Leading Childhood Trauma Doctor: 10 Lies They Told You About Your Childhood Trauma! - Paul Conti

1. 0:00 – 2:41

   Intro

   1. PCDr. Paul Conti0:00

      Trauma is like a virus and it gets passed along to your children, even if the children are not born until years later, because trauma can change the expression of our genes. So, we need to understand whether trauma is afflicting us, how it's afflicting us, and how we can treat it if it's there.

   2. SBSteven Bartlett0:16

      Dr. Paul Conti.

   3. PCDr. Paul Conti0:17

      Psychiatrist and expert in treating trauma.

   4. SBSteven Bartlett0:20

      He's worked with Kim Kardashian-

   5. PCDr. Paul Conti0:21

      ... and saved Lady Gaga's life.

   6. SBSteven Bartlett0:23

      ... and been in clinical practice for over two decades. How many people have some form of trauma?

   7. PCDr. Paul Conti0:28

      Well over half the population. And trauma can change us in very negative ways. For example, the odds of traumatic brain changes are very, very high. We know trauma makes us age faster than our calendar age, and we know that ultimately, the root of depression, addiction, Parkinson's disease, is from trauma. Modern science knows this, but we'll give them pills, with the idea the pill is going to fix everything, and then we're surprised that tens of thousands of people die each year from prescribed pills, and we've let that happen.

   8. SBSteven Bartlett0:59

      What should we be doing instead?

   9. PCDr. Paul Conti1:01

      The key to all of this is curiosity. So for example, let's say someone is addicted to their phone. Oftentimes, addictive behavior is meant as an escape from something or even to self-punish. But when you scratch the surface of that, you might learn about an episode of sexual abuse that happened when the person was a child. This is not uncommon.

   10. SBSteven Bartlett1:19

       What are the telltale signs that I am traumatized? What can I do to alleviate the trauma? And then, can you completely get rid of a trauma?

   11. PCDr. Paul Conti1:26

       The answer is based in hard science. So...

   12. SBSteven Bartlett1:31

       It's absolutely crazy to me that so many of you have decided to watch our show, um, and so many of you have decided to subscribe to our show. We now have five million subscribers on YouTube, which is a number that I just can't comprehend, and it's a dream that I absolutely never could have had. We started the Diary of a CO just over three years ago now, and in my wildest expectations, we might have had 100,000 subscribers by now. So you can imagine how shocked I am that so many of you have chosen to tune into these conversations every week, um, and spend some time with us. So, thank you. And I made a deal with you. I made a deal that if you subscribe to this show, that we would continue to raise the bar. And in 2024, we're going to raise the bar like never before. I've been working for the last nine months on a surprise for all of you that have subscribed to this show, and I'm very excited to deliver that for you. The production's going to change. We're going to go even further with our guests, and we're going to tell even more global stories. So as always, if you appreciate what we're doing here, the simple, free favor I'll ask from you is to hit the subscribe button. Let's get on with the episode.

2. 2:41 – 4:48

   The Invisible Epidemic

   1. SBSteven Bartlett2:41

      Dr. Paul Conti, on the front of your book, it says, "Trauma, the Invisible Epidemic."

   2. PCDr. Paul Conti2:47

      Mm-hmm.

   3. SBSteven Bartlett2:49

      Why did you use those two words, invisible and epidemic?

   4. PCDr. Paul Conti2:52

      Mm-hmm. Well, so as a practicing psychiatrist, what I started seeing over and over and over again is that the- the root cause of the vast majority of what I was treating, whether it was depression or addiction or panic, that- that ultimately, the root of it was trauma, that if we traced back, what we would learn is that there was something that had happened in that person's life. It could have been acute or it could have been chronic over time, but that changed their brain so that the brain is then different going forward, and that is the root of the problem. So from that sense, I- I could see there's an epidemic because this is behind what is ailing us, right? The- the 50% or more of complaints to general medical doctors are coming from mental health, right? These are general physical medical, medicine doctors. So you imagine how much of what is going on inside of us is affecting our health. So the- the epidemic of trauma is touching us in so many ways, but we're not identifying it. We're identifying different illnesses, for example, like, oh, that- that person has depression, that person has cardiovascular disease and had a heart attack, right? But those things may be linked, including autoimmune diseases, all aspects of mental and physical health, but we're not seeing that at the heart of it is the trauma that then changes us, and our brains and our bodies are different as we move forward. So to start seeing this commonality, that this is everywhere, and we're not identifying it, because one of the impacts of trauma is to make a reflexive sense of guilt and shame in us. So then we sort of hide things away. So we're changed, made less healthier, and the- the very trauma itself leads us to have a tendency to keep it inside, to not share, to not get help, to not do the kinds of things that would lead us to recognize the

3. 4:48 – 7:15

   What Percentage of the Population Has Traumas?

   1. PCDr. Paul Conti4:48

      epidemic.

   2. SBSteven Bartlett4:49

      How many people have some form of trauma? Because when we think of trauma, sometimes people think of PTSD, soldiers coming back from war.

   3. PCDr. Paul Conti4:56

      Mm-hmm.

   4. SBSteven Bartlett4:57

      So how many people does this subject speak to in some way?

   5. PCDr. Paul Conti5:00

      The numbers and estimates vary, but i- it'd be hard to imagine you wouldn't have roughly one in five. I mean, uh, likely, you have more than that. But if you look at, you know, data a- across demographics and data for occurrences of traumatic events and- and the impacts we see downstream of these brain changes, we're talking about a very significant portion of the population. And then if you think of people who are either experiencing the post-trauma effects themselves, right, the changes to themselves, or experiencing those changes through someone close to them, through someone they love, a parent, a child, a significant other, right now, we're- we're well over half the population that will- that will experience a significant and negative life impact from something that either was, with high likelihood, avoidable or treatable. In other words, change...... for the worse, that doesn't have to be that way. And again, it's not just, as if just mental health, we're saying something small. I mean, mental health is how we interface with the world but it's our bodies too. It's, is that person going to get lupus? Is that person going to have a heart attack or a stroke? And how rapidly is that person aging? So we know that trauma, by this definition, that changes us because our coping mechanisms are overwhelmed, makes us age faster than our calendar age. So you could say, "Well, that person is 40 years old by the calendar, but they're really 46," right? "That person is 65, but really 73," if you look at the aging that occurs in us as a result of trauma. So if, you know, I say this in part to, to really speak to how, like, concrete and real this is. So something that happens and changes you so that you are actually older than your calendar age, closer to death, right, than the calendar might suggest, is, is, is so real and so tangible. And it's, this is the effect of trauma upon us. And, and modern science knows this, modern neurobiology, modern psychiatry. The research around us tells us this, but the things that we know aren't always at the forefront of our consciousness in society, which is a reason I think it's so important to spread the word about it.

4. 7:15 – 10:19

   Your Brother's Suicide

   1. PCDr. Paul Conti7:15

   2. SBSteven Bartlett7:15

      Why does this matter so much to you?

   3. PCDr. Paul Conti7:18

      I had a youngest brother who died by suicide when, uh, he was 20 years old. I was in my mid-, uh, twenties. Which, which had, um, um, just a, a terrible effect upon the family structure and upon me. And I, and I felt the reflexive sense of, of guilt and shame without really being aware of it. I hadn't felt that before. You know, I hadn't felt like I couldn't be in the world or make my way forward in the world. And I started feeling very, very different about myself, and I started behaving in ways that weren't healthy, you know, that were very unhealthy. Drinking too much, un- unhealthy friendships and relationships. And real change in me that I was fortunate to be able to get help for, um, that really brought to the surface how much had changed after the trauma, that I felt very different about myself and the world. I just felt cursed and maybe our family was cursed, and I couldn't make my way forward and bad things were always gonna happen. And it was the realization that, like, "I'm really different and this is not okay." And it wasn't, like, just grief, you know, in the sense that sadness and loss, of course, were, were a huge part of that. But, but realizing also, like, "I am different." And, you know, that had a very big effect on me, um, both the depression and the, the, the issues in him that weren't seen and addressed that led to his suicide, and then the downstream effect on the rest of us. And that led me to, to leave. I had a business career, and I went back to college and took some pre-med classes and went to medical school and then became very interested in psychiatry and, and brain function. Both the psychology of how we think and the, the brain biology that underpins how we think. And have been very much fascinated, uh, ever since.

   4. SBSteven Bartlett9:00

      Did you process and, or deal with the loss of your younger brother, Jonathan, by suicide-

   5. PCDr. Paul Conti9:05

      Yes.

   6. SBSteven Bartlett9:05

      ... at the time?

   7. PCDr. Paul Conti9:08

      No. No, at the, at the time, I just went inside. Like, people didn't talk about it and were overwhelmed and, you know, became less healthy and felt different about the world. But there wasn't an outlet for talking about it. I just wasn't... How I had grown up, like, there wasn't a way people would say, "Let's check in." Like, "How are you doing?" And, "Maybe you should see someone." Like, like, it didn't happen and, and it took a- it took... Until I realized, like, "Hey, I'm kind of in trouble here, I need to get some help," to then... You know, I had an insurance card and to look on the back and say, "Oh, maybe I should go talk to someone." But that was a stretch for me and I felt even embarrassed about doing that. Like, I really didn't understand neither what had happened nor how to help myself. And, and then, you know, I went to someone and, you know, I just remember just how amazing it was to just have her tell me that, you know, I wasn't, like, I wasn't sick or crazy or, or like, not gonna be okay because I felt this way. That, like, she helped normalize what I was feeling and, and helped me put some of it into perspective. And I realized, like, well, that was very basic what was just done for me. And, you know, many, many, many people do not get that and I almost didn't have it myself. And I was, I was very struck by it and by how much of a difference it made to have a better understanding and get some

5. 10:19 – 13:11

   Trauma Is Causing All Sorts of Illnesses in Our Bodies

   1. PCDr. Paul Conti10:19

      help.

