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This is your brain on trauma.

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meta that these things happen to them

thought may this person be

happy may this person be

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m [Music]

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oh [Music]

so what we want to do is cultivate the compa

compa

kindness

Eyes take a few moments to breathe in

h [Music]

[Music] [Applause]

[Applause] [Music]

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w [Music]

but I would say on a on a deeper level

yourself that involves all kinds of like

things about moving your life forward

and they struggle with motivation in

it's because when I don't think I'm worth

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oh [Music]

when you develop empathy and compassion

for other

people there's going to be room for

someone else in the

relationship and then this in turn is

object now two people can

connect and now it's not about getting

it's about two human beings forming a relationship

relationship [Music]

oh [Music]

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alrighty chat let's get started sorry

for being a little bit late

today um we are doing a deep dive into cptsd

cptsd

and uh I found some really interesting

research over the last 24 hours that

took me a little bit of time to

incorporate um so it took a little bit

longer and I was just prepping

everything so that once we get started I

won't be stumbling around trying to find

stuff so

today we

are speaking of stumbling

around today we are stumbling around no

um so today we are going to be doing a

deep dive into

cptsd um just to remind that although

I'm a psychiatrist nothing we discussed

on stream today is intended to be taken

as medical advice everything is for

educational and entertainment purposes

only um if yall have a concern or

question please go see a licensed

professional this is especially

important as we're talking about today

because oh my God quiet you um this is

very important today because today we

are going to be talking about clinical

stuff right so this is not a substitute

for clinical treatment the goal of what

we try to do here on stream is to

educate people

and if yall resonate with some of the

stuff that we're talking about I highly

recommend that you go see a clinical

professional um we're going to talk a

little bit about evidence-based

treatment for cptsd at the end of the Deep

Deep

dive and yeah

so uh today we're doing a deep dive into

cptsd and then the other thing that

we're going to do today actually just as an

FYI so we're going to start with this so

I know that often times people will want

us to do things at HG so I want to show youall

youall something

something

so uh

oh hold on

fail there works okay so you'll notice

that someone made a post about a year

ago when is Dr K going to make a

comprehensive or even short video on

cptsd or does he have one that I already

missed so and then can Dr K make a video

on cptsd these are both from one year

ago these are just the two posts that we

found that were about a year old but

people have been asking this for a while

so the first thing that I want to say is

that when y'all ask for stuff like this

we pay attention it just takes a while

to do right so like between someone

posting this and actually like building

it um sometimes we have faster

turnaround times but many times like it

takes a while so we're paying attention

to everyone's requests I saw a post a

couple days ago that I responded to uh

from someone sort of saying like hey HG

feels like a boy club is it and yeah we

get that it feels that way sometimes but

we have a lot of great content coming

out for women there's certain challenges

to that so I know sometimes like on the

internet we're getting used to instant

gratification in some kind of response

but we do pay attention to the stuff and

we add this stuff to the list which is

very large and then we get around to it

when we can so since this thing got

posted in addition to this deep dive

which we're going to do today we also

built a whole trauma module so this uh

is about it basically takes about as

long to build a module as it does to

write a book um the scripting for the

module is about 50 to 80,000 words a

non-fiction book so the book that I

words so like we built a a guide um I'll

show you all just real quick so like the

other cool thing is that guides are

getting more complicated so like the

cool thing about a guide is that we can

add a lot of other stuff right so we're

trying to build like graphics and stuff

like that um that help emphasize like

the understanding of the principles that

play right so we teach a lot of science

and sometimes a picture is worth a

thousand words and thankfully we have a

whole team here at HG that helps us make

pictures um so this these are the trauma

guide Graphics that we're building uh so

I know this sounds like really this

seems like kind of overwhelming but I

guarantee you that when I talk about the

neuroscience and explain the

Neuroscience like this is going to help

people actually understand right so we

teach a lot of in-depth Neuroscience in

the guide um

so this these are this is the temporo

parietal Junction so we're going to talk

about this like just so you all know

something cool if you electrically

stimulate the temporo parial junction

you can trigger an out-of- Body

Experience super

cool um don't go trying that at home

kids so uh you know just as we're we're

teaching some of these like so here's

the challenge is like Neuroscience can

help us a lot right so in the same way

that we can understand things like how

muscles build and like taking creatine

and and exercising and we want to do

some number of reps like there's a bunch

of exercise physiology which has been

demystified and made available to human

beings the challenge is that we have a

ton of Neuroscience that has not been

demystified and made available instead

what we try to do is like translate

things into layman's terms and then try

to make it somewhat accessible through

like Publications like hbr and stuff

like that right where we'll have some

pop Neuroscience where they'll say like

hey this one trick will transform your

life like we do that stuff too so

especially in the guide we try to really

like teach all this stuff because I

think that when I when I work with my

patients I actually teach them all of

these things or not I mean not

everything but as much as I can about

how their physiology works because

that'll help you a lot especially with

trauma um so there's a bunch of

different stuff that we've got going on

you know we're building things for y'all

uh and super excited about it the guide

I think comes out soon and so what we're

going to do today is actually watch one

video of the guide after the Deep dive

so we're going to do a deep dive into

cptsd then we're going to show you all a

video from the guide just to illustrate

something because it's explained in

there and I think it's a it's a cool

video um and then we're going to get to

Q&A okay let's see if anyone has

questions before we begin I'm going to

um okay will will you ever talk yeah

we've talked about schizophrenia before

um but we'll we'll talk about it again for

for

sure uh I had a we're actually working

on something where we may um

get into schizophrenia soon actually

okay um yeah so as as mods are telling

y'all the guide video that we're going

to showing be showing y'all today is not

the Final Cut um it's still in like post

so we're just going to be sharing it

with y'all today this will be by the way

this stream is going to be available

okay so it you know like I think it just

stays on our our various channels um

okay okay so we're all

traumatized so that's a great way to

start so today we're going to be talking

about complex PTS D and the reason that

I think this is really important to talk

about is because it's my belief that

features of PTSD are present in large

percentages of the population without

being a full-blown diagnosis now let me

explain what the hell that

means so if we look at the

epidemiology the rates the the

prevalence of PTSD is about 1.5% so 1.5%

of human beings on the planet have

post-traumatic stress disorder

about half a percent or about a third of

those people have something called

complex PTSD and we'll get to what that

is so the interesting thing is if you

look at what separates PTSD and

cptsd if you remove the PTSD component

what is left over I think is actually

quite common in our society today that's

why despite the fact that only one out

of 20000 people has a diagnosis of cptsd

it is my firm belief that understanding

that component will be very helpful to a

lot of the people in our community and

in the world so for me for example when

I work with people who have other

diagnoses like major depressive disorder

or addictions especially what I found is

that the more that I learned about cptsd

the more effective of a clinician I

became at treating these people so

that's why we're kind of diving it into

it today and as I think a a large

portion of our community and people

today resonate with some of the features

of P

cptsd so let's start with a little bit

of History so the first thing is like

what are these diagnoses and where do

they come from so a couple maybe about

80 years

ago soldiers came back from War and what

doctors noticed was that these soldiers

like weren't all there so they seem to

have like this brain fog they have

difficulty concentrating they're like

having like emotional problems they

drink more they can't incorporate back

into society so the first round of

doctors said oh this is something called

shell shock and so what they thought

happened is that even though this person

doesn't have an actual physical injury

the concussive blast of an explosion

must have hit their brain in some way

and caused

damage so okay the original form of PTSD

was born and we called it shell shocked

it's because a bomb went off off like

very close close to you you didn't

actually get hurt and then but there was

some kind of vibration or concussive

blast that affected your brain that's

the injury it's not like shrapnel or

anything like that so no bleeding but an

internal injury so then what happened is

as we started to like work with veterans

more and more and more we started to

realize that this is happening to a lot

of people that like weren't in the

concussive blast zone so they like saw

one of their friends die or something

like that they were only on the field of

battle for like a day and they just like

retreated but still they saw someone die

and then these people had the symptoms

of shell shock so shell shock started

with like concussive blast and then we

noticed that people have these symptoms

but haven't experienced concussive

blasts this is where PTSD was born so

PTSD is

usually an adaptation or a maladaptation

of the body to an acute specific

traumatic event in in its original form

PTSD was primarily found in soldiers so

seeing a friend die or something like

that results in

PTSD then what happened is once we had

this construct once we had these like

diagnostic criteria and stuff clinicians

made a really interesting observation we

see this kind of PTSD or shell shock

whatever phenomenon in people who have

never been in combat and they're like

what on Earth they have all the same

symptoms but they've never been in

combat then we expanded PTSD to being

non combat related things things like

sexual trauma or physical abuse or even

things like bullying and stuff like that

so the the the web of PT or the scope of

pts group PTSD group we'll talk about

what it is in a

second then what happened is a group of

researchers noticed that some people with

with

PTSD have more a different flavor to it

and have different kinds of symptoms and

they noticed something really important

that if the trauma is chronic if it is

consistent over time that results in a

different clinical picture and this is

where complex PTSD was born so if we

look at regular PTSD here's the way that

I understand it okay so first of all it

has three core features so one is

reexperiencing the second is avoidance

and the third is I'm blanking I can't

believe I'm blanking on this

um so there's lots of diagnostic

criteria but they get lumped into three

things reexperiencing avoidance

hypervigilance maybe hold on I will

figure this out give me a second

chat the joys of AATA

memory okay oh hyper yeah so hyper hyper

vigilance hyperarousal is the word that

they use okay so basically PTSD has

three core clusters of of symptoms

hypervigilance or hyperarousal um

reexperiencing in avoidance so let's

understand what PTSD is so we start off

off with a human being who is relatively

well formed and

healthy and then some kind of traumatic

event happens to them and then their

physiology their brain their being

adapts to try to survive that thing the

problem is the way that we adapt to

survive that one instance creates

maladaptations or problems going forward

so let's use a very simple

example so let's say that I end up in a

car crash right so I'm a relatively

healthy person I'm in my mid 20s and I

get into a car accident so once I get

into a car accident there is a

hyperactivation of my nervous system my

autonomic nervous system so I have

adrenaline pumping through my body I

have cortisol getting flushed into my

body and then my brain is being

hyperactive I'm hyperventilating I get

taken to the hospital and then I end up

I end up being okay now the problem is

that our

brain has evolved to adapt so a human

being can adapt to circumstances and

what the brain does is says hey we

almost died there let's be extra extra

extra careful and make sure that never

happens again so this is where what we

see in PTSD is first of all people will

have then other things happen we'll get

into this in more detail but other

things happen that will kind of numb out

our brain and so then what happens is

all of these experiences get dissociated

they live dorm they're dormant in our

subconscious and then they will arise

again so people will have flashbacks

they will have nightmares this is these

are both diagnostic features but this is

what we call reexperiencing even though

the event is over people a part of their

mind gets stuck in that moment and that

part the part of that part of their mind

will arise and fall over time so the

second thing that happens is people have

avoidance right so now our brain our

brain remember our bra brain is designed

to help us and Keep Us Alive so for

example if I almost drown in a lake I

will anytime I see a body of water I

will get scared and my brain will tell

me Don't Go Near The Water Don't Go Near

The Water Don't Go Near The Water right

and you'll understand this if you've

played video games especially

multiplayer video games where you play a

video game once and then you have a

really bad game because your teammates

are feeding and then your brain is like

never again never again never again and

the thought of playing the game makes

you hyperventilate in in nauseous which

is why most people play multiplayer

games for about 5 to 10 hours over the

course of their lifetime because they

get so traumatized that they never come

back right same thing you all should be

familiar with that

phenomenon so it'd be interesting I

wonder if we could

explore the mechanism through which

people keep going back to video games

that are consistently traumatic as a way

to desensitize people with PTSD and

actually get them to re-engage in life

that's really interesting I never

thought about that for but I actually

wonder why we don't why are video games

so traumatic but we keep going back

that's really

interesting anyway conversation for a

different day so in PTSD you have a solo

event you have reexperiencing of it you

have avoidance of whatever it is so

people will avoid getting into a car

again and the third thing that you have is

hyperarousal so what happens in our

brain in our in our phys physiology is

that we wire differently so I don't know

if this kind of makes sense but like you

