Latest / Radically Genuine / 99. At the Crossroads of Psychiatry, Psychedelics and Spirituality w/ Dr. Craig Heacock
Transcript
- Welcome to the Radically Genuine Podcast. I'm Dr. Roger McPhil and I want to thank all our loyal listeners recently for five star ratings. And if you can subscribe to it makes things a lot easier for us. You can get the podcast, you know, right to your app every morning Thursday morning when we release this. But we really do appreciate the five star ratings. If you can take a second right now, just click five stars that really helps us get the message out. Also we have a YouTube channel now. Many people probably are not yet aware unless you were following us on Twitter and the whole censorship stuff and Joe Rogan, but at radically genuine, you can go to our YouTube channel, you'll find clips from our podcast, but also we're going to be creating a lot of informational videos. I'm also have a free weekly newsletter on sub stack dr mcphillan.substack.org.com? I forget. Substack Dr. McPhillan, Radically Genuine. Links in the show summary. click on the link. Yeah. Sean, good to have you back on the podcast. Really interesting guest today before we get into introductions. You know, he actually before we got started, he considered this to be an anti psychiatry podcast. And I'm going to correct him on that. I'm not anti psychiatry. I am pro science, pro ethics, pro informed consent, and really fascinated and interested in having in depth conversations when it comes to the health and wellbeing of people who are really struggling. I believe the guest we have today has the background, the experience, and he's outside the mainstream enough to get into some, I think, fascinating discussions that are not typical to people who are receiving psychiatric treatment. But I'll be honest, I have a love-hate relationship with his podcast. I like his podcast. You know, there'll be moments like, he gets it, this is fascinating. And he's got areas of expertise that I don't have. So I'm trying to learn from him in areas around like psychedelics and so forth. And he speaks towards spirituality and he's got this open mind. He brings an interesting guest and then I'll listen to another podcast. I'm like, this just sounds like the same old stuff. So I can't wait to get into some of the questions about that. He kind of sounds like he's confused sometimes. He's all over the place. So, but we can get into some of those conversations. I wanna welcome Dr. Craig Heacock. to the podcast, he's an adolescent, adult, and addiction psychiatrist in Fort Collins, Colorado, where he also hosts and produces a psychiatric storytelling podcast called Back from Abyss. I do highly recommend this podcast. He has a special interest in the use of ketamine and psychedelics to treat mood disorders and PTSD. And he was also a co-therapist in the MAPS Phase III MDMA trial. So this is just an area. that we're going to start venturing into on the podcast from an educational perspective and with an open mind. He is a graduate of the University of New Mexico School of Medicine. He did psychiatry training at Brown University. We are bringing in physicians, psychiatrists onto this podcast because we all benefit from having healthy debate. We benefit from being able to examine the nuance and try to inform people who are in the mental health system who are struggling, who are trying to improve their life and wellbeing. We all benefit from healthy debate and discussion. And I am certainly against any times we push people to the extremes. That's why I'm not anti-psychiatry. Dr. Craig Hickok, Craig: Thank you. Sean: welcome to the Radically Genuine Podcast. Craig: Oh, that was a really sweet intro. And, um, yeah, I'm really excited to be here. I have to admit I've been a little nervous this week, but our little talk before we started recording, I feel better now. Thank Sean: Good. I think sometimes Craig: you. Sean: that people have a misunderstanding of what my purpose is and what my goal is because I can be so outspoken. I often get that initial reaction. But as I said, I'm hoping for really nuanced reasonable discussion today. We can ask difficult questions. We can say where we don't know because I think both of us are certainly, as you said, coming on here, we're on the same team and we care about people and that's what we're trying to do. We're trying to improve the lives of others. But you You reached out to me. So let me just start with that. I was interested in what motivated you to come on the Radically Genuine Podcast. And then if you can just tell my listening audience a little bit about you and your background. Craig: Well, I guess I first became aware of some of the critiques and commentary on psychiatry through Will Hall, who was on Psychedelics Today. I think three years ago they did a two-part interview with him. And he laid out a whole bunch of critiques about psychiatry, which got me sort of riled up. But I also thought, you know, I agree with some of this. So since then, I've started just kind of keeping my eye on, you know, what are people saying about psychiatry? Because it's... I've devoted my life to it and I believe in it. And I also believe it has a ton of flaws and problems and we're struggling through the muck for sure. But in my experience, most