   2. SBSteven Bartlett10:19

      The impact it had on the rest of your family. I was reading that your mother was depressed for the rest of her life almost because of, potentially because of that incident.

   3. PCDr. Paul Conti10:29

      Mm-hmm. Mm-hmm. Yeah, I think she was clearly different afterwards too and, and was much more isolated. Again, in hindsight it's so clear to see, but I think the guilt and shame that she felt, um, was, was overwhelming and she had, was not able to get help. You know, no matter how much encouragement. You know, at some point I... It was actually a psychiatrist and he still couldn't... (laughs) You know, couldn't get her to get help because I think she was, just felt so ashamed and, and felt that help was inaccessible or that getting help was even more shameful. And, you know, the patterns change. I mean, there were still some happy times in her life but the whole tenor changed and changed towards, towards progressively more depression. And it didn't have to be that way either but there weren't support resources for, you know, mothers who lose a child to suicide. And, and my father who was more extroverted, you know, than just had more natural support mechanisms. And that's what you see sometimes, that, that it shouldn't be that one person does better than the other because they just happen to have different proclivities. You know, but when we're not really paying attention to this and we're just kind of running forward, you know, and trampling people, then maybe the person who's a little more introverted and has a situation like that, a little more inclined to be self-blaming, you know, like, that's the person who doesn't do okay. And, you know, my mother didn't and, and died I think much younger than she should have of, of cancer. But this kind of trauma predisposes to the immune system not functioning as it should and I can't say that this trauma caused her early death by cancer, but, but certainly there, there are a lot of scientific reasons to think that, um, that it was likely a factor.... in it. And, and unless we're aware of, like, what trauma is and what it's doing to us, that, like, we can prevent it. We can identify it and treat it. These changes to us don't have to stay the same. Like, the person who's blaming themselves and ashamed and depressed doesn't have to stay that way. The person who's abusing a substance to try and cope, or to try and kill themselves because they feel so bad, doesn't have to be living like that. Like, we really and truly can make change. The person who has an autoimmune disease or heart disease or r- rheumatoid arthritis that's inflamed after the trauma, like everything is worse after the trauma, doesn't have to be medically ill like that. Like, the- the message I'm bringing is- is one based in hard science, and it's one that has a real message of change. That it's not an esoteric principle, but we can and should be healthier. Even if you think about more than 50% of complaints brought to physical medicine doctors come from a mental health perspective. You know, how much of that is based in trauma? It's the- the majority of what is ailing us, and the numbers actually do tell us that.

6. 13:11 – 15:07

   How Trauma Speeds Up Your Ageing

   1. PCDr. Paul Conti13:11

   2. SBSteven Bartlett13:11

      At the top of this conversation, you referred to aging and the impact that trauma has on aging.

   3. PCDr. Paul Conti13:16

      Mm-hmm.

   4. SBSteven Bartlett13:16

      How does that work? So trauma makes me older?

   5. PCDr. Paul Conti13:19

      Mm-hmm. Because there are- there's cellular mechanisms in us, you know, people often talk about telomeres, which is one aspect that change as we grow older. 'Cause we're very interested in figuring out, like why do we grow older, right? So there are processes in us that sort of mark time, and that change across the aging process of humans. Now, and we don't understand everything about this. If we did, we could change it and, you know, live much, much, much longer. But we're trying to understand about it, and- and I think science has made a lot of very significant headway in understanding. And part of that understanding is the biological age of a person is different from the calendar age. So if you, you know, an example would be if you took two identical twins at birth and, you know, one of them is able to live in pretty good c- circumstances and free of trauma, and you know, s- has a pretty good life going. And the other person, uh, lives in a way that has ex- has privation and a lot of trauma. Maybe direct physical assaults or seening- seen as less than, denigrated by society. It's a theoretical example, but the idea would be you- you go follow them 30, 40, 50 years later, and you- you find two people who are not the same age anymore, right? The person who had the better life, if they're 40, well they're 40, and if you match up cellular aging mechanisms... And again, we don't know how close a person is to death, but the aging mechanisms are telling us how far along our path we are, so to speak. You see, okay that kind of matches with being that person's age, but then you see the person who has been through so much trauma, the presumption here being there are the brain changes of trauma, there's a post-trauma syndrome, right? That- that person is going to actually be older in terms of how far they have traversed down that path of the machinery in them running itself forward than what the calendar tells you.

7. 15:07 – 16:25

   How Trauma Affects Us at a Cellular Level

   1. PCDr. Paul Conti15:08

   2. SBSteven Bartlett15:08

      I'm trying to figure out why and how that's happening. What is the mechanism that's causing them to apparently accelerate in age?

   3. PCDr. Paul Conti15:14

      So the- the less healthy environment within the person, so some of that is- is likely say the signaling molecules that we- we talked about. It's just not as, you know, the bloodstream isn't as- as clean and healthy and, you know, running in as lock-step a fashion as we might want. But there are inflammatory signaling markers and, you know, that impacts cellular function, and cells are more likely to die earlier than they might otherwise. And then elements of neurotransmission and anxiety and tension states within us. You know, it's- it's really environmental. One, you know, one set of aging machinery is in a healthy environment, and the other isn't, so it's gonna deteriorate more quickly. I mean, it's- it's one way of kind of trying to capture that. The environment is- is very different in those two people, so how, what is functioning in that environment ages is going to change. Like having a car maybe in a- in a- a nice warm, dry environment, you know, versus having a car where, you know, there's snow and ice six months of the year and then it's terribly hot the other six months. You know, th- that, it's gonna be different, it's gonna age differently so to speak, right? If you go look at those two cars 10 years later, and to some extent, it's like that in us too.

8. 16:25 – 18:37

   Trauma Leads to Early Death

   1. PCDr. Paul Conti16:25

   2. SBSteven Bartlett16:25

      Death, disease and trauma. A 2021 study by the British Medical Journal found that adults who experience sexual abuse by the age of 16 have 2.6 times the chance of dying in middle age than those who didn't experience it. It's not commonly believed that trauma can result in disease, like physical disease directly, but you argue that it can, and you also talk about how it can result in n- um, autoimmune disorders.

   3. PCDr. Paul Conti16:53

      Right.

   4. SBSteven Bartlett16:53

      Things like arthritis, um, Crohn's disease.

   5. PCDr. Paul Conti16:58

      Mm-hmm. Crohn's disease, ulcerative colitis. Parkinson's disease probably has an autoimmune component. I mean, we're learning that much, much more is autoimmune, so.

   6. SBSteven Bartlett17:07

      Do you believe that trauma is the underlying reason behind many diseases that r- lead to early death?

   7. PCDr. Paul Conti17:13

      Absolutely. Think about w- what you just read. Can we- can we take a look at that again? Like, I think what you just read is absolutely momentous. So think about that. Sexual assault in the teen years, the, leads to a two and a half fold increase in death risk. That's staggering.

   8. SBSteven Bartlett17:33

      What's causing that?

   9. PCDr. Paul Conti17:34

      The whole cascade from the biological to the behavioral. So, gene transcription is changed. Healthier genes are more likely to be off, unhealthier genes are more likely to be on. That's not good for our blood vessels. That's not good for heart disease, or a possibility of having a stroke when the immune system is more activated and more likely to attack itself. And some of the mechanisms within us that are protective against cancers, for example, are less likely to function. All of those things change biologically. Neurotransmission, endocrine function, signaling markers in the bloodstream. All of that is changing, and at the same time behaviors are changing. Higher risks of depression, higher risks of addiction, higher risks of impulsive behaviors, risk taking behaviors. You have to put a lot of things together before you get a death risk that is two and a half times higher. But that's how we get there, because it does put a lot of things together, from the genes all the way through to complex risky behavioral taking.

9. 18:37 – 19:51

   Is There Anything Killing More Than Trauma?

   1. PCDr. Paul Conti18:37

   2. SBSteven Bartlett18:37

      Do you think there's anything killing more people than trauma, fundamentally?

   3. PCDr. Paul Conti18:43

      Not if we look for root cause. I've seen many, many things that kill people, and I- I wrote about this in the book, uh, people that I was taking care of who, at times, died, and I was always so struck by what the death certificate said versus why they had really died. You know, so the death certificate might have said, "Car accident." Okay, under- understand that, but w- why was that person driving 120 miles an hour in bad conditions, or why were they being so reckless? Why had they had five car accidents? I know that's the trauma, right? Why... Well, it was a heart attack. Why did that person have a heart attack when they were 62 if they didn't have huge risk factors f- from other any w- except the trauma and its impact? And th- th- so if we're looking at root cause analysis of what is hurting us, what is hurting our quality of life, what is hurting the quality of life of people that we love and what is killing us, then I think that need we know more than even just that. And, and there's so much we could, we could pile the information a mile high that supports that piece of information, which I think is quite staggering.

