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

27:49Sure. Sure. Right. The area under the curve, right? The increasing weight of the chronic denigration. And you can see how in our medical systems, and I've been fortunate to spend about a year of my life in the UK, and I love coming to England. I think I understand the healthcare system enough that there are problems in the US healthcare system that are in other systems too, right? which is just being too concrete about things, where it's hard to get attention and care, especially human -driven attention, like psychotherapy. So our system wants to look at, have you had the big fireworks event? Okay, well, if not, we'll put you in a different category.

28:30It doesn't wanna say, are there changes in your brain? Because of trauma, whether that was acute or chronic or vicarious, that's what we would look at. But the systems aren't sophisticated or often interested enough to do that. I went to my GP when I was probably 21 or 22 in the UK, northeast of the UK, classic, very working class town. Now, I go in and I sit down and I'd been sad for quite a while on and off and then every so often, there would be maybe a couple of days where I couldn't get out of bed and I would feel quite ashamed about this and I wouldn't want to talk to people and I'd keep the curtains drawn and you know, I'd make excuses about why I couldn't see people or do things or whatever.

29:09And I went in, I sat down with my GP, and the way it works in the UK for the people that aren't from there, you have a 10 -minute window with your GP. That's your general practitioner, that's the person you go to. And you book in for, and it's usually kind of hard to get an appointment. Again, National Health Service, it's free, great. But the standard of care, perhaps, leaves a little bit to be desired. So I sit down and I said, I'm a, I think I might be depressed or something. I've probably mumbled some word out about sad or depressed or something like that. I'm pretty sure I use the word depression.

29:38And this GP said, have you had a recent family bereavement? No. Says, are you in financial trouble? No. Did you recently lose a job? No. Did you recently break up with the relationship? No. No, no, no, no, all the way down. Like a cute trauma, a cute trauma, a cute trauma, a cute trauma. No. And so I've got to the end of it and essentially said, what are you sad about? I was like, I don't know. Like just the fucking crushing weight of existence. I don't know, I don't know what I'm sad about. And then she printed off this single piece of A4 paper that was like, here's some website URLs on the NHS website about how to improve your mental health and go along your way.

30:20And you left person when you came in. I felt like, I don't know, I was making a mountain out of a molehill. It definitely taught me the lesson that I took away from that, I think was, I'm blowing this out of proportion. It doesn't have to be that big of a deal. And that's what we have so much to do, we have loss of productivity because often people in power in decision making capacities are to think about dollars and cents or pounds and are we, what are we losing economic? We lose a tremendous amount of human productivity because of depression. And if we want to anchor to what is, of course, infinitely more important, we lose human life to depression.

31:00So when you walk out of there, you're walking out at great risk. You have a real medical problem. If you went in and you had right lower quadrant abdominal pain, then it had been a morpheus, and then all of a sudden started being focused here. No one would say, why do you have appendicitis? Why does your abdomen hurt? We know one would say that. They would honor what was going on with you. But here you get a non -response, and you leave worse than you came in because it's so invalidating. And no one is then looking at, hey, if we could take a picture of your brain chemistry, we're not sophisticated enough to just do that.

31:33We'd see, yeah, you have a medical problem, no different than if you had appendicitis, but you walk out and validated. And this is the problem. And it's part of why, at some point, realizing that most of what I was treating was coming from trauma, whether I was treating substance abuse, depression, panic attacks, insomnia, Even the more medicalized schizophrenia, higher incidence when people are feeling a sense of aloneness and isolation and vulnerability that we need to understand this because a huge part of what else what makes all of us suffer is coming from this. It's coming from unrecognized and unaddressed trauma and unrecognized and unaddressed mental health issues because people can get depressed because their brain chemistry is off.

32:20Right? So there doesn't have to be no reason whatsoever. The people, everything in their life is as good as possible. But cyclically, the brain chemistry comes offline and now they're depressed. So what about a purely biological depression? There is always a reason. I mean, there's a lot of times a reason. But think about how we're just invalidating people. And then is it a surprise that substance abuse, substance dependence, addiction, overdose rates go up and up, that suicide rates go up and up? It is not a surprise. It is a predictable outcome. It's a predictable consequence of how the healthcare system handles itself.

32:57And what you described so many years ago is not different. In many settings now, that's what would happen now. And even the doctor, I have so much compassion for GPs, primary care physicians, because what are you supposed to do in 10 minutes? How do you just have a real conversation in 10 minutes? And that's why there's more depression and self -harm and suicides in physicians has grown over time. That's an interesting question. What about, you talked about vicarious trauma, firefighters that need to cut people out of cars, paramedics that are unable to resuscitate people, therapists that are dealing with massacres that are permanently working with people who are in pain?

