Leading Childhood Trauma Doctor: 10 Lies They Told You About Your Childhood Trauma! - Paul Conti

Trauma is like a virus, and it gets. passed along to your children even if. their children are not born until years. 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. Conti psychiatrist, expert in treating. trauma. He's worked with Kim Kardashian and. saved Lady Gaga's life. and been in clinical practice for over. two decades. How many people have some. form of trauma? Well over half the. population. And trauma can change us in.

very negative ways. For example, the. odds of traumatic brain changes are very. very high. We know 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 them pills. with the idea that pills is going to fix. everything, and then we're surprised. that tens of thousands of people die. each year from prescribed pills. And. we've let that happen. What should we be.

doing instead? The key to all of this is. curiosity. So, for example, let's say. someone is addicted to their phone. Oftentimes addictive behavior is 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 that happened. when the person was a child. This is not. uncommon. What are the telltale signs that I am. traumatized? What can I do to alleviate. the trauma? And then, can you completely. get rid of a trauma? The answer is based. in hard science. So,

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is to hit the subscribe button. Let's. get on with the episode. [music]. [music]. Dr. Paul Conti. On the front of your book, it says. trauma, the invisible epidemic. Why did you use those two words, invisible and epidemic? [clears throat]. Well, as a practicing 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 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 could have been acute. or it could have been chronic over time, but that changed their brain. So, that. the brain is then different going. forward, and that is the root of the. problem. So, from that sense, I could.

see there's an epidemic because this is. behind what is ailing us, right? The the. 50% or more of complaints to general. medical doctors are coming from mental. health. Right? These are general. physical medical medicine doctors. So, you 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. different illnesses. For example, like,

"Oh, that that person has depression. That person has cardiovascular disease. and had a heart attack." Right? But. those things may be linked, including. autoimmune diseases, all aspects of. 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 commonality, that this is. everywhere, and we're not identifying it. because one of the impacts of trauma is. to make a reflexive sense of guilt and.

shame in us. So, then we sort of hide. things away. So, we're changed, made. less healthier, and 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. have some form of trauma? Because when. we think of trauma, sometimes people. think of PTSD, soldiers coming back from. war. 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. 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. the impacts we see downstream of these. brain changes, we're talking about a. very significant portion of the. population. And then, if you think of. people who are either. experiencing the post-trauma effects. themselves, right? The changes to.

themselves, or experiencing those. changes through someone close to them, through someone they love, a parent, a. child, a significant other. Right now, we're we're well over half the. population that will that will. experience a significant and negative. life impact from something that either. was with high likelihood avoidable or. treatable. In other words, change. for the worse that doesn't have to be. that way. And again, it's not just as if.

just mental health, we're 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 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 trauma, by this. definition that changes us because our. coping mechanisms are overwhelmed, makes. us age faster than our calendar age. So, you could say, "Well, that person is 40. years old by the calendar, but they're. really 46." Right? "That person is 65,

but really 73." If you look at the aging. that occurs in us as a result of trauma. So, if, you know, I say this in part to. to really speak to how like concrete and. 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, it is is so real and so. tangible. And it's this is the effect of. trauma. A trauma I said. And modern.

science knows this. Modern neurobiology, modern psychiatry, the research around. us tells us this, but the things that we. know aren't always at the forefront of. our consciousness in society, which is a. reason I think it's so important to. spread the word about it. Why does this matter so much to you? I had a youngest brother who died by. suicide when he was 20 years old. I was. in my mid 20s, which which had. um. um just a a terrible effect on the.

family structure and upon me. And I and. I felt the reflexive sense of of guilt. and shame without really being aware of. it. I hadn't felt that before. You know, I 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. different about myself. And I started. behaving in ways that weren't healthy. You know, they were very unhealthy. Drinking too much, unhealthy friendships. and relationships, and real change in me. that I was fortunate to be able to get. help for. Um that really.

brought to the surface how much had. changed after the trauma. That I felt. very different about myself in the. world. Like so cursed and maybe our. family was cursed, and I couldn't make. my way forward, and bad things were. always going to happen. And it was the. realization that like I'm really. different, and this is not okay. 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 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 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 college and took some pre-med classes. and went to medical school and then. became very interested in psychiatry and. and and brain function, both the. psychology of how we think and the the. brain biology that underpins how we. think. And I've 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 the at the time, I just went. inside. Like people didn't talk about. it, and we're overwhelmed, and you know, we became less healthy and felt. different about the world, but there. wasn't an outlet. for talking about it. It just wasn't the. the how I had grown up. Like there. wasn't a way people would say, "Let's. check in. Like, how are you doing? And. maybe you should see someone." Like it. like it didn't happen. And and it took a. it took until I realized like I'm kind.

of in trouble here. I need to get some. help to then, you know, I had an. 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, and I felt even embarrassed. about doing that. Like I really didn't. understand neither what had happened and. nor how to help myself. And and then you. know, I went to someone, and you know, I. just remember just how amazing it was to. just have her tell me that, you know, I. wasn't. like I wasn't sick or crazy or or like. not going to be okay because I felt this. way that I helped normalize what I was.

feeling and and helped me put some of it. into perspective and I realized like. well, that was very basic what was just. done 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 very struck by it. and by how much of a difference it made. to have a better understanding and get. some help. The impact it had on the rest. of your family. I was reading that your. mother was depressed for the rest of her. life almost because of. potentially because of that incident. Mhm.

Yeah, and I think she was clearly. different afterwards, too and and was. much more isolated. Again, in hindsight, it's so clear to see, but I think the. guilt and shame that she felt um. was was overwhelming and she didn't was. not able to get help, you know, no. matter how much encouragement. You know, at some point I it was actually a. psychiatrist and I still couldn't you. know, couldn't get her to get help. because I think she was just felt so. ashamed and and. felt that help was inaccessible or that. it getting help was even more shameful.

And you know, the patterns changed. I. mean, there were still 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 resources for, you know, mothers who lose a a child to. suicide and and my father who was more. extroverted you know, then just had more. natural support mechanisms and that's. what you see sometimes that that 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 paying. attention to this and we're just kind of. running forward, you know, and trampling. people then maybe the person who's a. little more introverted in a situation. like that a little more inclined to be. self-blaming, you know, like that's the. person who doesn't do okay and you know, and my mother didn't and and died I. think much younger than she should have. of of cancer, but this kind of trauma. predisposes to the immune system not. functioning as it should and I can't say. that this trauma caused her early death. by cancer, but but certainly there there.

a lot of scientific reasons to think. that. um. that it was likely a factor. in it and again, unless 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 it. These. changes to us don't have to stay the. same. Like the person who's blaming. themselves and ashamed and depressed. doesn't have to stay that way. The. person who is abusing a substance to try. and cope or to try and kill themselves. because they feel so bad it doesn't have.

to be. living like that. Like we really and. truly can make change. The person who. has an autoimmune disease or heart. disease or rheumatoid arthritis that's. inflamed after the trauma. Like. everything is worse after the trauma. doesn't have to be medically. ill like that. Like it's the the message. I'm bringing is is one based in hard. science and it's one that has a real. message of change that it's not an. esoteric principle what we can and. should be healthier. Even you think. about more than 50% of complaints.

brought to physical medicine doctors. that come from a mental health. perspective. I mean, how much of 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 top of this conversation you. referred to aging and the impact that. trauma has on aging. Mhm. How does that. work? So, trauma makes me older? Mhm. There's there are there's cellular. mechanisms in us, you know, people often. talk about telomeres which is one aspect. that change as we grow older cuz we're. very interested in figuring out like why.

do we grow older? Right? So, there are. processes in us that sort of mark time. and that change across the aging process. of humans. Now, I mean, we don't. understand everything about this. If we. did, we could change it and we'll live. much much much longer, but we're trying. to understand about it and and I think. science has made a lot of very. significant headway in understanding and. part of that understanding is the. biological age of a person. is different from the calendar 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 able to. live in pretty good circumstances and. free of trauma and you know, has a. pretty good life going and the other. person lives in a way that has has. privation and a lot of trauma, maybe. direct physical assault or seeming seen. as less than denigrated by society. It's. a theoretical example, but 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 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 mechanisms are telling us how far. along our path we are so to speak. They. say, okay, that kind of matches with. being that person's age, but then you. see the person who has been through so. much trauma, the presumption here being. there are the brain changes of trauma, there's a post-trauma syndrome. I that. that person is going to actually be. older in terms of how far they have.

