Feel Better, Live More with Dr Rangan Chatterjee - How Trauma Impacts Your Physical Health & How To Heal From It with Dr Bessel van der Kolk #336

Episode Date: February 15, 2023

CAUTION: This conversation contains themes of an adult nature and references to sexual assault. My guest today is someone who I’ve been wanting to speak to for a very long time. Dr Bessel van der Kolk is a professor of psychiatry at Boston University School of Medicine and President of the Trauma Research Foundation in Massachusetts. He’s also the author of the wildly popular book, The Body Keeps the Score, a book about trauma, published in 38 languages and read by millions of people worldwide. The central philosophy behind Bessel’s work is that traumatic, psychological experiences in life leave a physical imprint within us, which can result in physical and mental health problems. We begin by talking about what exactly trauma is, how it differs from stress, and why it is important for all of us to have compassion and empathy for those affected. He explains the factors that lead to some people becoming traumatised by an experience while others aren’t. And we talk about the importance of family, support, and community when it comes to emotional resilience. We discuss the variety of different medical conditions and symptoms that may have their root in trauma, from misunderstood illnesses like fibromyalgia to mental health disorders and autoimmune disease. Often, these are the conditions where western medicine really struggles to help. Bessel has carried out years of research into trauma and studied the many modalities that can help us finally heal. Because our bodies quite literally keep the score and store the trauma, it’s often body-oriented therapies that may prove most helpful. We discuss why yoga (the union of body and mind), dancing or singing can be powerful ways to do this. Movement, he says, is the opposite of being ‘stuck’ in trauma. It’s a somatic pleasure response, an expression of life, and can put vulnerable, traumatised people back in touch with their bodies. Bessel also shares some fascinating evidence on the power of EMDR (eye movement desensitisation reprogramming), neurofeedback, and talks about his involvement in psychedelic therapy. Such is the prevalence of trauma in society that whether we have experienced it ourselves or we know people who have, it’s vital that we all learn about it and the various ways we can heal. This is a powerful and insightful conversation with one of the world’s leading authorities on trauma. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Apple Podcasts https://apple.co/feelbetterlivemore or https://fblm.supercast.com. Thanks to our sponsors: https://www.vivobarefoot.com/livemore https://www.boncharge.com/livemore https://www.athleticgreens.com/livemore Show notes https://drchatterjee.com/336 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 with any questions you may have. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

When you get traumatized, it's not the external event, but your reaction to that external event. You cannot cope with it, and then you're vulnerable to react to other things as if they're catastrophes. And then oftentimes they start off blaming the people around them for having caused them to be so angry or panicked or something or another. But after a while, people start realizing... Hey guys, how are 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. My guest today is someone who I've wanted to talk to for a very long time. Dr. Bessel van der Kolk is a professor of psychiatry at Boston University

School of Medicine and president of the Trauma Research Foundation in Massachusetts. He's also the author of the wildly popular book, The Body Keeps the Score, which is a book about trauma that has been published in 38 different languages and read by millions of people across the globe since its publication almost 10 years ago. Now, it continues to find new readers to this day as more people discover Bessel's incredible work on this common, misunderstood, and under-recognized human experience. Now, the central philosophy behind Bessel's work is that traumatic psychological experiences in life leave a stamp or an imprint within us, which can result in physical and mental health problems. We start off by discussing what exactly trauma is, how trauma is different from

stress, and why it's so important for all of us to have compassion and empathy for those affected. Now, one of the things that I find fascinating about trauma is that we can all be exposed to the same experiences, but not all of us will end up feeling traumatized. And in our conversation, we talk about some of the key factors that may play a role here. We also talk about the variety of different medical conditions and symptoms that may have their roots in trauma, conditions like fibromyalgia, mental health disorders, autoimmune disease, to name just a few. And often these are the conditions where Western medicine really struggles to help. Now, Bessel has carried out years of research into trauma and studied the many treatment modalities that can help us to finally heal.

Because our bodies quite literally keep the score and store the trauma, it's often body-orientated therapies that can prove most helpful. The goal being to help us feel safe inside our bodies. Now we talk about a variety of different therapies that can help, including things like yoga, dancing, singing, and theatre. In fact, Bessel shares a powerful example where young offenders in Massachusetts are sometimes allowed to study Shakespeare instead of facing a custodial sentence. Movement also plays an important role in the treatment of trauma because with trauma, we feel stuck and the right movement can help us feel free again. We also touch on a therapy called

EMDR. We talk about neurofeedback as a way to change our brain circuits. We talk about the potential role of psychedelic therapy and the importance of face-to-face connection in healing, something that has huge relevance for so many of us in our increasingly digital worlds. Such is the prevalence of trauma in society today, whether it has affected you, is still affecting you, or whether it is affecting someone else in your life, I think it's vital that we all learn about it and the various ways we can heal. On that note, I love Bessel's final words in our conversation that all of us are just doing what we need to survive. So we all deserve compassion and understanding before judgment or punishment. This really is an insightful and powerful conversation

with one of the world's leading authorities on trauma. I hope you enjoy listening. Please note we do cover some sensitive topics in this conversation, often adult nature. So please do bear this in mind if you are listening within the vicinity of children. It may not be appropriate in places. And now, my conversation with Dr. Bessel van der Kolk. van der Kolk. I wanted to start with a quote from your iconic book, The Body Keeps the Score. Trauma robs you of the feeling that you are in charge of yourself.

Oh, that's a true statement. What did you mean by that? When you get traumatized, it's not the external event, but your reaction to that external event is that you cannot cope with it and then you're vulnerable to react to other things as if they're a catastrophe. So you may suddenly find yourself very scared or very angry or very aroused or very panicky, or you can shut down. And so you really have no control over those intense emotional reactions that happen after a trauma. Yeah. So in many ways, people who are traumatized feel that their lives are out of control, that life is, I guess, happening to them rather than them being in control of their lives. things are disorganized. And then oftentimes they start off blaming the people around them for having caused them to be so angry

or panic or something or another. But after a while, people start realizing, oh, it's really my reactions that make life so difficult. And so how do I control these reactions becomes a major issue. And oftentimes people learn to sort of shut themselves down and learn to not react.

But with that, they become very distant to themselves and the people around them. I think what you said there was really quite poignant for me, that we often think it's the people around us that are causing us to feel a certain way without that deep realization that actually we're generating those emotions we may not know why we're generating them but ultimately it's coming from within us isn't it yeah not the whole story because you know negotiating your ways through the world is complex um people will say things that may

not be pleasant or they may not respect you as much as you'd like it to be but uh the core issue is how do i react to adverse issues and i cannot change everybody else i have to actually learn to manage my own arousal and my own reactivity. Yeah. What's the difference between trauma and stress? The big difference is when stress is over, it's over. And so when you sit for an exam, you're working hard. You may not be able to sleep. But once you take the exam, you can go for a walk.

You can go do whatever you want to do. And the stress disappears. And stress is not bad for people because we really are programmed to deal with very adverse circumstances. People can deal with a great deal of stress, but the critical thing is when the stress is over and you've done whatever you needed to do to deal with it, then your body resets itself, you become calm, and you stop being hyper-focused or whatever.

When you get traumatized, those reactions don't stop. So trauma is almost like a severe stress response that never ends and that starts to change our nervous system and how we view the world, how we react to the world. Is that one way of putting it? No, it's not as cognitive as view the world. It's really how we react to the world. Our reactivity changes,

and we may become too intensely aroused by minor issues. Actually, so trauma, talking from a neuroscience point of view, we have some networks in the brain that help us to select what's important and what's unimportant. It's called the salience network. And after you get traumatized, that salience network makes you react to minor issues as if it's a catastrophe. Yeah.