33:41Is this something that you see? Sure. There are higher rates of all that ails us in populations that are exposed to, to situations that can make fear or terror. If you're coming up to cut someone out of an accident, there's, it's hard to do that without some. If you're doing that, you're a person who has empathy. So your person is going to feel something as you're doing that and, and sure people have education and training and support to try and make boundaries. But that doesn't mean that that works all the time. We don't give people enough ongoing support. And we see that on the other side of it, where people in these kinds of helping professions have higher rates of depression, substance abuse, suicide.

34:21The rates are higher. And again, it all makes sense. There's this concept in a certain type of therapy that says everything is as it should be. It doesn't mean that it's right, morally right, or just. What it means is that it's predictable. It's predictable. So if you see the increasing rates of loneliness, isolation, depression, substance use, suicides in the general population, or more specifically in people who are caregiving, that's not surprising. Since everything is as it should be, meaning we've made these decisions as a society. How many healthcare workers came to the other side of COVID, traumatized by all the things that the awful things they saw and they need to work double shifts because co -workers aren't coming in.

35:04there's so, so much of that. And what happened after the pandemic, go back to the same unreasonably high workloads and the way everything was before that we don't put resources in society towards the people who help us, which is also us. Like, you know, we're all part of this and we weigh so many resources and so many ways our political struggles and strivings and it's that the idea isn't to get political but just to say how much resources we waste And we often don't have resources to like give the person with depression more than a 10 minute misleading questionnaire, right or help that person who who has a real post trauma syndrome get better But that's going to take some human time And we look at the at the shirt end of it, which is why I focus on the economic cost of course the human cost are more But but we can get money allocated sometimes resources allocating when we look at the cost the everyone We don't treat for trauma who then uses hospital resources coming to emergency rooms or we lose out of the workforce It's you know, it's like we was like a borrow a penny today to pay a dollar tomorrow You know, and it's but we treat ourselves that way we treat ourselves that way as Societies and you know people don't see it until they often need to go to an emergency room and they have good insurance But guess what you're still out in the hallway right?

36:28You're still sat there for seven hours. You know, you still went in and had somebody ask you a 10 minute questionnaire when you're really in trouble inside, you know, maybe, you know, it's, you know, we don't handle things in a way that uses a lot of foresight and we pay for it and we pay for it, I believe around trauma more than anything else. I say one more quick fact that more than half, we don't know exactly how many, but more than half of the physical health complaints people make, they go to a physical health doctor, something hurts. They have shortness of breath. They're feeling something inside.

36:58Half of those complaints, they're not mental health complaints. They're physical health complaints that come from mental health. Yet how much are we integrating mental health into our physical health care systems? Very, very, very poorly. And therefore, you have physical health physicians who want to help people they know so much that's coming to them as mental health, but they're not equipped, they're not trained, they don't have enough time. And that's part of the frustration is people are coming with mental health problems, but they're presenting as physical health problems. And it's not because the person wants to say that.

37:31It's because they often don't know. They are hurting, but they do have depression. They don't know. And the healthcare system is so dumbed down that we're not asking the right questions to try and figure out what is actually going on with you and how do we help you? I talked to me about what actually happens to the brain and body after someone's gone through trauma. So there will be very complex changes, but we can sort of summarize to some degree by saying that there are alterations and the balances in our brains. You know, our brains are trying to maintain antibodies, homeostasis, things are in balance.

38:05And there are hundreds of thousands of things that happen inside of us in each moment to hold us in balance. What happens is that we get imbalanced. So, for example, vigilance mechanisms in the brain, or whole systems of the brain, salience mechanisms, start looking more for negative things. So someone who, for example, is interested in finding a relationship, who is walking down the street or hallway and sees someone look at them. Instead of being curious, oh, how's that person looking at me, or might I track that person, might I smile back? The immediate is like, the person is looking negatively at me.

38:44What's wrong with me? Right? Why are they looking at me? It's hard to make life move forward then. Right? There's a change towards vigilance and vulnerability inside of us. So you don't see maybe that's a coworker we could collaborate on something. Maybe that's the potential romantic partner who's smiling at me. People don't see that because the brain has shifted from curiosity. How is that person looking at me? There's mostly something wrong. it looking at me in a negative way because there's something negative about me. So those things change in us in very complicated ways, but it changes the whole climate, so to speak within us, and then it changes endocrinologically.

39:20So then we have more stress hormones flowing in us, and stress hormones predispose to vascular disease, to heart disease, to strokes, to autoimmune diseases, to aging faster than our calendar age. So it's to to gaining weight when we don't want a gain weight to not being able to lose weight when we're working hard to lose weight So then what happens we get changed from head to toe because these systems shift and again, we don't Realize that you're the person who says I'm a loser because I can't lose weight and I'm and I'm trying how many times do I hear that and then you see They're actually doing the right things They have a good diet.

