Holistic Psychiatry Podcast

Over the years, a number of practitioners have reached out, sometimes with specific questions, but more often to ask how they can learn more about root cause psychiatry. The amount of information can feel overwhelming: * One condition, such as depression, can be caused by different roots. * One root, such as copper overload, can cause a range of symptoms, including anxiety, hyperactivity, inattention, depression, and insomnia. * One root, such as mold toxicity, can contribute to other roots, in fact, to almost all of them. * A seemingly psychological root such as attachment disruption, trauma, or chronic stress, can lead to limbic and autonomic nervous system dysfunction, but also drive inflammation and high pyrroles. Most people will have more than one root at play. After thinking about what would have been a helpful starting place for me, I put together one page of what I see as the most common roots, each with a few of its more prominent symptoms and traits. Simply a place to start. Though this was written for practitioners, anyone is welcome to download it. Common Root Causes of Brain Symptoms Checklist You’ll notice the checklist asks for your email. That’s because I’m creating a separate email list for practitioners, so I can send resources meant for clinical work without filling everyone’s inbox. This includes an upcoming free 4-week course for practitioners (described below). If you’re not a practitioner but interested in a potential course for individuals and families, you can share your interest here. Coming soon for practitioners On Monday, October 26, I’m starting a free 4-week pilot course for practitioners and those in training. We’ll go deeper into recognizing these roots and how they’re evaluated. You’ll find the invitation right after you download the checklist, but I’ll also share more here next week. Until next time, Courtney Courtney Snyder MD is a holistic, functional, and environmental psychiatrist for children and adults. Find her at courtneysnydermd.com and on the Holistic Psychiatry Podcast on all major platforms. Medical Disclaimer This newsletter is for educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Consult your own physician for any medical issues you may be having. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

If you’ve been working very hard to heal and still feel stuck, I made this episode for you. I also made it for practitioners who wonder whether they’re overwhelming some patients with too much information, too many protocols, and too many steps. I share my own story of perfectionism during my illness, who tends to be vulnerable to this pattern, how it affects the whole family, and the tools that help the body and mind feel safe enough to heal. Chapters * 01:56 My experience with perfectionism * 04:28 Who is vulnerable? * 06:46 The risks and benefits of research * 10:51 The impacts on family, spouses, partners, and children * 13:27 Practitioners can be perfectionistic too * 14:57 Healing requires safety * 17:24 What helps? * 20:41 Advice for the practitioner * 21:53 My own turning point * 24:57 Resources If you’d like to help get this information out into the world, please consider liking, sharing, or commenting. Leave a comment Share Until next time,CourtneyCourtney Snyder MD Dr. Courtney Snyder MD is a holistic and functional child and adult psychiatrist and host of the Holistic Psychiatry Podcast and can be found at courtneysnydermd.com Resources mentioned: * High Sensitivity Through 3 Lenses: The Highly Sensitive Person, Pyrrole Disorder & RCCX Theory — https://www.courtneysnydermd.com/blog/high-sensitivity-hsp-pyrrole-disorder-rccx-theory * Limbic System Dysfunction & What We Can Do About It — https://courtneysnydermd.substack.com/p/limbic-system-dysfunction-and-what * The Vagus Nerve: Your New Ancient Best Friend — https://www.courtneysnydermd.com/blog/the-vagus-nerve-your-new-ancient-best-friend * Complex Illness, Brain Symptoms & Paths to Healing with Neil Nathan, MD — https://www.courtneysnydermd.com/blog/complex-illness-brain-symptoms-paths-to-healing-with-neil-nathan-md Medical Disclaimer This podcast is for educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Consult your own physician for any medical issues you may be having. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

