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Dr Rangan ChatterjeeDr Rangan Chatterjee

The 7 SURPRISING Ways To Heal Trauma WITHOUT MEDICATION | Dr. Bessel Van Der Kolk

My guest today is someone who I’ve been wanting to speak to for a very long time. Dr Bessel van der Kolk is a professor of psychiatry at Boston University School of Medicine and President of the Trauma Research Foundation in Massachusetts.

Dr. Rangan ChatterjeehostDr. Bessel van der Kolkguest
Feb 15, 20231h 31mWatch on YouTube

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Transcript

  1. 0:00 – 2:46

    How Trauma Robs You of Self-Control

    1. RC

      I wanted to start with a quote from your iconic book, uh, The Body Keeps the Score. "Trauma robs you of the feeling that you are in charge of yourself."

    2. BK

      Oh, that's, that's a true statement. Yeah, yeah. [laughs]

    3. RC

      Well, what did you mean by that?

    4. BK

      Um, when you get traumatized, had, uh... it's not the external event, but your reaction to that exter- external event is that you, uh, you cannot cope with it, and then you're vulnerable to react to other things as if they're catastrophes. So you may find, suddenly find yourself very scared or very angry or very aroused or very panicky or you can shut down. And so you really have no control over those intense emotional reactions that happen after trauma.

    5. RC

      Yeah. So in many ways, people who are traumatized feel that their lives are out of control, that life is, I guess, happening to them rather than them being in control of their lives.

    6. BK

      Yeah. They ha- they, they keep reacting to stuff, uh, and things are disorganized. And then oftentimes they start off blaming the people around them for having caused them to be so angry or panicky or something or another. But after a while, people start realizing, oh, it's really my reactions that, uh, that make life so difficult. And so how do I control these reactions becomes a major issue. And oftentimes people learn to sort of shut themselves down and learn to not react, but with it, they, they become very, uh, distant to themselves and to people around them.

    7. RC

      I think what you said there was really quite poignant for me, that we often think it's the people around us that are causing us to feel a certain way without that deep realization that actually we're generating those emotions. We may not know why we're generating them, but ultimately-

    8. BK

      That's right

    9. RC

      ... it's coming from within us, isn't it?

    10. BK

      Yeah. Yeah. However, not the whole story. Had big... 'Cause, you know, negotiating your way through the world is complex. Um, people will say things that may not be pleasant, or they may not respect you as much as you'd like it to be. But, uh, the core issue is, how do I react to adverse issues? And I cannot change everybody else. I have to actually, uh, learn to manage my own arousal and my own reactivity.

    11. RC

      Yeah.

  2. 2:46 – 4:39

    Trauma vs. Stress and the Salience Network

    1. RC

      What's the difference between trauma and stress?

    2. BK

      The big difference is when stress is over, it's over. And so when you sit for an exam, you're working hard, and you may not be able to sleep, but once you take the exam, you can go for a walk, and you can go do whatever you want to do, and the, the stress disappears. And, and stress is not bad for people, uh, because we really are, uh, uh, programmed to deal with very adverse circumstances. Uh, uh, uh, the people can deal with a great deal of stress, but the critical thing is when the stress is over and you've done whatever you needed to do to deal with it, then your body resets itself. You become calm, and you stop being hyper-focused or whatever. When you get traumatized, those reactions don't stop.

    3. RC

      So trauma is almost like a severe stress response that never ends, and that starts to change our nervous system and how we view the world, how we react to the world. Is that, is that, uh, one way of putting it?

    4. BK

      Yeah. It, it's not, it's not as cognitive as view the world, it's really how we react to the world. Uh, our reactivity, uh, changes, and, uh, we may become too intensely, uh, aroused by minor issues. Uh, so, uh, actually, so trauma, uh, when talking from a neuro, neuroscience point of view, we have some networks in the brain that help us to select what's important and what's unimportant. It's called the salience network, and after you get traumatized, that salience network makes you react to minor issues as if it's a catastrophe.

    5. RC

      Yeah.

  3. 4:39 – 7:22

    How Common Trauma Is and Why It Stays Hidden

    1. RC

      How common is trauma, would you say?

    2. BK

      Oh, extremely common, uh, and there's of course all kind of gradations. Uh, but things like being abused by your own parents, uh, being, uh, brutalized in your personal relationships by somebody, uh, is extremely common. And it is really ironic that when we first defined PTSD, we said, "This is an extraordinary event outside the usual range of human experience," and we were completely wrong about it. But 'cause when we started to look at it, we found out that at least one out of four women and one out of five or six men has sexual abuse, uh, experiences before the onset of adulthood, uh, for example. That a very large number of women get raped. A very large numbers of people are involved in domestic violence situations. And so it's in fact, it's turned out to be much more common than we ever thought it would be.

    3. RC

      I mean, those statistics are, are really alarming when you put it like that.

    4. BK

      Yeah.

    5. RC

      I imagine, uh, Dr. van der Kolk, that some people who are listening or watching right now will think, "Wow, is it that many people?" They will think, "Well, I know loads of women and loads of guys, and I've never heard about this happening to them," which potentially speaks to- Secrecy, shame, the fact that many people have suffered this and are continuing to suffer because of the traumatic imprints, but they're not talking about it, right?

    6. BK

      Uh, that is on the mark, huh, that, uh, when you... after you get tra- if you, after you get assaulted or after you get raped, you don't go around telling people about it. There's always this issue of, I, uh, I must be to blame for what happens. Or if you're in the domestic violence situation, you don't tell people, "Oh, my s- my boyfriend or my girlfriend just beat me up," because that reflects badly on you. And so shame and secrecy is very much part of trauma situations, huh? It's very striking when there's a public trauma. Uh, my example in the culture I live in is 9/11, uh, the attack on the World Trade Center. When there's an overt trauma, people tend to be very generous in terms of coming to people's help. But these private traumas of abuse, et cetera, uh, become hidden and, uh, people try to go on with their lives, but they keep reacting as if it's still going on. Yeah.

  4. 7:22 – 11:31

    Why Some People Recover: Temperament and Social Support

    1. RC

      Now, when I think about trauma-

    2. BK

      Yeah

    3. RC

      ... and traumatic events, I think about the fact that different people being exposed to the same trauma will react in different ways. Some people will end up becoming heavily traumatized-

    4. BK

      Yeah

    5. RC

      ... whereas some people won't. So what are the factors then that determine if someone is going to have that chronic imprint of trauma, or whether they're going to be able to deal with it, you know, deal with that stress response and return back to baseline? Do we know what those factors are?

    6. BK

      Well, there certainly is an issue of temperament. Uh, anybody who has more than one child knows that we all come into the world with very different reactivity and different responses. So that is one factor. But the other major factor is the, uh, is the social environment and who is there for you when something bad happens. By and large, if you go through a terrible experience and you have a partner, a spouse, a parent, a boss who says, "Oh my God, uh, how can I help you? I'll be there for you." When your social environment, uh, helps you to protect yourself and to feel safe again, that makes a huge difference. So the, the principle, for example, after natural disasters or after accidents, uh, war situations, the first thing you do is you reconnect people with the people they love and care for because that is really what, for human beings, is the main source of comfort. And so as long as you have people around you who acknowledge the reality of what you've been through and who are with you in a very deep way, you probably will be okay.

    7. RC

      Yeah.

    8. BK

      Uh, and that of course is what happens in, like, wartime situations, uh, when people are at war, like what's happening in Ukraine right now, uh, is that people feel very close to each other. And that's sort of a natural biological thing almost, that when we are under extreme stress, we really become very dependent on each other, and we form very close bonds.

    9. RC

      Yeah.

    10. BK

      And that's how people survive. But if the people who are your most intimate people are the source of the trauma, you lose that sense of connection and protection, and then that oftentimes that is when people go over the edge.

