Huberman Lab Essentials: Therapy, Treating Trauma & Other Life Challenges | Dr. Paul Conti

Release Date: January 22, 2026
Host: Andrew Huberman, Ph.D.
Guest: Dr. Paul Conti
Theme: Understanding trauma, the therapeutic process, and science-based tools for healing and self-care.

Overview

In this episode, Dr. Andrew Huberman hosts psychiatrist and trauma expert Dr. Paul Conti for a deeply insightful conversation on the nature of trauma, how it imprints on the brain, and the pathways to personal and therapeutic healing. The discussion moves from definitions and mechanisms of trauma—including guilt and shame, repetition compulsion, and arousal regulation—to practical strategies for self-care and optimal therapy experiences. Dr. Conti also addresses the clinical use and nuances of medications, psychedelics, language around mental health, and the foundational importance of self-care.

Key Discussion Points & Insights

1. Defining Trauma

• Dr. Conti: Trauma is not merely any negative event, but something that "overwhelms our coping skills, then leaves us different as we move forward." It's visible in our mood, behaviors, sleep, health, and can even produce changes in brain function. (00:30)

  • Notable Quote:

    “We have to look at trauma as not anything negative that happens, but something that overwhelms our coping skills and leaves us different moving forward.” — Dr. Paul Conti (00:30)

• Trauma responses often include guilt and shame, which can lead people to avoid or bury what happened—counterproductive to healing.

2. Guilt, Shame, and Evolutionary Roots

• Guilt and shame are "aroused affect" responses encoded for survival but are often maladaptive in the modern environment.
  • Trauma imprints deeply for adaptive reasons (to enhance vigilance, remember harm), but in modern life, this often results in persistent, undesired changes in worldview and functioning.
  • Notable Quote:

    “The limbic system, the emotion system inside of us, always trumps logic ... Affect is aroused without our choice.” — Dr. Paul Conti (03:42)

3. Repetition Compulsion & The Brain’s Emotional Logic

• People commonly reenact old traumas in new relationships or situations, attempting at a subconscious level to "fix" the original wound.
  • Logic is often overruled by the emotional (limbic) system; the drive is not to repeat suffering but to try to resolve it.
  • Notable Quote:

    “What people are trying to do [with repetition compulsion] is make things right … If we can repeat the situation and make it right, it will fix everything.” — Dr. Paul Conti (09:29)

• Clinical improvement requires directly addressing and unpacking the original trauma.

4. Processing and Healing Trauma

• Effective healing often involves turning directly toward the trauma and expressing it, whether in therapy, through writing, or with trusted others.
  • Describing trauma aloud or in writing can dramatically shift internal dynamics from shame and anxiety to compassion for oneself.
  • Notable Quote:

    “When the person puts words to it … things start to change.” — Dr. Paul Conti (13:22)

• Emotional release (such as crying) is important; grief cannot be processed if it is blocked by guilt and shame.

5. Avoiding Retraumatization during Processing

• Passive rumination (repetitively replaying trauma mentally) is unproductive.
• Distancing oneself enough to observe the trauma from an outside perspective is key; writing and speaking help bring the observing ego online.
  • Notable Quote:

    “If we just think about [trauma] the same way we always do, all we're doing is reinforcing it.” — Dr. Paul Conti (16:54)

6. Qualities of an Effective Therapist

• Rapport and trust are paramount—more important than modality (CBT, DBT, etc.).
  • Notable Quote:

    “If you look at what are the top 10 important factors to find in a therapist? Just repeat rapport ten times. It's trust." — Dr. Paul Conti (19:39)

• It’s important to try different therapists if needed and to value word-of-mouth recommendations.

7. Therapeutic Dose and Ownership

• Both therapist and patient need to track progress and engagement. Therapy should empower self-observation and self-care, not passive attendance.

8. Medications & Systemic Problems

• Medicines are often overused as a quick fix; true healing comes from addressing root causes.
  • Notable Quote:

    "We want to polish the hood when there's a problem in the engine." — Dr. Paul Conti (22:00)

• Many people are medicated to treat symptoms without addressing the underlying trauma or dysfunction, sometimes leading to overmedication and side effects.

