How To Fix Your Negative Inner Thoughts - Dr Paul Conti

Dr. Paul Conti is a Stanford and Harvard trained psychiatrist and author specialising in unconscious trauma. If our mind was an iceberg, our conscious thoughts are the tip, and the huge mass below the surface are our unconscious thoughts. Dr Conti's research works on bringing the forgotten, traumatic, painful and unseen into the light so you can heal and improve. Expect to learn what people mean when they refer to the unconscious mind, what Paul wished people knew more about how trauma works, whether ancestral trauma is something that can actually be passed down through genetics, what happens to your brain and body after experiencing trauma, what we can learn from the little voices in our head and much more... - 00:00 What Actually is the Unconscious Mind? 09:27 How to Bring the Unconscious Into Consciousness 11:06 What Everyone Needs to Know About Trauma 14:43 The Function of Shame & Guilt 21:40 Different Categories of Trauma 28:43 Doctors Need to Take Depression Seriously 33:25 Can Emergency Workers Experience Vicarious Trauma? 37:45 How Trauma Impacts the Brain & Body 42:24 Correcting Our Inner Voices 54:51 Is Ancestral Trauma Real? 1:00:38 How to Increase Mental Resilience 1:03:59 Practical Tips to Eradicate Unconscious Trauma 1:14:23 Where to Find Dr Conti - Get access to every episode 10 hours before YouTube by subscribing for free on Spotify - https://spoti.fi/2LSimPn or Apple Podcasts - https://apple.co/2MNqIgw Get my free Reading List of 100 life-changing books here - https://chriswillx.com/books/ Try my productivity energy drink Neutonic here - https://neutonic.com/modernwisdom - Get in touch in the comments below or head to... Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx Email: https://chriswillx.com/contact/

Chris WilliamsonhostDr. Paul Contiguest

Jan 25, 20241h 15mWatch on YouTube ↗

EVERY SPOKEN WORD

150 min read · 30,043 words

0:00 – 9:27
What Actually is the Unconscious Mind?
1. CWChris Williamson
  What are people talking about when they refer to the unconscious mind?
2. PCDr. Paul Conti
  A lot of times, people are talking about a- a mystery that they kind of know is within them because it gets talked about, but they're not sure how much of an influence does that have over me. Like, is that me, but I'm not aware? Do I know who I am consciously, but then there's other things in the background? And- and I think often, it can be confusing and even scary if we don't understand, what does that mean? How does it have control over us if we think, like, us is the conscious part of us, and how can we have control over it?
3. CWChris Williamson
  Yeah. It's strange to think, what does it mean that there's a part of me I'm basically entirely unaware of that somehow influences me in ways that I can become aware of?
4. PCDr. Paul Conti
  Right. Right. Right. And that's why the sort of height of- of understanding ourselves through the- the- the lens of understanding all aspects of the mind, including the unconscious mind, includes an awareness of some of what's going on there, but also an awareness that we're not aware of it all.
5. CWChris Williamson
  (laughs) Yeah. It's a little bit of a paradox. Why- why is it so important? Is there an analogy? Is it- is it like the surface web and the dark web? Is it 99% of ourselves are unconscious and only 1% of us is conscious?
6. PCDr. Paul Conti
  Well, far more of us is unconscious than conscious. Far, far more of us. The- the iceberg model where the- our conscious mind is a little part of the iceberg that's above the water, but the vast majority of it is underwater. We need that in order to be able to move through time. You know, just like, say, a car engine might be, you know, rotating several thousand, uh, revolutions per minute, right? We're not aware of all those revolutions, but that needs to happen for us to seamlessly be able to maneuver the car forward. Right? So in a far more complicated way, that's going on inside of us, where there are thousands upon thousands upon thousands of c- of calculations that are going on so that we can sum things and come up to the consciousness where we can then make conscious decisions. So- so even the idea of, say, walking down the street and seeing someone walking towards you, right? There's so much that then goes on. What does that person look like? Does that person... Is the person looking at you or are they looking down? If they're looking at you, do they look happy? Do they look not happy? Do you recognize them? Do you not recognize them? Are there markers of threat? Are there not markers of threat? You're- you know, we're doing all sorts of things. And let's say, that person looks like someone who had been aggressive before, but is not that person. Then we're triggered to, like, have this- an extra sense of anxiety and tension that all that happens automatically. Then we have to say, "Okay, but it's- but it's not a person who's been aggressive before." But it all goes on in us in a way of kind of bringing us up to speed with that moment so that we can make whatever conscious decision we're making. So the conscious decision could be walk to the other side of the street or say hello or look down. You say, "Oh, you're just doing one thing." You're only- you're doing one thing because it's riding atop thousands upon thousands of things that let you, i- in the conscious world, so to speak, do the one thing that there- that choice that there is to make.
7. CWChris Williamson
  There's obviously lots of other unconscious things that go on. The, uh, impetus to breathe in and breathe out.
8. PCDr. Paul Conti
  Right.
9. CWChris Williamson
  The impetus for our body to digest the food...
10. PCDr. Paul Conti
  Correct.
11. CWChris Williamson
  ... and for our heart to pump and all the rest of the things.
12. PCDr. Paul Conti
  Yes.
13. CWChris Williamson
  But presumably, there are certain things that are more salient to our day-to-day experience, especially, uh, phenomenologically, what it feels like to be-
14. PCDr. Paul Conti
  Right.
15. CWChris Williamson
  ... a person in the world with thoughts. There are areas, right? I don't often think about my digestion unless I've got something wrong.
16. PCDr. Paul Conti
  Yeah.
17. CWChris Williamson
  But I do think about that person or that situation that's kind of similar to one that's from before and made me feel a little bit like I might not be liked by people, and what does that mean for me now? And it is, yeah, there's like a triage. There's a- a priority-
18. PCDr. Paul Conti
  Right.
19. CWChris Williamson
  ... list of things that are, uh, salient to you.
20. PCDr. Paul Conti
  Right. The- the key word there is salience, right? Because i- in fact, we could put two S's here. It's safety and salience. So- so our- our brains want to keep us alive, right? So- so we- we wanna be safe. And- and what is salient will be determined by that. Like, if we're safe, we can think about other things. We can read a book. We can relax. We can d- we can have a podcast. We- we can do whatever we choose to do when we're safe. But safety has to come first. So as you said, you're not spending a lot of time thinking about your GI system. But it- let's say, you know, we hope there isn't, but let's say there's some problem. E- now, it's gonna tell you that, right? You're gonna have pain, and the pain is gonna make your GI system salient. Then you think about it. But if there's not a- a risk that's coming from it, it- it stays in the background. So- so first and foremost, our brains want to keep us safe, which is why the- the triggering of negative events, of trauma becomes so salient. So th- the example I- I often give is imagine in- we're hunter-gatherers, and- and if we're hungry and we- we go out and we find a new berry to eat, right? If that's- tastes good and it's nourishing, it's really good to remember that. Let's say it makes us very, very sick. Then we better remember that, right? We have to remember that. So there- there's more salience to negative things, things that are charged with negative emotion because those are more commonly about safety, which is why if you see someone who looks like someone you've had conflict before, it triggers all sorts of reactions in us. Same thing if a person who's been in a car accident then gets in a car, right? I talked to someone this morning who had a- a very difficult event happen 24 years ago and- and was saying that when he's in that similar situation, which in the course of his work he is on a daily basis, he feels as if it was a moment ago, because it was very, very distressing. It's immediate to this person even after 20-something years because it was about...... safety at the time, and the brain w- does not wanna let that go. It wants reassurances that we're safe before it lets those things go. That's why trauma and traumatic stimuli are so salient in us, and so dominant in the unconscious mind because first and foremost, it wants to keep us moving from this moment to the next moment, which means we gotta make it to the next moment (laughs) , so we have to stay safe.
21. CWChris Williamson
  I was in a head-on collision when I was 20 years old, 20 or 21 years old, at 60 miles an hour with a snowplow-
22. PCDr. Paul Conti
  Oh, good-
23. CWChris Williamson
  ... on the main British motorway in the UK. And for the next probably six weeks or so after that, maybe, maybe even more, maybe, like, two months to three months or so, uh, every time that I was close to contraflow traffic, so traffic coming in the other direction on the side of the road-
24. PCDr. Paul Conti
  Right.
25. CWChris Williamson
  ... near the side of the road that I was, where there wasn't a barrier between us, I felt anxious. And it's like s- I guess it's like stubbing your toe. You don't realize how often things touch your toe until there is a hypersensitivity-
26. PCDr. Paul Conti
  Right.
27. CWChris Williamson
  ... around it. I didn't realize how often I was, you know, five feet away from another vehicle coming basically-
28. PCDr. Paul Conti
  Right.