    11. RC

      Yeah, it's interesting. As I was preparing for this conversation and I was reading in your work the importance of human connection at making us, I guess, generally more resilient, but in many ways insulating us from the likelihood that a traumatic event is gonna leave a chronic imprint inside us.

    12. BK

      Yes. It's, it's, insulate is a bit of an extreme word here.

    13. RC

      Okay.

    14. BK

      It helps. It's, uh, it makes a significant contribution.

    15. RC

      Yeah.

    16. BK

      But insulate, no, it's too total a word. Uh, that... But overall, when you're a kid, for example, and you need to go through an operation or, uh, terrible things happen to you and your parents are there for you and acknowledge it, then that kid is likely to be okay.

    17. RC

      Yeah.

    18. BK

      Yeah.

    19. RC

      Yeah. Really, really interesting.

    20. BK

      Yeah.

    21. RC

      I, I think one of my aims with having this conversation with you-

    22. BK

      Yeah

    23. RC

      ... uh, is to try and raise awareness of trauma, certainly to my audience.

    24. BK

      Yeah.

    25. RC

      And as you've already touched on, it's much more common than we might think.

    26. BK

      Yeah.

    27. RC

      I certainly feel that the word is now much more commonly known about, spoken about, potentially in settings that you may not regard as trauma. Like we can-

    28. BK

      Right

    29. RC

      ... we can maybe talk about that. But I do think this affects everyone on some level, whether individually or judging from your statistics that you shared-

    30. BK

      Yeah

  5. 11:31 – 17:01

    Trauma-Informed Schools and Triggers in Relationships

    1. RC

      I think it's imperative that we all have a deeper and more compassionate understanding of, of what it is, and therefore what we can do to help people.

    2. BK

      Absolutely. Uh, and it's true that people are beginning to... it, the concept gets inflated. Uh, people pin too much on trauma also in some ways. At the same time, uh, trauma is a very real issue. Uh, let me give you an example. I, I live in a county in the mountains of Western Massachusetts, and I gave a big public talk, and after the school principals of this area invited me to meet with them, and they say, "Can you set up a, a clinic for traumatized kids?" And I asked them, "So many, how many of the kids in our country see domestic violence, witness people overdosing on drugs, uh, uh, get beaten up at home?" And the school principals said, "About half of our kids." And my response then was, "Then you should not have a clinic for traumatized kids. You should have a school system that helps traumatized kids, which is at least, uh, half of your population, to really learn to regulate our bodies and to, and to... You need to have a trauma-informed school and not treat it as an individual problem because it's largely social problems." And so once you understand trauma, you change the workplace, you change your schools, you change your hospitals, and you really start paying more attention to the issue of individual safety and agency to help people to function.

    3. RC

      Yeah. Now, with the term trauma, I think most of the public would understand intuitively if someone's been to war, let's say, we would say that's a traumatic experience.

    4. BK

      Yeah.

    5. RC

      But what about something that I think pretty much anyone who's ever been in a relationship will experience something like this at some point when their partner says something to them that may well be on the surface quite trivial, but for some reason the other partner disproportionately reacts. Maybe they're being reminded-

    6. BK

      Right

    7. RC

      ... of when a parent criticized them when they were five years old. And when their partner says something, it isn't about what the partner said, it's about the feeling that evokes, very, very similar-

    8. BK

      Right

    9. RC

      ... to what you just mentioned-

    10. BK

      Right. Right

    11. RC

      ... that happened when you were a child. Can we say that is trauma as well?

    12. BK

      Well, no, I would say it's part of the experience, but, uh, I'm glad you brought this up, up, up this example because, you know, about a third of all couples engage in violence, violent interactions. So, uh, a lot of people carry a lot of trauma, and in relationships it comes out. And, uh, e- once you get become intimate with somebody else, you live with that triggered behavior. And then some things may be extremely upsetting for your partner who may become very angry or shut down in response to things that you have no, no idea what was so awful about it. And at that point, once you become trauma sensitive, you can go like, "Oh, my partner is not being, just being nasty, mean, and horrible. My partner gets upset by something. It has very little to do with me."

    13. RC

      Mm.

    14. BK

      And then you can really sort of take a step back and say, "Honey, let's go for a walk before we, uh, address this," or, "Let's play some tennis together," or, "Let's, uh, sit in this for a moment or talk to somebody who else about what's going on here," so you get the heat off the situation. Uh, you c- you decrease the heat of what's going on. But it happens in relationships all the time, of course.

    15. RC

      Yeah. In fact, in my experience at least, I see this playing out in people's close personal relationships all the time.

    16. BK

      Yeah.

    17. RC

      It's-

    18. BK

      Right

    19. RC

      ... of course it could be about what's happened in their relationship, but in my experience [laughs] it's very rarely about what happened in that moment.

    20. BK

      Right.

    21. RC

      It's what that-

    22. BK

      Right

    23. RC

      ... is making that-

    24. BK

      Right

    25. RC

      ... other person feel.

    26. BK

      Right. Yeah.

    27. RC

      Um, which is why I think your work is so important-

    28. BK

      Yeah

    29. RC

      ... both for people who have experienced trauma, but also for people who wanna help their loved ones who have been traumatized.

    30. BK

      Yeah. Yeah. Uh, and indeed, it comes out in intimate relationships. Most people are, are able to, uh, to organize themselves pretty well under in neutral conditions. Uh, for example, I have no idea that whether you become violent in your personal relationships or not, uh, you don't know that about me because we don't have the sort of relationship where we would get triggered about these very core issues. It's not until you really negotiate very complex issues about that happens in close relationships that these issues come out, huh. Uh, so, uh, it gets, it gets contained within relationships, and I keep urging my colleagues who do outcome studies to always not only ask people themselves but h- how do you react, but ask their spouses or their loved ones because they oftentimes can be, say more about people's emotional reactions.

  6. 17:01 – 26:27

    Medicine's Blind Spot: Fibromyalgia and Re-traumatization

    1. RC

      As a medical doctor, I'm incredibly fascinated stroke frustrated that trauma is not really spoken about that much to medical students because I think-

    2. BK

      Yeah

    3. RC

      ... about, particularly in general practice, you know, the sort of chronic conditions that often come in to primary care doctors, you know, anxiety, depression, addictions-

    4. BK

      Yeah. Yeah

    5. RC

      ... uh, migraines, fibromyalgia, all, you know, whole hosts of-

    6. BK

      Yeah

    7. RC

      ... issues, autoimmune problems. Actually, the, the scientific research seems to suggest that trauma could well play a role in a significant number of these conditions.

    8. BK

      Absolutely. And indeed, um, you know, it's, again, a temperamental issue-

    9. RC

      Yeah

    10. BK

      ... that most people going into medicine want to have clear answers and clear paradigms. And we go to medical school and we learn about all these diseases, uh, and they are diseases, and we don't... To start talking about social context would make it even more complicated, so you, you don't learn about it. And actually right now I was me- meeting with some old friends from- My medical school days is that we oftentimes did terrible things to patients and did not really understand how terrified they were of, let's say, white doctors, and how they would be neglected, neglecting their physical care because they were too terrified about doctors to actually bring it up with them. Uh, and so, uh-

    11. RC

      Yeah

    12. BK

      ... I'm very glad that some people in some medical schools and medical settings are beginning to pay attention to it because the title of my book, The Body Keeps the Score, is not just a cute title. Uh, uh, it actually, uh, that it affects your immune system, it affects your stress responses, and people who have long trauma histories oftentimes have multiple medical problems-

    13. RC

      Yeah

    14. BK

      ... which have to do with their body. They get stuck in, uh, fear, fight and flight. Uh, and so fibromyalgia is a very good example. Fibromyalgia is pretty much related to trauma, but it's so diffuse that, uh, like I am friends with very old man who used to... The National Institute for Rheumatology in America, and I say, "So do you guys study fibromyalgia?" He says, "No, that's a disease of crazy people." Uh-

    15. RC

      Yeah

    16. BK

      And here's the guy who's the top rheumatologist in America who just dismisses this very complex and very debilitating illness because the people who have it are just too complex to deal with, and difficult, and resistant.