traversed down that path of the. machinery in them running itself forward. than what the calendar tells you. Trying to figure out why and how that's. happening. What is the mechanism that's causing. them to apparently accelerate in age? So, the the less healthy environment. within the person. So, some of that is. is likely say the signaling molecules. that we we talk about is just not as you. know, the bloodstream isn't as as clean. and healthy and you know, running in as. lockstep a fashion as we might want, but. there are inflammatory signaling markers.

and you know, that impacts cellular. function and cells are more likely to. die earlier than they might otherwise. and and elements of neurotransmission. and anxiety and tension states within. us. You know, it's it's really. environmental. One you know, one set of. aging machinery is in a healthy. environment and the other 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 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 an in. a. a nice warm dry environment, you know, versus having a car where you know, there's snow and ice 6 months of the. year and then it's terribly hot the. other 6 months. You know, it's that it's. going to be different. It's going to age. differently so to speak. Right? If you. go 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 study by the British Medical. Journal found that adults who.

experienced sexual abuse by the age of. 16 have 2.6 times. 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. you also talk about how it can result in. new autoimmune disorders, things like. arthritis. um. Crohn's disease Crohn's disease, ulcerative colitis, Parkinson's disease.

probably has an autoimmune component. We're learning that much much more. is autoimmune. So, Do you believe that trauma is the. underlying reason behind many diseases. that lead to early death? Absolutely. And think about what you 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. Sexual assault in the teen years. like. leads to a two and a half fold increase. in death risk.

That's staggering. What's causing that? The whole cascade from the biological to. the behavioral. So, gene transcription is changed. Healthier. genes are more likely to be off. Unhealthier genes are more likely to be. on. That's not good for our blood. vessels. That's not good for heart. disease or possibility of having a. stroke and the immune system is more. activated and more likely to attack. itself and some of the mechanisms within. us that are protective against cancers.

for example are less 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 changing. Higher. risks of depression, higher risks of. addiction, higher risks of impulsive. behaviors, risk-taking 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 the genes all. the way through to complex risky. behavioral taking. Do you think there's. anything killing more people than. trauma? Fundamentally? [sighs]. Not if we look for root cause. I've seen. many many things that kill people and I. I wrote about this in the book people. that I was taking care of who at times. died and I was always so struck by what. the death certificate said versus why.

they had really died. You know, so the. death certificate might have said car. accident. Okay, I. understand that, but why was that person. driving 120 miles an hour in bad. conditions or why were they being so. reckless? Why they had five car. accidents? I know that's the trauma. Right? Well, well, it's. heart attack. Why did that person have a. heart attack when they were. 62? They didn't have huge risk factors. from other any way except the trauma and. its impact and. so if we're looking at root cause.

analysis of what is hurting us, what is hurting our quality of life, what is hurting the quality of life of. people that we love and what is killing. us, I think that need we know more than. even just that. And and there's so much we could we. could pile the information a mile high. that supports that piece of information. which I think is quite staggering. What. are the different types of trauma? Are. there sort of different categorizations. of of trauma from like small to big or. If we're if we're using the definition. that trauma is anything that overwhelms.

our coping mechanisms, so so there there. are changes in the brain when our coping. mechanisms are overwhelmed and on the. other side of that our brains are. different. So that's the biological. 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 categories that are 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 shell-shocked after. World War I,

right? That was acute trauma, combat. trauma. So our traditions of looking at. trauma come from acute trauma and it's. 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 that oh, okay, gosh, that. could what makes some difference in the. in the person, like we can kind of get. that and sometimes we can see the change. in the person from before and after. So. we have tended to equate. trauma and post-trauma syndromes, like. what happens to us after those changes. in the brain are now with us, to acute.

trauma. But but again, it's 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, 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 a child is being emotionally or. physically abused. at school? Sure, bullied at school, absolutely. Right, 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. situations of chronic trauma just as it. is in acute trauma. Now, it doesn't mean. all acute traumas or all chronic traumas. make these changes in the brain. And. then the vicarious, so the third. category there would be vicarious. trauma, which means like human beings. are empathetic, right? I mean, thank. thank goodness, right? That's how all.

goodness comes in the world through our. ability to have empathetic connection, but that also means that our trauma can. communicate from one to another. And. again, it's not a soft concept, so. people who are very much involved in. other people's trauma, so in health care. settings, sometimes in in journalism. settings, just in intimate home settings. and just spending a lot of time with the. news, right? Can become traumatized and. have the changes in the brain that look.

the same as the person who lost two. family members in the car accident. So. it 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 actually makes no. sense, right? Like what we're talking. about are brain changes and brain. changes can come through acute trauma, chronic trauma, or vicarious trauma. because of our ability to have. empathetic connection and compassion. with other humans. I want to make sure. that I've nailed this before we move on.

So the acute trauma is I get it, it's. the the big events, it's the going to. war, it's the car accident, big events. that happen typically in an instant. Mhm. Typically. Chronic trauma, this is. things like racism, sexism, bullying. that happen over a long period of time, gradually, that make you often feel less. than Right. than other people. And the vicarious. trauma is the trauma that as you say, you get from empathy. So feeling someone. else's pain, feeling someone else's. trauma Yes. and it becomes 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 person's brain is. still doing okay, right? It's not. changed towards greater vigilance, right? It's not changed towards greater. inflammation in their blood vessels, then, you know, another person could have one incident. that might seem more mild than the other. three, the person and that person can. then have brain changes. So part of this.

is who are we genetically, how are we. built, what kind of life experience have. we had, especially early life. experience, how susceptible are we to. one thing versus another? And then this. idea of the multiple hit hypothesis that. I could have a number of traumas and. then on a certain trauma that might be. even mild compared to the ones that came. before it, now it makes the changes. What is that hypothesis? So the multiple. hit, which which which says that this. idea that what what doesn't kill us. makes us stronger.

is completely wrong, I mean, in in. absolutely every way. What what doesn't. kill us 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 don't get weaker, we get. stronger. But what can happen is we can. become more susceptible to the more. likely that the next trauma, if we. experience one, will then create the. brain changes. Cuz I have I've often wondered, I'm. the youngest of four kids. We all grew. up in the same household. We experienced. a variety of different traumas in my. opinion. Much of it was chronic, but.

again, being the only black family in an. all white area, all these kinds of. things. But I thing I've always. reflected on is for some reason, I think. I experienced it much more, the trauma. of that, than my older siblings. Yes. And I've pondered whether that's. because of the timeline. Being the. youngest, it was worse in the later. years. So I I think my hypothesis has. been that I experienced it more than my. siblings. Mhm. And I think I've embodied. the shame a lot more than my siblings. have, yet we both went through the same. thing. So Mhm. for 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. Mhm. And I look at my siblings and I go, they're not [ __ ] up 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 variables of life. matter, right? So if circumstances are. different, say for one child in. formative years than for another, the those children could be affected. differently, like economic. circumstances. So some of it. may be and and probably is impacted by. the things that you're saying, but there.

probably are almost surely other. factors, too. This kind of nature and. nurture, that people have what sometimes. gets called different levels of. attunement of the of the emotional. compass. So you know, some people are. very sensitive and sensitized to things. and very aware of what's going on around. them and and aware of their own feeling. states. You know, and other people can. kind of go through life and, you know, emotionally buffeting things can happen, but they kind of keep going, you know, and and look, there pros and cons to. both of those ways of being, but the.