29. CWChris Williamson
  ... head-on toward me, until I'd been hit by a snowplow at 60 miles an hour.
30. PCDr. Paul Conti
  Right. Right, then your brain, of all the things that could be a risk to you, your brain says, "That is a risk to me. Oncoming traffic is a risk to me." And then it becomes very, very sensitized to it. And if you're having intrusive thoughts and a high level of vigilance, you know, that's when it can become problematic. You said for some period of time, right, a, a few months, then it, it sort of settles back down in you. But, but the, that makes sense, right? And it may be that you change behaviors or you don't change behaviors. Y- you know, it's, "I don't wanna be on, you know, roads with fast-traveling traffic." You know, you might change behaviors due to that, but your brain is bringing it to the forefront because in some ways, it's saying, "Is this okay? Is this, does this really make sense to do?" Now, even if you decide it does make sense to do, even though something bad has happened, your brain is gonna persist in ways because the, the trauma has such a deep emotional resonance. Our, our memories don't have meaning in and of themselves. They're brought to life by the emotion that's attached to them. So, if we had asked you a week before, um, person going one way in traffic and a vehicle coming the other way hits them, you'll be like, "Okay, that doesn't sound great," but it, but it's not gonna raise a lot of emotion in you. Let's say we asked you one week later. It will raise a huge amount of emotion because now your brain says, "Of all those risks, to me, that is one that is salient." And then it'll wanna sort out, should you change behaviors, but sometimes even after that goes away, th- that question and you've made an answer to it, it can linger on in the brain and, and, and beh- hang on the person and the situation and the specifics for years and years and years or the rest of a person's life, which if you think from the perspective of safety and salience, we can understand why. But, but also, that's not the way we wanna be living life. If we understand safety, salience, the unconscious mind, how our minds work, then we can change that and say, "I don't want that thing to carry along with me just because something bad happened. I, I understand what happened. I'm m- I'm making decisions about it. I don't need my brain to continue to shove that to the forefront."
9:27 – 11:06
How to Bring the Unconscious Into Consciousness
1. CWChris Williamson
  the important thing here is bringing the unconscious into the conscious.
2. PCDr. Paul Conti
  Mm-hmm.
3. CWChris Williamson
  How do you, how do you do that? What does that mean?
4. PCDr. Paul Conti
  Well, oftentimes, there, there are other ways we can come at it too. You know, sometimes there are specific tactics around decreasing symptomatology. So, there are other ways of coming at symptoms we may have on the mental health front, right, including symptoms after trauma. But a big part of what we're doing is what you're saying, is to be aware of what is in the unconscious mind and to be able to bring it to consciousness. So, a lot of times if the brain is saying, "You are not safe if you're in a car going at onco- uh, coming at oncoming traffic. You are not safe. You are not safe. You are not safe." It's gonna say that over and over, unless you can validate, "Hey, let's bring that to consciousness and say I understand why I feel that way. I understand why that is, that is in me, and I am aware of it." And then that enables a set of processes. Some of them can occur through therapy, some don't have to, though, where you get your mind around it, so to speak, and then your brain doesn't have to continue to push it to the forefront. I mean, that, that's what trauma therapy is doing in, in some sense, but it doesn't often require therapy. Sometimes it does. But bringing the unconscious to conscious, to the conscious mind, lets us have much greater control over it, including often validating, "Hey, I know why that's in me. Like, thank you in a sense, brain, but I don't need it at the forefront." And it's remarkable how much, like, that works. I mean, it's, it's part of what trauma therapy is, and it can take symptoms and decrease them through insight.
5. CWChris Williamson
  What do you wish more people knew
11:06 – 14:43
What Everyone Needs to Know About Trauma
1. CWChris Williamson
  about trauma?
2. PCDr. Paul Conti
  I wish that more people knew that it comes so frequently to so many of us, and that it is insidious, and the meaning of that word, like, something that is sneaky and, like a, a wolf in sheep's clothing. Like, it doesn't announce itself that I'm now in your brain and changing you, including changing your memories. So, uh, and I don't know what happened to you a- after, and, and again, I'm sorry to learn about what happened, but an, an example would be on the other side of that, a person who's gone through what you've gone through could conclude, "I never feel safe in a car. I've, I've never felt safe in a car. I don't like driving. I don't feel..." Could conclude that without it being true.
3. CWChris Williamson
  Oh, so they've retroactively gone back and changed their-
4. PCDr. Paul Conti
  Right.
5. CWChris Williamson
  ... memory of situations prior to that trauma as a compensatory mechanism, as a story they tell themselves?
6. PCDr. Paul Conti
  Well, it's, it's a way because th- the brain is gonna paint with a broad brush if we're not bringing the trauma to conscious understanding, then it's saying it's a very simple conclusion, right? Being in car, coming at opposite traffic is not safe, right? And that's all the brain knows. Like, we got hurt doing that, so we can't do that anymore. So it'll bring that to you and the emotion is so strong that it can color the old memories, saying, "Well, you never wanted to be in a car anyway," right? "You never felt comfortable. In fact, you don't even wanna travel places." Like, it can s- bring these things to the surface. And it's remarkable how many people will say, "I never had faith or confidence in myself. I never thought I could do well at my job. I never thought I was smart enough. I never wanted to get out of my hometown. I never wanted to be in a relationship." People says, but when you talk to them, that's not true. I mean, I'm not saying it's always not true, but in many, many situations, it's not true. It's the brain trying to keep them safe, but that's where the brain will... Like, I'm exaggerating a little bit, like, have you hiding under the bed all day to keep you safe, right? When that's not what we want. We wanna be able to keep ourselves safe. So maybe if y- you were in the accident when the road conditions were poor, that's why a snowplow was out, you might say, "Look, I don't wanna be g- going against oncoming traffic if its speed is more than 30 kilometers per hour," whatever it may be in bad conditions. Like, maybe you learned that and you're like, "I, you know what? I'd take that away with me and I'm gonna change that." You might conclude that, right? Or you might conclude not that, but you're concluding something that tells your brain it doesn't have to be lost in that trauma. Now for you, it sounds like it went down after some period of time. But for some people, it doesn't until it's processed. Like again, person I saw earlier today, 20-something years ago, it is still with the person as if it were yesterday. And I see this many days, not just that I happened to see that today. It's like, I see that a lot, which is why I had a conversation about it just this morning.
7. CWChris Williamson
  So insidious, more frequent than people think, more persistent than people think.
8. PCDr. Paul Conti
  And changeable. And chain-
9. CWChris Williamson
  And, uh, not, uh, uh, locked, set in stone for the rest of your life.
10. PCDr. Paul Conti
  Right. It's not hardwired in us. Uh, it, we don't have to be afraid of it because trauma triggers a reflex of guilt and shame. So if we are traumatized, there is some reflex. And, and I don't know if you had that after your trauma. People say, "Oh, I shouldn't have been where I was when someone attacked me or when there was an accident." Now sometimes we may have some, bear some responsibility, but that's different than a reflex of guilt and shame, which tells you, "Shove the trauma down below. Don't look at it. If you look at it, w- well, g- Lord knows what you will find.
14:43 – 21:40
The Function of Shame & Guilt
1. PCDr. Paul Conti
  If you look at it-"
2. CWChris Williamson
  Wh- What, what's the function of the shame and the guilt?
3. PCDr. Paul Conti
  So the, the function is probably around behavior modification. Again, it's all theoretical, right? But if you think about psychological history of humans and even anthropological psychology, like how humans developed, that we have what are called affects. And I don't wanna get too off into the weeds, but neurobiologically, there's a difference between affects, feelings and emotions. And affects are just aroused in us. Like, if you're just walking down the street and someone jumps in front of you and shoves you, you're gonna feel anger or fear or both before you know it. Think about that. You're gonna feel anger or fear or both. It'll be coursing ar- inside of you, and then you become aware. Why? Because affects are cre- they create change in us. If someone just jumps in front of you and shoves you or yells at you, you better be ready to fight, to flee, right? You boot up all these systems, and then you're aware. So these very deep affects in us, very primary, fear, love, joy, shame, uh, they, they, they, anger, they ca- they're created in us in order to protect us. So shame is very, very powerful for altering behavior. So imagine if you're in small groups of people and, you know, you've got the food inside the cave and you close the cave door. And then somebody wakes up in the middle of the night and eats a bunch of the food. The rest of the people may make that person feel ashamed, right? Or they, you know, they're, they're keeping... Th- they're doing something that makes the supply at risk, you know, where the people are, are relieving themselves as tuna the food. Like, it w- then... Shame is a mechanism of change. "Don't do that any, don't do that again." It puts you at risk. It puts others at risk. So it has a very strong impact upon us, but it gets harnessed in ways that are not about survival. Like, we're not living in a hunter-gatherer society where if you and I go foraging for berries and we almost die, we better never forget it, right? Like, it's different from that. We live longer lives, right, that are much more diverse and can be impacted by shame in ways that can have a person who was attacked by someone else decades ago with no fault of their own still feeling guilty that they were attacked, ashamed that they were attacked, and deeply altering their behaviors because of that. That survival mechanism's hijacked in a way that shuts down people's lives. And trauma does not have to have this kind of control over us, but in doing what I do for a living, I've seen, whoa, the greatest external control mechanism upon us i- is the one we don't see that alters even our memory so we don't even recollect accurately.
