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trauma is like a virus and it gets passed along to your children even if their children are not born until years
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later because trauma can change the expression of our genes so we need to understand whether trauma is afflicting us how it's afflicting us and how we can treat it if it's there Dr Paul K
00:00:17
psychiatrist expert in treating trauma he's worked with Kim Kardashian and saved Lady Gaga's life and been in
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clinical practice for over two decades how many people have some form of trauma well over half the popul ation and
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Trauma can change Us in very negative ways for example the odds of traumatic brain changes are very very high we know
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trauma makes us age faster than our calendar age and we know that ultimately the root of depression addiction Parkinson's disease is from trauma modern science knows this but we'll give
00:00:49
them pills with the idea that a pill is going to fix everything and then we're surprised that tens of thousands of
00:00:55
people die each year from prescribed pills and we've let that happen What should we be doing instead the key to
00:01:01
all of this is curiosity so for example let's say someone is addicted to their phone often times addictive behavior is
00:01:07
meant as an escape from something or even to self- punish but when you scratch the surface of that you might learn about an episode of sexual abuse
00:01:14
that happened when the person was a child this is not uncommon what are the telltale signs
00:01:20
that I am traumatized what can I do to alleviate the trauma and then can you completely get rid of a trauma the
00:01:26
answer is based in hard science so it's absolutely crazy to me that so many of you have decided to watch our show um and so many of you have decided to subscribe to our show we now have five
00:01:39
million subscribers on YouTube which is a number that I just can't comprehend and it's a dream that I absolutely never
00:01:45
could have had we started the dire of a CO just over three years ago now and in my wildest expectations we might have
00:01:51
had 100,000 subscribers by now so you can imagine how shocked I am that so many of you have chosen to tune into
00:01:57
these conversations every week um and spend some time with us so thank you and I made a deal with you I made a deal
00:02:04
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00:02:11
never before I've been working for the last 9 months on a surprise for all of you that have subscribed to the show and
00:02:17
I'm very excited to deliver that for you the production's going to change we're going to go even further with our guests
00:02:23
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00:02:30
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00:02:40
episode Dr Paul Cony on the front of your book it says trauma the invisible epidemic why did you use those two words invisible and epidemic well so as a practicing
00:02:55
psychiatrist what I started seeing over and over and over again is that the the root cause of the vast majority of what I was treating whether it was depression
00:03:07
or addiction or Panic that that ultimately the root of it was trauma that if we traced back what we would learn is that there was something that had happened in that person's life it
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could have been acute or it could have been chronic over time but that changed their brain so that the brain is then
00:03:25
different going forward and that is the root of the problem so from that sense I
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I could see there's an epidemic because this is behind what is ailing us right the the 50% or more of complaints to
00:03:39
General medical doctors are coming from mental health right these are General physical medical medicine doctors so you
00:03:46
imagine how much of what is going on inside of us is affecting our health so the the epidemic of trauma is touching Us in so many ways but we're not identifying it we're identifying
00:03:58
different illnesses for example like oh that that person uh has depression that person has cardiovascular disease and
00:04:04
had a heart attack right but those things may be linked including autoimmune diseases all aspects of
00:04:10
mental and physical health but we're not seeing that at the heart of it is the trauma that then changes us and our brains and our bodies are different as we move forward so to start seeing this
00:04:23
commonality that this is everywhere and we're not identifying it because one of the impacts of trauma is to make make a
00:04:30
reflexive sense of guilt and shame in us so then we sort of hide things away so we're changed made less healthier and
00:04:38
the the very trauma itself leads us to have a tendency to keep it inside to not share to not get help to not do the kinds of things that would lead us to recognize the epidemic how many people
00:04:50
have some form of trauma because when we think of trauma sometimes people think of PTSD soldiers coming back from war
00:04:56
mhm so how many people does this subject speak to in some way the numbers and estimates vary but it'd be hard to imagine you wouldn't have roughly one in
00:05:07
five I mean likely you have more than that but if you look at you know data across demographics and data for occurrences of traumatic events and and
00:05:18
the impacts we see Downstream of these brain changes we're talking about a very significant portion of the population
00:05:24
and then if you think of people who are either experiencing the post-t trauma effect themselves right the changes to
00:05:31
themselves or experiencing those changes through someone close to them through someone they love a parent a child a
00:05:38
significant other right now we're we're well over half the population that will that will experience a significant and
00:05:45
negative life impact from something that either was with high likelihood avoidable or treatable in other words change for the worst that doesn't have
00:05:58
to be that way and it's not just as if just mental health were saying something small I mean mental health is how we interface with the world but it's our bodies too it's is that person going to
00:06:09
get lupus is that person going to have a heart attack or a stroke and how rapidly is that person aging so we know that
00:06:16
trauma by this definition that changes us because our coping mechanisms are overwhelmed makes us age faster than our
00:06:24
calendar age so you could say well that person is 40 years old by the calendar but they're really 46 right that person
00:06:31
is 65 but really 73 if you look at the Aging that occurs in us as a result of trauma so if you I say this in part to to really speak to how like concrete and
00:06:43
real this is so something that happens and changes you so that you are actually older than your calendar age closer to death right than the calendar might suggest is is is so real and so tangible
00:06:57
and it's this is the effect of PR upon us and and modern science knows this modern neurobiology modern Psychiatry the research around us tells us this but
00:07:07
the things that we know aren't always at the Forefront of our Consciousness in society which is a reason I think it's
00:07:13
so important to spread the word about it why does this matter so much to you I had a youngest brother who died by
00:07:21
Suicide when he was 20 years old I was in my mid uh 20s which which had um um just a a terrible effect upon the family structure and upon me and I and I felt
00:07:33
the reflexive sense of of guilt and shame without really being aware of it I hadn't felt that before you know I
00:07:40
hadn't felt like I couldn't be in the world or make my way forward in the world and I started feeling very very
00:07:45
different about myself and I started behaving in ways that weren't healthy you know that were very unhealthy
00:07:50
drinking too much unhealthy friendships and relationships and real change in me that I was fortunate to be able to get
00:07:58
help for um that really brought to the surface how much had changed after the trauma that I felt
00:08:04
very different about myself in the world I cursed and maybe our family was cursed and I couldn't make my way forward and
00:08:11
bad things were always going to happen and it was the realization like I'm really different and this is not okay
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and it wasn't like just grief you know in the sense that sadness and loss of course were were a huge part of that but
00:08:24
but realizing also like I am different and you know that had a very big effect on me um both the depression and the the the the issues in him that weren't seen and addressed that led to his suicide
00:08:36
and then the downstream effect on the rest of us and that led me to to leave I had a business career and I went back to
00:08:42
college and took some Premed classes and went to medical school and then became very interested in Psychiatry and and in
00:08:49
brain function both the psychology of how we think and the the brain biology that underpins how we think and have
00:08:56
been very much fascinated uh ever since did you process and or deal with the loss of your younger brother Jonathan by Suicide at the time no no at at the time I just went
00:09:11
inside like people didn't talk about it and were overwhelmed and you know I became less healthy and felt different about the world but there wasn't an
00:09:17
outlet for talking about it it just wasn't know how I had grown up like there there wasn't a way people would
00:09:23
say let's check in like how are you doing and maybe you should see someone like like it didn't happen and and it
00:09:28
took a it it took until I realized like I'm kind of in trouble here I need to get some help to then you know had an
00:09:34
insurance card and to look on the back and say like oh maybe I should go talk to someone but that was a stretch for me
00:09:39
and I felt even embarrassed about doing that like I I really didn't understand neither what had happened nor how to
00:09:46
help myself and and then I went to someone and and I just remember just how amazing it was to just have her tell me that you know I wasn't like wasn't sick
00:09:56
or crazy or or like not going to be okay because I felt this way that like she helped normalize what I was feeling and
00:10:02
and helped me put some of it into perspective and I realized like well that was very basic what was just done
00:10:08
for me and you know many many many people do not get that and I almost didn't have it myself and I was I was
00:10:14
very struck by it and by how much of a difference it made to have a better understanding and get some help the
00:10:19
impact it had on the rest of your family I was reading that your mother was depressed for the rest of her life
00:10:24
almost because of potentially because of that incident mhm yeah I think she was clearly different
00:10:32
afterwards too and and was much more isolated again in hindsight it's so clear to see but I think the guilt and
00:10:39
shame that she felt um was was overwhelming and she was not able to get help you know no matter how much encouragement you know at some point I he was actually a psychiatrist and he still couldn't you know couldn't get her
00:10:51
to get help because I think she was just felt so ashamed and and felt that help was inaccessible or that again help was even more shameful and you know the patterns Chang I mean there were still
00:11:03
some happy times in her life but the whole tenor changed and changed towards towards progressively more depression and again it didn't have to be that way either but there weren't support
00:11:15
resources for you know mothers who lose a child to suicide and and my father who
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is more extroverted you know then just had more natural support mechanisms and that's what you see sometimes that that
00:11:27
it shouldn't be that one person does better than the other because they just happen to have different proclivities you know but when we're not really
00:11:33
paying attention to this and we're just kind of running forward you know and trampling people then maybe the person
00:11:39
who's a little more introverted in a situation like that a little more inclined to be self-blaming you know
00:11:44
like that's the person who doesn't do okay and you know my mother didn't and and died I think much younger than she
00:11:50
should have of of cancer but me this kind of trauma predisposes to the immune system not functioning as it should and
00:11:56
I can't say that this trauma caused her early death by cancer but but certainly there there are a lot of scientific reasons to think that um that it was likely a factor in it and again unless
00:12:09
we're aware of like what trauma is and what it's doing to us that like we can prevent it we can identify it and treat
00:12:16
it these changes to us don't have to stay the same like the person who's blaming themselves and ashamed and
00:12:22
depressed doesn't have to stay that way the person who's abusing a substance to try and cope or to try and kill
00:12:28
themselves because they feel so bad it doesn't have to be living like that like we really and truly can make change the
00:12:34
person who has an autoimmune disease or heart disease or rheumatoid arthritis that's inflamed after the trauma like
00:12:41
everything is worse after the trauma doesn't have to be medically ill like that like this the the message I'm
00:12:46
bringing is is one based in hard science and it's one that has a real message of
00:12:51
change that it's not an esoteric principle what we can and should be healthier even you think about more than
00:12:58
50% of complaints brought to Physical Medicine doctors come from a mental health perspective I mean how much of
00:13:05
that is based in trauma it's the the majority of what is ailing us and the numbers actually do tell us that at the
00:13:11
top of this conversation you referred to aging and the impact that trauma has on Aging how does that work so trauma makes
00:13:18
me older there are there's cellular mechanisms in us you know people often talk about teir which is one aspect that change as we grow older because we're very interested in figuring out why do