In this episode, I have the pleasure of speaking with Dr. Neil Nathan about the intersection between brain symptoms and complex illness. Dr. Nathan has practiced medicine for over 50 years. He is one of the leading experts in complex chronic illness and mold toxicity — author of the bestselling Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivity, and Chronic Environmental Illness and The Sensitive Patient's Healing Guide. I am grateful to call Dr. Nathan a mentor and colleague. His pioneering work has been responsible for my healing from chronic illness, as well as that of many patients I've treated. Together, we co-lead a small peer group (within the larger mentoring group he provides with Marie Matheson, ND), supporting practitioners who treat those with complex chronic illness. In this episode we discuss: 03:43 – Dr. Nathan’s path to understanding complex illness11:20 – Why complex illness is rising and underrecognized19:30 – Why new medical ideas take decades to reach patients23:15 – Mold, Lyme, and long-COVID: the “big three” root causes25:58 – The limbic-vagal-mast cell “trifecta”30:31 – Are some people born more vulnerable?44:39 – The risk in “just do limbic retraining” advice 47:35 - Biochemical contributors49:26 – Structural root: jaw and cervical instability53:58 – Differentiating Between Mold, Lyme & Long-COVID58:49 – A message of hope, and where to learn more Full Transcript below You can find Dr. Nathan’s books, consultations and mentoring program through his website at neilnathanmd.com. If you’d like to help get this information out into the world, please consider liking, sharing, or commenting. Until next time,CourtneyCourtney Snyder MD Dr. Courtney Snyder MD is a holistic and functional child and adult psychiatrist and host of the Holistic Psychiatry Podcast and can be found at courtneysnydermd.com Medical Disclaimer This podcast is for educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Consult your own physician for any medical issues you may be having. Full Transcript Dr. Nathan’s Path to Understanding Complex Illness 03:43 Courtney: I’m so glad we’re doing this, and I feel like it’s long overdue. As you know, in the mental health space in psychiatry, there’s a lot of recognition of a dysregulated nervous system, threat response in the body, but oftentimes that’s attributed to external forces or trauma, and not necessarily internal threats that we see, obviously, in complex chronic illness, which we’ll be talking about. There’s also not the recognition of the relationship between physical symptoms and brain-related symptoms. So I know you’re going to help us connect a lot of these dots. As we sort of just lay the groundwork for what complex chronic illness is — when in your path did you start to recognize the distinction, when was the beginning of your work and appreciation of complex health issues? Neil: Okay, there are two answers to that question. First, when I went to medical school, my hope was to become a healer. And I was very disappointed that when I got there, I realized they weren’t going to teach me to be a healer. And back then I used to question my professors at medical school — why do you do it this way, and how is that? And I kept feeling in all of our interactions that we were missing something. And my professors would go, “Okay, Mr. Wise Guy, smart guy, what are we missing?” And I’d go, “I don’t know, I just know we’re missing something.” Later I would come to recognize that we were missing the emotional and spiritual component to whatever was affecting people in their illnesses. And I have language for it now — I didn’t then. The person in medical school who influenced me the most was Elisabeth Kübler-Ross, who I view as my main mentor in medical school. She, unlike anyone else, had a one-and-a-half-hour seminar once a week. Back then there weren’t video cameras — you were in a small confined room with a two-way mirror, and you’re sitting there watching someone do this. And she would simply interview one of her patients. She was a psychiatrist, but she was the only one in medical school who demonstrated how to really listen to people, how to really communicate with them, and not have this standard review of systems — here’s my questions, here’s your answers, and that’s what I do, and this is what I write up. She was really listening. She was trying to really take in, okay, what happened to you, and what’s going on with you? So I would want to give her credit as a role model to change how I learn to listen. Okay, that was step one. I’m going to fast forward to the early 1980s. And I am, at that point, the medical director of a regional pain clinic. And we are starting to see a whole bunch of patients who had this complicated process of fatigue, unrefreshed sleep, irritable bowel syndrome, and pain migrating all over their body. And back then we called it fibrositis. Now we call this fibromyalgia. And so whenever medicine encounters a thing that they don’t know what they’re looking at, it’s psychological until proven otherwise. And people would get therapy, and they would take antidepressants and