Essentials: Therapy, Treating Trauma & Other Life Challenges | Dr. Paul Conti

Welcome to Huberman Lab Essentials, Welcome to Huberman Lab Essentials, [music] where we revisit past episodes [music] where we revisit past episodes [music] where we revisit past episodes for the most potent and actionable for the most potent and actionable for the most potent and actionable science-based tools for mental health, science-based tools for mental health, science-based tools for mental health, physical health, and performance. physical health, and performance. physical health, and performance. I'm Andrew Huberman and I'm a professor I'm Andrew Huberman and I'm a professor I'm Andrew Huberman and I'm a professor of neurobiology and opthalmology at of neurobiology and opthalmology at of neurobiology and opthalmology at Stanford School of Medicine. And now for Stanford School of Medicine. And now for Stanford School of Medicine. And now for my discussion with Dr. Paul Ki. Paul, my discussion with Dr. Paul Ki. Paul, my discussion with Dr. Paul Ki. Paul, thank you so much for being here today. thank you so much for being here today. thank you so much for being here today. >> Oh, thank you so much for having me. We >> Oh, thank you so much for having me. We >> Oh, thank you so much for having me. We could just start off very basic and just could just start off very basic and just could just start off very basic and just get everyone oriented. How should we get everyone oriented. How should we get everyone oriented. How should we define trauma? define trauma? define trauma? >> I think we have to look at trauma as not >> I think we have to look at trauma as not >> I think we have to look at trauma as not anything negative that happens to us, anything negative that happens to us, anything negative that happens to us, right? But something that overwhelms our right? But something that overwhelms our right? But something that overwhelms our coping skills and then leaves us coping skills and then leaves us coping skills and then leaves us different as we move forward. So it different as we move forward. So it different as we move forward. So it changes the way that our brains changes the way that our brains changes the way that our brains function, right? And then that change is function, right? And then that change is function, right? And then that change is evident in us as we move forward through evident in us as we move forward through evident in us as we move forward through life. We can see it in mood, anxiety, life. We can see it in mood, anxiety, life. We can see it in mood, anxiety, behavior, sleep, physical health. So we behavior, sleep, physical health. So we behavior, sleep, physical health. So we so we can identify it and we can also so we can identify it and we can also so we can identify it and we can also see it in brain changes. If trauma rises see it in brain changes. If trauma rises see it in brain changes. If trauma rises to the level of changing the functioning to the level of changing the functioning to the level of changing the functioning of our brains, then there's almost of our brains, then there's almost of our brains, then there's almost always a reflex of guilt and shame always a reflex of guilt and shame always a reflex of guilt and shame around the trauma that can lead us and around the trauma that can lead us and around the trauma that can lead us and often leads us to bury it, right? To often leads us to bury it, right? To often leads us to bury it, right? To avoid it, which is exactly the opposite avoid it, which is exactly the opposite avoid it, which is exactly the opposite of what needs to be done. We need to of what needs to be done. We need to of what needs to be done. We need to communicate and put words to what's gone communicate and put words to what's gone communicate and put words to what's gone on inside of us. And and very often a on inside of us. And and very often a on inside of us. And and very often a person knows, but they're not admitting person knows, but they're not admitting person knows, but they're not admitting it to themselves because they're afraid it to themselves because they're afraid it to themselves because they're afraid of it, right? They don't know what to of it, right? They don't know what to of it, right? They don't know what to do. But if they start talking then do. But if they start talking then do. But if they start talking then they'll they'll talk about the event or they'll they'll talk about the event or they'll they'll talk about the event or the situation. It could be something the situation. It could be something the situation. It could be something acute or it could be something chronic acute or it could be something chronic acute or it could be something chronic that really has been harmful to them, that really has been harmful to them, that really has been harmful to them, right? And then they feel different right? And then they feel different right? And then they feel different afterwards. But that doesn't always afterwards. But that doesn't always afterwards. But that doesn't always happen. Sometimes it's a process of happen. Sometimes it's a process of happen. Sometimes it's a process of exploration, you know, through dialogue, exploration, you know, through dialogue, exploration, you know, through dialogue, right? whether whether it's written or right? whether whether it's written or right? whether whether it's written or whether it's spoken of of the person whether it's spoken of of the person whether it's spoken of of the person sort of exploring the changes inside of sort of exploring the changes inside of sort of exploring the changes inside of themselves maybe changes to their self-t themselves maybe changes to their self-t themselves maybe changes to their self-t talk inside changes to their thoughts talk inside changes to their thoughts talk inside changes to their thoughts about the world and whether they can about the world and whether they can about the world and whether they can navigate safely and readily in it and navigate safely and readily in it and navigate safely and readily in it and you know it anchors as I talk about this you know it anchors as I talk about this you know it anchors as I talk about this the example I'll use at times is the the example I'll use at times is the the example I'll use at times is the example of my own life where you know example of my own life where you know example of my own life where you know when I was much younger in my early 20s when I was much younger in my early 20s when I was much younger in my early 20s my younger brother took his life by my younger brother took his life by my younger brother took his life by suicide and the you know the response of suicide and the you know the response of suicide and the you know the response of guilt and shame and and hiding all of it guilt and shame and and hiding all of it guilt and shame and and hiding all of it inside of me was was this is very inside of me was was this is very inside of me was was this is very dramatic but but I wasn't acknowledging dramatic but but I wasn't acknowledging dramatic but but I wasn't acknowledging it right because I didn't know what to it right because I didn't know what to it right because I didn't know what to do about it and I felt guilty and I felt do about it and I felt guilty and I felt do about it and I felt guilty and I felt responsible and I felt ashamed so there responsible and I felt ashamed so there responsible and I felt ashamed so there was a an avoidance inside of me so so I was a an avoidance inside of me so so I was a an avoidance inside of me so so I didn't see that the change was in me but didn't see that the change was in me but didn't see that the change was in me but I was taking care of myself poorly like I was taking care of myself poorly like I was taking care of myself poorly like there was enough going on that was there was enough going on that was there was enough going on that was unhealthy that I couldn't avoid the unhealthy that I couldn't avoid the unhealthy that I couldn't avoid the realization that like hey I'm different realization that like hey I'm different realization that like hey I'm different now and in these ways that are automatic now and in these ways that are automatic now and in these ways that are automatic you know my reflex to can I make my way you know my reflex to can I make my way you know my reflex to can I make my way in the world can I have a good life can in the world can I have a good life can in the world can I have a good life can I be happy my reflexes to that were all I be happy my reflexes to that were all I be happy my reflexes to that were all different and they were coming through different and they were coming through different and they were coming through the lens of heightened anxiety the lens of heightened anxiety the lens of heightened anxiety heightened vigilance a sense of guilt a heightened vigilance a sense of guilt a heightened vigilance a sense of guilt a sense of shame uh and a sense of sense of shame uh and a sense of sense of shame uh and a sense of non-belonging in the world and and was non-belonging in the world and and was non-belonging in the world and and was ultimately good and helpful people ultimately good and helpful people ultimately good and helpful people around me um and my own realization that around me um and my own realization that around me um and my own realization that hey things are not going well right that hey things are not going well right that hey things are not going well right that led me to to then get some help and to led me to to then get some help and to led me to to then get some help and to be able to talk about it and realize be able to talk about it and realize be able to talk about it and realize like, oh my gosh, like I need to face like, oh my gosh, like I need to face like, oh my gosh, like I need to face these things that are going on inside of these things that are going on inside of these things that are going on inside of me. me. me. >> Why do you think that when we experience >> Why do you think that when we experience >> Why do you think that when we experience trauma, these things that we call guilt trauma, these things that we call guilt trauma, these things that we call guilt and shame surface? Those emotions must and shame surface? Those emotions must and shame surface? Those emotions must exist in us for some reason. exist in us for some reason. exist in us for some reason. >> Um, but in this case, it seems like they >> Um, but in this case, it seems like they >> Um, but in this case, it seems like they they don't serve us well. So why is it they don't serve us well. So why is it they don't serve us well. So why is it that we seem to be reflexively wired to that we seem to be reflexively wired to that we seem to be reflexively wired to feel guilty and feel ashamed when that's feel guilty and feel ashamed when that's feel guilty and feel ashamed when that's the exact opposite of what we need to do the exact opposite of what we need to do the exact opposite of what we need to do in the case of trauma? There's something in the case of trauma? There's something in the case of trauma? There's something adaptive that has happened in us through adaptive that has happened in us through adaptive that has happened in us through evolution that now becomes maladaptive evolution that now becomes maladaptive evolution that now becomes maladaptive in in the way we live in the modern in in the way we live in the modern in in the way we live in the modern world. Right? So if you think of through world. Right? So if you think of through world. Right? So if you think of through most of human development, you know, most of human development, you know, most of human development, you know, people weren't living that long, right? people weren't living that long, right? people weren't living that long, right? And the idea was to survive and And the idea was to survive and And the idea was to survive and reproduce. So, so traumatic things that reproduce. So, so traumatic things that reproduce. So, so traumatic things that happened to us, it would make sense for happened to us, it would make sense for happened to us, it would make sense for them to stay with us, right? So, you them to stay with us, right? So, you them to stay with us, right? So, you know, if you ate a new food and got know, if you ate a new food and got know, if you ate a new food and got really, really sick, it's like you really, really sick, it's like you really, really sick, it's like you better remember that, right? You know, better remember that, right? You know, better remember that, right? You know, if you see someone from the group of if you see someone