4. CWChris Williamson
  Wow. That's so interesting and it, it's so crazy to think that scenarios we go through become interpreted by ourselves and woven into a story that we tell ourselves about who we've always been.
5. PCDr. Paul Conti
  Right.
6. CWChris Williamson
  Then the incident that was the genesis of that is not forgotten, but its being the genesis of it is forgotten.
7. PCDr. Paul Conti
  Right.
8. CWChris Williamson
  And it just becomes a part of us, and then people will begin to identify with that. "Oh, that's me."That's how I've always been.
9. PCDr. Paul Conti
  Yes.
10. CWChris Williamson
  I've always been an X or a Y or a Z person.
11. PCDr. Paul Conti
  Yeah.
12. CWChris Williamson
  And if you, we all know how much people try to defend their egos and their personalities, if you tried to say, "Oh, you know, w- w- why don't we go away on holiday?" It's like, "You know I don't like going away on holiday. I've never liked going away on holiday." No, you had a- a very turbulent flight when you were seven years old or 13 years old or 25 years old and this landing came in and you told yourself a story that you no longer want to go on. What I'm fascinated by, not only that, not only the fact that... instances, formative instances-
13. PCDr. Paul Conti
  Mm-hmm.
14. CWChris Williamson
  ... can change the story we tell ourselves about ourselves, and then make us forget the fact that that is what caused it to happen, but that shame and guilt are almost like the delivery mechanism for enforcing the change.
15. PCDr. Paul Conti
  Yeah.
16. CWChris Williamson
  And it doesn't need to come from other people. You know, you're right-
17. PCDr. Paul Conti
  Right.
18. CWChris Williamson
  ... that (clears throat) you do a thing and guilt is the, uh, internal version of the external eye that your tribe would have had on you saying-
19. PCDr. Paul Conti
  Right. Yes.
20. CWChris Williamson
  ... that "You p- probably shouldn't be doing, you shouldn't be eating those berries." "Oh, God, I hope no one catches me." But you're deploying this to yourself about yourself and maybe about something-
21. PCDr. Paul Conti
  Yeah.
22. CWChris Williamson
  ... that wasn't even your fault.
23. PCDr. Paul Conti
  Yes, it's something i- i- yes, it's all of that. So you're really getting it. It's all of that, and it's even worse, because that shame and guilt, all of the things you just said, are like sentries protecting us from insight, protecting us from help. They'd say, "It's not safe to go look at that. It's not safe to talk about that. You want to go talk about something you're ashamed about? Th- that's not gonna go well," right? It has us keep it all inside because guilt and shame keep us stuck inside of ourselves, which is a reason why people don't g- don't go and get help. They don't go and process 'cause guilt and shame tells us to keep it private and it tells us, well, people say all the time, "I'll start crying and never stop. I'll curl up into a fetal position and never get out." That is never what happens. Those are the lies of trauma-driven guilt and shame that keep us in places where we not only don't know who we are, but we forget who we are. How many times I've had a person tell me, "I've always been someone no one likes. No one was..." And I learned, like, that's not, that's not true at all. Th- the people, this person understood themselves to be different and- and interacted in the world differently until that trauma happened because the thing you said about the airplane flight could happen when someone is seven, happen when they're 57 too. And- and then we go back and we map the past, which English, interestingly, um, English modernism really, really captured this, so it, so it's not like this wasn't known before, but the English modernists like Ford Madox Ford, Virginia Woolf's writing, w- w- really, there were others too that started writing about how we retroactively change. I think it was Ford Madox Ford who wrote about if you're eating an apple, and it's a goodly apple, I think he wrote, and you get to the center of it and there's a worm, is it retroactively a bad apple? Right? And- and th- that was quite a revelation that was part of the English modernist movement that- that- that really realized, and I, I, in my opinion, I- I think Virginia Woolf captured it the most deeply of- of how time, uh, changes for us in- in the context of how we see things in retrospect, how we see ourselves, that the- the past is malleable. And- and it is our- our responsibility to ourselves that our past isn't malleable. If something changed in me after a trauma, I want to know how I was before, what that trauma was, how it impacted me, how it changed me, how I am different afterwards so that I can decide what that means and how I'm going to go about doing about it whatever it is I choose to do.
21:40 – 28:43
Different Categories of Trauma
1. CWChris Williamson
  Are there different categories of trauma? Do you, do you bucket them into broad types somehow?
2. PCDr. Paul Conti
  Well, on- on the one hand, this is what I emphasize here, that this is based in science. Right? Th- this is not, um, a- some soft concept of, oh, anybody who has trauma or anything bad, not chosen for the team or... No, the- the answer to your question can be answered through the lens of hard science, but in two ways. On the one hand, the answer is no. In that if my brain changes because of, let's say, vicariously experienced trauma through sitting with other people through their trauma or being present for something, and your brain changes because of some acute trauma that happened to you, our brains look the same afterwards. The patterns of neurotransmission change. We're both more vigilant. We will both tend to have different patterns. Like if you see a new face coming at you, instead of being, looking at it objectively, "I wonder who that is?" Or- or what- what that person's expression is or feelings, we look at it biased. "Is that person gonna harm me?" Right? We change and we change in the same way. So in one sense, no, because the brain changes are the same and- and physical data, like he- heart disease risk, for example, can be higher, and when trauma's really manifesting itself, aging can be greater. So- so think about this. Because of the impact of trauma, we can be older than we are. Where the calendar says that person is 42 years old, but if you go and you kind of think about telomeres and how the person is actually 46 by the, by the actual biology of it. So the hard brain biology and- and physical biology tells us that the- the final common pathway is the same. But we can get traumatized in different ways. The easiest way to see is acute. Right? You told me about a head-on collision. Like, whoa. I mean, anyone can understand, yeah, that will traumatize a person. You know, I've, as I've written about it and talked about in podcasts, I lost my youngest brother by suicide. Everyone can understand, like, that's a big trauma. We're less likely to understand chronic traumas. So chronically b- being, um, made to feel less than, so people who are chronically denigrated, whether it's, it's ethnicity, it's sexual, uh, uh, preference or identity, like, there are many, many things that- that we in society, socioeconomic status, lead people to feel chronically less than. So there's research showing when immigrant groups, when people immigrate to a country with very different traditions and they tend to live together, there's a lower, uh, incidence of schizophrenia.So people live apart, there's a higher incidence. This is fascinating, right? Because when people are living together, there's more of a sense of belonging. Right? We don't know this for sure, but the data points that way, and it fits with this idea, uh, uh, that we see, like we see it to be true, that chronic trauma is impactful. So someone who's in an, an abusive circumstance and nothing has risen to some drama where they went to the hospital or police came, but it's always, they're always denigrated, only that will make brain changes, just like acute trauma. So acute, chronic and vicarious trauma, where it was why I often am telling people, "My prescription for you is less news." Right?
3. CWChris Williamson
  (laughs)
4. PCDr. Paul Conti
  Use the news to inform yourself. Right? Use, use the news to learn. When I was young, there was a newspaper that came. You look through it, that was it. Now, people are often, they're looking at news so to speak, but what they're doing is experiencing vicariously other people's trauma. And we need to be very careful about that. It happens in the helping professions, it happens if someone's near someone who's been hurt, and it happens if we're constantly inundating ourselves because of our own anxiety with other people's suffering.
5. CWChris Williamson
  I read a study from the Boston Marathon bombing...
6. PCDr. Paul Conti
  Mm-hmm.
7. CWChris Williamson
  ... which was a few years ago, and they looked at people who had actually been at the marathon during the bombing and compared their levels of stress to people who had watched 90 minutes or more of news coverage about it. And the people who watched 90 minutes or more of news coverage on average showed higher levels of stress.
