SUMMARY: In this episode of “It’s Just Coffee”, hosts Phillip Crum, Content Marketing Coach and Kathleen Mills of Lifetree Counseling discuss psychiatric treatment of trauma and related disorders with Colin Ross, MD, of Timberlawn Hospital in Dallas. They further discuss his model of treatment, which involves a combination of cognitive, psychoanalytic, and experiential therapies.
Episode #28 | Dr. Colin Ross discusses counseling methods with Kathleen
Kathleen Mills-Proprietor, Counselor at Life Tree Counseling
Phillip Crum-The Content Marketing Coach
Dr. Colin Ross-Psychiatrist, Timberlawn Hospital
PHILLIP CRUM: Do you know what time it is?
KATHLEEN MILLS: I do.
PC: It’s time for another edition of “It’s Just Coffee” with the unsinkable Kathleen Mills. What do you know today? Tell me what’s new at Lifetree?
KM: We’re doing well. We’re up and running. We’ve got the new girls running. They’re excited. We’re just not looking back and looking forward and planning our next speaking. October.
PC: I’m still PC, Content Marketing Coach. We are going to talk to Dr. Colin Ross today. This gentleman has written more books, tell you what. Tell me about this gentleman.
KM: I’m just going to read the bio. Dr. Ross is an internationally-renowned clinician, a research, author, and lecturer in the field of dissociation and trauma-related disorders. He also is the founder and president of Colin A. Ross Institute for Psychological Trauma. And if you’re on your laptop, go to Colin A. Ross Institute and you’ll see his website and you can look through that while you and I talk, Colin. Dr. Ross obtained his MD from the University of Alberta in 1981 and completed his training in psychiatry at the University of Manitoba in 1985. He has been running a hospital-based trauma program in Dallas, Texas since 1991, and he also consults to various trauma programs in Grand Rapids, Michigan and Torrance, California. You travel quite a bit, sir.
CR: Quite a bit, yes.
PC: Are you a hockey guy?
CR: I’m a hockey dad. Amazingly, from based in Texas, our three kids played college hockey.
KM: That’s awesome.
CR: That takes a lot of miles and a lot of travel by itself.
KM: You have also written a myriad of papers and books. You have 27 books out, all to deal with…
CR: All to deal with all kinds of stuff, actually. There’s a large chunk of professional books, which is mostly trauma, dissociative disorders, PTSD. Then there’s literary, philosophical type writing, which includes all kinds of different things. One book about energy fields, I have modeled dealing with energy fields.
KM: That’s awesome. Tell the listeners a little bit about you, then we’re going to segue what your expertise is.
CR: Like you pointed out there, I grew up in Canada, was a high school dropout for six or seven years, living up in the Canadian Arctic, which is where I got into the anthropology side of things that I’m interested in. I decided that I’d better get down south and go to college. I went down to Edmonton, did my pre-med and medical school always intending to be a psychiatrist. Worked as an academic psychiatrist in Winnepeg for six years, ’85 to ’91, and then moved down to Dallas, where I’ve been ever since. Initially at a hospital called Charter Dallas, moved over to Timberlawn in ’97, and the same parent corporation owns the programs I consult to in Michigan and California. Basically, the trauma programs are about half the people have Medicare and half have managed care. Inpatient, they stay an average of 12 days, and half will go to the day program for a couple of weeks. They have all of the above. They have dissociative disorders, depression, lots of PTSD, substance abuse problems, all kinds of mental health problems. Lots of self-mutilation, addictions, cutting, and we’ve got this treatment model that I developed. The program isn’t just sit-around-and-wait-for-your-meds style, it’s 20-plus hours of groups per week, three hours of individual therapy, all designed, thought out, organized under this treatment model.
KM: You developed this particular treatment model that’s at Timberlawn, and then the hospital in Grand Rapids?
CR: And the one in LA.
KM: And the one in LA. How long has that been going?
CR: Well, I first published the book called The Trauma Model in 2000, and a second edition, and Trauma Model Therapy, which is the therapy part of the model, was 2009. I really started developing it, I guess, in my residency and year by year by year, it took shape, took shape, and shape. The program has been running based on those principles since the 90s.
KM: How would you say the recovery or the outcome of people who go through this particular treatment program?