    17. RC

      Yeah.

    18. BK

      And so get nice clean illnesses.

    19. RC

      Yeah. Uh, hey, listen. I, I'm, I wa-

    20. BK

      Yeah

    21. RC

      ... I wanna just pause on this for-

    22. BK

      Yeah

    23. RC

      ... point because I think it's really important. First of all, I do think medicine, uh, for all its benefits, for all the conditions that we do manage to help with, there's many conditions that we don't do a very good job with, and I think we can be quite condescending as a profession sometimes to certain sufferers of certain conditions like fibromyalgia because they don't fit in a neat box that we can do, "Oh, this is the problem. This is the pill. It's gonna get better."

    24. BK

      Yeah. Yeah.

    25. RC

      And so I think doctors often feel quite frustrated and powerless as well. I don't think they're necessarily wanting to be derogatory. I think they thought they were gonna learn what they needed to treat these patients, and then they're faced with people who keep coming back, and they don't know what to do, so I think that's one point I wanted to raise. But-

    26. BK

      No, absolutely

    27. RC

      ... you also mentioned something that I think we should just explore a little bit. You said fibromyalgia is a condition, uh, that, that is, I don't know if you said often or always related to trauma. Now, I think we... Let's just clarify what we mean there because there will be people listening with fibromyalgia. This may be the very first time they've heard it, so can we just-

    28. BK

      Yeah

    29. RC

      ... just broaden that out a little bit so that they can understand what you mean by that?

    30. BK

      Yeah. When you study fibromyalgia and you do a trauma history on people, you usually find a severe trauma history, usually within the attachment system of them not feeling safe. Uh, and what happens I think is very much what happens with all of us to some degree. When we come, we scared, we become uptight, huh, and we start physically becoming defensive and, uh, hold onto ourselves, and that uptightness and trying to control things may then, uh, eventually get expressed as fibromyalgia. Uh, but you become a very anxious and chronically upset person, and, uh, the hard thing for medicine is there is no clear answer. It's not like, "Oh, let's g- let me give you a pill, and you feel better." You really need to go through a whole process, uh, that might very well involve body, uh, oriented therapy, maybe massages, maybe really working with bodily reactions, which of course in medicine we never do. Uh, that, uh, that really need much more intervention than we are capable of or that our systems allow us to intervene with. I know quite a few people who have resources in America with fibromyalgia who find the right people to work with, who know about bodily reactions, but they're very hard to find.

  7. 26:27 – 36:15

    Feeling Safe in the Body and the Role of Yoga

    1. RC

      I really wanna get to a central, uh, philosophy of your work that I take from it at least, which is about The Body Keeping the Score, that's the title of your book.

    2. BK

      Yeah.

    3. RC

      But this idea that the body keeps a record of what has happened, and that one of the goals of therapy is to help people feel safe in their bodies.

    4. BK

      Yeah.

    5. RC

      Now, I think a lot of people may not understand what that means. What do you mean when you say we need to feel safe in our bodies?

    6. BK

      Well, you know, I think Darwin already back in 1872, uh, wrote a beautiful book in which he talks about trauma actually. He calls it getting stuck in fight or flight, or stuck in avoidance and defensive reactions, which is not a bad definition. And he, he talks about how these experiences are expressed in the course of the vagus nerve. Uh, he, Darwin calls it pneumogastric nerve back then, and that you experience your emotions as gut-wrenching and heartbreaking b- physical sensations. And I think we all are familiar with that. When something hurtful happens, we do feel it in our chest, and we feel it in our bodies, and so our bodies respond to these things. And when you get traumatized, that feeling of, uh, of, uh, gut wrench and heartbreak really stays with you, and it become a, you become an intolerable person to yourself.

    7. RC

      Mm.

    8. BK

      Does that r- Does that ring a bell with you? Because I, you know, I, I make it a point whenever I travel and is, go to a place where I don't know the language, I always ask, "In your language, do you have a, do you have a word for gut wrench?"

    9. RC

      [laughs]

    10. BK

      And every language has a word for it.

    11. RC

      Yeah.

    12. BK

      [laughs] It's a universal response that you experience deep disappointment and betrayal and fear in your body.

    13. RC

      Yeah. I think people have experienced that. If anyone's ever been through heartbreak before, they-

    14. BK

      Which we all have

    15. RC

      ... which, yeah, pretty much everyone has been through on some level.

    16. BK

      Yeah. Yeah.

    17. RC

      You feel it-

    18. BK

      Yeah

    19. RC

      ... in your hearts. Like, you literally can feel it, the pain-

    20. BK

      Yeah

    21. RC

      ... the discomfort there.

    22. BK

      Yeah. Yeah.

    23. RC

      So I think when we start thinking about it, it's like, oh yeah, that's in our body. Like, something's happened up here in our mind. We perceive it a certain way, and then our body is expressing-

    24. BK

      Yeah

    25. RC

      ... a symptom of that.

    26. BK

      Yeah.

    27. RC

      So I think this is a really good point to talk about some of these practical things that people can start doing to help themselves. I mean, frankly, the things you're talking about are helpful for anyone. But can we start with yoga, right? I know yoga is something you talk about as a really fantastic way for many people to start feeling that safety within their bodies. How did you come across yoga, and why do you think it's so effective for so many people?

    28. BK

      Well, you know, these things are usually a issue of accident. That you happen to meet somebody who does yoga and who says, "Come and do yoga class with me," and then you do that. And then you feel that your body feels calmer, and your mind is more focused afterwards, and you say, "Oh, that's interesting." So actually, so I went to National Institute of Mental Health and got the money to study yoga as a way of calming that body down. Uh, but now people say, oh, yoga is treatment of choice. I don't know. Maybe for some other people qigong may be better, or tai chi, or, uh, some other musical practice. As- But for me, going to yoga was really a way of exploring to what degree people can change their relationship to their bodily sensations, and yoga turned out to be very good for that. And certainly it's not the only way. A study I still love to do someday is, uh, see how tango dancing works for trauma. Uh, theoretically, that would make a lot of sense as being a really good trauma treatment actually. Uh, and so, so it... And what I see all the time is that the people who are in my life who are traumatized, they go and start exploring different things that help them. Uh, and, uh, some people find that, let's say, acupuncture is very helpful. Other people say, "Doesn't do a thing for me." Uh, so we don't know precisely what is right for whom, but it's very important for us to have an open mind about, uh... And you need to have an open mind for yourself also to really see what can help me to feel alive in the body that I live in.

    29. RC

      To make sure you're taking action after watching this video, I've created a free Breathing Guide that's gonna help you reduce stress, calm your mind, and boost your energy. In this guide, I share with you six really simple breathing practices that work immediately. Even just one minute a day will start to make a big difference. To receive your free guide, all you have to do is click on the link in the description box below. So is that the commonality then? You mentioned a few things there. Let's say yoga-

    30. BK

      Yeah

  8. 36:15 – 38:35

    Beyond One-Size-Fits-All: Evidence and Open-Mindedness

    1. RC

      Yeah. Wow. Very, very powerful. It's interesting-

    2. BK

      But it's just... But I want to say it's really... And, uh, then people say, "Oh, yoga is the answer." No. Yoga was a paradigm That helped us to understand how engaging with your body in a particular way is helpful, but it's not the final word on the story, huh?