from the group of if you see someone from the group of people, you know, a couple miles away, people, you know, a couple miles away, people, you know, a couple miles away, right? And one of those people attacks right? And one of those people attacks right? And one of those people attacks you, right? It's like you better you, right? It's like you better you, right? It's like you better remember that. So, so the traumatic remember that. So, so the traumatic remember that. So, so the traumatic things that are sort of emlazed in our things that are sort of emlazed in our things that are sort of emlazed in our brain are built to last, right? Things brain are built to last, right? Things brain are built to last, right? Things that are positive will generate some that are positive will generate some that are positive will generate some emotion inside of us, but things that emotion inside of us, but things that emotion inside of us, but things that are profoundly negative are much more are profoundly negative are much more are profoundly negative are much more likely to stay with us. And I think that likely to stay with us. And I think that likely to stay with us. And I think that that was adaptive, right? When all of that was adaptive, right? When all of that was adaptive, right? When all of that was about survival, right? And I that was about survival, right? And I that was about survival, right? And I think the same thing is true with with think the same thing is true with with think the same thing is true with with say shame. The lyic system, right, the say shame. The lyic system, right, the say shame. The lyic system, right, the system often is called the emotion system often is called the emotion system often is called the emotion system, right? In our in our brains has system, right? In our in our brains has system, right? In our in our brains has actually of course varying function, actually of course varying function, actually of course varying function, right? And one aspect is affect, right? right? And one aspect is affect, right? right? And one aspect is affect, right? So affect is aroused in us. It's created So affect is aroused in us. It's created So affect is aroused in us. It's created in us without our choice. Right? So if in us without our choice. Right? So if in us without our choice. Right? So if if we're walking down the road and if we're walking down the road and if we're walking down the road and someone jumps in front of us or pushes someone jumps in front of us or pushes someone jumps in front of us or pushes us, right? Then there's a response of us, right? Then there's a response of us, right? Then there's a response of fear, anger, right? Heart starts beating fear, anger, right? Heart starts beating fear, anger, right? Heart starts beating faster, you know, more blood to the faster, you know, more blood to the faster, you know, more blood to the muscles, you we're getting ready to to muscles, you we're getting ready to to muscles, you we're getting ready to to fight, right? Or or run, right? And then fight, right? Or or run, right? And then fight, right? Or or run, right? And then we become aware of it. So the aroused we become aware of it. So the aroused we become aware of it. So the aroused affect in us is also about survival. And affect in us is also about survival. And affect in us is also about survival. And it has a very deep impact upon us and it has a very deep impact upon us and it has a very deep impact upon us and shame is an aroused a effect. So it can shame is an aroused a effect. So it can shame is an aroused a effect. So it can be raised in us without our choice and be raised in us without our choice and be raised in us without our choice and it's very powerful which if you think it's very powerful which if you think it's very powerful which if you think about that is an extremely strong about that is an extremely strong about that is an extremely strong deterrent. You know, imagine a a tribe deterrent. You know, imagine a a tribe deterrent. You know, imagine a a tribe or a group of people, right, that are or a group of people, right, that are or a group of people, right, that are sheltered together and you know, someone sheltered together and you know, someone sheltered together and you know, someone eats half the food at night or eats half the food at night or eats half the food at night or something, right? And like there's a something, right? And like there's a something, right? And like there's a very negative response, right? And that very negative response, right? And that very negative response, right? And that person feels shame because shame is so person feels shame because shame is so person feels shame because shame is so powerful to to control behavior, right? powerful to to control behavior, right? powerful to to control behavior, right? So the way that trauma can change our So the way that trauma can change our So the way that trauma can change our brains and and stay with us in a way brains and and stay with us in a way brains and and stay with us in a way that says be more vigilant, look at the that says be more vigilant, look at the that says be more vigilant, look at the world in a different way, act more world in a different way, act more world in a different way, act more defensively, right? and and how that defensively, right? and and how that defensively, right? and and how that links to shame and to guilt. So then links to shame and to guilt. So then links to shame and to guilt. So then guilt in invol guilt becomes what gets guilt in invol guilt becomes what gets guilt in invol guilt becomes what gets called feeling technically where we called feeling technically where we called feeling technically where we relate the aroused affect to ourselves relate the aroused affect to ourselves relate the aroused affect to ourselves right. So, so shame, the aroused apect right. So, so shame, the aroused apect right. So, so shame, the aroused apect and guilt, the next step, right? When we and guilt, the next step, right? When we and guilt, the next step, right? When we when the shame gets related to self are when the shame gets related to self are when the shame gets related to self are such profound behavioral interventions such profound behavioral interventions such profound behavioral interventions and and deterrence that you can see, I and and deterrence that you can see, I and and deterrence that you can see, I think how evolutionarily kind of all think how evolutionarily kind of all think how evolutionarily kind of all makes sense. If we're fighting for makes sense. If we're fighting for makes sense. If we're fighting for survival, you know, and we're an elder survival, you know, and we're an elder survival, you know, and we're an elder statesman, if we make it to 20, this statesman, if we make it to 20, this statesman, if we make it to 20, this makes sense. But it doesn't make sense makes sense. But it doesn't make sense makes sense. But it doesn't make sense in a world where we live much longer, in a world where we live much longer, in a world where we live much longer, right? We navigate in all sorts of right? We navigate in all sorts of right? We navigate in all sorts of different ways. And there's so much different ways. And there's so much different ways. And there's so much coming at us that can be traumatizing. coming at us that can be traumatizing. coming at us that can be traumatizing. Our brains are built to change from Our brains are built to change from Our brains are built to change from trauma, but not in the way we experience trauma, but not in the way we experience trauma, but not in the way we experience trauma and not in the way that we live trauma and not in the way that we live trauma and not in the way that we live life in terms of the nature of living life in terms of the nature of living life in terms of the nature of living life and the duration of life in the life and the duration of life in the life and the duration of life in the modern world where these traumas that modern world where these traumas that modern world where these traumas that happen to us are often so bad for us happen to us are often so bad for us happen to us are often so bad for us because they they change how our brain because they they change how our brain because they they change how our brain is functioning and then our entire is functioning and then our entire is functioning and then our entire orientation. So the world is different orientation. So the world is different orientation. So the world is different and that could be for you know years and and that could be for you know years and and that could be for you know years and years. years. years. >> This idea that I've heard about before I >> This idea that I've heard about before I >> This idea that I've heard about before I think it was a Freudian concept of a think it was a Freudian concept of a think it was a Freudian concept of a repetition compulsion. My understanding repetition compulsion. My understanding repetition compulsion. My understanding of this concept of the repetition of this concept of the repetition of this concept of the repetition compulsion is that we all want to solve compulsion is that we all want to solve compulsion is that we all want to solve our traumas and it allows us to put our traumas and it allows us to put our traumas and it allows us to put ourselves into micro or um again macro ourselves into micro or um again macro ourselves into micro or um again macro versions of that over and over again. We versions of that over and over again. We versions of that over and over again. We get to run the experiment again and get to run the experiment again and get to run the experiment again and again in an attempt to solve it. Right? again in an attempt to solve it. Right? again in an attempt to solve it. Right? Why is it that somebody who is in an Why is it that somebody who is in an Why is it that somebody who is in an abusive relationship goes on to have a abusive relationship goes on to have a abusive relationship goes on to have a second and third or fourth verbally or second and third or fourth verbally or second and third or fourth verbally or physically abusive relationship? We see physically abusive relationship? We see physically abusive relationship? We see that over and over. It's not necessarily that over and over. It's not necessarily that over and over. It's not necessarily in everyone, but boy, it is in a lot of in everyone, but boy, it is in a lot of in everyone, but boy, it is in a lot of people who have suffered trauma. On the people who have suffered trauma. On the people who have suffered trauma. On the surface of it, it's like it makes no surface of it, it's like it makes no surface of it, it's like it makes no sense. But then if we think, well, how sense. But then if we think, well, how sense. But then if we think, well, how does the brain how does our brains does the brain how does our brains does the brain how does our brains actually function, right? We're sort of actually function, right? We're sort of actually function, right? We're sort of trained, at least in Western society, I trained, at least in Western society, I trained, at least in Western society, I think, to think of ourselves as logical think, to think of ourselves as logical think, to think of ourselves as logical creatures, right? that like, oh, we're creatures, right? that like, oh, we're creatures, right? that like, oh, we're logical and ultimately everything in us logical and ultimately everything in us logical and ultimately everything in us can just boil down to logic, which is can just boil down to logic, which is can just boil down to logic, which is completely not true. The limbic system, completely not true. The limbic system, completely not true. The limbic system, right, the emotion system, so to speak, right, the emotion system, so to speak, right, the emotion system, so to speak, inside of us always trumps logic, right? inside of us always trumps logic, right? inside of us always trumps logic, right? If you think about does it ever make If you think about does it ever make If you think about does it ever make sense to run into a burning building? I sense to run into a burning building? I sense to run into a burning building? I mean, logic says no, right? But if mean, logic says no, right? But if mean, logic says no, right? But if someone you love is in the burning someone you love is in the burning someone you love is in the burning building, you people run right in, building, you people run right in, building, you people run right in, right? Because the lyic system says yes. right? Because the lyic system says yes. right? Because the lyic system says yes. So when logic and emotion come So when