Peter Attia MD339 - Unpacking trauma: How early wounds shape behavior and the path toward healing
EVERY SPOKEN WORD
125 min read · 25,262 words- 0:00 – 1:38
Intro
- PAPeter Attia
Talk a little bit about this loaded word of trauma.
- JEJeff English
Really embracing a definition, moments of perceived helplessness. You know, that's what's gonna activate the limbic system.
- PAPeter Attia
What would you say to a person who's listening to us who's trying to even understand if they've experienced trauma?
- JEJeff English
Learning coping skills in safe offices with therapists. It's really hard to recreate that back at home.
- PAPeter Attia
I'm going to day two of my journal here.
- JEJeff English
[laughs]
- PAPeter Attia
I can't help but feel like it's a mistake to be here. How could this place, this experience, possibly make a meaningful difference in my life? Trust the process, they say. Surrender to it, in quotes, I'm told. Okay, I'm here, and I guess I'll try. Hmm.
- JEJeff English
This is hard work, and this is uncomfortable, and if it wasn't, there'd be a line of people all the way back up that hill trying to get in here.
- PAPeter Attia
[laughs]
- JEJeff English
But if you noticed, there's no-
- PAPeter Attia
There's no line
- JEJeff English
... there's no line to get in here, right?
- PAPeter Attia
You know, if, if someone's listening to us and they're sort of contemplating either dipping their toe in-
- JEJeff English
Mm-hmm
- PAPeter Attia
... you know, by working with a therapist and trying to probe some of these things, or if they're thinking about jumping in the lake-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and then going to a residential place like The Bridge, um, what would you say to them?
- JEJeff English
If there's a voice saying it, listen. If there's a voice, even if it's a whisper, it's there for a reason. And I say more important than anything else, you're either gonna deal with it or it's gonna deal with you.
- PAPeter Attia
[upbeat music] Hey, everyone, welcome to the Drive podcast. I'm your host, Peter Attia.
- 1:38 – 5:14
Defining trauma
- PAPeter Attia
Jeff.
- JEJeff English
Peter.
- PAPeter Attia
Kinda hard to believe we're sitting here, huh?
- JEJeff English
Yeah. It is hard to believe. Um, and it's amazing, and it's, it's good to see you.
- PAPeter Attia
Likewise. Um, I thought long and hard about how I wanted to sort of structure our discussion today, um, knowing that this was, um, a conversation I've wanted to have for a very long time.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And, y- you know, I, I think, um, maybe the easiest way to start is just to kind of talk a little bit about this loaded word of trauma. Um, I... You know, when I first was introduced to this idea of, of trauma, I didn't know what it meant, and I think today it's become such a catchy buzzword that everybody is traumatized by something. And, and, and I don't know if that represents a pendulum swing or a normalization or what, but, um, why don't we just start with, with kind of how you describe trauma-
- JEJeff English
Mm-hmm
- PAPeter Attia
... as a trauma therapist and as someone who's been doing trauma therapy, uh, for many years, not just in the, you know, in the, in the recent trendy years, uh, for whatever that means. But h- how do you describe this to people?
- JEJeff English
Well, I would have described it the same way that you described it initially, you know, back in the day. You know, trauma. I, you know, I have to have been at Vietnam wartime, uh, 9/11. Um, these are those big T traumas. You hear some folks use that type of terminology. But within the spirit of the work, the knee-to-knee work, um, really embracing a definition, moments of perceived helplessness. Okay? Um, so, you know, that's what's gonna activate the limbic system, right? So who is to say what one limbic, limbic system evaluates as helplessness versus another, right? So that's when we get into this, um, I think discovery of most of the people that I meet, have been meeting over the last several years, are the ones, "Wow," like, "I think I did experience trauma," right? Um, you mentioned it's, it's a much more popular thing, and now are we trending in a different direction? So in a lot of my work with clients individually or groups, you know, h- I say I hate to oversimplify things, but I think sometimes we just make things too damn complex, okay? And so, you know, a lot of what I do is try to depolarize for folks, you know? And we're getting into these situations to where, you know, we live in this world of get over it, it doesn't matter, versus, like you mentioned perhaps, stay stuck in it, right? So, um, but yeah, moments of perceived helplessness, you know, activating that limbic system. And these things can happen, you know, sometimes at The Bridge, you remember we talked about wounding events.
- PAPeter Attia
Mm-hmm.
- JEJeff English
And one of those would be a tragic event. You know, life seems to be going one way before this thing happens, and then this thing happens, and life changes, and everything is different on the other side of that, right? A big T event, um, versus someone, again, who maybe you could describe it as a thousand paper cuts.
- PAPeter Attia
Mm-hmm.
- JEJeff English
Right? Someone growing up, going through childhood daily, being limbically activated. But moments of perceived helplessness, that stuck for me, and it stuck for a lot of clients.
- 5:14 – 12:31
Therapeutic process at The Bridge to Recovery: discomfort, vulnerability, & reframing one’s story
- PAPeter Attia
I've written about this in the book, which is that, you know, you and I met at a place called the, The Bridge to Recovery, um, in December of 2017.
- JEJeff English
Wow.
- PAPeter Attia
Seven years ago.
- JEJeff English
Yeah.
- PAPeter Attia
Um, and, you know, that was a very hard chapter for me to write, um, and one I wrote somewhat reluctantly, but also in the end felt I couldn't not write it.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Like, so the book was sort of incomplete without that chapter.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, so m- maybe we can even frame this discussion around how a place like that comes to exist-
- JEJeff English
Mm-hmm
- PAPeter Attia
... um, and how therapists like you work at places like that. Um, I'll throw one idea out that's worth discussing, but it's literally one of a hundred, which is It might be shocking to some to realize how much group therapy is done at a place like The Bridge to Recovery.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, in fact, as I looked through my journal, which I brought back-
- JEJeff English
Yeah
- PAPeter Attia
... um, looking through the notes, it's amazing how complex it was for me-
- JEJeff English
Mm-hmm
- PAPeter Attia
... to be able to open up in front of a group-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and how I spent the first few days saying virtually nothing-
- JEJeff English
Mm-hmm
- PAPeter Attia
... largely because of, I think, that, that, that discomfort.
- JEJeff English
Sure.
- PAPeter Attia
So, um, [lips smack] maybe tell folks a little bit about The Bridge, the type of work that's, that's done there.
- JEJeff English
Mm-hmm.
- PAPeter Attia
I forget exactly how I described it in the book, but I describe it as this wonderful, horrible place in the woods of Bowling Green, Kentucky.
- JEJeff English
Yeah. [laughs] Some folks call it, uh, a residential treatment. Some people call it trauma camp. Uh, there's a lot of different names.
- PAPeter Attia
Oh, I, I wrote some other names down here.
- JEJeff English
Yeah.
- PAPeter Attia
Do you wanna know what I have? I have, uh, Camp Misery [laughs]
- JEJeff English
[laughs]
- 12:31 – 19:28
Roots of the trauma tree: the wounding experiences that shape adaptive survival behaviors
- PAPeter Attia
You talked about the trauma tree. Maybe we can describe the roots and branches of that tree in some detail, because that is kind of the meta structure-
- JEJeff English
Mm-hmm
- PAPeter Attia
... that I think that story gets told. It's the cause and effect piece of it.
- JEJeff English
Right.
- PAPeter Attia
At least that's how I sort of came to understand it.
- JEJeff English
Right.
- PAPeter Attia
Um, I, I've seen many different ways that, um, trauma is described. Obviously, since I left The Bridge, I've-
- JEJeff English
Mm-hmm
- PAPeter Attia
... I've... It's a topic I'm personally very interested in for myself, for patients, et cetera. But I'll, I say, Jeff, I always come back to that structure, and I think it is the single best one I've seen.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Now, that doesn't mean that it is the best one. It's just the one that resonates the most with me-
- JEJeff English
Mm-hmm
- PAPeter Attia
... because causality means so much in my world.
- JEJeff English
Absolutely.
- PAPeter Attia
And I like the idea that even though it's not a one-to-one mapping-
- JEJeff English
Mm-hmm
- PAPeter Attia
... you know, everyone who experiences this trauma will have this manifestation.
- JEJeff English
Right.
- PAPeter Attia
Clearly not.
- JEJeff English
Right.
- PAPeter Attia
But, um, if you accept a little bit of the, um, the randomness in the system, it's, it's pretty powerful. So maybe walk people through the, uh, the five roots and the four branches of the trauma tree.
- JEJeff English
The five roots of the trauma tree, that's the what happened to me, okay? So this can be seen through the lens of trauma. And, and for folks where trauma's just too big of a word, like, can I, can you believe I'm saying that on this podcast? But okay, then lose it, right?
- PAPeter Attia
Mm-hmm.
- JEJeff English
Highly stressful events.
- PAPeter Attia
Mm-hmm.
- JEJeff English
Okay? So abuse tends to be the one that we talk really the least about at The Bridge, because that's the one that folks tend to know the most about. That's not to mean that we minimize it. There's just so many different forms of abuse, physical, emotional, abject, social. So you move over from abuse and you look at something like neglect, which can be very tricky. So many folks that have experienced neglect, it's an eye-opening experience, because while something like abuse is something that happened to me, neglect is something that failed to happen for me, right? And so to see that through the lens of high stress or pain, um, so many different way, ways one can be neglected. Um, you know, an example that's used there is the little boy that is going to school and he's being bullied, okay? And he's got these parents who are professionals and they're successful and they're busy and they've got the best of intentions, but they're missing it. They're missing the look on this kid's face when he comes in every day and before he gets on that bus every morning. That question's not being asked, "What's happening?" And so every day, this little person's being required to go to this place where this thing's gonna happen, and evidently, these folks at my house don't have time, right? And it's important to emphasize, I think, the word intention, because intention is not required, right? How many times have I said, have I heard, "Well, they had the best of intentions. They tried the... It still happened." Or in the case of neglect, it failed to happen, okay? Enmeshment, that's a wounding experience where you've got a boundary violation, right? So that can happen within the spirit of what we call emotional incest, where a child is put in an inappropriate, an age-inappropriate position. Maybe the child becomes best friend, counselor, and confidant for mom or dad. Um, and then you've just got this engulfing enmeshment, which happens a lot of times in successful families where outcomes and expectations are celebrated and they're not so much the journey. And so that engulfing enmeshment can be one of those situations where this is the way to be, um, more of a me, mini me relationship between a parent and a child instead of that I, thou relationship.
- PAPeter Attia
Mm-hmm.