of the psychiatry critics are not mental health experts. And then I stumbled upon your podcast and I thought, this guy is smart, he's well-spoken, he's a psychologist. And as I told you before we started recording, I have to admit I have a huge bias towards psychologists. I actually love some of my best, most favorite people are psychologists. So I liked you already from that. But then when I listened to a couple of your episodes, I thought, I really want to talk to him. I don't want to argue or yell or debate or win. Or, you know, I want to just sit down and have a conversation because I think, I think there's so many things that we agree on. I think there's things we don't agree on. And that might be really interesting for people to hear today. Not that, you know, I'm going to convince you or you're going to convince me, but just that there can be two well-educated professionals on the mental health field who... maybe don't agree on all the tactics, but that we can talk about it and we can have a reasonable discussion and just try to understand where we come from. Sean: Love it. Now you're a little bit outside what we see in at least my region as typical psychiatry. I mean, I think you're aware of that it's kind of transitioned itself into DSM diagnoses and handing out prescriptions fairly quickly, monitoring meds and then often adding more and more prescriptions, shifting diagnoses and so forth. The outcomes are astonishingly poor in you know, a lot of like research trials and what we see in community based settings, we don't see really like strong recovery rates. We do see some, you know, symptom reduction or modification in certain conditions, but all available evidence to us suggests we had a long way to go. And people need to be more informed. I want to just get a sense of your, your journey in this and where you are now. Craig: Yeah, well, I think my interest in this area, in sort of psychiatry, what is it, what do we do? I mean, it really started in residency and I went to a residency that celebrated therapy. We had, I mean, it was, I mean, yeah, we learned psychopharmacology and medical diagnostics, but we spent a ton of time doing therapy and so therapy was celebrated. I remember the first letter to the editor I ever wrote to a psychiatric journal was about this whole idea of psychiatrists calling themselves psychopharmacologists. And I wrote, and this is back, you know, one was like 2002, and I wrote the journal, I said, this is a terrible idea. This is a terrible idea for people to think of themselves as psychopharmacologists, for people to use that term. Because it would be like if landscape architects started saying, you know what, we are soil managers, or if general contractors said, we're gonna be toilet mechanics. It's like, wait, why limit the beauty and the complexity down to just... So that said, I think medicines can be game changing. And I think that's a place that maybe you and I don't agree, but this whole idea of med management is, I think is insane. And it's one of the things that I talk about a lot in my podcast. I try to give examples of people healing. There's no healing through med management on the podcast. I mean, there are people who heal with meds as part of the picture, but you know, one of the things I'm trying to paint is that, I mean, I often tell my patients like, if this is the jigsaw puzzle of your treatment, maybe these two pieces up here are your meds and this is your sleep and this is your weed addiction and this is your relationship and this is your exercise and this is your diet and it's all part of it. And we're gonna talk about all of it, but this whole idea that in psychiatry that you can manage psychiatric illness with meds primarily is largely insane. Sean: Yeah, let's start with, you know, I was listening to a very interesting podcast you had with one of your colleagues who I think was part of the outside of Boulder, I can't recall his name, Craig: Will Sean: but Craig: Vanderveer. Sean: the Yeah, I thought it was great podcasts. I mean, I do. I you know, I found that one fascinating. And I think you opened it up by asking, you know, what is wrong with psychiatry? And is it will said, Well, it starts with basically, it's the diagnostic system and the treatments. Craig: Yeah. Sean: So what are you critical of when it comes to your field as far as the diagnostic system and its conventional treatments? Craig: Yeah, well, as I said to Will, I was joking, but I wasn't really joking. I said in that episode, I said to Will, I said, I think the DSM could really just have maybe five diagnoses, maybe six. And it would be the state of the art, what we understand about the brain and mental psychiatric illness now to have five or six diagnoses and the splitting to come up with all these BS diagnoses like intermittent explosive disorder, social anxiety disorder, you know, um, it's it's all fake. I mean, they're real pain, but they mean nothing. And even, we'll probably get into this, but I think one of the things a lot of people don't understand is in the whole placebo antidepressant thing is that psychiatry not only has a huge classification problem understanding, we have a huge naming problem. And I did an episode on this, I don't know if you heard it, but I did an episode on how