The People, Process, & Progress Podcast - My Most Powerful and Helpful Tools from Dr. Besel Van Der Kolk's book "The Body Keeps the Score" | PPP #109

Episode Date: September 6, 2022

“The Body Keeps the Score” was a suggestion from the first Therapist I spoke to after my panic attack. This episode is my way of sharing Dr. Van Der Kolk’s fantastic work and how I think others like me can benefit from his research and the shared stories within the book.

While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival, deep below our rational brain, is not very good at denial. Long after our traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions, intense physical sensations, and impulsive and aggressive actions. These post-traumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged

to the core and beyond redemption. But know that if you've experienced trauma, you're not beyond redemption. My hope with this episode and quick review of The Body Keeps His Core by Dr. Wessel van der Kolk is to share his years and years of research and tools that can help us all work past our past traumas. But first, it's time to lace up, chalk up, get logged in, and get locked on as we put people first, share our processes, and help each other make progress on the People, Process, Progress podcast with Kevin Pinnell.

Hey everybody, September 2022. I am back. The podcast is back. Thank you so much for those that continued to listen, went back and listened to old episodes. To put it short, I needed a break. I had to work through some stuff. I'm still working through some stuff. Podcast is back. Thank you so much for those that continued to listen, went back and listened to old episodes. To put it short, I needed a break. I had to work through some stuff. I'm still working through some stuff. Some of that I'll mention today, some throughout the next series of book reviews and other resources that helped me work through a hard time.

So today, I'm going to review and share, hopefully what you all find is helpful I know I did some great research background and more importantly right at the end tools for all of us to make progress from the book called the body keeps the score from Bessel van der Kolk Bessel van der Kolk MD so he's a physician he's the founder of the medical director of the trauma center in Brooklyn Massachusetts he's also a professor of psychiatry at Boston University School of Medicine and director of the National complex Trauma Treatment Network. When he's not teaching around the world, he works and lives in Boston. This book in particular, which is kind of the why, why do I want to share this one?

Because that's what I do on this podcast, right? Either myself or guests share our knowledge, and I think that's a great you know way to use the podcast medium but the body keeps the score was a suggestion from the first therapist I saw after I had a panic attack this episode is my way of sharing you know Dr. Vandercook's amazing work how I think others like me can benefit I have a history of both acute family personal military public safety chronic trauma post-traumatic stress, those kind of things. Some I treated, some I didn't. And so this book has been really helpful for me.

So we're going to hopefully benefit from his research and the shared stories within it. I highly recommend this book as someone who's in the counseling business recently actually posted on something that I shared. You know, this is kind of a standard and a must-read for anyone that's going to help other folks that are suffering. And so that's kind of the why of this and a very brief background on Dr. Bessel van der Kolk. But I highly recommend this book. You can find it on Amazon, libraries, et cetera. There are five parts to this book. So I'm going to go kind of quickly through the first four.

The fifth is where Dr. van der Kolk provides us with these methodologies to begin to treat and in some cases cure past traumas. And it's pretty amazing. One, it's a hard read in some areas, as you can imagine, or if you as the listener have gone through traumas, whether it's a car accident or abuse or neglect or, you know, an attack or something like that. And that's a thing, right? And a good friend of mine who also experienced PTSD from military and public safety,

we talked to each other, there's no trauma Olympics, right? So there's no my trauma is worse than your trauma. And almost getting in a car accident can be just as traumatic to some people as a lifetime of public service. It's different and we don't need to judge each other. So let's get into this book. Let's get into these parts, give you a brief. And again, doing a book review as an episode is very hard because there's so much in this book and so much good stuff, and you really need to read it. But I'll do my best to share the parts,

the overview of the parts, some key takeaways or quotes from there, and then particularly the tools that Dr. Vandekolk suggests that he knows work based on his research and that I've used that have helped me process a lot of trauma as well. So part one in this book is called The Rediscovery of Trauma. And again, a high-level overview of this. It begins with Dr. Vandekolk. So he's early in his career. He's learning lessons and some of the first lessons he learns are from Vietnam veterans. And as he says, you know, war, like disasters, teach us a great many good and terrible lessons. And some of the, you know, examples he talks about in some of the cases he follows is a Vietnam veteran, you know, his whole unit was wiped out in a rage. He then went on a revenge

