The Childhood Trauma Doctor: Your Childhood Trauma Changes The Shape Of Your Brain & Causes Parkinson's! How Not To Ruin Your Kids! Dr. Paul Conti

26:22So it's this part like, what is the nature, like who is the person, right? And then what is the nurture, meaning like, what are the variables, you know, that that seeds that are falls into as we go through life? You must have seen this a lot in your practice where an individual went through a really traumatic early event, and you've got the person in your practice set in front of you, that is an alcoholic, they are experiencing sort of suicidal thoughts. But then when you look at the rest of the family, the family just doing fine. To some of whatever that means fine, but. Right, well, one thing to look at is the rest of the family doing fine because sometimes what it seems like on the outside is not true on the inside.

27:01And then we do think about genetics, especially around alcoholism, there are, we don't understand all of it, of course, but, but they're genetic factors that can be very impactful. Then we'll look at personality structure, you know, is that person built to sort of internalize or externalize bling, you know, so why alcohol for this person and not for someone else, how much is nature and how much maybe form it if it may be that, for example, that person was in social circumstances, just real example that happens with some frequency is a mental 18s where alcohol was accepted as a way of coping. And maybe other people in the family weren't this circumstances were just different where the winter school was different, and they didn't have it modeled for them that this is how they cope.

27:43So maybe they're genetic factors that push more towards alcoholism, maybe there are social factors that was modeled for that person. So you can put those things together and which is why we follow patterns and there's a science underlying all of this, but we have to look at who is that person. You have to look at, you know, the family history, so the genetics that may have been passed on, and what does that seem like may be the case in the person, how can you be informed by that and what were the formative life experiences, and you start, we start to build a picture of what's going on inside of us so that we can understand and change by looking at our history, which is why mental health doesn't often do this.

28:24It takes an inventory of your symptoms now to reflexively prescribe a medicine, right? So we need to understand ourselves if we're going to understand whether trauma is afflicting us, how it's afflicting us, how we can prevent it, how we can treat it, if it's there. And I think that means accepting that this is real and this is real science, which actually when you were talking it made me think of an example, look if I say it, an example to the science of it, one of the earlier studies, and I forget exactly how many years ago this was, but 15 or 20 years maybe was looking at immigrants, and I believe there were immigrants from Somalia to Holland.

28:59I think I'm remembering that correctly. And so the incidence of schizophrenia in the human population is about 1 % across the human population. But when stressors are higher, they can predispose people to having the syndrome of schizophrenia. So it's about 1 % of the population, but it's not evenly distributed if there are people in sort of pressure cooker environment, so to speak, become more susceptible. And so they looked at immigrants who integrated into the community in Holland versus immigrants who lived in primarily immigrant communities. And the incidence of schizophrenia was higher in the people who had integrated.

29:42So the thought is, and again, there have been subsequent studies, and we don't know for sure, but when you look at that and say what is that, is the feeling of otherness, is different trying to integrate into a society that was looking at not everyone in that society, of course, but there was a much more pervasive sense of otherness when people were integrating than when they were living in the communities where food and dress and the day -to -day of life was normalized. What's otherness and what's the sort of cost of otherness? The otherness in the way I'm defining is a sense of difference in a way that's not good.

30:19A sense of difference in a way that involves either being seen as less than, and again, sometimes it can be over -pregidious, but it can be also stratification of opportunity. In some way, I'm not on an equal footing here, and then there can be a sense of isolation that builds, the sense of otherness then say building tension inside the person. The person doesn't feel quite as safe. It doesn't feel quite as validated, because when we're young, we look around us to see what's normal. People are looking, talking, dressing, like us, we just feel validated in ways that we might not feel if we see that we are different, especially if the difference isn't embraced.

31:03We see this across immigrant communities who at some point integrate, but initially people will tend more to stay together because there's a sense of validation in the community. So then the children often then will integrate, which is why it's such an interesting study to look at people who were first -generation immigrants who would be likely to feel very strongly, whether they were integrated or whether they were somewhere different, because they weren't a subsequent generation. They're the generation that just come from the home culture that either they could still live in or live in a new culture, and not that everyone felt a pervasive sense of otherness, but there's more of that sense of otherness.

31:47And the fact that that would change susceptibility to an illness that otherwise distributes itself across the population, I think is a very profound marker of scientific proof upon the things we don't pay attention to as much, subtle prejudices, discriminations, whatever they may be that are in our society that we look the other way and don't see it. We're really harming people who then can come to the, that come to the adult phase of life in a place where we have marginalized them, and we've made things different inside of them that makes it harder to make their way in the world. And I think we overlook very much whether it's bullying, many, many things that can be based upon what can make people feel less than, but the effect of it is seen in actual brain biology.

32:39And like we know this, we've known this for a long time, but in some ways I see that we're more fragmented and pushing more towards these experiences of otherness or experiences of vulnerability and lack of safety that push people towards the chronic aspects of traumatic brain change. When we think about trauma, we often focus on childhood, but what you're saying now with this study of the simoleons that immigrated to Europe, presumably those adults. Yes, so the highest incidence of schizophrenia is in people who are in young adulthood. So we're not seeing changes in people who are already deep into adulthood, but the changes that we're seeing is in the sort of transition to adulthood, which honors both that, yes, we are much more impressionable in all sorts of ways, including how our society is going to be.

33:26And our brains are forming when we are younger. So these are people still, their brains still have enough formative ideas. The thought would be they have enough formative processes going on in their brains that the brains can be changed by the trauma. But when we talk about these three types of trauma, the acute chronic and vicarious, can you experience these types of trauma in any age phase chapter of life? Yes, the earlier in the lifespan, the more impactful. Okay. Yes, absolutely, which is why childhood trauma is so important in my, in the book, I interview Darren Richter, who's a psychiatrist at Sanford and Stephanie von Gutenberg, who's a child wellness advocate, because we're talking about trauma from both ends of the spectrum.

34:12So the chapter that's the interview with Stephanie von Gutenberg talks about how childhood trauma so deeply impacts the sense of self of the child, like things that we know, but I dedicated chapter to it because childhood trauma is so tremendously impactful. And they can we don't pay enough attention to helping children who are traumatized into, to projecting ahead to the increased burdens of illness and decreased role performance and all the awful things that happen. So, so childhood trauma is one thing on the other end of the spectrum. Dr. Richarders work has highlighted the fact that when people are traumatized, they are changed in ways that changes subsequent generations.

34:58So, if we're talking about childhood trauma, we can talk about traumatized children. We can also talk about traumatized adults whose trauma changes their children, even if their children are not born until years later. How do we know that trauma can and is being passed on? What is the best evidence we have to support that? So, the field of epigenetics, which has become so epigenetics really come to the forefront in the last two to three decades, which is the understanding that our life experiences can change the expression of our genes. So, so you or I may have a gene that is active now because we inherited an active gene, for example, and then maybe that gene is producing something, it's just helping us in some way, bolstering mood, decreasing anxiety, then something can happen, something can change in us that turns off the expression of that gene or turns on the expression of another gene.

36:03So, then even though you have that gene, you don't have the benefit of it because the gene has been turned off. And this is a very, it's a very revolutionary understanding that it's not just what your genes are, your genes. You know, we could look when sperm and egg come together, well, that's telling us what's going on. If we could understand that fully, we would see, oh, here's the array of genes that are active in the array of genes that are not active, but that's not the story. Right? That's just part of the story. The story continues that one's experiences of life changes how those genes function, which ones are on, which ones are off, and how they get passed along.