10. 19:51 – 24:22

    The Different Types of Trauma

    1. PCDr. Paul Conti19:51

    2. SBSteven Bartlett19:51

       What are the different types of trauma? Uh, are there sort of different categorizations of, of trauma, from, like, small to big or-

    3. PCDr. Paul Conti19:57

       If we're, if we're using the definition that trauma is anything that overwhelms our coping mechanisms, so, so there, there are changes in the brain when our coping mechanisms are overwhelmed, and on the other side of that, our brains are different. So that's the biological definition. Then we would look at, well, how, how does we... How do we get there, right? And, and we... It breaks down into three categories then of acute, chronic, or vicarious. So the acute trauma is how we've traditionally seen trauma. So if you think about the idea that people were shell-shocked after World War I, right? That was acute trauma, combat trauma. So our traditions of looking at trauma come from acute trauma, and it's just more evident, you know, after someone dies or there's an injury or there's a car accident. Like, you know, we can see that, oh, okay, gosh, that could put... Make some difference in the, in the person (laughs) . Like, we can kind of get that, and sometimes we can see the change in the person from before and after. So we have tended to equate trauma and post-trauma syndromes, like what happens to us after those changes in the brain are now with us, to acute trauma. But, but again, it's not a soft definition. It's based on do those changes in the brain happen in other ways, and the answer to that is yes, that if a person is seen as less than, for example, in a society for whatever reason across time, or even within a household, a person is being abused in a household, a child is being neglected, or a child is being emotionally or physically abused-

    4. SBSteven Bartlett21:27

       Bullied, bullied at school.

    5. PCDr. Paul Conti21:28

       Sure, bullied at school w- absolutely, right? Th- this over... So, so nothing happens all at once, right, but that brain changes just the same. So it's a scientific definition of traumatic change, and it is true in situations of chronic trauma just as it is in acute trauma. Now, it doesn't mean all acute traumas or all chronic traumas make these changes in the brain. And then vicarious, so the third category there would be vicarious trauma, which means, like human beings are empathic, right? I mean, thank, thank goodness, right? That's how all goodness comes in the world through our ability to have empathic connection, but that also means that our trauma can communicate from one to another. And again, it's not a soft concept. So people who are very much involved in other people's trauma, so in healthcare settings, sometimes in, in journalism settings, just in intimate home settings, and just spending a lot of time with the news, right, can become traumatized and have the changes in the brain that look the same as the person who lost two family members in the car accident. So it is true that vicarious trauma can change us in just the same way. The, the modern field acknowledges that if it's in the context of professional endeavors, which like really makes no sense, right? Like, what we're talking about are brain changes, and brain changes can come through acute trauma, chronic trauma, or vicarious trauma because of our ability to have empathic connection and compassion with other humans.

    6. SBSteven Bartlett22:59

       I wanna make sure that I've nailed this before we move on. So the acute trauma is, I get it, it's the, the big events. It's the going to war. It's the car accident-

    7. PCDr. Paul Conti23:06

       Mm-hmm.

    8. SBSteven Bartlett23:06

       ... big events that happen typically in an instant-

    9. PCDr. Paul Conti23:09

       Mm-hmm.

    10. SBSteven Bartlett23:10

        ... typically. Chronic trauma, this is things like racism, sexism, bullying that happen over a long period of time gradually that make you f- often feel less than-

    11. PCDr. Paul Conti23:19

        Right.

    12. SBSteven Bartlett23:20

        ... than other people. And the vicarious trauma is the trauma that, as you say, you get from empathy, so feeling someone else's pain, feeling someone else's trauma-

    13. PCDr. Paul Conti23:28

        Yes.

    14. SBSteven Bartlett23:28

        ... and it becomes your own.

    15. PCDr. Paul Conti23:29

        Yes.

    16. SBSteven Bartlett23:30

        Okay.

    17. PCDr. Paul Conti23:30

        Yes, and they can all lead us to the same brain changes, but people have different levels of susceptibility, right? So one person may have three big acute traumas and that person's brain is still doing okay, right? It's not changed towards greater vigilance, right? It's not changed toward, towards greater inflammation in their blood vessels. Then, you know, a- a- a- another person could have one incident that might seem m- more mild than the other three, the per- and that person can then have brain changes. So part of it is who are we genetically? How are we built? Uh, what kind of life experience have we had, especially early life experience? Uh, how susceptible are we to one thing versus another? And then this idea of the multiple hit hypothesis that I could have a number of traumas and then on a certain trauma that might be even mild compared to ones that came before it, now it makes the

11. 24:22 – 27:06

    What Doesn't Kill You Makes You Weaker

    1. PCDr. Paul Conti24:22

       changes.

    2. SBSteven Bartlett24:22

       What is that hypothesis?

    3. PCDr. Paul Conti24:23

       So multiple hit, which, which, which says that, you know, this idea that what, what doesn't kill us makes us stronger is completely wrong. (laughs) Right, I mean, in, in absolutely every way. What, what doesn't kill us often makes us weaker, right?

    4. SBSteven Bartlett24:36

       Yeah.

    5. PCDr. Paul Conti24:36

       And that's why we have to be attentive to what hurts us but doesn't kill us so that we don't get weaker, we get stronger. But what can happen is we can become more susceptible to... More likely that the next trauma, if we experience one, will then create the brain changes.

    6. SBSteven Bartlett24:51

       'Cause I have, I've often wondered, I'm the youngest of four kids.

    7. PCDr. Paul Conti24:55

       Mm-hmm.

    8. SBSteven Bartlett24:55

       We all grew up in the same household. We experienced a variety of different traumas, in my opinion. Much of it was chronic, but again, being the only Black family in an all-White area, all these kinds of things.

    9. PCDr. Paul Conti25:05

       Mm-hmm.

    10. SBSteven Bartlett25:05

        But I think I've always reflected on is for some reason, I think I experienced it much more-

    11. PCDr. Paul Conti25:09

        Mm-hmm.

    12. SBSteven Bartlett25:10

        ... the trauma of that, than my older siblings.

    13. PCDr. Paul Conti25:13

        Yes.

    14. SBSteven Bartlett25:13

        And I've pondered whether that's because of the timeline. Being the youngest, it was worse in the later years, so I, I think my hypothesis has been that I experienced it more than my siblings.

    15. PCDr. Paul Conti25:22

        Oh.

    16. SBSteven Bartlett25:22

        And I think I've embodied the shame a lot more than my siblings have, yet we both went through the same thing. So-

    17. PCDr. Paul Conti25:27

        Mm-hmm.

    18. SBSteven Bartlett25:27

        ... for whatever reason, I'm like really... Like, I'm a workaholic and I'm exceptionally driven. Not that my siblings are, but I'm obsessed in a way that's probably not completely healthy.

    19. PCDr. Paul Conti25:37

        Mm-hmm.

    20. SBSteven Bartlett25:38

        And I look at my siblings and I go, "They're not fucked up in the same way that I am."

    21. PCDr. Paul Conti25:41

        Mm-hmm.

    22. SBSteven Bartlett25:41

        But we all went through the same thing.

    23. PCDr. Paul Conti25:42

        Mm-hmm. Part of what you're pointing out is that the, the variables of life matter, right? So if circumstances are different, say for one child in formative years than for another, th- those children could be affected differently, like economic circumstances. So some of it may be and, and probably is impacted by the things that you're saying, but there probably are almost surely other factors too that's kind of nature and nurture, that people have what sometimes gets called different levels of attunement of the, of the, uh, emotional compass. So, you know, s- some people are very sensitive and sensitized to things and very aware of what's going on around them and, and aware of their own feeling states. And, you know, and other people can kinda go through life and, you know, emotionally buffeting things can happen, but they kinda keep going, you know? And, and look, there are pros and cons to both of those ways of being, but the person with a sort of more finely attuned emotional compass is the person who's likely to, to register more things that are negative, like things like subtle expressions of prejudice, right, that, that someone with a, a less attuned compass may just, you know, kind of not see that or just, it doesn't make it, you know, into their conscious awareness, whereas someone else w- who would be very attuned might see a lot of those things. So it's, it's part of like what is the nature, like who is the person, right, and then what is the nurture, meaning like w- what are the variables, you know, that, that that seed sort of falls into as we go through life?

12. 27:06 – 30:43

    Why Some People Experience Trauma Stronger Than Others

    1. PCDr. Paul Conti27:06

    2. SBSteven Bartlett27:06

       You must have seen this a lot in your practice where an individual went through a really traumatic early event-

    3. PCDr. Paul Conti27:12

       Mm-hmm.

    4. SBSteven Bartlett27:12

       ... and you've got the person in your practice sat in front of you that is an alcoholic, they are experiencing sort of suicidal thoughts, but then when you look at the rest of the family, the family are just doing fine. To some b-

    5. PCDr. Paul Conti27:24

       Right.

