The Body Trauma Expert: Medicating Kids Can Harm Brain Development! Eye Movement Trick That Fixes Trauma! The Secret To EMDR Therapy! - Bessel van Der Kolk

00:00I've proven how helpful EMDR can be for PTSD and depression. Why and how? Well, trauma is a reliving and whatever you're feeling is real. As opposed to feeling like a memory. But in our research, you discover that if you move your eyes back and forth, as you recall a traumatic experience, your brain is able to say, this is what happened to me in the past. And 78% of the people we studied who had adult ulcer trauma were completely cured. Can you do it on me?

00:24I could. What do you see? Bessel van der Kolk has been described as maybe the most influential psychiatrist of the 21st century. And for over 40 years, his clinical research has revolutionized how we understand trauma and its impact on our brain and body. Your early childhood experiences create who you are. And how many of the people that you treated in your practice have childhood trauma? About 90%. And it's very difficult to change. Are they changeable?

00:49Yes, that is the great news. But the problem is the focus is not on helping people. The focus is on running successful financial organizations. And even though I was the first person who studied yoga for PTSD, which was very effective. And then there's psychodrama and neurofeedback, where our results were stunning. We already know the answers, let's not explore anything new. But let's do the science and see how it works and for whom. And what about psychedelic therapy?

01:13It's very effective. Have you ever done the psychedelic drug? Yeah, of course. What did you learn? That my quest for understanding trauma had to do with my own childhood trauma. All the pain is suffering. Earlier on, I asked if people could heal from their trauma. Have you healed from yours? The diary of a CEO is independently fact-checked. For any studies or science mentioned in this episode, please check the show notes. Quick one before we get back to this episode.

01:39Just give me 30 seconds of your time. Two things I wanted to say. The first thing is a huge thank you for listening and tuning into the show week after week. It means the world to all of us. And this really is a dream that we absolutely never had and couldn't have imagined getting to this place. But secondly, it's a dream where we feel like we're only just getting started. And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app.

02:05Here's a promise I'm going to make to you. I'm going to do everything in my power to make this show as good as I can now and into the future. We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about this show. Thank you. Thank you so much. Back to the episode. to Bessel van der Kolk. You've been described as maybe the most influential psychiatrist of the 21st century by the Financial Times.

02:38What is the mission you've spent your life pursuing? I have been interested in how people survive extreme situations, how people can overcome the history of people doing terrible things to each other. and how we can create a better world in that regard, actually. So the mission has been rather social, but the investigation has been very much based on what we're learning about brain science, what we're learning about psychological functioning, et cetera, et cetera.

03:14And this word trauma seems to be central to your work. And when I looked before this conversation at the rise in the use of this word online and people searching this word, it's pretty staggering what I found. There's this graph that shows a huge jump in people using the word trauma. What is your view on the subject matter of trauma, specifically how we've misunderstood what it is? Well, there has been evolution, which is quite striking. And when I first started to study trauma, I was on the research floor at Harvard.

03:49And my colleagues said, why are you studying trauma? Bessel, when you croak, nobody will ever talk about trauma again. Like, this is a completely alien subject. Yeah. And now everybody talks. Everything is a trauma. And so from being non-existent has become a total explanatory mode. And so we have gone, as we always do, from one extreme to the other. And my primary interest these days is not so much into trauma. Trauma started it, but somewhere along the line, I got to realize that trauma is, to a large degree, a breakdown of connection between human beings and synchronicity between other human beings.

04:32And these days, I'm much more focused on how we can help people establish a relationship to themselves and to the people around them.

04:43When people are suffering from some kind of psychological disorder, whether it's depression, anxiety, PTSD, what is it that you disagree with, with the traditional view of how to treat them? People are being taught methods that they say can cure people in eight sessions, which they can't. And so there still is this, but people learn in school these days, although no good clinician I know actually practices that, is to help people thinking out. to straighten out people's thinking and to make them not think these crazy thoughts like.

05:19And there really is no evidence that we can do that. Is that cognitive behavioral therapy? Yeah, yeah, yeah. Cognitive restructuring sort of thing. Or do you get people better by blasting them with trauma and then before long they get desensitized with trauma. And I think both of these methods are just, they don't get it. That completely doesn't get the issue at hand actually. Why? I cannot talk you into being a reasonable person. People are not reasonable people.

05:48And trauma is as unreasonable as you can be. That's really at the core of, if you understand trauma, is that your brain and perceptual system gets rewired. So you see things.

06:03almost entirely through the past experience rather than current experience. Okay, so if I'm traumatized, talking about my trauma doesn't necessarily fix my trauma. Trauma is a speechless experience. So we did the first neuroimaging study about people reliving their trauma, and we saw that the entire cognitive part of their brain disappears, that when you're in your trauma, you're just one ball of emotion, and there's no thinking. So you're confused, you're befuddled.

06:34It is, as Shakespeare says, you suffer from speechless terror. You become dumbfounded. So the whole traumatic experience is just beyond belief And so you stay in a state of confusion and agitation. And then finding language for yourself at this point is terribly important to help you to begin to organize your relationship to yourself. It's not enough, but language and defining your experience is terribly important.

07:07The word trauma, as you say, has been thrown around a lot. And it's become a bit of a cultural joke to some people. When you say, you know, something happens to you, you go, oh, I feel triggered. I'm traumatized, et cetera. What actually does count as trauma? Trauma really is an overwhelming experience of, oh, my God. when something happens and you're completely helpless and there's nothing in you that knows how to deal with it. People talk a lot about small T trauma and big T trauma.

07:41Yeah, I'm not a fan of that. Okay. So explain why not. Well, you need to be more accurate. But the small T trauma is a very real trauma when your environment about you doesn't acknowledge your existence. Most people, for example, after natural disasters do very well. Because people get together after natural disasters. I've seen it. We have a cabin in Northern Vermont. We've had terrible floods. The neighbors get together. They help each other. And you get a sense of cohesion, actually, and a sense of meaning.

08:14We're doing this together. The small T traumas have to do with not acknowledging what's going on with you. Saying to kids, stop crying, I'll give you something to cry about. No, you don't matter. No. No, actually, your dad is a drunk because you are such a difficult kid that your father was doing okay until you came into the family and you were too much for him and you caused him to be the person that he is. I think that people mean small t trauma.

08:47It's relational trauma, which is a very big deal for most of the people I get to see in my practice. Most people come in not because of big T traumas. It is because nobody saw me. Nobody heard me. I was irrelevant. We always had to take care of my mom or my dad, but there was no room for us. So if you get fired from your job and it's a traumatic event for you because you get, I don't know, you get, you lose your friends, you lose the job, your parents are embarrassed about you.

09:27Can that become trauma, something like that? Yes, you could, depending on how you define it. For some people it doesn't, for some people it doesn't. No, it depends, again, on the context. For some people, you get fired, you go like, well, I didn't like those assholes anyway.

09:46I ask this because I'm wondering if there's a lot of people listening now that I'm trying to understand if their small experience, which other people think is trivial, actually could have resulted in some kind of deeper trauma response. Absolutely. At the end, the issue is the perception. Your perception. Your perception. The issue is not the event itself. You and I may have the same events happening. And for me, it reminds me about my brother torturing me or it reminds me about my mom being sick and not paying attention to me or whatever.

10:18And for me, it becomes a very big deal.

10:20And for you, it goes like, yeah, you know, but I have so many talents. Why not try something else? And can you give me an overview of the work you've done in your life that have fed into all of the knowledge and information that you have? Just for anyone that might not know who you are, what is that sort of body of work? I had a very good psychiatric training in one of the Harvard hospitals. And then I was, I ran the last state mental hospital in Boston, which was also interesting.

10:51I, it was a sanctuary for very disturbed people. And so that institution gets closed. I go work at the Veterans Administration Hospital. I met these guys who, were people who I looked up to. They were good athletes, competent people, helicopter pilots all my age. And these guys had broken apart. And they had fallen apart. And they go, oh. And they reminded me of some of my relatives who I grew up with, who also had been concentration camp survivors and Japanese camp survivors.

11:24And then I learned much else after that. But that really opened up my eyes to that people can be And that really intrigued me tremendously. This is central to your story, is this early experience. You said earlier that you were born in 1943. 1943, very important. When you're born, it has a huge influence on who you become. So my early age imprint was... is of my father at some point was detained by the Germans. He was not in the illustration camp, but he was supposed to go off there.

12:00My mom is by herself, raising small kids in hiding, right next to the place where the Nazis are launching their rockets to go to. London, so half of the rock is fell into our backyard. And I have no conscious imprint of that, but I grew up like a kid growing up in Ukraine today. And a lot of kids my age died. I was a very sickly child. There was a lot of hunger and misery. Half my generation died of starvation. And so I grew up with incredible pre-conscious imprint of what gets in Ukraine and Gaza going through right now.

12:41And that must have left a trace in my curiosity and my being, including a trace of having a body that's very sickly.

12:49You were born in 1943 in Nazi-occupied... Netherlands. Netherlands, okay. And you're the middle children of five. That's right, yep. You were very sick as a child. Yep. What were your parents like in terms of love, affection, all those kinds of things? My mother was more or less broken by the pandemic of 1919, in which her father developed Parkinsonism and became one of those all-over-sex type people. So my mother was a very frozen person, which had a very impact on me.

13:22My father was very conscientious, loving. You described your mother as being a frozen person. Yeah. And it had an impact on you. Yeah. Having a frozen mother has an impact on you. What was that impact? The impact is that if you have a mother who is not available to love you and care for you, that becomes part of your perception of the world. And that means that there's a lot of work to be done about learning about affection and intimacy and closeness and vulnerability and all those sorts of things.

13:58Your mother would faint whenever Bessel would ask her what her life was like when she was a little girl. No, no. I asked her only once. I was already a junior professor at Harvard, had two kids and my parents came to visit me. And here's an example of, sorry, parents I had. I left at age 18 for the US because I wanted some distance between me and my parents. 10, 15 years later, quite a few years, I wrote to my parents and said, it's customary for parents to come and visit their children sometimes.

14:34We should be interested in coming to visit me. That never crossed my mind. And so they came. And we actually had a very pleasant time, very civilized. And so on the last day that my parents were visiting us, I said to my parents, you know, you probably don't really know what I do for a living, but a lot of my work has to do with incest. And I wonder where does that come from? And I turned towards my mom and I said, you know, I wonder if something happened to you that I've picked up, that you were, were you ever sexually abused?

