Integrating Spirituality and Trauma Care in Addiction Recovery with Dr. Michael McGee. Ep.48

Episode Overview

• Episode Topic: Welcome to Mastering Counseling, where we engage in the innovative intersection of wellness and vitality within psychiatric practice, guided by Dr. Michael McGee, the esteemed distinguished psychiatrist. His pioneering approach marries traditional psychiatric methods with profound spiritual insights, offering a fresh perspective on mental health care. Anyone can heal past trauma, transform patient care, and live life from the heart with clinical skills training, online courses, and much more from Dr. Michael McGee. His expertise in trauma-integrated care, particularly in addiction psychiatry, illuminates the path to a holistic understanding of wellness and vitality in therapeutic settings.
• Lessons You’ll Learn: Listeners are in for a treat as the discussion will reveal the transformative power of integrating spirituality into psychiatry, enhancing wellness and vitality in patient care. Dr. McGee shares his journey and the positive impacts of spiritual practices on addiction and trauma recovery outcomes. You’ll learn about the hurdles of incorporating these interventions clinically and the profound benefits they offer. The episode also highlights the crucial role of clinician vitality, emphasizing self-care and compassion as essential tools for practitioners. Dr. McGee’s strategies for balancing personal and professional growth provide actionable advice for fostering a nurturing therapeutic environment that supports wellness and vitality for both clinicians and clients.
• About Our Guest: Dr. Michael McGee stands out as a beacon of “Wellness and Vitality” in the psychiatric field. With over thirty years of experience, his work is at the forefront of integrating spiritual practices into mental health care. Dr. McGee’s focus on trauma and addiction psychiatry is complemented by his deep commitment to enhancing the well-being of both patients and clinicians. His approach not only aims to treat mental health conditions but also to enrich lives with greater meaning, compassion, and connection. Listeners will be inspired by Dr. McGee’s dedication to advancing mental health practices that promote holistic wellness and vitality.
• Topics Covered: The episode navigates through a series of engaging segments, all centered around the theme of “Wellness and Vitality” in mental health care. From the practicalities of blending spirituality with psychiatry to nurturing clinician vitality and compassion, Dr. McGee offers profound insights into creating more effective therapeutic relationships. The discussion extends to the resources and tools that can enhance mental health and well-being, including impactful books, online courses, meditations, and podcasts. For those new to the field or looking to integrate spiritual practices into their work, Dr. McGee provides invaluable guidance and inspiration.

Episode Transcript

Michael McGee: Basically, this is developing our capacity to love and be loved, basically to benefit ourselves and others. It’s a skills-based approach, like developing, for example, the capacity for empathy, or assertiveness, or collaboration, or forgiveness, or for practicing gratitude with others. If you haven’t learned how to love and be loved, I’m very interested in the idea and devoted to the idea that we can develop our capacity to love through intentional, dedicated, daily gentle practices.

Becky Coplen: Welcome to Mastering Counseling, the weekly business show for counselors. I’m your host, Becky Coplen. I’ve spent 20 years working in education in the role of both teacher and school counselor. Each episode will be exploring what it takes to thrive as a counseling business owner. From interviews with successful entrepreneurial counselors to conversations with industry leaders on trends and the next generation of counseling services to discussions with tech executives whose innovations are reshaping counseling services. If it impacts counseling, we cover it in Mastering Counseling. So glad, we are back for another episode in Mastering Counseling. Today we are very privileged to have Doctor Michael McGee in California, who is a distinguished psychiatrist with over three decades of experience, who has focused on blending spiritual insights and especially helping people with trauma and addiction psychiatry. Thank you so much for being here today.

Michael McGee: My pleasure.

Becky Coplen: Why don’t you go ahead and tell us, doctor McGee, how did you begin integrating spirituality with psychiatry? How did that process evolve over the years? We love hearing the history of how your profession has developed.

Michael McGee: I’m sure it started with my first job out of residency, which was on a unit treating patients with Alcohol Use Disorder and other addictions and learning about the 12-step recovery model, which is still the most effective model for recovery from addiction. And that is a spirituality-based program. And so in learning about the 12 steps and the integration of spirituality into recovery, I got very interested in the role of spirituality. And then over the years, learning about mindfulness and heart-mind practices and the work of Kristin Neff on compassion and other principles of Buddhist psychology that have now been integrated into the mainstream of mental health practice. It really has been super interesting to see the impact of that on people’s healing and recovery programs like, like dialect or treatment methods like Dialectical Behavioral Therapy, which has a strong mindfulness-based component, and then also my own personal meditation practice. I don’t have a particular religion, but I find that these kinds of mindfulness and heart-mind practices are just very beneficial for leading a wise and loving life.