39:59They have exercise They're not losing weight because there's so many stress hormones in them that it triggers all these don't lose weight systems in us. So these are just examples, but you can see I hope from the examples that what we're talking about is whole life change from top to bottom. It gets not happening in everyone, but this is happening a lot in small medium or big ways, but any amount of it is unacceptable. And then we just don't know it. I've always been someone nobody likes or no one likes how I look. If people say they'll say this and they know it was before that trauma, that's not how they felt.

40:30And that's why they were good. They got better jobs. They would leave one job for another if it was better. They had good relationships. They didn't stand up. They didn't stand for denigration in a relationship. That kind of off putting. They didn't stand for that. Now they do. And they don't even realize that they never did. And like, how are we going to get out of it? Right? If we think this is how I've always been when that's not true. It seems like the story that we tell ourselves about ourselves is so important that it's such a huge part, this narrative that we weave together. Yes, yes, yes.

41:09I'm so interested in knowing people's life narratives, because I'm in the business of trying to help people. So you have to understand what their narrative is. And I say, no one comes out of the room thinking, you know, abuse is okay for me. No one thinks that, right? So how do we get to the point of thinking that, Even being in a relationship, as you said, there's not physical violence, but it's always denigrating. Oh, sure, you're going to, yeah, that's going to go well for you this time. Give it a try. See what happened. Why would people put up with that all the time and say, hey, I don't want this.

41:43This is worse than not having a relationship. I'll not have a relationship till I find one that's better. We have to trace what is the roots of that? Was there some trauma in that person started feeling differently? Does that come from early formative years? Was that person seen as less than or denigrated? Because of race, because, say, gender in the home. Right, for example, because of sexual orientation, socioeconomic status in the communities around us, was that bred into that person? Because that's not natural either. You get to feel that you're good enough to have a safe life in which you strive for good things.

42:14And if a person doesn't, I wanna understand where that came from. Well, just in informative years or big trauma at once, we've gotta understand it. Yeah, I think so many people, you know, myself included, the voice in our heads is so regularly negative that it seems like that's just the physics of brains, that the texture of mind, not mind -mind. Because you know that. The mind, yes, the factory settings are critical, self -deprecating, fearful, vigilant, mocking, risk of us, all of those things. There is a negativity bias. We are concerned finite creatures, infinite surrounding this asymmetry between things that can make us a little bit more alive and make us a lot more dead and how much worse those are.

43:08But are you saying that that's not the way that we should be? Because that, I think, to a lot of people, maybe myself included, is a rather wild claim that we shouldn't. Our minds aren't built to just be negative. We're not built to be that way. And the salience of negative things doesn't have to make us that way. So in the Barry example, what does that mean? Don't eat that Barry again. It doesn't mean be afraid of any food now, be afraid of any berries, be afraid of being outdoors. It doesn't mean that the negativity bias is meant to protect us. It's what happens inside of us in complex situations because we live lives that are complicated to have different phases and we're often not aware of our life narratives.

43:52It's that negativity bias that can help us to feel negative all the time, but it certainly is not deterministic of that, which is why in an oversimplified example, I'm simple fun if you say, it realized you shouldn't need that berry. You're not a dummy for eating that berry. It looked like a good berry. You don't have to feel like you're incompetent and you're not worth it because you ate the berry like, you're okay. You came through it. Here's the lesson. Don't eat that berry again. And maybe be just more careful about barriers that good okay, it's good But that's often not how it goes is like I don't I don't know how to pick what to eat and you know And I you know what I gave someone to someone else that person got sick too much terrible You know we this is what we do To ourselves and it is not our natural state.

44:34We're not built to be Like that, but we end up like that because we are trying to keep ourselves safe in a difficult and complex world and we accumulate more negativity by its more negativity now I've got a voice in my head Telling me what's wrong with me all the time and you know I had this voice in my head for a long long long long time and through a lot of psychotherapy I've been able to move it out of my primary consciousness But there was a time when I thought that shadow voice was normal You know if I dropped something or oh so stupid or what's wrong with you like I was I mean that was a shadow to me inside of me and I had to realize, that's not normal.

45:10I said, I didn't come out of the womb metaphorically, but it have words, but you know what I mean? Like, no one comes out of the womb thinking that way. It's not normal. Mine's around it. That does not have to stay with us. I'm not saying my power got of mental health and I still need my work and I do my work. But I'll tell you that oppressive, miserable, mirth robbing, depression, producing voice is not in my head anymore because I had to realize that it's not natural. I do not want it. there, I want to understand it, my arms run wide. It's there. And I wanted to go just like, I never, I always felt I could go out and work hard and achieve things.