15:13And my mom fainted, fell off her chair, and my father said, look what you did to your mother. And my dead wife and her, my father carried my mother into her bed. So I don't know if my mother was sexually abused. She just fainted when I asked her the question.

15:31But that's how it goes. you barely get a straight answer to any of these things. You said that child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death, such as diabetes, heart disease, cancer, stroke, and suicide. That's true. And in your book, you say that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, drug use, and domestic violence by three-quarters.

16:01That doesn't come from me. There's data from this very big CDC study run by Vincent Fennetti.

16:09So this is data on 25,000 people. People have got increasingly interested in their early childhood experiences as a lens to understand who they are as adults. Is that overblown or is it important to understand? It's not overblown to be curious about how. how you became who you became and what the internal ingredients of your cake are. And I think that's very good for people to be aware of how they have become the creatures who they are. I think being curious about yourself is very necessary also to be curious in order to be curious of other people.

16:48When you said about your mother and the incest thing, you'd realized as an adult much of your work focused on incest. And then you turned to your mother and asked her if there was an experience she had had and she fainted. Do you believe that there's a part of you that knew? No, but I don't know if my mother was incested. I know that my mother was very uptight about sex. And I wonder what happened to her. And her fainting... And my response to that means that I triggered something, but I don't know what I triggered.

17:19I would not jump to conclusions that my mother was an incident victim. Something happened to her, but I don't know what it is. Okay, but the indicator was that she was always uptight about sex. It wasn't that you? Unbelievably uptight about sex.

17:33Terrified about sex. Yep. How many of the people that you treated in your practice have, could you trace their adult dysfunction back to an early childhood experience? Pretty much 90%, let's say, yeah. 90%? But that's me. I mean, people with autism or people with OCD... don't come to see me.

18:01And so I have a very narrow filter in a way of who comes to see me. And what's the crux of what happened to them as a child, if you had to simplify it? The crux is not being acknowledged and honored for who they were as kids. That's the big thing is they were unseen and people did terrible things to them and nobody seemed to bother the protectors. When you say terrible things. Terrible things is being beaten up, being sexually molested, having their bones broken.

18:39What if it was just words? Also words. One of my patients, mother, et cetera, all the time, oh, you'll never have friends. If people really get to know you, they will all reject you because you're such a terrible person. That's pretty good. Who said that? Well, mother of one of the people I'm treating. But it would not be an unusual thing to say. People do terrible things to kids. Intentionally and unintentionally? Automatically. Automatically? Yeah.

19:10Is that people hurting people? Yeah. No, you see it in supermarkets and parking lots and stuff like that. What do you see?

19:18You see people abusing their kids, saying terrible things to their kids. I guess it's difficult for parents because they sometimes think, well, I've got to raise a child that's not dysfunctional, so I'm going to have to punish them and I'm going to have to discipline them as a way to make sure that they grow up to be healthy and well-rounded. Yeah. There's an interesting cultural issue. That is sort of how my parents' and grandparents' generation saw their kids and And then people who grew up in Northern Europe completely changed their attitude.

19:51Now you go to jail if you hit your kids in Sweden, for example. I think me in Holland also, not in the U.S. So people have really changed their mind. But in the U.S., when they talk about the downsides of... of physical punishment of their kids, oftentimes particularly black people will say, I want to raise my children, knowing about right and wrong, and the Bible says I need to punish my children, and that's what I'm doing, and you should not subvert the teachings of my church.

20:23And they don't argue with that because at least not straight on. I grew up in a household where I was punished physically in pretty significant ways, ways that I probably can share because it's just quite, you know, significant. Quite horrendous. Yeah. And they are horrendous stories, actually. I was born in Africa, so I've got an African mother and an English father. Yeah. It's funny because I look back on it and I go, and this is just me rationalizing in hindsight, I go, I'm happy that I had a home where there was discipline.

20:57Because if I didn't have that home, then I wouldn't maybe have left the city. We're one of the few families that actually left the city, the fairly small town, relatively small town to some of the towns I live in now. and went and did a lot of things with my life and i was i didn't get caught up in drugs like some of my friends i wasn't dysfunctional and my mother couldn't read or write as well so i feel somewhat thankful but i'm doing i'm like rationalizing in hindsight because it somewhat ended up okay in certain measures of my life in other areas of my life there's dysfunction you know and your perception may change Really?

21:32My perception about my life and who I became has changed quite a bit over time as layers come open. But what you talk about, that things were predictable, is very important. My parents also were predictable. which is enormously helpful for at least for you to anticipate, to know what you are supposed to do, et cetera, et cetera.

21:55Chaos is a terrible thing. I think that point is really interesting because although there was, I was physically punished a lot. Yeah. it was predictable. Yeah. So I knew that if I... I understood why I was being punished. So I kicked... I was playing football in the house and broke ornaments or something like that. It was never unpredictable. Right. But something comes to my mind as you're talking is that same visits that my parents finally came.

22:21I had a three-year-old daughter at the time. We were staying at a house and put my parents on the first floor right next to the main bathroom. And then my three-year-old daughter... went to that bathroom that was next to my parents' bedroom. And my mother came out and yelled at me, said, how dare she use our bathroom? You should punish her. And I almost did. I had an immediate impulse. I'm saying I should punish my three-year-old. And I started to walk to her and go, oh, my god, I'm about.

22:55I feel like, oh, my god, I feel I'm about to reenact what my parents did to me. And I made a physician, no, mom, she is allowed to use his bathroom. And I said, the limit on my mom, which is a transformative experience for me to actually realize that I'm about to repeat what's done to me, which people do routinely. And I was about to beat my daughter. And I said, that's the end of the story. Yeah. It still causes you a lot of emotion. It's actually, I'm surprised how much emotion comes up talking about it.

23:30Yeah. Why do you think so much emotion comes up when you talk about that? Good question. It's an interesting question. Because it allowed me to have a life. You know, much of life is automatic, but you can make a choice to do things differently. You start owning yourself. And that's the moment I started to own myself.

24:03I'm responsible for my kids. I'm going to follow what I think is right. It's a really moment of liberation, but also a moment of separation. Like, I will not be like you. It's tremendously hard to do that because it's going against your... Right. I think that's a big thing for all of us because we want to belong. We want to be a member of a tribe. And if you do things differently... You lose your tribe, and you become a lonely traveler. So this is incredibly complex because people want to be part of a tribe.

24:43We cannot do without a tribe. And so the act of actually leaving your tribe is a very, very major pilgrimage to make, yeah. There's parts of me that manifest sometimes, and I understand that this is the behavior that I learned. Yeah. And I think there's a part of me that's worried, actually, because I learned, I grew up in a home where physical discipline was the response to most kind of forms of unwanted behavior, that I'm worried that if I become a dad, that will be my natural...

25:19Probably will be. Yeah, I don't want it to be. But you don't have to follow it. Yeah, yeah. Your kids will drive you crazy because kids do. Yeah. And at that point, I think having kids has found a great learning experience in life, you know. We all... None of us knows what we're doing and then the kids teach us how to, very important teachers for how do you deal with this.

25:47It was very challenging. What did you learn from your children? Oh, I learned a lot from my kids. For one thing, so my firstborn was just easy and loving girly, and she now is gender ambiguous, and just divorced her husband to be with a woman. So that was completely transformed in her case. And to see go through that journey with her, like, wow, wow, wow, wow. And my son was a neurotypical child, very out of control much of the time. Many physical reactions, very bright but wonderful.

26:39reactive, staying in bed, only playing computer games. And he's grown up to be one of the most loving, thoughtful adult parents you can hope to meet. So both my kids have become very different people who I saw they were, but I have a very good relationship with both of them, even though I really don't quite understand either of them.

27:06When we see dysfunctional behavior in children, I think one of the natural reactions is to give them some kind of medication or to attach some label to them and say that they're broken in this way. How do you feel about that? Well, that is what saved my son. Because... I am a psychiatrist, and I know about how these labels are little crutches that never quite capture what somebody is suffering from. And people started wanting to put my son on medications.

27:37But I was a psychopharmacologist. I really studied drugs and what I can and cannot do. And it was very clear that they were not helping him, and I didn't have to submit to authority as most... Parents would do and say, oh, my doctor says this and this and this. I say, I'm a doctor. I know about brains and I know about kids. And I don't know what the hell is going on with my kids. But he doesn't have bipolar disorder and he is not going to respond to lithium.

28:05And so both my kids were major inspirations for really exploring what was good for them. And I'm particularly grateful for my son, who was such a really, very scary kid in many ways, that my wife, whom I'm now divorced from, she was really great also in terms of exploring what might be helpful. And so what I really got to also be aware of is the issue of privilege, that I made enough money that we could spend a lot of time trying to find things that would help my son.

28:43We had lived in a housing project. My son would have been a terrible misfit. But because we were able to give him so much support and care by exploration, that he actually found a way of regurgitating his mental state. I mean, just on that point, there's a stat I read that children from low-income families are four times more likely, as the privately insured, to receive antipsychotic medicines. That's right. That's true. 400% more likely to receive antipsychotic medications, if you will.

29:20Yeah, and that's a very big issue. It's not really my area of expertise, but giving drugs to kids is potentially very dangerous because you interfere with natural processes of brain growth. Brain growth. Yeah. So if you give people medication that changes certain chemicals in their brain at the developmental phase, it may actually change the way that your brain gets formed and may not allow, as happened to my son, who was able to compensate for many things and his brain was able to learn how to react differently.

29:56If you suppress all that, your brain may not learn these new adaptations. You think we should be looking at social conditions before we look at social conditions, physical conditions, movement, touch, synchrony, music. So in our world, we got stuck in, Western people are allowed to do things. They can do one thing, is they can, what I call, take a swig. And that makes you feel better. So that's part of our respected tradition is taking a chemical to change the way you feel.

30:37And anybody who says you should take that chemical, nobody ever say, you're crazy. And the other thing that Western people are very good at is yakking. So let's talk, talk, talk, talk, talk, talk, talk, talk, and understand things. And then I like to tell people a story that the first time we happened to Beijing in 1992, and China was still very poor and deprived and miserable and coming back from this cultural revolution, and nobody could talk about anything.

31:07No, nothing happened on the mile, no, nothing happened. No, Gentleman's Square didn't happen, it didn't happen. And China was filled with every park then as now is filled with people doing qigong and tai chi. And I go down into the park and do tai chi, with the Chinese. What's that? Qigong, the Chinese movement stuff. And I do that and I go like, oh my God, that's how they survive by making these Qigong Tai Chi movements, which if you do it in Boston, people say you're crazy.

