
BITESIZE | How To Begin Healing Your Past & How Trauma Impacts Your Physical Health | Dr Bessel van der Kolk #564
June 12, 2025
Key Takeaways
- Trauma is a severe stress response that doesn’t end, altering the nervous system and leading to persistent, often disproportionate reactions to minor stimuli, unlike stress which resolves once the situation is over.
- Human connection and a supportive social environment are crucial protective factors that can significantly mitigate the long-term impact of trauma, helping individuals feel safe and reconnect with themselves.
- Practices like yoga, qigong, and martial arts can help traumatized individuals reconnect with their bodies, regulate their nervous systems through breathwork, and ultimately foster a sense of safety and self-experience, aiding in recovery.
Segments
Impact of Trauma on Self (00:02:05)
- Key Takeaway: Trauma robs individuals of the feeling of control over themselves, leading to intense, uncontrollable emotional reactions and a sense that life is happening to them rather than being in charge.
- Summary: Dr. Bessel van der Kolk explains how trauma disrupts a person’s sense of agency, causing them to react uncontrollably to external events and feel a loss of control over their own emotions and lives.
Resilience and Social Support (00:07:36)
- Key Takeaway: Individual temperament and, more significantly, the presence of a supportive social environment are key factors determining whether someone develops a chronic imprint of trauma or can return to baseline.
- Summary: The discussion explores the factors that influence trauma’s impact, highlighting that while temperament plays a role, the availability of supportive relationships during and after a traumatic event is critical for resilience and recovery.
Body-Focused Healing Practices (00:10:35)
- Key Takeaway: Practices like yoga help traumatized individuals reconnect with their bodies, calm their nervous systems, and open pathways for self-experience, making them feel safer and more alive within themselves.
- Summary: The conversation delves into the concept of the body keeping the score and how therapies like yoga can help individuals feel safe in their bodies by regulating the stress response, improving breathwork, and fostering self-awareness.
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[00:01:15.520 --> 00:01:25.200] Welcome to Feel Better Live More Bite Size, your weekly dose of positivity and optimism to get you ready for the weekend.
[00:01:25.200 --> 00:01:36.560] Today's clip is from episode 336 of the podcast with Professor of Psychiatry and author of the best-selling book, The Body Keeps the Score, Dr.
[00:01:36.560 --> 00:01:38.720] Bessel Vanderko.
[00:01:39.040 --> 00:01:57.760] In this clip, we discuss how trauma is different from stress, how traumatic experiences leave an imprint in our bodies, and why he thinks that body-focused therapies such as yoga could play a vital role in healing.
[00:01:58.720 --> 00:02:04.520] I wanted to start with a quote from your iconic book, The Body Keeps the Score.
[00:02:05.080 --> 00:02:10.360] Trauma robs you of the feeling that you are in charge of yourself.
[00:02:10.360 --> 00:02:13.160] Oh, that's that's a true statement.
[00:02:13.800 --> 00:02:15.560] What did you mean by that?
[00:02:15.560 --> 00:02:32.440] When you get traumatized, it's not the external event, but your reaction to that external event is that you cannot cope with it, and then you're vulnerable to react to other things as if they're catastrophes.
[00:02:32.440 --> 00:02:42.920] So, you may suddenly find yourself very scared, or very angry, or very aroused, or very panicky, or you can shut down.
[00:02:42.920 --> 00:02:49.720] And so, you really have no control over those intense emotional reactions that happen after trauma.
[00:02:49.720 --> 00:02:50.280] Yeah.
[00:02:50.920 --> 00:03:05.000] So, in many ways, people who are traumatized feel that their lives are out of control, that life is, I guess, happening to them rather than them being in control of their lives.
[00:03:05.000 --> 00:03:12.440] Yeah, they keep reacting to stuff and things are disorganized.
[00:03:12.440 --> 00:03:20.840] And then, oftentimes, they start off blaming the people around them for having caused them to be so angry or panic or something or another.
[00:03:21.160 --> 00:03:29.480] But after a while, people start realizing, oh, it's really my reactions that make life so difficult.
[00:03:29.480 --> 00:03:34.280] And so, how do I control these reactions becomes a major issue?
[00:03:34.280 --> 00:03:40.840] And oftentimes, people learn to sort of shut themselves down and learn to not react.
[00:03:40.840 --> 00:04:01.440] But with that, they become very uh distant to themselves and the people around them i think what you said there was really quite poignant for me that we often think it's the people around us that are causing us to feel a certain way without that deep realization that actually we're generating those emotions.
[00:04:01.440 --> 00:04:06.160] We may not know why we're generating them, but ultimately it's coming from within us, isn't it?
[00:04:06.400 --> 00:04:06.960] Yeah.
[00:04:07.440 --> 00:04:08.480] Not the whole story.
[00:04:09.040 --> 00:04:13.360] Because, you know, negotiating your ways through the world is complex.
[00:04:13.920 --> 00:04:21.280] People will say things that may not be pleasant or they may not respect you as much as you'd like it to be.
[00:04:21.280 --> 00:04:27.280] But the core issue is how do I react to adverse issues?
[00:04:27.280 --> 00:04:29.680] And I cannot change everybody else.
[00:04:29.680 --> 00:04:39.040] I have to actually learn to manage my own arousal and my own reactivity.
[00:04:39.040 --> 00:04:39.680] Yeah.
[00:04:41.200 --> 00:04:45.600] What's the difference between trauma and stress?
[00:04:46.240 --> 00:04:50.560] The big difference is when stress is over, it's over.
[00:04:51.200 --> 00:05:05.120] And so when you sit for an exam, you're working hard, you may not be able to sleep, but once you take the exam, you can go for a walk, you can go do whatever you want to do, and the stress disappears.
[00:05:05.760 --> 00:05:13.680] And stress is not bad for people because we really are programmed to deal with very adverse circumstances.