    6. SBSteven Bartlett27:24

       ... whatever that means, fine, but-

    7. PCDr. Paul Conti27:26

       Right. Well, ƒ (1:10:00) is the rest of the family doing fine, 'cause sometimes what it seems like on the outside is not true on the inside. Uh, and then we do think about genetics, especially around alcoholism. There are, um... We don't understand all of it, of course, but, but there are genetic factors that can be very i- impactful. Uh, then we'll look at personality structure, you know, is that person built to sort of internalize or externalize blame, you know? So why alcohol for this person and not for someone else? How much is nature or nurture? And how much may be formative? It may be that, for example, that person was in social circumstances... Uh, just real example that happens with some frequency is, say, mid to late teens where alcohol was accepted as a way of coping, right, and, and maybe s- other people in the family weren't. The circumstances were just different, where they went to school was different, whate- and, and they didn't have it modeled for them that this is how they cope. So maybe there are genetic factors that, that push more towards alcoholism. Maybe there are s- social factors, right, that it was modeled for that person. So, you know, you put, kind of put those things together and... Which is why, and we follow patterns and there's a science underlying all of this, but we have to look at who is that person, right? 'Cause you have to look at, you know, the, the family history, so the genetics that may have been passed on and what does that seem like may be the case in the person? How can you be informed by that and what were their formative life experiences? And, you know, you start, we start to build a picture of what's going on inside of us so that we can understand and change by looking at our history, which is why mental health doesn't often do this. You know, it takes an inventory of your symptoms now to reflexively prescribe a medicine, right? So w- we need to understand ourselves if we're gonna understand whether trauma is afflicting us, how it's afflicting us, how we can prevent it, how we can treat it if it's there. And, and I think that means accepting that this is real and this is real science. Which, which actually when you were talking, it made me think of an example. So if I say a, an, an example to the science of it, o- one of the earlier studies in, I forget exactly how many years ago this was, but 15 or 20 years maybe, was looking at immigrants, and I believe they were immigrants from Somalia to Holland. I think I'm remembering that correctly. And, and so the incidence of schizophrenia in the human population is about 1% across the human population. But when stressors are higher, right, it, y- they can predispose people to, to having, to coming do- to having the syndrome of schizophrenia. So it's about 1% of the population, but it's not evenly distributed. If there are, you know, people in sort of pressure cooker environments, so to speak, become more susceptible. And so they looked at, at immigrants who integrated into the community in Holland versus immigrants who lived in primarily immigrant communities. And the incidence of schizophrenia was higher in the people who had integrated, right? So the thought is... And again, there have been subsequent studies and we don't know for sure, but the, the, the... When you kind of look at that and say, "What, what is that?" is the feeling of otherness, right, is, is different trying to integrate into a society that was looking at, you know, not everyone in that society, of course, but there was a much more pervasive sense of otherness when people were integrating than, than when they were living in the communities where food and dress and like the, the, the day-to-day of life was normalized.

13. 30:43 – 33:30

    The Impact of Being Different

    1. PCDr. Paul Conti30:43

    2. SBSteven Bartlett30:43

       What's otherness and what's the sort of cost of otherness?

    3. PCDr. Paul Conti30:47

       I think otherness in the way I'm defining it is just a sense of difference in a way that's not good, right? A sense of difference in a way that involves either...... being seen as less than. And again, sometimes it can be over prejudice, but it can be also stratification of opportunity, you know. Just s- seeing that, okay, like, i- in some way, I'm not on an equal, I don't feel on an equal footing here, right? And then that, there's a, there's, can be a sense of isolation there, that, that builds. The sense of otherness then, say, building tension inside the person, right? The person doesn't feel quite as safe, right? It doesn't feel quite as validated 'cause, you know, when we're, especially when we're young, we look around us to see what's normal. And if, you know, people are looking, talking, dressing like us, like, we just feel validated in ways that we might not feel if we see that we are different, especially if the difference isn't embraced, right? And we see this across immigrant communities who, you know, at, at some point, a- integrate, right? But initially, people will tend more to stay together because there's, there's a sense of validation in the community. Um, so then the children often then will, will integrate, right? Which is why it's such an interesting study to look at people who were first generation immigrants, who would be likely to feel very strongly, you know, whether they were integrated or whether they were somewhere different 'cause they weren't the subsequent generations, right? They're the generation that just come from the home culture that either they could still sort of live in or live in a new culture. A- and not that everyone felt a pervasive sense of otherness, but there's more of that sense of otherness. And the fact that that would change susceptibility to an illness that otherwise is, i- it distributes itself across the population, I think is a very profound, you know, marker of scientific proof upon the things we don't pay attention to as much, you know, subtle prejudices, discriminations, whatever they may be that are in our society that we kind of look the other way and don't see. We're really harming people who then can come to the, the, could then come to the adult phase of life in, in a place where we have marginalized them, and we've, we've made things different inside of them that makes it harder to make their way in the world. And I think we overlook very much, whether it's bullying, there's many, many things it can be based upon what can make people feel less than. But the effect of it is, is seen in actual brain biology. And, like, we know this. We've known this for a long time, but in some ways, I see that we're more fragmented and pushing more towards these experiences of otherness or experiences of vulnerability and lack of safety that push people towards the, the, the chronic aspects of, of traumatic brain change.

14. 33:30 – 36:57

    Developing Trauma Later in Life

    1. PCDr. Paul Conti33:30

    2. SBSteven Bartlett33:30

       When we think about trauma, we often focus on childhood.

    3. PCDr. Paul Conti33:33

       Yes.

    4. SBSteven Bartlett33:33

       But what you're saying now with this study of the Somalians that immigrated to Europe, um, presumably, those were adults.

    5. PCDr. Paul Conti33:40

       Yes. So the, the highest incidents of schizophrenia is in people who are in young adulthood.

    6. SBSteven Bartlett33:45

       Yeah.

    7. PCDr. Paul Conti33:45

       So, so we're not seeing changes in people who are already deep into adulthood, but the, but the, the changes that we're seeing is in this sort of transition to a- to adulthood, which honors both that, yes, we are much more impressionable in all sorts of ways, including how our brains are forming when we are younger. So the, so these are people still, their brains still have enough formative... The idea is, the thought would be they have enough formative processes going on in their brains that the brains can be changed by the trauma.

    8. SBSteven Bartlett34:14

       But-

    9. PCDr. Paul Conti34:14

       Right?

    10. SBSteven Bartlett34:14

        ... when we talk about these three types of trauma, the acute, chronic, and vicarious, can you experience these types of trauma in any age, phase, chapter of life?

    11. PCDr. Paul Conti34:24

        Yes. The earlier in the, the lifespan, the, the more impactful.

    12. SBSteven Bartlett34:28

        Okay.

    13. PCDr. Paul Conti34:29

        Yes. A- absolutely, which is why childhood trauma is so important. In my, in the book, I, uh, interview, um, Darren Richerder, who's a psychiatrist at Stanford, and Stephanie Von Guttenberg, who's a, a child, uh, wellness advocate, because we're talking about trauma from both ends of the spectrum. So the, the chapter that's the interview with Stephanie Von Guttenberg talks about how childhood trauma so deeply impacts the, the sense of self of the child, like, things that we know, but I dedicate a chapter to it because childhood trauma is so tremendously impactful. And again, we don't pay enough attention to helping children who are traumatized and to, to, to projecting ahead to the increased burdens of illness and decreased role performance, and all the awful things that happen. So, so childhood trauma is one thing. On the other end of the spectrum, Dr. Richerder's work has highlighted the fact that when people are traumatized, they are changed in ways that changes subsequent generations. So if we're talking about childhood trauma, we can talk about traumatized children. We can also talk about traumatized adults whose trauma changes their children, even if their children are not born until years later.

    14. SBSteven Bartlett35:47

        How do we know that trauma can and is being passed on? What is the best evidence we have to support that?

    15. PCDr. Paul Conti35:54

        Mm-hmm. So the, the field of epigenetics, which has really come to the-

    16. SBSteven Bartlett35:59

        What does that mean?

    17. PCDr. Paul Conti35:59

        So, so epigenetics really come to the forefront in the last two to three decades, which is the understanding that our life experiences can change the expression of our genes. So, so y- you or I may have a gene that is active now because we inherited an active gene, for example, and th- maybe that gene is producing something, it's just helping us in some way, bolstering mood, decreasing anxiety. Then something can happen, something can change in us that turns off the expression of that gene, or turns on the expression of another gene. So then even though y- you have that gene, you don't have the benefit of it because the gene has been turned off. And, and this is a very, I mean, it's a very revolutionary understanding, that it's not just, "Well, your genes are your genes." You know, we could look when sperm and egg come together. Well, that's telling us what's going on. If we could understand that fully, we would

15. 36:57 – 40:31

    How Do We Know If Trauma Is Being Passed On?

    1. PCDr. Paul Conti36:57

       see, "Oh, here's the array of genes that are active and the array of genes that are not active." But, like, that's not......the story, right? That's just part of the story. The, the, the story continues that y- that one's experiences of life changes how those genes function, which ones are on, which ones are off, and how they get passed along. So, if the parent is not traumatized, the parent may pass along the active gene for something positive, say, to the child. If the child then is traumatized, the child may pass on that gene without it being expressed, so it's as if the gene isn't passed on. So, if you, you think about that, it's just amazing that our genetics in the sense of what's actually going on in us is not just the nature of what genes did we get, it's the nurture. How has what has happened to us affected the expression of those genes?

    2. SBSteven Bartlett37:50

       There's one study that I, I read about which says scientists at Emory University-

    3. PCDr. Paul Conti37:55

       Mm-hmm.

    4. SBSteven Bartlett37:55

       ... in Atlanta trained male mice to fear the smell of cherry blossom, shocking them whenever they smelled it. So, the mice got to the point where they shuddered when they smelled it, even when they were- weren't even being shocked. Um, the-

    5. PCDr. Paul Conti38:07

       Ah.

    6. SBSteven Bartlett38:07

       And I'm guessing the children then had the, the same reaction. I, I guess that's what the study concludes. But also the, um, the children of Holocaust survivors-

    7. PCDr. Paul Conti38:16

       Yes.

    8. SBSteven Bartlett38:16

       ... are another example of how trauma can be passed on because-

    9. PCDr. Paul Conti38:19

       Yes. Yes.

    10. SBSteven Bartlett38:20

        ... it's hard to think of a much more traumatic event than being involved in the Holocaust.

