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Welcome to Feel Better Live More Bite Size, your weekly dose of positivity and optimism to get you ready for the weekend.
Today's clip is from episode 336 of the podcast. with Professor of Psychiatry and author of the best -selling book, The Body Keeps the Score, Dr. Bessel van de Kolk.
In this clip, we discuss how trauma is different from stress.
How traumatic experiences leave an imprint in our bodies, and why he thinks that body focused therapies such as yoga could to play a vital role in healing.
I wanted to start with a quote from your iconic book, The Body Keeps The Score, trauma robs you of the feeling that you are in charge of yourself.
Oh, that's a true statement.
What did you mean by that?
When you get traumatized, it's not the external event, but your reaction to that external event is that you cannot cope with it and then you're vulnerable to react to other things as if they're catastrophes.
So you may suddenly find yourself very scared or very angry or very aroused or very panicky or you can shut down and so you really have no control over those intense emotional reactions that happen after a trauma.
Yeah. So in many ways, people who are traumatized feel that their lives are out of control, that life is, I guess, happening to them rather than them being in control of their lives.
Yeah, they keep reacting to stuff and things are disorganized.
And then oftentimes, they start off and blaming the people around them for having caused them to be so angry or panic or something or another.
But after a while, people started realizing, oh, it's really my reactions that make life so difficult.
And so, how do I control these reactions becomes a major issue.
And oftentimes, people learn to shut themselves down and learn to not react.
but with that they become very distant to themselves and the people around them.
I think what you said there was really quite poignant for me that we often think it's the people around us that are causing us to feel a certain way without that deep realisation that actually we're generating those emotions.
We may not know why we're generating them but ultimately it's coming from within us isn't it?
Yeah, the whole story had like, you know, negotiating your ways through the world is complex. And people will say things that may not be pleasant, or they may not respect you as much as you'd like it to be.
But the core issue is, how do I react to adverse issues, and I cannot change everybody else.
I have to actually learn to manage my own arousal and my own reactivity.
What's the difference between trauma and stress?
The big difference is when stress is over, it's over.
And so, when you sit for an exam, you're working hard, or you may not be able to sleep.
But once you take the exam, you can go for a walk, you can go do whatever you want to do and the stress disappears and stress is not bad for people because we really are programmed to deal with very adverse circumstances that people can deal with a great deal of stress, but the critical thing is when the stress is over and you've done whatever you need to do to deal with it, then your body resets itself, you become calm and you stop or being hyper -focused or whatever, but you get traumatized, those reactions don't stop.
So trauma is almost like a severe, stress response that never ends and that starts to change our nervous system and how we view the world, how we react to the world.
Is that one way of putting it?
Yeah, it's not as cognitive as view the world, it's really how we react to the world.
a reactivity changes, and we may become too intensely aroused by minor issues.
From a neuroscience point of view, we have some networks in the brain that help us to select what's important and what's unimportant.
It's called the salience network.
And after you get traumatized, the salience network makes you react to minor issues, as it's a catastrophe.
The title of my book, The Body Keeps Its Core, is not just a cute title.
It's actually the effectual immune system, the effectual stress responses, and people who have long trauma histories oftentimes have multiple medical problems which have to do with the body, they get stuck in fear, fight and flight.
Yeah. How common is trauma, would you say?
Or extremely common. It turned out to be much more common than we ever thought it would be.
Shame and secrecy is very much part of trauma situations.
Yeah and when I think about trauma and traumatic events, I think about the fact that different people being exposed to the same trauma will react in different ways.
Some people will end up becoming heavily traumatized, whereas some people won't.
So what are the factors then that determine if someone is going to have that chronic imprint of trauma, or whether they're going to be able to deal with it, you know, deal with that stress response, and return back to baseline.
Do we know what those factors are?
Well there certainly is an issue of temperaments.
Anybody who has more than one child knows that we all come into the world with very different reactivity and different responses, so that is one factor.
But the other major factor is the social environment and who is there for you when something bad happens.