all the names we use in psychiatry are wrong. The meds that we call antidepressants, SSRIs, mostly don't work for depression. The meds we call mood stabilizers mostly don't stabilize mood. The very best antidepressants are the atypical antipsychotics, which actually are very poor antipsychotics. And the very best mood stabilizer by far is an antipsychotic. So, and I could go on and on, but so we have this whole confusion where we talk about things like as if antidepressants were a thing or, or you know, MDD or a thing, but, but everything is just mushy and, and it doesn't even mean what we think it means. So, um, there's a psychiatry podcast called the car lat report, which I like a lot. And I've written him a few times cause he's always talking about antidepressants, this antidepressants, that, and I say, what are you talking about? Like, what does that mean? Like, are you, are you, do you mean SSRIs? Cause I've said, yeah, you know, those are not really antidepressants. He said, yeah, but that's what the general population thinks. I said, well, we need to be good with our words and not just throw out these meaningless titles. Sean: Yeah. Don't you think that there's a major, major problem with credibility in your field is when you misrepresent what you're able to do by calling it antidepressant. Now it's, it's gone an extended way beyond just psychiatry. We have like over 80% of antidepressants are being prescribed by primary care doctors. But when we talk about informed consent and people being able to be informed about the healthcare decisions that they're making, they are taking these drugs under the assumption that they will have antidepressant. inequalities, and most of them are not provided the legitimate harms. Like I have real concern about emotional blunting and numbing, and its potential long term consequences on sexual functioning, for example, and we're certainly seeing a number of cases that are implicated in, you know, self injury, suicide and violence. So your field has failed to adequately be able to communicate the legitimate dangers. And then overestimates over values the benefits through language by using words like antidepressant, which is in alignment with the pharmaceutical industry. And it's created, unfortunately, indelible harm. There's been withdrawal. People have hooked on these drugs, can't get off of it. We don't have good adequate data on the long-term consequences, but here we are. It still continues today. And that's where there's a credibility issue. Craig: Yeah, I'm still shocked and crushed at how many physicians think that SSRIs are antidepressants. You know, I'm like, these are for anxiety. Yeah, they work for a couple types of very specific types of depression, but in general, no, they aren't antidepressants. They are anti-ruminations, anti-panic, anti-anxiety meds. So we get, so like the patients are confused, the doctors are confused, everybody's confused. And a lot of times I'll, I've had patients, this happens all the time where people will come to me and they'll come in with horrific depression. And they'll say, well, Dr. Hickok, my therapist said I should go on an antidepressant. I'm like, you are onto antidepressants. But they might be on like Clozapine and Lamotrigine, which is an anti-psychotic and a mood stabilizer. But really those are actually meds that can powerfully help with suicidal depression, but nobody thinks of them that way. So that's a thing I've tried to put out on Back from the Abyss. for patients and families and docs and therapists to help them think about, I mean, even just the labels are so confusing. And then, I think you bring up a really good point about informed consent, and this is something nobody talks about, I'll just put it out there, I haven't heard you talk about it, but I think where informed consent gets really sketchy is with severely medullial. Because we have people, treatment-resistant schizophrenia, probably not able to make good medical decisions for themselves. You know, I regularly do this. I might say, I want you on clozapine. You know, I might say this has a white blood cell issue, da-da-da. But do we go into all the potentially scary side effects of some of these really serious meds with a very mentally ill? We don't, because it's so hard to get them to take the meds anyway, especially with the people with chronic psychosis. And that's kind of a hush secret in psychiatry, is that... the sickest people get the least informed consent. I don't know how that would change because again, I treat a lot of these people like they're, and these are a lot of folks who would come in my office and say, I don't have any illness. Meanwhile, they just got out of jail or they just tried to cut their penis off or they just ran naked in the woods and were found by EMS with hypothermia. So yeah, I agree with informed consent is complicated. Even just telling people, what I tell people with SSRIs is, you're very likely gonna have orgasm problems. Um, and that's people giggle and laugh like, Oh, that's, that's uncomfortable. Like, no, like if you, we do this med, it's going to be hard for you to come. Like that's, that's very likely. Um, and you know, I've had many people say, no one's ever told me that people come to me on a bunch of SSRI trials. They said, nobody's