Modern Wisdom - #736 - Dr Paul Conti - How To Fix Your Negative Inner Thoughts

Episode Date: January 25, 2024

Dr. Paul Conti is a Stanford and Harvard trained psychiatrist and author specialising in unconscious trauma. If our mind was an iceberg, our conscious thoughts are the tip, and the huge mass below the surface are our unconscious thoughts. Dr Conti's research works on bringing the, forgotten, traumatic, painful and unseen into the light so you can heal and improve. Expect to learn what people mean when they refer to the unconscious mind, what Paul wished people understood about how trauma works, whether ancestral trauma is something that can actually be passed down through genetics, what happens to your brain and body after experiencing trauma, what we can learn from the little voices in our head and much more... Sponsors: Get 20% off all Momentous orders and up to 32% off new customer subscriptions at https://livemomentous.com/modernwisdom (automatically applied at checkout) Get the Whoop 4.0 for free and get your first month for free at https://join.whoop.com/modernwisdom (discount automatically applied) Get $150 on everything from The Cold Plunge at https://thecoldplunge.com/ (use code MW150) Extra Stuff: Get my free reading list of 100 books to read before you die: https://chriswillx.com/books Try my productivity energy drink Neutonic: https://neutonic.com/modernwisdom Episodes You Might Enjoy: #577 - David Goggins - This Is How To Master Your Life: https://tinyurl.com/43hv6y59 #712 - Dr Jordan Peterson - How To Destroy Your Negative Beliefs: https://tinyurl.com/2rtz7avf #700 - Dr Andrew Huberman - The Secret Tools To Hack Your Brain: https://tinyurl.com/3ccn5vkp - Get In Touch: Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact - Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello friends, welcome back to the show. My guest today is Dr Paul Conti. He's a Stanford and Harvard trained psychiatrist and an author specializing in unconscious trauma. If our mind was an iceberg, our conscious thoughts are the tip and a huge mass below the surface are our unconscious thoughts. Dr Conti's research works on bringing the forgotten, traumatic, painful and unseen into the light so that you can heal and improve. Expect to learn what people mean when they refer to the unconscious mind, what Paul wished people understood about how trauma works, whether ancestral trauma is something that can actually be passed down through your genetics, what happens to your brain and body after experiencing trauma, what we can learn from

the little voices in our head, and much more. This Monday, brand new episode with Alex Hormozzi, three hours long recorded in Vegas last week, goes live. And the only way you can make sure you won't miss it is by pressing subscribe, so go to Apple Podcasts or Spotify and press the button. Thank you. You might have heard me say that I took my testosterone level from 495 to 106 last year, and two of the supplements I used throughout that were Fidogeo Agrestus and Toncat Allee. I first heard Dr. Andrew Human talk about these really impressive effects that tons

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Go to plunge.com to get your cold pl and Sauna today with $150 off your purchase by using the code MW150. A check out that's plunge.com and the code MW150. A check out. But now, ladies and gentlemen, please welcome Dr. Paul Conti. What are people talking about when they refer to the unconscious mind? A lot of times people are talking about a mystery that they kind of know is within them because it gets talked about, but they're not sure how much of an influence does that have over me.

Like, is that me? But I'm not aware. Do I know who I am consciously? But then there's other things in the background. And I think often it can be confusing and even scary if we don't understand what does that mean. How does it have control over us if we think like us is the conscious part of us

and how can we have control over it? Yeah, it's strange to think, what does it mean that there's a part of me I'm basically entirely unaware of that somehow influences me in ways that I can a part of me I'm basically entirely unaware of that somehow influences me in ways that I can become aware of. Right, right, right. And that's why the sort of height of understanding ourselves through the lens of understanding all aspects of the mind, including the unconscious mind, includes an awareness of some of what's going on there but also an awareness that we're not aware of it all.

Yeah, it's a little bit of a paradox. Why is it so important? Is there an analogy? Is it like the surface web and the dark web? Is it 99% of ourselves are unconscious and only 1% of us is conscious? and only 1% of us is conscious? Well, far more of us is unconscious than conscious, far, far more of us. So the iceberg model where our conscious mind is a little part of the iceberg that's above the water, but the vast majority of it is underwater, we need that in order to be able to move through time. You know, just like say a car engine might be, you know, rotating several thousand revolutions per minute, right? We're not aware of several thousand revolutions per minute. We're not aware of all those revolutions, but that needs to happen for us to seamlessly be able to maneuver the car forward.

In a far more complicated way, that's going on inside of us, where there are thousands upon thousands upon thousands of calculations that are going on so that we can sum things and come up to the consciousness where we can then make conscious decisions. So even the idea of, say, walking down the street and seeing someone walking towards you, right? There's so much that then goes on. What does that person look like? Does that person is a person looking at you? Are they looking down?

If we're looking at you, do they look happy? Do they look not happy? Do you recognize them? Do you not recognize them? Are there markers of threat? Are there not markers of threat? We're doing all sorts of things and let's say that person looks like someone who had been aggressive before, but it's not that person. Then we're triggered to have an extra sense of anxiety and tension that all that happens automatically. Then we have to say, okay, but it's not a person

who's been aggressive before, but it all goes on in us in a way of kind of bringing us up to speed with that moment so that we can make whatever conscious decision we're making. So the conscious decision could be walk to the other side of the street or say hello or look down. You say, oh, you're just doing one thing. You're doing one thing because it's riding atop thousands upon thousands of things that let you in the conscious world, so to speak, do the one thing

that choice that there is to make. There's obviously lots of other unconscious things that go on, the impetus to breathe in and breathe out, the impetus for our body to digest the food and for our heart to pump and all the rest of the things. But presumably there are certain things that are more salient to our day-to-day experience, especially phenomenologically, what it feels like to be a person in the world with thoughts. There are areas, I don't often think about my digestion unless I've got something wrong,

but I do think about that person or that situation that's kind of similar to one that's from before and made me feel a little bit like I might not be liked by people and what does that mean for me now? And there's, yeah, there's like a triage. There's a priority list of things that are salient to you. Right. The key word there is salience. Right. Because in fact, we could put two S's here. It's safety and salience. So our brains want to keep us alive. So we want to be safe. And what is salient will be determined by that. Like if we're safe, we can think about other things. We can read a book. We can relax. We can have a podcast. We can do whatever we choose to do when we're

safe. But safety has to come first. So as you said, you're not spending a lot of time thinking about your GI system. But let's say, you know, we hope there isn't, but let's say there's some problem. Now it's going to tell you that, right? You're going to have pain and the pain is going to make your GI system salient. Then you think about it. But if there's not a risk that's coming from it, it stays in the background. So first and foremost, our brains want to keep us safe, which is why the triggering of negative

events of trauma becomes so salient. So the example I often give is the imagine we're hunter gatherers, and if we're hungry, and we go out and we find a new berry to eat Right if that's tastes good and it's nourishing. It's really good to remember that Let's say it makes us very very sick then we better remember that right we have to remember that so there's more salience To negative things things that are charged with negative emotion because those are more commonly about safety, which is why if you see someone who looks like someone you've had conflict before,

it triggers all sorts of reactions in us. Same thing if a person has been in a car accident, then gets in a car. I talked to someone this morning who had a very difficult event, happened 24 years ago and was saying, but when he's in that similar situation, which in the course of his work, he is on a daily basis, he feels as if it was a moment ago because it was very, very distressing. It's immediate to this person, even after 20-something years,

because it was about safety at the time. And the brain does not want to let that go. It wants reassurances that we're safe before it lets those things go. That's why trauma and traumatic stimuli are so salient in us. And so dominant in the unconscious mind because first and foremost, it wants to keep us moving from this moment to the next moment, which means we got to make it to the next moment, so we have to stay safe. I was in a head-on collision when I was 20 or 21 years old at 60 miles an hour with a snow plow on the main British motorway in the UK.

