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Integrative Psychiatry

Integrative Psychiatry: Past, Present and Future by Scott Shannon, MD

By November 21, 2020No Comments

Where are we in Psychiatry? What is the future for mental health?

Come join us with Dr. Scott Shannon as he talks about Integrative Psychiatry: Past, Present and Future.

FULL TRANSCRIPT

Not to be too morose on this, but I think, you know, we don’t want to dismiss all the advances and scientific underpinnings that have been developed, and how far we’ve come. But I think we really need to be able to see that history has something to teach us. And basically, one of the things that teaches us is that because the brain is so complex, and so difficult to understand and manage, that we will develop these ideas about how we can approach mental illness that makes sense to some degree and give us some comfort.

Where are we in Mental Health?

Number one, neuro psychiatric disorders are contributing most to morbidity in the modern world in the United States. As of 2020, depression is the number one disabling condition worldwide according to the World Health Organization, medical spending, if we look at medical spending, both institutionalized active duty military and civilian, we see that mental disorders at far outpaced the next competition and and this spending is accelerating. So in 10, or 15 years, probably the spending for mental disorders will be twice that of the next most impairing condition.

Trauma

As we understand the profound, lifelong implications of early life trauma, this becomes something that could shift and potentially dramatically change should shift and potentially dramatically change our approach to all mental illness. If you go into a community mental health center, it seems unusual to find someone who doesn’t have an ACE score over five. And this is one of the great flaws the problem. And the reason why the DSM is not built more centrally around trauma, is because it creates a shift that moves us from a biological perspective, that there is a chemical imbalance that we and we alone can master and treat to an understanding that people’s life experience changes and alters their trajectory. And that it’s incumbent upon us to not only relate to them and their life experience and trauma, but also to figure out ways to prevent it. And I think we’re doing horrifically, in both of those.

Here is what we have: Our medications place us in a fight with homeostasis.

We’re losing ground in mental health, our culture is toxic and debilitating. And I think as psychiatrists and mental health professionals, we need to be advocates for that type of change. We have no interest in defining what the health and mental health is. And as such, we have little ability to practice prevention, talk therapy works, but has little true support or philosophical inclusion. And our medications place us in a fight with homeostasis. So that basically, when you introduce a neuroleptic in someone, their body and their brain does its best to create more dopamine and more dopamine receptors.

Our Future: The Body is Impportant

So I think the future for mental health is understanding that the body is damn important. And I mean, this should not be a revolutionary insight. And the fact that if inflammation is going on in the body, it affects the brain. If gut function is impaired, it affects the brain, you know that if diet is poor, it affects the brain, that if our water is polluted, and our air is polluted, it affects the brain. So this is important, and this is crucial. And this seems like sort of common sense. our grandmothers could have told us this, but we’re going to discover it psychiatry is on that path to discovering it. And that new paradigm is opening up from here, I think this new paradigm is going to be one that honors the psyche in ways and it’s going to be a paradigm that moved from a model of suppressing the psyche, with antidepressants, anti psychotics, and medications, that blunt awareness and blunt capacity to a new model that is an evocative model that calls through and respects and honors all that we are an all that we can be as colleagues and collaborators for the people that we’re working with.

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.