know if I get attacked by something my

brain will be more sensitive to

detecting it in the

future and I will be more

um I will be like my response to that

stimulus will be a lot more robust so

let's say I get attacked by a dog on the

street the next time I see a dog first

of all my brain will be able to pick out

dogs out of a field of people if I'm

walking down the street and there's like

a 100 people in the park across the

street my brain will notice if there's a

single dog and it'll raise that to my

awareness and then the moment that I see

a dog my my physiology will activate it

will go back to like being attacked so

I'll see a rush of adrenaline and

cortisol so these are the features of

PTSD basically I I'm a normal person I

have a traumatic event and then these

three things

activate now then what happened is

people noticed that like okay so this is

a fundamentally different picture from

when we have complex PTSD which is

consistent trauma over

time so what happens when you have let's

say a teenager living at home who has an

emotionally and physically abusive

parent so this is the kind of thing where

where

like you know it's not a single event

this is the kind of thing where it's not

like uh you know our our body and and

brain are are just adapting over the

course of one day this is a chronic form

of abuse or trauma that results in a far

larger scale change to our sense of self

even so what we

see is um in in complex PTSD we have a

cluster of three symptoms which are

referred to as a disorganized self okay

so this involves first of all emotional

disre ation a loss of your sense of

identity and a difficulty with

relationships now you can see features

of these things in regular

PTSD let's actually start

disturbances in

self-organization okay so let's take a look

chat all right so here is a

person okay and if they have one

traumatic event but they are relatively well

well

formed so what this means is they have

relatively normal life this results or

can result in PTS SD and this has reexperiencing

um avoid oh

avoidance and hyperarousal and we'll

we'll get into all these okay now let's

say that the C trauma is

chronic so then what happens is that

this person is not usually well formed

disturbances in self

organization so if you kind of look at

this this so those the way I understand

it if you have PTSD PTSD is happening to

you this is an adaptation but you are

sort of separate from the traumatic

event when the trauma is is more

constant and when it happens earlier so

we'll get to this in a second in a

little bit more detail it changes who

you are it changes so it's not something

that happens to you the trauma becomes a

part of you so this is what disturbances

and self-organization mean so what this

disregulation there

is uh disturbances in a the sense of

relationships okay so let's take a quick

think

this so predictors of complex PTSD the

role of trauma characteristics dissoc

dissociation and comorbid

psychopathology so findings largely

confirm earlier research suggesting

that cptsd is a associated with

traumatic events that start earlier in

life and are perpetrated by

acquaintances okay so if we look at

cptsd how is this different what this

means is that remember we're well formed

in PTSD so we have like you know like a

random like if I get mugged by a random

person I can get PTSD but I have no

relationship with that person what leads to

cptsd is first of all it happens earlier

so our sense of self is not well-crafted

and furthermore it often times relates

to having someone that is close to us in

life so our sense of self really gets

messed up when our parents are abusive

and that results in this symptom cluster

okay now let's take a second to look at

the original paper on cptsd and by the

way if you guys want to read about

trauma the two references I would

recommend is this one so uh Judith

Herman um was the one who coined the

term and this is an an excellent paper

excellent excellent excellent paper

Okay so uh we're going to just talk

about we're just quickly look at this

the current diagnostic formulation of

PTSD derives primarily from observations

of survivors of relatively circumscribed

traumatic events right so she's saying

basically PTSD is talking about it

relates to people have single events or

like you know circumscribed so they're

they're you can draw a circle around

this formulation fails to capture the

protein seil of prolonged repeated

trauma so now Dr Herman is saying this

is a different thing if the trauma

happens all the time in contrast to a

single traumatic event prolonged

repeated trauma can occur only where the

victim is in a state of captivity under

the control of the perpetrator the

psychological impact of subordination to

coercive control has many common

features uh whether it occurs within the

public sphere of politics or within the

private sphere of sexual and domestic

relations so what what Dr Herman basically

basically

noticed is that we have a group of

people who are put in situations where

they no longer have control over their

life and this has a different kind of of

effect on the psyche right so like if I

get into a car accident that doesn't

fundamentally change like what I'm

capable of doing tomorrow so Dr Herman

was looking a lot at at people like uh

prisoners of War where these people had

was not this isn't just a single you

know military conflict on a single day

this is someone who day after day is

abused abused abused abused abused and

it changes the way that they function So

today we're going to be talking about

that since then things have evolved a

lot by the way the other reference on

trauma that I would highly recommend

we're just going to flash to real quick

um is this so the body keeps the score

is a great book on trauma but I think

you all can get a lot of this summarized

in bestl Vander KK's awesome paper from

dialogues and clinical Neuroscience so

this talks a lot about

stuff this talks a lot about stuff Dr K

2024 okay so now what we're going to do

is dig into what happens in trauma so

when we built this trauma guide what we

basically have so we did a trauma work

Workshop a couple months ago maybe about

a year ago now and the trauma Workshop

was like incredibly successful so like

basically there were 200 spots it sold

out in 24 hours and then we increased it

to 250 spots and so a lot of people were

super confused like hey like are you

going to do this again why aren't you

doing again we realized that the demand

was so high and there's no way that we

can get to everyone that we actually

decided to just build a guide instead

said so we took the trauma Workshop

which was about 8 or 9 hours and we

expanded it to like 15 16 hours of stuff

I think maybe that's last I don't know

what the actual video size is but we

built this guide and the guide also has

meditations and exercises and stuff like

that so today what we're going to go

through is some of the core features

that we explained in the guide obviously

there're in more detail there and we're

going to focus on the features of

complex PTSD so let's try to understand

what happens in

now so we're going to start with the

body so the first thing that happens

when we get traumatized is we get

hyperarousal okay so our nervous system

changes our nervous system changes to be

jittery so what does this mean this

means I'm walking along and I see a oh

God I can't draw a

dog okay I see a dog and normally like

when I see a dog I don't have a robust

physiologic response but once I have

PTSD what starts to happen is even

benign stimuli will trigger a very

strong sympathetic nervous system

response so we have this part of our

nervous system called the autonomic

nervous system or ANS and the autonomic

nervous system is divided into the

sympathetic nervous system and the

parasympathetic nervous system

okay so the sympathetic nervous system

governs fight or

flight the parasympathetic nervous

system governs rest and digest and the

simplest way to understand that is when

I was in college I used to talk to my

friends we used to have this phrase

called being

owned and it's like I just ate this

gigantic sandwich I am now owned I can't

do anything I am gg gg and there are

other times before you eat a gigantic

sandwich where you feel active you feel

energetic you feel you know you feel

like optimistic about the future

whatever so our body has periods of

activity and then it has periods of rest

and digest so I I don't know if you guys

like H you know after you have a meal

what happens is our parasympathetic

nervous system

activates so when the parasympathetic

nervous system activates and it's

triggered by things like food in your

stomach and then our body sends so our

stomach sends signals to our brain

that's like hey we've got a bunch of

food coming in

we we need to divert blood flow from our

skeletal muscles like our arms and our

legs and our brain to our digestive

system our liver needs blood our GI

system needs blood our stomach needs

blood intestines need blood um you know

our gallbladder needs blood this is

where we need all of our blood flow so

we'll feel sleepy we'll feel like

sitting around we'll digest things and

then there are other times where like

when I'm walking down the street and I

get attacked by a you know like a a

Thief so if someone's trying to mug me

then my Paras my sympathetic nervous

system will activate I'll get a surge of

adrenaline and cortisol and then I will

fight or I will run away now if we look

at diseases like anxiety disorders or

panic attacks what we see is that in

these disorders we have a

hyperactivation of the sympathetic

nervous system in our society

today we have a very high stress State

and the reason for that

is that generally speaking the

sympathetic nervous system was something

that was supposed to turn on and off

right so this evolved in like deer so if

you think about a deer like a deer

doesn't worry about paying mortgage at

the end of the month they don't worry

about GPA they don't worry about being

alone for the rest of their life the

deer has like is basically chilling and

then responds to its environment if it

sees like a wolf it runs away and then

it kind of Cs down so in most animals if

we look at a 30-day period they may have

an activation of sympathetic nervous

system system here or here oh I see a

deer that I'm sexually attracted to so I

get a spike of it what happens in human

beings is we get prolonged activation

because if I have a test in two weeks I

don't stress about that in two weeks I

start stressing today and I stay

stressed so hyperarousal is basically

the same thing it is a a elevated

triggering of our sympathetic nervous

system so it's not chronic it just means

that so here here's the way that I would

put it so here's a normal human being

and let's say that I need a danger

signal that is this high so if my danger

point actually let's do this way so

let's say here's our stress

response I'm going to redo this chat

because this is done wrongly and here's

our danger so let's say danger level one

danger level 10 danger level 10 is like

there's a tornado flying towards me

level one

is I don't know there's like

a someone rings the doorbell let's say

so normally what happens is we need like

a danger level of seven so as we go over

here as we get a danger level of seven

then we see an increase in the stress

response so this is like for a normal

human being when you have PTSD what we

tend to find is that a danger level of

four is sufficient to trigger a stress

response so our threshold to trigger the

sympathetic nervous system goes way down

it is easy for us to get

triggered right and we use this term so

much in in common language nowadays like

this triggers me this triggers me this

triggers me right it's it's and the

things that we say trigger us I mean all

kinds of stuff can trigger us but

usually what people are referring to is

that a very small dose of

exposure will lead to a robust or disproportionate

disproportionate

response so this is the first feature

this by the way is very physiologic so

has nothing to do do with your mind or

your feelings or stuff I that's not true

but it has a lot to do with that but

this is like at the level of biology

okay so the second thing that we see um

okay now hyperarousal will result in

things like avoidance we'll kind of get

to those in a little bit but now what

we're going to talk about is the second

level that we're going to focus on is

emotions so the other thing that we see

in in PTSD is that in complex PTSD is

that people have a tendency to

dissociate so we've explained this

concept before but it's really important

so our brain has two hemispheres the

right Hemisphere and the left hemisphere

the right hemisphere governs a lot of

our emotions and the left hemisphere

governs a lot of our analytical

capability now this is an

oversimplification because we also know

that the dorsal dorso parietal area in

the amydala in the limic system there we

have emotional structures on both sides

of our brain so like there's like other

ways that this is not really that

accurate but it sort of

is so what Vander kulk he's a he's a

great trauma researcher I think this was

vander's research what he noticed is

that he basically dug into how people

dissociate so what happens in trauma is

that a very low

threshold of exposure is necessary for a

hyperactive physiologic response so if

diagram I wonder if this is a good way

to explain it

so like I don't know if this makes sense

but like so we can go from here to here

but if we look at trauma what happens in

dissociation is we can't we can't keep

going up right this is like this is the

max this is the top you can't get any

more stress than that this is maximal

maximal

activation of the sympathetic nerve

system you can't just keep going up so

what Vander Kul basically noticed is

that somewhere around here I'm just sort

sort of approximating okay this triggers

dissociation so the stress level is so

high that are are are it's kind of

like you know I can I can put wattage

through a light bulb I can increase the

number of the amount of of Watts that go

through a light bulb and the light bulb

will get brighter and brighter and

brighter until it burns out so this is

what happens in dissociation

dissociation is usually triggered by a

hyperactivation of the sympathetic

nervous system it's like you go all the

way around the world you're heading east

and then suddenly you head up end up

like west of where you started which is

like really weird so this is what

happens in

dissociation is that the the signals are

so overwhelming the emotions are

overwhelming the physiology is

overwhelming that it triggers this

process of dis dissociation now what

happens in dissociation a couple of

different things happen but the key

thing that we're going to focus on is

decreased activity across the Corpus

colossum so our right hemisphere is

where we experience emotions our left

hemisphere is where we experience

analysis so as you all know when I get

emotional my analysis starts getting

messed up and so our brain is like I

can't handle these emotions I can't

handle this is too much activity too

much activity too much activity and

there's even um some studies let me see

this prepped but let me see if I can find

yes okay so what happens this is super

cool dude so cool but

weird okay the mechanism underlying this

process is understood as being analogous

to kindling which involves the emergence

of generalized seizures in in response

to repeated Sub sub threshold electrophysiological

electrophysiological

stimulation in PTSD similar to the

kindling of seizures the progressive

augmentation and amplification of

symptoms occurs over time possibly as

the result of neural circuitry

associated with emotional memory

response becoming increasingly reactive

and also expanding into neighboring

neural circuits so I know that that

probably doesn't make a whole lot of

sense to youall but let's explain what's

going on so basically what happens in

PTSD is we almost get something like

seizures right it's not really a seizure

but what happens is that there's an

activity so if you think about what a