logic and emotion come So when logic and emotion come head-to-head, emotion wins all the time. head-to-head, emotion wins all the time. head-to-head, emotion wins all the time. And the lyic system does not care about And the lyic system does not care about And the lyic system does not care about the clock or the calendar. So how I the clock or the calendar. So how I the clock or the calendar. So how I would relate that to the repetition would relate that to the repetition would relate that to the repetition compulsion is is when people are compulsion is is when people are compulsion is is when people are repeating what they're trying to do is repeating what they're trying to do is repeating what they're trying to do is to make things right, right? With the to make things right, right? With the to make things right, right? With the idea that if we can repeat the situation idea that if we can repeat the situation idea that if we can repeat the situation and make it right, it will fix and make it right, it will fix and make it right, it will fix everything. Right? which makes perfect everything. Right? which makes perfect everything. Right? which makes perfect sense if if we think well where is that sense if if we think well where is that sense if if we think well where is that concept coming from right it's coming concept coming from right it's coming concept coming from right it's coming from the emotional part of the brain from the emotional part of the brain from the emotional part of the brain that wants relief from suffering of the that wants relief from suffering of the that wants relief from suffering of the trauma and does not understand the clock trauma and does not understand the clock trauma and does not understand the clock or the calendar so if I can solve or the calendar so if I can solve or the calendar so if I can solve something now I will also solve something now I will also solve something now I will also solve something in the past right which is why something in the past right which is why something in the past right which is why I can't tell you how many times I've sat I can't tell you how many times I've sat I can't tell you how many times I've sat with someone and say we're starting to with someone and say we're starting to with someone and say we're starting to do therapy right and a person will say do therapy right and a person will say do therapy right and a person will say my last seven relationships have and my last seven relationships have and my last seven relationships have and abusive and I'll say back something abusive and I'll say back something abusive and I'll say back something sometimes like well look if if you tell sometimes like well look if if you tell sometimes like well look if if you tell me that you've had seven relationships me that you've had seven relationships me that you've had seven relationships that have been abusive in different ways that have been abusive in different ways that have been abusive in different ways I'll agree with you like I only say that I'll agree with you like I only say that I'll agree with you like I only say that cuz that's never what someone says right cuz that's never what someone says right cuz that's never what someone says right but I think what you're going to tell me but I think what you're going to tell me but I think what you're going to tell me is you've kind of had the same is you've kind of had the same is you've kind of had the same relationship seven times so think the relationship seven times so think the relationship seven times so think the light bulb that goes off like I have not light bulb that goes off like I have not light bulb that goes off like I have not had seven different abusive had seven different abusive had seven different abusive relationships I have had one that I have relationships I have had one that I have relationships I have had one that I have repeated seven times and now we start repeated seven times and now we start repeated seven times and now we start getting to what's really going on or getting to what's really going on or getting to what's really going on or what needs to happen. That person needs what needs to happen. That person needs what needs to happen. That person needs to face what happened in that original to face what happened in that original to face what happened in that original abusive relationship. And it always abusive relationship. And it always abusive relationship. And it always comes down to the same sort of concepts comes down to the same sort of concepts comes down to the same sort of concepts of of the person feeling terrified while of of the person feeling terrified while of of the person feeling terrified while the abuse was going on, feeling guilty, the abuse was going on, feeling guilty, the abuse was going on, feeling guilty, feeling ashamed, feeling like, oh, they feeling ashamed, feeling like, oh, they feeling ashamed, feeling like, oh, they brought it on themselves. They deserve brought it on themselves. They deserve brought it on themselves. They deserve it. They don't deserve anything better. it. They don't deserve anything better. it. They don't deserve anything better. Right? Because the brain is trying to Right? Because the brain is trying to Right? Because the brain is trying to make sense of it. Right? Or I I thought make sense of it. Right? Or I I thought make sense of it. Right? Or I I thought I could make that okay, but I couldn't. I could make that okay, but I couldn't. I could make that okay, but I couldn't. Right? And then there's more guilt and Right? And then there's more guilt and Right? And then there's more guilt and more shame. And if that's stuck inside more shame. And if that's stuck inside more shame. And if that's stuck inside of someone, like that's bundled up of someone, like that's bundled up of someone, like that's bundled up inside of someone, you know, like a inside of someone, you know, like a inside of someone, you know, like a medical abscess inside a person, you medical abscess inside a person, you medical abscess inside a person, you know, a walled off infection inside the know, a walled off infection inside the know, a walled off infection inside the body. This is the same concept in the body. This is the same concept in the body. This is the same concept in the brain, then of course the lyic system is brain, then of course the lyic system is brain, then of course the lyic system is going to want to fix that and and it going to want to fix that and and it going to want to fix that and and it fixes it by trying to let's recreate fixes it by trying to let's recreate fixes it by trying to let's recreate that situation and make it right this that situation and make it right this that situation and make it right this time. I see that play out clinically time. I see that play out clinically time. I see that play out clinically over and over again. And why do things over and over again. And why do things over and over again. And why do things get better? Because we go to the trauma get better? Because we go to the trauma get better? Because we go to the trauma and we unlock it. It's not hidden inside and we unlock it. It's not hidden inside and we unlock it. It's not hidden inside where it can control things, right? We where it can control things, right? We where it can control things, right? We bring it to the surface and then we we bring it to the surface and then we we bring it to the surface and then we we can take away its power. The thought can take away its power. The thought can take away its power. The thought about the thing, the event about the thing, the event about the thing, the event >> or events plural evokes this arousal, >> or events plural evokes this arousal, >> or events plural evokes this arousal, this internal state makes some people this internal state makes some people this internal state makes some people feel sleepy and exhausted, other people feel sleepy and exhausted, other people feel sleepy and exhausted, other people feel really anxious, other people feel feel really anxious, other people feel feel really anxious, other people feel angry. I mean that arousal has all these angry. I mean that arousal has all these angry. I mean that arousal has all these different dimensions. As you know, it's different dimensions. As you know, it's different dimensions. As you know, it's clear we need to confront these things. clear we need to confront these things. clear we need to confront these things. And so, how do we deal with arousal? How And so, how do we deal with arousal? How And so, how do we deal with arousal? How does one take what they feel inside does one take what they feel inside does one take what they feel inside about something shameful? What do you do about something shameful? What do you do about something shameful? What do you do with it in a moment? And does that have with it in a moment? And does that have with it in a moment? And does that have to be done in the presence of a skilled to be done in the presence of a skilled to be done in the presence of a skilled trained therapist? How do we deal with trained therapist? How do we deal with trained therapist? How do we deal with that internal arousal? that internal arousal? that internal arousal? >> We so often try and change the trauma of >> We so often try and change the trauma of >> We so often try and change the trauma of the past in order to control the future. the past in order to control the future. the past in order to control the future. And what what that really adds up to is And what what that really adds up to is And what what that really adds up to is the trauma of the past dominates our the trauma of the past dominates our the trauma of the past dominates our present. And and then we're not really present. And and then we're not really present. And and then we're not really living in the present, right? As we're living in the present, right? As we're living in the present, right? As we're trying to control the future, we're not trying to control the future, we're not trying to control the future, we're not going to do a great job of controlling going to do a great job of controlling going to do a great job of controlling our future if we're not really living in our future if we're not really living in our future if we're not really living in the present. And so the way to come at the present. And so the way to come at the present. And so the way to come at that again in the moment, if we're that again in the moment, if we're that again in the moment, if we're saying, okay, in the moment, if I need saying, okay, in the moment, if I need saying, okay, in the moment, if I need to fall asleep, right, I might say, to fall asleep, right, I might say, to fall asleep, right, I might say, okay, let me try and put that out of my okay, let me try and put that out of my okay, let me try and put that out of my mind. Let me try and thought redirect. mind. Let me try and thought redirect. mind. Let me try and thought redirect. So, so there's short-term strategies So, so there's short-term strategies So, so there's short-term strategies that can let us be functional in the that can let us be functional in the that can let us be functional in the context of these changes. But the answer context of these changes. But the answer context of these changes. But the answer is to go look directly at that thing, is to go look directly at that thing, is to go look directly at that thing, look at that trauma, explore that look at that trauma, explore that look at that trauma, explore that trauma. And sure, that can be done with trauma. And sure, that can be done with trauma. And sure, that can be done with a professional and sometimes that's what a professional and sometimes that's what a professional and sometimes that's what makes sense. But not always, right? makes sense. But not always, right? makes sense. But not always, right? Sometimes it can be done by talking to Sometimes it can be done by talking to Sometimes it can be done by talking to another person, right? Writing it down, another person, right? Writing it down, another person, right? Writing it down, right? Looking at what's going on inside right? Looking at what's going on inside right? Looking at what's going on inside of me that my mind is so stuck to this. of me that my mind is so stuck to this. of me that my mind is so stuck to this. Let's explore that. We're so afraid so Let's explore that. We're so afraid so Let's explore that. We're so afraid so often of looking at the trauma that has often of looking at the trauma that has often of looking at the trauma that has changed us that we'll look anywhere but changed us that we'll look anywhere but changed us that we'll look anywhere but at that. What ends