00:13:31
we grow older right so there are processes in us that sort of Mark time and that change across the aging process
00:13:38
of humans now and we don't understand everything about this if we did we could change it and live much much much longer
00:13:45
but we're trying to understand about it and and I think science has made a lot of very significant Headway in
00:13:51
understanding and part of that understanding is the biological age of a person is different from the calendar
00:13:59
under age so if you you know an example would be if you took two identical twins at Birth and you know one of them is
00:14:06
able to live in pretty good circumstances and free of trauma and you know has a pretty good life going and
00:14:11
the other person uh lives in a way that has has privation and a lot of trauma maybe direct physical assaults or seening seen as less than denigrated by Society it's a theoretical example but
00:14:23
the idea would be you you go follow them 30 40 50 years later and you you find two people who are not the same age anymore right the person who had the better life if they're 40 well they're
00:14:35
40 and if you match up cellular aging mechanisms and again we don't know how close a person is to death but the Aging
00:14:41
mechanisms are telling us how far along our path we are so to speak they say okay that kind of matches with being
00:14:46
that person's age but then you see the person who has been through so much trauma the presumption here being there
00:14:52
the brain changes of trauma there's a post-trauma syndrome right that that person is going to actually be older and
00:14:59
in terms of how far they have traversed down that path of the Machinery in them running itself forward than what the
00:15:05
calendar tells you trying to figure out why and how that's happening what is the mechanism
00:15:11
that's causing them to apparently accelerate in age so the the less healthy environment within the person so
00:15:17
some of that is is likely say the signaling molecules that we we talked about is just not as know the
00:15:23
bloodstream isn't as as clean and healthy and you know running in as lock step a fashion as we might one but there
00:15:30
are inflammatory signaling markers and you know that impacts cellular function and cells are more likely to die earlier
00:15:36
than they might otherwise and and elements of neurotransmission and anxiety and tension States within us you
00:15:43
know it's it's really environmental one you know one set of Aging Machinery is in a healthy environment and the other
00:15:49
isn't so it's going to deteriorate more quickly I mean it's it's one way of kind of trying to capture that the
00:15:55
environment is is very different in those two people so how what is functioning in that environment ages is going to change like having a car maybe in a in a a a nice warm dry environment
00:16:08
you know versus having a car where you know there's snow and ice six months of the year and then it's terribly hot the
00:16:14
other six months you know that that it's going to be different it's going to age differently so to speak right if you go
00:16:20
look at those two cars 10 years later and to some extent it's like that in us too death disease and Trauma a 2021
00:16:28
study by the British medical journal found that adults who experience sexual abuse by the age of 16 have 2.6 times
00:16:35
the chance of dying in middle age than those who didn't experience it it's not commonly believed that trauma can result in disease like physical disease directly but you argue that it can and
00:16:49
you also talk about how it can result in NE um autoimmune disorders things like arthritis um Crohn's disease Cron's disease ulcerative colitis Parkinson's
00:17:01
disease probably has an autoimmune component we we learning that much much more is autoimmune so do you believe
00:17:08
that trauma is the underlying reason behind many diseases that lead to early death absolutely think about what you
00:17:14
just read can can we take a look at that again like I think what you just read is absolutely momentous so think about that
00:17:22
sexual assault in the teen years leads to a two and a half full increase in death risk that's staggering what's causing that the whole Cascade
00:17:36
from the biological to the behavioral so Gene transcription has changed healthier
00:17:42
genes are more likely to be off unhealthier genes are more likely to be on that's not good for our blood vessels
00:17:48
that's not good for heart disease or possibility of having a stroke and the immune system is more activated and more
00:17:54
likely to attack itself and some of the mechanisms within us that are protected against cancers for example are less
00:18:01
likely to function all of those things change biologically neurotransmission endocrine function signaling markers in the bloodstream all of that is changing and at the same time behaviors are
00:18:13
changing higher risks of depression higher risks of addiction higher risks of impulsive behaviors risk-taking
00:18:20
behaviors you have to put a lot of things together before you get a death risk that is two and a half times higher but that's how we get there because it does put a lot of things together from
00:18:32
the genes all the way through to complex risky behavioral taking do you think there's anything killing more people
00:18:38
than trauma fundamentally not if we look for root cause I've seen many many things that kill people and I I wrote about this in
00:18:49
the book uh people that I was taken care of who at times died and I was so so struck by what the death certific ific said versus why they had really died you
00:19:02
know so the death certificate might have said car accident okay under understand that but why was that person driving 120
00:19:09
M an hour in bad conditions or why were they being so reckless why they had five car accidents I know that's the trauma
00:19:16
right what well it's a heart attack why did that person have a heart attack when they were 62 they didn't have huge risk
00:19:23
factors from other any way except the trauma and its impact and so if if we're looking at root cause analysis of what is hurting us what is hurting our
00:19:34
quality of life what is hurting the quality of life of people that we love and what is killing us I think that need
00:19:40
we know more than even just that and and there's so much we could we could pile the information a mile high that
00:19:47
supports that piece of information which I think is quite staggering what are the different types of trauma are there sort
00:19:53
of different categorizations of of Trauma from like small to big or if we're if we're you using the definition
00:19:59
that trauma is anything that overwhelms our coping mechanisms so so there there are changes in the brain when our coping
00:20:07
mechanisms are overwhelmed and on the other side of that our brains are different so that's the biological
00:20:13
definition then we would look at well how how do we how do we get there right and and we it breaks down into three
00:20:19
categories then of acute chronic or vicarious so the acute trauma is how we've traditionally seen trauma so if you think about the idea that people were Shel shocked after World War I
00:20:30
right that was acute trauma combat trauma so our traditions of looking at trauma come from acute trauma and it's
00:20:37
just more evident you know after someone dies or there's an injury or there's a car accident like you know we can see
00:20:43
that oh okay gosh that could what makes some difference in the in the person like we can kind of get that and
00:20:49
sometimes we can see the change in the person from before and after so we have tended to equate trauma and post-t truma
00:20:56
syndromes like what happens to us after those changes in the brain are now with us to acute trauma but but again it's
00:21:03
not a soft definition it's based on do those changes in the brain happen in other ways and the answer to that is yes
00:21:10
that if a person is seen as less than for example in a society for whatever reason across time or even within a household a person is being abused in a household a child is being neglected or
00:21:23
a child is being emotionally or physically abused B at school sure bullied at school right absolutely right
00:21:31
this over so so nothing happens all at once right but that brain changes just the same so it's a scientific definition of traumatic change and it is true in
00:21:44
situations of chronic trauma just as it is an acute trauma now it doesn't mean all acute traumas or all chronic traumas
00:21:51
make these changes in the brain and then vicarious so the third category there would be vicarious trauma which means
00:21:57
human beings are imp right I mean thank thank goodness right that's how all goodness comes in the world through our
00:22:02
ability to have empathic connection but that also means that our trauma can communicate from one to another and
00:22:09
again it's not a soft concept so people who are very much involved in other people's trauma so in health care
00:22:16
settings sometimes in in journalism settings just in Intimate home settings in just spending a lot of time with the news right can become traumatized and
00:22:29
have the changes in the brain that look the same as the person who lost two family members in the car accident so it
00:22:35
is true that vicarious trauma can change Us in just the same way the the modern field acknowledges that if it's in the context of professional Endeavors which really makes no sense right like what
00:22:46
we're talking about are brain changes and brain changes can come through acute trauma chronic trauma or vicarious
00:22:53
trauma because of our ability to have empathic connection and compassion with other hum I want to make sure that I've
00:22:59
nailed this before we move on so the acute trauma I get it it's the the big events it's the going to war it's the
00:23:05
car accident big events that happen typically in an instant typically chronic trauma this is things like racism sexism bullying that happen over
00:23:15
a long period of time gradually that make you often feel less than right than other people and the vicarious trauma is
00:23:22
the trauma that as you say you get from empathy so feeling someone else's pain feeling someone else's trauma and comes
00:23:28
your own yes okay yes and they can all lead us to the same brain changes but people have different levels of susceptibility right so one person may have three big acute traumas and that
00:23:42
person's brain is still doing okay right it's not changed towards greater vigilance right it's not changed towards
00:23:48
greater inflammation in their blood vessels then you know another person could have one incident that might seem
00:23:56
more mild than the other three breathe the person and that person can then have brain changes so part of is who are we
00:24:03
genetically how are we built uh what kind of life experience have we had especially early life experience uh how
00:24:09
susceptible are we to One Thing versus another and then this idea of the multiple hit hypothesis that I could
00:24:15
have a number of traumas and then on a certain trauma that might be even mild compared to ones that came before it now
00:24:21
it makes the changes what is that hypothesis so that multiple hit which which which says that this idea that
00:24:27
what what does kill us makes us stronger is completely wrong I mean in absolutely every way what what doesn't kill us
00:24:34
often makes us weaker right and that's why we have to be attentive to what hurts us but doesn't kill us so that we
00:24:40
don't get weaker we get stronger but what can happen is we can become more susceptible to the more likely that the
00:24:46
next trauma if we experience one will then create the brain changes because I have often wondered I'm the youngest of four kids we all grw up in the same household we experienced a variety of
00:24:58
different traumas in my opinion much of it was chronic but again being the only black family in a nor white area all
00:25:04
these kinds of things but I thing I've always reflected on is for some reason I think I experienced it much more the
00:25:10
trauma of that than my older siblings yes and I've pondered whether that's because of the timeline being the
00:25:15
youngest it was worse in the later years so I I think my hypothesis has been that I experienced it more than my siblings
00:25:22
and I think I've embodied the shame a lot more than my siblings have yet we both went through the same thing so for
00:25:27
whatever reason I'm like really like I'm a workaholic and I'm exceptionally driven not that my siblings are but I'm obsessed in a way that's probably not completely healthy and I look at my siblings and I go they're not [ __ ] up
00:25:39
in the same way that I am but we all went through the same thing part of what you're pointing out is that the the
00:25:45
variables of Life matter right so if circumstances are different say for one child in formative years than for
00:25:51
another th those children could be affected differently like economic circumstances so some of it may be and
00:25:58
probably is impacted by the things that you're saying but there probably are almost surely other factors too this
00:26:04
kind of Nature and nurture that people have what sometimes gets called different levels of Attunement of of the
00:26:10
emotional Compass so you know some people are very sensitive and sensitized to things and very aware of what's going
00:26:17
on around them and and aware of their own feeling States and you know and other people can kind of go through life and you know emotionally buffeting
00:26:24
things can happen but they kind of keep going you know and and look there are pros and cons to both of those ways of
00:26:30
being but the person with the sort of more finely attuned emotional Compass is the person who's likely to to register
00:26:37
more things that are negative like things like subtle expressions of prejudice right that that someone with a
00:26:43
a less attuned combus may just you know kind of not see that or just it doesn't make it you know into their conscious
00:26:50
awareness whereas someone else who be very attuned might see a lot of those things so it's this part like what is
00:26:56
