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The Hidden Price Of Unprocessed Trauma - Bessel van der Kolk

Bessel van der Kolk is a psychiatrist, researcher, and an author. Trauma is often discussed as a mental and psychological issue. But what if it affects more than just the mind? What does it mean if your body is holding onto trauma, and how might these memories manifest outside of our brains? Expect to learn what is meant by the body keeping the score, what is wrong with the traditional way we talk about trauma, how you can learn to be more self-compassionate, how trauma manifests and masks itself as illnesses, the best therapies and modalities for understanding and releasing trauma and much more... - 00:00 Do We Think About Trauma Wrong? 03:56 Link Between Trauma & Chronic Stress 07:28 Why Trauma Causes Us to Shield Ourselves 12:41 How to Not Be at the Mercy of Your Feelings 21:34 Does Trauma Make Us More Vulnerable to Future Trauma? 26:48 Tips to Being More Self-Compassionate 33:58 How Trauma Manifests as Illness 38:32 Principles for Treating Trauma 50:49 Opening Up to Other People 1:01:40 What Bessel is Excited About 1:04:38 Bessel’s New Book 1:05:04 Where to Find Bessel - 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 WilliamsonhostBessel van der Kolkguest
May 23, 20241h 5mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:003:56

    Do We Think About Trauma Wrong?

    1. CW

      Let's say that someone has never been exposed to your ideas in The Body Keeps the Score. How do you introduce your thesis?

    2. BK

      How do I introduce my things? I usually show movies, uh, ho- actually, Hollywood movies, uh, that, because, you know, when you make a movie, you have to show it correctly. Um, when you see somebody getting stuck and somebody being traumatized, like, scenes from The Hurt Locker or other movies about veterans coming home, or about, uh, kids who have been molested. Uh, usually movies capture it pretty well. You can really see how the way that people move and people hold their bodies and how people's bodies react to the world around them is very visible, actually. Yeah.

    3. CW

      Right. So you're trying to demonstrate an outward, uh, exposure in terms of how the body looks of an internal, uh, emotional state?

    4. BK

      Yeah. It's a bit how we can read each other, how they, how you, we look at each other and hopefully, you look pretty calm, and I might see you getting upset or something, I'll go, "Oh, I'm seeing something is upsetting him." That's how we give signals to each other. Uh, and of course, as a body-oriented therapist, uh, you get pretty good in reading bodily signals. Yeah.

    5. CW

      So that, uh, eh- everybody understands. They see someone that stands in a particular way, has a facial expression in a particular way, is holding themself. That doesn't sound, uh, that surprising. If that's the case, why is the traditional way that we try to think about trauma wrong? What does the traditional paradigm get wrong?

    6. BK

      It is, it is interesting indeed that it's so obvious, and I actually have gotten, you know, my books have sold five million copies. I've hardly had any blowback of people who say that I'm getting it wrong. I mean, it's really obvious. But, you know, we come from a world of medicine where we try to define things very carefully. Uh, medicine, of course, is a very disembodied profession. Uh, we deal with the body, but w- we really don't know about the body. And psychology is about minds and how people think and about their behavior. Uh, but psychology is a very, has also traditionally been a very disembodied profession. Uh, the people who, to my mind, really get it are, uh, theater directors, teachers, uh, yoga instructors, martial arts people, musicians, uh, because in the real world, you really get to see how bodies really move together through the world. Yeah.

    7. CW

      What is the difference between trauma and stress then?

    8. BK

      Stress is what it's like to be human. Um, we're, we're wired for stress. We're wired to rise to the occasion. We are wired to have hard days and broken relationships, and you know, life is rough for actually all of us in one form or another. But when that stress is over, you can look, "Wow, I'm feeling better now." Huh? And the issue with trauma is that trauma is an assault on one's being that really changes the way you feel, experience yourself, how you s- experience the world about you. And so trauma really changes the way you move through the world and who you are. And so stress is a temporary thing. Uh, we have great biology of stress, and there's basically nothing wrong with stress. Uh, this is how, how we have come as far as we have as human beings. But trauma gets you stuck and frozen in that particular spot of being enraged or fearful or terrified or something like that. Yeah.

  2. 3:567:28

    Link Between Trauma & Chronic Stress

    1. BK

    2. CW

      Is there a link between trauma and chronic stress? Is that just another word for the same thing?

    3. BK

      Yeah. You know, it gets difficult. You know, uh, you know, like chronic stress, if you work on a project, if you're in the military, can actually be quite enjoyable in a way, because you feel that all your capacities are being used. Um, you see this after disasters, that people who work on cleaning up disasters, uh, tend to feel very close to the people who they have gone through the experience with, gives them a sense of intimacy also. Um, and so, but the big issue that is being left out in most psychology texts and most peop- conceptualizations is that we're basically, we are social creatures. Uh, we don't exist by ourselves. We don't, and we're always thinking about other people. We're defining ourselves through who we belong to, what ethnic group we belong to, our religions, our neighborhoods, et cetera, et cetera. So we are social species. And in trauma, usually those connections with other people break down. Uh, the very first study I did on Vietnam veterans, what we found is that they actually were doing quite well during the war. But one, if one of their best friends got killed, that really was what blew them up and disintegrated. This was really, it's the loss of that social connection that really made something traumatic. We saw this again in studies after 9/11 in New York, and that, uh, you know, it was a horrendous event and all of us who are old enough to remember that, most of us still are, uh, really remember very vividly what happened at the time. But very few people got PTSD because there was such an enormous amount of social support, and nobody blamed anybody. And then it turned out-

    4. CW

      Hmm.

    5. BK

      ... that the people with PTSD were the people who were in domestic violent relationships or who do not feel home, safe at home actually.

    6. CW

      ... that's interesting.

    7. BK

      And so, and so being able to go home at night and feel safe in your own home with the people you're with is a very powerful protection against getting messed up by outside events.

    8. CW

      Yeah, the role of casting off the stress. You know, uh, uh, my favorite example of this is if anyone that's listening has an intense phone call, they're on the phone to somebody, and they... i- it's a difficult work call or they're really trying to think things out, but it's audio only, they're not on Zoom, uh, you'll find yourself like a puppet master has gotten ahold of you and made you stand up from your seat, and you'll find yourself walking around the room.