- JEJeff English
And so, and in those situations with, with enmeshment, what typically happens is we either drink the Kool-Aid and get on board with it, or what do we do? We rebel, and I'm not gonna do anything that looks anything like this. Neither of those things is probably who I was meant to develop into, yes? I think probably, in my opinion, the umbrella wound, or it, we're talking about the tree, the root of the tree, would be abandonment, okay? And physical desertion or abandonment, that's low-hanging fruit as far as I think the general public and knowledge, yes, when somebody leaves. Now, a permanent abandonment, obviously someone passes away. There's death. Um, there's seasonal. Folks leave for work, military deployment. Um, folks go to prison. Um, parents get separated. Parents leave, come back. Um, now emotional abandonment, that's that situation where someone's there, but they're really not there, you know? And this emotional self gets denied. And, and a lot of times when you're emotionally abandoned, um, you know, it can be a situation where it's emotionally cut back, meaning the house I grew up in, we did anger. You know? That's what we did. Um- Wasn't okay to be sad, wasn't okay to be scared, but, but we did anger, okay? Um, so it wasn't like we were emotion-free. It was just we were cut back to that one. That's the one that I saw the most. Um, and then sometimes it's just a situation where it's cut off and it's blank n- and no emotion. Um, and I mentioned already the tragic event root of that trauma tree. And so I guess what I mean by the abandonment for me being this umbrella wound is, is when you abuse me, you abandon me. I keep going to parents because those are the folks that we spend the most of our time with in those formative years. But any of these wounds can happen with anybody in our life, and they can also happen anytime in life. It's not limited to childhood. When you get something happening when the brain and the body's developing, right? You get something, what I call, it, it gets concrete. You know? That gets cemented. It gets burnt in. And what-- That, that thing that I'm talking about getting burnt in is how I adapted. All right? I mentioned that the question is what happened to me, but I believe the most important discovery is how I adapted. Okay? When
- 19:28 – 27:36
Branches of the trauma tree: how trauma manifests
- JEJeff English
you talk about that tree, and you were talking about the roots being the wounding experiences, and then that top of that tree is the manifestations, if you will, of the woundedness, right? This is how I survived. Okay? And so you have codependence, you have addictive patterns, you have attachment issues, and a whole slew of just survival strategies, maladaptive survival strategies. And as I say that word maladaptive, I wanna wash my mouth out with soap.
- PAPeter Attia
[chuckles]
- JEJeff English
Okay? Because they are ingenious damage control strategies. The way I describe them, it's an old friend that served me well, and perhaps now it's making life hard. And the best example I can give is of a four-year-old boy spending a lot of time in his bedroom, playing with the door closed, playing loud, so that he doesn't have to hear what's going on in the rest of the house. And then one particular day, he hears his mother, in a voice he's, has never heard before, tell his father that she thinks her arm's gonna be broken, and he has to open the door. And when he opens the door, he sees his mother up against the refrigerator, and her father, the boy's father, he's got her in a hammerlock, arms behind her, and the little boy's got to do something, right? And he's really outgunned, 'cause let's say Dad's thirty-five and he's four. So he starts walking towards them, and the first room on the right is the bathroom. And he goes into the bathroom, and he lifts the lid on the toilet, and he feigns, fakes, acts as if he's vomiting. And the next thing he hears is, "Do you hear that? Your son's getting sick." And Dad lets Mom go. Now, does the boy go back into his bedroom and get out a little journal and write down, "Manipulation and deception are very effective in life"? Probably not. But I say he learned a powerful lesson that day about deception and manipulation, right? It got him out of trouble. It got his mom out of trouble that day, right? An old friend that served him well, but perhaps is making life hard. 'Cause, you know, healthy folks in adult relationships, Peter, you know, they don't dig deception and manipulation, right? So that's where my old friend can get in my driver's si- seat, you could say, and make life hard for me. But a very adaptive skill. I would call it a skill. Some folks would use the language of a character defect. I'm not against that language. I just prefer a skill.
- PAPeter Attia
I really think that's a powerful bucket because, um, it has enough breadth to include things that don't easily pathologize.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, maybe for the sake of completeness, we could just go back and talk about the codependencies, addictions, and attachment issues.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, I think everybody's familiar with the terminology, but just as within abuse, there are things that mayb- people don't quite think-- Everybody thinks of sexual and physical abuse.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Very few people think of emotional abuse or religious abuse, those kinds of things.
- JEJeff English
Mm-hmm.
- PAPeter Attia
So similarly, maybe talk through the breadth of what we think of as addiction, codependency, and attachment disorders.
- JEJeff English
Yeah. Codependency, it, it's the spirit of it, and it's not my definition. It's an old one, but, um, it's the one I prefer. It's an outer reach for inner security, okay? I can't draw that thing from inside of me, right? I have to get that from something or someone else. You let Jeff know he's okay, I can be okay. But if you're not okay with Jeff, it's hard for me to be okay with Jeff. That's a blanket summary, and I think an accurate summary of codependence. Um, and your addictive patterns, addictions, addictive patterns, I mean, again, these can be substances, these can be process, right? When I talk about the ego states, the parts, my guards, those parts of me that jump in my driver's seat, I look at those through the lens of addictive patterns. Because it's that concept of powerlessness. You'll hear folks that are, um, in the programs, um, such as 12-step programs, they talk, they talk about being powerless to something, you know, and to, um, get into the surrender of being powerless. Well, you can just, again, you can take the word alcohol, remove it, and replace it with whatever that behavior is. It's, it's the thing that I do. It's not a, it's not a bad thing that I can do it sometimes. It's the problem is I can't not do it, right? So again, this could be work. This could be ambition. This could be anger. This could be a many things. And usually, these things, they're, they're there for a reason, right? And again, we're back to vulnerabi- vulnerability is the enemy, right? So the goal of all of these maladaptive coping skills, patterns, whatever we wanna call them, is we gotta keep Jeff from being vulnerable, right? We gotta keep that little boy that had that situation with his mother and that refrigerator. We got-- we've, we've had a bad experience with vulnerability. So all these parts of me that step into my driver's seat, they've got a goal, and they do d- they do their job in different ways, but the goal is to keep me from being vulnerable. Attachment styles. You know, you get four books, you're probably gonna get four different numbers of attachment styles. I, I like simplicity. Um, you'll, you'll probably hear me say that more than once. But simplicity, let's just... The three, the three most popular, right? So you've got anxious attachment, right? It can be clingy, clingy. It can be charming. You know? It can, it can look a lot of different ways, but the more of me I give to you, the more of you I expect from you. That's gonna be the best chance to keep this thing going. Now, avoidant attachment, right? The distance. I can be in a relationship and still not give you all of me. I can be in with a person, but still have distance, right? And then there's, I'm not crazy about it, but disorganized attachment, which is kind of a mixed bag of, you know, "Come here, come here, come here. Now get away." You know? "Get you close. Now I ne- now I need you to get back." And, you know, that's what happens, unfortunately, with these wounding, a lot of these wounding situations. The thing that we were created for, right? Belonging, connection, right? Oftentimes, that gets coupled with fear. So that's a powerful thing when you get fear, intensity, things of that coupled with belonging, right? And you, you can have 10 different attachment styles, unhealthy attachment styles, if you will. Um, but the commonality, the common denominator's gonna be the insecurity. They may play out differently behaviorally, but it's the insecurity, right? Well, what does secure attachment look like, Jeff? Well, I don't know. I don't meet those people, right? But it exists because those folks have trust. And if we go back to the tree, I often think that the wounds or the roots that you keep referring to, it's really the story of my broken trust, right? How did my trust get broken? And here are all these things that I do ingeniously to handle that, right?
- 27:36 – 38:41
Connection between trauma manifestations & underlying wounding experiences & trauma triggers
- PAPeter Attia
Jeff, when, when we examine ourselves or we examine, you know, or, or witness others where one or more of the branches of the tree, i.e. the manifestations of trauma are present-
- JEJeff English
Mm-hmm
- PAPeter Attia
... is it your belief that that automatically implies there is at least one tie to a root? In other words, is there, is there a scenario whereby these manifestations exist minus the injuring events?
- JEJeff English
I mean, I suppose anything's possible. But with the folks that I've met, crossed paths with, had the honor to work with therapeutically, there's typically always a connection, you know? And, you know, it's-- it gets so tricky because it doesn't really need to be an A plus B equals C.
- PAPeter Attia
Mm-hmm.
- JEJeff English
It's, you know, it's the science of, of this kind of undo- undoes itself, so to speak. But, like, when you, when you bring this up, this question up for me, it, it brings up a stumbling block that I've witnessed a lot with, with clients within the spirit of... Or before they even become clients. And what I'm getting at is, is, like, nothing happened to me. I don't think about that. Why do I need to talk about that, right? And that's-- I, I honor that as someone's truth, right? And of course, the answer therapeutically within the setting of somewhere like The Bridge is, "Well, well, that... Okay. Like, I believe you, so you won't have any trouble telling your story, right? It'll be a breeze for you," you know? So, um, you gotta roll with that resistance. Um, but the example that comes up for me, and that's where we get into implicit and explicit memory, okay? And this is... It's a scenario of... A good example, I think, is flashbacks, right? Like, so, you know, go back to the example of something where somebody has an image. And I think what comes to mind for most folks is an image. Like, I see this thing. So then back to this other person who says, "I don't think about this stuff anymore. Like, I didn't... I don't go into the room and think about my dad cheating on my mother. Like, I don't reme- I don't even remember that stuff." And oftentimes the answer is, "Sure you do." "What do you mean?" "Well, you remember it through your anxiety perhaps," right? Maybe it's not an image, maybe it's not a sound, maybe it's not a smell. But that thing that you, that discomfort that you're experiencing, maybe that's the way you remember it, right? Something that's coming up for me, um, and again, there's so many case studies, if you will, but Within the spirit of making the implicit explicit, um, in the example that I just gave, um, you know how that process works at The Bridge. So after the group's over in the evenings, we have, usually have meetings where the folks can experience some type of maybe a 12-step meeting, some kind of meeting. Um, and, you know, it's part of the curriculum, if you will, and it's, uh, you know, it's, it's mandatory. And so, um, we've had clients, you know, have panic attacks. S- I would qualify some of those as that in these situations. And so, you know, the next day when you're in group trying to unravel something that happened on the previous night, you know, and we're talking about a, a client that I've been describing and they're like, "You know, I don't, I don't know what... You know, like, I need to s- obviously I need to see a medical doctor." But, 'cause it's like, "Well, possibly you do, but let's try to work it at both end. Like, let's, let's unravel this. What was going, you know?" Well, let's th- this process, you, you give up a certain amount of control. This client, let's say this client had control issues, right? And so it's one of the things we ask you to do is give up control at The Bridge, right? And so, and, and clients, Client X says, "Yes, yes, yes, that's right." So, okay, so you're sitting here and, you know, you know there's exits, you know the people are in the room, you know all the players are here, but for some reason you're anxious, that your anxiety's building to the point to where you experience or you describe this thing as a panic attack. I said... He said, "Right. Exactly. And I don't need to talk about any of this stuff that you guys are talking about." I said, "Okay, great. So, but just play along with me. Who's the most controlling person that you've ever met in your life?" "Oh, you should have met my grandmother." "Okay. Well, tell me one of the most controlling things your grandmother may have done." "Well, you know, I lived with her for, you know, three or four years in my childhood. You know, there was that deal with, you know, the basement, you know, when I was in trouble." "The deal with the basement, you know. Can you say more about that?" "You know, I'd get locked, maybe I'd get locked down there." "How long?" "I don't know. It was, it was dark, and I learned how to not think about it." You know? So back to the implicit with the explicit. So I think of it about this, like, files. Like, there's this, there's this loss of control file in the traumatized brain, right? Does, can I prove that A plus B equals C? No, I can't, right? There's not gonna be anything evidence-based that says that was a situation based on that grandmother's control and abuse in childhood. That is why that panic attack happened. But it certainly gives us something to look at. It's like coordinates on this war board, if you will, in therapy. Wow, there's a part of you that really gets activated when you seemingly don't have control and can't leave a situation. So may... And, and, and, and the hope that c- that can come out of that, right? Like, to see someone who could have been described as resistant to the process all of a sudden at least start to, like you're doing right now, nodding your head.