talked about orgasm. And I say that we're going to talk about orgasm. I'm going to have med students and. Psych and Pisa rotate with me. I say always in the first, um, session, first evaluation, we're going to talk about sexuality. I want you to ask about orgasm because I want people to realize that is a huge issue with psych med sexual functioning. So many mental health or so many primary care docs and psychiatrists don't ask about arousal. Sean: Yeah, and I want to get back to that statement you made about serious mental illness. But before that, you know, I think my concern is, is that those side effects can become permanent. And we have enough evidence to know that they're permanent in a specific percentage of people who develop those symptoms. We're giving those drugs to kids, kids who are in primary areas of like identity development, sexual development, puberty. And we're seeing this. uptick pretty significantly in teens either identifying as like asexual, non-binary, no one's really talking about its implication in the multiple psychiatric drugs that they're being provided that could impact sexual development, identity development. So the propensity for them to be permanent and when you weigh that with any potential you know, I really have concerns about their value in society. But always, it always gets to the point where, um, you know, psychiatrists will say, well, yes, but there are, you know, really severely ill people that aren't responding to other treatments and we have to consider improving their quality of life. And so my thoughts on, on these drugs, and this is how I communicate it. That's not that I'm anti drug in any respect. There might be. situations under certain conditions with certain people, where it can be beneficial. And I describe them generally in terms of this, when the condition is extremely severe and can impact one's life or the life of others, like let's say that it's a severe manic episode, someone's delusional, they're at risk of like harming themselves or others based on the mental state that they're in, like... cutting their penis off or running around naked, then drugs like that can induce a reaction, neurochemically, neurologically, that can suppress or alter, change that physiological state that is stabilizing. And in that respect, I would agree, that might be an absolute necessary form of treatment. But I see it as short-term, generally, because I think the long-term outcomes are quite poor. In crisis situations, and rare. So in a society that would be using these drugs in a responsible way, I think the drugs would be rarely prescribed and in all likelihood most people would not be interacting or know somebody who's on psychiatric drugs. In reality, almost everybody now knows somebody who's taking some drug we're like, we're moving up into the like one in four. in American society on some form of psychiatric drug. I mean, that's scary because that's way outside the bounds of any safety or efficacy. Yeah, I just I just got an alert on my end. We're going to continue to have the conversation. What I'll probably end up losing is some of the visual components on your end. Audio is fine in terms of uploading the audio only. How about we ask if everything closed out on your on your computer right now? If you like can close out anything that's utilizing a lot of your space. Other websites. Cause if we can get it, I mean, if we can get some, but I think it's uploading locally on his end, which could be a large file size, so it could just be about desktop. I usually just close out of everything except for my Google Chrome. This happened on a previous podcast. Audio came through fine for posting it. It was just social was impacted. But I might be able to come up with a solution around it. Okay, that might help and allow us to get some of that. So just to remind you where I was, I was kind of just critical of the widespread prescriptions of psychiatric drugs and I think they're best utilized in just kind of like short-term crisis situations, rarely. So you just made me think of a question. We just got done interviewing Dr. Jessica Taylor, who made the argument that where psychiatry is influential in the U S and the UK, there's higher rates of depression, higher rates of suicide, and you look at countries where there isn't as much influence of psychiatry, they don't have that. So, um, are you trying to make the case that there's not a psychiatry problem? There's a medication problem in the United States. Okay. Yeah, but the point I think she was making was that where that influence is more prominent, you would think people would be healthier, they would be happier. And this current, I guess, paradigm isn't really providing solutions for people, it could be actually making them more miserable. Yeah, you're bringing up really good points and that's like the limitations of language, right? And so one of my concerns that I had, I said I have a love hate with your love hate kind of relationship with your podcast is that you, as you tend to fall into that paradigm where you're talking about the these conditions as illnesses and the human experience of thought, emotion, physical sensations as symptoms of illness. when I believe it is much more complicated and complex than that, because even in my