    9. BK

      Yeah. But...

    10. CW

      Why?

    11. BK

      ... if you have somebody who you trust and care for who's in the next room, you tell them, "Honey, listen to what just happened to me, what this asshole did to me." And when your honey says, "Boy, I don't know how you can stand that," you know, and the person, uh, backs you up, you feel much better inside. But if your honey says, "Well, I'm not surprised he said that to you because I've seen the same stupid thing that you do all the time, and he's absolutely right in the way he talks to you," then it really becomes a much more invasive issue. And so, the social reception makes a huge difference.

  3. 7:2812:41

    Why Trauma Causes Us to Shield Ourselves

    1. BK

    2. CW

      Why would it be the case... Can you think of a, an adaptive reason or an explanation for why individuals going through trauma would shield themselves from other people around them, given that people around them are exactly the thing they need to improve their relationship to that emotional state?

    3. BK

      That's because they have learned that the people around them, at some points, could not be trusted. That the people who were close to them hurt them, or pushed them away, or, uh, they don't want anything to do with them, or criticized them all the time. And so, uh, you know, it is really... What you learn during your trauma is that, uh, "I thought I could trust people, but I can't. I trusted people will be there for me, but I can't." And that becomes... So you get very suspicious about people reaching out to you, because you have had experiences that people do terrible things to you. And so that may get... become part of your woof and warp of your brain actually. Yeah.

    4. CW

      Hmm. Is... It's... What's your definition of trauma? Is it, uh, an event which occurs outside the bounds of normal human experience? Something like that?

    5. BK

      So then how we started off, and it was a crazy definition, because, uh, you know, the majority of people have had trauma in their lives. Uh, you know, I keep looking for people who come from a perfectly normal family, and I still have a hard time finding them actually. (laughs) Like, you know, we all have major challenges. And so, uh, so, you know, I... My organization, the Trauma Research Foundation, just is putting out a statement right now, and we're still really wrestling with the idea, how do you define trauma? And the trauma is really that you get hurt by something, and you get changed by it. But that something may be any variety of things. It may be a rape. You are very clear. It may be seeing your kid being run over or killed. That's very clear. But sometimes it's just being chronically ignored and dismissed. That eventually really gets into you, and that becomes part of your framework of with who you see the world, yeah.

    6. CW

      When it comes to the body keeping the score, what do you mean? How does the body actually register this? What is the mechanism? How does it manifest?

    7. BK

      Uh, the brain registers it, but your body experiences it, and your body lives it down. So, what happens is that, uh, you don't remember the trauma so much as you continue to react as if you're being traumatized. Uh, so let's say you have, have been, uh, sexually assaulted, and you go on with your life, you say, "Oh, that was just one incident. I'm really stupid for getting involved in it, and it's not happening." And then you get excited about somebody who you want to be with, and then that person touches you, and your body freezes, or you start crying, or you become really angry. And your body reacts as if you're getting assaulted. You don't make that connection and say, "Oh, I really like this guy, and, uh, I'd like to be involved with him, but my memory of the trauma interferes." No, it's an over- automatic mind process that gets in the way of your letting go at that point.

    8. CW

      Yeah. You say that trauma robs you of the feeling that you are in charge of yourself.

    9. BK

      That's true. Yeah.

    10. CW

      It's such a harrowing, harrowing but accurate statement, I think.

    11. BK

      Yeah. And so, you know, people defend themselves against that and say, "Oh, uh, it is because he did something wrong," or, "Because he talked to me the wrong way," or... Uh, but at the end, uh, you know, I'm just writing our new book, finished last chapter of a new book, uh, and I started off with a quote from Marcel Proust, "In order to change, you need to see the world with new eyes." So at the end, uh, if you really want to recover from trauma, you need to... we need to help people to change their perceptions of the world. We're not going to change the world out there, but we're going to change what they see and how they experience themselves and the people around them.

    12. CW

      Well, ultimately, we are not in control of what is going to happen to us in life.

    13. BK

      No, uh-

    14. CW

      We really only have control over our reactions.

    15. BK

      Well, d- we don't even have control of our reactions. At some point, you need to go to the bathroom. At some point, you need to not hold your breath. At some point, you need to go asleep. Uh, uh, some people will make you angry, and other people will make you feel all warm inside. Uh, and you don't have much control over your reactions. You have some control over how you behave, uh, and that's really, yeah, the difference between little kids and adults. Little kids do whatever happens to them, and they react to it. As adults, we get a prefrontal cortex, and hopefully, most of the time, we can make decisions about how we act. Even though our bodies could tell us, "Don't trust this guy," you can still...... talk to that person as if you trust them-

    16. CW

      Mm-hmm.

    17. BK

      ... even though you don't ĩut to.

    18. CW

      This is

  4. 12:4121:34

    How to Not Be at the Mercy of Your Feelings

    1. CW

      something I really want to dig into, and I think a lot of people listening will resonate with this. They are thoughtful, inquisitive, reflective people. They like their cerebral horsepower and their cognitive ability. They understand that something can occur, and they can control their behavior, and yet at the same time, I f- th- they have a degree of control over their behavior, even if they don't have a d- degree of control over their reaction and the way it makes them feel. At the same time, we also need to be aware and give respect and integrate and be, uh, uh, become, um, noticing of the emotions that arise inside of us. And I can see a degree of tension between these two things, the person that wants to feel like they're in control of their life and has agency, the person who also wants to appreciate and integrate the signals that their body is giving them, but not be at the mercy of them. How do you, how do you think about the tension-

    2. BK

      Yeah.

    3. CW

      ... between these things?

    4. BK

      Well, what traumatized people oftentime discover is how little control they have. And in some ways, the people who become my patients are among the most conscious people you ever hope to meet, because they're willing to explore their, themselves. Uh, and most people aren't all so eager to do that. Uh, they want to, they'd rather stick with their habi- habits in, in life and push away anybody who interferes with their usual habits. And the people who come to my office say, "I cannot stand what's happening inside of me anymore, and I need to be, actually become in charge more of my own reactions." And so therapy actually is a, a very courageous act of confronting, uh, your internal demons and confronting, uh, the pain and hurt of your life actually, yeah.

