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

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

Huberman LabJun 6, 20222h 24m

Andrew Huberman (host), Dr. Paul Conti (guest)

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

In this episode of Huberman Lab, featuring Andrew Huberman and Dr. Paul Conti, Therapy, Treating Trauma & Other Life Challenges | Dr. Paul Conti explores rewiring Trauma: Therapy, Self-Care, and Psychedelics for Healing Andrew Huberman and psychiatrist Dr. Paul Conti unpack what trauma actually is, emphasizing that it’s not just any negative event but an experience that overwhelms coping systems and produces lasting brain and behavior changes.

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

Andrew Huberman and psychiatrist Dr. Paul Conti unpack what trauma actually is, emphasizing that it’s not just any negative event but an experience that overwhelms coping systems and produces lasting brain and behavior changes.

They explore how guilt, shame, and avoidance often hide trauma from conscious view and drive destructive patterns like repetition compulsion, addictions, and self-sabotaging relationships.

The conversation covers how to work with trauma through talk therapy, journaling, self-inquiry, careful use of medications, and emerging psychedelic-assisted therapies such as psilocybin and MDMA.

They also delve into how to choose and use therapy effectively, the dangers of over-medication and casual stimulant use, and why basic self-care is a non-negotiable foundation for psychological health.

Key Takeaways

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

Conti distinguishes ordinary disappointments from trauma that overwhelms coping capacity and leaves the brain functioning differently over time. ...

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

Shame is a powerful, automatically aroused affect that historically helped regulate social behavior in small groups; guilt arises when that shame is attached to the self. ...

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

The limbic system “doesn’t care about the clock or calendar,” so it tries to resolve old injuries by repeating similar situations now, hoping for a different outcome. ...

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

Research and Conti’s experience show that a strong therapeutic alliance—trust, eye contact, feeling genuinely attended to—matters more than whether the therapy is CBT, psychodynamic, or DBT. ...

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

Productive self-work requires an ‘observing ego’—curiosity about one’s own thoughts and patterns rather than mindlessly looping the same narrative. ...

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Psychiatric medications are powerful tools but are often overused and misapplied due to systemic pressures.

Conti criticizes 15-minute med checks and diagnosis-by-number that lead to polypharmacy: multiple drugs for symptoms and then additional drugs for side effects. ...

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Psychedelics and MDMA may powerfully catalyze trauma healing by shifting brain states—if used in the right hands.

Classic psychedelics (psilocybin, LSD) appear to quiet cortical ‘chatter’ and increase activity in midline/insular regions associated with core humanness, compassion, and spiritual experiences—allowing people to see their trauma and self with unprecedented clarity and reduced shame. ...

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Notable Quotes

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

Paul Conti

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

Paul Conti

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

Paul Conti

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

Paul Conti

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

Paul Conti

Questions Answered in This Episode

You emphasize that trauma must change brain function to qualify clinically; what practical criteria could a non-clinician use to distinguish between ‘big disappointment’ and true trauma in themselves?

Andrew Huberman and psychiatrist Dr. ...

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When someone realizes they’ve repeated the ‘same relationship seven times,’ what are the first three concrete steps you’d have them take in therapy to break that repetition compulsion?

They explore how guilt, shame, and avoidance often hide trauma from conscious view and drive destructive patterns like repetition compulsion, addictions, and self-sabotaging relationships.

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You’re critical of overprescribing yet also see targeted use of antidepressants and antipsychotics as powerful; can you walk through a specific case where a short-term medication plan dramatically improved someone’s ability to do trauma work—and how you safely took them off those meds later?

The conversation covers how to work with trauma through talk therapy, journaling, self-inquiry, careful use of medications, and emerging psychedelic-assisted therapies such as psilocybin and MDMA.

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Given the promising data on psilocybin and MDMA, what specific safeguards, training standards, and clinical structures do you believe must be in place to prevent a ‘wild west’ of psychedelic treatments that could harm patients or trivialize these tools?

They also delve into how to choose and use therapy effectively, the dangers of over-medication and casual stimulant use, and why basic self-care is a non-negotiable foundation for psychological health.

Get the full analysis with uListen AI

You’ve linked media consumption and online hate speech to vicarious trauma and increased fear; what concrete boundaries or ‘information hygiene’ practices do you recommend individuals adopt to protect their mental health without becoming uninformed or avoidant of reality?