field, our path sometimes to healing or overcoming very difficult and challenging emotional experiences or episodes, sometimes that path is very painful. So it's actually like eliciting sometimes strong emotions, like when we think about the value of exposure-based treatments, whether it's in trauma or OCD or just transcending And I think there's really good neuroscience around that, specifically around learning models of fear extinction and those things. The integrated nature of mind, body, and experience are really critical. And so as a psychologist, I'm often trying to facilitate that new learning through experiences. And to do that, we have to sometimes create this new relationship to what we're feeling, what we're thinking, an allowance. of those emotions without judgment, without identifying them as symptoms of something that's a problem. Because I believe when we start to develop an association with our internal experience as dangerous, then we have a relationship to that exacerbates the experience, right? So now our internal experience, whether it's our heart rate or our breathing, or the feeling of anxiety. When we view that as dangerous, then we have a reaction to it. So the paradigm of trying to see mental health as reduction in certain emotions or thoughts or experiences, I think in the long term creates more harm. But what if they weren't symptoms? It becomes them. Yeah, so Dr. Hicak, I know that you have an interest in like the treatment of trauma. And I know you do a lot of psychotherapy yourself and you're combining it with new innovative therapies like psychedelics and so forth. So a great example of how, you know, I'm kind of against the pathology of the emotional experience is to kind of think about things from almost like evolutionary biology perspective. So we've kind of evolved in order to be able to... procreate and stay alive. And so there's a lot of experiences that we have. So I think about someone who might've undergone like a traumatic situation where their safety or their security was threatened. Well, then we would certainly expect them to be hypervigilant, to have anxiety and fear. They would replay it in their mind to determine like, how can I prevent this from ever happening again? And you would avoid anything that is associated with that traumatic event based on safety. And obviously that can then become generalized into one's own personal life and it can create severe impairment. And I think the idea of looking at those symptoms from a perspective as an illness is problematic. And I think in and itself is going to exacerbate PTSD symptoms. Instead, we want to look at that as something that is biologically evolutionarily beneficial. given the circumstances and part of the recovery process then would be to obviously create new learning, right? So yeah, this situation was dangerous under that condition and you can still recover from this and move, go on to live a full life. You could love, you can take risks under a number of things, but it requires us to process that emotionally. It requires us to examine the way we're thinking about our lives. It certainly requires exposure. into new situations that were otherwise avoided because it maintains the condition. And I've been doing a lot of research over my 20 year career into, you know, how to work with people who have PTSD. And there's not a lot of good evidence that's going to suggest that trying to use a biological agent to try to alter the symptomatology provides much of value in treatment. In fact, I think there's more evidence that it's going to create. So I just want to get your thoughts on that perspective of viewing this as symptoms. So you sound like we're in agreement when you're, this is where I get confused with your podcast, because I hear you say these things and I think it's brilliant and I really agree with it because I think you're considering the complexity of it and how resilient we all are and our capabilities. And to think about it that way would almost kind of move us past this limitation from categorical illnesses that are of psychiatry and it would expand the paradigm. But then I'll listen to an episode you have and it'll be like the top 10 psychiatric drugs. And you know, and I really feel like you are really overvaluing potential benefits to those drugs like you're selling it. And I've heard this before, it's part of my concern is that, and it's not to say that there aren't some anecdotal evidence that it could have helped somebody under certain conditions. It's just the the generalized overvaluing of talking about drugs like life saving and life changing just does not seem to fit any data science that really exists. And it seems to contradict maybe some of the other things that you're talking about on other episodes. In fact, it feels confusing to me to know where you stand. Okay. For how long? So let me ask you a question about the motor train. Now, from what I aware, it's used to treat seizures. It's an anti-convulsant, correct? That's been maybe approved or used as off label in the psychiatric community. What do you think is, if you've seen some success with a certain subset of people, you used the word rapid cycling. So you see it for a subset of people, you feel like it's really been able to be helpful. What is