person with the sort of more finely. attuned emotional compass is the person. who's likely to to register more things. that are negative, like things like. subtle expressions of prejudice, right? That that someone with a less attuned. compass may just, you know, kind of not. see that or just it doesn't make it, you. know, into their conscious awareness, whereas someone else who would be very. attuned might see a lot of those things. So it's this part, like what is the. nature, like who is the person, right? And then what is the nurture, meaning.

like what are the variables, you know, 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 individual went through a really. traumatic early event Mhm. and you've. got the person in your practice sat in. front of 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 are just doing. fine. To some whatever that means, fine, but. Right. Well, one of the things to look. at is the rest of the family doing fine. cuz sometimes what it seems like on the.

outside is not true on the inside. And then we do think about genetics, especially around alcoholism. There are. um we don't understand all of it, of. course, but but there are genetic. factors that can be very impactful. Then we'll look at personality. structure, you know, is that person. built to sort of internalize externalize. blame, you know, so why 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 in social. circumstances, just real example that.

happens with some frequency, is they. middle late teens where alcohol was. accepted as a way of coping, right? And. and maybe other people in the family. weren't. The circumstances were just. different. The way they went to school. was different. Whatever and and they. didn't have it modeled for them that. this is how they cope. So maybe there. genetic factors that that push. alcoholism. Maybe there are social. factors, right? That it was modeled for. that person. So you know, you can put. those things together and which is why. and we follow patterns and there's a.

science underlying all of this, but we. have to look at who is that person, right? You have to look at. you know, the the family history, so the. genetics that may have been passed on. and what does that seem like may be the. case in the person. How can you be. informed by that? And what were their. formative life experiences? And you. start we start to. build a picture of what's going on. inside of us so that we can understand. and change by looking at our history, which is why mental health doesn't often. do this. You know, it takes an inventory. of your symptoms now to reflexively.

prescribe a medicine, right? So we need. to understand ourselves if we're going. to understand 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 think that. means accepting that this is real and. this is real science, which which. actually when you were talking, it made. me think of an example. So if I say a an. example to the science of it, one one of. the earlier studies and I forget 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 and so the incidence of. schizophrenia in the human population is. about 1% across the human population. But when stressors are higher, right? It. they can predispose people to to having. to coming down to having the syndrome of. schizophrenia. So it's about 1% of the. population, but it's not evenly. distributed. If there are, you know, people in sort of pressure cooker. environment, so to speak, become more. 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. schizophrenia was higher in the people. who had integrated. Right? So the thought is, and again. there've been subsequent studies and we. don't know for sure, but this the the. when you kind of look at that and say, "What what is that?" is the feeling of. otherness, right? Is is different trying. to integrate into a society that was. looking at, you know, not everyone in.

that society, of course, but there was a. much more pervasive sense of otherness. when people were integrating than then. when they were living in the communities. where food and dress and like the the. day-to-day of life was normalized. What's otherness? I'm mostly sort of. cost of otherness. I think otherness in the way I'm. defining is a sense of difference in a. way that's not good. Right? A sense of difference in a way. that. involves either. being seen as less than, and again. sometimes it can be over prejudice, but.

it can be also stratification of. opportunity. You know, just to 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 there's a. there's can be a sense of isolation. there that that builds that the sense of. otherness then say building inside the. person, right? The person doesn't feel. quite as safe, right? It doesn't feel. quite as validated cuz you know, when. we're especially when we're young, we. look around us to see what's normal. And. if, you know, people are looking, talking, dressing like us, like we just.

feel validated in ways that we might not. feel if we see that we are different, especially if the difference isn't. embraced, right? And we see this across. immigrant communities who you at some. point integrate, right? But initially. people will tend more to stay together. because there's there's a sense of. validation in the community. Um so then. the children often then will will. integrate, right? Which is why it's such. an interesting study to look at people. who were first generation immigrants who. would be likely to feel very strongly,

you know, whether they were integrated. or whether they were subsequent. generations, right? They're the. generation that just come from the home. culture that either they could still. sort of live in or. live in a new culture and not that. everyone felt a pervasive sense of. otherness, but there's more of that. sense of otherness. And the fact that. that would change susceptibility. to an illness that otherwise is. distributes itself across 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 may be. that are in our society that we kind of. look the other way and don't see that. we're really harming people who then can. come to the they come to the adult phase. of life in in a place where we have. marginalized them and we've we've made. things different inside of them that. makes it harder to make their way in the.

world. And I think we overlook very much. whether it's bullying, many many things. that can be based upon what can make. people feel less than, but the effect of. it is is seen in actual brain 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 and pushing more towards. these experiences of otherness or. experiences of vulnerability and lack of. safety that push people towards the the. the chronic aspects of of traumatic. brain change. When we think about.

trauma, we often focus on childhood. But. what you're saying now with this study. of the Somalis that emigrated to Europe, um presumably those were adults. Yes, so the the highest incidence of. schizophrenia is in people who are in. young adulthood. Yeah. So so we're not. seeing changes in people who are already. deep into adulthood, but the but the the. changes that we're seeing is in the sort. of transition to it to adulthood, which. honors both that. yes, we are much more impressionable in. all sorts of ways including how our. brains are forming when we are younger.

So these so these are people still their. brains still have enough formative The. idea is the thought would be they have. enough formative processes going on in. their brains that the brains can be. changed by the trauma. But when we talk. about these three types of trauma, the. acute, chronic, and 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, absolutely,

which is why childhood trauma is so. important. My in the book I interview. Darren Richer, who's a psychiatrist at. Stanford, and Stephanie von Gutenburg, who's a child wellness advocate, because. we're talking about trauma from both. ends of the spectrum. So that the. chapter that's the interview with. Stephanie von Gutenburg talks about how. childhood trauma so deeply impacts the. the sense of self of the child. Like. things that we know, but I dedicate a. chapter to it because childhood trauma.

is so 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 performance. and all the awful things that happen. So. so childhood trauma is one thing. On the. other end of the spectrum, Dr. Richer's. work has highlighted the fact that when. people are traumatized, they are changed. in ways that changes subsequent.

generations. So if we're talking about. childhood trauma, we can talk about. traumatized children. 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. that trauma. can and is being passed on? What is the. best evidence we have to support that? So the the field of epigenetics, which. has really come to the So so epi.

epigenetics really come to the forefront. in the last. two to three decades, which is the. understanding that our life experiences. can change the expression of our genes. So so. you or I may have a gene that is active. now because we inherited an active gene, for example. And then maybe that gene is. producing something it's it's helping us. in some way, bolstering 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 have that gene, you don't have the benefit of it because. the gene has been turned off. And and. this is a very. I mean it's a very revolutionary. understanding that it's not just, well, your genes are your genes. You know, we. could look when sperm and egg come. together, well, that's telling us what's. going on. And if we could understand. that fully, we would see, oh, here's the. array of genes that are active and the. array of genes that are not active. But.

like that's not the story, right? That's. just part of the story. The the the. story continues that you that one's. experiences of life changes how those. genes function, which ones are on, which. ones are off, and how they get passed. along. So if the parent is not. traumatized, the parent may pass along. the active gene for something positive, say, to the child. If the child then is. 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 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 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. to fear the smell of cherry blossom, shocking them whenever they smelled it.

So the mice got to the point where they. shuddered when they smelled it even when. they were weren't even being shocked. Um. the and. I'm guessing the children then had the. the same reaction. I mean, I guess. that's what the study concludes. But. also the. the children of Holocaust survivors are. another example of how trauma can be. passed on because Yes. Yes. It's hard to. think of a much more traumatic event. than being involved in the Holocaust. Right. And for a long time the thought. was that the the reason that children of. Holocaust survivors had higher levels of.

anxiety and of anxiety spectrum. illnesses was because of anxious. parenting that understandably that 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 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, because the. the experience of what 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 parents, the. genetic expression of the parents, and. the genetic expression that they pass. along to their children is changed by. the Holocaust experience itself. With. this understanding of epigenetics, do. you in your practice then consider. deeply what someone's parents 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 we all deserve, so. to speak, to to. think about our life narrative, right? And and and so many of us don't. I if. we're trying to help ourselves, you. know, whether someone listening to this. like feels that they're depressed or. that 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. Well, let me start with like where have. I come from and like who came before me. and And then wait, this happened and. then that happened and And when we build.

a narrative, it's remarkable how much we. can come to understand about ourselves. cuz often we don't do that. Like we have. isolated pieces of information about. ourselves, but we don't knit it all. together and and it's really remarkable. what can happen, what can be elucidated. by doing that. So, absolutely yes, just. for the the general understanding of the. person and also to understand what did. the parents. go through, you know, what what. experiences did they have, how might. that impact this person and you might. then ask questions of.

let's say the family situation changed, you know, between say. 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 of how much you. learn then not just about. the person's experiences growing up, but. but just about the the biological. aspects of how were the parents. functioning, how did it impact the. children and what were the situations, how were the children similar or. different? There's so much we can learn. from that.

