In this episode we discuss trauma and how it is stored in the body. What causes trauma and what does it do to your body? We explore whether the rational, thinking mind can deal with trauma and look at some of the ways you can deal with traumatic experiences in your life. What are the best strategies for feeling safe, feeling calm, and feeling in control of your own body? How do you release trauma from your body and feel safe? We discuss all of this and much more with our guest Dr. Bessel Van Der Kolk.
Dr. Bessel Van Der Kolk is a Boston-based psychiatrist and The New York Times best-selling author of The Body Keeps the Score. He was previously the President of the International Society for Traumatic Stress Studies, Professor of Psychiatry at Boston University Medical School, and Medical Director of the Trauma Center. He has taught at universities around the world and his work has been featured in TIME, The New York Times, The Boston Globe, and more!
What is Trauma?
How do we define and understand trauma in today’s society?
It makes you want to forget, it makes you want to push it away, it makes you want to erase it.
Trauma is something that is so horrendous that you can’t cope with it, it’s too much to deal with
Trauma renders you helpless and makes you feel like there is no way out
Helplessness is an absolute precondition for a traumatic experience
Our society continuously ignores how trauma is formed and created - pushing it under the rug and hiding from it
Trauma is not a story - trauma is not a memory about the past. Trauma changes the brain. Trauma sits within you and within your body.
People experiencing trauma keep behaving and reacting as if they were stuck in that experience
When we are traumatized - the brain often cannot process it and the body “stores it” - the body gets stuck in a state of hyper alertness, the mind gets stuck in a state of hyper-alertness
The perceptual situation in the brain becomes rewired to be on “high alert"
Your body, your mind, your entire system gets frozen or stuck in “fight or flight” mode
When you’re traumatized, it’s very hard to learn or integrate new experiences - thats what makes treating trauma so difficult
Trauma is not typically rationally processed, it goes into the irrational part of the brain and your body gets locked into a place of constantly reacting as if you’re in a sense of danger
Your body starts generating stress hormones as inappropriate times and you begin to feel out of control and helpless
One of the most tragic results of trauma is people try to shut the feeling down and end up shutting down their ability to feel - or they turn to drugs, alcohol, and pharmaceuticals
Studies show that yoga is more effective than any drug that has been studied for solving trauma
There is promising research around psychotropics (psylocbin and MDMA) for trauma relief
Neurofeedback is another promising solution for trauma
"Playing computer games with your brain waves” to solve trauma
Trying to remove delta or theta waves in the frontal lobe
Self regulation - learning to control your own physiology using ancient Chinese and Indian methods - research is starting to show these solutions help as mind body interventions to solve trauma in the body
Our mainstream western culture is “if you feel bad, take a drug”
Practically what does it looks like to use something like yoga to regulate your own physiology?
Chanting is also a very good mind body intervention - singing in unison with others
One of the biggest struggles of trauma is that you feel isolated or lonely or by yourself
Exposure treatment misunderstands how to treat real trauma
It’s not the memory its that you brain/body - entire system - is locked in a state of being “high alert” - and that these mind body interventions are some of the best ways to help people feel “Safe” inside their own bodies
How do you feel Feeling safe, calm, and in control over y our own physiology?
What are the best strategies for feeling safe, feeling calm, and feeling in control of your own body?
Trauma is a bodily experience of being intolerable physical sensations - people can’t stand the way their bodies feel
Breathing, moving, chanting, yoga, qigong, massage, dancing - these are all ways that you can make your body feel safe.
Once your body feels safe, you can allow yourself to slowly go to experiences from the past that caused the body to be put into a traumatic state
Your body has to feel safe and be present to heal trauma
Sitting still and meditating is often a challenge when you’re experiencing trauma
None of this has to do with understanding or explaining why you’re experiencing trauma - understanding WHY your’e experiencing trauma doesn’t make you resolve it
The rational brain has nothing to do with solving trauma in the body - it has to do with your “animal brain”
This is NOT a rational problem - you can’t solve it rationally
What are some of the best solutions?
EMDR is another effective technique or strategy for laying small traumas to rest
What is somatic experiencing and how does it work?