happening? biochemically to actually provide that type of reaction. And then my question is for how long? Obviously we're always brain is seeking homeostasis. There's an adaptation process. We probably don't even fully aware are aware of how everything is so uniquely integrated in a way that's supposed to be serving us. These trials are maybe 12 weeks, right? So they're relatively short term measured with symptom reduction checklist. So my question is, what's happening? Who's it going to work for under what conditions and how long and what's the science base for this? And that's, I think that's my concern, right? Is that it's very, this is very experimental. And, you know, even you have a hard time being able to really communicate what it's doing, who it's gonna be most effective for, long-term safety, and when to get somebody off of it. And most of what I'm seeing even with Lamotradrine, it's not a standalone treatment. You know, they're combining that with, you know, polyfarm. Polypharmacy, three, four, five, six, seven different drugs. And some of them are developing adolescents. But I do want to transition into psychedelics. You're the first person I have on the podcast who can speak intelligently of it. I'm a spiritual man. I've had a number of profound spiritual experiences that have occurred for me over the past three years. I've mentioned some of them on the. the podcast, I meditate, I try to connect with nature, really believe that there's a divine soul within all of us. I think purpose and meaning in our lives is actually extremely critical for mental well-being. I question whether we in our secular society and modern capitalism that where a lot of our misery is related to spiritual emptiness in a lot of ways. fear and mood related to disconnection from people, nature and purpose. So with all those being said, the psychedelic community seems to be more aligned with an understanding of some of those connections. And sometimes it's even facilitated by the therapy in itself, which allows us to get into some interesting conversations about maybe that... form of treatment is something that can help some people. But again, I also come from it from a scientific and ethical perspective where I'm concerned that this is the next fad, the next fad that is being promoted in psychiatry. And it is being utilized in ways that, you know, don't really serve people and people are turning to it for a quick fix. So I'm gonna, you know, sit back and listen for a little bit. Because I think our listeners have to really understand what this is, how it's helping people and get your thoughts and experiences on it. Yeah, actually, you know, Craig, let me just give you some, uh, some perspective. I was just on a trip out to California and one of my old neighbors is a, um, a clinical social worker. So he does therapy and he was getting, um, kind of like certification or training in MDMA and ketamine therapy. And I was surprised cause he told me that he actually had to take ketamine, um, during one of his sessions and it was part of the learning experience. And. He seemed very open about it in terms of a new approach that could be very beneficial based on the experience that he personally had. So I'm wondering what that connection was to you that drew your interest into it and then how you're applying it. Ah. Yeah, so let me ask you, what is happening? I've never done a psychedelic, but I felt like I've had psychedelic experiences through meditation, which we can get into. What is happening that leads you to believe there's a profound experience that occurs from it? That's what Andrew Huberman says. So does that give us some insight into some of the factors that influence mental suffering? Is it a disconnection from each other? And is it a disconnection from a greater purpose? Overwhelmingly I think what drives people into the mental health system, if you're just talking about a blanket, is some struggle with fear and emptiness, depression. It's those two like experiences now, they can lead to so many different things, right? You can become OCD and fixated on trying to control your life in a certain way to, to control for fear, right? You can, you can turn to substances, alcohol, drugs as a way of changing that feeling and trying to just relax or integrate into society, eating disorders and so forth. Like there's a number of problem reactions we have to the experience of fear. loneliness, depression, boredom that drive people into the psychiatric system. But if you're seeing benefits when someone has a spiritual experience, doesn't that maybe open the door for us to better understand where we need to go in culture and society in order for us to feel like this life has meaning? I have no... Yeah, so this was my experience in meditation was how we're all connected, which is just, I mean, I can use my language to state it, but it doesn't do it justice, this feeling of connection. But the oneness of the universe and the experience was profound. But I transcended fear through this. Nothing seems too big for me right now. is the is the way I can describe it. I feel like the potential of doing great things in love is almost limitless and it creates an excitement. So even the little things like the value what I'll get from a psychotherapy session from doing