up happening is when at that. What ends up happening is when at that. What ends up happening is when the person puts words to it, right? It the person puts words to it, right? It the person puts words to it, right? It could be in writing, it could be talking could be in writing, it could be talking could be in writing, it could be talking to a trusted other or with a therapist, to a trusted other or with a therapist, to a trusted other or with a therapist, right? Things start to change. I mean, right? Things start to change. I mean, right? Things start to change. I mean, just the fact that you can talk about just the fact that you can talk about just the fact that you can talk about it, you can put words to it and other it, you can put words to it and other it, you can put words to it and other people don't recoil. that you know that people don't recoil. that you know that people don't recoil. that you know that example of of the person who says okay I example of of the person who says okay I example of of the person who says okay I was abused by a coach when I was a child was abused by a coach when I was a child was abused by a coach when I was a child and once they start talking about it and once they start talking about it and once they start talking about it then they start talking about how you then they start talking about how you then they start talking about how you know they were just innocent kids right know they were just innocent kids right know they were just innocent kids right like they didn't know and like they like they didn't know and like they like they didn't know and like they really wanted to be on the team or this really wanted to be on the team or this really wanted to be on the team or this coach was treating them as special and coach was treating them as special and coach was treating them as special and and now they can look at themselves from and now they can look at themselves from and now they can look at themselves from the outside right they can look at the outside right they can look at the outside right they can look at themselves like they would look at themselves like they would look at themselves like they would look at someone else you think it's so easy for someone else you think it's so easy for someone else you think it's so easy for us to see what's real and true if it's us to see what's real and true if it's us to see what's real and true if it's someone else, right? If you ask someone, someone else, right? If you ask someone, someone else, right? If you ask someone, what do you think of someone who's 10, what do you think of someone who's 10, what do you think of someone who's 10, 11 years old who's abused and 11 years old who's abused and 11 years old who's abused and manipulated and abused by an adult, we manipulated and abused by an adult, we manipulated and abused by an adult, we say, "Oh my goodness, I feel compassion say, "Oh my goodness, I feel compassion say, "Oh my goodness, I feel compassion for that person," right? But if it's us, for that person," right? But if it's us, for that person," right? But if it's us, right? Then, oh no, it's guilt and shame right? Then, oh no, it's guilt and shame right? Then, oh no, it's guilt and shame and we have to hide it away. And when and we have to hide it away. And when and we have to hide it away. And when the person starts looking at it, they the person starts looking at it, they the person starts looking at it, they can sort of see it from the outside and can sort of see it from the outside and can sort of see it from the outside and it starts to take the energy out of it. it starts to take the energy out of it. it starts to take the energy out of it. All the guilt and shame inside the All the guilt and shame inside the All the guilt and shame inside the person gets juxtaposed like what really person gets juxtaposed like what really person gets juxtaposed like what really happened there? And then they say right happened there? And then they say right happened there? And then they say right I was a terrified child right I didn't I was a terrified child right I didn't I was a terrified child right I didn't understand at all and they can come to a understand at all and they can come to a understand at all and they can come to a place of compassion and now we are place of compassion and now we are place of compassion and now we are working against the guilt and shame and working against the guilt and shame and working against the guilt and shame and if the person cries about it that's if the person cries about it that's if the person cries about it that's great right I mean crying is one of the great right I mean crying is one of the great right I mean crying is one of the best coping mechanisms we have it best coping mechanisms we have it best coping mechanisms we have it doesn't hurt us and it lets us grieve doesn't hurt us and it lets us grieve doesn't hurt us and it lets us grieve things you we can't grieve if there's things you we can't grieve if there's things you we can't grieve if there's guilt and shame inside of us it just guilt and shame inside of us it just guilt and shame inside of us it just blocks grief right we have to there has blocks grief right we have to there has blocks grief right we have to there has to be a clean slate in a sense in order to be a clean slate in a sense in order to be a clean slate in a sense in order to feel sadness and then You see that it to feel sadness and then You see that it to feel sadness and then You see that it shifts from anxiety, anger and shifts from anxiety, anger and shifts from anxiety, anger and frustration, usually directed towards frustration, usually directed towards frustration, usually directed towards the self, guilt and shame towards uh the self, guilt and shame towards uh the self, guilt and shame towards uh towards being able to process it and towards being able to process it and towards being able to process it and being able to bring to bear some being able to bring to bear some being able to bring to bear some compassion and being able to direct the compassion and being able to direct the compassion and being able to direct the negative emotions so to speak where negative emotions so to speak where negative emotions so to speak where they're warranted. And my goodness, the they're warranted. And my goodness, the they're warranted. And my goodness, the changes. It's remarkable how just changes. It's remarkable how just changes. It's remarkable how just getting it out there and having like one getting it out there and having like one getting it out there and having like one hour of talking like that like like what hour of talking like that like like what hour of talking like that like like what we're talking about now can can leave a we're talking about now can can leave a we're talking about now can can leave a person feeling immensely better. How do person feeling immensely better. How do person feeling immensely better. How do we do that in a way that isn't we do that in a way that isn't we do that in a way that isn't retraumatizing oursel in a major way or retraumatizing oursel in a major way or retraumatizing oursel in a major way or in a minor way? in a minor way? in a minor way? >> It starts with real introspection. You >> It starts with real introspection. You >> It starts with real introspection. You know, when things are bouncing around in know, when things are bouncing around in know, when things are bouncing around in our minds, often it's very our minds, often it's very our minds, often it's very non-productive, right? It's the same non-productive, right? It's the same non-productive, right? It's the same thing over and over again. And that's thing over and over again. And that's thing over and over again. And that's not helpful for us, right? So if we're not helpful for us, right? So if we're not helpful for us, right? So if we're just thinking about it and we're just thinking about it and we're just thinking about it and we're thinking in the same way we sort of in a thinking in the same way we sort of in a thinking in the same way we sort of in a sense always think about it, then all sense always think about it, then all sense always think about it, then all we're doing is reinforcing the trauma, we're doing is reinforcing the trauma, we're doing is reinforcing the trauma, right? But if we can distance enough, right? But if we can distance enough, right? But if we can distance enough, then we can think in ways that allow us then we can think in ways that allow us then we can think in ways that allow us to have new thoughts, right, that that to have new thoughts, right, that that to have new thoughts, right, that that we weren't having. It's not just we weren't having. It's not just we weren't having. It's not just bouncing around in our minds. And if we bouncing around in our minds. And if we bouncing around in our minds. And if we speak or write, there are even more speak or write, there are even more speak or write, there are even more mechanisms that come online in our mechanisms that come online in our mechanisms that come online in our brains, right? That that are then sort brains, right? That that are then sort brains, right? That that are then sort of monitoring mechanisms. We think in a of monitoring mechanisms. We think in a of monitoring mechanisms. We think in a different way if we're using words, different way if we're using words, different way if we're using words, right? And we we are better able often right? And we we are better able often right? And we we are better able often to bring in that observing ego like to bring in that observing ego like to bring in that observing ego like what's going on inside of me. So, so it what's going on inside of me. So, so it what's going on inside of me. So, so it can be very helpful to think. It can be can be very helpful to think. It can be can be very helpful to think. It can be helpful to talk to someone to a trusted helpful to talk to someone to a trusted helpful to talk to someone to a trusted other, you know, friend, family, clergy, other, you know, friend, family, clergy, other, you know, friend, family, clergy, uh to write. I mean, these are things uh to write. I mean, these are things uh to write. I mean, these are things that can be done without expending any that can be done without expending any that can be done without expending any resources. And sometimes if the symptoms resources. And sometimes if the symptoms resources. And sometimes if the symptoms are significant enough like we really do are significant enough like we really do are significant enough like we really do need to talk to somebody professional need to talk to somebody professional need to talk to somebody professional who can who can help us get to the root who can who can help us get to the root who can who can help us get to the root of the trauma. But what are some of the of the trauma. But what are some of the of the trauma. But what are some of the characteristics that one should look for characteristics that one should look for characteristics that one should look for in looking for a therapist? in looking for a therapist? in looking for a therapist? >> If you look at what are the top 10 uh >> If you look at what are the top 10 uh >> If you look at what are the top 10 uh important factors to find in a therapist important factors to find in a therapist important factors to find in a therapist just repeat rapport 10 times. It's just repeat rapport 10 times. It's just repeat rapport 10 times. It's trust. It's a back and forth. It's it's trust. It's a back and forth. It's it's trust. It's a back and forth. It's it's like yeah even though I'm doing I'm like yeah even though I'm doing I'm like yeah even though I'm doing I'm doing something difficult. I'm doing it doing something difficult. I'm doing it doing something difficult. I'm doing it with someone who's really helping me. with someone who's really helping me. with someone who's really helping me. Someone who's in it with me, right? Someone who's in it with me, right? Someone who's in it with me, right? someone who's really paying attention, someone who's really paying attention, someone who's really paying attention, wants me to be better, that's wants me to be better, that's wants me to be better, that's indispensable. I think that good indispensable. I think that good indispensable. I think that good therapists are not pigeonholed by a therapists are not pigeonholed by a therapists are not pigeonholed by a certain modality. They they may, you certain modality. They they may, you certain modality. They they may, you know, come at the world largely through know, come at the world largely through know, come at the world largely through a psychonamic or a CBT