seizure is a seizure is when you have

normally we have controlled electrical

activity so neuron turns on second

neuron turns on first neuron turns off

second neuron turns off this is how it

works right so it's like I'm sending a

signal and it's goes from here to there

and then we're done so in a seizure what

happens is we have unreg ated electrical

activity across the brain so everyone is

just activating each other and

activating each other and activating

each other so what people have noticed

in PTSD is there is a similar thing

going on where we have this feeding and

unregulated upswing of whatever Badness

is going on so we have panic attacks we

have reexperiencing we have flashbacks

we feel overwhelmed we feel triggered

and then much like a seizure so after

you after you have a seizure people have

this thing called a postal state where

they're not quite comos they're like

sort of semiconscious because their

brain just shuts

off and so the same thing happens in in

PTSD okay or in trauma is that you have

this overactivation and then the brain

is like enough is enough and then we

dissociate we just completely unplug now

what happens in dissociation is that we

have decreased activity across the

Corpus colossum so the emotional center

of our brain which is going absolutely

Haywire the emotional hemisphere which

is going absolutely Haywire the left

side of our brain is like enough is

enough we can't handle this cut off all

contact with the right side of the brain

then we dissociate so what this what

this feels like is you can watch

terrible things happening

dispassionately to yourself the logical

part of your brain is like this is

happening now I'm getting now this

person is hurting me now they're hurting

me more now they're hurting me more this

is painful period there's no emotional

connection to this experience

okay so once we dissociate once this

this process happens and and this is

where I think Vander Co coined this term

and apologies to the researchers who

coined it if I'm misattributing this we

call this process hemispheric

lateralization now this creates all

kinds of problems because once we

disconnect from our emotions we have all

kinds of challenges okay so if we look

emotion so emotions do a couple of

things emotions give us

motivation right so let me give you yall

an example of how they give us

information so if I walk into a room and

everyone is laughing and then they

suddenly go quiet and look at me I feel

weird right I feel uncomfortable so like

what really happened like my logical

brain doesn't know but my emotional

brain is like giving me

information when someone calls and

cancels on you for the third time and

you feel angry your brain is telling you

something okay second thing is emotions

give us

motivation so what we find is that when

when people struggle with trauma and

this is the video that we're going to

this so right so like the paralysis of

initiative of chronic trauma combines

with the apathy and helplessness of

depression so what Dr Herman

noticed was that when when people have

been traumatized they become like

listless like these veterans come back

from their P camps and they don't feel

like doing anything they just kind of

sit around they kind of exist they have

no Drive they have no passion and if we

look at like where does drive and

passion come from it comes from our

emotions right well like I'm not going

to stand for this anymore I want to go

achieve something I want to be the best

I want to do better I want to be free I

want to relax these are all emotional

things the whole problem that a lot of

people see in our generation we're

talking like Millennials gen Z gen Alpha

is that we're told that we should do a

certain thing so our logical brain is

like should study for this test instead

of playing a video game but my emotional

brain is not motivated to do it I'm

motivated to do something else so

emotions are a big part of motivation

and when we disconnect from our em

emotions we lose information and then we

also lose

motivation but there's more at

play it turns out that when we lose our emotions

emotions

okay we also lose our sense of identity

now the question is why so let's

understand what your identity

is so identity is formed through

stringing together emotional

events so if I ask someone who thinks

that they are a loser and I say what

makes you a loser let's say there's

someone who's been who's 25 years old so

they've been on this Earth for like

8,000 days okay

yeah so like way more than 10,000 days

so let's say someone has been on this

Earth for 10,000 days and if I ask them

what makes you a loser they are not

going to look at their average

experience on a day-to-day basis that's

not what makes them a loser 8,000 out of

the 10,000 Days my day was relatively

normal and like nothing good happened

nothing bad happened I was just straight

chilling what makes them a loser is the

emotional moments in their life that

moment that I asked this girl out to a

dance and she laughed in my face and

then told the whole school about it and

then everyone made fun of me for the

week before school ended and so seven

days out of 10,000 becomes this person's

identity the flip of it is also true in

terms of positive things right so when

someone says when I ask someone hey like

how do you think about yourself then

someone says I'm I'm a really strong

person who's just trying to make do good

in the world and then I asked them like

how did you develop that identity like

what makes you say that tell me about

your life and they will tell you

emotional moments in their life once

again it's not about the 10,000 days

that they've been alive it's not like

that they ate PB and J every single day

like that's not a part of their identity

what makes your identity is a string of

emotional experiences this is why people

who like survive cancer like they they

it becomes a part of their identity like

I am a cancer survivor because it's an

emotionally grueling experience right

joining the military

very um you know in my case right so

like I failed out and like those were

very uh powerful emotional experiences

getting into med school like I remember

the day that I I still remember the day

before Thanksgiving I got a call from

the dean of the medical school after

three years of applying saying that hey

I've been accepted and I wanted to call

I've been accepted to med school and I

wanted to call so that you you know

weren't worried and you had like a Happy

Thanksgiving and then I called my dad

and I called my grandmother and it was

like very joyous and ful and things like

that and my you know anyway it was a

very powerful moment for me um we can go

into more detail if youall want but my

point is that if we look at what makes

our sense of identity it is like strings

of emotional experiences this breakup

this marriage the birth of this child

Landing this job you know surviving a

shark attack like like these are the

moments getting this award it's

emotional experiences that create our

sense of identity so the moment that you

start dissociating you lose your sense

of identity then you're simply existing

you're not

living so what we see in complex PTSD is

disturbances of self-organization and it

starts with emotional disregulation so

when your emotions are disregulated when

you can't control them you can't really

make sense of the world right so like

there are times where your emotions get

out of control and then you end up

triggering dis iation so now it's like

hyperactive emotion followed by

dissociation there's no way to make

sense of that it's just like you get

it's like someone is like it's there's a

difference between like painting a

painting and taking a bucket of paint

throwing it on a canvas and then burning

the canvas this is the best analogy that

I can come up with in this moment of the

difference between emotional

disregulation and disorganization

there's no order to it it's just

emotions out of whack followed by

unplugging the whole experience

so when we have this process then we

lose our sense of identity and this is

what we see in in cptsd so there's if we

look at uh diseases like or diagnoses

like borderline personality disorder or

narcissistic personality

disorder what we find in this these

diagnoses is a disturbed sense of self

so in someone with BPD they do not have

a stable sense of self so what does this

mean so what this means is

that if someone if I'm walking down the

street and someone insults me and says

hey Dr K you're bad at

games they opinion of me whatever it is

or I'm great at games they're saying I'm

the best human being on the planet and

I'm so good at video games whatever

their opinion of me is their opinion

exists out here and my opinion of me

exists in here and as they say one thing

and I say another thing these two things

conflict so in if enough people say this

to me then my sense of self will change

so if you have like this entitled little

prick of a

kid how do they become entitled because

too many times their parents or the

people around them are telling them over

and over they're getting signals from

the outside world you can do whatever

you want you can do whatever you want

you can do whatever you want so you internalize

internalize

this and on the flip side if you get

told the opposite if you have someone

who has low self-esteem because they're

told you're a piece of you're a

piece of you're a piece of

then that becomes internalized so you

have a stable sense of self and then you

have the outside world's opinion of you

so what happens in in borderline

personality disorder is that their

stable sense of self disappears it's not

stably high or stably low so remember

that people like who have let's say a

mood disorder like major depressive

disorder they may have a stably low

sense of self but in BPD the sense of

self is absent so what that sort of mean

Not absent but it's it's not well formed

so what that sort of means is if people

are treating me well I feel great I am a

good person if people are treating me

well and if they're treating me poorly

then I'm a shitty

person this is an unstable sense of self

and now if you sort of think a little

bit about complex PTSD PTSD and

BPD so this is kind of

where you know we're going to I'm going

to try to explain this a little bit more

clearly so we know that if you have BPD

you have a

unstable sense of self which by the way

if youall haven't seen our video on on

BPD apparently it's really good so like

I was just like someone told me recently

that has a ton of views and we've gotten

really positive feedback about it so so

watch it we've got PTSD over here with our

our arousal

arousal

vigilance and

avoidance and then we have

cptsd which is these Plus plus this DSO

which is Disturbed

disregulation left out an S there but GG

disregulation identity

issues and relationship issues and we'll

get to relationships in a bit so what we

kind of see is that like BPD has these two

two

but BPD doesn't have these so BPD so now

like this is really important to

understand C cptsd is this plus this BPD

is just this without this and then maybe

some additional stuff does that make

sense so we know that

trauma can cause this if it's one time

if it's chronic causes this and if it's

chronic causes

this but it depending on the nature of

the trauma and the fre fre quency and

your genetics and and stuff like that

like it it kind of changes the

manifestation so the reason I think this

lecture is super important is because I

am seeing this as its own independent

set of cluster the cluster of symptoms

grow in the population more and more

problem are more and more people are

having problems with this without

necessarily this or

this okay so what happens in in cpts is

identity which then results in all kinds

of problems okay so the first thing is

in BPD you know what the way that people

feel about me determines the way that I

feel about myself so there's no

persistent sense of self to fight

against other people's opinions right if

I'm confident in here people can bully

me and I can fight back but in BPD they

can't do that and in cptsd they can't do

that because this is not well formed the

reason it's not well formed is because

we don't we're so emotionally

disregulated that we do not lay down a

foundation of of who we are this all

also creates all kinds of other problems

so in cptsd and in

BPD we see that there's a lot of

impulsivity so why is there impulsivity

so on the one hand there's paralysis of

initiation so people have difficulty

getting things started that's the video

that we're going to watch at the end of the Deep dive today by the way okay so

the Deep dive today by the way okay so we're going to teach all this because so

we're going to teach all this because so this is like half of our community

this is like half of our community struggles with this I have trouble

struggles with this I have trouble getting started and it's so cool that

getting started and it's so cool that the research on trauma helps us

the research on trauma helps us understand why your brain has difficulty

understand why your brain has difficulty getting

getting started so we have difficulty getting

started so we have difficulty getting started and then we also have

started and then we also have impulsivity very common in complex PTSD

impulsivity very common in complex PTSD and the question is why

and the question is why so impulsive

so impulsive is the desire to do something for a

is the desire to do something for a little

little while right so it's like I'm impulsive

while right so it's like I'm impulsive so impulsive is not in action it is

so impulsive is not in action it is temporary action it is sudden

temporary action it is sudden action and so what what we see a lot is

action and so what what we see a lot is people have difficulty with follow

people have difficulty with follow through right I can't stay

through right I can't stay consistent why so if you look at where

consistent why so if you look at where consistency comes from consistency comes

consistency comes from consistency comes from two places the environment outside

from two places the environment outside you if you have an environment that is

you if you have an environment that is structured then you will be consistent

structured then you will be consistent right so like let's say you're in

right so like let's say you're in prison and like I used to have patients

prison and like I used to have patients who would tell me oh yeah I had such big

who would tell me oh yeah I had such big problems with insomnia and I was like

problems with insomnia and I was like what worked for you and he was like

what worked for you and he was like going to prison I don't have insomnia

going to prison I don't have insomnia anymore and I was like why not and he's

anymore and I was like why not and he's like well I have no choice I have no

like well I have no choice I have no cell phone I have to go to sleep at the

cell phone I have to go to sleep at the same time I've been here for 3 years for

same time I've been here for 3 years for 365 days for 3 years in a row I've gone

365 days for 3 years in a row I've gone to sleep at the same time and I wake up

to sleep at the same time and I wake up at the same time like I have no

at the same time like I have no choice but if we do not have a horribly

choice but if we do not have a horribly structured life then our consistency

structured life then our consistency comes from our sense of

comes from our sense of identity right why do you go to the gym

identity right why do you go to the gym every day because I want to be in shape

every day because I want to be in shape I want to be healthy I enjoy it why do

I want to be healthy I enjoy it why do you play games every day I enjoy them

you play games every day I enjoy them why do you play games every day I don't

why do you play games every day I don't know I hate them so your sense of self

know I hate them so your sense of self is what gives you a Drive in a direction

is what gives you a Drive in a direction over time so I worked with a I've worked

over time so I worked with a I've worked with a couple but I'm thinking about one

