Peter Attia (2:51)

English Jeff Peter Kind of hard to believe we're sitting here, huh?

Unknown (3:01)

Yeah, it is hard to believe. It's amazing.

Peter Attia (3:04)

It's good to see you. Likewise. I thought long and hard about how I wanted to structure our discussion today, knowing that this was a conversation I've wanted to have for a very long time. Maybe the easiest way to start is just to talk a little bit about this loaded word of trauma. When I first was introduced to this idea of trauma, I didn't know what it meant. And I think today it's become such a catchy buzzword that everybody is traumatized by something. And I don't know if that represents a pendulum swing or a normalization or what. But why don't we just start with how you describe trauma as a trauma therapist and as someone who's been doing trauma therapy for many years, not just in the recent trendy years for whatever that means. But how do you describe this to people?

Unknown (3:48)

Well, I would have described it the same way that you described it initially back in the day, trauma, I have to have been at Vietnam wartime, 9, 11. These are those big T traumas. You hear some folks use that type of terminology, but within the spirit of the work, the knee to knee work, really embracing a definition, moments of perceived helplessness, that's what's going to activate the limbic system. So who is to say what one limbic system evaluates as helplessness versus another? That's when we get into this, I think discovery of most of the people that I meet have been meeting over the last several years are the ones, wow, I think I did experience trauma you mentioned. It's a much more popular thing. And now are we trending in a different direction? So in a lot of my work with clients, individually or groups, I say, I hate to oversimplify things, but I think sometimes we just make things too damn complex. A lot of what I do is try to depolarize for folks and we're getting into these situations to where we live in this world of get over it, it doesn't matter versus like you mentioned, perhaps stay stuck in it. But yeah, moments of perceived helplessness, activating that limbic system. These things can happen sometimes. At the bridge, you remember we talked about wounding events and one of those would be a tragic event. Life seems to be going one way before this thing happens and then this thing happens and life changes and everything is different. On the other side of that, a big T event versus someone again who maybe you could describe it as a thousand paper cuts. Someone growing up, going through childhood daily, being limbically activated, but moments of perceived helplessness. That stuck for me, and it stuck for a lot of clients.

Peter Attia (5:46)

So I've written about this in the book, which is that you and I met at a place called the Bridge to Recovery in December of 2017, seven years ago. That was a very hard chapter for me to write, and one I wrote somewhat reluctantly, but also, in the end, felt I couldn't not write it. So the book was incomplete without that chapter. Maybe we can even frame this discussion around how a place like that comes to exist and how therapists like you work at places like that. I'll throw one idea out that's worth discussing, but it's literally one of a hundred, which is. It might be shocking to some to realize how much group therapy is done at a place like the Bridge to Recovery. In fact, as I looked through my journal, which I brought back, looking through the notes, it's amazing how complex it was for me to be able to open up in front of a group and how I spent the first few days saying virtually nothing, largely because of that discomfort. Maybe tell folks a little bit about the Bridge, the type of work that's done there. I forget exactly how I described it in the book, but I described it as this wonderful, horrible place in the woods of Bowling Green, Kentucky.

Unknown (6:56)

Some folks call it residential treatment. Some people call it trauma camp. There's a lot of different names.

Peter Attia (7:01)

Oh, I wrote some other names down here. Do you want to know what I have? I have Camp Misery, the Sadness Factory, and the Tree of Pain. Those are the names I wrote down.

Unknown (7:12)

And I couldn't argue with any of those. So what is it? It could be described as residential treatment, and I would describe it as residential treatment for disconnection. I think when most folks think of disconnection, they get a little like, well, that's vague. But when most folks think about residential treatment, we tend to jump to substance abuse. That's where people go so that they can go away and get sober. Oftentimes the question would be like, well, why would somebody go to a place like this that's not an addict? We want to use that type of terminology. Disconnection is just the concept that's used at the Bridge. And one way of disconnecting is substance abuse, but also screens, sex, relationships, ego, anger. So you just take away the substance, take away the word alcohol, and plug in whatever word you want to. You mentioned the group process, so you might have a group of eight Folks. And there may be three folks in there that identify as substance abusers, and there could be two workaholics in that room. The commonality within the circle is going to be. You may disconnect differently than I do, Peter. But the commonality is, is that especially when life throws us a curveball, this disconnected version of me seems to come out, jump in my driver's seat, if you will. And that's probably been happening a lot. As far as acuity goes, if that's how you find yourself at the bridge, the old saying is, nobody gets there because it's a slow Monday, okay? And then the big word that you use, which I think there's a part of me that wants to say, like, ooh, don't give away the secrets. Let the magic happen. But I also going through the program to work there and know that you can know everything that's going to happen. And then you start going through the process and discomfort, what it's all about. That's when my stuff comes up. So that's the whole idea. If you remember, admissions day is on a Monday, so we would usually meet the groups by Tuesday. Countless times I've tried to help talk folks off the ledge of leaving. In summary, their reason, all of them, different details. But I came to the bridge and my anxiety was at a 7. Right now, I think it's a 9. I need to get the heck out of here. This place ain't for me. And sometimes they look at me like I've got two heads when I say, you know, actually, you're providing the evidence that this is exactly the type of place for you.

Peter Attia (9:37)

That first day there, that Monday, it's a very unpleasant day, I'm sure, for everybody. I don't think that's a stretch to take my experience and say that that was unique. Maybe it's worth explaining. What are the objectives of this phase one that you describe from the beginning?

Unknown (9:52)

I would say getting my history straight. The telling of my life story seems simple. Several folks, many folks have done it before. But within and through the lens of what we introduce, as far as the trauma tree that you referred to, it's the what happened to me story. And so many of us, for so many years, sometimes decades, have been telling the story of what's wrong with me. And so from the very beginning, the shift, the hope is to move a little bit closer to what happened to me. Not within the spirit of an excuse, but an explanation. Oh, wait a second. It makes sense that I do this thing now. There was a utility to this behavior, the group process. It just brings up the stuff. I call them the guards, parts. Therapists will call them protective parts. And this isn't new. We use terminology that's new, but it's ego states. But when I say guard this protective side of Jeff, that comes up when he gets vulnerable. And when do I get vulnerable? Typically when I get dropped into a different situation. So that first week I'm going to live with some new people, I'm going to eat with some new people, I'm going to share story, share deep information about myself. And that's really the objective, is to start within the technical thing that's happening therapeutically is there's a window of tolerance that we all don't have and so don't want to drop into week two work when we start doing these experiential therapies. But within the spirit of a window of tolerance and experiential therapy. Telling your life story is experiential therapy. The content's important, Peter, but so many times the way the story is told is more important or as important at least as the content of the life story.

Peter Attia (11:37)

You talked about the trauma tree. Maybe we can describe the roots and branches of that tree in some detail because that is kind of the meta structure that I think that story gets told. It's the cause and effect piece of it. At least that's how I sort of came to understand it. I've seen many different ways that trauma is described, obviously since I left the bridge. It's a topic I'm personally very interested in for myself, for patients, et cetera. Jeff I always come back to that structure and I think it is the single best one I've seen. Now that doesn't mean that it is the best one. It's just the one that resonates the most with me because causality means so much in my world. And I like the idea that even though it's not a one to one mapping, everyone who experiences this trauma will have this manifestation. Clearly not. But if you accept a little bit of the randomness in the system, it's pretty powerful. So maybe walk people through the five roots and the four branches of the trauma tree.

Unknown (12:40)

The five roots of the trauma tree. That's the what happened to me. This can be seen through the lens of trauma. And for folks where trauma is just too big of a word. Can you believe I'm saying that on this podcast? But okay, then lose it. Highly stressful events. So abuse tends to be the one that we talk really the least about. At the bridge, because that's the one that folks tend to know the most about. That's not to mean that we minimize it. There's just so many different forms of abuse. Physical, emotional, abject, social. You move over from abuse and you look at something like neglect, which can be very tricky. So many folks that have experienced neglect, it's an eye opening experience because while something like abuse is something that happened to me, neglect is something that failed to happen for me. And so to see that through the lens of high stress or pain, so many different ways one can be neglected. An example that's used there is the little boy that is going to school and he's being bullied and he's got these parents who are professionals and they're successful and they're busy and they've got the best of intentions, but they're missing it. They're missing the look on this kid's face when he comes in every day and before he gets on that bus every morning. That question's not being asked, what's happening? And so every day this little person's being required to go to this place where this thing's going to happen. And evidently these folks at my house don't have time. And it's important to emphasize, I think, the word intention, because intention is not required. How many times have I said, have I heard, well, they had the best of intentions, it still happened. Or in the case of neglect, it failed to happen. Enmeshment, that's a wounding experience where you've got a boundary violation. So that can happen within the spirit of what we call emotional incest, where a child is put in an age inappropriate position. Maybe the child becomes best friend, counselor and confidant for mom or dad. And then you've just got this engulfing enmeshment which happens a lot of times in successful families where outcomes and expectations are celebrated and they're not so much the journey. And so that engulfing enmeshment can be one of those situations where this is the way to be more of a me mini me relationship between a parent and a child instead of that I thou relationship. And in those situations with enmeshment, what typically happens is we either drink the kool aid, get on board with it, or what do we do? We rebel. And I'm not going to do anything that looks anything like this. Neither of those things is probably who I was meant to develop into. I think probably in my opinion, the umbrella wound. We're talking about the tree, the root of the tree. Would be abandonment and physical desertion or abandonment. That's low hanging fruit as far as I think the general public and knowledge. Yes, when somebody leaves permanent abandonment, obviously someone passes away. There's death, there's seasonal folks leave for work, military deployment, folks go to prison, parents get separated, parents leave, come back. Now emotional abandonment, that's that situation where someone's there but they're really not there. And this emotional self gets denied. And a lot of times when you're emotionally abandoned, it can be a situation where it's emotionally cut back. Meaning the house I grew up in, we did anger, that's what we did. Wasn't okay to be sad, wasn't okay to be scared, but we did anger. So it wasn't like we were emotion free, it was just we were cut back to that one. That's the one that I saw the most. And then sometimes it's just the situation where it's cut off and it's blank in no emotion. And I mentioned already the tragic event route of that trauma tree. And so I guess what I mean by the abandonment for me being this umbrella wound is it's when you abuse me, you abandon me, I keep going to parents because those are the folks that we spend the most of our time with in those formative years. But any of these wounds can happen with anybody in our life and they can also happen anytime in life. It's not limited to childhood. When you get something happening, when the brain and the body is developing, it gets concrete, that gets cemented, it gets burnt in. That thing that I'm talking about getting burnt in is how I adapted. I mentioned that. The question is what happened to me. But I believe the most important discovery is how I adapted. When you talk about that tree, we're talking about the roots being the wounding experiences. And then that top of that tree is the manifestations, if you will, of the woundedness. This is how I survived. And so you have codependence, you have addictive patterns, you have attachment issues and a whole slew of just survival strategies, maladaptive survival strategies. And as I say that word maladaptive, I want to wash my mouth out with soap. Because they are ingenious damage control strategies. The way I describe them, it's an old friend that served me well and perhaps now it's making life hard. The best example I can give is of a four year old boy spending a lot of time in his bedroom playing with the door closed, playing loud so that he doesn't have to hear what's going on. In the rest of the house. And then one particular day, he hears his mother, in a voice he has never heard before, tell his father that she thinks her arm's going to be broken and he has to open the door. When he opens the door, he sees his mother up against the refrigerator. And the boy's father scattering a hammer lock arms behind her. And the little boy's got to do something. And he's really outgunned because, let's say dad's 35 and he's 4. So he starts walking towards them. And the first room on the right is the bathroom. And he goes into the bathroom and he lifts the lid on the toilet. And he feigns, fakes, acts as if he's vomiting. And the next thing he hears is, do you hear that your son's getting sick? And dad lets mom go. Now, does the boy go back into his bedroom and get out a little journal and write down? Manipulation and deception are very effective in life. Probably not. But I say he learned a powerful lesson that day about deception and manipulation. It got him out of trouble. It got his mom out of trouble that day. An old friend that served him well but perhaps is making life hard. Because healthy folks in adult relationships, Peter, they don't dig deception and manipulation. So that's where my old friend can get in my driver's seat, you could say, and make life hard for me. But a very adaptive skill. I would call it a skill. Some folks would use the language of a character defect. I'm not against that language. I just prefer a skill.