    5. CW

      So, it seems to me that when we're talking about trauma, people have a reaction to an event which typically would not engender that reaction. They are, uh, trauma sensitive. They are overly reactive in a, a, a scenario that maybe doesn't warrant it because of something which they have learned in their past. Is that a correct framing?

    6. BK

      It's a, uh, learned, I wouldn't say learned, something has been installed in them from the past. And these are not higher level cognitive processes.

    7. CW

      Mm-hmm. Mm-hmm.

    8. BK

      These are elementary reacti- reactivities that have to do with the area of the brain involved in the housekeeping of the body, as Antonio Damasio calls it.

    9. CW

      What is that, from a, from a neuroscientific sense?

    10. BK

      Oh, it is your ventral tegmental area, your amygdala, your, uh, periaqueductal gray, the, uh, precuneus. It's the back part of your brain that we have in common with all animals that help us to, uh, perceive what's happening to us on a elementary level, the same way that your dog hears the thun- a thunderstorm and crawls underneath the couch. Uh, uh, we are, have the same brain as the dogs have. And on top of that, we have a big frontal lobe that hopefully makes us slightly more capable of managing our emotions than dogs do, but many people don't.

    11. CW

      I, yes, I- I've met many people who don't have any more emotional control than dogs do. And I think that tension between wanting to feel like the architects of our own life and understanding that we have a limbic system which very much is the elephant that we sit on top of, and it's not the elephant that's got blinders on, it's us, the rider-

    12. BK

      Yeah.

    13. CW

      ... but we have this belief that we're the one that's in control, I think that tension is where, um, some people are probably resistant to ideas like this, because it feels disempowering. It feels like there is a, an architect pulling their strings.

    14. BK

      Well, you know, uh, yes and no. You know, with any sort of self-reflection, we all know that. (laughs) Uh, we all are aware of that, in a way. Um, you know, it just... You know, there may be some people who don't want to go there, but they're all very simply-

    15. CW

      I think, I, I mean, I, I, I understand that may not be the truth, but I think that it explains, at least to me, you know, I, I don't like the idea that I'm not in charge. I don't, and I will find ways to resist that belief. Even if I know that it's true, I try and sort of finagle and find ways to go through things. So, I guess one of the in- you, you mentioned it earlier on, different people reacting to the same event will react in different ways. Some people will be traumatized, and others won't be.

    16. BK

      Yeah, pe- peop- people make a big deal out of that, you know, having the practice that I do, uh, running the center that I have for 50 years, um, I never meet somebody who has been traumatized where I go like, "Boy, that was a pretty silly thing to get traumatized by." Uh, you know, usually if you dig deeper to what people have been exposed to, you go like, "My god, and you're still here, you're still able to tell the story." Uh, it is not like, oh, something happens and everybody else is fine and you got traumatized by it. Usually if you really look at the details what happens, uh, you see that it really was a very painful experience. And my reaction almost invariably hearing the story about the people I, I work with, uh, what they have b- gone through, is like, "Oh my god, how the hell did you survive?" And I never have the feeling that, "Oh, I would've done much better" than they did.

    17. CW

      Mm-hmm. This is something else I really wanted to dig into, which is the minimization and the shame that people feel around them not having anything worthy...... of being labeled as tr- "Oh, no, you know, that was when I was a child. Oh, you know, it was just one time. Oh, it was..." Whatever. Could y- Talk to me about that? Talk to me how that can hide in the dark some of the things we've experienced.

    18. BK

      Well, you know, we all want to be normal. Uh, uh, you know, one thing came up in the last few days is how almost everybody, uh, wants to tell other people, "I came from a very happy family." And you don't really want to know that your father was a drunk and your mom spent half her time in bed and stuff like that. And so, so we want to be normal, we want to be acceptable. And so we make a construct of ourselves, of people who are in charge of ourselves and who have always been loved by the people we're close to. Right? That is how we like to experience ourselves. It's not all barely true, but, you know, we like to look good to the world. (laughs)

    19. CW

      (laughs) Yeah. You know, no one, no one wants to admit just how insane they are, I think. And there's two layers-

    20. BK

      Yeah.

    21. CW

      There's two layers to this that I was thinking about when looking at your work.

    22. BK

      Yeah.

    23. CW

      The first one being the minimization and the shame, uh, that we have around situations that have happened to us in the past. And the second one being the shame around being triggered by seemingly small events in the present.

    24. BK

      Yeah. Yeah. Yeah. A- and you say to yourself, "Don't be stupid." Uh, uh, you become very judgmental about yourself and very ashamed about your own reactions.

    25. CW

      Mm-hmm.

    26. BK

      And when you're ashamed, you don't want anybody to see you for who you are. Yeah.

    27. CW

      It's the story that we tell ourselves-

    28. BK

      Yeah.

    29. CW

      ... about our reactions that seems to be the really unnecessary degree of suffering that we've layered on top of all of this.

    30. BK

      Yeah. You know, uh, you know, it's a way of coping. Uh, and so dismissing things is a very good initial reaction. Like, I want to go on with my life and push it behind me, and-

  5. 21:3426:48

    Does Trauma Make Us More Vulnerable to Future Trauma?

    1. CW

      of the things I've been thinking is whether, uh, experiencing traumatic events and having trauma sensitivity predisposes us to being more sensitive to future traumas. Does this become a, a recursive loop in that way?

    2. BK

      Oh, uh, absolutely. That, uh... Well, generally. Uh, you know, it's also true that some people who have been traumatized become very good at stuff. Uh, uh, so let's look at the positive thing first. Um, I have met a number of nurses or kindergarten teachers who are spectacular nurses, spectacular kindergarten teachers, because they were traumatized as kids, and they know what I- they would have needed back then. And so they give to people what they felt they didn't get themselves as kids. That is one adaptation that happens sometimes. Um, but more often, people are out of touch and repeat their trauma early on. But I meet quite a lot of people where deep down I think to myself, I don't say it because most people don't have a good enough sense of humor about it to say, "Go back and thank your abusive parents for having been abusive, because it made you very good how to take care of dysfunctional people around you."