How common is trauma, would you say? Oh, extremely common. And there's, of course, all kinds of gradations, but things like being abused by your own parents, being brutalized in your personal relationships by somebody is extremely common. It is really ironic that when we first defined PTSD, we said, this is an extraordinary event outside the usual range of human experience. And we were completely wrong about it. But because we started to look at it, we found out that at least one out of four women, one out of

five or six men, had sexual abuse experiences before the onset of adulthood. For example, a very large number of women get raped. Very large numbers of people are involved in domestic violence situations. very large numbers of people are involved in domestic violence situations. So it's in fact, it turned out to be much more common than we ever thought it would be. I mean, those statistics are really alarming when you put it like that. I imagine, Dr. van der Koop, that some people who are listening or watching right now will think, wow, is it that many people? They will think, well, I know loads of women and

loads of guys, and I've never heard about this happening to them, which potentially speaks to secrecy, shame, the fact that many people have suffered this and are continuing to suffer because of the traumatic imprints, but they're not talking about it, right? That is on the mark. If you have to get assaulted or after you get raped, you don't go around telling people about it. There's always this issue of, I must be to blame for what happens.

Or if you're in the domestic violence situation, you don't tell people, oh, my boyfriend or my girlfriend just beat me up, because that reflects badly on you. And so shame and secrecy is very much part of trauma situations. It's very striking when there's a public trauma. My example in the culture I live in is 9-11, the attack on the World Trade Center. When there's an overt trauma, people tend to be very generous in terms of coming to people's help. But these private traumas of abuse, et cetera, become hidden, and people try to go on with their lives, but they keep reacting as if it's still going on yeah now when i think about trauma and traumatic events i think about the fact that different

people being exposed to the same trauma will react in different ways some people will end up becoming heavily traumatized whereas some people won't so what are the factors then that determine if someone is going to have that chronic imprint of trauma or whether they're going to be able to deal with it you know deal with that stress response and return back to baseline do we know what those factors are? Well, there certainly is an issue of temperament. Anybody who has more than one child knows that we all come into the world with very different reactivity and different responses. So that is one factor. But the other major factor is the social environment and who is there for you when something bad

happens. environment and who is there for you when something bad happens. By and large, if you go through a terrible experience and you have a partner, a spouse, a parent, a boss who says, oh my God, how can I help you? I'll be there for you. When your social environment helps you to protect yourself and to feel safe again, that makes a huge difference. So the principle, for example, after natural disasters, after accidents, war situations, the first thing you do is you reconnect people with the people they love and care for.

Because that is really what for human beings is the main source of comfort. And so as long as you have people around you who acknowledge the reality of what you went through and who are with you in a very deep way, you probably will be okay. Yeah. And that, of course, is what happens in like wartime situations when people are at war, That, of course, is what happens in like wartime situations when people are at war, like what's happening in Ukraine right now, is that people feel very close to each other. And that's sort of a natural biological thing almost that when we are under extreme stress, we really become very dependent on each other and we form very close bonds. And that's how people survive.

on each other and we form very close bonds. That's how people survive. But if the people who are your most intimate people are the source of the trauma, you lose that sense of connection and protection. Then oftentimes, that is when people go over the edge. Yeah, it's interesting. As I was preparing for this conversation, and I was reading in your work the importance of human connection at making us, I guess, generally more resilient, but in many ways insulating us from the likelihood that a traumatic event is going to leave a chronic imprint inside us. Yes, insolence is a bit of an extreme word here. Okay. It helps. It makes a significant contribution. Yeah. But insolent is too total a word.

But overall, when you're a kid, for example, and you need to go through an operation or terrible things happen to you, and your parents are there for you and acknowledge it, then that kid is likely to be okay. Yeah. Really, really interesting.

I think one of my aims with having this conversation with you is to try and raise awareness of trauma, certainly to my audience. And as you've already touched on, it's much more common than we might think. I certainly feel that the word is now much more commonly known about, spoken about, potentially in settings that you may not regard as trauma. We can maybe talk about that. But I do think this affects everyone on some level, whether individually or judging from your statistics that you shared, there's absolutely going to be someone in our life who we interact with who has been traumatized. So I think it's imperative that we all

have a deeper and more compassionate understanding of what it is and therefore what we can do to help people. Absolutely. And it's true that people are beginning to, the concept gets inflated. People spin too much on trauma. Also, in some ways, at the same time, trauma is a very real issue. Let me give you an example.

I live in a country in the mountains of Western Massachusetts, and I gave a big public talk. And after the school principals of this area invited me to meet with them, and they said, can you set up a clinic for trauma-tested kids? I asked them, how many of the kids in our country see domestic violence, witness people overdosing on drugs, get beaten up at home? And the school principals said, about half of our kids. And my response to them was, then you should not have a clinic for traumatized kids. You should have a school system that helps trauma-tested kids, which is at least half of your population, to really learn to regulate our bodies.

You need to have a trauma-informed school and not treat it as an individual problem because it's largely social problems. And so once you understand trauma, you change the workplace, you change your schools, you change your hospitals, and you really start paying more attention to the issue of individual safety and agency to help people to function. Yeah. With the term trauma, I think most of the public would understand intuitively, if someone's been to war, let's say. We would say that's a traumatic experience. But what about something that I think pretty much anyone who's

ever been in a relationship will experience something like this at some point when their partner says something to them that may well be on the surface quite trivial, but for some reason, the other partner disproportionately reacts. Maybe they're being reminded of when a parent criticized them when they were five years old. And when their partner says something, it isn't about what the partner said.

It's about the feeling that evokes, very similar to what you just mentioned, that happened when you were a child. Can we say that is trauma as well well no i would say it's part of the experience but i'm glad you brought this up this example because you know about a third of all couples engage in violent violent interactions so a lot of people carry a lot of trauma and in relationships it comes out and once you become intimate with somebody else, you live with that triggered behavior. And

some things may be extremely upsetting for your partner who may become very angry or shut down in response to things that you have no idea what was so awful about it. And at that point, once you become trauma sensitive, you can go like, oh, my partner is not just being nasty, mean and horrible. My partner gets upset by something that has very little to do with me. And then you can really take a step back step back and say honey let's go for a walk before we address this or let's play some tennis together or let's sit in this for a moment or talk to somebody who else about what's going on here so you get the heat of the situation uh you you decrease the heat of what's going on but it's the relationships all the

time of course yeah in my experience at least i see this playing out in people's close personal relationships all the time it's of course it could be about what's happening in their relationship but in my experience it's very rarely about what happened in that moment it's what that is making that other person feel um which is why i think your work is so important both for people who have experienced trauma but also for people who want to help their loved ones who have been traumatized yeah yeah and indeed it comes out in intimate relationships most people are are able to organize themselves pretty well in neutral conditions. For example, I have no idea whether you become violent in your personal relationships or not, and you don't know that about me, because we don't have the sort of relationship where we will get triggered about these very core issues.

That's not until you really negotiate very complex issues about what happens in close relationships that these issues come out. So it gets contained within relationships. And I keep urging my colleagues who do outcome studies to always not only ask people themselves but how do you react but ask their spouses or their loved ones because they oftentimes can be say more about people's irrational reactions yeah yeah so if we think about trauma we're saying it's very common It's more common than many of us realize. As a medical doctor, I'm incredibly fascinated, stroke frustrated that trauma is not really spoken about that much to medical students. Because I think about, particularly in general

practice, you know, the sort of chronic conditions that often come in to primary care doctors, anxiety, depression, addictions, migraines, fibromyalgia, a whole host of issues, autoimmune problems. Actually, the scientific research seems to suggest that trauma could well play a role in a significant number of these conditions. Absolutely. And indeed, it's a temperamental issue that most people going into medicine want to have clear answers and clear paradigms. And we go to medical school, we learn about all these diseases and their diseases, and we don't,

to start talking about social context would make it even more complicated. So you don't learn about it. And actually right now, I was meeting with some old friends from my medical school days, is that we oftentimes did terrible things to patients and did not really understand how terrified they were of, let's say, white

doctors and how they would be neglecting their physical care because they were too terrified about doctors to actually bring it up with them. And so I'm very glad that some people in some medical schools and medical settings are beginning to pay attention to it because the title of my book, The Body Keeps the Score, is not just a cute title. It actually affects your immune system. It affects your stress responses. And people who have long trauma histories

oftentimes have multiple medical problems, which have to do with their body, they get stuck in fear, fight and flight. And so fibromyalgia is a very good example. Fibromyalgia is pretty much related to trauma, but it's so diffuse that, like, I am friends with a very old man who used to do the National Institute for Rheumatology in America. And they say, so do you guys study fibromyalgia? He says, no, that's a disease of crazy people. Yeah. And here's the guy who's the top rheumatologist in America who just dismisses this very complex and very debilitating illness because the people who have it are just too complex to deal with and difficult and resistant. And so they get nice, clean illnesses.