or a DBT lens. a psychonamic or a CBT or a DBT lens. a psychonamic or a CBT or a DBT lens. There's lots of different, you know, There's lots of different, you know, There's lots of different, you know, ways to do therapy, but when you really ways to do therapy, but when you really ways to do therapy, but when you really talk to those people, really good, talk to those people, really good, talk to those people, really good, experienced therapists, it's all coming experienced therapists, it's all coming experienced therapists, it's all coming through the vehicle of the rapport, but through the vehicle of the rapport, but through the vehicle of the rapport, but they're practically shifting to what the they're practically shifting to what the they're practically shifting to what the person needs. If you have that, you've person needs. If you have that, you've person needs. If you have that, you've got a winning combination. got a winning combination. got a winning combination. >> So, people should perhaps try a few >> So, people should perhaps try a few >> So, people should perhaps try a few therapists and maybe have a session or therapists and maybe have a session or therapists and maybe have a session or two or three to see if they the rapport two or three to see if they the rapport two or three to see if they the rapport feels like it's taking root. feels like it's taking root. feels like it's taking root. >> Yeah. And I think that's why word of >> Yeah. And I think that's why word of >> Yeah. And I think that's why word of mouth is important, right? If someone mouth is important, right? If someone mouth is important, right? If someone you trust tells you, hey, this is a good you trust tells you, hey, this is a good you trust tells you, hey, this is a good person, that says a lot, right? It person, that says a lot, right? It person, that says a lot, right? It already makes the pretest probability already makes the pretest probability already makes the pretest probability you is quite high. How does one gauge you is quite high. How does one gauge you is quite high. How does one gauge how much therapy they they ought to be how much therapy they they ought to be how much therapy they they ought to be um doing and uh should it always be on um doing and uh should it always be on um doing and uh should it always be on the therapist to decide that? the therapist to decide that? the therapist to decide that? >> Yes, I think a lot of times it would be >> Yes, I think a lot of times it would be >> Yes, I think a lot of times it would be the therapist to say it like more work, the therapist to say it like more work, the therapist to say it like more work, you know, more intensive work or can you know, more intensive work or can you know, more intensive work or can make a a difference. But I think the make a a difference. But I think the make a a difference. But I think the person also needs to, you know, take person also needs to, you know, take person also needs to, you know, take ownership, right, of their own therapy ownership, right, of their own therapy ownership, right, of their own therapy and if I don't feel helped enough, well, and if I don't feel helped enough, well, and if I don't feel helped enough, well, I have to think about that, right? And I have to think about that, right? And I have to think about that, right? And and talk to the therapist about that and talk to the therapist about that and talk to the therapist about that because maybe maybe that therapist isn't because maybe maybe that therapist isn't because maybe maybe that therapist isn't a match. People can get into a rhythm of a match. People can get into a rhythm of a match. People can get into a rhythm of therapy where it's really not helping therapy where it's really not helping therapy where it's really not helping them, right? But they either feel sort them, right? But they either feel sort them, right? But they either feel sort of nihilistic about it, like I'm no of nihilistic about it, like I'm no of nihilistic about it, like I'm no better and I'm going to therapy. Do we better and I'm going to therapy. Do we better and I'm going to therapy. Do we really need to look at ourselves? And really need to look at ourselves? And really need to look at ourselves? And this is where the insurance systems this is where the insurance systems this is where the insurance systems often are very difficult because it's often are very difficult because it's often are very difficult because it's hard sometimes for a person to say I hard sometimes for a person to say I hard sometimes for a person to say I need more therapy because that may not need more therapy because that may not need more therapy because that may not be possible. So there are sort of be possible. So there are sort of be possible. So there are sort of negative factors in the world around us. negative factors in the world around us. negative factors in the world around us. But ultimately I think the answer to the But ultimately I think the answer to the But ultimately I think the answer to the question comes down to observing question comes down to observing question comes down to observing ourselves and taking ownership of like ourselves and taking ownership of like ourselves and taking ownership of like what's going on in us and how we're what's going on in us and how we're what's going on in us and how we're feeling and and then feeling that that feeling and and then feeling that that feeling and and then feeling that that um commitment to self or to self-care to um commitment to self or to self-care to um commitment to self or to self-care to say I need to go change this. say I need to go change this. say I need to go change this. >> Now I'd like to talk a little bit about >> Now I'd like to talk a little bit about >> Now I'd like to talk a little bit about chemistry. chemistry. chemistry. >> Yes. um drugs. How do you think about >> Yes. um drugs. How do you think about >> Yes. um drugs. How do you think about prescription drugs in the context of prescription drugs in the context of prescription drugs in the context of treating uh trauma and other and other treating uh trauma and other and other treating uh trauma and other and other conditions? Right? I think that we tend conditions? Right? I think that we tend conditions? Right? I think that we tend to overutilize medicines in this country to overutilize medicines in this country to overutilize medicines in this country because we have a health care system because we have a health care system because we have a health care system that that often that's so based on that that often that's so based on that that often that's so based on throughput that we want to polish the throughput that we want to polish the throughput that we want to polish the hood when there's a problem in the hood when there's a problem in the hood when there's a problem in the engine, right? So, we overutilize engine, right? So, we overutilize engine, right? So, we overutilize medicines often as an end point, right? medicines often as an end point, right? medicines often as an end point, right? Oh, we're going to make that person's Oh, we're going to make that person's Oh, we're going to make that person's depression better with an depression better with an depression better with an anti-depressant. most of the time for anti-depressant. most of the time for anti-depressant. most of the time for that person's depression to really get that person's depression to really get that person's depression to really get better and stay better they need to better and stay better they need to better and stay better they need to unravel what's driving the depression. unravel what's driving the depression. unravel what's driving the depression. So the first kind of branch point can be So the first kind of branch point can be So the first kind of branch point can be what is the diagnosis? What is the level what is the diagnosis? What is the level what is the diagnosis? What is the level of severity? Right? And I think that of severity? Right? And I think that of severity? Right? And I think that that's very very important. I mean the that's very very important. I mean the that's very very important. I mean the vast majority of people who are helped vast majority of people who are helped vast majority of people who are helped by anti-depressants, they're not they by anti-depressants, they're not they by anti-depressants, they're not they don't have clinically severe depression, don't have clinically severe depression, don't have clinically severe depression, right? Those medicines create more right? Those medicines create more right? Those medicines create more distress tolerance in us. If you can distress tolerance in us. If you can distress tolerance in us. If you can improve someone's distress tolerance and improve someone's distress tolerance and improve someone's distress tolerance and you can use medicines that that take you can use medicines that that take you can use medicines that that take away what clinically is rumination, away what clinically is rumination, away what clinically is rumination, right? Not a not the standard meaning of right? Not a not the standard meaning of right? Not a not the standard meaning of that word, but the clinical meaning of that word, but the clinical meaning of that word, but the clinical meaning of it where there are distress centers in it where there are distress centers in it where there are distress centers in our brain that are overactive and then our brain that are overactive and then our brain that are overactive and then we get stuck in these maladaptive we get stuck in these maladaptive we get stuck in these maladaptive negative pathways where we think about negative pathways where we think about negative pathways where we think about something over and over and over again something over and over and over again something over and over and over again with no real chance of solving it with no real chance of solving it with no real chance of solving it because that's not what's going on because that's not what's going on because that's not what's going on inside of us. So medicines can help that inside of us. So medicines can help that inside of us. So medicines can help that but we have to have some flexibility but we have to have some flexibility but we have to have some flexibility around their conception. and know the around their conception. and know the around their conception. and know the modern medical system of like 15minute modern medical system of like 15minute modern medical system of like 15minute visits you know to a psychiatrist that visits you know to a psychiatrist that visits you know to a psychiatrist that are that are weeks apart I mean I don't are that are weeks apart I mean I don't are that are weeks apart I mean I don't understand how that goes well we use I understand how that goes well we use I understand how that goes well we use I think approximately five times as much think approximately five times as much think approximately five times as much medicine I think across the board as say medicine I think across the board as say medicine I think across the board as say the Dutch population they have a health the Dutch population they have a health the Dutch population they have a health care system and a and a cultural system care system and a and a cultural system care system and a and a cultural system that to the best of my understanding is that to the best of my understanding is that to the best of my understanding is more rooted in taking responsibility for more rooted in taking responsibility for more rooted in taking responsibility for oneself so if a person comes in and oneself so if a person comes in and oneself so if a person comes in and cholesterol is high right the first cholesterol is high right the first cholesterol is high right the first order of business is hey you take better order of business is hey you take better order of business is hey you take better care care of yourself, right? Like this care care of yourself, right? Like this care care of yourself, right? Like this person really needs to lose some weight, person really needs to lose some weight, person really needs to lose some weight, exercise more, right? They they're not exercise more, right? They they're not exercise more, right? They they're not just jumping to like let me give you a just jumping to like let me give you a just jumping to like let me give you a medicine and and you know, and shift medicine and and you know, and shift medicine and and you know, and shift shift you through the health care system shift you through the health care system shift you through the health care system and out the other side of the door. So, and out the