[00:05:14.400 --> 00:05:29.280] People can deal with a great deal of stress, but the critical thing is when the stress is over and you've done whatever you needed to do to deal with it, then your body resets itself, you become calm and you stop being hyper-focused and whatever.
[00:05:29.280 --> 00:05:33.080] When you get traumatized, those reactions don't stop.
[00:05:29.920 --> 00:05:46.920] So, trauma is almost like a severe stress response that never ends and that starts to change our nervous system and how we view the world, how we react to the world.
[00:05:46.920 --> 00:05:48.600] Is that one way of putting it?
[00:05:48.600 --> 00:05:54.520] Yeah, it's not as cognitive as view the world, it's really how we react to the world.
[00:05:54.520 --> 00:06:03.960] Our reactivity changes, and we may become too intensely aroused by minor issues.
[00:06:03.960 --> 00:06:12.680] From a neuroscience point of view, we have some networks in the brain that help us to select what's important, what's unimportant.
[00:06:12.680 --> 00:06:14.760] It's called the salience network.
[00:06:14.760 --> 00:06:23.720] And after you get traumatized, that salience network makes you react to minor issues as if it's a catastrophe.
[00:06:23.720 --> 00:06:28.520] And the title of my book, The Body Keeps a Score, is not just a cute title.
[00:06:29.160 --> 00:06:35.240] It actually affects your immune system, it affects your stress responses.
[00:06:35.240 --> 00:06:47.480] And people who have long trauma histories oftentimes have multiple medical problems, which have to do with the body that gets stuck in fear, fight, and flight.
[00:06:47.480 --> 00:06:48.440] Yeah.
[00:06:49.400 --> 00:06:51.560] How common is trauma, would you say?
[00:06:51.560 --> 00:06:53.320] Oh, extremely common.
[00:06:53.320 --> 00:06:57.080] It turned out to be much more common than we ever thought it would be.
[00:06:57.080 --> 00:07:02.280] Shame and secrecy is very much part of trauma situations.
[00:07:02.280 --> 00:07:03.000] Yeah.
[00:07:04.040 --> 00:07:15.840] When I think about trauma and traumatic events, I think about the fact that different people being exposed to the same trauma will react in different ways.
[00:07:16.080 --> 00:07:22.720] Some people will end up becoming heavily traumatized, whereas some people won't.
[00:07:23.040 --> 00:07:36.560] So what are the factors then that determine if someone is going to have that chronic imprint of trauma or whether they're going to be able to deal with it, you know, deal with that stress response and return back to baseline?
[00:07:36.560 --> 00:07:38.400] Do we know what those factors are?
[00:07:38.400 --> 00:07:41.200] Well, there certainly is an issue of temperament.
[00:07:41.520 --> 00:07:50.160] Anybody who has more than one child knows that we all come into the world with very different reactivity and different responses.
[00:07:50.160 --> 00:07:52.320] So that is one factor.
[00:07:52.320 --> 00:08:00.720] But the other major factor is the social environment and who is there for you when something bad happens.
[00:08:00.720 --> 00:08:12.720] By and large, if you go through a terrible experience and you have a partner, a spouse, a parent, a boss who says, oh my God, how can I help you?
[00:08:12.720 --> 00:08:13.920] I'll be there for you.
[00:08:13.920 --> 00:08:22.400] When your social environment helps you to protect yourself and to feel safe again, that makes a huge difference.
[00:08:22.400 --> 00:08:42.800] So the principle, for example, after natural disasters or after accidents, war situations, the first thing you do is you reconnect people with the people they love and care for, because that is really what for human beings is the main source of comfort.
[00:08:42.800 --> 00:08:54.320] And so as long as you have people around you who acknowledge the reality of what you went through and who are with you in a very deep way, you probably will be okay.
[00:08:54.640 --> 00:09:06.440] And that, of course, is what happens in like wartime situations when people are at war, like what's happening in Ukraine right now, is that people feel very close to each other.
[00:09:06.440 --> 00:09:18.280] And that's sort of a natural biological thing almost that when we are under extreme stress, we really become very dependent on each other and we form very close bonds.
[00:09:18.520 --> 00:09:20.680] And that's how people survive.
[00:09:20.680 --> 00:09:29.960] But if the people who are your most intimate people are the source of the trauma, you lose that sense of connection and protection.
[00:09:29.960 --> 00:09:33.480] And then oftentimes, that is when people go over the edge.
[00:09:33.480 --> 00:09:34.280] Yeah, it's interesting.
[00:09:34.280 --> 00:09:53.480] As I was preparing for this conversation, and I was reading in your work, the importance of human connection at making us, I guess, generally more resilient, but in many ways, insulating us from the likelihood that a traumatic event is going to leave a chronic imprint inside us.
[00:09:55.080 --> 00:09:58.040] Insulin is a bit of an extreme word here.
[00:09:58.040 --> 00:09:58.680] Okay.
[00:09:58.680 --> 00:10:00.120] It helps.
[00:10:01.080 --> 00:10:03.960] It makes a significant contribution.
[00:10:04.280 --> 00:10:06.840] But insulin, it's too total a word.
[00:10:07.320 --> 00:10:22.360] But overall, when you're a kid, for example, and you need to go through an operation or terrible things happen to you, and your parents are there for you and acknowledge it, then that kid is likely to be okay.
[00:10:22.360 --> 00:10:22.760] Yeah.
[00:10:23.560 --> 00:10:23.960] Yeah.
[00:10:23.960 --> 00:10:25.720] Really, really interesting.
[00:10:25.720 --> 00:10:35.160] I really want to get to a central philosophy of your work that I take from it at least, which is about the body keeping the score.
[00:10:35.160 --> 00:10:36.840] That's the title of your book.
[00:10:37.160 --> 00:10:46.640] But this idea that the body keeps a record of what has happened, and that one of the goals of therapy is to help people feel safe in their bodies.
[00:10:44.680 --> 00:10:50.480] Now, I think a lot of people may not understand what that means.
[00:10:50.720 --> 00:10:54.800] What do you mean when you say we need to feel safe in our bodies?