mission and then he lived with that secret for a long time and he became a successful lawyer. Then down the road, he started having a whole lot of problems. For Dr. Vander Kolk, the Vietnam veterans taught him how trauma can stay hidden within us, within those that are seemingly excelling. This guy was a successful lawyer when he was focused, when he was working hard on a case, he was doing really well. I mirrored that, I reflected that in me as well. So do good at my job, doing really good on big projects

or other big planned events before in the past. And then continue to accumulate trauma or maybe don't process things in the past. And then it comes out. And with this example, it would come out with rage and just really having a hard time drinking too much. And that's a common public safety and military, and probably from the pandemic, even more so a lot more people, alcohol.

It's a drug, it's a depressant, it helps us to forget. And this example is no different. And so Dr. Van Der Kolk realized, you know, talking through, hearing his story, letting, you know, kind of the shame of the revenge that this veteran had done for the loss of his unit, plus the trauma from losing everyone except you in this, you know, ambush that happened in a rice paddy. And so he really shares a lot in this first section, the rediscovery of trauma, of learning from war, learning from combat. And we've done that over the past 20 years, particularly in traumatic medicine and PTSD and treatments for that. And I'll mention some of those later on too.

He also walks us through kind of the new technology, like in the 70s and 80s of being able to scan the brain and look at brainwaves and his experience with different patients, listen to their stories, you know, and how being there for patients kind of really helped the study of neuroscience grow. And not just from him, he credits a whole bunch of people in the book that would take a long time just to read them all. But this part one, this rediscovery of trauma is a really good section and a key takeaway, and I'm going to use quotes from the book for this, I think that really summarizes it and its sentiments is that, quote, for real change to take place, the body needs to learn the danger has passed and to live in the reality of the present,

quote. And that's really hard, right? Because if we've been in something really scary, if we've had chronic traumatic events, going to call after call in public safety or in combat, which I'm not familiar with, but more the acute patient care for hospital workers, for counselors that heal terrible things. You start to feel unsafe. You start to feel like you're in danger, even though when you're not, because you're always hyper aroused, you're always ready to respond. You're always maybe thinking of that bad thing. And that's a part that he touches on and how he starts to learn more and his field starts to learn more here in this first part one,

this rediscovery of trauma. And then he takes us to part two, which is, this is your brain on trauma. So again, the technology continues to grow, we can see the different parts of the brain, and they go through the anatomy. And it was a good refresher or even build on, you know, the hippocampus and the sympathetic and parasympathetic. And he gets all into those parts of the science of the brain and how that works. And the chemistry and the anatomy and the key for the medical and the layperson alike is how our minds and bodies are so interconnected. Hence the title of the book, The Body Keeps the Score. But one can't be impacted without affecting the other, right?

If our bodies get hurt, it impacts us mentally. Maybe we don't have the capacity to do work or to keep doing calls with our crews when our brain is hurt, which is like any other organ, again, because remember, we're lifting the stigma. I think I've seen the stigma lifted a lot between anxiety and depression and PTSD over the past 10, 20 years, which is great, which is well past parts of the early parts of this book. But we recognize, and if you've seen someone with nervous tics, or you've seen videos of the old World War I veterans where they just have this blank stare, or they're constantly moving, our minds and our bodies are interconnected. And we'll get into that a little bit more. But they're so interconnected, we can actually use the body there down the road to help heal the mind and vice versa.