    11. PCDr. Paul Conti38:23

        Right. And for a long time, the thought was that the, the reason that, say, children of Holocaust survivors had higher levels of anxiety and of anxiety spectrum illnesses was because of anxious parenting. That understandably, the, the parents had a, a, a much more sense of vulnerability, you know? So, so across the population, they were, they were more anxious and they were raising the children with more anxiety. And what we have, have learned is that, that the experiential aspect is part of it, but that exactly what you and I are talking about is part of it too. Because the, the experience of what they went through changed genetic expression in the children. Right? So that's, that's just a sea change in understanding that the, the genes of the parents, the genetic expression of the parents, and the genetic expression that they pass along to their children is changed by the Holocaust experience itself.

    12. SBSteven Bartlett39:21

        With this understanding of epigenetics, do you in your practice then consider deeply what someone's parents went through in their life and how that might have changed someone's sort of genetic expression that sat in front of you in your practice?

    13. PCDr. Paul Conti39:33

        Sure, sure. I, I think we all deserve, so to speak, to, to think about our life narrative, right? And, and so many of us don't. I think if we're trying to help ourselves, you know, whether someone listening to this, like, feels that they're depressed or that they, they don't have any mental health issue, but they wanna understand themselves better. It's like, think about a narrative of, "Okay, where... Wait, let me start with like, where have I come from and like who came before me?" And, um, and then, "Wait, this happened and then that happened." Then, you know, when we build a narrative, it, it's remarkable how much we can come to understand about ourselves. 'Cause often we don't do that. Like, we have isolated pieces of information about ourselves, but we don't knit it all together. And, and it's really remarkable what can happen, what can be elucidated by doing that. So absolutely, yes, just for the, the general understanding of the person and also to understand what did the parents go through. You know, what, what experiences did they have? How might that impacted this person? And you might then ask questions of,

16. 40:31 – 44:58

    Do We Need to Understand Our Parents' Trauma to Understand Ours?

    1. PCDr. Paul Conti40:31

       let's say, the family situation changed, you know, between say, uh, older siblings and younger siblings, right? Then by learning about that history and learning about older siblings versus younger siblings and the parents, I mean, think about how much you learn then, not just about the person's experiences growing up, but, but just about the, the biological aspects of how are the parents functioning? How did it impact the children? And what were the situations? How are the children similar or different? There's so much we can learn from that.

    2. SBSteven Bartlett41:00

       You liken trauma to a virus. It's a very interesting way for us to start thinking about trauma because we seem to think of it, uh, at least I did, as being sort of isolated to the person. But the idea-

    3. PCDr. Paul Conti41:10

       Right.

    4. SBSteven Bartlett41:10

       ... that it somewhat has a contagion to it and that we can-

    5. PCDr. Paul Conti41:13

       Right.

    6. SBSteven Bartlett41:13

       ... spread it vicariously to other people that are around us, but also down through the family tree via our epigenetics and via our, our genes makes you kind of understand both the importance of treating it. But yeah, I've just never heard anyone describe it as a virus before.

    7. PCDr. Paul Conti41:29

       Right. You know, you know, because there's a reflexive guilt and shame to trauma and our society doesn't recognize it, it often gets hidden inside the person, right? But when it's hidden inside the person, it's still spinning off symptoms. So, I think the best analogy to use here is of an abscess in the body. So, an abscess is a walled-off area of infection in the body, and it's good that the infection is walled off because if, if it wa- weren't, it could be fatal, right? So it's good that it's walled off, but the body is still aware that it's there and it's still spinning off symptoms because it's there. So, for example, a person might have an intermittent low-grade fever or just feel kind of jittery or, you know, they're sweating and they're not sleeping well, right? So, there are pervasive symptoms that are impacting this person, but it's not obvious that the abscess is there, right? So, what often happens in general medicine is a person is having non-specific symptoms, you know, people go looking, scan, they see, "Oh, there's an abscess there," right? Once we know that, then we might have an understanding for why that person just never feels good, right? They always feel lethargic or they never feel comfortable. We know there's something there now, and we can go in and fix it, right? And it involves, you know, there's a surgical process, right? So, something has to happen that's not a fun thing, right? If you go through a surgery and recovery, now the abscess is gone. So, I think the, the example of the abscess i- in the body is, is a very good way to understand what trauma does to us in the mind.So if we shove it down inside of us, there's reflexive guilt and shame. Society isn't helping us take a look at it. Now it's there inside of us, it's going to spin off symptoms. And those symptoms aren't always symptoms that make, say, one person hurtful to another. They- they- they may not be. That person may be very, very vigilant and- and just kind as can be to- to someone else. But across the population, those symptoms inside of us are not good, so they give us shorter tempers, right? We're more likely... We're more anxious, so we may be more, uh, quick to anger or we're less functional in the world around us because of depression, anxiety, sleep problems, right? We can be more impulsive. Like, it works against us being in the world as best we can be. And-

    8. SBSteven Bartlett43:48

       Is that- is that what you refer to as post-trauma syndromes? Is that a similar thing?

    9. PCDr. Paul Conti43:52

       Yeah. R- right. Post-trauma syndromes are ways in which we can recognize the changes in ourselves, so higher levels of anxiety, for example, lower, uh, levels of mood, right? Um, different... Changes in sleep, uh, physical health changes, um, and then changes in just how comfortable we feel in the world, right? So what we'll see is changes in behaviors that are driven by just feeling differently in the world. So we have... We're in a different self-states. We have different behaviors. The syndromes can do all sorts of different things to us, from mood, anxiety, sleep, behavioral change. So someone who might wanna find a relationship partner, you know, stops going to places where they could meet someone, right? So we- we change our behaviors. This is what shows us that there is a post-trauma syndrome.

    10. SBSteven Bartlett44:38

        That's how we know we're traumatized, effectively, 'cause that's what I'm- I'm trying to figure out. Like, people could be listening to this now and hearing you talk about these different types of trauma, what are the sort of telltale signs, I'm assuming it's this, that I am traumatized?

    11. PCDr. Paul Conti44:51

        Right. Yeah. This is what we're looking for, right? So- so someone might present with, uh, that person is depressed now, and they weren't before.

17. 44:58 – 45:47

    Post-Trauma Syndrome

    1. PCDr. Paul Conti44:58

       That person is having panic attacks, and they weren't before. That person is dr- using alcohol to soothe, and they weren't before. Because in medicine, we look at just the surface, right? What we wanna look at is like, "Oh, why are you here? Oh, you're here because you're drinking too much. Let's talk about how you can drink less. You're here because you're depressed. Well, can we give you a depression medicine?" Right? So then, we're not looking at, like, "Why?" Right? "Why are you depressed?" I mean, some people biologically will become depressed, you know, no matter what, even when things are going very, very well. But this isn't the majority, right? Most- most of us, if we're depressed, there are likely factors, like, so we should be curious. Why is that person depressed? Why is that person having panic attacks? Why has that person changed their behaviors, right? And so now if we get curious, we get curious about the person, then we're gonna figure... We're gonna figure out things we wouldn't have

18. 45:47 – 48:54

    How to Know If We Are Traumatised?

    1. PCDr. Paul Conti45:47

       before, right? So if a person gets depressed because everyone in their family gets depressed every nine to 12 months, no matter what, like, okay, let's- let's come at that biologically. Like, we don't... That- that doesn't necessarily map to trauma, right? But- but if we start looking at that person being depressed, do we see that, you know, they kind of started getting depressed, you know, a couple of years ago around the time their sleep started being a little bit different, and, you know, they started behaving differently, and they, you know, they didn't spend as much time with family? And then you start getting more curious, and- and you start learning, oh, you know, that something- something happened then, right? Again, with acute traumas, it's easiest to see, but when you look for the whole picture of like, might there be a post-trauma syndrome going on here, you know? Maybe that person who's depressed and is drinking too much started drinking too much when their mood started decreasing after the trauma, or maybe they started drinking after the trauma, and it's driving their mood down. Like, and it's not always this, but we're never gonna know and understand unless we're curious. Like, this is how we trace to the roots of it, and this is how we get back to the narrative, right, of- of what is going on inside of me, and have I changed, right? And the- the idea, we started talking about how the changes in behavior are the post-trauma syndrome, are the changes that- that make trauma like- like a virus, right? Because we start behaving differently, and for some people, that is the- the... Their mood isn't as good, and it's not as healthy to be raised by a parent who's depressed, right? So that can be a way in which the virus of trauma gets passed along to the next generation. Or maybe that person is drinking or using a drug to cope, and that doesn't make for the best parenting. That's how the virus of trauma gets passed down to the next generation. Or there are times when- when a reaction to trauma, to the feeling of disempowerment can be aggression, right? Envious, aggressive behavior. So- so not all abuse of children comes through the lens of trauma, but a lot of it does.

    2. SBSteven Bartlett47:44

       I'm interested as well in the subtle symptoms of trauma. You know-

    3. PCDr. Paul Conti47:48

       Mm-hmm.

    4. SBSteven Bartlett47:48

       ... we talked about some of the big picture stuff, which is like suicidality, you know, becoming an alcoholic or all those kinds of things, but there's subtle ways that trauma shows up in everyday life.

    5. PCDr. Paul Conti47:56

       Mm-hmm.

    6. SBSteven Bartlett47:57

       I was... Uh, some of them I was hypothesizing over are things like phone addiction-

    7. PCDr. Paul Conti48:02

       Mm-hmm.

    8. SBSteven Bartlett48:02

       ... being addicted to your phone, or video game addictions. These kind of things that I think maybe originate from the sort of more chronic traumas, but are less easy to spot.

