Feel Better, Live More with Dr Rangan Chatterjee - How To Heal Your Past, Improve Your Mental Wellbeing & Unlock Your Full Potential with Dr Bessel van der Kolk #483

Episode Date: October 8, 2024

Today’s returning guest is Dr Bessel van der Kolk. Bessel is a professor of psychiatry at Boston University School of Medicine and President of the Trauma Research Foundation. He's also the author of the iconic book, 'The Body Keeps the Score’, which first came out over 10 years ago and has sold millions of copies all around the world. In fact, the book has been somewhat of an international sensation and is as popular today as it ever has been.   In this conversation, we discuss the meaning of trauma and how it’s different from stress. Bessel shares common signs of trauma and describes how traumatic experiences leave a physical imprint in our bodies, which can contribute to a variety of physical and mental health problems. Interestingly, despite his extensive work with patients who have gone through some quite horrific, traumatic events, Bessel is still very optimistic about the world and what he has seen has deepened his belief and faith in human resilience.   We talk about healing and the many methods and techniques that Bessel has found to be helpful.  He explains why he thinks that body-oriented therapies such as yoga can play such a vital role and he also explains why he is so passionate about the new research on psychedelic-assisted therapy - for trauma, depression, OCD, and addiction. He explains how these treatments can essentially 'reboot' the brain, opening up new possibilities for healing.*   Throughout the conversation, we emphasise the crucial role of human interaction and supportive communities in dealing with trauma and fostering resilience. Bessel also offers some valuable advice for parents on raising resilient children.   This conversation really is one of hope and positivity. Yes, sometimes life presents us with some challenging times, but as BESSEL MAKES VERY CLEAR - we ALL have a remarkable capacity to move on, change and heal.   Throughout our conversation, Bessel's message is one of hope and the remarkable capacity of humans to change and heal. He provides practical suggestions for those beginning to address their own trauma, including approaches that are affordable and widely available. This is a powerful and insightful discussion with one of the world's leading authorities on trauma. I hope you enjoy listening.   *PLEASE NOTE: the psychedelic compounds discussed are illegal in many countries around the world and, as Bessel says, these drugs should only be taken under the guidance of trained healthcare professionals.   Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com.   Thanks to our sponsors: https://drinkag1.com/livemore https://thriva.co https://calm.com/livemore https://airbnb.co.uk/host   Show notes https://drchatterjee.com/483   DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website. 

Our study costs 163 million dollars. It has the most potential of anything I've studied. I've studied more different methods for dealing with trauma than anybody else alive. And here we see something where you go like, wow, there really is hope. Hey guys, how you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More. Today's returning guest is Dr. Bessel van der Kolk. Bessel is a professor of psychiatry at Boston University School of Medicine and president of the Trauma Research Foundation. He's also the author of the iconic book, The Body Keeps the Score,

which first came out over 10 years ago and has sold millions of copies all around the world. In fact, the book has been somewhat of an international sensation and is arguably as popular today as it ever has been. Now, in our conversation, we discuss the actual meaning of trauma and how it's different from stress. Bessel shares common science of trauma and describes how traumatic experiences leave a physical imprint in our bodies which can contribute to a variety of physical and mental health problems. Interestingly, despite his extensive work with patients who have gone through some quite horrific traumatic events, he's still very

optimistic about the world and what he has seen has actually deepened his belief and faith in human resilience. We talk about healing and the many possible methods and techniques that he has found to be helpful. He explains why he thinks that body-orientated therapies such as yoga can play such a vital role. And he also explains why he is so passionate about the new research on psychedelic assisted therapy for trauma, depression, OCD and addiction. He explains how these treatments can essentially reboot the brain, opening up new possibilities for healing. Please note that these psychedelic compounds are illegal in many countries around the world and as Bessel says, these drugs should only be taken under the guidance of trained healthcare professionals.

Throughout the conversation, we emphasise the crucial role of human interaction and supportive communities in dealing with trauma and fostering resilience. And Bessel offers some valuable advice for parents on raising resilient children. This conversation really is one of hope and positivity. Yes, sometimes life presents us with some difficult challenges, but as Bessel makes very clear, we all have a remarkable capacity to move on, change and heal. Change and heal. You are one of the leading voices globally on trauma.

It's so fascinating that despite everything you've seen, you have this very optimistic view of the world and humanity. Actually, I'm somewhat surprised about it myself. And I've seen really horrendous stuff. I still have a basic sense of optimism in part because of my work. Because in my work I see people who have come from extreme hardship and pain and horror who find a way out and who become wonderful teachers, sometimes great parents, movers and shakers who make the world a better place.

So what you also meet when you deal with trauma is the life force. And you really get in touch with that we are meant to survive and that we really want to live. And even the most traumatized people who I see, where I hear their stories you're like oh my god how can you go on with your life after this oftentimes not always find a way of creating meaning for themselves to go on yeah yeah the word trauma i think compared to 10 years ago when you published your book, The Body Kicks the Score,

I think the word trauma is more well known now. I think it's worth, at the start of this conversation, you defining what you mean by trauma, and then really try and give us an understanding of how prevalent do you think trauma is. So it's very hard to define trauma in a way. Is it external? Is it internal? Is it the event? Is it the reaction? But basically, the way I like to say it, it's something that overwhelms your capacity to cope and nobody else takes over for you at that particular point.

And then you get stuck. And so your whole central nervous system continues to experience the ongoing world through the lens of that particular overwhelming experience. So you continue to be constantly scared or feel like people are going to attack you or feeling like you're going to be left for dead. So you continue to react to oftentimes fairly trivial uh challenges as if it's a catastrophe and it's really the ongoing reaction that really defines what trauma is about it's so that your mind and your brain gets changed by trauma and then you from then on you live in this traumatic internal world so the trauma lives inside of you basically

in the country in which you now live in practice the united states do you know do we know how prevalent trauma is is it even possible to measure it well there's things you can measure incidents of domestic violence in US, it's about one out of three couples engages in domestic violence. One out of three? Yeah. And probably in the UK would be similar. Can we just pause there for a minute? That is a staggering amount.

You know, I think every relationship is a miracle. You know, to put up with each other, we drive each other a little bit crazy, for people to actually get along and live so close together and having to make adjustments with each other is a very complex thing. But it takes a fair amount of maturity, actually, and being able to understand other people's point of view. I think it is precious for people to be able to get along with each other. And oftentimes they don't. Yeah. And let's take it away from domestic violence for a minute. Yeah.

This is an idea I've been really playing around with, Basil, and it's kind of, is it external, is it internal? Yeah. An external event happens. The same external event could happen to 100 people, and 100 people are not all going to have the same response. Some people will be able to manage that better. Some people, I'm guessing, may not be traumatized from the same incident. So if our responses are individual to external events, is it easy for us to see how prevalent trauma is in

society? Because on one level, trauma, whether an event is traumatic or not, actually depends on how we perceive it and our internal response. Not only how we perceive it, but how people around us perceive it. So you may look like a very well put together person and people say they clearly didn't get affected by the particular incident but basically I like to say you don't know somebody until you marry them for some length of time.

We all have our personas and somebody may be calm and brilliant under certain situations and something minor happens and they blow up. But we may never get to see that. So it's very hard to know as an outsider who has survived the trauma and to what degree people have. And in my world, oh, some people are resilient.

Really? Are you sure? Why? world to say oh some people are resilient uh really are you sure like how do people wake up with diapers or do they actually uh freeze in front of their children and uh become all uptight and don't respond to their kids needs that wouldn't be weighted as being post-traumatic just i saw that all the time in many of my patients, particularly my German patients. They all had these traumatized parents. And there was very quiet. The household, nobody ever talked.

Nobody talked about anything. People worked all the time. And there was a pall of dead iciness over the family. You wouldn't rate it as traumatic because nobody blows up at anybody. Yeah, for me, that raises a really interesting point, which I want to come to, which is how different cultures deal with trauma or don't deal with trauma.

Before we get to that, though, I have been constantly amazed by how many people say they've had happy, safe, secure childhoods. And when you go a little bit deeper and just probe a little bit, it's not always the case. And so I feel that humans have a remarkable capacity to bury stuff and get on with their life, right? So it's still there. Absolutely. They haven't dealt with it, but they tell themselves a story that, yeah, my childhood was great.

Everything was fine. My parents loved me. So could you, with all your experience, outline some common signs of trauma? For one thing, the family you come from defines who you are. So if you tell people, my family was really messed up and violent, then you tell people, I'm a messed up person.