36:44So, if the parent is not traumatized, the parent may pass along the active gene for something positive, say, to the child. If the child then is traumatized, the child may pass on that gene without it being expressed. So, it's as if the gene isn't passed on. So, if you think about that, it's just amazing that our genetics, in the sense of what's actually going on in us, is not just the nature of what genes did we get. It's the nurture, how has what has happened to us affected the expression of those genes? There's one study that I read about, which says, scientists at Emory University in Atlanta trained male mice to fear the smell of cherry blossom, shocking them whenever they smelled it.

37:28So, the mice got to the point where they shuddered when they smelled it even when they weren't even being shocked. And I'm guessing the children then had the same reaction, I guess that's what was studied, but also the children of Holocaust survivors are another example of how trauma can be passed on. Because it's hard to think of a much more traumatic event than being involved in the Holocaust. And for a long time, the thought was that the reason that the children of Holocaust survivors had higher levels of anxiety and anxiety spectrum illnesses was because of anxious parenting that understandably the parents had a much more sense of vulnerability.

38:09So, across the population, they were more anxious and they were raising the children with more anxiety. And what we have learned is that the experiential aspect is part of it, but that exactly what you and I are talking about is part of it too, because the experience of what they went through changed genetic expression in the children. So, that's just a sea change in understanding that the genes of the parents, the genetic expression of the parents and the genetic expression that they pass along to their children is changed by the Holocaust experience itself. With this understanding of epigenetics, do you in your practice then consider deeply what someone's parents went through in their life and how that might have changed someone's genetic expression that's sat in front of you in your practice?

39:00Sure. Sure. I think we all deserve, so to speak, to think about our life narrative. And so many of us don't. I think if we're trying to help ourselves, whether someone listening to this feels that they're depressed or that they don't have any mental health issue, but they want to understand themselves better, think about a narrative of where, let me start with, where have I come from? Who came before me and then like this happened and then that happened, and when we build a narrative, it's remarkable how much we can come to understand about ourselves, because often we don't do that. Like we have isolated pieces of information about ourselves, but we don't knit it all together.

39:39And it's really remarkable what can happen, what can be elucidated by doing that. So absolutely yes, just for the general understanding of the person and also to understand what did the parents go through, what experiences did they have, how might that impact this person? And then you might then ask questions of, let's say that family situation changed, you know, between say older siblings and younger siblings, right? Then by learning about that history and learning about older siblings versus younger siblings and the parents, I mean, You like in trauma to a virus, it's a very interesting way for us to start thinking about trauma because we seem to think of it, at least I did as being sort of isolated to the person, but the idea that it's somewhat has a contagion to it and that we can spread it vicariously to other people that are around us, but also down through the family tree, viral epigenetics and viral genes, makes you kind of understand both the importance of treating it, but you've just never heard anyone describe it as a virus before.

40:56Yeah, because there's a reflexive guilt and shame to trauma and our society doesn't recognize it, it often gets hidden inside the person, right? But when it's hidden inside the person, it's still spinning off symptoms. So I think the best analogy to use here is of an abscess in the body. So an abscess is a walled off area of infection in the body and it's good that the infection is walled off because if it weren't, it could be fatal, right? So it's good that it's walled off, but the body is still aware that it's there and it's still spinning off symptoms because it's there. So for example, a person might have an intermittent low grade fever or just feel kind of jittery or they're sweating and they're not sleeping well, right?

41:43So there are pervasive symptoms that are impacting this person, but it's not obvious that the abscess is there, right? So what often happens in general medicine is person is having non -specific symptoms, you know, people go looking, scan, they say, oh, there's an abscess there, right? Once we know that, then we might have an understanding for why that person, this never feels good, right? They always feel lethargic, they never feel comfortable. We know there's something there now and we can go in and fix it, right? And it involves, you know, there's a surgical process, right? So something has to happen that's not a fun thing, right?

42:17If you go through surgery and recovery, now the abscess is gone. So I think the example of the abscess in the body is a very good way to understand what trauma does to us in the mind. So if we shove it down inside of us, there's reflexive guilt and shame, societies and helping us take a look at it. Now it's there inside of us, it's going to spin off symptoms. And those symptoms aren't always symptoms that makes a one person hurtful to another. They may not be that person, maybe very, very vigilant and just kind of can be to someone else, but across the population, those symptoms inside of us are not good.

42:54So they give us shorter tempers, right? We're more likely, we're more anxious, so we may be more quick to anger or we're less functional in the world around us because of depression, anxiety, sleep problems, right? We can be more impulsive, like it works against us being in the world as best we can be. Is that what you refer to as post trauma syndromes? Is that a similar thing? Yeah, as post trauma syndromes are ways in which we can recognize the changes in ourselves. So higher levels of anxiety, for example, lower levels of mood, right? Different changes in sleep, physical health changes, and then changes in just how comfortable we feel in the world, right?

43:39So what we'll see is changes in behaviors that are driven by just feeling differently in the world. So we have it, we're in a different self -states, we have different behaviors. The syndromes can do all sorts of different things to us for mood, anxiety, sleep, behavioral change. So someone who might want to find a relationship partner, you know, stops going to places where they could meet someone, right? So we change our behaviors. This is what shows us that there is a post trauma syndrome. That's how we know we're traumatized, effective, because that's why I'm trying to figure out how people will be listening to this now and hearing you talk about these different types of trauma.

44:13What are the sort of tell, tell signs? I'm assuming it's this, that I am traumatized. Right. Yeah, this is what we're looking for, right? So someone might present with that person is depressed now and they weren't before. That person is having panic attacks and they weren't before. That person is using alcohol to soothe and they weren't before. Because in medicine, we look at just the surface, right? What we want to look at is like, oh, why are you here? Oh, you're here because you're drinking too much. Let's talk about how you can drink less. You're here because you're depressed. What can we give you a depression medicine?

44:42Right? So we're not looking at like, why? Why are you depressed? I mean, some people biologically will become depressed, no matter what, even when things are going very, very well. But this is at the majority, right? Most of us, if we're depressed, there are likely factors. Like, so we should be curious. Why is that person depressed? Why is that person having panic attacks? Why is that person change their behaviors? Right? And so now if we get curious, we get curious about the person, then we're going to figure out things we wouldn't have before. So if a person gets depressed because everyone in their family gets depressed every night to 12 months, no matter what, like, okay, let's come at that biologically.

45:22That doesn't necessarily map the trauma. But if we start looking at that person being depressed, do we see that they started getting depressed a couple of years ago around the time their sleep started being a little bit different and they started behaving differently and they, you know, they didn't spend as much time with family or they started getting more curious and you start learning, oh, if it's something something happened, then, right? Again, with acute traumas, it's easiest to see. But when you look for the whole picture of like, might there be a post trauma syndrome going on here? You know, maybe that person who's depressed and is drinking too much, started drinking too much, when their mood started decreasing after the trauma or maybe they started drinking after the trauma and it's driving their mood down.

46:07Like, again, it's not always this, but we're never going to know and understand, unless we're curious. Like, this is how we trace to the roots of it. And this is how we get back to the narrative, right? Of what is going on inside of me and have I changed? Right? And the idea we started talking about how the changes in behavior of the post trauma syndrome are the changes that make trauma like a virus because we start behaving differently. And for some people, that is the mood is as good and it's not as healthy to be raised by a parent who's depressed. Right? So that can be a way in which the virus of trauma gets passed along to the next generation or maybe that person is drinking or using a drug to cope.