You likened trauma to a virus. It's a. very interesting way for us to start. thinking about trauma because we seem to. think of it at least I did as being sort. of isolated to the person, but your idea. that it somewhat has a contagion to it. and that we can spread it. vicariously to other people that are. around us, but also. down through the family tree via our. epigenetics and via our 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.

Yeah. It It'll because. there's a reflexive guilt and shame to. trauma and our society doesn't recognize. it. It often gets hidden inside the. person, right? But when it's hidden. inside the person, it's still spinning. off symptoms. So, I think the best. analogy 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 infection is walled off. because if if it weren't it could be.

fatal, 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 symptoms because it's there. So, for. example, a person might have an. intermittent low-grade fever or just. feel kind of jittery or you know, they're sweating and they're not. sleeping well, right? So, there are. pervasive symptoms 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 looking, scan, they see oh, there's.

an abscess there, right? Once we know. that, then we might have an. understanding for why that person just. never feels good, right? They always. feel lethargic or they never feel. comfortable. We know there's something. there now and we can go in and fix it, right? And it involves, you know, there's a surgical process, right? So, something has to happen that's not a fun. thing, right? You go through surgery and. recovery. Now the abscess is gone. So, 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, there's reflexive guilt and shame, society isn't helping us take a look at. it. Now it's there inside of us, it's. going to spin off symptoms. And those. symptoms aren't always symptoms that. make say one person hurtful to another. 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. the population, those symptoms inside of. us are not good. So, they give us. shorter tempers, right? We're more.

likely we're 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 being in the world as. best we can be. Isn't that Isn't that. what you refer to as post-trauma. syndromes? Is that a similar thing? Yeah, yes, post-trauma syndromes are. ways in which we can recognize the. changes in ourselves. So, higher levels. of anxiety, for example, lower levels of.

mood, right? Um different changes in. sleep, uh physical health changes, um. and then changes in just how comfortable. we feel. 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 a we're in a. different self states, we have different. behaviors. The syndromes can do all. sorts of different things to us from. mood, anxiety, sleep, behavioral change. So, someone who might want to find a. relationship partner, you know, stops.

going to places where they could meet. someone, right? So, we we change our. behaviors. This is what shows us that. there is a post-trauma syndrome. That's. how we know we're traumatized. Effectively cuz that's what I'm trying. to figure out like people be listening. to this now and hearing you talk about. these different types of trauma, what. are the sort of 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. weren't before. That person is having. panic attacks and they weren't before.

That person is using alcohol to soothe. and they weren't before because in. medicine we look at just the surface, right? What we want to look at is like. oh, 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. Well, can we give you a depression. medicine, right? So, then we're not. looking at like why? Right? Why are you. depressed? I mean, some people. biologically will become depressed, you. know, no matter what, even when things. are going very very well, but this isn't. the 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 changed 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. person gets depressed because everyone. in their family gets depressed every 9. to 12 months, no matter what, like okay, let's let's come at that biologically. We don't that that doesn't necessarily. map to trauma, right? But but if we. start looking at that person being.

depressed, we see that. they kind of started getting depressed, you know, a couple of years ago around. the time their sleep started being. a little bit different and you know, they started behaving 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, there's something. happened then, right? Again, with acute. traumas it's easiest to see, but when. you look for the whole picture of like. might there be a post-trauma syndrome. going on here, you know, maybe that. person who's depressed and is drinking.

too much started drinking too much when. their mood started decreasing after the. trauma or maybe they started drinking. after the trauma and it's driving their. mood down. Like again, it's not always. this, but we're 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 what is going on. inside of me and have I changed, right? And then the idea we started talking. about how the changes in behavior of the. post-trauma syndrome are the changes.

that that make trauma like like a virus, right? Because we start behaving. differently and for some people that is. the the the their mood isn't good and. it's not as healthy to be 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 generation. Or maybe that. person is drinking or using a drug to. cope and that doesn't make for the best. parenting. That's how the virus of. trauma gets passed down. to the next generation or there are.

times when when a reaction to trauma to. the feeling of disempowerment can be. aggression, right? Envious, aggressive. behavior. So, so not all abusive. children comes through the lens of. trauma, but a lot of it does. I'm. interested as well in the subtle. symptoms of trauma. You know, we've. talked about some of the big picture. stuff, which is like suicidality, you. know, becoming an alcoholic or all those. kinds of things, but the subtle ways. that trauma shows up in everyday life. I. was I Some of them I was hypothesizing. over are things like.

phone addiction, being addicted to your. phone 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 think the. key to all of this is curiosity, right? So, let's say someone is like say. addicted to their phone. Okay, maybe. that's because phones are addictive and. the person has just spent too much time. on their phone, maybe, right? But. addiction mechanisms in human beings are. similar. Like it's the same machinery.

across addictions, right? And and often. times addictive behavior is meant as an. escape from something or to soothe. against something or even to self-punish. because of something. So, addictive. behaviors that's similar brain. machinery, whether it's 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. 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 and understand if they mean. something. Is that phone addiction the. 14th addictive behavior in a row, right? Because that person has sort of. particularly adapted addictive machinery. inside of them and they're trying to. escape from something. Like that doesn't. happen all the time, but it is not. untrue that when you scratch the surface. of that, you might learn about an.

episode of sexual abuse that happened. when the person was a child. Like these. are real examples, right? And that the. person isn't built to run from things. through addiction. And maybe they're. saying things about their own character. that's negative. They're saying negative. things about themselves and they feel. disempowered and they're disempowering. themselves. But if you go 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 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 why a life. narrative is so important. If you think. about changes like. after trauma that changes the brain, we. respond differently when we see a new. face. So, so without the trauma, it's. I'm simplifying a little bit, but you. see a new face we might be curious. Like, oh, like. you know, could we could he be a friend? Or if someone's romantically interested, like, oh, my might that person like me? Or might they not? People are interested. and curious. Whereas after trauma, there's a there's a difference of.

feeling a little bit on the back foot. So, people tend less to look up and. engage and more to look away or to more. have negative thoughts. So, you don't. That person doesn't like me. You know, instead of something that might be more. constructive. How do they test for this? Is there a test that able to be done to. see if someone after trauma has like a. different set of sunglasses that they. view the world with? Mhm. Yes. Yeah, there's a there test from from the. brain biology. all the way through to to very clever.

psychological experiments. Like, we can. see all of this. And it's these these. signs we should be looking for in. ourselves. Right? Because it is very. obvious if someone who always was 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 these more subtle ways. where we're just less interactive and, you know, people notice their friends a. little bit different and less outgoing. It's these things that, as you're. saying, the subtle ones, the subtle. signs and the nuances are often.

very impactful and indicative of other. things going on under the surface, you. know, that can bring even greater. problems. On the 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, and suffering makes us desperate to. soothe our pain.". Whatever form it takes. Sadly, we're. seeing the terrible cycle play out on a. larger societal level. with the opiate epidemic. Yes. This idea of soothing, we will find. ways to soothe ourselves.