    9. PCDr. Paul Conti48:11

       Right. Right. Yeah. I think the key to all of this is curiosity, right? So let's say someone is, like, say, addicted to their phone. Okay. Maybe that's because phones are addictive, and the person has just spent too much time on their phone. Maybe, right? But addiction mechanisms in human beings are similar. Like, it's the same machinery across addictions, right? And- and oftentimes, addictive behavior is meant as an escape from something or to soothe against something or even to self-punish because of something. So addictive behaviors, it's similar brain machinery, whether it's cocaine, it's alcohol, it's brownies, it's the telephone, it's sex, it's exercise. I mean, there are things that people do in addictive

19. 48:54 – 51:54

    Trauma Shows Up as Addiction

    1. PCDr. Paul Conti48:54

       ways as routes of unhealthy coping. So- so if we get curious why, again, why the drug? Why the phone addiction? Why the things that might seem more subtle, um, and maybe are more subtle? But we should scratch on the surface of them to- to try and understand if they mean something. Is that phone addiction?...the 14th addictive behavior in a row, right? Because that person has sort of particularly adept addictive machinery inside of them and they're trying to escape from something. Like, that doesn't happen all the time, but it is not untrue that when you scratch the surface of that, you might learn about, uh, an episode of sexual abuse that happened when the person was a child. Like, these are real examples, right? And that the person isn't built to run from things through addiction, and maybe they're saying things about their own character that's negative. They're saying negative things about themselves and they feel disempowered and they're disempowering themselves. But if you go look at that narrative, you know, that, that person that might have a dialogue running over and over again in their head of shame about something that happened 30, 40 years ago. Like, this is not uncommon. So we need to be curious and we need to scratch on the surface of things, whether they're really big things or they're subtle things. Like, which is why life narrative is so important. If you think about changes, like after trauma that changes the brain, we respond differently when we see a new face. So, so without the trauma is... I'm simplifying a little bit, but you see a new face and we might be curious, like, "Oh, you know, could we, could you be a friend?" Or if someone's romantically interested, like, "Oh my... Might that person like me? Or I might..." People are interested and curious. Whereas after trauma, there's a, there's a difference of feeling a little bit on the back foot. So people tend less to look up and engage and more to look away or to more have negative thoughts. "Oh, you don't... That person doesn't like me." You know, instead of something that might be cons- more constructive.

    2. SBSteven Bartlett50:43

       How do they test for this? H- is there tests that are able to be done to s- see if someone after trauma has, like, a different set of sunglasses that they view the world with?

    3. PCDr. Paul Conti50:52

       Mm-hmm. Yes. Yeah. The- the- there's a, there're tests from, from the brain biology, uh, all the way through to, to very clever psychological experiments. Like, we can see all of this, and it's these, these signs we should be looking for in ourselves, right? Because it is very obvious if someone who always was an extrovert now won't leave the house. Right? Like, we can tell something's wrong and someone's probably gonna come ask something, right? But if we just change in these more subtle ways where we're just less interactive and, you know, people notice their friends a little bit different and less outgoing. You know, it's these things that, as you're saying, the subtle ones, the subtle signs and the nuances are often very impactful and indicative of other things going on under the surface, you know, that can bring even greater problems.

    4. SBSteven Bartlett51:38

       On this subject of soothing that you were talking about a second ago, there's this quote that you say in your book, "Trauma promotes pain. Pain increases suffering, and suffering makes us desperate to soothe our pain, whatever form it takes. Sadly, we're seeing the terrible cycle play out on a larger societal level with the

20. 51:54 – 52:48

    What Tests Can Be Done to See If We Have Trauma?

    1. SBSteven Bartlett51:54

       opiate epidemic."

    2. PCDr. Paul Conti51:56

       Yes.

    3. SBSteven Bartlett51:57

       This idea of soothing, we all find ways to soothe ourselves, and some of those ways that we find to soothe ourselves become destructive in and of themselves. And it almost makes me think that, like, our... Sometimes our attempt... We think of, like, alcoholism typically as people that are s- self-destructing. But when you understand the soothing component of drinking alcohol-

    4. PCDr. Paul Conti52:18

       Mm.

    5. SBSteven Bartlett52:19

       ...it actually is them trying to not self-destruct, not destroy themselves, but to take care of themselves-

    6. PCDr. Paul Conti52:26

       Right.

    7. SBSteven Bartlett52:26

       ...in a weird way.

    8. PCDr. Paul Conti52:27

       If we're under huge amounts of distress, our perspective of the world narrows, right, very, very dramatically. I mean, if there's an elephant standing on my foot, I only have one thing I'm guessing I would think about, which is the elephant not standing on my foot anymore, right? So when we're under tremendous stress and strain, right, something that soothes us in

21. 52:48 – 56:09

    Self-Destructive Shooting Methods

    1. PCDr. Paul Conti52:48

       the short term, right, becomes acceptable because there's a desperation in us that has us focused on the short term. Like, I know that may... I know that's not good in the long term, but I'm just trying to get through today, right? And, and it's this lack of perspective in the world and the society around us that if we're not recognizing what trauma does to us, can it... That it can drive us to places of desperation, then is it any wonder that short-term soothing will have a big appeal to us? And that could be sooth- soothing through excess eating, and now, you know, that person is overweight and has diabetes and wants to be healthier, but, like, doesn't really feel that they can stop and ping-pongs back on different dis- diets. And, you know, what they're really doing is they learned self-soothing with food i- in a way that, that was, you know, in the context of really feeling some sense of despair or desperation. The same way that person may have learned that, "Oh, alcohol soothes." Now, again, there's, there are genetic factors and there, there are all sorts of factors that come into play too, but unhealthy coping mechanisms are beckoning to us all the time, which is why, you know, I did a lot of treatment of, of opiates and opiate dependence, uh, over a number of years, and, you know, it's just outrageous to me that these, these are the most powerful psychoactive medicines on Earth, right? Opiates, right? They soothe psychic distress, like, you know, feeling not good mentally inside of us very, very rapidly and effectively, and almost immediately start building tolerance and danger, right? But I had no education and training around opiates as psychoactive medicines. So, so here we are in a society that's so... Uh, is under-appreciating trauma and, and where people are, are at in a, a sense of isolation or otherness or desperation in so many facets of our society, and then we start handing them the most powerful short-term soothing mechanism with the absolute highest risk of long-term danger and death, and then we're surprised at how many tens of thousands of people die each year from prescribed opiates.

    2. SBSteven Bartlett54:59

       What kind of opiates are p- are people being s- prescribed?

    3. PCDr. Paul Conti55:02

       So how the opiate epidemic really began was with opiates in pill form, so, so...... that they would be prescribed, say, for, for conditions of pain, but conditions of pain that were more chronic conditions or conditions not amenable to opiates. So if you come out of surgery, an opiate is a great idea, right? Like, there's a lot of pain that needs medicine to soothe that pain until the pain decreases. But it's judicious use of a very powerful medicine in high-acuity circumstances. What we started trying to do, and part of this was, you know, we know there's a whole story behind the politics and the business of this, was to say, "Well, people shouldn't be in pain, so there's a short-term solution, right? No one should be in pain, we'll give them pills," right? A- and opiates do not work in those situations. They soothe a lot early on, but they rapidly build tolerance, addiction. Uh, they suppress breathing drive. So, so we started doling out opiate pills with the idea that we're treating pain and isn't that good, but with an absolute inattention to the immense risks

22. 56:09 – 58:14

    People Are Dying from Prescribed Meds

    1. PCDr. Paul Conti56:09

       of that. And I think it fits with the short-term view of, you know, of relieving all pain. Like, we're human beings, we can't relieve all of our pain, right? Sometimes what there is to do is to work hard to mitigate pain, and that might be, that might be pain, you know, e- even from a mental health perspective, it might be pain from a physical health perspective. But this idea that a pill is gonna fix everything, and now everyone has pain pills and won't be in pain, you know, has resulted in hundreds of thousands of deaths in this country alone from prescribed opiates, you know, let alone i- illicit opiates. So there's the short-term thinking on the part of our society that then almost lures people into the, the seduction of the short-term soothing, right? You feel miserable and you want things to be better, take this pill. Now you're seduced and addicted and at huge risk. And, you know, we've let that happen.

    2. SBSteven Bartlett57:04

       For us to know how to treat trauma, we have to understand the physiological consequences of it. How does trauma change our brain? When we look at brain scans, what do we see in a traumatized person?

    3. PCDr. Paul Conti57:16

       Brain scan data is more complicated and harder to interpret. You can see different patterns in the brain. We're not at the point where brain scan science can really can pinpoint, right? But what we do see is parts of the brain that are sort of inflamed, so to speak, by trauma. So, so the amygdala and pathways around the amygdala, which is a part of the brain that gets called sometimes Grand Central Station for negative emotion, right? We see that pathways involving this part of the brain become more prominent, right? So we, we see changes in brain connectivity, right? 'Cause how our brains function is by communicating from one place to another. They function through connectivity and which pathways are more prominent. So what we see then is pathways that are involved in trust, say, and feeling a sense of safety are less prominent. Pathways that are more activated when we feel less safe and more vigilant

23. 58:14 – 59:53

    How Does Trauma Change Our Brains?

    1. PCDr. Paul Conti58:14

       are more activated. And then we see the climate, so to speak, in the brain change in a way that's less healthy. And you may also see specific aspects of a post-trauma syndrome. So, so mood regulation areas are not functioning as well because now there's, uh, depression intruding. So we see patterns in the brain that show us this change, although the science hasn't come far enough to, to pinpoint, like, at some point, we'll be able to do with much greater accuracy.