46:51And that doesn't make for the best parenting. That's how the virus of trauma gets passed down to the next generation. Or there are times when a reaction to trauma to the feeling of disempowerment can be aggression, an envious aggressive behavior. So not all abuse of children comes through the lens of trauma, but a lot of it does. I'm interested as well in the subtle symptoms of trauma. You know, we talked about some of the big picture stuff, which is like suicidality, you know, becoming an alcoholic or all those kinds of things. But the subtle ways that trauma shows up in everyday life, I was some of the most hypothesizing over a things like phone addiction, being addicted to your phone or video game addictions.

47:31These kind of things that I think maybe originate from this more chronic trauma is but are less easy to spot. Right. Right. Yeah, I think the key to all of this is curiosity. Right. So loosely, someone is addicted to their phone. Okay, maybe that's because phones are addictive and the person just spent too much time on their phone. Maybe. Right. But addiction mechanisms in human beings are similar. It's the same machinery across addictions. And oftentimes addictive behavior is meant as an escape from something or to soothe against something or even to self punish because of something. So addictive behavior is the similar brain machinery, whether it's cocaine, it's alcohol, it's brownies, it's the telephone, it's sex, it's exercise.

48:19I mean, there are things that people do in addictive ways as routes of unhealthy coping. So if we get curious why they get why the drug, why the phone addiction, why the things that might seem more subtle and maybe are more subtle. But we should scratch on the surface of them to try and understand if they mean something is that phone addiction, the 14th addictive behavior in a row. Right. Because that person has sort of particularly adept addictive machinery inside of them and they're trying to escape from something. Like that doesn't happen all the time. But it is not untrue that when you scratch the surface of that, you might learn about an episode of sexual abuse that happened when the person was a child.

49:01Like these are real examples. Right. And that the person isn't built to run from things through addiction. And maybe they're saying things about their own character that's negative. They're saying negative things about themselves. And they feel disempowered and they're disempowering themselves. But if you go look at that narrative, you know, that that person that made of a dialogue running over and over again in their head of shame about something that happened 30, 40 years ago. So this is not uncommon. So we need to be curious and we need to scratch on the surface of things, whether they're really big things or they're subtle things, like which is why a life narrative is so important.

49:34If you think about changes like after trauma that changes the brain, we respond differently when we see a new face. So without the trauma, I'm simplifying a little bit, but you see a new face, we might be curious. Like, oh, could you be a friend or if someone's romantically interested, like, oh, my, that person like me, or I might be interested in curious, whereas after trauma, there's a difference of feeling a little bit on the back foot. So people tend less to look up and engage and more to look away or to more negative thoughts. So you don't, that person doesn't like me, you know, instead of something that might be more constructive.

50:11How do they test for this? Is there a test that I'm able to be done to see if someone after trauma has like a different set of sunglasses that they view the world with? Yes, there's a test from the brain biology all the way through to very clever psychological experiments. Like, we can see all of this. And it's these, these signs we should be looking for in ourselves, right? Because it is very obvious if someone who always was an extrovert now won't leave the house. We can tell something's wrong and someone's probably going to come ask something, right? But if we just change in these more subtle ways where we're just less interactive and, you know, people notice their friends a little bit different and less outgoing.

50:51It's these things that, as you're saying, the subtle ones, the subtle signs and nuances are often very impactful and indicative of other things going on under the surface, you know, that can bring even greater problems. On this subject of soothing that you're talking about a second ago, there's this quote that you say in your book, trauma promotes pain, pain increases suffering and suffering makes us desperate to soothe our pain. Whatever form it takes, sadly, we're seeing the terrible cycle play out on a larger societal level with the opiate epidemic. Yes. This idea of soothing, we will find ways to soothe ourselves and some of those ways that we find to soothe ourselves become destructive in and of themselves.

51:32And it almost makes me think that like our sometimes our attempt, we think of like alcoholism typically as people that are self -destructing. But when you understand the soothing component of drinking alcohol, it actually is them trying to not self -destruct, not destroy themselves, but to take care of themselves. In a way, in a way. If we're under huge amounts of distress, our perspective of the world narrows very, very dramatically. I mean, if it's an elephant standing on my foot, I only have one thing I'm guessing I would think about, which is the elephant not standing on my foot anymore. So when we're under tremendous stress and strain, something that soothes us in the short term becomes acceptable because there's a desperation in us that has us focused on the short term.

52:22Like I know that, man, no, that's not good in the long term, but I'm just trying to get through today. And it's this lack of perspective in the world and the society around us that if we're not recognizing what trauma does to us, that it can drive us to places of desperation. Is it any wonder that short term soothing will have a big appeal to us? And that could be soothing to excess eating. And now that person is overweight and has diabetes and wants to be healthier, but doesn't really feel that they can stop and ping -pong's back on different diets. And what they're really doing is they learned self -suiting with food in a way that was in the context of really feeling some sense of despair or desperation.

53:05The same way that person may have learned that, oh, alcohol soothes. Now again, there are genetic factors and there are also factors that come into play too, but unhealthy coping mechanisms are beckoning to us all the time, which is why I did a lot of treatment of opiates and opiate dependence over a number of years. And it's just outrageous to me that these are the most powerful psychoactive medicines on earth, opiates. They soothe psychic distress, feeling not good mentally inside of us very, very rapidly and effectively, and almost immediately start building tolerance and danger. But I had no education in training around opiates as psychoactive medicines.

53:55So here we are in a society that is so under -appreciating trauma and where people are at in a sense of isolation or otherness or desperation and so many facets of our society. And then we start handing them the most powerful short -term soothing mechanism with the absolute highest risk of long -term danger and death. And then we're surprised that how many tens of thousands of people die each year from prescribed opiates. What kind of opiates are people being prescribed? So how the opiate epidemic really began was with opiates and pill form. So that there would be prescribes for conditions of pain, but conditions of pain that were more chronic conditions or conditions not so amenable to opiate.

54:46So if you come out of surgery and opiate is a great idea, right? There's a lot of pain that needs medicine to soothe that pain until the pain decreases. But it's judicious use of a very powerful medicine in high -equality circumstances. What we started trying to do and part of this was, you know, we know there's a whole story behind the politics and the business of this. What this said was people shouldn't be in pain. So there's a short -term solution right now and should be in pain, we'll give them pills. Right? And opiates do not work in those situations. They soothe a lot early on, but they rapidly build tolerance, addiction, they suppress breathing drive.

55:23So we started doling out opiate pills with the idea that we're treating pain and isn't that good, but with an absolute inattention to the immense risks of that. And I think it fits with the short -term view of relieving all pain. Like what we're human beings, we can't relieve all of our pain. Right? Sometimes what there is to do is to work hard to mitigate pain. And that might be, that might be pain, you know, from a mental health perspective, it might be pain from a physical health perspective. But this idea that a pill is going to fix everything and everyone has pain pills and won't be in pain, you know, has resulted in hundreds of thousands of deaths in this country alone from prescribed opiates.

56:08They're let alone illicit opiates. So there's the short -term thinking on the part of our society that then almost lures people into the seduction of the short -term soothing. Right? You feel miserable and you want things to be better, take this pill, now you're seduced and addicted and at huge risk. And, you know, we've let that happen. First to know how to treat trauma, we have to understand the physiological consequences of it. How does trauma change our brain? When we look at brain scans, what do we see in a traumatized person? Brain scan data is more complicated and harder to interpret. You can see different patterns in the brain.