Yeah. Hey, listen, I want to just pause on this point because I think it's really important. First of all, I do think medicine, for all its benefits, for all the conditions that we do manage to help with, there's many conditions that we don't do a very good job with. And I think we can be quite condescending as a profession sometimes to suffer as a certain conditions like fibromyalgia because they don't fit in a neat box that we can do, oh, this is the problem, this is the pill, it's going to get better. And so I think doctors often feel quite frustrated

and powerless as well. I don't think they're necessarily wanting to be derogatory. I think they thought they were going to learn what they needed to treat these patients, and then they're faced with people who keep coming back and they don't know what to do. So I think that's one point I wanted to raise. But you also mentioned something that I think we should just explore a little bit. You said fibromyalgia is a condition that is, I don't know if you said often or always related to trauma. Now, I think we think let's just clarify what we mean there

because there will be people listening with fibromyalgia. This may be the very first time they've heard it. So can we just broaden that out a little bit so that they can understand what you mean by that? Yeah. When you study fibromyalgia and you do a trauma history on people, you usually find a severe trauma history usually within the attachment system of them not feeling safe and what happens i think is very much what

happens with all of us to some degree when we come we scared we become uptight and we start physically becoming defensive and hold on to ourselves. And that uptightness and trying to control things may then eventually get expressed as pharmacomyalgia. But you become a very anxious and chronically upset person. And the hard thing for medicine is there is no clear answer. It's not like, oh, let me give you a pill and you feel better. You really need to go through a whole process that might very well involve body-oriented therapy,

maybe massages, maybe really working with bodily reactions, which, of course, in medicine we never do, that really need much more intervention than we are capable of or that our systems allow us to intervene with. I know quite a few people who have resources in America with fibromyalgia who find the right people to work with, who know about bodily reactions, but they're very hard to find. Yeah, I would agree with that. I've seen many patients with conditions like fibromyalgia, and I've found what can be effective

is when you take this multi-pronged approach. You do lots of different things. It's not just one thing. Different patients will need different things. Different things are going to appeal to them. But in my experience, at least, Dr. Van der Koek, and I appreciate you've got a vast amount of experience in this area, I have found that you just have to experiment

and you need to try different things but i also would say you know i would share with you that if i think back to a lot of my patients who i've seen in the past with fibromyalgia when you explore deep enough yes it's it's not unusual to find some history of trauma there as well i would definitely agree with that see and then you say the right thing here you need to be patient and try multiple times but probably nhs and our insurance system doesn't give us the time to really explore these things because i think all physicians really are on a gritty of pressure to alleviate, get rid of their patients and move on. And so these patients are time consuming and require a team approach and our assistants may not be prepared for that. And then the next thing

happens, we become frustrated and then we start being mean and nasty to the people who suffer from it, only aggravating their condition. And so I think the place to start for us as caregivers is if we get particularly mad at a particular person or feel frustrated by a particular person to really mark that and say, oh, this person is really driving me mad. Let's see what's going on with that patient. That patient makes me feel so helpless. So the natural thing then is to become somewhat abusive with people like that. Because they make us feel bad and they take our time and they don't follow the rules.

And so when you have people like that, it's really important for us to have our capacity to step back with our colleagues and to really reassess what's going on here. Yeah. So I think our own reactions are a very important bellwether of whether we're dealing with a traumatized person. And I think as physicians, we have an amazing capacity to help recreate trauma for our patients. Wow.

And I hear that all the time from people who go to medical systems. You know, I know people who have breast cancer and heart disease, and they tell me about the exquisitely good care they got in our systems and how great the nurses were and how great the doctors were and then you deal with people with trauma histories who have sort of these unknown issues and they always tell us tell me how terrible they get

treated by the system and i go yep that's what happens yeah that that's very very profound because what we're saying is that us the medical system healthcare professionals as you just put it are re-traumatizing patients who are already traumatized we may not realize we're doing it but because of the lack of understanding the lack of knowledge the lack time, those patients who are already struggling, these are a lot of the time the ones who, they feel lost. They don't know where to go. They're seeking out books or new information just to see what can I do? I don't want to stay like this forever. And it's not just, you know, the conditions you mentioned, even a lot of people with autoimmune illness, you know, I've found that they also respond very well to this kind of multi-pronged approach. I really want to get to a central philosophy of your work

that I take from it, at least, which is about the body keeping the score. That's the title of your book. But this idea that the body keeps a record of what has happened and that one of the goals of therapy is to help people feel safe in their bodies. Now, I think a lot of people may not understand what that means. What do you mean when you say we need to feel safe in our bodies? you're safe in our bodies. 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

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vitamin D and K2 and five free travel packs with their first order. But until the end of January, they are doubling the five free travel packs to 10. And these packs are perfect for keeping in your backpack, office or car. If you want to take advantage of this limited time offer, all you have to do is go to drinkag1.com forward slash live more. That's drinkag1.com forward slash live more that's drinkag1.com forward slash live more i think darwin already back in 1872 wrote a beautiful book in which he talks about trauma actually he calls it getting stuck in fight or flight or stuck in avoidance and defensive reactions, which is not a bad definition. And he talks about how these experiences are expressed in the course of the vagus nerve.

Darwin calls it pneumogastric nerve back then. And that you experience your emotions as gut-wrenching and heartbreaking physical sensations. And I think we all are familiar with that. When something hurtful happens, we do feel it in our chest and we feel it in our bodies. And so our bodies respond to these things. And when you get traumatized, that feeling of gut-wrench and heartbreak really stays with you

and you become an intolerable person to yourself. Does that ring a bell with you? Because I make it a point whenever I travel and go to a place where I don't know the language, I always ask, in your language, do they have a word for gut word for gut wrench and every language has a word for it yeah it's a universal response that you experience deep disappointment and betrayal and fear in your body yeah i think people have experienced that if anyone's ever been through heartbreak before they all have which yeah pretty much everyone has been through on some level you feel it yeah in your hearts like you literally can feel it the pain

the discomfort there so i think when we start thinking about it's like oh yeah that's in our body like something's happened up here in our mind we've perceived it a certain way and then our body is expressing a symptom off that. So I think this is a really good point to talk about some of these practical things that people can start doing to help themselves. I mean, frankly, the things you're talking about are helpful for anyone, but can we start with yoga, right? I know yoga is something you talk about as a really fantastic way for many people to start feeling that safety within their bodies. How did you come across yoga and why do you think it's so effective for so many people? Well, you know, these things are usually an issue of accident.