Becky Coplen: Very interesting. And yeah, we have seen so many more practices everywhere involving the whole person. We see that in schools as well. Can you talk to us about some of these patient outcomes, particularly with addiction or trauma recovery? What are some of the ways that you have been able to help these people who are struggling so deeply?

Michael McGee: Sure. In terms of spirituality in particular, there’s limited literature, but there is a signal in the literature that shows that people who have had spiritual awakening type experiences may have as much as 2 to 3 to even 4 times higher rates of recovery than people who haven’t had spiritual awakening experiences. So it’s a super interesting kind of cutting-edge area of research of how to facilitate spiritual awakening experiences, to promote recovery outcomes. And we see that in some of the research with psilocybin, for example, and people having mystical experiences leading to just profound, incredible outcomes, for example, for nicotine, Tobacco Use Disorder, and Alcohol Use Disorder. So super interesting cutting-edge stuff that’s going on. And in terms of what we think about the awakening experiences, the experience of oneness or unity creates a sense of profound reverence and a sense of awe, and wonder, a profound sense of wanting to live to benefit oneself and others. Some might call that love, right? So that sense of unity can be simplified to a sense of love. And then that really a transition of motivation or intent to the way one lives one’s life from, let’s say, just trying to stay shut off and dependent and avoiding one’s pain and figuring and trying to manage one’s pain, to moving to living life from a place of wholeness and living to benefit one’s self and others.

Michael McGee: Just a profound transformation of agenda that can lead to downstream changes in behavior, in terms of being more open to connection and loving and being loved, and to taking care of oneself. So these kinds of awakening experiences can just be profoundly transformative. So how we go about nurturing and cultivating those experiences in our clinical work, in a responsible and evidence-based way, I think is a great and exciting challenge. Now, apart from that, I think that optimizing outcomes for recovery from any kind of illness really involves a holistic, biopsychosocial spiritual approach. So you need to really look at the recovery environment that people are in, their support, their structure, the stresses they’re dealing with, giving them a supportive relationship where they feel seen safely and apprised and affirmed and understood, undoing isolation and aloneness. Psychopharmacological interventions for Opioid Use Disorder, for example, with medications like buprenorphine and naltrexone, are a mainstay of treatment of Substance Use Disorders for Opioid Use Disorder in particular, but even for Alcohol Use Disorder. So this really comprehensive, holistic approach is really important for optimizing outcomes.

Becky Coplen: Yes, a lot of things that when you’re even involved in this field, if you’re not particularly working with addictions or trauma recovery, things that people may not have studied yet, or it might open up a window for those who are wanting to go into this type of work and understanding what they’d be learning about and understanding the human body and brain. So thank you for that. At this point, your practice, and I think we may get into this a little bit more later as well, but it seems like you are still working with patients and have your own practice, but then you are also coaching up and advising and speaking to other clinicians. Can you talk about how that works? Is it within your practice? Is it all over the state or the country? How does your network look?

Michael McGee: Yeah, my practice is moving more now toward training, mentoring, and nurturing other clinicians. And I have a national podcast on medcentral.com called Be Well, Practice Well. And basically, I’m super interested in the integration of clinician vitality with clinician skill. And I see an interplay and interaction between the two, between vitality and skill. One thing that has really become clear to me is that many clinicians who go into our field have their own history of trauma, and we know that in the general population, about 60% of people have had at least one adverse childhood experience. And from another perspective, in terms of Little “t” Trauma, we live in a somewhat toxic and traumatizing culture, all of us, in many different ways. So as clinicians, we are all dealing with some degree of trauma and it can be quite significant, or it can just be what you might call everyday trauma. So that affects our capacity as clinicians and it informs our capacity as clinicians. And so I think one of the most important things that we can do to be a good clinician is to attend to our own vitality, including our own trauma. And there are just so many aspects of that, right? So our own self-care and working in stressful systems, health care systems, and then developing our clinical skills in the context of vitality and wholeness is really super important.