And so you own that and it becomes a source of shame. So you try to kill the lily. And people generally do that. They try to make things pretty... I don't know how common it is for people to have perfectly happy childhoods i know

a few people but not in the mental health field so what are the various qualities that define a healthy non-traumatic childhood warmth uh usually a lot of food a lot of music but people being attuned to each other people spending a lot of time with each other, having time for each other, not hiding themselves behind screens or workaholism or whatever. It does happen. And people who do things together,

they're pleasurable and interesting. Yes, it happens. Okay, so for someone who's listening who thinks, I don't think I had a traumatic childhood, or I don't think I'm suffering from any trauma, what are common signs that might indicate trauma? Well, people rarely start off with a trauma. They go into, I get so angry with my partner,

or my kids make noise, I cannot control myself and I start screaming at them, or I need to hide myself in my room when stuff is happening because I get easily overwhelmed, or you are in a job and you start hating your boss and you leave your job and the next one, you hate your boss again and you hate your boss again. And then at some point you may start thinking,

is it my boss or is it me? That is really so bad. And usually, I think people usually get in touch with these things, not by their own observations, but the people around them. People who say, honey, I love you, but if you continue to do this, I just cannot be with you any longer. Friends who no longer talk to you, co-workers who avoid you.

So usually it is your irritability or you're being out of tune or you're blowing up all the time or making no space for other people that creates interpersonal conflicts and misery. And you start off usually saying, it's all your fault. And at some point you realize, maybe it's not all my fault. It's interesting in my work, I'm into psychedelic treatments these days, that people deal with stuff from their past and suddenly they say,

I thought my sister was the most terrible person around. We always fight. And now I spend time with my sister and we enjoy each other. And so nothing has happened between the two of them, but their own energy has changed. So they don't irritate other people anymore or don't scare other people anymore.

Yeah, that's a fascinating example. Those signs that you mentioned, there were quite a few there. And I think there were really great examples because I think a lot of people will go, hmm, wait wait a minute that might be me that might be me that might be me if I'm on my fifth marriage and I keep choosing somebody who is horrible uh maybe there's something about me yeah yeah I mean let's say let's say one example you I think one example you said was if my kids are shouting I I shout or I get annoyed.

Or if my kids even make a little bit of noise. Okay, so let's take that as a practical example. Someone might say, well, Bessel, yeah, but if my kids are making noise, is it not okay for me to get frustrated and want them to be quiet? What would you say to them? I'd say, of course, you need your warning signs and you cannot shut off your warning signs and it's very good to know what scares you

and what upsets you. But if it scares you, as a result, you blow up your family and everybody becomes scared of you and people walk tiptoe around you, you have a problem with your hand. And so maybe there is something about you that gets triggered by that noise of your kid.

And then you go into, where else has this shown up? Yeah. And we oftentimes talk the language of parts. How old is this part? How long have you noticed you suddenly going into these rage reactions? Is the kid seven years old or four years old? And people oftentimes say, yeah, I remember kindergarten. But before that time, it didn't feel that way.

Then you start dissecting the situation to see where this stuff has its origin sometimes. What does trauma actually do to us physiologically? What does it do to our brain? What does it do to our body? Well, it really changes what Antonio Damasio calls the housekeeping of the body. what Antonio Damasio calls the housekeeping of the body. And trauma is really about an overwhelming experience of terror. Terror is already too high.

It is your whole organism freezes or gets disorganized and then that continues. And it affects many, many different parts of the brain, mainly deep down having to do with appetite, having to do with motivation, having to do with arousal, having to do with sleep. Very elementary bodily functions get affected by trauma. And it's really about a body that no longer knows how to take care of itself in some ways.

And that's something people barely mention, but most trauma symptoms are symptoms of a body that cannot take care of itself. We talked before about the enormous amount of drug addiction and alcoholism, according to trauma, people take these drugs in order to calm their bodies down or in order not to get out of control. People don't take heroin in order to make you feel bad about somebody taking heroin. You take this stuff because you cannot stand the way you feel. And so

traumatized people are enormously vulnerable to indulge in substances and behaviors to just desperately try to not lose control over themselves yeah yeah as a medical doctor myself i probably thought many years ago that if you can educate patients and and help them understand what they need to do let's say food you know nutrition you know adequate sleep moving your body regularly you know managing stress i used to think that would be enough yeah but i've realized time and time again that knowledge in and of itself is not enough and i think one of the things we get wrong in medicine or let's say wrong maybe i say it's's incomplete. Let's take alcohol as that example.

We might say with public health guidelines, how many units of alcohol you can drink a week without it impacting your liver and your cancer risk. It's very dry. I don't think it connects with people. And what it fails to do is help that individual understand what role does alcohol play in my life? What role does excess sugar play in my life? What role does gambling play in my life? And I feel that the missing link for many people is this kind of hidden trauma that they've not processed.

So they can try their best to make better choices, but they'll always be driven back because there's a dysregulation in how they feel about themselves. There's a dysregulation in their nervous system. Yeah. Trauma lodges itself in a very elementary housekeeping part of your brain. It's not a rational process. It's not like, oh, let me drink some alcohol

in order to make the feeling go away. You feel discombobulated, you feel out of control, you feel out of sorts, and then you discover that if I drink alcohol, I feel so much better. Or my doctor says alcohol is bad for my liver, but to hell with my liver, because alcohol makes me feel so much better, and I don't care if my liver gets diseased because this very elementary feelings, Darwin already talks about this,

that trauma is lived out as heartbreaking and gut-wrenching sensations. Yeah. And that's something we all are familiar with. If something terrible happens in our lives, we feel it in our gut. Yeah. It's gut-wrenching uh heartbreaking and and so it's the sensory world you live in that becomes unbearable and then you start doing stuff whatever you can to make the feelings go away but really struck me about a study

had a famous study of the prevalence of traumatic insulin. This is adverse childhood experiences. Yeah. That all of the things that they identify have to do with your relationship to your body. An increase in smoking, an increase in obesity, an increase in heart disease, an increase in alcoholism, an increase in heart disease, increase in alcoholism, increase in drug use. These are all things having to do with I don't like my body or I don't trust my body or I cannot take care of my body. So the very thing that you try to promote needs to come from inside. Your doctor cannot tell you you have to love your body.

I have to learn to love my body. But if I've been beaten up as a kid and I'm always feeling terrible inside, my body is not my friend. Yeah. Your book, your seminal book, is called The Body Keeps the Score. A few things to sort of comment on.

It's over 10 years since that first came out. It's still selling by the bucket loads today, right? It's one of those once-in-a-generation phenomenas. Something comes out. I imagine you couldn't have predicted this sort of level of success and connection with people all over the world. I'm interested in why you think it has resonated so deeply with so many people and then it also for people who haven't read the book first of all you really should read it

but 10 years on how would you briefly summarize the key message in that book well the key message is that horrendous life events, including disruptive attachment, a very big thing is who do you feel safe with? Who cares for you? Determine or shape your biology and then leads a life of its own and it expresses itself in a variety of different ways.

But you can do something about it. Basically, I try to give a message of hope. You need to develop language for yourself. You need to understand yourself. And then you may want to start doing yoga. And alter the relationship you have to your body. And yoga, our research shows, is very effective. Or you may want to do neurofeedback

to change the neural circuits in your brain so you can be more focused and pay more attention. Or you may do theater and see what it feels like to play a different role and to embody a different role than the role you ordinarily inhabit. You and I went through that. We went to medical school.

And the first day in medical school, people call you doc. You go, who are you talking to? And you feel like this inadequate, stupid little kid who's trying to lose it. And then slowly over time, you become a doctor. And it changes your identity. And it changes your relationship to yourself. And then it gives you a certain sense of, I'm a very competent person

who can sometimes make an enormous difference. So your identity changes by the roles you play. And if you're an unemployed person in a poverty-stricken area, your role is to be an unemployed. How can you feel proud? How can you feel competent if you cannot bring home the bacon for your family? So the social conditions make a huge difference, but also the identity you get.

And one of the things I'm worried about with the popularity of my book make a huge difference, but also the identity you get. And one of the things I'm worried about with the popularity of my book and the word trauma coming into our culture is that people increasingly may claim the mantle of being a victim. And because this happened to me, I cannot be held responsible for what I am. And so once you get an identity as a victim,

then you're allowed to do all kinds of things. And so it's so important for us as physicians, as therapists, as school teachers to help people to get a sense of competency. A very deep, deep sense of I can do stuff. But that's not really the focus of many of our social systems. I think that's such an important point. I mean, for me, one of the root cause decisions we make as individuals in life

that will determine massively the quality of our lives is whether we take a victim mindset or not. And we have no idea that's going to happen. Yeah. And also, I also acknowledge that some people, many people have lived through horrendous experiences, right? So I'm not saying I don't understand it. I fully understand it. But whilst you remain a victim to your past or external events you well this is in essence what you're talking about trauma it lives on inside you how would you phrase it i would frame it that i need to function and that's what i see in most people i work with i need to go on with my life

so i'm going to be the best school teacher i can be i can the best tennis player I can be, I can be the best tennis player I can be, despite the fact that I feel scared to death when I am in a sexual situation. I'm going to try to function as well as I can and then, but don't but to realize that life goes on. And when you get stuck in your victimhood,

life passes you by. The only thing that you can experience is insult and injury. Yeah. But how to shift that orientation is not like you tell yourself that. It's mainly being with somebody, a spouse, a boyfriend, a girlfriend, a friend,

who helps you to focus on what's going on and to help you focus on being able to do things that give you a sense of pleasure and enjoyment. So okay if someone says look Bessel, your book and the wider education around trauma compared to 10 years ago has really helped me see that my childhood is a huge part of why I feel the way I feel today around the world. If someone says to you, my parents weren't there for me, they weren't attuned to me like you've already mentioned, it's a key thing, right? There wasn wasn't joy there wasn't music when i was growing up it was uh scary for me i didn't know how my dad was going to react right the tv was always

blaring yeah okay and they then say to you you know understanding that has really helped me understand who i am today i have every right to be reactive and angry and drink alcohol because that was my upbringing, what would you say to them? Just taking a quick break to give a shout out to AG1, one of the sponsors of today's show. Now, if you're looking for something at this time of year to kickstart your health, I'd highly recommend that you consider AG1. AG1 has been in my own life for over five years now. It's a science-driven daily health drink with over 70 essential nutrients to support your overall health.