Peter Attia (20:01)

I really think that's a powerful bucket because it has enough breadth to include things that don't easily pathologize. Maybe for the sake of completeness, we could just go back and talk about the codependencies, addictions and attachment issues. I think everybody's familiar with the terminology. But just as within abuse, there are things that people don't quite think. Everybody thinks of sexual and physical abuse. Very few people think of emotional abuse or religious abuse, those kinds of things. So similarly, maybe talk through the breadth of what we think of as addiction, codependency and attachment disorders.

Unknown (20:36)

Codependency, the spirit of it. And it's not my definition, it's an old one, but it's the one I prefer. It's an outer reach for inner security. I can't draw that thing from inside of me. I have to get that from something or someone else. You let Jeff know he's okay. I can be okay. But if you're not okay with Jeff, it's hard for me to be okay with Jeff. That's a blanket summary and I think an accurate summary of codependence and your addictive patterns. Addictions, addictive patterns. I mean, again, these can be substances, these can be process. When I talk about the ego states, the parts my guards, those parts of me that jump in my driver's seat, I look at those through the lens of addictive patterns because it's that concept of powerlessness. You'll hear folks that are in the programs, such as 12 step programs, they talk about being powerless to something. To get into the surrender of being powerless. Well, you can just take the word alcohol, remove it, and replace it with whatever that behavior is. It's the thing that I do. It's not a bad thing that I can do it sometimes. The problem is I can't not do it. So again, this could be work, this could be ambition, this could be anger, this could be many things. And usually these things, they're there for a reason. And again, we're back to vulnerability is the enemy. So the goal of all of these maladaptive coping skills, patterns, whatever we want to call them, is we got to keep Jeff from being vulnerable. We gotta keep that little boy that had that situation with his mother in that refrigerator. We've had a bad experience with vulnerability. So all these parts of me that step in to my driver's seat, they've got a goal. They do their job in different ways, but the goal is to keep me from being vulnerable. Attachment styles. You get four books, you're probably going to get four different numbers of attachment styles. I like simplicity. You'll probably hear me say that more than once. But simplicity, like three, most popular. So you've got anxious attachment. It can be clingy, it can be charming. It'll look a lot of different ways. But the more of me I give to you, the more of you I expect from you, that's going to be the best chance to keep this thing going. Now, avoidant attachment, the distance I can be in a relationship and still not give you all of me. I can be with a person but still have distance. And then there's. I'm not crazy about it, but disorganized attachment, which is a mixed bag of come here, come here, come here. Now get away. Get you close. Now I need you to get back. That's what happens, unfortunately, with these wounding situations. The thing that we were created for, belonging, connection. Oftentimes that gets coupled with fear. So that's a powerful thing when you get fear, intensity, Things of that coupled with belonging. You can have 10 different attachment styles, unhealthy attachment styles, if you will. But the commonality, the common denominator is going to be the insecurity. They may play out differently behaviorally, but it's the insecurity. Well, what does secure attachment look like, Jeff? Well, I don't know. I don't meet those people. But it exists because those folks have trust. And if we go back to the tree, I often think that the wounds or the roots that you keep referring to, it's really the story of my broken trust. How did my trust get broken? And here are all these things that I do ingeniously to handle that.

Peter Attia (24:04)

Jeff, when we examine ourselves or we examine or witness others, where one or more of the branches of the tree, I. E. The manifestations of trauma are present, is it your belief that that automatically implies there is at least one tie to a root? In other words, is there a scenario whereby these manifestations exist minus the injuring events?

Unknown (24:29)

I mean, I suppose anything's possible. But with the folks that I've met, crossed paths with, had the honor to work with therapeutically, there's typically always a connection. It gets so tricky because it doesn't really need to be an A plus B equals C. The science of this undoes itself, so to speak. When you bring this up, this question up for me, it brings up a stumbling block that I've witnessed a lot with clients within the spirit of or before they even become clients. And what I'm getting at is, nothing happened to me. I don't think about that. Why do I need to talk about that? And I honor that as someone's truth. And of course, the answer therapeutically, within the setting of somewhere like the bridge, is, okay, I believe you. So you won't have any trouble telling your story. It'll be a breeze for you. You got to roll with that resistance. But the example that comes up for me, and that's where we get into implicit and explicit memory. A good example, I think, is flashbacks. Go back to the example of something where somebody has an image. I think what comes to mind for most folks is an image. Like, I see this thing. So then back to this other person who says, I don't think about this stuff anymore. Like, I don't go into the room and think about my dad cheating on my mother. I don't even remember that stuff. And oftentimes the answer is, sure you do. What do you mean? Well, you remember through your anxiety, perhaps, maybe it's not an image. Maybe it's not a sound, maybe it's not a smell, but that thing, that discomfort that you're experiencing, maybe that's the way you remember it. Something that's coming up for me. And again, there's so many case studies, if you will, but within the spirit of making the implicit explicit, the example that I just gave, you know how that process works at the bridge after the group's over in the evenings, we usually have meetings where the folks can experience some type of maybe a 12 step meeting, some kind of meeting. And it's part of the curriculum, if you will, and it's mandatory. We've had clients have panic attacks. I would qualify some of those as that in these situations. The next day when you're in group trying to unravel something that happened on the previous night and we're talking about a client that I've been describing and they're like, obviously I need to see a medical doctor. Because I said, possibly you do. Well, let's try to work in a both and let's unravel this, this process. You give up a certain amount of control. Let's say this client had control issues. And so it's one of the things we ask you to do is give up control at the bridge. And client X says yes, yes, yes, that's right. So, okay, so you're sitting here and you know there's exits, you know the people are in the room, you know all the players are here. But for some reason you're anxious that your anxiety is building to the point to where you experience or you describe this thing as a panic attack. Right, exactly. And I don't need to talk about any of this stuff that you guys are talking about. I said, okay, great, but just play along with me. Who's the most controlling person that you've ever met in your life? Oh, you should have met my grandmother. Okay, tell me one of the most controlling things your grandmother may have done. Well, I lived with her for three or four years in my childhood. Now there was that deal with the basement when I was in trouble. The deal with the basement. Can you say more about that? I get locked down there. How long? I don't know. It was dark. I learned how to not think about it. Back to the implicit with explicit. So I think about this like files. There's this loss of control file in the traumatized brain. Can I prove that A plus B equals C? No, I can't. There's not going to be anything, evidence based that says that was a situation based on that grandmother's control and abuse in childhood. That is why that panic attack happens. But it certainly gives us something to look at. It's like coordinates on this war board, if you will, in there. Wow. There's a part of you that really gets activated when you seemingly don't have control and can't leave a situation. The hope that can come out of that. To see someone who could have been described as resistant to the process, all of a sudden, at least like you're doing right now, nodding your head, I'm going to start thinking about this. Maybe I'm not buying into it, but maybe something did happen to me.

Peter Attia (28:43)

Gosh, Jeff, I don't even know where to start. I think there are so many huge hurdles for people to get over when they at least begin to entertain the idea that this is something they should look at. So that's the first one. So the first one is there's something wrong. Unfortunately, as a species, I suppose we have so many remarkable layers of protection that we have to be suffering quite a bit to go through this. I go back to some amazing lines in my journal. No one showed up here on a winning streak. Like, I mean, I'm not gonna name who said that, but I bet you can remember who said that. I mean, could not be more true. When I think back to us all sitting there on day one, the 12 of us. I mean, what a collection of losers we were. I mean, if we're just being honest, we were all on the outs. We had lost everything. And we were there not because we wanted to be, but almost because we had no choice. How often do you see that? How often do you see people that somehow manage to show up there on the basis of pure introspection as opposed to, if I don't do this, I'm going to lose my family. If I don't do this, I'm going to lose my job. If I don't do this, I'm going to lose my life.

Unknown (29:57)

Well, what you just described, I'll call that answer B. That's the status quo. That's usually how folks get there. Every now and then someone may come in, maybe I could call it a tourist or whatnot. But that doesn't happen much, we would say. And if you remember how that property is, you kind of drive down into it and all the things that are Kentucky, you see on the way in. And we used to play around with this, like, this is hard work and this is uncomfortable, and if it wasn't, there'd be a line of people all the way Back up that hill, trying to get in here. But if you notice, there's no line. There's no line to get in here. And there's also no gate on this place, meaning you're free to go. Also, I use. It's just an average 7 or 8. When I think of groups, they could be 10, but I use 7 and 8. And I think about those folks in that room. There's so many different stories. Just about every group has got somebody in it that's pretty close, if not right on. Surrender. And surrender within the spirit of my way does not work. I don't know if your way is going to work, Jeff, but I'm willing to try it on for a couple weeks because my way does not work. Now, that is a wonderful place to get to that I believe most people.

Peter Attia (31:02)

Don'T, meaning most people don't show up.

Unknown (31:04)

There, don't get to that type of surrender. I spent many decades. This may sound familiar. In this space right here. Life's pretty bad. And I hear what you're saying, but I still think I know what's best for me. And I think that's where most of us spend a lot of time. But when you get in that circle, see, to me, that never mattered because if you were there, you had a chance. You had a chance to get some different perspective. And if you're not there, I think just about every group that I've worked with has had at least one person in there that's they're out of obligation just to get somebody off their ass and quite honest with you, to do the thing so that they can go back and say, I tried your thing and it didn't work. I've seen that quite a bit. But there's still a chance for something to happen within that group dynamic. If I tell somebody they're an asshole, I might just be saying that from Therapy Hill. And maybe that's the same thing that their spouse has been telling them. But if somebody in this circle that's living with you, eating with you, doing this uncomfortable thing with you, if they in some way let you know that they don't dig that thing that you do, I. E. The thing that makes you maybe an asshole. Hmm. Okay, so maybe my spouse isn't the only one saying this. Now, if you like it, I love it. I tried to retire from force and change on folks, but if you examine that, this person's letting me know they don't dig that either. Now I've got a chance to think about doing something different, right? And to pinpoint the explanation for why it is. It's hard for me not to do that. It can be so fruitful even with folks there that are have less than what I would call healthy intentions, because they do show up there.