And for the next probably six weeks or so after that, maybe even more, maybe like two months to three months or so. Every time that I was close to contra-flow traffic, so traffic coming in the other direction on the side of the road, near the side of the road that I was, where there wasn't a barrier between us, I felt anxious. It's like, I guess it's like stubbing your toe. You don't realize how often things touch your toe until there is a hypersensitivity around it. I didn't realize how often I was five feet away from another vehicle coming basically head on toward me until I'd been hit by a snowplow at 60 miles an hour.

Right. Then you're rain of all the things that could be a risk to you. Your brain says, that is a risk to me. Oncoming traffic is a risk to me. And then it becomes very, very sensitized to it. And if you're having intrusive thoughts and a high level of vigilance, that's when it can become problematic.

You said, for some period of time, a few months, then it sort of settles back down in you. But that makes sense, right? And it may be that you change behaviors or you don't change behaviors. You know, it's like, I don't want to be on, you know, roads with fast traveling traffic. You know, you might change behaviors due to that,

but your brain is bringing it to the forefront because in some ways it's saying, is this okay? Does this really make sense to do? Now, even if you decide it does make sense to do, even though something bad has happened, your brain is gonna persist in ways because the trauma has such a Deep emotional resonance our memories don't have meaning in and of themselves They're brought to life by the emotion that's attached to them. So if we had asked you a

week before Person going one way in traffic and a vehicle coming the other way hits them. They're like, okay, that doesn't sound great, but it's not going to raise a lot of emotion in you. Let's say we asked you one week later, it will raise a huge amount of emotion because now your brain says of all those risks to me, that is one that is salient and then it'll want to sort out should you change behaviors. But sometimes even after that goes away, that question, and you've made an answer to it, it can linger on in the brain and be hanging on the person and the situation and the specifics for years and years and years with the rest of a person's

life, which if you think from the perspective of safety and salience, we can understand why. But also, that's not the way we want to be living life. If we understand safety, salience, the unconscious mind, how our minds work, then we can change that. And say, I don't want that thing to carry along with me just because something bad happened. I understand what happened. I'm making decisions about it. I don't need my brain to continue

to shove that to the forefront. It seems like the important thing here is bringing the unconscious into the conscious. How do you do that? What does that mean? Well, oftentimes there are other ways we can come at it too. Sometimes there are specific tactics

around decreasing symptomatology. So there are other ways of coming at symptoms we may have on the mental health front, including symptoms after trauma. But a big part of what we're doing is what you're saying, is to be aware of what is in the unconscious mind, and to be able to bring it to consciousness. So a lot of times, if the brain is saying,

you're not safe if you're in a car, going and coming at oncoming traffic. You are not safe, you are not safe, you are not safe. It's going to say that over and over unless you can validate. Hey, let's bring that to consciousness and say I understand why I feel that way. I understand why that is that is in me and I am aware of it. And then that enables a set of processes. Some of them can occur through therapy. Some don't have to though where you get your mind around it so to speak. And then your brain doesn't have to continue to push it to the forefront. I mean, that's what trauma therapy is doing in some sense, but it doesn't often require therapy. Sometimes it does. But bringing the unconscious to the conscious mind

lets us have much greater control over it, including often validating, hey, I know why that's in me, like, thank you in a sense, brain, but I don't need it at the forefront. And it's remarkable how much like that works. I mean, it's part of what trauma therapy is, and it can take symptoms and decrease them through insight. What do you wish more people knew about trauma? I wish that more people knew that it comes so frequently to so many of us and that it is insidious and the meaning of that word, like something that is sneaky

and like a wolf in sheep's clothing. Like it doesn't announce itself that I'm now in your brain and changing you, including changing your memories. So, and I not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything.

I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I'm not going to be able to say anything. I never felt safe in a car. I don't like driving. I don't feel, could conclude that without it being true. Oh, so they've retroactively gone back and changed their memory of situations prior to that trauma as a compensatory mechanism,

as a story they tell themselves? Well, it's a way because the brain is gonna paint with a broad brush. If we're not bringing the trauma to conscious understanding, then it's saying it's a very simple conclusion, right? Being in car, coming at opposite traffic is not safe. Right? And that's all the brain knows.

Like we got hurt doing that, so we can't do that anymore. So it'll bring that to you and the emotion is so strong that it can color the old memories saying, but you never want to to be in a car anyway. Right? You never felt comfortable. In fact, you don't even want to travel places. Like it can bring these things to the surface. It's remarkable how many people will say, I never had faith or confidence in myself.

I never thought I could do well at my job. I never thought I was smart enough. I never wanted to get out of my hometown. I never wanted to be in a relationship. People say, but when you talk to them, that's not true. I mean, I'm saying it's always not true, but in many, many situations, it's not true. It's the brain trying to keep them safe,

but that's where the brain will... Like, I'm exaggerating a little bit. Like, have you hiding under the bed all day to keep you safe? Right? When that's not what we want. We want to be able to keep ourselves safe. So maybe if you were in the accident when the road conditions were poor, that's why a snowplow was out,

you might say, look, I don't want to be going against oncoming traffic. If it's the speed is more than 30 kilometers per hour, whatever it may be in bad conditions, like maybe you learn that. And you're like, you know what, I take that away with me and I'm gonna change that. You might conclude that. Or you might

conclude not that, but you're concluding something that tells your brain it doesn't have to be lost in that trauma. Now for you, it sounds like it went down after some period of time, but for some people it doesn't until it's processed. Like again, a person I saw earlier today, 20-something years ago, it is still with the person as if it were yesterday. And I see this many days, not just that I happened to see that today. It's like I see that a lot, which is why I had a conversation about it just this morning. So insidious, more frequent than people think, more persistent than people think? And changeable.

And not set in stone for the rest of your life. It's not hardwired in us. We don't have to be afraid of it because trauma triggers a reflex of guilt and shame. So if we are traumatized, there is some reflex and I don't know if you had that after your trauma people. So I shouldn't have been where I was when someone attacked me or when there was an accident. Now sometimes we may have some bear some responsibility, but that's

different than a reflex of guilt and shame, which tells you shove the trauma down below. Don't look at it. If you look at it, well, Lord knows what you will find. If you look at it, what's the function of the shame and the guilt? What's the function of the shame in the guilt? So the function is probably around behavior modification. Again, it's all theoretical. But if you think about psychological history of humans and even anthropological psychology, like how humans develop, that we have what are called affects. And I don't want to get too off into the weeds, but neurobiologically, there's a difference between affects, feelings and emotions. And affects are just aroused in us. Like if you're just walking down get too off into the weeds, but neurobiologically, there's a difference between affects, feelings

and emotions. And affects are just aroused in us. Like if you're just walking down the street and someone jumps in front of you and shoves you, you're going to feel anger or fear or both before you know it. Think about that. You're going to feel anger or fear or, but it'll be coursing inside of you and then you become aware. Why? Because affects are create they create change in us if someone just jumps in front of you and shoves you or

yells at you you better be ready to fight to flee right you boot up all these systems and then you're aware. So these very deep affects in us very very primary, fear, love, joy, shame. They anger, they're created in us in order to protect us. So, shame is very, very powerful for altering behavior. So, imagine if you're in small groups of people and you've got the food inside the cave and you close the cave door, and then somebody wakes up in the middle of the night and eats a bunch of the food. The rest of the people may make that person feel ashamed, right? Or they're doing something that makes the supply at risk.