anti-anxiety agents. Didn’t help much. And so it became clear to me that we didn’t understand what this was at all. It was not psychological. Something was going on in their bodies — now I recognize it as an inflammatory process. Back then there was no concept of that at all. And then, slowly, in the early nineties, we began to find pieces of the puzzle to understand what was triggering fibromyalgia. I was working back then with Jacob Teitelbaum, who did a lot of work with chronic fatigue and fibromyalgia, and we both independently came up with an understanding that a deficiency of magnesium, DHEA, adrenal issues, thyroid issues, sex hormone deficiencies, GI dysbiosis, and food allergy — if we looked at those and treated those, the majority of people with fibromyalgia got cured. It was different for different patients. It was not like there was one thing that caused it. And as time evolved, we began to realize that there was lots of other biochemical imbalances in the body that would contribute to this kind of a process that represented chronic fatigue and fibromyalgia. We discovered that Lyme disease and coinfections was a huge piece of that. And later still we discovered that mold toxicity was a huge piece of that. And so my understanding of the complexity — and it’s not really confined to chronic fatigue and fibromyalgia at this point, we’re really talking about almost all chronic illness — with a huge psychological component to that. So we’ve begun to understand this as essentially some version of inflammation. And if we start to really dig into what are the potential causes of that inflammation, we can make a huge impact for them. So this is a multi-year evolving understanding of how a person’s genetics, biochemistry, physiology impacts their whole being in every way. And that inflammation extends to the nervous system, contributing greatly, if not causing directly, a large number of what are now called psychiatric diagnoses. Courtney: Right. So even among those patients that you were seeing — you were seeing, I’m assuming, depression, anxiety, brain fog? Neil: Yeah, the vast majority of our patients with mold toxicity have brain fog and anxiety, depression, OCD behaviors, mood swings, depersonalization, derealization. I mean, all of that is super common in our patients. Complex Illness Is Rising — and Underrecognized 11:20 Courtney: Do you feel like this is more recognized now — or do you feel like the number of people being hit with these complex health issues is increasing — or both? Neil: Both. I would love to say that the medical profession is increasingly recognizing all of this as important, but that recognition is coming very, very slowly. The majority of folks out there, if they were to list the symptoms that they… This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

In this episode, I have the pleasure of speaking with Andy Mort. I think you will appreciate his wisdom, poetic way with words and sense of humor. Andy is a UK-based songwriter and musician whose work as a creativity coach explores the intersection of high sensitivity, creativity, and the influence of culture. Aside from sharing some of our own experiences with high sensitivity and gentle rebellion, we discuss various ways those of us with high sensitivity (as described by Elaine Aaron) might better align with our nature. We also discuss: * 00:00 — High Sensitivity and Its Misconceptions * 01:54 — The Concept of Differential Susceptibility and Environmental Impact * 03:47 — Andy Mort’s Journey Into Understanding Temperament and Sensitivity * 07:05 — The Discovery of the Highly Sensitive Person Trait and Its Biological Roots * 09:58 — The Idea of Being a Gentle Rebel and Leading With Authenticity * 14:51 — The Importance of Creating Supportive Environments for Sensitive People * 19:47 — Creativity as a Form of Self-Expression and Nervous System Regulation * 25:07 — The Role of Sensitivity in Leadership and Group Dynamics * 29:58 — The Challenges and Opportunities of Sharing Creative Work * 34:46 — The Societal Narratives Around Sensitivity and Self-Acceptance * 39:57 — The Importance of Community and Support for Sensitive Individuals * 45:06 — The Concept of Gentle Rebellion and Aligning With One’s Nature * 49:45 — Closing Thoughts on Sensitivity, Creativity, and Leadership Full transcript included below Where to find Andy Mort: * 🔗 Website: andymort.com * 🏡 The Haven (his coaching community for gentle rebels): the-haven.co * 🎧 The Gentle Rebel Podcast on Apple Podcasts: listen here * 📺 The Gentle Rebel Podcast on YouTube: watch here As always, I welcome your thoughts and questions. Until next time,Courtney Dr. Courtney Snyder MD is a holistic and functional psychiatrist for children