- PAPeter Attia
Mm-hmm.
- JEJeff English
I'm gonna start thinking about this. Maybe I'm not buying into it, but maybe something did happen to me.
- PAPeter Attia
I think that's one of the... Well, I mean, gosh, Jeff, I don't even know where to start. I think there are so many huge hurdles for, for people to get over when they, when they at least begin to entertain the idea that this is something they should look at. So that's the first one, right?
- JEJeff English
Mm-hmm.
- PAPeter Attia
So the first one is there's something wrong.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, unfortunately, as a species, [chuckles] I suppose we have so many remarkable layers of protection that we have to be suffering quite a bit to go through this.
- JEJeff English
Mm-hmm.
- PAPeter Attia
That's... I, a- again, I go back to some amazing lines in my journal. Um, [chuckles] "No one showed up here on a winning streak."
- JEJeff English
[laughs]
- PAPeter Attia
Like, I mean, could not be... I'm not gonna name who said that, but I bet you can remember who said that. I mean, could not be more true.
- JEJeff English
Mm-hmm.
- PAPeter Attia
When I think back to us all sitting there on day one, the 12 of us-
- JEJeff English
Mm-hmm
- PAPeter Attia
... I mean, what a collection of losers we were.
- JEJeff English
[laughs]
- PAPeter Attia
I mean, if we're just being honest-
- JEJeff English
Yeah
- PAPeter Attia
... like, we were, we were all on the outs. We had lost everything.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And we were there not because we wanted to be, but almost 'cause we had no choice.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, how often do you see that? And how, how often do you see people that somehow manage to show up there on the basis of pure introspection as opposed to, "If I don't do this, I'm gonna lose my family. If I don't do this, I'm gonna lose my job. If I don't do this, I'm gonna lose my life."
- JEJeff English
Well, what you just described, I'll call that answer B, is that's the status quo, okay? That's usually how folks get there, right? Every now and then someone may come in, you know, maybe, maybe I could call it a tourist or whatnot, but that doesn't happen much. You know, it's like, like we would say, and if you reali- if you remember how that property is, you kinda drive down into it, right? Um, and all the things that are Kentucky you see on the way in. Um, and so the, we used to, we used to play around with this like, this is hard work and this is uncomfortable. And if it wasn't, there'd be a line of people all the way back up that hill trying to get in here.
- 38:41 – 51:48
How surrendering control, eliminating distractions, & practicing vulnerability are essential
- PAPeter Attia
You alluded to control. Um, one of the huge impediments to people, I think, making the journey to a place like The Bridge is that you have to completely cede control. So you show up and you hand over your phone, and you go to your room, which is literally like a room from a camp with a sh- You're sharing a room with somebody else, sleeping on a cot-
- JEJeff English
Mm-hmm
- PAPeter Attia
... that's not comfortable.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And there's no luxury, and you're sharing bathrooms with a bunch of other people, and they rummage through your books and make sure you-- They, they sign off on everything. I mean, I, I, I, I don't think they-- I didn't bring any contraband, but I, I know that I was very limited in what I could bring.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Basically, you didn't want anything there that would distract me.
- JEJeff English
Right.
- PAPeter Attia
I don't think I could have brought books about F1 and-
- JEJeff English
Right
- PAPeter Attia
... sports or whatever, right? So, so talk a little bit about the control, 'cause that for many people is this-- the-- I know many people who have ultimately gone to The Bridge, and this was the thing that made it almost impossible for them to go, and-
- JEJeff English
Mm
- PAPeter Attia
... they had to fall to a certain level of pain before they would go. And I know other people who, who just haven't been able to pull the trigger. And I put myself almost in that situation, which is y- I can't go off the grid for two weeks, four weeks, six weeks. That's not possible. You don't understand the complexity of my life.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Surely knowing that, you must have a very strong conviction for why it's required.
- JEJeff English
And it's such a real thing too. And, you know, and it's, it, it's true. Some folks can't do it, you know? And we can't box ourselves into a world where we're talking about all the fruits of residential programs, right? But this doesn't have to be an either/or thing. But within the spirit of that residential process that you described so many different ways that I love the titles that you gave the place, right? But the control, it's got vulnerability written all over it. I keep going back to that word. We're in- introducing vulnerability. I d- I-- We don't try to induce suffering, okay? But distractions. You mentioned the word distraction. We want to take away as many distractions as possible. I don't pretend to know what you need to happen, what the magic's gonna be. But I know that we got a hell of a lot better chance of it happening if you don't have your phone, if you don't have your cigarettes, if you don't have all of these things that help you disconnect, 'cause I need you to be present, right? And for some of us, that's the vulnerability, is being present where my feet are.
- PAPeter Attia
Do you still-- Uh, the one thing you didn't take away that I don't-- I think if it had been taken, I'm not sure I could have gone, was exercise. So I was still able to run at 5:30 in the morning in the woods and, and do some push-ups and stuff like that. Had I not been permitted to do that, I might have lost my mind. Have you guys ever-- Ha- has that ever been questioned that, hey, for some people, exercise is also a bit of a numbing distraction?
- JEJeff English
That's an excellent point, because each case is different. There's no one size fits all. This brings up to me how many times do clients come to me, um, when group breaks and everybody's going to the bathroom, they come up to me and they're like, "What do I need to do on breaks or in the evenings?" Like, "What am I gonna do with this downtime?" And the answer is, you know, some folks need to get serious. So they might wanna pick up one of those books on the shelf and read a little bit, um, in our library. You know? Some people need to get serious, and some people need to play ping pong. You know? And what, what might look different for you? So-
- PAPeter Attia
I, I did a lot of coloring.
- JEJeff English
[laughs] Okay.
- PAPeter Attia
And I did a lot of dot to dot. You know, you guys had a book of super elaborate-
- JEJeff English
Mm-hmm
- PAPeter Attia
... dot to dots, like a thousand dot puzzles-
- JEJeff English
Yeah, exactly
- PAPeter Attia
... that would actually make beautiful pictures.
- JEJeff English
Yes.
- PAPeter Attia
I never thought I could find something like that so interesting, but I-
- JEJeff English
Right
- PAPeter Attia
... but I enjoyed it.
- JEJeff English
Well, you know, and one might say you had the disconnect and come to the hills of Kentucky to find the space to even discover that or rediscover that, right? But w- that control thing, that is, that is such a player for so many. It's a human thing. It's not just a client thing, it's a human thing, right? It's like everyone, I believe, wants to have a sense of c- some, a certain sense of control, right? And most folks who have a hysterical reaction, as we say, if it's hysterical, it's historical to the sense of a lost piece of control. You know, that's where we get back into there's probably a precipitating event. There could be something that needs to be healed here, and that's tricky, too. Healing versus integration. How can we integrate this trauma, this thing that happened, right? This-- All these words bring up so much for me. But I, I do wanna mention with control, because again, it, it just, it's case study and it's st- and it's everything is so connected to these, in my experience, to the trauma. You know? Let's take another client, for instance. We're gonna stay on this control, um, this, this control topic. So let's say this client comes into the group room, and this client is getting ready to check in. You know how that thing starts. Like, we kind of just, like, say something to start the day, and then everything gets quiet until somebody gets nervous enough that can't stand the silence and starts checking in, right? Somebody always does it.
- 51:48 – 59:15
How adaptive behaviors developed during childhood in response to trauma can become maladaptive
- PAPeter Attia
versions of the kid.
- JEJeff English
Okay.
- PAPeter Attia
There's, there's the kid that's born, the unwounded child-
- JEJeff English
Mm-hmm
- PAPeter Attia
... right? What is the-- What-- Remind me of the name of that, that child again.
- JEJeff English
The inner child?
- PAPeter Attia
Inner child.
- JEJeff English
Yeah.
- PAPeter Attia
That's right.
- JEJeff English
Yeah.
- PAPeter Attia
Okay, so inner child.
- JEJeff English
Some folks will refer to the inner child. Some folks prefer the original child.
- PAPeter Attia
Original child, okay.
- JEJeff English
The original me-
- PAPeter Attia
Yeah
- JEJeff English
... authentic me. But yes.
- PAPeter Attia
And then we have a wounded child-
- JEJeff English
Mm-hmm
- PAPeter Attia
... that goes through this, this experience-
- JEJeff English
Mm-hmm
- PAPeter Attia
... or these experiences. Again, very important to remind everybody, this could be a bunch of little Ts, none of which look like much. Um, it's, it's too easy, I think, to look at the big Ts and-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and say, like, "I, I don't have a big T," like... Or it, it could be that the, the sum of the little ts actually matters more than a big T in some individuals. Um, and then you have this adaptive child.
- JEJeff English
Mm-hmm.
- PAPeter Attia
So the example is that kid who figured out that by being deceptive, he could protect his mom.
- JEJeff English
Yeah.
- PAPeter Attia
And that's, that was the right thing to do.
- JEJeff English
Mm-hmm.
- PAPeter Attia
I mean, clearly the right thing to do.
- JEJeff English
Mm-hmm.
- 59:15 – 1:03:35
Difference between shame & guilt & addressing shame-driven behaviors
- PAPeter Attia
how, how do you talk about the difference between guilt and shame, and how do you work somebody out of that?
- JEJeff English
Shame's about-- [sighs] Well, guilt's about making a mistake. Shame's about being a mistake, right? You know, guilt, I did something. I made a mistake. I did something that I wish I hadn't have done. I need to make an apology, right? And there's a way back from that. I'm thinking of this classic John Bradshaw, when he's talking about healthy shame versus toxic shame. And what-- when, when you talk about a difference between guilt and shame, we're talking about toxic shame, right? That there's something flawed. This, this flawed, defective, um, core, if you will, um, my identity, is there's something wrong with me, right? Uh, there's a way back from the guilt. Shame registers so differently. So w-when we talk about folks being wounded and the shame, and that's how the shame gets registered, somebody once told me that, that my father never had to get sober because he had me and my f- mother and my sister to carry his shame for him, okay? So it's-- can be a generational thing, and it comes from somewhere else. But shame can play out two different ways. Some of us, out of when we're living from our shame, we I live out of superiority, right? So
- PAPeter Attia
Grandioshame.
