The Body Trauma Expert: Medicating Kids Can Harm Brain Development! Eye Movement Trick That Fixes Trauma! The Secret To EMDR Therapy! - Bessel van Der Kolk

The Body Trauma Expert: Medicating Kids Can Harm Brain Development! Eye Movement Trick That Fixes Trauma! The Secret To EMDR Therapy! - Bessel van Der Kolk

December 23, 2024 2h 4m
50-70% of people will experience a trauma in their life, but how do you heal from these devastating experiences? If the Body Keeps the Score, according to Bessel van der Kolk this is how you get even with trauma. Bessel van der Kolk is Professor of Psychiatry at Boston University School of Medicine and President of the Trauma Research Foundation. He is the author of the global bestselling book ‘The Body Keeps The Score’. In this conversation, Bessel and Steven discuss topics such as, how to heal from childhood trauma, the benefits of EMDR therapy, the link between screens and loneliness, and how trauma physically changes your brain. 00:00 Intro 02:32 Bessel's Mission 03:09 What Is Trauma? 04:37 What Trauma Treatments Do You Disagree With? 06:03 Does Rationalising Your Trauma Help? 07:01 What Is Considered Trauma? 09:40 Can Small Events Lead to Trauma? 10:20 Bessel's Experience as a Psychiatrist 12:43 Bessel's Parents 15:31 Consequences of Child Abuse 16:07 Is It Important to Understand Childhood Experiences? 16:42 Was Your Mother an Incest Victim? 17:31 How Many Patients Trace Issues to Childhood Experiences? 18:01 Examples of Child Abuse 19:18 How Culture Influences Parenting 21:52 Disciplining Children 24:03 Liberation Equals Separation 25:44 What Did You Learn for Your Children? 27:01 Medical Treatment for Behavioural Dysfunctions in Children 30:36 Impact of Movement on Healing 32:00 Importance of Secure Attachment to a Caregiver 32:57 Can You Heal from Childhood Trauma? 34:32 The Body Keeps the Score 36:27 Somatic Approach to Healing 36:53 Are Women More in Touch with Somatic Healing? 38:02 Impact of Trauma on Creativity 41:14 Trauma as a Perception 45:05 How Many People Have Trauma? 45:50 How Does Trauma Affect Brain Activity? 50:00 Study: Reliving a Traumatic Event 55:13 Most Radical Improvement in Clinical Practice 55:55 EMDR 59:01 Demonstration of EMDR 1:04:12 Breath work 1:05:55 Impact of Yoga on Trauma 1:06:23 Study: Effects of a Weekly Yoga Class 1:08:09 Disconnection and Hypersensitivity 1:10:26 Impact of Physical Activity on Trauma 1:13:15 Picking Up People's Energy 1:16:01 Challenges of Individualistic Cultures 1:16:48 Role of Community and Social Connections in Trauma 1:17:37 Are Women Better at Forming Connections? 1:18:19 Building Relationships in the Army 1:19:13 Building Connections Through Sports 1:20:19 How to Get By in an Individualistic Society 1:21:13 Are You Optimistic About the Future? 1:22:12 Are You Able to Point Out Anything Good About Trump? 1:22:33 Human Inclination Toward Fighting 1:22:54 Three Ways to Reverse the Damage of Trauma 1:25:52 Types of Brainwaves 1:27:48 Psychedelic Therapy 1:28:26 Body Practices 1:29:07 Is Touch Healing? 1:29:21 Talk Therapy 1:29:46 Bessel's View on Taking Medications 1:30:08 The Bottom-Up Approach 1:31:53 Does Going to the Gym Help? 1:34:05 Bessel's View on Psychedelic Therapy 1:38:00 Effects of MDMA 1:39:25 Impact of Psychedelics on Treatment-Resistant Depression 1:40:32 Bessel's Experience with Psychedelics 1:43:11 How Did Psychedelic Experiences Change You? 1:43:48 Have You Healed from Your Trauma? 1:44:36 Psychodrama 1:49:33 The Rise in ADHD Diagnoses 1:51:45 Cause of ADHD 1:52:42 Is ADHD Over diagnosed? 1:55:21 How Can We Raise Untraumatised Kids? 1:56:24 Helping People in Traumatic Events 1:58:20 Question from the Previous Guest Follow Bessel:  Website - https://g2ul0.app.link/fJd55uRwqPb  Studies mentioned: besselvanderkolk.tiiny.co You can purchase Bessel’s book, ‘The Body Keeps The Score’, here: https://g2ul0.app.link/hLePea0wqPb  Get your hands on the Diary Of A CEO Conversation Cards here: https://appurl.io/iUUJeYn25v You can purchase the The Diary Of A CEO Conversation Cards: Second Edition, here: https://g2ul0.app.link/f31dsUttKKb  Follow me: https://g2ul0.app.link/gnGqL4IsKKb   Sponsors: PerfectTed - https://www.perfectted.com with code DIARY40 for 40% off Learn more about your ad choices. Visit megaphone.fm/adchoices

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Full Transcript

I've proven how helpful EMDR can be for PTSD and depression. Why and how? Well, trauma is a reliving, and whatever you're feeling is real, as opposed to feeling like a memory.
But in our research, you discover that if you move your eyes back and forth, as you recall a traumatic experience, your brain is able to say, this is what happened to me in the past. And 78% of the people we studied who had adult ulcer trauma were completely cured.
Can you do it on me? I could. What do you see? Vessel van der Kolk has been described as maybe the most influential psychiatrist of the 21st century.
And for over 40 years, his clinical research has revolutionized how we understand trauma and its impact on our brain and body. Your early childhood experiences create who you are.
And how many of the people that you treated in your practice have childhood trauma? About 90 percent and it's very difficult to change. Are they changeable? Yes that is the great news but the problem is the focus is not on helping people the focus is on running successful financial organizations and even though I was the first person who studied yoga for PTSD which was very effective and then there's psychedrama and neurofeedback, where our results were stunning.

People are so conformist,

we already know the answers, let's not explore anything new.

But let's do the science and see how well it works and for whom.

And what about psychedelic therapy?

It's very effective.

Have you ever done a psychedelic drug?

Yeah, of course.

What did you learn?

That my quest for understanding trauma had to do with my own childhood trauma.

All the pain is suffering.

Earlier on, I asked if people could heal from their trauma have you healed from yours the diary of a ceo is independently fact-checked for any studies or science mentioned in this episode please check the show notes quick one before we get back to this episode just give me 30 seconds of your time two things i wanted to say the first thing is a huge thank you for listening and tuning into the show week after week means the world to all of us and this really is a dream that we absolutely never had and couldn't have imagined getting to this place but secondly it's a dream where we feel like we're only just getting started and if you enjoy what we do here please join the 24 of people that listen to this podcast regularly and follow us on this app. Here's a promise I'm

going to make to you. I'm going to do everything in my power to make this show as good as I can now and into the future.
We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about this show. Thank you.
Thank you so much back Back to the episode.

Dr. Bessel van der Kolk, you've been described as maybe the most influential psychiatrist of the 21st century by the Financial Times.
What is the mission you've spent your life pursuing? I have been interested in how people survive extreme situations, how people can overcome the history of people doing terrible things to each other, and how we can create a better world in that regard, actually. So the mission has been rather social, but the investigation has been very much based on what we're learning about brain science, what we're learning about psychological functioning, et cetera, et cetera.
And this word trauma seems to be central to your work. And when I looked before this conversation at the rise in the use of this word online and people searching this word, it's pretty staggering what I found.
There's this graph that shows a huge jump in people using the word trauma. What is your view on the subject matter of trauma, specifically how we've misunderstood what it is? Well, there has been evolution, which is quite striking.
And when I first started to study trauma, I was on the research floor at Harvard, and my colleagues said, why are you studying trauma? That's all. When you croak, nobody will ever talk about trauma again.
Like, it's a completely alien subject. And now everybody talks.
Everything is a trauma. And so from being non-existent has become a total explanatory mode.
And so we have gone, as we always do, from one extreme to the other. And my primary interest these days is not so much into trauma.
Trauma started it. But somewhere along the line, I got to realize that trauma is, to a large degree, a breakdown of connection between human beings and synchronicity between other human beings.
And these days, I'm much more focused on how we can help people establish a relationship to themselves and to the people around them. when people are suffering from some kind of psychological disorder, whether it's depression, anxiety, PTSD, what is it that you disagree with with the traditional view of how to treat them? People are being taught methods that they say can cure people in eight sessions, which they can't.
And so there still is this, But people learn in school these days, although no good clinician I know actually practices that, is to help people thinking out, to straighten out people thinking and to make them not think these crazy thoughts like. And there really is no evidence that we can do that.
Is that cognitive behavioral therapy? Yeah, yeah, yeah. Cognitive restructuring sort of thing.
Or do you get people better by blasting them with trauma and then before long they get desensitized to trauma? And I think both of these methods are just, they don't get it. That completely doesn't get the issue at hand, actually.
Why? I cannot talk you into being a reasonable person. People are not reasonable people.
And trauma is as unreasonable as you can be. That's really at the core of, if you understand trauma, is that your brain and perceptual system gets rewired.
So you see things almost entirely through the past experience rather than current experience. Okay.
So if I'm traumatized, talking about my trauma doesn't necessarily fix my trauma. Trauma is a speechless experience.
So we did the first neuroimaging study about people reliving their trauma. And we saw that the entire cognitive part of the brain disappears.
That when you're in your trauma, you're just one ball of emotion, and there's no thinking. So you're confused, you're befuddled.
It is, as Shakespeare says, you suffer from speechless terror. You become dumbfounded.
So the whole traumatic experience is just beyond belief. And so you stay in a state of confusion and agitation and then finding language for yourself at this point is terribly important to help you to begin to organize your relationship to yourself.
It's not enough, but language and defining your inner experience is terribly important. The word trauma, as you say, has been thrown around a lot.
And it's become a bit of a cultural joke to some people. When you say, you know, something happens to you, you go, oh, I feel triggered.
I'm traumatized, et cetera. What actually does count as trauma? Drummer really is an overwhelming experience of oh my god when something happens and you're completely helpless and there's nothing in you that knows how to deal with it people talk a lot about small t trauma and big fan of that okay.
So explain why not. Well, you need to be more accurate.
But the small T trauma is a very real trauma when your environment about you doesn't acknowledge your existence. Most people, for example, after natural disasters, do very well because people get together after natural disasters.
I've seen it. We have a cabin in northern Vermont.
We've had terrible floods. The neighbors get together.
They help each other. And you get a sense of cohesion, actually, and a sense of meaning.
We're doing this together. The small T traumas have to do with not acknowledging what's going on with you, saying to kids, stop crying or I'll give you something to cry about.
No, you don't matter. No, actually, your dad is a drunk because you are such a difficult kid that your father was doing okay until you came into the family and you were too much for him and you caused him to be the person that he is.
I think that people mean small T trauma. It's a relational trauma, which is a very big deal for most of the people I get to see in my practice.
Most people come in not because of big T traumas. It is because nobody saw me.
Nobody heard me. I was irrelevant.
We always had to take care of my mom or my dad, but there was no room for us. So if you get fired from your job and it's a traumatic event for you because you get, I don't know, you lose your friends, you lose the job, your parents are embarrassed about you.
Can that become trauma, something like that? Yes, you could, depending on how you define it. For some people it doesn't, for some people it doesn't.
You know, it depends again on the context. For some people you get fired, you go like, well, I didn't like those assholes anyway.
I i ask this because i'm wondering if there's a lot of people listening now that i'm trying to understand if their small experience which other people think is trivial actually could have resulted in some kind of deeper trauma response absolutely at the end the issue is the perception your perception your perception the issue is not the event itself you and i may have the same events happening and for me it reminds me about my brother torturing me or it reminds me about my mom being sick and not paying attention to me or whatever and for me it becomes a very big deal and for you it goes like yeah you know but i have so many talents not try something else? And can you give me an overview of the work you've done in your life

that have fed into all of the knowledge and information that you have?