and adults. Find her at courtneysnydermd.com and on the Holistic Psychiatry Podcast on all major platforms and on YouTube. Medical Disclaimer: This newsletter is for educational purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Consult your own physician for any medical issues you may be having. Full Transcript Introduction to High Sensitivity and Its Misconceptions 00:00 Courtney: I was just reading on your website, how nicely you ask, “ What drew you here.” And you say — “you might have been told you’d solve your innate sensitivity by toughening up and squeezing yourself into a shape and rhythm you don’t belong to. But sensitivity is not a problem to fix. Working with it may require a creative way of understanding yourself, and of building environments and rhythms that support you.” Seems fitting with what we’re gonna talk about. Andy Mort: Yeah, that’s good — it all, it all fits, it all relates together, yeah. Courtney: It does. I should tell you too, the last podcast was on high sensitivity in children — helping parents sort of create environments for highly sensitive children to thrive. But this is more about how we can create our own lives. I think we’ll see where our conversation evolves, but how — how can we as adults do that? The Concept of Differential Susceptibility and Environmental Impact 01:54 Andy Mort: Yeah, I think those two things are two sides of the same coin. And in the, I guess, the context of environmental sensitivity — I don’t know if you talked about sort of differential susceptibility, and that research that’s shown how the more sensitive you are, the more affected you are by your environment. And so for children — those early years’ environments are really important, in terms of, for better or worse, a sensitive child is impacted by their environment, and they will thrive and flourish if it’s nurturing and supportive, and vice versa if it’s not. But as we will, I think, talk about — that is not the end of the story. It’s not that there’s this sort of deterministic element that means you will forever be screwed as a sensitive person if you grow up in a non-supportive environment. Courtney: Yeah. Andy Mort: And there are things that we can get in place around us today that actually start to heal that stuff — Courtney: Right. Andy Mort: — if it’s gone wrong. Courtney: Yeah, a lot of what I try to share is how people can lower that physiologic stress response — whether it’s related to toxins, trauma, early attachment. But included in that, and which I have never until recently spent time on, is how not being in alignment with our temperament would be creating a chronic physiologic stress response. You’ve been teaching, talking about high sensitivity — is it twelve years now, or is that really when your community started? Andy Mort’s Journey Into Understanding Temperament and Sensitivity 03:47 Andy Mort: Yeah, the community started twelve years ago, 2014. And for a few years before that, I was exploring it really out of, I guess, the background was my music, as a songwriter and as a performer. I was exploring aspects of temperament and personality as it came up — as it was relevant, really, because I’ve found myself struggling with certain elements of going out on tour, being — yeah — both on the road and also at shows themselves, where it’s like, man, my energy is just depleted at certain points. And I’m finding myself energized by other things that don’t make a whole lot of sense when I speak to other people, who are like, how can you get on stage and perform? It’s like, well, that’s the part I love, that’s where I’m in my happy place. It’s the navigating to the venues, working out what am I going to eat, where am I — like, all of that sort of the details around it, like that. That was the stress for me. And so, started hearing or reading — there was articles about introversion, the first time I’d heard about introverts and extroverts at that point — and that just took me, I guess, down a rabbit hole that ended up with me talking about it, and then people responding to it, saying, that sounds like me, that’s similar to this situation I have at work. And it just all — yeah, I guess — kind of moved together, and ended up with me somewhat accidentally creating the community, but as a place for people to just gather and share those sorts of experiences, and for me to workshop things and stuff as well. Yeah, was never an intention — which is a theme in my life. But then I kept seeing this term, highly sensitive person, coming up, and dismissed it over and over, because it didn’t feel particularly relevant. I think it was — as I’ve reflected on it, sort of in the years since — it’s the word “highly” rather than “sensitive” that I have