Where people are relieving themselves is to their food. Then shame is a mechanism of change. Don't do that and don't do that again. It puts you at risk. it puts others at risk. So it has a very strong impact upon us, but it gets harnessed in ways that are not about survival. We're not living in a hunter-gatherer society where if you and I go foraging for berries

and we almost die, we better never forget it. Right, it's different from that. We live longer lives that are much more diverse and can be impacted by shame in ways that can have a person who was attacked by someone else decades ago with no fault of their own still feeling guilty that they were attacked, ashamed that they were attacked, and deeply altering their behaviors because of that. That's survival mechanisms hijacked in a way that shuts down people's lives. And trauma does not have to have this kind of control over us. But in doing what I do for a living, I've seen, whoa, the greatest external

control mechanism upon us is the one we don't see that alters even our memory. So we don't even recollect accurately. Wow, that's so interesting and it's so crazy to think that scenarios we go through become interpreted by ourselves and woven into a story that we tell ourselves about who we've always been. Right. about who we've always been, then the incident that was the genesis of that is not forgotten, but it being the genesis of it is forgotten. And it just becomes a part of us. And then people will begin to identify with that. Oh, that's me. That's how I've always been. I've always been an X or a Y or a Z person. And if you, we all know how much people try to defend their egos and their personalities, if you try to say, well much people try to defend their egos and their personalities.

If you tried to say, well, you know, why don't we go away on holidays? You know, I don't like going away on holiday. I've never liked going away on holiday. No, you had a very turbulent flight when you were seven years old or 13 years old or 25 years old. And this landing came in and you told yourself a story that you no longer want to go on. Well, I'm fascinated by not only that, not only the fact that instances, formative instances, can change the story you tell ourselves about ourselves and then make us forget the fact that that is what caused it to happen. But that shame and guilt are almost like the delivery mechanism for enforcing the change.

And it doesn't need to come from other people. You know, you're right that you do a thing and guilt is the internal version of the external eye that your tribe would have had on you saying, you probably shouldn't be doing, you shouldn't be eating those berries. Oh God, I hope no one catches me. But you're deploying this to yourself, about yourself, and maybe about something that wasn't even your fault. Yes, it's something, yes, it's all of that.

So you're really getting it, it's all of that. And it's even worse, because that shame and guilt, all the things you just said are like centuries, protecting us from insight, protecting us from help. That say it's not safe to go look at that. It's not safe to talk about that. You wanna go talk about something you're ashamed about, that's not gonna go well, right?

It has us keep it all inside because guilt and shame keep us stuck inside of ourselves, which is the reason why people don't go and get help. They don't go in process because guilt and shame tells us to keep it private and it tells us, well, people tell them, I'll start crying and get help. They don't go in process, because guilt and shame tells us to keep it private. And it tells us, well, people tell them, I'll start crying and never stop. I'll curl up into a fetal position and never get out.

Then is never what happens. Those are the lies of trauma-driven guilt and shame that keep us in places where we not only don't know who we are, but we forget who we are. How many times I've had a person tell me, I've always been someone no one likes. And I learned, like, that's not true at all. People, this person understood themselves to be different

and interacted in the world differently until that trauma happened. Because the thing you said about the airplane flight could happen when someone is seven, happen when they're 57 too. And then we go back and we map the past, which interestingly on English modernism Really really captured this so it says not only this wasn't known before but the English modernist like Ford Maddox Ford

Virginia Wolf's writing really there were others too that started writing about how we Retroactively change I think it was Ford Maddox Ford who wrote about if you're eating an apple and it's a goodly apple I think you get to the center of it and there's a worm, is it retroactively a bad apple? And that was quite a revelation that was part of the English modernist movement that really realized, and in my opinion, I think Virginia Woolf captured it the most deeply of how time changes for us in the context of how we see things

in retrospect, how we see ourselves. The past is malleable, and it is our responsibility to ourselves that our past isn't malleable. If something changed in me after a trauma, I want to know how I was before. What that trauma was, how it impacted me, how it changed me, how I am different afterwards so that I can decide what that means and how I'm going to go about doing about it, whatever it is I choose to do. Are the different categories of trauma, do you bucket them into broad types somehow? Well, on the one hand, this is why I emphasize here that this is based

in science, right? This is not some soft concept of, oh, anybody who has trauma or anything bad, not chosen for the team or no, no, the answer to your question can be answered through the lens of hard science, but in two ways. On the one hand, the answer is no. In that, if my brain changes because of, let's say, vicariously experienced trauma through sitting with other people through their trauma or being present for something, and your brain changes because of some acute trauma that happened to you, our brains look the same afterwards. The patterns of neurotransmission change. We're both more vigilant. We will both tend to have different patterns,

like if you see a new face coming at you, instead of being looking at it objectively, I wonder who that is, or what that person's expression is or feelings, we look at it biased. Is that person gonna harm me? We change and we change in the same way. So in one sense, no,

because the brain changes are the same. And physical data like heart disease risk, for example, can be higher. And when trauma is really manifesting itself, aging can be greater. So think about this, because of the impact of trauma, we can be older than we are. Where the calendar says that person is 42 years old. But if you go and you kind of think about telomeres and how the person is actually 46 by the by the actual biology of it. So the hard brain biology and and physical biology tells us that the final common pathway is the same, but we can get traumatized in different ways.

The easiest way to see is acute, right? You told me about a head-on collision like whoa, I mean anyone can understand. Yeah Right? You told me about a head-on collision. Like, whoa. I mean, anyone can understand. Yeah. That will traumatize a person. You know, as I've written about and talked about in podcasts, I lost my youngest brother by suicide. Everyone can understand, like, that's a big trauma. We're less likely to understand chronic traumas. So, chronically being made to feel less that. So, people who are chronically denigrated, whether it's ethnicity, it's sexual preference or identity, there are many, many things that we in society, socioeconomic status, lead people to feel chronically less than. So there's research showing when immigrant groups, when people immigrate to a country

with very different traditions and they tend to live together, there's a lower incidence of schizophrenia. So people live apart, there's a higher incidence. This is fascinating, right? Because when people are living together, there's more of a sense of belonging, right? We don't know this for sure, but the data points that way and it fits with this idea that we see, like we see it to be true, that chronic trauma is impactful. So someone who's in an abusive circumstance and nothing has risen to some drama where

they went to the hospital or police came, but they're always denigrated. That will make brain changes just like acute trauma. So acute, chronic, and vicarious trauma, where it was why I often am telling people, my prescription for you is less news, right? Use the news to, I'm forgetting that, Dalton. Right, use the news to learn. When I was young, there was a newspaper that came,

you looked through it, that was it. Now people are often, they're looking at news, so to speak, but what they're doing is experiencing vicariously other people's trauma. And we need to be very careful about that. It happens in the helping professions. It happens if someone's near someone who's been hurt, and it happens if we're constantly inundating ourselves because of our own anxiety with other people's suffering.

I read a study from the Boston Marathon bombing, which was a few years ago, and they looked at which was a few years ago. And they looked at people who had actually been at the marathon during the bombing and compared their levels of stress to people who had watched 90 minutes or more of news coverage about it. The people who watched 90 minutes or more

of news coverage on average showed higher levels of stress. Yes, that does not surprise me. That fits with all the other data. We'd say if you're there, yes, something very bad has happened and you're in proximity to it. But then we're talking about people who then weren't hurt in it, right?

Or didn't have someone close to them who was hurt. Then you realize that there is safety, right? Now that doesn't mean it's not gonna have an impact on the person who realized that happened and I was close to it. But should it surprise us that if not in 90 minutes of, oh my goodness, that could have been me or someone I love and just imagining that and feeling for the people.

We are so fortunate as humans, we have empathy. If we didn't, we wouldn't be here. We're lucky in some ways we're here anyway without close we come to destroying ourselves even with empathy. So empathy is wonderful. If someone is hurt and they're on the ground, that's why we lend them a helping hand metaphorically and truly.

Empathy is great, but empathy can work against us. That's why we see people who have a full blown trauma syndrome and it's all through vicarious trauma. And that is real because the brain science will show it to be just as real as someone who's had the trauma in a more acute and obvious way. I'm going to guess that chronic and vicarious trauma are the ones that sneak up on people. You know, when we think about trauma, we think about a single formative fireworks event. That goes on we.