45:46I did not feel like I was cursed. I did not feel like there was something wrong with me or the place or people I came from. But I certainly did after my brother died by suicide. What's wrong with me that I didn't see that? What's wrong with us that that would happen to us? I would never say that about someone else. What's wrong with you that a family member died by suicide? But I would say to me, Then that's how we are is a good people don't want to denigrate someone else, but we'll say to ourselves, and we'll take it inside, and I started realizing I was feeling so differently about myself, and wait, I never felt like this before, and I'd good people around me enough to realize I started getting myself some help.

46:21But it shows if we don't know our narratives, and that this negativity is not natural to be at the forefront, it can become the new normal, and then we think it was the old normal too. Wow. How much can we change that voice? Can we actually get rid of negative pathways? I remember once reading something about once neurons are laid down, there is no undoing them. They're only building up other neurons. So is it a case of layering better voices on top of worst voices or can worst voices actually go away entirely? Yeah. Worst voices can go away entirely. Now I'll get to put a little asterisk and I'll explain.

46:58This is both very, very complicated and very, very simple. Okay, we don't, this complicated part is for the neuroscientists, of how does neurosurgeon mission work and how to complex systems work. Like there's a lot, there's a lot, lot, lot there. But let's just go to the simple part. Anything that has been over learned doesn't go away overnight. Okay, so here's the example. I, this example I use all the time and I, I think it's, it captures it, I think. Let's say you and I randomly took a word. word. We just picked a word. I look around like the word simply is staring at me from something else on my desk.

47:34Let's say we ran the word. Let's you and I say it together 500 times. Let's say we did that. Then this evening, my time, you tomorrow morning, it's going to be in your head or in my head, right? Let's say we say instead of 500 times, 5000 times, it'll be in our brain several days later. But it can atrophy and go away. In this case, It's just a silly experiment, but our brains still won't let go of it. If you and I say that word a thousand times, our brains are going to say, I know that was just a silly experiment. Let's get rid of that. No, it's going to keep the word coming and it's going to keep it coming.

48:11That's what goes on with the negative biases inside of ourselves. You have a set of feelings state and a set of words and self -talks. I'm not good enough. I suck. You keep doing that over and over again. It is not going away quickly. But we live in a society that wants rapid results. That often packages psychotherapy as we get 10 sessions of this and then it's over. All that stuff can get better, tremendously better, but it takes time. If that's been in your head for three, four months to a moderate degree, let's plot out a several -month course to getting it out. If it's been in your head for years, well, we're going to have to work on it over time.

48:48But it doesn't mean nothing good happens until we're years down the road. It means we start working on it now and it starts getting better. And that's the simplicity of it. That example really holds. If we said that word a thousand times and we didn't say it anymore, it'll fall out of our brains. And the same is true with the lies of trauma that we tell ourselves. Now again, if something has been so impactful upon us, it can still come back. People have had who have had thoughts of hurting themselves or hurt themselves at some point in time who haven't for years. could still have something really bad going on and the thought will come into their head.

49:21If I make a very big mistake, I can still, that voice can come back in and go, you're an idiot, right? So it's like, but I recognize that doesn't mean I'm back at square one. It just means if there's a strong stimulus, that reflex and come back. But it's not, let me just, I push it back out. Like I get it, I made a mistake. I don't need this inside me. Let's have it back out. So sometimes it, we can, it can kind of rush us once or twice if it's been strongly in us, but the answer to your question about change is a very strong yes. All of that can change. And it's not rocket science. Neuroscience is more complicated than rocket science.

49:56So in some sense, it is that's why there are countless brilliant people who spend their careers in psychiatry, neuroscience, psychology. That's wonderful that that's happening. What you and I and everyone listening needs to know is not that. I take comfort that people are doing that. What we need to know is this is absolutely approachable. And we understand But the mechanisms of helping around us don't help. They don't teach us how to understand it They don't tell us that things take time But there's an understanding driven by science and experience of of the profession that tells us the answers to this and gives us a roadmap to how to make it different It's so interesting that you say Affirmative experience particularly stressful experience can cause something like this to to re -emerge So a while ago I was doing a very important podcast episode high stakes and I tend to fast before I do this.

50:48Which is good, it keeps me nice and alert, a little bit of cortisol and adrenaline running through the blood is nice for mental focus, but I overshot it and I went hypo partway through the podcast. As I'm watching this person talk in front of me, all that I can hear in my own mind is blank. There's nothing. My whole mind's gone blank and I'm like, well that's not good, I'm supposed to be here and I'm here in burba burba burba burba burba burba burba burba burba burba burba burba and I'm thinking, wow, I've got nothing to say. And as soon as that happened, the first thought that came to my mind was, you're not supposed to be here.

51:21You were never supposed to be here. Everyone's laughing at you, you're boring, no one thinks that you've got anything interesting to say. You're blowing it, this was your shot. Burb burb burb burba burba burba burba burba burba burba your useless, nobody likes you, no one's ever liked you. And I thought, like where has that voice coming from? Because I thought I'd got rid of that voice. I spent 1 ,500 sessions of meditation, like five years of daily journaling, all of that stuff, and I'd looked at me inwardly as well as I could and tried to look at that part of me. I don't know where it comes from, something from my childhood.