Michael McGee: And for that, I’ve been doing more and more coaching on both individually, but I also speak at a number of different conferences and to different programs, and do a lot of training on how to provide a skillful treatment. And my focus really is on person-centered care and really accountable care, that is really focusing on developing both the therapeutic alliance and developing a buy-in, and a therapeutic allegiance and agreement about what work we’re going to do together, and also coaching on motivational interviewing type skills and in other words, how to help people change and grow. As part of that work, I, not only do this personally, but I also do coaching on what’s called feedback-informed treatment. And this is the work of Scott Miller and Bruce Wampold and others, and really moving towards measurement-based care and moving, for example, towards really not only getting satisfaction and outcome results with all of your patients but perhaps even interviewing or videotaping your sessions with your patients. I’m doing that now. And then finding coaches or other people who can review your work with you and go over it and give you feedback. I really believe that one of the core paradigms for excellence is the work of Anders Ericsson and others who have developed these models of deliberate practice, where you basically get feedback from your patients, videotape your work, work with the coach, review your work, and then identify areas for improvement of your clinical skills. Maybe it’s providing accurate empathy, for example, and then deliberately practicing those clinical skills in an over-and-over way to hone those skills intentionally over time. So I think that combination of practicing skills, developing those skills, and then and then really intentionally attending to nurturing our own vitality and addressing our own healing, that’s, again, the holistic way that I’m approaching training.

Becky Coplen: When I was looking at your website, two words did stand out to me, “Love” for sure, and everyone’s approach, and then the word “Vitality”. I really like that. A lot of people are saying self-care or recovery, but the word vitality, I really like that, and it speaks personally to me too. When you talked about most people having some type of adverse childhood experience, there is also the day-to-day, the things we’re seeing in schools or therapists, the stories that you hear, they affect you greatly and affect sleep and just your stress level. So I hear that. I’m on about day nine of my break from school. So right now, I’m feeling pretty good, but it’s always looming in the back of your head for sure. So thank you for taking all the things you’ve learned and trying to help out the younger, newer clinicians. Can you talk about some very specific ways that you help clinicians balance their personal and professional life? Do you give a lot of personal suggestions? Do you help them with scheduling? Do you advise on how many clients they should take? What are some really specific ways that you help clinicians in that way?

Michael McGee: Yeah, so that’s a really good question. There’s a superficial level of looking at what is the optimal balance of work, love and play, and self-care, those four dimensions for every different person. And it’s different for everybody. So everybody has to find that optimal balance for them. So that’s really super important. And part of that involves the skill of being able to say “No”. And the ability to prioritize and to schedule your priorities and all that kind of stuff and developing healthy habits. And so there’s all that cognitive, behavioral, organizational stuff that we all have to do, hopefully in the context of support and accountability and structure and routines and blah, blah. So and that’s all pretty much well known. But I think that stuff is very difficult to do. And my approach is actually to go a little bit deeper than that and look at the underlying dynamic issues that are sometimes driving people to self-neglect, to internal stress and burnout, and to living a life where they’re not getting their needs met in a way that’s balanced, that’s right for them. So those deeper issues really have to do with, I mean, there are different words for this in my approach. I call this appreciative attending, where you’re attending with inquiry and non-judgmental appreciation of what you find within yourself. And I know the government talks about compassionate inquiry.

Michael McGee: I think it’s the same thing. But really looking within in a very careful, open, and honest way and hopefully doing that with a mentor or a therapist or good friends, because I don’t think anybody can really, truly do this work alone. And then looking at what you see within. So for example, a refinement of intention, a lot of times people get burned out and are living a life which is harmful to them and not balanced because maybe they feel like they need to please other people. Maybe there’s fear, maybe there’s a sense of inadequacy, or maybe there’s a sense of a need for more money, or more achievement, or more recognition, or more status, or these things can be very subtle. So I really think that part of the practice of maintaining our balance and vitality is grounding ourselves in our goodness and a refinement of intent that is an ongoing day-to-day, meditative lifetime practice. So a lot of my coaching and work with people is around looking very deeply and honestly at those issues. And I don’t see a lot of that actually in the kind of burnout wellness literature. I mean, a lot of people have written about these issues, and there’s a lot that can be done on its systemic and organizational ways in terms of saying “No” and asserting yourself and even lobbying to address, for example, toxic corporate interests that are harming you and your workplace. So all of that is fine and good, but I’m super interested in the way that we process what’s happening to us. And then respond to it ourselves. That comes out of just so much of our wellness and vitality, is not so much what happens to us, but the way that we process it and then respond to it. So I think that that kind of that both internal and external orientation to managing wellness is important.

