Full transcript
0:00[Music]
0:14welcome to this how to academy event in
0:17collaboration with mind health 360 which
0:19is the home of integrative mental health
0:21and functional medicine psychiatry
0:23we believe that you can only heal mental
0:25illness by treating all the factors that
0:27impact your mental health from the
0:29psycho spiritual
0:30to the biochemical to the lifestyle
0:33behavioral
0:34one such factor which affects all those
0:36areas is traumatic stress
0:38and tonight we're in for a treat as dr
0:40bessel van der kolk and benjamin frye
0:42discuss
0:43trauma its impact on mental health and
0:46how we can heal from its detrimental
0:48effects
0:49dr bessel van der kolk is one of the
0:51world's leading experts on traumatic
0:52stress he's the founder and chair of the
0:54trauma research foundation
0:56was a professor of psychiatry at boston
0:58university medical school
1:00and is the author of several books and
1:02hundreds of scientific papers
1:04his best-selling book body keeps the
1:06score brain
1:07mind and body in the treatment of trauma
1:09has been over 111 weeks on the new york
1:11times bestseller list
1:13and has revolutionized our understanding
1:16of trauma its neurobiological effects
1:18and its treatment benjamin fry is the
1:21founder of neural solution
1:23chiron clinics and get stable he's an
1:25accredited psychotherapist
1:27author and entrepreneur whose first book
1:29led to him presenting a popular tv
1:31series for the bbc
1:33his most recent book the invisible line
1:35helps us to understand the detrimental
1:37effects of a dysregulated nervous system
1:39on our mental
1:40health and how to fix it so bessel and
1:43benjamin thank you both so much for
1:45being here for the how to academy
1:46and mind health 360. we really
1:48appreciate it
1:50and you'll speak for about 45 minutes
1:52and then take questions from the floor
1:55so ladies and gentlemen enjoy what
1:57promises to be a very exciting
1:59informative and helpful conversation on
2:01one of the most pernicious and prevalent
2:04causes of mental health issues worldwide
2:06which is traumatic stress
2:08or psychological stress there are
2:09different terms for it
2:11so enjoy thank you traumatic stress is
2:14not the same as psychological stress
2:17so everybody's life is stressful
2:20fantastic so we look forward to hearing
2:22more about
2:23that right
2:26thank you so much kirkland though that's
2:28a very generous introduction and
2:30uh i would say that your work at
2:33mindhealth360.com
2:34is well worth a visit and your uh your
2:37podcasts and your interviews
2:39the mind health 360 show i would commend
2:42to
2:42to all of our audience um so
2:46vessel i first heard your name
2:49when i was in treatment myself uh in
2:52arizona in a in a a trauma unit i guess
2:57you would call it now
2:58and this was 11 years ago subsequently
3:02i've got to know you and your work with
3:04much in much more detail
3:06partly because i uh foolishly set up my
3:09own
3:09clinic in the uk to copy the one in
3:11america which has been a very exciting
3:14adventure which you've helped with
3:16um one of the things that i had to do in
3:19that adventure was
3:20to receive people who wanted
3:24wanted to explore help and to understand
3:27this new paradigm
3:28they would come with a basket of prior
3:31mental health
3:32diagnosis and they'd want to understand
3:33what was really going on and
3:35had to find ways to very quickly tell
3:37them a new story
3:38in you know an hour and a half or two
3:40hour consultation
3:42one of the stories that i came up with
3:44was a story about
3:45so there's this guy running down the
3:47road he's like
3:48wildly looking around barefoot screaming
3:52and i asked them you know what do you
3:53think of this guy and they'd say well he
3:55seems crazy
3:56i said would you help him or avoid him
3:57they said well i'd avoid him
3:59and i say so coming around the corner
4:02you see a fully grown adult lion chasing
4:04him
4:05now what do you think and they say well
4:07you know he seems
4:08seems normal now and i said if you could
4:11help him would you help him they said
4:12yes
4:12you know obviously i'd help them and
4:14what's instructive for me in that is
4:16that the man in the store is identical
4:18so there's no difference uh it's just
4:21that
4:22the difference between us saying that
4:23they've got a mental health problem
4:25and not is an understanding of the
4:27context
4:28and of course that's uh you know why i
4:30called my book the invisible lion
4:32and people some people connect with that
4:35idea and there is this sense that people
4:36can understand that we're all to a
4:38greater or lesser degree
4:39running away from some invisible lion
4:42where the context has been lost
4:44so my first question to you is really