other side of the door. So, and out the other side of the door. So, I think medicines get overused in large I think medicines get overused in large I think medicines get overused in large part for systemic reasons. Um, and also part for systemic reasons. Um, and also part for systemic reasons. Um, and also for some of these categorization for some of these categorization for some of these categorization reasons. Oh, that person meets some reasons. Oh, that person meets some reasons. Oh, that person meets some technical criteria for depression. We technical criteria for depression. We technical criteria for depression. We got to give them this medicine instead got to give them this medicine instead got to give them this medicine instead of really thinking, wait, what's going of really thinking, wait, what's going of really thinking, wait, what's going on in this person? And I see this over on in this person? And I see this over on in this person? And I see this over and over again. And I see one is on and over again. And I see one is on and over again. And I see one is on seven medicines and they're on seven seven medicines and they're on seven seven medicines and they're on seven medicines to treat seven different medicines to treat seven different medicines to treat seven different symptoms and now they have side effects symptoms and now they have side effects symptoms and now they have side effects from all those seven medicines. Maybe from all those seven medicines. Maybe from all those seven medicines. Maybe two of them are to treat the side two of them are to treat the side two of them are to treat the side effects from the other five. Right? And effects from the other five. Right? And effects from the other five. Right? And that's bad. I'd love to talk about that's bad. I'd love to talk about that's bad. I'd love to talk about psychedelics with the preface that uh psychedelics with the preface that uh psychedelics with the preface that uh we're talking about this in in a legal we're talking about this in in a legal we're talking about this in in a legal clinical setting. What are your thoughts clinical setting. What are your thoughts clinical setting. What are your thoughts on these drugs for therapeutic potential on these drugs for therapeutic potential on these drugs for therapeutic potential also potential hazards also potential hazards also potential hazards etc? the data coming from the the labs etc? the data coming from the the labs etc? the data coming from the the labs and the academic centers um is so and the academic centers um is so and the academic centers um is so powerfully positive. These are used in powerfully positive. These are used in powerfully positive. These are used in professional hands and with the right professional hands and with the right professional hands and with the right kind of guidance are extremely powerful kind of guidance are extremely powerful kind of guidance are extremely powerful tools but used in the right way. What tools but used in the right way. What tools but used in the right way. What happens is we see less communication or happens is we see less communication or happens is we see less communication or less chatter in the outer parts of the less chatter in the outer parts of the less chatter in the outer parts of the brain right in the outer parts of the brain right in the outer parts of the brain right in the outer parts of the cortex. That's where language is, that's cortex. That's where language is, that's cortex. That's where language is, that's where vision is. That's where executive where vision is. That's where executive where vision is. That's where executive function is. So planning and t task function is. So planning and t task function is. So planning and t task execution. So so much of that is about execution. So so much of that is about execution. So so much of that is about making our way in the world around us. making our way in the world around us. making our way in the world around us. And I think when we take the And I think when we take the And I think when we take the neurotransmission out of those places, neurotransmission out of those places, neurotransmission out of those places, right, and we set it in a part of the right, and we set it in a part of the right, and we set it in a part of the brain and say the insular cortex, right? brain and say the insular cortex, right? brain and say the insular cortex, right? The parts of the brain that are sort of The parts of the brain that are sort of The parts of the brain that are sort of in the middle, right? Which which I in the middle, right? Which which I in the middle, right? Which which I think I believe is where our humanness think I believe is where our humanness think I believe is where our humanness really is. So the psychedelics make really is. So the psychedelics make really is. So the psychedelics make there be less chatter, communication in there be less chatter, communication in there be less chatter, communication in these other parts of the brain and then these other parts of the brain and then these other parts of the brain and then we become seated in the part of the we become seated in the part of the we become seated in the part of the brain that I I believe is most about our brain that I I believe is most about our brain that I I believe is most about our experience of true humanness. You know, experience of true humanness. You know, experience of true humanness. You know, it's why people can sort of see with it's why people can sort of see with it's why people can sort of see with clarity that oh that trauma clarity that oh that trauma clarity that oh that trauma like that thing is not my fault, right? like that thing is not my fault, right? like that thing is not my fault, right? Like we feel a sense of compassion for Like we feel a sense of compassion for Like we feel a sense of compassion for ourselves. We relieve ourselves, release ourselves. We relieve ourselves, release ourselves. We relieve ourselves, release ourselves from guilt and and it's like ourselves from guilt and and it's like ourselves from guilt and and it's like why is this so helpful to people? And I why is this so helpful to people? And I why is this so helpful to people? And I think it's because it can do what we are think it's because it can do what we are think it's because it can do what we are trying to get at in good therapy. But it trying to get at in good therapy. But it trying to get at in good therapy. But it can really catalyze that by just putting can really catalyze that by just putting can really catalyze that by just putting a person in that part of the brain that a person in that part of the brain that a person in that part of the brain that can see it for what it is without all can see it for what it is without all can see it for what it is without all that chatter in the cortex about how you that chatter in the cortex about how you that chatter in the cortex about how you got to think it's your fault or you got to think it's your fault or you got to think it's your fault or you won't avoid it again and and that makes won't avoid it again and and that makes won't avoid it again and and that makes the repetition compulsion. How do I the repetition compulsion. How do I the repetition compulsion. How do I think ahead to the next thing that might think ahead to the next thing that might think ahead to the next thing that might happen and what else bad might happen? I happen and what else bad might happen? I happen and what else bad might happen? I mean, we don't get anywhere doing that. mean, we don't get anywhere doing that. mean, we don't get anywhere doing that. these psychedelics, the medicinal value, these psychedelics, the medicinal value, these psychedelics, the medicinal value, I believe, is putting us in that part of I believe, is putting us in that part of I believe, is putting us in that part of the brain where a person can really find the brain where a person can really find the brain where a person can really find truth. And that's why I think that that truth. And that's why I think that that truth. And that's why I think that that that's come so far in these few years that's come so far in these few years that's come so far in these few years because I I I think that is very because I I I think that is very because I I I think that is very clinically evident. And I think we're clinically evident. And I think we're clinically evident. And I think we're going to see more and more the value of going to see more and more the value of going to see more and more the value of that and how what the psychedelics do that and how what the psychedelics do that and how what the psychedelics do can become I believe a heruristic for can become I believe a heruristic for can become I believe a heruristic for understanding like wait how are our understanding like wait how are our understanding like wait how are our brains really functioning and what are brains really functioning and what are brains really functioning and what are the parts that really matter to our the parts that really matter to our the parts that really matter to our experience of being human. It's those experience of being human. It's those experience of being human. It's those parts of the brain, right? The deep parts of the brain, right? The deep parts of the brain, right? The deep parts of the brain, the insular cortex parts of the brain, the insular cortex parts of the brain, the insular cortex and the and the areas around it that say and the and the areas around it that say and the and the areas around it that say light up when a person has an uh an light up when a person has an uh an light up when a person has an uh an experience of spiritual ecstasy or an experience of spiritual ecstasy or an experience of spiritual ecstasy or an experience of connection with another experience of connection with another experience of connection with another person, right? So, we we kind of have person, right? So, we we kind of have person, right? So, we we kind of have these telltale markers that something is these telltale markers that something is these telltale markers that something is going on there that's very important and going on there that's very important and going on there that's very important and very special. And then when they come in very special. And then when they come in very special. And then when they come in a sense back online with with in a a sense back online with with in a a sense back online with with in a normal cognitive way they realize like normal cognitive way they realize like normal cognitive way they realize like wow now I'm applying all those wow now I'm applying all those wow now I'm applying all those mechanisms of trying to understand truth mechanisms of trying to understand truth mechanisms of trying to understand truth and to to that and what what I see is and to to that and what what I see is and to to that and what what I see is that it's true and wow it's true like I that it's true and wow it's true like I that it's true and wow it's true like I mean we hear that all the time which mean we hear that all the time which mean we hear that all the time which tells me hey something different is tells me hey something different is tells me hey something different is going on there and of course these are going on there and of course these are going on there and of course these are powerful tools so misused like very bad powerful tools so misused like very bad powerful tools so misused like very bad things can happen but you think about things can happen but you think about things can happen but you think about the clinical utility and what does it the clinical utility and what does it the clinical utility and what does it mean that so many people change for the mean that so many people change for the mean that so many people change for the healthier or even change their lives. I healthier or even change their lives. I healthier or even change their lives. I think we're likely to see that they are think we're likely to see that they are think we're likely to see that they are powerful anti-trauma mechanisms again powerful anti-trauma mechanisms again powerful anti-trauma mechanisms again used clinically in the right hands. And used clinically in the right hands. And used clinically in the right hands. And and I think that we're also going to see and I think that we're also going to see and I think that we're also going to see that they're a heruristic for that they're a heruristic for that they're a heruristic for understanding our brain that goes understanding our brain that goes understanding our brain that goes against what I see as some of the against what I see as some of the against what I see as