    3. CW

      Hmm. Well, I suppose if-

    4. BK

      Yeah.

    5. CW

      ... if every trauma made you more susceptible to future traumas, you would just have a lineal graph over time of people getting more and more traumatized as they get into older age. They would just continue to accumulate and continue to get sensitive and continue to be... Accumulate and continue to get sensitive.

    6. BK

      Yeah. That's of course not how it goes.

    7. CW

      Yep.

    8. BK

      Uh, because people also have lives, and, uh, some people are able to arrange to have lives that are more or less predictable, and where they can play a useful role, and where they shield themselves against, uh, unpleasant surprises, more or less. Easier to do when you're somewhat privileged person, harder to do when you're poor and brown, let's say.

    9. CW

      Mm-hmm. Is there anything that we can do during difficult events to minimize the way that they imprint on us?

    10. BK

      You know, my agenda, I like to say as often as I can, is that, uh, in every school from K through 12, we should have weekly classes and laboratories on understanding ourselves. To learn about how our brain functions, how our body functions, what happens to us when somebody touches us, what happens when we throw a ball, what happens when you make music together, what happens when you interact with people. And that, uh, uh, to my mind, the... A very important part of the solution is teaching every k- kid from the beginning, uh, of classes the four R's: reading, writing, 'rithmetic, and self-regulation, and make yourself an important part of the study that we do. And I think our society would change if all of us would learn that systematically. Uh, that we learn about brains and neuroscience and how brains interact with each other, and experience what it's like to, um...... to, to play ball with other people, to be involved in rhythmical activities. What does music do for me? What does things like these crazy Qigong movements do for me? What is it like, is it like for me to sing with other people? How do I affect other people? All this stuff should be part of our basic training, as it oftentimes, okay, of course is for many privileged people, who actually go to schools where, and live in households where people learn stuff like that. Yeah.

    11. CW

      Yeah. I understand that self-regulation is a, a great tool for dealing with and making yourself feel better.

    12. BK

      Yeah. And, uh, but also understanding yourself, really knowing, "Oh, when I get upset, listening to that piece of music makes me feel better." Or, "I have found that when I sit in front of a piano and play some music that I just calm myself down."

    13. CW

      Mm.

    14. BK

      If somebody, um, "If I can play volleyball with somebody." And to really, that, in your course of your education and your growing up, you really learn what makes you feel good and what can you do for yourself when somebody upsets you.

    15. CW

      Yeah. Yeah. I'm, I'm really trying to work out how much of that... Oh, I, I, I really want you to dig into, is that an ability to simply cope with the emotions that come up? Or is it something which will reduce down the echo that it continues in the future? Or is that one and the same?

    16. BK

      No, uh, what I'm talking about really is that, uh, we raise conscious human beings, who, who are really aware of themselves, uh, aware of their own reactions, who are aware of the people around 'em, and what effect they have on other people. And th- this really becomes a serious area of study, to live in a more conscious society.

  6. 26:4833:58

    Tips to Being More Self-Compassionate

    1. CW

      How can people learn to be more self-compassionate? We live in a meritocracy. People want to achieve things, they want to grow and, and improve. And yet, a lot of this seems to rely on self-compassion. What's your advice?

    2. BK

      Mm, you know, self-compassion really comes from, uh, having been met and having been seen, and that becomes your framework of yourself. And so, if you come from, indeed, a loving, kind, and responsive family, it's likely that you f- do feel self-compassion. And that... I mean, you learn that, "When I fall down, somebody will be there to pick me up. Uh, people don't yell at me and scream at me for falling down, but they're really there for me in a way." That's, that's how you learn to be there for yourself also. Huh? Um, and, uh, the m- a huge thing that we see in our work is, uh, having a history of abuse and neglect early on in your life really, more or less guarantees that you see yourself as defective and wrong and not a good person and disgusting and sort of stuff. An extremely difficult thing to treat. Uh, the first things that I've actually seen work for that was the research of which I was the PI, uh, on psychedelics, MDMA, where we saw that psychedelics really dramatically increased people's capacity for self-compassion, where they really were able, in a psychedelic state, to go to whatever happened to them, and to really feel very deeply what happened back then, and to go, "Yeah, that's what happened to this kid. This kid was only three years old and did the best he could." Or, "He's only eight," or, "He didn't know how to deal with the bullies in high school, and he felt so weak and stupid, but that's all he could do." And so, on psychedelics, you really, uh, MDMAs particularly, uh, we see this emergence of this capacity to really accept yourself for what has happened to you and not blame yourself for things. Uh, and I've never seen it to the same degree with any other form of treatment that I've studied.

    3. CW

      That's really beautiful to think about the person that you were when that thing happened to you and to say something like, "You did your best." Um-

    4. BK

      Yeah.

    5. CW

      ... you know, uh, you want to pick that person up and give them a hug.

    6. BK

      But it's, it's not cognitive. It's not like your frontal lobe. It's really, in psychedelics, you really deeply experience yourself on a very deep level. And it's not an outside person telling you, "It wasn't your fault. You were just poor."

    7. CW

      Mm-hmm.

    8. BK

      'Cause that's... You'd never believe that, really. Uh, but it's yourself that really feeling what happened to you and getting an internal sense of time, uh, so you don't l- no longer identify with that kid who was being bullied or he was being put down or whatever. You say, "Oh, I'm so sorry that you, I, back then, had to go through that."

    9. CW

      You say that we shouldn't keep secrets from ourselves. And it seems to me that what we're doing with psychedelics, also breathwork practices, in some ways, anything that allows you to, to sort of both dysregulate and regulate a little bit under control, uh, and make yourself feel safe to tap into these things.

    10. BK

      Yeah.

    11. CW

      Uh, it breaks down the secret wall that we are able to construct around those thing... "Uh, this doesn't feel safe. I can't think about that thing. I don't wanna go back to that place." And it helps you to sink into that more.