the nature like who is the person right and then what is the nurture meaning like what are the variables you know
00:27:03
that that that seed sort of falls into as we go through life you must have seen this a lot in your practice where an
00:27:09
individual went through a really traumatic early event and you've got the person in your practice that in front of
00:27:14
you that is an alcoholic they are experiencing sort of suicidal thoughts but then when you look at the rest of the family the family just doing fine to some whatever that means fine but right
00:27:27
well when if to look at is the rest of the family doing fine because sometimes what it seems like on the outside is not
00:27:32
true on the inside uh and then we do think about genetics especially around alcoholism there are um we don't
00:27:39
understand all of it of course but but there are genetic factors that can be very impactful uh then we'll look at
00:27:46
personality structure you know is that person built to sort of internalize or externalize blame you know so why
00:27:51
alcohol for this person and not for someone else how much is nature or nurture and how much may be formative it may be that for example that person was
00:27:59
in Social circumstances just real example that happens with some frequency say mid to late teens where alcohol was
00:28:06
accepted as a way of coping right and and maybe other people in the family weren't this circumstances were just
00:28:12
different where they went to school was different what and and they didn't have it modeled for them that this is how they cope so maybe they're genetic
00:28:18
factors that that push more towards alcoholism maybe there are social factors right that was modeled for that person so you put kind of put those things together and which is why and we
00:28:30
follow patterns and there's a science underlying all of this but we have to look at who is that person right you
00:28:36
have to look at you know the the family history so the genetics that may have been passed on and what does that seem
00:28:42
like may be the case in the person how can you be informed by that and what were their formative life experiences
00:28:47
and you know you start we start to build a picture of what's going on inside of us so that we can understand and change
00:28:53
by looking at our history which is why mental health doesn't often do this you know it takes inventory of your symptoms
00:28:59
now to reflexively prescribe a medicine right so we we need to understand ourselves if we're going to understand
00:29:05
whether trauma is afflicting us how it's afflicting us how we can prevent it how we can treat it if it's there and and I
00:29:11
think that means accepting that this is real and this is real science which which actually when you were talking it
00:29:17
made me think of an example look if I say it an example to the science of it one of the earlier studies and I forget
00:29:24
exactly how many years ago this was but 15 or 20 years maybe was looking at immigrants I believe they were immigrants from Somalia to Holland I think I'm remembering that correctly and
00:29:34
and so the incident of schizophrenia in the human population is about 1% across the human population but when stressors are higher right it they can predispose
00:29:46
people to to having to coming down having the syndrome of schizophrenia so it's about 1% of the population but it's
00:29:52
not evenly distributed if there are you know people in sort of pressure cooker environment so to speak become more
00:29:58
susceptible and so they looked at at immigrants who integrated into the community in Holland versus immigrants who lived in primarily immigrant communities and the incidence of
00:30:11
schizophrenia was higher in the people who had integrated right so the thought is and again there have been subsequent studies and we don't know for sure but the the when you kind of look at that
00:30:22
what what is that is the feeling of otherness right is is different trying to integrate into to a society that was
00:30:29
looking at you know not everyone in that Society of course but there was a much more pervasive sense of otherness when
00:30:35
people were integrating than then when they were living in the communities where food and dress and like the day-to-day of life was normalized what's
00:30:44
otherness and what's the sort of cost of otherness I think otherness in the way I'm defining it is just a sense of
00:30:50
difference in a way that's not good right a sense of difference in a way that involves either being seen as less
00:30:58
than and again sometimes it can be over Prejudice but it can be also stratification of opportunity you know
00:31:04
just seeing that okay like in some way I'm not on an equal I don't feel on an equal footing here right and then that
00:31:10
there's a there's can be a sense of isolation there that that builds the sense of otherness than say building
00:31:16
tension inside the person right the person doesn't feel quite as safe right it doesn't feel quite as validated
00:31:22
because you know especially when we're young we look around us to see what's normal and if you know people are
00:31:27
looking talking dressing like us like we just feel validated in ways that we might not feel if we see that we are
00:31:33
different especially if the difference isn't embraced right and we see this across immigrant communities who you at
00:31:41
some point integrate right but initially people will tend more to stay together because there's there's a sense of
00:31:47
validation in the community um so then the children often then will will integrate right which is why it's such
00:31:53
an interesting study to look at people who were first generation immigrants who would be likely to feel very
00:32:00
strongly you know whether they were integrated or whether they were somewhere different because they W in the subsequent Generations right they're
00:32:06
the generation that just come from the home culture that either they could still sort of live in or live in a new
00:32:14
culture and not that everyone felt the pervasive sense of otherness but there's more of that sense of otherness and the
00:32:21
fact that that would change susceptibility to an illness that otherwise is it distribut itself across
00:32:28
the population I think is a very profound you know marker of scientific proof upon the things we don't pay attention to as much you know subtle prejudices discriminations whatever they
00:32:40
may be that are in our society that we kind of look the other way and don't see we're really harming people who then can come to the that come to the adult phase
00:32:52
of life in in a place where we have marginalized them and we've we've made things different inside of them that
00:32:59
makes it harder to make their way in the world and I think we Overlook very much whether it's bullying there many many
00:33:05
things that can be based upon what can make people feel less than but the effect of it is is seen in actual brain
00:33:12
biology and like we know this we've known this for a long time but in some ways I see that we're more fragmented
00:33:18
and pushing more towards these experiences of otherness or experiences of vulnerability and lack of safety that
00:33:24
push people towards the the The Chronic aspect of of traumatic brain change when
00:33:30
we think about trauma we often focus on childhood but what you're saying there with this study of the Somalians that
00:33:36
immigrated to Europe um presumably those were adults yes so the the highest incidence of schizophrenia is in people who are in young adulthood so so we're not seeing changes in people who are
00:33:47
already deep into adulthood but the but the the changes that we're seeing is in the sort of transition to to adulthood
00:33:53
which honors both that yes we are much more impressional in all sorts of ways including how our brains are forming when we are younger so the so these are people still their brains still have
00:34:04
enough formative the ideas the thought would be they have enough formative processes going on in their brains that
00:34:10
the brains can be changed by the trauma but when we talk about these three types of trauma the acute chronic and
00:34:17
vicarious can you experience these types of trauma in any age phase chapter of Life yes the earlier in the the lifespan the the more impactful okay yes
00:34:29
absolutely which is why childhood trauma is so important my in the book I uh interview um Darren richer who's a
00:34:36
psychiatrist at Sanford and Stephanie Von Gutenberg who's a a child Wellness Advocate because we're talking about
00:34:43
Trauma from both ends of the spectrum so the the chapter that's the interview with Stephanie Von Gutenberg talks about
00:34:50
how childhood trauma so deeply impacts the the sense of self of the child like things that we no but I dedicate a chapter to it because childhood trauma is so
00:35:03
tremendously impactful and again we don't pay enough attention to helping children who are traumatized and to to to projecting ahead to the increased burdens of illness and decreased role
00:35:15
performance and all the awful things that happen so so childhood trauma is one thing on the other end of the
00:35:22
spectrum Dr Richer's work has highlighted the fact that when people are traumatized they are changed in ways
00:35:29
that changes subsequent Generations so if we're talking about childhood trauma we can talk about traumatized children
00:35:36
we can also talk about traumatized adults whose trauma changes their children even if their children are not born until years later how do we know
00:35:49
that trauma can and is being passed on what is the best evidence we have to support that so the field of epigenetics which has really come to the so so Epi
00:36:00
epigenetics really come to the Forefront in the last two to three decades which is the understanding that our life
00:36:08
experiences can change the expression of our genes so so you you or I may have a gene that is active now because we inherited an
00:36:20
active Gene for example and then maybe that Gene is producing something it's it's helping us in some way bolstering
00:36:25
mood decreasing anxiety then something can happen something can change in us that turns off the expression of that Gene or turns on the expression of another Gene so then even though you
00:36:38
have that Gene you don't have the benefit of it because the gene has been turned off and and this is a very it's a
00:36:46
very revolutionary understanding that it's not just well your genes are your genes you know we could look when sperm and
00:36:51
egg come together well that's telling us what's going on and if we could understand that fully we would see oh
00:36:57
here's the array of genes that are active and the array of genes that are not active but that's not the story
00:37:03
right that's just part of the story the the the story continues that that one's experiences of Life Changes how those
00:37:12
genes function which ones are on which ones are off and how they get passed along so if the parent is not
00:37:19
traumatized the parent may pass along the active Gene for something positive say to the child if the child then is
00:37:25
traumatized the child May pass on that Gene without it being expressed so it's as if the gene isn't passed on so if you you think about that it's just amazing
00:37:37
that our genetics in the sense of what's actually going on in US is not just the nature of what genes did we get it's the
00:37:43
nurture how has what has happened to us affected the expression of those genes there's one study that I I read about which says scientists at Emory University in Atlanta trained male mice
00:37:56
to fear the smell of cherry blossom shocking them whenever they smelled it so the mice got to the point where they
00:38:02
shuddered when they smelled it even when they W weren't even being shocked um and
00:38:08
I'm guessing the children then had the the same reaction I guess that's what the study concludes but also the um the
00:38:14
children of Holocaust Survivors are another example of how trauma can be passed on because yes it's hard to think
00:38:20
of a much more traumatic event and being involved in the Holocaust right and for a long time the thought was that the the
00:38:27
re reason that the children of Holocaust Survivors had higher levels of anxiety and of anxiety Spectrum illnesses was because of anxious parenting that
00:38:37
understandably the the parents had a much more sense of vulnerability you know so so across the population they were they were more anxious and they were raising the children with more
00:38:48
anxiety and what we have have learned is that that the experiential aspect is part of it but that exactly what you and I are talking about is part of it too too because the the experience of what
00:38:59
they went through changed genetic expression in the children right so that's that's just a sea change in understanding that the the genes of the
00:39:11
parents the genetic expression of the parents and the genetic expression that they pass along to their children is
00:39:16
changed by the Holocaust experience itself with this understanding of epigenetics do you in your practice then consider deeply what someone's parents
00:39:27
went through in their life and how that might have changed someone's sort of genetic expression that sat in front of you in your practice sure sure I I think
00:39:35
we all deserve so to speak to to think about our life narrative right and and and so many of us don't I think if we're trying to help ourselves you know whether someone listening to this like feels that they're depressed or that
00:39:47
they they don't have any mental health issue but they want to understand themselves better it's like think about a narrative of okay where let me start
00:39:54
with like where have I come from and like who came before me and um and then way this happened and then that happened
00:40:00
and you when we build a narrative it's remarkable how much we can come to understand about ourselves because often
00:40:06
we don't do that like we have isolated pieces of information about ourselves but we don't knit it all together and
00:40:13
and it's really remarkable what can happen What can be elucidated by doing that so absolutely yes just for the the
00:40:20
general understanding of the person and also to understand what did the parents go through you know what what