And he starts to touch on that and kind of lead us to some of these solutions that we're going to get to later in the book. But they are so intertwined, they're not disconnected. A particular note to me, I think, was how trauma affects the confidence of survivors of trauma to the point of not making eye contact so as to avoid conflict or even just looking at a picture. And they did this where they scanned a person's brain, showed them these pictures, and they wouldn't look at the eyes of the picture. Or even when they would go in to have therapy with Dr. Vandercolk or other folks that he mentions, they wouldn't make eye contact. And if you know some basic psychology, you know, even from dogs, right, they don't stare at each other because staring at each other is a form of aggression, even people, right, we kind of make eye contact, hey, how you doing, a lot of people

look down, that it's an aggressive kind of thing. It's a confidence thing, too, right? You can have a good conversation with somebody when you make eye contact that that denotes, you know, that you respect them that you want to hear what they're saying, which is different than staring at someone you don't know. And so it's really interesting to read about that in a lot of the cases he talks about where some folks were just horribly abused or had this horrific trauma, car accidents, these kind of things. And particularly for me, my example, after my panic attack, after having a scary situation like that, of breathing hard and I thought it was my heart.

And the fear that I had when nothing was going wrong was kind of like that scary feeling when you're going up over a roller coaster or the elevator jumps or you hit turbulence, bad turbulence on a flight. But it stays there. It gets stuck. And we'll talk about how we release that from the body. And there's a great quote that I think he summarizes this part two with that talks about what do we do in those instances. And some of it is pretty primal and takes us back to our childhood where he says, the most natural way for human beings to calm themselves when they are upset is by clinging to another person. Human to human contact is critical.

I know for me, when I've gotten very anxious, or maybe if I do, and before I learned some better coping mechanisms, you know, my wife was critical, right? Giving her a hug, her giving me a hug, my parents, same thing. Just knowing you're safe, you're there. If you're having a hard time, if you have anxiety,

just know that that makes a big difference and it can help alleviate and give you some safety. It won't quite cure it, but it can make you feel like, okay, I'm not in that situation right now. I'm not in that danger. And again, this is an early touch on some of the tools that we're going to get. So then Dr. Van Der Kolt takes us to part three, the mind of children. And he takes us through the minds of children and how trauma affects them, and particularly the cost of abuse and neglect, which doesn't go away when you're an adult. And for those of you out there that, you know, were victims of abuse and neglect, you know that. Admittedly, as he says, he's very open about it. Dr. Verdecoke didn't, you know, he knew very little about the minds of children at this point in his career in the 80s.

And when he keeps learning and get more exposure. But he and his colleagues were determined or would help determine how important a secure base for children is right before they can successfully step out into the world on their own. And the groundbreaking results rather of this ACE study or adverse childhood experiences, which is a study that revealed traumatic experiences during childhood or adolescence are far more common than expected than are out in the open. And additionally, you know, we learned that abused children become very attuned to facial expressions and voice changes. So if you're a parent and you raise your voice because your kids didn't hear, they just didn't listen or you're like, hey, because they're going to,

you know, run out on the road or something something and you see the startled look on their face, imagine that over and over and over again and that's the norm, then they become very attuned to that, the body language. Is the body language maybe going to lead to an abusive situation? Is that voice going to lead to a negative interaction or something like that? And so Dr. Vannikult goes through that a lot in this section, similar episodes like that, how he's helped the children, how he helps them work through things, feel safe, talk through stuff, and things like that. And one of the quotes that I'll close this kind of very brief part three overview on

is Dr. Varnacook says that people with histories of abuse, neglect, or severe deprivation remain mysterious and largely untreated unless we heed the admonition of Alan Shroof. So Alan Shroof is another professor emeritus. He's of child psychology out of the Institute of Child Development at the University of Minnesota. And what he says is, to fully understand how we become the persons we are, the complex step-by-step evolution of our orientations, capacities, and behavior over time requires more than just a list of ingredients. However important any one of them might be, it requires an understanding of the process of development, how all of these factors

work together in an ongoing way over time. So you can hear what I hear from this statement is it's a whole bunch of things together, right? It's never just that Johnny is acting out because Johnny has a bad attitude. What they get to is what happened to his attitude? Why does he act out? Does he feel safe? Is he in an unsafe environment at home or somewhere else? And so what you see sometimes when a child acts a certain way, and then even adolescents and adults, as we'll learn more in the book,

