How to Heal From Post-Traumatic Stress Disorder (PTSD) | Dr. Victor Carrión

In this episode, my guest is Dr. Victor Carrión, M.D., the Vice-Chair of Psychiatry and Behavioral Sciences at Stanford School of Medicine and a world expert on the understanding and treatment of post-traumatic stress disorder (PTSD) in children, adolescents, and adults. We explain why, as children, we are particularly vulnerable to PTSD and how stress and trauma affect the developing brain. We also discuss how PTSD is related to attention-deficient hyperactivity disorder (ADHD) and vice versa. Dr. Carrión shares effective therapeutic interventions for PTSD, including cue-centered therapy (CCT) and how to create a custom “toolbox” to help you identify triggers and manage stress. We discuss an emerging curriculum that combines yoga and mindfulness to help people with PTSD improve their stress resilience, mood, and sleep. The episode will provide listeners of all ages with a clear understanding of PTSD and effective strategies to heal from it. Access the full show notes for this episode: https://go.hubermanlab.com/aTALcMs Use Ask Huberman Lab, our chat-based tool, for summaries, clips, and insights from this episode: https://go.hubermanlab.com/y2fb9n Pre-order Andrew's book, Protocols: https://go.hubermanlab.com/protocols *Thank you to our sponsors* AG1: https://drinkag1.com/huberman Eight Sleep: https://eightsleep.com/huberman BetterHelp: https://betterhelp.com/huberman Waking Up: https://wakingup.com/huberman Function: https://functionhealth.com/huberman *Dr. Victor Carrión* Stanford academic profile: https://stan.md/3zELetj Stanford Health Care profile: https://shc.is/4e9xZzZ Early Life Stress and Resilience Program: https://stan.md/4gCLNo7 Books: https://amzn.to/4gxYosS LinkedIn: https://www.linkedin.com/in/victor-carrion-3291b813 *Timestamps* 00:00:00 Dr. Victor Carrión 00:01:56 Sponsors: Eight Sleep, BetterHelp & Waking Up 00:06:19 Stress, Post-Traumatic Stress Disorder (PTSD), Avoidance 00:11:41 Stressors, Perseverate; Children & PTSD 00:16:13 Transgenerational Trauma 00:19:20 Post-Traumatic Stress Injury (PTSI); Children, Dissociation & Cortisol 00:27:17 Cortisol & Brain, Post-Traumatic Stress Symptoms 00:31:48 Sponsor: AG1 00:33:19 PTSD, Attention Deficit Hyperactivity Disorder (ADHD) 00:40:17 PTSD & ADHD; Identifying Cues, Triggers & Interventions 00:47:49 PTSI, Autonomic Nervous System Seesaw; Sleep 00:53:11 PTSD, Brain Development & Kids; Cue-Centered Therapy 01:02:37 Sponsor: Function 01:04:25 Limbic Pathway, Inner Dialogue, Therapy Toolbox 01:12:34 Agency & Control, Deliberate Cold Exposure, Narrative 01:18:11 Custom Toolbox Development; Energy 01:26:32 Tool: 4-Corner Square Response, Understanding Cues 01:32:59 Tool: “Creating Space,” Feelings Thermometer, Analyzing 4-Corners 01:38:47 Social Media, Boundaries 01:46:07 School, Yoga & Mindfulness Curriculum 01:55:31 Implementing School Mindfulness Programs, Sleep 02:00:52 Barriers to School Programs 02:06:08 Redefining Success, Identity 02:10:33 Resilience & Adaptation; Organoids, Epigenetic Treatment Response 02:21:42 Listening to Kids & Adults 02:24:19 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter #HubermanLab #Science #PTSD Disclaimer & Disclosures: https://www.hubermanlab.com/disclaimer

Andrew HubermanhostVictor Carriónguest

Sep 22, 20242h 26mWatch on YouTube ↗

WHAT IT’S REALLY ABOUT

Healing PTSD In Kids: Cue-Based Tools To Rewire Stress Responses

Andrew Huberman interviews child psychiatrist and PTSD expert Dr. Victor Carrión about the science and treatment of post‑traumatic stress, especially in children and adolescents.
Carrión explains stress as a spectrum—from beneficial challenge to toxic, traumatic stress—and describes how chronic or traumatic stress can dysregulate cortisol, alter brain development, and be misdiagnosed as other disorders such as ADHD.
He details “cue‑centered therapy,” which teaches children to identify triggers (cues), build a personalized coping toolbox, and use structured cognitive frameworks to create alternative responses and narratives.
The conversation also covers resilience, intergenerational trauma, school‑based yoga and mindfulness that improved children’s sleep and reduced amygdala activity, and cutting‑edge organoid research aimed at uncovering the biology of resilience.