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LIVEMORE at checkout. Just visit Thriver.co to get started today. That's T-H-R-I-V-A dot C-O. Thriver, listen to your blood. What people say is, I now understand why I do the things I do, and that gives me a better handle on how to create a life for myself. And so, you know, it's very interesting that Jamie Pennebaker is a language researcher at University of Texas, and he asked one group of people to write about their trauma, another group of people to write about their trauma, and how it's affecting their life right now. The people who wrote about their trauma, nothing changed.

He studied immune systems, health, and functioning, and when people said, this is how it has affected me, it made a huge difference. Because once you know how it affects you, you can actually start making decisions about yourself of like, okay, I get very angry with my kids. My dad used to beat me up when I make kids scream. I get into a sense of panic and I lose control of myself,

just like my dad. And I am going to try not to do that. And I'm going to learn to sit down on the floor on my knees and play with a model train. But that's the key for me. Yes, get an understanding of your upbringing and your experiences and your childhood and the way you were parented.

But don't stay there. like use it to understand yourself. And then, I don't know, that's how I see it. I feel that I think that victimhood mentality is very, very common. And I do think that is, as you say, that's one of the unforeseen risks of an increased education around trauma is I feel and i guess i've seen this with many patients over the years that they they stay it it's a progress of evolution and learning

and understanding right but you can stop and stay locked in what happened to you in your past without using it as a way of learning and moving forward and taking agency? I think it may become an alibi, an alibi for your dysfunctional behavior. But telling people you should make different choices doesn't work either. Then people need to be offered the possibility of doing things differently. And somebody needs to say to them, have you ever thought about joining a church choir? Have you ever thought about cooking for homeless people?

Have you ever thought about doing karate lessons? So people need to be invited and given the opportunity to discover what makes a difference. People generally don't do that on their own. And that's the thing, that's where we as physicians and mental health professionals come in, not to tell people

you shouldn't behave that way. No, for sure. But to really say, boy, it really looks like you don't see other possibilities and let's explore some other possibilities and I will be with you

as you explore that. Just giving people a little sheet to take home with instructions is not going to work. People need that human encouragement. And that is certainly in the US, the breakdown of medicine is that people no longer have a relationship with their doctor. You go to the doctor to fix a little problem, to get a pill,

but you don't have somebody who is there for you and guides you in your health. But when you have somebody, like I happen to have somebody in rural Vermont of all places, in a very far, you know, I live among some of the most famous hospitals in the world, in Boston. I get my primary medical care in a rural community far away. Why is that?

Because the doctor there knows me. And we spend time together. And you know each other over time. And that's what we all need. Somebody who says, hey, how are you doing? Last time you were struggling with this, how is that going? And what has worked and what hasn't worked and so we need all need people in our lives who have a very deep interest in us yeah and medicine is

really falling apart on that score i i mean i completely agree and and i i really do believe that any good healthcare professional doctor nutritional therapist, psychotherapist, counselor, whatever it is, I think having that deep connection with your patient or client, and it's not about us telling them what to do, it's helping them, as you say, see possibilities, helping them have agency.

There has to be something, I believe that they feel they can do proactively in their life that's going to make a difference it can't just be I'm dependent on this psychotherapist I'm I'm dependent on this doctor and without this person I'm going to struggle you know I think that that agency is really important but walking out of out of an office as I do with my my biochemist, this guy knows me. Yeah. This guy sees me.

In Boston, the big hospitals, I never have the feeling anybody sees me. They just give me a pill to fix my problem. I had a great example this past week. I was visiting my brothers in the Netherlands, and we talked about different parts of our youth. And my brother suddenly says to me oh you know I think what made a big difference for you growing up was your fourth

grade teacher and he mentioned the name and I think you're my brother 70 years later you know the name of my fourth grade teacher and what effect he had on me. It was just stunning for me to feel, my brother knows me and he remembers details of my life that nobody else knows. And that was, somebody should measure my cytokines and stress hormones at that moment because I bet something changed in my body, feeling seen and known by somebody. Yeah, super powerful. And I think that's very, if, you know, John Bowlby,

the great attachment researcher from here, he said, if you're not known to other people, you're not known to yourself. And I think that's a huge dimension

in medicine and education that oftentimes people are not known by the people. But the moment you feel like this person knows me, the shame goes down and you become accepting of yourself and you start making changes.

For someone to know you, you have to be vulnerable with them. You have to open up with them and let them see you, which of course some people find very hard. Now, people pleasing is a very common trait that many people have. I certainly used to have it to a very high degree. I hope, I think it's much, much less than it used to be. But people pleasing is often an attempt to, I guess,

manipulate other people's perception of you because you're often not truly being yourself because you want to be accepted right so you're saying the right things doing the right things so the people around you like you but that's not the same as knowing you is it that's true and you know and it it depends very much on the giver part, the doctor, the professional, that they take an interest in you. Not only whether you behave well. You know, psychiatry is all about behavioral health.

What does behavioral health mean? Don't be a pain in the ass. That's really what it means to me. It's totally like like let me control you so you don't bother other people but that's not that's not our job, our job is for people to actualize themselves

and to really bring out the optimal functioning and so if you say to people if you deal with people like let's really get to know each other then maybe the people pleasing part will hold on. You may even say to people, you know, I think it's important for you to feel like I like you. But do you like yourself?

And how do you feel about yourself? How do you feel how you are doing? And you say that with compassion and people say, oh, this person really wants to know me. And once people want to, you feel that somebody else knows you, your whole existence changes. Yeah, I learned that very on in my career as a doctor,

especially when I moved to general practice from specialism. And I think I've mentioned this a couple of times on the podcast in the past, but I think it was in my first or second week as a GP. I do remember this young lady came in and she definitely had symptoms consistent with a diagnosis of depression. And I was looking at the protocols that we had

and it would be very easy for me to have prescribed her an antidepressant, like an SSRI or something. But I didn't want to do that. I just thought, I need to know her first. I can't just see her for 10 minutes, give her that and say, I'll see you in four weeks. It just feels completely wrong

and against everything I stand for. So I did something really that's getting less and less common in medicine. I talked to her. We had a 10 minute consultation, but I ended up spending 30, 35 minutes with her talking, even though there were patients waiting. I invited her back the following day.

I said, look, at the end of my morning surgery tomorrow, if you come in, we'll chat a bit more. And I would see her once a week for the next few weeks. And I just talked to her. And I'm not kidding you, Vessel. Within four to six weeks, she was like a different person. A lot of those symptoms have started to fall away. She was feeling better. And I thought, wow, I didn't learn this at medical school. But I've done for her and maybe she doesn't have this in her own life I I provided for her yeah a safe non-judgmental space to speak to talk to listen right it really it was such a powerful lesson for me you know it's ironic that I did the first study on project forac for trauma, and it wasn't bad. And at that time we thought, boy, we're going to find the right drug for the right disease.

And to some degree, that study as decent as it was, was part of the ruin of psychiatry, because people chose pills over human connection. And I don't have anything against psychiatric drugs. Sometimes they help some people. But what we lost is that connection and that feeling of somebody knows me, somebody sees me,

somebody is concerned about me. I think that's basically disappeared out of American medicine. It's going that way here in the UK as well. Bessel, in your book, one of my favorite phrases, and there are many, but the one I've written down to talk to you about is this one. If the body is storing trauma in its musculature, in its hormonal pathways, then it is the body that needs experiences that deeply and viscerally contradict the helplessness,

rage, or collapse that result from trauma. I think it's really, really powerful. We in the West, at least, are a very head-based society. Everything's about thought and our rational minds. One of the key things I got from your book many years ago when i first came across it is this idea that the the body stores trauma right yeah but but go on how would you explain that because that's a controversial idea to some people yeah but although it's become a meme it's stunning that the new york times crossword puzzle had the body keeps the score it's like uh rock songs are being written about the body oh you can retire now you made it that's crazy like but and it's not right through that the body

remembers but you live out the traumas through your to the periphery of your body how your muscles turns up somebody said way before me, an angry person lives in an angry body. A depressed person lives in a depressed body. That you carry these things inside of you. Very meaningful to me because I had asthma as a kid. And that's had a huge influence on my interpretation of the world because I could oftentimes couldn't breathe.