31:42But in China, you cannot talk. You can calm that body down by the way you move. And I became very interested in how cultures around the world actually have very different ways of helping people to regulate their physiology and their synchronicity. I want to talk about all of that, specifically this idea of movement and the role it plays in healing.

32:02Just to close off on the part about childhood trauma. Yeah. Why is it so important for a child to grow up with a secure attachment to a caregiver? You become how people see you. You become how people see you. Yeah. So if you're a kid and most people, most kids, their parents find me cute or you have at least a grandparent, they say, oh, you're cute. You're lovely. You're so sweet. And no kid is able to say, I'm just average. Look at building kids in the world and I'm not any cute than anybody else.

32:36No. When the kids get told you're really cute, that is your reality. And if your kids get told, you're really ugly and nasty, I mean, that becomes our identity. So you really become how people treat you early on in your life. And there's a very big legacy that I, as a therapist, deal with, is these imprints of early experience, which are very difficult to change.

33:03Imprints of early experience, are they changeable? Yes, that is the great news. And also the amazing news that even though we know how to do some of that, we're not going there. So you can heal from your childhood trauma? Absolutely. Everyone? That's my assumption when I see people. In your experience, you've dealt with patients your whole life, your whole professional life. How many of those patients do you think were healable patients? I really think that if given a chance and given the resources, you can pretty much do something for everybody.

33:42One of the other... But the problem is, again, we go back to where we started before the microphone was on, is that our focus these days is on productivity and behavioral change and not in how do we find out how to help you. All the things that I describe in my book, almost most of the things that I describe in my book as being helpful, and that was 10 years ago, I know some other things since that time, are unconventional methods that do not get practiced in mainstream psychology and psychiatry.

34:18Because they need to be productive, and they need to be cheap, and whether you get better or not doesn't matter, but you're cheap. It's the main motivation.

34:32I think the profit point is killing good practice. Your book was very interesting because when I read the cover and then I watched a video you'd made talking about the sort of six sort of treatments and stuff that exist within the body, things like yoga, you talk about theater and acting and how that helps you to get out of your trauma. The body keeps the score. This was a pretty radical approach to thinking through trauma. And it became a meme, which is an interesting thing to see.

35:07Well, I use it in my everyday language with my partner. Yeah. And I've heard people say the body keeps the score, the body keeps the score. When we're talking about how our body is holding on to those traumatic memories, traumatic things that have happened to us. For someone who has never read your book and doesn't even understand the, like, base premise here, what is the, like, base premise of your, of the title there? It's really that trauma is a visceral experience.

35:37What does visceral mean? It's in your body. Heartbreak and gut wrench. You stiffen up. You've... Surrender, you lose your power. You tighten up. That's really where trauma is lived. I kind of see it as two approaches. You can either go, let's try and change the mind, which will then change the body downstream. Or you can say, let's change the body, which will then change the mind. But you could. But I do a lot of CBT with my wife, let's say. Yeah.

36:09I point out her irrational behavior and that she should really see things from a different angle and that I should really see things correctly. And I barely have much success with that. And I'm a bit surprised that psychology does things that most spouses have failed in using very well.

36:31This somatic approach, I've only recently heard this term from my partner. And she says it's amazing. And she told me to speak to you on this podcast because she says, you know, you'll really help to change her opinion on this. What is this somatic approach to healing? Somatic approach is to really experience what your body feels. And also allowing your body to do things that it has been afraid to do and to explore how your body moves to the world in some ways.

36:59Why are women just to seem to be so much better at this stuff than men? Because they're doing like Pilates. I'm not sure. Pilates, yoga, these are all things, dancing. These are things typically women do more than men. Yeah, yeah, yeah, yeah. And it seems women are just more in touch with it. Yeah, I think it's an intriguing question because it's not exclusively women. Of course, men have always done it in armies. Yeah. and basic training, and the military.

37:25And what's intriguing to me is that, you know, when people join the military, they oftentimes are not very well put together people, and they go through basic training, and they really march together, they sing with people, and they climb barricades and they go through composite physical experiences with other people. At the end of 12 weeks, they feel competent and they feel connected and they have found a band of brothers. How do they do it? Not by yakking, but by having very deep shared physical experiences.

37:59One of the interesting things that you write about, which I found particularly interesting, because I saw little flashes of myself in the words, is you said, I found that the more traumas your patients have in their background, the more creative and successful they often become.

38:15Often, huh? Often. Often. And we don't know how often that is, but I get to meet quite a few. Yeah, yeah. It's the people who have had to struggle, who often see new possibilities and have no choice but to discover new options. That's true. That's true. Yeah. But, you know, but those are the people who managed to get into my practice. The people who don't find their solutions don't have the wherewithal and the capacity to make it into therapy with me.

38:46They might be outside with a drug addiction. Getting drugs, lying on the streets, et cetera, et cetera. And to a large degree, I see it as an issue of accident. You know, this past year I visited a program in Los Angeles called Homeboy Industries. It's a program for formerly incarcerated, largely Latin men who had no fathers who had been criminals. And it's a spectacular program where they say, what do you need? How can we take care of you? How can we make a safe place for you?

39:23And I saw real treatment there, St. Quentin Hospital, St. Quentin Prison, famous prison in California. It's now trauma-based. They use my book as a protector. And they're transforming people's lives by acknowledging the reality of what they're dealt with, helping people to be part of the healing system, working in groups, working with movement. Like it's in Quentin, they have hula dancing classes. I go like, yeah. together with other people, gives you a sense of connection, a sense of pleasure.

40:00They're really beginning to understand you can do it. At the Harvard Hospital, you wouldn't do the whole thing I think there's a bit of a joke in the investment community that says you'll get better returns if you invest in someone, an entrepreneur or a founder, that is a little bit traumatized. And I actually think, I don't want to misquote her, but I had Barbara Cochran, who's a shark on Shark Tank in the USA here on the show. And one of the things she said to me was, with all of her investments, the ones that tend to do the best are those that have a little bit of a trauma in their past.

40:37And she says, because when they call me with a problem, they call me with the solution attached versus people who have never had trauma. They call me and just tell me the problem. So they'll call me and say, listen, Barbara, this has happened and this is what we're going to do about it. And that was her, you know, she said it in a slightly humorous way, but I wondered if you thought there was any truth in this idea that... Yeah, I think that's, again, a selection bias of people she worked with.

41:01I know certainly plenty of people have had plenty of people working for me who really get paralyzed in the face of challenges and who don't have a solution and become very dependent on getting them action.

41:15So I think she has a bit of an unusual sample, actually. Because I wondered if you've had an anomalous early upbringing, does that make you an anomalous adult? Does it increase the probability that you become an anomalous, slightly different adult? Oh, absolutely. Okay, and that can go everywhere. You develop a mind and brain to fit with that particular situation. And if that particular situation doesn't help, you need to find new solutions. And so trauma and abuse really forces you to try to find other solutions, but many of them are not successful.

41:52Is trauma a story in your brain? No, trauma is a perception in your brain. A perception, what's the difference? So the issue is something happens and your brain and mind takes it in and then makes an adaptation to that particular event. That depends on how old you are in the circumstances. And it's very different for different people. Give me an example of a perception. If you would beat me up right now, I'd go... I can call people and ruin your reputation, et cetera.

42:26If I'm three years old and you start hitting me as a kid, I don't know what the hell to do about it. And I'll likely think I did something wrong that I caused the guy to beat me up and I'm a terrible person and no wonder that he beat me up because I'm a horrible creature. And that's what almost everybody I know who was beaten as a child. That's the internal understanding of it. Not when you're eight years old or 15 years old, but when you're very young, that becomes your experience.

42:56Because you're still forming your perception of the world. Yeah, yeah. Your brain creates a map of the world. In very deep ways. And so your experiences form an internal roster of the world that makes you expect certain things at certain times. So if I walk into a room and I see a person who looks like my old uncle who he has to play with, I start signing up to you because you're on a deep level of that very nice uncle that I once had. I don't know that, but my brain is set to interpret the world in a particular way.

43:31So one of the things, most profound research experience I had was purely accidental. We started to do Rorschach tests on people. What's that? Ink blood tests. So you show some formless ink picture and we showed it to people. And we saw that people had completely different interpretations of what they projected on that inkblot test. And that really brought home to me that we all are living in different worlds. And that like a lot of the Vietnam veterans I saw saw bloody corpses or mutilated bodies in those cards.

44:12People who had never been in combat didn't see that. Rape victims saw torn vaginas and torn bodies. Other people didn't see this. So once that becomes lodged into your perceptual system, you continue to interpret the world in that particular way having to do with what you have done through in the past. And an inkblot test, for anyone that doesn't know, is basically just a piece of paper with random ink. That's all it is. Yeah. But it's been analyzed on about 100,000 people over the years.

44:42So there's certain patterns you can detect in it, yeah. I've never done an inkblot test. I feel like I should do one. I learned as much from my inkblot test as I learned from my brain imaging. But the brain imaging is respectable, and the mind has sort of disappeared. But, for example, in our psychedelic research, I still very much hope to do in-blood tests because, as Michael Pollan says, how do you change your minds?

45:07But we're not measuring how people change their minds. How many people do you think, I mean, this is maybe a ridiculous question, but how many people, what percentage of people do you think have trauma in some form? How you define it? You know, the figures are a quarter of people get physically abused, one out of five people get sexually abused, one out of eight kids witnesses, violence being their parents, etc., etc. So, you know... If I sit in a room, it's not a binary issue.

45:42It's not either you were traumatized. You didn't get traumatized. But when I talk to a room of professionals, which I do a lot, I assume that at least half the group viscerally knows what trauma means.

45:56And what is trauma doing to my brain? You said you've done a lot of neuroimaging scans. If I was traumatized and you scanned my brain, is there something you could see? Not necessarily, I can see how your brain may be different from other people's brains. I may take a particular population, you can average it out and you can say, oh, there's a little more activation of the periacidotric to gray, a little bit less of the bite insulin. So you see certain patterns of connectivity in the brain.

46:29But to some degree, you know, I think we learn a lot about the brain, but we don't know much about the brain. And I think people tend to overstate how much the brain pictures can teach us. You know, I love the Hubble telescope or the Webb telescope. You know, our brain is like a universe, and our technology is very inadequate to really know about all the unbelievably complex connections the brain has. But we have learned a few things in the last 20 years.