Just for anyone that might not know who you are,

what is that sort of body of work?

I had a very good psychiatric training in one of the Harvard hospitals.

And then I went to the last state mental hospital in Boston, which was also interesting. It was a sanctuary for very disturbed people.
And so that institution gets closed. I go work at the Veterans Administration Hospital.
I met these guys who were people who I looked up to. They were good athletes, competent people, helicopter pilots all my age.
And these guys had broken apart. And they had fallen apart.
And they reminded me of some of my relatives who I grew up with, who also had been concentrating of survivors and Japanese camp survivors. And then I learned much else after that.
But that really opened up my eyes to that people can be broken by life experiences. And that really intrigued me tremendously.
This is central to your story, is this early experience. You said earlier that you were born in 1943.
1943, very important. When you're born, it has a huge influence on who you become.
So my earliest imprint is of my father, at some point was detained by the Germans. He was not in an illustration camp, but he was supposed to go off there.
My mom is by herself, raising small kids in hiding, right next to the place where the Nazis are launching their rockets to go to London. So half of the rockets fell into our backyard.
And I have no conscious imprint of that. But I grew up like a kid growing up in Ukraine today.
And a lot of kids my age died. I was a very sickly child.
It was a lot of hunger and misery. Half my generation died of starvation.
And so I grew up with the incredible pre-conscious imprint of what kids in Ukraine and Gaza are going through right now. And that must have left a trace in my curiosity and my being, including a trace of having a body that was very sickly.

You were born in 1943 in Nazi-occupied...

Netherlands.

Netherlands, okay.

And you're the middle children of five.

That's right, yeah.

You were very sick as a child.

Yeah.

What were your parents like in terms of love, affection,

all those kinds of things? My mother was more or less broken by the pandemic of 1919, in which her father developed Parkinsonism and became one of those all over sex type people. So my mother was a very frozen person, which had a very impact on me.
My father was very conscientious, loving. You described your mother as being a frozen person.
Yeah. And it had an impact on you.
Yeah. Having a frozen mother has an impact on you.
What was that impact? The impact is that if you have a mother who is not available to love you and care for you, that becomes part of your perception of the world. And that means that there's a lot of work to be done about learning about affection and intimacy and closeness and vulnerability and all those things.
Your mother would faint whenever Bessel would ask her what her life was like when she was a little girl. No, no.
I asked her only once. I was already a junior professor at Harvard.
I had two kids. And my parents came to visit me.
And here's an example of what sort of parents I had. I left at age 18 for the U.S.
because I wanted some distance between me and my parents.

Then, 15 years later, quite a few years,

I wrote to my parents,

it's customary for parents to come and visit their children sometimes.

We should be interested in coming to visit me.

It never crossed our mind.

And so they came.

And we actually had a very pleasant time, very civilized.

And so on the last day that my parents were visiting us,

I said to my parents,

you know, you probably don't really know what I do for a living, but a lot of my work has to do with incest.

And I wonder, where does that come from?

And I turned towards my mom and I said,

you know, I wonder if something happened to you that I've picked up.

Thank you. And I wonder, where does that come from? And I turned towards my mom and I said, you know,

I wonder if something happened to you that I've picked up,

that you were ever sexually abused.

And my mom fainted, fell off her chair, and my father said,

look what you did to your mother.

And my dad and wife and her, my father carried my mother into her bed.

So I don't know if my mother was sexually abused. She just fainted when I asked her the question.
But that's how it goes. You barely get a straight answer to any of these things.
You said that child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer,

stroke, and suicide. That's true.
And in your book, you say that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, drug use, and domestic violence by three-quarters. Yeah, that doesn't come from me.
This is data from this very big CDC study, run by Vincent Felletti.

So these is data on 25,000 people, yeah. People have got increasingly interested in their early childhood experiences as a lens to understand who they are as adults.
Yeah. Is that overblown or is it important to understand? It's not overblown to be curious about how you became who you became and what the internal ingredients of your cake are.
I think that's very good for people to be aware of how they have become the creatures who they are. I think being curious about yourself is very necessary also to be curious in order to be curious of other people.

When you said about your mother and the incest thing,

you'd realized as an adult much of your work focused on incest.

And then you turned to your mother and asked her

if there was an experience she had had and she fainted.

Do you believe that there's a part of you that knew?

No, but I don't know if my mother was incested.

I know that my mother was very uptight about sex.

And that's what we what happened to her. And her fainting in response to that means that I triggered something, but I don't know what I triggered.
I would not jump to conclusions that my mother was an incestive victim. Something happened to her, but I don't know what it is.
Okay, but the indicator was that she was always uptight about sex. It wasn't that you? Unbelievably uptight about sex.
Terrified about sex. Yeah.
How many of the people that you treated in your practice have, could you trace their adult dysfunction back to an early childhood experience?

Pretty much 90%, let's say, yeah.

90%?

But, you know, that's me.

I mean, people with autism or people with OCD don't come to see me.

So I have a very narrow filter, in a way, of who comes to see me. And what's the crux of what happened to them as a child, if you had to simplify it? The crux is not being acknowledged and honored for who they were as kids.
That's the big thing is they were unseen and people did terrible things to them and nobody seemed to bother to protect them. When you say terrible things.
Terrible things is being beaten up, being sexually molested, having their bones broken. What if it was just words? Also words.
One of my patients, Monica, et cetera, all the time, oh, you'll never have friends. If people really get to know you, they will all reject you because you're such a terrible person.

That's pretty good.

Who said that?

Well, mother of one of the people I'm treating. But it would not be an unusual thing to say.

People do terrible things to kids.

Intentionally and unintentionally um automatically automatically yeah is that hurt people hurting people yeah no you see it in supermarkets and parking lots and stuff like that yeah what do you see you see people abusing their kids saying terrible things to their kids i guess it's difficult for parents because they sometimes think well i've got to raise a child that's not dysfunctional so i'm going to have to punish them and i've got to have to discipline them as a way to make sure that they grow up to be healthy and well-rounded yeah there's an interesting cultural issue that um that is sort of how my parents and grandparents generation saw their saw their kids. And then people who grew up in Northern Europe completely changed their attitude.
Now you go to jail if you hit your kids in Sweden, for example. I think me in Holland also, not in the U.S.
So people have really changed their mind. But in the U.S., when they talk about the downside of physical punishment of their kids, oftentimes particularly black people will say, I want to raise my children knowing about right and wrong.
And the Bible says I need to punish my children. And that's what I'm doing.
And you should not subvert the teachings of my church. And they don't argue with that because, at least not straight on.
I grew up in a household where I was punished physically in pretty significant ways, ways that I probably can share because it's just quite, you know, significant. Quite horrendous.
Yeah. And they are horrendous stories, actually.
I was born in Africa, so I've got an African mother and an English father. It's funny because I look back on it and I go, and this is just me rationalizing in hindsight, I go, I'm happy that I had a home where there was discipline because if I didn't have that home, then I wouldn't maybe have left the city.
We're one of the few families that actually left the city, the fairly small town, relatively small town, to some of the towns I live in now, and went and did a lot of things with my life. And I didn't get caught up in drugs like some of my friends.
I wasn't dysfunctional. And my mother couldn't read or write as well, so I feel somewhat thankful.
But I'm rationalizing in hindsight, because it somewhat ended up okay in certain measures of my life. In other areas of my life, there's dysfunction.
You know, and your perception may change. Really? My perception about my life and who I became has changed quite a bit over time as layers come open.
But what you talk about, that things were predictable is very important. My parents also were predictable, which is enormously helpful for at least for you to anticipate, to know what you are supposed to do, et cetera, et cetera.
Chaos is a terrible thing. I think that point is really interesting because although I was physically punished a lot, it was predictable.
Yeah. So I knew that.
I understood why I was being punished. to say I was physically punished a lot.
It was predictable.

Yeah.

So I knew that if I,

I understood why I was being punished.

So I kicked,

I was playing football in the house and broke ornaments

or something like that.

It was never unpredictable.

Right.

But something comes to my mind

as you're talking

is that same visits

that my parents finally came.

I had a three-year-old daughter

at the time.

We were staying at a house and put my parents on the first floor right next to the main

bathroom.

And then my three-year-old daughter went to that bathroom that was next to my parents'

bedroom.

And my mother came out and yelled at me, said, how dare she use our bathroom?

You should punish her.

And I almost did.