    12. BK

      Yeah. And f- to my mind, this is becoming a very urgent social issue. I don't know whether you have heard or seen the new book by Jonathan Haidt?

    13. CW

      He was on the show a couple of weeks ago.

    14. BK

      Okay. Uh, it's very important book, uh, that, um, that we are raising our kids behind screens and not to explore and not to feel things. And we give kids a false, um, reward system by screens where they don't have to do anything. And I think screens will have major negative effects, uh, on self-knowledge.... and self-experience, actually. And I think, uh, we really need to listen very carefully what Jonathan has to say about that, yeah.

    15. CW

      Digital anesthetic is one of the ways that I think about it. Uh, people who are going through something emotionally uncomfortable can distract themselves with their screens.

    16. BK

      Yeah.

    17. CW

      Um, that results in you basically not connecting with your life. The emotions, but-

    18. BK

      Yeah. You, you know, it's not black and white, of course. Uh, it's okay to distract yourself. It's okay to not confront all the misery of the world all the time. So, uh, I, I totally understand that, and actually encourage it, that when something bad happens to people, they could do something else to not dwell on it. And there's actually another very important research, piece of research, that's just beginning to make it into our consciousness by, uh, Farb and Zindel, uh, Siegel, about how your sensory experiences, uh, your, your feeling things, your senses, and doing things that make you alive to your senses help you to get out of habitual ways of doing things. Uh, uh, for example, I did a first study on yoga for trauma, and we had amazingly positive results. And now, with the ev- evolution of neuroscience, I'm beginning to understand more and more why yoga can be so effective, because in yoga, you really pay attention to your internal sensory world, and that seems to be a very important avenue for you to feel that you can meet yourself and be in control of yourself.

    19. CW

      Say more about that. Why is that so important? What is it about the attention being deployed?

    20. BK

      Uh, because, um, we all get into habits. Uh, our brain creates habitual system. That's a ... that basically the brain is a predictive organ. How the brain tell us, tells us when I talk to you in Austin, Texas, um, I, I can expect certain things. And if you do something that is very different from what I expect, I have to sort of change my take on you. But ordinarily, I go into a habit of doing the same thing and talking the same w- thing. But if your habits no longer work for you, uh, you always blow up at your kids, or you, uh, you always freeze in front of your boss, you need to get a new habit. And the new ha- new habits get formed by activating the sensory system in your brain. So, so the opposite of what you do with screens. You dull the sensory system in your brain with screens. By doing action, uh, meditation, yoga, uh, probably martial arts, uh, stuff like that, you really activate new habits.

  7. 33:5838:32

    How Trauma Manifests as Illness

    1. CW

      Talk to me, uh, there, there'll be a lot of people listening who go, "Okay, Bessel, that sounds spot-on. That makes sense to me. I understand how our emotions and our reactivity can become hypersensitized." But this goes quite a few steps further. How does trauma manifest as an illness, a, a, an illness that people would typically recognize? What are the ways that can happen?

    2. BK

      Well, you know, uh, of course, I'm an MD and a professor in medical school, so, so I know the medical model.

    3. CW

      Mm-hmm.

    4. BK

      But, um, in our work, I don't have a medical model, not, "You're diseased and you aren't." You know, um, a lot of people who, uh, never been to a psychiatrist are crazy as loons, and people who are, been to psychiatrists are some of the most sensible people I know. So, pathology is when you g- miss the boat, right? When you keep doing things that mess up your life and the life of people around you. That's the pathology. And so I, uh, you wouldn't necessarily give this a psychiatric label, but all somebody's friends will say, "They're doing it again." (laughs) You know?

    5. CW

      (laughs) Yeah. Talk to me about some of the, uh, more typical illnesses that people would not think stress and trauma in this way contribute to, and yet can, stuff like fibromyalgia and-

    6. BK

      Yeah. You know, these are, you know, and these are questions that should be asked more often, uh, in part because we have so few answers at this point, is that it's very clear that fibo- e- fibromyalgia, chronic pain, um, uh, autoimmune diseases ... I'm not saying that autoimmune diseases are caused by trauma, but they certainly are made much worse by trauma. It makes you much more vulnerable to develop them. All these somatic responses, um, have been identified but barely studied and barely really systematically looked at, how, what can you do and how can you best take care of it? But they're clearly trauma-related, uh, and they're clearly body-related, and – but because there is so little attention in the research world on how we process bodily experiences, that this is very largely still an unknown territory. And my, my foundations I started, uh, the Timely Research Foundation, actually is particularly interested in promoting studies on these sort of things that have not been studied or funded before.

    7. CW

      It seems interesting to me, uh, totally unsurprising, that chronic elevated concern and worry and inflammation in the mind and the body would not ma- ... Uh, how, how could it make anything better? I don't understand why that wouldn't be something which is a contributing factor.

    8. BK

      Uh, it clearly is, um, but I think our...Academic work is not there to really systematically explore body sensations and how to change people's, uh, relationship to their bodily experience.

    9. CW

      Well, I suppose that testing that is very difficult. You know, here is a dose of a drug. We gave this many people in this cohort that dose for this long. These are the results. These are the self-reports. For you to say, "Chris, how does your body, uh, describe to me the sensation, what's the inner texture of your mind like today?"

    10. BK

      Yeah. But, you know, you can study it if you put your mind to studying it. You know, like, um, like, at the beginning, you don't have vocabulary for it or you don't know how to do it, but you learn how to do it. For example, the very first study that we funded, uh, from our foundation, is a study on the impact of touch and various forms of touch on a group of people who have no trauma and a group of people who have been traumatized. You know, to me, it's just fascinating that people have studied eyesight, people have won Nobel Prizes studying vision, people have won Nobel Prizes in audition, but touch has barely been studied. That's very

    11. CW

      What did you find?

    12. BK

      Oh, we're not... We're still in middle of the study actually. Uh, we're funding it, and next week, I hope the first... to hear the first report on what they're finding.

    13. CW

      Hell, yeah. Okay.