- JEJeff English
Grandiosity. I, I, I control, I perfect, I judge, I criticize, um, out of my woundedness, out of my shame. That can be the me that you see on the outside. And some folks, the other side of that coin, of course, is inferiority, right? Broken, worthless, you know. I am my pathology.
- PAPeter Attia
Why do you think one chooses preferentially one of those? I mean, I know that my tendency is always more towards grandiosity than inferiority.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, what, what do you think it is in some individuals that steers them one way or the other when they're in that... And, and by the way, I love that these are-- I, I, I don't even say this to be judgmental. I just think that this is a really interesting way to observe.
- JEJeff English
Mm-hmm.
- PAPeter Attia
But, um, uh, the, I, I know that my-- when my inner monologue becomes more judgmental, that's, that's a great yellow light for me.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Right? It's like, "Oh, look at, look at the judgy wordges-- the words-
- JEJeff English
Right
- PAPeter Attia
... you're using. Look at the black and white thinking-
- JEJeff English
Mm-hmm
- PAPeter Attia
... that permeates every statement that you're making." But, but again, it's, it, it, that's, that, that's just, that tends to be the gravitational pull. Why do, why do you think certain people have that?
- JEJeff English
[sighs] That thing you just said is the thing, though, that I can't not hold focus on. Like, that little conversation that you just had with self. Now, you've done the work. You're still doing the work. I'm looking at the journal sitting in front of me. That's just a portion of the work.
- PAPeter Attia
Mm-hmm.
- JEJeff English
Right? But having that voice that you've obviously cultivated, that's where the hope is. Because again, to, to live in simplicity, I say I hate to oversimplify, but I don't. At the end of the day, I got bad news for the folks out there who think that there's gonna come a time through my healing that I just never get triggered again, especially those of us who have experienced trauma. Bad news, you will be triggered again. And this whole integration game is about starting to live a life where I tell stories that go like this. I noticed that I was starting to be really judgmental. I noticed I was getting triggered. I had this little short, subtle thought, conversation, whatever that looked like. Maybe there was something somatic that happened with my body that I did, but I had this thing that I cultivated, this new muscle that gave me enough space to choose my next step. When so many of us, especially out of our shame, out of our trauma, have lived a life telling so many stories that go like this. I got triggered, and then I did this, right? And that's the reaction versus the response. Simple goal, right? Complex process.
- PAPeter Attia
Yeah, absolutely. Simple and complex, never to be distinguished. Um,
- 1:03:35 – 1:09:45
Unique rules at The Bridge to Recovery that support healing
- PAPeter Attia
there were a bunch of interesting rules at The Bridge.
- JEJeff English
Mm-hmm.
- PAPeter Attia
No minimizing. You gotta stand up to get your own Kleenex. Tell me again some of the rules and the reasons behind them.
- JEJeff English
First thing is trying to create an emotionally safe place, right? If we can create a space where folks feel like they can let their outside match their inside, then we got a chance for the magic to happen, right? So, you know, learning a new language, like one of those is-- one of those things is I statements. You know, where so many of us wanna make statements for the world-
- PAPeter Attia
Mm
- JEJeff English
... the we. It's a lot easier to address someone's behavior, um, you know, when we're, we're tired of this, or we're tired of you doing that. Like, how many times-
- PAPeter Attia
Hmm
- JEJeff English
... a client may come up to me and say something to the effect of, "When is somebody gonna say something to Peter about being 10 minutes late to group?" You were never, right? But hear me out here. And the answer is, I think the appropriate answer is, "We're wondering the same thing."
- PAPeter Attia
[chuckles]
- JEJeff English
Okay? 'Cause if I say it, it weighs about 10 pounds. But again, within that group process, if another peer going through this rigorous journey with me says it, it tends to weigh a little bit more. Um, you know, that Kleenex rule, you mentioned that. It's, there's so much that comes out of... I don't even know what a box of Kleenex costs nowadays, but like, uh, used to say 99 cents, right? Like, so much can come out of that. Like, how hard it is for, for some clients not to give somebody a Kleenex, right? You can have the best of intentions in the world, right? But out of our woundedness, our trauma, our shame, so many of us, the commonality is professional feeling stuffers, right? Like, a lot of muscle memory and-
- PAPeter Attia
Hmm
- JEJeff English
... stuffing emotions, especially sadness, right? And so the very act of handing someone a Kleenex can cut off something that maybe had been 25 years in the making, right? And there's so much more that can come out of that because, you know, for the person who's having the emotion, like I think about my healing journey that I'm still on, and like out of my codependence, like I expected a lot of people to read my mind, right? I don't ask for what I need, but maybe I'm, maybe I, maybe I'm sitting there thinking, "Why the hell isn't somebody giving me a Kleenex? Can't they see I'm crying?" And the answer is 'cause you're a grown man. You need to ask for them and go get them yourself, Jeff, right? But like... And, and is the person rescuing me from my pain, or are they rescuing themselves?
- PAPeter Attia
Hmm.
- JEJeff English
Right? Um, language that feels guilty, part of those rules back to the I statements and learning how to have, um, I'm not crazy about the word confrontation, but like it's group, it's group dynamics, right? So I need to let my outside match my inside. So how can I tell another human being that I've got issue with this thing that they're doing, you know? And to, to learn how to say, "I get angry when you check in every day As if you love this place. And then on our walks in the afternoon, you're making fun of the process, and you're making fun of the therapist, and you're talking about the sick behaviors you're gonna do as soon as you get back home, right? I didn't grow up in a house where we talked like that, when you, I feel. Okay? So just, it's so, it, it's so... It, it just feels clumsy-
- PAPeter Attia
Hmm
- JEJeff English
... just to learn to, to, again, to create some new muscle memory, and to d- to listen, to be able to listen to somebody, you know? We ask for folks to be present. That sounds like present and supportive. Sounds like the easiest rule you could... Like, why would you have to explain that? But, like, it's hard to be present when you're not in the room. That's why, if you remember, we take breaks as a group, right? We try to take them every hour, every 50 minutes, but sometimes, you know, we always encourage the clients, "If you need to answer the call of nature before then, just let us know, and we'll, you know, we'll take a break." 'Cause it can be also really handy to go and use the restroom when Jane checks in, because Jane gets underneath my skin every day, right?
- PAPeter Attia
Mm-hmm.
- JEJeff English
And I, and brings up something for me that I need to say out loud. So the rules are there to create hopeful- hopefully the safety so that the magic, if you will, can happen. Um, and also, um, to give folks some n- a chance at some new muscle memory, you know? And I encourage clients in these scenarios, like, start it off by acknowledging you're taking a risk. "I'm getting ready to take a risk. Peter, I need to say something to you." You know? Um, and, and, and that's the spirit of the rules.
- PAPeter Attia
And what about minimizing? That was a, that was a very interesting rule.
- JEJeff English
Yeah. Well, and I mean, minimizing is a, it's an ingenious damage control strategy. Back to the utility of behaviors, right? Like, if it wasn't that bad, then I don't need to address it, right? But my behaviors also affect other folks. So when I minimize, let's say, for example, a client, um, you know, like, "It doesn't matter. You know, like, I got abused. So what? A lot of people get abused. You know, you get over it. It didn't have any effect on me. It doesn't have any effect." Like, and another client, hopefully using some healthy language, "When you speak as if child abuse, especially physical child abuse, doesn't affect the child, I feel sad and I feel angry. Because you've got a right to your own truth, but I know how much that abuse affected me." You know? So, um, that minimizing, again, it's very adaptive, but also, if it didn't matter, you know, if, if none of this stuff matters, then, then I, I just am, right? And I think you've proven the theory something's wrong with me, or nothing's wrong with me, superiority or inferiority.
- PAPeter Attia
How many folks find themself
- 1:09:45 – 1:18:20
Internal resistance to healing due to the fear of losing positive traits associated with trauma
- PAPeter Attia
in a situation where, and I say this 'cause I, I definitely had a bit of this feeling myself, and I can't imagine I was alone, where there's almost a reluctance to get better because there's also a belief that, yeah, I get it, like, my life's a bit messy right now-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and I'm, you know, the, my my, my, my response is spilling out into bad areas. But look at all the good.
- JEJeff English
Right.
- PAPeter Attia
Like, you know, I, I remember in particular one of the, one of the rants I went on was about how much good has come from my trauma.
- JEJeff English
Mm-hmm. Mm-hmm.
- PAPeter Attia
Um, uh, and I, I think in telling my life story, it was virtually all good.
- JEJeff English
Mm-hmm.
- PAPeter Attia
It was, look at this good thing and this good thing and this good thing, and like, why? You know, I mean, I, we don't want to erase any of this stuff.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And, and I, and I, and I suspect you have a number of people who show up, and yes, they're, they're... You know, it sounds ridiculous because on the one hand, there's clearly a bunch of things that are not good.
- JEJeff English
Mm-hmm.
- PAPeter Attia
But they're sort of like, "Okay, but that's a, maybe that's a reasonable price to pay in exchange for all this other stuff." How, how do you, how do you, how do you help people think through that process and, and what the trade-offs are?
- JEJeff English
Yeah. You, you, when you describe that scenario, it's like it was, it was your fuel, right?
- PAPeter Attia
Mm-hmm.
- JEJeff English
And I'm using the language of parts when I-- or guards, I call them guards, these protective parts, these protective adaptive behaviors, and I've looked at many a folks. In, in your example, it would be, thank God you've got ambition. Thank God you've got grit. Thank God you can get angry and you've got a voice. Like, I don't believe I would have met you if you didn't. And I'd say the same thing to somebody who was an alcoholic. Like, like, thank, thank God you had that then. I don't think I would have met you would, should you not have had that, right? But now, you know, again, can we look at this thing and can we just at least look through the lens of, is it making life hard? An important thing for folks to remember going into, am I gonna do the work? Do I need to do the work? Am I working on a part of me? Is that these guards, these protective parts of self, we are not necessarily trying to retire them, and that's what happens, I think, to a lot of folks, is, is that part of them, there's almost a fear of like, how do I exist? Does that mean that ambitious, at times perfectionist Peter has to go away, right? Think of, think of folks who go through life out of their woundedness that, um, we might describe as they're always waiting for the other shoe to drop, right? I mean, I can think of clients, multiple clients who have said, "It's not if it's gonna drop, it's when and how loud," right? Like, so they are really good, detailed at finding negativity, at finding danger, at find-- And they'd be a hell of a good person to have along on a walk in a bad side of town. Right? Like, I'm sure if they were a building inspector, they'd be the best damn one out there.