I had an immediate impulse. I'm saying I should punish my three-year-old.
And I started to walk to her. I said, oh, my God, I'm about to reenact what my parents did to me.
And I made a decision. No, Mom, she is allowed to use his bathroom.
And I said, the limit of my mom, which is a transformative experience for me to actually realize that I'm about to repeat what's done to me, which people do routinely. And I was about to meet my daughter.
And I said, that's the end of the story. It still causes you a lot of emotion.
It's actually, I'm surprised how much emotion comes up talking about it. Why do you think so much emotion comes up when you talk about that? Good question.
It's an interesting question. Because it allowed me to have a life.
Look, much of life is automatic, but you can make a choice to do things differently. You start owning yourself.
And that's the moment I started to own. I'm responsible for my kids.
I'm going to follow what I think is right. It's really a moment of liberation, but also a moment of separation.
Like, I will not be like you. It's tremendously hard to do that because it's going against your level.
I think that's a big thing for all us, because we want to belong, we want to be a member of a tribe, and if you do things differently, you lose your tribe, and you become a lonely traveler. So this is incredibly complex, because people want to be part of a tribe.
We cannot do without tribe and so the act of actually leaving your tribe is a is a very very major pilgrimage to make yeah there's parts of me that manifest sometimes and i understand that this is the behavior that i learned yeah and i i think there's a part of me that's worried, actually, because I learned, I grew up in a home where physical discipline was the response to most kind of forms of unwanted behavior, that I'm worried that if I become a dad, that will be my natural. Probably will be.
Yeah, I don't want it to be. But you don't have to follow it.
Yeah. Your kid will drive you crazy, because kids do.
Yeah. And at that point, I think having kids has found a great learning experience in life, you know.
We all, none of us knows what we're doing, and then the kids teach us how to, to be a very important teacher for how do you deal with this. It was very challenging.
What did you learn from your children? Oh, I learned a lot from my kids. For one thing, so my firstborn was just easy and loving and luminous and pretty and girly.
And she now is gender ambiguous and just divorced her husband to be with a woman. So that was completely transformed in her case.
And to see go through that journey with her like, wow, wow, wow, wow. And my son was a neurotypical child, very out of control much of the time, many physical reactions, very bright but reactive, staying in bed, only playing computer games.
and he's grown up to be one of the most loving, thoughtful adult parents you can hope to meet. So both my kids have become very different people who I saw they were, but I have a very good relationship with both of them, even though I really don't quite understand either of them.
When we see dysfunctional behavior in children, I think one of the natural reactions is to give them some kind of medication or to attach some label to them and say that they're broken in this way. How do you feel about that? Well, that is what saved my son.
Because I am a psychiatrist and I know about how these labels are little crutches

that never quite capture what somebody is suffering from,

and people wanted to put my son on medications,

but I was a psychopharmacologist.

I really studied drugs and what I can and cannot do,

and it was very clear that they were not helping him,

and I didn't have to submit to authority, as most parents would do, and say, oh, my doctor says this and this and this. I say, I'm a doctor.
I know about brains and I know about kids. And I don't know what the hell is going on with my kids.
But he doesn't have bipolar disorder and he is not going to respond to lyceum. And so both my kids were major inspirations for really exploring what was good for them.

And I'm particularly grateful for my son who was such a really, very scary kid in many ways.

My wife, whom I'm now divorced from, she was really great also in terms of exploring what might be helpful. And so what I really got to also be aware of is the issue of privilege, that I made enough money that we could spend a lot of time trying to find things that would help my son.
If we had lived in a housing project, my son would have been a terrible misfit. But because we were able to give him so much support and care by exploration, that he actually found a way of regurgitating his mental state.
I mean, just on that point, there's a stat I read that children from low-income families are four times more likely as the privately insured to receive antipsychotic medicines. That's right.
That's true. 400% more likely to receive antipsychotic medications, if you were to.
Yeah, and that's a very big issue. It's not really my area.
But, you know, giving drugs to kids is potentially very dangerous because you interfere with natural processes of brain growth. Brain growth.
Yeah. So if you give people medication that changes certain chemicals in their brain at the developmental phase, it may actually change the way that their brain gets formed.
And it may not allow, as happened to my son, who was able to compensate for many things and his brain was able to learn how to react differently. If you suppress all that, your brain may not learn these new adaptations.
You think we should be looking at social conditions before we look at social conditions physical conditions movement touch uh synchrony music um we i say so in our world we got stuck in western people are allowed to do things they can do one thing is they can, what I call, take a swig. If you feel bad, you take alcohol, and that makes you feel better.
So that's part of our respected tradition, is taking a chemical to change the way you feel. And anybody who says you should take that chemical, nobody ever say, you're crazy.
And the other thing that Western people are very good at is yakking. So let's talk, talk, talk, talk, talk, talk, talk, talk, and all the same things.
And then I'd like to tell people a story that the first time we went to Beijing in 1992 and China was still very poor and deprived and miserable and coming back from this cultural revolution and nobody could talk about anything.

No, nothing happened on the mile.

No, nothing happened.

No, Gentleman's Square didn't happen.

It didn't happen.

And China was filled with every park then as now

is filled with people doing qigong and tai chi.

And I go down into the park and do qigong with the Chinese.

What's that? Qig. It's like a dancing.
Chinese movement stuff. And I do that and I go like, oh, my God, that's how they survive, by making these Qi Gong Tai Chi movements, which if you do it in Boston, people say you're crazy.
But in China, you cannot talk. You calm that body down by the way you move.
And I became very interested in how cultures around the world actually have very different ways of helping people to regulate their physiology and their synchronicity. I want to talk about all of that, specifically this idea of movement and the role it plays in healing.
Just to close off on the part about childhood trauma,

why is it so important for a child to grow up with a secure attachment to a caregiver?

You become how people see you.

You become how people see you.

Yeah, so if you're a kid, and most people,

most kids, their parents find being cute,

or you have a little grandparent,

they say, oh, you're cute, you're lovely, you or you have at least a grandparent, they say,

oh, you're cute, you're lovely, you're so sweet.

And no kid is able to say, I'm just average.

Look at building kids in this world,

and I'm not any cute than anybody else.

No, when the kids get told you're really cute,

that is your reality.

And if the kids get told you're really ugly and nasty and mean,

that becomes our identity.

So you really become how people treat you early on in your life.

Thank you. And if your kids get told, you're really ugly and nasty, I mean, that becomes our identity.
And so you really become how people treat you early on in your life. And that's a very big legacy that I, as a therapist, deal with, is these imprints of early experience, which are very difficult to change.
Imprints of early experience, are they changeable? Yes, that is the great news. And also the amazing news that even though we know how to do some of that, we're not going there.
So you can heal from your childhood trauma? Absolutely. Everyone? That's my assumption when I see people.
In your experience, you've dealt with patients your whole life, your whole professional life. How many of those patients do you think were healable? I really think that if given a chance and given the resources, you can pretty much do something for everybody.
One of the other... But the problem is, again, we go back to where you started before the microphone was on,

is that our focus these days is on productivity and behavioral change and not in how do we find out how to help you. All the things that I describe in my book, almost most of the things that I describe in my book as being helpful,

and that was 10 years ago, I know some other things since that time,

are unconventional methods that do not get practiced in mainstream psychology and psychiatry.

Because they need to be productive, and they need to be cheap,

and whether you get better or not doesn't matter, you're cheap is the main motivation I think the profit motive is killing good practice your book was very interesting because when I read the cover and then I watched a video you'd made talking about the sort of six sort of treatments and stuff that exist within the body, things like yoga, you talk about theater and acting and how that helps you to get out of your trauma. The body keeps the score.
This was a pretty radical approach to thinking through trauma. And it became a meme, which is an interesting thing to see.
Well, I use it in my everyday language with my partner. Yeah.
And I've heard people say the body keeps the score, the body keeps the score. When we're talking about how our body is holding on to those traumatic memories, traumatic things that have happened to us.
For someone who has never read your book and doesn't

even understand the like base premise here what is the like base premise of your of the title there it's really that trauma is a visceral experience what does visceral mean it's in your body heartbreak and God bench

you stiffen up

you

surrender, you lose your power

you Heartbreak and gut bench. You stiffen up.
You surrender. You lose your power.
You tighten up. That's really where trauma is lived.
I kind of see it as two approaches. You can either go, let's try and change the mind, which will then change the body downstream.
Or you can say, let's change the body, which will then change the mind. Right.
You could. But I do a lot of CBT with my wife, let's say.
Yeah. I point out her irrational behavior and that she should really see things from a different angle and that I should really see things correctly.
And I really have much success with that. And I'm a bit surprised that psychology does things that most spouses have failed in using very well this somatic approach i've only recently heard this term from my partner and she says it's amazing and she's told me she told me to speak to you on this podcast because she says you know you'll really help to change her opinion on this what is this somatic approach? The somatic approach is to really experience what your body feels and also allowing your body to do things that it has been afraid to do and to explore how your body moves to the world in some ways.
Why are women just to seem to be so much better at this stuff than men? Because are they doing like Pilates? I'm not sure. Pilates, yoga.
These are all things. Dancing.
These are things typically women do more than men. Yeah, yeah, yeah, yeah.
And it seems women are just more in touch with it. Yeah.
I think it's an intriguing question. Because it's not exclusively women.
Of course, men have always done it in armies and basic training and the military. And what's intriguing to me is that, you know, when people join the military, they oftentimes are not very well put together people and they go through basic training and they really march together.
They sing with people and they climb barricades and they go through composite physical experience with other people. At the end of 12 weeks, they feel competent and they feel connected and they have found a band of brothers.
How do they do it? Not by yakking, but by having very deep shared physical experiences. One of the interesting things that you write about, which I found particularly interesting, because I saw little flashes of myself in the words, is you said, I found that the more traumas your patients have in their background, the more creative and successful they often become.
Often, huh? Often. And we don't know how often that is, but I get to meet quite a few.
Yeah. It's the people who have had to struggle, who often see new possibilities and have no choice but to discover new options.
That's true. That's true.
Yeah. But, you know, but those are the people who manage to get into my practice.
And the people who don't find those solutions, don't have the wherewithal and the capacity to make it into therapy with me. They might be outside with a drug addiction.
Getting drugs, lying on the streets, et cetera, et cetera. And largely, I see it as an issue of accident.
You know, this past year, I visited a program in Los Angeles called Homeboy Industries. It's a program for formerly incarcerated, largely Latin men who had no fathers who had been criminals.
And it's a spectacular program where they say, what do you need? How can we take care of you? How can we make a safe place for you? And I saw a real treatment

there, St. Quentin Hospital, St.
Quentin Prison, famous prison in California, is now trauma-based. They use my book as a protector.
And they're transforming people's lives by acknowledging the reality of what they dealt with, helping people to be part of the healing system, working in groups, working with movement.

Like at St. Quinton, they have hula dancing classes.

I go like, yeah.

Moving together with other people gives you a sense of connection,

a sense of pleasure.

They're really beginning to understand you can do it.