By and large, if you go through a terrible experience and you have a partner, a spouse, a parent, a boss who says, oh my God, how can I help you?
I'll be there for you.
But your social environment helps you to protect yourself and to feel safe again.
That makes a huge difference.
So the principle, for example, after natural disasters, after accidents, in war situation, the first thing you do is you reconnect people with the people they love and care for Because that is really what, for human beings, is the main source of comfort, and so as long as you have people around you who acknowledge the reality of what you went through and who were with you in a very deep way, you probably will be okay.
And that, of course, is what happens in like wartime situations when people are at war, like what's happening in Ukraine right now, is that people feel very close to each other.
And that's sort of a natural, biological thing almost, that when we are under extreme stress, we really become very dependent on each other and we form very close bonds.
And that's how people survive.
But if the people who are your most intimate people are the source of their trauma, you lose that sense of connection and protection.
And then, oftentimes that is when people go over the edge.
Yeah, it's interesting.
I was preparing for this conversation.
And I was reading in your work, the importance of human connection at making us, I guess, generally more resilient, but in many ways, insulating us from the likelihood that a traumatic event is going to leave a chronic imprint inside.
Yes, insulin is a bit of an extreme word here, it helps, it makes a significant contribution.
But insulin is too total a word. But overall when your kid for example and you either go through an operation or terrible things happen to you and your parents are there for you and acknowledge it then that kid is likely to be okay.
Yeah. Yeah, really, really interesting.
I really want to get to a central philosophy of your work that I take from at Elise, which is about the body keeping the score.
That's the title of your book, but this idea that the body keeps a record of what has happened and that one of the goals of therapy is to help people feel safe in their bodies.
Now, I think a lot of people may not understand what that means.
What do you mean when you say we need to feel safe in our bodies?
I think Darwin already back in 1872, wrote a beautiful book in which he talks about trauma, actually, he calls it Getting Stuck in Fight or Flight, or Stuck in Avoidance and Defensive Reactions, which is not a bad definition.
And he talks about how these experiences are expressed in the course of the vagus nerve, Darwin calls it pneumogastric nerve back then, and that you experience your emotions as gut -wrenching and heartbreaking physical sensations.
And I think we all are familiar with that.
Have been something hurtful happens.
We do feel it in our chest and we feel it in our bodies.
And so our bodies respond to these things and we get traumatized, that feeling of gut -wrench and heartbreak really stays with you And you've become an intolerable person to yourself.
Does that ring a bell with you?
Because it's a universal response, that you experience deep disappointment and betrayal and fear in your body.
Yeah, I think people have experienced that.
If anyone's ever been through heartbreak before they all have, which yeah, pretty much everyone has been through on some level.
Well, you feel it in your heart.
So I think when we start thinking about it, it's like, oh yeah, that's in our body.
Like something's happened up here in our mind.
We've perceived it a certain way.
And then our body is expressing a symptom of that.
So I think this is a really good point to talk about some of these practical things that people can start doing.
I mean, frankly, the things you are talking about are helpful for anyone, but can we start with yoga, right?
I know yoga is something you talk about as a really fantastic way for many people to start feeling that safety within their bodies.
How did you come across yoga and why do you think it's so effective for so many people?
You know, these things are usually an issue of accidents.
You happen to meet somebody who does yoga and who says come and do yoga class with me and then you feel that your body feels calmer and your mind is more focused afterwards.
They say, oh, that's interesting.
So, actually, so I went to National Institute of Mental Health and got the money to study yoga as a way of calming that body down.
But now people say, oh, yoga is treatment of choice.
I don't know. Maybe some other people, chi gong may be better, or tai chi, or some other musical practice, but for me going to yoga was really a way of exploring to what degree people can change their relationship to their bodily sensations, and yoga turned out to be very good for that.
And certainly it's not the only way, a study I still love to do someday is see how tango dancing works for trauma, theoretically, that would make a lot of sense as being a really good drama chief actually.
And what I see all the time is that the people who are in my life who are traumatized, they go and start exploring different things that help them.