Sensory motor psychotherapy
Traumatic sensitive yoga
Trauma Research Foundation
This work is 30 years old - people are just discovering the best treatments for trauma and its a cutting edge field - lots of the solutions don’t have a lot of evidence yet because its so new - its all a work in progress - it’s not definitive yet
How to help release trauma from your body, how to feel safe in your body
What is EMDR? A strange technique that may be revolutionary for solving trauma according to new research and brain scans.
Does cardio help or hurt when trying to connect with the body? Not necessarily - it’s all about trying to make your mind and body connect more deeply.
Homework: Take care of your body. Develop a loving relationship to taking care of your body.
Thank you so much for listening!
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Want To Dig In More?! - Here’s The Show Notes, Links, & Research
[Article] Medium - “What MDMA Therapy Did For Me” by Tucker Max
[Article] Interview on Psychotherapy.net - “Bessel van der Kolk on Trauma, Development and Healing” by David Bullard
[Article] NY Times Magazine (2014) - “A Revolutionary Approach to Treating PTSD” by Jeneen Interlandi
[Article] NY Times (2018) - “How to Rewire Your Traumatized Brain” by Concepción de León
[Podcast] - On Being: BESSEL VAN DER KOLK - How Trauma Lodges in the Body
[Podcast] - Shrink Rap Radio: #436 – Brain, Mind, and Body in The Healing of Trauma with Bessel van der Kolk MD
Meg-Roitwell - “Bessel van der Kolk - how to detoxify the body from trauma”
2015 Walden Behavioral Care Conference - The Body Keeps the Score. Bessel van der Kolk
KripaluVideo - Bessell van der Kolk: Overcome Trauma With Yoga
Big Think (2015) - Psychiatry Must Stop Ignoring Trauma, with Dr. Bessel van der Kolk
Open to Hope - Episode 47: Healing Trauma/Creative Activities
Dance based on the book - The Body Keeps the Score: Dancing with Trauma and Recovery
[Book Site] The Body Keeps Score
[Book Citation] The body keeps the score: Brain, mind, and body in the healing of trauma. by Bessel van der Kolk
[Book] The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk M.D.
[Book] Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society by Bessel A. van der Kolk, Alexander C. McFarlane, and Lars Weisaeth
[Book] Post-Traumatic Stress Disorder: Psychological and Biological Sequelae (Clinical Insights) by Bessel A. van der Kolk
[0:00:00.8] MB: Today, we have another exciting guest on the show, Dr. Bessel van der Kolk. Dr. van der Kolk is a Boston-based psychiatrist and the New York Times bestselling author of The Body Keeps The Score. He was previously the President of the International Society for Traumatic Stress Studies, a professor of psychiatry at Boston University Medical School and Medical Director of the Trauma Center. He has taught at universities around the world. His work has been featured in Time, the New York Times, The Boston Globe and much more.
Dr. van der Kolk, welcome to the Science of Success.
[0:00:34.1] BvdK: Good afternoon, Matt. Thanks for having me.
[0:00:37.8] MB: Yeah, we're very excited to have you on the show today. I'd love to start out with really a fundamental discussion, or understanding for listeners who I mean, the word trauma really gets thrown around a lot and it's a very deep subject. I'd love to just begin with something simple, which is how do you define trauma? What is trauma?
[0:00:59.8] BvdK: Trauma is an experience that overwhelms you, that just wipes you out, just makes you have an experience and reaction of, “Oh, my God.” Really makes you collapse and makes you want to forget, that makes you want to push it away, makes you want to erase it, is an experience that makes it too – it's too hard to go back to. You don't want to remember it. You don't want to feel it, because it's so horrendous.
[0:01:53.0] MB: is this something that only comes from the most extreme experiences of life, or can we experience or be traumatized by the experiences of everyday existence?
[0:02:08.7] BvdK: Time is really something that just is so horrendous that you cannot encompass it. You cannot cope with it. That is too much. Suddenly seeing your best friend getting killed or something it's just like, “Oh, my God. Oh, my God.” It's not just a lousy experience. Not flunking for an exam, or being fired from a job.
[0:02:37.5] MB: It has to be something more visceral, something that's almost the body can't quite process it.
[0:02:45.2] BvdK: Yes. The reaction is really, “Oh, my God.” It renders a person completely helpless and no way out basically. Yeah. It can be as simple as being beaten up by your mom when you're a kid. Even though you're screaming, she keeps going on, or he keeps going on. For kids, something in the family system can be quite horrendous in terms of being beaten up, or being kicked, or being molested in the way. For a child, the experience can be quite overwhelming. Just with adults, you could have fought back or you could have done something about it.