At the Harvard Hospital, you wouldn't do the hula with people. You wouldn't dance with people.
I think there's a bit of a joke in the investment community that says you'll get better returns if you invest in someone, an entrepreneur or a founder, that is a little bit traumatized. And I actually think, I don't want to misquote her, but I had Barbara Cochran, who's a shark on shark tank in the usa here on the show and one of the things she said to me was with all of her investments the ones that tend to do the best are those that have a little bit of a trauma in their past and she says because when they call me with a problem they call me with the solution attached versus people who have never had trauma they call me and just tell me the problem problem.
So they'll call me and say, listen, Barbara, this has happened, and this is what we're going to do about it. And that was her, you know, she said it in a slightly humorous way, but I wondered if you thought there was any truth in this idea that.
Yeah, I think that's, again, a selection bias of people she worked with. I know certainly plenty of people have had plenty of people working for me who really get paralyzed in the face of challenges and who don't have a solution and become very dependent on getting the vaccine.
So I think she has a bit of an unusual sample, actually. Because I wondered if you've had an anomalous early upbringing, does that make you an anomalous adult? Does it increase the probability that you become an anomalous, slightly different adult? Oh, absolutely.
Okay, and that can go everywhere. You develop a mind and brain to fit with that particular situation.
And if that particular situation doesn't help, you need to find new solutions. And so trauma and abuse really forces you to try to find other solutions, but many of them are not successful.
Is trauma a story in your brain? No, trauma is a perception in your brain. A perception.
What's the difference? So the issue is something happens, and your brain and mind takes it in and then makes an adaptation to that particular event. That depends on how old you are in the circumstances.
And it's very different for different people. Give me an example of a perception.
If you would beat me up right now, I'd go, this guy is crazy. And I can call people and ruin your reputation, et cetera.
If I'm three years old and you start hitting me as a kid, I don't know what the hell to do about it. And I'll likely think I did something wrong that I caused the guy to beat me up and I'm a terrible person and no wonder that he beat me up because I'm a horrible creature.
And that's what almost everybody who I know who was beaten as a child, that's the internal understanding of it. Not when you're eight years old or 15 years old, but when you're very young, that becomes your experience.
Because you're still forming your perception of the world. Yeah, yeah.
Your brain creates a map of the world in very deep ways. And so your experiences form an internal waster of the world that makes you expect certain things at certain times.
So if I walk into a room and I see a person who looks like my old uncle who he has to play with, I start signing up to you because you're on a deep level. It might be of that very nice uncle that I once had.
I don't know that, but my brain is set to interpret the world in a particular way. So one of the things, most profound research experience I had was purely accidental.
We started to do Rorschach tests on people. What's that? Inkblot tests.
So you show some formless ink picture, and we showed it to people. And we saw that people had completely different interpretations of what they projected on that inkblot test.
And that really brought home to me that we all are living in different worlds. And that our, like a lot of the Vietnam veterans I saw saw bloody corpses or mutilated bodies in those carts.
People had never been in combat, didn't see that. Vape victims saw torn vaginas and torn bodies.
Other people didn't see this. So once that becomes lodged into your perceptual system, you to interpret the world in that particular way having to do with what you have the answer in the past and an ink block test for anyone that doesn't know is basically just a piece of paper with random yeah but it's been analyzed on about 100 000 people over the years so there are certain patterns you can detect in it, yeah.

I've never done an inkblot test.

I feel like I should do one.

You know, I learned as much from my inkblot test as I learned from my brain imaging.

But the brain imaging is respectable

and the mind has sort of disappeared.

But for example, in our psychedelic research,

I still very much hope to do inkblot tests

because as Michael Pollan says, how to change your minds. But we're not measuring how people change their minds.
How many people do you think, I mean, this is maybe a ridiculous question, but how many people, what percentage of people do you think have trauma in some form? How you define it? You know, the figures are a quarter of people get physically abused. One out of five people get sexually abused.
One out of eight kids, witnesses, violence being their parents, et cetera, et cetera. So, you know, if I sit in a room, you know, it's not a binary issue.
It's not either you were traumatized. You didn't get traumatized.
But when I talk to a room of professionals, which I do a lot, I assume that at least half the group viscerally knows what trauma means. And what is trauma doing to my brain? You said you've done a lot of neuroimaging scans.
If I was traumatized and you scanned my brain, is there something you something you could see not necessarily i can see how your brain may be different from other people's brains i may take a particular population you can average it out and you can say oh there's a little more activation of the periacurator to gray a little bit less of the bite insulin so you see certain patterns of connectivity in the brain. But to some degree, you know, I think we learn a lot about the brain, but we don't know much about the brain.
And I think people tend to overstate how much the brain pictures can teach us. You know, I love the Hubble telescope or the Webb telescope.
You know, our brain is like a universe and our technology is very inadequate to really know about all the unbelievably complex connections in the brain. But we have learned a few things in the last 20 years.
So how does trauma affect the brain? It affects the brain that you tend to... There's one part of your brain that I call the cockroach center of your brain, the periacal gray that lights up.
It's sort of underneath the amygdala. Everybody knows the word amygdala these days.
It's the part of your brain that tells you that you're in danger. When you're traumatized, you're likely that that little part of your brain, way back in your brainstem, is firing all the time.
All the time you go like, I'm in danger, I'm in danger, I'm in danger. And that's where it starts, in a very elementary sensory level.
You don't know what the danger is, but you just feel that you should be scared. And then there's certain other parts of your brain, for example, your insula, which makes the connection with your physical sensations and your body awareness that for many people get shut down because the experience of trauma is a visceral experience of heartbreak and gut venge.
And if you have a lot of that, you can learn to shut that part of your brain down so you don't feel your body so much anymore. I mean, you don't feel your body so much.
You don't feel very alive either, but you don't feel so scared all the time. But it's likely that you will want to take some drugs to make yourself feel alive

sometimes.

Stuff like that.

So the part of my brain, you said just around the amygdala?

Below the amygdala.

People that are traumatized, they have some kind of dysfunction in that typically?

Well, the dysfunction is that it keeps firing.

It keeps firing.

And how does that make you feel?

And then the amygdala, so there's a constant sense of of subliminal dread is that anxiety anxiety is already too high a mental functioning okay it's more elementary it's like your dog shaking like yeah my daughter has adopted a dog two years at times and two years later the dog still walks to my house. You've adopted a dog and it shakes in your house still? Yeah, yeah.
But still never quite comfortable. And that's how many thumters you meet are never quite comfortable.
So when someone says they're triggered? No, trigger is in the higher level thing. Okay.
So then the next level is indeed the trigger that is in part mediated by the amygdala. If your amygdala is your smoke detector, that tends to become hypersensitive so that minor things get blown up.
And a minor thing that you may say to me, I take as the most insulting thing in the world. And so you're constantly triggered by things and that makes you feel like you are doing terrible things to me.
And it's not like I'm hypersensitive and when you have an off day, that is your issue and not my issue. No, when you have an off day, I feel your off day and we start getting into trouble together.
I've got a picture here of what the brain looks like when the brain smoke detector goes off. Is that what it looks like on the brain? That is one particular guy and nobody is exactly the same as everybody else.
Can you explain this to me? But basically, what you see here is, this is a guy who is reliving a terrible car accident he was involved in. What you see here is that the right posterior part of the brain, this temporal parietal junction, on the right side of the brain fires, and that's the feeling part of your brain.
So you go, oh, my God, oh, my God, I'm terrified. But there's no cognition.

Basically, the left side of the brain shuts down.

So when you're in your trauma, you're not a reasonable person.

You actually become a little bit of a blubbering idiot.

All of us, when we really are angry, upset, are not very articulate, but we have a lot of feelings.

And then the piece that I showed us is that as he is, this guy is reliving his trauma, these two parts of the brain go offline. This is the dorsolateral prefrontal cortex.
That's the part of the brain that's the timekeeper of your brain. So if something unpleasant happens between us, let's say, I'll go, oh, it's not a half hour and I'll be okay, so let me just sort of put up with this.
But when you get traumatized, the timekeeper disappears, and this is all there is. You lose your sense of perspective, and that is what happens when you're in your trauma.
You don't know the difference between the past and the present because the timekeeper of your brain goes offline and whatever is you're feeling is real as opposed to be feeling like a memory so do you get it yeah so for people that can't see it in this brain scan what i'm basically seeing is the right side is extremely activated the left side looks like it's off off yeah and then there's these two blanks um empty spaces that aren't activated called the doors the lateral prefrontal cortex so that's part of the system in the brain that gives you a sense of time okay and as long as you have a sense it's like little babies only a sense of time either whatever happens happens totally do you see a child slowly grow and they get a sense of perspective. It's happening right now, but tomorrow it will be different.
Okay, so that's when, I mean, presumably that's when you get anxiety, right? When you start thinking about the future. It is about having the perspective of this is happening right now, right now I'm really scared, but the moment I go home, the moment I call my friend, I'll feel better.
And so you need to have that capacity for perspective. And that perspective goes offline when you're in your trauma and you become a trauma-desperate person.
So this particular person, this brain scan that I have here, this guy was in a car accident. And the triggered brain that I'm looking at here is he was basically put in a uh an fmri scanner and he was intentionally triggered to see what would happen in his brain exactly so he was shown maybe a car accident or something no no we specifically his car accident oh you showed him a picture of his what did you see what did you hear what you smell what were you thinking very specific smell? What were you thinking? Very specific sensory details.
Okay, so you asked. Not somebody else's sensory details.
Your sensory details. And the right side of his brain was illuminated.
Yeah, his lighter brain became very active. Yeah.
But what got inactivated was the timekeeper of his brain. So he could not lie there and say, oh, I'm remembering what happened to me yesterday.
He's reliving what happened yesterday. Instantly? You feel like it's happening right now.
And that's the nature of trauma. Trauma is not a memory.
It's a reliving. Are you consciously reliving it, or is your subconscious reliving it? You feel like it's happening right now.
right now with all forms of trauma but not it's happening right now but my feeling is happening right now and my body you don't know that the feelings actually belong to the time that your dad used to beat you it is now i feel the same way because i disagree with you so i've been triggered in the past, and I felt that sort of instant fight or flight response because something's happened or whatever, and it's instantaneous. So although I don't feel like I'm back there, my body does feel like it's back there.
And so people are confused about it. They say, oh, you relive the past.
Now, actually, you're not aware that you relive the past because the past is the present. So you don't think, oh, this reminds me about a time that my dad used to beat me when I was four years old.
No, it feels like you are beating me right now. And is there a way for this particular gentleman here who's been through that car crash to ever stop this triggering? Yeah, he's done quite well.
He's done quite well. He did EMDR, actually.
Eye movement desensitization. And what was his results? He's an all right guy.
He's functioning. He's fine.
He's no longer a traumatized person. What's the most radical improvement you've seen in your clinical practice? Oh, really, people really coming to life.
People just saying it's over. Give me the most, the best example.
A good example is the videotape I showed people yesterday of a woman, again, terrible car accident, freezing, upset, freaked out. And then three sessions later, we go talk about it.
She says, yeah, this shitty thing happened to me. I was in this car accident and I jolted for it and my head was swollen.
And boy, that was terrible back then. But now I have a granddaughter and I drive my car to my granddaughter and I'm fine.
Three sessions it took? Three sessions, yeah. And we saw it in psychedelic therapy all the time.

What did you do in those three sessions?

Wiggle your fingers in front of people's eyes.

I mean, for me, EMDR was really the gateway drug.

Sorry, you know, I've written three books about PTSD. I actually wrote the very first book in which the word PTSD exists in 84 or something.