And I think part of my interest in trauma comes from my own experience of being a sickly child. And then I had somebody who Rolfed me. Rolf is a very intensive form of opening up muscles. Rolf is an R-O-L-F. Yeah, yeah, I know about it. And that may have been the most powerful therapeutic experience I've had

because my body was locked in the body of that asthmatic scared kid. And after getting involved, my body, I lived in a different body. Yeah. And no amount of psychotherapy would have been able to do that. This is such an important point

that I feel I've really, couple of things have happened over the last five or 10 years that have really helped me understand the body's role in trauma or health or the way the body holds things. In fact, I can think of five or six different examples. I mean, two that come to mind.

Quite a few years ago now, when I was experimenting with this trainer at a gym, I just did it for two or three months just to feel what it, you know, what is it like? I heard really good things about this guy. And he also did lots of active release on your muscles and things. And, you know, I always used to have in inverted commas, tight hamstrings. Okay. And at the end of each session, he'd spend some time stretching them and loosening them, but they'd always come back. Anyway, I didn't see him for a year or two. And in that time, I think I was doing some internal family system therapy work with this amazing guy who lives near to me called Christian. And I was just feeling lighter and freer just in my whole being. And I was driving past the gym one day and I sort of, or I knew I was going to be there. I called up and I said,

oh, let's have a session. And funnily enough, he basically examined my hamstrings. He said, Ron, what have you been doing? They're really, really loose. And again, there's a lot more detail there, but in essence, me working on my past and my trauma changed my body. Yeah. Right?

It wasn't through stretching my hamstrings. It was through other stuff. It was mechanical. Yeah. But I think it works both ways as well. Yeah, that's right. Because you can also free up your body. And there's a, I spoke to, we've not put this episode out yet, I spoke to this incredible movement coach called Lawrence van Lingen last week. And he takes a very holistic approach. And And he takes a very holistic approach. And like Helen Hall, who I work with,

and he basically was saying that what he's noticed over the years is that people who often have been traumatized often go into a more sort of flexion, it's like fetal position. And if he can help them open up, and in particular with running, he would talk about it from extending from the hips which many people can't do not only does their running get better yeah but their whole

being and who they are it's fascinating isn't it oh yeah and it goes both ways it goes both ways and for example if you have been molested as a kid you're likely to have problems with touch. One of the most, maybe the most comforting thing in life is to be touched, to be held throughout life. But if you're afraid of touch, you live in an untouched body. You live in an unloved body. And maybe, and I really take it very seriously with my patients who I almost always send to body people, body workers. You need to learn the pleasure of being touched, the safety of being touched.

But as long as you're afraid of human touch and comfort, your mind cannot really get better in some ways. This is fascinating. So in my second book, The Stress Solution, I wrote a whole chapter on touch and it was heavily influenced by Professor Francis McGlone at the University of Liverpool, who's done incredible work on touch

and how we have these CT afferent nerve fibers and when they're stroked, it goes all the way to the kind of primitive parts of the brain, the lowest stress levels, cortisol. And I remember when we put that episode out that I recorded with him and when the book came out, some people go on a touch and say, yeah, look, I understand that human touch,

effective, consensual, wanted human touch can be very, very beneficial, but I don't like to be touched. And you're now saying, it's really interesting, you're saying that if you were molested as a child, you may struggle with that. Is that something people can heal from? Like human touch is, as you say, one of those basic things that we need, that we thrive on. Have you had patients before who struggled with this and through various therapies, they got to the point where they could?

Yeah, absolutely. Maybe I should put in the plug for a book by my own body worker. I lived in a small village in the mountains of West Ham House and somebody touched me on my shoulder and says, I'm a body worker, would you like to have an experience with me? And so I have my own body worker. Carden Babin is his name.

Something about the body. But yes, you can change. And like my wife is a body worker and also a psychedelic therapist. And she starts off with tuning forks, just a little tuning fork and put it in your chest. And that may be almost too much for some people. So you need to very gradually open up your mind to your body. You need to activate those connections in the brain

that have to do, it's called the insula. Oh, you know that. But explain it anyway for the audience who may not. But so there's an organ in the body that tells you what your body is feeling and what your body needs. There's a two-way communication. For example, if you go out, you think, is it waning? And you feel the feeling of what wane would feel like in your body.

You go, I better get an umbrella. So you need to be aware of that. And if you're not aware of what would feel like in your body, you go, I better get an umbrella. So you need to be aware of that. And if you're not aware of what's going on in your body, you get situations like people who are pregnant and think they're just becoming obese because they saw such in their bodies that... Really? Oh, yeah.

It's not uncommon, actually, for people to actually feel nothing in their bodies. And so as long as you cannot feel anything in your body, you cannot feel pleasure. You cannot feel human connection. So your whole world gets locked up. And so you need to slowly open up your relationship to your body. You need to know when you have to go poop.

You need to know these things. And things can get so disrupted that people don't know anymore that need to go to the bathroom stuff like that but these are what we would call these i mean medicine might call these um dysfunctional states right but can we not just reframe this and go okay the reason you cannot at the moment, or one of the reasons why you cannot feel your bodily sensations is because it was an appropriate response to the trauma, right? Which served you for a period of time, perhaps, but is no longer serving you.

And I think people tell me that that information in my book was helpful for them. I'm not much of a cognitive therapist. I don't think you're wising people up much by doing that. But a lot of people say, yes, understanding that this is happening to me makes me not feel crazy. I think that's the big thing.

Oh, I can't feel my body because I shut down my contact feel my body because I shut down my contact with my body because I was being molested all the time. And that's how I learned to cope. As Dick Schwartz, who invented IFS, which you know about, says all parts are welcome because every

part of you used to fulfill a function. There's a reason why your body can't feel anything. For me, it's always how interesting that you cannot feel when you have to go to the bathroom rather than you bad person you can't feel it. It's like

that's fascinating. I mean, most people can. How does that happen? And you find always, and that's why the trauma model becomes terribly important. You said you're not much of a cognitive therapist okay and the thing i've been really sort of playing with in my mind particularly because i knew i was going to meet you and again and talk to you is that there's multiple ways to heal i think for most things there's multiple ways to heal and people think for most things, there's multiple ways to heal.

And people all have their own biases over the therapies that they've seen that work for them. And then think that the same therapy is going to work for everyone. It's kind of like, that's certainly not how I see the world. But if the body keeps the score, and many of us live in a very head-based society where we try and think our way through issues can you heal trauma with thoughts alone or do you have to deal with the body as well i don't have the answer for that.

You know, because I only see people who I see. And so there may be all sorts of people out there. One thing that I know is that doctors and therapists think that they're the answer. But there's multiple ways of getting better. Maybe it's your tennis coach. Maybe it's multiple ways of getting better yeah maybe it's your tennis coach maybe it's your yoga teacher maybe it's your theater teacher i know we're very much into trauma we have learned so much from theater experiences uh in order to help people to get better and so there's other ways besides so this legacy of freud you sit down, you talk about your internal world and you get better.

And in fact, I researched that and researched if people really get better from knowing and remembering everything. And what we found out, no,

even if you know everything and can talk about it, the symptoms oftentimes still don't go away. And so, for example, what you brought up earlier, experiences, for example, what you brought up earlier, experiences.

For example, I think doing martial arts is a spectacularly powerful way for people who have been molested as kids to get a sense of agency in their body. And like, I am a powerful person inside, not cognitively, but you feel like a powerful person after you do your karate chops

or if you become a tango dancer you know my body can really do all kind of complicated stuff yeah it's interesting when you first came on my podcast i don't know a year and a half ago something like that we spoke about various uh movement modalities that can be helpful for people, for all kinds of things, and also trauma. You mentioned yoga. I think you touched on martial arts. Theater is something,

and drama you spoke about, which I found fascinating. And I've got to say, when my son was making his subject choices for GCSE, I don't know what you would call it in America. So basically when you're about 13, 14, and then you've got two years of kind of, son was making his subject choices for GCSE. I don't know what you would call it in America. So basically when you're about 13, 14, and then you've got two years of kind of, when you narrow down the subjects and then you were examined on them at the age of sort of 15 or 16, right?

And he kind of, he loved all his subjects, right? So it wasn't easy. And when he was looking at various options, I think what you said to me about theatre and drama really was at the back of my mind. So he's actually doing drama as well as the academic stuff. He's also doing drama. And I think that conversation influenced me in the way I had those conversations because I kind of, I feel strongly that, I think I have a lot of concerns over how we educate kids in the UK and the US and the things that we focus on. And it's more about work and academics and the time they get to play and go outside and move their bodies. In some schools it's getting reduced and I think it's a very dangerous thing to do. Oh, absolutely.

Which we can talk about. But I thought, yeah, you know, very dangerous thing to do. Oh, absolutely. Which we can talk about. But I thought, yeah, you know, theatre, having to play other roles, move your body, do things that maybe are not natural to you at this point. Not natural to you. To you, exactly. I thought it'd be very, very helpful. So I want to say thank you for that because he is doing drama. But there's this wider point for me, which we touched on a little bit on stage yesterday, which I'd really want to put to you. The reason I asked you the question

about healing with thought alone wasn't necessarily to get the answer. It was more to promote discussion around this topic. So since my dad died in 2013, I feel that I've, that was the big moment for me to start going inwards and looking at my life

and making sense of my life. And I've done a variety of things on that journey. Including IFS, internal family systems therapy by Dick Schwartz, including working with great movement coaches to move more efficiently, right?