- PAPeter Attia
[chuckles]
- JEJeff English
Okay? But can you not do that thing when you go home and sit on your couch, right? That's, that's the spirit of... And, and, and back to the process and, and the vulnerability. The vulnerability can get brought up so many different ways. We keep talking about this group process that, that you experience. There's so many different ways, but the common denominator is the vulnerability is what triggers this protective side, this protective behavior to step in. And when that happens, we can work on it in real time should that person be in at least consideration of doing something different. I-- Every time I see you reading your journal, I think to myself, "What must that be like?"
- PAPeter Attia
It's surreal, actually. Um, I'm, I'm looking at a note. This must've been about day four. Day-- No, this is day five. So we, we went to 12-step meetings every night.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And I found it very difficult and awkward.
- JEJeff English
Mm-hmm.
- PAPeter Attia
I was-- I didn't understand why we were doing it. Why was-- I don't have a drinking problem. Why am I at an AA meeting?
- JEJeff English
Mm-hmm.
- PAPeter Attia
I don't have a sex addiction problem. Why am I in an SA meeting?
- JEJeff English
Mm-hmm.
- PAPeter Attia
I don't have a drug problem. Why am I at the Narcotics Anonymous meeting? Like, it just kept, we just kept going from one to the next to the next to the next.
- JEJeff English
Mm-hmm.
- PAPeter Attia
But I wrote something here. It said, "The SA meeting last night was amazing. Three men shared painful, shameful stories. One of them said that he was getting..." I can't even read my handwriting. Some-something, his wife said things about him and his kids. He was... Basically, he was, he was losing his family, right? He was losing his wife, he was losing his kids, and he was so upset. But his, his sponsor told him that he had no right to complain about how his wife feels. I found that very powerful.
- JEJeff English
Hmm.
- 1:18:20 – 1:23:58
Storytelling process at The Bridge, & the role of peer feedback
- PAPeter Attia
I recall, Jeff, the end of week one was when we do our story, right?
- JEJeff English
Kind of depending on where you were in the order, but yet tends, tends to be the last few days of week one.
- PAPeter Attia
Talk about what the instruction set was for how, for each of us as we went off and prepared to do that.
- JEJeff English
Well, the guidelines that we would typically give folks, again, was just, you know, we al- we al- we always suggest that the clients, you know, write something out, bullet point it. Um, and we ask that the story be told within the framework of the trauma tree. So, these stories don't need to be void of success and great moments and if it wasn't for my grandfather and that stuff. But, uh, you know, th- there's a thing we're here to focus on as well, right? So the what happened to me. Um, and that we'd be given the 45 minutes to, um, tell your story. And we try to stay out of the way as much as possible, okay? Unless it's therapeutically necessary. You know, some folks, you know, um, not-- rescue would be the wrong word, but some folks need to-- can get to going down the rabbit hole of dysregulation with their emotions and going into detail. So that client may need a little help moving forward, right? Whereas another client may machine gun through a story, right? And that's ingenious too, right? Don't have to feel it if I don't stop, and we might need to slow that client down, right? Um, but the essence of the story, again, is just to tell the what happened to me. And then I think where the real magic can happen is during the feedback. Because you get 45 minutes to use your mouth, and then we ask you to use your ears. And we ask folks to play by one more rule, and that is please do not give feedback to the feedback. And we're back to the control word, right? Because I've got this thing I'm ready to present, and perhaps I've presented it 10 times, and I've got it written out or I've at least got bullet points. So I feel good about-- no problem. But you start telling me how you felt and what came up for you, Peter, when I was talking about my dad and what he did, I don't know how that's gonna feel for me, right? And so-- and, and so many times, almost 100% of the time, within the spirit of not giving feedback to feedback is feedback is almost like equates to I'm gonna throw some love on you, okay? Like maybe I didn't have anything in the world in common with you, but when you talked about that thing at eight years old, I felt myself getting angry. And that's how somebody lets somebody know I was listening to you. I was there with you, right? And [chuckles] 90% of the time at least when-- and it's so hard for folks to not give, to just sit there and let somebody share from the heart and to not give feedback to that feedback, right? And but so many times it's like, "Well, but my brother had it, my brother had it a lot worse." It just... And it's like, it, it-
- PAPeter Attia
[laughs]
- JEJeff English
... I just throw my hands down and I'm like, "It happens almost. That's why we do it." It's like somebody throws some love on you, and it's almost like out of my shame and my woundedness, I need to remind you that I'm a piece of shit. [laughs] And it happens so often. So we're just like, you get to, you get to talk for-
- PAPeter Attia
Scott, how do you break that cycle? It's very, very difficult.
- JEJeff English
A lot of folks, they think that change is about announcing what-- that they, they know what they're about to do, right? I know this is gonna sound codependent, all right? Well, if you're firing on all, all pistons as a therapist, the response should be, "Then don't say it."
- PAPeter Attia
[laughs]
- JEJeff English
Right? 'Cause there's enough muscle memory there. We need to practice the uncomfortable thing of not saying the thing you've been saying for years, not doing the same. I'm the last person to be black and white about many things. I think much of my work with clients, individually, in groups, what have you, with human beings, is finding the gray, right? And but I tell you what, when it comes to compulsive behaviors, complex post-traumatic stress, these things that we've been doing for years and decades, um, you're either-- I'm either strengthening an old connection or I'm building a new one, you know? And so that's back to the-- when those clients say, "What should I do when I leave this group room?" Do something different and experience what it's like to do something different. And so many times it's not doing something, right? I mean, we've took the vacuum cleaner away from clients before.
- PAPeter Attia
[laughs]
- JEJeff English
I mean, it's an ingenious damage control strategy. It's a safety me- I mean, it's like it's written all over the walls, you know, we're here to talk about some deep stuff, and they-- and I'm finally gonna be expected to talk about my stuff, right? So and we, we've encouraged other clients to break rules. Some folks at The Bridge, you know, might not like that, but it's like you need to go on the-- you need to go take some coffee into the morning meeting. You've been a rule follower your whole life.
- PAPeter Attia
Yeah, we were only allowed one coffee a day or something, right?
- JEJeff English
Yeah.
- PAPeter Attia
Yeah, first day.
- JEJeff English
Yeah, that's not much.
- PAPeter Attia
Oh, God.
- JEJeff English
From what I understand, it's not the strongest coffee in the world either. [laughs]
- PAPeter Attia
[laughs] Um,
- 1:23:58 – 1:39:38
Differences between immersive residential therapy & individual therapy
- PAPeter Attia
you do a lot of work now with clients individually as well.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, I, I wonder how that is different. You know, I, I've obviously, um, I've, um, recommended a number of people-
- JEJeff English
Mm-hmm
- PAPeter Attia
... go to The Bridge. I've recommended a number of people go to PCS, a place I went to three years later.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And taken together, those two places changed my life. Um, and one of the things I've said when people ask me, "Yeah, but Peter, it's just such a huge commitment. Do I really need to do it?" Uh, I don't, I don't know the answer to that question.
- JEJeff English
Mm-hmm.
- PAPeter Attia
I'd love to hear your thoughts. But what I do say is, for me-
- JEJeff English
Mm-hmm
- PAPeter Attia
... in the state that I was in, it could not have been done any other way. I had to have immersion.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, and I say I suppose it's not unlike learning a new language, where if I decide I wanna learn Portuguese-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and I, I'm willing to take lessons two hours a week, I'll get there But if I move to Brazil-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and no one speaks English to me for a month, I think I'm gonna get there a lot faster. And it's not just the sum of the hours. There's something accretive about the total and utter immersion-
- JEJeff English
Mm-hmm
- PAPeter Attia
... literally in the experience that changes it. So how do you think about the difference between the work you do and have done at The Bridge, which is indeed what we're talking about here, this, this immersive-
- JEJeff English
Mm-hmm
- PAPeter Attia
... residential type of treatment versus someone who's listening to us that says, "I, I hear everything you guys are saying. I just don't-- I can't do that. I can't go there yet. Is there something in between? Can I start by working with Jeff-
- JEJeff English
Mm-hmm
- PAPeter Attia
... just an hour or two a week?"
- JEJeff English
Mm-hmm.
- PAPeter Attia
What, how, how do, how does your work with clients differ, and how do you help somebody decide... Maybe I'll start with this question. How would you give somebody the, the way to think about whether or not they could find some success in individual therapy versus whether or not it, it, it's really just rearranging the deck chairs on the Titanic, you gotta go hardcore?
- JEJeff English
Yeah. So the answer would be yes to the, to the can I do this or can I do that? Yes, because it's not a linear path, okay? And what- whatever, whatever it takes, whatever works, right? So I know that before I started doing this gig, before I found The Bridge, I know that I never thought about doing anything residential when it came to mental health and being a professional, being a therapist. Um, and then all of a sudden, I couldn't imagine doing it any other way, you know, and I couldn't imagine doing it without the group process because all those things that I'm talking about, there's so m- there's so much access to vulnerability and, and all of that. But let's not box ourself in, right? 'Cause some folks, it's their truth. Some folks, they can't. They just can't go do something like that. And so the way that it's changed the way that I approach the individual dynamic, the individual therapy, um, efficiency, right? Not a rush, but I think that through all of the years and all of the clients within the group process and how, how I see that works, and to be able to somehow synthesize that into my individual assessments and the way that I can work with clients too, that discovery process doesn't have to be as long as sometimes it plays out to be, right? So within the spirit of the individual process, it's like we may reach a point to where it's like, you know, and here's the next level, you know? Here's an... But the same could be said on the opposite side of that coin. Somebody might be like, "I'm going to a residential program," right? And then they find out all this stuff, and we can take that and integrate that into the individual therapy. So but I n- I w- practicing individually would've looked so different 10 years ago because of how the trauma and the unf... It's, it's something that h- that it, it, it's no one size fits all. And so to think that this intervention needs to be used because it's my specialty or this has to happen or this is exactly how long it takes for someone to have a window of tolerance, like every human being is different. Um, and I haven't seen everything because every Tuesday at The Bridge will remind you of that, okay? But I've seen a lot, right? And so my hope is that most people that I, that I meet or I have, [sighs] I have met so many people and continue to meet them that are-- You've described so-- You've described them when you talk about folks that like, "I've got a lot." Like if you wanna call it high-functioning, like I've got a lot, right? But there's something missing. Now, they won't all say that initially, but that tends to be the truth. There's still something missing. There's a hole there. Something's just not right. And so-
- PAPeter Attia
So why are they with you?
- JEJeff English
Why are they with me?
- PAPeter Attia
Meaning what, from their end, from their standpoint-
- JEJeff English
Mm-hmm
- 1:39:38 – 1:44:56
Personal journey as a client & therapist at The Bridge
- PAPeter Attia
what year were you a client at The Bridge?