You know if you were to say well you've been in a relationship where your partner is always put you down for a decade. You would say well are any of those instances by you know the lay person. instances by, you know, the lay person definition of trauma, are any of those instances traumatic? Yeah, well, no, like, it's just a joke. They're just saying like, oh, like, you know, going out for a run, good luck trying to get past one kilometer again this time, you know, but over time, there is a point, there is a point at which something which is not necessarily traumatic in isolation becomes traumatic, just

due to, like, weight. Sure. Sure. Sure. The area under the curve, the increasing weight of the chronic denigration. You can see how in our medical systems, and I've been fortunate to spend about a year of my life in the UK, and I love coming to England. I think I understand the healthcare system enough that there are problems in the US healthcare system that are in other systems too, which is just being too concrete about things, where it's hard to get attention and care, especially human-driven attention, like psychotherapy. Our system wants to look at, have you had the Big Fireworks event? Okay, if not, we'll put you in

a different category. It doesn't want to say, are there changes in your brain? Because of trauma, whether that was acute or chronic or vicarious, that's what we would look at. But the systems aren't sophisticated or often interested enough to do that. I went to my GP when I was probably 21 or 22 in the UK, northeast of the UK, classic very working class town. And I go in and I sit down and I'd been sad for quite a while on and off.

And then every so often there would be maybe a couple of days where I couldn't get out of bed and I would feel quite ashamed about this and I wouldn't want to talk to people and I'd keep the curtains drawn and, you know, I'd make excuses about why I couldn't see people or do things or whatever. And I went in and I sat down with my GP and the way it works in the UK for the people that aren't from there, you have a 10 minute window with your GP and that's your general practitioner.

That's the person you go to and you book in for and it's usually kind of hard to get an appointment. Again, National Health Service, it's free, great. But the standard of care perhaps leaves a little bit to be desired. So I sit down and I said, I'm, I'm, I think I might be depressed or something. I probably mumbled some word out about sad or depressed or something like that. But I'm pretty sure I use the word depression. And this GP said, have you had a recent family bereavement? No. So is are you in financial trouble? No. Did you recently lose a job? No. Did you recently break up with a relationship? No. No, no, no, no, no, all the way down. Like, acute trauma, acute trauma, acute trauma, acute trauma. No. And just sort of got toward the end of it and essentially said, well, what are you sad

about? I was like, I don't know, like just the fucking crushing weight of existence. I don't know. I don't know what I'm sad about. And then she printed off this single piece of A4 paper that was like, here's some website URLs on the NHS website about how to improve your mental health, like, and go along your way. And you're worse than when you came in. I felt like, I don't know, like I was making a mountain out of a molehill. It definitely taught me the lesson that I took away from that, I think, was I'm blowing this out of proportion. It mustn't be that big of a deal. And that's why we have so much loss of productivity, because often people in power, in decision-making

capacities, think about dollars and cents or pounds. And are we, what are we losing economically? We lose a tremendous amount of human productivity because of depression. And if we want to anchor to what is, of course, infinitely more important, we lose human life to depression. So when you walk out of there, you're walking out at great risk. You have a real medical problem. If you went in and you had right lower quadrant abdominal pain that had been a morphis and then all of a sudden started being focused here, no one would say, why do you have appendicitis? Why does your abdomen hurt? No one would say that. They would honor what was going on with you, but here you get

a non-response and you leave worse than you came in because it's so invalidating. And no one is then looking at, hey, if we could take a picture of your brain chemistry, we're not sophisticated enough to just do that, we'd see, hey, you have a medical problem, no different than if you had appendicitis, but you walk out and validate it. And this is the problem. And it's part of why, at some point, realizing that most of what I was treating was coming from trauma, whether I was treating substance abuse, depression, panic attacks, insomnia, even the more medicalized, like schizophrenia, higher incidents when people

are feeling a sense of aloneness and isolation and vulnerability that we need to understand this because a huge part of what ails us, what makes all of us suffer, is coming from this. It's coming from unrecognized and unaddressed trauma and unrecognized and unaddressed mental health issues. Because people can get depressed because their brain chemistry is off. So there doesn't have to be no reason whatsoever. The people, everything in their life is as good as possible, but cyclically, their brain chemistry comes offline and now they're

depressed. So what about a purely biological depression? There isn't always a reason. I mean, there's a lot of times a reason. But think about how we're just invalidating people. And then is it a surprise that substance abuse, substance dependence, addiction, overdose rates go up and up, that suicide rates go up and up? It is not a surprise.

It is a predictable outcome. It's a predictable consequence of how the healthcare system handles itself. And what you described so many years ago is not different in many settings now. See, that's what would happen now. And even the doctor, I have so much compassion for GPs, primary care physicians, because what are you supposed to do in 10 minutes? How do you just have a real conversation in 10 minutes and that's why there's more depression and self-harm and suicides in physicians has grown over time.

That's an interesting question. What about, you talked about vicarious trauma, firefighters that need to cut people out of cars, paramedics that are unable to resuscitate people, therapists that are dealing with masseuses that are permanently working with people who are in pain. Is this something that you see? Sure. There are higher rates of all that ails us in populations that are exposed to situations that can make fear or terror.

If you're coming up to cut someone out of an accident, it's hard to do that without some. If you're doing that, you're a person who has empathy. So you're a person who's going to feel something as you're doing that. And certain people have education and training and support to try and make boundaries, but that doesn't mean that that works all the time We don't give people enough ongoing support and and and we see that on the other side of it Where people in those these kinds of helping professions have higher rates of his depression substance abuse suicide

The rates are higher and again it all makes sense. Like there's this concept in a certain Type of therapy that says everything is as it should be. It doesn't mean that it's right, morally right or just. What it means is that it's predictable. It's predictable. So if you see the increasing rates of loneliness, isolation, depression, substance use, suicides in the general population and more specifically in people who are caregiving, that's not surprising. It says everything is as it should be, meaning we've made these decisions as a society. How many healthcare workers came to the other side of COVID traumatized by all the things,

the awful things they saw and they need to work double shifts because the co-workers aren't coming and there's so, so much of that. And what happened after the pandemic? Go back to the same And there's so, so much of that. And what happened after the pandemic, go back to the same unreasonably high workloads that the way everything was before, that we don't put resources in society towards the people who help us, which is also us. I think, you know, we're all part of this.

And, you know, we waste so many resources in so many ways, our political struggles and strivings. And it's like, oh, the idea isn't to get political, but just to say how much resources we waste. And we often don't have resources to like give the person with depression more than a 10 minute misleading questionnaire, right? Or help that person who, who has a real post trauma syndrome, get better, but that's going to take some human time.

And we look at the, at the short end of it, which is's going to take some human time. We look at the at the short end of it, which is why I focus on the economic cost. Of course, the human costs are more, but we can get money allocated sometimes. Resources allocated when we look at the cost, that for everyone we don't treat for trauma, who then uses hospital resources coming to emergency rooms or we lose out of the workforce, it's like we was like a borrow a penny today to pay a dollar tomorrow. But we treat ourselves that way. We treat ourselves that way as societies.

And people don't see it until they often need to go to an emergency room and they have good insurance but guess what? You're still out in the hallway. You still sat there for seven hours. You still went in and had somebody ask you a 10-minute questionnaire when you're really in trouble inside. Maybe we don't handle things in a way that uses a lot of foresight and we pay for it. We pay for it, I believe, around trauma more than anything else. I should say one more quick fact that more than half we don't know exactly how many but more than half of the physical health complaints people make. They go to a physical health doctor. Something hurts.

They have shortness of breath. They're feeling something inside. Half of those complaints, they're not mental health complaints. They're physical health complaints that come from mental health. Yet how much are we integrating mental health into our physical health care systems? Very, very, very poorly. And therefore, you have physical health physicians who want to help people they know so much that's coming to them as mental health, but they're not equipped. They're not trained.