    2. SBSteven Bartlett58:43

       And I've heard you talk about how that creates cognitive blind spots, so blind spots in our brain following a traumatic event. What do you mean by cognitive blind spots, and what's the, the harm or risk of that?

    3. PCDr. Paul Conti58:53

       Right. So a cognitive blind spot can occur when we take a lesson inside of us that is a lesson of trauma, not a lesson of truth, and then it changes how we may think about things. So, so for example, uh, a real, and sadly many examples of this I, that I can bring to mind and people's faces who come to mind as I say it, but someone who feel pretty good about themselves and able to navigate the world and, uh, striving for a better job and doing fun things, who then is assaulted, right? And after that assault, the person is much less present in the world and internalizes a bunch of different thoughts about themselves of, "I don't really like being out. I like being at home better," or, "It never goes well. I don't get along with other people." Like, they think about themselves differently. So there's a cognitive blind spot which makes it very, very difficult to think with accuracy about,

24. 59:53 – 1:03:50

    Trauma Creates Cognitive Blind Spots in Our Brain

    1. PCDr. Paul Conti59:53

       say, possibilities. So that person may have, say, been striving for a better job, right? But if they think of themselves differently, "I'm not the kind of person who can get ahead, and people don't really like me," then they don't strive for a better job. They just take for granted that they can't get it. It won't go well. They'll fail at it. But they never thought that before.

    2. SBSteven Bartlett1:00:11

       Is this what you kinda see when people refer to someone having daddy issues? You know, uh, the, the... I was thinking as you were saying that, that my dad lef- so f- say my dad left when I was four.

    3. PCDr. Paul Conti1:00:22

       Mm-hmm.

    4. SBSteven Bartlett1:00:22

       And I internalize this idea that men don't love me, for example.

    5. PCDr. Paul Conti1:00:27

       Right.

    6. SBSteven Bartlett1:00:27

       And then I go through life being an avoidant person in romantic situations or self-sabotaging or going for people that are unavailable to avoid the rejection.

    7. PCDr. Paul Conti1:00:35

       Right.

    8. SBSteven Bartlett1:00:35

       Is that somewhat similar? Like, I've created a cognitive blind spot, and now I'm living out that as an instruction manual for my life?

    9. PCDr. Paul Conti1:00:41

       Yes. Absolutely yes. And the, the earlier in life, the more powerful the lesson is. And the brain doesn't go back and revisit those lessons. So I think this is, this is just so amazing and s- surprising to me that our brains are so incredibly complex, right? More complex than the greatest supercomputer, right? Yet our brains don't do some very basic things. Like, we don't reboot and see is there a patch or is there something to fix, right? We don't go back and look at these earlier lessons. So if you learn at age four, "Oh, men don't love me," that's a hard lesson to unlearn because it gets solidified at an early age. And then once those lessons are there, there's an internalized danger to go revisit them.Like, if you go revisit that lesson, could you be disappointed? Right? The thought is, "That's the way it is, and that's the way it's going to be." Like, that's kind of what we tell ourselves inside, the trauma kind of walls it off, and then we don't just go back and look and say, "Is that really true?" Like, "Here I am. I'm an adult now and, you know, did I just carry forward something when, when I was four years old that wasn't about me? Is it really about the four-year-old," right? "Or is it about the adult?" Like, we learn all these things, but we don't go back and revisit the lesson. And then, yes, there's a person who could be very, very avoidant in ways that that lesson, that, quote unquote, "truth" that is not true can change that person's life. And that's why if we go back and look at that, life can really change. We can go back and look at, "Why do you feel that? It's interesting to feel that. Let's, let's think about it and, you know, what's the story behind it?" And we- we can get to a place where that can be undone and say, "Oh, I took that lesson inside because someone else made a choice that was about them and not me." No four-year-old is responsible for a parent leaving, right? But I took something in that was different and it's really affected me, and I kind of feel differently about myself. It's not that everything instantaneously changes, but boy, the world is different then.

    10. SBSteven Bartlett1:02:40

        On that subject as well of, say, the father leaving at four years old and me thinking that men were... Well, s- say I was four years old and my father was violent. What you sometimes see is people then are attracted to the familiar when they grow up. So, although it wasn't healthy, they have a sort of bias towards being attracted to something that was familiar, even if it wasn't healthy.

    11. PCDr. Paul Conti1:03:03

        Right. That gets complicated with what sometimes people will talk about is repetition compulsions are, are quite complicated. Often what a person is doing then is trying to gain a sense of mastery over a situation in which they had no control. So you will see this in abusive relationships where, you know, sometimes a person will come, uh, and say, "Okay, I'm coming to see you, but I know you can't help me," right? "But my last, like, eight relationships have been just awful, so how can you possibly help me?" And then I might say something like, "If you can tell me how you had eight different relationships that didn't go well, maybe I'll believe you, but you're gonna tell me about the same relationship eight times over." Right? It's something along those lines, because we repeat things that don't go well in an effort

25. 1:03:50 – 1:06:25

    We Tend to Seek What Harms Us in Order to Fix It

    1. PCDr. Paul Conti1:03:50

       to gain a sense of control. So, what often is the case in that kind of situation is whether it's repeating an abuse cycle or just someone who isn't attentive or isn't interested, the, the person is trying to feel better about something from the past. So, if the father was inattentive and that person has a romantic interest in men, that person may choose men who are inattentive with a desire to make them inattentive to fix the, the... to soothe the pain of the past, because the emotion systems in our brain don't care about the clock and the calendar. So you can't solve the past in the present as far as the emotion systems are concerned. And if the trauma is very strong in us, the emotion systems will rule the day. So they said if the father was violent, then maybe that person chooses a, a violent significant other, right? And then that relationship goes away and the person chooses another violent significant other, and then sometimes the thought is, "Well the person is choosing that because that's what they're comfortable with," or that's... It... But n- no. The, the, the person is, is trying to make sense of something and there's some desperation inside to feel better about themselves and to fix and heal something. Whereas why if we can intercede there and say, "The problem is if you want someone who's attentive, choose people who are attent- choose someone who's attentive," right? As opposed to, "Choose someone who's not attentive and try and make them attentive."

    2. SBSteven Bartlett1:05:15

       Can we become addicted to our victimhood?

    3. PCDr. Paul Conti1:05:18

       Sure. There's no internalized victim without an internalized persecutor. So, if someone is victimized in the sense of the law, right? Someone has done something bad to that person, that doesn't mean that person takes inside of them that they are a victim, right? But trauma can make us feel like victims. After the loss of my brother, when I felt like, um, maybe we're cursed and I'm not... I can't really get anywhere in the world. Like, there's a black magic to that, right? Then I start to feel like I'm a victim of something. I don't... I, I'm behind the eight ball. I then have a sense of otherness, right? And, and now I've taken something inside of myself where we don't need a persecutor anymore. I feel like I'm less than, so how's that gonna go well, right? So what we end up doing is we take inside of us sometimes this sense of victimness, but that also takes inside of us the idea that we are less than, that there is something magical that is bad and negative. And what we need to strive i- a- against is exactly that, that something may have happened that we might say, "Okay, that person is a victim in the eyes of the law. They were assaulted,"

26. 1:06:25 – 1:08:03

    Becoming Addicted to Our Victimhood

    1. PCDr. Paul Conti1:06:25

       right? But that doesn't mean that person has to take victimness inside, guilt and shame. How many people have I seen who are assaulted and they talk about how they're ashamed of it and it's their fault. Someone else attacked them, right? But the reflexive guilt and shame of trauma can lead us to feel less than, then we start feeling like victims, then we feel less than. We embrace this and we don't need someone to persecute us anymore.

    2. SBSteven Bartlett1:06:53

       The limbic system. We're talking about the brain here. What is the limbic system and what role is it playing in cementing our trauma?

    3. PCDr. Paul Conti1:07:01

       Yeah. So the, the limbic system is the name for the emotion systems in the brain. So we're simplifying a little bit, but the idea that there are logic systems and emotion systems. The emotion systems are limbic, those are the limbic systems, and they never lose when they come face to face with logic, right? Like the limbic, the emotional always rules the logic if the two come head to head, which is why if-... the emotion of trauma, the fear of being less than, the need to repair something that was unfair in the past, if that is driving us, logic will not have its say. You know, logic would say if you've dated six people who've all kind of seemed the same at the outset and then all behaved in the same negative way, don't choose a seventh like that, right? I mean, logic very... Logic was saying that at the second person, let alone the third, the fourth, the fifth. Why do we see repetition of unhealthy relationships? Because the limbic system, if it needs to feel different, it needs, so to speak, to solve that trauma by gaining

27. 1:08:03 – 1:11:37

    What's the Role of the Limbic System in Our Traumas?

    1. PCDr. Paul Conti1:08:03

       mastery, it's going to go look for the seventh person who's just like the first six. But once we take the energy, we lance the abscess, so to speak, of the trauma, then logic can have its say, and that person who says, "You can't help me because the last eight relationships were all awful," sees, "Oh, I did the same things, chose the same person in the last eight relationships, that's one paradigm, and I'm changing it now." And then things are different when they thought they couldn't be because they can see now what they couldn't see before. The limbic system isn't ruling the day anymore. There's a whole balanced brain that has an understanding of self and uses that understanding to move forward in life.

    2. SBSteven Bartlett1:08:42

       It seems like the limbic system is against us. But, but there must be some sort of evolutionary reason or rationale or purpose of that limbic system that is-

    3. PCDr. Paul Conti1:08:51

       Right.

    4. SBSteven Bartlett1:08:51

       ... I don't know, malfunctioning in the modern world.