Peter Attia (32:47)

You alluded to control. One of the huge impediments to people. I think making the journey to a place like the Bridge is that you have to completely cede control. So you show up and you hand over your phone and you go to your room, which is literally a room from a camp. You're sharing a room with somebody else, sleeping on a cot that's not comfortable and there's no luxury, and you're sharing bathrooms with a bunch of other people and they rummage through your books and they sign off on everything. I mean, I didn't bring any contraband, but I know that there was very limited in what I could bring. Basically. You didn't want anything there that would distract me. I don't think I could have brought books about F1 and sports or whatever. Talk a little bit about the control. I know many people who have ultimately gone to the Bridge, and this was the thing that made it almost impossible for them to go. And they had to fall to a certain level of pain before they would go. And I know other people who just haven't been able to pull the trigger. And I put myself almost in that situation, which is I can't go off the grid for two weeks, four weeks, six weeks. That's not possible. You don't understand the complexity of my life. Surely knowing that, you must have a very strong conviction for why it's required.

Unknown (34:01)

It's such a real thing too. It's true. Some folks can't do it, and we can't box ourselves into a world where we're talking about all the fruits of residential programs. But this doesn't have to be an either or thing. But within the spirit of that residential process that you described so many different ways that I love the titles that you gave the place the control. It's got vulnerability written all over it. I keep going back to that word, introducing vulnerability. We don't try to induce suffering, but distractions. You mentioned the word distraction. We want to take away as many distractions as possible. I don't pretend to know what you need to happen, what the magic's going to be, but I know that we got a hell of a lot better chance of it happening if you don't have your phone, if you don't have your cigarettes, if you don't have all of These things that help you disconnect because I need you to be present. And for some of us that's the vulnerability is being present where my feet are.

Peter Attia (34:56)

The one thing you didn't take away that I think if it had been taken, I'm not sure I could have gone was exercise. So I was still able to run at 5:30 in the morning in the woods and do some push ups and stuff like that. Had I not been permitted to do that, I might have lost my mind. Has that ever been questioned? That hey, for some people exercise is also a bit of a numbing distraction.

Unknown (35:16)

That's an excellent point. Each case is different. There's no one size fits. All this brings up to me, how many times do clients come to me when group breaks and everybody's going to the bathroom. They come up to me and they're like, what do I need to do on breaks or in the evenings? Like what am I going to do with this downtime? And the answer is some folks need to get serious. So they might want to pick up one of those books on the shelf and read a little bit in our library. Some people need to get serious and some people need to play ping pong. What might look different for you?

Peter Attia (35:47)

I did a lot of coloring.

Unknown (35:48)

Okay.

Peter Attia (35:49)

And I did a lot of dot to dot. You guys had a book of super elaborate dot to dots like a thousand dot puzzles that would actually make beautiful pictures. I never thought I could find something like that so interesting, but I enjoyed it.

Unknown (36:02)

One might say you had to disconnect and come to the hills of Kentucky to find a space to even discover that or rediscover that, that control thing that is such a player for so many. It's a human thing. It's not just a client thing, it's a human thing. It's like everyone I believe wants to have a certain sense of control. And most folks who have a hysterical reaction, as we say, if it's hysterical, it's historical to the sense of a lost piece of control. That's where we get back into. There's probably a precipitating event. There could be something that needs to be healed here. And that's tricky too. Healing versus integration. How can we integrate this trauma, this thing that happened? All these words bring up so much for me. But I do want to mention with control because again, it's case study. Everything is so connected to these in my experience, to the trauma. Let's take another client for instance. We're going to stay on this control topic. So let's Say this client comes into the group room and this client is getting ready to check in. You know how that thing starts? We kind of just say something to start the day. Then everything gets quiet until somebody gets nervous enough that can't stand the silence and starts checking in. Somebody always does it.

Peter Attia (37:21)

Can you describe what a check in is? Because it is actually a pretty interesting experience, and I needed a piece of paper to help me do it because I didn't know what the words were.

Unknown (37:31)

We try to let folks experience or start practicing letting their outside match their inside. And that sounds like a simple goal, and it is. But it's a complex scenario because, again, some of us have paid a price for letting our outside match our inside. And so that's really the spirit of the check in, is to get some practice doing that just rigorously, with as much honesty as possible. How am I starting this day? Where am I at right now? What's on my heart? Bringing the heart and head together kind of how I describe that. Some folks, it's very personal, and sometimes it's group dynamics. We want to introduce that. But again, it's. Let's just get honest. Let's get honest, because I think that's the beautiful thing about the group. And again, this scenario where if you can't do it with some yahoo at the bridge, I hope everybody's Facebook friends for the rest of their life. But the fact of the matter is, you'll never have to see these people again. So if you can't get honest with so and so or in front of so and so, how can you do it on the couch with the people that are closest to your heart? Because those are the people who end up being. If we want to fall back on the trauma word, our biggest trauma triggers are the people that are closest to our heart. Maybe I can build some muscle memory in being vulnerable in a scenario like we've been describing. So that's the spirit of the check in. The example that I'm given where this client is in this rocking back and forth, I believe I can take this client's pulse from where I'm sitting at. So I'm going to suggest that that client checks in first. It's kind of my job to notice something like that. They haven't said a crossword in my experience, in the first three or four days of their journey. I haven't heard them say the word hell flat out. That was a bunch of bullshit last night. Bunch of bullshit. Nobody told us that we were going to that place. I had to sit out there. I wasn't going. Nobody told us anything about that. And let's say this client, one of their calling cards when they approached the bridge was that they were really thrilled about, mentioned about nobody on a winning streak. But one of the wins, they're not void of wins. One of this client's wins, let's say, is that like their medication management finally was dialed in. I finally got their anxiety medication dialed in. And so this thing happened in. 18 hours later, I'm looking at this person having this response to. Literally what it was, was I didn't write on the board every detail that was going to happen that particular day, especially what was going to happen in.

Peter Attia (39:58)

The evening when you guys went to a 12 step program off site, Right?

Unknown (40:02)

Exactly. In this example, this is the type of reaction still 16 hours later. In this scenario, perhaps I roll the therapy dice if I have the rapport and say something to the effect of, well, at least the medications are dialed in. Perhaps there's an uncomfortable silence. That's probably five seconds, but it seems like five minutes. And then maybe in this scenario, we all sigh of relief because this pissed off client smiles and laughs a little. And knowing the journey, let's say this client a day later tells her story. And they tell a story about spending a significant amount of time with a spouse who was controlling and emotionally abusive. And the spirit of their relationship sounded kind of like this, get in the car, you'll know when you get there. Now, did this client have. Back to flashbacks of this. But there seems to be a file based on this trauma, based on this wounding experience that was able to push through the medication. So don't hear me saying medication's going the wrong way. But in this example, I think the discovery inspires hope in a situation where there seems to be so little hope. And in this scenario that I'm making up, what's the answer? Do I just keep upping the dosage? Well, that thing happened to me, so that must mean. Is that the answer? So back to this both and of maybe there's something to look at here.

Peter Attia (41:30)

I think that's profound, actually, because you could argue if you simply look at that experience and say, I need to up the dose, up the dose, up the dose. I mean, at some point you're going to be comatose. So in other words, there probably is a dose at which there will never be a breakthrough. But then you're also not alive. So maybe we're better off, as you said, taking this as a gift, saying, wow, the fact that I got hysterical is now going to point me to something historical that I still need to go and resolve.

Unknown (41:56)

Maybe there's some work that can be done. Maybe I do need to be on medication to get stabilized. Maybe the medication will help me be stabilized enough to build the window of tolerance that I need to do this type of historical work. But there's also some work that can be done, and we're not just treating symptoms.

Peter Attia (42:13)

I'm going to day two of my journal here. I can't help but feel like it's a mistake to be here. How could this place, this experience, possibly make a meaningful difference in my life? Trust the process, they say. Surrender to it. In quotes, I'm told, okay, I'm here, and I guess I'll try. That was day two. I didn't journal until I got to the bridge. And now it's reams and reams of journals that have been filled since. What fraction of folks show up there with a journal do you know?

Unknown (42:43)

20%. And now that number goes up oftentimes, the way you just described it and finding out something different, a different way to do your day. It is an artificial environment, one could say, when we're talking about the bridge. And also it's a metaphor for me in real life. It's not just these therapeutic interventions or what some group member says or what some therapist says. Like, all those things can be powerful. But, like, what are the things that you added to your day? And how can you take that back with you doing your day different, Checking in with which me's in the driver's seat? Journaling is an excellent way to do that. Or just simply some mindfulness and some meditation and life's busy. We don't always have time to do these things. But take a minute. Which me's in the driver's seat? That's the question.

Peter Attia (43:34)

So let's talk about the different versions of the kid. There's the kid that's born, the unwounded child. Remind me the name of that child again.

Unknown (43:42)

The inner child.

Peter Attia (43:43)

Inner child. Yeah, that's right. Okay, so inner child.

Unknown (43:45)

Some folks will refer to the inner child. Some folks prefer the original child, the original me, Authentic me. But yes.

Peter Attia (43:53)

And then we have a wounded child that goes through this experience or these experiences. Again, very important to remind everybody this could be a bunch of little T's, none of which look like much. It's too easy, I think, to look at the big T's and say, I don't have a big T. Could be that the sum of the little T's actually matters more than a big T in some individuals. And then you have this adaptive child. So the example is that kid who figured out that by being deceptive he could protect his mom. That was the right thing to do. I mean, clearly the right thing to do. He should do that all day, every day.

Unknown (44:29)

Yeah. The more time it's done successfully, the more power it takes on. Yep.

Peter Attia (44:34)

And then talk about some other examples of how these adaptations that occur to trauma are really valuable. And then they start to become net negative as opposed to net positive. This to me is the Darwinian nature of trauma. We're such resilient, adaptive creatures. The case of this kid. Right. That's brilliant. That's adaptive. That's great. All the things that we do to not succumb. Maybe just share a few other clinical examples so that people get a sense of how insidious this can be and why. When that kid is 30 and he's in a relationship and he's misbehaving and manipulating his spouse who's not his father, it starts to backfire.