56:50We're not at the point where brain scan science can really can pinpoint. Right? But what we do see is parts of the brain that are sort of inflamed, so to speak, by trauma. So though the amygdala and pathways around the amygdala, which is a part of the brain that gets called sometimes grand central station for negative emotion. Right? We see that pathways involving this part of the brain become more prominent. Right? So we see changes in brain connectivity. Right? Because how our brains function is by communicating from one place to another. They function through connectivity and which pathways are more prominent.

57:30So what we see then is pathways that are involved in trust, say, and feeling a sense of safety are less prominent. Pathways that are more activated when we feel less safe and more vigilant are more activated. And then we see the climate, so to speak, in the brain change in a way that's less healthy. And you may also see specific aspects of a post trauma syndrome. So mood regulation areas are not functioning as well because now there's depression and truting. So we see patterns in the brain that show us this change, although the science hasn't come far enough to pinpoint like at some point we'll be able to do with much greater accuracy.

58:10And I've heard you talk about how that creates cognitive blind spots. So blind spots in our brain following a traumatic event. What do you mean by cognitive blind spots? And what's the the harm or risk of that? So a cognitive blind spot can occur when we take a lesson inside of us that is a lesson of trauma, not a lesson of truth. And then it changes how we may think about things. So for example, a real and sadly many examples of this I that I can bring to mind and people's faces who come to mind as I say it, but someone who felt pretty good about themselves and able to navigate the world and striving for a better job and doing what we're doing.

58:49Doing fun things who then is assaulted. And after that assault, the person is much less present in the world and internalizes a bunch of different thoughts about themselves of I don't really like being out I like being at home better or never goes well I don't get along with other people like they think about themselves differently. So there's a cognitive blind spot which makes it very, very difficult to think with accuracy about say possibility so that person may have say been striving for a better job. But if they think of themselves differently, I'm not the kind of person who can get ahead and people don't really like me, then they don't strive for a better job.

59:32They just take for granted that they can't get it. It won't go well they'll fail at it. But they never thought that before. Is this what you kind of see when people refer to someone having daddy issues? I was thinking as you were saying that that my dad let's say my dad left when I was four and I internalized this idea that men don't love me for example. And then I go through life being an avoidant person in romantic situations or self sabotaging of going for people that are unavailable to avoid the rejection. Is that somewhat similar? Like I've created a cognitive blind spot and now I'm living out there as an instruction manual for my life.

1:00:08Yes, absolutely yes. And the earlier in life, the more powerful the lesson is and the brain doesn't go back and revisit those lessons. So I think this is just so amazing and surprising to me that our brains are so incredibly complex, more complex than the greatest supercomputer. Yet our brains don't do some very basic things like we don't reboot and see is there a patch or is there something to fix? We don't go back and look at these earlier lessons. So if you learn at age four, oh, men don't love me. That's a hard lesson to unlearn because it gets solidified at an early age and then once those lessons are there, there's an internalized danger to go revisit them.

1:00:52Like if you go revisit that lesson, could you be disappointed? Right. The thought is that's the way it is. And that's the way it's going to be like that's kind of what we tell ourselves inside the trauma kind of walls it off. And then we don't just go back and look and say, is that really true? Like here I am. I'm an adult now. And no, did I just carry forward something when I was four years old that wasn't about me? Is it really about the four year old? Right? Or is it about the adult? Like we learn all these things, but we don't go back and revisit the lesson. And then yes, there's a person who could be very, very avoidant in ways that that lesson, that quote unquote truth that is not true can change that person's life.

1:01:31And that's why if we go back and look at that, life can really change. I can go back and look at why do you feel that it's interesting to feel that let's let's think about it and you know what's the story behind it and we can get to a place where that can be undone and say, oh, I took that lesson inside because someone else made a choice that was about them and not me know four year old is responsible for apparent leaving. But I took something in that was different and it's really affected me and can you feel differently about myself? It's not that everything instantaneously changes, but boy, the world is different then.

1:02:07On that subject as well, I say the father leaving it four years old and me thinking that man was at the say I was four years old and my father was violent. What you sometimes see is people then are attracted to the familiar when they grow up. So although it wasn't healthy, they have a sort of bias towards being attracted to something that was familiar, even if it wasn't healthy. Right, that gets complicated, but sometimes people will talk about as repetition compulsions are quite complicated. Often what a person is doing then is trying to gain a sense of mastery over a situation in which they had no control.

1:02:45So you will see this in abusive relationships where sometimes a person will come and say, okay, I'm coming to see you, but I know you can't help me. But my last like eight relationships have been just awful. So how can you possibly help me? And then I might say something like, if you can tell me how you had eight different relationships that didn't go well, maybe I'll believe you. But you're going to tell me about the same relationship eight times over. There's something along those lines because we repeat things that don't go well in an effort to gain a sense of control. So what often is the case in that kind of situation is whether it's repeating an abuse cycle or just someone who is an attentive or isn't interested.

1:03:27That the person is trying to feel better about something from the past. So if the father was in attentive and that person has a romantic interest in men, that person may choose men who are in attentive with a desire to make them in attentive to fix the to sue the pain of the past because the emotion systems in our brain don't care about the clock in the calendar. So you can solve the past in the present as far as the emotion systems are concerned. And if the trauma is very strong in us, the emotion systems will rule the day. So they said the father was violent, then maybe that person chooses a violent significant other.

1:04:08Right. And then that relationship goes away and the person chooses another violent significant other. And then sometimes the thought is, well, the person is choosing that because that's what they're comfortable with. But no, the person is trying to make sense of something. And there's some desperation inside to feel better about themselves and to fix and heal something. Whereas why if we can intercede there and say the problem is if you want someone who's attentive, choose people who are attentive to someone who's attentive. Right. As opposed to choose someone who's not attentive and try and make them attentive.

1:04:42Can we become addicted to a victim hurt? Sure. There's no internalized victim without an internalized persecutor. So if someone is victimized in the sense of the law, someone has done something bad to that person. That doesn't mean that person takes inside of them that they are a victim. Right. But trauma can make us feel like victims after the loss of my brother when I felt like maybe we're cursed and I'm not sure if I'm going to be a victim. I'm not, I can't really get anywhere in the world. Like there's a block magic to that. Right. Then I feel like I'm a victim of something. I don't, I'm behind the eight ball.

1:05:14I then have a sense of otherness. Right. And and now I've taken something inside of myself where we don't need a persecutor anymore. I feel like I'm less than. So how's that going to go well? Right. So what we end up doing is we take inside of us sometimes this sense of victimness. But that also takes inside of us. The idea that we are less than that there is something magical that is bad and negative and what we need to strive against is exactly that that something may have happened that we might say that person is a victim in the eyes of the law. They were assaulted. Right. But that doesn't mean that person has to take victimness inside guilt and shame.

1:05:57How many people have I seen who are assaulted and they talk about how they're ashamed of it into their fault. Someone else attacked them. Right. But the reflexive guilt and shame of trauma can lead us to feel less than then we start feeling like victims. Then we feel less than we embrace this and we don't need someone to persecute us anymore. The limbic system we're talking about the brain here. What is the limbic system and what role is it playing in cementing our trauma. Yeah. So the limbic system is the name for the emotion systems in the brain. So we're simplifying a little bit but the idea that there are logic systems and emotion systems.

1:06:37The emotion systems are limbic. Those are the limbic systems and they never lose when they come face to face with logic. The limbic, the emotional always rules the logic if the two come head to head, which is why if the emotion of trauma, the fear of being less than the need to repair something that was unfair in the past. If that is driving us, logic will not have it say you know logic would say if you've dated six people who've all kind of seen the same at the outset and then all behaved in the same negative way, don't choose the seventh like that. Logic very logic was saying that the second person that let alone the third the fourth of it why do we see repetition of unhealthy relationships because the limbic system if it needs to feel different.