doesn't reflect them as a whole. There's a lot behind that person, right? And these past few years in particular, we've been so separated, and now we're coming back together, and people are divisive. That old, I don't want to get this saying wrong, but the adage of you never know what battle someone's fighting, or maybe like the body keeps the score, what battles did they already fight a long time ago when they were younger, when they're adolescents or, or even just a few months ago. And for me, and maybe for some of you listening out there too, like I lost friends from accidents when I was in high school. I was a volunteer firefighter when I started at 17, joined the Navy at 19, saw, you know, plenty of dead folks, hurt folks was in there trying to save people, lost some people, young and old, men and women, children, and then public safety, on and on. So I knew I had these

traumas, and then part of these bad incidents, a big balloon accident that happened, then family that gets sick. And I thought, well, I'm exercising regularly, but I'm also drinking to mask the pain, some a little bit, some a lot. My sleep's not great. And again, we'll learn about some of the tools that make that better. But that's a pattern too, is folks that experience trauma, whether it's the military, healthcare, day-to-day life, something happens. A lot of times substance abuse is the focus to it, whether it's long-term, short-term. It's a band-aid, not going to treatment, not going to rather therapy. And so the point of this kind of to circle back around is really, you know, you never know what someone's gone through.

And even if you know what you've gone through, maybe you haven't dealt with it. And so in a, in a section or two here, you know, we're going to hopefully help all of us deal with stuff a little better in the future. Um, also in the future, just quick plug. If you go to people process progress.com, you can see the write-ups for each episode. You can listen to older episodes. Subscribe there. All my social media stuff is there as well.

I'm at Penelokg, P-N-E-L-O-K-G on Twitter and Instagram. We have a Facebook page, it's People Process Progress. And reach out to me. There's also a store, so if you want to get a t-shirt, hat, notebook, something like that, kind of a cool People Process Progress stuff. I appreciate it. Support the show. Thanks a lot. Let's get to part four, the imprint of trauma. Here, some of the main things, and again, each of these sections, each of these parts rather has a lot of stuff in it. So I'm just touching on it, but it starts and speaks to trauma-induced amnesia, dissociation, and reenactment.

And the trauma-induced amnesia is when our minds are just overwhelmed with something, something horrible has happened or it keeps happening. Our minds may choose not to remember as like a survival mechanism. So even if you're asked, hey, what happened here? Your memory is either off a little bit or inaccurate, or maybe you just can't think about it or your mind chooses not to. And Dr. Van der Kolk talks about a patient that he had where, you know, this traumatic incident happened. She was stuck taking care of her mom who was deathly ill. Father was an alcoholic, not around. She ended up being there when her mom died, trying to give her medicine,

trying to help her. And so she both at first in therapy couldn't remember anything and then didn't want to because it was so traumatizing. I mean, she was there with her deceased mom and just a horrible situation. And again, this book's kind of heavy, but it's real. It's reality. It's what people go through. And so our mind tries to help us protect. And then at some point, though, it's going to come back. Dissociation is when our minds split off and isolate memories, right? So we get spotty memory trying to think about, you know, something bad that happened in the past, and maybe we remember part of it here and not part of it there. You know, it's an issue is it keeps traumas from being processed, too. So it gives us incomplete memories, or we can't put

the pieces together to then process them out and talk through it or what some of these other therapy methodologies or modalities. We also have a difference between spotty and often broken trauma, traumatic memory versus normal. So, you know, traumatic memory, kind of like I touched on before, it's broken up, it's not complete, we may be missing parts of it, our mind is so traumatized that we may forget things or add things in. Dead-end memories, like I just went to the grocery store. I turned right down the road, that kind of stuff. But again, it speaks to, to me, the self-preserving mechanisms that our mind has that can be helpful maybe in the short term when we're close to acute trauma or maybe down the road. But then eventually it's going to come back to bite us because it's built up over and over. We haven't been able to deal with it. And a great quote,