[00:10:54.800 --> 00:11:01.440] I think Darwin already back in 1872 wrote a beautiful book in which he talks about trauma.
[00:11:01.440 --> 00:11:09.520] Actually, he calls it getting stuck in fight or flight or stuck in avoidance and defensive reactions, which is not a bad definition.
[00:11:09.520 --> 00:11:16.960] And he talks about how these experiences are expressed in the course of the vagus nerve.
[00:11:17.600 --> 00:11:20.480] Darwin calls it pneumogastric nerve back then.
[00:11:20.480 --> 00:11:28.080] And that you experience your emotions as gut-wenching and heartbreaking physical sensations.
[00:11:28.400 --> 00:11:30.800] And I think we all are familiar with that.
[00:11:31.040 --> 00:11:36.800] When something hurtful happens, we do feel it in our chest and we feel it in our bodies.
[00:11:36.800 --> 00:11:40.160] And so our bodies respond to these things.
[00:11:40.160 --> 00:11:46.480] And when you get traumatized, that feeling of gut vengeance and heartbreak really stays with you.
[00:11:46.480 --> 00:11:51.200] And you become an intolerable person to yourself.
[00:11:53.200 --> 00:11:54.640] Does that ring a bell with you?
[00:11:54.640 --> 00:12:03.840] Because it's a universal response that you experience deep disappointment and betrayal and fear in your body.
[00:12:03.840 --> 00:12:04.320] Yeah.
[00:12:04.960 --> 00:12:06.800] I think people have experienced that.
[00:12:06.800 --> 00:12:14.000] If anyone's ever been through heartbreak before, which we all have, which, yeah, pretty much everyone has been through on some level.
[00:12:14.320 --> 00:12:17.520] You feel it in your heart.
[00:12:17.520 --> 00:12:21.200] So, I think when we start thinking about it, it's like, oh, yeah, that's in our body.
[00:12:21.200 --> 00:12:22.880] Like, something's happened up here in our mind.
[00:12:22.880 --> 00:12:24.080] We've perceived it a certain way.
[00:12:24.080 --> 00:12:27.680] And then our body is expressing a symptom of that.
[00:12:28.000 --> 00:12:34.760] So, I think this is a really good point to talk about some of these practical things that people can start doing.
[00:12:35.080 --> 00:12:38.120] I mean, frankly, the things you're talking about are helpful for anyone.
[00:12:38.120 --> 00:12:40.120] But, can we start with yoga?
[00:12:40.120 --> 00:12:40.280] Right?
[00:12:40.360 --> 00:12:49.160] I know yoga is something you talk about as a really fantastic way for many people to start feeling that safety within their bodies.
[00:12:49.160 --> 00:12:55.400] How did you come across yoga and why do you think it's so effective for so many people?
[00:12:55.720 --> 00:13:10.040] You know, these things are usually an issue of accident that you happen to meet somebody who does yoga and who says, Come and do yoga class with me, and then you feel that your body feels calmer and your mind is more focused afterwards.
[00:13:10.120 --> 00:13:11.800] They say, Oh, that's interesting.
[00:13:11.800 --> 00:13:20.920] So, actually, so I went to the National Institute of Mental Health and got the money to study yoga as a way of calming that body down.
[00:13:21.320 --> 00:13:24.360] But now, people say, Oh, yoga is a treatment of choice.
[00:13:24.360 --> 00:13:32.120] I don't know, maybe some other people, Qigong may be better, or Tai Chi, or some other musical practice.
[00:13:32.680 --> 00:13:41.640] But for me, going to yoga was really a way of exploring to what degree people can change their relationship to their bodily sensations.
[00:13:41.640 --> 00:13:43.880] And yoga turned out to be very good for that.
[00:13:44.040 --> 00:13:52.040] Certainly, it's not the only way study I still love to do someday is see how tango dancing works for trauma.
[00:13:52.440 --> 00:13:56.920] Theoretically, that would make a lot of sense as being a really good trauma treatment, actually.
[00:13:57.240 --> 00:14:07.480] And what I see all the time is that the people who are in my life who are traumatized, they go and start exploring different things that help them.
[00:14:07.480 --> 00:14:11.360] Some people find it, let's say, acupuncture is very helpful.
[00:14:11.360 --> 00:14:13.800] Other people say it doesn't do a thing for me.
[00:14:13.800 --> 00:14:19.840] So, we don't know precisely what is right for whom, but it's very important for us to have an open mind.
[00:14:20.160 --> 00:14:29.680] And you need to have an open mind for yourself also to really see what can help me to feel alive in the body that I live in.
[00:14:29.680 --> 00:14:40.960] You're saying that for many people who are traumatized, they don't feel safe in their body, they don't experience everything that's happening within their body, they shut down in certain ways.
[00:14:41.280 --> 00:14:50.320] And you're saying one method that may work for some people is through something like yoga or qigong or martial arts, for example.
[00:14:50.320 --> 00:14:51.440] What is it that's going on?
[00:14:51.440 --> 00:14:55.840] You're starting to connect to your body, you're starting to connect to your breath, and how do you put it?
[00:14:55.840 --> 00:14:59.360] What do you think may be happening there that's helpful?
[00:14:59.920 --> 00:15:19.600] What happens there is that you are stuck in the stress response syndrome, and for example, when you start breathing more slowly and more deeply, and you change your breath, you change your heart rate variability, which is a way of measuring how the heart and the central nervous system relate to each other.
[00:15:19.600 --> 00:15:27.760] And then you get a sense of relief and openness once you are able to do things that calm that system down.
[00:15:28.080 --> 00:15:33.600] And so, initially, having somebody work with your breath, you go, I don't want to do that.
[00:15:33.600 --> 00:15:41.680] And then, if you learn to breathe much more slowly and much more deeply, you get a sense of, oh, I feel calmer, I feel clearer.