You happen to meet somebody who does yoga and who says, come and do yoga class with me. And then you do that. And then you feel that your body feels calmer and your mind is more focused afterwards. They say, oh, that's interesting. So actually, so I went to National Institute of Mental Health and got the money to study yoga as a way of calming that body down. But now people say, oh, yoga is a treatment of choice. I don't know. Maybe for some other people, qigong may be better, or tai chi, or some other musical practice. But for me, going to yoga was really a way of exploring to what degree people

can change their relationship to their bodily sensations and yoga turned out to be very good for that and certainly it's not the only way study or still love to do someday is see how tango dancing works for trauma uh theoretically that would make a lot of sense as being a really good trauma treatment actually and so so it and what they see all the time is that the people who are in my life who are traumatized, they go and start exploring different things that help them. And some people find it, let's say acupuncture is very helpful. Other people say it doesn't do a thing for me. So we don't know precisely what is right for whom but it's very important for us to

have an open mind about uh and you need to have an open mind for yourself also to really see what can help me to feel alive in the body that i live in so is that the commonality then you mentioned a few things there let's say yoga and qig, for example. You're saying that for many people who are traumatized, they don't feel safe in their body. They don't experience everything that's happening within their body. They shut down in certain ways. And you're saying one method that may work for some people is through something like yoga or Qigong or martial arts, for example. What is it that's going on? You're starting to connect to your body.

You're starting to connect to your breath. And how do you put it? What do you think may be happening there that's helpful? What happens there is that you are stuck in the stress response syndrome. And for example, when you start breathing more slowly and more deeply and you change your breath, you change your heart rate variability, which is a way of measuring how the heart

and the central nervous system relate to each other. And then you get a sense of relief and openness once you are able to do things that calm that system down. And so initially having somebody work with your breath, you go like, I don't want to do that. And then if you learn to breathe much more slowly and much more deeply, you get a sense of, oh, I feel calmer. I feel clearer.

And what you do actually at this point is you open up some pathways in the brain between your frontal lobe and your insula, a part of your brain that's connected with your bodily sensations, and you open up new pathways of self-experience, basically. Yeah, it's so fascinating. I know when I was reading the section on treatment in your book, after you wrote about what trauma is, you said when you're starting to treat trauma, there was one part where you spoke about these four things that

need to happen. One, you need to find a way to become calm and focused. Two, you need to be able to maintain that calm in response to things and events and people that trigger you to the past. Then the third thing I think was being present. You have to find a way of being present in your life and with the people in your life. And then the fourth thing there was you have to not keep secrets from yourself. Now, the reason I bring that up there... Thank you. I had forgotten those four parts. Yeah, it was really beautiful the way you wrote about it in your book. And I think what you just said about yoga there

speaks to the first one there, which is number one, you've got to find a way to become calm and focused. So for people who are traumatized, if you're stuck, who won't go into certain parts of their body, who don't want to do certain poses or positions because it doesn't feel good,

it sounds as though what you're saying is that when people can find some sort of practice that helps them feel safe in their body, whether it's yoga or something else, that it's going to start to help them experience what does calm feel like? Because I guess many of these people don't actually know what it feels like to be calm even for just 10 or 15 minutes, right? I think what people mainly learn is how to cut off their feelings. Many people learn to not feel. And of course, psychiatry is very good at it also because things like Prozac make you feel less. Yeah. And so you get less overwhelmed by your feelings.

But by blunting your feelings, you also lose your capacity for pleasure and enjoyment. Yeah. So a very common adaptation to trauma is to just shut yourself down and becoming that uptight person that manages somehow to make it through your day but uh it's in order to recover you need to open up this pathways of self-experience and that you need somebody who really gently helps you to reconnect with yourself i think you published a study did you not on yoga and ptsd from recollection three of them three of them yeah yeah what do they show they show that uh if you do yoga for eight or twelve weeks that your ptsd scores go down we did some neuroimaging and we see some new linkages in the brain coming online particularly having to do with areas the brain having to do with self-experience, self-sensory experience.

And what the study showed is that when people do yoga, they are more open to being with other people, less frightened of being with other people, and less afraid of themselves, most of all. Yeah. Wow. Very, very powerful. It's interesting. But I want to say, it's really, then people say oh yoga is the answer no yoga was a paradigm that helped us to understand how engaging with your body in a particular way is helpful but it's not the final word on the story yeah i i love that i mean that is speaking to my heart. You're really touching on,

I think one of the big problems I see around today in terms of thinking about how we treat people with chronic health problems, whether it's trauma or anything else, it's like, what does that narrow reductionist study show? Oh, great. Oh, it works in that study. Okay, great. That means that's the treatment for every patient. And it's like, if you see real people with real problems, you realize that actually there's no one size fits all. Like for someone that might be brilliant, but for someone else, it may be, it isn't the right thing for them. But I feel like I say this a few times on the podcast. I think science is important. It's very important. But I think we make inferences and we draw conclusions

that we then think are applicable to all whereas as you say that just simply showed us that this paradigm here therapies like yoga which help us experience our bodies more have the potential to help so but you know in my, I meet a lot of people who claim that they do amazing things by doing, let's say, equine therapy, working with horses. And I say, interesting. And so I collect these people and on our website, the Trauma Research Foundation website, we have these people talk about their system sometimes. And then we do need the evidence. So then the next step is always for me to say,

let's help you to do a study where we can really see who it is effective for and who it's not effective for. I think evidence is terribly important, but we see in our field oftentimes that we close the barn door prematurely. We find that if a project works some of the time for some people,

say, oh, project is a treatment of choice. No, sometimes project works for particular people. Let's see for whom it works and for whom it doesn't work. Yeah, I love that. I think that's a really nice way of putting it. Moving on to another therapy, or I know when i've heard you speak before you talk about theater and movement you put those two things together and i i first of all i find it interesting that you put theater and movement together when you're when certainly when i heard

you talk about it but can you elaborate a little bit on what's so powerful about theater and movement and how it can help people with trauma yeah Yeah, I'd like to tease this apart a little bit. So the movement issue is terribly important, and that's not really part of how we think in psychology, psychiatry, or even medicine, but basically we express our aliveness through the movements we make. And when you work with children, for example, they explore their movement and their relationship of how their body affects the world around them and how the world around them affects their body. And many hypothesis studies over the past 150 years show that trauma oftentimes is related to physical immobility. When you get attacked by somebody,

it's very important to activate your fight-flight system and to fight and to punch back. But at the core of much trauma is people being unable to do something to change the situation. And so people go into a state of where the agency no longer matters. And so, and some very good studies in neuroscience also, Joe Ledoux has done some of that, that as long as you can move in response to a really challenging situation and do something, you're going to be all right. At the core of what makes something traumatic is oftentimes the inability to do anything.

And many traumatized people, as you, again, probably know as a physician yourself, tend to become very passive and tend to sort of ask us for pills and stuff to make their feelings go away, but it becomes very hard for them to do things and to activate their bodies. And so movement and doing something

that makes your body feel alive and capable is a very important part of being alive. Yeah, I've heard you speak previously about hurricanes that have happened, you know, big natural disasters. And you were speaking about the fact that, yes, a lot of people are affected, you know, big natural disaster has happened. But the fact that people are coming together, they're helping others, they're moving moving you were saying that in many ways that

helps them to process the trauma can you speak to that a little bit at all please exactly that exactly that we are you know we are an extremely resilient species and we are everywhere we have we're almost as good as cockroaches like human beings are very stress resistant and so we can adapt ourselves as long as we are doing things with other people and making things happen. We're building. We're homo faber. We're people who do things. And as long as you can do something, you get a sense of, yep, that hurricane sucked and I really miss my house and it's very terrible.

But my friends came over and helped me to build a house. terrible, but my friends came over and helped me to build a house. And wasn't it great that I was able to put a roof over my head again and help people to get supplies, et cetera. So doing something to overcome your helplessness is terribly important, actually. And of course, in medicine tends to be very passive. You have people go to a doctor and they have to be compliant with their doctor's orders. I don't like the word compliance very much because people really need to own what they do and experience what they do. Yeah. A few years ago, I wrote a book on stress.