51:55That I didn't like. There's very negative, very cutting, very cynical voice. And during a period of super, super, super high pressure, it came back. Yes. which makes sense and this is the danger. What's the danger? The danger is of a self -fulfilling prophecy, right? Because when those thoughts are going through your head, as you said, when you try and tune in on the person again, you're hearing the blah, blah, blah, blah, blah, you're not hearing the words. Why? Because all you've done in between is increased your distress level. So then there's the danger of it coming off the rails, so to speak, because you could inadvertently kind of make that true at least in the moment where like if that goes too far you don't have something to say back, right?

52:38And then it that when that happens to a person, now it really tells them, oh, this is back with you, this is all true. That can be very, very difficult for a person if they have a bad outcome when things are back in their mind. What we want to do if you and I let's say we're working together clinically and I knew the strength of that in your past, I would try and prepare you Hey, let's just be clear. That's going to come back to you at some point in time. And it doesn't mean anything. You're the best thing you can do when it comes back to, look, please. You know, just laugh at it a little bit.

53:09A little bit of like that kind of like good humor. Like I get it. I get it. When that, when that, you're an idiot comes back into my head or you're stupid, you're not good enough to be here. What made you think go to medical school? Like I get that. I'm like, look, this is it. This is coming from the past. Right. And then it takes the power out of it. Then if you can do that, then you can go back. And now you're going to hear the words the person is saying. But you have to be prepared for it. If you don't know that that's normal for it to come back, then you can't just do that. What you do is you inadvertently give it so much power.

53:41Oh my goodness. It's back. Now I really can't pay attention. Oh my gosh, it must be true. And you and all of that meditation was a waste. I knew that the journey wasn't there. This isn't the true me. That was the true me, et cetera. Right. That's why I talk about dismissive humor is our friend in situations. And I will prepare people for that because it's inevitable if you had these voices in your head, if you've worked very, very hard to get them out of your head, that's the victory. The victory isn't they never, ever encroach back in. That's just not how it works. But it's okay that they encroach back in if you say, I know that message isn't I rejected.

54:16Let me stop and ground myself. I'm not at my best. I overshot the mark with not eating before or whatever, like I'll learn from that, okay. I'm here for a reason. I, I, I, I, I, I will, um, work with athletes who are at the highest level of performance of whatever they do. And you see them in a slump, like I don't deserve to be here. I was like, they should be on the sand law instead of in the major league stadiums. Like you didn't accidentally get to the stadium, right? But even in a slump, the person can tell themselves they're no better than someone who doesn't even know how to play the sport.

54:44Like it shows what our brains can do to us and how dramatically we can lose our confidence. What about trauma being passed down? Is that a thing? I live in Austin, Texas now. So ancestral trauma is kind of a bit of a super meme over here with the psychedelic trips and the ayahuasca retreats and the indigenous cultures and stuff like that. What's the truth and the BS around epigenetics, ancestral trauma, all of that stuff? It's remarkable what epigenetics has contributed is just immense to our understanding. The thought was for a long time that trauma is passed down by role modeling. So someone say who has been through trauma and is very anxious communicates that to children.

55:35That the world is an unsafe place and they role model anxiety. And that can happen. We can nurture children to be like us in all sorts of ways, right? So that's why if I have a lot of anxiety in me, I do my best to have control over that. I don't want to role model that for my children. But but what we've learned is really quite remarkable. There are epigenetic changes in us in people that then can be passed down to children who aren't even conceived of yet. And that's where Darren Richarder, our EICH ERT ER, Dr. Darren Richarder, who I interviewed for the book is a trauma expert. He's an academic at Sanford and he testifies about trauma and this idea, so for example, in the World Court that if someone is traumatized, for example, some of this testimony has been around rape as an instrument of war.

56:28And it was seen through a criminal justice lens. This person ordered that and that was wrong. Okay, that's true, but we also need to look at that can extend across years and across generations. That could impact children that aren't even thought of yet and might not be born until 10 20 years later. Because the trauma in the person creates change in the person that can then be transmitted to children just through the changes in genetic expression years and years and years later. And that shift from looking at a war crime as something criminal that's just bounded by, it happened in this period of time, is it is a crime, but it's not only a crime in that moment.

57:16It's a crime against that person for the rest of their lives, especially if they don't get to help to deal with it. And it can be a crime against children that aren't even thought of yet. It's a transgenerational crime. And that truth, that epigenetics and epigenetics through the neurobiological lens tells us that's true. I was talking to Robert Sapolsky a couple of months ago, and he was talking about how mothers that enter poverty during pregnancy, the changes that you see epigenetically and the children. From that poverty, perfect example, I would guess, of a pretty good chronic trauma, chronic stress, it's not, it's just ambient concern, right?