[00:15:41.680 --> 00:15:59.120] And what you do actually at this point is you open up some pathways in the brain between your parts of your media frontal lobe and your insula, a part of your brain that's connected with your bodily sensations, and you open up new pathways of self-experience, basically.
[00:15:59.120 --> 00:16:01.160] Yeah, it's so fascinating.
[00:16:01.480 --> 00:16:14.280] I know when I was reading the section on treatment in your book, you said when you're starting to treat trauma, there was one part where you spoke about these four things that need to happen: one, you need to find a way to become calm and focused.
[00:16:14.280 --> 00:16:22.520] Two, you need to be able to maintain that calm in response to things and events and people that trigger you to the past.
[00:16:22.520 --> 00:16:25.080] Then the third thing I think was being present.
[00:16:25.080 --> 00:16:29.560] You have to find a way being present in your life and with the people in your life.
[00:16:29.560 --> 00:16:34.440] And then the fourth thing there was you have to not keep secrets from yourself.
[00:16:34.440 --> 00:16:45.640] Now, the reason I bring that up there, I think what you just said about yoga there speaks to the first one there, which is number one, you've got to find a way to become calm and focused.
[00:16:46.120 --> 00:17:11.320] So for people who are traumatized, if you're stuck, who won't go into certain parts of their body, who don't want to do certain poses or positions because it doesn't feel good, it sounds as though what you're saying is that when people can find some sort of practice that helps them feel safe in their body, whether it's yoga or something else, that it's going to start to help them experience what does calm feel like.
[00:17:11.320 --> 00:17:18.040] Because I guess many of these people don't actually know what it feels like to be calm, even for just 10 or 15 minutes, right?
[00:17:18.600 --> 00:17:23.960] I think what people mainly learn is how to cut off their feelings.
[00:17:24.120 --> 00:17:26.520] Many people learn to not feel.
[00:17:27.160 --> 00:17:38.280] So a very common adaptation to trauma is to just shut yourself down and becoming that uptight person that manages somehow to make it through your day.
[00:17:38.280 --> 00:18:06.240] But it's in order to recover, you need to open up these pathways of self-experience and that you need somebody who really gently helps you to to reconnect with yourself i think you published a study did you not on yoga and ptsd from recollection three of them three of them yeah yeah what do they show They show that if you do yoga for eight or 12 weeks, that your PTSD scores go down.
[00:18:06.240 --> 00:18:13.360] We did some neuroimaging and we see some new linkages in the brain coming online, particularly having to do with areas.
[00:18:13.440 --> 00:18:18.800] The brain having to do with self-experience, self-sensory experience.
[00:18:18.800 --> 00:18:32.080] And what the study showed is that when people do yoga, they are more open to being with other people, less frightened of being with other people, and less afraid of themselves, most of all.
[00:18:32.080 --> 00:18:32.560] Yeah.
[00:18:32.560 --> 00:18:33.040] Wow.
[00:18:33.040 --> 00:18:34.320] Very, very powerful.
[00:18:34.320 --> 00:18:35.200] It's interesting.
[00:18:35.840 --> 00:18:39.920] But I want to say it's really, then people say, oh, yoga is the answer.
[00:18:39.920 --> 00:18:51.360] No, yoga was a paradigm that helped us to understand how engaging with your body in a particular way is helpful, but it's not the final word on the story.
[00:18:51.360 --> 00:18:51.760] Yeah.
[00:18:52.400 --> 00:19:07.360] Just very, very finally, for anyone who's listening right now, who feels stuck in their life, who feels the way that they are right now is the way that they have to stay, what would you say to them?
[00:19:08.960 --> 00:19:14.080] I would talk about what might be available.
[00:19:14.080 --> 00:19:16.000] Have you tried yoga?
[00:19:16.000 --> 00:19:18.080] Have you ever seen an inquiry?
[00:19:18.080 --> 00:19:23.680] And it would very much, I always take very careful histories about when did things work for you?
[00:19:23.680 --> 00:19:26.080] What were you doing when you did not feel this way?
[00:19:26.080 --> 00:19:28.000] What sort of relationships were you in?
[00:19:28.000 --> 00:19:38.920] And I try to help people to not only remember the horrors of their past, but also that kid a long time ago who was able to do this and who coped somehow.
[00:19:38.920 --> 00:19:50.440] And to really revisit yourself as a survivor to see what has worked and what hasn't worked, what gave you a glimmer of hope, and then to look around in your environment.
[00:19:50.760 --> 00:19:52.840] Would sing in a choir work?
[00:19:52.840 --> 00:19:54.440] Would doing martial arts work?
[00:19:54.440 --> 00:20:10.520] We're going to yoga studio work to really look at what it is in your culture that might help your body to feel at home or safe or a feeling of pleasure and engagement.
[00:20:10.840 --> 00:20:13.080] Hope you enjoyed that bite-sized clip.
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Prompt 2: Key Takeaways
Now please extract the key takeaways from the transcript content I provided.
Extract the most important key takeaways from this part of the conversation. Use a single sentence statement (the key takeaway) rather than milquetoast descriptions like "the hosts discuss...".
Limit the key takeaways to a maximum of 3. The key takeaways should be insightful and knowledge-additive.
IMPORTANT: Return ONLY valid JSON, no explanations or markdown. Ensure:
- All strings are properly quoted and escaped
- No trailing commas
- All braces and brackets are balanced
Format: {"key_takeaways": ["takeaway 1", "takeaway 2"]}
Prompt 3: Segments
Now identify 2-4 distinct topical segments from this part of the conversation.
For each segment, identify:
- Descriptive title (3-6 words)
- START timestamp when this topic begins (HH:MM:SS format)
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Most important Key takeaway from that segment. Key takeaway must be specific and knowledge-additive.
- Brief summary of the discussion
IMPORTANT: The timestamp should mark when the topic/segment STARTS, not a range. Look for topic transitions and conversation shifts.