But I will still say, as I mentioned to you yesterday, that one of the most powerful experiences I've had that fundamentally changed me was my podcast conversation with Edith Eger. Yeah, right. Okay? So, 93-year-old lady, when I spoke to her, went to Auschwitz when she was 16, survived Auschwitz, came out, spoke with just forgiveness and love and compassion, really quite remarkable how forgiving as a human being she was. And there's many things she taught me in that conversation. One of the, you know, without going into the whole conversation you know one of the final things she said to me was that was wrong and look i have lived in auschwitz and i can tell you the greatest

prison you will ever create yeah it's the prison you create inside your own mind yeah okay and that that really resonated with me that's quite a perspective when auschwitz exactly because her statement is absolutely correct but if you can say that after auschwitz exactly so and so that that i i remember because it was a remote conversation it was in the middle of covid it wasn't in person and i remember finishing the conversation because of the time difference between California and the UK, it was in the evening. And by the time it finished, I knew I could get into the house and go and put my kids to bed. But I just had to pause. Like I fundamentally felt differently. I will still say

to this day, I was not the same person at the end of that two hours as at the start of those two hours. And so I can apply my rational mind and go, you know, whenever I struggle to reframe something in life, which is rare these days, but when I used to struggle, I'd go, hey, wrong and listen, Edith could reframe stuff in Auschwitz, right? She basically started to see the prison guards as prisoners she said they weren't free in their mind i was free in my mind so that was stunning it's stunning it's hugely inspiring to me so i've taken that as inspiration i'm not saying that would connect with everyone for some reason at that point in my life it deeply connected

with me so i feel now having practiced actively reframing situations in life, I feel now that unless I'm sleep deprived or chronically stressed, I feel that I rarely get triggered anymore in the way that I used to. Now I put a lot of it down to that conversation. So getting back to the point about thought or body, that was a cognitive conversation.

Well, that's why I'd like to disagree with you on that. The mental wellness app Calm are sponsoring today's show. If you're dealing with a lot of stress, these feelings don't just disappear at bedtime. You see trouble falling asleep, waking up in the middle of the night, or not feeling rested in the morning, are all signs that perhaps your bedtime routine could use an upgrade. Calm is the number one app for sleep and meditation,

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and calming music that will help you drift off for some restful sleep. For listeners of my show, Calm is offering an exclusive 40% off a Calm premium subscription at calm.com forward slash live more and new content is added every single week. Go to calm.com forward slash live more for 40% off unlimited access to Calm's entire library. That's calm.com forward slash live more. This episode is brought to you by Airbnb. My family and I have had some great trips over the years using Airbnb for pleasure and for work. In fact, a few weeks ago when I was in Oxford for a work conference, I stayed in an Airbnb and used the living room to record two wonderful podcasts,

which you'll be hearing on this show very, very shortly. Now, I personally prefer staying in an Airbnb when I'm traveling for work compared to hotels, as I like staying somewhere with a kitchen where I can prepare my own food instead of relying on eating out. In fact, I was chatting to the owner of this Airbnb and he told me that he only recently started hosting his home as a way to earn some extra income

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Your home might be worth more than you think. Find out how much at airbnb.co.uk forward slash host. See, what I think happens is you met an amazing person, a truly astonishing person, and your mirror neuron system in your brain picked up the energy of this unbelievably wise person. And that allows you to take a new take on reality, but it's her energy on a deeper level in your brain that makes you open

for reframing some stuff. Yes. And some people have the capacity. I spent a fair amount of time with Desmond Tutu. Have you? After you've met Tutu, you're not the same person.

You just feel the astounding energy and wisdom of this person. And I think most of us have the good fortune of sometimes meeting people where you go like, just sitting with this person, the energy of the wisdom of the person gets downloaded to some degree on you.

I love that perspective. And what I was going to get to was, although I can, with my rational mind, say it was thought and the wisdom she imparted in my brain that was what changed me i don't think that can completely explain it as you say i feel i can't remember how i felt but i know i felt different yes i just thought i was literally mesmerized afterwards and so i don't know if um if it was possible to measure certain things in my body, right?

I imagine it pre and post that conversation. I think my body was keeping score, and I feel that my body was able to let go of certain things probably through that interaction with her. Right. But I can't prove that. What comes to my mind is that the moment that our current president of America said,

I would not want for a re-election. I wish I had a physiological measurement of people in America. And I think our biology changed at that moment because up to then, we had a choice in the next election between a demented person and a psychopath.

And we were all in a state of despair. And then we had a new candidate who looked really bright and optimistic and my whole system has changed because the future no longer is between a demented person and a psychopath. There's options in the world.

Hope. Hope is such an important thing. And your conversation with this Auschwitz survivor, you go like, oh my God, if she can survive that. She can survive anything. And you got a sense of hope. And that is such a critical element. And so many people live in an environment locked into tv shows where they don't

have any hope and i think that's a very important part of our educational system to also give people possibilities so yeah show what can be done and it goes back to what we were talking about earlier which is the importance of any health care professional and frankly, any individual taking beyond healthcare, like you want to give that person your way, the agency. Yeah, and hope. Hope and agency, I think it's really important. I hear it all the time, doctors saying to the patient, you will not get better.

This is chronic condition. I know. And I know quite a lot of people who actually have, who have beaten the odds. Why they have beaten the odds, I can sort of speculate about where it was. But to tell a patient this is a hopeless condition, you have to live with it for the rest of your life, is malpractice.

Even though the statistics are on your side. Yeah, yeah. We've got to be so careful with the language we use and what information we impart to the person sitting across from us. And if our energy is incurable, it's bad for you as a physician, because I'm helpless and I cannot do anything for you.

And the patient says, you're helpless. Like what a condemnation that is okay best so in our first conversation we spoke of all these different movement and body-based therapies which people can revisit if they want to get your take on those things on stage yesterday at the master series conference in oxford i asked you a question i said to you if you were writing the body keeps the score today what would you change and you said to me the only thing you would change the only thing which i found staggering is that you would add a new chapter on psychedelics yeah okay maybe five chapters and for psychedelics five chapters okay maybe but because it's a very big deal so for someone who has come across this conversation and has grown up with the

view that uh in inverted commas drugs are illegal they're toxic and they're things to be avoided i want you from your perspective, to outline please, what is the big deal about psychedelics? Why are you so passionate about them? And why do you think they could be pivotal in the future of mental health? I did the research. That's the ultimate thing is you can look up my name

and type in MDMA and you'll see a bunch of papers that show that MDMA, our treatment method, was probably more effective than anything we have studied up to now. So there's data, it's not just feelings. But there's also an attitudinal difference, and that is that I'm 81 years old, so I grew up in the 60s. We took acid. That's part of my culture that I grew up in. And I didn't drop acid a lot, but several times.

And I have a bunch of very prominent scientific friends, and I say to my friends, did you also drop acid? And they all say, yeah, I did too. And I say, what did it do for you? How did it affect you? And they say, I think it's because of acid I became a great scientist because in acid, I got to understand that the reality that I live in, in my own head is such a small segment of an overall reality. And so that was also my experience i had not taken drugs since 50 years or something until this opportunity came along but i knew that psychedelic agents

open up your minds to new possibilities can we just pause there a minute so there's a couple of terms you've used which i think people may just need a bit of guidance through that. So you mentioned MDMA and you mentioned acid. Could you just quickly walk people through? When we say psychedelics, what are we talking about? What do these different terms mean? It's interesting. So MDMA is a party drug, supposedly. What does it stand for?

Ecstasy or molly. It's known on the street. That's the drug that we did this very serious research about. Acid is LSD. Okay. Not so many people use it these days, but still has potential. Psilocybin, of course, is very popular

and there's good research on it also. Ketamine is an anesthetic that I use a fair amount in my practice. A completely different organ. And you have ibogaine, a chemical from Africa that seems to have been studied for treatment of addictions.

So there's a whole range of drugs that what's fascinating to me, they all are very different chemical substances and they all give you a somewhat different experience, but the end result seems to be similar across these drugs. We haven't done that. They all, even though they work in different pathways, if you look at, broadly speaking, what they're all doing,

are you saying that in essence, they all open up your mind to new experiences? You get out of your locked state of viewing the world and realizing there's much more than what you thought. So if you want to know more about it, David Nutt at Imperial imperial college of course has done more studies on different things than anybody else so you may want to listen to a lot of people have heard the term ayahuasca oh ayahuasca is not a drug i'm not scared of ayahuasca it's it's very

impure substances come from the jungle you don't know what's in it. But I have seen people who were dramatically positively affected by ayahuasca. I also know a few people who got really messed up by it. Well, I think the potential negatives are definitely something we have to be aware of. So you're basically saying the category that we call psychedelic drugs, there's MDMA, there's acid, there's psilocybin,

there's ketamine and ayahuasca. Ibogaine and ayahuasca. There's actually many more. Many more. Okay, fine. So, but you're excited about their potential in helping people heal from trauma. Our data.