I think that's a takeaway from, to me, this part about the imprint of trauma, part four of this book, The Body Keeps the Score, is, quote, traumatized people simultaneously remember too little and too much. And I think that just hits home because maybe sometimes you're trying to remember something and you're traumatized. You were either attacked or you were at the scene of a crime and you have to remember something to give to the police. And you can't, right? Because your brain is so traumatized. And then other times you remember everything. There's patients I couldn't save. There's certain aspects of traumatic events I've been through. And I remember them clear as day and I don't want to, right. But that's part of processing as well. And so that's not, you know, for me, that's for,

you know, you have all that have been through trauma as well, probably can understand that. It's just an interesting, I think, statement there that sometimes it's too little and sometimes it's too much. Part five, the final part of the body keeps the score by Vessel van der Kolk, MD is the path to recovery. So this is where we start to get tools or reintroduction because there's some tools that are sprinkled out throughout the book that I just didn't mention yet because I wanted to group them here. So if you know folks listen to any part of this, listen to the last starting at about 19 and a half minutes. After that, this is the progress part where we can get these tools. I know some that have helped me and that have helped plenty of other people that Dr. Van Der Kolk and plenty of other therapists, psychiatrists, counselors have helped.

So one of the headings he has is dealing with hyper arousal, right? So post-traumatic stress and, you know, constant stress, particularly if you're dealing with the sick and injured in healthcare, in public safety, in the military, in somewhere where you're always going somewhere where you have to be on key, you're hyper aroused. And then even after a traumatic event, maybe you're always a little hyper aroused. So I. I now looking back had that where I would always be looking and some of it is good preparedness, right? It's good to have medical kit in your car. It's good to, you know, should you choose to carry a weapon, do so for protection. It's good to look around and pay attention. But there's a point where you maybe get too

hyper vigilant, too hyper aroused, like you're always, always ready, always ready to jump, you feel jumpy, that kind of stuff. Hyperarousal, kind of dealing with that, a good thing is breathing, right? Deep breaths in your nose, out your mouth to kind of calm down if you find yourself start to get agitated. Does that always work for PTSD stuff? No. For anxiety, it's very helpful, and there's some other tools I'm going to talk about in a future episode that helps.

But breathing is key. If you've ever been really upset, really hyped up, you notice that you hold your breath, that you breathe real fast, something like that, and we can learn emotional regulation techniques, and that's a whole podcast too, or a whole book. There's whole books about it, but that helps calm our hyperarousal. In particular, Dr. Randall Koch mentions martial arts, right? Tai Chi, Jiu-Jitsu, which of course I'm a big fan of, because you're looking at purposeful movement. So if I'm, when I'm at jujitsu, and this is something too that I realized, if I'm at jujitsu, I can only focus on my opponent, right? They're

trying to arm lock me, leg lock me, choke me, make me tap out, right? And in a friendly, quote, friendly way, but I'm very focused, right? So my mind can't wander a whole lot on the past or the future or catastrophize about things. It's a very focused thing. So the point is that it's just he gives examples of martial arts and yoga, yoga is throughout this book. It's fantastic. And it's really a combination of, you know, purposeful movement, focused movement and breathing, right? If you notice, if you've ever done a yoga class from beginner to advanced, they're all about the breath. Your own breath, your movements, those kind of things.

So yoga is a methodology, a modality to help heal trauma, to help with anxiety, to help with depression. It's in every text, every website, every YouTube, legit YouTube videos I've seen from therapists. Yoga is everywhere. I highly recommend it. I mix it in because I'm 48. I do jujitsu and exercise. And so my joints get sore in my muscles and it helps, but it also really does help your noggin. Sleep.

Sleep is critical for everything and overall health. PTSD then notoriously causes disturbed sleep, as Dr. Van Der Kolk reminds us. We don't want to sleep. We don't want to remember. Well, you know. Like I did, so my panic attack kicked off when I laid down to go to sleep, and I shot up and was just terrified. I don't know where it came from. It just did. Some folks have racing thoughts when they try and go to sleep, and there's a lot of different ways to help that, but it's critical for body and brain healing. One thing I've learned about and

I'll share, I'm going to share in a future episode is a thing called sleep hygiene. And then there's also cognitive behavioral therapy or CBT-I for insomnia. They go together, but basically it's, you know, reducing stimulus throughout the day. Certainly at nighttime, there's a whole routine that basically gets your mind and body ready for bed. And that helps. If you're really, you know, having a hard time racing, medications help, right? We take meds for aches and pains, meds for your mind is there's nothing wrong with it. And of course, that's another area of stigma, right? That I think is getting better and better. But sleep is a key factor in healing the body and brain. So for folks that are having problems with sleep, whether it's trauma induced or not, look up CBT-I and then sleep hygiene and you'll learn a ton and it'll be really helpful. It's hard because you're going to be tired, but it's going to make a big difference.