[0:03:35.0] MB: Does helplessness play into our experience of trauma?
[0:03:41.8] BvdK: Helplessness is an absolute precondition for. Defeating needs to be like, there is nothing I can do to change what's going on here.
[0:03:53.5] MB: I want to zoom out slightly and hear from you a little bit about the history of our relationship and understanding of trauma and how to treat it in the medical world.
[0:04:09.9] BvdK: Well, the history waxes and wanes. Basically, just like people have been traumatized, society at large doesn't really want to think about it. Doesn't really want to go there, because it's too painful and people feel horrendous and helpless and responsive. I've seen in my lifetime people tend to push things away after a war is over. Civilian populations and politician once again think, “Oh, let's go to war.”
For example, before the invasion of Iraq, I wrote an editorial to New York Times saying, “Yes, you can indeed go to war with Iraq, but what will happen is that after people come back, there will be more suicides than there were battle casualties, because we know that from every other previous war, about half of the people who we will send off will become drug addicted, or alcoholics because it [inaudible 0:05:07.2] to every war. Many of them will become unemployable. Their family relationships will oftentimes become extremely difficult and falters. We know what will happen. If you want to forget the reality of what happens after something like this, you can go to war.
People continuously just ignore what happens. We know there are about a million abused kids in America and we tend to just think, “Oh, somehow they will get over it. Kids are resilient.” No, the kids are not resilient and we will pay a heavy price for outgoing maltreatment for children.
Basically, the history or has been always let's push it under the rug. Let's make it disappear. Let's not pay attention to it. Then from time to time if something happens and something comes up in the culture right after war, people say, “Oh, my God. Look what happened?” Then before too long, it gets forgotten again. Again, something like, what happened in the Mexican border right now with the refugees and everybody goes, “Oh, my God. Isn't it terrible that's happening to these kids?” At the same time, we ignore the affected 2.3 million American children have kids, have parents in jail, are living under circumstances, not unlike what refugees do at the Mexican border.
[0:06:43.8] MB: One of the most interesting things that I've found in your work is this idea that trauma is not just a story, it's not just an experience, but it actually physically changes the brain. Tell me about that.
[0:06:56.1] BvdK: Yeah, because trauma is not a memory about something, about the past. The past is over, but the trauma sits inside of you and it makes you feel and behave as if it is still going on. Post-traumatic stress is really not post-traumatic. It is you right now feel like it's happening to you again, over and over again. You keep behaving and reacting as if you’re stuck there.
There is something very fundamental about the brain not knowing that it's over. Even though roughly it's over, how your system keeps reacting to all stuff as if it's still happening, because the brain changes.
[0:07:50.3] MB: Tell me a little bit more about how the brain changes and how trauma gets for a lack of a better word, or correct my phrasing if this is wrong, but stored in the body.
[0:08:04.6] BvdK: Well, basically what happens is that the capacity of the brain to process an experience as belonging to the past is [inaudible 0:08:13.2], and so the body automatically had the immune system and the endocrine system and the perceptual systems of the body, of the mind, of the brain continue to react as if they are still in danger, so your body is more likely to develop autoimmune diseases, to react to things in the extreme way, to develop heart disease, to develop a number of illnesses, because the body stays on constant alert for something and the body doesn't know where this place is alert for, but it's gets stuck. It is hyper alertness.
The mind gets stuck in a state of, “Oh, my God. I'm going to get hurt.” Suddenly, people may erupt in a defensive maneuver, or become upset. They know that it's irrational. They know they shouldn’t behave like this, but something makes them feel and behave in a particular way. That's basically because the perceptual system in the brain is rewired to overreact to current stresses.
[0:09:29.2] MB: Is trauma stored in certain parts, or areas of the body, or there's certain traumas that are that are stored in certain places, or how does that –
[0:09:40.4] BvdK: It is how the perceptual system of the body is organized. It's brain circuits and body circuits basically. It's about your whole orientation. Like learning how to speak a language, certainly your body, your mind is organized in a new way. That particular areas of the brain where you can say, yeah, you see it over there, you see it over there, you see it in that area called amygdala, you see it in an area called the periaqueductal gray, you see it is an area called anterior cingulate, you see it in an area called the parietal temporal junction, you see it in the insula, which is a connection within your brain and your body, how you perceive your body.