a bit of a resistance to, because, like, to me, “highly” is associated with, like, being very highly strung, or, like, high — it’s like very high frequency, like the opposite of me, because I’m quite chilled out and calm — Courtney: Right. Mm-hmm. Andy Mort: — in situations and things like that. So yeah, highly sensitive was like — yeah, that combo doesn’t work. The Discovery of the Highly Sensitive Person Trait and Its Biological Roots 07:05 Andy Mort: But then I just clicked through on one of these articles at some point, and landed on Elaine Aron’s initial self-test list. And for so many of the things, I was like — yeah. All but about three or four of them sounded right. And that made so much more sense as an underlying biological trait, rather than a personality type — because that allows for — Courtney: Mm-hmm. Right. Andy Mort: — like, all sorts of personalities, and preferences, and tastes, and all of that sort of stuff. It’s like, that’s more freeing, rather than what I kept seeing in these Myers-Briggs profiles, was — I’m being pushed into a box here, where the question is, do I rebel against that, or do I try and conform to how I’m supposed to be, given that I’ve got this label that I’m, you know, is defining me in some way. Yes. Courtney: Right. And so this idea of there being just diversity within high sensitivity… This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

With it being back to school season, this topic feels especially timely. In this episode, I have the pleasure of speaking with family advocate Tracy Spiaggia, founder of Slingshot Health Coaching, about recognizing high sensitivity in children and how to support sensitive children and their parents. We discuss the core traits of the Highly Sensitive Person (HSP) trait, Tracy’s great “power strip” analogy for sensory overload, and why the tripping of the power strip (the stress response) can look different in different children (fight, flight, freeze, or shutdown). We talk about challenges that may point to high sensitivity — school behavior problems, breakfast refusal, perfectionism, somatic complaints — and the practical framework Tracy uses with families to sort the “immovables” in their lives from what can actually be changed. We each share our own experience growing up as highly sensitive children, and how we each began our parenting journey largely unaware of this trait. We address the importance of awareness and self-compassion for parents. And, we close with commenting on the value of identifying and addressing pyrrole disorder- a fairly common biochemical imbalance in those with highly sensitive who are struggling with brain and physical symptoms. Timestamps: 0:00 Introduction to high sensitivity and its importance2:04 Recognizing high sensitivity in children and adults3:58 Parental support strategies for sensitive children5:52 Stress response styles and their impact7:56 The physiology of high sensitivity and overstimulation9:59 Creating modifiable environments for thriving12:06 The evolutionary purpose of high sensitivity14:04 Practical tips for supporting sensitive children in school and home15:58 The importance of self-awareness and compassion in parenting18:04 The role of nutrition and physical activity in sensitivity management20:02 Supporting adult highly sensitive persons22:11 The power of community and shared experiences24:04 Overcoming shame and embracing sensitivity as a strength25:59 Practical steps for creating supportive environments28:00 The importance of ongoing learning and adaptation29:53 Closing thoughts and resources for further support Introductions (0:00) Dr. Courtney Snyder Welcome to the Holistic Psychiatry Podcast. I’m Dr. Courtney Snyder, a physician and holistic child and adult psychiatrist. In this episode, I have the pleasure of having a conversation with Tracy Spiaggia, who is an experienced health coach who works with families. Using Elaine Aron’s term of the highly sensitive person, HSP, Tracy and I will discuss high sensitivity in children. This trait, as Tracy will mention, occurs in about 20% of the population. Tracy and I both consider ourselves to be highly sensitive, so in addition to sharing our professional experience, we’ll also share insights from our own childhoods, as well as insights from parenting highly sensitive children. Tracy is currently a candidate for a PhD in what will be Whole Health Leadership. She’s a Functional Nutrition and Lifestyle Practitioner, Certified Integrative Attachment Theory Coach, Brain Health Specialist, National Board Certified Health and Wellness Coach, and the author of the book From “Chained to Changed. Break Mental Strongholds and Transform Your Life Through Faith.” Courtney We have so many