    5. PCDr. Paul Conti1:08:53

       Oh, sure. The limbic system isn't against us. Uh, all these parts of our brain, none of them hate us, they're all part of, they're all parts of us, and some of the, the research and observations through the psychedelic sciences are really telling us that much more, that there aren't parts of our brain that hate us. They may work against us because, uh, as you're say- commenting, they're not built for the modern world. So, you know, if you think about the limbic system and the negative information, like, something bad happened when you were four or five. Like, take that in, and whatever lesson that is, never question it or change it, right? I mean, this is based upon survival mechanisms. The example I, I give is, you know, imagine for most of human history when people

    6. NANarrator1:09:33

       (laughs)

    7. PCDr. Paul Conti1:09:33

       ... were hunting and gathering and living in small groups and, and, like, having enough food was w- is very important for humans across human evolution. If you find a new food that it looks good, looks like something else that was good, and you, and you eat it, and it tastes good, and it's nourishing, like, it's good to remember that, right? But if you eat it and you get very, very sick, you better remember that forever, right? So the, the negative has much more salience in this and makes these lessons, "Never go near that thing again. Never go near that person again. Never do this again." I mean, they're designed to keep us alive, but we're trying to do more than that, right? We're trying to do more than stay alive. And these systems in us that evolve to keep us safe then can very much work against us. The person who's traumatized because someone attacks them and that system gives them panic attacks if they leave the front door, I mean, that's that person's brain trying to keep them safe.

    8. SBSteven Bartlett1:10:27

       You used the word shame a lot-

    9. PCDr. Paul Conti1:10:29

       Yes.

    10. SBSteven Bartlett1:10:29

        ... when we were talking about trauma. In the same way that I asked, um, is the limbic system against us, what is the use of shame? Why do we experience shame? Can't we just program ourselves to get rid of shame and then we'll all be fine?

    11. PCDr. Paul Conti1:10:44

        Right. Eh, exactly the same with the limbic question. No, we kinda need shame, but we need shame for a good reason. Right? So, so these primary affects that, that are very, um, primordial in us, anger, fear, love, shame, these are things that are just aroused in us. Like, they can become other things once we start thinking about them, but they're states that, that, that are very deep within us. They all have a survival adaptation. So, you know, love, feeling love is, you know, being more than one, you know. If we love someone, now you are too, and you're, and you're there with one another, and that's gonna help you survive and make your way forward in life. Love is adaptive, right? Fear can be very adaptive, that now you're in a fight or flight stage 'cause you're trying to survive and get through life. Shame is the same way. There are things that people do that bring shame that change behavior. Shame changes behavior a lot 'cause it

28. 1:11:37 – 1:13:33

    Shame Keeps Us Alive

    1. PCDr. Paul Conti1:11:37

       feels so bad. So, you know, I give the example of I imagine that, you know, in the old days, you know, someone who, um, you know, pees on the food in the cave instead of going outside, (laughs) you know, and, like, now puts the whole tribe at risk, or people... And then, and then, like, there's a sense of shame that comes to that person, like, "You can't do that anymore." And the person who feels bad and never does that again, and it's adaptive for the group, right? It's just one example of how shame can alter behavior so-

    2. SBSteven Bartlett1:12:01

       To keep us alive in that context.

    3. PCDr. Paul Conti1:12:03

       Right, to keep us alive. Like, now you feel shame, you will not forget to not do that anymore, right? (laughs) Like, it's gonna have an impression on you. It's gonna change you because you feel so much shame, which we would think should be the case in the modern world too, right? We, there, there are things people do that are shameful that are worth feeling shame about. I mean, sometimes the problem is we don't have enough shame where we should.

    4. SBSteven Bartlett1:12:23

       But we have a lot of new modern problems, don't we, with... I was thinking about bullying-

    5. PCDr. Paul Conti1:12:28

       Right.

    6. SBSteven Bartlett1:12:28

       ... for example. Like, I, I, I imagine back in the days of our tribes, there wasn't internet, like, obviously not, but there wasn't, like-

    7. PCDr. Paul Conti1:12:37

       Yeah.

    8. SBSteven Bartlett1:12:37

       ... mass internet bullying where a, a huge group of strangers could just pepper you with insults. And maybe our, our modern brain still has the same old mechanisms of, uh, kind of perceiving that as, "Our tribe are gonna kick us off the island here."

    9. PCDr. Paul Conti1:12:50

       Right.

    10. SBSteven Bartlett1:12:51

        So the brain malfunctions and it experiences shame, which causes all the things you've described.

    11. PCDr. Paul Conti1:12:55

        Yeah.

    12. SBSteven Bartlett1:12:55

        And then even in the context of, like, sexual assault, I was trying to rationalize that, how the shame of sexual assault can make you feel shame when really it was someone else's-

    13. PCDr. Paul Conti1:13:05

        Right.

    14. SBSteven Bartlett1:13:05

        ... behavior. But how does that make that, you know, that woman feel or that guy feel shame about themselves when they were attacked?

    15. PCDr. Paul Conti1:13:13

        Right. Right, because it doesn't start with the thought of it. Because you're right, because what you're saying, I think, is basically it makes no logical sense. Why would you feel ashamed of yourself if someone else came up behind you and jumped you and did something awful to you? Why would you feel ashamed of yourself, right? But, but the person doesn't get there by thought.I, I didn't get to feeling ashamed of myself

29. 1:13:33 – 1:17:44

    You Can Build a Different Story Around Your Shame

    1. PCDr. Paul Conti1:13:33

       after losing my brother by suicide by thinking, "That is a shameful thing. I should feel ashame." No. Though the shame is aroused in us, it's created in us because it's behavior-modifying. You know, there's, the, there's the a- adaptive, something bad has happened, feel something inside that creates aversion. The shame is created in us and then we make the meaning of it. "I feel ashamed. There's shame inside me." And then we make the meaning of, right, because, "I shouldn't have been there when that happened," and then, then we make a story around it. It starts with the limbic system, with the affect, and then we build a story around it, which is why we can build a different story where, for example, shame goes where it makes sense to go. Like, that's very, very effective of processing through. So, okay, so this thing happened, you can process through with someone how they felt and, you know, what was going on inside of them. Maybe they're in an ambulance or a hospital and they're filled with shame as they realize what has happened to them and, you know, and then that was a terrible state to be in. But then they start put it... They start making, trying to make meaning of that state and we can go back to, oh, that's a, that is a natural, completely understanding human state to be in after this happened, but now you get to decide what that means.

    2. SBSteven Bartlett1:14:46

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

    3. PCDr. Paul Conti1:15:26

       So-

    4. SBSteven Bartlett1:15:27

       I'm trying to think of it through that.

    5. PCDr. Paul Conti1:15:28

       Maybe. It's, it's a little diff- if you were out... Okay, let's say you're out and you're actually, like you're hunting a lion in the service of everyone else, and then you are attacked and hurt, that, it's, that's different because you're doing something then to, to feel proud of.

    6. SBSteven Bartlett1:15:42

       Yeah.

    7. PCDr. Paul Conti1:15:42

       Right? So, so that is, is different. We're, we're... Th- that's a situation where the person is approaching the trauma on the front foot and then when the, you return back, the thought would be, you would be respected and cared for. Like, you know, you went out to do something for everyone and got hurt. Right? That is very different than how people normally would, would ex- experience their, their trauma, which is when there, there isn't a sense of, of pride and self-sacrifice behind it. So, so if the person, let's say you're walking out in the Serengeti at night and you shouldn't be, then you should feel bad about that, right? Then, then the thought would be, "Yeah, I shouldn't have been doing that." And how bad you feel about it will make you not do it again, so you're le- not gonna get killed, right? And then you're gonna come back and talk about that or people are gonna go, "What were you doing?" And, "Well, you shouldn't have been out there." And, like, they made you feel bad that you got hurt, but, like, there's, there's then an experience that is a deterrent to others doing that too. Right? So...

    8. SBSteven Bartlett1:16:34

       This says something really interesting about how we treat people who've been through a trauma.

    9. PCDr. Paul Conti1:16:38

       Right. The di- look at the difference in the United States between veterans coming back from World War II and veterans coming back from Vietnam. There was far more post-trauma syndromes, p- and post-traumatic stress disorder after Vietnam because people were not coming home to a hero's welcome. The thought, the thought there would be they had gone out. Like, the person who goes out into the Serengeti to hunt the lion to s- to save everybody else is, that's what was going on when people went to fight in World War II and when, when peop- when people went to fight in Vietnam. But when people came back from World War II and if they'd been hurt, they were treated as heroes. They were treated with respect and, and that allows a person to shoulder that trauma without the brain changes happening. When people came back from Vietnam and were, were treated differently, which didn't happen to everyone, but it happened as a societal phenomenon that was, that was a terrible thing for the veterans who came back, you saw much greater rates of post-traumatic stress. I mean, that's, that, I think, captures very clearly what the impressions and perspectives of the people around us mean. There may be a reflexive

30. 1:17:44 – 1:19:22

    How You Are Treated Determines Whether a Situation Becomes Traumatic or Not

    1. PCDr. Paul Conti1:17:44

       guilt and shame from trauma, but that doesn't have to win the day. Right? But it was much more likely to win the day if there's a sense of otherness, 'cause now we're, we're, you know, we're, we're talking about the same thing of, you know, feeling less than chronically by society for some reason makes that person more susceptible. So that person who's been through combat trauma and then comes back and does not receive a hero's welcome b- is put at much, much greater risk for the brain changes of post-trauma syndromes.

Episode duration: 1:47:11