Some people find that acupuncture is very helpful.
Other people say, it doesn't do a thing for me.
And so we don't know precisely what is right for whom, but it's very important for us to have an open mind and you need to have an open mind for yourself also to really see what can help me to feel alive in the body that I live in.
You're saying that for many people who are traumatized, they don't feel safe in their body.
they don't experience everything that's happening within their body.
They shut down in certain ways.
And you're saying one method that may work for some people is through something like yoga or qigong or martial arts, for example.
What is it that's going on?
You're starting to connect to your body, you're starting to connect to your breath.
How do you put it? What do you think may be happening there that's helpful?
What happens there is that you are stuck in the stress response syndrome.
And for example, when you start breathing more slowly and more deeply, and you change your breath, you change your heart rate variability, which is a way of measuring how the heart and the central nervous system relate to each other.
And then you get a sense of relief and openness once you are able to do things that calm the system down.
and so initially having somebody work with your breath you go like I don't want to do that and then if you learn to breathe much more slowly and much more deeply you get a sense of oh I feel calm or I feel clear and what you do actually at this point is you open up some pathways in the brain between your parts of your media frontal lobe and your insula a part of your brain that's connected with your bodily sensations, and you open up new pathways of self -experience, basically.
Yeah. It's so fascinating.
I know when I was reading the section on treatment in your book, you said when you're starting to treat trauma, there was one part where you spoke about these four things that need to happen.
One, you need to find a way to become calm and focused.
Two, you need to be able to maintain that calm in response to things and events and people that trigger you to the past. Then the third thing, I think, was being present.
You have to find a way of being present in your life and with the people in your life.
And then the fourth thing there was you have to not keep secrets from yourself.
Now, the reason I bring that up there, I think what you just said about yoga there speaks to the first one there, which is, number one, you've got to find a way to become calm and focused.
So, for people who are traumatized if you're stuck, who won't go into certain parts of body who don't want to do certain poses or positions because it doesn't feel good.
It sounds as though what you're saying is that when people can find some sort of practice that helps them feel safe in their body, whether it's yoga or something else, that it's going to start to help them experience what does calm feel like because I guess many of these people don't actually know what it feels like to be calm even for just 10 or 15 minutes right?
But I think what people mainly learn is how to cut off their feelings.
Many people learn to not feel.
So what a very common adaptation to trauma is to just shut yourself down, becoming that uptight person that manages somehow to make it through your day.
But in order to recover, need to open up these pathways of self -experience.
and that you need somebody who really gently helps you to reconnect with yourself.
I think you published a study, did you not, on yoga and PTSD from recollection?
Three of them, three of them, yeah.
What did they show?
They showed us if you do yoga for eight or 12 weeks, that your PTSD scores go down.
We did some neuroimaging and we see some new linkages in the brain coming online, particularly having to do with areas, the brain having to do with self -experience, self -sensory experience and what our studies showed is that when people do yoga they are more open to being with other people, less frightened of being with other people and less afraid of themselves most of all.
Yeah, wow, very very powerful.
It's interesting. But I want to say it's really that people say, Oh, yoga is the answer.
No, yoga was a paradigm that helped us to understand how engaging with your body in a particular way is helpful, but it's not the final word on the story.
Just very, very finally, for anyone who's listening right now, who feels stuck in their life, who feels the way that they are right now the way that they have to stay.
What would you say to them?
I would talk about what might be available.
Have you tried yoga?
Have you ever seen a choir?
I would always take very careful histories about when did things work for you?
What were you doing but you did not feel this way?
What sort of relationships were you in?
And I tried to help people to not only remember the horrors of the past, but also that kid a long time ago, who was able to do this and who coped somehow and to really revisit yourself as a survivor, to see what has worked and what hasn't worked, what gave you a glimmer of hope?
And then to look around in your environment, would sing in a choir work, we're doing martial arts work, we're going to your yoga studio work, to really look at what it in your culture that might help your body to feel at home or safe or a feeling of pleasure and engagement.
Hope you enjoyed that bite -sized clip.
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