Return ONLY valid JSON. Ensure all strings are properly quoted, no trailing commas:
{
"segments": [
{
"segment_title": "Topic Discussion",
"timestamp": "01:15:30",
"key_takeaway": "main point from this segment",
"segment_summary": "brief description of what was discussed"
}
]
}
Timestamp format: HH:MM:SS (e.g., 00:05:30, 01:22:45) marking the START of each segment.
Prompt 4: Media Mentions
Now scan the transcript content I provided for ACTUAL mentions of specific media titles:
Find explicit mentions of:
- Books (with specific titles)
- Movies (with specific titles)
- TV Shows (with specific titles)
- Music/Songs (with specific titles)
DO NOT include:
- Websites, URLs, or web services
- Other podcasts or podcast names
IMPORTANT:
- Only include items explicitly mentioned by name. Do not invent titles.
- Valid categories are: "Book", "Movie", "TV Show", "Music"
- Include the exact phrase where each item was mentioned
- Find the nearest proximate timestamp where it appears in the conversation
- THE TIMESTAMP OF THE MEDIA MENTION IS IMPORTANT - DO NOT INVENT TIMESTAMPS AND DO NOT MISATTRIBUTE TIMESTAMPS
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Timestamps are given as ranges, e.g. 01:13:42.520 --> 01:13:46.720. Use the EARLIER of the 2 timestamps in the range.
Return ONLY valid JSON. Ensure all strings are properly quoted and escaped, no trailing commas:
{
"media_mentions": [
{
"title": "Exact Title as Mentioned",
"category": "Book",
"author_artist": "N/A",
"context": "Brief context of why it was mentioned",
"context_phrase": "The exact sentence or phrase where it was mentioned",
"timestamp": "estimated time like 01:15:30"
}
]
}
If no media is mentioned, return: {"media_mentions": []}
Full Transcript
[00:00:00.320 --> 00:00:11.520] Today's bite-size episode is sponsored by the brand new formulation of AG-1, the daily health drink that has been in my own life for over six years.
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[00:01:15.520 --> 00:01:25.200] Welcome to Feel Better Live More Bite Size, your weekly dose of positivity and optimism to get you ready for the weekend.
[00:01:25.200 --> 00:01:36.560] Today's clip is from episode 336 of the podcast with Professor of Psychiatry and author of the best-selling book, The Body Keeps the Score, Dr.
[00:01:36.560 --> 00:01:38.720] Bessel Vanderko.
[00:01:39.040 --> 00:01:57.760] In this clip, we discuss how trauma is different from stress, how traumatic experiences leave an imprint in our bodies, and why he thinks that body-focused therapies such as yoga could play a vital role in healing.
[00:01:58.720 --> 00:02:04.520] I wanted to start with a quote from your iconic book, The Body Keeps the Score.
[00:02:05.080 --> 00:02:10.360] Trauma robs you of the feeling that you are in charge of yourself.
[00:02:10.360 --> 00:02:13.160] Oh, that's that's a true statement.
[00:02:13.800 --> 00:02:15.560] What did you mean by that?
[00:02:15.560 --> 00:02:32.440] When you get traumatized, it's not the external event, but your reaction to that external event is that you cannot cope with it, and then you're vulnerable to react to other things as if they're catastrophes.
[00:02:32.440 --> 00:02:42.920] So, you may suddenly find yourself very scared, or very angry, or very aroused, or very panicky, or you can shut down.
[00:02:42.920 --> 00:02:49.720] And so, you really have no control over those intense emotional reactions that happen after trauma.
[00:02:49.720 --> 00:02:50.280] Yeah.
[00:02:50.920 --> 00:03:05.000] So, in many ways, people who are traumatized feel that their lives are out of control, that life is, I guess, happening to them rather than them being in control of their lives.
[00:03:05.000 --> 00:03:12.440] Yeah, they keep reacting to stuff and things are disorganized.
[00:03:12.440 --> 00:03:20.840] And then, oftentimes, they start off blaming the people around them for having caused them to be so angry or panic or something or another.
[00:03:21.160 --> 00:03:29.480] But after a while, people start realizing, oh, it's really my reactions that make life so difficult.
[00:03:29.480 --> 00:03:34.280] And so, how do I control these reactions becomes a major issue?
[00:03:34.280 --> 00:03:40.840] And oftentimes, people learn to sort of shut themselves down and learn to not react.
[00:03:40.840 --> 00:04:01.440] But with that, they become very uh distant to themselves and the people around them i think what you said there was really quite poignant for me that we often think it's the people around us that are causing us to feel a certain way without that deep realization that actually we're generating those emotions.
[00:04:01.440 --> 00:04:06.160] We may not know why we're generating them, but ultimately it's coming from within us, isn't it?
[00:04:06.400 --> 00:04:06.960] Yeah.
[00:04:07.440 --> 00:04:08.480] Not the whole story.
[00:04:09.040 --> 00:04:13.360] Because, you know, negotiating your ways through the world is complex.
[00:04:13.920 --> 00:04:21.280] People will say things that may not be pleasant or they may not respect you as much as you'd like it to be.
[00:04:21.280 --> 00:04:27.280] But the core issue is how do I react to adverse issues?
[00:04:27.280 --> 00:04:29.680] And I cannot change everybody else.
[00:04:29.680 --> 00:04:39.040] I have to actually learn to manage my own arousal and my own reactivity.
[00:04:39.040 --> 00:04:39.680] Yeah.
[00:04:41.200 --> 00:04:45.600] What's the difference between trauma and stress?
[00:04:46.240 --> 00:04:50.560] The big difference is when stress is over, it's over.
[00:04:51.200 --> 00:05:05.120] And so when you sit for an exam, you're working hard, you may not be able to sleep, but once you take the exam, you can go for a walk, you can go do whatever you want to do, and the stress disappears.
[00:05:05.760 --> 00:05:13.680] And stress is not bad for people because we really are programmed to deal with very adverse circumstances.
[00:05:14.400 --> 00:05:29.280] People can deal with a great deal of stress, but the critical thing is when the stress is over and you've done whatever you needed to do to deal with it, then your body resets itself, you become calm and you stop being hyper-focused and whatever.