Mindfulness. Again, another tool that is everywhere that I've seen for mental health or a lot of places, you know, thoughts to body sensations. And so meditation, taking time out to be there with your emotions, to be there with the silence, to use a guided meditation. I use Headspace. It's a great app. I'm getting nothing from them. I just use it and it works really good. So I do a couple of 10 minute meditations nothing from them. I just use it and it works really good. So I do a couple of 10 minute meditations throughout the day. It just helps you. It walks you through that breathing stuff I talked about. So getting a calm breath, sitting there with the silence,

letting your thoughts come and go. And again, it depends on where you are in your journey of processing trauma, right? If you've just experienced a traumatic event acutely, or you're just starting to have kind of negative breakthroughs with chronic trauma, this can be sprinkled in. But first, there's other stuff you're going to deal with to get a handle on just being able to kind of not be freaked out all the time. But mindfulness and meditation are great tools. And again, there's a whole bunch of different ways to do that. But it's something to consider when you're processing or as part of your toolkit to process trauma. Relationships are key, right? Those are key for project and program

management, but also for traumatic events. So having a support system, and I know not everybody has a great support system. So in addition to familiar faces, or maybe you don't have familiar faces, there are other community groups that you could maybe get in touch with. AA meetings if you need to do that. Church meetings, other community groups you can think of, other organizations, veterans groups, right? Particularly if military-based trauma, public safety groups, unions, things like that. But relationships are key. Talk to other folks. And this is something I know I relate to and I've heard a lot of as well. Most folks that have gone through trauma want to talk to somebody else that has shared a similar trauma or similar experience, right? Not someone that's going to theorize to them what was in the

book they studied that they think they can help, even though that can be helpful for getting tools to really talk stuff out. And talking stuff out, as I'll touch on in a second, isn't always the best option for PTSD because when you talk about it, you're going to relive it right you're going to bring it back up but but relationships matter they're huge knowing knowing someone you know or trusting someone helps you feel safe and like we talked about before when you're traumatized whether it's a long time ago or recently or chronically you don't feel safe you don't feel like there's a safe thing. Communal rhythms and synchronization, the healing power of community, this kind of speaks to the same kind of thing. So if you, and in 2022, it's different, right? Neighbors don't necessarily

talk to each other as much as we used to. Some communities do, some don't. There's been studies, not just in this book, but others that talk about how villages in other countries or communities in other countries are really close-knit and they have better mental health, right? Because they shore each other up, they lift each other up, and that makes a huge difference. Getting in touch, touch therapy, whether it's, you know, massage, a hug from someone, and massage therapy, again, not just in this book, The Body Keeps the Score, but other trauma treatment books that I've read, massage is huge. I've done a series of massages that make a huge deal. They just, one, they feel good. They relax your muscles. And again, it's that sense

of safety, right? I'm safe. I'm relaxed. It's okay. And what they talk about, you can really use it kind of prescriptive early in trauma with, you know, a therapist or, you know, physician, especially if you're not comfortable with people touching you, right? And then that way, the massage therapists that deal with either trauma or other events, other mental health folks, other mental health patients know to start slow. I'm just going to calmly put my hands on you. I'm going to calmly touch your arm. So it's a step-by-step, particularly folks that have been abused or attacked or raped or something like that. And that's what is mentioned in this book and others