There’s many brain areas that are changed by trauma and the longer it's – the longer its been going on, the more things changes and your whole system becomes a system that tries to cope as it continuously living over time.
[0:10:49.5] MB: Would it be correct to describe that almost as the body getting stuck or locked into that fight or flight mode?
[0:10:58.1] BvdK: Fight, flight and freeze. Not just the body, the whole system – the perceptions that people have, the body of reactions that people have, the way you interpret things with your mind. Yeah, they get stuck in – get stuck at the times of the trauma. I mean, they have a hard time moving on and getting new stuff in. Among the tragic things about being traumatized, it's very hard to learn new experiences, new integration. Somehow it becomes very hard to take in new experiences. It becomes hard to learn, that's why it's such a gigantic public health issue, and that's why treating and taking care of abuse and trauma, this gets important, because if gets kids get stuck there, it becomes very hard for them to become contributing members of society.
That's also true for veterans, of course. Their identity is, “I'm a warrior,” and gets stuck there. They keep having their military decals on their car and this identity. It's hard to move on and say, “That's a long time ago.”
[0:12:21.0] MB: Tell me a little bit more about some of the science behind – obviously you have a very robust research background, been studying and working on the problem of trauma for a long time. Tell me about some of the science and some of the research behind it.
[0:12:35.9] BvdK: Well, first the technology that we have is mainly in the area of page caps. The technology has changed over the past 30 years. We have been able to visualize a lot of how these changes are organized in the brain, so we get the first. One of the most important findings, was our very first study and very first brain study of trauma, there’s people where we saw that the trauma is really lodged in the right side of the brain, the back of the right side of the brain, which is the non-national reactive part of the brain that would be referred to as the housekeeping of the body, is the part of you that takes care of how your body is organized in many ways.
What we discovered is that basically, the trauma barely goes into your rational part of the brain, but it really goes into where your – into the way you organize your body. Your body keeps reacting as if you're in danger. You have these illogical reactions where you get upset and your heart starts racing, you start submitting stress hormones at inappropriate times. You feel out of control and the people around you think this person is nuts. It's not only the arousal, which is part of what happens after trauma, it’s also the shutting down and you feel completely helpless. You don't keep fighting, and so trauma is not primarily about a fight-flight response. It’s primarily about the shutdown response. Your body starts getting into a defensive mode to try not to feel, try to not experience, try not overreact.
One of the most tragic results of trauma is people try to show themselves down and not to feel anything at all. That of course makes it very hard to feel alive and to be engaged with your environment.
[0:14:51.4] MB: Often, people result to things like drugs and alcohol. Even in the western approach to solving trauma, in many cases people look to things like pharmaceuticals as the first step in that process, is that correct?
[0:15:04.4] BvdK: It fascinates me how doctors keep looking for psychotropic agents, or for drugs to make people better. In fact, our research that shows that drugs don't work very well at all. For example, we did a series of studies, three of them actually, where we showed that yoga is more effective than any drug that has been studied. The one drug that’s probably helpful to make you not feel anything is opioid drugs, that's maybe part of either such a large opioid epidemic, but doctors prescribes are not particularly helpful most of the time.
Drugs are generally are not the answer. In our most current research, actually we're using psychotropic agents as using hallucinogens. We're using psilocybin and MDMA, or ecstasy to help people to really reorganize these perceptual problems. That won't be legal for a number of years, but that’s our latest research that we’re involved in. You can allow yourself to get the courage to process all the information if you take these hallucinogens, these psilocybin, or MDMA ecstasy, seem to be very helpful to help people to serve in a very quiet and self-compassionate way to say, “Yes, this is what happened to me. It happened to me a long time ago.” Awful and painful. Now, I may live in a different stage of my life. One of the most exciting areas of research right now is the work that I and many of my colleagues are doing and these newer agents.
[0:17:11.8] MB: It's funny, I just read an article last week about MDMA therapy and obviously, it's illegal in the United States. As a fascinating read, not something I've done a lot of homework on, but it's curious to see that you've also recently been doing some research around MDMA and its solutions for trauma.