58:03It's just there in the background. And yeah, the difference that people go through and he reminded me, something that I learned in year nine in biology, that when a female is born, they have all of the eggs that they are going to have for the entirety of their life. So inside of this as yet unborn child, this infant baby fetus that's inside of you, is the next generation. So you've got grandmother to mother that's about to be born and inside of mother you have daughter who will be born in however many 25, 30, 40 years time. Yes, right? And you're wow that that warrants it warrants that kind of wow that this is the impact of trauma truly Transgenerational and think about the example you gave was not someone who has lived chronically in poverty people can live in poverty without poverty itself Being traumatic it predisposes to trauma, but it property doesn't have to be in and of itself traumatic But imagine you said a woman entering poverty while pregnant And even that, if I stop and think about that too much, I could generate a panic attack in myself of how that would feel.

59:22You're carrying a child and you feel responsible and now you go from not being in poverty to being in poverty. What is the cascade of stress hormones, neurobiologically, and cascading throughout the body? It's huge. That's why it makes the significant changes that Dr. Sapolsky is talking about. It's a huge trauma during a period of time that is a very, very crucial period of time to that developing fetus, which is crucial to the developing fetus, to the adult that fetus will become. And if that fetus can have children, to the subsequent children of that fetus, if this isn't a reason for us paying attention, it's not like borrow a penny today, pay back a pound tomorrow.

1:00:02But are we going to borrow a penny today and pay back 10 pounds tomorrow when what 100 pounds in 10 years and a thousand pounds down the road? I believe that that is not an exaggeration. And that is what we are doing as a society by turning away from trauma. And we see it in death rates through overdose and death rates through suicide. There are many, many things we could talk about where we see that right now. And what we see now will continue on and worsen. It's a guarantee. It will continue for it and worsen because we've planted the seeds of that into the future unless we do something about it.

1:00:35So, we've talked about the impact of trauma and unwinding of that, trying to make the unconscious into the conscious. What about trying to get out ahead of that a little bit more? Are there any predictors or ways that people can increase their resilience so that the bar for whatever could cause a traumatic interpretation, sort of bounces off during the event. What's the physics of that system? Oh, it's the same paradigm as for physical health. But the better health you're in, the better you'll be able to withstand and insult to your physical health, an injury, an illness. And the same is true in our mental health.

1:01:22So the healthier we are, if someone has, say, a chronic low grade trauma, they're in a relationship. And the relationship is just kind of dismissive or denigrating. They're not valued, but they're putting up with it. That predisposes to trauma having more of an impact. There's only called the multiple -hit hypothesis where we have more insults. We're more likely for the next insult to have a disproportionate impact. So be as healthy as we can. Part of the reason we want to be in physical shape is people want to look good and be healthy now, but we also want to, is preventive medicine, right? I'm looking ahead to what could happen in the future.

1:01:58And the same is true about our mental health. And this is why when we talk about a narrative, it doesn't cost any money. You don't need insurance. You don't need to be able to access care to sit and think about or write about your own life, your own life narrative. What's in your life that's not okay? They'd imagine a job. You see people who are in jobs where, no, they're not really liked by the people around them and maybe that's because they're good and other people don't want the good person to shine or whatever it is and they're just kind of putting up with it. Note that. That's something in your life that is causing misery and distress now that predisposes to problems in the future.

1:02:35So to be aware and to be honest about that instead of it's easy to shove it under the rug because like you said, it isn't the big fireworks thing. So look at what are our life narratives from past to present and what's going on in my life now, what's What's okay and what isn't? Because how many times will a person tell you everything's okay, sure things are fine. But then you ask, okay, let's talk about a little bit more. Things are not fine. They'll tell you what isn't fine. But the default of things are fine. Why that default? It's partly because if we don't feel we can really change anything, then we want to just kind of say it's all okay.

1:03:09And if we feel some guilt and shame about the things that aren't okay, more reason to sweep it under the rug. So there are a lot of reasons where we're not honest with ourselves. Tell me what's okay and what's not. Everything's okay. Usually that person isn't just lying to you. The question, they're lying to themselves. It's not because they like lying to themselves so life isn't as good. It's because there's a sense of, I should be ashamed of that. There's no way I can change that. I don't understand myself well enough. I'm afraid of that. It just does not have to be that way. There are routes to change that aren't rocket science routes to change, which is another message that I'm bringing.

1:03:44It's not like we need the most sophisticated help. Sometimes in extreme circumstances, but think about your life, right? A life narrative. Talk to somebody you care about and trust. These are things we can do for free that can really make a big difference in our lives. Talk to me about, again, this is not medical advice. Please seek your psychotherapist of choice, et cetera, et cetera. But in your experience, what are the modalities that are the biggest movers when it comes to helping people to sort of make the unconscious conscious to unpack the experiences of their lives, to stress test these assumptions and narratives that they have that may be erroneous and due to one incident or a number of incidents that's kind of whitewashed everything.