But I didn't know how to treat it. So I'm a world-renowned expert, but I have no idea how to treat it because people keep reliving their trauma and they don't know how to stop that.
And somebody starts telling me about EMDR and I don't believe a word of it. And they say, you move your fingers in front of people's eyes.
I mean, you move your eye from side to side as you relive the trauma. And I go, that's crazy.
Everybody who hears it, that's crazy. And then people start doing it and they show me how it works.
I go like, wow. And people indeed had a certain subsample of people we studied, indeed, after a few sessions of EMDR, go like, yeah, that really sucked.
But it's over. It belongs to the past.
It's not happening right now. You're telling me that wiggling your fingers in front of people's eyes can help heal their trauma? Well, then, of course, we had to do a little research, which took us 15 years to get enough funding to do it, to see what happens when you move your eyes back and forth.
And then we discovered that if you move your eyes back and forth, as you recall a traumatic experience, you activate certain pathways between the temporal parietal junction, which is your sense of self, and your insulence, your sense of your body. So your brain is able to say, oh yeah, this is what happened to me, but it happened to me in the past.
So these are pathways that makes it possible for your brain to make that distinction. And in the research that's been done on this, what did the outcome, what was the was the conclusion in terms of its efficacy oh in terms of uh in our research um 78 of the people who had adult onset trauma so so being assaulted or raped by a stranger 78 of them were completely

cured but that's not the majority of people we see because most people we see have early childhood trauma, which is much more complicated as a treatment. Early childhood trauma is much more sort of stubborn and resistant to this treatment.
Yeah, because your early childhood experiences create who you are.

So if you go to a fancy college when you're 18,

you do become identified with that college,

but it doesn't radically change you into a new person.

It becomes part of your identity.

But if you grow up in a certain family early on in your life,

you actually become that.

The imprint is very deep early on. So it's called eye movement desensitization and reprocessing treatment.
I was just looking up some stats about it. It says it's been extensively studied with evidence supporting its efficacy across various conditions.
With PTSD, a 2014 meta-analysis of 26 randomized control trials found that EMDR significantly reduced PTSD symptoms with a large effect size.

Depression, a 2024 systemic review and meta-analysis encompassing 25 studies and more than 1,000

participants reported that it alleviated depressive symptoms.

The same 2014 meta-analysis noted that EMDR led to significant reductions in anxiety symptoms among PTSD patients with a large effect. And finally, a 2024 systemic review and individual participation data meta-analysis concluded that EMDR is as effective as other psychological treatments for PTSD, achieving comparable symptom reduction and remission rates.
So can you show me how it works? Can you do it on me? I could. Can I move my chair? Of course you can.
You're going to come closer. So can you bring to mind a really unpleasant experience you've had not too long ago? Yeah.
And can you bring to mind what you saw at that point? Yeah. Can you remember what the voice sounded like at that point? Or whatever it was.
Any sounds come to mind? Yeah. Do you remember what your body felt like back then? Yeah.
Okay. Can you remember what you were thinking or bring to mind what you were thinking? Yeah.

Okay.

So how vivid is your feeling right now by collecting it?

Like a six, seven out of ten.

Okay.

So stay there.

Now follow my finger with your eyes.

So look at me right now.

Deep breath. So what comes to your mind right now as we're doing this? I feel calm.
Yeah, I just don't feel calm. Okay.
So when you go back to what you were just feeling, what's it like now um it's it's hard to recall why i was bothered that is the weird stuff you know why is that is that just because why is that no see that is that is what's so great about this work. We don't know the linearity.

And we don't know where the hell the emotional imprint is gone now.

But it is.

And, you know, of course,

if we bring up something much worse

than what you had going to,

it takes it much longer

and a lot of other stuff comes up.

But somehow EMDR seems to do, it creates new associative processes in the brain. So let's say, first, people did EMDR on me.
Something really very, very nasty had happened to me. And I started off being very upset.
And then during the EMDR, I don't know if this happened to you, I had images of sitting at my dining room table as a kid. And I had images of playing in a playground in primary school.
So I don't really, don't come in mind. And then we stopped it and, indeed, so, yeah, that really sucked.
Time to go on. An important part of this, you did not tell me what you were going through.
No. Because I'm suspicious of language, because language is always an interactive process.
And if I would ask you to tell me what happened, you will filter yourself, because certain things may be embarrassing, or you don't want me to know about it. And so we circumvent this whole verbal process of your making meaning out of it

and we organize some core ways in which your brain is perceiving this.

So you saw a little bit of this in a minor way.

For me, when I first saw this, I was blown away by it and thought I need to study this. So when they quoted studies, the main study was done by me.
NIH funded it. But it was also the last time that somebody got funded for NIH, for EMDR.
Breathwork. Yeah.
What role did... Breathwork's become a really big topic.
My partner runs a business called Barney Breathwork, hashtag ad.

And she takes women away.

She does these breathwork retreats all around the world, has a studio, etc.

What do you think of breathwork as a way to really draw?

It makes perfect sense.

Why?

For one thing, it's been used since time immemorial in certain cultures.

And people always discover it.

In India, people know it. Not Northern Europe, nobody knows about breathwork.
So these are culturally dependent things. I think the closest may know it.
I don't know. Go out there and see if people know it.
And so people are so conformist to be approved of by their teachers and their peers. That when people do something innovative, they tend to very quickly be, oh, they're cookie.
They're crazy. I really got into body work.
I've not done breath work myself, but I hear about it from people. And so it's perfectly legitimate to me.
But when we do something new, like I was the first person who studied yoga for PTSD. And people go like, putting your butt in the air and twisting your spine and breast off for trauma.
And I said, well, let's find out. And so we did the study.
And it turned out that yoga was very effective for treatment of PTSD. But the overwhelming reaction of my academic colleagues was, oh, there he goes again.
He's gone off to depend. And now yoga is sort of pretty well accepted.
So you can use yoga to treat trauma? No, you don't treat trauma. You do yoga to treat your relationship to your body.
It's not the same thing, but trauma really distorts your relationship to your body. And what our research also shows is that when you start doing yoga, certain brain areas that tend to get dampened by trauma come to life.

What did you find in those studies?

I've got one particular screenshot here.

Yeah, that's a little study.

So explain here what's going on.

This is a tiny study.

What you see here is that after doing yoga,

your insula gets more activated.

Your insula is the place in your brain

and make sure that the What you see here is that after doing yoga, your insula gets more activated. Your insula is the place in your brain that makes you know what your body feels.
Like when it rains and you have no raincoat on, you go, I better get an umbrella. So that you need to know what your body experiences and needs and anticipated.
And that dimension of self-experience tends to get very damaged by trauma.

The reason for that is it's an adaptive thing because trauma is so relived in visceral experiences, as Darwin said.

Heartbreak and gut venge is the visceral sensations.

And so if you're constantly heartbroken and gut venge,

you touch it, pull it down, and so you lose contact with your body as a defensive maneuver of feeling overwhelmed by these physical sensations. So I want to make sure I understand this.
So the insular part of the brain is the part that links what we do with how we feel? How we viscerally feel, yeah, what's happening in our bodies. Okay.
So it links how we're feeling in our bodies to... To what we know about ourselves.
Yeah. The stories we have in our head about ourselves.
So that's what the insula does. And trauma interrupts that, which causes what kind of dysfunction on a day-to-day basis? You feel numbed out.
Or feel numbed out or disconnected you don't feel alive you don't feel connected you uh you can't feel pleasure or you feel hypersensitive and you feel hypersensitive because you talk about the two sort of responses being disconnection or hypersensitivity so there's always these two contradictory things that coexist remembering too much and remembering too feeling too much and feeling too little. There is no happy medium.
You go from one extreme to another. You're agitated and non-doubted at the same time.
And I bet you know what it's like, because we all have been there, that we feel agitated, and at the same time, we feel completely nothing nothing at all and there's almost no mind there and i think it's a very non-common human experience and the insula is playing a role the insula plays a big role on that and many other brain structures so if i start doing yoga yeah what is that then doing to that hypersensitivity disconnection yoga makes it possible for you to reconnect your senses in a way uh to to feel what you feel and to make it safe what you feel so as we go to a yoga studio with a teacher with a nice voice who really helps you to now take a deep breath stretch out your, feel that warrior three pose,

and then you start feeling it. And for many people, doing yoga can be actually quite agitating, scary actually in a way.
For traumatized people, we see it all the time, is that something gets triggered and you start getting upset just doing a simple down dog, let's say. Or certainly the yoga pose that all sexual abuse victims have great trouble with is the happy baby pose.
Happy baby pose is when you put your feet in the air, you lie on your back, you hold your toes, and you spread your legs wide so your pelvis is up against the air. For most of us, that's a very pleasant pose, makes you relax.
If you're a sexual abuse survivor, that's going to trigger a lot of stuff. Really? Yeah.
And you have to be very careful doing that. Because it's? It's triggering.
And so because these positions may be triggering, you may hold your body in a frozen position in order not to trigger those feelings of sexual abuse. I was just thinking as you were speaking about a friend of mine who tends to go through life where they sort of crumpled up body.
And they're low self-esteem, they're quite low confidence. I don't know if they're traumatized in any way.
Can't pass judgment on that. But they started doing yoga, and it really has helped their mental health in a profound way.
And I'm just wondering what you think the link is between someone who, I'm just telling you on the surface, is like crumpled up through their life. Oh, absolutely.
I told you I was a sickly child. I was really sickly until I had asthma.

I was 13.

And I think the most helpful thing I ever did was rolfing.

Rolfing is a very intense form of massage,

where they sort of tear your muscles from your fascia.

And I came to live in a new body.