therapy is a level of wholeness and elation that I can't get anywhere else to be honest. almost like, okay, I am doing the work that I meant to do. But it comes out of a connection to that person, and a love energy that's created that I really did learn in meditation, not only meditation, but what comes after meditation. So sometimes I just ask for things, whether it's wisdom or connection, and a book will come my way. And I'll read this book, and it'll be a powerful learning that exists. So it's this nonstop journey. of experiences, but it's added purpose, it's added meaning. And the little things, the neurotic kind of things that you would worry about in your small self seem to kind of dissipate and fade away. And that's just been a profound experience. And I haven't had to do a psychedelic for it. I know I've had to do a lot of different things to be able to achieve it. Like before I came here, I did a cold bath, for example, cold plunge. And I think there's all these areas to... in psychiatry, because I do I'm not anti psychiatry, I believe psychiatry can actually do so much more for society, if it broke outside of its limitations, because I think we can try to we could try to provoke biological mechanisms to enhance performance and well being in so many different aspects. I just don't know if drugs are it but I don't even know where I'm going. I actually I love I love the idea of the experience. It's almost like you're taking a vacation without the travel, which I think we could all appreciate, you know, some time off and just to kind of like decompress a little bit. But the question comes up because you were able to participate in that phase three clinical trial. So. Based on that experience, you know, how can a clinical study effectively incorporate the placebo control when evaluating the effects of MDMA, because you would think. the participants would know whether or not they received it. Okay. Did she go off her meds too fast? What is bipolar? I hate to, I hate to jump in here, but like we throw that out there. How does someone, you know, why does somebody have bipolar one? You found Christopher Palmer's work at all? You know, so like his book, brain energy and metabolic syndrome and, you know, that there's some complicated science in there and, um, but being able to cure, I'll use the word cure or bring people into remission of symptoms for some of these severe psychiatric conditions like bipolar one disorder through a ketogenic diet is certainly like fascinating type research. And. I think the concern I have with how psychiatrists are communicating bipolar one disorder is they're saying you have this for life and you have to be on this drug for life. But when you look into some of the historical data, there I think close to 85% of bipolar one manic depressive episodes were single episodes back in 1950 and only required one remission. It seems like in the post drug era of trying to treat bipolar one, our outcomes are worsening. We're taking something that could have been episodic, could have been maybe an alternative viewpoint or treatment, and we're turning it into a chronic condition because we're placing people on these drugs where this is like I brought up the question before for how long, right? Because at some point the drug doesn't work anymore. even if it stabilized the condition initially and we're upping the dose and we're adding another and before you know it, we have chronic health conditions from the combination of drugs. And so that's why people like me who question the psychiatric diagnosis system or the idea of mental illness, it's, it's a label, it's a construct, but we haven't really identified what's influencing it to be able to target it. You know, like, like syphilis, for example, created psychosis before you knew syphilis existed. You know, it was just treated as like insanity. So like we have to be able to advance ourselves in the way we communicate this. We can talk about, yes, you are experiencing mania and we can do this now to try to stabilize it, but it is not the answer. Because we don't have the evidence that it's the long-term answer. And we have to be able to be open to alternative ways to be able to help people who are repeatedly having maybe mania or depressive episodes. So we were talking about this. Yeah, go ahead. Have you been talking to Sean? I didn't drain my 401k. Yeah, I mean, I think these are real legitimate questions and I have read some data that suggests that sometimes like up to three quarters of menia are induced by drug use. And so if the person weeds one of them. Yeah, I think we should get into that because a lot of our listeners are international and legalization of marijuana in the United States is it's a state by state thing. So Colorado gives you a unique perspective on what's happened over the last five to eight years. Mm-hmm. It's a powerful statement. And I guess I'm curious. So the adolescents using marijuana in Colorado, are you seeing any type of increase on your side? Because now they're entering into adulthood. So they've maybe have had three or four years of maybe chronic use, not even recreational use, I guess that's the way you would separate like somebody that's using marijuana every single day to function that could have some long term, you know, side