00:40:26
experiences did they have how might that impact this person and you might then ask questions of let's say that family
00:40:33
situation changed you know between say uh older siblings and younger siblings right then by learning about that history and learning about older siblings versus younger siblings and the parents I mean think how much you learn
00:40:44
then not just about the person's experiences growing up but but just about the the biological aspects of how
00:40:51
are the parents functioning how did it impact the children and what were the situations how are the children similar or different there's so much we can
00:40:58
learn from that you liken trauma to a virus it's a very interesting way for us to start thinking about trauma because
00:41:04
we seem to think of it at least I did as being sort of isolated to the person but the idea that it somewhat has a
00:41:11
contagion to it and that we can spread it vicariously to other people that are around us but also down through the
00:41:18
family tree via our epigenetics and Via our genes makes you kind of understand both the importance of treating it but yeah I've just never heard anyone describe it as a virus before right yeah
00:41:32
because there's a reflective guilt and shame to trauma and our society doesn't recognize it it often gets hidden inside
00:41:40
the person right but when it's hidden inside the person it's still spinning off symptoms so I think the best analogy
00:41:47
to use here is of an abscess in the body so an abscess is a walled off area of infection in the body and it's good that the the infection is Walled off because if if it w weren't it could be fatal
00:42:00
right so it's good that it's walled off but the body is still aware that it's there and it's still spinning off
00:42:06
symptoms because it's there so for example a person might have an intermittent low-grade fever or just
00:42:12
feel kind of jittery or you they're sweating and they're not sleeping well right so there are pervasive symptoms
00:42:18
that are impacting this person but it's not obvious that the abscess is there right so what often happens in general medicine is person is having non-specific symptoms you know people go
00:42:29
looking Scan they see oh there's an abscess there right once we know that then we might have an understanding for
00:42:35
why that person this never feels good right they always feel lethargic or they never feel comfortable we know there's
00:42:41
something there now and we can go in and fix it right and it involves you know there's a surgical process right so
00:42:48
something has to happen that's not a fun thing right if you go through a surgery and Recovery now the abscess is gone so
00:42:53
I think the the example of the abscess in the body is is a very good way to understand what trauma does to us in the mind so if we shove it down inside of us
00:43:05
there's reflex of guilt and shame Society isn't helping us take a look at it now it's there inside of us it's
00:43:10
going to spin off symptoms and those symptoms aren't always symptoms that makes say one person hurtful to another
00:43:17
they they they may not that person may be very very Vigilant and and just kind as can be to to someone else but across
00:43:24
the population those symptoms inside of us are not good so they give us shorter tempers right we're more likely we're
00:43:31
more anxious so we may be more quick to anger or we're less functional in the world around us because of depression anxiety sleep problems right we can be more impulsive like it works against us
00:43:45
being in the world as best we can be is that is that what you refer to as post-t trauma syndromes is that similar thing
00:43:52
yeah because post-t truma syndromes are ways in which we can recognize the changes in ourselves so higher levels of
00:43:58
anxiety for example lower uh levels of mood right um different changes in sleep uh physical health changes um and then changes in just how comfortable we feel
00:44:10
in the world right so what we'll see is changes in behaviors that are driven by just feeling differently in the world so we have we're in a different self- states we have different behaviors the
00:44:21
syndromes can do all sorts of different things to us from mood anxiety sleep behavioral change so someone who might
00:44:27
want to find a relationship partner you know stops going to places where they could meet someone right so we we change
00:44:33
our behaviors this is what shows us that there is a post-trauma syndrome that's how we know we're traumatized
00:44:40
effectively because that's why I'm trying to figure out how like people will be listening to this now and hearing you talk about these different types of trauma what are the sort of
00:44:46
telltale signs I'm assuming it's this that I am traumatized right yeah this is what we're looking for right so so someone might present with uh that person is depressed now and they they
00:44:57
weren't before that person is having panic attacks and they weren't before that person is using alcohol to soothe
00:45:03
and they weren't before because in medicine we look at just the surface right what we want to look at is like oh
00:45:09
why are you here oh you're here because you're drinking too much let's talk about how you can drink less you're here because you're depressed what can we
00:45:14
give you a depression medicine right so we're not looking at like why right why are you depressed I mean some people
00:45:20
biologically will become depressed you know no matter what even when things are going very very well but this isn't the
00:45:26
majority right most most of us if we're depressed there are likely factors like so we should be curious why is that person depressed why is that person having panic attacks why is that person
00:45:37
change their behaviors right and so now if we get curious we get curious about the person then we're going to figure we're going to figure out things we wouldn't have before right so if a
00:45:47
person gets depressed because everyone in their family gets depressed every 9 to 12 months no matter what like okay
00:45:53
let's let's come at that biologically we don't that that doesn't necessarily map the trauma right but but if we start
00:45:59
looking at that person being depressed do we see that they kind of started getting depressed you know a couple of
00:46:05
years ago around the time their sleep started being a little bit different and you know they started behaving
00:46:12
differently and they you know they didn't spend as much time with family or then you start getting more Curious and and you start learning oh you know
00:46:19
something something happened then right again with acute traumas it's easiest to see but when you look for the whole
00:46:25
picture of like might there be a post post trauma syndrome going on here you know maybe that person who's depressed
00:46:30
and is drinking too much started drinking too much when their mood started decreasing after the trauma or
00:46:36
maybe they started drinking after the trauma and it's driving their mood down like and it's not always this but we're
00:46:42
never going to know and understand unless we're curious like this is how we Trace to the roots of it and this is how we get back to the narrative right of of
00:46:52
what is going on inside of me and have I changed right and the idea we started talking about how the changes in
00:46:58
behavior of the post-t truma syndrome are the changes that that make trauma like like a virus right because we start
00:47:05
behaving differently and for some people that is the the the their mood isn't as good and it's not as healthy to be
00:47:12
raised by a parent who's depressed right so that can be a way in which the virus of trauma gets passed along to the Next
00:47:19
Generation or maybe that person is drinking or using a drug to cope and that doesn't make for the best parenting
00:47:26
that's how the virus of trauma gets passed down to the Next Generation or there are times when when a reaction to
00:47:33
trauma to the feeling of disempowerment can be aggression and envious aggressive
00:47:38
behavior so so not all abuse of children comes through the lens of trauma but a lot of it does I'm interested as well in
00:47:45
the subtle symptoms of trauma you know we've talked about some of the big picture stuff which is like suicidality
00:47:51
you know becoming an alcoholic or all those kinds of things but the subtle ways that trauma shows up in everyday
00:47:56
life m i was some of them I was hypothesizing over things like phone addiction being addicted to your phone
00:48:03
or video game addictions these kind of things that I think maybe originate from the sort of more chronic traumas but are less easy to spot right right yeah I
00:48:13
think the key to all of this is curiosity right so let's say someone is addicted to their phone okay maybe
00:48:20
that's because phones are addictive and the person just spent too much time on their phone maybe right but add ition
00:48:27
mechanisms in human beings are similar like it's the same Machinery across addictions and and often times addictive behavior is meant as an escape from something or to soothe against something
00:48:40
or even to self- punish because of something so addictive behaviors it's similar brain Machinery whether it's
00:48:46
cocaine it's alcohol it's brownies it's a telephone it's sex it's exercise I mean there are things that people do in addictive ways as routes of unhealthy coping
00:48:57
so so if we get curious why again why the drug why the phone addiction why the things that might seem more subtle um and maybe are more subtle but we should scratch on the surface of them to to try
00:49:10
and understand if they mean something is that phone addiction the 14th addictive behavior in a row right because that
00:49:17
person has sort of particularly Adept addictive Machinery inside of them and they're trying to escape from something
00:49:24
like that doesn't happen all the time but it is not untrue that when you scratch the surface of that you might
00:49:29
learn about an episode of sexual abuse that happened when the person was a child like these are real examples right
00:49:35
and that the person isn't built to run from things through addiction and maybe they're saying things about their own
00:49:41
character that's negative they're saying negative things about themselves and they feel disempowered and they're disempowering themselves but if you go
00:49:47
look at that narrative you know that that person that might have a dialogue running over and over again in their head of Shame about something that
00:49:53
happened 30 40 years ago like this is not uncommon so we need to be curious and we need to scratch on the surface of things whether they're really big things or they're subtle things like which is
00:50:05
why a life narrative is so important if you think about changes like after trauma that changes the brain we respond
00:50:12
differently when we see a new face so so without the trauma is I'm simplifying a
00:50:17
little bit but you see a new face we might be curious like oh you know could we could you be a friend or if someone's
00:50:23
romantically interested like oh my might that person like me or I might like people are interested and curious whereas after trauma there's there's a
00:50:30
difference of feeling a little bit on the back foot so people tend less to look up and engage and more to look away
00:50:37
or to more have negative thoughts so you don't that person doesn't like me you know instead of something that might be
00:50:42
con more constructive how do they test for this is there a test that able to be done to see if someone after trauma has
00:50:49
like a different set of sunglasses that they view the world with yes yeah there's a there test from from the brain
00:50:57
biology uh all the way through to to very clever psychological experiments like we can see all of this and it's
00:51:04
these these signs we should be looking for in ourselves right because it is very obvious if someone who always was
00:51:10
an extrovert now won't leave the house right like we can tell something's wrong and someone's probably going to come ask something right but if we just change in
00:51:17
these more subtle ways where we're just less interactive and you know people notice their friends a little bit different and less outgoing you know
00:51:24
it's these things that as you're saying the subtle ones the subtle signs and the nuances are often very impactful and
00:51:32
indicative of other things going on under the surface you know that can bring even greater problems on this
00:51:38
subject of soothing that you were talking about a second ago there's this quote that you say in your book trauma promotes pain pain increases suffering
00:51:44
and suffering makes us desperate to soothe our pain whatever form it takes sadly we're seeing the terrible cycle
00:51:50
play out on a larger societal level with the opiate epidemic yes this idea of soothing we all find ways to soothe ourselves and some of those ways that we find to soothe ourselves become
00:52:03
destructive in and of themselves and it almost makes me think that like our sometimes our attempt we think of like
00:52:09
alcoholism typically as people that are self-destructing but when you understand
00:52:15
the soothing component of drinking alcohol it actually is them trying to not self-destruct not destroy themselves but to take care of themselves right in a way if we're under huge amounts of
00:52:29
distress our perspective of the world Narrows right very very dramatically I mean if there's an elephant standing on my foot I only have one thing I'm guessing I would think about which is the elephant not standing on my foot
00:52:40
anymore right so when we're under tremendous stress and strain right something that soothes Us in the short term right becomes acceptable because
00:52:51
there's a desperation in us that has us focused on the short term like I know that man know that's not good in the
00:52:57
long term but I'm just trying to get through today right and and it's this lack of perspective in the world and the
00:53:04
society around us that if we're not recognizing what trauma does to us can it that it can drive us to places of
00:53:10
desperation that is it any wonder that short-term soothing will have a big appeal to us and that could be Soo soothing through excess eating and now that person is overweight and has