with a couple but I'm thinking about one Olympic Athlete many years ago and so

Olympic Athlete many years ago and so like when I talked to this person you

like when I talked to this person you know like how did you I was s curious I

know like how did you I was s curious I was like this the first person I worked

was like this the first person I worked with who was an Olympic Athlete I was

with who was an Olympic Athlete I was like how did you become an Olympic

like how did you become an Olympic Athlete like tell me about that like

Athlete like tell me about that like what's that like and it's like a very

what's that like and it's like a very strong sense of self that drives you

strong sense of self that drives you forward so that when there are setbacks

forward so that when there are setbacks when RNG happens that strong sense of

when RNG happens that strong sense of self keeps you focused on the task at

self keeps you focused on the task at hand

hand so what is impulsivity so impulsivity is

so what is impulsivity so impulsivity is a combination of emotional

a combination of emotional disregulation and a lack of sense of

disregulation and a lack of sense of self so when my emotions arise over here

self so when my emotions arise over here and I don't have a grounding from in

and I don't have a grounding from in here I'll I'll jump over there and as

here I'll I'll jump over there and as the emotion disappears I stop doing it

the emotion disappears I stop doing it because I have no driving force from it

because I have no driving force from it here so another very common feature of

here so another very common feature of cptsd is impulsivity and paradoxically

cptsd is impulsivity and paradoxically paralysis of initiation

paralysis of initiation so why how can those two things go

so why how can those two things go together well like because remember it's

together well like because remember it's not the problem with paralysis of

not the problem with paralysis of initiation is that you want to start

initiation is that you want to start something but you can't bring yourself

something but you can't bring yourself to start it so if if you're someone who

to start it so if if you're someone who really struggles to get things started

really struggles to get things started what you will find is that there's a

what you will find is that there's a correlation between getting things

correlation between getting things started and being

started and being impulsive because in both cases you're

impulsive because in both cases you're not in control in both cases in one case

not in control in both cases in one case you can't drive over your emotions and

you can't drive over your emotions and in the other case your emotions are

in the other case your emotions are taking advantage of you and they're

taking advantage of you and they're making you impulsive and now you do this

making you impulsive and now you do this and now you do that so these are common

and now you do that so these are common features in cptsd and they have to do

features in cptsd and they have to do with a combination of lack of identity

with a combination of lack of identity and emotional

and emotional disregulation now we get to the third

thing which is

relationships so people who have cptsd have difficulty in their relationships

have difficulty in their relationships now this is where we get to some really

now this is where we get to some really cool neuroscience

here okay let's actually take a look at some science to kind of support these

some science to kind of support these points

points okay

okay so um what we find in people who have

so um what we find in people who have cptsd is that they have poor emotional

cptsd is that they have poor emotional awareness so they're not aware when

awareness so they're not aware when they're feeling emotions right this is a

they're feeling emotions right this is a result of like this dissociative pathway

result of like this dissociative pathway or hemispheric

or hemispheric lateralization so an as emotional

lateralization so an as emotional awareness enables increased

awareness enables increased self-reflection and regulation of

self-reflection and regulation of affective states it is often considered

affective states it is often considered a Cornerstone of emotion regulation so

a Cornerstone of emotion regulation so let's understand this for a

let's understand this for a moment see you can't regulate an emotion

moment see you can't regulate an emotion unless you're aware of an

unless you're aware of an emotion and as we dissociate and we're

emotion and as we dissociate and we're not we we numb ourselves to our emotions

not we we numb ourselves to our emotions then we can't regulate them now this is

then we can't regulate them now this is very important to understand when you

very important to understand when you numb yourself to an emotion it doesn't

numb yourself to an emotion it doesn't mean that the emotion is inactive it

mean that the emotion is inactive it just means that you're not aware of its

just means that you're not aware of its activity so what happens when someone

activity so what happens when someone dissociates is that they're they don't

dissociates is that they're they don't feel any emotion but that part of their

feel any emotion but that part of their brain doesn't completely shut off it is

brain doesn't completely shut off it is still active we're just not aware of it

still active we're just not aware of it so people who struggle with

so people who struggle with cptsd will be less emotionally aware at

cptsd will be less emotionally aware at some times and also paradoxically hyper

some times and also paradoxically hyper emotionally aware at other times okay so

emotionally aware at other times okay so we're not going to go into the

we're not going to go into the neurobiology of emotional selfawareness

neurobiology of emotional selfawareness I think that's a bit too detailed but

I think that's a bit too detailed but let's talk about this okay the

let's talk about this okay the neurocircuitry underlying emotional

neurocircuitry underlying emotional numbing in

numbing in PTSD so increased emotional numbing

PTSD so increased emotional numbing symptoms predicted decreased brain

symptoms predicted decreased brain activation within the dorsomedial

activation within the dorsomedial prefrontal cortex during imagery of both

prefrontal cortex during imagery of both positive and negative social scripts

positive and negative social scripts consistent with the role of dorsomedial

consistent with the role of dorsomedial prefrontal Cortex in higher order

prefrontal Cortex in higher order reflective and metacognitive aspects of

reflective and metacognitive aspects of of emotional functioning

of emotional functioning um so we'll explain what that means in a

um so we'll explain what that means in a second I just want to read this too so

second I just want to read this too so uh the developmental the development of

uh the developmental the development of neural circuitry

neural circuitry facilitating May therefore be disturbed

facilitating May therefore be disturbed in PC PTSD leading to the difficulties

in PC PTSD leading to the difficulties these individuals often have in

these individuals often have in reflecting on interpreting and acting in

reflecting on interpreting and acting in accordance with emotion a patient

accordance with emotion a patient suffering from PTSD related to prolonged

suffering from PTSD related to prolonged childhood abuse summarized feelings of

childhood abuse summarized feelings of emotional numbing in the following

emotional numbing in the following statement it's like a blank I think

statement it's like a blank I think about my kids and I feel nothing for

about my kids and I feel nothing for them I'll be sitting there feeling

them I'll be sitting there feeling confused and numb and I wonder what I'm

confused and numb and I wonder what I'm supposed to be feeling it's like dead

supposed to be feeling it's like dead space and when that happens I have

space and when that happens I have trouble using words finding my words and

trouble using words finding my words and I can't

I can't talk so let's understand how you can

talk so let's understand how you can have

have numbness and feel emotionally

numbness and feel emotionally disregulated this is what we mean by

disregulated this is what we mean by disregulated disregulation doesn't just

disregulated disregulation doesn't just mean hyper action it also hyperactivity

mean hyper action it also hyperactivity it also means low levels of activity and

it also means low levels of activity and high levels of activity at the same time

high levels of activity at the same time and this is where the Neuroscience

and this is where the Neuroscience becomes

becomes important so as we look at the

important so as we look at the Neuroscience of cptsd versus PTSD we

Neuroscience of cptsd versus PTSD we find that there's actually different

find that there's actually different places that emotions come from in the

places that emotions come from in the brain

brain and it turns out that the

and it turns out that the cptsd affects different regions okay so

cptsd affects different regions okay so now we're going to get into the

now we're going to get into the Neuroscience so we have our amydala and

Neuroscience so we have our amydala and then we have this

dorsomedial prefrontal cortex now remember was we looked at

cortex now remember was we looked at this paper we saw that decreased

this paper we saw that decreased activation within the dorsal medial

activation within the dorsal medial prefrontal cortex okay so this is like a

prefrontal cortex okay so this is like a different region so most of the time

different region so most of the time when we talk about

when we talk about emotions what most people especially pop

emotions what most people especially pop neuroscientists like

neuroscientists like myself will talk about is the amydala

myself will talk about is the amydala this is the fear Center the survival

this is the fear Center the survival center the anxiety center of the brain

center the anxiety center of the brain fear

fear anxiety

anxiety survival and what we find in people with

survival and what we find in people with with PTSD is that this is hyperactive so

with PTSD is that this is hyperactive so like think about how this is okay

like think about how this is okay I want you to think about this

I want you to think about this this is so pardon my

this is so pardon my language so here we

language so here we have presumably a man or woman I'm not

have presumably a man or woman I'm not sure who is emotionally disregulated so

sure who is emotionally disregulated so has like panic attacks and stuff like

has like panic attacks and stuff like that has hyperarousal and then when they

that has hyperarousal and then when they look at their kids they feel confused

look at their kids they feel confused and numb so like this is like this is

and numb so like this is like this is not fair so we feel confused and numb to

not fair so we feel confused and numb to our positive emotions but we have a

our positive emotions but we have a hyperactivity of our negative emotions

hyperactivity of our negative emotions like how is that fair panic and anxiety

like how is that fair panic and anxiety and fear we can feel normally or even at

and fear we can feel normally or even at hyperactive levels because remember in

hyperactive levels because remember in PTSD we're we're

PTSD we're we're aroused but love and things like that I

aroused but love and things like that I can't feel so this is something very

can't feel so this is something very important to understand the amydala is

important to understand the amydala is where we feel feel fear and anxiety in

where we feel feel fear and anxiety in survival stuff but a lot of our positive

survival stuff but a lot of our positive emotions a lot of our other emotions

emotions a lot of our other emotions come from other parts of the brain like

come from other parts of the brain like the dorsal medial prefrontal

the dorsal medial prefrontal cortex and so what we see in complex

cortex and so what we see in complex PTSD is specifically a

PTSD is specifically a deactivation of those parts of the brain

deactivation of those parts of the brain we see a deactivation of the positive

we see a deactivation of the positive emotional circuits of the brain which

emotional circuits of the brain which are actually is actually the dorsal

are actually is actually the dorsal medial prefrontal

medial prefrontal cortex while we see a hyperactivation of

cortex while we see a hyperactivation of the amydala which is our fear center now