Unknown (45:21)

What it brings up for me so many things, but this concept that I prefer, that's not going to sound very clinical at all. It's grit. Grit is something that I think we all have. I think we're all born with. And you talk about this wounded child and these wounding events, these something happens and a lot of us out of that, our grit gets covered up. And so I've met so many people that to survive, they did it by submitting and so losing their voice, becoming compliant. To spend decades trying to find their grit while another human being out of their woundedness may have survived from grit. And they live from it. They can't not live from it. And they live from it from decades. And so the question tends to be at what cost? At what cost? When does this thing there was a utility to when is it enough? And I always fall back on. It's not typically the thing that's bad. It's not the fact that I can do it. It's the fact that I can't not do it. It seems like I can't not do it. That's where that takes me with the utility. And when you mention the big T and the little T or those thousand paper cuts, it brings up post traumatic stress and complex post traumatic stress. And in no way do I want to minimize what we or a lot of us would describe as big T traumas when we talk about those tragic event, those one time events. But in the spirit of unraveling things and the healing journey and integration. As a clinician, I would prefer not that this human had to go through that. But as far as there's that thing, there's the thing we need to work on. I know there's several interventions that have been very successful working on that thing versus this other thing that again, going back to the example of the child with neglect and every single day going to school knowing for three years that he was going to be bullied and knowing that no one was noticing and so having to develop something to survive that living in limbic activation. Just think about that. And so how many times, how many years that muscle memory created of going back to the parts language or of that guard of that adaptive child. Unraveling something like that is a whole nother ball game. Please don't hear me minimizing big T trauma. But within unraveling in the integration, it's just repetitive. In these limbic systems, we only know what we experience. So abject abuse. I've heard horrible stories. You've heard horrible stories. But let's take a child that knows that when mom gets home because of what's happened, her ear is going to be held to the burner on the stove. Abject abuse. Let's take another child that knows there are portions laid out on their plate that will be eaten in a certain way, in a certain manner, at a certain speed. And after that meal they will be weighed and their side will be pinched. And should things not be as expected, there will be a lecture. Who's to say which one of those humans are more limbically activated? The one doesn't know the experience of the other. It's helplessness. I can't get out of this thing. This thing I'm getting ready to have to do. So again. How can I survive it? And how many times does that happen? And how many years does that take place? And then we get frustrated and we have the shame bug that goes along with it because we're back to the what's wrong with me? Why can't I not do this thing? I know this thing's not serving me well now, but I just can't not do it. Yeah, the utility of the behavior.

Peter Attia (49:18)

How do you differentiate for folks, the difference between shame and guilt? Because for many people, when you show up at the bridge, there's a component of something that you've done that's wrong. You've hurt people along the way. Again, that's I think, part of the hitting rock bottom that gets you there. It's not Just that you've hurt yourself, you've probably injured others, and that's a part of this maladaptive behavior that's now spiraling out of just being adaptive. So how do you talk about the difference between guilt and shame? And how do you work somebody out of that?

Unknown (49:51)

Guilt's about making a mistake. Shame's about being a mistake. Guilt. I did something, I made a mistake. I did something that I wish I hadn't have done. I need to make an apology. There's a way back from that. I'm thinking of this classic John Bradshaw. He's talking about healthy shame versus toxic shame. When you talk about a difference between guilt and shame, we're talking about toxic shame. There's something flawed, this flawed, defective core, if you will. My identity. There's something wrong with me. There's a way back from the guilt. Shame registers differently. So when we talk about folks being wounded, shame, and that's how the shame gets registered. Somebody once told me that my father never had to get sober because he had me and my mother and my sister to carry. A shame for him can be a generational thing, and it comes from somewhere else. But shame can play out two different ways. Some of us, when we're living from our shame, we live out of superiority.

Peter Attia (50:54)

Grandiose shame, Grandiosity.

Unknown (50:56)

I control, I perfect, I judge, I criticize. Out of my woundedness, out of my shame. That can be the me that you see on the outside and some folks. The other side of that coin, of course, is inferiority, broken, worthless, and my pathology.

Peter Attia (51:14)

Why do you think one chooses preferentially one of those? I mean, I know that my tendency is always more towards grandiosity than inferiority. What do you think it is in some individuals that steers them one way or the other when they're in that. And by the way, I love that these are. I don't even say this to be judgmental. I just think that this is a really interesting way to observe. But I know that when my inner monologue becomes more judgmental, that's a great yellow light for me. It's like, oh, look at the judgy words you're using. Look at the black and white thinking that permeates every statement that you're making. That tends to be the gravitational pull. Why do you think certain people have that?

Unknown (51:49)

That thing you just said is the thing, though, that I can't not hold focus on. That little conversation that you just had with Self. Now you've done the work. You're still doing the work. I'm looking at the journal sitting in front of me. That's just a portion of the work. But having that voice that you've obviously cultivated, that's where the hope is. Because, again, to live in simplicity. I say, I hate to oversimplify, but I don't. At the end of the day, I got bad news for the folks out there who think that there's going to come a time through my healing that I just never get triggered again. Especially those of us who have experienced trauma. Bad news. You will be triggered again. And this whole integration game is about starting to live a life where I tell stories that go like this. I noticed that I was starting to be really judgmental. I noticed I was getting triggered. I had this little short, subtle thought conversation, whatever that looked like maybe there was something somatic that happened with my body that I did, but I had this thing that I cultivated, this new muscle that gave me enough space to choose my next step. When so many of us, especially out of our shame, out of our trauma, have lived a life telling so many stories that go like this, I got triggered. And then I did this. And that's the reaction versus the response. Simple goal, complex process.

Peter Attia (53:16)

Yeah, absolutely simple and complex. Never to be distinguished. There were a bunch of interesting rules at the bridge. No minimizing. You got to stand up to get your own Kleenex. Tell me again some of the rules and the reasons behind them.

Unknown (53:32)

First thing is trying to create an emotionally safe place. If we can create a space where folks feel like they can let their outside match their inside, then we got a chance for the magic to happen. Learning a new language. One of those things is I statements, where so many of us want to make statements for the world. The we. It's a lot easier to address someone's behavior when we're. We're tired of this or we're tired of you doing that. How many times a client may come up to me and say something to the effect of, when is somebody going to say something to peter about being 10 minutes late to group? You were never right. But hear me out here. And the answer is, I think the appropriate answer is we're wondering the same thing. Because if I say it, it weighs about 10 pounds. But again, within that group process, if another peer going through this rigorous journey with me says it, it tends to weigh a little bit more. That Kleenex rule you mentioned that there's so much that comes out of. I don't even know what a box of Kleenex costs nowadays. Used to say 99 cents, right? Like, so much can come out of that. How hard it is for some clients not to give somebody a Kleenex. You can have the best of intentions in the world, but out of our woundedness, our trauma, our shame, so many of us, the commonality is professional feeling stuffers. A lot of muscle memory and stuffing emotions, especially sadness. And so the very act of handing someone a Kleenex can cut off something that maybe have been 25 years in the making. And there's so much more that can come out of that, because for the person who's having the emotion, I think about my healing journey that I'm still on and, like, out of my codependence, like, I expected a lot of people to read my mind. I don't ask for what I need, but maybe I'm sitting there thinking, why the hell isn't somebody giving me a Kleenex? Can't they see him crying? And the answer is, because you're a grown man. You need to ask for them and go get them yourself. Jeff. And is the person rescuing me from my pain or are they rescuing themselves? Language that feels guilty. Part of those rules. Back to the I statements and learning how to have. I'm not crazy about the word confrontation, but, like, it's group dynamics, so I need to let my outside match my inside. So how can I tell another human being that I've got issue with this thing that they're doing to learn how to say I get angry. When you check in every day as if you love this place, and then on our walks in the afternoon, you're making fun of the process and you're making fun of the therapist and you're talking about the sick behaviors you're going to do as soon as you get back home. I didn't grow up in a house where we talked like that. When you. I feel. It just feels clumsy to. Again, to create some new muscle memory and to listen, to be able to listen to somebody, we ask for folks to be present. That sounds like present and supportive. Sounds like the easiest rule. Why would you have to explain that it's hard to be present when you're not in the room. That's why, if you remember, we take breaks as a group. We try to take them every hour, every 50 minutes. But sometimes, you know, we always encourage the clients. If you need to answer the call of nature before then, just let us know and we'll take a break. Because it can be also really handy to go and use the restroom when Jane checks in, because Jane gets underneath my skin every day and brings up something for me that I need to say out loud. So the rules are there to create, hopefully the safety so that the magic, if you will, can happen. And also to give folks a chance at some new muscle memory. And I encourage clients in these scenarios. Start it off by acknowledging you're taking a risk. I'm getting ready to take a risk. Peter, I need to say something to you. And that's the spirit of the rules.

Peter Attia (57:16)

And what about minimizing? That was a very interesting rule.

Unknown (57:19)

Yeah, it's an ingenious damage control strategy. Back to the utility of behaviors. If it wasn't that bad, then I don't need to address it. But my behaviors also affect other folks. So when I minimize, let's say, for example, a client, like, it doesn't matter, I got abused. So what? A lot of people get abused. You get over it. It didn't have any effect on me. Doesn't have any effect. And another client, hopefully using some healthy language. When you speak as if child abuse, especially physical child abuse, doesn't affect the child, I feel sad and I feel angry because you've got a right to your own truth. But I know how much that abuse affected me. So that minimizing, again, it's very adaptive. But also, if it didn't matter, if none of this stuff matters, I just am. And I think you've proven the theory, something's wrong with me or nothing's wrong with me, Superiority or inferiority.

Peter Attia (58:22)

How many folks find themselves in a situation where. And I say this because I definitely had a bit of this feeling myself and I can't imagine I was alone, where there's almost a reluctance to get better because there's also a belief that, yeah, I get it, my life's a bit messy right now and my response is spilling out into bad areas. But look at all the good. I remember in particular, one of the rants I went on was about how much good has come from my trauma. I think in telling my life story, it was virtually all good. It was, look at this good thing and this good thing and this good thing. And like, we don't want to erase any of this stuff. And I suspect you have a number of people who show up. And yes, it sounds ridiculous because on the one hand there's clearly a bunch of things that are not good, but they're sort of like, maybe that's a reasonable price to pay in exchange for all this other stuff. How do you help people think through that process and what the trade offs.

Unknown (59:19)

Are when you describe that scenario, it's like it was your fuel. I'm using the language of parts, or guards. I call them guards, these protective parts, these protective adaptive behaviors. I've looked at many folks in your example, it would be, thank God you've got your ambition. Thank God you've got grit. Thank God you can get angry and you've got a voice like, I don't believe I would have met you if you didn't. And I'd say the same thing to somebody who was an alcoholic. Thank God you had that then I don't think I would have met you should you not have had that. But now, can we look at this thing and can we just at least look through the lens of is it making life hard an important thing for folks to remember going into, am I going to do the work? Do I need to do the work? Am I working on a part of me? These guards, these protective parts of self, we are not necessarily trying to retire them. And that's what happens, I think, to a lot of folks, that part of them, there's almost a fear of, like, how do I exist? Does that mean that ambitious, at times, perfectionist Peter has to go away? Think of folks who go through life out of their woundedness that we might describe as they're always waiting for the other shoe to drop. I mean, I can think of clients, multiple clients, who have said, it's not if it's going to drop, it's when and how loud. So they are really good, detailed at finding negativity, at finding danger. And they'd be a hell of a good person to have along on a walk in a bad side of town. I'm sure if they were a building inspector, they'd be the best damn one out there. Okay, but can you not do that thing when you go home and sit on your couch and back to the process and the vulnerability. The vulnerability can get brought up so many different ways. We keep talking about this group process that you experience. There's so many different ways, but the common denominator is the vulnerability is what triggers this protective side, this protective behavior to step in. And when that happens, we can work on it in real time. Should that person be in at least consideration of doing something different? Every time I see you reading your journal, I think to myself, what must that be like?