1:07:27It needs so to speak to solve that trauma by gaining mastery it's going to go look for the seventh person who's just like the first six. But once we take the energy we lance the abscess so to speak of the trauma then logic and have it say in that person who says you can't help me because the last eight relationships were all awful seas. Oh, I did the same things chose the same person last eight relationships. That's one paradigm and I'm changing it now. And then things are different when they thought they couldn't be because they can see now what they couldn't see before the limbic system isn't ruling the day anymore.

1:08:02There's a whole balanced brain that has an understanding of self and uses that understanding to move forward in life. It seems like the limbic system is against us but there must be some sort of evolutionary reason or rationale or purpose of that limbic system that is I don't know malfunctioning in the modern world. Oh, sure, the limbic system isn't against us. All these parts of our brain, none of them hate us. They're all part of they're all parts of us and some of the research and observations through the psychedelic sciences are really telling us that much more that there are parts of our brain that hate us.

1:08:35They may work against us because as you're saying commenting they're not built for the modern world. So you know if you think about the limbic system and the negative information like something bad happened when you were four or five like 10 years ago. And you can make that in and whatever lesson that is never questioned it or change it right. And this is based upon survival mechanisms. The example I give is you know imagine for most of human history and people of hunting and gathering and living in small groups and and like having enough food was very important for humans across human evolution.

1:09:07If you find a new food that it looks good looks like something else that was good and you and you eat it and it tastes good and it's nourishing like it's good to remember that. But if you eat it and you get very very sick you better remember that forever. So that the negative has much more salience in us and makes these lessons never go near that thing again never go near that person again never do this again. They're designed to keep us alive but we're trying to do more than that right. We're trying to do more than stay alive and these systems in us that evolve to keep us safe than can very much work against us.

1:09:43The person who's traumatized because someone attacks them and that system gives them panic attacks if they leave the front door. I mean that's that person's brain trying to keep them safe. Use the word shame a lot when we're talking about trauma. In the same way that I asked, um, is the limbic system against us. What is the use of shame? Why do we experience shame? Can't we just program ourselves to get rid of shame and then we'll all be fine. Exactly the same with the limbic question. No, we kind of need shame but we need shame for good reason. So these primary affects that that are very primordial in us anger, fear, love, shame.

1:10:28These are things that are just aroused in us like they can become other things once we start thinking about them but their states that that that are very deep within us they all have a survival adaptation. So you know love feeling love is you know being more than one. You know we love someone now you are too and you're and you're there with one another and that's going to help you survive make your way forward in life love is adaptive right fear can be very adaptive that now you're in a fight or flight stage. Do you try to survive and get through life shame is the same way the things that people do that bring shame that change behavior shame changes behavior locks it feels so bad.

1:11:05So you know I give the example of I imagine that you know in the old days you know someone who, you know, he's on the food in the cave instead of going outside you know and like now puts the whole tribe at risk group you and then like there's a sense of shame that comes to that person like you can't do that anymore and the person feels better never does that again. And it's adaptive for the group right just one example of how shame can alter behavior so the keep us alive in that concert to keep us alive like now you feel shame you will not forget to not do that anymore right. Like it's going to have an impression is going to change you because you feel so much shame which we would think should be the case in the modern world to right we there are things people do that are shameful that are worth feeling shame about I mean sometimes the problems we don't have enough shame where we should.

1:11:50But we have a lot of new modern problems don't we with I was thinking about bullying right example like I imagine back in the days of our tribes there wasn't internet like obviously not but there wasn't like mass in the world. Internet bullying where a huge group of strangers could just pepper you within so maybe our modern brain still has the same old mechanisms of kind of perceiving that as our tribe are going to kick us off the island here right to the brain malfunctions and experiences shame which causes all the things you described and even in the context of like sexual assaults trying to rationalize that how the shame of sexual assault can make you feel shame when really it was someone else is right behavior but how does that make that you know that woman.

1:12:35I feel that guy feel shame about themselves when they were attacked because it doesn't start with the thought of it because you're right because what you're saying I think is basically it makes no logical sense why would you feel ashamed of yourself of someone else came up behind you and jumped you and did something awful to you why would you feel ashamed of yourself right but the person doesn't get there by thought right I didn't get the feeling ashamed of myself after losing my brother by suicide by thinking that is a shameful thing I should feel ashamed no no this is not the same thing. The shame is aroused in us it's created in us because it's behavior modifying there's the there's the adaptive something bad has happened feel something inside that creates a version the shame is created in us and then we make the meaning of it.

1:13:20I feel ashamed the shame inside me then we make the meaning of right because I shouldn't have been there when that happened and then we make a story around it it starts with the limbic system with the affect and then we build a story around it which is why we can build a different story. Where for example shame goes where it makes sense to go like that's very very effective of processing through so okay so this thing happened you can process through with someone how they felt and what was going on inside of them maybe they're in an ambulance or hospital they're filled with shame they realize what has happened to them and you know and then that was a terrible state to be in and then they start put it they start making trying to make meaning of that state and we can go back to oh that's a that's a natural completely understanding human state to be in after this happened but now you get to decide what that means.

1:14:13So in the context of our ancestors I'm walking through the I don't know Serengeti with my with my big spear and I'm walking an allion jumps out at me out of the blue I managed to survive it although I've been attacked I the shame is created in me because as a response to make sure my behavior changes so it doesn't happen again and then I write a story about that when I get back to the cave and tell myself like the story could be that I shouldn't have been walking out at night in the Serengeti alone when that line attacked me and that's adaptive and useful because it stops me from doing that in the future so.

1:14:54So try to think of it maybe it's a little different if you were out okay let's say you're out and you actually you're hunting a lion in the service of everyone else and then you are attacked and hurt that it's that's different because you're doing something then to to feel proud of yeah right so so that is is different what we're doing is a That's a situation where the person is approaching the trauma on the front foot. And then when you return back, the thought would be, you would be respected and cared for like, you know, you went out to do something for everyone and got hurt. That is very different than how people normally would experience their trauma, which is when there is an sense of pride and self -sacrifice behind it.

1:15:34So, if the person, let's say you're walking out in the serengeti at night and you shouldn't feel bad about that, right? Then the thought would be, yeah, I shouldn't have been doing that and how bad you feel about it will make you not do it again. So you're not going to get killed, right? And then you're going to come back and talk about that or people are going to go, what are you doing? And well, you should have been out there and like, they may feel bad that you got hurt. But like, there's an experience that is a deterrent to others doing that too, right? So... This is something really interesting about how we treat people who have been through a trauma.

1:16:05Right, that did lose the difference in the United States between veterans coming back from World War II and veterans coming back from Vietnam. There was far more post -traumatic syndrome after Vietnam because people were not coming home to heroes. Welcome to the thought there would be, they had gone out like the person who goes out and the serengeti to hunt the lion is to save everybody else is that's what was going on when people went to fight in World War II and when people went to fight in Vietnam. But when people came back from World War II and they'd been hurt, they were treated as heroes.

1:16:40They were treated with respect and that allows a person to shoulder that trauma without the brain changes happening. When people came back from Vietnam and were treated differently, which didn't happen to everyone, but it happened as a societal phenomenon that was a terrible thing for the veterans who came back, you saw much greater rates of post -traumatic stress. I mean, that I think captures very clearly what the impressions and perspectives of the people around us mean. There may be a reflexive guilt and shame from trauma, but that doesn't have to win the day. But it was much more likely to win the day if there's a sense of otherness because now we're talking about the same thing of feeling less than chronically by society for some reason makes that person more susceptible.