I no longer live frozen in that body of this little child who almost died. It had a profound effect on me as much as anything I've ever done.
Why and how? Because you get stuck in habits. In a way, trauma becomes a habit.
My habit is that when I see a phone guy in the room, I get scared. Hypothetical situation.
And so you have habitual responses. And part of what you do therapy for is to get to realize your habitual responses.
And become curious about it. Like, you know, whenever a person like that comes to the room, I freeze and I sound like an idiot.
And your therapist says, so what happens to your body? And how long have you felt this way? Do you feel this way when you were six or three or eight? And then at some point people get a narrative that may begin to explain it. And that narrative may say, oh, I was bullied by somebody.
And that feeling comes back when I meet somebody who reminds me of my bully and then you go like have you ever tried martial arts it seems what it would be like for you to actually learn to use your body to fight somebody and that's for example a treatment that I have never studied but I was amazed how many of my close colleagues who were very much into trauma tell me at some point, oh, and now I have to go to my martial arts class. And nobody sees that as a legitimate way of dealing with what they're dealing with.
But I think people are doing their martial arts because they have memories of being victimized and it gives me a visceral experience of my body can defend itself my body i can use my body to take care of myself and that's not the intellectual process that's a visceral experience people often describe meeting somebody and their body just being off yeah so they say, I met this person and my body was just, I just felt something in my body that they can't consciously articulate, but they just feel it in their body. This person's a bit off.
What do you think they're describing there? I think they're describing two things. We pick up each other's energy.
There's such a thing as the mirror neuron system, which hasn't received much attention in the past few years, but I think it's a very important invention that I pick up your energy. And if, let's say, you're depressed, but you have a job to do some, to talk with me today, it's very likely that I, on some level, will pick up your depression.
And it will affect our conversation. I'm not saying that I do.
That's a hypothetical thing, you know. But we pick up each other's energy.
And so we may be somebody who is very angry, but who's trying to behave themselves and behave very well. But you may pick up that anger.
And that's really the very complicated stuff in psychotherapy. Am I picking up your energy or am I picking up my energy? And so if I feel uncomfortable in your presence, is that because you're triggering something in me about my past or am I picking something up about you? And that is the complexity of our interactions.
And from an evolutionary standpoint, as you were speaking, I was thinking, where has this come from? You know, this ability to subconsciously just get a read for someone and then form a pattern of, okay, this type of person helped me in the past. And 20 years later, I meet someone in the street and I immediately feel the same.
Is that just a survival thing? I think that makes perfect sense to me. Because we are primates.
It's something that came up in your interview with Trevor, the deep degree to which we're interconnected creatures, that we really don't exist as individuals. So we are meant to live, troops, we're meant to be with other people.
And so what is safe with other people becomes a critical issue of our survival. The reason that humans have survived is not because of your individual gifts or mine, it's because we can band together and build buildings and airplanes and all sorts of stuff it's all communal communal things so our it's it's not central in our science anywhere today but it's it's at the core if you understand human beings we are a collective bunch of creatures who collectively create something and so knowing how to do that and how to adjust to each other is at the core of who we are are we losing that a little bit you know people are getting lonelier and lonelier and more huge huge issue screens as virtual realities is our biggest challenge i think yeah why uh because screens give you a virtual reality of pleasure, et cetera, et cetera, but it's not real and it's not a product of your efforts of doing something.
You get a cheap reward, but ordinarily it takes a lot of activity. And so you get your little dopamine rush and it feels like you had experience, but you don't learn how to get along with other people you don't learn that visceral reaction of pleasure of we are friends what role does community and social connection play in trauma everything critical and there's another thing that is troublesome about the development of our field.
Namely, in our generation, Thomas, who started with experiences like mine, worked with combat veterans. I'm not a combat veteran.
I was a conscientious objector during the Vietnam War. I don't know anything about the U.S.
Marine Corps. And so I couldn't have told people what it was like,

but I went in groups and I talked to each other and I learned about what it's like to be a combat veteran from each other.

And the moment they made this connection with each other,

they were becoming a band of brothers.

And that's how people survive trauma, by bonding with other people.

It seems that women are better at forming those connections than men.

Yeah, I think so.

Although, no, that's not entirely true.

I learned a lot about love from my combat veterans.

To some degree, I think most human beings don't know what love is

until you know what it's like to be in combat together with other people.

It creates an enormously deep deep deep bond between people uh so i know something about male love

more from working with combat wrestlers than anything else when you're great danger guys are

there for each other they really protect each other they really look after each other

what is it about that environment that forms what you're describing there as real love and how do we it's danger the natural instinct when you are in danger you know you and i become much better friends than we are if something bad happened to us right now we start clinging to it is that because we would probably need each other you need each other yeah you need each other and you count on each other and you have each other's back and you're saying to me i have your back um us making commitment to each other is a very profound human experience you don't get that from a screen well as also in an individualistic society you're almost trained to not need anyone else but yourself.

Well, but, you know, I have friends who went to Eton.

Actually, so the definition for me of many Englishmen is,

your mother hates you and sends you off to boarding school when you're six years old and never looks after you anymore.

And what helped my friends who went to the public schools in England was sports enormously powerful people felt really close to each other moving together throwing balls together fighting in the in the fields that's additionally has been the way that that guys get close together yeah that may ring a bell with you somewhere of course yeah I was thinking back to playing football growing up and just, yeah, you're one unit effectively. And if there's a problem in this part of the pitch, then it's my problem too.
If you're in trouble, I'm there to help you. And I bet you still make easy contact with your friends who you played football with 20 years ago.
No, 30 years ago. It's really interesting because as you were talking, I was wondering how we can bring that back into our lives in the modern world yeah in a modern world where we live on screens and exactly white walls alone yeah you know the studies say that yeah the average i think it said something like the average american has an average of zero people that they feel they could turn to at a time of crisis which is down from like three i think two decades right i'll have a look i'll look at the stats.
I'll pull up the stats. But the general idea of like us being lonelier than ever before, and how do we, in a society that's like designed to be lonely, how do I, on an individual level, fix that? I think that's the big challenge, actually.
We have a foundation now, and the main thing that brings us to is in finding funding for projects like that, of how do you help people to connect to each other, be in sync with each other. We're very much into people making music together, making theater together, creating projects together.
That is who we are. That is our glory as human beings.
It's this collaborative, active, physical creation of things.

That has not been part of mental health.

We talk and we give pills,

but we don't really connect people on a very deep level.

Are you optimistic about this?

Not after the last election, no. Really? I'm very desperate after the election, yeah.
You're very desperate after the last election. Why? Because the last election was based on uttering.
You are different, projection. You're evil.
These immigrants come and kill us, and they project their own discomfort themselves on people from different religions and different skin colors etc etc it's all projection of people's own discomfort with themselves and there's no honesty about the problem is inside of me and not you yeah so I take it you're not a fan of Trump? Let's leave it at that. No, I think he's an obvious psychopath who doesn't give a shit about anybody else.
Are you able to point at anything good about him? And when I've had people on this show that are pro-Trump, I ask them same questions i say can you point about anything bad about him because he's got a family anybody who goes to china and says i've been received better than anybody else in chinese history is a fool the guy's gone bankrupt any number of times he says terrible things to other people He insults other people all the time. I'm sure there's something good about him.
Ivanka seems to have loved him at some point. He's a terrible person.
Going back to this point of trauma, you said that there's three broad ways to reverse the damage of trauma. Yeah.
So if to you and i was a traumatized person whatever that trauma might be what would what would step one be if i came to you for support with my trauma step one is tell me about yourself who are you okay uh what do you value what is working what do you want to work and what gets in the way? So at the start of, really, language is terribly important. I don't make a list of how screwed up you are.
I helped to create a DSM at some point in a very minor role, but the DSM is not a good way of starting off. Namely, how sick are you? I want to know who you are.
What is working? What isn't working? What has helped you? What hasn't helped you? What gets in the way? And so we create a map together of who you are. And to some degree, who you are in relation with me.
And I would check a lot with people about, is this helping you? So I don't prescribe. At some point I may say, well, have you thought about doing some martial arts? Would you be interested in going to a yoga studio? But by and large, I give very little advice.

But I help people to discover what's going on and where that leads them in a way.

And then once you've done that,

so you find out that I had some early traumatic experience,

how do you know, what treatment would you give me?

That is not a tricky thing.

That is something, in my book, I tried to do that and I failed. And in my new book, I'm not doing very much better.
I would see how agitated you get, how much can you stay in focus. And if I would see that whenever a particular subject comes up, I see you're getting agitated or shut down, I would focus on that particular experience.
And if I would see that you are sort of chronically agitated and unable to focus, I would say, let's just do something. You should do something that's helped to calm your body, your brain down.
And I'd say when you're sort of overall overwhelmed, let's start with yoga or qigong or whatever makes sense to you in terms of how to move your body. And I'd probably do neurofeedback.
What's neurofeedback? Neurofeedback is you hook your skull up to electrodes that can harvest underlying brainwaves. So you can project your brain activity on a computer screen screen and then you can play computer games with your own brainwaves to uh to to organize your brainwaves in a way that you can be more focused and pay more attention so i've got some uh a graph up on the screen for anybody yeah watching and it shows five different types of brainwaves.
Gamma brainwaves, which are very close brainwaves. Beta, less close.
Alpha, less close. Theta, less close.
And then delta, which is when you're sort of sleeping and dreaming. The waves are very, very far apart, almost flat.
So looking at these different types of brainwaves, if we just categorize them from one being when the brainwaves are really tight close to five which is delta when they're really far apart is one gamma is that like anxiety or something no no anxiety is very focused thinking okay fine but it depends on where it is so the back of your brain is supposed to have these slow waves because your back of the brain is uh dealing with the housekeeping of your body. The back of the brain tells you you have to breathe a little bit more, you have to go to the bathroom, you have to eat, you have to have a bodily regulation.
A very large part of your brain is about your body regulation, which gets messed up in a major way by trauma. So, for example, when you close your eyes, the back of your brain is supposed to develop nice, slow waves to tell you, I'm feeling peaceful.
When you're traumatized, when they ask you to close your eyes, it is very likely that the back of your brain will get agitated and create much faster waves than you should. And so you get a sense of agitation the moment you close your eyes, which, of course, is very detrimental to your health.
So my job then becomes how to train your brain so that when you close your eyes, the back of your brain becomes very calm, for example. Again, this is not about trauma.
It's about brain organization. Trauma leads to brain organization, but you don't treat the trauma, you treat the brain disorganization.
So for the average person that comes to you, what do you typically end up telling them to do? The average person. Some people these days, I say, I think it would be very good for you to have a psychedelic experience.
A psychedelic experience? And you found yourself telling people that more and more recently? Well, because I have done the research now, and our results were really quite stunning. Much better than I ever expected, actually.
But I may tell you, no, you're not ready for psychedelics i think you should really do

some neurofeedback and some body practices to live more in your body before we start blowing your mind open when you say body practices we'll get on to psychedelics but body practices these are the things you're talking about like the yoga the martial arts um massages massages any massage well I happen to know

some very good body people

who if you

have been beaten up or molested, human touch tends to become very complicated. And so you may not feel comforted by human touch.
And other humans may not have a calming effect on your body, which is really what we're supposed to have in each other. So learning to live in a body that can be touched is quite important.
Is touch healing? Oh, absolutely. You don't have kids yet? No.
Well, you have a girlfriend. You know.
Yeah, it's true. Touch is an elemental human comfort thing.
thing you described these three broadways of reversing trauma the top-down approach which is i guess talk therapy yeah yeah it's understanding insight etc and you're a fan of that no basically uh no i am such a cerebral person so i'm very suspicious of that piece that's uh you know explaining things understanding things is not my greatest handicap so um so i tend to downplay that the importance of that number two is taking medications yeah which is to shut down the body's alarms signals essentially um are you a fan of that well that's how i started life off as a psychopharmacologist i did the first studies ever on prozac and zoro for ptsd and so they're not bad uh they can be helpful to people and the third approach the bottom-up approach is allowing the body to have experiences that contradict the helplessness or rage or trauma yeah and this is really what you focus on which are somatic therapies, which target the body rather than the mind.