the amydala which is our fear center now the reason I think this is important is

the reason I think this is important is I see this in a lot of people who do not

I see this in a lot of people who do not have

have cptsd I see a hyperactivation of our

cptsd I see a hyperactivation of our fear for the future the world is going

fear for the future the world is going to hell I'm screwed I'm going to be

to hell I'm screwed I'm going to be alone today is Friday so we have a bunch

alone today is Friday so we have a bunch of posts on our subreddit about how

of posts on our subreddit about how everyone is

everyone is hopeless and yet they have a

hopeless and yet they have a hyperactivation of their negative

hyperactivation of their negative emotions but a hypoactivation of their

emotions but a hypoactivation of their positive emotions how is this Fair it's

positive emotions how is this Fair it's not now we understand the

not now we understand the neuroscientific

neuroscientific mechanism right it's because not all

mechanism right it's because not all emotions come from the same

emotions come from the same place and what we see in P cptsd is

place and what we see in P cptsd is hypoactivation of the dorsomedial part

hypoactivation of the dorsomedial part of the brain so this is where look

of the brain so this is where look positive emotion dorsal medial

positive emotion dorsal medial prefrontal

prefrontal cortex negative emotion was also kind of

cortex negative emotion was also kind of in the same place anyway it's kind of

in the same place anyway it's kind of weird the amydala I think is usually

weird the amydala I think is usually over

over here but yeah it's also weird because

here but yeah it's also weird because this person's backwards anyway so we may

this person's backwards anyway so we may experience negative emotion there it's

experience negative emotion there it's complicated so now what we're going to

complicated so now what we're going to do is talk a little bit uh okay so

do is talk a little bit uh okay so that's that's emotional

that's that's emotional disregulation

disregulation okay um let now let's talk a little bit

okay um let now let's talk a little bit about self-awareness and identity okay

about self-awareness and identity okay so specifically during traumatic memory

so specifically during traumatic memory recall increasing severity of trait

recall increasing severity of trait Alexia we talk a lot about Alexia which

Alexia we talk a lot about Alexia which is emotional color blindness was

is emotional color blindness was associated with reduced activity within

associated with reduced activity within the vent medial prefrontal cortex and

the vent medial prefrontal cortex and interior

interior insula okay we talked about

insula okay we talked about kinling

kinling um so I think we already covered

um so I think we already covered this okay now let's talk about identity

this okay now let's talk about identity right so remember we said that this

right so remember we said that this disturbs our sense of identity

disturbs our sense of identity individuals with PTSD often exhibit

individuals with PTSD often exhibit disturbances in self-referential

disturbances in self-referential processing uh Johnson at Al proposed

processing uh Johnson at Al proposed that the ability to reflect upon on ones

that the ability to reflect upon on ones self requires a robust sense of self

self requires a robust sense of self which has been described as a collection

which has been described as a collection of schemata regarding one's abilities

of schemata regarding one's abilities traits and attitudes that guides our

traits and attitudes that guides our behaviors choices and social

behaviors choices and social interactions so we kind of already

interactions so we kind of already explained this but does this make sense

explained this but does this make sense like the sense of self is a collection

like the sense of self is a collection of ideas they use schemata because it's

of ideas they use schemata because it's not quite an idea about your abilities

not quite an idea about your abilities your traits and your attitudes I like

your traits and your attitudes I like tacos I don't like hot dogs I'm good at

tacos I don't like hot dogs I'm good at this game I'm bad at studying I'm a I'm

this game I'm bad at studying I'm a I'm a dog person I'm a cat person I'm a I'm

a dog person I'm a cat person I'm a I'm a night owl I'm a morning Lark like we

a night owl I'm a morning Lark like we have like this kind of stuff and then

have like this kind of stuff and then also when we have these kinds of beliefs

also when we have these kinds of beliefs about oursel they affect our behaviors

about oursel they affect our behaviors choices and social

choices and social interactions right so if I'm if I am a

interactions right so if I'm if I am a gamer if I identify as a gamer I'm more

gamer if I identify as a gamer I'm more likely to play more video

likely to play more video games

games so now let's understand the mechanism

so now let's understand the mechanism through which people with CP TSD have

through which people with CP TSD have difficulty doing

difficulty doing this neuroimaging studies suggest that

this neuroimaging studies suggest that self-referential processing is partly

self-referential processing is partly mediated by via cortical midline

mediated by via cortical midline structures we're going to focus on the

structures we're going to focus on the anterior singulate okay and the temporal

anterior singulate okay and the temporal pulse temporal prial Junction and

pulse temporal prial Junction and temporal

temporal pulse see if that

pulse see if that no all

no all right so this is

right so this is where basically what happens is the

where basically what happens is the parts of our brain that that give us our

parts of our brain that that give us our sense of self which is the anterior

sense of self which is the anterior singulate the default mode Network and

singulate the default mode Network and our parietal temporo parietal regions of

our parietal temporo parietal regions of the brain these parts are impaired in

the brain these parts are impaired in cptsd so our sense of self does not

cptsd so our sense of self does not function quite the same way now if you

function quite the same way now if you all remember at the very beginning I

all remember at the very beginning I said if you electrically stimulate the

said if you electrically stimulate the temporoparietal junction this is the not

temporoparietal junction this is the not the junction but those regions of the

the junction but those regions of the brain are impaired in cptsd if I

brain are impaired in cptsd if I electrically stimulate the Pro parietal

electrically stimulate the Pro parietal Junction I will trigger an outof Body

Junction I will trigger an outof Body Experience so what is an outof body

Experience so what is an outof body experience that an outof body experience

experience that an outof body experience is an experience of my

is an experience of my Consciousness existing outside of my

Consciousness existing outside of my body right so this is the part of the

body right so this is the part of the brain that governs like my experience of

brain that governs like my experience of self and if it is impaired in some way

self and if it is impaired in some way my sense of identity will not form well

my sense of identity will not form well if my sense of identity does not form

if my sense of identity does not form well that'll result in problems in terms

well that'll result in problems in terms of behaviors the choices that I make

of behaviors the choices that I make Etc the last Dimension that we're going

Etc the last Dimension that we're going to talk

to talk about is

about is relationships so in order to have a

relationships so in order to have a relationship we must have a sense of

relationship we must have a sense of identity because a relationship is

identity because a relationship is something between me and you there's a

something between me and you there's a chunk of you in there and there's a

chunk of you in there and there's a chunk of me in there but if my sense of

chunk of me in there but if my sense of identity is Disturbed my capacity to

identity is Disturbed my capacity to have a relationship with another human

have a relationship with another human being is impaired

being is impaired practically what this looks like is

practically what this looks like is something very similar to BPD where when

something very similar to BPD where when you have cptsd and you try to have a

you have cptsd and you try to have a relationship with someone else like you

relationship with someone else like you don't add a whole lot to the equation

don't add a whole lot to the equation I'm not saying that you don't factually

I'm not saying that you don't factually add value to the relationship what I'm

add value to the relationship what I'm saying is that your personality does not

saying is that your personality does not enter and shape the relationship in the

enter and shape the relationship in the same way that someone who's well formed

same way that someone who's well formed has a well formed sense of identity does

has a well formed sense of identity does you know you sometimes what this means

you know you sometimes what this means is that you become a doormat you become

is that you become a doormat you become a people pleaser you don't really have a

a people pleaser you don't really have a whole lot of strong opinions you become

whole lot of strong opinions you become a chameleon these are all three

a chameleon these are all three different variants of how cptsd shapes

different variants of how cptsd shapes our

our relationships in BPD like sometimes like

relationships in BPD like sometimes like so I I've worked with some women who

so I I've worked with some women who have BPD

have BPD and the people that they date feel like

and the people that they date feel like they found the perfect partner for the

they found the perfect partner for the first couple of weeks because whatever

first couple of weeks because whatever their partner is into they're into and

their partner is into they're into and like I've had friends male friends who

like I've had friends male friends who have who've probably dated women with

have who've probably dated women with BPD and I I've heard what the way that

BPD and I I've heard what the way that they describe them they'll say like oh

they describe them they'll say like oh my God this person is amazing she's into

my God this person is amazing she's into like anime and she's into this and she

like anime and she's into this and she likes she hates wine and she loves beer

likes she hates wine and she loves beer she likes she loves matcha but she hates

she likes she loves matcha but she hates coffee she's like perfect she's like a

coffee she's like perfect she's like a female version of me and she's

female version of me and she's hot and so they'll say things like this

hot and so they'll say things like this and the gender roles can be reversed too

and the gender roles can be reversed too absolutely but what happens is when when

absolutely but what happens is when when we don't have a sense sense of self it

we don't have a sense sense of self it becomes hard to have a relationship

becomes hard to have a relationship because we absorb the other person's

because we absorb the other person's things so in BPD it's more about

things so in BPD it's more about absorption of the other person in cptsd

absorption of the other person in cptsd it doesn't have to be that way we can

it doesn't have to be that way we can see doormat we can see people pleaser

see doormat we can see people pleaser because I don't have a sense of

because I don't have a sense of identity and once we have these doormat

identity and once we have these doormat and people pleaser Tendencies we also

and people pleaser Tendencies we also open ourselves up for more toxicity in

open ourselves up for more toxicity in relationships because I don't advocate

relationships because I don't advocate for

for myself right because I you're better

myself right because I you're better than I am I don't have a sense when you

than I am I don't have a sense when you treat me like crap I do not have

treat me like crap I do not have something in here that instinctively

something in here that instinctively Rebels so if you have a well-formed

Rebels so if you have a well-formed sense of

sense of identity and someone treats you like

identity and someone treats you like crap you recognize that you deserve

crap you recognize that you deserve better and that idea that you deserve

better and that idea that you deserve better where do that idea comes from it

better where do that idea comes from it comes from a sense of self it when you

comes from a sense of self it when you just think about the mechanics of this

just think about the mechanics of this okay think about the language that I'm

okay think about the language that I'm using when I say I deserve better there

using when I say I deserve better there is a stable

is a stable conception of what I this quantity of I

conception of what I this quantity of I deserves I don't deserve $10 million I

deserves I don't deserve $10 million I don't deserve zero doar I deserve

don't deserve zero doar I deserve $100 that is based on your

$100 that is based on your identity now in the case of narcissism

identity now in the case of narcissism that identity is too

that identity is too high so what that means is if anyone

high so what that means is if anyone remember this root of narcissism is

remember this root of narcissism is actually insecurity so if anyone gives

actually insecurity so if anyone gives you even 1% less than you deserve you

you even 1% less than you deserve you become prickly like a

become prickly like a porcupine you're like I deserve better

porcupine you're like I deserve better and it's like bro like you got what you

and it's like bro like you got what you deserve this is crazy like I did

deserve this is crazy like I did everything that I could for

everything that I could for you and the opposite is also true where

you and the opposite is also true where when you don't deserve any like when you

when you don't deserve any like when you deserve when you don't have a sense of

deserve when you don't have a sense of self then how can you deserve if you

self then how can you deserve if you have no eye no stable sense of self and

have no eye no stable sense of self and what you

what you deserve so this creates all kinds of

deserve so this creates all kinds of problems in relationships and we see

problems in relationships and we see that in in cptsd right so the dis

that in in cptsd right so the dis disturbances of self-organization result

disturbances of self-organization result in emotional

in emotional disregulation hyperactivity using

disregulation hyperactivity using something like a kindling mechanism

something like a kindling mechanism especially in the negative emotional

especially in the negative emotional regions of the brain where you have this

regions of the brain where you have this sub threshold electrical activity that

sub threshold electrical activity that then activates it's like you're just

then activates it's like you're just going about your day and then suddenly

going about your day and then suddenly you feel intensely sad and you're like

you feel intensely sad and you're like what the right you don't actually

what the right you don't actually think that way because it's normal for

think that way because it's normal for you but people outside of you look at

you but people outside of you look at you and they're like I don't understand

you and they're like I don't understand why this person just gets so upset so

why this person just gets so upset so randomly and they do what they can to

randomly and they do what they can to help and if you know people in your life

help and if you know people in your life who do this right they just go into

who do this right they just go into funks for like very intensely for a day

funks for like very intensely for a day and you're like what's wrong and they're

and you're like what's wrong and they're like I don't know or nothing and then we

like I don't know or nothing and then we if you're if you're like a normal person

if you're if you're like a normal person right I don't mean that in a in a

right I don't mean that in a in a judgmental way I mean that if you have a

judgmental way I mean that if you have a brain that is not developed like this

brain that is not developed like this you look at this and you say tell me

you look at this and you say tell me what's wrong and they say nothing's

what's wrong and they say nothing's wrong and they're crying their

wrong and they're crying their eyes out and you're like what the

eyes out and you're like what the because and and the thing is in their

because and and the thing is in their case it they're right nothing is wrong

case it they're right nothing is wrong this is what's wild about trauma see

this is what's wild about trauma see when you look at someone like that and

when you look at someone like that and you think there must be something wrong

you think there must be something wrong why because in order for you to cry that

why because in order for you to cry that hard you need something that is so

hard you need something that is so powerful that it overcomes your sense of

powerful that it overcomes your sense of self and makes you cry really hard in

self and makes you cry really hard in their case they have a seizure

their case they have a seizure like activity in their amydala that just

like activity in their amydala that just disregulated

a different way the rules that the brain is playing by are different that's

is playing by are different that's what's wrong with you there's nothing

what's wrong with you there's nothing wrong with your personhood the way that

wrong with your personhood the way that your neurons are activating are closer

your neurons are activating are closer to a seizure which is why you have the

to a seizure which is why you have the disrupted emotional regulation and you

disrupted emotional regulation and you just feel things so intensely and it

just feel things so intensely and it comes out of nowhere and it's so

comes out of nowhere and it's so confusing and it's so

debilitating okay and then there's also dorso medial

okay and then there's also dorso medial numbness which results in like not being

numbness which results in like not being able to like do things like feel

able to like do things like feel spontaneous love for your kids and all

spontaneous love for your kids and all that kind of stuff it's all super sad

that kind of stuff it's all super sad and super debilitating cptsd is a really

and super debilitating cptsd is a really bad

bad diagnosis good news is that it can get

diagnosis good news is that it can get very you can get way better right so

very you can get way better right so this is not it's

this is not it's not

not um it's not your

um it's not your destiny so the cool thing and I guess

destiny so the cool thing and I guess we'll get into this now is that we

we'll get into this now is that we actually know we have a sequence of

actually know we have a sequence of things that you can do that will

things that you can do that will sustainably get you better now there are

sustainably get you better now there are a couple of good things about

a couple of good things about treatment the first thing to understand

treatment the first thing to understand is that trauma is an

is that trauma is an adaptation which means that you weren't

adaptation which means that you weren't born this way this is your brain

born this way this is your brain adapting to circumstances which means

adapting to circumstances which means that if your brain adapted once it can

that if your brain adapted once it can adapt again right this is very different

adapt again right this is very different from something like having a genetic you

from something like having a genetic you know a two recessive that result in a

know a two recessive that result in a genetic deficiency in the blueprint of

genetic deficiency in the blueprint of what your body is capable of making

what your body is capable of making there is a problem so until we get to

there is a problem so until we get to Gene replacement therapy like there's

Gene replacement therapy like there's nothing that can be done about that

nothing that can be done about that right like the fundamental Machinery

right like the fundamental Machinery like there's no it's like we're building

like there's no it's like we're building a computer but there's like no place for

