Director of Education at Innate Path in Denver, CO. Saj weaves together his three fascinating perspectives— that of a nationally recognized trauma expert, his own personal story of early childhood neglect and how this shaped everything else to come, and finally his long journey of healing the deepest wound a person can have, eventually coming to MDMA and then psilocybin at the latter part of his therapy journey.
The episode starts with some foundational concepts in understanding trauma and its long term effects, then shifts to compare and contrast psychotherapy vs somatic therapies vs psychedelic assisted therapies (cannabis vs ketamine vs MDMA vs psilocybin). Part 1 ends with Saj's life-changing MDMA therapy session and beautifully describes how MDMA might help people break through the dissociative legacy of complex PTSD and attachment trauma.
Saj Razvi and the Psychedelic Somatic Institute
https://www.psychedelicsomatic.org/
Dr. H
https://www.craigheacockmd.com
If you like this episode you’ll love
Promoted