00:53:22
diabetes and wants to be healthier but like doesn't really feel that they can stop and ping pong's back on different
00:53:28
diets and you know what they're really doing is they learned self- soothing with food in a way that that was you
00:53:35
know in the context of really feeling some sense of Despair or desperation the same way that person may have learned
00:53:41
that oh alcohol Su now again there there are genetic factors and there are all sorts of factors that come into play too
00:53:47
but unhealthy coping mechanisms are beckoning to us all the time which is why you know I did a lot of treatment of of opium opes and opiate dependence uh
00:53:58
over a number of years and you know it's just outrageous to me that these these are the most powerful psychoactive
00:54:05
medicines on earth right opiates right they soothe psychic distress like you know feeling not good mentally inside of us very very rapidly and effectively and
00:54:17
almost immediately start building tolerance and danger right but I Had No Education and Training around opiates as psychoactive medicines so so here we are
00:54:28
in a society that so is under appreciating trauma and and where people are are at in a a sense of isolation or
00:54:37
otherness or desperation in so many facets of our society and then we start handing them the most powerful
00:54:43
short-term soothing mechanism with the absolute highest risk of long-term danger and death and then we're surprised that how many tens of thousands of people die each from
00:54:57
prescribed opiates what kind of opiates are people being prescribed so how the opiate epidemic really began was with opiates in pill form so so that they
00:55:09
would be prescribed say for for conditions of pain but conditions of pain that were more chronic conditions
00:55:16
or conditions not so amenable to opiate so if you come out of surgery and opiate is a great idea right like there's a lot
00:55:23
of pain that needs medicine to soo that pain until until the pain decreases but it's judicious use of a very powerful
00:55:31
medicine in high Acuity circumstances what we started trying to do and part of this was you know we know there's whole
00:55:37
story behind the politics and The Business of this was to say well people shouldn't be in pain so there's a
00:55:42
short-term solution right no one should be in pain we'll give them pills right and opiates do not work in those
00:55:49
situations they sooth a lot early on but they rapidly build tolerance addiction uh they suppress breathing drive so so we started Doling out opiate pills with
00:56:01
the idea that we're treating pain and isn't that good but with an absolute inattention to the immense risks of that
00:56:09
and I think it fits with a short-term view of you know of relieving all pain like we're human beings we can't relieve
00:56:15
all of our pain right sometimes what there is to do is to work hard to mitigate pain and that might be that
00:56:22
might be pain you know from a mental health perspective it might be pain for a physical health perspective this idea
00:56:28
that a pill is going to fix everything and now everyone has pain pills and won't be in pain you know has resulted
00:56:34
in hundreds of thousands of deaths in this country alone from prescribed opiates you let alone elicit opiate so there's the short-term thinking on the
00:56:46
part of our society that then almost lures people into the the seduction of the short-term soothing right you feel miserable and you want things to be better take this pill now you're seduced
00:57:00
and addicted and at huge risk and you know we've let that happen for us to know how to treat trauma we have to
00:57:07
understand the physiological consequences of it how does trauma change our brain when we look at brain
00:57:13
scans what do we see in a traumatized person brain scan data is more complicated and harder to interpret you can see different patterns in the brain we're not at the point where brain scan
00:57:25
science can really can pinpoint right but what we do see is parts of the brain that are sort of inflamed so to speak by trauma so so the amygdala and Pathways
00:57:38
around the amydala which is a part of the brain that gets called sometimes Grand Central Station for negative
00:57:43
emotion right we see that Pathways involving this part of the brain become more prominent right so we we see changes in brain connectivity because how our brains function is by
00:57:55
communicating from one place to another they function through connectivity and which pathways are more prominent so
00:58:03
what we see then is Pathways that are involved in trust say and feeling a sense of safety are less prominent
00:58:09
Pathways that are more activated when we feel less safe and more Vigilant or more activated and then we see the climate so
00:58:17
to speak in the Brain Change in a way that's less healthy and you may also see specific aspects of a post-trauma syndrome so so so mood regulation areas
00:58:28
are not functioning as well because now there's depression intruding so we see patterns in the brain that show us this
00:58:35
change although the science hasn't come far enough to to pinpoint like at some point we'll be able to do with much
00:58:41
greater accuracy and I've heard you talk about how that creates cognitive blind spots so blind spots in our brain
00:58:47
following a traumatic event what do you mean by cognitive blind spots and what's the the harm or risk of that right so a
00:58:53
cognitive blind spot can a occur when we take a lesson inside of us that is a lesson of trauma not a lesson of Truth and then it changes how we may think
00:59:06
about things so so for example a real and sadly many examples of this I that I can bring to mind in people's faces who come to mind as I say it but someone who felt pretty good about themselves and
00:59:17
able to navigate the world and uh striving for a better job and doing fun things who then is assaulted right and
00:59:25
after that assault the person is much less present in the world and internalizes a bunch of different thoughts about themselves of I don't really like being out I like being at
00:59:38
home better or it never goes well I don't get along with other people like they think about themselves differently
00:59:44
so there's a cognitive blind spot which makes it very very difficult to think with accuracy about say possibilities so that person may have say they've been striving for a better job right but if
00:59:58
they think of themselves differently I'm not the kind of person who can get ahead and people don't really like me then they don't strive for a better job they
01:00:05
just take for granted that they can't get it it won't go well they'll fail at it but they never thought that before is
01:00:11
this what you kind of see when people refer to someone having daddy issues the I was thinking as you were
01:00:18
saying that that my dad let so say my dad left when I was four mhm and I internalized this idea that men don't
01:00:25
love me me for example right and then I go through life being an avoidant person in romantic situations or
01:00:31
self-sabotaging or going for people that are unavailable to avoid the rejection is that somewhat similar like I've
01:00:36
created a cognitive blind spot and now I'm living out that as an instruction manual for my life yes absolutely yes
01:00:43
and the the earlier in life the more powerful the lesson is and the brain doesn't go back and revisit those lessons so I think this is just so amazing and surprising to me that our
01:00:55
brains are so incredibly complex right more complex than the greatest supercomputer right yet our brains don't do some very basic things like we don't reboot and see is there a patch or is
01:01:07
there something to fix right we don't go back and look at these earlier lessons so if you learn at age four oh men don't
01:01:14
love me that's a hard lesson to unlearn because it gets solidified at an early age and then once those lessons are there there's an internalized danger to go revisit them like if you go revisit
01:01:26
that lesson could you be disappointed right the thought is that's the way it is and that's the way it's going to be
01:01:32
like that's kind of how what we tell ourselves inside the trauma kind of walls it off and then we don't just go back and look and say is that really
01:01:38
true like here I am I'm an adult now and know did I just carry forward something when when I was four years old that
01:01:45
wasn't about me is it really about the four-year-old right or is it about the adult like we learn all these things but
01:01:51
we don't go back and revisit the lesson and then yes there's a person who could be very very avoidant in ways that that
01:01:58
lesson that quote unquote truth that is not true can change that person's life and that's why if we go back and look at that life can really change and we go back and look at why do you feel that
01:02:09
it's interesting to feel that let's let's think about it and you know what's the story behind it and we we can get to
01:02:16
a place where that can be undone and say oh I took that lesson inside because someone else made a choice that was about them and not me no four-year-old is responsible for a parent leaving
01:02:28
right but I took something in that was different and it's really affected me and I came to feel differently about
01:02:33
myself it's not that everything instantaneously changes but boy the world is different then on that subject
01:02:41
as well of say the father leaving at four years old and me thinking that men were well say I was four years old and
01:02:47
my father was violent what you sometimes see is people then are attracted to the
01:02:52
familiar when they grow up so although it wasn't healthy they have a sort of bias towards being
01:02:59
attracted to something that was familiar even if it wasn't healthy right that gets complicated what sometimes people
01:03:05
will talk about as repetition compulsions are are quite complicated often what a person is doing then is
01:03:13
trying to gain a sense of Mastery over a situation in which they had no control so you will see this in abusive relationships where you know sometimes a person will come uh and say okay I'm
01:03:25
coming to see you but I know you can't help me right but my last like eight relationships have been just awful so
01:03:31
how can you possibly help me and then I might say something like if you can tell me how you had eight different
01:03:37
relationships that didn't go well maybe I'll believe you but you're going to tell me about the same relationship
01:03:42
eight times over right something along those lines because we repeat things that don't go well in an effort to gain
01:03:50
a sense of control so what often is the case in that kind of situation is whether it's repeating an abuse cycle or just someone who isn't attentive or isn't interested that the person is
01:04:02
trying to feel better about something from the past so if the father was inattentive and that person has a
01:04:09
romantic interest in men that person may choose men who are inattentive with a desire to make them inattentive to fix the the to soothe the pain of the past
01:04:20
because the emotion systems in our brain don't care about the clock and the calendar so you can solve the the past
01:04:26
in the present as far as the emotion systems are concerned and if the trauma is very strong in us the emotion systems
01:04:32
will rule the day so there you said the father was violent then maybe that person chooses a a violent significant
01:04:40
other right and then that relationship goes away and the person chooses another violent significant other and then
01:04:46
sometimes the thought is well the person is choosing that because that's what they're comfortable with or that's but
01:04:52
no no the the the person is is trying to make sense of something and there's some
01:04:57
desperation inside to feel better about themselves and to fix and heal something whereas why if we can interceded there
01:05:04
and say the problem is if you want someone who's attentive choose people who are attent choose someone who's attentive right as opposed to choose someone who's not attentive and try and make them attentive can we become
01:05:15
addicted to our victimhood sure there's no internalized victim without an internalized persecutor so if someone is VI victimized in the sense of the law right
01:05:27
someone has done something bad to that person that doesn't mean that person takes inside of them that they are a victim right but trauma can make us feel
01:05:35
like victims after the loss of my brother when I felt like um maybe we're cursed and I'm not I can't really get
01:05:41
anywhere in the world like there's a black magic to that right then I feel like I'm a victim of something I don't
01:05:46
I'm behind the eightball I then I have a sense of otherness right and and now I've taken something inside of myself
01:05:53
where we don't need a persecutor anymore I feel like I'm less than so how's that going to go well right so what we end up
01:06:00
doing is we take inside of us sometimes this sense of victim but that also takes inside of us the idea that we are less than that there is
01:06:12
something magical that is bad and negative and what we need to strive against is exactly that that something may have happened that we might say okay that person is a victim
01:06:23
in the eyes of the law they were assaulted right but that doesn't mean that person has to take victim inside
01:06:29
guilt and shame how many people have I seen who are assaulted and they talk about how they're ashamed of it and it's
01:06:34
their fault someone else attacked them but the reflexive guilt and shame of trauma can lead us to feel less than then we start feeling like victims then
01:06:46
we feel less than we Embrace this and we don't need someone to persecute us anymore the lyic system we're talking about the brain here what is the lyic system and what role is
01:06:58
it playing in cementing our trauma yeah so the the lyic system is the name for the emotion systems in the brain so we're simplifying a little bit but the idea that there are logic systems and
01:07:09
emotion systems the emotion systems are limic those are the limic systems and they never lose when they come face to face with logic right the limic the
01:07:19