46:57So how does trauma affect the brain? It affects the brain that you tend to... There's one part of your brain that I call the cockroach center of your brain, the periacal gray that lights up underneath the amygdala. Everybody knows the word amygdala these days. So the part of your brain that tells you that you're in danger. When you're traumatized, you're likely that that little part of your brain, way back in your brainstem, is firing all the time.

47:29All the time you go like, I'm in danger, I'm in danger, I'm in danger. And that's where it starts, in a very elementary sensory level. You don't know what the danger is, but you just feel that you should be scared. And then there's certain other parts of your brain, for example, your insula, which makes the connection with your physical sensations and your body awareness, that for many people get shut down, because the experience of trauma is a visceral experience of heartbreak and gut venge.

48:07And if you have a load of that, You can learn to shut that part of your brain down so you don't feel your body so much anymore. Or you don't feel your body so much. You don't feel very alive either. You don't feel so scared all the time. But it's likely that you will want to take some drugs to make yourself feel alive sometimes. Stuff like that. So the part of my brain, you said just around the amygdala? Below the amygdala. Below the amygdala. People that are traumatized, they have some kind of dysfunction in that typically?

48:38The dysfunction is that it keeps firing. It keeps firing. And how does that make you feel? And then the amygdala, so there's a constant sense of subliminal dread. Is that anxiety? Exactly, it's already too high of mental functioning. Okay. It's more elementary. It's like your dog shaking. My daughter has adopted a dog. And two years later, the dog still walks from my house. You've adopted a dog and it shakes in your house still? Yeah, yeah. But still never quite comfortable.

49:13And that's how many times you meet are never quite comfortable. So when someone says they're triggered, Now trigger is in the higher level thing. Okay. So then the next level is indeed the trigger that is in part mediated by the amygdala. If your amygdala is your smoke detector, that tends to become hypersensitive. so that minor things get blown up. And a minor thing that you may say to me, I take it as the most insulting thing in the world. And so you're constantly triggered by things.

49:46And that makes you feel like you are doing terrible things to me. And it's not like I'm hypersensitive, and when you have an off day, that is your issue and not my issue.

50:00No, when you have an off day, I feel your off day, and we start getting into trouble together. I've got a picture here of what the brain looks like when the brain smoke detector goes off. Is that what it looks like on the brain? That is one particular guy, and nobody is exactly the same as everybody else. Can you explain this to me? But basically, what you see here is... This is a guy who is reliving a terrible car accident he was involved with.

50:28What you see here is that the right posterior part of the brain, this temporal parietal junction on the right side of the brain fires, and that's the feeling part of your brain. So you go, oh, my God, oh, my God. I'm terrified. But there's no cognition. Basically, the left side of the brain shuts down. So when you're in your trauma, you're not a reasonable person. You actually become a little bit of a blubbering idiot. All of us, when we really are angry, upset, are not very articulate.

51:01But we have a lot of feelings. And then the piece that I showed is that... As this guy is reliving his trauma, these two parts of the brain go offline. This is the dorsolateral prefrontal cortex. That's the part of the brain that's the timekeeper of your brain. So if something unpleasant happens between us, let's say, I'll go, oh, it's not a half hour and I'll be okay, so let me just put up with this. But when you get traumatized, the timekeeper disappears.

51:33And this is all there is. You lose your sense of perspective. And that is what happens when you're in your trauma. You don't know the difference between the past and the present because the timekeeper of your brain goes offline. And whatever you're feeling is real. As opposed to feeling like a memory. Do you get it? Yeah. So for people that can't see it in this brain scan, what I'm basically seeing is the right side is extremely activated. The left side looks like it's off.

52:02Off, yeah. And then there's these two blanks, empty spaces that aren't activated called the doors. Dorsolateral prefrontal cortex. Dorsolateral prefrontal cortex. So that's part of the system in the brain that gives you a sense of time. Okay. And as long as you have a sense, it's like little babies only have a sense of time either. Whatever happens, it happens totally. And you see a child slowly grow and they get a sense of perspective. It's happening right now, but tomorrow it will be different.

52:31Okay. So that's when, I mean, presumably that's when you get anxiety, right? When you start thinking about the future. It is about having the perspective of, of this is happening right now, right now I'm really scared, but the moment I go home, the moment I call my friend, I'll feel better. So you need to have that capacity for perspective, and that perspective goes offline when you're in your trauma, and you become a trauma-desperate. So this particular person, this brain scan that I have here, this guy was in a car accident.

53:02And the triggered brain that I'm looking at here is he was basically put in an FMRI scanner and he was intentionally triggered to see what would happen in his brain. So he was shown maybe a car accident or something. No, no. Specifically his car accident. Oh, you showed him a picture of his. What did you see? What did you hear? What did you smell? What were you thinking? Very specific sensory details. Okay, so you asked. Not somebody else's sensory details.

53:29Your sensory details. And the right side of his brain was illuminated. Yeah, the right side of his brain became very active. Yeah. But what got inactivated was the timekeeper of his brain. So he could not lie there and say, oh, I'm remembering what happened to me yesterday. He's reliving what happened yesterday. Instantly? You feel like it's happening right now. And that's the nature of trauma. Trauma is not a memory. It's a reliving. Are you consciously reliving it or is your subconscious reliving it?

54:04You feel like it's happening right now. With all forms of trauma. But not, it's happening right now, but my feeling is happening right now. And my body. You don't know that the feelings actually belong to the time that your dad used to beat you. It is now I feel the same way because I disagree with you. So I've been triggered in the past, and I felt that sort of instant fight or flight response because something's happened or whatever, and it's instantaneous.

54:32So although I don't feel like I'm back there, my body does feel like it's back there. And so people are confused about it. They say, oh, you relive the past. No, actually, you're not aware that you relive the past because the past is the present. So you don't think, oh, this reminds me about a time that my dad used to beat me when I was four years old. No, it feels like you are beating me right now. And is there a way for this particular gentleman here who's been through that car crash to ever stop this triggering?

55:03Yeah, he's done quite well. He's done quite well. He did EMDR, actually. Eye movement desensitization. And what was his results? Yes. He's an all right guy.

55:14He's functioning. He's fine. He's no longer a traumatized person. What's the most radical improvement you've seen in your clinical practice? Oh, really, people really coming to life. People just saying it's over. Give me the most, the best example. A good example is the videotape I showed people yesterday of a woman, again, terrible coaxing, freezing, upset, freaked out. And then three sessions later, we go talk about it. She says, yeah. Yeah. This shitty thing happened to me.

55:48I was in this car accident and I was jolted for it and my head was swollen. And boy, it was terrible back then.

55:55But now I have a granddaughter and I drive my car to my granddaughter and I'm fine. Three sessions it took? Three sessions, yeah. And we saw it in psychedelic therapy all the time. What did you do in those three sessions? So wiggle your fingers in front of people's eyes. I mean, for me, EMDR was really the gateway drug. I've written three books about PTSD. I actually wrote the very first book in which the word PTSD exists in 84 or something. But they didn't know how to treat it.

56:28So I'm a world-renowned expert, but I have no idea how to treat it because people keep reliving their trauma and they don't know how to stop that. And somebody starts telling me about EMDR and I don't believe a word of it. And they say, yes, you move your fingers in front of people's eyes. You move your eye from side to side as you relive the trauma. And I go, that's crazy. Everybody who hears it, that's crazy. And then people start doing it, and they show me how it works.

56:58I go like, wow. And people, indeed, a certain subsample of people we studied, indeed, after a few sessions of EMDR, go like, yeah, that really sucked. But it's over. It belongs to the past. It's not happening right now. You're telling me that wiggling your fingers in front of people's eyes can help heal their trauma? Well, then of course we had to do a little research, which took us 15 years to get enough funding to do it, to see what happens when you move your eyes back and forth.

57:30And then we discovered that if you move your eyes back and forth, as you, we call it traumatic experiences, you activate certain pathways between the temporal-priotal junction, which gives you a sense of self, and you're in the life of your son's your body so your brain is able to say oh yeah this is what happened to me but it happened to me in the past so these are pathways that makes it possible for your brain to make that distinction and in the research that's been done on this what does the what did the outcome what was the conclusion in terms of its efficacy Oh, in terms of, in our research, 78% of the people who had adult onset trauma, so being assaulted or raped by a stranger, 78% of them were completely cured.

58:25But that's not the majority of people we see, because most people we see have early childhood trauma, which is much more complicated as the tree. early childhood trauma is much more sort of stubborn and resistant to this treatment. Yeah, because your early childhood experiences create who you are. So if you go to a fancy college when you're 18, you do become identified with that college, but it doesn't radically change you into a new person. How about it becomes part of your identity.

58:57But if you grow up in a certain family early on in your life, you actually become that.

59:03And the imprint is very deep early on, yeah. So it's called eye movement desensitization and reprocessing treatment. I was just looking up some stats about it. It says it's been extensively studied with evidence supporting its efficacy across various conditions. With PTSD, a 2014 meta-analysis of 26 randomized controlled trials found that EMDR significantly reduced PTSD symptoms with a large effect size. A 2024 systemic review and meta-analysis encompassing 25 studies and more than 1,000 participants reported that it alleviated depressive symptoms.

59:41The same 2014 meta-analysis noted that EMDR led to significant reductions in anxiety symptoms among PTSD patients with a large effect. And finally, a 2024 systemic review and individual participation data meta-analysis concluded that EMDR is as effective as other psychological treatments for PTSD, achieving comparable symptom reduction and remission rates. So can you show me how it works? Can you do it on me? I could. Can I move my chair? Of course you can.

60:17You're going to come closer. So can you bring to mind a really unpleasant experience you've had not too long ago? Yeah. And can you bring to mind what you saw at that point? Yeah. Can you remember what the voice sounded like at that point? Or whatever it was. Any sounds come to mind? Yeah. Do you remember what your body felt like back then? Yeah. Okay. Can you remember what you were thinking or bring to mind what you were thinking? Yeah. Okay. So how vivid is your feeling right now of recollecting it?

61:13Like a six, seven out of ten. Okay. So stay there. Now follow my finger with your eyes. So look at me right now. Deep breath. So what comes to your mind right now as we're doing this? I feel calm. Uh-huh. Yeah, I just don't feel calm. Okay. So when you go back to what you were just feeling, what's it like now? It's... It's hard to recall why I was bothered. It's the best way to describe it. That is the weird stuff. Why is that? Is that just because, why is that?