And some of those ways that we find to. soothe ourselves become destructive in. and of themselves. And it almost makes. me think that like our. sometimes our attempt, we think of like. alcoholism typically as people that are. self-destructing, but when you. understand. 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 weird way? If we're under huge amounts of distress,

our perspective of the world narrows, right? Very, very dramatically. 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 anymore, right? So, when we're under tremendous stress. and strain, right? Something that. soothes us in the short term, right? Becomes acceptable because there's a. desperation in us that has us focused on. the short term. Like, I know that may. know that's not good in the 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. society around us. that if we're not recognizing what. trauma does to us or can it that it can. drive us to places of desperation, then. is it any wonder that short-term. soothing will have a big appeal to us? And that could be soothe soothing. through excess eating. And now, you. know, that person is overweight and has. diabetes and wants to be healthier, but. like doesn't really feel that they can. stop and ping-pongs back on different. diets. And, you know, what they're. really doing is they learned.

self-soothing with food in a way that. that was, you know, in the context of. really feeling some sense of despair or. desperation. The same way that person. may have learned that, oh, alcohol. soothes. Now, again, there's there are. genetic factors and there there are all. sorts of factors that come into play, too, but unhealthy coping mechanisms are. beckoning to us. all the time, which is why, you know, I. did a lot of treatment of of opiates and. opiate dependence. over a number of years. And you know,

it's just outrageous to me that these. these are the most powerful psychoactive. medicines on Earth, right? Opiates. Like, they soothe psychic distress. Like, you know, feeling not good. mentally inside of us very, very rapidly. and effectively and 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 in a. society that's so.

is under appreciating trauma and and. where people are are at in a sense of. isolation or otherness or desperation in. so many facets of our society. And then. we start handing them the most powerful. 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 year from prescribed. opiates. What kind of opiates have people being.

prescribed? So, how the opiate epidemic really began. was with opiates in pill form. So, so. that they would be prescribed, say, for. for conditions of pain, but conditions. of pain that were more chronic. conditions or conditions not so amenable. to opiates. So, if you come out of. surgery, an opiate is a great idea, right? Like, there's a lot of pain that. needs medicine to soothe that pain until. the pain decreases. But it's judicious. use of a very powerful medicine in high.

acuity circumstances. What we started. trying to do, and part of this was, you. know, we know there's a whole story. behind the politics and the business of. this, was to say, "Well, people. shouldn't be in pain, so there's a. short-term solution." Right? No one. should be in pain, we'll give them. pills. Right? And opiates do not work in. those situations. They soothe a lot. early on, but they rapidly build. tolerance, addiction, they suppress breathing drive. So, so we. started doling out opiate pills with the.

idea that we're treating pain and isn't. that good, but with an absolute. inattention to the immense risks of. that. And I think it fits with the. short-term view of, you know, of relieving all pain. Like, we're human beings, we can't relieve all. of our pain, right? Sometimes what there. is to do is to work hard to mitigate. pain. And that might be that might be. pain, you know, from a mental health. perspective, it might be pain from a. physical health perspective. This idea. that a pill is going to fix everything.

and now everyone has pain pills and. won't be in pain, you know, has resulted. in hundreds of thousands of deaths in. this country alone from prescribed. opiates. You know, let alone illicit. opiates. So, there's the short-term. thinking on the 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 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 understand the physiological. consequences of it. How does trauma. change our brain? When we look at brain. 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. 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 around the amygdala, which is a. part of the brain that gets called. sometimes Grand Central Station for. negative emotion, right? We see that. pathways involving this part of the. brain become more prominent. Right? So, we we see changes in brain connectivity. Right? Because how our brains function. is by communicating from one place to. another. They function through. connectivity and which pathways are more.

prominent. So, what we see then is. pathways that are involved in trust, say, and feeling a sense of safety are. less prominent. Pathways that are more. activated when we feel less safe and. more vigilant or more activated. And. then we see the climate, so 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 mood regulation areas are not. functioning as well because now there's.

depression intruding. So, we see. patterns in the brain that show us this. change, although the science hasn't come. far enough to to pinpoint like at some. point we'll be able to do with much. greater accuracy. And I've heard you talk about how that. creates cognitive blind spots, so blind. spots in our brain 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 cognitive. blind spot can 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. about things. So, so for example, a a. real and sadly. many examples of this I that I can bring. to mind and people's faces who come to. mind as I say it, but someone who felt. pretty good about themselves and able to. navigate the world and. striving for a better job and doing fun. things who then is assaulted. Right? And 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. home better, or never it goes well, I. don't get along with other people. Like. they think about themselves differently. So, there is a cognitive blind spot, which makes it. very, very difficult to think. with accuracy about say possibility. So, that person may have say been striving. for a better job, right? But, if 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. 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 this what you kind of see when people. refer to someone having daddy issues? And the I was thinking as you were. saying that that my dad let So, is say. my dad left when I was four. Mhm. And I. internalized this idea that men don't. love me, for example. Right. And then I. go through life being an avoidant person. in romantic situations, or.

self-sabotaging, or going for people. that are unavailable to avoid the. rejection. Right. Is that somewhat. similar? Like I've created a cognitive. blind spot, and now I'm living out that. as an instruction manual for my life. Yes. Absolutely, yes. And the the earlier in. life, the more powerful the lesson is. And the brain doesn't go [clears throat]. back and revisit those lessons. So, I. think this is this is so amazing and. surprising to me that our 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 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 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 that lesson, could you be disappointed, right? The. thought that's the way it is. And that's.

the way it's going to be. 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 true? Like here. I am, I'm an adult now, and now did I. just carry forward something when when I. was four years old that 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 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 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. We can go. back and look at why do you feel that? It's interesting to feel that. Let's. let's think about it, and you know, what's the story behind it? And we can. get to 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. Right? But, I took something in that was. different, and it's really affected me,

and I came to feel differently about. myself. It's not that everything. instantaneously changes, but boy, the. world is different then. On that subject as well of say the. father leaving at four years old, and me. thinking that men were Well, let's say I. was four years old, and my father was. violent. What you sometimes see is. people then are attracted to the. familiar when they grow up. So, although. it wasn't healthy, they have a sort of bias towards being. attracted to something that was.

familiar, even if it wasn't healthy. Right. That gets complicated with. sometimes people will talk about as. repetition compulsions are are quite. complicated. Often, what a person is. doing then is 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. and say, okay, I'm coming to see you, but I know. you can't help me, right? And then my. last like eight relationships have been. just awful. So, how can you possibly.

help me? And then I might say something. like, if you can tell me how you had. eight different relationships that. didn't go well, maybe I'll believe you. But, you're going to tell me about the. same relationship eight times over. Right? Something along those lines, because we repeat things that don't go. well. in an effort to gain 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 is. inattentive, or isn't interested. The.

the person is trying to feel better. about something from the past. So, if. the father was inattentive, and that. person has a 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, because the. emotion systems in our brain don't care. about the clock and the calendar. So, you can solve the past in the present as. far as the emotion systems are. concerned. And if the trauma is very.

strong in us, the emotion systems will. rule the day. So, they said the father. was violent, then maybe that person. chooses. a violent significant other, right? And. then that relationship goes away, and. the person chooses another violent. significant other. And then sometimes. the thought is, well, the person is. choosing that because. that's what they're comfortable with, or. that's it. But, no the the the person is is trying to. make sense of something, and there's. some desperation inside to feel better. about themselves, and to fix and heal.

something. Whereas why if we can. intercede there and say the problem is, if you want someone who's attentive, choose people who are attentive Choose. someone who's attentive, right? As. opposed to choose someone who's not. attentive and try and make them. attentive. Can we become addicted to our. victimhood? Sure. There's no internalized victim. without an internalized persecutor. So, if someone is victimized in the. sense of the law, right? 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 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 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 I'm behind the eight. ball. I then have a sense of otherness, right? And and now I've taken something. inside of myself, 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 doing is we.

take inside of us sometimes this sense. of victimness, but that. also takes inside of us the idea that we. are less than, that there is something. magical that is bad and negative. And. what we need to strive it against is. exactly that. That something may have. happened that we might say, okay, that. person is a victim in the eyes of the. law. They were assaulted, right? But, that doesn't mean that person has to. take victimness. inside, guilt and shame. How many people.

have I seen who were assaulted, and they. talk about how they're ashamed of it, and it's their fault. Someone else. attacked them. Right? But, the reflexive guilt and. shame of trauma can lead us to feel less. than. Then we start feeling. like victims. Then we feel less than, we. embrace this, and we don't need someone. to persecute us. anymore. The limbic system, we're talking about. the brain here. What is the limbic system, and what role. is it playing in cementing our trauma?