9. Psychedelics in Therapy

• Clinical use of psychedelics (in controlled, legal contexts) appears highly promising in reducing trauma’s grip by dampening cortical “chatter” and enhancing contact with “core humanness.”
  • These substances can catalyze deep self-compassion and insight, similar to effective therapy, but "supercharged."
  • Notable Quote:

    "These psychedelics ... catalyze that by just putting a person in that part of the brain that can see it for what it is without all that chatter." — Dr. Paul Conti (24:42)

• Caution is critical; misuse can be harmful.

MDMA-Specific Effects

• Unlike classic psychedelics, MDMA floods the brain's emotional centers with positive neurotransmitters, making it easier to approach trauma without fear or shame.
  • Notable Quote:

    "MDMA is ... more permissive to think about [trauma] ... without all the chatter of 'that's your fault.'" — Dr. Paul Conti (30:01)

• Clinical benefit is maximized with skilled therapeutic guidance during these sessions.

10. The Power and Pitfalls of Language

• Overuse or misuse of terms like “trauma” and “depression” risks diluting their meaning.
• Clarity, specificity, and honest communication about definitions are essential for understanding and effective intervention.
  • Notable Quote:

    “The specificity of language—what are we really trying to say, how are we defining it ... Anchoring it to something that's overwhelming our coping skills and changing us.” — Dr. Paul Conti (32:30)

11. Self-Care: The Core of Healing

• Self-care goes beyond superficial acts; it's about meeting basic physiological and psychological needs.
  • Sleep, nutrition, natural light, supportive interactions, healthy environments, and leisure are all foundational.
  • Neglecting self-care is often linked to internalized trauma or harmful beliefs about power and productivity.
  • Notable Quote:

    “Self-care is not light ... Are you sleeping enough? Eating enough? Getting natural light? ... Very basic premises, but so often we’re not looking at them at all.” — Dr. Paul Conti (34:07)

Memorable Quotes & Timestamps

• On the nature of trauma:

  • “Trauma is something that overwhelms our coping skills and leaves us different.” — Dr. Paul Conti (00:30)

• On guilt and shame:

  • “Shame is an aroused affect … which is an extremely strong deterrent.” — Dr. Paul Conti (03:42)

• On repetition compulsion:

  • “Emotion wins all the time. … The limbic system does not care about the clock or the calendar.” — Dr. Paul Conti (09:29)

• On writing or speaking trauma:

  • “When the person puts words to it … things start to change.” — Dr. Paul Conti (13:22)

• On finding a good therapist:

  • “Just repeat rapport ten times. It’s trust.” — Dr. Paul Conti (19:39)

• On medicine and the healthcare system:

  • “We want to polish the hood when there’s a problem in the engine.” — Dr. Paul Conti (22:00)

• On psychedelics:

  • “Psychedelics … seat our consciousness in parts of the brain which are most about our experience of true humanness.” — Dr. Paul Conti (24:42)

• On self-care:

  • “It's not a light concept to say: are you sleeping enough, eating enough, getting sunlight … these basics are the building block for all else.” — Dr. Paul Conti (34:07)

Timestamps for Key Segments

| Timestamp | Segment Summary | |-----------|----------------------------------------------------------------------------| | 00:30 | Defining trauma; physiological and behavioral impact | | 03:42 | Roots and purpose of guilt, shame, and trauma in evolutionary context | | 09:29 | Repetition compulsion—reenacting trauma | | 13:22 | Facing arousal and the value of articulating trauma | | 16:54 | Avoiding retraumatization; importance of new perspectives | | 19:39 | Finding the right therapist—importance of rapport | | 22:00 | Appropriate (and inappropriate) use of medications | | 24:42 | Clinical potential and mechanism of psychedelics in trauma therapy | | 30:01 | Effects and therapeutic potential of MDMA | | 32:30 | Language—precision and honesty in discussing trauma and mental health | | 34:07 | Deep meaning of self-care; practical essentials for recovery |

Conclusion

This episode delivers a roadmap for recognizing, understanding, and healing trauma—centrally, by learning to turn toward what hurts with honesty and compassion, building supportive relationships (including with therapists), wisely using available medical tools, and rigorously honoring the simple foundations of self-care. Dr. Conti offers actionable tools and reflections, encouraging listeners to think both deeply and compassionately about themselves and others grappling with trauma and life challenges.

Read Dr. Paul Conti’s book on trauma for further insights and practical guidance, as recommended by Dr. Huberman (“I think this is the definitive book on trauma”—Andrew Huberman, 37:39).