In this 2010 episode of At the Table, a late-night Maritimes television series on CBC Gem, psychiatrist Dr. Jackie Kinley joins host Amy Smith for a thoughtful conversation on mental health, healing, and the role of human connection. The discussion reflects many of the principles that continue to guide AIR’s work today, including the importance of relationship-based care, emotional resilience, and addressing mental health at its roots.
The following transcript has been lightly edited for clarity. Interview conducted by Amy Smith (CBC).
Why Psychiatry
What made you decide to move from your family practice into psychiatry?
Dr. Jackie Kinley: I’d been unsettled in medicine ever since I started. I was very interested in people, but I was disillusioned with the practice – the machinery of the hospital, the technology, and how patients feel sometimes. There are a lot of good people in medicine, but sometimes you feel like the patient gets lost.
I was always very interested in understanding people. I wanted to get out of a medical model and get more into a psychological model, to really understand the mind, the person behind the disorder.
When you were making this decision, a family tragedy happened.
Dr. Jackie Kinley: Yes. I had moved out to Vancouver at one point because I had a brother there. We came from a very strong family – lots of overachievers and successful, good people – but one of my brothers was lost and trying to find his way. He moved out to the West Coast, so I moved out as well.
I got married to my husband, I got pregnant, and we were going to have a baby. We came back to the East Coast, and I was preparing to go to the United States to train. Just before we left to go to Colorado, we got the phone call that my brother had killed himself.
In some ways, it wasn’t a surprise, because we knew he had been struggling. But even in a medical family, we had no idea how to help him.
That’s one of the reasons why I went down to Colorado, I did my analytic training. I had done some work as what they called a “whole person doctor” at the Nova Scotia Hospital, working alongside psychiatrists as a GP. I knew they were practicing biological psychiatry – they were medicating people, they weren’t doing therapy, they weren’t spending a lot of time. That wasn’t everybody, but it was the predominant paradigm.
Does what happened to you personally continue to influence how you think about patients and how you treat them?
Dr. Jackie Kinley: Absolutely. With the case of my brother – this good-looking guy, smart, college graduate – it looked like he should have everything together. But he was in emotional pain and suffering and tormented.
People he would see would give him a pill, and off he’d go, and nobody really knew him or understood him or felt his pain.
That’s what it’s about – being there with your patients and actually experiencing the difficulty. I talk about moving into their anxiety, feeling their pain, and helping them heal, as opposed to giving them a medication to get rid of symptoms.
There’s nothing against medication. It can be useful in the short term, but it’s not a way to bring somebody out of illness into a place of wellness.
What kinds of symptoms and disorders are you seeing in the mental health community today?
Dr. Jackie Kinley: The disorders we see are culturally bound. In earlier times, you’d see hysteria in the Freudian era because that was the cultural context. As times change, disorders change. We began seeing more bipolar disorder in a dysregulated culture.
Are doctors diagnosing it more often, or is society producing this?
Dr. Jackie Kinley: I think it’s co-created. It’s a system.
As we’ve lost external boundaries – shared values, institutions – people are less grounded. We see more anxiety and mood instability. Mental health develops in relationships, and if you don’t have solid, real-time relationships, you don’t learn how to regulate your body or settle yourself down.
Online relationships don’t help in the same way. They’re one-word exchanges. You lose all of the other contextual contact. You don’t feel the response of the other person. You have your own response with the computer, but you don’t develop empathy, compassion, or emotional connection with the other person. That doesn’t mean that you don’t feel angry or frustrated, but you don’t feel the other person’s feelings. It becomes a one-sided relationship.
My experience with youth is that they are more fragile and less resilient. Parents try to buffer them from adversity, but adversity is necessary to build strength. At the same time, boundaries are looser – anything goes. That produces entitlement and a lack of structure.
We used to see more borderline patterns. Now I’m seeing a shift toward more narcissistic and antisocial traits, which reflect a lack of relational understanding.
Narcissism
Why do you think narcissism is so prevalent?
Dr. Jackie Kinley: Part of it is that we don’t have role models. Anger isn’t a bad thing. Usually, there’s anger because people feel things should be a certain way and they’re not.
We’re seeing this in response to a lack of respect for authority structures – legal systems, medical systems, judicial systems, military systems.
Is society making us sick?
Dr. Jackie Kinley: It’s not cause and effect. It’s a perfect storm. We’re living in a society that’s unsustainable. We want everything without having to work for it. We live virtually, and we can’t carry on like that.
People need people to stay well. There’s an old saying: it takes a person to make someone sick, and it takes a person to make someone well. As we become more disconnected, we become more dysregulated.
What’s the solution? How are people being treated?
Dr. Jackie Kinley: There are a lot of different options for treatment in psychiatry. The first step is to glue the person back together. Medication can help stabilize someone. I call it ego glue – it helps glue the person back together. Once they’ve settled, that’s when the real work starts.
Do people often stop there?
Dr. Jackie Kinley: Yes. If you see the symptom as the problem, once it’s treated, that’s it. But if you see the symptom is the result of a deeper issue, you treat the symptom, and then you deal with the problem.
We live in a quick-fix, band-aid culture. People don’t get to the core of the issue. That’s where psychotherapy and deeper work come in, and reconnecting with other people.