  8. 38:3250:49

    Principles for Treating Trauma

    1. CW

      So, when it comes to modalities, uh, and getting better, both dealing with in the moment and unwinding, uh, the broader patterns, what are the principles? Is, is there a framework? What is it that people need to focus on when it comes to treating trauma?

    2. BK

      Well, the, the main focus is, when you're traumatized, you lose your core sense of safety and internal integrity. As, so, the greatest challenge is how you induce a sense of total safety in the organism that a person lives in. And certainly, judging by my own experience and many other people since that time, uh, uh, having- having body work done on you, working with yoga, tai chi, qigong, everything you have that activates your relationship to your own body, uh, is- is sort of step number one. Uh, sitting in a hot tub, being able to be touched, being able to- to just sort of let go, uh, is the first step to- to- to- to shut down the alarm system that's always active. Yeah.

    3. CW

      Presumably, if that isn't shut down, no further work can be done.

    4. BK

      That is my sense, yeah. And, but it's also very striking actually, is that up to now, basically, all of our treatments didn't work all that well with very shut-down people. And one of the surprising findings of our MDMA study was that very shut-down people actually came to life on MDMA. It was like, wow.

    5. CW

      Why would you think? What could you hypothesize would be the reason for that?

    6. BK

      Uh, what we hypothesize is that, uh, hy- the MDMA changes people's awareness of themselves. You know, we can talk, do some what I call bio babble. We can talk about the serotonin receptors in the brain. You'll say, "Oh, he must be very smart. He knows about serotonin receptors," but it doesn't really explain anything. Now, I have some words to use to explain it. The brain is an incredibly complex organ, um, but we're beginning to get some little understanding about what might be going on to make that happen.

    7. CW

      Okay, so that's step one.

    8. BK

      Yeah.

    9. CW

      What does step two look like?

    10. BK

      Step two is to be able to, uh, to feel what you feel and to really be, uh... You know, that's what, for example, mindfulness practice, uh, be good for, uh, for... It's not as hot a topic as it was a few years ago, uh, but mindfulness is very big. And, uh, what is also true is that doing mindfulness exercise, doing medica- meditation can be very stressful, because as you shut down all external input, you feel yourself. And feeling yourself can be a very scary and unpleasant experience actually, uh, which a lot of people don't want to do. So, they turn on the TV, and they have a lot of input in order not to feel themselves, uh. But if you cannot live in silence with yourself, you're not okay. And that's what you see with soldiers who come back from Iraq and Afghanistan. Uh, first thing they do, they turn up the volume, they make a lot of noise. They don't want to feel what's inside of them. They just want to go (imitates music) all the stuff out there. Um, and that's because they're scared of themselves. And so, uh, learning how to, uh... And most of us need guides for that, somebody who encourages us to do it, and is with us, and say, "Well, I know it is difficult, but I'll help you to meet yourself." And that's a really important thing. Yeah.

    11. CW

      It's a common realization of mine that, on the days when I haven't allowed my mind to talk to me during the day, it usually comes back and gets its revenge when I'm trying to go to sleep on a nighttime.

    12. BK

      Yep. Yep. No, it's, uh, it- it's interesting how it is going to evolve. I see things sort of going up and down, and it depends very much on the environment you live in. Uh, when I go to the Bay Area, I see a lot of people, uh, doing the sort of things I'm talking about. There seems to be some consciousness about it. Maybe Austin, Texas, maybe another place. It's very sort of geographically, uh, happening at different places at different times, yeah.

    13. CW

      Yeah, you've got an odd sort of domain-centric, uh...

    14. BK

      Yeah.

    15. CW

      ... trickle- trickle-down effect. Uh, and the UK, as is tradition, will be last to do it, but...

    16. BK

      Well, but I know some very...... very mindful people in the UK who are very-

    17. CW

      I know some m- mindful people, too. It's a slow adoption state, though. Apparently, the Atlantic is a little bit bigger to get health and wellness things to go across it.

    18. BK

      Oh, it's interesting how, in many ways... I just came back from two months in Australia, and I think Australia is... I met some Australians who said... I said, "You know, Australia is so much like America. We're just slightly more screwed up than the US."

    19. CW

      (laughs)

    20. BK

      Slightly. (laughs) Uh, uh, and, uh, you know, it's interesting. A friend of mine just wrote me. He said, "Can you help this friend of mine who's, uh, writing about all the trauma in America?" And I said, "Well, I'll talk to him, but he also should talk about the enormous creativity and the innovation that continues to come out of our culture." And maybe the two of them are two sides of the same coin. Huh? And it's interesting. I go to Europe quite a bit also. Um, and, you know, standard of living is great in Europe. I think standard of life is great. But they're not quite as sharp and innovative as Americans. I think our world, being as unpredictable and ofttime scary, does keep us on edge a little bit here in the US. (laughs)

    21. CW

      (laughs)

    22. BK

      Slightly. (laughs) Uh, uh, and, uh, you know, it's interesting. A friend of mine just wrote to me. He said, "Can you help this friend of mine who's, uh, writing about all the trauma in America?" And I said, "Well, I'll talk to him, but he also should talk about the enormous creativity and the innovation that continues to come out of our culture, and maybe the two of them are two sides of the same coin." Uh, and it's interesting. I go to Europe quite a bit also. Um, and, you know, standard of living is great in Europe. I think standard of life is great. But they're not quite as sharp and innovative as America is. I think our world, being as unpredictable and ofttime scary, does keep us on edge a little bit here in the US. (laughs) Again, the same theme as we talked about before. If you're privileged, it's a great place to be cre- creati- creative. But if you're- if you're downtrodden, it's mhm. ... a terrible place to be. But, yeah.

    23. CW

      Yeah, I mean, I- I- I love Italy. Rome is my favorite city on the planet.

    24. BK

      Yeah.

    25. CW

      And I- I- I'll never forget the first time that I went from Leonardo da Vinci Airport to the center of Rome on the metro.

    26. BK

      Yeah.