CR: I actually have six or seven published papers with standardized measured that are used in research all over the place. People fill them out at admission, at discharge, and in some studies, three months’ follow-up, and in a couple studies, two years’ follow-up. It shows what we see clinically, which is – of course, there’s no treatment approach that works for everybody. There are always treatment failures whether it’s meds or AA or psychotherapy. Basically, the three main measures are the Hopelessness, Depression, and Suicide scales. Those scores, from admission to discharge, drop 45-50%, on average. Those gains are sustained at three months and even greater at two years. In a study I did in the 90s where about – it varies from week to week – but maybe a third to half of the people have multiple personalities, equals dissociative identity disorder, 80% have PTSD and 90% have depression. In a two-year follow-up, out of the 54 people that we followed up, all had multiple personalities, 12 of them got to integration in that two years. It actually takes longer than two years, but they had been diagnosed before this first admission. Of those people who got to integration, their scores would drop from 97th or 98th percentile, so they’re way at the top of the scores, down to the average for the general population on all kinds of different measures, disassociation measures. None of them had any more substance abuse, none had an active eating disorder. Their psychotic diagnoses – they’re not really, really, really psychotic but the DSM can’t really tell the difference – those all went away. Hearing voices, self-mutilation, all these things stopped in the successfully-treated people. On average, there’s big improvement for the average person, and then of course, there are some people who take longer or aren’t committed to recovery or aren’t doing the work.
KM: How do people get to your recovery trauma program? How do people find out about this? It seems to be extremely specialized based on your treatment model, and not all hospitals do that. Is that correct?
CR: It’s a sad state of affairs in inpatient psychiatry is no psychotherapy really at all, most hospitals all around the country, all around the world. You get a few groups that are kind of not very well thought out, and you wait around for your psychiatrist to come chat with you about your meds and have your meds changed, and that’s all you get for treatment. Compared to same insurance, same payment rate, we deliver over 20 weeks of groups, three hours a week of individual.
KM: That’s stunning to me.
CR: I think that my trauma program is actually a specialty program. It’s actually general psychiatry. The whole mental health system should operate that way, but that’s not the way the whole world works. The way people find out about it is sometimes, searching around on the Internet, but mostly word of mouth and their therapist. The therapist makes the referral. You can refer yourself to – it’s called “intake” – you phone the hospital and ask for intake and say, “I’m interested in being treated. How does it work?”
KM: It’s important for mental health professionals who might be in a private practice setting who might be listening to this podcast to be mindful or just think about, at least here in the Dallas area. I mean Timberlawn is down the street.
CR: People come from outside Dallas. We have people from other states all the time. Our catchment area, in theory, is the entire United States. In practice, it’s mostly the middle half of the country.
KM: How do mental health professionals here in the state, they need to know about the program.
CR: They can go to Timberlawn, which is the name of the hospital, which is in Dallas, and there’s a website for Timberlawn, or they can go to my website, which they can find through my name, or through r-o-s-s-i-n-s-t dot com. There’s a bunch of buttons on the side, one of which gives all the phone numbers for the hospitals and so on. And one way people do find out about it is mostly I talk all over the place at different conferences and so on, and reading the different books and papers that I’ve written.
KM: What would you like mental health professionals who might be listening to this podcast to have a criteria, or no, about a patient that would fit a good criteria to come in to your program?
CR: Complicated, difficult cases with lots of childhood trauma. The person needs hospitalization, which means they can’t be managed on an outpatient basis. They’re too suicidal, too disorganized, too overwhelmed with symptoms, too heavily into their addictions, and where are you going to send them? The reason you’re going to send them to us is, first of all, they have insurance that will cover it, but they’re committed to recovery, they have a work ethic, and they have really serious problems and need some containment and structure and help, and basically, in a couple of weeks, we can pour in 40-50 hours a week of therapy, which is totally impossible on an outpatient basis. We don’t just have the person sit there until they cool off sort of thing, we do a lot of work, and the way we achieve stabilization so you’re less suicidal, more committed to recovery, able to be sent back to your therapist as a whole lot of therapy work. The person leaves our facility with the toolbox that’s got a lot more tools in it than when they arrived. The model is a combination of – no model’s totally unique — it’s a combination of cognitive therapy, experiential therapies, systems ideas, family systems-type approach, and some psychoanalytical ideas thrown in there. It’s a technically eclectic type of psychotherapy, but it’s within this model that’s very organized and structured, focuses on ambivalent attachment to the perpetrator and self-blame, which is my model, is called the locus of control shift. Those are two core things we focus on. We do a lot of teaching, so there’s a group called Trauma Education group, we teach in the groups, we teach in the individual, we have handouts, we have homework assignments, and it’s very structured.
KM: It’s very proactive and very involved.
KM: That’s awesome.
CR: One cool feature we have, and the reason we have this – it’s called the Visiting Professionals Program – is that, when I was in medical school, in one day, the coolest rotation I had – of course, I liked psychiatry the best – but the coolest rotation as the surgery rotation. The surgeon was this Scotsman with a very thick Scottish accent. He was always ranting on about nursing had just gone all to pieces because these crazy holistic nurses wanted to take over. Medical students had gone down the tubes because they didn’t wear ties anymore. But he was the most amazing clinician that I ever met. His surgical technique was so fantastic. On one day, it was in a smaller hospital. If you’re in the main teaching hospital, there’s a crowd of 2000 in the OR and the medical student can’t see anything. But here, there’s just me, the intern, and the anesthetist, and the nurses and the surgeon. I’m standing right there for six-and-a-half hours in one procedure. So in one day, I got to watch a surgeon at work for six and a half hours. That’s more than the total time watching psychiatrists at work in four years in residency.