4:45about that it's about
4:47what is the mechanism for that how
4:50exactly
4:50is it that the body keeps the score
4:55well um we have a brain that helps us
4:59our bodies to survive and so basically
5:02we learn how to get along and we learn
5:04how to
5:05manage our lives and we learn to eat at
5:07the right moment and get to collaborate
5:09with other people
5:10and this development of the brain gets
5:15can be really thrown off when
5:18something happens and you're at a
5:20complete loss about what to do about it
5:22and what causes to be a complete loss is
5:26usually a state of terror uh of like oh
5:29my god
5:30and and your whole system collapses
5:34and um if you raise babies you see it
5:37happen all the time
5:38little kids have terrible events all the
5:40time you see kids being
5:41extreme distressed and if you're a cool
5:45parent you pick up the kid
5:46you rock them you sing songs to them you
5:48feed them and before long the kids come
5:51so way in which people learn to regulate
5:55themselves
5:56is through each other but if there's
5:59nobody there for you
6:00and particularly if the source of your
6:03extreme distress is the very
6:04person who is supposed to be there for
6:07you
6:08then it really starts affecting the
6:11growth
6:11and development of not only your brain
6:15but also you your personhood and you
6:18start
6:19you at the center of the brain the
6:21limbic system
6:22um as neuroscientists know that
6:26nobody talks about as much anymore but
6:28there's a
6:30neuroscientist nyu called for adolfo
6:32dinos
6:33who really mapped this out and said in
6:36the middle of our brain is a map of the
6:38brain
6:39and the map of the brain is
6:43the brain is a predictive organ that if
6:46i
6:47sit in the tv show and i suddenly start
6:49doing weird stuff
6:51that sooner or later somebody's going to
6:53cut off the camera
6:54or if i start yelling at benjamin sooner
6:58or later benjamin's going to yell back
6:59at me
7:01and so i know that certain actions have
7:03certain consequences
7:04on the basis of what i've learned and
7:08if you learn somewhere along the line
7:11that something may suddenly happen to
7:13you and you'll
7:15uh you'll get raped you'll get destroyed
7:17you could get
7:18made to feel completely helpless your
7:21brain starts
7:22getting ready for something terrible to
7:24happen
7:25you start spending your energy on trying
7:28to control yourself
7:30before that energy that explosive
7:33emergency part of your brain
7:35blows up and you become a defensive
7:38person
7:38you spend a lot of time trying to keep
7:41control of yourself
7:42and yet the moment that primitive part
7:45of your brain
7:45which basically has no cognition there's
7:48nothing thinking there's an automatic
7:50animal type response
7:51the moment it feels like oh my god it's
7:53happening again
7:54you start acting as if you're getting
7:58hurt as if you're getting assaulted etc
8:01etc
8:02and when that happens
8:05you react excessively or you shut
8:08yourself down
8:09and not only does it do terrible things
8:12to you
8:13in that you start feeling like i cannot
8:15control myself
8:17um people are doing terrible things to
8:19me i get beleaguered so you start really
8:21getting a very
8:23negative idea about yourself but
8:26the world around you starts shutting you
8:30because you react in a way that other
8:33people don't react
8:34and you become angry but other people
8:36don't become angry
8:38or you shut down and when people are
8:40dancing and suddenly
8:41you behave like a terrified person and
8:44so your whole
8:45social environment starts reacting to
8:48you like
8:49uh let's not get involved with this
8:51person so it has
8:52major effects on your personality
8:57and on your friendship patterns and your
9:00social patterns
9:01and so can i go yeah i can i just break
9:05that
9:06down a little bit um because it sounds
9:08like what you're saying is that there's
9:10there's two discrete problems here the
9:12first one
9:13is that your brain starts to
9:16learn to expect a reality that's not
9:19necessarily there maybe that's the
9:21invisible analogy and as a result
9:24it it starts to do things which are
9:27highly appropriate
9:28if there was at some point it would have
9:31been appropriate yeah
9:33it's not like we've malfunctioned per se
9:36because that would be a great
9:37function to have if the scenario was
9:40real
9:41but the somehow information
9:44has become corrupted um the expectation
9:48has taken over from reality and so once
9:51that process is on board then a
9:52secondary factor
9:54begins to occur which is that how does
9:56this then affect our relationships
9:58because
9:59if i look like i'm reacting to something
10:01that's not there
10:03a third party can see it's not there so
10:06you me as a difficult person to have a