    27. CW

      And it was 2:00, 2:00 PM, something like that. There was a- an Icelandic girl that I was going on holiday with. And, uh, I... She was a- and, uh, gonna be an hour's time. And I was like, "I'm in Rome. I'm getting an espresso, and I'm gonna sit outside and eat a croissant." So sure enough, I find a local cafe. And this dude comes in, in a business suit, no tie. And it's 2:00, and I presumed that this must be his lunch break. And I saw him spend probably 35 to 40 minutes of what I'm gonna guess is maybe a 50 or an hour-long lunch break, just with a glass, large glass of red wine.

    28. BK

      (laughs)

    29. CW

      Sat outside, just sipping it. M- some people were coming in and out. Maybe he was a local. He sort of had a little chat to them. And, uh, yeah, that culture does not engender the permanent ambient anxiety and vigilance of spurning creativity that you would have in, uh, you know, the caffeine-fueled Americas.

    30. BK

      Yep, yep. But as you sort of imply, his life is slightly better.

  9. 50:491:01:40

    Opening Up to Other People

    1. CW

      you've said, (clears throat) you mentioned about giving yourself language, giving yourself th- the language to be able to understand and- and make sense of why might this be the case. Everything that we've spoken about so far, uh, except for, you know, body work, and you can do things in classes, but the unpacking and the unpicking of these stories hasn't yet, you haven't yet, uh, talked about it being in relation to somebody else, about opening up and explaining the story to somebody else. What's the role of- of sort of communion and- and conversation-

    2. BK

      Yeah.

    3. CW

      ... and other people here?

    4. BK

      It's a tricky issue. You know, therapists always talk about relation. And then, my reaction is, it's not merely a relationship. A relationship is if I look out for you and you look out for me. But in therapy, it's a, some way, not entirely, it's a one-way street. Uh, as a therapist, I look after you, and you don't have to look after me. I use my reactions to understand you better, but I don't expect you to, uh, to take care of me or to be considerate of me all that much. And so, yes, I think the interpersonal aspect is terribly important. You need to feel that somebody is on your side, that somebody has your back. Um, and I think relationships become important, and when you're traumatized, oftentimes your relationships become very impoverished. But the relationships you have with real people and not so much with your therapist. Your therapist becomes a role model to some degree maybe, but most of all, it becomes a deeply accepting person who helps you to be curious and open about yourself, and who gives you the courage to meet yourself, actually. That's what I would say.

    5. CW

      There's a lot of criticism and skepticism at the moment about therapy and therapy culture. Abigail Shrier recently wrote a book called Bad Therapy. She went on Joe's show, she came on this show.

    6. BK

      Oh.

    7. CW

      Um, what- what do you think therapy looks like when it's at its best?

    8. BK

      Oh, well, I- I, you know, I'm also, I see a lot of terrible therapy going also. And, you know, I do a lot of supervision in various countries and places, and I meet therapists all the time who says, "How do I manage these patients?" And I go, "You don't manage other people. I can barely manage myself, I cannot manage other people at the same time. But I can help you to feel yourself, to understand yourself, and to, uh, to- to really go deep inside." And I have some tricks in my book of a variety of different techniques that will help you to go deeper into yourself. But in order to do so, you have to become subject of that yourself. Uh, so you have to go through it yourself and really have explored, deeply explored your own mind, your own history, your own psyche. Uh, I can proudly say, in my book, I experience every technique I write about, and I know what it did for me. Some of them were more- more helpful than others. Uh, but it's very important for a therapist to become the subject of therapy themselves. And that's no longer a requirement. In psychiatry-

    9. CW

      Is that right?

    10. BK

      Yeah, in psychiatry, people are not at all expected to do their own therapy.

    11. CW

      How interesting.

    12. BK

      Or to enjoy the drugs that they give to people. You know, I almost got fired from my medical school because I used to tell my residents, "You know, when you give these drugs to people, you should take it yourself to see what it does to your mind." And the dean said, "One more comment like that, and I'm going to lose your faculty appointment." (laughs)

    13. CW

      Francis Galton, who was the man-

    14. BK

      Oh.

    15. CW

      ... that invented eugenics back in the nine- 1900s, early 1900s, such a fascinating, absolutely fascinating guy. He submitted a patent for how to cut a birthday cake so that you don't ever get it to go hard. So rather than cutting it in slices, you cut a- a- a bit down the middle, and then you push the two outer parts together. Um, his sister was, uh, born with a- a spinal condition, so she laid on a table while he spoke to her and he educated her through speaking to her. He's- he was a- a- a very quirky guy. It's very worth, uh, looking into his history. But one of the things that he did was he went through (laughs) , he went through the list of, um, pharmacology treatments and medicines alphabetically, and I think he got to C, and then when he got to C, he took something, I can't remember the name of it, it's like cat's wood or something? He took some-

    16. BK

      Yeah, yeah.

    17. CW

      ... he- he took something that caused- caused him to shit himself so badly that five decades later, when he wrote his autobiography, he still had memory of, like, this-

    18. BK

      Yeah, yeah.

    19. CW

      ... violent diarrhea.

    20. BK

      Yeah. (laughs)

    21. CW

      (laughs) I love that story.

    22. BK

      I'm doing a thing on William James right now, uh, the founder of American psychology, and he tried it all himself also. Uh, and, and he did some weird things with himself.

    23. CW

      The things, the things that we do for science.

    24. BK

      No, but, but we should. You know, you, I don't think you can be a dete- detached scientist. You still make selections of what's important, what's unimportant, and still your emotional brain labels what's important, what's unimportant, yeah.

    25. CW

      Mm. Okay, so we're talking about therapy being one of those things which, when done well, can be fantastic, when done badly, and, and, and sometimes is done badly, uh, doesn't necessarily help. I think one of the questions I had coming in was how much of the modalities that you're suggesting are dealing with symptoms or able to unpick deeper responses, and it seems to me like they... Most of the effective ones do both, that they create a state in which you can then move a little step deeper, and I can feel, I can still feel safe and this is okay, and let's have a look at the story, what's the emotion that's coming up? And then that's okay, so we move one step deeper. Okay, what's the story? Why might this be the case? I can use a little bit of executive functioning without ripping myself out of the emotion, but I can still use, bring a little bit of the front brain in and start to see this for what it is. Okay, what might be a good way for me to continue? How, how can I stress test this? How is this true? And that, that seems like a, a good model to me. It seems like a nice balance of, of control and of ease. Um, that, that makes a lot of sense.