Well, it's a very important piece. And I very much think that's a very big missing piece in the therapy, mental health and medical field in general, to give people experiences of connection and pleasure.
That's terribly important. But when I wrote this book before I got into psychedelic therapies, I would add another dimension of experiences that really blow your mind, that really allow you to have an alternate reality experience also.
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And if you do it, please tag me, send me a message online. Can the gym help? Yeah.
But that tends to become a very solitary experience also. You're sitting in a little treadmill watching Fox News is not my ideal trauma treatment.
Because I go to the gym, I lift weights, so I'm wondering if that's going to help me. That's interesting.
One of my close colleagues, former friend, is a weightlifter. And she really is very committed that lifting weights can be extremely helpful for trauma.
And when she says that, I'm sure that's true for her. And I wonder for how many other people that's true.
The trouble is that in their current system, you're not going to get the money to study weightlifting for trauma. Even though say it's helpful for you my friend mariah says help for i go like interesting let's see for how many people it's helpful yeah one of the ways i think about it is actually a lot of the people that i've interviewed that are weightlifters are bullied kids i think about mike who i had on the show chrissy cello who i show, both of them speak to, even Lane Norton, actually, I think he speaks to some early trauma as well.
They're kids that were bullied in some form or had a traumatic early upbringing, and they are just massive now. And I wonder, you know, some people on the surface go, or even Leverking, actually, you're that way because you're learning to defend yourself and to build your self-esteem.

But there's some...

Yeah, but that gesture is not the right gesture.

Like, oh, you're just doing that because.

Yeah.

As if you're being dismissive, instead of saying, good for you,

you're doing that because you felt so helpless

and you want to build up your body.

Interesting.

My association is that I testified on behalf of many people

who were abused by Catholic priests. And almost to a person, they had become weightlifters and bodybuilders.
Really? Clearly for the reason that you also mentioned. They were just trying to bulk up to feel a sense of agency and power.
And it didn't work well enough for them. So that alone wasn't enough.
I think you also needed to make a connection with the helplessness. Psychedelic therapy.
Yeah. What's your view on psychedelic therapy? There's my own personal background.
Of course, I'm a child of the 60s. So I knew about LSD.
And I think LSD for me at that time, I became a good medical student and came with the culture, stopped taking drugs. But my memory of taking LSD was very positive in that at that time, I got to see that I'm a very small part of a very large universe and that whatever constructs I make in my mind are just very small constructs of a much larger reality.
And over time I've had, quite a few of my friends have become very, very good scientists and they say the same thing about our early LSD experiences of really, truly having opened up their minds to many possibilities. But then the culture changed, and they became illegal, criminalized, and people stopped doing that.
And then Rick Doblin and Michael Mithoffer started to open up the world of psychedelics, and they asked me about it 50 years ago or something. And I said, I think it's a great idea because when you are traumatized, you live in a very constricted world.
Basically, the trauma dominates your perceptions and regularly sort of interferes with your exploring larger realities. And I think in theory, having a psychedelic experience, a mind-opening experience, would be very helpful.
But I discouraged them from doing it because they thought it was too, you'll never get by the regulatory practices. And then they raised enough money and asked me if I wanted to run the Boston side of a very large study, which I was eager to do, where we compared very good psychotherapy by people who I largely had trained with psychotherapy plus MDMA, and the results were stunning.
You described? Stunning. I thought that therapy would be very helpful in many regards, and it turned out that therapy didn't make that much of a difference.
A little bit. But the MDMA vastly changed the situation.
And I wrote up the paper, but I'm actually astounded by how little that paper gets quoted. I mainly focused on the so-called secondary data of the study, which was how trauma changed your experience of yourself.
And what we saw is that people became much more aware of themselves. People had compassion for themselves.
So people always went into their traumatic experience and had this sense of time of, oh my God, this happened to me. That was so awful.
It happened to me personally also, actually, on psychedelics, of things coming up that you were unaware of were so vivid deep down inside. And I think, oh, this poor kid, look what he went through.
He was so little, he was so small, he couldn't defend himself. And so you get this very deep sense of self-compassion instead of the usual response of self-hatred and self-blame.
And then the next thing that we saw happen all the time is, and I was such a beautiful kid, and I had this alcoholic, violent father. I'm not talking about myself, but good.
And my poor dad, he never got to really enjoy this beautiful kid that he had. And they have compassion for their perpetrators.
Like, it's an astounding compassion-opening drug, which is what we have been looking for in so many areas in life you call psychedelics a true revolution yeah it is yeah and you say it's a particular revolution because we don't know how it works and i was looking at some stats but we don't know how anything works you know we just have a bunch of hypotheses yeah i was looking at some stats that say um mdma therapy uh assisted which is an important point we did, yeah. Assisted with a therapist there or someone who's a practitioner there.
A phase three clinical trial reported that 67% of participants who received MDMA-assisted therapy no longer met the PTSD criteria compared to 30-odd percent in the placebo group, which is a pretty drastic change that is the main paper that on which i'm also an author it gets quoted but but i think it's more important not whether the ptsd did so well but people's relationship to themselves changed and my my other paper describes that, actually.

But it doesn't get quoted as much.

People can focus on the PTSD.

The real issue is, do you love yourself?

Is your heart open?

Are you open to new experiences?

You know, not do we have this little list of symptoms in the PTSD scale,

but are you a human being who embraces himself as a human being? It's a really interesting study around treatment-resistant depression as well. One with psilocybin, which is what people know as magic mushrooms.
A treatment-resistant depression study in 2021 showed that a single dose of psilocybin led to a significant reduction in depression with effects lasting up to six weeks for many participants. 30% of participants were in remission after three weeks.
And a study by Johns Hopkins University showed that 71% of participants experienced a more than 50% reduction in symptoms after two psilocybin sessions with 54% achieving remission four weeks after the treatment. And the last study that I'll share is a follow-up study found that nearly 60% of participants maintained reductions in depression symptoms one year after treatment.
But these compounds aren't even legal in America and the UK yet. That's right.
But ketamine is. Ketamine is.
And we do a fair amount of ketamine-assisted therapy these days. And I'm intrigued that ketamine seems to have similar effects to psilocybin and MDMA, even though they're completely different chemical substances.
Have you ever done a psychedelic drug? Yeah, of course. As part of my being PI of this MDMA study, I had to do MDMA.
But for example, I thought MDMA was ecstasy and gave you a place of pleasure. As part of my job, I had to take MDMA myself.
And I was ready for my magical experience. I'd never done it before.
and instead I'd always poo-poo the issue of vicarious trauma.

No, it didn't really hurt me all that much to see all this trauma in the world. And while I was

having my MDMA experiences, all the trauma test people's pain that I had experienced over them

came back. I lied there for eight hours in agony, going, oh my God, oh my God.
And I got in touch

with that hearing all these trauma stories

did have had a profound effect on me.

And so I was really changed by that.

And the MA experience, I became a much sadder but somewhat wiser man.

You became a sadder man.

Absolutely.

I really felt all the pain much more deeply.

Yeah.

I was able to sort of ball it off onto that point

and the ball came down

and it was quite painful.

But what helped me

is that my guide,

Michael Mithoffer,

when I told him how

I felt like a failure

having had such painful experience,

he said,

yeah, I know.

I used to be an emergency room physician

and one of my psychedelic experiences, all the patients who died in my hands came to visit me. So that was helpful for me, because it made me feel like I had a connection with another human being.
And so that context is terribly important. And that's really what much of the issues are about right now.

And I think we may very well lose that.

And that is that clearly you need to do psychedelics in very safe conditions with a lot of support.

And that the set and setting of psychedelics, which the Johns Hopkins study also took very good care of, all the studies you mentioned, did it.

Thank you. And what our world, profit-driven world, is looking for is to give people psychedelics, give them one pill and go off by yourself and then deal with it.
The majority of the people in our study said to us, and the study was over, I couldn't have done this if you guys hadn't been here with me. Did that experience with psychedelics, the MDMA experience you had, change you? Yeah, I think it did.
It made me a much more humble person and much more compassionate to people in general yeah just one dose well i've had some other experiences also i've had a number of other really painful experiences on psychedelics uh and it made me much more so you know people say oh you how's your life gone I became much more aware to what degree my quest for understanding trauma had to do with me than, and I learned more so than after age 70, actually. Really? Yeah.
Earlier on, I asked if people could heal from their trauma. Yeah.
Have you healed from yours? No, healing is a complex word. I would say, yes, I'm doing well, as do many people I've worked with.
I think the willpower of my book is that it's a very hopeful book. Every chapter tells stories about people who are better, and as much science as I've been able to do, I've proven how helpful EMDR can be.
I've proven how well yoga can be. I've proven how well neurofeedback can do.
That's really been my mission

is to not only be an advocate, but really say, let's do the science and see how well it works

and for whom. Yeah.
What is the, of all the things that you've tried in your life to help

you with your own personal trauma, what are the things that have personally helped you the most? There's another thing that's really helped me and that got me into theatre is the issue of psychodrama. Psychodrama.
Yeah, the chapter in the book, and I've never done the science behind it, but I still love doing it. And that is when you act out things in three-dimensional space, it becomes a completely different phenomenon.
If I tell you, let's put your family in this room. Yeah.
And I say, when you choose somebody to play the role of your dad, where would you put your dad? You know where you would put your dad.

I'd put my dad in this room right now.

I'd put him there.

Right there.

Yeah.

Not there, but there.

Yeah, yeah.

So that's what the hell's happening here.

You know precisely where you want him.

And if somebody would play that role for you,

the feelings to which your dad would come up.

Maybe even in your imagination to some degree right now, if you imagine your dad there, what's the first thing that comes to your mind? Well, I put my dad at the head of the table that we're at because he was always at the head of the table in my household. He was always the one when we're at a table, he was in charge of us eating his thing.
What sort of reaction would you have as you see him here um it's complicated because exactly yeah it's complicated because one of the reactions is like one of the reactions i had is when he sits there he's in charge yeah but now as an adult i have this other feeling which is like no i'm in'm in charge now. Because I'm the head of the table.
I'm the head of my house. So it's just this authority thing of like, yeah.
That would come up. It doesn't come up abstractly, but concretely, when you're sitting there, it comes up.
And you may say, actually, dad, I'm the boss now. Yeah.
Or, I hate that you're being the boss. Or something, some feeling comes up.
My freedom. And what is striking is that for everybody, when they put that virtual person in the room, the feelings towards that person become very vivid.
And it overlaps quite different from what the story that people tell, actually. It brings up the three-dimensional.
And oftentimes, people have had harsh and neglectful fathers. And then what I say, at some point after you do things with him, I may even say you want to hit your dad.
Possibly. I might actually do that, actually.
Have you hit your dad, put a pillow in front of him, but to feel it, oh, my God, if I could have done that, would it be so great, or how guilty I feel. So you do something virtually, which you could never do in your words.
And then I would say, would you like to pick somebody in this room to play the role of the dad that you always wanted? The dad you always wanted. And then you choose somebody, and I encourage you to see how you would like that person to hold you.
And when you have that, you usually have a very deep emotional release and say, oh my God, if my dad would have helped me like that when I was three years old or five years old or eight years old and I needed this, my life would have been completely different.