[00:05:29.280 --> 00:05:33.080] When you get traumatized, those reactions don't stop.
[00:05:29.920 --> 00:05:46.920] So, trauma is almost like a severe stress response that never ends and that starts to change our nervous system and how we view the world, how we react to the world.
[00:05:46.920 --> 00:05:48.600] Is that one way of putting it?
[00:05:48.600 --> 00:05:54.520] Yeah, it's not as cognitive as view the world, it's really how we react to the world.
[00:05:54.520 --> 00:06:03.960] Our reactivity changes, and we may become too intensely aroused by minor issues.
[00:06:03.960 --> 00:06:12.680] From a neuroscience point of view, we have some networks in the brain that help us to select what's important, what's unimportant.
[00:06:12.680 --> 00:06:14.760] It's called the salience network.
[00:06:14.760 --> 00:06:23.720] And after you get traumatized, that salience network makes you react to minor issues as if it's a catastrophe.
[00:06:23.720 --> 00:06:28.520] And the title of my book, The Body Keeps a Score, is not just a cute title.
[00:06:29.160 --> 00:06:35.240] It actually affects your immune system, it affects your stress responses.
[00:06:35.240 --> 00:06:47.480] And people who have long trauma histories oftentimes have multiple medical problems, which have to do with the body that gets stuck in fear, fight, and flight.
[00:06:47.480 --> 00:06:48.440] Yeah.
[00:06:49.400 --> 00:06:51.560] How common is trauma, would you say?
[00:06:51.560 --> 00:06:53.320] Oh, extremely common.
[00:06:53.320 --> 00:06:57.080] It turned out to be much more common than we ever thought it would be.
[00:06:57.080 --> 00:07:02.280] Shame and secrecy is very much part of trauma situations.
[00:07:02.280 --> 00:07:03.000] Yeah.
[00:07:04.040 --> 00:07:15.840] When I think about trauma and traumatic events, I think about the fact that different people being exposed to the same trauma will react in different ways.
[00:07:16.080 --> 00:07:22.720] Some people will end up becoming heavily traumatized, whereas some people won't.
[00:07:23.040 --> 00:07:36.560] So what are the factors then that determine if someone is going to have that chronic imprint of trauma or whether they're going to be able to deal with it, you know, deal with that stress response and return back to baseline?
[00:07:36.560 --> 00:07:38.400] Do we know what those factors are?
[00:07:38.400 --> 00:07:41.200] Well, there certainly is an issue of temperament.
[00:07:41.520 --> 00:07:50.160] Anybody who has more than one child knows that we all come into the world with very different reactivity and different responses.
[00:07:50.160 --> 00:07:52.320] So that is one factor.
[00:07:52.320 --> 00:08:00.720] But the other major factor is the social environment and who is there for you when something bad happens.
[00:08:00.720 --> 00:08:12.720] By and large, if you go through a terrible experience and you have a partner, a spouse, a parent, a boss who says, oh my God, how can I help you?
[00:08:12.720 --> 00:08:13.920] I'll be there for you.
[00:08:13.920 --> 00:08:22.400] When your social environment helps you to protect yourself and to feel safe again, that makes a huge difference.
[00:08:22.400 --> 00:08:42.800] So the principle, for example, after natural disasters or after accidents, war situations, the first thing you do is you reconnect people with the people they love and care for, because that is really what for human beings is the main source of comfort.
[00:08:42.800 --> 00:08:54.320] And so as long as you have people around you who acknowledge the reality of what you went through and who are with you in a very deep way, you probably will be okay.
[00:08:54.640 --> 00:09:06.440] And that, of course, is what happens in like wartime situations when people are at war, like what's happening in Ukraine right now, is that people feel very close to each other.
[00:09:06.440 --> 00:09:18.280] And that's sort of a natural biological thing almost that when we are under extreme stress, we really become very dependent on each other and we form very close bonds.
[00:09:18.520 --> 00:09:20.680] And that's how people survive.
[00:09:20.680 --> 00:09:29.960] But if the people who are your most intimate people are the source of the trauma, you lose that sense of connection and protection.
[00:09:29.960 --> 00:09:33.480] And then oftentimes, that is when people go over the edge.
[00:09:33.480 --> 00:09:34.280] Yeah, it's interesting.
[00:09:34.280 --> 00:09:53.480] As I was preparing for this conversation, and I was reading in your work, the importance of human connection at making us, I guess, generally more resilient, but in many ways, insulating us from the likelihood that a traumatic event is going to leave a chronic imprint inside us.
[00:09:55.080 --> 00:09:58.040] Insulin is a bit of an extreme word here.
[00:09:58.040 --> 00:09:58.680] Okay.
[00:09:58.680 --> 00:10:00.120] It helps.
[00:10:01.080 --> 00:10:03.960] It makes a significant contribution.
[00:10:04.280 --> 00:10:06.840] But insulin, it's too total a word.
[00:10:07.320 --> 00:10:22.360] But overall, when you're a kid, for example, and you need to go through an operation or terrible things happen to you, and your parents are there for you and acknowledge it, then that kid is likely to be okay.
[00:10:22.360 --> 00:10:22.760] Yeah.
[00:10:23.560 --> 00:10:23.960] Yeah.
[00:10:23.960 --> 00:10:25.720] Really, really interesting.
[00:10:25.720 --> 00:10:35.160] I really want to get to a central philosophy of your work that I take from it at least, which is about the body keeping the score.
[00:10:35.160 --> 00:10:36.840] That's the title of your book.
[00:10:37.160 --> 00:10:46.640] But this idea that the body keeps a record of what has happened, and that one of the goals of therapy is to help people feel safe in their bodies.
[00:10:44.680 --> 00:10:50.480] Now, I think a lot of people may not understand what that means.
[00:10:50.720 --> 00:10:54.800] What do you mean when you say we need to feel safe in our bodies?