And I mean, so part-time I'm a researcher and data is straight, obsessive, and part-time I'm a clinician. Our data are spectacular and we have our clinical experiences, but clinical experience you cannot quite trust

because you have an N of one or you've only seen five people and there's five people. So you need to do research to see what happens to a larger group of people. So they need to do research to see what happens to a larger group of people. And so what we found in our research is that there was a dramatic change in the PTSD score with very good MDMA psychotherapy assisted therapy.

So you have therapists to be with you as she goes through the experience. People in our study generally accessed very painful material. So it was not a fun trip at all. It's actually puzzling in a way to me that it's known as a party drug because in our setting, it's mainly a trauma drug.

People really come up with very bad stuff. They go through the pain and they become aware of this happened to me but this happened to me when I was three years old or 18 and people get a sense of time and perspective and say I was just a little kid or I was just

a stupid kid who was handed a machine gun and sent to a place where people were blowing each other up so he did terrible things but I was just a stupid kid and sent to a place where people were blowing each other up. So he did terrible things. But I was just a stupid kid back then. And what you see is a dramatic change in people's self-perception. What you see is people become compassionate about themselves. And our earlier conversation was much about shame.

You should do this. You're inadequate. Chronically traumatized people always feel ashamed about themselves why am i so fat why am i drinking why am i taking drugs i'm just a terrible person and on the substances people go like oh i eat so much because i can't stand my body and i don't want anybody to take a sexual interest in me and so you get this different perspective in yourself and you go like but today is today and the past is the past and the past may have been horrible but I don't relive the past anymore it is a sensational thing for me to see

that people really change their whole perspective and orientation primarily on themselves in practical terms so someone can visualize what this looks like does a patient obviously i'm guessing there's there's counseling or preparation beforehand getting them ready is it a one hit where they they take it once and they have a psychotherapist with them whilst they're doing it or is it multiple? Or are we still looking into that? So the day we did our studies is you get a lot of preparation time. You can really form an alliance

with the therapist or therapists. Then you have a whole day. You get debriefed. People are there with you. You process the information. You talk about it. You find language for yourself. And then a month later, you have another session, you talk about it, you find language for yourself. And then a month later, you have another session.

And a month later, you have another session. So three. So there's the research protocol. Quite a few people said, the study was over, boy, I learned a lot, but I'm not done yet. But because we do research protocol, we stopped at three. And some people, after one session said oh my god that's fantastic i'm done so but we do research protocol you should make it widget and don't make variations some people basil who i know uh some sort of acquaintances and friends

who have previously suffered with addiction yeah and let's say have gone through 12 steps to kind of move beyond their addiction. Some people I know who have gone down that path, they feel nervous about taking another, in inverted commas, drug because it's taken them so long to break free from another addiction they're they're scared yeah but there is research now showing that it can help with addiction oh absolutely so are they right to be fearful well they're fearful okay yeah sure see that's where you start yeah they, they are fearful. You don't say, don't be fearful. I get it, totally.

And then you say, well, you give them some data, which reassures them a little bit. Deep down, it doesn't make the fear go away, but you form an alliance with them. And you say, your experience is that it's dangerous, but I've seen so many people who really were helped by this medication. So I think it's worth your while to try it

because you're being locked in this addiction or the fear that it will come back, which is sort of there every day for you, is so huge that I recommend that we do it very carefully and I'm with you while you go through it and I'll take care of you but during the experience and afterwards. From what you've seen with patients

and from your research, what are the various situations where you feel it can be helpful? You mentioned addiction, you mentioned PTSD. What other kind of collection of symptoms might you think chronic depression depression oftentimes uh i'm very curious about ocd obsessive compulsive disorder which is so treatment resistant let's be clear what we mean by that treatment resistance but people don't get better they don't get better whatever we do

yeah ocd is a very ingrained disease. But it hasn't been studied yet through the lens of psychedelics. Some people are beginning to do it and I'm somewhat hopeful because again, OCD is a pattern, you always react a certain way and the psychedelics may open up your pattern network. So psychedelics have been shown

to change your neuroplasticity in your brain. It's actually a huge issue. And for someone who's never heard that term, what does neuroplasticity mean? So the essential thing is, so your brain gets organized over time. And as everybody who listens to this knows, at some point it becomes pretty stable.

You're pretty much the same person tomorrow as you you're today and if today you're basically shy and there's a lot of shame inside of you you can pretty much count it tomorrow you'll feel the same way because these patterns get locked in and in therapy you try to change those patterns but they're very ingrained neuronal patterns in your brain of what gets connected to what. And for a certain window of time, and it's different for different one of these drugs, your brain becomes wide open for a new re-patterning. So that the things, for example, you were neglected and abused as a kid, that sort of becomes part of who you are and how you continue to live your life.

And after MDMA, and we've shown that actually scientifically, you may feel like, now I know what it feels like to be a loved child. Is it a bit like, this is probably not a great analogy, but I don't know. Let's say you've got an iPhone and you reset it to factory settings, right?

And suddenly everything's working again and it's flowing again, right? Could we look at it in some way that if you are stuck and your views and the way you are has become quite rigid and inflexible, are psychedelic drugs potentially almost like a reboot to kind of, I know it's not a perfect analogy, but can we look at it a little bit like that? I would have no quarrel with that, yeah. See, the thing is, you become wide open, and whatever comes into you

around that time can have a much more profound impact than before and so but the big thing that we actually just lost on is we try to have MDMA legalized as a psychiatric substance

in America in America and but we said you need to do psychedelic assisted psychotherapy. Somebody needs to be with you because what comes into your brain, into your mind, into your being

at that time can have a transformative experience. So if you're left alone with a drug and you're reliving your childhood abuse you're going to have a very scary experience. If you have somebody sitting with you and holds your shoulder while it's going on or talks and is like, just stay there, notice that.

It will be over before too long. And you have this gentle voice and a gentle presence. Then what comes into your brain is, I can feel badly, but I can be comforted during that time, which of course is exactly what's missing in your past abuse experience. Why did the FDA turn it down? Was it the FDA?

The most ridiculous, they said, the risks outweigh the benefits. We focused more on risk. We focused on every possible side effect. There were no serious side effects. So why do you think they're saying the risks outweigh the benefits? You know, I think the Nixon years are back with us again.

Right. It is like, like- You mean it's preconceived ideas over what these things are? Our data were so clear, but I think in psychiatry people are afraid of people feeling pleasure. Medicine also.

Medicine never talks about pleasure and it talks a lot about addiction potential. No, on MDMA it wears off after a certain time so if you take MDMA for several weeks in a row it doesn't do anything for you anymore

because there's actually no addiction potential because the effects are not reinforcing themselves. The effects become less and less with every use. So it was a completely misinformed study by people who knew neither about psychedelics nor about PTSD. And on the panel, there was nobody who knew about trauma. That's a state of play in America. What's the state of play in the UK at the moment

with psychedelics? I don't quite know where it's in the UK. I'll meet with the Psychedelic Society here. Oh, you're gonna see the Psychedelic Society. Yeah, and I'll spend time with David. So I'm curious how it is, but I've been in the Netherlands, they put out a report about how safe MDMA is, largely based on our research, actually, in this thing.

In Australia, they also legalized it. And what I'm saying to my European colleagues, America is such a dominant cultural force that the world still follows America, even though they follow the broken things of america also and i say as europeans and brits you guys need to get your own voice and not follow americans in this but you can of course you should use our research to make a deal yeah earlier on in the conversation uh we touched on different cultures and their relationship with trauma yeah and of course there's certain cultures that don't like to talk about stuff

you know it's you don't talk about stuff i think you mentioned uh german upbringings before i could what did you say about them so certainly german families germans never talked about what the war did to them. Right. The Japanese never talked about what the war did to them. In China, you cannot talk about a cultural revolution or Tiananmen Square. It didn't happen. But boy, the Chinese are very good in body work. So they are very good in dealing with the body, but they're terrible about talking. Hold on.

That's really interesting, isn't it? So if one of the things you're saying is that the body, I was gonna say stores trauma, it's perhaps not the correct word. Contains it. Contains it, okay. It's expressed through the body, yeah. Okay, so expressed through your body, yet you live in a culture where it's not acceptable,

or at least the done thing that you talk about it. Do you think things like Tai Chi and Qigong, for example, came about maybe as a way of managing trauma and dealing with it without having to talk about it? Absolutely. That's very much my take on things. I think every culture, there's trauma, it's always been ubiquitous.