62:18No, see, that is what's so great about this work. We don't know the linearity. And we don't know where the hell the emotional imprint has gone now. But it is. And, you know, of course, if we bring up something much worse than what you had going to, it takes it much longer and a lot of other stuff comes up. But what somehow EMDR seems to do, it creates new associative processes in the brain. So let's say, First time people did EMDR on me. Something really very, very nasty had happened to me.

62:59And I started off being very upset. And then during the EMDR, I don't know if that happened to you, I had images of sitting at my dining room table as a kid. And I had images of playing in a playground in primary school. Something don't come in mind. And then we stopped it. And indeed, so yeah, that really sucked. Time to go on. An important part is you did not tell me what you were going through. No. Because I'm suspicious of language, because language is always an interactive process.

63:34And if I were to ask you to tell me what happened, you will filter yourself, because certain things may be embarrassing, or you don't want me to know about it. And so we circumvent this whole verbal process of your making meaning out of it, and we organize some core ways in which your brain is perceiving this. So you saw a little bit of this in a minor way. For me, when I first saw this, I was blown away by it and thought I need to study this. So when they quoted studies, the main study was done by me.

64:10NIH funded it.

64:12But it was also the last time that somebody got funded for EMDR. Breathwork. Yeah. Yeah. What role did, breathwork's become a really big topic. My partner runs a business called Barney Breathwork, hashtag ad. Yeah. And she takes women away. She does these breathwork retreats all around the world, has a studio, et cetera. Yeah. What do you think of breathwork as a way to really draw? It makes perfect sense. Why? For one thing, it's been used since time immemorial in certain cultures.

64:42And people always discover it. In India, people know it. Northern Europe, nobody knows about breathwork. And so these are culturally dependent things. I think the closest may know it. I don't know. Go out there and see people. And so people are so conformist to be approved of by their teachers and their peers. that when people do something innovative, they tend to very quickly be, or they're cookie, they're crazy. I've like, I really got into body work, and I've not done breath work myself, but I hear about it from people, So it's perfectly legitimate to me.

65:29But when we do something new, like I was the first person who studied yoga for PTSD, and people go like, putting your butt in the air and twisting your spine and the breast for trauma. I said, well, let's find out. And so we did the study, and it turned out that yoga was very effective for treatment of PTSD. But the overwhelming reaction of my academic colleagues was, oh, there he goes again, he's gone off the deep end.

65:56And now yoga is pretty well accepted as a routine. So you can use yoga to treat trauma? No, you don't treat trauma. Yoga to treat your relationship to your body. It's not the same thing, but trauma really distorts your relationship to your body. And what our research also shows is that when you start doing yoga, certain brain areas that tend to get dampened by trauma come to life.

66:28What did you find in those studies? I've got one particular sort of screenshot here. Yeah, that's a little story. So explain here what's going on. This is a tiny study. What you see here is that after doing yoga, your insula gets more activated. Your insula is the... the place in your brain that makes you know what your body feels. Like when it rains and you have no raincoat on, you go, I better get an umbrella. So that you need to know what your body experiences, it needs and anticipated.

67:02And that dimension of self-experience tends to get very damaged by trauma. The reason for that is it's an adaptive thing because trauma is so relived in visceral experiences. As Darwin said, heartbreak and gut venge is the visceral sensations. And so if you're constantly heartbroken and gut venge, you touch it, pull it down, and so you lose contact with your body. as a defensive maneuver of feeling overwhelmed by these physical sensations. So I want to make sure I understand this.

67:36So the insular part of the brain is the part that links what we do with how we feel. how we viscerally feel, yeah, what's happening in our bodies. Okay, so it links how we're feeling in our bodies to... To what we know about ourselves, yeah. The stories we have in our head about ourselves. So that's what the insula does, and trauma interrupts that, which causes what kind of dysfunction on a day-to-day basis? Because you are out of such ways, you feel numbed out.

68:04Or disconnected. You don't feel alive, you don't feel connected, you can't feel pleasure.

68:11Or you feel hypersensitive? And you feel hypersensitive. Because you talk about the two sort of responses being disconnection or hypersensitivity. There's always these two contradictory things that coexist. Remembering too much and remembering too little. Feeling too much and feeling too little. There is no happy medium. You go from one extreme to another. You're agitated and numb down at the same time. And I bet you know what it's like, because we all have been there.

68:41We feel agitated, and at the same time, we feel completely nothing at all. And there's almost no mind there. And I think it's a very uncommon human experience. And the insula is playing a role. The insula plays a big role in that, and many other brain structures. So if I start doing yoga, what is that then doing to that hypersensitivity disconnection? Yoga makes it possible for you to reconnect your senses in a way, to feel what you feel and to make it safe what you feel.

69:13So as we go to a yoga studio with a teacher with a nice voice who really helps you to now take a deep breath, stretch out your arms, feel that warrior three pose, and then you start feeling it. And for many people, doing yoga can be actually quite agitating, scary actually in a way. For traumatized people, we see it all the time, is that something gets triggered. And you start getting upset just doing a simple down dog, let's say. Or certainly the yoga pose that all sexual abuse victims have great trouble with is the happy baby pose.

69:53Happy baby pose is when you put your feet in the air, you lie on your back, you hold your toes, and you spread your legs wide so your pelvis is up against the air. For most of us, that's a very pleasant part, makes you relax. If you're a sexual abuse survivor, that's going to trigger a lot of stuff. Really? Yeah. And you have to be very careful doing that. Because it's? It's triggering. And so because these positions may be triggering, you may hold your body in a frozen position in order not to trigger those feelings of sexual abuse.

70:32I was just thinking as you were speaking about a friend of mine who tends to go through life with a sort of crumpled up body. In their low self-esteem, they're quite low confidence. I don't know if they're traumatized in any way. Can't pass judgment on that. But they started doing yoga and it really has helped their mental health in a profound way. And I'm just wondering what you think the link is between someone who, I'm just telling you on the surface, is like crumpled up through their life.

70:57Oh, absolutely. Yeah. I told you I was a sickly child. I was really sickly until I had asthma when I was 13. And I think the most helpful thing I ever did was rolfing. Rolfing is a very intense form of massage, really to tear your muscles from your fascia. And I came to live in a new body. I no longer live frozen in that body of this little child who almost died. It had a profound effect on me as much as anything I've ever done. Why and how? Because you get stuck in habits.

71:34In a way, trauma becomes a habit. My habit is that when I see a phone guy in the room, I get scared. Hypothetical situation. And so you have habitual responses. And part of what you do therapy for is to get to realize your habitual responses and become curious about it. Like, you know, whenever a person like that comes to the room, I freeze and I sound like an idiot. And your therapist says, so what happens to your body? And how long have you felt this way?

72:08You feel this way when you were six or three or eight. And then at some point, people get a narrative that may begin to explain it. And that narrative may say, oh, I was bullied by somebody. And that feeling comes back when I meet somebody who reminds me of my bully. And then you go like, have you ever tried martial arts? see what it would be like for you to actually learn to use your body to fight somebody. And that's, for example, a treatment that I have never studied.

72:45But I was amazed how many of my close colleagues who were very much into trauma tell me at some point, oh, and now I have to go to my martial arts class. And nobody sees that as a legitimate way of dealing with what they're dealing with. But I think people are doing their martial arts because they have memories of being victimized. And it gives me a visceral experience of my body can defend itself. My body, I can use my body to take care of myself.

73:16And that's not the intellectual process. That's the visceral experience. People often describe meeting somebody and their body just being off. Yeah. So they say, I met this person and my body was just, I just felt something in my body that they can't consciously articulate, but they just feel it in their body. This person's a bit off. Yeah. What do you think they're describing there? I think they're describing two things. We pick up each other's energy.

73:43There's such a thing as the mirror neuron system, which hasn't received much attention in the past few years, but I think it's a very important invention, that I pick up your energy. And if, let's say, you're depressed, but you have a job to do some, to talk with me today, It's very likely that I, on some level, will pick up your depression. And it will affect our conversation. I'm not saying that I do. That's a hypothetical thing. But we pick up each other's energy.

74:14And so we may be somebody who is very angry, but who's trying to behave themselves and behave very well. But you may pick up that anger. And that's really the very complicated stuff in psychotherapy. Am I picking up your energy or am I picking up my energy? And so if I feel uncomfortable in your presence, is that because you're triggering something in me about my past, Or am I picking something up about you? And that is the complexity of our interactions.

74:47Yeah. And from an evolutionary standpoint, as you were speaking, I was thinking, where has this come from? You know, this ability to subconsciously just get a read for someone and then form a pattern of, okay, this type of person hurt me in the past. And 20 years later, I meet someone in the street and I immediately feel the same. Is that just a survival thing? I think that makes perfect sense to me. Like, because we are primates. It's something that came up in your interview with Trevor.

75:18The deep degree to which we're interconnected creatures, that we really don't exist as individuals. So we are meant to live, troops, we're meant to be with other people. And so what is... safe with other people becomes a critical issue of our survival. The reason that humans have survived is not because of your individual gifts or mine, it's because we can band together and build buildings and airplanes and all sorts of stuff. It's all communal things.

75:48So it's not central in our science anywhere today, but it's at the core, if you understand human beings, we are a collective bunch of creatures who collectively create something. And so knowing how to do that and how to adjust to each other is at the core of who we are.

76:07Are we losing that a little bit? You know, people are getting lonelier and lonelier and more individualistic. Huge, huge issue. Screens as virtual realities is our biggest challenge, I think. Yeah. Why? Because screens give you a virtual reality of pleasure, et cetera, et cetera, but it's not real and it's not a product of your efforts of doing something. You get a cheap reward. Yeah. But ordinarily it takes a lot of activity. And so you get your little dopamine rush and it feels like you had experience, but you don't learn how to get along with other people.

76:47You don't learn that visceral reaction of pleasure of we are friends.

76:53What role does community and social connection play in trauma? Everything. Critical. Critical. And there's another thing that is troublesome about the development of our field. Namely, in our generation, Thomas, who started with experiences like mine, worked with combat veterans. I'm not a combat veteran. I was a conscientious objector during the Vietnam War. I don't know anything about the US Marine Corps. And so I couldn't have told people what it was like, but I made groups and I talked to each other and I learned about what it's like to be a combat veteran from each other.

77:31And the moment they made this connection with each other, they were becoming a band of brothers.