Is disconnection the most prevalent issue?
Dr. Jackie Kinley: Disconnection isn’t a disorder – it’s the context. From it come anxiety, anger, and dysregulation. Real relationships ground us.
People respond differently: fight, flight, or freeze. Narcissistic and antisocial responses, borderline responses, and dependent people-pleasing responses. Each requires a different treatment approach.
Neuroplasticity and Core Strength
You talk about core strength – in the body, mind, and heart. Can you explain that?
Dr. Jackie Kinley: I see the brain as a muscle. There’s a whole area of neuroscience around neuroplasticity – the brain’s ability to rewire itself.
Thirty or forty years ago, the brain was thought to be static. Genes were destiny. Resilience was seen as a trait you either had or didn’t have. Now we know resilience develops across the lifespan.
Changing the brain requires the mind. You need their active attention. What somebody attends to influences the structure of their brain.
Are your brain and your mind different?
Dr. Jackie Kinley: Yes, absolutely. Your brain and your mind are different. The brain is similar to the body – it’s something that our mind can influence. The mind is something that’s beyond our brain and beyond our body. We can harness the energy of our mind to influence our brain. It’s mind over matter.
When you fix your intention on something, you condition the system over time. It’s like training for a marathon. You fix your intention, you get out there, and you start to condition your body. It takes time to build that structure, but over time, you’re able to do it.
It’s the same thing with your brain. It’s about focusing on what you want to do and then actively healing the relationship that you have with yourself and your relationship with others.
People avoid internal work because it’s uncomfortable. Psychiatry often focuses on reducing anxiety, but anxiety can signal a hot spot – a place where real work can happen.
Hot Spots
We were talking about getting to the hot spots of mental illness. What do you mean by that?
Dr. Jackie Kinley: It is getting at the heart of the matter. Mental illness is often less a disease of the brain than of the heart. Most of the patients that we see who have symptoms are inherently very sensitive. People who are sensitive experience hurts over time. They suppress them instead of dealing with them.
Those hurts build up like an abscess. Medication can cover it, but it doesn’t remove it. Healing requires accessing the core issue safely. You want to be able to access what the drivers of your patients’ difficulties are.
How do you get someone to open up?
Dr. Jackie Kinley: The relationship. You need to have a solid sense of what it is you’re trying to do, and you need to be able to do it safely. That’s why the relationship matters. It’s like open-heart surgery – you need the right conditions.
This is what the AIR program does. It’s about getting people to access those core issues. They are often deep moral and psychological conflicts. When people are hurt by people they love, they carry guilt and shame about their feelings, especially anger. People don’t like to go back and experience those feelings. However, that is what the program is designed to do. It’s about breaking down that scar tissue and rewiring the brain.
Oftentimes, we meet people and talk with them, and they say that this is the first time they’ve ever talked about their feelings. They haven’t experienced their feelings in their body. Oftentimes, when people are angry, they’re just anxious. They don’t actually feel the emotions. They haven’t learned how to differentiate them. A huge part of our work is to differentiate your feelings and feel them so you can access the core hurt. Grieving releases trapped energy so healing can occur.
Since you’ve been doing this, are there any cases that stand out?
Dr. Jackie Kinley: We’ve had a couple of cases that really show you the tension in the body. There was a woman recently who had seizures, and a fellow with tic disorders. They first came into the program overwhelmed with the idea of going near the feelings that triggered seizures and tics.
But once we were able to access a breakthrough and start to drain some of that pressure and tension that’s held in the body, the seizures stopped, the tics stopped. These disorders they had been medicated for – for 15-20 years – were gone.
The body knows how to heal itself. It’s about using the mind to influence and to access those spots so you can actually drain that tension. Then the body knows how to heal itself. It’s about liberating the natural flow of things. We have a natural order, and what happens is we get out of sync with that. We resist knowing what we don’t want to know.
How intense is this kind of therapy? I can imagine that after years of emotional suppression, you’d be resistant to letting it go.
Dr. Jackie Kinley: It’s intense, but we do it in group sessions, because the healing power of the group is that it comes from other people.
In the same way that you have physical needs, like eating food, you have emotional needs too. You need to feel safe, cared for, and respected. The power of the group is that they are able to nourish each other. They come into the group, and they feel safe in the group. It’s almost like a safety net.
I remember one patient who said, “You can feel your feelings. We’re all here, and we’ll hold your heart.” It’s a safety. Then they can experience their feelings, and they can be validated and consolidated by the feedback from other group members. So it’s exceedingly powerful.
So, you see this as a cure, not a treatment?
Dr. Jackie Kinley: It’s a step along the way. The challenge is that you start to re-align, and then you go out into the real world, and sometimes people face difficulties. Things don’t work out, and people can be re-injured.
It’s sort of like riding a bike. Your old way of being has become second nature. You have this first nature, but then you develop a second nature – the way you protect yourself. We’re talking about reclaiming your first nature. But sometimes people go back out into the world, and things happen that make them slip back.
It’s about consolidating the new connections that the brain makes. It’s about consolidating that second nature. The challenge that we have is that we live in a world that actually doesn’t support that.
Sometimes you feel like you’re swimming upstream, but I don’t ever stop what I do because I love the success of the patients.