Peter Attia (61:31)

It's surreal, actually. I'm looking at a note. This must have been about day four, though. This is day five. We went to 12 step meetings every night, and I found it very difficult and awkward. I Didn't understand why we were doing it. I don't have a drinking problem, why I'm at an AA meeting. I don't have a sex addiction problem, why I'm in an essay meeting. I don't have a drug problem, why I'm at the Narcotics Anonymous meeting. It just kept going from one to the next to the next to the next. But I wrote something here. I said the essay meeting last night was amazing. Three men shared painful, shameful stories. One of them said that he was getting. I can't even read my handwriting. Something his wife said. Things about him and his kids. He was losing his family, right? He was losing his wife, he was losing his kids. And he was so upset. But his sponsor told him that he had no right to complain about how his wife feels. I found that very powerful. And it was like he was taking responsibility for his action. And this was interesting because I remember walking into that meeting kind of thinking, good lord, another one of these meetings. How many of these things do I have to sit through? People have to remember too. Like we're doing these meetings in a part of town where you're seeing people on the wrong side of the tracks. You are not looking at the affluent part of society showing up to these meetings. You're really seeing people who are hurting beyond just, this is my dirty little secret. How many people have the same reaction I do initially, which is, I'm not a fill in the blank addict. Why do you keep making me go to these meetings every night? By the way, I've already done 12 hours of group therapy. Can't I just go to sleep?

Unknown (63:15)

Just about 100% of the folks whose survival strategy is not substances. As far as that type of reaction, what am I gonna do during the 12 step meeting? Well, you're going to hopefully sit there and get something out of it. You're just going to take alcohol and put in caretaking, put in control. Fill in the blank with your word. Helping folks wrap their brain around they're having an area of powerlessness. It's not always well received at first. For example, let's say that the client's there because he's married. Let's say he's married to an addict. Okay? Wife's an addict, he's considering the same thing, she's the addict or whatever. And so within the spirit of sharing, maybe not in the group, maybe it was overheard, but anyway, the information comes out that this husband talking about his teenage daughter and going through the laundry, found birth controls. So discovers that teenage daughter is on Birth controls. And so the first words that come out of his mouth, what if the people at church find out? And so when you can in some way try to help someone, use a different lens, one would say, and I would say this one might say that you're no less powerless to your image management than your wife is to alcohol. Because you can't get into couples therapy. You're not going to not go to church on Wednesday night and tell the people that you're married to an alcoholic. So the area of powerlessness is image management. So back to that meeting. You're going to fill in image management in that blank where everybody else or some of those people have got alcohol and some of those people have got cocaine. Again, to tell someone that they've got an area of powerlessness or to suggest it is not always received well initially, but it can be an aha eventually an aha moment.

Peter Attia (65:12)

So if I recall, Jeff, the end of week one was when we do.

Unknown (65:15)

Our story right, depending on where you were in the order, but yet tends to be the last few days of week one.

Peter Attia (65:22)

Talk about what the instruction set was for each of us as we went off and prepared to do that.

Unknown (65:27)

The guidelines that we would typically give folks, we always suggest that the clients write something out, bullet point it. We ask that the story be told within the framework of the trauma tree. These stories don't need to be void of success and great moments. And if it wasn't for my grandfather and that stuff, there's a thing we're here to focus on as well. So the what happened to me and that we'd be given 45 minutes to tell your story. And we try to stay out of the way as much as possible unless it's therapeutically necessary. Some folks rescue would be the wrong word, but some folks can get going down the rabbit hole of dysregulation with their emotions and going into detail. So that client may need a little help moving forward, whereas another client may machine gun through a story that's ingenious too. Don't have to feel it if I don't stop. And we might need to slow that client down. But the essence of the story, again is just to tell the what happened to me. And then I think where the real magic can happen is during the feedback because you get 45 minutes to use your mouth and then we ask you to use your ears. And we ask folks to play by one more rule, and that is please do not give feedback to the feedback. And we're back to the control word because I've got this thing I'm ready to present. Perhaps I've presented it 10 times and I've got it written out or I've at least got bullet points. So I feel good about no problem. But you start telling me how you felt and what came up for you. Peter, when I was talking about my dad and what he did, I don't know how that's going to feel for me. And so many times, almost 100% of the time, within the spirit of not giving feedback to feedback is feedback equates to, I'm going to throw some love on you. Maybe I didn't have anything in the world common with you, but when you talked about that thing at 8 years old, I felt myself getting angry. And that's how somebody lets somebody know I was listening to you. I was there with you 90% of the time, at least. And it's so hard for folks to not give, to just sit there and let somebody share from the heart and to not give feedback to that feedback. But so many times it's like, well, my brother had it a lot worse. And it's like I just throw my hands down and I'm like, it happens almost. That's why we do it. It's like somebody throws some love on you. And it's almost like out of my shame and my woundedness, I need to remind you that I'm a piece of shit. It happens so often.

Peter Attia (68:05)

How do you break that cycle? It's very, very difficult.

Unknown (68:09)

A lot of folks, they think that change is about announcing what they know what they're about to do. I know this is going to sound codependent. Well, if you're firing on old pistons as a therapist, the response should be, then don't say it, because there's enough muscle memory there. We need to practice the uncomfortable thing of not saying the thing you've been saying for years, not doing. I'm the last person to be black and white about many things. I think much of my work with clients individually, in groups, what have you with human beings, is finding the gray. But I tell you what, when it comes to compulsive behaviors, complex post traumatic stress, these things that we've been doing for years and decades, I'm either strengthening an old connection or I'm building a new one. When those clients say, what should I do when I leave this group room? Do something different and experience what it's like to do something different. And so many times it's not doing something. I mean, we've took the vacuum cleaner Away from clients before. It's an ingenious damage control strategy. It's written all over the walls. We're here to talk about some deep stuff, and I'm finally going to be expected to talk about my stuff. We've encouraged other clients to break rules. Some folks at the Bridge might not like that, but it's like, you need to go take some coffee into the morning meeting. You've been a rule follower your whole life.

Peter Attia (69:28)

Yeah, we were only allowed one coffee a day or something, right? Yeah.

Unknown (69:31)

That's not much. From what I understand, it's not the strongest coffee in the world either.

Peter Attia (69:38)

You do a lot of work now with clients individually as well. I wonder how that is different. I've recommended a number of people go to the Bridge. I've recommended a number of people go to PCs, a place I went to three years later. And taken together, those two places changed my life. And one of the things I've said when people ask me, yeah, but, Peter, it's just such a huge commitment. Do I really need to do it? I don't know the answer to that question. I'd love to hear your thoughts. But what I do say is, for me, in the state that I was in, it could not have been done any other way. I had to have immersion. And I say, I suppose it's not unlike learning a new language, where if I decide I want to learn Portuguese and I'm willing to take lessons two hours a week, I'll get there. But if I move to Brazil and no one speaks English to me for a month, I think I'm going to get there a lot faster. And it's not just the sum of the hours. There's something accretive about the total and utter immersion, literally, in the experience that changes it. So how do you think about the difference between the work you do and have done at the Bridge, which is indeed what we're talking about here, this immersive, residential type of treatment versus someone who's listening to us that says, I hear everything you guys are saying. I just can't do that. I can't go there yet. Is there something in between? Can I start by working with Jeff just an hour or two a week? How does your work with clients differ? And how do you help somebody decide? Maybe I'll start with this question. How would you give somebody the way to think about whether or not they could find some success in individual therapy versus whether or not it's really just rearranging the deck chairs on the Titanic? You gotta go hardcore yeah.

Unknown (71:30)

So the answer would be yes to the can I do this or can I do that? Yes, because it's not a linear path. Whatever it takes, whatever works. Before I started doing this gig, before I found the Bridge, I never thought about doing anything residential when it came to mental health and being a professional, being a therapist. And then all of a sudden, I couldn't imagine doing it any other way. Couldn't imagine doing it without the group process, because all those things that I'm talking about, there's so much access to vulnerability. And let's not box ourselves in, because some folks, it's their truth. Some folks, they can't. They just can't go do something like that. The way that it's changed the way that I approach the individual dynamic, the individual therapy efficiency, not a rush, but I think that through all of the years and all of the clients within the group process and how I see that works and to be able to somehow synthesize that into my individual assessments and the way that I can work with clients, that discovery process doesn't have to be as long as sometimes it plays out to be so within the spirit of the individual process. It's like we may reach a point where it's like, here's the next level. But the same could be said on the opposite side of that coin. Somebody might be like, I'm going to a residential program, and then they find out all this stuff, and we can take that and integrate that into the individual therapy. Practicing individually would have looked so different 10 years ago because of how the trauma, it's no one size fits all. And so to think that this intervention needs to be used because it's my specialty, or this has to happen, or this is exactly how long it takes for someone to have a window of tolerance. Every human being is different. And I haven't seen everything because every Tuesday at the Bridge will remind you of that. But I've seen a lot. And so my hope is that most people that I meet, or I have, I have met so many people and continue to meet them that you've described them. When you talk about folks like, I've got a lot, if you want to call it high functioning, I've got a lot, but there's something missing. Now, they won't all say that initially, but that tends to be the truth. There's still something missing. There's a hole there. Something's just not right.

Peter Attia (73:54)

So why are they with you? Meaning from their end, from their standpoint, why are they seeking therapy if it seems all Right.

Unknown (74:02)

Well, it could be because they've just discovered, been exposed to something that happened to let them know. Maybe not. Oftentimes that client that I just described may have got to see me to get somebody off their back. Like, you need to go do some work. You need to go get some help. You need to get to go help. And then it becomes pretty evident whether the person's there for that reason or for something a little more authentic and for self. I think part of my paperwork should also include Jeff English cannot fit a square peg into a round hole, which oftentimes translates into, I can't change somebody else's behavior. In your life, you see that a lot, too. This person that has finally gotten to a point to where they have been willing to go talk to somebody. And so that is so often the people that I'm seeing.

Peter Attia (74:50)

One of the things about the Bridge that I assume it's still true, but it was remarkable to me was that everybody who worked there had been a client there. Is that still the case?

Unknown (74:58)

Outside of some staff members, Certainly all of the clinicians, most of the staff members. And I can't imagine being a clinician there or working there without having done that. And that honestly, has been the reason why some folks won't work at the Bridge. So we don't operate from therapy Hill. Right. I'm in my own journey, too. I've got my challenges as well. Yes. And so to know I'm going to have to do some work. And then to wrap your brain around, these are the people I'm going to work with. To be able to look at a client like yourself and say, I'm literally not going to ask you to do anything that I haven't done. And to be able to say that.

Peter Attia (75:38)

From the heart, that's really an amazing feature. And I sort of imagine that through the lens of anyone who takes care of another person. It's sort of like people, I think are right to be frustrated when they have a doctor who's asking them to take care of themselves. When the doctor clearly doesn't take care of themselves. How is it that you can tell me that I need to eat better and exercise? When looking at you, it's clear you're not doing those things. It doesn't mean that the advice is incorrect or that you shouldn't listen to it. It's just you're asking me to do something you won't do. Whereas, yeah, at the Bridge, we can talk about some of the other things that are very difficult to do there, such as in the second week when you're beating the shit out of things, those are not easy things to do. But to know that when Jeff and Julie are asking you to do it, they did it.