Yeah. So, the the limbic 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 emotion systems. The emotion. systems are limbic. Those are the limbic. systems, and they never lose when they. come face to face with logic. Right? Like the limbic, the 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. driving us, logic will not have its say. You know, logic would say, if you've dated six people who've all. kind of seemed the same at the outset, and then all behaved in the same. negative way, don't choose a seventh. like that, right? I mean, logic very. logic was saying that at the second. person, not let alone the third, the. fourth, the fifth. Why do we see. repetition of unhealthy relationships? Because the limbic system, if it needs. to feel different, it needs, so to.

speak, to solve that trauma by gaining. mastery, it's going to go look for the. seventh person 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 relationships. were all awful, sees, oh, I did the same. things, chose the same person last eight. relationships. That's one paradigm, and. I'm changing it now. And then things are different when they. thought they couldn't be.

Because they can see now what they. couldn't see before. The limbic system. isn't ruling the day anymore. There's a. whole balanced brain that has an. understanding of self, and uses that. understanding to move forward in life. It seems like the limbic system is. against us. But, but there must be some. sort of evolutionary. reason, or rationale, or purpose of that. limbic system that is I don't know. malfunctioning in the modern world. Oh, sure. The limbic system isn't against. us. Like all these parts of our brain, none of them hate us. They're all part. of They're all parts of us. And some of.

the the research and observations. through the psychedelic sciences are. really telling us that much more, that. 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. limbic system and the negative. information, like something bad happened. when you were four or five. Like take. that in, and whatever lesson that is, never question it or change it, right? I. mean, this is based upon survival. mechanisms. The example I give is, you.

know, imagine for most of human history. when people are hunting and gathering. and living in small groups and and like. having enough food was is very important. for humans across human evolution. If. you find a new food that it looks good, looks 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. Right? But if you eat. it and you 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. Never do this again. Right? They're designed to keep us alive. But. we're trying to do more than that, right? We're trying to do more than stay. alive. And these systems in us that. evolved to keep us safe then can very. much work against us. The person who's. traumatized because someone attacks them. and that system gives them panic attacks. if they leave the front door. I mean, that's that person's brain. trying to keep them safe. You used the word shame a lot when we. were talking about trauma.

In the same way that I asked um. is the limbic system against us? What is. 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 fine? Exactly the same with the limbic. question. No, we kind of need shame, but. we need shame for good reason. Right? So. so these primary affects that that are. 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, but they're states that that. that are very deep within us. They all. have a survival adaptation. So, you. know, love feeling love is you know, being more than one. You know, if if we. love someone, now you are two and you're. and you're there with one another and. that's going to help you survive, make. your way forward in life. Love is. adaptive. Right? Fear can be very. adaptive that now you're in a fight or. flight stage. You're trying to survive. and get through life. Shame is the same.

way. They're things that people do that. bring shame that change behavior. Shame. changes behavior a lot cuz it feels so. bad. So, you know, I give the example of. I imagine that you know, in the old. days, 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 whole tribe at risk or. people and 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 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. context. Right. To keep us alive. Like now you. feel shame, you will not forget to not. do that anymore, right? Like it's going. to 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 things people. do that are shameful that are worth. feeling shame about. I mean, sometimes. the problem is we don't have enough. shame where we should. But we have a lot. of new modern problems, don't we? With I. was thinking about bullying. for 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 a huge group of strangers could just. pepper you with insults and maybe our. our modern brain still has the same old. mechanisms of kind of perceiving that as. our tribe are going to kick us off the. island here. Right? So the brain malfunctions and. experiences shame, which causes all the. things you've described. And then even. in the context of like sexual assault, I. was trying to rationalize that, how. the shame 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 were. attacked? Right. Because it doesn't. start with the thought of it. Cuz you're. right. Because what you're saying, I. think, is basically it makes no logical. sense. Why would you feel ashamed of. yourself if someone else came up behind. you and jumped you and did something. awful to you? Why would you feel ashamed. of yourself? Right? But but the person. doesn't get there by thought. Right? I.

didn't get the feeling ashamed of myself. after losing my brother by suicide by. thinking that is a shameful thing, I. should feel ashamed. No no, the shame is. aroused in us. It's created in us. because it's behavior modifying. And. there's there's the adaptive something. bad has happened, feel something inside. that creates aversion. The shame is. created in us and then we make the. meaning of it. I feel ashamed, the shame inside me and. then we make the meaning of right. because I shouldn't have been there when. that happened and then then we make a. story around it. It starts with the.

limbic system, with the affect and then. we build a story around it, which is why. we can build a different story where, for example, shame. goes where it makes sense to go. Like. that's very, very effective of. processing through. So, okay, so this. thing happened, you can 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 with shame they realize. what is. happened to them and you know, and then. that was a terrible state to be in. But.

then they start putting they start. making trying to make meaning of that. state and we can go 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 context of our ancestors, I'm. walking through the I don't know, Serengeti with my. with my big spear. [snorts]. and I'm walking and a lion jumps out at. me. out of the blue.

I managed to survive it, although I've. been attacked. I the shame is created in. me because as a. response to 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 could be that I shouldn't have. been walking out at night in the. Serengeti alone when that lion attacked. me and that's 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 that. Maybe. It's it's a little different. If. you were out Okay, let's say you're out.

and you actually you're hunting a lion. in the service of everyone else. And. then you were attacked and hurt, that. it's that's different because you're. doing something then to to feel proud. of. Yeah. Right? So so that is is. different. We're we're. That's a situation where the person is. approaching the trauma on the front. foot. And then when the you return back, the thought would be you would be. respected and cared for. Like, you know, you went out to do something for. everyone and got hurt. Like that is very. different than how people normally would.

would ex- experience the their trauma, which is when there there isn't a sense. of of pride and self-sacrifice behind. it. So so if the person Let's say you're. walking out in the Serengeti at night. and you shouldn't be, then you should. feel bad 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 you not do it again. so you're 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 you doing?" And. well, you shouldn't have been out there. And like they may feel bad that you got. hurt, but like there's there's then an.

experience that is a deterrent to others. doing that, too. Right? So. This says something really interesting. about how we treat people who've been. through a trauma. Right. The look at the difference in the. United States between veterans coming. back from 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 welcome. The thought. The thought there would be they had gone. out like the person who goes out into. the Serengeti to hunt the lion to to.

save everybody else is that's what was. going on when people went to fight in. World War II and when when when people. went to fight in Vietnam. But when. people came back from World War II if. they'd been hurt, they were treated as. heroes. They were treated with respect. 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. phenomenon that was that was a terrible. thing for the veterans who came back,

you saw much greater rates of. post-traumatic stress. I mean, that's. that I think captures very clearly what. the impressions and perspectives of the. people around us mean. There may be a. reflexive. guilt and shame from trauma, but that. doesn't have to win the day. Like but it was much more likely to win. the day if there's a sense of otherness. cuz now we're we're you know, we're. we're talking about the same thing of. the feeling less than chronically by. society for some reason makes that. person more susceptible. So that person.

who's been through combat 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-trauma syndromes. What role does vulnerability and being. open with others about how we're feeling. play in alleviating our shame? I'm sure it plays it plays. in it for most of us in most cases, it. plays a very big role. Because the. reflex 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 ourself 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 sat with someone who. is putting words to their trauma for the. first time. You know, 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 survived and my two. buddies died. These are real things that. I have. that I have heard people say and then be. shocked that I, the other human in the. room, don't recoil from that. Because they've held so. long inside of them that it is shameful. that they were assaulted. It is shameful. that they survived. That that it's so. dangerous to even utter it. The fear of.

how person will react that someone is. surprised like, "Wow, you could hear that?" Or they they say. it in ways and kind of step back a. little bit because there's such an. expectation of rejection was what the. person is telling me is something that. from a any reasonable human being would. only elicit 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 what we. kind of think of as these trauma cycles?