And when I'm talking about stress to companies or to people or groups of people, to companies or to people or groups of people, one of the things I often say is that you've got to understand the stress response on one level is preparing your body to move, right? It's, you know, the predator, the lion, the tiger, whatever it was, you're getting ready to move. But if you're sat on your bottom and it's your email inbox that's stressing you out and your workload

and the fact that you're on zooms for 10 hours in a row your body is is getting primed and ready to move but because you're not moving that it almost gets stuck and you're not processing the stress energy that's built up yeah do you think that's accurate well i i think it's accurate i think it's a very very important issue in our current culture yeah we become more and more virtual living in virtual realities including you and me i really enjoy talking with you but if we sat in the same room together we would actually have a relationship afterwards yeah we don't really form this sort of bond that you ordinarily form with other people by interacting the way we do. And I think it's a major challenge for us to really look at the impact of that.

And I think it's going to have a major negative impact on us as human beings to become, to sitting on our butts and living through a virtual reality and virtual people. It's a very big issue. I don't think we know very much about it because it's a relatively recent phenomenon, but it's something worthy of a great deal of attention. It's really interesting as I think about your writings about trauma, about movements like yoga, for example, that can help us feel safe in our bodies. And then what we're just talking about the stress response, and actually without movement, we can't really discharge that energy. It's very hard. And I've been thinking about this for a few months now, it's very hard to not draw the conclusion that movement and exercise, whatever

you want to call it, for many years has been talked about through the lens of physical health. And I think we're now becoming more and more aware that yes, movement is very important for our mental health as well. But I actually think it goes beyond that. It feels to me as though if we're not moving our bodies in a whole variety of different ways, our bodies in a whole variety of different ways, we can't actually express and tap into our full potential as a human being, right? It's that important to who we are, I believe. Yeah, I'm with you on that. That's something that we get that sense of pleasure from being engaged with our body. Pleasure is a very somatic response. And I think people don't talk much about pleasure.

But I think pleasure is a very important part of life. You need to have a sense of, when I get together with a friend, like I did this weekend, and you have arguments about stuff, and you move together, and then you get a feeling of, wow, life is worth living.

Because I really made that connection with that person distance together with that person and the i i'm very concerned about the virtual world world that we're moving into yeah in that regard let's talk about theater yeah because we've mentioned you know yoga then movement in terms of really practical things that people can take away from this conversation, to go, oh, I wonder if this will work for me. I wonder if this is useful for someone in my life. Theater and Shakespeare that I've heard you talk about is fascinating. So tell us what's going on there.

How can this be helpful? Well, let's start. I'm a development person. I just spent some time with my grandkids, and they're always playing different roles. And now I'm going to be an astronaut, and they try it out. And now I'm going to be a hunter, and they try it out. And that's how human beings learn what it feels like in your body to have different roles.

What struck me with traumatized people is at some point, the identity becomes the identity of defeat. I used to be a warrior, but now I cannot move anymore. I used to be a sexy woman, but now I'm frozen in my body, or a sexy man for that matter. And so trauma sort of fixates people in a particular role in life which has to do with helplessness. And when I look at my kids, and then we have this wonderful theater

in the area where I live called Shakespeare in the Court, where they teach juvenile delinquents, who have all of terrible trauma histories, to play Shakespeare roles. And they get to feel, oh, this is what it feels like to be a king. This is what it feels like to feel powerful. This is what it feels like to be a murderer. And you get to, on a visceral level, experience the very different multimodality of ourselves and we get to really feel oh i can be powerful and that's what it feels like but you cannot be powerful

until you actually hold it in your body and so playing macbeth gives you a feeling, oh, that's what it feels like to be a warrior, a nasty person. And you can play these different roles and theatre helps you to really viscerally experience other ways of moving in the world than your ordinary habitual responses. Is it right that where you live, that juvenile delinquents,

when they're up before the judge, they're often given the choice between, you know, jail time or detention center time and learning Shakespeare? That's what's actually happening. It is doing. You learn sword fighting. And that's a very, very complex thing to do, is to learn to hold a sword. But once you do that, you feel like, wow, I can defend myself. I could really be a powerful person.

So you need to have a visceral experience of power and control that has been taken away from you by your trauma. Are we seeing that those kids then are improving? I mean, can you tell us any stories? What's happened to these kids? Because I think it sounds, I can believe that rashly. It's, you know, I think we all know, maybe we don't think about it,

but if you stand up tall with your chest puffed out, you feel completely differently. You feel powerful and strong. And if you roll your shoulders and compress your ribs, you feel a bit insecure. And I think we can get that. So it totally makes sense to me that, as you said, a lot of people who are traumatized get stuck.

They get stuck in, I guess, certain body positions as well, right? Yes, absolutely. Yeah, body positions of defensiveness, of collapse. And the way you hold your body, and you put it very well, because the research shows exactly what you say, is that when you put yourself at a position of, let's say, there's a body position that denotes joy. Every culture in the world, you raise your hands, you open your mouth, you open your ribcage.

And when you freeze people in a bodily position of joy and you say to them, now I want you to be angry, they say, I can't be angry as long as I stand like this, because in order to be angry, I need to stand like that. And so it's really important to honour that piece of knowledge by helping people to experience different states of being by the way you hold your body. So on that then, what happens? I love the idea that around the world, people, juveniles who have committed crimes, who've been traumatized, are offered this or other modalities as a way of rehabilitating

themselves, experiencing different feelings and sensations. How did it get to the point where the judge is now saying this? mean was were trials done was there you know growing evidence space what happened to make that a reality because that sounds really quite profound these things always start with individuals who are charismatic who convince some other people to work with them on something yeah so we always this always starts before there's evidence and i see this all over the world that wherever i've gone i see amazing programs done by charismatic individuals but then when the charismatic individual dies it becomes altered of something else the programs die yeah and so what i'm very much in favor of and trying to promote is when you have this good

method then we do the research yeah and we make it evidence-based but for example i've never been able to get money to do a tango study i've never gotten the money to uh see what choral singing does for people but i have a friend in russia who studied choral singing and showed what it changed how it changes the brain but as long as you're frozen in that treat that disorder then singing and theater and yoga and all kinds of other things may not cross your mind as being effective say oh that's that's woozy but so i'm very much in favor of people actually studying a whole bunch of different things and see how effective it is. Yeah, it's kind of what you were saying before about you may hear someone saying that equine therapy is working for this group of patients. So you're going, okay, that's

interesting. So you start off open-minded, you believe people and go, okay, that's interesting. Let's now study that. And I think that's what the scientific method should be really good for. We listen to humans and real people who are experiencing things, and instead of poo-pooing it, going, isn't that interesting? Why don't we try and get some real scientific validity behind that so we can expand it out? I think that's a really beautiful approach to take that would help so many more people see it's a paradigm issue and so right now if you're a psychiatrist or other medical person and you start talking about theater your colleagues will go he's gone off to deep end it's amazing how many people how many times my colleagues said oh he used to be quite

good but now he's studying yoga so he's gone off to deep end uh, he used to be quite good, but now he's studying yoga, so he's gone off the deep end. Oh, he used to be good, but he's now studying EMDR, this crazy method where you build your, oh, he's gone off the deep end. I've been accused of having gone off the deep end so many times in my academic career. And so most people are, most academicians want to be respectable and get money for their research. And if you go this route, it's not very likely that you'll get a lot of financial support. On an individual level, how did you cope with that kind of criticism? Because a lot of the things you're talking about are certainly things that are not conventionally taught to Western medical doctors. But how was it for you as a respected academic clinician when you started getting

this pushback? Well, I used to be a respected academic clinician when I studied drugs. I did the first studies on Prozac and Zoloft. And at that time, my star was high. But once you start doing other things, but that's a characterological issue. I'm just a guy who is curious, who likes to explore new things. And so respectability was not my most important thing in my life. And so character is destiny. And so I'm a person who likes to explore many different things. I'm a person who speaks several different languages. And so I can think in different paradigms.

