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Feel Better, Live More with Dr Rangan Chatterjee
BITESIZE | How To Begin Healing Your Past & How Trauma Impacts Your Physical Health | Dr Bessel van der Kolk #564
00:20:37
Today’s guest is the author of the iconic book, ‘The Body Keeps the Score’, which first came out over 10 years ago and has sold millions of copies all around the world. In fact, the book has been somewhat of an international sensation and is as popular today as it ever has been.
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- [00:00]
Dr. Rangan Chatterjee
Today's bite sized episode is sponsored by AG1. One of the most nutrient dense whole food supplements that I've come across and I myself have been drinking it regularly for over six years. AG1 makes it simple to be the best version of you over 70 ingredients, one scoop once a day for less than a cup of coffee. It's a science driven daily health drink which supports your energy focus and immune system. It's it also helps support your gut health. For example, it contains calcium which contributes to the normal function of digestive enzymes and biotin to maintain your own intestinal mucous membrane. Subscribe now and get a free bottle of vitamin D and five free AG1 travel packs with your first subscription. See all details at Drink 81 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 der 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 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.
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Dr. Bessel van der Kolk
Oh, that's a true statement.
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Dr. Rangan Chatterjee
What did you mean by that?
- [02:01]
Dr. Bessel van der Kolk
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.
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Dr. Rangan Chatterjee
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.
- [02:50]
Dr. Bessel van der Kolk
Yeah, they keep reacting to stuff and things are disorganized and then oftentimes they start off blaming the people around them for having caused them to be so angry or panicked or something or another. But after a while people start 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.
- [03:32]
Dr. Rangan Chatterjee
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 realization 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?
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Dr. Bessel van der Kolk
Yeah. Not the whole story. Negotiating your ways through the world is complex. 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.
- [04:24]
Dr. Rangan Chatterjee
Yeah. What's the difference between trauma and stress?
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Dr. Bessel van der Kolk
The big difference is when stress is over, it's over. And so when you sit for an exam, you're working hard, 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 needed to do to deal with it, then your body resets itself, you become calm and you stop being hyper focused or whatever. But you get trauma test. The those reactions don't stop.
- [05:19]
Dr. Rangan Chatterjee
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?
- [05:34]
Dr. Bessel van der Kolk
Yeah. It's not as cognitive as view the world. It's really how we react to the world. Our 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, what's unimportant. It's called the Salience Network. And after you get traumatized, the Salience Network makes you react to minor issues as if it is a catastrophe. The title of my book, the Body Keeps a Score, is not just a cute title. It actually affects your immune system. It affects your stress responses. And people who have long trauma histories oftentimes have multiple medical problems which have to do with their body. They get stuck in fear, fight and flight.
- [06:33]
Dr. Rangan Chatterjee
Yeah. How common is trauma, would you say?
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Dr. Bessel van der Kolk
Oh, 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?
- [06:48]
Dr. Rangan Chatterjee
Yeah. Now, 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?
- [07:24]
Dr. Bessel van der Kolk
Well, there certainly is an issue of temperament. 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. When 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, war situations, 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 are 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 the trauma, you lose that sense of connection and protection. And then oftentimes, that is when people go over the edge.
- [09:19]
Dr. Rangan Chatterjee
Yeah. It's interesting, as 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 us.
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Dr. Bessel van der Kolk
Insulate 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 you're a kid, for example, and you need to 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.
- [10:08]
Dr. Rangan Chatterjee
Yeah, yeah. Really, really interesting. I really want to get to a central philosophy of your work that I take from it, 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. 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?
- [10:40]
Dr. Bessel van der Kolk
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 called the 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. When 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. When you get traumatized, that feeling of gut wrench and heartbreak really stays with you and you 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.
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Dr. Rangan Chatterjee
Yeah, I think people have experienced that. If anyone's ever been through heartbreak before, which we all have, which, yeah, pretty much everyone has been through on some level, 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're talking about are helpful for anyone. 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?
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Dr. Bessel van der Kolk
You know, these things are usually an issue of accidents that 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 you 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, qigong may be better, or tai chi or some other musical practice. But for me, going into 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 trauma treatment, 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 it, let's say acupuncture is very helpful. Other people say, it doesn't do a thing for me. 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.
- [14:15]
Dr. Rangan Chatterjee
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, and how do you put it? What do you think may be happening there that's helpful?
- [14:45]
Dr. Bessel van der Kolk
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 that 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 calmer, 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 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.
- [15:44]
Dr. Rangan Chatterjee
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, who feel stuck, who won't go into certain parts of their 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 gonna start to help them experience what does calm feel like? Cause 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.
- [17:04]
Dr. Bessel van der Kolk
I think what people mainly learn is how to cut off their feelings. Many people learn to not feel. So 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, you need to open up these pathways of self experience and that you need somebody who really gently helps you to reconnect with yourself.
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Dr. Rangan Chatterjee
I think. You published a study, did you not, on yoga and PTSD from recollection?
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Dr. Bessel van der Kolk
Three of them. Three of them, yeah.
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Dr. Rangan Chatterjee
What do they show?
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Dr. Bessel van der Kolk
They show that 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 of the brain, having to do with self experience, self sensory experience. And what the study 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.
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Dr. Rangan Chatterjee
Yeah. Wow. Very, very powerful. It's interesting, but I want to say.
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Dr. Bessel van der Kolk
It'S really Then 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.
- [18:37]
Dr. Rangan Chatterjee
Yeah, 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 is the way that they have to stay, what would you say to them?
- [18:54]
Dr. Bessel van der Kolk
I would talk about what might be available. Have you tried yoga? Have you ever sing in choir? I always take very careful histories about when did things work for you? What were you doing when 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 their 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, would doing martial arts work, would go to yoga studio work to really look at what it is in your culture that might help your body to feel at home or safe or a feeling of pleasure and engagement.
- [19:56]
Dr. Rangan Chatterjee
Hope you enjoyed that Bite sized clip. Do spread the love by sharing this episode with your friends and family. And if you want more, why not go back and listen to the original full conversation with my guest. If you enjoyed this episode, I think you will really enjoy my bite sized Friday email. It's called the Friday five and you if each week I share things that I do not share on social media. It contains five short doses of positivity, articles or books that I'm reading, quotes that I'm thinking about, exciting research I've come across, and so much more. I really think you're going to love it. The goal is for it to be a small yet powerful dose of feel good. To get you ready for the weekend, you can sign up for it free of charge@doctor chatterjeed.com Friday 5 Hope you have a wonderful weekend. Make sure you have pressed subscribe and I'll be back next week with my long form conversational Wednesday and the latest episode of Bite Science next Friday.