1:17:28So that person who's been through combat trauma and then comes back and does not receive a hero's welcome is put at much, much greater risk for the brain changes of post -traumatic symptoms. What role does vulnerability and being open with others about how we're feeling play in alleviating our shame? I'm sure it plays in for most of us in most cases, it plays a very big role because the reflex to the trauma is guilt and shame and the reflex to the guilt and shame is to hide it inside. What we are doing is cutting ourselves off from the human contact that we need in order to process what has gone on with us.

1:18:10So very many times over 25 years of being a psychiatrist, I've sat with someone who's putting words to their trauma for the first time. When I was five years old, I was assaulted in that way. This coach did this to me when I was a certain age. I was hurt this way and I'm the only one who survived and my two buddies died. These are real things that I have heard people say and then be shocked that I, the other human in the room, don't recoil from that because they've held so long inside of them that it is shameful that they were assaulted. It is shameful that they survived that it's so dangerous to even utter it, the fear of how person will react that someone is surprised like, wow, you could hear that or they say it in ways and kind of step back a little bit because there's such an expectation of rejection where what the person is telling me is something that from any reasonable human being would only elicit compassion.

1:19:15Now, that person who's telling me would only ever be compassionate to someone saying that, but they're not compassionate to themselves. Is shame really the cause of what we kind of think of as these trauma cycles? Because someone experiences a trauma, they suppress it, which changes how they behave, which means that they're more likely to experience more trauma in some way or at least perceive it as a trauma via shame. And then their life gets more and more full of different types of trauma. Does that make sense? Because I'm wondering if trauma can be quite a self -fulfilling thing where you get into a cycle of trauma in your life?

1:19:52Well, it can be. In the case of the person who now finally puts words to something they've held inside of them that they would know is not shameful to anyone else, but they hold this shameful for them. What is going on inside of them may or may not have caused further trauma. It's caused suffering. There's no doubt about that. When a person is saying that and they're putting words to something that's so important has been inside of them, they has caused them suffering. They're as happy as they could be, enjoyed life as much as they could be, been as outgoing as they can be, been depressed, maybe they didn't have to be depressed.

1:20:27So the trauma is impacting them because they've hit it down inside. If you can talk about it and bring light to it, let's say after that thing that happened when the person was assaulted at five years old or survived in accident, others didn't. If someone did trauma work with them of, hey, what are you feeling now? Okay, let's get to the fact that person is feeling guilt and shame and the naturalness that they are, but it doesn't tell them truth. It's just telling them how they feel and in fact it comes from compassionate places inside of us. We can help to unwind that before it becomes a thing inside the person that yes, may make life less enjoyable or may also in a way that's worse, push towards repeated trauma.

1:21:08So the trauma of choosing the same unhealthy partner or the same abusive partner over and over is an example of what you're saying. If a person doesn't look at the trauma and like, why am I doing this? What am I trying to solve here? I'm trying to solve something maybe from childhood that was somebody else's shortcoming or fault or something else to say, okay, I can stop doing that. Then the person can stop with repeating the behavior. So the answer to all, I think the answer to what you're asking is absolutely yes. And if we're curious and we strive for understanding ourselves and we know that there are routes to change, this is how we heal from charms.

1:21:44And ultimately invisible epidemic is a message of warning, but it's not a negative or a pessimistic message. The positive message is if we understand this and we look at it, we'll guess what happens is we get better. We prevent trauma. We take care of the trauma in ourselves and others. And we get healthier. Like I see this play out in 25 years of doing this. Like this is what happens. But we only get there if we have the curiosity. We're interested in we know enough to go looking and thinking and making a narrative and talking about ourselves and wanting things to be different and knowing that they can be.

1:22:19So it's a message of hope because when we do that, we really see change. So clinically when doing this work, you see a lot of difference in people. And that's part of what's been so heartening and led me to write the book is it's not just a message of oh, this is what's going on with us. Let's take a look at it. This is what's going on with us. And if we look at it, absolutely we make life better. I want to talk about some of the ways that trauma impacts us that are less obvious. One of them I'm interested in is sleep. A lot of people are struggling with sleep these days. Is there a link between sleep issues and trauma Yes.

1:22:52And how strong means that link? So sleep is one of the symptoms of a post trauma syndrome. It's not an all post trauma syndrome. So higher anxiety, lower mood, behavioral changes, sleep is one of these factors and sleep is very often negatively impacted by trauma. So the changes you had asked about in the brain and then we talked about how they go more towards vigilance, more towards activation. They make it harder for the brain to settle down and be in a restorative state. So sometimes we get what's called a ruminative where there's just thought loops going on inside of us. And the brain doesn't want to quiet down to a place where we can get restorative sleep.

1:23:33So people have more fragmented sleep. They have shallower less restorative sleep, more time until they can fall asleep earlier awakenings. So this is very, very bad for us across the board. I mean, talk about the union of physical and mental health. Sleeping very poorly is terrible for us from head to toe. And very often, after trauma, if there is a post trauma syndrome, which is not uncommon, sleep patterns are dramatically changed and sleep restorative function is changed. What happens is we're in higher states of arousal. And neurobiologically, this is in about sexual arousal. It's it's just state of alertness.

1:24:10Right. So we're in too high a state of arousal, too high a state of alertness. And then the brain systems inside of us that need to really simmer down in order to restore are unable to fully do that. I guess there must be some kind of link there as well, because if I'm in that, if I'm less comfortable with being with my own thoughts, because they're room, room in a tube that I'm overthinking all the time, I'm then also more likely when I'm trying to settle down to be trying to stimulate myself, like a lot of people aren't comfortable with just being sitting in a room alone with their thoughts, especially if they're, you know, an overthinker.

1:24:43So then they might grab their phone. They might be, you know, doing things to stimulate themselves at a later hour of night, but it all comes back to the trauma. Absolutely. Yes. Here's a new describing how the downstream effect of all of this are tremendous. So absolutely. Yes. So we're saying getting less sleep is just bad for us from head to toe. Okay. And also there's all the things that you're talking about. So if you know you're going to try and sleep and it's going to be just going over and over again in your head. And it might be, I'm not safe or I'm going to be something that's simple and negative that you don't even relate to trauma.

1:25:22Like, oh, this is awful or light. I mean, these are things that go over and over again in people's heads when they're trying to sleep. Like, I'm not okay. What's going to happen? And it's going over and over again. So of course, you're going to want to distract from that. And you, because the way we've kind of framed it there is that you're aware and conscious of that. But can that be taking place in like the back room of your mind? Oh, sure. Sure. Sometimes people are aware and sometimes they are not. So that's to ask a person, why aren't you sleeping well the last four months, which seems like a good question to ask instead of just giving the person a sleeping medicine.

1:25:51But in modern medicine, sometimes the question doesn't get asked. But you know, maybe the answer is, it's just some really different trying to fall asleep. And like, I just don't feel peaceful anymore. But the person is not thought of that. And to ask them, then what's the logical next question? Why? Right. What happened when anything changed around then? And a lot of times you get an answer. And that person is a trauma problem, not a sleep problem. You can probably pound the sleep system to sleep with medicine. But now we're doing something that ultimately is harmful for the person. So yes. And also, when you know we need to talk about avoidance behaviors of sleep, this is also why the person can avoid, avoid, avoid, and then have three or four drinks to get the sleep.