Because someone experiences a trauma, they suppress it, which changes how they behave, which. means that they're more likely to. experience more trauma in some way or at. least perceive it as a trauma via shame, and then they kind of their life gets. more and more full of different types of. trauma. Does that make sense? Cuz I'm. wondering if trauma can be quite a. self-fulfilling thing where you get into. a cycle of Right. Trauma in your life. Well, it can be. I mean, in the case of. the person who now finally puts words to. something they've held inside of them.

that they would know is not shameful to. anyone else, but they hold it shameful. for them. Right, what is. going on inside 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 about that. When. a person is is is saying that and. they're they're putting words to. something that's so important has been. inside of them. It has caused them. suffering, so they haven't been as happy. as they could be, enjoyed life as much. as they could be, been as outgoing as. they can be, been depressed when maybe they didn't. have to be depressed. So, so the trauma.

is impacting them because they've hid it. down inside. Right? If you can talk. about it and bring light to it, let's. say after that thing that happened when. the the person was assaulted at 5 years. old or survived an accident others. 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 a person is feeling guilt and. shame. And the naturalness that they. are, but it doesn't tell them truth. Right, it's just telling them how they. feel and in fact 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 worse, push towards. repeated trauma. So, the the trauma of. choosing the same unhealthy partner or. the same abusive 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 doing this? What am I. trying to solve here?" Right, I'm trying. to solve something maybe from childhood. that was somebody else's. shortcoming or fault or somebody else's. [ __ ] Okay, I can stop doing that. Then.

the person. So, the answer to all I think the answer. to what you're asking is absolutely yes. And if we're curious and we strive for. understanding ourselves and we know that. there are routes to change, this is how. we heal from traumas. And ultimately, Invisible Epidemic is a is a message of. warning, but it's not a a negative or a. pessimistic message. It's a positive. message. This is if we understand this. and we look at it, well, guess what. happens is we get better. We prevent.

trauma. We take care of the trauma in. ourselves and others and we get. 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 the. curiosity. We we, you know, we're interested and we know. enough to go looking and thinking and. making a narrative and you know, talking. about ourselves and wanting things to be. different and knowing that they can be. So, it's a message of hope because when. we do that, we really see change. So, clinically when doing this work, you see a lot of 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 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 we look. at it, absolutely we make life better. I. want to talk about some of the ways that. trauma impacts us that are less obvious. One of them. I'm interested in is sleep. A lot of. people are struggling with sleep these. days. Is there a link between sleep. issues and trauma? Yes. And how strong. is that link? Yes, so so sleep is one of. the symptoms of a post-trauma syndrome.

It's not in all post-trauma syndrome, so. higher anxiety, lower mood, behavioral. changes, sleep is one of these factors. and sleep is very 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 brain to settle. down and be in a restorative state. So, sometimes we get what's what's is. called ruminative where there are just. thought loops going on inside of us and.

the brain doesn't want to quiet down to. a place where we can get restorative. sleep. So, people have more fragmented. sleep. They have shallower, less. restorative sleep, more time until they. 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 toe. And very often, after trauma, if there is a post-trauma. syndrome, which is not uncommon, sleep.

patterns are dramatically changed and. and sleep restorative function is. changed. What happens is we're in higher. states of arousal. And. neurobiologically, this isn't about. sexual arousal. It's it's just 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. inside of us that need to really simmer. down and in order to restore aren't able. to fully do that. 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 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 stimulate myself. Like, a lot of people aren't comfortable. with just being sitting in a room alone. with their thoughts, especially if they're, you know, an. overthinker. So, then they might grab. their phone. They might Sure. be, you know, doing things to stimulate. themselves at a later hour of night, but. it all comes back to the trauma. Absolutely yes. Yes, and you're. describing how the downstream effects of. all of this are tremendous.

So, absolutely yes. So, so we're saying. getting less sleep is just bad for us. from head to toe. Okay, and also, there's 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 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 may just be something. that's simple and negative that you. don't even relate to trauma. Like, "Oh, this is awful." Or like, I 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 going over and over. again. So, of course, you're going to. want to distract from that. And you cuz. the way we've 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 your mind where. Oh, sure. Sure, sometimes people are aware and. sometimes they are not. Sometimes they. ask a person, "Why. why aren't you sleeping well the last 4. 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. doesn't get asked. But you know, maybe. the answer. is.

is just I'm 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 question? Why? Right, what happened? Did anything. change around then? And a lot of times. you get. an answer and that person has a trauma. problem, not a sleep problem. You can. probably pound the sleep system to sleep. with medicine, but now we're doing. something that ultimately is harmful. for the person. So, yes. And also, you. know, when you talked about avoidance. behaviors of sleep, this is also why the.

person can avoid avoid avoid and then. have three or four drinks. to get to 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 don't know. why things are different in their sleep, but a lot of the time if you stop 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. time they're telling themselves, which.

is why we should ask ourselves this. question. You said to Rich Roll, "Amongst the. conditions I have seen treated, the. absolute worst in mental health. treatment and indeed in general medical. treatment are sleep problems.". Mhm. Mhm. Why? Because sleep underlies so much and. because we when we we have a lot of. hammers in medicine, so we see a lot of. nails. So, if someone is not sleeping, the reflex in medicine, and not everyone. does this and I'm not trying to say.

they're all physicians or practitioners. are not behaving in the right way, but. we we work in systems that are high. volume and designed for throughput. So, they're designed for symptom. identification. So, what we say is, "Okay, you're not sleeping. So, we'll. give you a sleeping medicine." Like, it's that simple. But. the reasons people are not sleeping are. very, very often not related to their. sleep systems. They're related to these. vigilance and activation systems inside. of us. So, if if that's what's going on. in me and I'm agitated and have this.

highly aroused state after trauma and. maybe it's been going on for 2 weeks or. maybe it's been going on but getting. worse for 2 years. But this is what's. going on and I can't settle down and my. 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 it. Right? Because we're. trying to make the sleep system overcome. the distress, I'm more likely to get. addicted to it. Right, I 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 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. those questions, we get answers and more. often than not, those answers are in the. realm of trauma. Then the person does. not get a trauma medicine. They may get. a different medicine that in the short. term can quiet the vigilance systems. This we do this a lot where the person. has a sleeping problem, we learn the.

trauma history, we use a short course of. a medicine that calms the vigilance. systems. It's nothing to do with making. the person sleep, and then they start. sleeping well. And maybe this is true, they might not. have slept well with five, six, 10. sleeping medicines. But that is not the medicine that they. need. Right, they need a medicine to. calm these distress systems inside of us. so that the sleep system, which is not. damaged, can go and do its thing. And. and while we realize this, we can start. talking about the trauma. And maybe the.

person can process some of the trauma. 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 have to be more than. reflexive. Right, there are a lot of reasons people. don't sleep. What about a link between weight and. trauma? I've heard I've heard a ton of. studies over the years about how. um various people who are obese have. high levels of sort of traceable trauma. Is there any truth to this?

Yes, so there are probably or almost. surely a couple of factors. One is Look, 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 care of oneself. If a. person adds trauma to the mix, it. becomes harder to take care of oneself. And one way we can not take care of. ourselves is, you know, what we're. eating and whether we're exercising. So, the trauma makes it harder to take care.

of ourselves and predisposes to poor. self-care. Now we have, you know, a. person who's overweight and then maybe. pushing towards diabetes or heart. disease or cardio or cerebrovascular. disease. And also, just like we talked. about epigenetics and and changes in. gene. transcription, what genes are active in. us, trauma puts us in a 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 as we would like it to be.