intersections in terms of what we care about and are interested in — nutrition, functional medicine, attachment, families. Tracy Why I hang on every word you put out. Courtney Thank you. Thank you. Courtney One of the things that I was thinking about is how much people do to support children that have all these different issues, but there’s not a lot of recognition of high sensitivity in children, nor what their unique needs are. They’re living in a world that’s not designed for high sensitivity. As we talk, we can help raise awareness about what that looks like — how to recognize when a child is highly sensitive, and not in a symptomatic, pathologic frame, but really, that’s who they uniquely are. And then we’ll move into how to help people make choices to support these children so that they can thrive, and also recognize the situations where they’re probably not going to thrive as easily. Tracy Correct. And then how, as a mom and dad, can I modify my expectations on the child and give them a lived experience that best aligns with their sensitive nature — so that they can become who they’re supposed to be, not vicariously living through the child, especially if you’re a non-sensitive parent. Courtney We should talk about both — when the parent is also sensitive, and then when they’re not necessarily, ‘cause there’s different dynamics that would come up. Tracy Yes, yes, yes, absolutely. Especially if the sensitive parent never knew — hello, never knew anything about HSP. And so you’re raising your children, and then when you come to find out, like, your whole brain just explodes in. And then I just kind of really became a completely different parent, almost on a dime, finding this work. And I felt the most free I’ve ever felt in my life when I came across the work. So yeah, we’ll talk about that too. Growing Up Without an Awareness of the HSP Trait(3:21) Courtney I know — I think like you, I look back and there’s things I would have done differently. Now having a daughter who’s twenty-one, certainly learning when I did has helped her, and this information helps her even make her own choices at this point. When I thought about parenting, it also made me think about being a highly sensitive person, and my own experience as a child, because there certainly wasn’t language back in the sixties and seventies. Tracy Here’s a great example. I’m going to make it personal instead of hypothetical. My parents — we came from a household where my dad was a police officer, my mom stayed home, four kids, money was super tight. And so the summer would come, and I now, as a seasoned mother, I can only imagine how she’d be like, almost dreading it — like, “oh my gosh, they’re all here.” So we would have to go to swim team ‘cause it was free from the town. We’d have to go to the town pool. We’d have a choice — we weren’t asked, “you’re going to swim team.” And if my memory serves, it started super early, maybe seven, eight o’clock in the morning. Back then I was just a bag of bones, I was so thin, and that water was freezing. I had no idea why I was so terrified to perform in front of others, but that’s part of the HSP. Like I shared earlier — when I came across this work and all of the questions that were asked to see if you fall on the spectrum of HSP, I’m like, yep, yep, yep, yep, yep. But when it was my turn to compete, I would nine out of ten times not show up on my block. I would hide in the bathroom. I’d even get good at climbing up on top of the toilet with the door closed, so if my mom came in — you know, you can’t see feet. So I would hear my name being called, like, “McMurray, block three,” and I wouldn’t show up the vast majority of the time, because I’d rather the punishment on the back end than have to endure a public display of competing in swim team. So I give that as an example — if a parent were skilled, the first time I don’t show up for my competition, there should be some really safe but powerful questions being asked, like, “hey, what’s going on for you? I noticed you weren’t there, you didn’t show up.” Obviously you’re not doing that to — the parent should be able to say, “obviously you’re not doing that just to irritate me,” but we take it all so personally as exhausted parents. But if they were skilled, they could ask questions, and I’d be able to say to them, “this is really scary for me, I don’t want to do this, I don’t like getting into the pool at seven in the morning, I’m freezing, I’d be blue, I don’t like this, I don’t want to do this.” And then they’d say, “my goodness, okay, you don’t have to do this anymore, you can come and stay home and we can figure out what you enjoy.” I didn’t grow up… This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com