8. PCDr. Paul Conti
  Yes, yes. That does not surprise me that, that fits with all the other data, right? Which says if you're there, yeah, something very bad has happened and you're in proximity to it. But then we're talking about people who then weren't hurt in it, right? Or didn't have someone close to them who was hurt, then you realize that there is safety, right? Now that doesn't mean it's not gonna have an impact on the person to realize that happened and I was close to it, but should it surprise us that if ni- in 90 minutes of, "Oh my goodness, you know, that could have been me or someone I love," and you're just imagining that and feeling for the people, I guess, well, we are so fortunate as humans we have empathy. If we didn't, we wouldn't be here. Right? We're lucky in some ways we're here anyway with how close we come to destroying ourselves even with empathy. So empathy is wonderful. If someone is hurt and they're on, on the ground, that's why we lend them a h- helping hand metaphorically and, and truly. Empathy is great, but empathy can work against us. That's why we see people who have a full-blown trauma syndrome and it's all through vicarious trauma. And that is real because the brain science will show it to be just as real as someone who's had the trauma in a more acute and obvious way.
9. CWChris Williamson
  I'm going to guess that chronic and vicarious trauma are the ones that sneak up on people. You know, when we think about trauma, we think about a single formative, uh, fireworks event-
10. PCDr. Paul Conti
  Right.
11. CWChris Williamson
  ... that goes on. We, you know, if you were to say, "Well, you've been in a relationship where your partner has always put you down for a decade," you would say, "Well, are any of those instances by, you know, the layperson definition of trauma, are any of those instances traumatic?" "Yeah, well, no, like, it's just a joke. They're just saying-"
12. PCDr. Paul Conti
  Right.
13. CWChris Williamson
  "... like, oh, like, you know, oh, going out for a run. Good luck trying to get past one kilometer again this time."
14. PCDr. Paul Conti
  Right.
15. CWChris Williamson
  You know, but over time, there is a poi- (laughs) there is a point at which something which is not necessarily traumatic in isolation becomes traumatic-
16. PCDr. Paul Conti
  Right.
17. CWChris Williamson
  ... just due to, like, weight.
18. PCDr. Paul Conti
  Sure, sure. Right. The area under the curve. Right? The increasing weight of the, the chronic denigration. A- and you can see how in our medical systems, and, and I've been fortunate to spend about a year of my life, uh, in the UK and I'm, I'm, I, I love coming, uh, to, to England, but I think I understand the healthcare system enough that there, there are problems in the US healthcare system that are, that are in other systems too, r- whi- which is just being too concrete abou- about things, where it's al- it's hard to get attention and care, especially human-driven attention like psychotherapy, right? So, so our system wants to look at, "Hey, have you had the big fireworks event? Okay, we'll, if not, we'll put you in a different, in a different category." It doesn't want to say, "Are there changes in your brain because of trauma, whether that was acute or chronic or vicarious?" That's what we would look at. But that, the systems aren't sophisticated or, or often interested enough to do that.
19. CWChris Williamson
  I went
28:43 – 33:25
Doctors Need to Take Depression Seriously
1. CWChris Williamson
  to my GP when I was probably 21 or 22 in the UK, northeast of the UK, classic very working class town. And I go in and I sit down and I'd been sad for quite a while on and off. And then every so often there would be maybe a couple of days where I couldn't get out of bed and I would feel quite ashamed about this-
2. PCDr. Paul Conti
  Mm-hmm. Mm-hmm.
3. CWChris Williamson
  ... and I, I wouldn't wanna talk to people and I'd keep the curtains drawn and, you know, I'd make excuses about why I couldn't see people or do things or whatever. And uh, I went in and I sat down with my GP. And the way it works in the UK for the people that aren't from there, you have a 10-minute window with your GP-
4. PCDr. Paul Conti
  Mm-hmm.
5. CWChris Williamson
  ... and that's your general practitioner, that's the person-
6. PCDr. Paul Conti
  Right.
7. CWChris Williamson
  ... you go to and you book in for, and it's usually kind of hard to get an appointment. Again, National Health Service, it's free, great. But the standard of care perhaps leaves a little bit to be desired. So I sit down and I said, "I'm, uh, I'm, I, I think I might be depressed or something." I probably mumbled some word out about sad or depressed or something like that, but I'm pretty sure I used the word depression. And this GP said, uh, "Have you had a recent family bereavement?" I said, "No." He says, "Are you in financial trouble?" "No." "Did you recently lose a job?" "No." "Did you recently break up with a relationship?" "No." No, no, no, no, no, all the way down, like acute trauma, acute trauma, acute trauma, acute trauma. "No." And sort of got toward the end of it and essentially said, "Well, what are you sad about?" I was like, "I don't know, like just the fucking crushing weight of existence. I don't know. (laughs) I don't know what-"
8. PCDr. Paul Conti
  Right.
9. CWChris Williamson
  "... I'm sad about." And then she printed off this single piece of A4 paper that was like, oh, here's some website URLs on the NHS website about how to improve your mental health, like, and go along your way. And I remember-
10. PCDr. Paul Conti
  And you left feeling worse than when you came in.
11. CWChris Williamson
  I, I, I felt like, I don't know, like I was making a mountain out of a molehill. Uh, it, it, it definitely taught me, the lesson that I took away from that I think was, um-... I'm blowing this out of proportion. It mustn't- it mustn't be that big of a deal.
12. PCDr. Paul Conti
  And that's why we have so much what seems to be a loss of productivity, because often people in- in power, uh, in- in decision-making capacities are- think about dollars and cents or pounds, and- and are we- what are we losing economically? We lose a tremendous amount of human productivity because of depression. And if we wanna anchor to what is, of course, infinitely more important, we lose human life to depression. So when you walk out of there, you're walking out at great risk. You have a real medical problem. If you went in and you had right lower quadrant abdominal pain that had been amorphous and then- and then all of a sudden it started being focused here, no one would say, "Why do you have appendicitis? Why does your abdomen hurt?" I mean, no one would say that, right? They would honor what was going on with you. But here you get a- a- a non-response and you leave worse than you came in because it's so invalidating. And no one is then looking at, "Hey, if we could take a picture of your brain chemistry," we're not sophisticated enough to just do that, we'd see, "Yeah, you have a medical problem," no different than if you had appendicitis, but you walk out invalidated. And this is the problem, and it's part of why at some point realizing that most of what I was treating was coming from trauma, whether I was treating- treating substance abuse, depression, panic attacks, insomnia, right? Even the- the- the more medicalized, like schizophrenia, higher incidents when people are- are feeling a- a- a sense of aloneness and isolation and vulnerability, that we need to understand this, because a huge part of what ails us, what makes all of us suffer, is coming from this. It's coming from unrecognized and unaddressed trauma and unrecognized and unaddressed mental health issues, because look, people can get depressed because their brain chemistry is off, right? So there doesn't have- there could be no reason whatsoever that people who everything in their life is as good as possible, but cyclically, their brain chemistry comes offline, and now they're depressed. So what about a purely biological depression? Right?
13. CWChris Williamson
  Mm-hmm.
14. PCDr. Paul Conti
  There isn't always a reason. There- I mean, there's a lot of times a reason, but think about how we're just invalidating people, and then is it a surprise that substance abuse, substance dependence, addiction, overdose rates go up and up, that suicide rates go up and up? It is not a surprise. It is a predictable outcome, uh, it's a predictable consequence of how the healthcare system handles itself. And- and what you described so many years ago is not different in- in many settings now. See, that's what would happen now. And- and even the doctor, I have a- I have so much compassion for GPs, primary care physicians, 'cause what are you supposed to do in 10 minutes? How are you supposed to have a real conversation-
15. CWChris Williamson
  (laughs)
16. PCDr. Paul Conti
  ... in- in 10 minutes? And that's why there's more depression and self-harm and suicides in physicians has grown over time. Like all of this makes-
17. CWChris Williamson
  Ooh, that's an- that's an interesting
33:25 – 37:45
Can Emergency Workers Experience Vicarious Trauma?
1. CWChris Williamson
  question. What about, you know, you talked about vicarious trauma. Firefighters that need to cut people out of cars-
2. PCDr. Paul Conti
  Yeah.
3. CWChris Williamson
  ... paramedics that are unable to resuscitate people, therapists that are dealing with... uh, uh, masseuses that are permanently working with people who are in pain. Is this something that you see?