[00:10:54.800 --> 00:11:01.440] I think Darwin already back in 1872 wrote a beautiful book in which he talks about trauma.
[00:11:01.440 --> 00:11:09.520] Actually, he calls it getting stuck in fight or flight or stuck in avoidance and defensive reactions, which is not a bad definition.
[00:11:09.520 --> 00:11:16.960] And he talks about how these experiences are expressed in the course of the vagus nerve.
[00:11:17.600 --> 00:11:20.480] Darwin calls it pneumogastric nerve back then.
[00:11:20.480 --> 00:11:28.080] And that you experience your emotions as gut-wenching and heartbreaking physical sensations.
[00:11:28.400 --> 00:11:30.800] And I think we all are familiar with that.
[00:11:31.040 --> 00:11:36.800] When something hurtful happens, we do feel it in our chest and we feel it in our bodies.
[00:11:36.800 --> 00:11:40.160] And so our bodies respond to these things.
[00:11:40.160 --> 00:11:46.480] And when you get traumatized, that feeling of gut vengeance and heartbreak really stays with you.
[00:11:46.480 --> 00:11:51.200] And you become an intolerable person to yourself.
[00:11:53.200 --> 00:11:54.640] Does that ring a bell with you?
[00:11:54.640 --> 00:12:03.840] Because it's a universal response that you experience deep disappointment and betrayal and fear in your body.
[00:12:03.840 --> 00:12:04.320] Yeah.
[00:12:04.960 --> 00:12:06.800] I think people have experienced that.
[00:12:06.800 --> 00:12:14.000] If anyone's ever been through heartbreak before, which we all have, which, yeah, pretty much everyone has been through on some level.
[00:12:14.320 --> 00:12:17.520] You feel it in your heart.
[00:12:17.520 --> 00:12:21.200] So, I think when we start thinking about it, it's like, oh, yeah, that's in our body.
[00:12:21.200 --> 00:12:22.880] Like, something's happened up here in our mind.
[00:12:22.880 --> 00:12:24.080] We've perceived it a certain way.
[00:12:24.080 --> 00:12:27.680] And then our body is expressing a symptom of that.
[00:12:28.000 --> 00:12:34.760] So, I think this is a really good point to talk about some of these practical things that people can start doing.
[00:12:35.080 --> 00:12:38.120] I mean, frankly, the things you're talking about are helpful for anyone.
[00:12:38.120 --> 00:12:40.120] But, can we start with yoga?
[00:12:40.120 --> 00:12:40.280] Right?
[00:12:40.360 --> 00:12:49.160] I know yoga is something you talk about as a really fantastic way for many people to start feeling that safety within their bodies.
[00:12:49.160 --> 00:12:55.400] How did you come across yoga and why do you think it's so effective for so many people?
[00:12:55.720 --> 00:13:10.040] You know, these things are usually an issue of accident that you happen to meet somebody who does yoga and who says, Come and do yoga class with me, and then you feel that your body feels calmer and your mind is more focused afterwards.
[00:13:10.120 --> 00:13:11.800] They say, Oh, that's interesting.
[00:13:11.800 --> 00:13:20.920] So, actually, so I went to the National Institute of Mental Health and got the money to study yoga as a way of calming that body down.
[00:13:21.320 --> 00:13:24.360] But now, people say, Oh, yoga is a treatment of choice.
[00:13:24.360 --> 00:13:32.120] I don't know, maybe some other people, Qigong may be better, or Tai Chi, or some other musical practice.
[00:13:32.680 --> 00:13:41.640] But for me, going to yoga was really a way of exploring to what degree people can change their relationship to their bodily sensations.
[00:13:41.640 --> 00:13:43.880] And yoga turned out to be very good for that.
[00:13:44.040 --> 00:13:52.040] Certainly, it's not the only way study I still love to do someday is see how tango dancing works for trauma.
[00:13:52.440 --> 00:13:56.920] Theoretically, that would make a lot of sense as being a really good trauma treatment, actually.
[00:13:57.240 --> 00:14:07.480] And what I see all the time is that the people who are in my life who are traumatized, they go and start exploring different things that help them.
[00:14:07.480 --> 00:14:11.360] Some people find it, let's say, acupuncture is very helpful.
[00:14:11.360 --> 00:14:13.800] Other people say it doesn't do a thing for me.
[00:14:13.800 --> 00:14:19.840] So, we don't know precisely what is right for whom, but it's very important for us to have an open mind.
[00:14:20.160 --> 00:14:29.680] And you need to have an open mind for yourself also to really see what can help me to feel alive in the body that I live in.
[00:14:29.680 --> 00:14:40.960] You're saying that for many people who are traumatized, they don't feel safe in their body, they don't experience everything that's happening within their body, they shut down in certain ways.
[00:14:41.280 --> 00:14:50.320] And you're saying one method that may work for some people is through something like yoga or qigong or martial arts, for example.
[00:14:50.320 --> 00:14:51.440] What is it that's going on?
[00:14:51.440 --> 00:14:55.840] You're starting to connect to your body, you're starting to connect to your breath, and how do you put it?
[00:14:55.840 --> 00:14:59.360] What do you think may be happening there that's helpful?
[00:14:59.920 --> 00:15:19.600] What happens there is that you are stuck in the stress response syndrome, and for example, when you start breathing more slowly and more deeply, and you change your breath, you change your heart rate variability, which is a way of measuring how the heart and the central nervous system relate to each other.
[00:15:19.600 --> 00:15:27.760] And then you get a sense of relief and openness once you are able to do things that calm that system down.
[00:15:28.080 --> 00:15:33.600] And so, initially, having somebody work with your breath, you go, I don't want to do that.
[00:15:33.600 --> 00:15:41.680] And then, if you learn to breathe much more slowly and much more deeply, you get a sense of, oh, I feel calmer, I feel clearer.
[00:15:41.680 --> 00:15:59.120] And what you do actually at this point is you open up some pathways in the brain between your parts of your media frontal lobe and your insula, a part of your brain that's connected with your bodily sensations, and you open up new pathways of self-experience, basically.