IDEAS WORTH REMEMBERING

5 ideas

Stress is a spectrum and some stress is essential for development.

Carrión frames stress as an inverted U‑shaped curve: modest stress improves performance, learning, coping skills, and problem‑solving, while too little stress leads to disengagement and too much leads to allostatic load (physiological cost to the body). Overprotecting children from any stress deprives them of the experiences that build coping mechanisms and resilience. The goal is not to eliminate stress but to return to the optimal mid‑zone on the curve.

PTSD in children is often cumulative and easily missed or misdiagnosed.

PTSD symptoms in kids commonly arise from an accumulation of stressors (violence, poverty, instability) rather than a single event. Many children have functionally impairing post‑traumatic stress symptoms (PTSS) without meeting full diagnostic criteria, and they can be mislabeled as having ADHD: hypervigilance looks like hyperactivity and dissociation looks like inattention. First‑line treatment for PTSD is psychosocial, not stimulant medication.

Avoidance fuels PTSD, but unstructured rumination is also harmful.

Carrión’s team uses the phrase “PTSD feeds on avoidance”: denying events, avoiding treatment, or pretending symptoms will disappear allows the condition to worsen and invites complications like substance use or self‑harm. At the same time, being alone with repetitive, unstructured ‘traumatic play’ or rumination typically does not resolve trauma and often focuses on the wrong element (e.g., a lifetime of adversity rather than one earthquake), so structured, supportive processing is crucial.

Evening cortisol dysregulation in traumatized kids disrupts sleep and development.

Children with PTSD symptoms retain a normal circadian cortisol rhythm overall, but their pre‑bedtime cortisol remains abnormally high. This correlates with nighttime symptoms such as nightmares, bedwetting, shallow sleep, and fear. Research inspired by Sapolsky and McEwen shows chronic glucocorticoid exposure can be neurotoxic to hippocampus and prefrontal cortex, areas rich in glucocorticoid receptors and central to memory, context‑processing, and emotional regulation.

Cue‑centered therapy teaches children to map triggers and build a personalized coping toolbox.

Cue‑centered therapy targets neutral sensory cues (colors, weather, sounds, timbres of voices) that became linked to trauma via classical conditioning. Children learn psychoeducation on stress, identify their own cues, and then build a ‘toolbox’ of coping tools they choose themselves (e.g., breathing techniques, mindfulness, self‑talk, sports, music, even idiosyncratic tools like drinking orange juice). Empowering kids to decide which tools work strengthens self‑efficacy and treatment adherence.

WORDS WORTH SAVING

5 quotes

PTSD feeds on avoidance.

— Dr. Victor Carrión

Children are really not [inherently] resilient; they’re more vulnerable. They have the opportunity to become resilient if we help them.

— Dr. Victor Carrión

What if it’s not the presence of that adult, but there’s something in that child that makes them seek and maintain that type of relationship?

— Dr. Victor Carrión

The best psychiatrists that I know actually say very little. They listen.

— Dr. Victor Carrión

Stress operates in our lives as an inverted U‑shaped curve. We don’t want to get rid of stress; we just want to return to that optimal point.

— Dr. Victor Carrión

Spectrum of stress: beneficial, chronic, and traumatic stressPTSD vs. anxiety, stress, and ADHD in childrenCue‑centered therapy and the personalized coping toolboxNeurobiology of PTSD: cortisol, HPA axis, hippocampus, prefrontal cortex, amygdalaTransgenerational and learned trauma (nature–nurture, modeling)School‑based yoga/mindfulness and sleep improvementResilience, adaptation, and organoid research on stress biology

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