    3. RC

      Yeah. I, I love that. I mean, that is speaking-

    4. BK

      Yeah

    5. RC

      ... to my heart. You're, you're really touching on, I think-

    6. BK

      Yeah

    7. RC

      ... one of the big problems I see around today in terms of thinking about how we treat people with chronic health problems, whether it's trauma or anything else, it's like, what does that narrow reductionist study show up? Oh, great. Oh, it works in that stu- Okay, great. That means that's the treatment for every patient.

    8. BK

      Yeah.

    9. RC

      And it's like-

    10. BK

      Yeah

    11. RC

      ... if you see real people with real problems, you realize that actually there's no one size fits all. Like, for someone-

    12. BK

      Yeah

    13. RC

      ... that might be brilliant, but for someone else, it may be it isn't the right thing for them. But I feel like I, I've, I say this a few times on the podcast, I think the science is important. It's very important. But I think we make inferences and we draw conclusions that we then think are applicable to all. Whereas as you say, that just simply showed us that this paradigm here, therapies like yoga, which help us experience our bodies more, have the potential to help.

    14. BK

      So, but you know, in my travels, I meet a lot of people who claim that they do amazing things by doing, let's say, equine therapy, uh, do- working with horses. And, uh, and I say, "Interesting." And so I collect these people, and on our website, the Trauma Research Foundation website, we have these people talk about their system sometimes, and then we do need the evidence. So then the next step is always for me to say, "So, uh, let's help you to do a study where we can really see-"

    15. RC

      Yeah

    16. BK

      ... "which is effective for it, who it's not effective for." I think evidence is terribly important, but what we see in our field oftentimes that we close the barn door prematurely.

    17. RC

      Yeah.

    18. BK

      Huh? And we find that if ProZach works some of the time for some people, say, oh, treat, ProZach is treatment of choice. No. Sometimes ProZach works for particular people. Let's see for whom it works and for whom it doesn't work.

    19. RC

      Yeah, I love that. I think that's a-

    20. BK

      Yeah

    21. RC

      ... it's a really nice way of putting it.

    22. BK

      Yeah.

    23. RC

      Um,

  9. 38:35 – 45:49

    Movement, Agency, and Virtual Life

    1. RC

      moving on to another therapy, or I know when I've heard you speak before, you talk about theater and movement.

    2. BK

      Mm.

    3. RC

      You put those two things together. And I, I first of all find it interesting that you put theater and movement together when you're, when certainly when I heard you talk about it. But can you elaborate a little bit on what's so powerful about theater and movement and how it can help people with trauma?

    4. BK

      Yeah. I, I'd like to tease this a- apart a little bit, huh? So the movement issue is terribly important, and that's not really part of how we think in psychology, psychiatry, or even medicine. But basically, uh, we express our aliveness through the bo- the movements we make. Huh? And when you work with children, for example, they explore their movement and their relationship of how their body affects the world around them and how the world around affects their body. And f- many hypothesis studies over the past 150 years show that trauma oftentimes is related to physical immobility. Huh? Uh, when you get attacked by somebody, it's very important to activate your fight-flight system and to fight and to punch back. But at the core of much trauma is people being unable to do something to change the situation. And so people go into a, an state of where their agency no longer matters. And so, um, and some very good studies in neuroscience also, Jodi Dew has done some of that, that as long as you can move in response to a really, uh, challenging situation and do something, you're going to be, uh, all right. And that, uh, at the core of what makes something traumatic is oftentimes an inability to do anything. And, uh, many traumatized people, as you again probably know as a physician yourself, tend to become very passive and tend to sort of, uh, ask us for pills and stuff to make their feelings go away, but it ve- becomes very hard for them to do things and to activate their bodies. Uh, and so movement and doing something that makes your body feel alive and, uh, capable is a very important part of being alive.

    5. RC

      Yeah. I've heard you speak previously about hurricanes that have happened, you know, big natural disasters, and you were speaking about the fact that, yes, a lot of people are affected, you know, nat- big natural disaster has happened. But the fact that people are coming together, they're helping others, they're moving, you were saying that-

    6. BK

      Yeah

    7. RC

      ... in many ways, that helps them to process the trauma. Can you speak to that a little bit at all, please?

    8. BK

      Yeah. E- exactly. That, exactly. That we are, you know, we are an extremely resilient species. We are everywhere. We have ... We're, we're almost as good as cockroaches. Like, uh, human beings are very stressful, just the way, huh? And so we can adapt ourselves as long as we're doing things with other people and making things happen. Uh, we're, we're, we're building, we're homo faber, we're, we're people who do things. And as long as you can do something, you get a sense of, yep, that hurricane sucked, and I really miss my house, and it's very terrible, but my friends came over and helped me to build a house. And wasn't it great that I was able to put a roof over my head again and help people to get supplies, et cetera. So doing something to, to, uh, to overcome your helplessness is terribly important actually, huh? And, uh, and of course, in medicine tends to be very passive.

    9. RC

      Yeah.

    10. BK

      You have people who go to a doctor, and they have to be compliant with their doctor's orders. I don't like the word compliance very much because people really need to own what they do, huh, and experience what they do.

    11. RC

      Yeah. A few years ago, I wrote a book on stress, and when I am talking about stress to companies or to people or groups of people, one of the things I often say is that you gotta understand the stress response on one level is preparing your body to move, right?

    12. BK

      That's right.

    13. RC

      It's, you know, the predator-

    14. BK

      Yeah

    15. RC

      ... the lion, the tiger, whatever it, it was, you're getting ready to move. But if it's your... If you're sat on your bottom and it's your email inbox that's stressing you out-

    16. BK

      Yeah

    17. RC

      ... and your, your workload and the fact that you're on Zooms for 10 hours in a row, your body is, is getting primed and ready to move. But because you're not moving, that-

    18. BK

      Yeah

    19. RC

      ... it almost gets stuck, and you're not processing-

    20. BK

      Yeah

    21. RC

      ... the stress energy that's built up.

    22. BK

      Yeah.

    23. RC

      Do you think that's accurate?

    24. BK

      Well, I, I think it's accurate. I think it's a very, very important issue in our current culture-

    25. RC

      Yeah

    26. BK

      ... that we become more and more virtual, living in virtual realities, including you and me. I really enjoy talking with you, but if we sat in the same room together, we'd actually have a relationship afterwards.

    27. RC

      Yeah.

    28. BK

      But we don't really form the sort of bond that you ordinarily form with other people by interacting the way we do. And I, I think it's a major challenge for us to, uh, to really s- look at the, at the impact of that. And I think it's going to have a major negative im- impact on us as human beings to become, to sitting on our butts and living through a virtual reality and virtual-

    29. RC

      Yeah

    30. BK

      ... interaction with people. It's, it's, it's a very big issue. I don't think we know very much about it because it's a relatively recent phenomenon, but it's something worthy of a great deal of attention, yeah.

  10. 45:49 – 53:46

    Theater, Shakespeare, and Body Posture

    1. RC

      Let's talk about theater. Um-

    2. BK

      Yeah, I'm glad. [laughs]

    3. RC

      Because we've mentioned, you know, yoga, then movement.

    4. BK

      Yeah.

    5. RC

      In terms of really practical things that people can take away from this conversation and go, "Oh, I wonder if this will work for me. I wonder if this is useful for someone in my life," theater and Shakespeare that I've heard you talk about is fascinating.

    6. BK

      Yeah.

    7. RC

      So, so tell, tell us what's going on there. What, what's... You know, w- what... How can this be helpful?