10:09have a relationship with and then you're
10:12saying that's a compounding factor
10:13because
10:14the degradation of the relationship then
10:16reinforces the
10:18original problem which is that we're not
10:20really
10:21getting on very well with our reality is
10:23that right correct
10:24and that's the outside thing is people
10:27start challenging you
10:28but the inside thing is that you start
10:30shunning yourself
10:32and you think about yourself i'm a
10:35defective
10:37shame i'm feel very ashamed of who i am
10:40and that they have these reactions that
10:43i cannot control
10:45and then you start compensating for it
10:48and
10:49being excessively nice to everybody to
10:51make up for the fact that you have lost
10:53control at some point or
10:55you start avoiding people or you so go
10:57live by yourself and you start drinking
10:59because
11:00you can no longer trust yourself but at
11:03the core
11:04is that you get stuck somewhere
11:07and that the part of your brain that
11:10support
11:10that is in charge of time doesn't know
11:14that the threat is over yeah
11:17and so the critical issue of overcoming
11:20it
11:21is to get a sense of time back on the
11:23line
11:24and go like oh yeah okay
11:28i was really brutalized as a kid
11:31or i was raped and it was terrible it
11:34was
11:34terrible what happened to me but today
11:37i'm talking to benjamin
11:38on zoom and i it's okay
11:42nobody's raping me nobody's attacking me
11:45and i can focus on the present
11:47but when you get traumatized
11:50a large part of your mind is always
11:52ready to go like
11:53when will it happen again and are they
11:56going to do it and can i
11:57trust myself because my i cannot trust
12:01either my own system or the people
12:03around me
12:05okay but you're you're articulating the
12:07problem through the language of
12:09the the kind of prefrontal cortex if you
12:11like you're saying i'm thinking this i'm
12:12thinking that
12:14and uh it is a it is a problem of of
12:17time but your book is called the body
12:19keeps the score
12:20and i think that um there's more to the
12:24story because it's not really just that
12:25there's a sort of cognitive expectation
12:29you can't easily defeat it by a
12:31cognitive reframing because there's
12:33something deeper
12:34going on here exactly so so you know
12:38as westerners we think that we're
12:41rational human beings
12:44of course our history completely
12:46contradicts that we're national human
12:48beings when we have been
12:50brutalizing each other and doing
12:51terrible things to each other since
12:53time immemorial but our basic notion
12:56about ourselves
12:58is still we are rational people and we
13:00can work things out
13:02and that we're when we think that we are
13:04in charge of ourselves
13:06and can control our behavior the reality
13:09is that about three quarters of our
13:12brain
13:13is in the back of our brain that you
13:14have basically no control over
13:17and that's in charge of your body
13:20we have a brain in order to steer our
13:22body and take care of our body
13:24and so at some point you need to go to
13:26the bathroom
13:27and you can say to your primitive brain
13:29don't be stupid don't waste your time
13:31going to the bathroom
13:32but when you need to go to the bathroom
13:34to go to bathroom i mean the primitive
13:36brand says i'm hungry i need to eat
13:38um before it long you have to eat and if
13:40you
13:41have to sleep you have to sleep and so
13:44and you have to breathe
13:45and so basically the whole big part back
13:47of your brain is there
13:49just like your dog and just like your
13:50cockroach
13:52is there to steer your waist for the
13:54world
13:55and then as humans we got a little
13:56frontal lobe on top of it
13:58to explain what we do and to understand
14:01what we do
14:02it's a marvelous part of the brain i
14:03wouldn't knock it at all
14:05but the problem is that um
14:08if you let's say like benjamin
14:11if you happen to have been molested by
14:14somebody who has a dutch accent now you
14:17talk to me
14:18and you feel threatened
14:21and angry triggered by my accent
14:24and you can say to yourself
14:28don't get angry with the guy don't get
14:29freaked out by him because he's a
14:31reasonable guy with a
14:32funny exit but your the back of your
14:35brain
14:36is impervious to that rational stuff and
14:40you will have that intense reaction to
14:43let's say my accent or any number of
14:45things
14:47and much of the time your frontal lobe
14:49will not even be able to understand
14:51why you freak out so much and that
14:55only when you go into therapy you go dig
14:58inside of yourself
14:59oh the reason why this guy freaks me out
15:01is because he just
15:02talked like that uncle who molested me
15:05who had his exits