And so that made it possible for me to look at different options. And that's just a question of character. Yeah. You mentioned EMDR. EMDR, of course, is another therapy that I've heard you speak about that can be helpful for certain people with trauma. What is EMDR? And can you explain a little bit about your experience with it?

When did you find out about it? What can it be helpful for? How do people do it? Do they do it themselves with a therapist? Maybe speak to EMDR a little bit, please. Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the

architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life, and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour, and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now,

journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision making and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are of course many different ways to journal and And as with most things, it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe

that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much this has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of the questions within the three-question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to

drchatterjee.com forward slash journal or click on the link in your podcast app. The EMDR is indeed a very strange treatment where you ask people to call up the stuff that really bothers them, but not to talk about it, to just say, remember what you saw, remember what you felt in your body, remember what you were thinking back then. So become aware of that. And then you ask people, so stay there. And you ask people to, you move your fingers in front of people's eyes from side to side. And you say, just follow my fingers.

Now, if there ever was a crazy treatment, that's a crazy treatment. And so my and everybody else's first reaction is like, that's bizarre. Don't listen to that stuff. And then some of my own patients who I'd worked with started coming back and said, I did an EMDR. And I see profound transformations. And some of my colleagues started doing it. And they showed me their videotapes. And I go, that's a dramatic change.

And so I see my patients and I see the videos of my colleagues. And I say, this clearly changes the brain in very profound ways. This clearly changes the brain in very profound ways. And being sort of a neuroscientist-oriented person, I became fascinated by studying what does eye movements do to the brain. It took us 15 years to get enough money together to begin to do that study. But I started off by doing a simple study comparing EMDR with Prozac. And it turned out that these eye movements caused a very significant change in most people. And so that was the first time I studied a method that didn't fit

in with the Western paradigm. And the Western paradigm is you yak or you take a drug. And now you did something else. And then from EMDR, I learned that things that don't fit in our cultural paradigm may work. And so then some other people say tapping acupressure points may be helpful. And I say, what's the evidence for that? There is no evidence for that. And then we study it, and it turns out that tapping

these Chinese acupressure points indeed seems to have an effect on people's physiological arousal. But EMDR was particularly important here for me, both because it was my first foray into something that didn't fit with the paradigm, and our results were extraordinary. We had a 60% cure rate with EMDR in a trauma sample. Nobody's ever received 60% cure, let all the symptoms were gone. And I think because it's so strange, it doesn't fit with our paradigms, many people tend to still poo-poo it,

even though the evidence how well it works is very clear. But so EMDR helps you to actually neutralize the memory. A part of being traumatized is that certain remembrances, certain events freak you out, make you upset. And what EMDR specifically does is those particular triggers to past events get calmed down and you don't longer get freaked out by the memory of particular traumas. And then people have a method and then they say, oh, let's use it for children who are chronically abused and in orphanages. I say, no, that's probably not the right treatment for them. So it's important to also know for whom it works and for whom it doesn't work.

And what we showed in our research is that people with longstanding histories of child abuse, it didn't work all that well for them, at least in the way that we did it. Yeah. You know, in your book, which I think, was it published in 2014 for the first time? Yeah, it first came out 2014. 2014, right? And I've got the page up in front of me. While we don't yet know precisely how EMDR works, the same is true of Prozac. And it's a very powerful paragraph that at the end of chapter 15, and it's a very powerful paragraph that at the end of chapter 15. Whereas that was, you know, what, eight, nine years ago now when you wrote that. So certainly when it was published, you probably wrote it 10, 11 years ago, that section. Do we now know how EMDR works compared

to when you actually wrote that book? Yes, so my colleague shireen her harzarian and ruth lanius and i did a study where we put people in a scanner and make eye movements and you saw that it activates certain circuitry in the brain and the circuitry in the brain that it particularly activates is the salience network the part of your brain that determines whether something is relevant or not. And so what we see with the people who lie in the scanner is that their brain organizes the experience in a different way by creating new circuits of experience. So it is not about understanding or insight.

You just sort of tweak the brain circuits in a way that helps you to not be overwhelmed by it you don't erase it but it becomes a memory yeah so so a traumatic experience is not a memory because the moment you go there you relive it and that's the nature of traumatic stuff if if you have been raped you get really upset thinking or talking about your rape, but it is not a memory of something belonging to the past. It's you currently, right now, recreate the physiological state of that past event. yoga and neurofeedback and our psychedelics all seem to help us to do is to go there and to reorganize our perception of it and become aware on a very deep level of this happened to me back then it's not happening right now and so some circuits in the brain change that allow you to put it in the past to say yes it happens it happens. It was awful, but I'm not

feeling it today. Yeah. Yeah. Very clear. Very clear. Thank you. Would you say EMDR should always be done with a therapist? And the follow-up from that is there's a lot of what are called EMDR music tracks available now on streaming platforms, which know people like listening to i don't know if you have any experience of the music what it might do for people is that something quite different from what you're talking about in terms of seeing a seeing an emdr therapist to take you through that process i wonder if you could speak to that a little bit please interesting actually i cannot speak about it because i have not studied that. And see, I'm so aware that trauma is about shame and about being disconnected from other people that I actually love the work of joining somebody and helping somebody to deal with it

in the context of a relationship with somebody with whom you no longer are ashamed about what happened to you. So I'm not really a fan of mechanical devices because a lot of recovery from trauma is to re-establish your capacity to connect with the people around you. But that's my particular prejudice in a way. Yeah, I probably would have that slight bias as well in general. And I do want to get to psychedelics and neurofeedback that you've just mentioned. But just to sort of close that loop a little bit, yoga, which we started off talking about when we talked about the sort of things that people can do to heal from trauma,

I guess you would encourage people to do yoga as part of a group rather than by yourself on YouTube, right? Yeah, absolutely. I'm really impressed. I'm not a natural yoga person, but if I'm in a group with other people who are much more limber than I am and do a much better job, I sort of absorb their limberness and I enjoy doing it with other people. I think that's true for many things. Psychedelic therapies also these days, we

sometimes do psychedelics in groups. And I like it a lot because you experience it. I have one particular experience and you have a different experience. And then you really get to see that I'm part of mankind and I'm holding something that we all hold in different ways. And I think the feeling of emotional isolation or the word I used in the previous book a lot, not in this one, is the feeling of being God-forsaken. It's a very important part of trauma. So I think doing it in groups of other people adds a dimension of humanity to the whole thing. Yeah. And just before we get to neurofeedback, just on that point, talking about the Western medical system and how it's set up,

it's very individualistic. We see a patient in isolation, we say, this is what's wrong with you, and this is what you need to do. And I touched on this in my last book a little bit, that maybe we've got the whole setup wrong for certain people, because there's a movement in the UK called social prescribing that's growing massively where people are healing in communities. They're going to, let's say, cooking classes or reading things. There's something called park run in the UK where people go every Saturday morning in all the villages and towns, maybe 50, 100, 300 people get together and they complete 5K together. Some walk, some run,

but it's a very community-orientated environment. People are healing in communities, not in isolation, which I think really speaks to what you're talking about. We're all watching the British baking show around the world of people cooking together, making food together. And it's interesting, this point.

So when trauma was sort of reinvented or rediscovered, I like to say Boston was to trauma, but Vienna was to music. We had a group of people in Boston like Judy Herman and Eli Neuberger and Terry Keane and other people who all were deeply into trauma. We talked to each other. And our initial treatment was always group treatment, because we didn't know what it had been like to be raped or to be a Marine in Iraq or Afghanistan, but they did. And so we found that getting people in a group who really had been there decreased people's shame and also gave a lot of recognition to people.