- JEJeff English
2016.
- PAPeter Attia
Okay. So only a year before me.
- JEJeff English
Hmm.
- PAPeter Attia
So you'd been a therapist-
- JEJeff English
Mm-hmm
- PAPeter Attia
... obviously for many years before.
- JEJeff English
Mm-hmm.
- PAPeter Attia
How did you find The Bridge?
- JEJeff English
So it was, it was an email that I probably wouldn't have read, and I r- there was an opening, and a mentor of mine, um, sent me an email and said, "I think... I know you. I know your story. I know your background. I think you, I think you ought to check this place out." And, you know, and to grow up somewhere like that, Bowling Green, Kentucky, and to not know this place that's existed now for 50 years, it's, it says something. Um, and, and again, I had, I had a certain mindset about what residential therapy would look like and residential treatment and, um, yeah, so I was just blown away. And, and privileged to be able to do the work. I mean, it's a gift. I talk about folks not wanting to do it and sometimes that being the reason that they won't, um, join the team there. That's a very true thing. And, and, you know, I wasn't crazy about doing it either, right? Like, I knew there was stuff that I was still working on and will still be working on, and it was gonna be very vulnerable because I'm almost... I- in one way, I was like, "I'm almost interviewing," you know? Like, "This is an audition. You want, you wanna know all my crazy?" And they're like, "Yes, we do."
- PAPeter Attia
What is it that attracted you to this field?
- JEJeff English
You know, I've done a lot of different things, um, sales, marketing. I used to build... I used fencing. People would say, "Oh, really?" Like, think they think jousting. I'm like, "No," like wooden chain link fences. Yeah.
- PAPeter Attia
[laughs]
- JEJeff English
Let's not take the glamour, go too far with that. Um, but, you know, I did undergraduate in psychology, um, and then there was that gap in between me determining and realizing that, you know, this is what I need, this is what I need to do. Um, and, you know, it's, it's just that it... The self-discovery part for me, it was like starting to do my own work and then realizing that, you know, to see someone get a taste of hope, right? To see somebody get a taste of hope and, and then, and to be part of that. You know, I think when I, when I tell clients, you know, it's like, "You've got it in you. You know, maybe I can create a space where it can come out," you know? And it's, it's a privilege. You know, it's a, it's a... D- I don't take it lightly w- what I do a- and what, and what clients trust me with, you know?
- PAPeter Attia
Yeah, I, I, I, I think you have a, a really special talent for it, Jeff, and I, I just wonder, is that something that only comes because you've experienced the pain as well? Does, does someone have to have necessarily been through this journey to be able to guide someone through it? Do you think that's necessary?
- JEJeff English
I don't think it's necessary, but it sure as hell helps. Um, I'll say that. Um, the, the depth of the connection with the heart and the work, 'cause it's one thing to say, you know, "My profession, the profession... I've got purpose," right? Like, I, I, I could say I, I do something that matters, right? But does that thing matter to me? Right. And it does. And, and, and just me personally, I think the weight of that purpose is from the pain in addition to the hope. Um, having that type of impact to where I feel like I heal a little bit each time I help somebody integrate their trauma. Um, and I've had some amazing things happen in the group room. Um, and I'm human, you know. Like, there are certain things that I've done in the group room where I'm not-- I don't need to be doing my therapy while I'm a leading a group. But certain things that I would do on a, like art therapy or something, I use the same scene on the board that I use time after time because again, that's something that I've tried to unpack and process, and I don't need to be doing anything new while I'm... And then to be sitting there and because of something that happened in the group room or maybe it's where I hadn't realized that I look at that scene that I just drew on the board differently, you know. Um, and it's also, um, it's also-- it's personal, you know. With trauma and we talk about how it's shame, like it's something that's touched my family. Um, unfortunately, um, there's not much of that family left. And so, um, yeah. Um, my sister passed away in two thousand and fourteen, um, and she, uh, she grew up in the same house that I did. And so, um, yeah, a piece of my, piece of my heart's connected, um, because it doesn't have to go that way.
- PAPeter Attia
You alluded earlier to, to sort of the generational nature of trauma.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, Terry Real has, has written about this in, in some, in, in, in some
- 1:44:56 – 1:48:44
Generational transmission of trauma, & breaking the cycle
- PAPeter Attia
of the most eloquent ways I've, I've seen. And I think that for some people, that can be the motivation to, to change once they realize that there's a pattern-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and, and that it's not linear, right? 'Cause y- if, if you, if you, if you have a belief that it's linear, then it's really easy to say, "Well, I've already stopped it." So for example, if-
- JEJeff English
Mm-hmm
- PAPeter Attia
... your, your parents were alcoholics-
- JEJeff English
Mm-hmm
- PAPeter Attia
... um, and you're not.
- JEJeff English
Right.
- PAPeter Attia
Well, I mean, the story's over. I don't need any help-
- JEJeff English
Mm-hmm
- PAPeter Attia
... regardless of whatever other behaviors I'm manifesting.
- JEJeff English
Yeah.
- PAPeter Attia
And, um, but if a person can accept that no, that's not how it works, right? There, there could be, you know, this type of trauma in generation G minus two-
- JEJeff English
Mm-hmm
- PAPeter Attia
... that manifested as a different trauma in G minus one.
- JEJeff English
Right.
- PAPeter Attia
And now here in G zero where you are, you have this blind spot to-
- JEJeff English
Right
- PAPeter Attia
... what's going on.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, I know that for me, that was among the most powerful motivations to stop the cycle-
- JEJeff English
Mm-hmm
- PAPeter Attia
... as, as Terry described it.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Right? And, um, h- how much do you think that that factors into, to, to people's willingness to kind of endure the, the challenges and discomfort of the journey?
- JEJeff English
I think it oftentimes it becomes pivotal in willingness and in that surrender game that I mentioned. Um, because I think as a parent, you know, one of my jobs or the most important job is, in my opinion, that my children go to bed and wake up safe, right? That they don't, they don't grow up in fear, right? And I have a lot to do with that, right? But like the analogy, you know, like they tell you on the airplanes about your oxygen mask, right?
- PAPeter Attia
Mm.
- JEJeff English
Like, you gotta have yours on first, right? And, and, and, and that, you know, at the, at the end of the day, being a parent has made... You, you mentioned about why I do what I do and what I get out of it and whatnot, and, and to kn- to know my clients on a, on a different level because doing the work is hard. And like, you know, sometimes at the end of the day, when you need to have that hard discussion with somebody, when a boundary needs to be set, you know, when conflict resolution in a relationship needs to happen, some days, you know, when, when people finally go to bed and the house is quiet, you just don't-- You just wanna watch Netflix, right?
- PAPeter Attia
Hmm.
- JEJeff English
You just... You know? And so to understand, like you just... And, and, and but what happens and what can happen is, is that you, you put off these things, and things start to build, and they build and they build. And then when the, the levee breaks, I'm the worst version of Jeff, right? If I let that happen, right, then what about that generation? You know? What about that next generation? And, and it's, it's responsibility on a whole different level. But a gift too. You mentioned like, yeah, a, a misconception you were describing of, "Well, at least I don't drink. Uh, at least I'm not an alcoholic, so that means that I'm not as bad as my parents, and there's no work to be done," right? 'Cause there's so many other ways that I can have, um, an unhealthy impact on that next generation, right? But to just, to be in that place of, "Okay," like, "this is it. This is it." And, and, and I have the opportunity, like, to change this thing. In my case, reverse the cycle.
- 1:48:44 – 1:53:38
Challenge of addressing socially acceptable maladaptive behaviors like workaholism, perfectionism, & overachievement
- PAPeter Attia
a lot of people who have these socially acceptable-
- JEJeff English
Mm-hmm
- PAPeter Attia
... maladaptive behaviors.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And the-- I- in many ways, it makes it even more difficult to reconcile because society is externally sort of patting you on the back for your-
- JEJeff English
Yeah
- PAPeter Attia
... workaholism, your perfectionism, um, you know, your achievements and all of those things.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, and, and I don't know. I don't know. I- is one pattern, in your view, harder to address than the other or is it all about the individual? In other words, if you, if you think about the individual characteristics-
- JEJeff English
Mm-hmm
- PAPeter Attia
... the manifestation of the trauma, and the nature of the injuries, those are three kind of things that are all blended.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Do you, do you try to disentangle those when you're working with people and, and, and look, and pattern recognize, or do you just say, "Nope, I literally... Every person's a, a clean slate and we're, we're just trying to figure out how those three things fit together"?
- JEJeff English
That's a place I try to operate from. Out of, I think, my humanity, our humanity as clinicians, we create... There's client files.
- PAPeter Attia
Hmm.
- JEJeff English
And you know, I've seen-
- PAPeter Attia
The pattern, yeah
- JEJeff English
... I've seen this. We've seen this one before, right? And sometimes it needs to be said out loud. Some people need to hear, "You know I've seen you-
- PAPeter Attia
You're not unique
- JEJeff English
... you know I've seen you before, right?"
- PAPeter Attia
Yeah.
- JEJeff English
Um, not always appreciated, but sometimes it lands, right? But, um, so-
- PAPeter Attia
Yeah, it's funny. I, I... For me, that's a very calming message actually.
- JEJeff English
Okay.
- PAPeter Attia
The, "You know what, Peter? You're not unique here."
- JEJeff English
Right.
- PAPeter Attia
Like, "There's a, there are lots of people like you out here." It's really easy to think you're the only one.
- JEJeff English
Mm-hmm. Yeah. And amazing to wrap your brain maybe around the fact that that's actually calming. It's, it's nice to know. Yeah. Um, so that's just, you know, there's certain interventions that tend to go along with certain, you know, personalities or certain, uh, maladaptive behaviors, if you will. Um, but yeah, God, to the best of the a- my ability, clean slate, you know? Like, what is, what, what is this person telling me? What, how they're telling me, you know?
- PAPeter Attia
Jeff, when, when you think about examples, um, uh, I've, I've... You know, I've seen examples where this, it seems like everything we're talking about has been taken too far.
- JEJeff English
Okay.
- 1:53:38 – 2:01:54
How to determine whether struggles stem from deep-seated trauma or just bad habits, & how rewiring maladaptive behaviors requires addressing the underlying emotional wounds
- PAPeter Attia
who's listening to us who's trying to even understand if they've experienced trauma? Which it sounds like a dumb thing to say, but let me, let me give an example, right? So you have a person who's listening-
- JEJeff English
Mm-hmm
- PAPeter Attia
... who's either introspective enough to realize that there's some, some of, some of those things we described as the four branches of the trauma tree-
- JEJeff English
Mm-hmm
- PAPeter Attia
... whether it be codependency, attachment disorders, some sort of maladaptive behavior, et cetera-
- JEJeff English
Yes
- PAPeter Attia
... addiction maybe.
- JEJeff English
Mm-hmm.