CR: That’s because the psychiatrist never let you watch what they’re doing. You’re supposed to somehow absorb it from the walls or something. I said to myself, “That doesn’t make any sense.” I thought, “I’m not going to do it that way.” We have interns all the time working in the program who are providing service but also learning and getting trained. The Visiting Professionals Program is you contact Christie Lewis, who you can find through my website or through Timberlawn.
PC: That would be the lovely gal next to you?
CR: That’s her right there, recently returned refreshed from a week in Florida. But you contact her and she just organizes that there’s not going to be too many people visiting on one day, plus I’ll be in town. Usually, that’ll be on Monday or Wednesday. You can come for a half-day, a full day, a couple of days, a week, there’s not really any time limit. We don’t charge you a fee at all, and you get five CEUs per day, which is kind of good. You sit in on the groups, you can chat with the staff, sit in on a team meeting, if you want, and actually see how this works. I think that’s a very good opportunity.
KM: You’re very gracious with that time for professionals to really learn from you.
CR: It’s gracious, but I also think it’s important and how else are we going to let people know about the program? It’s smart from a business perspective, it’s good for the patients because they see that this is a serious place where people are coming to learn, and it helps teach and train professionals, so it’s win-win-win-win.
KM: For everybody. You really like doing this.
CR: I absolutely think…
KM: What do you love about it the most?
CR: I don’t know what would be at the top of the list, but high up on the list is, first of all, it’s really interesting. Just how the mind works and how life affects people. It’s kind of like you get to go to a Shakespeare play every day. It’s so full of tragedy, triumph, trauma, and just all the intense things that go on in life. The amazing things that people have been through. Just amazing that you’re still walking around speaking the English language. Despite all that adversity, people still have enough hope to come for treatment, still working hard, committed on their recovery path.
KM: They feel vulnerable enough but safe enough to share that with you and the staff because their heart is in their recovery. That’s pretty brave.
CR: It’s awesome watching people triumph and recover. It’s intellectually really complicated and interesting to try and figure out, so it’s academically, intellectually interesting. And I think it’s a good personal discipline to stay centered, stay focused, not get off on this side track or that side track, so there’s a Zen discipline aspect to it.
PC: I think based on what I heard, you like teaching the most. You like to learn and you like the subject matter, but you really like to share it. You can call it consulting; there are lots of terms for it.
CR: I love teaching and consulting, writing, but my teachers are the people who are called patients. That’s who I learn from.
KM: I finally got to hear you for the first time, I’m embarrassed to say, at the EPA conference, the state conference in Austin a couple of months ago. You were talking and I was talking, but I got to hear you and yours was on self-blame and suicide of combat veterans, and I thought that was…
CR: I wrote a paper about six months ago called “Suicide and Self-Blame in Combat Veterans”, and more so in the Los Angeles program, they happen to have a lot of combat people come through their program, so I work with them. Most weeks, at least one combat veteran. I’ve built up dozens and dozens and dozens of people. Self-blame is a huge part of my treatment model in general, but my experience in the purpose of the paper and the talk is that in combat, we know people come back with PTSD, we know all kinds of horrible stuff happens. As far as I can see, the engine that’s really driving being stuck in PTSD, being suicidal, is the self-blame. It’s always like, 90-plus percent of the time, there’s a foundation of self-blame in childhood, blaming yourself for the abuse and neglect by your parents, and on top of that, we layer on self-blame for a buddy who died in combat, a civilian died, “I failed to prevent something. Something’s my fault.” The self-punishment just rolls and rolls and rolls forever until you address that self-blame.
KM: I just thought the talk was amazing and I enjoyed listening to it. You’ve got a lot of conference speaking this year on your website, I see.
CR: There’s a list of all the different places.
KM: All over the place. Kalamazoo, Michigan, my alma mater, Western Michigan University.
CR: I like Kalamazoo. I go to Kalamazoo because of the program in Grand Rapids, Michigan.
KM: Kalamazoo will be blessed for sure. Denver. You’re speaking in Dallas, hoarding. You did.
CR: That’s actually my colleague, Melissa, who gave that talk.
KM: You’re going to be in California later in the fall. And PTSD and all that.
CR: I’m delivering the self-blame combat talk on a naval base in San Diego in October, so that’ll be a good experience.
KM: That will be good experience. On your website, tell me about Fred’s Story workbook.