4. PCDr. Paul Conti
  Yeah. Sure. There- there are higher rates of all that ails us in- in populations that are exposed to- to situations that can make fear or terror. If you're coming up to cut someone out of an accident, there's- it's- it's hard to do that without some... If you're doing that, you're a person who has empathy, so you're a person who's gonna feel something as you're doing that. And- and sure, people have education and training and support to try and make boundaries, but that doesn't mean that that works all the time. We- we don't give people enough ongoing support, and- and- and we see that on the other side of it where people in tho- these kinds of helping professions have higher rates, so it's depression, substance abuse, suicide. The rates are higher, and again, it all makes sense. Like there's this concept in a certain m- um, type of therapy that says everything is as it should be. It doesn't mean that it's right, morally right or j- or just. What it means is that it's predictable. It's predictable. So if you see the- the increasing rates of loneliness, isolation, depression, substance use, suicides in- in the general population, and more specifically in- in- in people who are caregiving, that's not surprising since everything is as it should be, meaning we've made these decisions as a society. How many healthcare workers came to the other side of COVID traumatized by all th- the- the things that- the awful things they saw and the need to work double shifts because their co- coworkers aren't coming in? There's so, so much of that. And what happened after the pandemic? Go back to the same unreasonably high workloads (laughs) and the way everything was before that we don't- we don't put resources in society towards the people who help us, which is also us. Like, you know, we're all part of this and, you know, we- we- w- we waste so many resources in so many ways, our political struggles and strivings. And it's not- the whole idea isn't to get political, but just to say how mu- much resources we waste, and we often don't have resources to like give the person with depression more than a 10-minute misleading questionnaire, right? Or help that person who- who has a real post-trauma syndrome get better, but that's gonna take some human time. We look at the- at the short end of it, which is why I focus on the economic cost. Of course the human costs are more, but- but we can get money allocated sometimes, resources allocated when we look at the cost. The- for everyone we don't treat for trauma who then s- uses hospital resources coming to e- e- emergency rooms or we lose out of the workforce, it's, you know, it's like people say like, uh, uh, borrow a penny today to pay a dollar tomorrow, you know? It- it's... But we treat ourselves that way. We treat ourselves that way as societies. And, you know, people don't see until they often need to go to an emergency room, and they have good insurance, but guess what? You're still out in the hallway, right? You still sat there for seven hours. You know, you still went in and had somebody ask you a 10-minute questionnaire when you're really in trouble inside, you know, maybe. You know, it's, you know-... we don't handle things in a way that uses a lot of foresight, and we pay for it. And we pay for it, I believe, around trauma more than anything else. I should say one more quick fact that more than half, we don't know exactly how many, but more than half of the physical health complaints people make, they go to a physical health doctor. Something hurts. They have shortness of breath. They're feeling something inside. Half of those complaints, they're not mental health complaints, they're physical health complaints that come from mental health. Yet how much are we integrating mental health into our physical healthcare systems? Very, very, very poorly. And, and therefore, you have physical health physicians who wanna help people. They know so much that's coming to them is mental health, but they're not equipped, they're not trained, they don't have enough time, and, and that's part of the frustration, is people c- are coming with mental health problems, but they're presenting as physical health problems. And it's, it's not because the person wants to say that. It's because they often don't know. They are hurting, but they do have depression. They just don't know, and the healthcare system is so dumbed down that we're not asking the right questions to try and figure out what is actually going on with you and how do we help you?
5. CWChris Williamson
  Talk
37:45 – 42:24
How Trauma Impacts the Brain & Body
1. CWChris Williamson
  to me about what actually happens to the brain and body after someone's gone through trauma.
2. PCDr. Paul Conti
  So there'll be very complex changes, but we can sort of summarize to some degree by saying that there are alterations in the balances in our brains. You know, our brains are trying to maintain, and bodies, homeostasis, which means things are in balance. And there are hundreds of thousands of things that happen inside of us in each moment to hold us in balan- in, in balance. What happens is that we get imbalanced. So for example, vigilance mechanisms in the brain, there are whole systems of the brain, salience mechanisms, start looking more for negative things. So someone who, for example, is interested in finding a relationship, who, who is walking down the street or a hallway and sees someone look at them, instead of being curious, "Oh, how's that person looking at me?" Or, or, "Might I, am I attracting that person? Might I smile back?" Th- the immediate is like, "Does that... Mm. That person's looking negatively at me. What's wrong with me?" Right? "Why are they looking at me?" Like, it's hard to make life move forward then, right? 'Cause there's a change towards vigilance and vulnerability inside of us. So you don't see, "Maybe that's a coworker and we could collaborate on something. Maybe that's a potential romantic partner who's smiling at me." People don't, don't see that because the brain has shifted from curiosity, "How is that person looking at me?" to, "There must be something wrong. They're looking at me in a negative way 'cause there's something negative about me." So those things change in us in very complicated ways, but it changes the whole climate, so to speak, within us, and then it changes endocrinologically. So then we have more stress hormones flowing in us. And stress hormones predispose to vascular disease, to heart disease, to strokes, to autoimmune diseases, to, to aging faster than our calendar age, so t- to g- to gaining weight when we don't wanna gain weight, to not being able to lose weight when we're working hard to lose weight. So then what happens, we get change from head to toe because these systems shift. And again, we don't realize that. You know, the person who says, "I'm, I'm a loser because I can't lose weight, and I'm tr- and I'm trying." How many times do I hear that? And then you see they're actually doing the right things. They, they have a good diet. They have exercise. They're not losing weight because there's so many stress hormones in them that it triggers all these don't lose weight systems in us. So it's just, these are just examples. But you can see, I hope, from the examples that what we're talking about is whole life change from top to bottom. And again, it's not happening in everyone, but this is happening a lot in small, medium, or big ways. But any amount of it is unacceptable. And then we just don't know it. "I've always been someone nobody likes," or, "No one I, no one likes how I look," right? And people say, they'll say this, and they know much before that trauma, that's not how they felt. And that's why they were g- they got better jobs. They would leave one job for another if it was better. They had good relationships. They didn't stand up. They didn't stand for denigration in a relationship, that kind of off-putting. They didn't stand for that. Now they do. And they don't even realize that they never did. And like, how are we gonna get out of it, right? If we think this is how I've always been when that's not true.
3. CWChris Williamson
  It seems like the story that we tell ourselves about ourselves is so important.
4. PCDr. Paul Conti
  Yes.
5. CWChris Williamson
  That it's such a huge part, this narrative that we weave together.
6. PCDr. Paul Conti
  Yes. Yes. Yes. Yes. I'm so interested in knowing people's life narratives, right? 'Cause I'm in the business of trying to help people. So you have to understand what their narrative is. As I say, no one, no one comes out of the womb thinking, "You know, abuse is okay for me." No one thinks that, right? So how do we get to the point of thinking that? Even being in a relationship, as you said, there's not physical violence, but it's always denigrating. "Oh, sure, you're gonna ch- Yeah, that's gonna go well for you this time. Give it a try. See what happens." Like, why would people put up with that all the time instead of saying, "Hey, I don't, I don't want this. This is worse than not having a relationship. I'll not have a relationship till I find one that's better." We, we have to trace, what is the roots of that? Was there some trauma and that person started feeling differently? Does that come from early formative years? Was that person seen as less than or denigrated because of race, uh, because, say, gender in the home? Right? For just one example. Because of sexual orientation, socioeconomic status in the communities around us. Was that bred into that person? 'Cause that's not natural either. You get to feel that you're good enough to have a safe life in which you strive for good things. And if a person doesn't, I wanna understand where that came from.
7. CWChris Williamson
  What-
8. PCDr. Paul Conti
  Was this inculcated in formative years or big trauma at once? We've gotta understand it.
9. CWChris Williamson
  Yeah, I,
42:24 – 54:51
Correcting Our Inner Voices
1. CWChris Williamson
  I think so many people, m- you know, myself included, the voice in our heads is so regularly negative that it seems-
2. PCDr. Paul Conti
  Mm-hmm.
3. CWChris Williamson
  ... like that's just the physics of brains, that the texture of the mind-
4. PCDr. Paul Conti
  Right.
5. CWChris Williamson
  Not my mind.
6. PCDr. Paul Conti
  It just comes with that.
7. CWChris Williamson
  The mind, yes-
8. PCDr. Paul Conti
  Right.
9. CWChris Williamson
  ... the factory settings are-
10. PCDr. Paul Conti
  Yes.
11. CWChris Williamson
  ... critical, uh-
12. PCDr. Paul Conti
  Yes.
13. CWChris Williamson
  ... self-deprecating, uh, fearful, vigilant, uh, mocking, you know, risk averse, all of those things. Um-
14. PCDr. Paul Conti
  Yes.
15. CWChris Williamson
  ... are you... You know, there is a negativity bias. We are concerned, finite creatures, infinite surrounding, you know, this asymmetry between things that can make us a little bit more alive and make us a lot more dead, and how much worse those are. But are you saying that that's not the way that we should be? Because that, I think, to a lot of people, maybe myself included, is like a rather wild claim, that we shouldn't... uh, our minds-
16. PCDr. Paul Conti
  Right.