1:04:28What are the biggest modalities, the most effective ones that you like? I mean, there are ways to get to come at it, but most of the ways that would come at what you were talking about is an insight oriented psychotherapy. therapy. And that could be a kind of psychotherapy, psychodynamic psychotherapy, for example, that is very, very interested in the unconscious mind. Or it could be psychotherapy that's not just focused on the unconscious mind, but focused on self -understanding. Can you tell me about you now? Can you tell me about you growing up? How much can you tell me? Can you link the two?

1:05:03So that can be insight -oriented psychotherapy, too. It doesn't have to go right for the unconscious mind, but it's some aspect of curiosity about the person. When we just go strategies to make things better, so to speak, like cognitive behavioral strategies, they can be very, very helpful, but we need to understand what is underlying first. So otherwise, we just go to what else that we're going to polishing the hood instead of looking under the hood. Maybe it's maybe we don't feel so great about the car and we really should polish the hood, maybe, but maybe if we're not so happy with the car, let's look underneath at the engine.

1:05:39So let's look at where is something coming from because then we can gain greater insight and that in and of itself can make a difference, bring the unconscious to conscious. Then we have strategies that can actually help. Sometimes if strategies just decrease symptoms without going to where the problem is, that doesn't necessarily help. Maybe that allows the person to tolerate the abuse of situation longer. That's not so good. So we want to come, I don't, with rare exceptions, I don't understand not coming at the process through the lens of insight. Like let's start there. We might spend a lot of time there or a little bit of time there.

1:06:17So maybe we get the insight, for example, that this person who is depressed is experiencing a purely biological depression. They're handling their life quite well. They've had some trauma, but they've dealt well with it. They're a good job, a good relationship, they're meditating, they can care themselves, The problem is neurobiological. Oh, then there's a family history where on that side of the family people get depressed out of the blue. We might rapidly go to just the psychopharmacological. It happens at times, but we haven't just gone there. We've gone there because we've investigated and decided that that's where to go.

1:06:52So it's just an example even when the answers are not through the psychotherapeutic lens, we have to have some insight to decide that. And if I learn that you were never depressed until a certain thing happened or until something big didn't happen, but you change maybe from one place to another, a job, a relationship, and then things started changing and then you become depressed. Well, we may still think maybe, some medicines, a good idea or this or that, but we're not going to leave it at that. We're going to go to why that is different than what you understand about it or what you don't understand and we can bring to the surface.

1:07:26So it's a process that honors, I think, people and our stories and what goes on inside of us and and I think we deserve that from the systems that are allegedly taken care of us. You've mentioned a couple of times about writing things down, journaling or something analogous to journaling. Is there a process that you're a particularly big fan of when it comes to that? No, not a single process because it works differently for different people. And some people like doing that or if they don't know if they like it can take to it pretty readily. For others it can be painstaking and it's too much to do now.

1:08:02Maybe then they could speak words and then listen to the words back from them. So it's not how it's done. It's that when we when we make words, whether we say them out loud, it's kind of better in some of we say them out loud or if we write them. But when we make words, it's different than things bouncing around in our minds. There are different systems of error checking that come online, which is why it's kind of a joke and psychotherapy, but it is true that every now and then someone will come in and they'll talk the whole time. And then at the end of the week, oh my gosh, thank you. You solved all my problems.

1:08:37We didn't say anything. So sometimes that happens. It happened in my own therapy a little while ago. I said, wait, that thing happened. I actually saw the friends by talking about them, because in talking about them, they become real in a different way. I'm putting words, and the words of therapists is still relevant, because I'm putting words that are listened to by another person that I know and trust and feel safe with. And they're going to be scrutinized by them as well. They're going to be there to, you need to not just say complete gobbledy gook, you need to not just trail off in the middle of sentences.

1:09:10There's a type of structure that needs to be there as well. Right. It's a communication structure. Right. It's scrutinized not in a way that that person's going to fault me, but that person's interested in what I'm saying and I want to convey it. Then in this case, what it allows is not that I conveyed it to the other person. It's that, as I conveyed it, I understood it better. And it's that that we're going for. If you get that through long -hand journaling and you're like, whoa, I read that and I understand myself better. Do that. If you get it through more sparse journaling, but it's putting together, hey, I've veered these patterns of how I feel or what I do and how it links to how I feel, then do that.