[0:17:30.4] BvdK: Yeah. This is one of the promising frontiers. It's not the only one. The other thing that we're doing is somebody called neurofeedback. Now that we know what the circuits are of the brain, it get disturbed, we actually are able to harvest people's brainwaves project it in a computer and then have people play computer games with their own brain waves in a way to reorganize their brain waves. That's actually for me an even more exciting prospect. Not nearly as sexy as the hallucinogens, but it would be a fantastic thing. If you could do this for school children who are traumatized, because we could help kids to be alert and attentive and to manage their emotions, so they can actually be children and be engaged with the classroom procedures.
[0:18:29.5] MB: That sounds really interesting. Tell me a little bit more about this idea of playing computer games with your brainwaves.
[0:18:36.0] BvdK: Well, it's a fairly old technique by now. You can harvest people's brainwaves by putting electrodes on the skull and harvest with outputs underneath it. Then you can project it on the screen and then you can play a computer game where we can serve [inaudible 0:18:51.3] for a certain brainwave patterns for people. Whenever your brain does divide in you, a spaceship starts moving, or color starts coming up, or something happens when the brain gets reinforced to create new patterns of engaging with the world around us, away from the habitual traumatizing patterns.
[0:19:19.2] MB: Which kinds of brainwaves are you typically trying to produce or reinforce with this neurofeedback?
[0:19:25.4] BvdK: Well, we certainly tried to not have the frontal lobe part of the brain be asleep, as it's oftentimes isn't traumatized people, so you certainly don't want to have delta or theta, where is in the front. You certainly don't want to have very fast, agitated waves in the back of the brain, which is supposed to quietly monitor your body, instead of exciting your body. You need the circuits of the brain that you try to rearrange, so that you actually are in the state, that you can play very good attention to what's going on around you, and when your brain is not primarily oriented towards, “Oh, my God. Something terrible is going to happen to my body and I’m in danger.” This basic applied neurophysiology, applied through science where we can actually help people to rewire how different parts of the brain communicate to each other.
[0:20:27.7] MB: I want to come back to something you touched on a minute ago and explore a little bit more some of the really simple mind-body interventions that people can use to help overcome, or deal with trauma. Tell me a little bit more about yoga. I know you've also written and spoken about Qi Gong as another potential solution. Tell me more about those, what the research shows.
[0:20:53.5] BvdK: I don't study Qi Gong, but I'd be amazed if Qi Gong would do something very different to yoga. Certainly, learning how to – See, our culture is not a culture that's very much focused on self-regulation. There's other cultures, like how the Chinese are very good at, some Indians are very good at, where you can really learn to control your own physiology. As I did, there's these age-old Chinese and Indian methods where you can actually learn to by controlling your breath that comes out of your movements, can manage your own physiological arousal.
The only thing that I've studied there is yoga. I’ve not really studied tai chi, or Qi Gong, but these parts if they wouldn't do the same thing, you can actually learn to manage the housekeeping of your body, which gets so disturbed by trauma. by engaging in a regular yoga practice and really learning how to move and to breathe in a way that makes you feel calm and safe. I call this, so a post-alcoholic culture. The mainstream culture, the western culture is very much if you feel bad, take a drug. It gives these very contradictory messages to our kids. You say to our kids, don't take drugs, but take this drug for your ADHD, or take this drug for your bipolar illness.
We don't really teach kids, or adults that our culture is you can actually regulate your own physiology and a lot of the things that I'm really pushing with whoever I can talk to is that every school should learn the four R's, reading [inaudible 0:22:37.8] and self-regulation and that every school actually should teach kids how to regulate their own physiology. It should be a basic skill as all of us as humans should learn.
[0:22:51.7] MB: Let's dig into that a little bit. Tell me practically what does it look like to use some of these techniques to regulate your own physiology?
[0:23:01.5] BvdK: You start every day with doing yoga, or Qi Gong. You start by sitting still, focusing on your body, activating the interoceptive part of your brain, the midline cortical structures of your brain which has to do with self-regulation, you pay attention to your internal world, you pay attention the way you move, you pay attention to the way you breathe and notice how your breathing patterns change your thinking and your mood patterns and you really become familiar with your own internal world.
Basically, what I advocate is that everybody, but particularly traumatized people really have it, practice in which every day they practice being still and working with their bodies to regulate their physiology.
[0:23:54.4] MB: What would you say to somebody who's listening to this interview who thinks that yoga, or meditation, or some of these practices are unscientific, or new agey, or not really effective interventions for traumatic experiences?