And so you make a virtual new reality that is physical and visceral with other people.

And the memory of what it feels like can be very profound.

And you're doing this with a group of people?

I do this about four times a year with a group of people. It's my favorite clinical activity because I'm always just so astounded by what comes out of it.
It's almost role-playing, your past. Role-playing, but you really, because you work in three-dimensional space, it feels much more real.
And so, but therapists usually, they have this hope that if I'm respectful and caring towards you, I'll give you a reparative emotional experience that will give you the feeling of what it would have been like if you had gotten that in the past. And what my old teacher said was, it's a mismatch.
I, as an 18-year-old guy, cannot give you, as a 30-something-year-old guy, the feeling of what it would have been like if your mom would have loved you at age three. We cannot do that.
But in these theoretical enterprises in three-dimensional space, they're very physical, you do get an imprint of, oh, that is what it felt like. That's what I was missing.
So it's a very powerful way of creating a virtual reality. So the subject matter of ADHD has become very popular in culture.
In 2022, approximately 11% of children aged 3 to 17 have been diagnosed with ADHD, up from 9% roughly in 2016. And in the UK, between 2000 and 2018, ADHD diagnosis in adults rose 20-fold, what? With a 20-fold increase in medication prescriptions among men aged 18 to 29.
that's from the nhr and in australia over the past decade adhd medication has surged nearly 300 percent with more than a 450 increase among adults and a significant rise among women what is going on here i really see see that somewhat differently from the way you talked about it before. And that is, all these things are on a continuum.
You don't have PTSD or you don't have ADHD or you don't have ADHD. There's no binary issues.
And so this capacity to focus, to pay attention, to be flexible in your attention is a dimensional issue. A dimensional issue.
So some people have it better more than others. Some people cannot sit still at all, and other people can sit still under certain conditions.
So it's not like you have ADHD or not. You may have some issues staying focused or staying still or paying attention.
And there may be very many underlying issues. It may be that your mom took some toxins while she was pregnant with you.
It's possible that it is in your genes. Just about every traumatized kid I've ever seen met criteria criteria for ADHD, because trauma really messes up your capacity

to focus and concentrate.

So this is not an entity.

It is a fictitious entity.

It's not like cancer of the gallbladder.

It's not having astrocytoma in your brain.

And these mental phenomena are networks

of complicated ways of organizing your mind and our diagnostic system just sucks when i spoke to gabel mate he do you know gabel mate yeah sure yeah he he was describing what adhd was to me and he said um he reviews it as a response to early childhood stress and trauma rather than purely genetic or neurological well but i wouldn't say that i'd say it could be genetic it could be toxic it could be trauma it is the surface behavior of not being able to focus and concentrate like my son certainly had criteria met criteria with adhd my son other than that he disappointed me was not a particularly traumatized kid. No, he really had real issues, organically based, but that he outgrew also at some point.
So these things are not stable. These are configurations that you can grow with over time.
And they're multifactorial. They're phenomena because i was i was diagnosed with adhd but the way other people that have adhd have just like drastically different yeah symptoms to me like drastically different like we're not the same people at all we're not even close to the same ballpark like for example i'm really good at focusing on something for quite a long time if I'm interested.

Whereas I often hear people with certain types of ADHD

be very unfocused on things.

And so I have struggled with understanding

what it means to be diagnosed with ADHD

when there can be so many types.

Yeah, that's right.

So it almost makes me feel that the label,

the singular label, which we share,

although there's all these subtypes, isn't necessarily helping me to understand myself in any way. Yeah.
I would really, you know, everybody who is serious about this stuff knows that our diagnostic system totally sucks. Really? Yeah.
But it just is a total artifact of us sitting in a room 40 years ago making up little lists of diagnoses. There's no scientific validity to this.
Actually, PTSD is one of the more scientifically reliable diagnoses of all the diagnoses. There are just very primitive ways of categorizing human mind, and we know so much more, and we should move beyond that, and everybody who knows something about science knows that we should move beyond it.
But we are not. Why? I think we're not doing it because our focus is not on helping people.
Our focus is on bonding successful financial organizations. You know, I teach neurofeedback.
And there's a chapter on neurofeedback there. And there's serious research on neurofeedback.
And we do neurofeedback trainings. And so the head of an insurance company took a training with me in neurofeedback.
And he pulled me aside and said, Bessel, of course, you know, as a head of insurance company, I'm not interested in getting people better. I'm interested in having as many subscribers to my band as I can.
You know, if we really went back to being real doctors, we'd say, how do I get you better? What is wrong with you? And we know so much about neuroscience these days, about how the brain organizes information, that it's time to actually update ourselves to 2024 and start thinking about networks in the brain and what part of the brain is connected with but and mental functioning at different ages and what kids understand at age three which is different than age five and think in terms of how well is your brain able to filter out a bell of information how well is your brain able to be still and quiet and how well are you able to take on a task and complete it how do i not raise a traumatized kid that's all because i'm gonna have kids probably quite soon hopefully and i don't want to raise traumatized kids um be sure to listen to people in your environment don't raise them by yourself i think raising a kid by yourself um you'll give the full brunt of your own pathology. So it's very important for a kid to be raised by a number of people.
So the kid gets to see, oh, my dad is a little bit reactive, but my neighbor across the street is much calmer. And so the kid gets to see multiple perspectives as all of us idealize African villages as people having many different parents who look after you.
It takes a village. It takes a village.
I think kids need to be really part of a large environment where they can see their parents as safe people, but also flawed people. And the more nuclear you get, the harder it gets to keep your pathology out of your kids' life, actually.
So community is everything, also in terms of raising a child. Is there anything that you think is healing towards trauma, childhood trauma, all forms of trauma that we haven't talked about? Well, the critical issue is that trauma is about being helpless and not nobody coming to your rescue.
And so it's very important to have the experience that if you really cannot do something or you're scared, that somebody comes to your help at this point. And you get an imprint that even when I feel really bad, somebody will come and be there for me.
And that is what many people miss. When you have a drunken parent, we see this all the time in our practice, people have a violent parent, usually defile, but not always.
And then mom or dad, in my case more my dad than my mom, turns a blind eye and doesn't say, I'll take care of you even though the other parent is hurting you. And the betrayal of a parent to let the other parent do terrible things to them and not really say, no, you cannot do this to my kid is a huge thing for for many people it's interesting yeah it's by being having bystanders who do not come to your help very big deal yeah and the way to recover from that is to contract it with adult information yeah it's um have life experience where people come to your help and And I think being part of a sports team, being part of a theatre group, being part of a musical group, where people really feel, now it's your turn, come in.
I think the issue of rhythmicity and synchronicity is really at the core of our internal sense of safety and belonging. Vessel, we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for.
And the question that's been left for you is, what do you believe is the question that the audience have just heard this conversation or screaming down the camera? The question is, where do I get the help I need? I think that's really the big thing because it is so hard. It is such an exploration.
Almost everybody who I know who have found a way of getting better has been an explorer and quite an accidental explorer. And then I found this karate teacher, and then I found this yoga teacher, and then I found this psychodramatist.
But it's very largely accidental. I think the mainstream is not on the white road.
So you have to discover what works for you. And that's a very tough one because you'll feel stupid and ignorant and if something is not helping you, it is very hard for yourself.
This is not helping me because this person is not helping me. Rather than blaming yourself, there must be something wrong with me that is not helpful for you.
And making that distinction is a very tough one. I know it from my experience.
I've been in treatments for long periods of time, despite all my qualifications, where it took me a long time to go like, I'm wasting my time and my money. And if you don't have my education and background, it's even harder to say I'm wasting my time and my money.
It's interesting as you're speaking, I was reflecting on the things that, I was thinking a lot about this idea of community and you're talking about how being in sports teams helps. And I was thinking about in my adult life, in some of my most difficult times, when things were difficult and I went and played football or some kind of sports

with a group of people.

I just felt radically better.

And I think actually I put it down to, oh, well,

because, you know, I did some exercise.

But actually I think there's something deeper.

Oh, no.

It's that connection.

Passing that ball, somebody catching it,

you know, I made a difference.

Playing music, my little piece of music that I made,

made a better place. Being in a theatre group, being a cook.
You know, there's many dimensions along which you can do that. Many of us, especially, I think, adult men, don't have these kind of things.
I mean, we go to watch Manchester United play or something like that. We go to a football ground, but maybe we need to fill our lives with more of these things.
Yeah, we do, I think. And and we should say to ourselves because i need to do more of that also yeah well we kind of just assume that society is designed in such a way where it'll give us what we need yeah yeah but in fact if you think about the loneliness stats and the way things even like the pub is less pubs on the high street shutting down across the uk and less community centers the church is a good example is I grew up singing all the time.
And people around me made me sing in schools. And now then we got iPods.
Aren't we lucky we got iPods? And then before too long you stop singing and you start listening to your iPod. And so technology has been an unbelievable blessing and what a curse it has been for us.
Yeah. Yeah.
Dr. Bessel van der Kolk, thank you so much for the work that you do.
As I said to you before we started recording, you have so many extremely passionate followers, advocates, fans, because your work has made them completely rethink and understand their lived experience and also given them a much more optimistic, hopeful cure or treatment for their lived experience. One of which is my partner who, when she, she's been telling me for three years to get you on the show and was so extremely excited.
I think it's the happiest I've made her in the last three years when I said that you'd agreed to come on. But that for me is such a personal and sort of local um sign of evidence of the impact you have on people it is tremendous so thank you on behalf of all of those people for the work that you do and please do keep on doing it because it's opening all of our eyes and you too thank you i love you i appreciate you thank you isn't this cool every single conversation i have here on the diary of a, at the very end of it, you'll know I asked the guest to leave a question in the Diary of a CEO.
And what we've done is we've turned every single question written in the Diary of a CEO into these conversation cards that you can play at home. So you've got every guest we've ever had, their question, and on the back of it, if you scan that QR code, you get to watch the person who answered that question.
We're finally revealing all of the questions and the people that answered the question. The brand new version two updated conversation cards are out right now at theconversationcards.com.

They've sold out twice instantaneously,

so if you are interested in getting hold of some limited edition conversation cards,