emotional always rules the logic if the two come head-to-head which is why if the emotion of trauma the fear of being less than the need to repair something that was unfair in the past if that is
01:07:32
driving us logic will not have its say you know logic would say if you've dated six people who've all kind of seem the same at the outset and then all behaved in the same negative way don't choose a
01:07:47
seventh like that right I mean logic very logic was saying that at the second person let Al in the third the fourth
01:07:52
the fifth why do we see repetition of unhealthy Rel relationships because the lyic system if it needs to feel
01:07:59
different it needs so to speak to solve that trauma by gaining Mastery it's going to go look for the seventh person
01:08:05
who's just like the first six but once we take the energy we Lance the abscess so to speak of the trauma then logic can have its say and that person who says you can't help me because the last eight
01:08:17
relationships were all awful sees oh I did the same things chose the same person in the last eight relationships
01:08:23
that's one Paradigm and I'm changing it now and then things are different when they
01:08:28
thought they couldn't be because they can see now what they couldn't see before the lyic system isn't ruling the
01:08:34
day anymore there's a whole balanced brain that has an understanding of self and uses that understanding to move
01:08:41
forward in life it seems like the lyic system is against us but but there must be some sort of evolutionary reason or rationale or
01:08:48
purpose of that lyic system that is I don't know malfunctioning in the modern world oh sure the lyic system isn't
01:08:54
against us I all these parts of our brain none of them hate us they're all part of they're all parts of us and some
01:09:00
of the the research and observations through the Psychedelic Sciences are really telling us that much more that
01:09:05
there aren't parts of our brain that hate us they may work against us because as you're say commenting they're not built for the modern world so you know if you think about the limic system and
01:09:17
the negative information like something bad happened when you were four or five like take that in and whatever lesson
01:09:24
that is never question it or change it right me this is based upon survival mechanisms the example I give is you
01:09:31
know imagine for most of human history and people of hunting and Gathering and living in small groups and and like
01:09:36
having enough food was is very important for humans across human evolution if you find a new food that it looks good looks
01:09:44
like something else that was good and you and you eat it and it tastes good and it's nourishing like it's good to remember that but if you eat it and you
01:09:51
get very very sick you better remember that forever right so that the negative has much more salience in us and makes these lessons never go near that thing again never go near that person again
01:10:02
never do this again right they're designed to Keep Us Alive but we're trying to do more than that right we're
01:10:08
trying to do more than stay alive and these systems in us that evolve to keep us safe then can very much work against us a person who's traumatized because
01:10:18
someone attacks them and that system gives them panic attacks if they leave the front door I mean that's that
01:10:24
person's brain trying to keep them safe you use the word shame a lot when we're talking about trauma in the same way that I asked um is the lyic system against us what is
01:10:37
the use of Shame why do we experience shame can't we just program ourselves to get rid of Shame and then we'll all be
01:10:43
fine right exactly the same with the limit question no we kind of need shame but we need shame for good reason right so so these primary aects that that are
01:10:55
very um primordial in US anger fear love shame these are things that are just aroused in us like they can become other things once we start thinking about them
01:11:05
but there states that that that are very deep within us they all have a survival
01:11:11
adaptation so you know love feeling love is you know being more than one you know
01:11:16
if we love someone now you are two and you and you're there with one another and that's going to help you survive make your way forward in life love is
01:11:23
adaptive right fear be very adaptive that now you're in a fight or flight stage you're trying to survive and get
01:11:29
through life shame is the same way there are things that people do that bring shame that change Behavior shame changes
01:11:36
Behavior a lot because it feels so bad so you know I give the example of I imagine that you know when the old days
01:11:41
you know someone who um you know pees on the food in the cave instead of going outside you know and like now puts the
01:11:48
whole tribe at risk or people and then and then like there's a sense of shame that comes to that person like you can't do that anymore and the person feels bad
01:11:55
and never does that again and it's adaptive for the group right it's just one example of how shame can alter Behavior so to Keep Us Alive in that
01:12:02
context to Keep Us Alive like now you feel shame you will not forget to not do that anymore right like it's going to
01:12:08
have an impression it's going to change you because you feel so much shame which we would think should be the case in the modern world too right we there are
01:12:17
things people do that are shameful that are worth feeling Shame about I mean sometimes the problem is we don't have
01:12:22
enough shame where we should but we have a lot of new modern problems don't we with I was thinking about bullying for
01:12:28
example like I I I imagine back in the days of our tribes there wasn't internet like obviously not but there wasn't like Mass internet bullying where a huge group of strangers could just pepper you
01:12:41
with insults and maybe our our modern Brain still has the same old mechanisms of kind of perceiving that as our tribe
01:12:48
are going to kick us off the island here right so the brain malfunctions and experien the shame which causes all the
01:12:53
things you described and then even in the context of like sexual assault I was trying to rationalize that how the shame
01:12:59
of sexual assault can make you feel shame when really it was someone else's right Behavior but how does that make that you know that woman feel or that guy feel shame about themselves when they
01:13:12
were attacked right because it doesn't start with the thought of it because you're right because what you're saying
01:13:17
I think is basically it makes no logical sense why would you feel ashamed of yourself if someone else came up behind
01:13:23
you and jumped you and did something off to you why would you feel ashamed of yourself right but but the person doesn't get there by thought right I
01:13:31
didn't get the feeling ashamed of myself after losing my brother by suicide by thinking that is a shameful thing I
01:13:36
should feel ashamed no no the shame is aroused in us it's created in us because it's Behavior modifying there's there's
01:13:44
the Adaptive something bad has happened feel something inside that creates aversion the shame is created in us and
01:13:51
then we make the meaning of it I feel ashamed the shame inside me then we make the meaning of right because I shouldn't
01:13:57
have been there when that happened and then then we make a story around it it starts with the lyic system with the
01:14:03
aect and then we build a story around it which is why we can build a different story where for example shame goes where
01:14:10
it makes sense to go like that's very very effective of processing through so okay so this thing happened you can
01:14:16
process through with someone how they felt and you know what was going on inside of them maybe they're in an ambulance or a hospital they're filled
01:14:22
with shames they realize what is to them and you know and then that was a terrible state to be in but then they start put they start making trying to make meaning of that state and we can go
01:14:33
back to oh that's a that's a natural completely understanding human state to be in after this happened but now you get to decide what that means so in the
01:14:47
context of our ancestors I'm walking through the I don't know Serengeti with my with my big spear and I'm walking and a lion jumps out at me out of the
01:15:00
blue I managed to survive it although I've been attacked I the shame is created in me because as a response to
01:15:08
make sure my behavior changes so it doesn't happen again and then I write a story about that when I get back to the cave and tell myself like the story
01:15:16
could be that I shouldn't have been walking out at night in a sing gey alone when that lion attacked me and that's
01:15:22
adaptive and useful because it stops me from doing that in the future it's like a so I'm trying to think of it through
01:15:28
maybe it's it's a little different if you were out okay let's say you're out and you're actually you're hunting a lion in the service of everyone else and
01:15:35
then you are attacked and hurt that it's that's different because you're doing something then to to feel proud of yeah
01:15:42
right so so that is is different we we're that's a situation where the person is approaching the trauma on the
01:15:49
front foot and then when you return back the thought would be you would be respected and cared for like you know
01:15:54
you went out to do something for everyone and got hurt that is very different than how people normally would
01:16:00
would experience the their trauma which is when there there isn't a sense of of Pride and self-sacrifice behind it so so
01:16:08
if the person let's say you're walking out in the serengetti at night and you shouldn't be then you should feel bad
01:16:13
about that right then the thought would be yeah I shouldn't have been doing that and how bad you feel about it will make
01:16:19
you not do it again so you're Le not going to get killed right and then you're going to come back and talk about that or people are going to go what were
01:16:24
you doing and well you should have been out there and like they may feel bad that you got hurt but like there's there's an experience that is a
01:16:31
deterrent to others doing that too right so this says something really interesting about how we treat people
01:16:36
who' have been through a trauma right the look at the difference in the United States between veterans coming back from
01:16:42
World War II and Veterans coming back from Vietnam there was far more post-trauma syndromes post-traumatic stress disorder after Vietnam because people were not coming home to a hero's
01:16:55
welcome the thought the thought there would be they had gone out like the person who goes out into the seretti to hunt the Lion is to save everybody else
01:17:02
is that's what was going on when people went to fight in World War II and when when people went to fight in Vietnam but
01:17:09
when people came back from World War II and they'd been hurt they were treated as Heroes they were treated with respect
01:17:15
and and that allows a person to shoulder that trauma without the brain changes happening when people came back from Vietnam and were were treated differently which didn't happen to everyone but it happened as a societal
01:17:27
phenomenon that was that was a terrible thing for the veterans who came back you saw much greater rates of post-traumatic
01:17:34
stress I mean that's that I think captures very clearly what the Impressions and perspectives of the
01:17:40
people around us mean there may be a reflexive guilt and shame from trauma but that doesn't have to win the day but it was much more likely to win the day
01:17:51
if there's a sense of otherness cuz now we're we're you know we're talking about the same thing of feeling less than
01:17:57
chronically by Society for some reason makes that person more susceptible so that person who's been through combat
01:18:02
trauma and then comes back and does not receive a hero's welcome is put at much much greater risk for the brain changes of post- truma syndromes what role does
01:18:12
vulnerability and being open with others about how we're feeling play in alleviating our shame sure it plays it
01:18:20
plays in for most of us in most cases it plays a very big role because the reflex
01:18:26
to the trauma is guilt and shame and the reflex to the guilt and shame is to hide it inside what we are doing is cutting
01:18:34
oursel off from the human contact that we need in order to process what has gone on with us so very many times over 25 years of being a psychiatrist I've
01:18:47
sat with someone who is putting words to their trauma for the first time you know
01:18:52
when I was 5 years old I was assaulted in that way this coach did this to me when I was a certain age uh I was hurt this way and I'm the only one who
01:19:03
survived and my two buddies died these are real things that I have that I have heard people say and then be shocked
01:19:11
that I the other human in the room don't recoil from that because they've held so long inside
01:19:21
of them that it is shameful that they were assaulted it is shame shameful that they survived that that it's so
01:19:28
dangerous to even utter it the fear of how a person will react that someone is surprised like wow you could hear that
01:19:34
or they say it in ways and kind of step back a little bit because there's such an expectation of rejection where what
01:19:41
the person is telling me is something that from any reasonable human being would only elicit
01:19:47
compassion now that person who's telling me would only ever be compassionate to someone saying that but they're not compassionate to themselves is shame really the cause of
01:19:59
what we kind of think of as these trauma Cycles because someone experiences a trauma they suppress it which changes
01:20:06
how they behave which means that they're more likely to experience more trauma in some way or at least perceive it as a
01:20:13
trauma via shame and then they kind of their life gets more and more full of different types of trauma does that make
01:20:19
sense cuz I'm wondering if like trauma can be quite a self-fulfilling thing where you get into a cycle of trauma in
01:20:24
your life well it can be I mean in the case of the person who now finally puts words to
01:20:29