We're not as healthy and this works. against the health of our blood vessels. and the health of our immune system. So, the soup we swim in, so to speak, is. changed by the 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 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 biological. effect of trauma, just like the. epigenetics, right? And part of it is. the changes psychologically and the. changes in self-care. How do you convince someone that comes. into your practice and tells you that. they can't change? 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 knowledge and. the power of information, which I think. goes back to how powerless I felt as a. kid when we couldn't 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 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. 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. with some group or another, right? I. think that's a reaction to feeling so. disempowered and that what we really. want is knowledge. And I think that's. the reason why, for example, knowledge-imparting podcasts are so. valued because 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 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 person, or you're an. engineer or an accountant, it's like, I. might try and get at you through this. through the science, right? I might get. try and get at you through that article. Right, so something that can like let. you see that. Or I might try and get at. it through examples of, hey, here's it. like people do change. Like here's kind. of really what the state of the art is. now. And like can I get you excited. about that? Give me an example. There.

are a lot I could cite, but the one that. comes to mind is the one story in in my. book that is just an amazing story of a. person who had had a trauma in her life. that had just changed everything. Mood, anxiety, behavior, choices in the world. I mean, so much had gone in a way that. was not how this woman was built to live. her life, 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 was really. a night and day difference. And it. became clear there was a very abrupt. change at this. at the time of 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 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 willing to see this darkness. 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 that's we could think about it, talk. about it, understand it. And like. changed her entire life. And it really.

is 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 the situation. differently? Yes. Yes, we are creatures of neuronal habit. So, if you think the example I give I. usually use is let's say you and I just. picked a word, random word, and we said. it 500 times. Right, we'd each be saying. it to 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? Right, even though we know it's a silly. example, why would it still stay with. us? Because when we say that word so. many times, we're strengthening memory. connections. That word comes to mind. more, it's stronger within us. And then. the only way it goes away is it. atrophies over time. You know, you can't. just make that go away after you said it. a couple thousand times. It'll go away. over time. It gets less and less powerful over. time. So, if you don't keep saying that. word, you know, comes to mind maybe 10. times the next day, five the second day,

three times, then not again. But this is. how processes of change work inside of. us. So, someone who has, for example, had self-talk in them that, "Oh, it'll. never work out for me." Or like, "I suck. and no one likes me." Or, "You know, I'm. terrible." Or, "How could you, idiot?". Or, you know, things like I had a shadow. voice saying these things to me for. years. Like that doesn't want to go away. at once because it's just habituated. inside of us. So, we have to realize. that is not real and 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 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. 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. 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, if 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 parent, that person always said.

that to me over and over and over. And. then, you know, I chose bad relationships cuz. I didn't think I was worth anything. better, and they didn't go well, and it. reinforced that to me. Like a person. really understands that, we bring that. understanding to bear in a way that you. speak against that when it comes into. your mind. Cuz we can't make it not come. into your mind. It can atrophy, meaning. this process of slowly over time it goes. away. But we have to say, "Hey, the. whole me," I call it 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 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 the memory of it. All right, something bad has happened. We're not going to entirely forget it. That means it can trigger us in the. again in the future. Well, the the. question is how much does it trigger? Right, how much does it trigger? The. idea is to 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 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. like they know they had a car accident. They're not trying to hide it from. themselves and go, "Oh my god, I can't. see a car. I had a car accident. It. triggers me. Like I'm I'm understanding. that. I understand the naturalness of. the responses in me and how they maybe. were perpetuated by the fear that I felt. and and I wasn't working through it or. working through the loss that happened. Now that I'm understanding that, well, I. don't have to be afraid of this. So, I. see a car and yes, it makes me kind of. uncomfortable, but it's okay. A lot of.

people beat themselves up because. they've done a lot of work. Right. And. their trauma still remains. I think I'm. one of those people where there's. certain traumatic things from my. childhood, done a lot of work. I. logically know that it's not true. Like. that that belief I had is not true. Yeah, I'm still prone to be triggered on. a bad day about that particular thing. Right. Right, look, that's that's that's. how it goes. When a person is navigating. through trauma and really getting. through it, getting over a lot of. difficult things and getting to a much.

better place, but responds to the. triggering in a way that inadvertently. reinforces the trauma. So, I would say. if you're having a bad day and you have. a memory of something that you kind of. know you got over but then it raises the. same set of thoughts or feelings that. aren't good. Right? Instead of my guess. is that you're feeling bad about that. Like, "Oh, I did all this work and I. didn't get over it." Right? To say, "Look, isn't it interesting like how. strong 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 dropped something.

in the morning and I don't feel great. about myself. Like, this stuff is very. very powerful but still not telling me. truth. You know, that shoulder shrug. about it. Okay, it's going to come into. your head. It was neuronally reinforced. and sometimes you'll be having a bad day. and it'll come in. It doesn't mean. anything. Lady Gaga sits at the very top of your. book and she's written the forward in. your book. There's this wonderful quote inside. there that says, "I can now say with certainty that this. man saved my life.

He made life 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. eloquent and generous of spirit and I. and I so appreciate that she. wrote such lovely words and I and I so. so appreciate that. Just 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 understanding and be able to. ground to the things about her that are. wonderful and she's a wonderful person. There's wonderful There's wonderfulness. in us no matter who we are and I think. from the perspective of her on such a. big world 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 pathways. of thought about self. Like the kind of. thing any of us need after trauma and. she had the the bravery, the fortitude. to you know, to take chances to be. different. You know, just like someone. would say, "Oh, I can't be any. different." We 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 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 also did that. It's a very.

It's a very very human story and 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 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 understand it. We can. get our arms around it and I think. that's what she is. You know, that's what she's. communicating in that quote. 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 celebrities um.

on the book inside the book that have. given [clears throat] you quotes for the. book. People like Kim Kardashian, Tommy. Hilfiger, etc. etc. Lady Gaga as I. mentioned. I'm guessing these these people at some. point. came to you. Without sort of disclosing client. confidentiality issues. I'm just wondering how you find yourself. in a position as a. psychiatrist that. the this 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 diligent person who wants to continue. working at things and moving them. forward and and uh seeing where they can. 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 have who are public facing, I mean, there are a lot of stresses to that. You.

know, we we people can think, "Oh, it it. seems so wonderful 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 complexity of. that and to be able to help people who. have a. big impact on the world around them. uh um. was um. and sort of a joy to pursue. We have a closing tradition on this. podcast where the last guest leaves a. question for the next guest not knowing. who they're going to be leaving it for. And the question that's been left for. you feels quite fitting and very. interesting. I really like this one.

It just says it's not even written as a. question. It just says, "Erase one 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 was. younger 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 path. and I think it made me harder. I think. my brother hadn't found his path and I. think there was a lot of. frantic anxiety or fear driven forward. movement without pausing and. circumspection and it may be that we. just talked about you know, we've talked. about his suicide and we've talked about. that in this podcast. So, 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 circumspect. including about what may have been going. on in him or in me and um.

I'm happy I got myself on a path that's. led to places that feel good and that I. think are generative and productive. Um. I wish I had more 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 maybe seen that in others, too. Um cuz some You're talking about. Jonathan. And others where I where where. I was born and raised. I think there. were there were a lot of good people and.

a lot of forward movement but um. we maybe could have looked around. 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. 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. about that. Well, I have to say Dr. Paul Conti, the work you've committed your life to. and the understanding you've committed. your life to spreading um.

is going to save many many many many. many many people's lives. Thank you. And not just save their lives. but sometimes it's not always about. saving a life. It's about improving the. standard of someone's life which I think. can have a generational impact if that. person is to stay alive and they are to. you know, if we look through the lens of. epigenetics or just about the how. internalized shame and guilt and all of. this can be passed 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. and improve thousands and thousands and. tens of thousands, hundreds of thousands. of people's lives. And that is an. unbelievably remarkable thing to commit. one's life to. Thank you. There's no words that I could say in the. 30 seconds I 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 can't imagine those people that are. here and not here how. proud they would be and are of you 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. Wow. Well, you're very welcome and thank you. for those kind words which I take to. heart and thank you for having me on. I. appreciate it. [music]. [music].

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