Becky Coplen: This episode is brought to you by mastersincounseling.org. If you’re considering enrolling in a master’s level counseling program to further your career, visit mastersincounseling.org to compare school options via our search tool that allows you to sort by specific degree types, tuition, costs, online flexibility, and more. You mentioned some different authors and some of the ways that you’re working with clinicians, but what are some specific books? I believe you’ve written at least one book or online course that you find most impactful, or you find yourself sharing the most with future therapists, psychiatrists, and counselors.

Michael McGee: Sure, I am actually right now super interested and have been really enjoying the work of Gabor Maté. His book, The Myth of Normal. I’ve really enjoyed it, and I’m actually working on another book which actually extends deeper. Some of the principles he’s articulated are called Heal the Hurt. And I hope to have that out next year. But basically, I think his work is good. I think the work of Tara Brach is very good at integrating mindfulness into healing. Those have been two really important influences for me from a larger systemic book. A really great book out there is called Healing by Thomas Insel, and that gives a more sociocultural, psychosocial look at our larger systemic issues, the work we can all make an impact on mental health at various different levels, both in our individual work but also on social, on larger sociocultural levels. So the book, Healing has been a big influence on me. I’ve written two books on recovery from addiction. One is called “The Joy of Recovery”, and the other one is called “101 Things to Know If You’re Addicted to Painkillers.” And I have an online course on my website on basically developing our capacity to love and be loved, basically to benefit ourselves and others and it’s a skills-based approach, like developing, for example, the capacity for empathy, or assertiveness, or collaboration, or forgiveness, or practicing gratitude with others.

Michael McGee: If you haven’t learned how to love and be loved, I’m very interested in the idea and devoted to the idea that we can develop our capacity to love through intentional, dedicated, daily, gentle practices. So anything in those realms I think is really helpful. I’m super interested in what’s evolving in the field of psychedelic psychotherapy, but it’s all very initiative, very tentative, and very initial. And I’m very concerned about the exploding kind of craze and fad about it and everybody doing it underground and unmonitored and those kinds of things. So I’m cautiously optimistic and hopeful about it, but also very alarmed about what’s going on right now and about the potential harm from the indiscriminate use of these agents. And then I’ll mention one other thing to you that has had a huge impact on me right now. There’s this sort of mushrooming of ketamine clinics and anesthesiologists and others giving ketamine with very little evidence base so far. I mean, there is some evidence base, and I think there’s hope and promise, but it really concerns me the way this is happening, with the risk of addiction and cystitis and people using these medications that in a way that is not paired with very skillful integration at work and risks of harm to patients and underground psychedelic use. And there are a lot of states like Colorado, and Oregon that are on a collision course with the DEA and the FDA around the approval of the use of psychedelics that are still Schedule One drugs. And so, even though I’m really interested from a research point of view and clinical point of view in cultivating awakening and the potential for psychedelics, for that, I think we’re maybe five or more years off from figuring out how to use them in a safe and responsible way.

Michael McGee: Another resource I’m going to mention to you that any counselor should really look into is our accelerated experiential dynamic psychotherapy. And this was developed first about 20 years ago by Diana Fosha. And it’s what we would call Fourth Wave Therapy. And it is, I think, the future of counseling and therapy. There’s a book that I would recommend people read called Undoing Aloneness and the Transformation of Suffering into Flourishing: AEDP 2.0, edited by Diana Fosha. And I think this book is just a game changer, it’s going to transform our field. And I do see great potential for integrating AEDP, potentially, safely, and legally with psychedelics in the future for profound transformations and healing of interpersonal wounds and trauma. The thing about AEDP is, it’s really an intensely interpersonal approach that really leverages a very direct, honest, warm, transparent relationship of knowing and being known, seeing and being seen and being understood, being cared for, being held in the relationship. But then also what’s called meta therapeutic processing, where you actually then above that begin to talk about what is like to have that experience with the therapist and then to process to get to very painful core emotions like hurt and anger and sadness and grief and process those emotions to completion and then be left in a state of what’s called transformation, where you then feel the sense of hope and a sense of knowing the truth of what happened to you and of where you’re at and maybe tapping into a core feeling of wholeness and then meta therapeutically processing. What is it like to have that experience with another human being who knows and understands and cares for you? And that leads to what they call in the AEDP language, transformation, spiral of growth. And I first learned about this from a colleague, Mark Green. And there’s a great book on the healing of complex PTSD that also really moved me by Stephanie Foo called “What My Bones Know” and that book she worked with a person who I think does ATP AEDP-like work. His name is Johnny Hamm. I think he’s the head of a trauma recovery program in New York. And his work and the way that Stephanie Foo talks about her therapy with him are just brilliant. And I would really recommend that for any therapist who really wants to see what healing from severe trauma looks like, in these emerging therapies, that’s what has been a big influence on me.

