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Therapy, Treating Trauma & Other Life Challenges | Dr. Paul Conti

My guest this episode is Dr. Paul Conti, M.D., a psychiatrist and expert in treating trauma, personality disorders and psychiatric illnesses and challenges of various kinds. Dr. Conti earned his MD at Stanford and completed his residency at Harvard Medical School. He now runs the Pacific Premiere Group—a clinical practice helping people heal and grow from trauma and other life challenges. We discuss trauma: what it is, its far-reaching effects on the mind and body and the best treatment approaches. We also explore how to choose a therapist and how to get the most out of therapy, as well as how to do self-directed therapy. We examine the positive and negative effects of antidepressants, ADHD medications, alcohol, cannabis and the therapeutic potential of psychedelics (e.g., psilocybin and LSD), ketamine and MDMA. This episode is a must-listen for anyone seeking or already doing therapy, processing trauma and/or considering psychoactive medication. Both patients and practitioners ought to benefit from the information. For an up-to-date list of our current sponsors, please visit our website: https://www.hubermanlab.com/sponsors. Previous sponsors mentioned in this podcast episode may no longer be affiliated with us. Social & Website Instagram - https://www.instagram.com/hubermanlab Twitter - https://twitter.com/hubermanlab Facebook - https://www.facebook.com/hubermanlab TikTok - https://www.tiktok.com/@hubermanlab Website - https://hubermanlab.com Newsletter - https://hubermanlab.com/neural-network Subscribe to the Huberman Lab Podcast Apple Podcasts: https://apple.co/3thCToZ Spotify: https://spoti.fi/3PYzuFs Google Podcasts: https://bit.ly/3amI809 Other platforms: https://hubermanlab.com/follow Dr. Paul Conti Links Website: https://www.drpaulconti.com Pacific Premier Group, PC: https://www.pacificpremiergroup.com Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It: https://amzlink.to/az01KBLaUX3m6 Timestamps 00:00:00 Dr. Paul Conti, Trauma & Recovery 00:02:30 ROKA, InsideTracker, Blinkist 00:07:00 Defining Trauma 00:14:05 Guilt & Shame, Origins of Negative Emotions 00:21:38 Repeating Trauma, the Repetition Compulsion 00:28:23 How to Deal with Trauma & Negative Emotions/Arousal 00:37:17 Processing Trauma, Do You Always Need a Therapist? 00:45:30 Internal Self-talk, Punishing Narratives & Negative Fantasies 00:51:10 Short-Term Coping Mechanisms vs. Long-Term Change 00:53:22 Tools: Processing Trauma on Your Own, Journaling 00:57:00 Sublimination of Traumatic Experiences 01:02:34 Tool: Finding a Good Therapist 01:07:20 Optimizing the Therapy Process, Frequency, Intensity 01:14:51 Tool: Self-Awareness of Therapy Needs, Mismatch of Needs 01:16:35 Self-talk & Journaling, Talking to Trusted Individuals 01:19:00 Prescription Drugs & Treating Trauma, Antidepressants, Treating Core Issues 01:28:35 Short-term vs. Long-Term Use of Prescription Drugs, Antidepressants 01:32:18 Attention Deficient Hyperactivity Disorder (ADHD) & Prescription Drugs 01:37:31 Negative Effects of ADHD Prescription Drugs 01:40:37 Alcohol, Cannabis – Positive & Negative Effects 01:44:53 Psychedelics: Psylocibin & LSD, Therapeutic Uses, Trauma Recovery 01:54:32 Sentience, Language, Animals 01:55:48 Psychedelic Hallucinations, Trauma Recovery 02:00:01 MDMA (Therapeutic Uses) 02:04:47 Clinical Aspects of MDMA 02:07:28 Language, Processing Trauma, Social Media, Societal Divisions 02:15:09 Defining “Taking Care of Oneself” 02:21:13 Dr. Conti, Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter The Huberman Lab Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

Andrew HubermanhostDr. Paul Contiguest
Jun 5, 20222h 24mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