a computer but there's like no place for the

the CPU right and then like there's no way

CPU right and then like there's no way to get that computer to work the good

to get that computer to work the good news about trauma is even though it is

news about trauma is even though it is so debilitating even though it it feels

so debilitating even though it it feels like it it screws over every dimension

like it it screws over every dimension of your

of your life the majority of it can get better

life the majority of it can get better because these are all adaptations

because these are all adaptations they're not the core thing they're the

they're not the core thing they're the stuff that you've layered on top so you

stuff that you've layered on top so you can systematically go about changing

can systematically go about changing that okay so how do we change this the

that okay so how do we change this the first thing that we have to do is rewire

first thing that we have to do is rewire our physiology okay so we go through

our physiology okay so we go through this in a more step-by-step process in

this in a more step-by-step process in the guide so a lot of people with trauma

the guide so a lot of people with trauma and Vander kulk is a big advocate of

and Vander kulk is a big advocate of this so he runs this place called the

this so he runs this place called the center of trauma and they do a lot of

center of trauma and they do a lot of yoga so what we tend to find is there

yoga so what we tend to find is there are a couple of key principles the first

are a couple of key principles the first is you have to be comfortable in your

is you have to be comfortable in your own body and mind body practices are

own body and mind body practices are very good at doing this so we what we

very good at doing this so we what we specifically want to do to be

specifically want to do to be comfortable within our own body our body

comfortable within our own body our body has these the sense of we actually have

has these the sense of we actually have six senses okay the six sense the six

six senses okay the six sense the six sense is

sense is not being able to see dead people the

not being able to see dead people the sense is something called

sense is something called proprioception so proprioception is our

proprioception so proprioception is our sense of our body in space so if I like

sense of our body in space so if I like close my eyes and I lift my arm I can

close my eyes and I lift my arm I can tell where my arm is that's technically

tell where my arm is that's technically not the same as touching something right

not the same as touching something right this is like a sense of where my body is

this is like a sense of where my body is and proprioception seems to be really

and proprioception seems to be really good at helping us rewire our physiology

good at helping us rewire our physiology so a lot of studies show that things

so a lot of studies show that things like yoga and taii are very effective

like yoga and taii are very effective for condition that have hyperactivity of

for condition that have hyperactivity of the central nervous system or sorry not

the central nervous system or sorry not Central autonomic nervous system panic

Central autonomic nervous system panic attacks high blood pressure anxiety

attacks high blood pressure anxiety disorders postural orthostatic tartic

disorders postural orthostatic tartic syndrome Mind Body practices are really

syndrome Mind Body practices are really good at this we know that mindbody

good at this we know that mindbody practices recruit things like the vagus

practices recruit things like the vagus nerve which is our our primary

nerve which is our our primary parasympathetic nerve in the body so

parasympathetic nerve in the body so when we meditate our vagus nerve turns

when we meditate our vagus nerve turns on it slows down our heart rate it slows

on it slows down our heart rate it slows down it decreases our blood pressure it

down it decreases our blood pressure it activates our GI system it does all

activates our GI system it does all kinds of good

kinds of good stuff so practically what I describe is

stuff so practically what I describe is what we really want to do is something

what we really want to do is something called autonomic

called autonomic stretch so the best way to so this is

stretch so the best way to so this is important to understand so remember that

important to understand so remember that our nervous system our autonomic nervous

our nervous system our autonomic nervous system has sympathetic and

system has sympathetic and parasympathetic okay actually go back to

parasympathetic okay actually go back to this

this work okay great so I'm going to show you all this okay so let's take a

look okay so our nervous system our autonomic nervous system has sympathetic

autonomic nervous system has sympathetic nervous system and parasympathetic

nervous system and parasympathetic nervous system

nervous system okay so normally what happens is this

okay so normally what happens is this one is active about 50% of the time and

one is active about 50% of the time and this one is active about 50% of the time

this one is active about 50% of the time and anywhere between 45 minutes and 2

and anywhere between 45 minutes and 2 hours

hours is the oscillation between the

is the oscillation between the two so the problem with stress is not

two so the problem with stress is not the stress it's that it's chronic so

the stress it's that it's chronic so when we have chronic strength stress we

when we have chronic strength stress we have 90% activation over here and we

have 90% activation over here and we have 10% activation over here so it

have 10% activation over here so it becomes difficult then what happens is

becomes difficult then what happens is our body gets stuck in this

our body gets stuck in this mode so anytime the body gets stuck it

mode so anytime the body gets stuck it loses flexibility I know it's kind of

loses flexibility I know it's kind of like a silly statement but so in in

like a silly statement but so in in Physical Medicine right so Physical

Physical Medicine right so Physical Medicine and Rehab sometimes we'll have

Medicine and Rehab sometimes we'll have something called a muscle

something called a muscle contracture so muscle contracture is

contracture so muscle contracture is when you hold your your body in a

when you hold your your body in a certain way okay and when you wow that

certain way okay and when you wow that vein looks

vein looks huge sorry distracted by

huge sorry distracted by it's a real pity I don't shoot

it's a real pity I don't shoot heroin cuz that's one hell of a

heroin cuz that's one hell of a pain okay um

so this is why I love streaming like you know when I'm when I'm like teaching at

know when I'm when I'm like teaching at like medical schools like you can't do

like medical schools like you can't do that all right this is why I love

that all right this is why I love teaching here all right so if I hold my

teaching here all right so if I hold my body in a particular posture I will

body in a particular posture I will develop something called a contracture

develop something called a contracture so a muscle can get locked into

so a muscle can get locked into tightness okay so if I'm like sitting at

tightness okay so if I'm like sitting at my computer all day the trapezius will

my computer all day the trapezius will get very tight your scaling muscles will

get very tight your scaling muscles will get very tight your anterior scalings

get very tight your anterior scalings will get super tight if you want to feel

will get super tight if you want to feel how tight your anterior scalings are by

how tight your anterior scalings are by the way this is super cool exercise you

the way this is super cool exercise you can do what I want you to do is tuck

can do what I want you to do is tuck your chin back and turn and what you'll

your chin back and turn and what you'll feel if you just tuck your chin back and

feel if you just tuck your chin back and then turn you'll feel like this super

then turn you'll feel like this super tight muscle over here so when our when

tight muscle over here so when our when our muscles are in a sustained

our muscles are in a sustained contraction they lose flexibility

contraction they lose flexibility so this happens in our nervous system as

so this happens in our nervous system as well they get locked into a sympath a

well they get locked into a sympath a hyperactivation of the sympathetic

hyperactivation of the sympathetic nervous system so what we want to do is

nervous system so what we want to do is increase our autonomic stretch and the

increase our autonomic stretch and the beautiful thing about this is that when

beautiful thing about this is that when when you look at stress okay this is

when you look at stress okay this is fascinating you can meditate to decrease

fascinating you can meditate to decrease stress or you can exercise to decre

stress or you can exercise to decre decrease stress that's weird because

decrease stress that's weird because when you exercise you're not relaxing

when you exercise you're not relaxing you're actually doing the opposite you

you're actually doing the opposite you are activating the par the sympathetic

are activating the par the sympathetic nervous system so the cool thing about

nervous system so the cool thing about autonomic stretch is anytime we

autonomic stretch is anytime we hyperactivate the sympathetic nervous

hyperactivate the sympathetic nervous system we automatically send a signal to

system we automatically send a signal to our body that we are going to rest when

our body that we are going to rest when we are done so if I'm at a chronic state

we are done so if I'm at a chronic state of

is let's say this is the midpoint and let's say this is sympathetic

and let's say this is sympathetic nervous system this is parasympathetic

nervous system this is parasympathetic nervous system so most of us live over

nervous system so most of us live over here but if you are in a chronic stress

here but if you are in a chronic stress state you live over here so how do we

state you live over here so how do we get things back over here one thing we

get things back over here one thing we can do is

can do is meditate meditate brings us

meditate meditate brings us here and then after we're done

here and then after we're done meditating maybe we'll go to there the

meditating maybe we'll go to there the other thing that we can actually do is

other thing that we can actually do is exercise so exercising will actually

exercise so exercising will actually bring us up here but when we get up here

bring us up here but when we get up here right so when you exercise a lot what do

right so when you exercise a lot what do you feel like doing you feel like

you feel like doing you feel like resting so if I run really really hard

resting so if I run really really hard and my CO2 level

and my CO2 level spikes and my O2 level starts to drop as

spikes and my O2 level starts to drop as I'm increasing muscular respiration I

I'm increasing muscular respiration I mean muscular respiration my body is

mean muscular respiration my body is like oh crap we've run out of oxygen now

like oh crap we've run out of oxygen now sit the down and rest so we feel

sit the down and rest so we feel exhausted after exercise we don't feel

exhausted after exercise we don't feel energetic which means that once we hit

energetic which means that once we hit this point this triggers a signal in our

this point this triggers a signal in our body to go back down

body to go back down here and then when we end up we'll end

here and then when we end up we'll end up here now the cool thing is when you

up here now the cool thing is when you do both exercise and meditate you will

do both exercise and meditate you will get here

get here faster and if you do this kind of thing

faster and if you do this kind of thing it will actually improve

it will actually improve your it'll improve your autonomic

your it'll improve your autonomic arousal so it'll help with things like

arousal so it'll help with things like trauma it'll help with things like

trauma it'll help with things like generalized anxiet disorder it'll help

generalized anxiet disorder it'll help with things like panic attacks you can

with things like panic attacks you can do both the key thing is actually

do both the key thing is actually oscillating see if I want to stretch a

oscillating see if I want to stretch a muscle stretching a muscle isn't just

muscle stretching a muscle isn't just doing this stretching a muscle is doing

doing this stretching a muscle is doing this and then doing this and then doing

this and then doing this and then doing this and then doing this this is what

this and then doing this this is what really increases

really increases flexibility okay it's not just going

flexibility okay it's not just going like this and keeping it there this in

like this and keeping it there this in turn will lock the muscle into this

turn will lock the muscle into this configuration so we want to alternate

configuration so we want to alternate between the

between the two so as we rewire that physiology our

two so as we rewire that physiology our hyperarousal will come down second thing

hyperarousal will come down second thing we need to do is reconnect with our

we need to do is reconnect with our emotions now this is where the cool

emotions now this is where the cool thing is that we actually don't have to

thing is that we actually don't have to reconnect with our emotions to reconnect

reconnect with our emotions to reconnect with our emotions okay give me a

with our emotions okay give me a second

second um let me see if I can find

um let's see if I can find I think it's over here hold on you guys can look with

me ah there we go

there we go okay thank God I remember the word that

okay thank God I remember the word that they used okay um

they used okay um [Music]

[Music] and okay so conceptual emotional

and okay so conceptual emotional awareness refers to the the ability to

awareness refers to the the ability to reflect on interpret and make a decision

reflect on interpret and make a decision about an embodied sensation or emotion

about an embodied sensation or emotion okay um so there are a couple of

okay um so there are a couple of different things that we can do to

different things that we can do to increase our

this yeah okay during this phase of treatment patients have to develop an

treatment patients have to develop an awareness and language that helps them

awareness and language that helps them identify bodily Sensations and how

identify bodily Sensations and how different bodily Sensations relate to

different bodily Sensations relate to different emotional experiences for

different emotional experiences for example for one person tension in the

example for one person tension in the jaw in combination with a feeling of

jaw in combination with a feeling of tightness in the throat May correlate

tightness in the throat May correlate with sadness while in another individual

with sadness while in another individual sadness May correlate with tightness in

sadness May correlate with tightness in the stomach and a feeling of heaviness

the stomach and a feeling of heaviness in the chest by developing emotional

in the chest by developing emotional awareness patients can learn to identify

awareness patients can learn to identify precursors blah blah blah blah blah blah

precursors blah blah blah blah blah blah blah okay so there's basically two or

blah okay so there's basically two or three things that we're going to do to

three things that we're going to do to reconnect with our emotions the first is

reconnect with our emotions the first is just be aware of your bodily Sensations

just be aware of your bodily Sensations so remember and this is what's cool

so remember and this is what's cool about the

Neuroscience okay I'm going to try to explain this because this is huge but I

explain this because this is huge but I don't know if I can explain

don't know if I can explain it so if we look at this

it so if we look at this paper okay what this paper tells

paper okay what this paper tells us where's table one is that different

us where's table one is that different parts of our brain are messed up by

parts of our brain are messed up by PTSD come on table one where are you at

PTSD come on table one where are you at table one there we go okay so if we look

table one there we go okay so if we look at table one here are all the things

at table one here are all the things that are affected so medial prefrontal

that are affected so medial prefrontal cortex self

cortex self referential you know um let's look at

referential you know um let's look at the anterior singulate integrates

the anterior singulate integrates cognitive and emotional aspects of

cognitive and emotional aspects of experience right we have all these

experience right we have all these different parts of the

different parts of the brain now the thing is these parts of

brain now the thing is these parts of the brain have these broad functions

the brain have these broad functions right so the the thing to understand

right so the the thing to understand about the brain is we used to think that

about the brain is we used to think that like a particular part of the brain does