So very much part of a culture is how do we deal with trauma? Yoga in India. And yoga in India, and qigong and tai chi, and acupuncture in China, singing and marching in Germany. So every culture has this Sufi dancing,

maybe in the Muslim religion. We don't know. We haven't studied it. But every religion has inculcated trauma methods. And I think for us as Western researchers, doctors, it's very important to discover what that particular culture has already has and to honor what is in place there. I mean, I've seen Tai Chi, Qigong being practiced in China and my first reaction is, I was back in early 90s,

I go, what are these people doing? And then join people in the park and I go, wow, my whole body feels so much calmer and more focused. And yoga, bending over, touching your toes and putting your butt in the air. And then you start doing it. I said, wow, this is amazing. This really helps people.

Yeah, one of the things I mean, I won't quite go as far as say i've been concerned about it but but i think about a lot and that we now live these sedentary lives yeah so moving our body is clearly important for physical mental emotional spiritual health you know we literally changes us as we move our bodies even just go for a walk in nature you can feel fundamentally different about yourself and your life and i feel and i have to take responsibility that sometimes we have these conversations on this podcast about the importance of let's say resistance training as you get older you lose lean muscle mass and so it's important as you get older to do things that mitigate that loss to keep you well as you get older. But I feel like with many things, we've become quite reductionist. And so often, of course,

moving your body is a good thing, right? But if you're sedentary and you're in a flexed posture all day, and then you go to the gym to work on your muscles and you're doing more flexed movements and bicep curls. I'm not saying that has no value, but if we look at movement as much more than our lean muscle mass, as much more than our physical health, but as an expression of who we are as a human being, you talk about these Eastern modalities and there's sort of an energy flow through the body with these various movements. I sometimes I wonder, are we missing like the big picture of movement?

We're missing a big picture. Like when you talk about weight training, I know at my age, I should do weight training. 100%, I don't do it. 100% I don't do it because it is awkward and not rewarding to do it but if there were a little shop in my little town that I live in

where I would see my friends and every Friday morning at night we're doing weight training I'll go see my friends and I'll do weight training so you also need to think about what is rewarding and what are the social conditions. We are tribes.

We're connected human beings. So I don't know how you do it, but when you go to a gym by yourself and you don't know anybody, it's not so much fun. Yeah, it reminds me, have you heard of the Kenyan marathon runner, Elid Kipchoge?

Yeah, I've heard of him. He's the only, yeah you know he's regarded as one of the greatest of all time marathon runners he's the only human that we know that has run a marathon in under two hours and i spoke to him on this podcast a couple of years ago a week after he broke uh the world record. And he's a very calm, softly spoken individual, very, very wise. And one of the things I always remember is that he told me he never trains alone. Even though he's like one of the fastest people on the planet.

It makes everybody else feel terrible. He never trains alone. He goes, no, no, we always train together. Cause it means that if I'm feeling tired or I don't want to do it, someone's going to be on the phone. Hey, so Elliot, where are you? That's right.

Where are you today? And I said to him, I'm pretty sure I said to him, hey, look, you know, it's kind of interesting because in the West, there's nothing wrong with this necessarily, right? It's just, you know, it's just interesting to observe. We often go for a run by ourselves to deal with our stressed out lives, right? So we then motivate ourselves to put our

shoes on and go. Whereas I feel in certain cultures, it's not used for those purposes. They run together. They're chatting. They're, you know, like what you said about if you were meeting your friends every Friday, you might weight train, but if you have to go to the hotel gym here in Oxford, like I'd rather- I ain't gonna do it. You ain't gonna do it? So it's fascinating how different cultures

perceive things, isn't it? And you know, we go to Italy and all these old men are doing bocce together. And they sit together and throw their balls together and they get their weight training because it's social. Yeah. And I think that's the key thing we learned from the Blue Zones more and more,

these communities that have been studied where they live to a ripe old age. And they all have hills. And they've got hills. You know, they are, you know, everyone of course, the modern reductionist scientific mind wants to reduce it down. What is it?

I don't think it's one thing. I think it's a combination of factors. And it's very hard to get away from the fact that every single blue zone has community at its heart. Yeah. A good example is that, so I have a research team and we were all crestfallen

that MDMA was declared illegal. And so we had a research retreat at my home to think about what to go do next. And one of the members of the group has a new baby. And his wife wasn't well. He said, I can't come to the research retreat because I have a new baby. And his wife wasn't well. He said, I can't cut the research receipt because I have a new baby. And I said to him, well, if you follow the FDA, it's all a chemical disorder. So why don't you make sure that your little baby gets the right chemicals

and just have some neighbor give it to him and come over to the research receipt. Ha, ha, ha. It's not all to be reduced to one little chemical a neighbor give it to him and come over to research for she's, ha, ha, ha. It's not all to be reduced to one little chemical because we need that human interaction with each other. That's at our core, that's the essence of who we are. But this FDA ruling has really frustrated you, hasn't it? It is devastating no our study cost 163 million dollars to do it just right it has the most potential of anything i've studied i've studied more different

methods for dealing with trauma than anybody else alive from yoga to neurofeedback to theater to prozac and here we see something where you go like wow there really is hope and now it will go on the ground and well that's what already is happening because he's but here you get to the great racial and economic disparities if you're a black man and you start using illegal drugs, you go to jail. If you are a person of color who's poor, you go like, I'm not going to touch illegal substances because look,

I have this fentanyl epidemic going on in my community. I'm not going to take these illegal drugs. So you get into very educated people who'll know the research and will know how to choose somebody for themselves on the ground and not being afraid

of going to jail well if you're poor and a person of color you're crazy to do it yeah but all these things have these huge social implications

yeah have you got a plan as to what to do next around that? Doing podcasts. So that the general public can get to know what it's like.

And so in America, actually every state can make things legal. And so we're actually going to not argue with the FDA. Talking to the FDA is like talking to Trump,

you know, like, what makes any difference? But we're going to put it on the ballot and get it legalized state by state, which we're planning to work on, actually, yeah. It's kind of interesting. Many things throughout the course of human history, many, many significant changes haven't actually come from the top down.

They've come from the bottom up, these big grassroots movements. Absolutely. You know, my passion in life has been to see what can help people. And I was sort of a very promising junior professor at Harvard studying Prozac and stuff like that. Very respectable. Then I start studying yoga. And people go like,

oh my God, he's gone off the deep end. And then I study EMDR, this crazy eye movement treatment, which is spectacularly helpful. Yeah, for sure. And people go, oh my God, this guy, he doesn't belong at Harvard. He's studying eye movements.

That's crazy like and now everybody's doing it uh but academia is not very exploratory academia like judges are interested in being respectable and getting a lot of donor donations from rich people they're not into innovative stuff the innovative stuff happens in the trenches we often find or i've often seen that clinicians medical doctors like yourself often speak more freely in the latter stages of their career now first of all i'm not saying you're in the latter stage of your career okay let's pretend they're still true okay yeah so yeah. So to be really clear, I think you've always spoken your mind

from what I can tell and been very open. You wrote this book, for example, 10 years ago. You must have been writing it 12, 13, 14 years ago. Oh, longer than that, yeah. Right? So do you feel at the age of 81 more empowered to talk about these things less worried about judgment and critique from others which i know a lot of junior clinicians are the early stages of their career

they don't want to rust they don't want to ruffle feathers it's like they need the respectability or they feel they need that to progress in their careers especially i think it's a generational issue and like most of my colleagues, including the colleagues you meet at this conference, many of them, we have known each other for 40 years. The people who are now in the late 70s, early 80s in the US are a different population. We were not motivated by getting tenure

or we're not afraid about making a living. Somehow money were not motivated by getting tenure or being, we're not afraid about making a living. Somehow money was not on our way. We were impassioned by finding something and I think it had something to do with Vietnam. If you didn't protest against the war in Vietnam, you will get sent to Vietnam, you get killed.

So we were all very politically active and the civil rights movement and those are major forces in all of our lives growing up. so we were all very politically active, and the civil rights movement. And those are major forces in all of our lives growing up. Like we're going to change society, and there was very active. And I've had students for 50 years now, and every generation is slightly different.

And at some point people start talking about self-care. And I go, what is self-care? I didn't think about self-care going to medical school and being every other night on call for my surgery rotation. You just do it. And then, oh, maybe self-care is relevant. And then people say, I need to have financial security. I say, financial security? I never thought about that.

But that's what people are into. So the culture changes. It is, that's fascinating because last time I spoke to Gabor Mate, I think for the fourth time on the show, it was a few months ago, Gabor had just turned 80. Yeah, he's my year. So it's fascinating to me that you, Dr. Gabor Mate,

and many others are of that age. And we've spoken in this conversation about how our culture influences our beliefs and how we deal with things but yes of course the generation yeah like what we deem or what society deemed important at that time strongly influences your motivation to do your work it's incredible but i'd like to say in the contemporary culture, they ignore six out of the seven deadly sins and they only focus on greed. How the hell did that happen?

I mean, acquisition of money was not the primary driver as I was growing up. You want to do something meaningful or you want your dad to approve of you and all kinds of other things. But again, we have to acknowledge that if you grow up in poverty, the acquisition of money may well be,

for good reason, a primary driver. Could be, but that's not what I see. Really? No. I think this whole, you have to be more successful and make more money, that is not what I grew up with. And I didn't see it in my patients either it's like I need to have

a good life I want to have a house I want to have kids I want to be able to go on vacation but in order to go on vacation I also need money but it's really I really want to travel or I really want to do something and the money really was largely secondary for most people I've known. Yeah. We started off this conversation and you were very optimistic about humanity in the world. Well, no, no, that's not true either. Okay. No, no.