77:38And that's how people survive trauma, by bonding with other people. It seems that women are better at forming those connections than men. Yeah, I think so. Although, no, that's not entirely true. I learned a lot about love from my combat veterans. To some degree... I think most human beings don't know what love is until you know what it's like to be in combat together with other people. It creates an enormously deep, deep bond between people. So I know something about male love more from working with combat wrestlers than anything else.

78:15When you're in great danger, guys are there for each other.

78:19They really protect each other. They really look after each other. What is it about that environment that forms what you're describing there as real love? And how do we- It's danger. The natural instinct when you are in danger, you know, you and I will become much better friends than we are if something bad happened to us right now. We'd start clinging to each other. Is that because we would probably need each other? You need each other, yeah. You need each other and you count on each other and you have each other's back.

78:50And you're saying to me, I have your back. Us making commitment to each other is a very profound human experience. You don't get that from a screen. Well, also in an individualistic society, you're almost trained to not need anyone else but yourself. Well, but, you know, I have friends who went to Eton. Actually, so the definition for me of many Englishmen is, your mother hates you and sends you off to boarding school when you're six years old and never looks after you anymore.

79:19And what helped my friends who went to the public schools in England was sports. Enormously powerful. People felt really close to each other, moving together, throwing balls together, fighting in the fields. That traditionally has been the way that guys get close together. Yeah. That may ring a bell with you somewhere. Of course, yeah. I was thinking back to playing football growing up and just, you know, you're one unit effectively. And if there's a problem in this part of the pitch, then it's my problem too.

79:52If you're in trouble, I'm there to help you. But you still make easy contact with your friends who you played football with 20 years ago. No, 30 years ago. It's really interesting because as you were talking, I was wondering how we can bring that back into our lives in the modern world. Yeah. In a modern world where we live on screens and white walls alone. Yeah. You know, the studies say that the average, I think it said something like the average American has an average of zero people that they feel they could turn to at a time of crisis, which is down from like three, I think two decades ago.

80:22Is that right? I'll have a look. I'll have a look at the stats. Yeah. I'll pull up the stats, but the general idea of like us being lonelier than ever before. And how do we, in a society that's like designed to be lonely, how do I on an individual level fix that? I think that's the big challenge. Actually, we have a foundation now. And the main thing that brings us to is in finding funding for projects like that. of how do you help people to connect to each other, be in sync with each other.

80:52We're very much into people making music together, making theater together, creating projects together. That is who we are. That is our glory as human beings. It's this collaborative, active, physical creation of things. That has not been part of mental health. We talk and we give pills, but we don't really connect people on a very deep level.

81:20Are you optimistic about this? Not after the last election, no. Really? I'm very desperate after the election. You're very desperate after the last election. Why? Because the last election was based on uttering. you are different projection you're evil these immigrants come and kill us and they project their own discomfort themselves on people from different religions and different skin colors etc etc it's all projection of people's own discomfort with themselves and there's no honesty about the problem is inside of me and not you yeah so i think you're not a fan of trump Let's leave it at that.

82:12No, I think, no, you're an obvious psychopath who doesn't give a shit about anybody else. Are you able to point at anything good about him? And when I've had people on this show that are pro-Trump, I ask them the same questions. I say, can you point at anything bad about him? Because he's got a family. Anybody who goes to China and says, I've been received better than anybody else in Chinese history, is a fool of...

82:40The guy's gone bankrupt any number of times. He says terrible things to other people. He insults other people all the time. I'm sure there's something good about him. Ivanka seems to have loved him at some point.

82:56He's a terrible person. Going back to this point of trauma, you say that there's three broad ways to reverse the damage of trauma. Yeah. So if I came to you and I was a traumatized person, whatever that trauma might be, what would step one be if I came to you for support with my trauma? Step one is tell me about yourself. Who are you? Okay. What do you value? What is working? what you want to work, and what gets in the way. So at start of, really, language is terribly important.

83:29I don't make a list of how screwed up you are. I helped to create a DSM at some point in a very minor role, but the DSM is not a good way of starting off. Namely, how sick are you? I want to know who you are, what is working, what isn't working, what has helped you, what hasn't helped you, what gets in the way. And so we create a map together of who you are and to some degree who you are in relation with me. And I would check a lot with people about, is this helping you?

84:08So I don't prescribe anything. At some point I may say, well, have you thought about doing some martial arts? Would you be interested in going to a yoga studio? But by and large, I give very little advice. But I help people to discover what's going on and where that leads them in a way. And then once you've done that, say you find out that I had some early traumatic experience, how do you know, what treatment would you give me? That is another tricky thing.

84:43And that is something in my book, I tried to do that and I failed. And in my new book, I'm not doing very much better. I would see how agitated you get, how much can you stay in focus. And if I would see that whenever a particular subject comes up, I see you're getting agitated or shut down, I would focus on that particular experience. And if I would see that you are sort of chronically agitated and unable to focus, I would say, let's just do something.

85:16You should do something that's helped to calm your body and your brain down. And I'd say when you're sort of overall overwhelmed, let's start with yoga, let's start with yoga. or qigong or whatever makes sense to you in terms of how to move your body. And I'd probably do neurofeedback. What's neurofeedback? Neurofeedback is you hook your skull up to electrodes that can harvest underlying brainwaves. So you can project your brain activity on a computer screen and then you can play computer games with your own brainwaves to...

85:54Organize your brainwaves in a way that you can be more focused and pay more attention. So I've got a graph on the screen for anybody watching, and it shows five different types of brainwaves. Gamma brainwaves, which are very close brainwaves. Beta, less close. Alpha, less close. Beta, less close. And then delta, which is when you're sort of sleeping, dreaming. The waves are very, very far apart. Almost flat. So looking at these different types of brainwaves, if we just categorize them from one being when the brainwaves are really tight and close to five, which is delta, when they're really far apart, Is one gamma, is that like anxiety or something?

86:32No, no, anxiety is very focused thinking. Okay, fine. But it depends on where it is. So the back of your brain is supposed to have these slow waves because your back of the brain is dealing with the housekeeping of your body. The back of the brain tells you you have to breathe a little bit more, you have to go to the bathroom, you have to eat, you have to... So a very large part of your brain is about your body regulation, which gets messed up in a major way by trauma.

87:02So for example, when you close your eyes, the back of your brain is supposed to develop nice, slow waves to tell you, I'm feeling peaceful. When you're traumatized, when they ask you to close your eyes, it is very likely that the back of your brain will get agitated and create much faster waves than you should. And so you get a sense of agitation the moment you close your eyes, which, of course, is very detrimental to your health. So my job then becomes how to train your brain so that when you close your eyes, your back of your brain becomes very calm.

87:39It works out. Again, this is not about trauma. It's about brain organisation.

87:48So trauma leads to brain organisation, but you don't treat the trauma, you treat the brain organisation. So for the average person that comes to you, what do you typically end up telling them to do, the average person? Some people these days, I say, I think it would be very good for you to have a psychedelic experience. A psychedelic experience. And you found yourself telling people that more and more recently. Well, because I have done research now and our results were really quite stunning.

88:18Much better than I ever expected, actually. But I may tell you, no, you're not ready for psychedelics. I think you should really do some neurofeedback and some body practices to live more in your body before we start blowing your mind open.

88:32When you say body practices, we'll get on to psychedelics, but body practices, these are the things you're talking about, like the yoga, the martial arts. Massages. Massages. Any massage? Well, I happen to know some very good body people. Okay. So if you have been beaten up or molested, human touch tends to become very complicated. And so you may not feel comforted by human touch. And other humans may not have a calming effect in your body, which is really what we're supposed to have in each other.

89:07So learning to live in a body that can be touched It's quite important. Is touch healing? Oh, absolutely. You don't have kids yet? No. Well, you have a girlfriend. You know.

89:21Yeah, it's true. Touch is an elemental human comfort thing. You described these three broadways of reversing trauma, the top-down approach, which is, I guess, talk therapy? Yeah, yeah. It's understanding, insight, et cetera. And are you a fan of that? No, basically, I'm such a cerebral person, so I'm very suspicious of that piece. That's, you know, explaining things, understanding things is not my greatest handicap.

89:49So I tend to downplay that, the importance of that. Number two is taking medications. Yeah. Which is to shut down the body's alarm signals, essentially. Yeah. Are you a fan of that? Well, that's how I started life off as a psychopharmacologist. I did the first studies ever on Prozac and Zoro for PTSD.

90:09And so they're not bad. They can be helpful to people. And the third approach, the bottom-up approach, is allowing the body to have experiences that contradict the helplessness or rage or trauma. And this is really what you focus on, which are called somatic therapies, which target the body rather than the mind. Well, it's a very important piece of... And I very much think that's a very big missing piece in the therapy, mental health, and medical field in general to give people experiences of connection and pleasure.

90:41That's terribly important. But when I wrote this book before I got into psychedelic therapies, I would add another dimension of experiences that really blow your mind, that really allow you to have an alternate reality experience also. In terms of energy, there are so many reasons why I'm a big matcha fan, if you don't already know by now. And so much so that I actually invested in the UK's leading matcha company called Perfect Ted. And one of my favourite Perfect Ted products is these delicious matcha pouches that come in every flavour from salted caramel to peach flavour to mint flavour to berry flavour.

91:19One of my favourites is this vanilla flavour, which I'm going to make... in just two seconds. You just take this mixer here, get a little bit of the powder, pop it on top of the shaker like that, put the lid on. Shake, shake, shake. Delicious. If you haven't tried this yet, you can find Perfect Ted at Tesco and Holland Barrett stores or online where you can get 40% off with my code, Diary40. Head to perfectted.com and put in code Diary40 to try this delicious multi-flavoured matcha now.

91:54Highly recommend. And if you do it, please tag me, send me a message online. Can the gym help? Yeah. But that tends to become a very solitary experience also. You're sitting in your little treadmill watching Fox News. It's not my ideal of trauma treatment. Because I go to the gym, I lift weights. And so I'm wondering if that's going to help me. That's interesting. Like one of my close colleagues, former friend, is a weightlifter. And she really is very committed that lifting weights can be extremely helpful for trauma.

92:32And when she says that... I'm sure that's true for her. And I wonder for how many other people that's true. The trouble is that in their current system, you're not going to get the money to study weightlifting for trauma. Even though you say it's helpful for you, my friend Mariah says it's helpful for you, I go like, interesting, let's see for how many people it's helpful. It's helpful. Yeah, one of the ways I think about it is actually a lot of the people that I've interviewed that are weightlifters are bullied kids.