Unknown (76:22)

Yeah, absolutely. And if you think to the way the journey starts is we disclose and some professionals will be like, be careful with self disclosure. It's not about me, it's about them. But like, hey, we're going to ask you all pretty quickly to start showing us a piece of your soul, so to speak. So I'm going to tell you a little bit about mine. Hopefully we can start building that rapport early. I think we can trust these folks. I think that they can lead us. Maybe not everybody, but like to introduce that because like you say in week two, we ask folks to go places with us that experiential therapy. And you mentioned one way of doing experiential therapy, the somatic part of what we do. But things have come a long way within the spirit of that process. And when you talked about that, learning a language, I love that analogy because you are immersed in that. But it's being able to experience the emotion, hijacking, if you will, of the emotional brain. I liken it to we're going to walk you down to the edge of the river and we're going to put your foot into the water. Now, the water being here, your past, your pain, right? Because we want you to feel a little bit of the temperature. But we're going to stand here right beside of you and our job is to keep you in 20, 24, 25, whatever year, we're going to go there, but we're going to stay here. Dual awareness, that's the integrative part. Some people need to yell because they haven't had a voice. Some people need to learn that they yelled and they were able to not get lost in it. Everybody's journey, being different and befriending. It's almost like some people say, well, I can't put my finger on what it was, but I just. Something was different. What is it that you did? I said, well, sometimes you might say we were activating your limbic system so that you could do something different while activated. Learning how to get space from the emotional brain. So many clients, especially clients with trauma, years of frustration, learning coping skills in safe offices with therapists, they're done beautifully and repetitively within that environment. But it's really hard to recreate that back at home or at work when triggered. My coping skills live in a part of the brain that gets hijacked when the emotional brain takes over. And this doesn't always have to be about trauma. Can you believe I'm saying that? The example I give, I'm a professional, right? My mother's 87 years old with dementia. She's living in a nursing home. All the things that go along with that irrationality that's involved with that. And so Jeff goes to these visits, and he starts noticing that all these visits are starting with my mother talking about how somebody is stealing her blue ink pens and what I call her old lady blue jeans. And so I'm sitting there saying, are you kidding me? Who would want your blue ink pens? Think about this rationally. Mom, who wants these old blue jeans and how many of my visits? That's how that visit started. It just went downhill from there. To literally be sitting in the truck outside before a visit, praying, give me what needs to happen here. And so many times as clinicians, we ask clinicians, you take your hat off, take your therapist's hat off, but sometimes you need to put it on. Because Jeff the clinician is not sitting there in front of his mother. There's a son sitting there in front of his mother who is facing the reality that it's not his mother anymore. And that's very sad. The anger is a much more comfortable place to be, or frustration. So I'm going to argue with mom about how irrational this thought is, right? But it's breaking because I don't want my mom to think that people are stealing her blue ink pens. I want her to change. I want this to be corrected. But I'm forgetting, like, one of the golden rules of change when it comes to therapy rolling with resistance. The more that I fight for change, the more this other person is going to fight for the status quo. It happens 99% of the time. But when you sell crazy back to somebody tenfold, they start to suggest rationality. Here's what I mean by that. One day in that truck, I realized, I have got to do something different, right? So I'm going to go in there. And when I went in there, I went in there with my executive functioning. I went in there from the prefrontal cortex. And so when mom started talking about her blue jeans and her blue ink pens, my response was, you know what? You're right. And I think I know exactly the lady that's doing it. I'm going to go give her a piece of my mind. And what did my mom say? Jeff, sit down. Be sensible. Right? I didn't have access to something that I do all the time with clients selling crazy back to him. You go home, you'll get your cigarettes back. If you're talking about the bridge, you'll get your cigarettes back, you'll get your phone back, you'll go back home, you'll go back to your perfect girlfriend, and life will be okay. And no, I didn't say life's okay. All right, well, then we got something to talk about. You got to stay here. You're going to die if you don't change. They just fight. They just fight. Fight for the status quo. But that Jeff that I was talking about, I didn't have access to those skills. I wasn't being driven. Now there's all the baggage, there's the bee in the son, there's the trauma related to mom. There's all of that that played into that. But to be able to get access to the. What some folks call the bill paying brain.

Peter Attia (82:08)

What year were you a client at the bridge?

Unknown (82:11)

2016.

Peter Attia (82:14)

Okay, so only a year before me. So you'd been a therapist obviously for many years before. How did you find the bridge?

Unknown (82:23)

It was an email that I probably wouldn't have read. And there was an opening, and a mentor of mine sent me an email and said, I know your story, I know your background. I think you ought to check this place out. And to grow up somewhere like that, Bowling Green, Kentucky, and to not know this place that's existed now for 50 years, it says something. I had a certain mindset about what residential therapy would look like in residential treatment. And, yeah, so I was just blown away and privileged to be able to do the work. I mean, it's a gift. I talk about folks not wanting to do it and sometimes that being the reason that they won't join the team there. That's a very true thing. I wasn't crazy about doing it either. I knew there was stuff that I was still working on and will still be working on, and it was going to be very vulnerable. In one way, I was like, this is an audition. You want to know all my crazy? And they're like, yes, we do.

Peter Attia (83:18)

What is it that attracted you to this field?

Unknown (83:21)

I've done a lot of different things. Sales, marketing. I used to build fencing. People would say, oh, really? Like jousting? I'm like, no wooden chain link fences. Let's not go too far with that. I did undergraduate in psychology, and then there was that gap in between me determining and realizing that this is what I need to do. The self discovery part, for me, it was like Starting to do my own work and then realizing that to see someone get a taste of hope, to see somebody get a taste of hope, and to be part of that. When I tell clients, you know, it's like you've got it in you. Maybe I can create a space where it can come out. It's a privilege. I don't take it lightly, what I do and what clients trust me with.

Peter Attia (84:07)

I think you have a really special talent for it, Jeff. And I just wonder, is that something that only comes because you've experienced the pain as well? Does someone have to have necessarily been through this journey to be able to guide someone through it? Do you think that's necessary?

Unknown (84:25)

I don't think it's necessary, but it sure as hell helps. I'll say that. The depth of the connection with the heart and the work, because it's one thing to say my profession, I've got purpose. I could say I do something that matters, but does that thing matter to me? And it does. Me personally, I think the weight of that purpose is from the pain, in addition to the hope. Having that type of impact to where I feel like I heal a little bit each time I help somebody integrate their trauma. And I've had some amazing things happen in the group room. I'm human. Certain things that I've done in the group room, I don't need to be doing my therapy while I'm leading a group. But certain things that I would do on, like, art therapy or something, I use the same scene on the board that I use time after time, because, again, that's something that I've tried to unpack and process, and I don't need to be doing anything new and then to be sitting there and because of something that happened in the group room, or maybe it's where I hadn't realized that I look at that scene that I just drew on the board differently. And it's personal with trauma. And we talk about how it's shame, like it's something that's touched my family. Unfortunately, there's not much of that family left. My sister passed away in 2014. She grew up in the same house that I did. And so piece of my heart's connected because it doesn't have to go that way.

Peter Attia (85:53)

You alluded earlier to the generational nature of trauma. Terry Real has written about this in some of the most eloquent ways I've seen. And I think that for some people, that can be the motivation to change once they realize that there's a pattern and that it's not linear. If you have a belief that it's linear, then it's really easy to say, well, I've already stopped it. So, for example, if your parents were alcoholics and you're not, well, the story's over. I don't need any help, regardless of whatever other behaviors I'm manifesting. But if a person can accept that, no, that's not how it works. There could be this type of trauma in generation G2 that manifested as a different trauma in G minus one. And now here in G0, where you are, you have this blind spot to what's going on. I know that for me, that was among the most powerful motivations to stop the cycle, as Terry described it. How much do you think that that factors into people's willingness to kind of endure the challenges and discomfort of the journey?

Unknown (87:03)

Oftentimes it becomes pivotal in willingness and in that surrender game that I mentioned, because I think as a parent, one of my jobs, or the most important job is, in my opinion, that my children go to bed and wake up safe. They don't grow up in fear. I have a lot to do with that. But like they tell you on the airplanes about your oxygen mask, you gotta have yours on first. At the end of the day, being a parent, you mentioned about why I do what I do and what I get out of it and whatnot, and to know my clients on a different level. Because doing the work is hard sometimes. At the end of the day, when you need to have that hard discussion with somebody, when a boundary needs to be set, when conflict resolution in a relationship needs to happen. Some days when people finally go to bed and the house is quiet, you just want to watch Netflix to understand, like, what happens and what can happen is, is that you put off these things, and things start to build, and they build and they build. And then when the levy breaks, I'm the worst version of Jeff. If I let that happen. What about that generation? What about that next generation? It's responsibility on a whole different level, but a gift, too. A misconception. You were describing of, well, at least I don't drink. At least I'm not an alcoholic. So that means that I'm not as bad as my parents and there's no work to be done because there's so many other ways that I can have an unhealthy impact on that next generation. But to be in that place of, okay, this is it, this is it, and I have the opportunity to change this thing, in my case, reverse the cycle.

Peter Attia (88:48)

You must encounter A lot of people who have these socially acceptable maladaptive behaviors. In many ways, it makes it even more difficult to reconcile because society is externally sort of patting you on the back for your workaholism, your perfectionism, your achievements, and all of those things. I don't know, is one pattern, in your view, harder to address than the other? Or is it all about the individual? In other words, if you think about the individual characteristics. Characteristics, the manifestation of the trauma and the nature of the injuries. Those are three things that are all blended. Do you try to disentangle those when you're working with people and pattern recognize? Or do you just say, nope, every person's a clean slate. And we're just trying to figure out how those three things fit together.

Unknown (89:34)

That's a place I try to operate from out of, I think, my humanity, our humanity as clinicians. There's client files. I've seen this. We've seen this one before. And sometimes it needs to be said out loud. Some people need to hear, you know, you know, I've seen you before. Right. Not always appreciated, but sometimes it lands for me.

Peter Attia (89:54)

That's a very calming message. Actually, the. You know what, Peter? You're not unique here. There are lots of people like you out here. It's really easy to think you're the only one.

Unknown (90:06)

Yeah. And amazing to wrap your brain maybe around the fact that that's actually calming. It's nice to know there's certain interventions that tend to go along with certain personalities or certain maladaptive behaviors, if you will. But to the best of my ability, clean slate. What is this person telling me, how they're telling me?

Peter Attia (90:27)

When you think about examples, I've seen examples where it seems like everything we're talking about has been taken too far. There's a story I read about a teacher who started every day with her school children, basically trying to get them each to talk about what was making them sad. The story digressed so much. One kid would say, well, I'm sad about the fact that something happened. And it was a legitimate. It sounded actually quite traumatic in that kid's life. They were getting yelled at all the time at home or locked in a room, and it sort of derailed the ability to do anything. This is a group of kindergarten kids that ought to be learning how to write and color and stuff like that. Everything was being pathologized for them. So what do you say to the person listening to us that says we've gone too far? And I get it. I'm sure that some of the people that Jeff works with who have genuinely been abused deserve to be there. But aren't we just coddling people too much? And don't people just need to sort of buck her up? I mean, isn't this what makes us who we are?