    8. BK

      Well, you know, let, let's start, um, with development of the person. I actually just spent some time with my grandkids, and they're always playing different roles, and, "Now I'm going to be an astronaut," and they try it out. And, "Now I'm going to be a hunter," and they try it out. And that is how human beings learn, uh, what it feels like in your body to have different roles. What struck me with traumatized people is at some point their identity becomes the identity of defeat. I used to be a warrior, but now I cannot move anymore. I used to be a sexy woman, but now I'm frozen in my body. Uh, uh, or a sexy man, for that matter. Uh, and, and so trauma sort of fixates people in a particular role in life of... which has to do with helplessness. And, uh, when I look at my kids, and then we have this wonderful theater in the area where I live called Shakespeare in the Court, where, uh, where they teach juvenile delinquents who are all have terrible trauma histories to Shakesp- play Shakespeare roles. And they get to feel, "Oh, this is what it feels like to be a king. This is what it feels like to feel powerful. This is what it feels like to be a murderer." And then you get to, on a visceral level, uh, experience the very different mo- multimodality of ourselves. And we g- get to really feel, "Oh, I can be powerful, and that's what it feels like." But you cannot be powerful until you actually hold it in your body.

    9. RC

      Yeah.

    10. BK

      And so playing Macbeth gives you a feeling, oh, that's what it feels like to be a warrior and a nasty person. And, uh, and you can play these different roles. And theater helps you to really viscerally experience other ways of moving in the world than your, than your ordinary habitual responses.

    11. RC

      Is it right that where you live that juvenile delinquents-

    12. BK

      Yeah

    13. RC

      ... when they're up before the judge-

    14. BK

      Yeah

    15. RC

      ... they're often given the choice between, you know, jail time or detention center time-

    16. BK

      Right

    17. RC

      ... and learning Shakespeare? That's what's actually happening?

    18. BK

      No, not learning Shakespeare to act in [laughs] a play. It, it is doing. You learn sword fighting, and that's a very, very complex thing to do is to learn to hold that sword well. But once you do that, you feel like, wow, I can defend myself. I could really be a powerful person. So you need to have a visceral experience of power and control that has been taken away from you by your trauma.

    19. RC

      Are we seeing that those kids then are improving? I mean, can you tell us any stories? What's happened that, they, to these kids? Uh, because I think it sounds-

    20. BK

      Yeah

    21. RC

      ... I can believe that rashly it's... You know, I think we, we all know, maybe we don't think about it, but if you stand up tall with your chest puffed out-

    22. BK

      Yeah, exactly

    23. RC

      ... you feel completely differently. You feel powerful and strong. And-

    24. BK

      Yeah

    25. RC

      ... if you roll your shoulders and compress your ribs, you, ah, you feel a bit insecure-

    26. BK

      Yeah, yeah

    27. RC

      ... and, and, you know, I think we can get that. So it totally makes sense to me that, as you said, a lot of people who are traumatized get stuck. They get stuck in, I guess, certain body positions as well, right?

    28. BK

      Yes, absolutely. Yeah, body positions of, of, uh, defensiveness, of collapse. Uh, and, and y- And the way you hold your body, and you put it very well because the research show, shows exactly what you say, is that when you put yourself in a position of, let's say, there's a body position, uh, that denotes joy. Every culture in the world, you raise your head, you open your mouth, [laughs] you open your ribcage, and when you freeze people in a bodily position of joy, and you say to them, "Now I want you to be angry," they say, "I can't be angry as long as I stand like this," because in order to be angry, and they stand like that.

    29. RC

      Yeah.

    30. BK

      And so it's really important to, to honor that piece of knowledge by helping people to experience different states of being by the way you hold your body.

  11. 53:46 – 54:58

    Going Off the Deep End: Paradigm Pushback and Character

    1. RC

      On an individual level, how did you cope with that kind of criticism? Because a lot of the things you're talking about-

    2. BK

      Yeah

    3. RC

      ... are certainly things that are not conventionally taught to Western medical doctors. But how was it for you as a respected academic clinician when you started getting this pushback?

    4. BK

      Well, I u- I used to be a ve- respected academic clinician, but I studied drugs. I did the first studies on Prozac and Zoloft, and at that time, my star was high. [laughs] But once you start doing other things, uh... But, you know, that's a characterological issue. Uh, I'm just a guy who is curious, who likes to explore new things. And so, uh- Respectability was not my most important thing in my life. And so character is destiny. And so I'm a person who likes to explore many different things. I'm a person who speaks several different languages, and so I can think in different paradigms. And so that made it possible for me to look at different options. Uh, and that's just a question of character.

    5. RC

      Yeah.

    6. BK

      Uh, yeah.

  12. 54:58 – 1:02:59

    EMDR: How It Works and Its Limits

    1. RC

      You mentioned EMDR.

    2. BK

      Yeah.

    3. RC

      EMDR, of course, is another therapy that I've heard you speak about-

    4. BK

      Yeah

    5. RC

      ... that can be helpful for certain people-

    6. BK

      Yeah

    7. RC

      ... uh, with, with trauma. Uh, what is EMDR, and can you explain a little bit about your experience with it? You know, when did you find out about it? What can it be helpful for? How do people do it? Do they do it themselves, with a therapist? Maybe speak to EMDR a little bit, please.

    8. BK

      Look, EMDR is indeed a very strange treatment where you call- ask people to call up the stuff that really bothers them, but not to talk about it, to just say, "Remember what you saw. Remember, remember what you felt in your body. Remember what you were thinking back then." So become aware of that, and then you ask people, "So stay there", and you ask people to... You move your fingers in front of people's eyes from side to side, and you say, "Just follow my fingers." Now, if there ever was a crazy treatment, that's a crazy treatment. And so my and everybody else first reaction is like, "That's bizarre. Don't listen to that stuff." And then some of my own patients who I'd worked with started coming back and said, "I did an EMDR, and I see profound transform- formations." And some of my colleagues started doing it, and they showed me their videotapes and I go, "That's a dramatic change." And so I see my patients, I see the videos of my colleagues, and I say, "This clearly changes the brain in very profound ways." And being sort of a neuroscientist, uh, oriented person, I was became fascinated by studying what does eye movements do to the brain. It took us 15 years to get enough money together to begin to do that study, but I started off by doing a simple study comparing EMDR with Prozac, and it turned out that these eye movements caused a very significant change in most people. And so that was the first time I studied a method that didn't fit in with the Western paradigm. And the Western paradigm is you yak or you take a drug. And now you did something else. And then from EMDR, I learned that things that don't fit within our cultural paradigm may work. And so then some other people say tapping acupressure points may be helpful. And I say, "What's the evidence for that? There is no evidence for that." And then we study it, and it turns indeed, turns out that tapping these Chinese acupressure points indeed seems to have an effect on people's physiological arousal. Uh, and so, uh, but EMDR was particularly important here for me, both because it was my first foray into something that didn't fit with the paradigm, and our results were extraordinary. Uh, that, uh, we had a 60% cure rate with EMDR in a trauma sample. Now, nobody's ever ch- achieved 60% cure that all the sym- symptoms were gone. And I think because it's so strange, it doesn't fit with our paradigms, uh, many people tend to still poo poo it, even though the evidence how well it works is very clear. Uh, but so, uh, so EMDR helps you to actually neutralize the memory. A part of being traumatized is that certain remembrances, certain events freak you out, make you upset. And what EMDR specifically does is those particular triggers to past events get, get calmed down, and you no longer get freaked out by the memory of particular traumas. Uh, and then people have a method and then they say, "Oh, let's use it for children who are chronically, uh, abused and in orphanages." I say, "No, that's probably not the right treatment for them." And so, so it's im- important to also know for whom it works and for whom it doesn't work. And what we showed in our research is that people with longstanding histories of child abuse, it didn't work all that well for them, at least in the way that we did it.

    9. RC

      Yeah. You know, in your book, which I think, was it published in 2014 for the first time?

    10. BK

      Yeah. It first came out 2014, yeah.

    11. RC

      2014, right. And I, I've got the page up in front of me. "While we don't yet know precisely how EMDR works, the same is true of Prozac." Sorry to interrupt. If you are enjoying this content, there's loads more just like it on my channel, so please do take a moment to press subscribe, hit the notification bell, and now back to the conversation. And it's a, it's a very powerful paragraph that at the end of chapter 15. Um-

    12. BK

      Yeah

    13. RC

      ... whereas that was, you know, what, eight, nine years ago now when you wrote that.