as well. But massage therapy is huge. Taking action. And this quote actually heard first. I don't think she made it up, but from Emma McAdam on Therapy in a Nutshell, fantastic YouTube channel. Go check that out. But she says, move a muscle, change a thought. So taking action doesn't just mean like I'm going to do all these things, but if you're sitting still and if you notice this, if you're someone that suffers anxiety, depression, or particularly like we're talking about trauma, you've been traumatized and that's the catalyst for your anxiety and depression and you start feeling anxious, move, right? You know when you sit there, when you lay around, your mind is swirling and swirling and swirling. So if you

get up and go for a walk, if you get an exercise in, if you do a task, if you do some chores, if you reorganize your bookshelves, if you something, right? You're moving and it changes your thought because then you're focused on something else that makes a big difference. I know when I was having some really anxious times, I just, one, I got a kick in the butt from my wife and my mom, honestly, and they were like, you know, because they could see me getting spun up and they're like, go for a walk, go do something. And I did. And it made a huge difference, right? And again, exercise is also another area that's just, it's key in here.

One for overall health, but particularly for mental health. But that move a muscle, change a thought concept, it works. It's hard to do sometimes if you're just not feeling it, if you're just really having a tough time, but highly recommend it. Writing and journaling is another tool that we can use to process. We can do free writing where we just kind of train a thought, just write stuff out, right? We can focus writing. I did this as well. And again, you need to be careful with this because it can be triggering. But I did a whole history of traumas from my childhood, things that just popped up that maybe bothered me, whether I had a rough time at home, through, you know, recently having some negative diagnosis of health for family members,

right? But you journal all that out. And it's, it's kind of this cathartic thing. It's also, I talked about sleep. But one thing we'll talk about in a future episode where we focus on quality sleep and hygiene is a worry time. So set a time during the day where you put all your worries down and you write them down like earlier in the afternoon, not right before bed. And that makes a big difference. But then you can also then process that with a therapist and go through and, you know, for folks in public safety and healthcare and the military and, you know, survival's guilt's a big thing from traumas as well and help process that you couldn't save everybody. Whether it was a patient or your buddies in combat or someone on the street or the person in isolation or whatever it is.

But writing and journaling is very helpful. It's a huge part of the savers from the Miracle Morning that I've talked about here on the podcast. Journaling is one of those or writing and scribing, but that's huge. Another tool Dr. Van Der Kolk uses and that I actually watched a bunch of videos on and researched a bit myself is called Eye Movement Desensitization and Reprocessing or EMDR. And the basic, basic explanation of it is your therapist holds their finger up and you track it with your eye and they just move their finger back and forth laterally or horizontally. It stimulates something in the brain where the therapist or the physician sits there.

It's lateral eye movement with minimal back and forth discussion. You do a history beforehand, but during the session, there's not a lot of talking, but the therapist would prompt you with notice that if they see you starting to feel emotions. And there's something that triggers in the mind. And as they mentioned, they're not exactly sure how it happens. They're not exactly sure how it helps, but it does. It's helped a lot of folks process trauma and feel like they didn't ignore it, but they feel like it's okay. It's also a benefit. I mentioned exercise.

So walking, when you walk in nature, when you go out and you're moving, naturally we're looking side to side, you know, just in general. And that kind of helps too. So it's a sub kind of EMDR, if you will, a benefit of walking. And that's a huge help and really is akin to that, you know, move muscle, change of thought. Another area, of course, that he mentions that's big business, of course, the past few years is medication, not necessarily vaccines. But an interesting fact is the DOD and Department of Veteran Affairs have spent over 4.5 billion on antidepressants and antipsychotics and anxiety meds. They've helped plenty of folks get through problems,

deal with them for life, any mixture they're in. Dr. Vandekook's perspective, though, is that certainly they can dampen them. There's a place for them, but it doesn't cure or provide self-regulation. So yes, meds work. I know there was a new study out too recently about serotonin levels.

Do SSRIs, or that's a type of antotonin levels, do SSRIs or, you know, that's a type of antidepressant, do those actually change the chemicals? What's the need? But the bottom line is they help folks, right, and make a difference. The addition to that, though, is they need to happen with processing, with using some of the tools we talked about before, with counseling, with working in partnership. And we do need to learn some of that self-regulation. So it's not just a here's a pill, you're all good to go. It's maybe medication plus behavioral changes plus self-regulation and getting to the bottom of what your trauma is about, where it comes from.