[0:24:11.8] BvdK: I would say read the literature. That means that you really are all familiar with the science and you should look up my name and go into Google Scholar and see our researches I and other people have done. If you want to stay with taking drugs, you should definitely do so, but it won't help you very much.
[0:24:35.7] MB: The science is resoundingly clear that a lot of these sometimes ancient mind-body interventions are really bearing out to be really effective ways of managing our own bodies and integrating our mind and body more closely.
[0:24:48.7] BvdK: Yeah. That may be why people have been doing it for thousands of years. Yeah. Chanting is also very good for people. Chanting cases, your heart rate variability changes it. Whereas, your brainstem, the core of your brain just regulate in your body works. Every religion involves chanting basically. It’s very sad that people don't chant so much in our culture anymore. Our grandparents all chanted and sang, but we don't do it very much anymore. Everybody should go back to actually singing in unison with other people, as people have always done in every religion, because it helps people to feel calm and safe. The military also does it. They do the cadences, and so moving and singing together is very good for people's physiology.
[0:25:42.1] MB: Is that something that you have to be chanting with other people to sync up collectively together, or can you do it by yourself?
[0:25:51.5] BvdK: You probably can do it by yourself, but traditionally for since time immemorial, people have worked in making themselves feel calm and a member of community by singing together. Making music together is a communal enterprise and one of the big things of trauma is that you feel isolated, lonely and bereft and separated from anybody else. Learning how to get in tune with other people, being in sync with other people is undoubtedly a very good thing when you’re traumatized.
[0:26:31.7] MB: What about something, or what has your research shown around things like exposure therapy, or revisiting past experiences, or past traumas as a methodology for healing or overcoming traumatic experiences?
[0:26:47.6] BvdK: Well, I think blasting people with the memory of the trauma is the worst thing you could do to people. You may if you blast people long enough, make them desensitize them, but you also desensitize them to themselves and everything else around them. As of making people, their sensitivity is not a purpose of treatment. I think the whole notion of exposure treatment is really a misunderstanding about the traumatic stress does, because it's not the memory that really is the primary issue, but it's affected your brain has changed in response to the old saying you need to help your brain to feel safe in the present.
It’s indeed helpful to be able to relive the memory from a very safe point of view, but the most important thing is that the mind and the brain needs to be very calm as you revisit the horror of the past, and so making people feel horrified as they relive the past is very, very bad for them and would be anti-therapeutic. The reason why we do things like psychedelics and MDMA when we give people, to people with PTSD is because these drugs help people feel very safe, very calm, so did the mind and the brain is capable of actually going back there and saying, “Yes, this happened to me, but this happened to me a long time ago.” Just blasting people with their past is very bad for them.
[0:28:26.2] MB: I think this is obviously a point you made earlier in the conversation, but it bears repeating because it's such an important understanding of the way that this functions, that it's not about the memory of the experience, but rather that because of the experience, the brain, the body, or really the entire system, or your entire system is locked into this state of being on high alert, or being in threat mode and that these interventions, these mind-body interventions like yoga or the chanting, etc., are ways to help people feel safe inside their own bodies.
[0:29:02.3] BvdK: Yes. The core, the operative word here is feeling safe, calm and in control over your own physiology. You don't want to do anything to just blast people with things that make them feel out of control again. The whole teaching issue is how can I help you to feel safe inside and if you have the courage to face very, very difficult things while you feel safe and you feel no harm can occur to you. The most important thing is to create an environment of safety and physiological calm in which healing can occur.
[0:29:51.2] MB: At the risk of rehashing, some of these we've already talked about, I think it bears digging back into this a little bit. Tell me really specifically what are the best strategies that your science, your research, decades in trauma treatment have uncovered for helping people feel safe, calm and in control of their own bodies and their own physiologies?
[0:30:12.0] BvdK: Look, so it starts off as feeling safe in your body. That means that you need to actually do something that allows you to feel your sensations without being freaked out by them. The experience of trauma is we lived in the form of heartache and gut-wrenching physical sensations as a bodily experience of, “Oh, my God. I'm in danger and this is intolerable.” The reason why people take drugs is because they have intolerable physical sensations. They cannot stand the way their body feels. The core issue is we need to help people to feel safe in their bodies. Breathing, moving, chanting, yoga, Qi Gong, maybe dancing massages maybe one – people have to discover first how can I make my body feel safe?