    14. BK

      Yeah.

    15. RC

      So certainly when it was published, you probably wrote [laughs] it 10, 11 years ago, that section. Um, do we now know how EMDR works compared to when you-

    16. BK

      Yes

    17. RC

      ... actually wrote that book?

    18. BK

      Yes. We, we... So my colleague, Shirin Har- Hariri and Ruth Lanius and I did a study, uh, where we put people in a scanner and made eye movements, and you saw that it activates certain circuitry in the brain. And the circuitry in the brain that it particularly activates is the salience network, the part of your brain that determines whether something is relevant or not. And so what we see with the people who lie in the scanner is that their, their brain organizes the experience in a different way by creating new circuits of experience. And so it is not about understanding or insight. You just sort of tweak the brain circuits in a way that helps you to not be overwhelmed by it. You don't erase it, but it becomes a memory.

    19. RC

      Yeah.

    20. BK

      So, so a traumatic experience is not a memory because the moment you go there, you relive it. Now, that's the nature of traumatic stuff. If, if you have been raped, you get really upset thinking or talking about your rape, but it is not a memory of something belonging to the past. It's a ... You currently right now recreate the physiological state of that past event. And what EMDR and to some degree yoga and neurofeedback and now psychedelics all seem to help us to do is to go there and to reorganize our perception of it and, and become aware on a very deep level of, "This happened to me back then. It's not happening right now." And so some circuits in the brains change that allow you to put it in the past and say, "Yes, this happened. It was awful, but I'm not feeling it today."

    21. RC

      Yeah. Yeah. Very clear. Very clear. Thank you. Um, would you say EMDR should always be done with a therapist? And the follow-up from that is there's a lot of what are called EMDR music tracks available now on streaming platforms-

    22. BK

      Oh

    23. RC

      ... which I know people like listening to. I don't know if you have any experience of the music, what it might do for people. Is that something quite different from what you're talking about in terms of seeing a, seeing an EMDR therapist to take you through that process? I wonder if you could speak to that a little bit, please.

    24. BK

      Interesting. Actually, I cannot speak about it because I've not studied that. And see, I'm so aware that trauma is about shame and about being disconnected from other people that I actually love the work of joining somebody and-

    25. RC

      Yeah

    26. BK

      ... helping somebody to deal with it in the context of a relationship with somebody with whom you no longer are ashamed about what happened to you. So I'm not really a fan of mechanical devices because a lot of recovery from trauma is to reestablish your capacity to connect with the people around you.

    27. RC

      Yeah.

    28. BK

      Huh? And, uh, but that's, that's my particular prejudice in a way.

    29. RC

      Uh,

  13. 1:02:59 – 1:07:43

    Healing in Groups and Communities

    1. RC

      yeah. I, I probably would have that slight bias as well in general. And I do wanna get to psychedelics, uh, and neurofeedback that you just mentioned. But just to sort of close that loop a little bit, yoga, which we started off talking about when we talked about the, the, the sort of things that people can do to heal from trauma, I guess you would encourage people to do yoga as part of a group rather than by yourself on YouTube, right?

    2. BK

      Yeah, absolutely. Uh, you know, I'm really impressed. I'm not a, a natural yoga person. But if I'm in a group with other people who are much more limber than I am and do a much better job than I, I sort of absorb their limberness, and I enjoy doing it with other people. Um, I think that's true for many things. I ... In psychedelic therapies also these days, we sometimes do psychedelics in groups, and I like it a lot because you experience it. I have one particular experience, and you have a different experience, and then you really get to see that I'm part of mankind and I'm holding something that we all hold in different ways. And I think this feeling of emotional isolation or the word I used in the previous book a lot, not in this one, is the, the feeling of being God-forsaken is a very important part of trauma. So I, I think doing it in groups of other people, uh, adds a dimension of humanity to the whole thing.

    3. RC

      Yeah. And just before we get to neurofeedback, just on that point, talking about the Western medical system and how it's set up, it's very individualistic. You know, we see a patient in isolation. We say, "This is what's wrong with you, and this is what you need to do." And I touched on this in my last book a little bit, that maybe we've got the whole setup wrong for certain people. Because there's a movement in the UK called social prescribing that's growing massively where people are healing in communities. They're, they're going to, let's say, cooking classes or reading things or, you know, there's something called Parkrun in the UK where people go every, every Saturday morning in all the villages and towns. You know, maybe 50, 100, 300 people get together, and they complete 5K together. Some walk, some run, but it's a very community-orientated environment.

    4. BK

      Wow.

    5. RC

      People are healing in communities, not in isolation, which I think really speaks to what you're talking about.

    6. BK

      We're all watching the British Baking Show around the world, [laughs] you know, of people cooking together, making food together. And, uh, you know, it's interesting, this point. Um, so w- when trauma was sort of reinvented or rediscovered, uh, I like to say Boston was to trauma what Vienna once was to music. And so [laughs] we had a group of people in Boston like Judy Herman and Eli Neuberger and Terry Keane and other people who all were into, deeply into trauma. We talked to each other, and our initial treatment was always group treatment, uh, because we didn't know what it had been like to be raped or to be a Marine in Iraq or Afghanistan, but they did.

    7. RC

      Mm.

    8. BK

      And so we found that getting people in a group who really have been there decreased people's shame and also gave a lot of recognition to people. It is actually quite horrifying to me how group treatment has sort of become a very tertiary treatment. Uh, of course, in the addiction community, uh, group treatment, uh, you know- Self-step programs is still central, and the sense of community of people who have had similar experiences is terribly important

    9. RC

      Yeah

    10. BK

      And I, and I, I'm actually sort of pushing people to go back to do much more group treatment where if ... Let's say you have been molested, and you deal with it by cutting yourself. It's shameful to cut yourself. But when you're in a group of other people say, "You know, when I get really upset, I cut myself," or, "I, I s- put a burning cigarette out on my arm," uh, you don't go ... other people don't go, "You should never do that." You go like, "Oh, yeah, I cope it in the same way."

    11. RC

      Yeah.

    12. BK

      "And I also feel very embarrassed about it." But what does it do for you? It actually helps me when I do that.

    13. RC

      Yeah.

    14. BK

      And so you, you meet ... You have the potential of meeting people who are much more understanding about what you go through-

    15. RC

      Yeah

    16. BK

      ... than somebody who's gone to medical school.

    17. RC

      Yeah. No, 100%.

    18. BK

      Yeah.

    19. RC

      And they can all help each other, of course-

    20. BK

      Yeah, yeah

    21. RC

      ... probably in a much more powerful way than a doctor or healthcare professional who's never experienced that. Um,

  14. 1:07:43 – 1:14:47

    Neurofeedback and Apps vs. Human Connection

    1. RC

      neurofeedback, what is it? I know you think it's, or you've shown that it's a, it's a powerful therapy potentially for people suffering from trauma. Can you explain what exactly it is? Does it help us rewire our brain?

    2. BK

      Yeah.

    3. RC

      Who is it helpful for? All kinds of things like this.