They don't have enough time. And that's part of the frustration is people are coming with mental health problems, but they're presenting as physical health problems. And it's not because the person wants to say that. It's because they often don't know. They are hurting, but they do have depression. They don't know, and the healthcare system is so dumbed down that we're not asking the right questions to try and figure out what is actually going on with you and how do we

help you? Talk to me about what actually happens to the brain and body after someone's gone through trauma. So there'd be very complex changes, but we can summarize to some degree by saying that there are alterations in the balances in our brains. You know our brains are trying to maintain and bodies homeostasis means things are in balance. And there are hundreds of thousands of things that happen inside of us in each moment to hold us in balance. And there are hundreds of thousands of things that happen inside of us in each moment to hold us in balance. What happens is that we get imbalanced. So for example, vigilance mechanisms in the brain, their whole systems of the brain, salience mechanisms, start looking more for negative things. So someone who, for example, is interested in

finding a relationship who is walking down the street or a hallway and sees someone look at them, instead of being curious, oh, how's that person looking at me? Or am I attracted to that person? Or might I smile back? The immediate is like, does that person is looking negatively at me? What's wrong with me? Why are they looking at me? It's hard to make life move forward then. There's a change towards vigilance and vulnerability inside of us. So you don't see maybe that's a co-worker, we could collaborate on something. Maybe that's a potential romantic partner who's smiling at me. People don't see that because the brain has shifted from curiosity. How is that person looking at me? There must be something wrong. They're looking at me to, there must be something wrong, looking at me in a negative way, because there's something negative about me. So those things change in us in very complicated ways, but it changes the whole climate, so to speak, within us.

And then it changes endocrinologically. So then we have more stress hormones flowing in us. And stress hormones predispose to vascular disease, to heart disease, to strokes, to autoimmune diseases, to aging faster than our calendar age. So to gaining weight when we don't want to gain weight, to not being able to lose weight when we're working hard to lose weight. So then what happens?

We get changed from head to toe because these systems shift. And again, we don't realize that. You're the person who says, I'm a loser because I can't lose weight and I'm trying. How many times do I hear that? And then you see, they're actually doing the right things. They have a good diet. They have exercise. They're not losing weight because there's so many stress hormones in them that it triggers all these don't lose weight systems in us. So these are just examples, but you can see, I hope, from the examples that what we're talking about

is whole life change from top to bottom. I guess it's not happening in everyone, but this is happening a lot in small, medium, or big ways, but any amount of it is unacceptable, and then we just don't know it. I've always been someone nobody likes, or no one likes how I look. People say they'll say this,

and they don't know it was before that trauma, that's not how they felt. People say they'll say this and they don't was before that trauma. That's not how they felt. And that's why they got better jobs. They would leave one job for another if it was better. They had good relationships. They didn't stand up. They didn't stand for denigration in a relationship, that kind of off-putting.

They didn't stand for that. Now they do. And they don't even realize that they never did. And like, how are we going to get out of it, right? If we think this is how I've always been realize that they never did. And like, how are we gonna get out of it, right? If we think this is how I've always been when that's not true. It seems like the story that we tell ourselves about ourselves is so important.

That it's such a huge part, this narrative that we weave together. Yes, yes, yes. I'm so interested in knowing people's life narratives, because I'm in the business of trying to help people. So you have to understand what their narrative is. As I say, no one comes out of the womb thinking, you know, abuse is okay for me.

No one thinks that, right? So how do we get to the point of thinking that? Even being in a relationship? As you said, there's not physical violence, but it's always denigrating. Oh, sure, you're going to, yeah, that's going to go well for you this time. Give it a try. See what happens. Why would people put up with that all the time instead of saying, Hey, I don't want this. This is worse than not having a relationship. I'll not have a relationship till I find one that's better. We have to trace. What is the roots of that?

Was there some trauma and that person started feeling differently? Does that come from early formative years? Was that person seen as less than or denigrated? Because of race, because gender in the home, right, for just one example, because of sexual orientation, socioeconomic status in the communities around us, was that bred into that person? Because that's not natural either. You get to feel that you're good enough to have a safe life in which you strive for good things. And if a person doesn't, I want to understand where that came from.

What just integrated informative years or big trauma at once, we've got to understand it. Yeah. I think so many people, you know, myself included, the voice in our heads is so regularly negative that it seems like that's just the physics of brains, that the texture of the mind, not my mind, the mind, yes, the factory settings are critical, self-deprecating, fearful, vigilant, mocking, risk averse, all of those things. There is a negativity bias. We are concerned, finite creatures, infinite surrounding, this asymmetry between things

that can make us a little bit more alive and make us a lot more dead and how much worse those are. But are you saying that that's not the way that we should be? Because that, I think, to a lot of people, maybe myself included, is like a rather wild claim that we shouldn't, our minds, aren't built to just be negative. We're not built to be that way. And the salience of negative things doesn't have to make us that way. So in the berry example, what does that mean? Don't eat that berry again. It doesn't mean be afraid of any food now, but it would be afraid of any berries,

be afraid of being outdoors. It doesn't mean that. It's the negativity bias is meant to protect us. It's what happens inside of us in complex situations because we live lives that are complicated at different phases and we're often not aware of our life Narratives it's it's that negativity bias that can help us to feel negative all the time But it certainly is not deterministic of that which is why in an oversimplified example

I'm simplified if you say realize you shouldn't eat that berry You're not a dummy for eating that berry. It looked like a good berry You don't have to feel like you're incompetent and you're not worth anything because you ate the berry. Like, you're okay, you came through it. Here's the lesson. Don't eat that berry again. And maybe be just more careful about berries. Is that good? Okay, it's good. But that's often not how it goes. It's like, I don't know how to pick what to eat. And you know what? I gave someone to someone else, that person got sick too, I'm a terrible person. This is what we do to ourselves and it is not our natural state.

We're not built to be like that but we end up like that because we are trying to keep ourselves safe in a difficult and complex world and we accumulate more negativity by us, more negativity. Now I've got a voice in my head telling me what's wrong with me all the time and I had this voice in my head for a long, long, long, long time and through a lot of psychotherapy, I've been able to move it out of my primary consciousness but there was a time when I thought that shadow voice was normal. If I dropped something or oh, it's so stupid or what's wrong with you? I mean, that was a shadow to me inside of me. And I had to realize that's not normal. Like I said, I didn't come out of the womb metaphorically,

we didn't have words, but you know what I mean? Like no one comes out of the womb thinking that way. It's not normal. Minds around it, that does not have to stay with us. I'm not saying I'm a power God of mental health and I still need my work and I do my work, but I'll tell you that oppressive, miserable, mirth robbing, depression, producing voices

not in my head anymore because I had to realize that is not natural. I do not want it there. I want to understand and get my arms around why it's there and I want it to go just like I never, I always felt I could go out and work hard and achieve things. I did not feel like I was cursed.

I did not feel like there was something wrong with me or the place or people I came from, but I certainly did after my brother died by suicide. What's wrong with me that I didn't see that? What's wrong with us that that would happen to us? I would never say that about someone else. What's wrong with you that a family member died by suicide? But I would say to me, then that's how we are.

It's like, you know, good people don't want to denigrate someone else, but we'll say it to ourselves and we'll take it inside. And I started realizing I was feeling so differently about myself and wait, I never felt like this before and I had good people around me enough to realize I started getting myself some help. But it shows if we don't know our narratives and that this negativity is not natural to be at the forefront, it can become the new normal, and then we think it was the old normal too.

Wow. How much can we change that voice? Can we actually get rid of negative pathways? I remember once reading something about once neurons are laid down, there is no undoing them, they're only building up other neurons. So is it a case of layering better voices on top of worse voices or can worse voices actually go away entirely? Worse voices can go away entirely. Now, I'm going to put a little asterisk and I'll explain.