    26. BK

      Yeah. See, you know, it is not a culture we live in. The culture we live in is, uh, that people adhere to a particular treatment, let's say you're a Freudian psychiatrist, and that becomes your answer to everything. And you see that oftentimes in therapy, I see it in many of my colleagues who are about my age who have studied the same treatment their entire lives, and they found their data 30 years ago, but they're still doing the same stuff. Instead of saying, "Now, let's see what else works and what worked for the people, who it didn't work for," they keep doing the same thing. And a lot of therapists tend to be like that. They find one little thing and they continue with the same thing. And what my program has always been very much about is, we learn a lot of different things, and, uh, and so therapists tend not to evaluate on a regular basis, something I'm very much promoting these days, uh, to on a regular basis, see, so how far have we come? What has been accomplished and what hasn't been accomplished? And what do we know can help with that? Let's say, if you are chronically anxious or frazzled, despite the fact you've done a lot of stuff, how do we deal with that? Does a yoga practice help for that? Let's see. Maybe a neurofeedback practice helps to calm the brain down by changing the wiring of your brain. So, uh, it's very important, and that's not happening right now in any program that I know of, uh, where people learn about multiple options and learn about what options are best under what particular circumstances.

    27. CW

      You mentioned that you'd tried every modality that you put in The Body Keeps the Score.

    28. BK

      Yeah, yeah.

    29. CW

      Which is the one that you have found to be either most impactful or the one that you keep coming back to most regularly?

    30. BK

      I, I come back to basically all of them. Uh, uh, my favorite clinical activity is psychodrama, uh, where you can have a, a virtual three-dimensional experience of how things could have been different back then. So that's my clinical practice. What was most helpful for me, I think, of all things I've done, was Rolfing. I was born in 1943, uh, on the conditions pretty similar what the kids in Ukraine are experiencing right now, and that became imprinted on me. I was a very sickly child, uh, like many people of my generation at the end of the war, a lot of kids died, and I was a sickly kid, and I was sort of living in a semi-sickly body. And what was extraordinarily helpful for me was getting Rolfed. Rolfing is a very intense form of, uh, body work where my body was rearranged to be more flexible and not be stuck in this, uh, frightened little kid part that was part of me. It had nothing to do with cognition. It is just my body was free up- freed up to respond differently to the world. So it was very different from how I was trained with, with Freudian psychoanalysis, basically.

  10. 1:01:401:04:38

    What Bessel is Excited About

    1. CW

      Looking to the future, I know that you have a lot of, uh, studies that you're either involved in or funding at the moment. You've got this new book coming out. What, from a modality and research perspective, what are you most excited about?

    2. BK

      It all depends on, on the culture we live in. At the end, everything is political, huh? Um, what gets funded is political, what gets paid attention to is political. And so, uh, what I'm, in terms of what I'm working on that's exciting is psychedelics. Uh, because I think psychedelic, psychedelics bring the mind back into psychiatry, it allows you to look at mental processes that change, and it allows people to discover things about themselves that nothing else that I've seen does so. But, at the same time, uh, as psychedelics become legal, I worry that it will get totally screw- screwed up.

    3. CW

      How so?

    4. BK

      As people, kind of, pharmaceutical companies trying to create new concoctions so they can make an optimal amount of money.

    5. CW

      Mm-hmm.

    6. BK

      Are, people getting psychedelic drugs without any, uh, contextual input. They're just giving a drug, uh, without helping people to process them. And I'm very, very concerned that this is very likely to get screwed up, um, in the same way that... You know, you know, I'm old enough to be part of the first LSD revolution, um, and it was very exciting then also. But, uh, totally, people blamed the Nixon administration for good reason. But the people who were doing psychedelics weren't all the most responsible people either.

    7. CW

      Yeah. Yeah. Well, I mean, look at the original introduction of MDMA, you know, over a hundred years ago.

    8. BK

      Yeah.

    9. CW

      It, we- we've come full horseshoe back around to exactly where we started, except for the fact that it was regulated for a century-

    10. BK

      Right.

    11. CW

      ... and no one actually got to do any research with it.

    12. BK

      Yeah. Well, some people did, actually. There was a little bit of research before it was But, you know, here's a good example of what happens in politics. So, I'm a senior medical student at the University of Chicago, and my last rotation was a drug addiction rotation, uh, where we more or less invented methadone treatment for heroin addiction. Uh, my boss, Chuck Schuster, uh, was a very lovely guy, very f- actually interesting to work with, and he used to smoke dope from time to time. That's normal for those days. He became Nixon's health czar.

    13. CW

      (laughs)

    14. BK

      And he goes on television, and he says, "These drugs rot your brain." I go, "Huh?" You know better than that. But because it is so politically the right thing to say, he was the lead person saying that these drug- ****** your brain. He knew better than that.

    15. CW

      Perverse incentives everywhere.

  11. 1:04:381:05:04

    Bessel’s New Book

    1. CW

    2. BK

      Yeah. Yeah.

    3. CW

      What can you tell us about this new book?

    4. BK

      The new book is very much about, uh, it's called Come To Your Senses, and it's about really, uh, the critical issue of introspective embodied self-awareness. Uh, that, how do we become aware of ourselves and how we change our relationship to ourselves? And that's really what the book is about. Very cool. And being-

  12. 1:05:041:05:35

    Where to Find Bessel

    1. BK

      Bessel van der Kolk, ladies and gentlemen. Bessel, you're fantastic. I love your energy. I love the fact that you're so dedicated to this. Where should people go if they wanna keep up to date with the stuff you're doing? Hm? Oh. Where should people go? Talmud Research Foundation is our... uh, talmudresearch.org is our website, and there's always a lot of stuff happening. Hell yeah. Bessel, I appreciate you. Thank you. Thank you. Thank you, Chris. Bye. If you enjoyed that episode, you will love a selection of the best clips from the podcast over the last couple of months, and it's available right here. Go on, give them a watch.

Episode duration: 1:05:35

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