15:06but these are automatic reactions that
15:08come from that
15:10map that we that gets created for us in
15:13the back of our brain
15:15as we grow up so would it be fair to say
15:18this is what some people refer to as the
15:19limbic hijack
15:22that that's not unreasonable yeah it's
15:26not only limit because it goes even
15:27deeper than that
15:29you're going through the brainstem that
15:30arousal reptilian brain
15:32and as you know when people get really
15:35really uh
15:36traumatized they become can become
15:38extremely
15:41freaked out extremely angry very out of
15:44control
15:45and then of course what happens is that
15:48we have these
15:50systems where our nervous system
15:52communicates with each other
15:54so we have this mirror neural system and
15:57here you're sitting
15:58in front of me and you look really nice
16:00and peaceful
16:01and so i go oh
16:04and your nice fullness i mean your
16:06peacefulness
16:08really becomes part of me and the kinder
16:10you look and the
16:11sweeter your voice is the calmer i feel
16:14and the safer i feel
16:16but if you start getting if i start
16:18hearing some tension in your voice
16:20a little clinking about your eyes that
16:22you get frightened or fearful
16:24i pick that up and i start mirroring
16:27your response
16:28before too long we will be fighting with
16:31each other
16:32because this that primitive part of her
16:34brain gets activated
16:36and a frontal lobe will find out all
16:37kinds of excuses
16:39why i should hate you so
16:42really part of the problem here is that
16:44we
16:45are in our internal dialogues in our
16:48heads
16:49we're usually persuaded that we are just
16:50one person
16:52so i think of myself as benjamin and i
16:54chat to myself in my head
16:56but there's a huge amount of activity
16:58going on in the posterior part of my
17:00brain
17:00which is hardwired into the autonomic
17:03nervous system which
17:04goes throughout my entire body you've
17:06got too many pathways i've got signals
17:08coming from the body and going to the
17:09body
17:10and that's all happening on its own um
17:12without the governance
17:14if you like of the executive branch
17:16upstairs
17:18which inherits whatever goes on at the
17:20back of the brain in the body
17:22and then maybe that that doesn't fit in
17:25and then you're saying that that can
17:26actually
17:27stimulate itself a reaction
17:30in the posterior parts of someone else's
17:33brain
17:34that we're trying to relate to is that
17:35right yeah that's right
17:37but but the back of our brain had a
17:41survival brain is there to to help us to
17:44survive
17:45and it's very powerful and so the moment
17:48that that banker's bank gets feeding off
17:50like
17:50you better get out of here or you've got
17:52to get killed your frontal lobe can work
17:54like crazy
17:56to say don't do it don't do it but
17:59there's enormous power to that back of
18:01your brain
18:03and so what we also slowly discover
18:06is that the engine of all this is in
18:08that
18:09survival part of your brain and then
18:13what
18:15we discovered although people have
18:17discovered it over and over again in
18:18various cultures
18:20is that you know if you help the body to
18:22feel safe
18:24the mind starts feeling safe also and uh
18:28you know i had my great lesson about
18:30that
18:31in south africa when i hang out with
18:34bishop tutu for a while
18:35the country was about to explode
18:38and you know two tutu mandela all those
18:42people
18:43they knew like we're going to be born in
18:46a country like
18:46india that's going to explode the moment
18:49it's all over
18:50and so tutu and the other guys would to
18:52the board than anybody else
18:53took it upon himself to try to help
18:56people to feel calm
18:58and not live by their trauma and i saw
19:01tutu at work
19:02and it was spectacular he
19:05sang with people he danced with people
19:09he moved people he prayed his people
19:12and just having these people's bodies
19:15move together
19:16gave me that feeling of safety and
19:18containment
19:19there's no nothing cognitive about it
19:22but there was a sense of
19:23synchrony and safety and pleasure
19:27that came through rhythms and movements
19:30and
19:30what to me has been interesting is that
19:33when you travel around the world
19:35is that people around the world have
19:38most people have traditions in response
19:41to
19:42terrible events people move sing and
19:45hold each other
19:47but that somehow disappeared in northern
19:49europe
19:50except during a national tragedy you get
19:53together in your cathedrals
19:55and you think oh god and are helping
19:58ages last
19:59and when you sing together you start
20:01feeling calm again
20:02but psychotherapy has never really
20:05bought into that
20:21you