CR: That’s been out – it’s pretty new. It’s been out for six weeks now. There’s a therapist who’s worked in the program quite a while and she now helps us out, consults, and is in her private practice. Her name is Ruth Long, and she’s here in the Metroplex. She wrote this – it’s couple of years ago – she showed it to me, and I thought, “I’ll take a look at this.” People are often sending me things they’ve written and sometimes they’re absolutely fantastic and sometimes not so good. This one was fantastic. It’s a small, short, and not too expensive. It’s an e-book on Amazon or a physical book. Fred is an elephant who grows up in the zoo and goes through a whole bunch of abuse, neglect, and trauma, and he gets on the path of recovery. That’s the first half of the story. It’s very charming, it has the air of a child’s book, but it’s really for adults, trauma survivors. The second half is a workbook with all these exercises. You take what happened to Fred, you apply it to yourself. How do you relate to what Fred went through? And there’s “What are you going to do to work on that?” It’s a recovery workbook.
KM: It’s a downloadable book off your website?
CR: You can get it buy it as a Kindle book through Amazon, or you can purchase it from me or purchase it from Amazon as a physical book.
KM: And it’s called Fred’s Story Workbook.
CR: A trauma recovery workbook.
KM: Very cool.
PC: I find most people that begin writing – I’m going to call it a children’s-type book just because it’s got an elephant in it – are generally new grandparents or about to be. Is that right?
CR: She’d be in the right age bracket for that. It really catches your heartstrings. I remember when I was reading it, I said, “Oh, Fred. I feel sorry for you. Oh, Fred, it’s going to be OK.” Then that really catches the heartstrings of the survivor.
PC: I was going to ask you, and we’ve kind of touched on it a little bit, if somebody wants to read or listen to more of you, where can they get that?
CR: For reading, the easiest place to go is number one, my website; number two, Amazon. You just go to the books Colin A. Ross, MD, and up comes a whole bunch of books. From a therapy perspective, the number book to read is Trauma Model Therapy, which goes into a whole lot of detail how the treatment model works, techniques, strategies, and examples of therapist-client conversation. For therapists, that would be the number one book to get. It’s also written in general, it’s not real technical or all kinds of long words. It’s meant to be very accessible. It’s not that clients and survivors need to read it, but they’re welcome to and could benefit from it.
PC: I see you have some videos on your site, also.
CR: I’ve got a whole series of videos with Melissa, who works with me, Melissa Caldwell Engel, who’s a highly skilled therapist, is also really good at role-playing people with mental health problems. There is a whole series of I’m interviewing her because she has an eating disorder, or because she self-mutilates or because she’s depressed. There are educational videos.
PC: Those are also on your website and on YouTube, it appears, various places.
CR: I’ve also got a whole series of YouTube interviews under the Psyche Truth channel talking about all kinds of different things in psychiatry. I’m pretty critical of mainstream regular psychiatry.
PC: I noticed that, and I like that.
CR: So do I. I think psychiatry is, as a profession as a whole, way off course with all this genes, brain chemical, medications. The problem with it is that it just doesn’t result in effective treatment. The medications really don’t work all that well, we’ve been searching for fifty years and spending literally billions of dollars and we haven’t come up with a single thing that has affected the life of a single person in terms of genes or brain chemicals or blood tests or brain scans. It’s all up there in the research realm, none of it has trickled down to actually help a single person. That’s a brief summary of what I have to say.
PC: What do your detractors say to that statement?
CR: They’ll say that I’m some kind of theory conspiracy nut, fringe flake person, I don’t believe in the science, but it’s actually the opposite. The scientific truth, which is very clear in the literature, is the gap between psych meds and placebos is pretty small.
PC: Very interesting. We could spend several hours just talking about your website, but we’re out of time. Again, your website is rossinst.com, the main website, and I noticed the book at your bookstore, which can be accessed from there, will take you to another site called Manitoucommunications.com
CR: I chose that name because my mother’s summer cabin when she was growing up was at Lake Manitou in Quebec, and I wasn’t born there, but I more or less grew up in Manitoba.
PC: So you’ve got lots and lots of material. Is there any other contact information that you’d like to share, aside from your website? How do we get a hold of that?
CR: Christie Lewis? You can call Timberlawn Hospital and ask for her, or you can go into my website – there’s a button there with her contact info.
PC: I notice on your speaking schedule, her name is quite prominent with her phone number there next to it.
CR: She helps with lots of different speaking things.
PC: Do you answer the phone?
CHRISTIE LEWIS: I do.
PC: Excellent. And where can we find you, Miss Kathleen?
KM: Lifetreecounseling.com. That’s it. Well, 972-234-6634, extension 104.
PC: One more time.
KM: 972-234-6634, extension 104.
PC: And if you’re interested in talking to me, PC, but you can find me at contentmarketingcoach.us, 214-264-6297 and that’s about all the time we have. So thank you very much.
KM: Thank you, Colin. Thank you, Christie, very much.
PC: Thanks for listening, everybody, and we’ll see you next time. And on we go.