17. CWChris Williamson
  ... aren't built to just be negative?
18. PCDr. Paul Conti
  We're, we're not built to be that way. And the salience of negative things doesn't have to make us that way. So in the berry example, like what does that mean? Don't eat that berry again. It doesn't mean be afraid of any food now, be afraid of any berries, be afraid of being outdoors. It doesn't mean that. It's... The, the negativity bias is meant to protect us. It's what happens inside of us in complex situations because we live lives that are complicated, have different phases, and we're often not aware of our life narratives. It's, it's that negativity bias that can help us to feel negative all the time, but it certainly is not deterministic of that, which is why in an oversimplified example, I'm simplifying if you say, "Realize you shouldn't eat that berry. You're not a dummy for eating that berry. It looked like a good berry." You don't have to feel like you're incompetent and you're not worth anything 'cause you ate the berry. Like, "You're okay. You came through it. Here's a lesson. Don't eat that berry again. And maybe be just more careful about berries. Is that good? Okay, it's good." But that's often not how it goes. It's like, "I don't, I don't know how to pick what to eat," and, you know, and, uh, you know, "and I gave someone to someone else. That person got sick too. I'm a terrible..." Per- You know, we... This is what we do to ourselves, and it is not our natural state. We're not built to be like that, but we end up like that because we are trying to keep ourselves safe in a difficult and complex world, and we accumulate more negativity bias, more negativity. Now, I've got a voice in my head telling me what's wrong with me all the time and... Well, you know, I had this voice in my head for a long, long, long, long time, and through a lot of psychotherapy, I, I've been able to, to move it out of my primary consciousness. But there was a time when I thought that shadow voice was normal. You know, if I dropped something or, "Oh, so stupid," or, "What's wrong with you?" Like I was... I mean, that was a shadow to me inside of me, and I had to realize, that's not normal. Like I said, I didn't come out of the womb, metaphorically, we don't have words, but you know what I mean? Like no one comes out of the womb thinking that way. It's not normal.
19. CWChris Williamson
  Mm-hmm.
20. PCDr. Paul Conti
  Get our minds around it. That does not have to stay with us. I'm not saying I'm a paragon of mental health, and I still need my work and I do my work. But I'll tell you, that oppressive, miserable, mirth-robbing, depression, you know, uh, producing voice is not in my head anymore because I had to realize that is not natural. I do not want it there. I want to understand and get my arms around why it's there, and I want it to go, just like I never... I always felt I could go out and work hard and achieve things. I did not feel like I was cursed. I did not feel like there was something wrong with me or the place or people I came from, but I certainly did after my brother died by suicide. What's wrong with me that I didn't see that? What's wrong with us that that would happen to us? I would never say that about someone else. "What's wrong with you that a family member died by suicide?" But I would say it to me. And that's how we are, is like, you know, good people don't want to st- denigrate someone else, but we'll say it to ourselves and we'll take it inside. And I started realizing I was feeling so differently about myself that, wait, I never felt like this before, and I had good people around me enough to realize. I started getting myself some help. But it, it shows. If we don't know our narratives and that this negativity is not natural to be at the forefront, it can become the new normal, and then we think it was the old normal too.
21. CWChris Williamson
  Wow. How much can we change that voice? Can we actually get rid of negative pathways? I remember once reading something about once neurons are laid down, there is no undoing them. They are only building up other neurons. So, is it a case of layering better voices on top of worse voices, or can worse voices actually go away entirely?
22. PCDr. Paul Conti
  Yeah. Worse voices can go away entirely. Now, again, I'll put a little asterisk and I'll explain. This is both very, very complicated and very, very simple. Okay. We don't... This complicated part is, for the neuroscientists, right, the, of how do neurons m- uh, how does neurotransmission work and how do complex systems work? Like, there's a, uh, there's a lot, (laughs) a lot, lot there. But let's just go to the, the simple part. Anything that has been overlearned doesn't go away overnight. Okay, so here's, here's the example. I... This example I use all the time, and I, I, I think it's... it captures it, I think. Let's say you and I randomly took a word. We just picked a word. I look around, like, I... The word simply is staring at me from something else on my desk. Let's say we s- Random word. Let's you and I say it together 500 times. Let's say we did that. Then this evening, my time, your tomorrow, tomorrow morning, the... It's gonna be in your head or in my head, right? Let's say we say it instead of 500 times, 5,000 times. It'll be in our brains several days later. But it can atrophy and go away. In this case, it's just a s- a silly experiment, but our brains still won't let go of it. If you and I say that word a thousand times, our brain isn't gonna s-... Our brains aren't gonna say, "I know that was just a silly experiment, let's get rid of that." No, it's gonna keep the word coming, and the w- it's gonna keep it coming. That's what goes on with the negative biases inside of ourselves. You c- You have a set of feeling state and a, and a set of words and self-talk that's like, "I'm not good enough. I suck. I..." This... You keep doing that over and over again, it is not going away quickly. But we live in a society that wants rapid results, that often packages psychotherapy as you get 10 sessions of this and then it's over. All that stuff can get better, tremendously better, but it takes time. If that's been in your head for three, four months to a moderate degree, let's plot out a several month course to getting it out. If it's been in your head for years, well, we're gonna have to work on it over time, but that doesn't mean nothing good happens until we're years down the road. It means we start working on it now and it starts getting better.And that's the simplicity of it. That example really holds. If we said that word 1,000 times and we didn't say it anymore, it'll fall out of our brains. And the same is true with the lies of trauma that we tell ourselves. Now, again, if something has been so impactful upon us, it can still come back. People who have had, who have had thoughts of hurting themselves or hurt themselves at some point in time who haven't for years could still have something really bad go on and the thought will come into their head. If I make a very big mistake, I can still... that voice can come back in and go, "You're an idiot!" Right? So- so- but I recognize that doesn't mean I'm back at square one. It just means if there's a strong stimulus, that reflex can come back. But it's not with me. I just- I push it back out. Like, I- I- I get it. I made a mistake. I don't need this inside me. Let's have it back out. So sometimes it- we can- it can kind of rush us once or twice if it's been strongly in us. But the answer to your question about change is a very strong yes. All of that can change, and it's not rocket science. Like, neuroscience is more complicated than rocket science. So in some sense, it is. That's why there are countless brilliant people who spend their careers in psychiatry, neuroscience, psychology. That's wonderful that that's happening. What you and I and everyone listening needs to know is not that. I- I take comfort that people are doing that. What we need to know is this is absolutely approachable. And- and we understand it, but the- but the mechanisms of helping around us don't help. They don't teach us how to understand it. They don't tell us that things take time. But there's an understanding driven by science and experience of- of the profession that tells us the answers to this and gives us a roadmap to how to make it different.
23. CWChris Williamson
  It's so interesting that you say, uh, a formative experience, a particularly stressful experience, can cause something like this to- to reemerge. So, a while ago, I was doing a very important podcast episode, high stakes.
24. PCDr. Paul Conti
  Yeah.
25. CWChris Williamson
  And I tend to fast before I do this, which is good. It keeps me nice and alert.
26. PCDr. Paul Conti
  Yeah.
27. CWChris Williamson
  A little bit of cortisol and adrenaline running through the blood is- is nice for- for mental focus.
28. PCDr. Paul Conti
  Mm-hmm. Mm-hmm.
29. CWChris Williamson
  But I overshot it and I went hypo partway through the podcast.
30. PCDr. Paul Conti
  Uh-huh.
54:51 – 1:00:38
Is Ancestral Trauma Real?
1. PCDr. Paul Conti
2. CWChris Williamson
  What about trauma being passed down? Is that a thing? I'm living... I live in, uh, Austin, Texas now, so ancestral trauma is kind of a bit of a- a super meme over here with the psychedelic trips and the ayahuasca retreats-
3. PCDr. Paul Conti
  Mm-hmm.
4. CWChris Williamson
  ... and the indigenous cultures and stuff like that. What's the- what's the- the-... the truth and the BS around, uh, epigenetics, ancestral trauma, all of that stuff.