effects on them. Are you seeing something in that area? Yeah. Um, I'm sorry. I wanted to go back to the MDMA therapy or, or ketamine. I know you use it for PTSD. Um, are there certain situations when it's not appropriate? So let's stay with ketamine. Yeah, let's stay with ketamine because based on personal experiences, people I've spoke to have done ketamine treatment. And I wonder if it's being applied universally instead of for specific, you know, treatments. Let's use PTSD as the example. But what about like for severe grief or depression? Mm-hmm. Let me ask you, sorry, go ahead. Ugh. Now, if I came out to Colorado and you don't have any mental health symptoms, but I'm just Yeah, I'm a maybe Sean would argue with that. But I'm a searcher, right? So like, I want the experience, can it enhance my life? Okay. Would you be open to me coming out there doing a treatment and then us having a podcast? Yeah, my sister lives in Broomfield. Yeah, Broomfield, Colorado. So easy drive and plan on making a trip anyway. So maybe we can set that up. That would be an interesting podcast. I would love to record the episode there. Yeah, that would be cool. Um, all right. So let me ask another question. And this come, this came to me in meditation. And so I want to, this is like a deep thoughts type of thing that, um, those who are actually looking beyond themselves outside of them in order to feel better. For example, a drug are not going to find it, but those who are able to find it within them and understand that their experience on this physical plane in this body, they have the capacity within themselves to be able to find that meaning and overcome. Is it those who are seeking out external means are going to struggle the most in this life? talking with one of my postdoctoral residents. Actually, no, she's an extern here. She's a doctoral extern training here at our center and I think she's fabulous, very talented, but she's certainly an old, mature soul. So she's devout, Judaism, she's, I think, has this brilliant kind of perspective on things that are much bigger than the... normal pains in our lives. And we're, we're talking about how there's so much more to learn in terms of like energy, and the energy that is created between two people. And I've been experimenting with this. And I, I'm kind of an experimental guy in a lot of ways. And some of the some of the things I've also learned through my own meditation and some other spiritual experiences is that I have often been somebody who tries to intervene too much. Meaning like, I've a, we have a full model dialectical behavior therapy treatment center here. I do DBT and board certified in behavioral and cognitive psychology. So sometimes when I'm at my worst, I'm intervening too much, right? And I've learned that there are multiple avenues to heal. And I think you do some psychodynamic you're talking about some spiritual modalities and ketamine and so forth, I've just been, I've been kind of focusing on like altering my energy around clients who are in emotional pain. And sometimes that's just simply like taking a deep breath and cultivating compassion and love towards that person. And I can almost feel it in my body, like a tingle sound, tingly feeling. clients regulate. So I do work with clients who have a hard time regulating intense emotions. And when they're in pain, I can just see them respond to that nonverbal like energy that's cultivated. And there is somewhat of an awakening, I believe that is occurring globally, people are starting to talk about things more spiritually. But from just a pure empirical perspective, it sounds almost like it's insane. right? But I think we have like cognitive or we have quantum physics and it's other like ideas around frequency and time, space and energy that we have yet to really tap into that gets when I am deep in this meditative state, I can experience it. I understand those different dimensions as different realms. And so I think that they're going back to your, you know, you're just understanding of feeling love. Love as a healing energy is possible. outside of the limitations of what we currently know. Yes. Yeah, I've stopped doing telehealth because of that. I felt like it's like I lost my powers. I wish we could. Well, listen, we've kept you a long time. I thought this was a fascinating discussion and we're just really honored to be able to have the conversation. Grateful for you reaching out. I found you fascinating. Even though there's areas I think that we practice differently or we have different concerns, I really feel strongly that you are trying to do what's best for the person that's in front of you to try to ease their suffering and create some purpose in their life. And for that, I just... want to just say how grateful it is for you to come on and I'm going to take you up on that. I'm coming out and we're gonna I'm gonna do ketamine and then we're going to talk about it. And I think the listening audience might be fascinated to hear some of the kind of consequences of doing that or see how it how it affected me. So any final words? How, how can people how can people find you get in touch with you listen to your podcast, things like that. Yeah, loved it. Dr. Craig Heacock, well, really appreciative of a radically genuine conversation.