[00:15:59.120 --> 00:16:01.160] Yeah, it's so fascinating.
[00:16:01.480 --> 00:16:14.280] I know when I was reading the section on treatment in your book, you said when you're starting to treat trauma, there was one part where you spoke about these four things that need to happen: one, you need to find a way to become calm and focused.
[00:16:14.280 --> 00:16:22.520] Two, you need to be able to maintain that calm in response to things and events and people that trigger you to the past.
[00:16:22.520 --> 00:16:25.080] Then the third thing I think was being present.
[00:16:25.080 --> 00:16:29.560] You have to find a way being present in your life and with the people in your life.
[00:16:29.560 --> 00:16:34.440] And then the fourth thing there was you have to not keep secrets from yourself.
[00:16:34.440 --> 00:16:45.640] Now, the reason I bring that up there, I think what you just said about yoga there speaks to the first one there, which is number one, you've got to find a way to become calm and focused.
[00:16:46.120 --> 00:17:11.320] So for people who are traumatized, if you're stuck, who won't go into certain parts of their body, who don't want to do certain poses or positions because it doesn't feel good, it sounds as though what you're saying is that when people can find some sort of practice that helps them feel safe in their body, whether it's yoga or something else, that it's going to start to help them experience what does calm feel like.
[00:17:11.320 --> 00:17:18.040] Because I guess many of these people don't actually know what it feels like to be calm, even for just 10 or 15 minutes, right?
[00:17:18.600 --> 00:17:23.960] I think what people mainly learn is how to cut off their feelings.
[00:17:24.120 --> 00:17:26.520] Many people learn to not feel.
[00:17:27.160 --> 00:17:38.280] So a very common adaptation to trauma is to just shut yourself down and becoming that uptight person that manages somehow to make it through your day.
[00:17:38.280 --> 00:18:06.240] But it's in order to recover, you need to open up these pathways of self-experience and that you need somebody who really gently helps you to to reconnect with yourself i think you published a study did you not on yoga and ptsd from recollection three of them three of them yeah yeah what do they show They show that if you do yoga for eight or 12 weeks, that your PTSD scores go down.
[00:18:06.240 --> 00:18:13.360] We did some neuroimaging and we see some new linkages in the brain coming online, particularly having to do with areas.
[00:18:13.440 --> 00:18:18.800] The brain having to do with self-experience, self-sensory experience.
[00:18:18.800 --> 00:18:32.080] And what the study showed is that when people do yoga, they are more open to being with other people, less frightened of being with other people, and less afraid of themselves, most of all.
[00:18:32.080 --> 00:18:32.560] Yeah.
[00:18:32.560 --> 00:18:33.040] Wow.
[00:18:33.040 --> 00:18:34.320] Very, very powerful.
[00:18:34.320 --> 00:18:35.200] It's interesting.
[00:18:35.840 --> 00:18:39.920] But I want to say it's really, then people say, oh, yoga is the answer.
[00:18:39.920 --> 00:18:51.360] No, yoga was a paradigm that helped us to understand how engaging with your body in a particular way is helpful, but it's not the final word on the story.
[00:18:51.360 --> 00:18:51.760] Yeah.
[00:18:52.400 --> 00:19:07.360] Just very, very finally, for anyone who's listening right now, who feels stuck in their life, who feels the way that they are right now is the way that they have to stay, what would you say to them?
[00:19:08.960 --> 00:19:14.080] I would talk about what might be available.
[00:19:14.080 --> 00:19:16.000] Have you tried yoga?
[00:19:16.000 --> 00:19:18.080] Have you ever seen an inquiry?
[00:19:18.080 --> 00:19:23.680] And it would very much, I always take very careful histories about when did things work for you?
[00:19:23.680 --> 00:19:26.080] What were you doing when you did not feel this way?
[00:19:26.080 --> 00:19:28.000] What sort of relationships were you in?
[00:19:28.000 --> 00:19:38.920] And I try to help people to not only remember the horrors of their past, but also that kid a long time ago who was able to do this and who coped somehow.
[00:19:38.920 --> 00:19:50.440] And to really revisit yourself as a survivor to see what has worked and what hasn't worked, what gave you a glimmer of hope, and then to look around in your environment.
[00:19:50.760 --> 00:19:52.840] Would sing in a choir work?
[00:19:52.840 --> 00:19:54.440] Would doing martial arts work?
[00:19:54.440 --> 00:20:10.520] We're going to yoga studio work to really look at what it is in your culture that might help your body to feel at home or safe or a feeling of pleasure and engagement.
[00:20:10.840 --> 00:20:13.080] Hope you enjoyed that bite-sized clip.
[00:20:13.080 --> 00:20:17.240] Do spread the love by sharing this episode with your friends and family.
[00:20:17.240 --> 00:20:23.080] And if you want more, why not go back and listen to the original full conversation with my guest?
[00:20:23.080 --> 00:20:29.000] If you enjoyed this episode, I think you will really enjoy my bite-sized Friday email.
[00:20:29.000 --> 00:20:35.080] It's called the Friday 5, and each week I share things that I do not share on social media.
[00:20:35.080 --> 00:20:45.160] It contains five short doses of positivity, articles or books that I'm reading, quotes that I'm thinking about, exciting research I've come across, and so much more.
[00:20:45.160 --> 00:20:46.840] I really think you're going to love it.
[00:20:46.840 --> 00:20:53.000] The goal is for it to be a small yet powerful dose of feel-goods to get you ready for the weekend.
[00:20:53.000 --> 00:20:59.640] You can sign up for it free of charge at drchatgy.com forward slash Friday5.
[00:21:00.040 --> 00:21:02.200] Hope you have a wonderful weekend.
[00:21:02.200 --> 00:21:12.520] Make sure you have pressed subscribe, and I'll be back next week with my long-form conversation on Wednesday and the latest episode of Byte Science next Friday.