It is actually quite horrifying to me how group treatment has sort of become a very tertiary treatment. Of course, in the addiction community, group treatment, self-step programs is still central. And the sense of community of people who have had similar experiences is terribly important and and i'm actually sort of pushing people to go back to do much more group treatment where if let's say you have been molested and you deal with it by cutting yourself it It's shameful to cut yourself. But when you're in a group of other people say, you know, when I get really upset, I cut myself

or I put a burning cigarette out of my arm. Other people don't go, you should never do that. You go like, oh yeah, I cope in the same way. And I also feel very embarrassed about it. But what does it do for you? It actually helps me when I do that. So you have the potential of meeting people who are much more understanding about what you go through

than somebody who's gone to medical school. Yeah, no, 100%. And they can all help each other, of course, probably in a much more powerful way than a doctor or a healthcare professional who's never experienced that um neurofeedback what is it i know you think it's or you've shown that it's a it's a powerful therapy potentially for people suffering from trauma can you explain what exactly

it is does it help us rewire our brain who is it helpful for all kinds of things like this so so neurofeedback is a method that you can put electrodes on people's skulls and our technology is good enough right now that despite the fact that the skull is quite sick you can actually harvest these electrical brainwaves that are underneath that skull and by putting a number of electrodes on people's heads, you can project the brain's electrical activity on a computer screen. And you can sort of see what part of the brain is talking to what part of the brain and what is most active and what's most inactive. And we have pretty good ideas about what sort of electrical activity helps with optimal

functioning. sort of electrical activity helps with optimal functioning. And oftentimes when we do this, what's called quantitative EEGs on traumatized people, my reaction is, oh my God, how can you have a life for yourself? Because your brain is really messed. I don't say it to people, but you see some very serious disconnection

between different parts of the brain, which people can sometimes compensate for. But by having a map of the brain, which people can sometimes compensate for. But by having a map of the brain, you can say, okay, you can now play computer games with your own brainwaves, where whenever your brain creates the sort of brain connections that are good for you, a little color changes or some music changes. So you play back feedback to people's brains of that's good. And if you don't make the right brain forms,

sort of brain forms that make you angry or hyper aroused, you don't get feedback. So you can sort of subtly give people a little sensory feedback through sounds and images of, yeah, make more of that. So you can train the brain to make different connections. It's not a trauma treatment. It's a brain organization treatment. I'm astounded that this is not done more widely and more often because it makes a lot of sense

from a scientific point of view is that you can actually visualize these things and you can actually sort of nudge the brain to organize itself in a different way. And so what's been stunning to me is that there's a guy in London, John Gruselier, who's done good research, some people in Belgium, some people in Germany, and Ruth Lanius,

and we are among the few people who actually have studied this brain-computer interface methods. I think it's enormously powerful. We have done studies with kids who are just completely off the wall, unable to go to school, unable to learn. We can calm their brains down so they can actually focus and not get out of control. So this can be for many of us with depression, anxiety, chronic stress, kids who feel out of control. It's just a way of harmonizing yourself a little bit with your brain, right? Yeah, right.

And my dream is that every school in America has a neurofeedback system and a neurofeedback capacity. So when kids come to school and they're just off the wall and terrified and angry because they have all these experiences they have just had at home, that you can help these kids to calm their brains down so they can actually learn and get along with other kids. I wish every medical clinic had neurofeedback it is such a nice simple way of just helping you to smooth out your brain functioning yeah i like you i'm a fan of people healing with others in real life you know i get

it there's a lot of great tech out there to help, but I think we've got to be not too reliant on that web host or make sure we're experiencing things in the real world. But there are some apps I think now where they help with things like coherent breathing and you can, you know, they can help you harmonize various parts of your body and your brain through different methods. So I think technology is going to potentially revolutionize this. Have you experienced that as well? Have you come across apps like that? Oh, absolutely. And I know those apps and actually have those apps on my phone. But I'm also impressed with is how I don't use them. Even though I know how helpful it could be. And sometimes I do get a little unfocused or whatever.

And what I'm impressed with is that if a friend of mine calls me, are you going to come to this class? Are you going to go for a walk? That that's rewarding enough for me that I will actually do it. But apps in and of themselves, most people just don't love their apps to say let me just the international interpersonal process is still a very rewarding part so so doing it in a group of people who say where were you last night when we did this uh uh that's who we are as human beings

do you know what's really interesting, Dr. Vandeko, because if I, this is not relating to trauma at all, but a few months ago, I spoke to this chap called Elliot Kipchoge on this podcast, the Kenyan marathon runner, the only person to have ever run under two hours in a marathon. He's considered the fastest marathon runner of all time. And it was a beautiful conversation with him about all kinds of things. And one thing he said, well, many things, but one particular thing really struck me. He never trains alone, ever. He never goes to a run alone. Whereas in the West, we often run alone where

we do it to de-stress or unwind by ourselves. He goes, no, no, we always run alone. Whereas in the West, we often run alone where we do it to de-stress or unwind by ourselves. He goes, no, no, we always run together. And he says, if you're not showing up or your motivation's not there for a few days, one of your buddies is going to be on the phone and say, hey, Elliot, where are you? What's going on? Is everything okay? And it really struck me how much culture plays a role here. I thought, wow, this incredible athlete, the fastest marathon runner on the planet, never goes for a run by himself. It's always in a group. Yeah.

And I think that's who we are. You know, I just was lucky enough to go to the Serengeti Plains. I got to see all these animals. They're all living groups. You know, mammals live in groups. They're all living groups. Mammals live in groups. Human beings live in groups. That's how we define ourselves.

That's our identity. That's our reward system. And there may be people out there who just love their little apps, but they don't know many of them. And the apps are really quite wonderful. Yeah. But I guess you wouldn't know them because they're at home on their apps so you wouldn't be interacting with them potentially but i i think it's a very very important point we must just briefly touch on psychedelics you mentioned group psychedelic

therapy and of course psychedelics are getting a lot of media they're all the rage um they're still illegal of course in many, I have to say that. Where do you stand at the moment on the use of certain psychedelics as a treatment or as part of the treatment for people suffering from trauma or other mental health issues? What does the evidence say at the moment and who do you think it might be useful for and who should be cautious would you say so luckily this is not just an issue of opinion my lab actually does psychedelic studies and i'm really very happy to be part of this burgeoning thing and we do be a part of the studies and uh one of my papers will come out with specifically about what psychedelic can do on the basis of research. And so I have a license to give MDMA, ecstasy, to people and part of the larger study. That's almost done.

And so I have good data. And the only psychedelic-like substance that's legal in America right now is ketamine. And I'm involved in training people in ketamine-assisted psychotherapy. So I know ketamine quite well. I know MDMA quite well. I don't know psilocybin from a research or personal experience well, but we all talk to each other. And I see the beautiful work that's being done started at Johns Hopkins.

And let me give you an example. A friend of mine who is a very major person in the trauma field and a person who we all deeply love developed severe cancer eight years ago, and he was angry, bitter, as one would be when you hear the diagnosis. He joined the psilocybin study at Hopkins and I visited him and he started to cry. He said, it's an amazing experience. My friend doesn't have a mystical bone in his body. And he said, I was blasted in the universe. And I had these visions of little villages with smoke coming out of the chimneys.

And all my ancestors were there. And they were waving at me and said, hi. Yes, good to join us. We are all here. And we all die. And it's part of life. And my friend had this mystical experience. And he accepted his death.

Except he's still alive. Eight years after we all thought he was going to die, which really makes me very intrigued. We really should study whether the psychedelics change the immune system to actually change some of the bodily stuff. This is an interesting issue. But what happened to my friend Frank was a very important inspiration for me to look at how psychedelics can be helpful. And one of the reasons that I got intrigued with it is, of course, I'm from the 60s generation. I had good experience with LSD when I was a young man and then became all straight and have done it for a long time. But I do remember from taking LSD back then is how it opens up your mind and it makes you aware of that the reality that I've constructed for myself is just a very small part of the overall reality that surrounds us. And you become really aware of that your reality is your own personal construction.