Unknown (91:26)

Yes and no. I'm certain that those things are happening. I would not be comfortable painting a broad brush and saying, yes, we are too far. Again, I'm back to depolarizing things. Most of my folks that I meet through the therapeutic work grew up in much more of the get over it, buck up. And then the other end of this continuum, if you will, is everything is trauma. Let's not box ourselves in. I worry about the example that you just give there, because I'm just thinking about kids in general, especially younger kids. Kids can be mean. Is that the space for that, emotions? Yes. It can be so powerful, I believe, for children to learn about their emotions, but to be guided by them. That's a tricky statement. I would hope the spirit of guiding is learning what the behaviors are learning when the time and place for emotional attention is, and the time and place that it's not for. Again, my experience comes from individuals, typically who are from the far other end of that.

Peter Attia (92:35)

What would you say to a person who's listening to us, who's trying to even understand if they've experienced trauma? Which sounds like a dumb thing to say, but let me give an example, right? So you have a person who's listening, who's either introspective enough to realize that some of those things we described as the four branches of the trauma tree, whether it be codependency, attachment disorders, some sort of maladaptive behavior, et cetera, addiction, maybe they're like, okay. I mean, if I'm being brutally honest, I'm not flying on a perfect level. My spouse has complained about X, Y, and Z. And there does seem to be a little bit of interpersonal discontent in this nature, in this relationship, et cetera. Okay, fine. And then they. If they're again, in a particularly charitable mood, they look at the kind of five roots of the tree and they're like, well, okay, yeah. I mean, these sort of things happen, but they can't make the leap to say, but does any of that stuff actually rise to the level of quote, unquote, trauma? Even little T. Trauma is the answer. Just that I need to get my act together and drink a little less and just try to be more present with my kids. It doesn't matter what the fix is, but they're just not sure that going back and stirring the pot of what happened to them during the first 10 years of their life is going to be an exercise worth engaging in. How would you help that person decide that you're right? It's probably not worth stirring that up. Let's just work on some behavioral tools right now to address the behavior versus actually, I don't think you're ever going to truly fix these things until you go back to the root.

Unknown (94:11)

I think that's a perfect way to approach it. Let's try that in your example. Like maybe I should just do this less and do this more. All these behaviors, let's try that. Let's put together a plant goal setting. I'm coaching you. We're not doing an intervention here. Therapeutic intervention. And if it happens, it happens. Folks who realize or already know that they have trauma or have been wounded significantly. Sometimes I think the word just trips folks up and they just can't get over the word wounded survivors, whatever we want to call these folks, they have a really hard time putting knowing into action. I spent many years as a very well informed prisoner. I know all this stuff about why it is I do the things that I do. But it's the putting it into action. The thing that you said about the not doing, that's where we get to realize, hopefully admit to self. If that's the fact when I come back to see Jeff or whoever, well, the goal is still failing for some reason. I just can't do that. Well, perhaps there's something significant connected to this. Maybe something needs to be integrated. The part of you that is unwilling to do this thing that you say is the goal and the plan when you sit in front of me, that's who we need to work with.

Peter Attia (95:33)

So how do you begin to do that? Integration. Let's go back to the example you gave because it's so profound and probably tragic where that 4 year old boy that learned how to manipulate and deceive to protect his mom has now carried that behavior into his marriage. So step one is obviously getting to the point where we uncover that story and make the connection which was an inner child is wounded. That inner child adapted with a strategy that was very positive. Everything about that strategy made sense. But guess what? Your dad isn't kind of hurting your mom anymore because luckily she got a divorce and he's gone. You're now applying that same behavior pattern in relationships that have nothing to do with the relationship in which that was developed to be protective. And he says, okay, I get it. Jeff, how Do I change? What are the next steps? How do I go from the understanding of that to creating a new pattern of behavior? Because this is really wired. These paths are heavily, heavily myelinated.

Unknown (96:36)

At this point in general, what we're going to have to do is we're going to have to expand your window of tolerance, if you will, to vulnerability. Because typically that protective behavior, again the enemy, is vulnerability. And so to create some muscle memory, doing something different when vulnerable, not doing that same thing. When you talked about your experience at the bridge and you talked about what it would have been like if we had have taken away exercise, simply sitting still for some folks is a very vulnerable experience. And so to create an environment where that person can experience the discomfort. And that's why I think that within my work and a lot of professionals looking at individuals from a parts perspective, there's different systems, different theories, internal family systems, structural dissociation. But this language that I'm using, it's not necessarily new because it's like you're talking about this original self, this wounded self, this adapted self. The adapted self tends to have some really hard line beliefs. Safety equals control, safety equals distance, safety equals self abandonment, safety equals somebody else. And as long as that part of self has that core belief, I believe it's going to be damn near impossible to do those things that I know I should do. So to know that there are interventions that will fit that process. The first question is, do you got issue with this? Because I'm back to if you like it, I love it when a client, they're at the bridge and they're there because their spouse, their spouse is going to leave them. Their spouse is finally fed up with it and they've got all these opinions about it. So here I am because they said I needed to go to a place like this. And you know, and you're like, doesn't sound like you got a problem at all. What do you mean? You can keep being you. You just got somebody telling you now that they're not going to deal with it. Maybe it's the biggest controlling jerk in the world. So all you need to do is go find another doormat. I'm just hearing you say your spouse is not. So you decide whether there's a problem there or not. This behavior, again, that's become the problematic behavior. How difficult it is to unravel and stop doing that behavior again, tied into the trauma, tied into it being an ingenious damage control strategy at a time in life, perhaps, and perhaps done multiple times successfully. So There's a part of self that says, why not do this? We've been doing pretty well like this for a long time.

Peter Attia (99:19)

There tend to be these moments along this journey. I assume I'm not unique in this, where people have really significant breakthroughs, breakthroughs in beliefs. And it's mostly that a belief gets shattered again. This is, I think one of the real joys of having a journal is you can kind of go back and read what that was like and read on this day, through this exercise, this really profound thing happened. I mean, I wrote about two of them in that last chapter of my book. I wrote about one at the Bridge and one about PCs that were undoubtedly the two biggest breakthroughs in beliefs I've ever had in my life. They've had a far greater impact on anything in my world. And they both happen in an instant. They were huge step function changes in a radical belief system. And what I find interesting about it is how much easier it became to make any change after the fact. I never want to represent that I'm better. We're all in recovery here. But when I think about the December 2017, April of 2020, or maybe it was by this point, May of 2020, those particular days when those things happened literally within an instant, I don't understand the neurobiology of how it happens. But something really switches and I never look at the world the same way I did before. There's an immediate acceptance of something. Typically that's the shattering of the belief system, is the acceptance of something that is more honest and more close to the innate child that we all were. Is that common? First of all, that people have these major, major life changing appreciations of something and then secondly, is that by itself sufficient sometimes to drive change?

Unknown (101:07)

I'd be careful with the common word, but it happens a lot. I typically hear about it kind of the way you described it, months even sometimes years later it hit me one day or this thing was happening and I was incredibly compelled to do it the old way. And I heard something so and so said in my ear, something against that belief system. That's what's so tricky about that process at the Bridge or if you want to talk about experiential journeys using experiential therapies, I mean just going to a process, a group therapy process, residential isn't experiential intervention. And so to be able to put my finger on, well, what was it, what exactly was it? And can I prove that that was the thing?

Peter Attia (101:49)

It's interesting for me, in both cases it Came down to a therapist pushing very hard but very kindly against a set of assumptions. It was me saying something, offering it up, the same answer, and the person saying, what about this? What about this? And just maybe describe it as a loving confrontation that when fully backed into a corner in an unthreatening way, collapsed the scaffolding of a mental model.

Unknown (102:27)

Yeah, and thank God, I mean, when you tell that about putting your finger on that, I've got so much gratitude sitting here. Obviously, I know the moments, several of the moments. And it is common, I think, the spirit of you in this example, putting yourself in a position for it to happen, and there being a process to get this guarded version of self out of the way enough to allow something like that to happen. And there's a lot going on to create that or to cultivate that possibility.

Peter Attia (103:02)

I think that's absolutely. Maybe the lesson I would want somebody to learn from this is in science there's an expression that. I think it was Louis Pasteur that said that chance favors the prepared mind. And the idea is that great scientific breakthroughs don't just happen. They happen to people who are toiling in the lab. Failing, failing, failing, trying again, trying again, trying again. Constantly thinking about the problem. And yes, usually something lucky happens that trips them in the direction of a discovery. It's often very much an accident. But that accident can't happen if you're not on the field. That accident doesn't happen if you're in the stands. Maybe that's the takeaway I would want somebody to have here, which is you're very unlikely to have that Eureka moment if you're not mired in the trenches of going through the painful work of figuring out your story, understanding, trying to create the map of what's happening. It's unlikely to happen when you're continuing the distractions or the numbing behaviors.

Unknown (104:09)

Absolutely. Sometimes, I guess the frustration with the individual, one on one therapeutic dynamic would be. I've heard many of the therapists who would ask the question, why would somebody go to a residential program that wasn't an addict or alcoholic? You talk about the frustrations of, like, the goals, not being able to put the knowing into acting. I see this person, we have four steps forward. We had this great 55 minute session, and then six days later they come back and I'm like, who the hell is this? What happened to them? Well, what happened to them is more than likely they went back and lived underneath the same roof with their biggest trauma trigger. And so, in your experience and many others having the ability to get that separation, season of separation to make that possible. Not the only way to make that possible. Because again, we paint ourselves in a hole to where? You mean if I can't go to a residential program, I can't heal? We certainly don't want to paint that because then we've got a lot of folks without hope. One of the ways. Absolutely.

Peter Attia (105:07)

Do you view your work today, the work you do just with individual clients, as something that you prefer to only do with people once they're coming out of a residential program, or do you take clients that are saying, hey, I think I need help. I'm not ready to fully commit to doing something as intensive and committed as residential care, either one.

Unknown (105:30)

Absolutely. Because you mentioned that it's a journey healed, past tense typically isn't a reality. We're all on a healing journey, I hope. Yeah, we can have these lightning bolt moments, get this momentum, make this progress. You described your experience of it. And also know that the work continues because back to the language of these maladaptive behaviors and all the muscle memory to have a eureka moment, just completely wipe that out. But when you talk about that scenario. Yeah, if I know somebody has been to a residential program and I have an idea of what they did because I have familiarity with where they were at, then I can do a certain thing with that. But at the same time, I guess the fire that it lights for that person that you've been talking about so much is finally getting to the cusp or to that place of, I think I need to look at something. I got a lot of good. You talked about that person, but something's just not right. And to be at that point of that journey that we talked about not being linear and having a system, if you will, where the background, I believe with that group experiential process has a different way of making that one on one relationship. I'm back to the word efficient and trauma efficiency. Hopefully being able to help recognize here's the what and the when. And let's make sure we're using our time wisely.

Peter Attia (106:56)

Jeff, what advice do you have for somebody who's out there trying to find a therapist? They've listened to us today and they've been like, okay, these two guys have got me at least thinking I ought to maybe scratch this a little bit, see if this scab bleeds. What are the attributes they should be looking for? First of all, how do they even begin to like, what do you go on Google and search trauma based therapy? How do you find somebody and More importantly, when you find somebody, how do you say, look, I'm going to give this three or four sessions to determine if this is a good use of my time. What are you looking for? Is it, hey, if I'm not uncomfortable in three or four sessions, this person probably isn't doing a good job. What are the metrics?