This is both very, very complicated and very, very simple. This complicated part is for the neuroscientists of how does neurotransmission work and how do complex systems work? Like there's a lot there. But let's just go to the simple part. Anything that has been over-learned doesn't go away overnight. OK, so here's the example.

This example I use all the time. And I think it captures it, I think. Let's say you and I randomly took a word. We just picked a word. I look around, the word simply is staring at me from something else on my desk. Let's say we say random word. Let's you and I say it together 500 times. Let's say we did that. Then this evening, my time, you're tomorrow morning, it's going to be in your head or in my head. Let's say we say it instead of 500 times, 5,000 times. It'll be in our brain several days later,

but it can atrophy and go away. In this case, it's just a silly experiment, but our brains still won't let go of it. If you and I say that word a thousand times, our brains are gonna say, I know that was just a silly experiment, let's get rid of that. No, it's gonna keep the word coming and it's going to keep it coming.

That's what goes on with the negative biases inside of ourselves. You have a feeling state and a set of words and self-talks like, I'm not good enough, I suck. You keep doing that over and over again. It is not going away quickly. But we live in a society that wants rapid results, that often packages psychotherapy as you get 10 sessions of this and then it's over. All that stuff can get better, tremendously better, but it takes time. If that's been in your head for three, four months to a

moderate degree, let's plot out a several month course to getting it out. If it's been in your head for years, well, we're going to have to work on it over time, but that doesn't mean nothing good happens until we're years down the road. It means we start working on it now and it starts getting better. And that's the simplicity of it. That example really holds.

If we said that word a thousand times and we didn't say it anymore, it'll fall out of our brains. And the same is true with the lies of trauma that we tell ourselves. Now, again, if something has been so impactful upon us, it can still come back. People who have had thoughts of hurting themselves or hurt themselves at some point in time who haven't for years could still have something really bad go on

and the thought will come into their head. If I make a very big mistake, I can still, that voice can come back in and go, you're an idiot, right? So, but I recognize that doesn't mean I'm back at square one. It just means if there's a strong stimulus that reflects and come back. But it's not with me. I just, I push it back out. Like I get it. I made a mistake. I don't need this inside.

Let's have it back out. So sometimes we can kind of rush us once or twice if it's been strongly in us. But the answer to your question about change is a very strong yes. All of that can change and it's not rocket science. Neuroscience is more complicated than rocket science. So in some sense, it is that's why there are countless brilliant people who spend their careers in psychiatry, neuroscience, psychology. That's wonderful that that's happening. What you and I and everyone listening needs to know is not that. I take comfort that people are doing that. What we need to know is this is absolutely

approachable and we understand it, but the mechanisms of helping around us don't help. They don't teach us how to understand it. They don't tell us that things take time, but there's an understanding driven by science and experience of the profession that tells us the answers to this and gives us a roadmap to how to make it different. It's so interesting that you say a formative experience, a particularly stressful experience can cause something like this to re-emerge. So a while ago, I was doing a very important podcast episode, high stakes, and I tend to

fast before I do this, which is good. It keeps me nice and alert. A little bit of cortisol and adrenaline running through the blood is nice for mental focus. But I overshot it and I went hypo partway through the podcast. And as I'm watching this person talk in front of me, all that I can hear in my own mind is blank. There's nothing.

My whole mind's gone blank. And I'm like, well, that's not good. I'm supposed to be here and I'm hearing buh-buh-buh-buh-buh-buh-buh-buh-buh-buh-buh-buh-buh-buh-buh. And I'm thinking, wow, I've got nothing to say. And as soon as that happened, the first thought that came to my mind was, you're not supposed to be here.

You were never supposed to be here. Everyone's laughing at you. You're boring. No one thinks that you've got anything interesting to say. You're blowing it. This was your shot. Bu-buh-buh-buh-buh-buh-buh-buh. Ba-ba-ba-ba-ba-ba-ba. Ba-ba-ba-ba-ba-ba.

You're useless, nobody likes you, no one's ever liked you. And I thought, like, where has that voice coming from? Because I thought I'd got rid of that voice. I spent 1,500 sessions of meditation, like five years of daily journaling, all of that stuff. And I looked at me inwardly as well as I could and tried to look at that part of me. I don't know where it comes from,

something from my childhood that I didn't like. This very negative, very cutting, very cynical voice. And during a period of super, super, super high pressure, it came back. Yes, which makes sense. And this is the Yes. Which makes sense. And this is the danger. What's the danger? The danger is of a self-fulfilling prophecy, right?

Because when those thoughts are going through your head, as you said, when you try and tune in on the person again, you're hearing the, blah, blah, blah, blah, you're not hearing the words. Why? Because all you've done in between is increase your distress level. So then there's the danger of it coming off the rails, so to speak, because you could inadvertently kind of make that true, at least in the moment where like if that goes too far, you don't have something to say back. And then when that happens to a person, now it really tells them, oh, this is back with you,

this is all true. That can be very, very difficult for a person if they have a bad outcome when things are back in their mind. What we want to do if you and I, let's say we're working together clinically and I knew the strength of that in your past, I would try and prepare you that, hey, let's just be clear, that's going to come back to you at some point in time and it doesn't mean anything. You're the best thing you can do when it comes back to you. Please, you know, just laugh at it a little bit, a little bit of like that kind of like good humor. Like, I get it. I get it. When that, that, when that, you're an idiot comes back into my head or you're stupid. You're not good enough to be here. What made you think go to medical school? Like, I get

that. I'm like, look, this is a, this is coming from the past. Right. And then it takes the power out of it. Then if you can do that, then you can go back and now you're going to hear the words the person is saying, right? But you have to be prepared for it if you don't know That that's normal for it to come back. Then you can't just You know do that what you do is you give it you inadvertently give it so much power. Oh my goodness It's back now. I really can't pay attention. Oh my gosh, it must be true. I knew all of that meditation was a waste I knew that the journaling wasn't there. This isn't the true me.

That was the true me, et cetera. Right. That's why I talk about dismissive humor is our friend in situations. And I will prepare people for that because it's inevitable if you had these voices in your head, if you've worked very, very hard to get them out of your head, that's the victory. The victory isn't they never ever encroach back in. That's just not how it works. But it's okay never ever encroach back in. That's just not how it works. But it's okay that they encroach back in if you say,

I know what that message is and I reject it. Let me stop and ground myself. I'm not at my best. I overshot the mark with not eating before whatever. Like I'll learn from that. Okay. I'm here for a reason. I, I, I, a lot of times I will work with athletes who are at the highest level of performance of whatever they do. And you see them in a slump, like I don't deserve to be here as if like they should be on the sandlot instead of in the major league stadiums. Like you didn't accidentally get to the stadium, right? But even in a slump, the person can tell themselves they're no better than someone who doesn't even know how to play the sport. Like it shows what our brains

can do to us and how dramatically we can lose our confidence. What about trauma being passed down? Is that a thing? I live in Austin, Texas now. So ancestral trauma is kind of a bit of a super meme over here with the psychedelic trips and the ayahuasca retreats and the indigenous cultures and stuff like that. the indigenous cultures and stuff like that. What's the truth and the BS around epigenetics, ancestral trauma, all of that stuff?

It's remarkable what epigenetics has contributed is just immense to our understanding. The thought was for a long time that trauma is passed down by role modeling. So someone say who has been through trauma and is very anxious communicates that to children. I did that the world is an unsafe place and they role model anxiety and that can happen. We can nurture children to be like us in all sorts of ways, right?

So that's why if I have a lot of anxiety in me, I do my best to have control over that. I don't wanna roll model that for my children. But what we've learned is really quite remarkable. There are epigenetic changes in us, in people that then can be passed down to children who aren't even conceived of yet. And that's where Darren Richarder, R-E-I-C-H-E-. R. T. E. R. Dr. Darren Richard or who I interviewed for the book is a trauma.