- PAPeter Attia
They're like, "Okay. I mean, if I'm being brutally honest, I'm not flying on, you know, a perfect level," right?
- JEJeff English
Mm-hmm.
- PAPeter Attia
Like, "Yeah, and my, you know, my, my spouse has complained about X, Y, and Z and-"
- JEJeff English
Mm-hmm
- PAPeter Attia
"... uh, there does seem to be a little bit of, you know, interpersonal, uh, discontent in, in this nature, in this relationship," et cetera. Okay, fine. And then they, if they're, again, in a particularly charitable mood, they look at the kind of five roots of the tree and they're like, "Well, okay, yeah. I mean, these sort of things happened." But they can't make the leap to say, "But does any of that stuff actually rise to the level of, of quote unquote trauma, even little T trauma?"
- JEJeff English
Mm-hmm.
- PAPeter Attia
Like, is the answer just that I need to get my act together and drink a little less and-
- JEJeff English
Mm-hmm
- PAPeter Attia
... you know, just try to be more present with my kids or, you know, whatever, whatever w- It, it doesn't matter what the, what the fix is. But, but they're just not sure that going back and stirring the pot of what happened to them during the first 10 years of their life is going to be an exercise worth engaging in.
- JEJeff English
Mm-hmm.
- PAPeter Attia
How would you help that person decide that, you know, you're right It's probably not worth stirring that up. Let's just work on some behavioral tools right now to, you know, address the behavior versus actually, I don't think you're ever going to truly fix these things until you go back to the root.
- JEJeff English
I think that's a perfect way to approach it. So let's try that. You just, in your example, like maybe I should just do this less and do this more, all these behaviors. Let's try that. Let's put together a plan. Goal setting, okay? This is, you know, I'm coaching you. We're not doing an intervention here, a therapeutic intervention. And then we, and if it happens, it happens, right? But folks who realize or already know that they have trauma or have been wounded significantly, sometimes I think the word just trips folks up and they just can't get over the word, right? Wounded, right? Survivors, whatever we want to call these folks. They have a really hard time putting knowing into action, right? Like I spent many years as a very well-informed prisoner, right? Like I know all this stuff about why it is I do the things that I do, but it's the putting it into action. The thing that you did, said about the not doing, that's where we get to realize, hopefully admit to self if that's the fact, when I come back to see Jeff or whoever, well, the goal is still failing. For some reason, I just can't do that, right? Okay. Well, perhaps there's something significant connected to this. Maybe something needs to be integrated. The part of you that is unwilling to do this thing that you say is the goal and the plan when you sit in front of me, that's who we need to work with.
- PAPeter Attia
So how do you begin to do that integration, right? So, you know, let's go back to the example you gave because it's so profound and probably tragic where that four-year-old boy that learned how to manipulate and deceive to protect his mom has now carried that behavior into his marriage.
- JEJeff English
Mm-hmm.
- PAPeter Attia
So step one is obviously getting to the point where we uncover that story and make the connection, which was, you know, an inner child is wounded. That inner child adapted with a strategy that was very positive.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Everything about that strategy made sense. But guess what? Your dad isn't kind of hurting your mom anymore because luckily she got a divorce and he's gone. And you're now applying that same behavior pattern in relationships that have nothing to do with the relationship in which that was developed to be protective.
- JEJeff English
Right.
- PAPeter Attia
And he says, "Okay, I get it, Jeff. How do I change? Like, what are the next steps? How do I go from the understanding of that to creating a new pattern of behavior? Because this is really wired."
- JEJeff English
Yeah.
- PAPeter Attia
These paths are heavily, heavily myelinated at this point.
- JEJeff English
So in general, what we're going to have to do is we're going to have to expand your window of tolerance, if you will, to vulnerability, right? Because typically that protective behavior, again, the enemy is vulnerability. And so to create some muscle memory doing something different when vulnerable, not doing that same thing, okay? And like when you talked about your experience at The Bridge and you talked about what it would have been like if we had a taken away exercise, okay? Like simply sitting still for some folks is a very vulnerable experience, right? And so to create an environment where that person can experience the discomfort. And that's why I think that within my work and a lot of professionals looking at individuals from a parts perspective, right? There's different systems, different theories, internal family systems, structural dissociation, but this language that I'm using, it's not necessarily new because it's like you're talking about. So this original self, this wounded self, this adapted self, right? The adapted self tends to have some really hard line beliefs, right? Safety equals control. Safety equals distance. Safety equals self-abandonment. Safety equals somebody else, right? And as long as that part of self, right, has that core belief, I believe it's going to be damn near impossible to do those things that I know I should do, right? So to know that there are interventions that will fit that process within, do you want, the first question is, do you got issue with this, right? Because I'm back to if you like it, I love it, right? Like when a client is talking about, you know, they're at The Bridge and they're there because their spouse, you know, their spouse is going to leave them. Their spouse is finally fed up with it. And, you know, they've got all these opinions about it. So here I am because they said I needed to go to a place like this. And, you know, and you're like, you know, it doesn't sound like you got a problem at all. What do you mean? I was like, it just sounds like you can keep being you. You just got somebody telling you now that they're not going to deal with it, right? So maybe it's the biggest controlling jerk in the world, right? So all you need to do is go find another doormat, you know? I'm just hearing you say your spouse is not, so you decide whether there's a problem there or not, right? And so this behavior, again, that's become the problematic behavior how difficult it is to unravel and stop doing that behavior. Again, tied into the trauma, tied into it being an ingenious damage control strategy at a time in life perhaps, and perhaps done multiple times successfully, right? So, you know, there's a part of self that says, "Why not do this? We've been doing pretty well like this for a long time."
- 2:01:54 – 2:11:49
Breakthroughs that shatter beliefs & allows change to occur, & the process that creates this opportunity
- PAPeter Attia
There tend to be these moments along this journey where I assume I'm not unique in this, where people have really significant breakthroughs-
- JEJeff English
Mm-hmm
- PAPeter Attia
... in beliefs. Um, and it's mostly that a belief gets shattered.
- JEJeff English
Yeah.
- PAPeter Attia
Um, I, again, this is, I think, one of the real, um, joys of having a journal is you can kind of go back and read what that was like.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And, and, and read, you know, on this day, like through this exercise, this really profound thing happened. I, I mean, I wrote about two of them in, in, in that last chapter of my book. I wrote about one at The Bridge and one about PCS-
- JEJeff English
Mm
- PAPeter Attia
... that were undoubtedly the two biggest breakthroughs in beliefs I've ever had in my life. They've had a far greater impact on anything in my world, and they both happened in an instant, right? Like, they both, they were huge step function changes in a radical belief system.
- JEJeff English
Mm-hmm.
- PAPeter Attia
And what I find interesting about it is how much easier it became to make any change after the fact. I never want to represent that I'm, I'm better. We're all in recovery here.
- JEJeff English
Mm-hmm.
- PAPeter Attia
But when I think about the December 2017, um, April of 2020, or maybe it was by this point May of 2020, those particular days when those things happened-
- JEJeff English
Mm-hmm
- PAPeter Attia
... I mean, l- literally within an instant, some... I, I don't understand, I don't understand the neurobiology of how it happens, but something really switches and I never look at the world the same way I did before.
- JEJeff English
Mm-hmm.
- PAPeter Attia
There's an immediate acceptance of something typically.
- JEJeff English
Mm-hmm.
- PAPeter Attia
That's, that's the shattering of the belief system is the acceptance of something that is more, uh, more honest and, um, and more genuine to the, to the, more, more close to the innate child that, that we all were.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, is that common, first of all, that people have these major, major sort of life-changing appreciations of, of, of something? And then secondly, um, is that, um, is that by itself sufficient sometimes to drive change?
- JEJeff English
I'd be careful with the common word, but it happens a lot, and I typically hear about it kind of the way you described it, um, months, even sometimes years later, right? Like, I-- s- it, it hit me one day, or this thing was happening and I was compre- incredibly compelled to do it the old way and I heard something so-and-so said in my ear, you know? Or something against that belief system. Um, and that's what's so tricky about, um, that process at The Bridge, or if you want to talk about experiential, um, journeys ex- using experiential therapies. I mean, just going to a process, a group therapy process, residential is an experiential-
- PAPeter Attia
Mm-hmm
- JEJeff English
... intervention, right? And so to be able to put my finger on, well, what was it? You know, what, what exactly was it, you know? And can I prove that that was the thing? Like, it's hard to do.
- PAPeter Attia
So for, it's, it's interesting. For me in both cases-
- JEJeff English
Yeah
- PAPeter Attia
... it came down to a therapist-
- JEJeff English
Mm-hmm
- PAPeter Attia
... pushing very hard-
- JEJeff English
Mm-hmm
- 2:11:49 – 2:19:27
Advice on finding a therapist for trauma work
- PAPeter Attia
Jeff, what advice do you have for, for somebody who's out there trying to find a therapist? Um, they've listened to us today, and they've been like, "Okay, you know, these two guys have got me at least thinking I ought to maybe, maybe, um, scratch this a little bit, see if this scab bleeds." Um, what are the attributes they should be looking for? First of all, how do they even begin to, like, what do you go on Google and search trauma-based therapy? H- how do you, how do you find somebody? And more importantly, when you find somebody, how do you say, "Look, I'm gonna give this three or four sessions to determine if this is a good use of my time"?
- JEJeff English
Mm-hmm.
- PAPeter Attia
What are you looking for? Is it, "Hey, if I'm not uncomfortable in three or four sessions, this probably, this person probably d- isn't doing a good job"?
- JEJeff English
Mm-hmm.
- PAPeter Attia
What are the metrics?
- JEJeff English
I certainly want some input from a professional, a seasoned professional, um, a personal referral, um, if you will. You, you mentioned do I just, do I go Google? Like, trauma-informed is kinda like the buzz thing, and what does this mean? Did you, did you go to a forty-five minute seminar on trauma does affect folks, and now you're trauma-informed, right?
- PAPeter Attia
Yeah. Is there a certification that people should be aware of that says you're a true trauma-based therapist?
- JEJeff English
There are several, but I would be more interested in... I, m- my-- What I, what I do when I look at bios, um, is sometimes I get more concerned about the more specialties I see.
- PAPeter Attia
Hmm.
- JEJeff English
Right? And, you know, a niche, you know, is... So when I see these lists that cover, um, every class that someone takes during a graduate program for counseling or, um, that, that troubles me, you know, because-
- PAPeter Attia
How come?
- JEJeff English
Well, because it, it looks great. I cover all of these different things, but like-
- PAPeter Attia
But no depth.