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Transcript Preview

Andrew Huberman

(uptempo music) Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today my guest is Dr. Paul Conti. Dr. Conti is a psychiatrist who did his training at Stanford School of Medicine, and then went on to be chief resident at Harvard Medical School. He now runs the Pacific Premier Group, which is a collection of psychiatrists and therapists focusing on solving complex human problems, including trauma, addiction, personality, and psychiatric disorders. Today we discuss trauma in detail, and the therapeutic process in detail. For instance, we discuss, what is trauma? How do you know if you have trauma? Dr. Conti shares with us, for instance, that not every experience that we think is traumatic is necessarily traumatic, and yet many people might have trauma without even realizing it. We also talk about the therapeutic process generally. For instance, how to pick a therapist, how to best approach and go through therapy, and how to evaluate whether or not therapy and your relationship to the therapist is working or not. We also talk about self-therapies because we acknowledge that not everyone has access to or can afford therapy, and we talk about drug therapies, for instance, antidepressants, antipsychotics. We talk about alcohol, cannabis, ketamine, and the psychedelics including psilocybin, LSD, and we talk about the clinical use of MDMA and what the future of that looks like. The reason for bringing Dr. Conti onto this podcast is because I see him as the person who has the greatest and most holistic view of therapy, trauma, drug therapies, talk therapies, and how self-therapy and work with others can be integrated for both healing and growing from difficult circumstances. Dr. Conti is also the author of an exceptional book entitled Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal from It. That book describes trauma and its many features, and many tools, some of which we discuss on the podcast today. So whether or not you have trauma or not, by the end of today's episode you will have a much deeper understanding about what trauma is. In fact, I'm confident that you will gain insight into whether or not you have trauma or not, whether or not people close to you have trauma or not, and the various paths to recovering and indeed growing from trauma that we can all take. As you will soon learn, Dr. Conti is an exceptional communicator and has a unique window into the trauma and therapeutic process that I know that all of us can benefit from. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is ROKA. ROKA makes eyeglasses and sunglasses that are of the absolute highest quality. The company was founded by two All-American swimmers from Stanford, and everything about ROKA eyeglasses and sunglasses was designed with performance in mind. I've spent a lifetime working on the visual system and I can tell you that our visual system has to contend with a lot of different challenges. For instance, when you move from a shady area to a brightly lit area, your eyes and your brain have to adjust in order for you to be able to see clearly. ROKA eyeglasses and sunglasses were designed with the biology of the visual system in mind, so you never notice those transitions, they're very seamless, you always see things with perfect clarity. The other terrific thing about ROKA eyeglasses and sunglasses is they are extremely lightweight. Most of the time I can't even remember that I'm wearing them. I wear readers at night and I wear sunglasses sometimes in the daytime when the l- it is very bright or I'm driving and so on. If you'd like to try ROKA eyeglasses or sunglasses, go to roka.com, that's R-O-K-A dot-com and enter the code Huberman to save 20% off on your first order. Again, that's R-O-K-A dot-com and enter the code Huberman at checkout. Today's podcast is also brought to us by InsideTracker. InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you reach your health goals. I've long been a believer in getting regular blood work done, for the simple reason that many of the factors that impact our immediate and long-term health can only be measured and assessed with a quality blood test. And nowadays, with the advent of modern DNA tests, we can also get insight into, for instance, our biological age and see how that compares to our chronological age. And, of course, despite what our birthday cake screams back at us, it is our biological age that really matters. If you're going to get blood tests or DNA tests, however, you need to be able to interpret the data, and that's really where InsideTracker stands apart. A lot of companies will give you a DNA test or a blood test, they'll send you values of hormones, metabolic markers, et cetera, but you don't know what to do with those data. InsideTracker has a very easy to use platform, so when you get the numbers back you can click on any of the numbers that either are in range or out of range, too low, too high, et cetera, and it will direct you towards specific behavioral tools, so lifestyle factors, nutritional tools, supplement tools, et cetera, that can help you bring those numbers into the ranges that are best for you, which is really an exceptional tool that makes all the blood tests and DNA tests really exceptionally powerful. If you'd like to try InsideTracker, you can go to insidetracker.com/huberman to get 20% off any of InsideTracker's plans. That's insidetracker.com/huberman to get 20% off. Today's episode is also brought to us by Blinkist. Blinkist is an app that has thousands of non-fiction books condensed down to just 15 minutes each of key takeaways that you can read or listen to to extract the most important knowledge from those books. I love reading physical books, literally physical hard copies of books, and I like listening to audiobooks. However, I also like to revisit books that I've read or listened to, and sometimes I just want to get the key points or the key takeaways from a book that I've never read or listened to. Blinkist is terrific for all of that. For instance, when researching our episodes on sleep, one of the books that I read and found very valuable is Matt Walker, professor at UC Berkeley's book, Why We Sleep. I've read that book, but then I wanted to also make sure that I hit the key takeaways. Blinkist was essential for that.Other books that I've read before and that I own and enjoy, but I listen to the Blinkist version of from time to time are things like Tim Ferriss's 4-Hour Body or Tim Ferriss's 4-Hour Chef book, which is, both of which are excellent. Or Nassim Taleb's The Black Swan. And there are many other titles as well. Blinkist is also a great way to finally get through many of the books that you've been meaning to read, but haven't had time for. With Blinkist, you get unlimited access to read or listen to a massive library of condensed non-fiction books. Right now, Blinkist has a special offer just for our Huberman Lab Podcast audience. If you go to blinkist.com/huberman, you can get a free seven-day trial and get 25% off a Blinkist Premier membership. That's Blinkist, spelled B-L-I-N-K-I-S-T, blinkist.com/huberman to get 25% off and a seven-day free trial. And now for my discussion with Dr. Paul Conti. Paul, thank you so much for being here today.

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