Expert is an academic at Sanford and he testifies about trauma and this idea so for example in the world court that that if someone is traumatized for example some of this testimony has been around rape as an instrument of war. And it was seen through a criminal justice lens. This person ordered that and that was wrong. Okay, that's true, but we also need to look at that can extend across years and across generations. That could impact children that aren't even thought of yet and might not be born until 10, 20 years later. that aren't even thought of yet and might not be born until 10, 20 years later. Because the trauma in the person creates change in the person that can then be transmitted to children just through the changes in genetic expression years and years and years later.

And that shift from looking at a war crime as something criminal that's just bounded by it happened in this period of time, is it is a crime, but it's not only a crime in that moment. It's a crime against that person for the rest of their lives, especially if they don't get the help to deal with it. And it can be, it's a crime against children that aren't even thought of yet. It's a transgenerational crime.

And that truth that epigenetics and epigenetics against children that aren't even thought of yet. It's a transgenerational crime. And that truth that epigenetics and epigenetics through the neurobiological lens tells us that's true. I was talking to Robert Sapolsky a couple of months ago and he was talking about how mothers that enter poverty during pregnancy, the changes that you see epigenetically in the children from that poverty, you know,

perfect example, I would guess, of a pretty good chronic trauma, chronic stress. It's not, it's just ambient concern, right? It's just there in the background. And yeah, the difference that people go through. And he reminded me something that I learned in year nine in biology, that when a female is born, they have all of the eggs that they are going to have for the entirety of their life. So inside of this as yet unborn child, this infant baby fetus that's inside of you, is the next generation. So you've got grandmother to mother that's about to be born, and inside of mother you have daughter who will be born in however many 25, 30, 40 years time. born in however many 25, 30, 40 years time.

Yes. And you're, wow, that warrants, it warrants that kind of, wow, this is the impact of trauma, truly transgenerational. And think about the example you gave was not someone who has lived chronically in poverty. People can live in poverty without poverty itself being traumatic. It predisposes to trauma, but poverty doesn't have to be in and of itself traumatic. But imagine you said a woman entering poverty while pregnant. And even then, if I stop and think about that too much, I can generate a panic attack in myself

of how that would feel. You're carrying a child and you feel responsible and now you go from not being in poverty to being in poverty. What is the cascade of stress hormones neurobiologically and cascading throughout the body? It's huge. That's why it makes the significant changes that Dr. Sapolsky's talking about. It's a huge trauma during a period of time that is a very, very crucial period of time

to that developing fetus, which is crucial to the developing fetus, to the adult that fetus will become. And if that fetus can have children, to the subsequent children of that fetus, if this isn't a reason for us paying attention, it's not like borrow a penny today, pay back a pound tomorrow. But are we going to borrow a penny today and pay back 10 pounds tomorrow? When what, 100 pounds in 10 years and 1000 pounds down the road? I believe that that is not an exaggeration. That is what we are doing as a society by turning away from trauma.

And we see it in death rates through overdose and death rates through suicide. There are many, many things we could talk about where we see that right now. And what we see now will continue on and worsen. It's a guarantee. It will continue forward and worsen because we've planted the seeds of that into the future unless we do something about it. So we've talked about the impact of trauma and unwinding of that, trying to make the unconscious into the conscious.

What about trying to get out ahead of that a little bit more? Are there any predictors or ways that people can increase their resilience so that the bar for whatever could cause a traumatic interpretation sort of bounces off during the event? What's the physics of that system? Oh, it's the same paradigm as for physical health. The better health you're in, the better you'll be able to withstand and insult to your physical health, an injury, an illness. And the same is true in our mental health. So the healthier we are, if someone has, say, a chronic low-grade trauma, They're in a relationship, and the relationship is just kind of dismissive or denigrating. They're not valued, but they're putting up with it. That predisposes to trauma having more of an impact. There's something called the multiple hit hypothesis where we have more insults. We're more likely for the next insult to have

a disproportionate impact. So be as healthy as we can. Part of the reason we want to be in physical shape is people want to look good and be healthy now, but we also want to is preventive medicine, right? I'm looking ahead to what could happen in the future. And the same is true about our mental health. This is why when we talk about a narrative, it doesn't cost any money. You don't need insurance. You don't need to be able to access care to sit and think about or write about your own life, your own life narrative. What's in your life that's not okay? Imagine a job. You see people who are in jobs where they're not really liked by the people around them and maybe that's because they're good and other people don't want the good person to shine or whatever it is and they're just kind of putting up with it.

to shine or whatever it is, and they're just kind of putting up with it. Note that. That's something in your life that is causing misery and distress now that predisposes to problems in the future. So to be aware and to be honest about that, instead of it's easy to shove it under the rug, because like you said, it isn't the big fireworks thing. So look at what are our life narratives from past to present, and what's going on in my life now, what's okay and what isn't? Because how many times will a person tell you, everything's okay, sure, things are fine.

But then you ask, okay, let's talk about a little bit more. Things are not fine. They'll tell you what isn't fine. But the default of things are fine, why that default? It's partly because if we don't feel we can really change anything, then we wanna just kinda say it's all okay, and if we feel some guilt and shame

about the things that aren't okay, more reason to sweep it under the rug. So there are a lot of reasons where we're not honest with ourselves. If you say to someone, tell me what's okay and what's not, everything's okay. Usually that person isn't just lying to you. The question, they're lying to themselves.

And it's not because they like lying to themselves, so life isn't as good. It's because there's a sense of, I should be ashamed of that. There's no way I can change that. I don't understand myself well enough. I'm afraid of that. And it just does not have to be that way. And there are routes to change that aren't rocket science routes to change, which is another message that I'm bringing. It's not like we need the most sophisticated help, sometimes in extreme circumstances. But think about your life, write a life narrative, talk to somebody you care about and trust. These are things we can do for free that can really make a big difference

in our lives. Talk to me about, again, this is not medical advice, please seek your psychotherapist of choice, etc., etc. But in your experience, what are the modalities that are the biggest movers when it comes to helping people to sort of make the unconscious conscious, to unpack the experiences of their lives, to stress test these assumptions and narratives that they have that may be erroneous

and due to one incident or a number of incidents that's kind of whitewashed everything? What are the biggest modalities, the most effective ones that you like? I mean, there are ways to get to come at it, but most of the ways that would come at what you were talking about is an insight-oriented psychotherapy. And that could be a kind of psychotherapy, psychodynamic psychotherapy, for example, that is very, very interested in the unconscious mind. Or it could be psychotherapy that's not just focused on the unconscious mind, but focused on

self-understanding. Can you tell me about you now? Can you tell me about you growing up? How much can you tell me? Can you link the two? So that can be insight-oriented psychotherapy too. It doesn't have to go right for the unconscious mind, but it's some aspect of curiosity about the person. When we just go, strategies to make things better, so to speak, like cognitive behavioral strategies can be, they can be very, very helpful, but we need to understand what is underlying first. So otherwise, we just go to what else. So we're going to polishing the hood instead of looking under the hood.

And maybe it's, maybe we don't feel so great about the car and we really should polish the hood, maybe. But maybe if we're not so happy with the car, let's look underneath at the engine. So let's look at where is something coming from because then we can gain greater insight and that in and of itself can make a difference, bring the unconscious to conscious.

Then we have strategies that can actually help. Sometimes if strategies just decrease symptoms without going to where the problem is, that doesn't necessarily help. Maybe that allows the person to tolerate the abusive situation longer. That's not so good. So we want to come. I don't, with rare exceptions, I don't understand not coming at the process through the lens of insight. Like let's start there.

We might spend a lot of time there or a little bit of time there. So maybe we get the insight, for example, that this person who is depressed is experiencing a purely biological depression. They're handling their life quite well. They've had some trauma, but they've dealt well with it. They have a good job, a good relationship, had some trauma, but they've dealt well with it.