    4. BK

      So, so neurofeedback is a method that you can put electrodes on people's skulls, and our technology is good enough right now that despite the effect of the skull is quite thick, you can actually harvest these electrical brainwaves that are underneath the skull. And by putting elect- number of electrodes on people's heads, you can project the brain's electrical activity, activity on a computer screen. And you can sort of see what part of the brain is talking to what part of the brain and what is most active and what's most inactive. And we have pretty good ideas about, uh, what sort of electrical activity helps with optimal s- functioning. And oftentimes when we do this, what's called quantitative EEGs on traumatized people, my reaction is, oh, my God, how can you have a life for yourself because your brain is really mess... I don't say it to people, but y- you see some very serious disconnection between different parts of the brain, which people then can sometimes compensate for. But by having a map of the brain, you can say, okay, you can now play computer games with your own brainwaves, where whenever your brain creates the sort of brain connections that are good for you, a, a little color changes or some music changes. So you, you play back feedback to people's brains of that's good. And if you don't make the right brain forms, the sort of brain forms that, uh, make you angry or hyperaroused, you don't get feedback. So you can sort of subtly give people a little sensory feedback through sounds and images of, yeah, make more of that. So you can train the brain to make different connections. It's not a trauma treatment. It's a brain organization treatment. I'm astounded that this is not done more widely and more often because it makes a lot of sense, uh, from a scientific point of view is that you can actually, uh, visualize these things, and you can actually sort of nudge the brain to organize itself in a different way. And so, uh, what's been stunning to me is that, uh, there's a guy in London, uh, John Gruzelier, who's done good research. Uh, some people in Belgium, uh, some people in Germany, and Ruth Lanius, and we are among the few people who actually have studied these brain computer interface methods, and I think it's enormously powerful. And, uh, we have done studies with kids who are just completely off the wall, unable to go to school, unable to, to learn, and we can calm their brains down, so they can actually focus and not get out of control.

    5. RC

      So this can be for many of us with depression-

    6. BK

      Yeah

    7. RC

      ... anxiety, chronic stress, kids who feel out of control. It's just a way of harmonizing yourself a little bit with your brain, right?

    8. BK

      Yeah. Right. And I ... You know, my dream is that every school in America has a neurofeedback system and a neurotherapy capacity, so when kids come to school, and they're just off the wall and terrified and angry because they have all these experiences they have just had at home, that you can help these kids to calm their brains down so they can actually learn and get along with other kids.

    9. RC

      Yeah.

    10. BK

      I, I wish every medical clinic had neurofeedback. It is such a nice simple way of just helping you to smooth out your brain functioning.

    11. RC

      Yeah. I, like you, am a fan of people healing with others in real life. You know-

    12. BK

      Yeah

    13. RC

      ... I get it. There's a lot of great tech out there to help, but I think we've gotta be not too reliant on that where possible and make sure we're experiencing things in the real world. But there are some apps, I think, now where they help with things like coherent breathing, and you can-

    14. BK

      Yeah.

    15. RC

      You know, they can help you harmonize various parts of your body and your brain through different methods. So I think technology is gonna potentially revolutionize this. Have you experienced that as well? Have you come across apps like that?

    16. BK

      Oh, absolutely. And I know those apps and actually have those apps on my phone. What I'm also impressed with is how I don't use them, even though I know how helpful they could be, and sometimes I do get a little unfocused or whatever. Uh, and I know ... And what I'm impressed with is that if a friend of mine calls me, "Are you going to come to this class? Are you going to go for a walk?" That that's rewarding enough for me that I will actually do it. But apps in and of themselves- Most people just don't love their apps. [laughs] To say, let me just, uh, so the inter- interpersonal process is still a very rewarding-

    17. RC

      Yeah

    18. BK

      ... part for us. So, so doing it in a group of people who say, "Where were you last night when we did this?" Uh, uh, it- that's who we are as human beings.

    19. RC

      Yeah. Do, do, do you know what's really interesting, Dr. van der Kolk?

    20. BK

      Yeah.

    21. RC

      Is if I ... This is not relating to trauma at all, but a few months ago I spoke to, uh, this chap called Eliud Kipchoge on this podcast, the Kenyan marathon runner, the only person to have ever run under two hours in a marathon. He's considered the fastest marathon runner of all time. And, you know, it was a beautiful conversation with him about all kinds of things. And one thing he said, well, many things, but one particular thing really struck me. He never trains alone, ever.

    22. BK

      Ah.

    23. RC

      He never-

    24. BK

      Ah

    25. RC

      ... goes for a run alone. Whereas in the West we often run alone where, you know, we do it to de-stress or unwind by ourselves. He goes, "No, no. We always run together." And he says, "If you're, you know, if you're not showing up or your motivation's not there for a few days, one of your buddies is g- gonna be on the phone and say, 'Hey, Eliud, where are you? What's going on? Is everything okay?'" And it really struck me how much culture plays a role here. I thought, "Wow, this incredible athlete, the fastest marathon runner on the planet-

    26. BK

      No

    27. RC

      ... never goes for a run by himself. It's always in a group."

    28. BK

      Yeah. And I think that's who we are. You know?

    29. RC

      Yeah.

    30. BK

      Uh, I, I just, uh, uh, was lucky enough to go on a, to the Serengeti plains. I got to see all these animals.

  15. 1:14:47 – 1:23:44

    Psychedelics: Promise and Cautions

    1. RC

      We must just briefly touch on psychedelics. You mentioned group psychedelic-

    2. BK

      Yeah

    3. RC

      ... therapy. And of course, psychedelics are getting a lot of media. They're all the rage. Um, they're still illegal, of course, in many countries. I have to say that. Um, where do you stand at the moment on the use of certain psychedelics as a treatment or as part of the treatment for people suffering from trauma or other mental health issues? You know, what, where does ... What does the evidence say at the moment, and who do you think it might be useful for, and who should be cautious, would you say?

    4. BK

      So, uh, luckily this is not just an issue of opinion. My lab actually does psychedelic studies, and I'm really very happy to be part of this burgeoning thing. And we do ... We're part of the studies. And, uh, one of my papers will come out with specifically about what psychedelics can do on the basis of research. And, uh, so, uh, I have a license to give MDMA, ecstasy, to people and part of the larger study that's almost done. Uh, and so I have good data. And the only psychedelic, uh, like substance that's legal in America right now is ketamine, and I'm involved in training people in ketamine-assisted psychotherapy. Uh, so I know ketamine quite well. I know MDMA quite well. I don't know psilocybin from a research or personal experience well, but we all talk to each other, and I see the beautiful work that's being done started at Johns Hopkins. Um, and let me give you an example. A, a friend of mine, uh, who is a very major person in the trauma field and a person who we all deeply love, ha- developed severe cancer eight years ago, and he was angry, bitter as one could, would be when he heard the diagnosis. He joined the s- the psilocybin study at, uh, at Hopkins, and I visit him and he sa- he started to cry. He said, "It's an amazing experience." My friend doesn't have a mystical bone in his body, and he said, "I was blasted into universe, and I had these visions of little villages with smoke coming out of the, uh, chimneys, and all my ancestors were there, and they were waving at me and said, 'Hi. Uh, yeah, it's good you joined us. We all, we are all here and we all die, and it's part of life.'" And my friend had this mystical experience, and he accepted his death, except he's still alive eight years after we all thought he was going to die, which really makes me very intrigued. We sh- really should study whether the psychedelics change the immune system, uh, to actually change some of the bodily stuff. That's an interesting issue. But what happened to my friend Frank was a very important inspiration for me to look at how psychedelics can be helpful, and one of the reasons I got intrigued with it is, of course, I'm, uh, from the '60s generation. I, I had good experience with LSD when I was a young man and then became all straight and haven't done it for a long time. Uh, uh, but I do remember from taking LSD back then is how it, it opens up your mind and makes you aware of that the reality that I've constructed for myself is just a very small part of the overall reality that surround us. And you become really aware of that y- your reality is your own personal construction, and by having this psychedelic experience, you see that the universe is much larger than the universe that you, uh, that you actually live in. And that's actually what we see when people do psychedelic therapy, is their mind becomes open to new possibility, to become more curious about exploring new things. Uh, um, I have a number of friends, uh, who are- Very famous scientist. And I've asked all of them, they're all about my age. I said, "Did you take LSD in, in college also?" They said, "Yeah, of course I did." I said, "How do you think it affected your career?" And every one of them says, "You know, I think I became a good scientist because the psychedelics, uh, made me realize that the reality that we have defined for itself is just a small part of what there is, and it made me a more open-minded and curious person."