something they've held inside of them that they would know is not shameful to anyone else but they hold is shameful for them right what is going on inside
01:20:37
of them may or may not have caused further trauma right I mean it it's it's caused suffering right there's no doubt
01:20:43
about that when a person is is is saying that and they're they're putting word to something that's so important has been
01:20:48
inside of them it has caused them suffering so they haven't been as happy as they could be enjoyed life as as much
01:20:54
as they could be been as outgoing as they can be been depressed when maybe they didn't have to be depressed so so
01:21:01
the trauma is impacting them because they've hid it down inside right if you can talk about it and bring light to it
01:21:07
let's say after that thing that happened when the the person was assaulted at 5 years old or survived in accident others
01:21:13
didn't if someone did trauma work with them of hey you're what are you feeling now okay let's get to the fact that person is feeling guilt and shame and
01:21:19
the naturalness that they are but it doesn't tell them truth right it's just telling them how they feel and in fact
01:21:25
it comes from compassionate places inside of us we can help to unwind that before it becomes a thing inside the person that yes may make life less enjoyable or may also in a way that's
01:21:38
worse push towards repeated trauma so the the trauma of choosing the same unhealthy partner or the same abusive
01:21:45
partner over and over is an example of what you're saying if a person doesn't look at the trauma and like why am I
01:21:51
doing this what am I trying to solve here right I'm trying to solve something maybe from childhood that was somebody
01:21:56
else's shortcoming or fault or someone else's okay I can stop doing that then the person can stop with repeating the
01:22:03
behavior so the answer to all I think the answer to what you're asking is absolutely yes and if we're curious and
01:22:10
we strive for understanding ourselves and we know that there are routes to change this is how we heal from trauma
01:22:16
that ultimately invisible epidemic is a is a message of warning but it's not a negative or a pessimistic message it's a positive POS message is if we understand this and we look at it well guess what
01:22:27
happens is we get better we prevent trauma we take care of the trauma in ourselves and others and we get
01:22:33
healthier like I see this play out in 25 years of doing this like this is what happens but we only get there if we have
01:22:41
the Curiosity we we you know we're interested and we know enough to go looking and thinking and making a
01:22:47
narrative and you talking about ourselves and wanting things to be different and knowing that they can be so it's a message of Hope because when
01:22:53
we do that we really see change so clinically when doing this work you see a lot of
01:22:59
difference in people and that's part of what's been so heartening and led me to write the book is it's not just a
01:23:04
message of oh this is what's going on with us let's take a look at it it's this is what's going on with us and if
01:23:10
we look at it absolutely we make life better I want to talk about some of the ways that trauma impacts us that are
01:23:16
less obvious one of them I'm interested in is sleep a lot of people are struggling with sleep these days is
01:23:21
there a link between sleep issues and TR yes and how strong is that link yes so so sleep is one of the symptoms of a post-t trauma syndrome it's not an all
01:23:32
post-trauma syndromes so higher anxiety lower mood behavioral changes sleep is one of these factors and sleep is very
01:23:40
often negatively impacted by trauma so the changes you had asked about in the brain and then we talked about how they go more towards vigilance more towards activation they make it harder for the
01:23:51
brain to settle down and be in a restored state so sometimes we get was called ruminative where there are just thought Loops going on inside of us and the brain doesn't want to quiet down to
01:24:03
a place where we can get restorative sleep so people have more fragmented sleep they have shallower less restorative sleep more time until they
01:24:10
can fall asleep earlier Awakenings so this is very very bad for us across the board I mean talk about the union of physical and mental health sleeping very poorly is terrible for us from head to
01:24:22
toe and very very often after trauma if there is a post-trauma syndrome which is
01:24:28
not uncommon sleep patterns are dramatically changed and and sleep restorative function is changed what
01:24:35
happens is we're in higher states of arousal and neurobiologically this isn't about sexual arousal it's it's just
01:24:42
state of alertness right so we're in too high a state of arousal too high a state of alertness and then the brain systems
01:24:48
inside of us that need to really simmer down in order to restore aren't able to fully do that
01:24:54
I guess there must be some kind of Link there as well because if I'm in that if I'm less comfortable with being with my own thoughts because they're rum
01:25:01
ruminative that I'm overthinking all the time I'm then also more likely when I'm trying to settle down to be trying to
01:25:08
stimulate myself like a lot of people aren't comfortable with just being sitting in a room alone with their
01:25:13
thoughts especially if they're you know an overthinker so then they might grab their phone they might sure be you know
01:25:19
doing things to stimulate themselves at a later hour of night but it all comes back to the trauma absolutely yes yes
01:25:25
and you're describing how the downstream effects of all of this are tremendous so
01:25:31
absolutely yes so so we're saying getting less sleep is just bad for us from head to toe okay and also there's
01:25:39
all the things that you're talking about so if you know you're going to try and sleep and it's going to be just going
01:25:45
over and over again in your head and it might be I'm not safe or I'm going to get fired or I'm going to get hurt or it
01:25:50
may just be something that's simple and negative that you don't even Rel to trauma like oh this is awful or light I
01:25:56
mean these are things that go over and over again in people's heads when they're trying to sleep like I'm not okay what's going to happen and it's
01:26:01
going over and over again so of course you're going to want to distract from that and and you because the way we've
01:26:07
kind of framed it there is that you're aware and conscious of that but can that be taking place in like the back room of
01:26:13
your mind where you oh sure sure sometimes people are aware and sometimes they are not sometimes to ask a personal why why aren't you sleeping well the
01:26:20
last four months which seems like a good question to ask instead of just giving the person a sleeping medicine but in modern medicine sometimes the question
01:26:26
doesn't get asked but you know maybe the answer is this some really different trying to fall asleep and like I just don't feel peaceful anymore but but the person has not thought of that until you ask them then what's the logical next
01:26:38
question why right what happen when anything change around then and a lot of times you get an answer and that person
01:26:45
has a trauma problem not a sleep problem you can probably pound the Sleep System to sleep with medicine but now we're
01:26:51
doing something that ultimately is harmful for the person so yes and also you know when you talked about avoidance
01:26:58
behaviors of sleep this is also why the person can avoid avoid avoid and then have three or four drinks to get to
01:27:04
sleep right so there's so much that is unhealthy that then perpetuates being unhealthy and it spreads and this is part of the epidemic aspect of this and and then people often
01:27:16
don't know why things are different in their sleep but a lot of the time if you stop
01:27:23
and you think and you talk about what's going on inside of them they will tell you and it may be that for the first
01:27:29
time they're telling themselves which is why we should ask ourselves this question you said to Rich Ro amongst the
01:27:35
conditions I've seen treated the absolute worst in mental health treatment and indeed in general medical treatment are sleep
01:27:43
problems why because sleep underlies so much and because we when we we have a lot of habbers in medicine so we see a lot of nails so if someone is not sleeping The Reflex in medicine and not
01:27:58
everyone does this and I'm not trying to say they're all Physicians or practitioners are not behaving in the
01:28:03
right way but we we work in systems that are high volume and designed for throughput so they're designed for
01:28:09
symptom identification so what we say is okay you're not sleeping so we'll give you sleeping medicine like that simple
01:28:15
but the reasons people are not sleeping are very very often not related to their
01:28:22
sleep systems they're related to these vigilance and activation systems inside of us so if if that's what's going on in
01:28:29
me and I'm agitated and have this highly aroused state after trauma and maybe it's been going on for two weeks or maybe it's been going on but getting worse for two years but this is what's going on and I can't settle down and my
01:28:42
sleep system can't overcome it you know if you give me a sleeping medicine for that I'm probably going to need a lot of
01:28:47
it right because we're trying to make the Sleep System overcome the distress I'm more likely to get addicted to it I
01:28:54
mean there's a lot of bad we do to people and I never have an opportunity to address my problem what should we be
01:29:00
doing instead we should be asking why why is it that you are not sleeping and maybe it came out of the blue maybe maybe your sleep system every now and then fails you but when we start asking
01:29:11
those questions we get answers and more often than not those answers are in the realm of trauma then that person does not get a trauma medicine they may get a different medicine that in the short
01:29:24
term can quiet the vigilance systems this we do this a lot where the person has a sleeping problem we learn the
01:29:30
trauma history we use a short course of a medicine that calms the vigilance systems has nothing to do with making
01:29:36
the person sleep and then they start sleeping well and maybe this is true they might not have slept well with five
01:29:43
six 10 sleeping medicines but that is not the medicine that they need right they need a medicine to calm these
01:29:50
distress systems inside of us so that the Sleep System system which is not damaged can go and do its thing and and
01:29:58
while we realize this we can start talking about the trauma and maybe the person can process some of the trauma
01:30:03
now the Sleep problem is gone everything is better the person's not going to be on a sleep medicine for the next 20 years it's healthier it's safer but we
01:30:11
have to be more than reflexive right there are a lot of reasons people don't sleep what about a link between weight
01:30:19
and Trauma I've heard I've heard a ton of studies over the years about how um various people who are obese have
01:30:26
high levels of sort of traceable trauma is there any truth to this yes so there are probably almost
01:30:34
surely a couple of factors one is it's hard enough to take care of ourselves you know even when things are going really well right I mean life is so busy and so stressful so it's hard to take
01:30:47
care of oneself if a person adds trauma to the mix it becomes harder to take care of oneself and one way we cannot
01:30:54
take care of ourselves is you know what we're eating and whether we're exercising so the trauma makes it harder
01:30:59
to take care of ourselves and predisposes to poor self-care now we have you know person who's overweight
01:31:05
and then maybe pushing towards diabetes or heart disease or cardiov or cerebrovascular disease and also just
01:31:10
like we talked about epigenetics and and changes in gene transcription what genes are active in US trauma puts us in a
01:31:18
place where we are more inflammatory within us like there are more inflammatory markers in our blood vessels so it's not as clean and clear
01:31:30
as we would like it to be we're not as healthy and this works against the health of our blood vessels and the
01:31:35
health of our immune system so the soup we swim in so to speak is changed by the
01:31:42
trauma and then those higher levels of inflammatory markers for example that are circulating in our bloodstream can make it harder to lose weight the body starts holding on to more calories and
01:31:56
it makes it harder for our blood vessels to stay healthy and then we get less and less healthy and part of that is the
01:32:02
biological effect of trauma just like the epigenetics right and part of it is the changes psychologically and the
01:32:08
changes in self-care how do you convince someone that comes into your practice and tells you that they can't change
01:32:15
they don't believe they can change how do you convince them that they can well I'm a huge believer in the power of
01:32:21
knowledge and the power of information which I think goes back to how powerless I felt as a kid when we couldn't
01:32:26
understand medical information it's like I want to know I want to understand and I think I think a lot of people are like
01:32:33
this I think we as humans don't get enough credit that we want to understand and I think so much in our society is
01:32:40
reflexive like you know what you know and you feel how you feel and then you know we have a whole set of beliefs about the world because we affiliate
01:32:46
with some group or another right I think that's a reaction to feeling so disempowered and that what we really
01:32:52
want is knowledge and I think that's a reason why for example knowledge imparting podcasts are so valued because
01:32:58
you're not trying to tell people what to do or how to think but you're you're giving them bringing them knowledge and
01:33:04
and that's what I try and do of like I know that's not true now it may be that if you're a science-based or rational
01:33:11
person or you're an engineer or an accountant who's like I might try and get at you through this through the science right I might get try and get at
01:33:17