They have a good job, a good relationship. They're meditating, they're taking care of themselves. The problem is neurobiological. Oh, then there's a family history where on that side of the family, people get depressed out of the blue. We might rapidly go to just the psychopharmacological. It happens at times, but we haven't just gone there. We've gone there because we've investigated and decided that that's where to go.

So it's just an example, even when the answers are not through the psychotherapeutic lens, we have to have some insight to decide that. And if I learn that you were never depressed until a certain thing happened, or until something big didn't happen, but you change maybe from one place to another, a job, a relationship, and then things started changing and then you become depressed. Well, we may still think maybe medicine's a good idea or this or that, but we're not going to leave it at that. We're going to go to why that is different than what you understand about it or what you don't understand and we can bring to the surface. So it's a process that honors, I think, people

and our stories and what goes on inside of us. And I think we deserve that from the systems that are allegedly taken care of us. You've mentioned a couple of times about writing things down, journaling or something analogous to journaling. Is there a process that you're a particularly big fan of when it comes to that? No, not a single process because it works differently for different people. And some people like doing that, or if they don't know if they like it, can take to it pretty readily. For others, it can be painstaking and it's too much to do. Now, maybe then they could speak words and then listen to the words back from them. So it's not how it's done.

It's that when we make words, whether we say them out loud, it's kind of better in some way if we say them out loud or if we write them. But when we make words, it's different than things bouncing around in our minds. There are different systems of error checking that come online, which is why it's kind of a joke in psychotherapy, but it is true that every now

and then someone will come in and they'll talk the whole time. And then at the end they'll be, oh my gosh, thank you, you solved all my problems. We didn't say anything. Right? So sometimes that happens. It happened in my own therapy a little while ago. I said, wait, that thing happened. I actually solved the problem by talking about them because in talking about them, they become real in a different way. I'm putting words and the words the therapist is still relevant because I'm putting words that are listened to by another person that I know and trust and feel safe with. And they're going to be scrutinized by them as well. They're going to be there to, to, you need to not just say complete gobbledygook. You need to not just trail off in the middle of sentences.

There's a type of structure that needs to be there as well. Right. It's a communication structure. Right. It scrutinized not in a way that that person's going to fault me, but that person's interested in what I'm saying and I want to convey it. Then in this case, what it allows is not that I conveyed it to the other person. It's that as I conveyed it, I understood it better.

And it's that that we're going for. If you get that through longhand journaling and you're like, whoa, I read that and I understand myself better, do that. If you get it through more sparse journaling, but it's putting together, hey, I've veered these patterns of how I feel or what I do and how it links to how I feel, then do that. If you kind of can't do that, but you can talk to somebody trusted, do that. The idea is to get it out of just bouncing around in our minds because we often don't solve our problems

that way. And then we make, like we talked earlier about the self-fulfilling prophecy. Then we make a self-fulfilling prophecy. I must be dumb, I can't solve my own problems. I've been thinking about it for years. I think, no, all I'm doing over that time is spinning wheels. How about another modality that makes things different, actually brings different brain

centers online, and then I can solve those problems? That can be the tremendous benefit of writing or talking. And again, it doesn't cost anything. You don't have to go anywhere. People can do this if they have a pen and paper or another human being they trust. So there are ways we can really help ourselves that we can do quite readily. What should we be paying attention to

when it comes to the little voice that sometimes appears in our heads? The things that we take for granted, the words that are said, the presumptions and assumptions when we encounter a situation. Is there something, is there a process that you advise people to go through when it comes to that repetitive thought, the sort of narrative that we say? Yeah.

I can say it in two words and I'll expand a little bit, but the two words are be curious. Be curious. It's interesting what's going on in our minds. If there's a shadow voice telling you how bad you are, be interested in that. Don't be cowed by it. Don't be frightened by it. Be interested in what comes into our minds because it's that curiosity that lets us better understand and it lets us put it in its place.

I have this voice in my head, not literally the voice of my own shadow voice. I kind of know where it comes from now that I think about it, right? That it came from that denigrating person, that bad trauma, how I was raised, how I was treated because I was a little bit different. And it's saying things to me. Do I think they're true? Do I believe they're true? I mean give an opportunity. I said well, how about instead of that negative voice just having the whole playing field? It's in your brain and it's got a megaphone How about let it have it say but let the other side have it say too. Do you really believe that? Maybe you do maybe you don't it's a little bit of devil's advocate

But maybe you do maybe you don't do you believe it or not believe it if you don't believe it like I'm the worst person in the world I can't do anything right. Okay. Do you do, maybe you don't. Do you believe it or not believe it? If you don't believe it, like, I'm the worst person in the world, I can't do anything right. Okay, do you believe that? If you don't, well, now we want to look at that for what it is, not telling you anything, except that there's something in your head that's not real or true or fair and you don't want it there. Now you more can see it as other. That's an otherness. How'd that get in my head? Now I start seeing it as alien. That doesn't really belong in me. Now I can start putting my foot in the door, so to speak. You give me a little bit of room.

You put your foot in the door. And next time that person goes, I'm stupid and I can't do anything. Okay, wait a second. That just goes on in my head and it's gone on in my head for a long time. And maybe even I know why it's gotten there. That is not what I believe. So let's start again. Can I do this thing?

Now it's a different decision-making process. Oh, no one ever likes me. I shouldn't go say hi to that person. Is that really true that no one ever likes? You've been taking it for granted for a long time. If there's a life narrative, actually a lot of people like me, but I had a bad relationship outcome

and now I feel like no one likes me if they're a potential relationship candidate. Okay, we put things in place and now maybe instead of that person going away from the potential romantic partner, they say hello. Now they start changing things because they're not making self-fulfilling problems. You know how many people said, I can't meet anyone? Why can't you meet anyone? I never meet anyone. Okay, then we look, they're avoiding everyone they could meet. You have to meet some people in order to meet some people. That's how that has to go.

So then we try and prepare the person, especially in relationships, kind of the law of large numbers so there's a lot of rejection involved. So then we think, okay, if you're going to go try something, we need to know what the expected outcome is. If you want to say hello and be nice to a child that lives next door and that's gone well in the past, that's probably going to go well. If you're going to approach a potential relationship partner, then be aware. It's a law of large numbers because that's probably gonna go well. If you're gonna approach a potential relationship partner, then be aware, it's a law of large numbers,

because if it doesn't go well, we don't want that person to then feel bad about themselves. Like, yeah, I gotta bring myself, I gotta be able to do this a bunch of times, and then there are gonna be some good things that are gonna come of it. So there are nuances to it, but you can kinda see, I think, the basic premise of it

is be curious about what's going on in here so it doesn't control you. Because if it is controlling you, what's going on in here so it doesn't control you. Because if it is controlling you, that's not the whole you. The whole you isn't to be controlled in some automatic way. It's to bring yourself to bear and think about things and arrive at conclusions and decisions. Dr. Paul Conti, ladies and gentlemen, this dude, I'm so impressed with you. Andrew told me to reach out and you are beyond the real deal. I love your affect.

I love how sort of caring and sort of gentle you are with this and insightful. I think you're absolutely fantastic. And I really, really appreciate your work. Where should people go? That's so many people are going to want to find out more about what you do. Where should they go? Well, I'm out there in podcast. You can find me through just Googling and I think they all get information out there in great ways.

Everyone interviews in a different way and then I enjoy them all, but they get information so they're more out there in the podcast realm. The book that I wrote is called Trauma, the Invisible Epidemic and that also can be just searched and found. There's a website that just has links to some of the other podcasts and to the book, which is just, it's Dr. D.R. Paul Conti. So, D-R-P-A-U-L-C-O-N-T-I dot com. And that has links to some of the other places that I've appeared.

Dr. Conti, I really appreciate you. Thank you for today. You're welcome. Thanks so much for having me.