93:02I think about Mike, who I had on the show, Chrissy Cello, who I had on the show, both of them speak to, even Lane Norton, actually, I think he speaks to some early trauma as well. They're kids that were bullied in some form or had a traumatic early upbringing, and they are just massive now. And I wonder, you know, some people on the surface go, or even Leverking, actually, You're that way because you're learning to defend yourself and to build your self-esteem.

93:26But there's some... Yeah, but that gesture is not the right gesture. Like, oh, you're just doing that because. Yeah. As if you're being dismissive, instead of saying, good for you, you're doing that because you felt so helpless and you want to build up your body. Interesting. My association is that I testified on behalf of many people who were abused by Catholic priests. And almost to a person, they had become weightlifters and bodybuilders. Really?

93:52Really for the reason that you also mentioned. They were just trying to bulk up to feel a sense of agency and power. And it didn't work well enough for them. So that alone wasn't enough.

94:07I think you also needed to make a connection with the helplessness. Psychedelic therapy. Yeah. What's your view on psychedelic therapy? Yeah. There's my own personal background. Of course, I'm a child of the 60s. So I knew about LSD. And I think LSD for me at that time, I became a good medical student and came with the culture, stopped taking drugs. But my memory of taking LSD was... very positive in that at that time I got to see that I'm a very small part of a very large universe.

94:47And whatever constructs I make in my mind are just very small constructs of a much larger reality. And over time I've had quite a few of my friends have become very, very good scientists. And they say the same thing about our early LSD experiences of really truly having opened up their minds to many possibilities. But then the culture changed dramatically. And they became illegal, criminalized, and people stopped doing it. And then Rick Doblin and Michael Mithoffer started to open up the world of psychedelics.

95:22And they asked me about it 50 years ago or something. And I said, I think it's a great idea because when you are traumatized, you live in a very constricted world. Basically, the trauma dominates your perceptions and regularly interferes with your exploring larger realities. And I think in theory, having a psychedelic experience, a mind-opening experience, would be very helpful. But I discourage them from doing it because they thought you'll never get by the regulatory practices.

95:57And then they raised enough money and asked me if I wanted to run the Boston side of a very large study, which I was eager to do, where we compared very good psychotherapy by people who I largely had trained with psychotherapy plus MDMA, and the results were stunning. You described? Stunning. I thought the therapy would be very helpful in many regards, A little bit, but the MDMA vastly changed the situation. And I wrote up the paper, but I'm actually astounded by how little that paper gets quoted.

96:43I mainly focused on the so-called secondary data of the study, which was how trauma changes you experience of yourself. Okay. And what we saw is that people became much more aware of themselves. People had compassion for themselves. So people oftentimes went into their traumatic experience and had this sense of time of, oh my God, this happened to me. That was so awful. It happened to me personally also, actually, on psychedelics, of things coming up that you were unaware of.

97:18were so vivid deep down inside. And I think, oh, this poor kid, look what he went through. He was so little. He was so small. He couldn't defend himself. And so you get this very deep sense of self-compassion instead of the usual response of self-hatred and self-blame. And then the next thing that we saw happen all the time is, and I was such a beautiful kid, and I had this alcoholic, violent father. I'm not talking about myself, but good. And my poor dad, he never got to really enjoy this beautiful kid that he had.

97:55And they have compassion for their perpetrators. Like, it's an astounding compassion-opening drug, which is what we have been looking for in so many areas in life.

98:06You call psychedelics a true revolution? Yeah, it is, yeah. And you say it's a particular revolution because we don't know how it works, and I was looking at some stats. No, we don't know how anything works, you know. We just have a bunch of hypotheses. I was looking at some stats that say MDMA therapy assisted, which is an important point. Yeah, that's what we did, yeah. Assisted with a therapist there or someone who's a practitioner there. A phase three clinical trial reported that 67% of participants who received MDMA-assisted therapy no longer met the PTSD criteria compared to 30-odd percent in the placebo group, drastic change.

98:49That is the main paper on which I'm also an author. It gets quoted. But what I think is more important, not whether the PTSD did so well, but people's relationship to themselves changed. And my other paper describes that actually, but it doesn't get quoted as much. People can focus on the PTSD. The real issue is, do you love yourself? Is your heart open? Are you open to new experiences? You know, not do we have this little list of symptoms in the PTSD scale, but are you a human being who embraces himself as a human being?

99:30So really interesting studies around treatment-resistant depression as well. One with psilocybin, which is what people know as magic mushrooms, a treatment-resistant depression study in 2021 showed that a single dose of psilocybin led to a significant reduction in depression, with effects lasting up to six weeks for many participants. 30% of participants were in remission after three weeks. Yep. And a study by Johns Hopkins University showed that 71% of participants experienced a more than 50% reduction in symptoms after two psilocybin sessions, with 54% achieving remission four weeks after the treatment.

100:08And the last study that I'll share is a follow-up study found that nearly 60% of participants maintained reductions in depression symptoms one year after treatment. But these compounds aren't even legal in America and the UK yet. That's right. Ketamine is. And we do a fair amount of ketamine-assisted therapy these days. And I'm intrigued that ketamine seems to have similar effects to psilocybin and MDMA, even though they're completely different chemical substances.

100:38Have you ever done a psychedelic drug? Yeah, of course. As part of my being PI of this MDMA study, I had to do MDMA. But for example, I thought MDMA was ecstasy and gave you a place of pleasure As part of my job, I had to take MDMA myself, and I was ready for my magical experience. I'd never done it before. And instead, I'd always poo-poo the issue of vicarious trauma. No, it didn't really hurt me all that much to see all this trauma in the world.

101:10And while I was having my MDMA experiences, all the trauma test people pain that I had experienced over the time came back. I lied there for eight hours in agony going, oh my God, oh my God. And I got in touch with that, hearing all these trauma stories did have had a profound effect on me. And so I was really changed by that. And the May experience, I became a much sadder, but somewhat wiser man. You became a sadder man. Absolutely. I really felt all the pain.

101:41Much more deeply, yeah. I was able to sort of ball it off onto that point, and the ball came down, and it was quite painful. But what helped me is that my guide, Michael Mithoffer, when I told him how I felt like a failure, having had such painful experience, he said, yeah, I know. I used to be an emergency room physician, and one of my psychedelic experiences, all the patients who died in my hands, came to visit me. So that was helpful for me because it made me feel like I had a connection with another human being.

102:20And that context is terribly important. And that's really what Martin did. issues are about right now, and I think we may very well lose that. And that is that clearly you need to do psychedelics in very safe conditions with a lot of support. And that the set and setting of psychedelics, which the Hopkins study also took very good care of all the studies you mentioned. did it, is that the context is terribly important. And while you're in these experiences, the environment needs to be completely supportive and safe and be there for you.

102:59And what our world, profit-driven world, is looking for is to give people sake of advice, give them one pill and go off by yourself and then deal with it. The majority of the people in our study said to us when the study was over, I couldn't have done this if you guys hadn't been here with me.

103:17Did that experience with psychedelics, the MDMA experience you had, change you? Yeah, I think it did. It made me a much more humble person and much more compassionate to people in general. Just one dose? Well, I've had some other experiences. Also, I've had a number of other really painful experiences on psychedelics. Yeah. And it made me much more... So, you know, people say, oh, how's your life gone? I became much more aware to what degree my quest for understanding trauma had to do with me than... And I learned more after age 70, actually.

103:53Really? Yeah. Earlier on, I asked if people could heal from their trauma. Yeah. Have you healed from yours? No, healing is a complex word. I would say, yes, I'm doing well. as do many people I've worked with. But I think the real power of my book is that it's a very hopeful book. Every chapter tells stories about people who are better, and as much science as I've been able to do, I've proven how helpful EMDR can be. I've proven how well yoga can be.

104:27We have proven how well neurofeedback can do. That's really been my mission, is to not only be an advocate, but really say, let's do the science and see how well it works and for whom.

104:40Yeah. What is the, of all the things that you've tried in your life to help you with your own personal trauma, what are the things that have personally helped you the most? There's another thing that's really helped me and that got me into theatre is the issue of psychoparmer. Psychodrama. Yeah, the chapter in the book, and I've never done the science behind it, but I still love doing it. And that is when you act out things in three-dimensional space, it becomes a completely different phenomenon.

105:11If I tell you, let's put your family in this room. Yeah. And I say, when you choose somebody to play the role of your dad, where would you put your dad? You know where you would put your dad. I'd put my dad in this room right now. I'd put him there. Right there. Yeah. Not there, but there. Yeah, yeah. So that's what the hell is happening here. You know precisely where you want him. And if somebody would play that role for you, the feelings to which your dad would come up.

105:43Maybe even in your imagination to some degree right now, if you imagine your dad there, that's the first thing that comes to your mind. Well, I put my dad at the head of the table that we're at because he was always at the head of the table in my household. He was always the one when we're at a table who was in charge of us eating. And what sort of reaction would you have as you see him here? It's complicated because one of the reactions is like, one of the reactions I had is when he sits there, he's in charge.

106:21But now as an adult, I have this other feeling, which is like, no, I'm in charge now because I'm the head of the table. I'm the head of my household. So it's just this authority thing of like, yeah. Does it come up? It doesn't come up abstractly, but concretely when you're sitting there, it comes up. And you may say, actually, Dad, I'm the boss now. Yeah. Or I hate that you're being the boss. Or something, something comes up. My freedom. And what is striking is that for everybody, when they put that virtual person in the room, the feelings towards that person become very vivid.

106:54Yeah. And it overlaps quite different from what the story that people tell actually. It brings up the three-dimensional. And oftentimes, people have had harsh and neglectful fathers. And then what I say, at some point after you do things with him, I may even say, you want to hate your dad? Possibly, I might actually. Do that, actually. Have you hit your dad, put a pillow in front of him, and have some people hold him. But to feel it, oh my God, if I could have done that, would it be so great?

107:28Or how guilty I feel. So you do something virtually, but you could never do it in your words. And then I would say, would you like to pick somebody in this room to play the role of the dad that you always wanted? The dad you always wanted. And then you choose somebody, and I encourage you to see how you would like that person to hold you. And when you have that, you usually have a very deep emotional release. And say, oh my God, if my dad would have helped me like that when I was three years old or five years old or eight years old and I needed this, my life would have been completely different.