5. PCDr. Paul Conti
  It's- it's remarkable what epigenetics has contributed, um, is- is just immense to our understanding. The thought was, for a long time, that trauma is passed down by role modeling. So someone, say, who has been through trauma and is very anxious communicates that to children, right? T- that the world is an unsafe place, and they role model anxiety. And that can happen. We- we can nurture children to be like us in all sorts of ways, right? So that's why if I have a lot of anxiety in me, I- I do my best to have control over that. I don't want to role model that for my children. But- but what we've learned is really quite remarkable. There are epigenetic changes in us, in people, that then can be passed down to children who aren't even conceived of yet. And that's where Darren Richerter, R-E-I-C-H-E-R-T-E-R, Dr. Darren Richerter, who I interviewed for the book, is a- is a- a trauma expert. He's an academic at Stanford, and he testifies about trauma and this idea. So for example, in the world court, that- that if someone is traumatized, for example, some of this testimony has been around rape as an instrument of- of war, and it was seen through a criminal justice lens, th- this person ordered that and that was wrong. Okay, that's true, but we also need to look at, that can extend across years and across generations. That could impact children that aren't even thought of yet and might not be born until 10, 20 years later, (coughs) because the trauma in the person creates change in the person that can then be transmitted to children just through the changes in genetic expression years and years and years later. And- and that shift from looking at, like, a war crime as something criminal that's just- just bounded by it- it happened in this period of time is- is it is a crime, but it's- i- it's not only a crime in that moment. It's a crime against that person for the rest of their lives, especially if they- they don't get the help to deal with it, and it can be a- it's a crime against children that aren't even thought of yet, it's- it's a transgenerational crime.
6. CWChris Williamson
  Yeah.
7. PCDr. Paul Conti
  And that truth, that epigenetics and- and- n- n- epigenetics through the neurobiological lens tells us that's true.
8. CWChris Williamson
  I was talking to Robert Sapolsky a couple of months ago, and he was talking about how mothers that enter poverty during, um, uh, pregnancy, the changes that you see epigenetically in the children from that poverty, you know, (clears throat) perfect example, I would guess, of a- a pretty good chronic trauma-
9. PCDr. Paul Conti
  Yeah.
10. CWChris Williamson
  ... chronic stressor.
11. PCDr. Paul Conti
  Yeah.
12. CWChris Williamson
  It's not- it's just ambient concern, right? It's just there in the background.
13. PCDr. Paul Conti
  Mm-hmm.
14. CWChris Williamson
  And, uh, yeah, the- the difference that- that people go through. And he reminded me, something (clears throat) that I learned in year nine in biology, that when a female is born, they have all of the eggs that they are going to have for the entirety of their life.
15. PCDr. Paul Conti
  Mm-hmm. Yes.
16. CWChris Williamson
  So inside of this, as yet unborn child, this infant baby fetus that's inside of you, is the next generation. So-
17. PCDr. Paul Conti
  Right.
18. CWChris Williamson
  ... you've got grandmother to mother that's about to be born, and inside of mother, you have daughter who is about, you know, will be born in however many, 25, 30, 40 years time.
19. PCDr. Paul Conti
  Yes. Yes, right? (laughs) And you're... Wow, that- that warrants, it warrants that kind of, wow, th- this is the impact of trauma, truly transgenerational. And think about the example you gave was not someone who has lived chronically in poverty. People can live in poverty without poverty itself being traumatic. It predisposes to trauma, but poverty doesn't have to be in and of itself traumatic. But imagine, you said a woman entering poverty while pregnant, I mean, even that, if I- if I stop and think about that too much, I could- I could generate a panic attack in myself of-
20. CWChris Williamson
  (laughs)
21. PCDr. Paul Conti
  ... how that would feel. You're carrying a child and you feel responsible, and now you go from not being in poverty to being in poverty. What is the cascade of stress hormones neurobiologically and cascading throughout the body? Uh, i- it's- it's huge, and that's why it makes the- the significant changes that Dr. Sapolsky's talking about. It's a huge trauma during a period of time that is a very, very crucial period of time to that developing fetus which is crucial to the developing fetus, to the adult that fetus will become, and- and if that fetus can have children, to the subsequent children of that fetus. I- if this isn't a reason for us paying attention, i- it's not like borrow a penny today, pay back a pound tomorrow, but are we gonna borrow a penny today and pay back 10 pounds tomorrow and, what, 100 pounds in 10 years and 1,000 pounds down the road? I believe that that is not an exaggeration, that that is what we are doing as a society by turning away from trauma, and we see it in death rates through overdose and deaths- death rates through suicide. There- there are many, many things we could talk about where we see that right now, and what we see now will continue on and worsen. It's a guarantee it will continue forward and worsen because we've planted the seeds of that into the future unless we do something about it.
22. CWChris Williamson
  So, we've talked
1:00:38 – 1:03:59
How to Increase Mental Resilience
1. CWChris Williamson
  about the impact of trauma and unwinding of that, trying to make the unconscious into the conscious. What about trying to get out ahead of that a little bit more? Are there any predictors or ways that people can increase their resilience so that the bar for whatever could cause a- a traumatic interpretation sort of bounces off during the event?
2. PCDr. Paul Conti
  Yeah.
3. CWChris Williamson
  What- w- what's the- the physics of that system?
4. PCDr. Paul Conti
  Oh, it's- it's the same paradigm as for physical health, right? The better health you're in, the better you'll be able to withstand an insult to your physical health....an injury, an illness. And the same is true i- in our mental health, so the healthier we are... If someone has, say, a chronic low-grade trauma. They're in a relationship and the relationship is just kind of dismissive or denigrating, they're not valued but they're putting up with it, you know, that predisposes to trauma having more of an impact. There's something called the multiple hit hypothesis where we have more, uh, insults. We're more likely for the next insult to have a disproportionate impact. So be as healthy as we can. I mean, part of the reason we want to be in physical shape is people want to look good and be healthy now, but we also wanna... It's preventive medicine, right? I'm, I'm, I'm looking ahead to what could happen in the future. And the same is true about our mental health. And this is why when we talk about a narrative, it doesn't cost any money. You don't need insurance, you don't need to be able to access care to ju- to sit and, and think about or write about your own life, your own life narrative. What's in your life that's not okay? I mean, imagine a job. You see people who are in jobs where, you know, they're not really liked by the people around them, and maybe that's because they're good and other people don't want the good person to, to shine or whatever it is, and they're just kinda putting up with it. Note that. That's something in your life that is causing misery and distress now that predisposes to problems in the future. So to be aware and to be honest about that instead of it's easy to shove it under the rug, because like you said, it isn't the big fireworks thing. So look at what, what i- what are our life narratives from past to present and what's going on in my life now? What's okay and what isn't? Because how many times will a person tell you, "Everything's okay. Sure, things are fine." But then you ask, "Okay, let's talk about it a little bit more." Things are not fine. They'll tell you what isn't fine. But the default of things are fi-... Why that default? It's, you know, partly because if we don't feel we can really change anything then we wanna just kinda say it's all okay, and if we feel some guilt and shame about the things that aren't okay, more reason to sweep it under the rug. So the- there are a lot of reasons where we're not honest with ourselves. If you say to someone, "E- uh, tell me what's okay and what's not?" "Everything's okay." Usually that person isn't just lying to you, the question. They're lying to themselves. A- and it's not 'cause they like lying to themselves so life isn't as good. It's because there's a sense of, "I should be ashamed of that. There's no way I can change that. I don't understand myself well enough. I'm afraid of that." And like, it just does not have to be that way, and there are routes to change that aren't rocket science routes to change, which is another message that I'm bringing. It's not like we need the most sophisticated help. Sometimes in extreme circumstances, but think about your life. Write a life narrative. Talk to somebody you care about and trust. These are things we can do for free that can really make a big difference in our lives.
5. CWChris Williamson
  Talk to
1:03:59 – 1:14:23
Practical Tips to Eradicate Unconscious Trauma
1. CWChris Williamson
  me about... Again, this is not medical advice. Please seek your psychotherapist of choice, et cetera, et cetera. But in your experience, what are the modalities that, uh, are the biggest movers when it comes to helping people to sort of make the unconscious conscious, to unpack the experiences of their lives, to stress test these assumptions and narratives that they have that may be erroneous and due to one incident or a number of incidents that's-
2. PCDr. Paul Conti
  Mm-hmm.
3. CWChris Williamson
  ... kind of whitewashed everything? Wh- what are the biggest modalities, the most effective ones that you like?
