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110. MDMA, Ketamine, or Psilocybin Psychedelic Therapy and Pleasure? with Dr. Craig Heacock

Nicole: Well then could you first introduce yourself to the listeners, to whatever capacity you would want someone to know what it is that you're doing in the world.

Dr. Craig Heacock: Hi, I'm Dr. Craig Heacock. I'm a psychiatrist in Fort Collins, Colorado. I'm an adolescent, adult and addiction psychiatrist, and I have a special interest in the use of psychedelics for treatment resistant depression and PS D.

Mm-hmm. Mm-hmm.

Nicole: Yeah. I'd love to hear how you got to that space too, of being, you know, a psychiatrist that works with these medicines.

Dr. Craig Heacock: Mm-hmm. Well, it actually goes way back because when I was, let's see, the year before med school, so this would've been like 1996, I was a member of MAPS way back then, the Multi-Disciplinary Association for Psychedelic Studies, and I saw in one of their bulletins that first psychedelic research in 3D decades was about to restart.

Psychedelic research on humans was about to start at U N M. Albuquerque and they were looking for volunteers for an for a D M T study. I contacted Rick Strassman at U N M and and and he screened me and I got into the study and that, that's a fascinating thing in and of itself. But I remember when I was talking to him at one point, I said, Hey, I'm gonna go to med school next year and I'm gonna be a psychiatrist.

And he said, cool. I said, yeah, I wanna work with psychedelics. And he said, well, That's a long ways away. Mm-hmm. That's a long, long ways away. So that was 96 and so, but now it's happening. You know, I started working extensively with ketamine in 2017, so six years ago. And then that was year also I started working with the maps, uh, M D M A assisted therapy for P T S D study.

So the last six years I've been pretty deep in it. Mm-hmm. And then now with the passage of Prop 1 22 in Colorado and the decriminalization of four different plant medicines, That already, just in the last couple months, like the whole landscape here is changing radically. Um, lots of patients are wanting to know how could they use psilocybin to treat different psychiatric and psychological woes.

And a lot of underground therapists formerly are now popping up above ground. Like, like mushrooms. Yes. And so, and so I really think Colorado is becoming. The national laboratory for what psychedelic decriminalization and, and medicalization might look like. Mm-hmm. So all of us here are super excited.

Mm-hmm. Yeah.

Nicole: You can feel that energy and the collective, I think, as more things even like, you know, Michael Pollen's, uh, piece on Netflix coming out or. Just more conversation about psychedelics becoming normalized and I think more people are seeing the potential benefits that could come from this sort of treatment that for a long time had so much stigmatization around it.

Right. And so I think you can just like feel the collective kind of changing and there's this energy around psychedelics that is really starting to, like you said, pop up in a way that's above ground. You know, coming out from the underground that has existed for a long time in the history of psychedelics.

Dr. Craig Heacock: And clearly many people have gotten help in the underground, but a lot of people have been harmed. And not that people won't be harmed with decrem and, and medicalization of psychedelics, but yeah, it's way easier for kind of the bad apples to be, uh, identified and mm-hmm. And sorted out, whereas when everything's in secret.

Yeah. I think some of the unknowing or unethical or just incompetent people can, can keep practicing and, and, and harming.

Nicole: Absolutely. Yeah. Which is tricky then because like, I'm, I'm curious what you think the future looks like in terms of these medicines and what sort of like, you know, control access looks like, or what you imagine it will be like.

Dr. Craig Heacock: Yeah, I'm guessing there's gonna be sort of two parallel trends happening. So one is on the federal level, medicalization is likely to happen soon with M D M A and psilocybin. So M D M A might might be 18, 24 months away from actually being an F D A approved treatment for the post-traumatic stress disorder.

And then SIL ibin might be a year or two behind that, but both of those are likely coming federally. I'm guessing what's gonna happen with D crim and legalization is kind of what's happening with abortion. I'm guessing like there will be states in the US like Colorado, where um, All sorts of things are possible, and there will be states in, you know, the south into actually much of the country where none of this will be permitted except for the, the federally medicalized things.

Yeah. So for, for example, um, D M T and Mescalin were part of a, this 1 22 that was just passed statewide in Colorado. Can't imagine that, you know, most states in the US are going to Decrem or legalize, D M T MM or Lan. Mm. Although, you know, those are, might be more fringe players in the psychedelic world.

We'll see. I mean, I think here in Colorado what people are most excited about with 1 22 is psilocybin. Mm-hmm. Because psilocybin is something people can do themselves. They can grow their own. And because what the, the proposition says is you can't sell, it can't be commercialized, but you can grow for a personal use or trade or gift.