And by having these psychedelic experiences, you see that the universe is much larger than the universe that you actually live in. And that's actually what we see when people do psychedelic therapy, is their mind becomes open to new possibilities, to become more curious about exploring new things. I have a number of friends who are very famous scientists, and I've asked all of them, they're all about my age, I said, did you take LSD in college also? They said, yeah, of course I did. I said, how do you think it affected your career?

And every one of them says, you know, I think I became a good scientist because the psychedelics made me realize that the reality that we have defined for ourselves is just a small part of what there is. And it made me a more open-minded and curious person. Yeah. And that's very much what we see in our psychedelic treatments, that people oftentimes go into their trauma and it's no picnic. It actually can be very painful. People may lie there and cry and say, oh my God, oh my God. But it opens them up to actually see themselves

and to visit themselves. And what our research shows, it will come out before too long, is that the psychosis leads to a dramatic increase in self-compassion. And that people really feel for themselves and have a feeling of compassion for themselves. It also makes people much more aware of who they are. It also makes people more aware of who they are it also makes people more aware of how who other people are so they're much better able to negotiate interpersonal conflicts and interpersonal relationships because they really get exposed to a larger reality that they ordinarily are locked into

so so for a person who has suffered trauma when they go through a psychedelic experience, let's say in your lab or in your studies, it opens up their mind. They see that the story they've constructed is just one story. There are multiple other stories they could construct around that. And other dimensions also. Visiting your trauma gets you always stuck because your body keeps a score.

And the moment you go back there, you feel that agitation, you feel that terror, and you want to get away from it as fast as you can. And there's something about both psilocybin and ketamine and MDMA, because we have seen it in all three, that allows people to go to these dark places and to not get engulfed by it, to not get hijacked by it and to plunge into a traumatic state,

but to also get to feel different dimensions and to understand things in a different way. Yeah, and that self-compassion piece you mentioned, of course, very, very important for any healing is if you come out of that feeling more compassion for yourself, less shame, less guilt, of course, that's going to help in anything further that you do. Are there any downsides, you know, as these things become more and more in the mainstream and people talk about them and, you know, more and more people are trying psychedelics

and of course there's plenty of good research showing how helpful it can be can it be harmful for some people you know i'm so glad you bring this up i tell my colleagues we are in the honeymoon phase and so i have a team of people who are 20 30 years younger than i am and they say we're part of the revolution and i say to them you're part of the second revolution. Because I had Timothy Leary's old office at Harvard at some point. Wow. I was the tail end of that last revolution. And that revolution collapsed, in part because of politics,

but also in part because people got way too careless and really got out of control. And I'm really afraid that things will get out of control again. These are very, very powerful substances. The way we do our study is extraordinarily careful. We get to know people really well. They have two therapists who are with them the whole time. Set and setting is everything. We have relationships with the people who we treat, and they feel safe with us. And so right now in our study, we just opened up the second study. First one was 91 people.

The last one is 103 people. And again, we have no significant side effects. But we have no significant side effects, but we have no significant side effects because we pay so much attention to certain setting. And what you see already as there's money at Dandar Hills, you can go to a catamen infusion clinic where you go to a little cubicle, get an infusion, and nobody is there with you. And you can ring a panic button if you become really upset. That horrifies me. Blowing your mind is a potentially very dangerous thing,

and very painful and horrible things can become manifested, and you need to really create a very careful container for it. Yeah, thank you. I'm worried it will blow up again. Yeah. Yeah. I just would love to just think about

what can trauma teach us as members of a society? Because you said something very profound once. Victims are members of society whose problems represent the memory of suffering, rage, and pain in a world that longs to forget. You know, when you quoted me, I always go like, I wish I had written that. It's so good. And then it turns out I had written it.

Yeah, I mean, they're your words. And I think they are so profound because look let's be really clear trauma traumatic experiences are horrible they're causing all kinds of problems to people hopefully the conversation we've had the work you are doing is going to help people first of all become aware of that and then start to make changes, maybe some of the modalities we've already spoken about. But I do wonder, what can we as a society learn from trauma? Traumatize individuals. Is there any upside? Is there anything that, for society, is that... I've got to be very sensitive how I say this, but I'm just saying every bit of adversity in life tends to have an upside at some point, whether we're ready to see it or not. And I just wonder with all your

experience, are there any upsides and what can we learn as a society from looking at people suffering from trauma? I think the big message is people generally do the best they can yeah and that's very important and so one of the things that's very gratifying about the work that i do i see a lot of people who have gone through experiences that i cannot imagine having been able to survive and you see what people have done to survive and they may have done weird things like become addicted to heroin in order to survive, but it was their way of survival. And so I think what trauma really teaches us is that people do the best they can to survive and that being punitive and nasty to people who do things that you don't like

is probably not the best way to help them. And that you need to really, it's very important that people do get traumatized if you yell at them, if you scream at them, if you put them in seclusion, and to become aware of the potential damage we can do to each other, but also how being heard and being in connection with people is terribly important for all of us at every stage of our lives and that uh that to honor people's reality also yeah i think many of us are familiar with certain pieces of art or songs or some just quite beautiful pieces of music that have come from trauma. So yes, that individual has had extreme pain and suffering, but what has come out of that has brought such joy to so many people. I don't know why. Again, I'm very cautious as I say that because I don't want to at all come across

as someone who is undermining how painful those experiences are. I'm just trying to maybe at the end of this conversation leave a slightly uplifting sort of tone there. You know, this is not a scientific statement, but I think most really truly innovative things in our world are discovered by traumatized people because they live in a world that's unbearable. And so they have no choice

but to find new ways of coping with things that is different from where they live, because if they would keep doing the same thing, they would die. A great example is Isaac Newton, the greatest physicist who ever lived. And you read his biography. This guy had the worst possible childhood. And so he hid himself into mathematics and physics, and that was his safe place that allowed him to create things. J.K. Rowling, the author of Harry Potter, she was a very traumatized person who, I don't want to go into details, I've never met her, but she was a very messed up traumatized person until she

started to put it together in these Harry Potter stories that actually come from the visions of a traumatized person. And she gave this unbelievable gift to the whole world of people to be able to imagine new possibilities. And you see this over and over again. And part of the pleasure of my job is when I really get to know people, I get to see how they have found their particular ways of surviving. They don't all become like Isaac Newton or J.K. Rowling. It's still an exceptional talent. But traumatist people have new ways of pointing things out to us.

We can learn from them. Dr. Vandeker, you are doing a great service to the world. All your work, the book, literally, it's such a phenomenal read. I can see why it keeps selling year on year and it keeps spreading through word of mouth. It's absolutely incredible. Thank you for making time. Thank you.

You know yourself also. I'm really impressed with the depth of the questions you asked me. I really for making time. Thank you. You know yourself also. I'm really impressed with the depth of the questions you asked me. I really, really liked it a lot. Oh, thank you. I appreciate that. Just very, very finally, for anyone who's listening right now or who's watching, who feels stuck in their life, who feels the way that they are right now is the way that they have to stay,

the way they have to remain, and they feel no hope, no possibilities for the future, what would you say to them? I would talk about what might be available. Have you tried yoga? Have you ever seen a choir? I always take very careful histories about when did things work for you?

What were you doing when you did not feel this way? What sort of relationships were you in? And I try to help people to not only remember the horrors of the past, but also that kid a long time ago who was able to do this and who copped somehow. And to really revisit yourself as a survivor, to see what has worked and what hasn't worked, what gave you a glimmer of hope. And then to look around in your environment, would sing in a choir work, would do martial arts work, would going to a yoga studio work. To really look at what it is in your culture that might help your body to feel at home or safe or a feeling of pleasure and engagement. Dr. van der Koop, that's the coming of the show.

Thank you very much. It's a pleasure. Really hope you enjoyed that conversation. As always, do think about one thing that you can take away and start applying into your own life. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I've been consuming,

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