4. PCDr. Paul Conti
  Yeah. I mean, there are ways to get to come at it, but most of the ways that would come at what you're talking about is an insight-oriented psychotherapy and that could be a kind of psychotherapy, psychodynamic psychotherapy, for example, that is very, very interested in the unconscious mind. Or it could be psychotherapy that's not just f- focused on the unconscious mind but focused on self-understanding. Can you tell me about you now? Can you tell me about you growing up? How much can you tell me? Can you link the two? C- so that can be insight-oriented psychotherapy too. It doesn't have to go right for the unconscious mind, but it's some aspect of curiosity about the person. When we just go strategies to make things better, so to speak, like cognitive behavioral strategies can be... They can be very, very helpful, but we need to understand what, what is underlying first. So, eh, otherwise, we just go to what I... So we're going to polishing the hood instead of looking under the hood. And maybe it's... Maybe we don't feel so great about the car and we really should polish the hood, maybe, but maybe if we're not so happy with the car, let's look underneath at the engine. So let's look at where is something coming from because then we can gain greater insight and that in and of itself can make a difference, bring the unconscious to conscious. Then we have strategies that can actually help. Sometimes if strategies just decrease symptoms without going to where the problem is, that doesn't necessarily help. Maybe that allows the person to tolerate the abusive situation longer. That's not so good. So we wanna come... I- I don't... With rare exceptions, I don't understand not coming at the process through the lens of insight. Like, let's start there. We might spend a lot of time there or a little bit of time there. So maybe we get the insight, for example, that this person who is depressed is experiencing a purely biological depression. They're handling their life quite well. They've had some trauma but they've dealt well with it. The- they're... They have a good job, a good relationship, they're meditating, they're taking care of themselves, they- The, the problem is neurobiological. Oh, then there's a family history where on that side of the family people get depressed out of the blue. We might rapidly go to just the psychopharmacological. Happens at times but we haven't just gone there. We've gone there because we've investigated and decided that that's where to go. So it's just an example, even when the answers are not through the psychotherapeutic lens, we have to have some insight to decide that. And if I learn that you were never depressed until a certain thing happened or until something big didn't happen but you changed maybe from one place to another, a job, a relationship and then things started changing and then you become depressed, well, we may still think maybe, is medicines a good idea or this or that, but we're not gonna leave it at that.... we're going to go to why that is different than what you understand about it, or what you don't understand, and we can bring t- to the surface. So, it's a process that honors, I think, people and our stories and what goes on inside of us. And, and I think we deserve that from the systems that are allegedly taking care of us.
5. CWChris Williamson
  You've mentioned a couple of times about, uh, writing things down, journaling or something analogous to journaling. Is there a, a process that you're a particularly big fan of when it comes to that?
6. PCDr. Paul Conti
  No, not a single process because it works differently for different people. And some people like doing that, or if they don't know if they like it, can take to it pretty readily. For others, it can be painstaking and it's- it's too much to do. Now, maybe then they could speak words, uh, and then listen to the words back from them. So, it's not how it's done. It's that when we, when we make words, whether we say them out loud, it's kinda better in some ways if we say them out loud or if we write them. But when we make words, it's different than things bouncing around in our minds. I mean, there are different systems of error-checking that come online, which is why it's kind of a joke in psychotherapy, but it is true that every now and then, someone will come in and they'll talk the whole time. And then at the end of it, "Oh my gosh, thank you. I- you solved all my problems," and we didn't say anything, right? So- so sometimes that happens. It happened in my own therapy a little while ago. I said, "Wait, that thing happened. I- I- I actually solved the problem by talking about them." Because in talking about them, they become real in a different way. I'm putting words and the words of the therapist is still relevant because I'm putting words that are listened to by another person that I know and trust and feel safe with, and then it's opened up.
7. CWChris Williamson
  And they're going to be scrutinized by them as well. They're going, they're going to be there to- to... You need to not just say complete gobbledygook. You need to not just trail off in the middle of sentences. There's a- a type of structure that needs to be there as well.
8. PCDr. Paul Conti
  Right, it's a communication structure, right? It's scrutinized not in a way that that person's gonna fault me, but that person's interested in what I'm saying and I wanna convey it. Then, in this case, what it allows is not that I conveyed it to the other person. It's that once I conveyed it, I understood it better, and it's that that we're going for. If you get that through long-hand journaling and you're, "Whoa, I read that and I understand myself better," do that. If you get it through more sparse journaling, but it's putting together, "Hey, I have these patterns of how I feel or- or what I do and how it links to how I feel," then do that. If you kinda can't do that, but you can talk to somebody trusted, do that. The idea is to get it out of just bouncing around in our minds because we often don't solve our problems that way. And then we make, like we talked earlier about the self-fulfilling prophecy, then we make a self-fulfilling prophecy. "I must be dumb. I can't solve my own problems. I've been thinking about it for years." Like, no, all I'm doing over that time is spinning wheels. How about another modality that makes things different, actually brings different brain centers online, and then I can solve those problems? That's the- that can be the tremendous benefit of writing or talking. And again, it doesn't cost anything. You don't have to go anywhere. People can do this if they have what? A pen and paper or another human being they trust. So, there are ways we can really help ourselves that we can do quite readily.
9. CWChris Williamson
  What should we be paying attention to when it comes to the little voice that sometimes appears in our heads, the things that we take for granted, the- the words that are said, the- the- the presumptions and assumptions when we encounter a situation? Uh, is there something... I- I- is there a process that you advise people to go through when it comes to that repetitive thought, the- the sort of, uh, narrative-
10. PCDr. Paul Conti
  Yeah.
11. CWChris Williamson
  ... that we say?
12. PCDr. Paul Conti
  Yeah. Well, I can say it in two words, and I'll expand a little bit, but the two words are, be curious. Be curious. It's interesting what's going on in our minds. If there's a shadow voice telling you how bad you are, be interested in that. Don't be cowed by it. Don't be frightened by it. Be interested in what comes into our minds because it's that curiosity that lets us better understand, and it lets us put it in its place. I have this voice in my head, not literally the voice of like my own shadow voice. I kinda know where it comes from now that I think about it, right? That it came from that denigrating person, that bad trauma, how I was raised, how I was treated because I was a little bit different, and it's saying things to me. Do I think they're true? Do I believe they're true? I mean, gi- give an opportunity. I said, "Well, how about instead of that negative voice, just having the whole playing field?" It's in your brain and it's got a megaphone. How about let it have its say, but let the other side have its say too? Do you really believe that? Maybe you do, maybe you don't. It's a little bit of devil's advocate, but maybe you do, maybe you don't. Do you believe it or not believe it? If you don't believe it, like, "I'm the worst person in the world. I can't do anything right." Okay. Do you believe that? If you don't, well, now we wanna look at that for what it is. It's not telling you anything except that there's something in your head that's not real or true or fair and you don't want it there. Now, you more s- get to- can see it as other. That's an otherness. How'd that get in my head? Now, I start seeing it as alien. This doesn't really belong in me. Now, I can start s- putting my foot in the door, so to speak. You give me a little bit of room, you put your foot in the door, and next time that person goes, "I'm stupid and I can't do anything." O- okay. Wait- wait a second. That just goes on in my head, and it's gone on in my head for a long time, and maybe even I know why it's- it's gotten there. That is not what I believe. So, no. So, let's start again. Can I do this thing? Right now, it's a different decision-making process. "Oh, no one ever likes me. I shouldn't go say hi to that person." Is that really true that no one ever likes... You've been taking it for granted for a long time. If there's a life narrative... Actually, a lot of people like me, but I had a bad relationship outcome and now I feel like no one likes me if they're a potential relationship candidate. Okay. We put things in place, and now maybe instead of that person going away from the potential romantic partner, they say hello. Now, they start changing things because they're not making self-fulfilling props. You know how many people have said, "I can't meet anyone." "Why can't you meet anyone?" "I never meet anyone." Okay. Then we look... They're avoiding everyone they could meet.Right? So you have to meet some people in order to meet some people. Right? That's how, that has to go. So then we try and prepare the person, because especially in relationships, kind of the law of large numbers, so there's a lot of rejection involved. So then we think, "Okay, if you're gonna go try something, we need to know what the expected outcome is." Right? If you wanted to say hello and be nice to a child that lives next door and that's gone well in the past, that's probably gonna go well. If you're gonna approach a potential relationship partner, then be aware, it's the law of large numbers, because if it doesn't go well, we don't want that person to then feel bad about themselves, like, "Yeah, I gotta, you know, I gotta bring myself, I gotta be able to do this a bunch of times, and then there are gonna be some good things are gonna come of it." So, so there are nuances to it, but you can kinda see I think the basic premise of it is be curious about what's going on in here so it doesn't control you, because if it is controlling you, that's not the whole you. The whole you isn't to be controlled in some automatic way. It's to bring yourself to bear and think about things and arrive at conclusions and decisions.
13. CWChris Williamson
  Dr. Paul Conti, ladies
1:14:23 – 1:14:44
Where to Find Dr Conti
1. CWChris Williamson
  and gentlemen. This, d- dude, I'm so impressed with you. Andrew told me to reach out, and, uh, you are beyond the real deal. I love your affect. I love how sort of caring and, and, and sort of gentle you are with this, and insightful. I think you're absolutely fantastic, and I, I really, really appreciate your work. Where should people go that so many people are gonna wanna find out more about what you do? Where should they go?

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