some of the reflexive hubris of well the outer parts reflexive hubris of well the outer parts reflexive hubris of well the outer parts must be the best because that's what must be the best because that's what must be the best because that's what makes us human and other animals don't makes us human and other animals don't makes us human and other animals don't have it and we're better because we're have it and we're better because we're have it and we're better because we're human. I mean this makes no sense. You human. I mean this makes no sense. You human. I mean this makes no sense. You know, know, know, >> I'd like to talk about MDMA. What sorts >> I'd like to talk about MDMA. What sorts >> I'd like to talk about MDMA. What sorts of states do you think MDMMA is creating of states do you think MDMMA is creating of states do you think MDMMA is creating um that can uh explain why it's a useful um that can uh explain why it's a useful um that can uh explain why it's a useful therapeutic tool in some cases and and therapeutic tool in some cases and and therapeutic tool in some cases and and what sorts of cases those might be? what sorts of cases those might be? what sorts of cases those might be? >> This is very different than the >> This is very different than the >> This is very different than the psychedelics, right? Which are seating psychedelics, right? Which are seating psychedelics, right? Which are seating our consciousness in these deep centers our consciousness in these deep centers our consciousness in these deep centers of the brain, right? Whereas what MDMA of the brain, right? Whereas what MDMA of the brain, right? Whereas what MDMA is doing is sort of flooding with is doing is sort of flooding with is doing is sort of flooding with positive neurotransmitters, right, in positive neurotransmitters, right, in positive neurotransmitters, right, in certain parts of the brain. And I think certain parts of the brain. And I think certain parts of the brain. And I think what that creates is a greater what that creates is a greater what that creates is a greater permissiveness inside to entertain or permissiveness inside to entertain or permissiveness inside to entertain or approach different things. And when approach different things. And when approach different things. And when these systems are are flooded with these these systems are are flooded with these these systems are are flooded with these neurotransmitters, it's more permissive neurotransmitters, it's more permissive neurotransmitters, it's more permissive to think about that, right? And to think to think about that, right? And to think to think about that, right? And to think about that without again all the chatter about that without again all the chatter about that without again all the chatter of that's your fault or you're never of that's your fault or you're never of that's your fault or you're never going to get anywhere because of that or going to get anywhere because of that or going to get anywhere because of that or you know what that means or right? They you know what that means or right? They you know what that means or right? They can kind of go away and then we can can kind of go away and then we can can kind of go away and then we can think about it in a way that isn't think about it in a way that isn't think about it in a way that isn't through the lens of fear. And I think through the lens of fear. And I think through the lens of fear. And I think that's the power there is that there that's the power there is that there that's the power there is that there it's permissive of approaching something it's permissive of approaching something it's permissive of approaching something contemplating something um you know a contemplating something um you know a contemplating something um you know a different a novelty as we talk about a different a novelty as we talk about a different a novelty as we talk about a dnovo approach and I think that's also dnovo approach and I think that's also dnovo approach and I think that's also why the experience can vary because you why the experience can vary because you why the experience can vary because you could also see how if you're not could also see how if you're not could also see how if you're not thinking about something right so thinking about something right so thinking about something right so there's not a clinical guidance to it there's not a clinical guidance to it there's not a clinical guidance to it you could you could be in a state where you could you could be in a state where you could you could be in a state where like I just feel good but it but that's like I just feel good but it but that's like I just feel good but it but that's not necessarily problem solving so the not necessarily problem solving so the not necessarily problem solving so the clinical guidance says is hey let's take clinical guidance says is hey let's take clinical guidance says is hey let's take that state and do something with it that state and do something with it that state and do something with it right let's now now that you're in this right let's now now that you're in this right let's now now that you're in this state let's hey let's make hey well the state let's hey let's make hey well the state let's hey let's make hey well the sun is shining right you're in a state sun is shining right you're in a state sun is shining right you're in a state where we can look at things that are where we can look at things that are where we can look at things that are traumatic right we can approach them traumatic right we can approach them traumatic right we can approach them from a denovo perspective and we're from a denovo perspective and we're from a denovo perspective and we're coming to understand that they have coming to understand that they have coming to understand that they have immense potential to be helpful to us immense potential to be helpful to us immense potential to be helpful to us but I think and hope that that only also but I think and hope that that only also but I think and hope that that only also increases our respect for those increases our respect for those increases our respect for those modalities and what can come what modalities and what can come what modalities and what can come what negative can happen if we're if we're negative can happen if we're if we're negative can happen if we're if we're not respectful. not respectful. not respectful. >> I have a question about language. Um, in >> I have a question about language. Um, in >> I have a question about language. Um, in your book, you talk about how we need to your book, you talk about how we need to your book, you talk about how we need to be careful about the use of language be careful about the use of language be careful about the use of language around trauma, maybe problem solving and around trauma, maybe problem solving and around trauma, maybe problem solving and problem describing in general. How problem describing in general. How problem describing in general. How should we think about language in should we think about language in should we think about language in parsing trauma? And in your book, you parsing trauma? And in your book, you parsing trauma? And in your book, you talk about um you give some cautionary talk about um you give some cautionary talk about um you give some cautionary notes about um talking about depression, notes about um talking about depression, notes about um talking about depression, trauma, and PTSD in terms that that trauma, and PTSD in terms that that trauma, and PTSD in terms that that might diminish their real um severity in might diminish their real um severity in might diminish their real um severity in some cases. And uh and I was really some cases. And uh and I was really some cases. And uh and I was really struck by that. So maybe just touch on, struck by that. So maybe just touch on, struck by that. So maybe just touch on, you know, how should we talk about these you know, how should we talk about these you know, how should we talk about these things in a way that um doesn't diminish things in a way that um doesn't diminish things in a way that um doesn't diminish them for ourselves or for other people them for ourselves or for other people them for ourselves or for other people >> and um at the same time honors the fact >> and um at the same time honors the fact >> and um at the same time honors the fact that there's a lot of trauma out there that there's a lot of trauma out there that there's a lot of trauma out there and um there's a lot of depression out and um there's a lot of depression out and um there's a lot of depression out there and and we need to talk about it. there and and we need to talk about it. there and and we need to talk about it. We just have to be very careful what We just have to be very careful what We just have to be very careful what we're saying and what we're we're saying and what we're we're saying and what we're communicating. And I think this doesn't communicating. And I think this doesn't communicating. And I think this doesn't mean because you know there's a sort of mean because you know there's a sort of mean because you know there's a sort of phenomenon now where where people are phenomenon now where where people are phenomenon now where where people are trying to control language I think too trying to control language I think too trying to control language I think too much like you can't say anything that much like you can't say anything that much like you can't say anything that someone else might find hurtful or you someone else might find hurtful or you someone else might find hurtful or you have to refer to people in ways they have to refer to people in ways they have to refer to people in ways they choose to be referred to even if those choose to be referred to even if those choose to be referred to even if those are ways that others don't understand or are ways that others don't understand or are ways that others don't understand or ways they themselves have decided or ways they themselves have decided or ways they themselves have decided or ways that might be psychologically or ways that might be psychologically or ways that might be psychologically or clinically unhelpful. So I think the clinically unhelpful. So I think the clinically unhelpful. So I think the over control of language is not good. over control of language is not good. over control of language is not good. But I think the specificity of language But I think the specificity of language But I think the specificity of language of what are we trying to say? How are we of what are we trying to say? How are we of what are we trying to say? How are we defining it? Even the word trauma, defining it? Even the word trauma, defining it? Even the word trauma, right? We're talking about trauma. So we right? We're talking about trauma. So we right? We're talking about trauma. So we want to define what that means, right? want to define what that means, right? want to define what that means, right? It doesn't just mean like oh anything It doesn't just mean like oh anything It doesn't just mean like oh anything kind of negative, right? Because then kind of negative, right? Because then kind of negative, right? Because then that dilutes it down to meaning nothing, that dilutes it down to meaning nothing, that dilutes it down to meaning nothing, right? It also doesn't just mean, you right? It also doesn't just mean, you right? It also doesn't just mean, you know, um injury in combat, right? Like know, um injury in combat, right? Like know, um injury in combat, right? Like we have to talk about what that is. So I we have to talk about what that is. So I we have to talk about what that is. So I think anchoring it to something that think anchoring it to something that think anchoring it to something that rises to the magnitude of overwhelming rises to the magnitude of overwhelming rises to the magnitude of overwhelming our coping skills and changing us like our coping skills and changing us like our coping skills and changing us like then at least I define it that way and I then at least I define it that way and I then at least I define it that way and I can communicate that to you and we can can communicate that to you and we can can communicate that to you and we can understand what we're talking about. understand what we're talking about. understand what we're talking about. >> I'd like to talk about a concept of >> I'd like to talk about a concept of >> I'd like to talk about a concept of taking care of oneself. We hear about taking care of oneself. We hear about taking care of oneself. We hear about this concept of taking care of oneself this concept of taking care of oneself this concept of taking care