I think, no, we are a self-destructive species. We won't stop climate change. For example, we're in Oxford. I live in Western Massachusetts. I spew a lot of carbon dioxide in the air flying over here. My brothers no longer fly because they take climate change seriously.

How many people do you know who have stopped flying because they don't want to put co2 into the air now we are going to destroy ourselves and we are not capable of stopping that hold on hold on so this is interesting i think you did strike a very optimistic tone at the start which which again you're talking to this kind of, these, I think these contradictions that we all have within us. And we try and make everything black and white.

And I feel all of us have an element of personal hypocrisy. I really do. And we're kind and we're awful, both at the same time. Well, I guess what I was trying to get to is, given that you have seen some of the darkest things, or you've been with people who have experienced some of the darkest things humans are capable of, despite that, it seems to me that you have a very optimistic and hopeful view

about the capacity of a human being yeah the human spirit what it really means to be human is is would you agree with that yes i would but very much if you're on the journey of discovery if so if i meet somebody who is motivated and say you know i always want to die but now i have kids and I want to live to see my kids grow up and I go to work on myself to be a real parent for my kids. We'll find a solution. And if that doesn't work, we'll try that. And if you have money, you can explore a lot of different options.

If you're poor, you go to pre-existing healthcare systems where you get cognitive treatment to tell people you should think differently and I will fix your thoughts. You know, you get this nonsense stuff. I think once you're in a position of some privilege, some position of agency, the world is open for you. And people can, you know, that's what I've seen in my practice all my life. People can change dramatically for the better.

They can. They can. They can. Given how important our childhood experiences are to how we see the world, experience the world, and our adult lives, to see the world, experience the world and our adult lives, what advice would you give to parents who are trying to raise resilient kids? You know, as I said yesterday,

in some ways parents are overvalued. Now insight is your mom, your dad. Yes, your mom and dad are important, but so are your siblings. So is the school that you go to. So is the culture you live in. So your friends are terribly important growing up. What sort of friends you happen to meet.

And then, you know, so I'm thinking about writing a memoir right now. And I actually met with a cousin of mine who has at some point became the foremost oncologist in the Netherlands. And he says to me, you know, there was nothing in my childhood that predicted I'd become as successful as I have become. And I'd say there's nothing in my childhood that would predict

that someday I'd write the best-selling book on psychiatry. So things keep happening and things keep growing. And what can we do for our kids to believe in them, to believe in them and to encourage them to explore the world and to take risks and to say, you can always come home. It doesn't work, but go. And really help our kids to feel safe in our affection and safe enough so they're willing to go take risks out there

so they know on some deep level, I can always go home and be taken care of. But once you know I'm safe, you don't stay home anymore. You go explore the world. Yeah, because you know you've got that sort of nest to come back to. But I see a lot in traumatized people, they stay close to home because they're scared.

Bowlby already talked about it with attachment. But the more scared you are, the less risk you're able to take, the less you're able to break away from your tribe, even if your tribe is a terrible tribe. What about if your tribe is a helpful, supportive tribe and you want to stay near that tribe? It's really fascinating, this for me.

Because we do have now one of the things that's massively changed from, let's say, a few hundred years ago. Now we talk about you versus me. You still close your family and live far away from it. Yeah, exactly. So it's fascinating. And again, not right or wrong,

just kind of interesting as to, we know having a strong supporter tribe around us is very... It can be very nurturing. Yeah, but it can also be problematic. It can also drive you crazy. Yeah, depending on the relationship you have. So anyway, this is deeply fascinating. One of the things you said earlier, Bessel,

which I think relates to this part of the conversation, is that you've witnessed people who've had that really safe, secure upbringing. And you said in that environment, the people around them were highly attuned to them. I believe that pretty much anything good in life or the most important things in life come from our ability to be present. Right. Absolutely. So if as a father, I can be present with my kids and hear them and listen to them. Not easy. No, no, not easy. Being present is...

If being present with the people around you, if being present as a parent is one of the most important gifts you can give your children, I imagine that being traumatized makes it harder for you to be present? Yeah. Darwin pointed this out already.

1872, he says, if you get stuck in fight or flight, which is sort of definite trauma, it interferes with your reproductive capacities and it works against you on an evolutionary basis because in order to create new life, you need to give up your fight-flight response to be totally there

for your offspring. And if you cannot be there for your offspring, it works against the welfare of your offspring. 1872! Amazing! And that's so true if you're traumatized and you see it all the time. You freeze with your kids.

You cannot be there for your kids. You cannot be. One of my joys in my life is to see my son. I'm not sure how good a father I was, but he has two kids, and I just love watching him be totally attuned to his kids. And I don't totally take credit for it, but I'm really glad that my kid is really a toot to his kids.

Like, it's beautiful. Wow. Hey, Bester, you really are someone who has done such incredible work over the years, both directly with your patients through your research, but also through publishing this incredible book that still continues to make an impact and I hope will do for many many more

years to come i first of all want to acknowledge you and thank you for everything you've done for the greater good of humanity i've just hung up with the right people you know yeah well it is pretty incredible nonetheless and to finish off if there's someone who's stumbled across this podcast or they've been on YouTube and they've just come across this and they heard those signs that you mentioned earlier on about the things that may indicate that they have some unresolved trauma and they're like okay like I reckon that's me I want to start somewhere but I don't know where to start what would your words to them be you know choosing finding a good therapist is very difficult uh i know this from my own

experience also i've also gone to therapists that were no good uh but so word of mouth is the best having if you tell me i went to this trainer and i just made a big difference i trust your judgment more than the credentials that people have and number one so really good personal recommendation of people say yeah to really help me is the best thing um in the u.s people call me from all over the u.s i say go on the website of american psychologist which is a website and find people who are well trained in at least three different methods because anybody who says i'm a freudian is a cult person they freud is more important to you than the welfare of your patients. I'm offending a lot of people by what I just said. And a lot of those therapists tend to become religious people, they know one method and they start saying this method is the best method. And

you have to go to somebody who is very good in a variety of methods, hopefully one having to do with the body. I think EMDR is very helpful for many people and very easy to do. And you just briefly explain what it is for someone who's never heard that? So EMDR is eye movement desensitization. It's a very strange method that I've studied very thoroughly

that helps you to dampen the memory somewhat. And the other thing that you did, IFS, I think is a very helpful fundamental thing to do with people. So I think that knowing something about somatics, knowing something about like EMDR type method and something like IFS is likely to lead you in the right direction. Yeah, I just want to touch on what you said

about someone who knows at least three different modalities. You can take that out of the trauma world and I think you can apply that to many things. So for example, the movement coach who I work with, who's incredible, the movement coach who I work with, who's incredible. She has trained in so many different modalities over the years, so she is able to use different methods for when, you know, she has a huge toolbox,

so she can use the right tool. And I kind of feel, you know, I'm very proud to be what I would call an expert generalist. I think we've got so super specialized, but I love being a generalist who can go, oh, with this person, I feel these things are gonna help you with this person, this is gonna help you. And I think we all have, please.

The other thing that I recommend to people is ask whoever you go to, has what you're going to do to me has it been helpful to you yeah and if people say no because i'm not messed up and you are walk immediately out of that office because nobody escapes bad things in our lives Yeah. I'm so glad that you talk about your own therapy experiences. You strike me as a very well put together guy. And so you know that there's things inside of you that also needs help. For sure. And people who don't know that they need help themselves are not good therapists.

Anybody who knows anything knows that we all are coping with really difficult. That no life is easy. That every life is difficult. And be sure that whoever you see knows that life is difficult and you don't want people to talk about their own trauma, it's get away from it also. But if people can say, this has really been helpful to me also,

that's a very important thing. And just finally, Bessel, if someone, because of where they live or their financial situation, cannot have the funds or the means to find someone or see someone,

what are some things that they can do themselves to start them on the road to recovery? I think anything that gets you in sync with other people is helpful. You know, it's no accident

that after national disasters, people get together and sing in cathedrals. Singing together is very powerful. Moving together with other people is powerful. I would imagine even joining a bowling league would be helpful for people you're saying that because you're in oxford at the moment maybe i don't know is i do have bowling leagues here did you say i think you said bowling oh i think you said boating no no no bowling bowling okay

so do something together in a group together so my friend uh who you may have met this weekend he went to ethan and he said he was privileged. I know his background. His mother died when he was one years old. Very painful background. He says, but the one thing I got from Eton, we were always playing together and doing sports together. And if you can do that, that's great. Or making music with other people,

or cooking with other people. Anything that gets you in a synchronous relationship with people around you is very good for you. Basil, you're doing great work in the world. It's been a real honor for me to have my second conversation with you on the show. Thank you. Thank you so much. Pleasure. Pleasure.

Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember when you teach someone, it not only helps them,

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