you through that article right is something that can like let you see that or I might try and get at it through examples of hey here's like people do
01:33:24
change like here's kind of really what the stateof the- art is now and like kind I get you excited about that ex give me an example there are a lot I
01:33:31
could site but the one that comes to mind is the one story in in my book that is uh just an amazing story of a person who had had a trauma in her life that
01:33:45
had just changed everything mood anxiety Behavior choices in the world I mean so
01:33:52
much had gone in a way that was not how this woman was built to live her life or
01:33:58
how she was living her life and it was so striking her telling me about who she was at some point in the past and contrasting that to how she was living and how she thought about herself and it
01:34:12
was really a night and day difference and it became clear there was a very abrupt change at this tra at the time of
01:34:19
this trauma like a night and day change towards dysfunction poor health poor social function misery and she had no thought or idea that she could be like
01:34:31
she was before because all she knew was that things had changed and now she was like this and this was not okay and never going to change but she was
01:34:42
willing to see the starkness of the change and to hear my observations and examples like look I I see something here that's looking from the outside that's really striking and and and
01:34:54
that's we could think about and talk about and understand and and like changed her entire life and it really is
01:35:00
true that 10 years later she looked 10 years younger absolutely is this a one hit wonder though or is it a training process like me being in the gym and picking up weights over and over again am I having to retrain my mind to view
01:35:14
that situation differently yes yes we are creatures of neuronal habit so if you think the example I give are us uses let's say you and I just picked a word random word and we said it 500 times
01:35:27
right we'd each be saying it this evening let's say we say it 2,000 times you know give it a couple days it's still there on the Mind why even when we
01:35:35
know it's a silly example why would it still stay with us because when we say that word so many times we're
01:35:40
strengthening memory connections that word comes to mind more it's stronger within us and then the only way it goes
01:35:46
away is it atrophies over time you know is you can't just make that go away after you said it a couple thousand
01:35:52
times it'll go away over it gets less and less powerful over time so if you don't keep saying that word
01:35:58
you know it comes to mind maybe 10 times the next day five the second day three times then not again but this is how
01:36:04
processes of change work inside of us so someone who has for example had selft talk in them that oh it don't never work out for me or like I suck and no one likes me or you know I'm terrible or how
01:36:15
could you you idiot or you know things like I had a shadow voice saying these things to me for years like that doesn't
01:36:20
want to go away at once because it's just habituated inside of us so we have to realize look that is not real and
01:36:27
true I don't that is not what I think what I want to say to myself so I want to know when it's there I want to
01:36:33
realize I'm saying this to myself and I don't believe it then we make it less strong right we make it less strong
01:36:39
every time we say something that's a negative lie to ourselves like no one will ever love me right people say that to themselves over and over we make that
01:36:46
more powerful as if it were true and if it's as if it were true is it true our brain can't tell the difference now so
01:36:53
we we understand that and now we want to change it like I know why I said that because when I was growing up that
01:36:59
parent a person always said that to me over and over and over and then you know I chose bad relationships cuz I didn't
01:37:05
think I was worth anything better and they didn't go well and it reinforced that to me like if person really understands that we bring that
01:37:11
understanding to bear in a way that you speak against that when it comes into your mind because we can't make it not
01:37:17
come into your mind it can atrophy mean this process of slowly over time it goes away but we have to say the hold me I
01:37:24
about the judge in the middle of all the opinions has to say okay I know I'm saying this to myself right but do I
01:37:29
believe that or not can you really completely get rid of a trauma can you take a trauma to zero well we won't lose
01:37:38
the memory of it something bad has happened we're not going to entirely forget it that means it can trigger Us
01:37:44
in again in the future well the question is how much does it trigger right how much does it trigger the idea is to
01:37:51
attenuate the response to it so if if it was a car accident and every time the person looks at a car they have a panic attack right it's probably it's probably
01:38:02
not going to happen that someday they look at a car and don't even remember right but they can look at a car and
01:38:07
like they know they had a car accident we're they're trying to hide it from themselves oh my God I can't see a car I had a car accident it triggers me like
01:38:14
I'm I'm understanding that I understand the naturalness of the responses in me and how they got maybe were perpetuated
01:38:20
by the fear that I felt and I wasn't working through it or working through the loss that happened now that I'm
01:38:25
understanding that more I don't have to be afraid of this so I see a car and this it makes me kind of uncomfortable but it's okay A lot of people beat
01:38:31
themselves up because they've done a lot of work right and this trauma Still Remains I think I'm one of those people
01:38:37
where there's certain traumatic things from my childhood done a lot of work I logically know that it's not true like
01:38:43
that that belief I had is not true yet I'm still prone to be triggered on a bad day about that particular thing right
01:38:50
right look that's that's that's how it goes when when a person is navigating through trauma and really getting
01:38:57
through like getting over a lot of difficult things and getting to a much better place but responds to the
01:39:03
triggering in a way that inadvertently reinforces the trauma so I would say if you're having a bad day and you have a
01:39:10
memory of something that you kind of know you got over but then it it raises the same set of thoughts or feelings that aren't good right instead of my
01:39:17
guess is that you're feeling bad about that like I did all this work and I didn't get over it right to say look isn't it interesting like how how strong
01:39:24
this imprints us that this is still going to come to my head today it's going to come into my head like I'm having a bad day or I drop something in
01:39:31
the morning and I don't feel great about myself this stuff is very very powerful but still not telling me truth you know
01:39:36
that shoulder shrug about it okay it's going to come into your head it was neuronally reinforced and sometimes
01:39:41
you'll be having a bad day and it'll come in it doesn't mean anything lady gagar sits at the very top of your book
01:39:47
and she's written the forward in your book there's this wonderful quote inside that says I can now say with certainty that this man saved my life he made life
01:40:01
worth living but most importantly he empowered me to find and reclaim myself again that is an incredible thing for anyone to say to anyone else thank you my first thought is she's
01:40:16
eloquent and generous of spirit and and I so appreciate that she wrote such lovely words and I and I so
01:40:23
so appreciate them thank you why did she say that you know as she has talked about there's trauma in her life and to gain an understanding a much better
01:40:35
understanding and be able to ground to the things about her that are wonderful and she's a wonderful person there's
01:40:42
wonderful there's wonderfulness in us no matter who we are and I think from the perspective of her on such a big world
01:40:49
stage acknowledging the trauma and the humanness in her and that like anyone else she needed some understanding she needed um some help forward in different
01:41:03
Pathways of thought about self like the kind of thing any of us need after trauma and she had the The Bravery the
01:41:10
fortitude to you know to take chances to be different you know just like someone would say I can't be any different we
01:41:16
can all feel that when we have a lot of trauma inside of us and it's hard to think I'm going to really try and be
01:41:22
different I'm going to take that chance but you know in order to to change our lives we have to do that and and and she
01:41:28
also did that it's a it's a very very human story in I think a deeply feeling person who then wants to bring that message forward to others that we can change trauma and I'm I'm I'm so
01:41:40
grateful she wrote the forward to my book but part of that is she's she believes in that message that trauma does not have to control us we can
01:41:47
understand it we can get our arms around it and I think that's what she is that's what she's communicating in that quote
01:41:53
that's the part of that quote that's important the part that's about everyone reading it and the and the capacity for change you have some incredible
01:42:00
celebrities um on the book inside the book that have given you quotes for the book people like Kim Kardashian Tommy
01:42:05
Hilfiger etc etc lady gagar as I mentioned I'm guessing these these people at some point came to you without
01:42:14
sort of disclosing client confidentiality issues I'm just wondering how you find yourself in a position as a psychiatrist that the this
01:42:22
C caliber of people are seeking out your support well and does that ever feel a bit surreal yeah I think I think it does I mean I like to think of myself as a
01:42:34
diligent person who wants to continue working at things and moving them forward and and uh seeing where they can
01:42:43
go and and I think at some point in time I realized I had the capacity to to perhaps Reach people who reach a lot of other people right and and there's been a real Joy I I think that people who
01:42:56
have who are public facing I mean there are a lot of stresses to that you know people can think oh seems so wonderful
01:43:02
from the outside but there's a lot of extra stress to that from the inside so to be able to address some of the extra
01:43:09
complexity of that and to be able to help people who have a big impact on the world around them uh was um and sort of
01:43:17
a joy to pursue we have a closing tradition on this podcast where the last guest leaves a question for the next guest not kn who they're going to be
01:43:23
leaving it for and the question that's been left for you feels quite fitting and very interesting I really like this
01:43:29
[Music] one it just says it's not even written as a question it just says erase one
01:43:37
regret from your life dot dot dot wow you know I think I should have paid more attention to the world around me when I
01:43:51
was younger and and more lost in trying to feel good enough at the moment and I think that it made it harder to sort of find my
01:44:03
path and I think it made it harder I think my brother hadn't found his path and I think there was a lot of frantic
01:44:10
anxiety or fear-driven forward movement without pausing and circumspection and it may be that we just talked about and we've talked about his suicide and we've talked about that in this podcast so
01:44:21
it's it's kind of at the Forefront of my memory but when I think back then I probably knew well enough to be more
01:44:27
circumspect including about what might have been going on in him or in me and um I'm happy I got myself on a path
01:44:35
that's led to places that feel good and that I think are generative and productive um I wish I had more
01:44:41
attention to the bigger picture when I was significantly younger why well I think I would have made better decisions I think I would have seen Pathways that led away from health and happiness and
01:44:53
maybe seen that in others too um CU some you're talking about Jonathan and others where where where I was born and raised
01:44:59
I think there there were a lot of good people in a lot of forward movement but um we maybe could have looked around
01:45:04
ourselves a little bit more and there'd be several people maybe still here as opposed to not being here and people being healthier and um I think I
01:45:12
probably had it in me to look around myself more than I did at that time and I do sometimes feel I will feel regrets
01:45:19
about that well I have to say Dr Paul the work you've committed your life to and the understanding you've committed your life to spreading
01:45:30
um is going to save many many many many many many people's lives thank you and not just save their lives but sometimes
01:45:36
it's not always about saving a life it's about improving the standard of someone's life which I think can have a
01:45:41
generational impact if that person is to stay alive and they are to you know if we look through the lens of epigenetics
01:45:47
or just about the how internalized shame and guilt and all of this can be passed
01:45:52
on through vicarious forms of trauma that the kids might feel and whatever you know your work and your your future work I deeply believe is going to save
01:46:04
and improve thousands and thousands and tens of thousands hundreds of thousands of people's lives and that is an
01:46:10
unbelievably remarkable thing to commit one's life to thank you there's no words that I could say in the 30 seconds I
01:46:16
have now that would would Express the extent of the good that that's going to do in the world wow and I I you know I
01:46:22
can't imagine those people that are here and not here how proud they would be and are of you
01:46:29
thank you for turning your trauma into such a wonderful healing important thing so on behalf of all of those people that you'll never get to meet that you've helped with your work I want to say thank you so much W well you're very
01:46:42
welcome and thank you for those kind words which I take to heart and thank you for having me on I appreciate
01:46:47
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