Mm. So we'll see what comes with that in the coming months and years. And then in about next six to 12 months, the state of Colorado will start certifying people to work above board with, with psilocybin. And presumably the state would supply that cuz it would be a, it would be a regulated, you know, again, not, not commercialized, but you, you would've state sanctioning to work with these medicines.

Mm-hmm. Mm-hmm. So that, that, mm-hmm. That regulatory structure's happening being put into place now and. So within the next year or two, the therapists, and one big question is, will it be only licensed therapists? I th the way 1 22 is written is they left it open for underground people who are unlicensed to have a root into the psychedelic treatment world.

So unless the. Point a commission changes that, or the legislature changes that. There's a path now for unlicensed people who, who have been working extensively with psychedelics to still get state sanctioning to do that if they want.

Nicole: Yeah. Yeah. I think that's an important conversation about the gate key being around access to this and being able to, Do this in a way that, like you said, can be harmful without proper, you know, experience with the medicine, but also trying to avoid the gatekeeping of it.

Only being to one type of trained professional, I think is gonna be a tricky piece and. Yeah, it's definitely scary to think about the world where it is kind of like abortion where, you know, like completely separate. Mm-hmm. Depending on the states. I mean, that sort of vision of the future is kind of scary to me to think about how separate we could become as a society without going too far into that sort of, you know, scary world and in visioning.

But I'm curious, I think a lot of questions that I get from clients when I'm doing my ketamine work. Uh, is, what's the difference between the different psychedelics? Do you feel like there's a difference between, you know, being able to access M D M A or ketamine or psilocybin and the potential treatments that are, you know, with each medicine?

Dr. Craig Heacock: Yeah. First of all, I think those three are really good prototypes, if you will, for psychedelic treatment. One is legal, the other two are. Gonna be likely medicalized sooner than later. Mm-hmm. And they're very different molecules. They have very different actions in the brain. They have very different actions on kind of the psycho-spiritual realm, but they're all quite helpful.

Mm-hmm. One way to look at these three is to think about what kinds of problems they're most helpful for. And then another is, maybe a bigger question is what are the, the contraindications and cautions with each of them. Mm-hmm. How about we start with Sil Sabin? That's we just talking about that? Sure, sure.

Sil Sabin has a sweet spot in at least three or four areas, and one is, and this isn't really a medical thing, although I think it is because you know, I'm publishing an episode of my podcast back from the Abyss in a couple weeks where I talk with a psychiatrist and we talk about this phenomenon of, you know, some percentage of depression is psychospiritual.

It's a demoralization, it's existential, it's not bipolar, it's not genetic, it's. It's, it's a spiritual emptiness. And so I think there's a real role for psilocybin, for people who are demoralized, existentially depressed. If you even look at, you know, some of these interesting work with end of life, uh, and psilocybin, there's some really interesting data on that using psilocybin with people who are terminally ill.

And I think, what is it doing? Is it treating their depression? No, I think what it's doing is, Is opening them up to the beauty and wonder and also just the timelessness of the whole biological cycle, and that their death becomes more of just, yeah, like this is part of something much bigger than yourself.

Mm-hmm. Like guess you're gonna die, but you're part of something so much greater and more amazing and timeless, which I think psilocybin has a unique ability to do that, to sort of dial you into. The collective conscious into anema, into spirit. And then another for sure, really interesting use of psilocybin would be for O c D.

Mm-hmm. There's some fascinating, uh, open label studies, case reports where people with severe treatment resistant ooc d do a big dose of psilocybin, like four, five grams, and they go into full remission of O C D for weeks to months. Wow. Wow. Which is, yeah, I, and OCDs really interesting. It doesn't have a placebo effect.

It's often medication resistant. So I think that's a really cool mm-hmm. Genre. And then if you also think of all the disorders that are related to O C D D, they're seeming like they might be very psilocybin responsive, like eating disorders, like tick disorders, like grooming, like picking and trichotillomania.

Those are all kind of in the O C D umbrella. Mm-hmm. And there's some interesting early evidence that psilocybin might be really helpful for those. Mm-hmm. Um, And then of course, trauma. And you know, I've had a number of people on my podcast talk about healing trauma with psilocybin, and arguably that's its mo.

Besides the wonder, joy and connection part of psilocybin, I think that might be the biggest use of psilocybin. Mm-hmm. As it comes to above board and becomes decriminalized. And medicalized. Yeah. What we don't know yet is how useful is psilocybin for what we might call like endogenous or. You know, bipolar, depression, even depression.

So people didn't have a big family history of endogenous, genetically based depression. How useful is celli be? We still don't know, like mm-hmm. That's a sweet spot of ketamine. Like we know if you have severe bipolar depression, um, mixed states of bipolar, ketamine is a home run for that. It arguably that the best thing we've ever seen treatment-wise, but.