- JEJeff English
Yeah, but, like, how many-- like, how much muscle memory do you have as a clinician-
- PAPeter Attia
Mm-hmm
- JEJeff English
... working with a certain Population the way that you do it, you know? And, and, and where did that muscle memory come from? Uh, so, um, and, and that's a, that's a big part of what I do, you know, is, is helping folks make sure, you know, that they are with the right person or they can, can go to... That's where I go with the efficiency of it. Like, knowing the story, learning the story, getting that eye-opening moment, and then that hint that someone wants something different, right? And then to be a part of that process or to put them in the direction, point them in the right direction.
- PAPeter Attia
What else should they be looking for? So, so they f- they find somebody, they think, you know, they even get a personal referral that says this person is good. How should they evaluate what is going on and if they're on the right path within a, a month, for example? What's a sign that things are going well? What's a sign that things are not going well?
- JEJeff English
I personally think that sometimes, uh, it-- I would, I would say that challenge. Like, how, how challenged do you feel, right? Um, how do you feel going into a session? How do you feel after the session, okay?
- PAPeter Attia
What's a good sign to that, to the going in? Is it, is, is going in apprehensive and coming out exhausted a good sign?
- JEJeff English
I think, yeah. Yeah, absolutely. I don't think we're-- I don't think it's a good story when it's like, "I can't wait to talk to Jeff 'cause I'm gonna get to gripe for 55 minutes, and he's gonna let me pay him for that," right? Now, it's happened before, and, and I would just say, we need to call this what it is, okay? You know, if this is where you wanna put your anger at for an hour, we're-- we can do that, but let's call it what it is 'cause we're not working on change here, right?
- PAPeter Attia
Mm-hmm.
- JEJeff English
So, um, what's happening? What, what's being illuminated, right? Because they wouldn't call it a blind spot if I could see it, right? So what's happening within that back and forth that's illum- that's what I, what did I not know? What made me think? What made me pause? But the main thing is what's different. And, you know, not all therapeutic relationships are a good match. And so to just know that that's a, that's a reality.
- PAPeter Attia
Mm-hmm.
- JEJeff English
And to give yourself permission to s- you know, after a, an adequate amount of time, this isn't working. Let's not keep doing this. You know? Let's not keep doing something that's not working, you know? Life's short.
- PAPeter Attia
I'm looking at, uh, my last entry before I left The Bridge. Uh, I see a couple of great lines here. So one of my, one of my favorite other co-residents there-
- JEJeff English
Mm-hmm
- PAPeter Attia
... um, she said this. She said, "I asked God why He beat me down this year. Uh, He said He broke me open." I, I thought that was very powerful.
- JEJeff English
Mm-hmm.
- PAPeter Attia
You said, um, on the way out, "The more you cry here, the more you win here." I also thought that was, uh, that was pretty interesting. There, there's just no escaping it, is there? Like, it's very, very difficult.
- JEJeff English
Mm-hmm.
- 2:19:27 – 2:25:21
Importance of connection & vulnerability
- JEJeff English
and human connection is vulnerable, right? It's, it's not something that's meant to be controlled. There's unknowns, right? There's another person. Um, we don't know. We really don't know what they're gonna do, what they're gonna say, how we're gonna be received, right? That's, that's vulnerable. And If you look at it within, look through the lens of these protective parts, my guards, like they s- the irony is the way, the means by which they do their job typically brings me the thing that they most fear. All right? So another example, okay? Let's say that a client, this is one that, that, that works sometimes. Um, let's say the client, like one of their things is they've got some trauma, they've got some insecurities around betrayals, right? And they're in a relationship, and one day their partner comes home and tells them that their ex is back working at the hospital where they work at, okay? Now, who wants to hear that? Nobody wants to hear that, right? But it's gonna be especially bad news for somebody with a betrayal file, right? It's gonna be very vulnerable, right? So here, introduce, introduce vulnerability into the equation. This is where the disconnected self shows up. I have to do something to take care of that vulnerability, right? So I have a, a, I, I have this avoidant part. I used to call him the too cool for school part, right? And he was born out of hearing a lot of what kind of man is he gonna be? What kind of man is he gonna be? So in other words, a man, this part of me doesn't believe that a man says something like, "You know, I'm scared. I'm vulnerable." So this part of me says, "Pfft, what are you... You know, like, you wanna hear about all the skeletons in my closet? I don't care that your ex is back at work. It's five years ago," right? But when that partner's on their 7:00 to 7:00 shifts, it's hard for me to be connected, Jeff, when all that stuff s- starts going on through insecurities and betrayals and things of that nature. So I need something, right? Something to step in and take me away, and that's where that disconnection comes in. For some folks, it would be drinking or whatnot. Within the spirit of the, the example that I'm giving and trying to give the irony is, again, the problem is not having the parts. It's how they do their job and the relationship between those parts, right? Because eventually what happens is, is that as I do the thing with, um, let's say the, let's say the behavior's drinking, right? So I'm drinking, I'm drinking, I'm drinking, and eventually, like I get to a point to where I'm not thinking that much about what might be going on at that hospital. And then I get to a point to where my buddy leaves. We were watching the ball game. I was able to be connected Jeff in front of him, but now I'm really starting to get up in my head about what might be going on at the hospital where my partner's at. Yeah? So when the phone finally rings, okay, at 11:30 or 12:00 or whatever, it's not connected Jeff that answers the phone, right? I'm using myself in this made-up example, right? But it's gonna be a disconnected version of Jeff, right? "You having fun? Why the night's so young? Maybe you guys will have time to go at it again," right? All this woundedness starts coming out. And so eventually what happens is, in this example, if this partner's got any healthy going on, I'm gonna come downstairs one day and there's gonna be a note that says, "I wasn't created to save you. I can't do this. You need some help." And now have I ever been any sadder, you know-
- PAPeter Attia
Mm-hmm
- JEJeff English
... than I am. Because that... It's a triangle of vulnerability, sad, shame, and fear, right? And that's what all these guarded parts of self, they're there to protect us against that. But you see the means by which the protected, disconnected self did its work actually lo- played out, brought me the thing that I feared the most, right? So now here I am sitting at this table alone, realizing what's happened, right? And that's, that's, that's, that's how that happened. So back to disconnection, connection. What is connected Jeff says, "I know this is my stuff, and I've got work to do. It's a reminder that I've got work to do. But I gotta tell you, I gotta be honest with me, it bothers me what you just told me about this person being back working with you. It bothers me." Um, but that's a very vulnerable thing to say.
- PAPeter Attia
Of course, you can only really say that if your partner is equally vulnerable, right? Because if your partner is not vulnerable, that, that message isn't gonna land, and that's gonna be triggering to that person. And I guess all of this is a long-winded way of saying you, you, you have to have two healthy people to make a relationship work. You can't just have one.
- JEJeff English
Absolutely. Abso-- That might not be welcomed, right?
- PAPeter Attia
Mm-hmm.
- JEJeff English
That emotional, vulnerable self might not be welcomed, and that's information that's necessary, right? Um, necessary information about my partner. Because in the example, I'm not asking, remember, I... It does, it bothers me in that example. It both- I'm not asking you to do anything. I'm not asking you to quit your job or anything like that, but I just need you to know my truth, and I've got work to do around this. But it does bother me. It scares me to death, see? And, and, you know, that I... It scares me to death. Probably the bravest words I've ever said to another human being in my life is, "It scares me to death." I spent so many years trying to act like it didn't.
- 2:25:21 – 2:27:37
How to encourage a resistant partner to seek help
- PAPeter Attia
If you're in that relationship where one of you is feeling like, "Hey, I, I can, I can be vulnerable here," but it's not being reciprocated-
- JEJeff English
Mm-hmm
- PAPeter Attia
... how do you... What are the tips for maybe helping your, your spouse if this is thinking about it as a sort of, you know, a marriage or something like that? Um, what, what can the, what can the vulnerable member of that relationship do to help the other one? Because it's not gonna be tenable indefinitely, right?
- JEJeff English
Yeah.
- PAPeter Attia
So it's... How do you, how do you lovingly get that person to, to come to a place where they, they wanna get help?
- JEJeff English
Well, you're certainly, a lot of folks have wasted years trying to pull and push people into help, right?
- PAPeter Attia
Hmm.
- JEJeff English
You just have to be the agent of change in the relationship, right? You have to break the dance. So in this particular dance is it's I'm wanting to be vulnerable and you're not having anything of it. Something's got to change, right? So you got to sharpen your skills with the boundaries, right? Boundaries, boundaries, boundaries. And, you know, sometimes it's a worn out word, but it's a hell of a skill to be able to utilize, right? Like, and to be able to set a healthy boundary, you know? Top tier boundary setting oftentimes doesn't include the word you. It blows folks away when you just talk about me. I realize when this behavior happens, whatever, fill in the blank, when this behavior, that it, it's affecting me. You know? I'm, I'm building resentment and this isn't good for me. So when this behavior happens again, I'm going to choose to do blank, right? And whatever blank is, is whatever change looks like.
- PAPeter Attia
Mm-hmm.
- JEJeff English
Right? It might be in this example, like, you know, I'm not taking, I want to be able to share my heart with you, but evidently I can't, right? So I'll be taking it to my best friend or, you know. And so to be able to, to, to set the boundary and set a boundary where, where there's a consequence, it's something that I can hold. It's something that I can do, right? Because a boundary without a consequence is useless.
- 2:27:37 – 2:29:46
Advice for those emotionally struggling
- PAPeter Attia
Jeff, I want to thank you very much for, um, for not just coming today, but for obviously being a really important part of my life. Um, I owe you a great debt of gratitude as I do a number of therapists who I've been really lucky to work with. Um, but I will forever reflect on [laughs] what can only be described as just an unbelievably difficult experience that I'm so glad I had no idea how bad it was going to be when I reluctantly agreed to go, because I just don't think I ever would have done it.
- JEJeff English
Mm-hmm.
- PAPeter Attia
Um, and I've had the privilege of encouraging many people to go since then, uh, not just to The Bridge, but to, to other places as well. And, um, I, I, I think almost without exception, it's, it's helped them. Uh, in fact, I know it has. I, I can't think of an exception where it hasn't. So, you know, if, if someone's listening to us and they're sort of contemplating either dipping their toe in-
- JEJeff English
Mm-hmm
- PAPeter Attia
... you know, by working with a therapist and trying to probe some of these things, or if they're thinking about jumping in the lake-
- JEJeff English
Mm-hmm
- PAPeter Attia
... and then going to a residential place like The Bridge, um, what would you say to them?
- JEJeff English
If there's a voice saying it, listen. If there's a voice, even if it's a whisper, it's there for a reason. And I say more important than anything else, you're either going to deal with it or it's going to deal with you. And my hope for the you and humanity and, and what we do as far as helping people, in this case we're talking about emotional health, but longevity, um, yeah, it's like, right, deal with this. Grab the bull by the horns.
- PAPeter Attia
Thank you, Jeff.
- JEJeff English
Thank you so much for having me. It's an honor to be part of your journey. Um, and congratulations on everything. Keep up the good work, brother. [outro music]
Episode duration: 2:29:46
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