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Integrative Psychiatry

The Future of Psychiatry By Scott Shannon, MD

By August 31, 2020No Comments

77% of the people in the US do not have access to a mental health in their county.

55% do not even have a provider in their county.

County’s around the country have reported that they are under a severe or extreme crisis.

The vast majority of children with mental health disorder ¾ or better as well as majority of adults that have the disorder never find treatment.

Functional Neuroimaging Modality relates how we assess the brain as psychiatry is the only specialty in medicine that does not base its treatments off of an organ assessment.

With Loreta technology you can see that you can do very specific localizations in the brain, getting feedback in what’s going on in different neurological centers.

Hypnosis on the other hand can offer an altered pain perception via sensory modulation or affect modulation based on the type of suggestion given.

FULL TRANSCRIPT:

A full 77% of the people in the US don’t have access to mental health in their county. 55% don’t even have a provider in their county, and counties around the country, the majority of them report that they’re in a severe or extreme crisis.

We have another above number of other features as a child adolescent psychiatrist. The vast majority of children with a mental health disorder, three quarters or better never find any treatment, the majority of adults with a mental health disorder, never find treatment. in Integrative Psychiatry, we’ve had this theme of body mind spirit that has sort of course through this field for the last 40 years that I’ve paid some attention to it. So, if we were to create these three pillars of body mind spirit, it might look something like this body is the hardware, mind is the operating system and controller, and soul or spirit depending on which term you like is the application.

So, the first thing that I want to talk about is not only functional neuro imaging, which is called Loretta, but this relates to how we assess the brain. Psychiatry is the only specialty in medicine that does not really study and basis treatments off of an organ assessment. neurology does it, every other specialty in medicine does it, psychiatry doesn’t. And I think that functional neuro-imaging, which is actually QEEG (Quantitative Electroencephalogram) has the opportunity to do that, as we start to go out into the realm of things that we can actually use in practice, we only have a few choices. Actually, the microscopic level because it involves cutting into the brain is just not practical. So, we get out to things like fMRI, PET scans, SPECT scans and one database.

If you look at the blue in the top, that blue rectangle, what you can see is that EEG gives us electrical detail down to the milliseconds which is critical on how fast the brain works. and it also gives us localization down to the seven to 10 millimeters so that is actually acute enough to be really helpful. It doesn’t have quite the detail of resolution of PET scans or SPECT scans, but it has a number of other positive attributes.

So what we see with Loretta technology and this is using a 19 lead, EEG assessment cap is that you can localize things down to very specific localizations in the brain. You can get feedback that helps you to understand what’s going on in different neurological centers and you can actually uptrain or down train, specific sites, like the cingulate or the amygdala.

Neurofeedback just building on that, is something that helps us to train the brain. It takes this quantitative electroencephalographic output, and we do real time biofeedback with it to alter the patterns. And we have very clear documentation that biofeedback works through opera and conditioning and, we now have very good evidence that neurofeedback works.

We also know that hypnosis can alter pain perception, and it can alter in different ways depending on the perception. We can do sensory modulation or affect modulation based on the type of suggestion that’s given. So there’s different ways to hack the system using different codes into the system. Hypnosis and this is something I learned in my study of Ericksonian hypnosis 20 and 30 years ago, is this really simply the power of communication and how do we learn to communicate well, to enhance the placebo effect, which is really at its core, our ability to self-heal.

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.