It's not clear what's, how helpful psilocybin will be for that. Yeah. And a little bit more about psilocybin. It's super safe, meaning like it's non-toxic. I mean, you can definitely have a really scary trip. You can be psychologically traumatized, like you take too much psilocybin. Or like you take someone who's say suicidal a bad mindset and they mm-hmm.

Take a bunch of psilocybin alone like that. That could be terrible. Right. But in general it's a very safe compound. And then when we look at sort of contraindications, say medications, there's a number of psyched that block the serotonin two A receptor where Sil simonin does its thing, right? So all the typical antipsychotics like Abilify and Seroquel and mm-hmm two and Geodon and what's uh, important about those people with serious depression are often on those, particularly bipolar depression.

So, That's gonna be a little tricky if people are trying to use psilocybin to treat, you know, severe depressive syndromes mm-hmm. Of different etiologies. Mm-hmm. If you're on one of those two A blockers, you have to come off that. Right. Hmm. Then we could transition. Talk a little bit about ketamine, ketamine's legal.

It's been, um, uh, FDA approved medication for 50 years. Mm-hmm. It's really only been used extensively for depression and ptsd. T S D for the last few, I'm say four or five years. So we know that ketamine is useful for a whole lot of things, but again, I think it's in psychiatry, what we're seeing is so many folks with mixed states of bipolar and, and treatment resistant bipolar depression who have been so hard to treat.

Mm-hmm. Like rapid cycling bipolar disorder is a bear to treat a lot of people on six, seven meds. Mm-hmm. Ketamine is an amazing mood stabilizer for them. Yeah. It's just shockingly good. I mean, think. I've argued in my podcast that ketamine is the best thing for depression, particularly bipolar depression, since Lamictal came on the market in 94.

Mm-hmm. So that's a long time. Mm-hmm. Mm-hmm. So, mm-hmm. And then there's the whole use of ketamine for psycholytic work. So, just to back up a little bit, one way to think about ketamine is that it kind of comes in the sort of three steps of ketamine, like the bottom rung, lower dose ketamine. Usually oral ketamine is.

Psycholytic, it opens the psyche. The psycholytic lytic effect can help people feel more comfortable with their therapist, feel more connected, uh, can help them access both conscious and unconscious mind. And trauma states. It's really an accelerant of therapy. I've had a number of people tell me that they felt like they could never really engage in psychotherapy until they did cap ketamine and psychotherapy.

And then, oh, okay. I open up. The second runner of ketamine is psychedelic ketamine, so that's usually IV, or I am, that's what I do primarily in my practice, and that's where you're, um, sending people deeply into ketamine, usually to a partially or fully dissociative state where they're in the, as they say, the K hole, or a place where there's no body, no room, no chair.

And then the top rung of ketamine, the high dose is for anesthesia. Right. But ketamine is a, is a very different molecule. It's a very different, has different treatment indications at each. Mm-hmm. Mm-hmm. Again, you know, in mental health, psychology and psychiatry we're most interested in the bottom rung, which is the lower dose.

Sessions where people doing oral ketamine, maybe spending a couple hours with their therapist doing somatic work and or on talk therapy versus kinda that middle or around where people are doing nearly dissociative or fully dissociative iv or Im maybe with therapy or maybe not. I mean, I find in my practice that I typically do pretty deep cable dives with people.

Mm-hmm. And they're, and they're usually pretty discombobulated afterwards. And so oftentimes, The most useful therapy is the next day, two days, three days. Mm. So I always encourage people to come see me within a couple days of their academy session or see their EMDR therapist, right, or psychologist or or whoever they're doing their primary therapy with.

Mm-hmm. To take advantage of that sort of window of resilience and peace that you get after a deep psychedelic dose academy. Mm-hmm. Mm-hmm. Yeah. Um, Ketamine has almost no medication interactions. I mean, the biggest one is, is opioids. If you're on opioids including suboxone, ketamine is not going to work as well, which is an interesting window into the mechanism.

Ketamine is that ketamine does a bunch of things in the brain, but one thing it appears to do is it desensitizes the endorphin receptors, the mu opioid receptors. Yeah. Which are involved in, in feeling safe and protected and mm-hmm. And interestingly, you know, a lot of people, especially with early childhood trauma neglect have derangement in their endorphin system.

Mm. Their opioid receptors are not functioning right, or the distribution of them is abnormal. So there's something about ketamine, I think that is reating, those receptors, and I think that's part of the. Few today is of, of really powerful resourcing you get after, uh, psyched Academy is that you're, you're in a state where you're sort of held.

Mm-hmm. So whatever kind of therapy you're doing, It's a sweet spot to really dive into that.

Nicole: Yes, absolutely. I definitely see things through a relational lens, like you mentioned, that child, you know, who has trauma from a young age, from the dynamics of whatever they've grown up, then has that connection to their biological response from that.