1:09:46If you kind of can't do that, but you can talk to somebody trusted, do that. The idea is to get it out of just bouncing around in our minds because we often don't solve our problems that way. And then we make like we talked early about the self -fulfilling prophecy. Then we make a self -fulfilling prophecy. I must be dumb. I can't solve my own problems. I've been thinking about it for years. I think no all I'm doing over that time is spinning wheels. How about another modality that makes things different actually brings different brain centers online and then I can solve those problems? That's that that can be the tremendous benefit of writing or talking and again It doesn't cost anything you don't have to go anywhere people can do this if they have what a pen and paper or another human being they trust So there are ways we can really help ourselves that we can do quite readily.

1:10:34What should we be paying attention to when it comes to the little voice that sometimes appears in our heads, the things that we take the granted, the words that are said, the presumptions and assumptions when we encounter a situation? Is there something, is there a process that you advise people to go through when it comes to that repetitive thought that the sort of narrative that we say. Yeah, well, I can say it in two words and I'll expand a little bit, but the two words are be curious, be curious. It's interesting what's going on in our minds. If there's a shadow voice telling you how bad you are, be interested in that.

1:11:18Don't be cowed by it. Don't be frightened by it. Be interested in what comes into our minds because it's that curiosity that lets us better understand and it lets us put it in its place. I have this voice in my head not little the voice of like my own shadow voice. I kind of know where it comes from now that I think about it right that you became from that denigrating person that bad trauma how I was raised how I was treated because I was a little bit different and it's saying things to me. Do I think they're true? Do I believe they're true? I mean give an opportunity. I said well how about instead of that negative voice just having the whole playing field.

1:11:55It's in your brain and it's got a megaphone. How about let it have it say, but let the other side have it say, too, do you really believe that? Maybe you do, maybe you don't. It's a little bit of devil's advocate, but maybe you do, maybe you don't. Do you believe it or not believe it? If you don't believe it, like I'm the worst person in the world, I can't do anything right. Okay, do you believe that? If you don't, well now we want to look at that for what it is, not telling you anything except that there's something in your head that's not real or true or fair and you don't want it there. Now you more can see it as other.

1:12:24That's an otherness. How'd that get in my head? Now I start seeing it as alien. That doesn't really belong in me. Now I can start putting my foot in the door so to speak. You give me a little bit of room. You put your foot in the door and next time that person goes, I'm stupid and I can't do anything. Okay, wait a second. That just goes on in my head and it's gone on in my head for a long time and maybe even I know white's got there. That is not what I believe. So, now, so let's start again. Can I do this thing? Now it's a different decision -making process. Oh, no one ever likes me. I shouldn't go say hi to that person.

1:12:57Is that really true that no one ever likes you've been taking it for granted for a long time? If there's a life narrative, actually a lot of people like me, but I had a bad relationship outcome and I feel like no one likes me. They're a potential relationship candidate. Okay, we put things in place and now maybe instead of that person going the way for the potential romantic partner, they say hello. Now they start changing things because they're not making self -fulfilling problems. You know what I mean? People said, I can't meet anyone. I can't meet anyone. I never meet anyone. Okay, then we look, they're avoiding everyone they could meet.

1:13:26You have to meet some people in order to meet some people. That's how that has to go. So then we try and prepare the person, because especially in relationships, kind of the law of large numbers. So there's a lot of rejection involved. So then we think, okay, if you're going to go try something, we need to know what the expected outcome is. Right? If you want to say hello and be nice to a child that lives next door and that's gone well in the past, that's probably going to go well. If you're going to approach a potential relationship partner, then be aware it's a law of large numbers because if it doesn't go well, we don't want that person to then feel bad about themselves.

1:13:55I got to bring myself, I got to be able to do this a bunch of times and there are going to be some good things are going to come of it. So there are new answers to it, but you can kind of say I think the basic premise of it is be curious about what's going on in here so it doesn't control you because if it is controlling you, that's not the whole you. The whole you isn't to be controlled in some automatic way. It's to bring yourself to bear and think about things and arrive at conclusions and decisions. Dr. Paul Conti, ladies and gentlemen, this, dude, I'm so impressed with you. Andrew told me to reach out and you are beyond the real deal.

1:14:30I love your affect. I love how sort of caring and sort of gentle you are with this and insightful. I think you're absolutely fantastic and I really, really appreciate your work. Where should people go? That so many people are going to want to find out more about what you do. Where should they go? Well, I'm out there in podcasting and find me through just googling and I think they all get information out there in great ways. Everyone interviews in a different way and then I enjoy them all but they get information so they're more out there in the podcast room. The book that I wrote is called Trauma, the invisible epidemic and that also can be just searched and found.

1:15:07There's a website that just has links to some of the other podcasts and to the book, which is just it's a doctor DR Paul Conti, so DR P -A -U -L -C -O -N -T -I .com. And that has links to some of the other places that I've that I've appeared. Dr. Conti, I really appreciate you. Thank you for the like. You're welcome. Thanks so much for having me.