Once your body feels safe, you can allow yourself to slowly go to experiences, or from the past are too horrifying to meet and to encounter again. Once you feel really safe, you can bite off little pieces of what happened back then and say, “Yes, that is horrible.” Then a three-years-old, when an eight-year-old seeing that person being blowed up, or being threatened, or big raped was horrendous. Because I feel safe right now, I can really deeply appreciate that's what's happened back then is something that belongs to my past, not to my present. You can only do that once your body feels safe and feels deeply rooted in the time that you live in 2018 in our case.
[0:32:17.9] MB: Mindfulness, yoga –
[0:32:19.6] BvdK: These issues – yeah, mindful. Mindfulness is difficult for most traumatized people, because becoming still it means they empty our mind and then the demons from the past tend to come up. Just sitting still in meditation is for most traumatized people a big challenge. Doing something like yoga might help your mind to focus and your body to focus and generally, it's more safe for people than just sitting in meditation. I have nothing but great respect for people who have the capacity to sit in silence for 10 days and allow the demons to come out and to wrestle with them and to lay them to rest.
[0:33:10.1] MB: That's an interesting point and one I think that's worth digging into a little bit more, this idea that meditation is a very effective strategy, but it's often very challenging to sit and experience those feelings. That's why something with a little bit of movement, with a little bit of activity to help ground you and your body really helps make it easier to deal with those feelings of fear and panic and anxiety that you're viscerally experiencing.
[0:33:40.7] BvdK: The other thing that's important to say is that none of this has to do with understanding, has nothing – so explaining why you're messed up helps people to understand, “Oh, now I know why I’m messed up.” Understanding why you're messed up does not stop you from being messed up. Explain your people, “Oh, you shouldn't feel that way because this happened a long time ago and today is December 2018. How can you be so stupid to continue to feel like that,” is not really a good treatment. You should not pay for treatments like that.
[0:34:21.9] MB: I think you previously phrased it in such a way that it's not a problem that you can rationally solve.
[0:34:29.9] BvdK: That's right. The irrational brain has nothing to do with this. This has to do with your animal brain, has to do with the housekeeping of your body and your core entity of yourself that feels in danger, even though you know that you're not in danger, you know that this – you know rationally this person is not going to hurt you, but your body feels like this person is about to rape you again.
It comes from a different part of your brain that comes from that right, deep survival part of your brain. You need to go into your survival brain. Sitting on your butt and talking about it is not going to solve the issue.
[0:35:22.4] MB: For somebody who's listening to this conversation, who wants to practically start implementing some of these solutions, whether it's breathing, chanting, yoga, etc., are there any particular resources, or practices, or strategies whether that either you've researched, or that you recommend, or that you think are great starting places for getting back into the body and creating that sense of calm and peace with yourself?
[0:35:52.7] BvdK: That is the big, big question. I think if you go to the American Psychological Association website and there are some people who advertise themselves as being trauma-savvy, they may or may not be. Anybody who can work with bodily states would be very helpful. I think EMDR, eye movement desensitization processing is a very nice technique to help lay relatively uncomplicated trauma to rest is important say to – so there's a lot of EMDR trainers. People have been trained in somatic experiencing, or sensory motor psychotherapy tend to be people who basically know the principles of this. Going to set promises with yoga is helpful, going to certain healing centers like Apollo Yoga Center here in Massachusetts is helpful.
Yeah, the Sidran Foundation. It’s a foundation it has good resources. The Trauma Center, the Trauma Research Foundation, we have resources on our website. Also that experiencing does, the Center for Self-leadership has very good resources. My book has a whole bunch of resources in the back of it, of people who do various things would help.
[0:37:35.1] MB: Sorry, I didn’t I mean to interrupt you.
[0:37:38.0] BvdK: What's important here is that we have this rush towards evidence-based treatments, but it's important to remember this work is 30-years-old. People had just been gradually discovering all kinds of things. For example, 10 years ago I had nothing about neurofeedback. Most people I know still don't know anything neurofeedback. Now a number of people are good with neurofeedback. Two years ago, we started to do MDMA therapy and that's very promising. All of this is a work in progress. Just not like, “Oh, we have discovered it. We know what the truth is. This is what the evidence has done.” People are continuously learning and finding new treatments, so it's important to know that this is an evolving field.