like a particular part of the brain does a particular

a particular thing but what I want youall to

thing but what I want youall to understand is that regions of the brain

understand is that regions of the brain are like letters of the

are like letters of the alphabet the way that they connect and

alphabet the way that they connect and combine with each other is actually what

combine with each other is actually what creates a particular phenomenon in our

creates a particular phenomenon in our life so curiosity or love there isn't a

life so curiosity or love there isn't a love Center to the brain a love Center

love Center to the brain a love Center the love Cent the the way we experience

the love Cent the the way we experience love in the brain can just hypothesize

love in the brain can just hypothesize based on this is some medial prefrontal

based on this is some medial prefrontal cortex some anterior singulate

cortex some anterior singulate cortex some

cortex some amygdala and some insula see when we

amygdala and some insula see when we combine

combine self-referential this is me I am in love

self-referential this is me I am in love and there's an emotion emotional aspect

and there's an emotion emotional aspect there's emotional salience what that

there's emotional salience what that means is feeling this means this thing

means is feeling this means this thing what is the significance of the emotion

what is the significance of the emotion I have a sense of me I have this emotion

I have a sense of me I have this emotion I attach a significance to the emotion

I attach a significance to the emotion and then I also have some degree of fear

and then I also have some degree of fear because what if this person doesn't love

because what if this person doesn't love me

me back and then I also have bodily

back and then I also have bodily self-awareness because when they're

self-awareness because when they're around I start to feel changes in my

around I start to feel changes in my body my body changes I ache for you I

body my body changes I ache for you I need your

need your body that's what love is there isn't a

body that's what love is there isn't a part of the brain it is a concert of

part of the brain it is a concert of different parts of the brain interacting

different parts of the brain interacting with each

with each other okay literally like so like if you

other okay literally like so like if you guys have been in love you know what I

guys have been in love you know what I mean like your body aches for someone

mean like your body aches for someone else like think about that from a

else like think about that from a neuroscientific perspective you can't

neuroscientific perspective you can't ache for someone else unless the part of

ache for someone else unless the part of your body that senses your

your body that senses your Sensations is aware of what you feel in

Sensations is aware of what you feel in here is active in some

here is active in some way okay so now we have a problem which

way okay so now we have a problem which is that these parts of the brain are

is that these parts of the brain are shut off in

shut off in trauma

trauma simplification so the cool thing is that

simplification so the cool thing is that in order to reverse this process we do

in order to reverse this process we do not have to fix it we just have to

not have to fix it we just have to awaken the part of the

awaken the part of the brain see if we increase the activity of

brain see if we increase the activity of the brain if we like reawaken our dorsal

the brain if we like reawaken our dorsal medial cortex prefrontal cortex right

medial cortex prefrontal cortex right this where positive emotions come from

this where positive emotions come from all we have to do is activate that in

all we have to do is activate that in some way and once it's on it will start

some way and once it's on it will start to feel other things we see this in

to feel other things we see this in clinical trials and I see it in my

clinical trials and I see it in my clinical practice I'm somewhat

clinical practice I'm somewhat extrapolating here so in clinical trials

extrapolating here so in clinical trials on yoga for trauma just think about this

on yoga for trauma just think about this for a second what the is the

for a second what the is the mechanism it's not just autonomic

mechanism it's not just autonomic nervous system what's happening is we

nervous system what's happening is we are activating this part of the brain

are activating this part of the brain through this yogic practice I can't find

through this yogic practice I can't find the sentence in in this paper but even

the sentence in in this paper but even the paper sort of talks about all we

the paper sort of talks about all we have to do is just activate the part of

have to do is just activate the part of the brain even just increasing your

the brain even just increasing your awareness of emotions and even awareness

awareness of emotions and even awareness of your body you don't have to increase

of your body you don't have to increase awareness of emotions you just increase

awareness of emotions you just increase awareness of the body and you will have

awareness of the body and you will have an increased awareness of emotion why

an increased awareness of emotion why because some part of an emotion is

because some part of an emotion is physical butter flies in the stomach

physical butter flies in the stomach tightness in the

tightness in the throat so you can kind of backend

throat so you can kind of backend emotional awareness through bodily

emotional awareness through bodily awareness then what you can do is by the

awareness then what you can do is by the way I don't know if yall noticed this

way I don't know if yall noticed this but we've been teaching you all this

but we've been teaching you all this crap for years and that wasn't because I

crap for years and that wasn't because I read this paper it's because I sort of

read this paper it's because I sort of found this in my clinical experience

found this in my clinical experience that especially for men accessing their

that especially for men accessing their emotions through their body is very

emotions through their body is very good okay so

good okay so increased autonomic flexibility number

increased autonomic flexibility number one increased awareness of the body

one increased awareness of the body number two third thing is articulate

number two third thing is articulate your emotions physically if you don't if

your emotions physically if you don't if you don't have awareness of them fourth

you don't have awareness of them fourth thing we want to

thing we want to do what's the fourth thing oh yeah

do what's the fourth thing oh yeah articulate our emotions

articulate our emotions actually attach language to them this we

actually attach language to them this we go into in a lot more detail we can't go

go into in a lot more detail we can't go into everything in all detail in in the

into everything in all detail in in the guide but the cool thing is remember we

guide but the cool thing is remember we have this problem of hemispheric

have this problem of hemispheric lateralization which means negative

lateralization which means negative emotions are over here or emotions are

emotions are over here or emotions are over here and languages over here when

over here and languages over here when we have decreased awareness I me

we have decreased awareness I me decreased communication through

decreased communication through decreased activity across the Corpus

decreased activity across the Corpus colossum right and left hemispheres

colossum right and left hemispheres aren't talking what do you feel I don't

aren't talking what do you feel I don't know frustrated stressed those aren't

know frustrated stressed those aren't emotion I mean frustration isn't emotion

emotion I mean frustration isn't emotion there's no emotional Nuance so in order

there's no emotional Nuance so in order to literally articulate your emotion you

to literally articulate your emotion you have to increase the connectivity so as

have to increase the connectivity so as you as I ask you what do you feel what

you as I ask you what do you feel what do you feel what do you feel as you

do you feel what do you feel as you struggle to answer what's going on is

struggle to answer what's going on is your neurons from this side are reaching

your neurons from this side are reaching over and connecting with your neurons

over and connecting with your neurons over here what do I feel it's like hard

over here what do I feel it's like hard it's like you're reaching reaching

it's like you're reaching reaching trying to grab it trying to grab it

trying to grab it trying to grab it trying to grab it and even if you fail

trying to grab it and even if you fail to say the right thing even if you don't

to say the right thing even if you don't know what you you experience you don't

know what you you experience you don't know what you feel those neurons are

know what you feel those neurons are reaching that's where the money

reaching that's where the money is so I've seen this a lot where people

is so I've seen this a lot where people feel like the therapy isn't

feel like the therapy isn't working because they don't see progress

working because they don't see progress in 3 weeks and if you're looking for the

in 3 weeks and if you're looking for the ability to articulate in 3 weeks it's

ability to articulate in 3 weeks it's not going to happen but the therapy is

not going to happen but the therapy is working because your neurons are

working because your neurons are Reaching Across the Corpus kosum

Reaching Across the Corpus kosum bridging that Chasm and eventually the

bridging that Chasm and eventually the they'll figure it out and if they figure

they'll figure it out and if they figure it out then once they figure it out it's

it out then once they figure it out it's figured out you will level up your EQ

figured out you will level up your EQ you will level up your emotional

you will level up your emotional awareness and that will be a neuronal

awareness and that will be a neuronal connection that is

connection that is formed this is why I have hope for

formed this is why I have hope for people with

people with trauma see everyone thinks it's all

trauma see everyone thinks it's all about these temporary States like I'm

about these temporary States like I'm emotional no what we're doing is we're

emotional no what we're doing is we're laying neuronal

laying neuronal highways and once the highway when the

highways and once the highway when the highway is 90% built there's no traffic

highway is 90% built there's no traffic but the moment it gets built you can get

but the moment it gets built you can get a ton of traffic across so what I tend

a ton of traffic across so what I tend to see when I work with people is that

to see when I work with people is that their progress is nothing nothing

their progress is nothing nothing nothing boom nothing nothing nothing

nothing boom nothing nothing nothing nothing boom nothing nothing nothing

nothing boom nothing nothing nothing nothing

nothing nothing so this is what we want to do we

nothing so this is what we want to do we want to utilize language so as we Pro

want to utilize language so as we Pro discover our emotions then that allows

discover our emotions then that allows us to do a couple of different things

us to do a couple of different things okay so we're going to go back to this

okay so we're going to go back to this person who's

person who's numb oh God

uh where is that quote looking for the one oh yeah okay

quote looking for the one oh yeah okay here it

here it is

is so remember this where we say it's a

so remember this where we say it's a blank I think about my kids and I feel

blank I think about my kids and I feel nothing for them I'll be sitting there

nothing for them I'll be sitting there feeling confused and numb and I wonder

feeling confused and numb and I wonder what's supposed to it's like a dead

what's supposed to it's like a dead space right so this is dorsal medial

space right so this is dorsal medial prefrontal cortex is not active

prefrontal cortex is not active now when this person lives this life

and they go to their child's birthday party and they feel

party and they feel nothing there's nothing they don't have

nothing there's nothing they don't have a s like their identity is lost does

a s like their identity is lost does this make sense because like if you

this make sense because like if you think about what does it mean to be a

think about what does it mean to be a parent like I went to this birthday

parent like I went to this birthday party for my kid I planned it I saw the

party for my kid I planned it I saw the Joy on their face I saw all their

Joy on their face I saw all their friends be super super happy they've

friends be super super happy they've been struggling to make friends at

been struggling to make friends at school but everyone had such a good time

school but everyone had such a good time that now their social like status

that now their social like status amongst their friends is now improved so

amongst their friends is now improved so that makes me happy now I feel like a

that makes me happy now I feel like a good parent but I can't feel like a good

good parent but I can't feel like a good parent unless I can connect with the joy

parent unless I can connect with the joy in my

in my child so not only does this person feel

child so not only does this person feel emotionally enough their sense of

emotionally enough their sense of identity is going to be

identity is going to be compromised so that's where once we

compromised so that's where once we start feeling things we're going to do

start feeling things we're going to do two things to rebuild our sense of

two things to rebuild our sense of identity the first is there's a lot of

identity the first is there's a lot of dormant negative emotion which our mind

dormant negative emotion which our mind has dissociated from which still lingers

has dissociated from which still lingers there and the reason we dissociate from

there and the reason we dissociate from it is because it's overwhelming if we

it is because it's overwhelming if we let it overwhelm us our sense of

let it overwhelm us our sense of identity will get swept away so as we

identity will get swept away so as we start connecting the two parts of our

start connecting the two parts of our brain and articulating stuff all of that

brain and articulating stuff all of that emotional Energy starts getting vented

emotional Energy starts getting vented and essentially the negative emotions

and essentially the negative emotions that we store start

that we store start leaving if you do this process in

leaving if you do this process in Psychotherapy even better because it'll

Psychotherapy even better because it'll go

go faster as these things start to

faster as these things start to leave then your negative sense of

leave then your negative sense of identity will disappear with it the

identity will disappear with it the second thing that will happen is you

second thing that will happen is you will start to be able to engage in

will start to be able to engage in positive experiences which will then

positive experiences which will then recreate your

recreate your identity so now when you climb to the

identity so now when you climb to the top of the mountain you'll feel

top of the mountain you'll feel something and then you'll be like I did

something and then you'll be like I did it right so in both cases you did it but

it right so in both cases you did it but in one case you don't feel that you did

in one case you don't feel that you did it and in the other case you feel that

it and in the other case you feel that you did it you need dorsal medial

you did it you need dorsal medial prefrontal activation to feel like you

prefrontal activation to feel like you did

did it

it okay then what happens is once we awaken

okay then what happens is once we awaken different parts of the

brain where's [Music]