Michael McGee: The other thing I’ll mention to you that is having another influence on me right now is I’m studying the work of David Cooperrider on Appreciative Inquiry, which was first developed at the Cleveland Clinic in the 1970s. And there’s a whole field now that’s evolving over the past 50 years on Appreciative Inquiry, and your listeners can read about it more at the centerforappreciativeinquiry.net. But Doctor Cooperrider, his work, and others over the past 50 years have really evolved this beautiful way of both personal and organizational development that’s based on a fundamental paradigm of really doing a careful, appreciative inquiry or inquiry into with appreciation of what’s good and right about our life, about our situation, about our society, about ourselves, about our relationships. And rather than taking sort of a problem-oriented approach, really moving to an appreciation or a strength-based approach and then growing and healing, based on an appreciation. So, for example, with our New Year’s resolutions appreciative inquiry approach, rather than saying, I want to lose £30 or making a resolution which almost never works an appreciative inquiry approach would be to say, what do I want to make as an intention? And the intention might be I want to nurture my relationships with my spouse and my friends, for example, as an intention. And that comes from a positive intent rather than a problem-solving resolution. I’m going to do this to fix this kind of approach. So it’s a fundamental paradigm change that I think is the field of psychiatry and therapy and psychology and counseling really needs to a more a strength-based, resilience-based approach rather than looking at what’s wrong with people. So that’s a background of where my head is at with who knows where I’ll be in a year from now, but right now that’s what’s on my mind.

Becky Coplen: No, thank you. That’s a wealth of so many books and sites, and I love that you’re sharing what you’re processing as well because we’re always learning new things. Even though you’re probably more of an expert than most, you’re still reading, studying, considering, and have probably. The cool thing is, you saw these studies begin in the 70s and 80s, and now you’re looking at where we are as a culture. So very interesting. One thing that stood out to me was just going deep into when people have trauma, a big thing we’ve been talking about in our school and district this year is sometimes the kids. They don’t even remember the trauma. They can’t place it or speak about it, but their body remembers. And it’s usually a sad situation. But it is so interesting to me how the biological response to some type of trigger experience and then is brought out in so many different ways, and then it’s hard for the adults to understand what is happening. But these types of studies and things help for sure. Well, you’ve given us so much information and lots of good words and terms to consider and read up on more about. Is there anything else that you’d want to share with people who are considering going into this field or are maybe in the middle of their program?

Michael McGee: Yeah, I would say this work is a calling. I think it is calling. And to do this work, we need the support of others to process our experience and make ourselves whole. I think every counselor and therapist should be in therapy themselves. I’m a strong believer in mentoring, having a coach, feedback-informed treatment, you’re getting satisfaction, tracking satisfaction outcomes, videotaping your sessions, and deliberate practice of specific clinical skills, especially motivational interviewing skills. And that should be a regular part. If you really want to be an excellent clinician, you have to have dedicated practice with iteration and supervision. And to do that, you have to be okay with getting feedback, be grounded in your goodness, and be okay with being imperfect. And that requires some humility. And I think it requires the practice of healthy professional doubt and always maintaining that and relentlessly, eagerly seeking feedback on your work. So that’s a summary of what I would recommend for anybody going into this field.

Becky Coplen: Sometimes people take so much offense to feedback that they don’t like, but I completely agree. It’s the only way to get better for sure. So thank you so much for being here and just for all of there’s so many things you could teach us about. Thank you for giving us a good overview and a lot of things that we can read and study. So appreciate you being here today. Mich.

Michael McGee: Good to be with you.

Becky Coplen: Thank you to our listeners. Thank you so much for interacting and listening to Mastering Counseling. Please leave us questions about new things you want to talk about. Leave us comments on Instagram, and Facebook, and continue to listen for future enlightening episodes. Have a wonderful day! You’ve been listening to the Mastering Counseling podcast by mastersincounseling.org. Join us again next episode as we explore what it takes to be a business success in the counseling industry.