108:09And so you make a virtual new reality. that is physical and visceral with other people. And the memory of what it feels like can be very profound. And you're doing this with a group of people? I do this about four times a year with a group of people. It's my favorite clinical activity because I'm always just so astounded by what comes out of it. It's almost role playing your past. Role playing, but you really, because you work in three dimensional space, it feels much more real.

108:46And so, but therapists usually, they have this hope that if I'm respectful and caring towards you, I'll give you a reparative emotional experience. that will give you the feeling of what it would have been like if you had gotten that in the past. And what my old teacher said was, it's a mismatch. I, as an 18-year-old guy, cannot give you, as a 30-something-year-old guy, the feeling of what it would have been like if your mom would have loved you at age three.

109:20We cannot do that. But in these theoretical enterprises in three-dimensional space, very physical, you do get an imprint of, oh, that is what it felt like. That's what I was missing. So it's a very powerful way of creating a virtual reality.

109:38So the subject matter of ADHD has become very popular in culture. In 2022, approximately 11% of children aged 3 to 17 had been diagnosed with ADHD, up from 9% roughly in 2016. And in the UK, between 2000 and 2018, ADHD diagnosis in adults rose 20-fold. What? with a 20-fold increase in medication prescriptions among men aged 18 to 29. And that's from the NHR. And in Australia over the past decade, ADHD medication has surged nearly 300%, with more than a 450% increase among adults and a significant rise among women.

110:19What is going on here? I really see that somewhat differently from... the way you guys talked about it before. And that is all these things are on a continuum. You don't have PTSD or you don't have ADHD or you don't have ADHD. These are no binary issues. And so there's a capacity to focus, to pay attention, to... be flexible in your attention is a dimensional issue. A dimensional issue. So some people have it better more than others. Some people cannot sit still at all, and other people can sit still under certain conditions.

110:55Other people can't. So it's not like you have ADHD or not. You may have some issues staying focused or staying still or paying attention. There may be many underlying issues. It may be, that your mom took some toxins while she was pregnant with you. It's possible that it is in your genes. Just about every traumatized kid I've ever seen met criteria for ADHD because trauma really messes up your capacity to focus and concentrate. So this is not an entity.

111:29It is a fictitious entity. It's not like cancer of the gallbladder. is not having astrocytoma in your brain. And these mental phenomena are networks of complicated ways of organizing your mind.

111:47And our diagnostic system just sucks. When I spoke to Gabor Mate, do you know Gabor Mate? Yeah, sure. Yeah, he was describing what ADHD was to me. And he said he reviews it as a response to early childhood stress and trauma rather than purely genetic or neurological. Well, but I wouldn't say that. I'd say it could be genetic. It could be toxic. It could be trauma. This is the surface behavior. of not being able to focus and concentrate. Like my son certainly had criteria, met criteria with ADHD.

112:21My son, other than that he disappointed me, was not a particularly traumatized kid. No, he really had real issues organically based, but that he outgrew also at some point. So these things are not stable. These are configurations that you can grow with over time. And they're not multi...

112:43They're multifactorial. They're surface phenomena. Because I was diagnosed with ADHD, but the way... other people that have ADHD have just like drastically different symptoms to me. Like drastically different. Like we're not the same people at all. We're not even close to the same ballpark. Like, for example, I'm really good at focusing on something for quite a long time if I'm interested. Whereas I often hear people with certain types of ADHD be very unfocused on things.

113:11And so I have struggled with understanding what it means to be diagnosed with ADHD when there can be so many types. Yeah, that's right. So it almost makes me feel that... the label, the singular label which we share, although there's all these subtypes, isn't necessarily helping me to understand myself in any way. Yeah. I would really... Everybody who is serious about this stuff knows that our diagnostic system totally sucks. Really? Yeah. It's just a total artifact of...

113:43I was sitting in a room 40 years ago making up a little list of diagnoses. There's no scientific validity to this. Actually, PTSD is one of the more scientifically reliable diagnoses of all the diagnoses. There are just very primitive ways of categorizing human mind. And we know so much more and we should move beyond that. And everybody who knows something about science knows that we should move beyond it. But we are not. Why? I think we're not doing it because our focus is not on helping people.

114:12Our focus is on bonding successful financial organizations. You know, I teach neurofeedback, and there's a chapter on neurofeedback there, and there's serious research on neurofeedback, and we do neurofeedback trainings. And so the head of an insurance company took a training with me in neurofeedback, and he pulled me aside and said, Bessel, of course, you know, as a head of an insurance company, I'm not interested in getting people better. I'm interested in having as many subscribers to my plan as I can.

114:44You know, if we really went back to being real doctors, we'd say, how do I get you better? What is wrong with you? And we know so much about neuroscience these days, about how the brain organizes information, that it's time to actually update ourselves to 2024 and start thinking about networks in the brain and what part of the brain is connected with the butt and mental functioning at different ages and what kids understand at age three, which is different than age five, And think in terms of how well is your brain able to filter out a relevant information?

115:18How well is your brain able to be still and quiet?

115:23And how well are you able to take on a task and complete it? How do I not raise a traumatized kid? Because I'm going to have kids probably quite soon, hopefully. And I don't want to raise traumatized kids. Be sure to listen to people in your environment. Don't raise them by yourself. I think raising a kid by yourself, you'll give the full brunt of your own pathology. So it's very important for a kid to be raised by a number of people. So the kid gets to see, oh, my dad is a little bit reactive, but my neighbor across the street is much calmer.

115:57And so the kid gets to see multiple perspectives as all of us idealize African villages as people having many different parents who look after you. It takes a village. It takes a village. I think kids need to be really part of a large environment where they can see their parents as safe people, but also flawed people. And the more nuclear you get, the harder it gets to keep your pathology out of your kid's life, actually.

116:25So community is everything, also in terms of raising a child. Is there anything that you think is healing towards trauma, childhood trauma, all forms of trauma that we haven't talked about? Well, the critical issue is that trauma is about being helpless and not nobody coming to your rescue. And so it's very important to have the experience that if you really cannot do something or get scared, that somebody comes to your help at this point. And you get an imprint that even when I feel really bad, somebody will come and be there for me.

117:03And that is what many people miss. When you have a drunken parent, we see this all the time in our practice, people have a violent parent, usually defile, but not always. And then mom or dad, in my case more my dad than my mom, turns a blind eye. and doesn't say, I'll take care of you, even though the other parent is hurting you. And the betrayal of a parent to let the other parent do terrible things to them and not really say, no, you cannot do this to my kid, is a huge thing for many people.

117:45That's interesting. Yeah. And it's having bystanders who do not come to your help. Very big deal. And the way to recover from that is to contract it with adult information. Yeah. Have life experience where people come to your help. And I think being part of a sports team, being part of a theater group, being part of a musical group. How people really feel, now it's your turn, come in. And you know, I think the issue of rhythmicity and synchronicity is really at the core of our internal sense of safety and belonging.

118:26Vessel, we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for. And the question that's been left for you is, what do you believe is the question that the audience have just heard this conversation or screaming down the camera? The question is, where do I get the help I need? I think that's really the big thing, because it is so hard. It is such an exploration.

118:53Almost everybody who I know who have found a way of getting better, has been an explorer. And quite an accidental explorer. And then I found this karate teacher. And then I found this yoga teacher. And then I found this psychodramatist. But it's very largely accidental. I think the mainstream is not on the white road. So you have to discover what works for you. And that's a very tough one because you'll feel stupid and ignorant. And if something is not helping you, It is very hard for yourself.

119:35This is not helping me because this person is not helping me. Rather than blaming yourself, there must be something wrong with me that is not helpful for you. And making that distinction is a very tough one. I know it from my experience. I've been in treatments for long periods of time, despite all my qualifications, where it took me a long time to go like... I'm wasting my time and my money. And if you don't have my education and background, it's even harder to say I'm wasting my time.

120:08It's interesting as you're speaking, I was reflecting on the things that... I was thinking a lot about this idea of community and you're talking about how being in sports teams helps. And I was thinking about in my adult life, in some of my most difficult times, when things were difficult and I went and played football or some kind of sports with a group of people, I just felt radically better. And I think actually I put it down to, oh, well, because, you know, I did some exercise.

120:33But I actually think there's something deeper. Oh, no. It's that connection. Passing that ball, somebody catching it. You know, I made a difference. Playing music. My little piece of music that I made, made a better place. Being in a theatre group. Being a cook. You know, there's many dimensions along which you can do that. Many of us, especially, I think, adult men don't have these kind of things. I mean, we go to watch Manchester United play or something like that.

120:59We go to football ground. But maybe we need to fill our lives with more of these things. Yeah, we do. I think. And we should say it to ourselves because I need to do more of that also. Yeah. Well, we kind of just assume that society is designed in such a way where it'll give us what we need. Yeah. Yeah. But in fact, if you think about the loneliness stats and the way things, even like the pub is less pubs on the high street, shutting down across the UK and less community centers.

121:23The church is. A good example is I grew up singing all the time. And people around me made me sing in schools. And now then we got iPods. Aren't we lucky we got iPods? And then before too long you stop singing and you start listening to your iPod. And so technology has been an unbelievable blessing and what a curse it has been for us. Yeah. Dr. Bessel van der Kolk, thank you so much for the work that you do. As I said to you before we started recording, you have so many extremely passionate followers, advocates, fans, because your work has made them completely rethink and understand their lived experience and also given them a much more optimistic, hopeful cure.

122:09or treatment for their lived experience one of which is my partner who when she she's been telling me for three years to get you on this show and was so extremely excited i think it's the happiest i've made her in the last three years when i said that you'd agreed to come on but that for me is such a personal and sort of local um sign of evidence of the impact you have on people it is tremendous so thank you on behalf of all of those people for the work that you do and please do keep on doing it because it's opening all of our eyes and you too thank you Isn't this cool?

122:42Every single conversation I have here on the Diary of a CEO, at the very end of it, you'll know, I asked the guest to leave a question in the Diary of a CEO. And what we've done is we've turned every single question written in the Diary of a CEO into these conversation cards that you can play at home. So you've got every guest we've ever had, their question, and on the back of it, if you scan that QR code, you get to watch the person who answered that question.

123:12We're finally revealing all of the questions and the people that answered the question. The brand new version two updated conversation cards are out right now at theconversationcards.com. They've sold out twice instantaneously. So if you are interested in getting hold of some limited edition conversation cards, I really, really recommend acting quickly.