And so then thinking about these medicines and the importance of the relational work that you can do. With the clients that you're working with to unpack things and to support them through that process and, and the importance of community being medicine, right? Like you could do all this sort of work in, in an office with a client, but the reality is if they still go back to a home space where there is trauma and ongoing abuse, there won't be that shift, right?

Like, The therapeutic alliance becomes a sort of example for a sort of relationship where there's space to be yourself, to be safe, and then taking that out into the relationships outside and then seeing that shift. Mm-hmm. I think it's been interesting too, working with clients who also open up too fast, right.

And have gone onto the medicine and then have spilled out their trauma and then had a whole response to that as well. So it, it's tricky that. Building of a rapport with the clients, that they feel safe to be able to talk about these things and have the holding container afterwards. Cuz yeah, when you do open up, if someone, you know, tells someone their story of sexual assault that they've never shared to anyone else, and then opens up in that time, like there can be a lot afterwards, that is really difficult to process with that.

So I think that's also been an interesting part of the work of like the pacing of opening up about trauma with these things. But yeah, I'm very curious in terms of my focus in terms of sexuality and healing. I definitely started my focus into this field with sexual trauma and have kind of talked about a lot in this podcast, how the field of psychology really only focuses on the trauma and not the whole spectrum of healing there, which is reconnecting to pleasure and embodiment.

Right? So I'm curious how you see. Psychedelics, M D M A, other sorts of medicines as playing a role in that sort of healing in that future for our collective. Yeah,

Dr. Craig Heacock: yeah. Well that, that's a good, probably entree into talking about M D M A. Yeah. So we talked a little bit about psilocybin ketamine. So M D M A is a totally different kind of molecule from those two.

It's methylene dioxide methamphetamine, so it's actually crystal meth with another little loop on the bensen ring. So it's not crystal meth, but it is an amphetamine and I think mm-hmm. That speaks to some of its medical RS and each of these, these sort of prototypical psychedelics can get us to the, well, you know, let's, let's talk about sexual trauma.

Clearly you can do really powerful healing with ketamine or psilocybin or MD ma, but I think what's unique about M D M A is its ability to dial down fear, dial up trust, and, and this speaks to what you just said. To feel love. It's been some beautiful stories on my podcast about people doing M D M A therapy and for the first time experiencing love and thinking like, is this, is this love?

Like, I've never felt this because they've been oftentimes so numbed and dissociated for so long, different kinds of attachment, wounding and right, and, and so M D M A can actually help you feel what that's like to be loved, like to feel. Have to love yourself and to be loved by the people you're working with.

And it's interesting, I would argue that ketamine and psilocybin don't have that, per se. My sense with psilocybin is more like there's this beauty and wonder that you're so con, so connected to all like anime spirit, but it's, it's not really love. It's more like a oneness and like everything's gonna be okay because the biosphere's churning and there's life and death and renewal and evolution and.

We're a teeny part of that, but we're part of it. Whereas M D M A is more like discovering that you are a being of love, and I think that is that heart opening, that love opening part of it. M D M A is maybe what's most exciting about it. Not just medically but, but psychologically and people just doing their own work, even with their partner.

But it's also, I think, what's led M D M A to have much more. Riskiness with boundary crossings and violations. And there's been a lot in the media, and this has been happening. This happened back in the fifties and sixties. It's happening now. And that is the fact that there's such a dissolution of fear and boundary and there's such profound trust that even well-meaning therapists and clinicians can, can cross, uh, physical and sexual boundaries and do great harm.

Yeah, absolutely. And I think there's a, uh, A belief in the mental health, psychological psychiatric community that these people that are crossing sexual boundaries with psychedelic treatment, particularly M D M A, that they're terrible people, that they're perpetrators. They're like, these, we have to weed out these bad actors.

But again, if you look at who's actually doing it, most of them are just, they're us. You know, Laura Northup was, was on my podcast this summer. We talked about this extensively, this idea that the. If we don't get our own shit together, we're gonna hurt people. And that's true as a therapist or psychiatrist, psychologist.

Yeah. And so, but the thing is, it's one thing to hurt your person, you know, your client or patient with your words, or your lack of response to a phone call or a text or showing up late, like those kind of, those empathic failures and counter transfers acting out. But in the psychedelics space, particularly I think with M D M A, if we as therapists don't.

Have it together and really have done our work. Like we are gonna hurt people, not because we're terrible, evil, um, sadistic people or, you know, or, um, preying on, no. It's just because we are in such a powerful space that we're, we're, we're letting our unconscious play out. Like there's a really powerful paper, um, Glen Gabbard wrote back in the late nineties.