Unknown (107:32)

Certainly want some input from a professional, a seasoned professional, a personal referral you mentioned. Do I just Google trauma informed is kind of like the buzz thing. And what does this mean? Did you go to a 45 minute seminar on trauma does affect folks and now you're trauma informed.

Peter Attia (107:51)

Is there a certification that people should be aware of that says you're a true trauma based therapist?

Unknown (107:56)

There are several. But I would be more interested in what I do when I look at bios is sometimes I get more concerned about the more specialties I see. So when I see these lists that cover every class that someone takes during a graduate program for counseling, that troubles me.

Peter Attia (108:16)

How come it looks great.

Unknown (108:17)

I cover all of these different things, but no depth. Yeah, but like how much muscle memory do you have as a clinician working with a certain population, the way that you do it and where did that muscle memory come from? That's a big part of what I do, is helping folks make sure that they are with the right person. That's where I go with the efficiency of it. Knowing the story, learning the story, getting that eye opening moment and then that hint that someone wants something different and then to be a part of that process or to point them in the.

Peter Attia (108:50)

Right direction, what else should they be looking for? So they find somebody, they think they even get a personal referral that says this person is good. How should they evaluate what is going on and if they're on the right path within a month, for example, what's a sign that things going well? What's a sign that things are not going well?

Unknown (109:07)

I personally think that sometimes I would say that challenge. How challenged do you feel? How do you feel going into a session? How do you feel after the session?

Peter Attia (109:18)

What's a good sign? Is going in apprehensive and coming out exhausted a good sign?

Unknown (109:23)

Yeah, yeah, absolutely. I don't think it's a good story when it's like I can't wait to talk to Jeff because I'm going to get to gripe for 55 minutes and he's going to let me pay him for that. Now it's happened before and I would just say we need to call this what it is. If this is where you Want to put your anger at for an hour? We can do that. But let's call it what it is because we're not working on change here. So what's happening? What's being illuminated? Because they wouldn't call it a blind spot if I could see it. So what's happening within that back and forth? What did I not know? What made me think, what made me pause? But the main thing is what's different? Not all therapeutic relationships are a good match. And so to just know that that's a reality and to give yourself permission after an adequate amount of time. This isn't working. Let's not keep doing this. Let's not keep doing something that's not working. Life's short.

Peter Attia (110:18)

I'm looking at my last entry before I left the bridge. I see a couple of great lines here. One of my favorite other CO residents there, she said this. She said, I asked God why he beat me down this year. He said, he broke me open. I thought that was very powerful. You said on the way out, the more you cry here, the more you win here. That was pretty interesting. There's just no escaping it, is there? Like, it's very, very difficult. If the name of the game is I have to become vulnerable to become connected. That's the central thesis here. I am disconnected, and I am using something to stay disconnected. Sometimes those things are obviously bad, like drugs and alcohol. Sometimes, and many times they are not that obviously bad, like work and perfectionism or cleanliness or you pick it. Right. Depending on the extent of it. But I have to get vulnerable to be connected. And being vulnerable feels like getting broken down. And you're going to shed some tears.

Unknown (111:18)

Exactly. And the sheer factor thought of shedding the tears might amplify the vulnerability. Through the roof. So it's written all over the walls, literally. I mean, if you remember group rooms with emotion words on the walls, and to have clinicians sit in that room as guests of ours and refer to them as negative emotions. I squirm in my seat. Maybe they're not as comfortable, but, like, there's a utility to all of these emotions. And I liken stuffing emotions to, like tightening the string on a guitar. And you think of how many times, how many times that you've stuffed that emotion. What happens? And that thing right there. I think a lot of folks have been misinformed, or it was an old way of doing things, but I think a lot of folks go into it thinking that they've got to have this explosion with their emotions for the thing to happen. And if being lost in my emotion, if drowning in a pool of tears is what trauma integration is, then let me have no part of it. Because if dysregulated emotions is what comes out of the work, then I keep referring to them as guards. My guards, my protective parts. They've got more reason than ever to do their job. You just introduced me to vulnerability, and it was overwhelming. So when working with the client, regardless of the setting, it's befriending vulnerability. And to introduce vulnerability as overwhelming, that is counterproductive. These protective selves you mentioned, back to the connection. And human connection is vulnerable. It's not something that's meant to be controlled. There's unknowns, there's another person. We really don't know what they're going to do, what they're going to say, how we're going to be received. That's vulnerable. And if you look through the lens of these protective parts, my guards, the irony is the means by which they do their job typically brings me the thing that they most fear. Another example, let's say that a client. This is one that works sometimes. Let's say that a client. One of their things is they've got some trauma, they've got some insecurities around betrayals. And they're in a relationship, and one day their partner comes home and tells them that their ex is back working at the hospital where they work at now. Who wants to hear that? Nobody wants to hear that. But it's going to be especially bad news for somebody with a betrayal file. It's going to be very vulnerable. Introduce vulnerability into the equation. This is where the disconnected self shows up.

Peter Attia (114:00)

Up.

Unknown (114:01)

Have to do something to take care of that vulnerability. So I have this avoidant part. I used to call him the too cool for school part. And he was born out of hearing a lot of what kind of man's he going to be, what kind of man's you going to be. So, in other words, this part of me doesn't believe that a man says something like, I'm scared, I'm vulnerable. So this part of me says, you want to hear about all the skeletons in my closet? I don't care that your ex is back at work five years ago. But when that partner's on their seven to seven shifts, it's hard for me to be connected, Jeff, when all that stuff starts going on through insecurities and betrayals and things of that nature. So I need something, something to step in and take me away. And that's where that disconnection Comes in. For some folks it would be drinking or whatnot. Then the spirit of the example that I'm giving and trying to give, the irony is again, the problem is not having the parts. It's how they do their job and the relationship between those parts. Because eventually what happens is, is that as I do the thing with, let's say the behavior is drinking. So I'm drinking, I'm drinking, I'm drinking. And eventually I get to a point to where not thinking that much about what might be going on at that hospital. And then I get to a point to where my buddy leaves. We were watching the ball game. I was able to be connected Jeff in front of him. But now I'm really starting to get up in my head about what might be going on at the hospital where my partner's at. When the phone finally rings at 11:30 or 12 or whatever, it's not connected. Jeff that answers the phone. I'm using myself in this made up example, right? But it's going to be a disconnected version of Jeff, you having fun while the night's so young, Maybe you guys will have time to go at it again, right? All this woundedness starts coming out. And so eventually what happens is in this example, if this partner's got any healthy going on, I'm going to come downstairs one day and there's going to be a note that says, I wasn't created to save you. I can't do this. You need some help. And now, have I ever been any sadder than I am? Because that, it's a triangle of vulnerability, sad, shame and fear. And that's what all these guarded parts of self, they're there to protect us against. That. But you see, the means by which the protected, disconnected self did its work actually played out, brought me the thing that I feared the most. So now here I am, sitting at this table alone, realizing what's happened. That's how that happened. So back to disconnection. Connection. What is connected? Jeff says, I know this is my stuff and I've got work to do. It's a reminder that I've got work to do. But I gotta tell you, I gotta be honest with me. It bothers me what you just told me about this person being back working with you. It bothers me. But that's a very vulnerable thing to say.

Peter Attia (116:44)

Of course, you can only really say that if your partner is equally vulnerable. Because if your partner is not vulnerable, that that message isn't going to land. And that's going to be triggering to that person. And I guess all of this is a long winded way of saying you have to have two healthy people to make a relationship work. You can't just have one.

Unknown (117:02)

Absolutely. That might not be welcomed. That emotional, vulnerable self might not be welcomed. And that's information that's necessary, necessary information about my partner. It bothers me in that example. I'm not asking you to do anything. I'm not asking you to quit your job or anything like that. But I just need you to know my truth. And I've got work to do around this. But it does bother me. It scares me to death. It scares me to death. Probably the bravest words I've ever said to another human being in my life just scares me to death. I spent so many years trying to act like it didn't.

Peter Attia (117:34)

If you're in that relationship where one of you is feeling like, hey, I can be vulnerable here, but it's not being reciprocated. What are the tips for maybe helping your spouse? If this is thinking about it as a marriage or something like that, what can the vulnerable member of that relationship do to help the other one? Because it's not going to be tenable indefinitely. How do you lovingly get that person to come to a place where they want to get help?

Unknown (118:02)

A lot of folks have wasted years trying to pull and push people into help. You just have to be the agent of change in the relationship. You have to break the dance. So in this particular dance is it's I'm wanting to be vulnerable and you're not having anything of it. Something's got to change. So you gotta sharpen your skills with the boundaries. Boundaries, boundaries, boundaries. And sometimes it's a worn out word, but it's a hell of a skill to be able to utilize and to be able to set a healthy boundary. Top tier boundary setting oftentimes doesn't include the word you. Blows folks away when you just talk about me. I realize when this behavior happens, whatever fill in the blank, that it's affecting me. I'm building resentment and this isn't good for me. When this behavior happens again, I'm going to choose to do blank. And whatever blank is, is whatever change looks like it might be in this example. Like I want to be able to share my heart with you, but evidently I can't. So I'll be taking it to my best friend. And so to be able to set the boundary and set a boundary where there's a consequence, it's something that I can hold, it's something that I can do, because a boundary without a consequence is useless.

Peter Attia (119:18)

Jeff, I want to thank you very much for not just coming today, but for obviously being a really important part of my life. I owe you a great debt of gratitude, as I do a number of therapists who I've been really lucky to work with. But I will forever reflect on what can only be described as just an unbelievably difficult experience that I'm so glad I had no idea how bad it was going to be when I reluctantly agreed to go, because I just don't think I ever would have done it. And I've had the privilege of encouraging many people to go since then, not just to the bridge, but to other places as well. I think almost without exception, it's helped them. In fact, I know it has. I can't think of an exception where it hasn't. So. So if someone's listening to us and they're sort of contemplating either dipping their toe in by working with a therapist and trying to probe some of these things, or if they're thinking about jumping in the lake, then going to a residential place like the bridge, what would you say to them?

Unknown (120:16)

If there's a voice saying it, listen. If there's a voice, even if it's a whisper, it's there for a reason. And I think more important than anything else, you're either going to deal with it or it's going to deal with you. My hope for the you and humanity and what we do as far as helping people. In this case, we're talking about emotional health, but longevity. Yeah, deal with this. Grab the bull by the horns.

Peter Attia (120:43)

Thank you, Jeff.

Unknown (120:44)

Thank you so much for having me. It's honored to be part of your journey and congratulations on everything. Keep up the good work, brother.

Jeff English (120:52)

Thank you for listening to this week's episode of the Drive. Head over to Peteratti md.com shownotes if you want to dig deeper into this episode, you can also find me on YouTube, Instagram and Twitter, all with the handle PeterAttiaMD. You can also leave us review on Apple Podcasts or whatever podcast player you use. This podcast is for general informational purposes only and does not constitute the practice of medicine, medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek the assistance of their healthcare professionals for any such conditions. Finally, I take all conflicts of interest very seriously. For all of my disclosures and the companies I invest in or Advise, please visit PeterAttiamD.com about where I keep an up to date and active list of all disclosures.