Rewiring Trauma: Therapy, Self-Care, and Psychedelics for Healing

  1. Andrew Huberman and psychiatrist Dr. Paul Conti unpack what trauma actually is, emphasizing that it’s not just any negative event but an experience that overwhelms coping systems and produces lasting brain and behavior changes.
  2. They explore how guilt, shame, and avoidance often hide trauma from conscious view and drive destructive patterns like repetition compulsion, addictions, and self-sabotaging relationships.
  3. The conversation covers how to work with trauma through talk therapy, journaling, self-inquiry, careful use of medications, and emerging psychedelic-assisted therapies such as psilocybin and MDMA.
  4. They also delve into how to choose and use therapy effectively, the dangers of over-medication and casual stimulant use, and why basic self-care is a non-negotiable foundation for psychological health.

IDEAS WORTH REMEMBERING

5 ideas

Trauma is defined by lasting brain and behavior change, not by how ‘dramatic’ an event looks from the outside.

Conti distinguishes ordinary disappointments from trauma that overwhelms coping capacity and leaves the brain functioning differently over time. Signs include persistent hypervigilance, intrusive re-experiencing, altered mood and anxiety, sleep disruption, physical health changes, and rigid negative beliefs about self and the world. Trauma can be acute, chronic (e.g., ongoing denigration), or vicarious (e.g., repeated exposure to disturbing news).

Guilt and shame are evolutionarily ‘adaptive’ emotions that become deeply maladaptive after trauma.

Shame is a powerful, automatically aroused affect that historically helped regulate social behavior in small groups; guilt arises when that shame is attached to the self. After trauma, these systems overactivate, leading people to blame and punish themselves, hide their experiences, and block grief. This reflex makes them avoid precisely the material they need to face to heal.

Repetition compulsion makes people recreate traumatic dynamics in an unconscious attempt to ‘fix’ the past.

The limbic system “doesn’t care about the clock or calendar,” so it tries to resolve old injuries by repeating similar situations now, hoping for a different outcome. That’s why people often have “the same relationship seven times” or re-enter abusive or self-denigrating contexts. Healing requires surfacing the original trauma, challenging misplaced guilt and shame, and breaking the automatic pattern, not simply changing partners, jobs, or locations.

Effective therapy hinges far more on rapport than on any specific modality.

Research and Conti’s experience show that a strong therapeutic alliance—trust, eye contact, feeling genuinely attended to—matters more than whether the therapy is CBT, psychodynamic, or DBT. Good therapists flexibly draw from multiple approaches rather than forcing patients into a rigid method. Patients should “interview” therapists, expect discomfort (not constant pleasantness), and be willing to change clinicians or increase intensity if they are not improving.

You can start meaningful trauma work without a therapist using structured self-inquiry and writing.

Productive self-work requires an ‘observing ego’—curiosity about one’s own thoughts and patterns rather than mindlessly looping the same narrative. Writing about intrusive thoughts (e.g., “I’m a loser”) and then rereading them creates distance and often reveals their origin in specific traumatic experiences. Talking with a trusted person (friend, family, clergy) can add further perspective, but people with suicidal ideation or severe distress should seek professional help rather than attempting intensive solo work.

WORDS WORTH SAVING

5 quotes

Trauma is not anything negative that happens to us, but something that overwhelms our coping skills and then leaves us different as we move forward.

Paul Conti

When logic and emotion come head-to-head, emotion wins all the time. If emotion is powerful enough, it will always win.

Paul Conti

We so often try and change the trauma of the past in order to control the future, and what that really adds up to is the trauma of the past dominates our present.

Paul Conti

Good therapists are not pigeonholed by a certain modality. They may favor one lens, but practically they shift to what the person needs.

Paul Conti

These short-term coping mechanisms may help us feel better, but they don’t help us make anything better.

Paul Conti

Clinical definition and mechanisms of traumaGuilt, shame, repetition compulsion, and self-sabotaging patternsHow to use therapy effectively and how to choose a therapistSelf-therapy tools: journaling, dialogue, observation of self-talkRole and misuse of psychiatric medications (antidepressants, stimulants, antipsychotics)Therapeutic and neurobiological perspectives on psychedelics and MDMAFoundations of self-care and the impact of cultural/media environment on mental health

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