He's a psychiatrist, psychoanalyst, and he looked at, it was like Edie, people, all psychiatrists and psychologists who had sexually. Cross sexual boundaries with their patients and clients. Mm-hmm. And he said the common factor that they all described was that they loved their patients. Mm-hmm. They felt such love for them that they thought this, this was the next step.

And you can imagine, like if you're working with a substance like M D M A, that's just can be so full of love and connection, that this is actually my biggest sphere of M D M A being more widely used in a therapeutic stance is that we have to police ourselves really carefully. Totally, totally. So people aren't hurt.

Nicole: Yes, yes, absolutely. Um, the reality is we're humans, right? We're humans in these professions with flaws and. And, and failures. Uh, I read Women in Madness, which is an interesting book on the feminist take on psychology and psychiatry, and there were some really dark stories about sexual assault violence that was going on through the power differentials of, you know, the psychologist or the psychiatrist coming in in ways that were not what you were talking about, about loving the client, but like quite literally dark use of that power relationship that.

You just, you, you would hope that we're moving past those points and that we have enough community and checks and co-therapists in this model, right. To be able to avoid these things. But the reality is we're still humans. Right? And so, yeah, it's gonna be a tricky navig navigating, you know, that reality as this drug and this medicine becomes more prevalent.

But my thought too is like, where is the future of this for people to do on their own? Do you know what I mean? Like there is, I, I see a world where there could be so much benefit for a couple, a partnership, any sort of dynamic of a sexual relationship that maybe has fallen out of the spark in their dynamic and wants to be able to use the substance to re bring more aliveness to their relationship, or being able to just connect back to pleasure in their body.

I'm curious how you see this playing out in, you know, in that spectrum of healing from sexual trauma to pleasure. Like, where is the future of this going? Because cuz yes, there is so much work to do in, in the initial processing of the sexual trauma. Absolutely. And substances, medicines like this can help us to open up, be able to process that with a therapist, but like what does that continued somatic work look like of reconnecting with the body after trauma?

Dr. Craig Heacock: My guess is that's gonna happen in parallel. So for example, if M D M A gets, um, medicalized that it will start being widely used across the country, but like so many things, I think it will break out. I wouldn't be surprised like in a state like Colorado after 2, 3, 4 years of medicalization that there we would move towards decrem.

Yeah. It's not kind of like what happened with with weed. Right. You know, so in some states, a lot of states, the medicalization of weed. Preceded the, the decor, the legalization. So I wouldn't be, because, well, if you look at what M D M A was used for before it was criminalized in 85, it was mostly used for couple's work.

Mm-hmm. I mean, yes, it was used for trauma, but no, it was mostly used for couples work. And there's some beautiful books about that era, and that's arguably one of the most powerful uses of it is to, because M D A, I think can clear away all the cobwebs and Detroit and just all the stickiness and the accumulated years of just.

Stuff that happens between two people and I think it can just sort of wipe it away and allow you to see like, oh, this is why I chose you. Mm-hmm. This I see you and I feel you and I can be with you now in this moment and not have so much just accumulate, like accumulated herd and baggaged and wounding and you know, all that kind of transferential stuff.

Mm-hmm. And I think, you know, that's clearly been Rick Dolan's intention when he's, you know, the head of the maps when he talks about why he started maps and why he has done, you know, decades of work to try to bring M D M A to medicalization. He said his goal is to have it widely spread in society, not just as a medicine, but as something that people can use for, you know, the betterment of themselves and, and connection and love and relationships.

So he's been pretty open about that. That medicalization is a strategy, which is fine. That's often the way it goes with these kind of things, right?

Nicole: You gotta start somewhere in the system, right? You gotta play, you gotta, you gotta prove, you gotta get the collective on board and Absolutely. But I think what you're talking about is so key is that there's space for this to be with people who are healthy, right?

Who aren't trying to process just trauma. Right. I think that some of my fears around how sexual education is in, you know, shared widely is it's so taboo that all we talk about is the, you know, the bad things, the, the things that might happen with sexual activity versus like the whole pleasure continuum.

And I wonder what sort of, you know, narrative is gonna be around psychedelics if it's really pinholed into the. It's used for trauma, it's used in a medical context. It's used for this compared to, you know, yeah. This other future of reality that these things can be used on a pleasure spectrum as well.

Dr. Craig Heacock: Right. Even the simple pleasure of being able to enjoy a hug. I mean, yeah. I know you had listened to M D M A and the Inner Healer episode of my podcast and mm-hmm. A podcasting. Yeah. And you know, he was the first person I worked with in the M D M A study, and I think we talked about in that episode that in the early months of knowing him, He wouldn't even look at me.

Mm-hmm. Maybe he could, it was hard for him to meet my gaze, much less like give me a hug. But by the end of the M D M A study, and whenever I've seen him since on and off over the years, he wants and gives me a really big, warm, lasting hug. Yeah. And every time he's, I see him, he's, he's like Dr. H and gives me a huge hug and it holds that hug, I think.