[0:38:40.7] MB: I think that's a very important disclaimer. We'll make sure to include all of the various resources, obviously link to your book and your website and all the resources you mentioned in the show notes for listeners who want to come and do some homework, or want to find some really detailed solutions and strategies. I wanted to clarify, or understand, dig a little bit deeper into two of the things you mentioned. One just a point of clarification and forgive me for mispronouncing, but you said something of the Cedron Foundation, or I missed that –
[0:39:10.4] BvdK: Sidran. S-I-D-R-A-N is the foundation that has paid close attention to this. Yeah.
[0:39:18.2] MB: Perfect. We'll make sure that's in the notes. Then the second one, you mention the phrase somatic experiencing. Tell me a little bit what is that and how does it work.
[0:39:28.6] BvdK: Somatic experiencing is one particular trauma treatment that very much focuses on the body getting stuck in trauma and helping to release and feel safe in your body. Similar to another sister method called somatic experiencing. It has been the sensorimotor psychotherapy. Two methods developed by two different friends of mine. EMDR is very important to mention –
[0:40:04.2] MB: Tell me a little –
[0:40:05.0] BvdK: It is very helpful to – yeah.
[0:40:08.3] MB: Yeah, so I apologize for talking over you. EMDR, tell me a little bit more about what that is and from –
[0:40:14.1] BvdK: EMDR is a very strange technique that is ended by Francine Shapiro about 25 years ago, who discovered that if you call up a memory and you move your eyes from side to side, that oftentimes lead to that memory losing some of its power. It's something that I did research on, funded by [inaudible 0:40:38.8] health and we thought the deed is very helpful in many, many cases. We recently finished the study in the brain scanner seeing what it does and this actually we're able to show that moving your eyes from side to side indeed does change – activate some brain circuits that has to do with self-perception and being able to put things in the proper time sequence.
[0:41:13.3] MB: It's great to see all of these different techniques and strategies. There's a lot of solutions out there for people who might be experiencing trauma who are suffering and struggling. For listeners who are listening this episode, we want to start with one simple action item, or piece of homework to implement some of the ideas and solutions we've talked about today, what would be one piece of advice you can to them?
[0:41:37.8] BvdK: The first action item actually is to – well, one is to take care of your body and to really begin to develop a loving relationship to taking care everybody. I think yoga, Qi Gong, maybe tango dancing, maybe martial arts, a way which really gets in touch with your bodily sensations and learn how to manage about new sensations will be the foundation as far as I'm concerned.
Being able to tell somebody what has happened to you and what you’re so terrified of is also very helpful. Being able to get things off your chest, being able to say to somebody, “I was raped. I was molested.” To really tell the truth is also very important. It doesn't make it go away, but being able to put it out there and say this is what I'm struggling with is a very important issue also. Then being by somebody who really takes you very seriously and doesn't try to fix you, but tries to help you to find ways in which you can feel better about yourself is very important.
[0:43:04.1] MB: For listeners who want to – actually before we get into that, I have one other theme or question that came up when you were talking about that that I wanted to ask about. For something as simple as a cardio workout, whether it's biking, walking, running, have you found any research, any work around whether that's an effective way to get back into the body and help alleviate some of those?
[0:43:33.0] BvdK: It can be, but cardio workouts can also be great ways of actually separating you from your body, being like a monster on a treadmill, it doesn't really make your mind feel more connected with your body. People can use marathon running and these very hard exercises as ways of not feeling themselves. The mindful body techniques into health, but if you go to a gym and you've go in the treadmill, you watch Fox News, I would not call it good trauma treatment.
[0:44:19.4] MB: I think that's an important insight and then I wanted to understand that. For listeners who want to find you, find your book, your work, etc., online, what's the best place for them to go to do that?
[0:44:33.1] BvdK: Well, I have a Facebook blog, The Body Keeps Score. My book is worth reading. I like to say that has sold extremely a copy, so it must be worth reading for some people. Our website is myresearchfoundation.org. Then I have a personal website called bessosvanderkolk.com.
[0:45:05.3] MB: Well, Dr. van der Kolk, thank you so much for coming on the show, for sharing all of your incredible research and experience and strategies and solutions for overcoming trauma.
[0:45:17.2] BvdK: Thank you. Good luck with your program.