1:26:31Right. So there's so much that is unhealthy that then perpetuates this being unhealthy and it spreads. And this is part of the epidemic aspect of this. And then people often don't know why things are different in their sleep. But a lot of the time, if you stop and you think and you talk about what's going on inside of them, they will tell you. And it may be that for the first time, they're telling themselves, which is why we should ask ourselves this question. You said to Rich Role, amongst the conditions I have seen treated, the absolute worst in mental health treatment. And indeed, in general, medical treatment are sleep problems.

1:27:10Why? Because sleep underlies so much. And because we, when we have a lot of habits and medicines, so we see a lot of nails. So if someone is not sleeping, the reflex in medicine, and not everyone does this. And I'm trying to say they're all physicians or practitioners are not behaving in the right way. But we work in systems that are high volume and designed for throughput. So they're designed for symptom identification. So what we say is, okay, you're not sleeping. So we'll give you a sleeping medicine. Like that simple. But the reasons people are not sleeping are very, very often not related to their sleep systems.

1:27:50They're related to these vigilance and activation systems inside of us. So if that's what's going on in me, and I'm agitated and have this highly aroused state after trauma, and maybe it's been going on for two weeks or maybe it's been going on getting worse for two years. But this is what's going on. And I can't settle down, and my sleep system can't overcome it. You know, if you give me a sleeping medicine for that, I'm probably going to need a lot of it, right? Because we're trying to make the sleep system overcome the distress. I'm more likely to get addicted to it. I mean, there's a lot of bad we do to people.

1:28:23And I never have an opportunity to address my problem. What should we be doing instead? We should be asking why? Why is it that you are not sleeping? And maybe it came out of the blue. Maybe, maybe your sleep system every now then fails you. But when we start asking those questions, we get answers. And more often than not, those answers are in the realm of trauma. Then the person does not get a trauma medicine. They may get a different medicine that in the short term can quiet the vigilance systems. This we do this a lot where the person has a sleeping problem. We learn the trauma history. We use a short course of a medicine that calms the vigilance systems.

1:29:03There's nothing to do with making the person sleep. And then they start sleeping well. And maybe this is true. They might not have slept well with five, six, ten sleeping medicines. But that is not the medicine that they need. They need a medicine to calm these distress systems inside of us so that the sleep system, which is not damaged, can go and do its thing. And while we realize this, we can start talking about the trauma. And maybe the person can process some of the trauma. Now the sleep problem is gone. Everything is better. The person is not going to be on a sleep medicine for the next 20 years.

1:29:35It's healthier. It's safer. But we have to be more than reflexive. There are a lot of reasons people don't sleep. Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learned just how crucial having the right systems in places, one which has helped me across many of my investments is net suite. They're also a sponsor of this podcast. Net suite is the number one cloud financial system through their streamlined platform. You'll find all of your accounting financial management inventory and HR in one place.

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1:30:45I've had I've had a 10 of studies over the years about how various people who are obese have high levels of sort of traceable trauma. Is there any truth to this? Yes. So there are probably almost surely a couple of factors. One is it's hard enough to take care of ourselves. You know, even when things are going really well, right? I mean, life is so busy and so stressful. So it's hard to take care of oneself. If a person adds trauma to the mix, it becomes harder to take care of oneself. And one way we cannot take care of ourselves is, you know, what we're eating and whether we're exercising. So the trauma makes it harder to take care of ourselves and predisposes to poor self -care.

1:31:27Now we have no person who's overweight and then maybe pushing towards diabetes or heart disease or cardiovascular or cerebral vascular disease. And also just like we talked about epigenetics and and changes in gene transcription, what genes are active in us. Trauma puts us in a place where we are more inflammatory within us. Like there are more inflammatory markers in our blood vessels. So it's not as clean and clear as we would like it to be. We're not as healthy and this works against the health of our blood vessels and the health of our immune system. So the soup we swim in, so to speak, is changed by the trauma.

1:32:07And then those higher levels of inflammatory markers, for example, that are circulating in our bloodstream can make it harder to lose weight. The body starts holding on to more calories and it makes it harder for our blood vessels to stay healthy and then we get less and less healthy. And part of that is the biological effect of trauma just like the epigenetics. And part of it is the changes psychologically and the changes in self -care. How do you convince someone that comes into your practice and tells you that they can't change? They don't believe they can change. How do you convince them that they can?

1:32:42I'm a huge believer in the power of knowledge, in the power of information, which I think goes back to how powerless I felt as a kid when we couldn't understand medical information. It's like, I want to know, I want to understand. And I think a lot of people are like this. I think we as humans don't get enough credit that we want to understand. And I think so much in our society is reflexive. Like you know what you know and you feel how you feel and then we have a whole set of beliefs about the world because we affiliate with some group or another, right? I think that's a reaction to feeling so disempowered and that what we really want is knowledge.

1:33:18And I think that's a reason why, for example, knowledge imparting podcasts are so valued because you're not trying to tell people what to do or how to think, but you're giving them, bringing them knowledge. And that's what I try and do of like I know that's not true. Now it may be that if you're a science -based or a rational person or you're an engineer or an accountant is like, I might try and get it you through the science, right? I might try and get it you through that article, right? This is something that can like let you see that or I might try and get at it through examples of, hey, here's like people do change.

1:33:49Like here's kind of really what the state of the art is now and like kind of get excited about that. Give me an example. There are a lot I could cite, but the one that comes to mind is the one story in my book that is just an amazing story of a person who had had a trauma in her life that had just changed everything, mood, anxiety, behavior, choices in the world. I mean so much had gone in a way that was not how this woman was built to live her life, how she was living her life and it was so striking. Her telling me about who she was at some point in the past and contrasting that to how she was living and how she thought about herself and it was really a night and day difference and it became clear there was a very abrupt change at this at the time of this trauma like a night and day change towards dysfunction poor health poor social function misery and she had no thought or idea that she could be like she was before because all she knew was that things had changed and now she was like this and this was not okay and never going to change.

1:35:05But she was willing to see the starkness of the change and to hear my observations and examples like look I see something here that's looking from the outside that's really striking and that's we could think about and talk about and understand and like changed her entire life and it really is true that 10 years later she looked 10 years younger. Absolutely. Is this a one hit wonder though or is it a training process like me being in the gym and picking up weights over and over again? Am I having to retrain my mind to view that situation differently? Yes. Yes. We are creatures of neuronal habit.

1:35:44So if you think the example I give usually uses let's say you and I just pick the word random word we set it 500 times right we need to be saying it this evening. Let's say we say 2000 times you know give it a couple days it's still there on the mind why even when we know it's a silly example why would it still stay with us because when we say that word so many times we're strengthening memory connections that word comes to mind more it's stronger within us and then the only way it goes away is it atrophies over time you know as you can't just make that go away after you set it a couple thousand times it'll go over time.