Mm-hmm. There's just so much joy and like we can just, yeah. Hold each other two men. And this is a man who is sexually assaulted by a man, right? By an older physician, you know? Wow. So there's so much transferential stuff with me, and you know, to me, like almost nothing speaks more powerfully about this guy's healing that he was sexually assaulted by an older physician, male, and then, and then he and I have such a trusting, loving relationship in that.

He likes to gimme a big hug. Yeah. Talk about bringing your body back online and safety back online and, and the joy of touch. Yes. And yeah, I think M D M A has really such great potential for sort of bringing sexual pleasure and connection back online or just like touch, touch, like, uh, another woman. Who I worked in this, in the study who was in the placebo arm and mm-hmm.

That's a whole other painful story, what happened to her being in the placebo arm, but, mm, she ended up finding underground work on her own and did M D M A work and was able to experience the pleasure of touch she had that had been extinguishing her in. And, um, and even just like holding a hand or having someone just touch her shoulder, like she talked about how the two therapists, the man and woman she worked with in.

Just, you know, they negotiated and talked about touch a lot, but by, um, the second or third M b a assisted session, she was really able to want and feel safe with touch. And that continued outside of sessions. Like it wasn't just though she's high on M D M A, the thing like No, she, um, and even, you know, when I see her now, occasionally she'll ask me, I was let lead, but you know, maybe one in three times.

I see. Seriously, couldn't, couldn't I have a hug? And it's, it's when I just, every time she says it, I think that's amazing. This is a woman who's spent so much sexual assault from men have hurt, so many men have hurt her so badly. The again, and here me, I'm, I'm a tall man in authority. Her doctor, and you know, she sees me like, I really want a hug.

Mm-hmm. Yeah. This says a lot about the healing power of M D M A assisted therapy and other psychedelic assisted therapies that. That you could go from, don't touch me to, to your touch feels safe and good.

Nicole: Yes. And the power of the relationship of the safe space that you are creating, you know, with your warm empathy, with that paired together can be so incredibly powerful.

And, you know, I'm thinking about my own experiences on the medicine and the benefit of pleasure even without touch, like the ability, I'd be curious if there's any sort of, um, Modalities that are walking people through or doing like guided meditation work on embodiment, right? Like I've had experiences where I've not been touched by anybody at all and felt deep, deep, deep pleasure in my body just by being able to connect and tune in and focus into those areas.

I think that's where my understanding of somatics and all this starts to tune in and come together where I'm just curious. Do we ever guide people through meditations of connecting to pleasure in their body? No touch clothes on everything. Right? Like just allowing someone to feel that in their body, I think can be a powerful space.

So much of our work is all up here in the cognitive. Mm-hmm. But I'm just curious about the actual embodiment and the therapeutic benefits of that as well. Yeah.

Dr. Craig Heacock: Well, I hope people are doing that. That needs to happen. Yeah. I mean, I was just reminded of my first psy psilocybin experience when I was 18. At one point I just laid down in this, um, in this meadow.

This was on the side of Pike's Peak, on this beautiful fall day and just talk about the touch. But this was like the, the ground and the grass. Ah, and it was one of the most vivid memories of my life, of just like going into oneness of all that. It just like, great, the right, just the, the buzzing humming.

Biosphere and just realizing like it's boundaryless and it's all connected. Mm-hmm. And again, that sounds kind of cliche and woo, but it's true. Like if, if you've experienced psilocybin, you know that to be true, that psilocybin opens you to that channel and you know that's touch like nobody was touching me, I was just touching nature.

True, true. Sure, true, true. No was touching grass and dirt and it was ecstatic. But I think you bring up a good point that so many people who are hurting, especially people who've been hurt by other people, Have become disembodied or numb or, yeah. And I think a lot of powerful work with ketamine or and psilocybin or and M D M A involves this get in touch and feel your body and your body's amazing.

Mm-hmm. And our bodies are here to help us and to serve us and to bring us pleasure and to, they're amazing. Yeah. But yes, so often trauma just shuts down the body and Right. And just becomes. Sort of screeching smoke alarm of the amygdala in the frontal lobe. Mm-hmm. But not, but the body is just offline.

Nicole: Right, right, right, right. And. It's important to be able to process those things in a cognitive way, have relational support and do all of that work. But I feel like the field of psychology is missing a piece. If we stop, if we don't reconnect to our body, we don't take the time to honor that. That is also a part of the therapy is being able to feel again, because that is part of what happens through trauma is that severe disconnect.

And so I think, you know, medicines like these can be so powerful, at least through my own lived experience mm-hmm. Have been very powerful in bringing back that sense of connection to my body in a way that I could have never imagined otherwise. And I think my, my hope is to continue to integrate that experience in a, you know, sober state of that mind body connection.