    5. RC

      Yeah.

    6. BK

      And that's very much what we see in our secondary treatments, that people oftentimes go into their trauma, and it's no picnic. It actually can be very painful. Uh, people may lie there and cry and say, "Oh my God, oh my God." But it opens them up to actually see themselves and to visit themselves. And what our research shows, uh, will come out before too long, is that, uh, the psychedelics lead to a dramatic increase in self-compassion, and that people really feel for themselves and have a, a feeling of compassion for themselves. It also makes people much more aware of who they are. Uh, it also makes people more aware of how, who other people are, so they're much better able to negotiate interpersonal conflicts and interpersonal relationships-

    7. RC

      Mm

    8. BK

      ... because they really get exposed to a, a larger reality than they ordinarily are locked into.

    9. RC

      So, so for a person who has suffered trauma-

    10. BK

      Yeah

    11. RC

      ... when they go through a psychedelic experience, let's say in your lab or in your studies-

    12. BK

      Yeah

    13. RC

      ... it opens up their mind. They see what ... That the story they've constructed is, is just one story. There are multiple other stories they could construct around that story.

    14. BK

      And other dimensions also. Uh, the, that visiting your trauma gets you always stuck because your body keeps the score. And the moment you go back there, you feel that agitation and you feel that terror, and you want to get away from it as fast as you can. And there's something about both psilocybin and ketamine and MDMA, because we have seen it in all three, that allows people to go to these dark places and to not get engulfed by it, to not get hijacked by it and to plunge into a traumatic state, but to also get to feel different dimensions-

    15. RC

      Yeah

    16. BK

      ... and to understand things in a different way. Yeah.

    17. RC

      Yeah. And that self-compassion piece you mentioned, of course, very-

    18. BK

      Yeah

    19. RC

      ... very important for any healing is if you come out of that feeling more compassion for yourself, less shame, less guilt-

    20. BK

      Yeah, yeah

    21. RC

      ... of course, that's gonna help in anything further that you do. Are there any downsides, you know, as these things become more and more, um, in the mainstream and people talk about them and, you know, more and more people are trying psychedelics. And of course-

    22. BK

      Yeah

    23. RC

      ... there's plenty of good research showing how helpful it can be. Can it be harmful for some people? You know-

    24. BK

      I'm so glad you bring this up. I tell my colleagues we are in the honeymoon phase. And so I have a team of people who are, uh, 20, 30 years younger than I am, and they say, "We're part of the revolution." And I say to them, "You're part of the second revolution," because I was ... I had Timothy Leary's old office at Harvard at some point.

    25. RC

      Wow.

    26. BK

      I was at the tail end of that last revolution, and that revolution collapsed in part because of politics, but also in part because people got way too careless and, uh, it really got out of control. And I'm really afraid that things will get out of control again. These are very, very powerful substances. The way we do our study is extraordinarily careful. We get to know people really well. They have two therapists who are with them the whole time. Uh, set and setting is everything. Uh, we have relationships with the people who, who we treat, and they feel safe with us. Uh, and so right now in our study, we just opened up the second study. Uh, first one was nine- 891 people. The last one is 103 people. And again, we have no significant side effects. But we have no significant side effects because we pay so much attention to set and setting. And what you see already as, as there's money at the Andara Hills, uh, you can go to a ketamine infusion clinic where you go to a little cubicle, get an infusion, and nobody is there with you, and you can ring a panic butto- button if you become really upset. That horrifies me.

    27. RC

      Yeah.

    28. BK

      Because, uh, blowing your mind is a potentially very dangerous thing and, and very painful and horrible things can become manifested, and you need to really create a very careful container for it.

    29. RC

      Yeah. Tha- thank you.

    30. BK

      I'm, I'm really worried it will blow up again. Yeah.

  16. 1:23:44 – 1:31:27

    What Trauma Teaches Society and Messages of Hope

    1. RC

      I just would love to, um, just think about what can trauma teach us as members of a society? Because you said something very profound once. "Victims are members of society whose problems represent the memory of suffering, rage, and pain in a world that longs to forget."

    2. BK

      You know, when you quoted me, I always go like, "I wish I had written that. It's so good." And then it turns out I had written it, like [laughs]

    3. RC

      Yeah. I mean, they're your words, and I think-

    4. BK

      Yeah, yeah

    5. RC

      ... they are so profound. Because-

    6. BK

      Yeah

    7. RC

      ... look, let's be really clear. Trau- traumatic experiences are horrible. They're causing all kinds of-

    8. BK

      Yeah

    9. RC

      ... problems to people.

    10. BK

      Yeah.

    11. RC

      Hopefully, the conversation we've had, the work you are doing is gonna help people-

    12. BK

      Yeah

    13. RC

      ... first of all, become aware of that and then start to make changes, maybe some of the modalities we've already spoken about.

    14. BK

      Yeah.

    15. RC

      But I do wonder, what can we as a society learn from trauma? Traumatic ... You know, traumatized individuals- You know, is there any upside? Is there anything that, you know, for society is that ... I've gotta be very sensitive how I say this, but I'm-

    16. BK

      Yeah

    17. RC

      ... I'm just saying every, every bit of adversity in life tends to have an upside at some point, whether we're ready to see it or not.

    18. BK

      Yeah. Yeah, yeah.

    19. RC

      And I just wonder, with all your experience, are there any upsides, and what can we learn as a society from looking at people suffering from trauma?

    20. BK

      I think, I think the big message is people generally do the best they can.

    21. RC

      Yeah.

    22. BK

      And that's very important. And so one of the things that's very gratifying about the work that I do, I see a lot of people who have gone through experiences that I cannot imagine having been able to survive. And then you see what people have done to survive, and they may have done weird things like become addicted to heroin in order to survive, but it was their way of survival. And so I think what trauma really teaches us is that people do the best they can to survive, and that, uh, being punitive and nasty to people who do things that you don't like is probably not the best way to help them, and that you need to really ... Uh, it's very important that, that people do get traumatized if you yell at them, if you scream at them, if you, uh, put them in s- seclusion, and to become aware of the potential damage we can do to each other, but also how being heard and being in connection with people is terribly important for all of us at every stage of our lives, and that, uh, that, that to honor people's reality also.

    23. RC

      Yeah. I think many of us are familiar with-

    24. BK

      Yeah

    25. RC

      ... certain pieces of art or songs or some-

    26. BK

      Yeah

    27. RC

      ... just quite beautiful pieces of music that have come from trauma. So yes, that individual has had extreme pain and suffering, but what has come out of that has brought such joy to so many people. Uh, I- I- I don't know why I ... Again, I- I'm very cautious as I say that because I don't wanna at all come across as someone who is undermining how painful those experiences are. I'm just trying to maybe at the end of this conversation leave a slightly uplifting, uh, sort of tone there.

    28. BK

      Well, you know, you know, this is no scientific statement, but I think most really truly innovative things in our world are a- are discovered by traumatized people, because they live in a world that's unbearable, and so they have no choice but to find new ways of coping with things that is different from where they live. Because if they would stay, keep doing the same thing, uh, uh, they would die. A great example is Isaac Newton, uh, the greatest physicist who ever lived. Uh, and then you read his biography. This guy had the worst possible childhood, and so he hid himself into mathematics and physics, and that was his safe place that allowed him to create things. Uh, J.K. Rowling, the author of, uh, Harry Potter, uh, she was a very traumatized person who I, I don't want to go about details, I've never met her, but she was a very messed up traumatized person until she started to put it together-

    29. RC

      Mm-hmm

    30. BK

      ... in these Harry Potter stories that actually come from the visions of a traumatized p- person.

Episode duration: 1:31:27

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