1:36:18It gets less and less powerful over time so if you don't keep saying that word you know it comes to mind maybe 10 times the next day five the second day three times than not again but this is how processes of change work inside of us so someone who has for example had self -talk in them said oh it'll never work out for me like I suck a known likes me or you know I'm terrible or how could you idiot or you know things like I had a shadow voice saying these things to me for years like that doesn't want to go away at once because it's just habituated inside of us so we have to realize look that is not real and true I don't that is not what I think what I want to say to myself so I want to know when it's there I want to realize I'm saying this to myself and I don't believe it then we make it less strong right we make it less strong every time we say something that's a negative lie to ourselves like no one will ever love me right people say that to themselves over and over we make that more powerful as if it were true and if it's as if it were true is it true our brain can't tell the difference now so if we we understand that and now we want to change it like I know why I said that because when I was growing up that parent a person always said that to me over and over and over and then you know I chose bad relationships that I didn't think I was worth anything better and they didn't go well and it reinforced that to me like a person really understands that we bring that understanding to bear in a way that you speak against that when it comes into your mind because we can't make it not come into your mind it can atrophy mean this process of slowly over time it goes away but we have to say hey the whole me I said what the judge in the middle of all the opinions has to say okay no I'm saying this to myself right but do I believe that or not can you really completely get rid of trauma can you take a trauma to zero well we won't lose the memory of it like something bad has happened we're not going to entirely forget it that means it can trigger us again in the future well the question is how much does it trigger right how much does it trigger the idea is to attenuate the response to it so if if it was a car accident and every time the person looks at a car they have panic attack right it's probably it's probably not going to happen that someday they look at a car and don't even remember right but they can look at a car and like they know they had a car accident we're not they're trying to hide it for themselves because oh my god I can't see a car I had a car accident it triggers me like I'm trying I'm understanding that understand the naturalness of the responses in me and how they maybe were perpetuated by the fear that I felt and I wasn't working through it or working through the loss that happened now that I'm understanding that well I don't be afraid of this so I see a car in the US it makes it kind of uncomfortable but so okay a lot of people beat themselves up because they've done a lot of work right and this trauma still remains I think I'm one of those people where there's certain traumatic things from my childhood done a lot of work I logically know that it's not true like that that belief I had is not true yeah I'm still prone to be triggered on a bad day about a particular thing right right look that's that's how it goes when a person is navigating through trauma and really getting through like getting over a lot of difficult things and getting to a much better place but responds to the triggering in a way that inadvertently reinforces the trauma say I would say if you're having a bad day and you have a memory of something that you kind of know you got over but then it if brazes the same set of thoughts or feelings that aren't good right instead of my guess is that you're feeling bad about that like I did all this work and I didn't get over it right to say look isn't it interesting like how strong this imprints us that this is still going to come to my head today's going to come into my head like so I'm having a bad day or I drop something in the morning and I don't feel great about myself this stuff is very very powerful but still not telling me truth you know that shoulder shrug about it okay it's going to come into your head it was neuronally reinforced and sometimes you'll be having a bad day and it'll come in it doesn't mean anything lady gargoyle sits at the very top of your book and she's written the forward in your book there's this wonderful quote inside there that says I can now say with certainty that this man saved my life he made life worth living but most importantly he empowered me to find and reclaim myself again that is an incredible thing for anyone to say to anyone else thank you my first thought is she's eloquent and generous of spirit and I so appreciate that she wrote such lovely words and I and I so so appreciate that just thank you why did she say that you know she has talked about this trauma in her life and to gain an understanding or much better understanding and be able to ground to the things about her that are wonderful and she's a wonderful person there's wonderful there's wonderfulness in us no matter who we are and I think from the perspective of her on such a big world stage acknowledging the trauma and the humaneness in her and that like anyone else she needed some understanding she needed some help forward in different pathways of thought about self like the kind of thing any of us need after trauma and she had the the bravery the fortitude to take chances to be different you know just like someone would say I can't be any different we can all feel that when we have a lot of trauma inside of us and it's hard to think I'm gonna really try and be different I'm gonna take that chance but you know in order to to change our lives we have to do that and and and she also did that it's a very very human story in I think a deeply feeling person who then wants to bring that message forward to others that we can change trauma and I'm so grateful she wrote the forward to my book but part of that is she's she believes in that message that trauma does not have to control us we can understand it we can get our arms around it and I think that's what she is you know it's what she's communicating in that quote that's the part of that quote that's important the part that's about everyone reading it and the and the capacity for change you have some incredible celebrities and on the book inside the book that have given you quotes for the book people like Kim Kardashian Tommy Hill figure etc etc Lady Gaga as I mentioned I'm guessing these these people at some point came to you without sort of disclosing client confidentiality issues I'm just wondering how you find yourself in a position as a psychiatrist that the this caliber of people are seeking out your support well and does I ever feel a bit surreal yeah I think I think it does mean I like to think of myself as a diligent person who wants to continue working at things and moving them forward and and thing where they can go and and I think at some point in time I realized I had the capacity to perhaps reach people who reach a lot of other people right and there's been a real joy I think that people who have who are public facing I mean there are a lot of stresses to that you know people can say oh it seems so wonderful from the outside but there's a lot of extra stress to that from the inside so to be able to address some of the extra complexity of that and to be able to help people who have a big impact on the world around them was sort of a joy to pursue we have a close -in tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're going to be leaving it for and the question that's been left for you feels quite fitting and very interesting I really like this one it just says it's not even written as a question it just says erase one regret from your life dot dot dot wow you know I think I should have paid more attention to the world around me when I was younger and more lost in trying to feel good enough at the moment and I think that it made it harder to sort of find my path and I think it made me harder I think my brother hadn't found his path and I think there was a lot of frantic anxiety or fear driven forward movement without pausing and circumspection and it may be that we just talked about and we've talked about his suicide and we've talked about that in this podcast so it's kind of at the forefront of my memory but when I think back then I probably knew well enough to be more circumspecute including about what might have been going on in him more in me and I'm happy I got myself on a path that's led to places that feel good and then I think our generative and productive I wish I had more attention to the bigger picture when I was significantly younger why well I think I would have made better decisions I think I would have seen pathways that led away from health and happiness and maybe seen that in others too because some you're talking about Jonathan and others where I where where I was born and raised I think there were a lot of good people in a lot of forward movement but we maybe could have looked around ourselves a little bit more and there be several people maybe still here as opposed to not being here and people being healthier and I think I probably had it in me to look around myself more than I did at that time and I do sometimes feel I will feel regrets about that.

1:45:45Well I have to say Dr. Paul Conti the work you've committed your life to and the understanding you've committed your life to spreading is going to save many many many many many many people's lives thank and not just save their lives but sometimes it's not always about saving a life it's about improving the standard of someone's life which I think can have a generational impact if that person is to stay alive and they are to you know if we look through the lens of epigenetics or just about the how internalized shame and guilt and all of this can be passed on through vicarious forms of trauma that the kids might feel and whatever you know your work and your future work I deeply believe is going to save and improve thousands and thousands and tens of thousands hundreds of thousands of people's lives and that is an unbelievably remarkable thing to commit one's life to thank you there's no words that I could say in the 30 seconds I have now that would express the extent of the good that that's going to do in the world and I you know I can't imagine those people that are here and not here how proud they would be in our of you thank you for turning your trauma into such a wonderful healing important thing thank you thank you so on behalf of all of those people that you'll never get to meet that you've helped with your work I want to say thank you so much well you're very welcome and thank you for those kind words which I take to heart and thank you for having me on I appreciate it you Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead and over the course of my career I've learnt just how crucial having the right systems in places one which has helped me across many of my investments is net sweet they're also a sponsor of this podcast net sweet is the number one cloud financial system through their streamlined platform you'll find all of your accounting financial management inventory and HR in one place their technology has been a real game changer especially for my team at flight studio as over the last year we've moved out of startup mode and into scale at mode we no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors over 41 ,000 businesses have chosen to future proof their business with net sweet so if you'd like to learn how it can help your business head to net sweet dot com slash Bartlett and free download the cfo's guide to AI and machine learning that's net sweet dot com slash Bartlett