You start with feeling that on the medicine and then continuing to integrate. Knowing that that level of connection and capacity of feeling is possible, but bringing it back, you know, maybe through other ways like yoga or breath work or other sorts of things like that, but that feels like such a key piece of the whole spectrum when we're talking about healing through sexual trauma.

You know, that initial processing, the relational safety, and also the body piece. I just, I get so frustrated that this gets left out of the

Dr. Craig Heacock: equation. What about in your doctoral training? Are you doing, are there any classes or nothing Somatic work?

Nicole: Nothing. Nothing on somatic therapy, and I scream all the time about it to my professors, because I'm like, where is this and why not?

And I think. I'm sure you can imagine, you know, it's, it's, it's part of the history of the field of what, you know, the, the way we do healing is talk therapy. We process these things and there, I mean, that's a whole western, you know, sort of thing, a colonial thing that has deconnect us from our bodies and doesn't see the benefit of that.

There was some discussion in my, um, trauma class about Peter Levine's work and somatic experiencing therapy, but one day, you know what I mean? There's, there's no deeper connection with this and I think. The medicines like M D M A and these other experiences, like you said, s Sabin. I think, you know, in my own, the safety of my own home, listening to music and feel the, the base in my body, that was a powerful experience that I think could really, at least for me as a sexual assault, uh, as a sexual assault survivor to reconnect to my body in that way has been life changing.

And it makes me one sad that there's not enough space because of the stigma around all these things to talk about that. And I imagine there's lots of stories of people who have these sorts of experiences, and I just am very passionate about making sure that that's a part of the discussion around sexual assault, healing, and especially psychedelic work.

Dr. Craig Heacock: Yeah, I'm guessing in psychiatry residency, somatic therapy's not a topic either. It wasn't when I was, when I was at residency oh 1 0 5 mean we learned, I think five different modalities of psychotherapy, which was awesome, but I don't think somatic and, yeah, I mean, I have to say that the few somatic therapies sessions I've done both with and with without psychedelics have been so unbelievably powerful, like shock, shockingly powerful that what lives in the body.

And each time I've done a somatic therapy session, I, I can't quite believe it as it's progressing. You think this is so powerful and I can't believe what's coming up. And we're only like four minutes in. Right. We're seven minutes in. Right. So it is a shame that psychiatry and psychology is largely ignored.


Nicole: right? Right. But that's also why we get to be a part of shaping that new future, right. Through having conversations like this through. Remembering this and through bringing this lens when we're talking with other colleagues about the importance of this part, that is often left out because, you know, the reality is our, our experiences are embodied.

And if we're forgetting that half we're, I would say we're forgetting half of the equation. Right? 50%, maybe more, who knows? But you know, like a huge chunk to say the least. Yeah,

Dr. Craig Heacock: so true.

Nicole: Yeah. Yeah. And I just hope that the people who are experiencing these things in their body and reconnecting outside of a, uh, trauma therapist lens and an office feel like they don't have to have shame for the experiences that they're having.

I think right now, without it being. Normalized as a powerful treatment. A lot of people probably still feel, you know, at least something I feel, feel shame to be able to talk about the healing that they've experienced on these things. And so I just, I hope that that can be normalized for people as we continue to legalize and create more space for this within the system that also people doing it outside of the system feel space for the true healing that they've experienced on these medicines.

Dr. Craig Heacock: Yeah. I wonder too, even thinking of like risks of these versus. You know, legal marijuana, legal cannabis. You know, I've talked about this in my podcast in a couple episodes, but you know, here in Colorado we're regularly seeing people have psychotic breaks mm-hmm. And convert to schizophrenia schizophrenic disorder from using large amounts of T hc, whether just straight up t hc like ding, or the really potent sativa's.

Yeah. And, you know, was the last time I saw someone in my office with a P Sabin problem? Never. I've never seen that. Never. Yeah. Have I seen, have I seen people that have abused? MD May. Sure. But as a primary reason to seek out psychiatric treatment, I've never seen that. Mm-hmm. I've had a, a small handful of people who are ketamine addicts mm-hmm.

In the last 20 years. But, but I generally think of these three that we spent time talking about today. I mean, having seen gazillion patients over the last two decades, tho those don't factor in terms of. Leading to big psychiatric problems. Nothing like, nothing like alcohol and weed.

Nicole: That's exactly what I was gonna say.

What about alcohol? The one that's completely legal and we're just like, yeah, that's fine. That's fine. Yeah. Death most, you know, suicide, you know, taking away, you know, lowering your, in your inhibitions and there's a lot of suicide that occurs on. Alcohol and all the other things that come with that, but that's the legal one.