of oneself and and I think uh at a surface level um and and I think uh at a surface level um and and I think uh at a surface level um it can sound a little bit light you know it can sound a little bit light you know it can sound a little bit light you know oh take care take care take good care oh take care take care take good care oh take care take care take good care you know we um you know we um you know we um >> but to me it's a deep and powerful >> but to me it's a deep and powerful >> but to me it's a deep and powerful concept and I was very um happy to see concept and I was very um happy to see concept and I was very um happy to see it in your book and also to learn a lot it in your book and also to learn a lot it in your book and also to learn a lot of um of um of um >> of ideas about what that really looks >> of ideas about what that really looks >> of ideas about what that really looks like like like >> how should we think about taking care of >> how should we think about taking care of >> how should we think about taking care of oneself oneself oneself >> I see here what I think is a very >> I see here what I think is a very >> I see here what I think is a very fascinating dichotomy, right? That in fascinating dichotomy, right? That in fascinating dichotomy, right? That in some ways, like think about how complex some ways, like think about how complex some ways, like think about how complex our brains are, right? How complex our our brains are, right? How complex our our brains are, right? How complex our psyches, our unconscious minds are, psyches, our unconscious minds are, psyches, our unconscious minds are, there's so much complexity there. But on there's so much complexity there. But on there's so much complexity there. But on the other hand, psychological concepts the other hand, psychological concepts the other hand, psychological concepts that are consistent with health are that are consistent with health are that are consistent with health are often very simple, right? Which by which often very simple, right? Which by which often very simple, right? Which by which I don't mean light, right? But but I don't mean light, right? But but I don't mean light, right? But but simple, straightforward, right? And and simple, straightforward, right? And and simple, straightforward, right? And and I think self-care is absolutely one of I think self-care is absolutely one of I think self-care is absolutely one of them. I mean, how much is talked about them. I mean, how much is talked about them. I mean, how much is talked about how to take care of oneself that just how to take care of oneself that just how to take care of oneself that just skips over the basics that are necessary skips over the basics that are necessary skips over the basics that are necessary as a building block for all else? Or it as a building block for all else? Or it as a building block for all else? Or it doesn't matter how many chefs or doesn't matter how many chefs or doesn't matter how many chefs or vacations or whatever a person has if vacations or whatever a person has if vacations or whatever a person has if the basics of self-care aren't squared the basics of self-care aren't squared the basics of self-care aren't squared away. And it's not a light concept to away. And it's not a light concept to away. And it's not a light concept to say like look, are you sleeping enough, say like look, are you sleeping enough, say like look, are you sleeping enough, right? Are you eating well? Are you right? Are you eating well? Are you right? Are you eating well? Are you getting natural light? Are you getting natural light? Are you getting natural light? Are you interacting with people who are good to interacting with people who are good to interacting with people who are good to interact with? Right? Are you accepting interact with? Right? Are you accepting interact with? Right? Are you accepting negative interactions in your life? Are negative interactions in your life? Are negative interactions in your life? Are you living in circumstances that make you living in circumstances that make you living in circumstances that make you feel okay or not? The they're very you feel okay or not? The they're very you feel okay or not? The they're very very basic premises, but so often we're very basic premises, but so often we're very basic premises, but so often we're not looking at them at all. Right? We're not looking at them at all. Right? We're not looking at them at all. Right? We're not looking at them at all because we not looking at them at all because we not looking at them at all because we tend to skip over them. And we tend to tend to skip over them. And we tend to tend to skip over them. And we tend to skip over them either because again in skip over them either because again in skip over them either because again in some automatic way that sometimes is some automatic way that sometimes is some automatic way that sometimes is traumdriven or we're not going to look traumdriven or we're not going to look traumdriven or we're not going to look at that, right? And often not taking at that, right? And often not taking at that, right? And often not taking care of ourselves can have the care of ourselves can have the care of ourselves can have the punishment, distraction, right? There's punishment, distraction, right? There's punishment, distraction, right? There's so much that can come into that or our so much that can come into that or our so much that can come into that or our sense of power is is tied to not taking sense of power is is tied to not taking sense of power is is tied to not taking care of ourselves. I mean, I'll give you care of ourselves. I mean, I'll give you care of ourselves. I mean, I'll give you an example is I I tend to for whatever an example is I I tend to for whatever an example is I I tend to for whatever reason do reasonably well um with very reason do reasonably well um with very reason do reasonably well um with very poor self-care, right? And like that was poor self-care, right? And like that was poor self-care, right? And like that was very adaptive when I was in medical very adaptive when I was in medical very adaptive when I was in medical training, right? And I'm like, okay, I training, right? And I'm like, okay, I training, right? And I'm like, okay, I can I can eat a lot today, I can not can I can eat a lot today, I can not can I can eat a lot today, I can not eat, right? I can sleep two hours, I can eat, right? I can sleep two hours, I can eat, right? I can sleep two hours, I can sleep eight, right? I mean overall sleep eight, right? I mean overall sleep eight, right? I mean overall that's not good and it hasn't been good that's not good and it hasn't been good that's not good and it hasn't been good for me as I've aged. But then I I I for me as I've aged. But then I I I for me as I've aged. But then I I I realized at some point look I'm doing realized at some point look I'm doing realized at some point look I'm doing all these things to make myself all these things to make myself all these things to make myself healthier but like what I ignore that healthier but like what I ignore that healthier but like what I ignore that right and why am I ignoring it? That was right and why am I ignoring it? That was right and why am I ignoring it? That was a key question. Why am I ignoring it? a key question. Why am I ignoring it? a key question. Why am I ignoring it? Because somewhere inside of me as it was Because somewhere inside of me as it was Because somewhere inside of me as it was and still to some extent is this idea and still to some extent is this idea and still to some extent is this idea that my ability to be really functional that my ability to be really functional that my ability to be really functional right to generate success in the world right to generate success in the world right to generate success in the world around me is tied to my ability to do around me is tied to my ability to do around me is tied to my ability to do that right that oh if I but if I stop that right that oh if I but if I stop that right that oh if I but if I stop doing that and now I'm like I'm eating doing that and now I'm like I'm eating doing that and now I'm like I'm eating and sleeping regularly then I'm going to and sleeping regularly then I'm going to and sleeping regularly then I'm going to lose some edge and so so you even I lose some edge and so so you even I lose some edge and so so you even I think about this all the time but I I think about this all the time but I I think about this all the time but I I realize hey I'm also I'm not doing it realize hey I'm also I'm not doing it realize hey I'm also I'm not doing it inside you know and and I think it's inside you know and and I think it's inside you know and and I think it's really grounding to the basics um that really grounding to the basics um that really grounding to the basics um that really help us of like what are the really help us of like what are the really help us of like what are the basics of what I'm doing and not doing basics of what I'm doing and not doing basics of what I'm doing and not doing in my life. Diet, exercise, sleep, in my life. Diet, exercise, sleep, in my life. Diet, exercise, sleep, people, circumstances, um leisure people, circumstances, um leisure people, circumstances, um leisure activities, I mean sunlight, I mean I activities, I mean sunlight, I mean I activities, I mean sunlight, I mean I think immensely important and think immensely important and think immensely important and dramatically undervalued. dramatically undervalued. dramatically undervalued. >> I want to thank you for today's >> I want to thank you for today's >> I want to thank you for today's discussion. Um I found it to be discussion. Um I found it to be discussion. Um I found it to be incredibly informative and I know our incredibly informative and I know our incredibly informative and I know our listeners will also. I also want to listeners will also. I also want to listeners will also. I also want to thank you for the work you do. I've done thank you for the work you do. I've done thank you for the work you do. I've done a wide and deep search for people um in a wide and deep search for people um in a wide and deep search for people um in these areas and there are so few who these areas and there are so few who these areas and there are so few who have the background in medical training have the background in medical training have the background in medical training and physiology in the psychoanalytic and and physiology in the psychoanalytic and and physiology in the psychoanalytic and psychiatric realm and also have um a psychiatric realm and also have um a psychiatric realm and also have um a grounding toward the future you know of grounding toward the future you know of grounding toward the future you know of what's coming and who can encapsulate so what's coming and who can encapsulate so what's coming and who can encapsulate so many different orientations and and many different orientations and and many different orientations and and bring them together into a coherent bring them together into a coherent bring them together into a coherent piece and for your book um which is piece and for your book um which is piece and for your book um which is incredible I will go on record saying I incredible I will go on record saying I incredible I will go on record saying I think this is the definitive book on think this is the definitive book on think this is the definitive book on trauma. trauma. trauma. >> Wow. >> Wow. >> Wow. >> And I really encourage people to to read >> And I really encourage people to to read >> And I really encourage people to to read it and we'll continue to encourage it and we'll continue to encourage it and we'll continue to encourage people to read it. It's so many uh people to read it. It's so many uh people to read it. It's so many uh valuable takeaways and insights and valuable takeaways and insights and valuable takeaways and insights and tools there. So uh on behalf of the tools there. So uh on behalf of the tools there. So uh on behalf of the listeners and myself, thank you so much listeners and myself, thank you so much listeners and myself, thank you so much for joining us today. for joining us today. for joining us today. >> You're very welcome and I I take that to >> You're very welcome and I I take that to >> You're very welcome and I I take that to heart and I'm very appreciative of being heart and I'm very appreciative of being heart and I'm very appreciative of being here. So you're very welcome and thank here. So you're very welcome and thank here. So you're very welcome and thank you as well. you as well. you as well. >> Thank you.