Another area is, and this was labeled drugs, not medication, but like MDMA or ecstasy. So getting into these, you know, not legal drugs, but using them in a medical environment because it decreases fear, defensiveness and numbing, and they use them as tools. Another area, and it wasn't in this book, but that I've heard about is like mushrooms and a whole bunch of other stuff. So psychology, psychiatry, you know, therapies, getting into looking at these kind of more alternative looking therapies, ketamine therapy, I've heard of, if some of you have as well, where it helps

folks and parts of the brain just, you know, get past traumas and do those. And you know, another thing that helps parts of the brain is neurofeedback. So that technology I touched on way, way back early in the episode, is we monitor the brain, or, you know, professionals monitor the brain activity, and they reward a patient you know that's having positive reactions to something and it makes like the screen a little brighter or something like that so it helps kind of reprogram the brain with positive reinforcement from a reaction from their interactions and that's just amazing to me it's not the old school like shock therapy that you see in probably horror movies where they're holding on their head and go, it's a different kind of thing, but it's interesting. And one of the last

ones, you know, the last one I'm going to talk about is theater. And I have not done this, but acting helps your body and mind kind of take its place in life and really tell stories under another guise. And so he has a really big section about this or, you know, a portion dedicated to it where theater has really helped a lot of folks process trauma by kind of getting out of their own head or getting out there and talking about it, being more comfortable in a theater, you know, setting rather than kind of in an office or in their home or something like that. So that's something I never would have thought of was theater as a treatment tool. And Dr. Vanderkoek closes The Body Keeps the Score with choices to be made, and he provides his view on the importance of a holistic, kind of multifaceted approaches for trauma treatments and the critical importance of helping traumatized children

to create a stronger society. And so, again, I mentioned I highly recommend this book if you're someone that has just gone through something, has gone through a long time ago, is a chronic trauma, particularly public safety, health care, military folks. It's really educational. It's really good to kind of get into what could be triggering me, what could be causing me to feel anxious because of these past events or something that happened to me or events

I was near. Very helpful. And again, what for sure I use regularly, yoga exercise therapy, supplements, which I didn't really get into. I can get into that in a future episode. Medication, increased social interaction. I've worked alone at home for a while, so gotten out more mindfulness and improved sleep hygiene has been a huge, huge difference for me. But I'd like to close with the words of Bessel van der Kolk, Dr. van der Kolk, this episode. One, before I close with his words, I just want to say thank you all so much for waiting for me to come back, for coming

back to the show, for listening while I was gone. And please share this. Share this with somebody that's maybe having a hard time, that you know has had a traumatic history. Get them the book. Maybe have this episode be a primer. It's a lot shorter than the whole book. The whole book's about 400 pages of kind of readable areas plus appendix and resources. But let me close by reading from page 350, paragraph two of the book. Quote, discussions of PTSD still tend to focus on recently returned soldiers, victims of terrorist bombings, or survivors of terrible accidents. But trauma remains a much larger public health issue, arguably the greatest threat to our national well-being. Since 2001, far more Americans have died at the hands of their partners or other family members than in the wars

in Iraq and Afghanistan. American women are twice as likely to suffer domestic violence as breast cancer. The American Academy of Pediatric estimates that firearms kill twice as many children as cancer does. All around Boston, I see signs advertising the Jimmy Fund, which fights children's cancer, and for marches to fund research on breast cancer and leukemia. But we seem too embarrassed or discouraged to mount a massive effort to help children and adults learn to deal with fear, rage, and collapse, the predictable consequences of having been traumatized. So for all of you out there that have experienced trauma, whether it was a malicious act against you, you happen to be in the wrong place at the wrong time, when something bad happened, or it's your job to go into horrible situations, there is help.

The Body Keeps the Score from Dr. Bessel van der Kolk is a good start. It's a good way to get some background and to get some tools to help manage and heal from your trauma. Thank you so much for being here. Stay safe, wash those hands, and Godspeed.