That's the one we can, we can take pictures of and, and post on our Instagram and that's fine. You know, like, it's just such an interesting world. I think people are starting to see more and more how, you know, the scheduling schedule one of these sorts of things are just a complete, you know, propaganda piece of what does and does not fit in.

Yeah. Within the system. Within the system. If we look at addiction rates with alcohol, our legal drug, Wow. Right. Like I just think the hypocrisy is becoming so clear that it's gonna be hard for people to ignore the more science comes out about these things. Yeah.

Dr. Craig Heacock: I know you think of alcohol rich sil, I mean, it's just comical and awful to think about the.

The risk profile Yes. Of those two. Yes. Yeah. How many, how many people's lives are completely destroyed by alcohol? How many marriages are ruined? How much child abuse is fostered and neglect. Mm-hmm. And I often think, like when you think of sort of the scary externalizing things of alcohol, like, would you weather rather walk down a dark street with, uh, a bunch of people who are really drunk or a bunch of people, like on mushrooms like you would.

Nicole: Yeah. Is that even a question? Mushrooms? A hundred percent. They'll give me a high five down the alley. I'll be like, cool.

Dr. Craig Heacock: We're one. Yeah. Or they might skidder away, like, are are you? Are you okay? But you know, alcohol, yeahs disinhibition Yeah. Tends to bring out the worst and all of us, so Yeah,

Nicole: I know. I know, I know, I know.

So it's one conversation at a time, like talking about these things, raising the collective consciousness about these things to. To understand that the narratives we've been sold might not be truth. Right. Hmm. Yeah. I wanna be conscious of your time too, and unless you have anything else on your heart that you really wanna share, I do have a closing question that I ask everyone on the podcast.

Dr. Craig Heacock: Sure. I might just say one thing before your closing question. Yeah. Um, I have a podcast called Back from the Abyss Psychiatry and Stories, and it's, it's a bit like this. American Life meets psychiatry. So it's patients telling stories of plunging into psychiatric darkness. Mm-hmm. And how they got it out and with cool music and yeah, it's, uh, check it out.

I think you might like it. Mm-hmm.

Nicole: Yeah. So the one question I ask everyone is, what is one thing that you wish other people knew was more normal?

Dr. Craig Heacock: I'm thinking, and this partially has to do with my age, and I'm 56 and I have twins, girls who are 21 and. My oldest is 24, my daughter. Mm-hmm. And I think, I wish we could normalize more that, um, we're all gonna fail our kids.

Mm. You know, like there is really something to being the good enough mother. Like, you know, as I tell my parents that I see when they're so upset about their young kids, I'm seeing, I'm like, look, we j if we can just like, we're aiming for a B minus, like if we can love our kids and have some patience and.

We're all gonna hurt our kids. You know, much like we do as therapists with our clients, like we're gonna fail them. We're gonna say and do things or not say and do things that are very hurtful, right? So, you know, my wife's a therapist too, and we often joke, uh, how are we screwing up our kids? But, you know, we have, we have heard our kids, you know, our kids have been in therapy cuz of the us we don't.

Um, so I think again, To have some compassion self-compassionate parents that it's totally normal, that you're gonna fail your kids and you just like get up and you try again and you try to give a heartfelt apology and learn from your mistakes and just keep going. Because perfectionism and parroting is a road to misery, right?

Nicole: Absolutely. And even to, to push on that and reframe with you, I mean, dare I say then that's actually. Wonderful parenting, right? Because the reality is we're all human, and so if you're teaching your children that I am human, I am going to fail, I am going to mess up, and we can still stay in relationship.

That's normalizing the rupture and repair of human connection so that when they grow up, when they're in other relationships, when they mess up, they don't feel like that's the end of the connection. It is part of the process that is part of the humanness of being in connection with other people. And always having that as part of the nature of any sort of relationship, I would say is wonderful parenting.

But yeah, normalizing that that rupture and repair humanists are failure in that as part of that process is mm-hmm. Is such an important thing. Cuz there's so much pressure to be perfect. To be good, to do it exactly this way. And, and like you said, I don't, I don't think that's possible because that's not human.

That's not what it means to be a human.

Dr. Craig Heacock: Yep.

Nicole: So great. Yeah, it was lovely to, this is so fun.

Dr. Craig Heacock: Yeah, it was lovely to, I'm glad you invited me. Thank you.

Nicole: Yeah, it was lovely to have your expertise and to learn from all your work and all your research. I really appreciate you coming onto the podcast today.

Yeah. Thank you so much.

Dr. Craig Heacock: Absolutely.

Nicole: If you enjoy today's episode, then leave us a five star review wherever you listen to your podcast and head on over to. To modern Anarchy to get resources and learn more about all the things we talked about on today's episode. I wanna thank you for tuning in and I will see you all next week.


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