I can't find it what the okay I'll just explain it to yall

okay I'll just explain it to yall without showing you all the paper okay

without showing you all the paper okay I'll try to find it later

I'll try to find it later oh okay so

oh okay so next thing

next thing is

um what did I want to say so the next thing is that if we look

thing is that if we look at the Neuroscience of

at the Neuroscience of emotions what we now know is that not

emotions what we now know is that not all emotions are like the same

all emotions are like the same Neuroscience so we have something called

Neuroscience so we have something called affective

affective Neuroscience which is the emotions that

Neuroscience which is the emotions that relate to like the way that we feel

relate to like the way that we feel about the way we feel about our not

about the way we feel about our not about ourselves the way that we feel let

about ourselves the way that we feel let me start over so we now know that

me start over so we now know that emotions can be divided into two

emotions can be divided into two camps affective Neuroscience are the

camps affective Neuroscience are the emotions that are independent of society

emotions that are independent of society so for example if I'm hiking down a

so for example if I'm hiking down a mountain and a bear shows

mountain and a bear shows up like I can feel fear or Joy or

up like I can feel fear or Joy or whatever right like I can feel that like

whatever right like I can feel that like I don't need a human being but if we

I don't need a human being but if we look at human emotions there's a pile of

look at human emotions there's a pile of human emotions that require a social

human emotions that require a social connection

connection shame guilt Pride you cannot be proud

shame guilt Pride you cannot be proud without someone observing your pride you

without someone observing your pride you cannot be shamed without being observed

cannot be shamed without being observed you can't feel guilty without doing

you can't feel guilty without doing something bad for someone else so what

something bad for someone else so what we've actually discovered is that there

we've actually discovered is that there a couple of different emotional centers

a couple of different emotional centers in the brain and these primitive

in the brain and these primitive emotions that reptiles reptiles can feel

emotions that reptiles reptiles can feel fear they can feel anger right but I

fear they can feel anger right but I don't know that reptiles can feel proud

don't know that reptiles can feel proud like I don't know if like a crocodile

like I don't know if like a crocodile like has the social connection with

like has the social connection with other crocodiles to feel Pride when we

other crocodiles to feel Pride when we get to primates and stuff they

get to primates and stuff they absolutely can so there is a social

absolutely can so there is a social connection pile of emotions those

connection pile of emotions those emotions exist in a different part of

emotions exist in a different part of the brain they get activated under

the brain they get activated under different circumstances so once we start

different circumstances so once we start developing our identity these emotions

developing our identity these emotions will arise as well they will start

will arise as well they will start getting fixed once these emotions get

getting fixed once these emotions get fixed so it's not just the sense of

fixed so it's not just the sense of identity so now I built a sense of

identity so now I built a sense of identity and my social cognitive

identity and my social cognitive emotions have become active so once

emotions have become active so once these two things get fixed now I can fix

relationships because when the shame Within Me is haywire and not functioning

Within Me is haywire and not functioning correctly it becomes very hard to engage

correctly it becomes very hard to engage in a relationship my partner tells me I

in a relationship my partner tells me I love you I think you're beautiful and I

love you I think you're beautiful and I feel ashamed of myself so I say no I'm

not so that becomes hard until that part of my brain gets kind of cleaned out and

of my brain gets kind of cleaned out and normalized then I can do things like

normalized then I can do things like accept

compliments okay so then the last thing to get fixed is

to get fixed is relationships now in our community why

relationships now in our community why is this

is this important see in our community there's a

important see in our community there's a lot of people especially because today's

lot of people especially because today's a Friday and Friday is relationships day

a Friday and Friday is relationships day who are saying I'm struggling to get

who are saying I'm struggling to get into a relationship and outside of our

into a relationship and outside of our community not just our commun everyone's

community not just our commun everyone's struggling to get into a relationship

struggling to get into a relationship right some people are you know having

right some people are you know having sex and stuff some people are friends

sex and stuff some people are friends with benefits very few people are happy

with benefits very few people are happy with their relationships and people say

with their relationships and people say how do I fix my relationship how do I

how do I fix my relationship how do I fix my relationship and what everyone

fix my relationship and what everyone says is work on yourself first and then

says is work on yourself first and then people get frustrated by this

people get frustrated by this answer now I hope yall understand the

answer now I hope yall understand the mechanism

mechanism see this is where like when I see people

see this is where like when I see people like tweeting stuff I can't say all of

like tweeting stuff I can't say all of this but if you want to understand how

this but if you want to understand how to fix your relationship or if anyone

to fix your relationship or if anyone you know wants to understand how to fix

you know wants to understand how to fix them Rel their relationship they need to

them Rel their relationship they need to watch this

watch this video because we have to understand that

video because we have to understand that the

the relationship is at the height of what a

relationship is at the height of what a human being can fix it is at the top of

human being can fix it is at the top of the pyramid you can't fix a relationship

the pyramid you can't fix a relationship if you don't feel emotions you can't fix

if you don't feel emotions you can't fix a relationship if your emotions are

a relationship if your emotions are disregulated you can't fix a

disregulated you can't fix a relationship if your dorsal medial

relationship if your dorsal medial prefrontal cortex cannot feel Joy and

prefrontal cortex cannot feel Joy and accomplishment you can't fix a

accomplishment you can't fix a relationship if your sense of identity

relationship if your sense of identity turns you into either a chameleon or a

doormat the relation the best way to make a healthy relationship is to be a

make a healthy relationship is to be a healthy human

healthy human being now this gets even further

being now this gets even further complicated because part of being a

complicated because part of being a healthy human being can come through

healthy human being can come through relationships absolutely

but this is what we're talking about right so this is where people say like

right so this is where people say like how do I like get this person to do this

how do I like get this person to do this get this person to do this get this

get this person to do this get this person to do this and here I am I'm

person to do this and here I am I'm talking about how to fix your

talking about how to fix your relationships and I've not given you one

relationships and I've not given you one ioda of advice about what to do if

ioda of advice about what to do if someone doesn't text you back and I

someone doesn't text you back and I don't need to and you don't need

don't need to and you don't need it if the brain that has evolved for

it if the brain that has evolved for millions of years to allow you to engage

millions of years to allow you to engage in

in relationships I hate to break it to

relationships I hate to break it to youall a thousand years ago 2,000 years

youall a thousand years ago 2,000 years ago there weren't all these guides from

ago there weren't all these guides from Dr K about how to get laate or how to go

Dr K about how to get laate or how to go on a date or how to set boundaries none

on a date or how to set boundaries none of that that crap existed and people got

of that that crap existed and people got along what has changed this has changed

along what has changed this has changed the activity of this the function of

the activity of this the function of this so if you fix this if you fix your

this so if you fix this if you fix your sense of identity fix your emotional

sense of identity fix your emotional awareness because why do we end up in

awareness because why do we end up in bad relationships because we're not

bad relationships because we're not aware of our emotions when someone

aware of our emotions when someone doesn't text me back in 5 minutes I get

angry like I can't regulate that anger there's emotional

there's emotional disregulation there are perception

disregulation there are perception problems we haven't touched on

problems we haven't touched on perception yet but we talk about it in

perception yet but we talk about it in the guide there's all kinds of problems

the guide there's all kinds of problems and then we'll have a whole video on sex

and then we'll have a whole video on sex and relationship I mean sex and trauma

and relationship I mean sex and trauma too because that's really

too because that's really important okay

important okay so complex

so complex PTSD oh let me show youall one last

oh boy hold

on there's something I got I got to show youall okay this is like very

okay I I I can okay here here it is so let's talk about treatment okay so

is so let's talk about treatment okay so um we talked a little bit teaching uh

um we talked a little bit teaching uh PTSD patients with impair impairments

PTSD patients with impair impairments and emotional awareness to identify

and emotional awareness to identify their affective feelings early on in

their affective feelings early on in treatment and make exposure Bas

treatment and make exposure Bas treatments more effective so we need to

treatments more effective so we need to understand our emotions um yoga has also

understand our emotions um yoga has also been suggested to be effective in

been suggested to be effective in treating PTSD partially by increasing

treating PTSD partially by increasing one's interoceptive ability here's what

one's interoceptive ability here's what I want to show

I want to show youall okay

youall okay okay further evidence for the latter

okay further evidence for the latter stems from investigation by hagars who

stems from investigation by hagars who reported a differential outcome for PTSD

reported a differential outcome for PTSD patients with high versus low

patients with high versus low dissociative

dissociative symptomatology okay so remember

symptomatology okay so remember dissociation is hemispheric

dissociation is hemispheric lateralization and remember that

lateralization and remember that exposure therapy is often times what we

exposure therapy is often times what we do so let's take a step back and I got

do so let's take a step back and I got to explain this I realized talk about

to explain this I realized talk about this so one of the treatments for PTSD

this so one of the treatments for PTSD is exposure therapy so the reason that

is exposure therapy so the reason that we do exposure therapy is if let's say

we do exposure therapy is if let's say that I'm a war veteran and when I hear a

that I'm a war veteran and when I hear a door slam my brain because I'm

door slam my brain because I'm hyperaroused triggers like we're getting

hyperaroused triggers like we're getting bombed exe that's the basic problem in

bombed exe that's the basic problem in PTSD is that we go to war and we hear a

PTSD is that we go to war and we hear a loud bang and then our brain is like I'm

loud bang and then our brain is like I'm going to code we're getting bomb. exe

going to code we're getting bomb. exe any time you hear a loud noise

any time you hear a loud noise dive under the

dive under the table so now as I return back to life I

table so now as I return back to life I will hear loud noises all the time car

will hear loud noises all the time car muffers going

muffers going off door slamming and now I'm triggering

off door slamming and now I'm triggering we're getting bomb. exe so we get this

we're getting bomb. exe so we get this hyperarousal so one of the ways to fix

hyperarousal so one of the ways to fix that is to expose

that is to expose people two things that induce their

people two things that induce their traumatic hyperarousal response until

traumatic hyperarousal response until they climatize to it so as I slam doors

they climatize to it so as I slam doors over and over and over again eventually

over and over and over again eventually like my brain will realize oh like we're

like my brain will realize oh like we're getting bomb. exe is not appropriate

getting bomb. exe is not appropriate here we don't need to pull this up and

here we don't need to pull this up and so exposure therapy is effective okay

so exposure therapy is effective okay but this is what's

but this is what's cool so whereas only 10% of PTSD

cool so whereas only 10% of PTSD patients with low dissociative criteria

patients with low dissociative criteria symptoms still met uh PTSD criteria

symptoms still met uh PTSD criteria after a trial of exposure therapy

after a trial of exposure therapy 69% of PTSD patients with high levels of

69% of PTSD patients with high levels of dissociation continued to meet PTSD

dissociation continued to meet PTSD criteria at followup so I'll translate

criteria at followup so I'll translate that for you all if y'all didn't catch

that for you all if y'all didn't catch that if I take someone with PTSD who

that if I take someone with PTSD who does not dissociate and I give

does not dissociate and I give them exposure

them exposure therapy only 10% of them still have

therapy only 10% of them still have PTSD so let's presume that 90% of them

PTSD so let's presume that 90% of them get better if I take someone with a high

get better if I take someone with a high amount of dissociation and a diagnosis

amount of dissociation and a diagnosis of PTSD and I just give them exposure

of PTSD and I just give them exposure therapy 69% of them will still have PTS

so we can conclude not entirely fair right CU this is science and you can't

right CU this is science and you can't make conclusions like that that simple

make conclusions like that that simple exposure therapy doesn't work for people

exposure therapy doesn't work for people who have high dissociative symptoms if

who have high dissociative symptoms if you have complex PTSD you're going to be

you have complex PTSD you're going to be further in that direction so let's see

further in that direction so let's see what they

discovered therefore it is crucial before commencing exposure-based

before commencing exposure-based treatments to assess the level of

treatments to assess the level of emotional over modulation and provide

emotional over modulation and provide interventions to reduce such symptomatic

interventions to reduce such symptomatic responses in trauma related stimuli okay

responses in trauma related stimuli okay so basically what this this talks about

so basically what this this talks about stare which is a trauma treatment

stare which is a trauma treatment program but basically what I'm trying to

program but basically what I'm trying to tell y'all is that see in Western

tell y'all is that see in Western medicine we think that there is a

medicine we think that there is a diagnosis and diagnosis has treatment if

diagnosis and diagnosis has treatment if you've got bipolar disorder take this

you've got bipolar disorder take this medication if you've got ADHD take this

medication if you've got ADHD take this medication it'll fix it if you've got

medication it'll fix it if you've got PTSD do exposure therapy it'll fix it

PTSD do exposure therapy it'll fix it and we're not wrong to think

and we're not wrong to think that because we do trials right and like

that because we do trials right and like only 10% of people who had PTSD still

only 10% of people who had PTSD still have symptoms of it after exposure

have symptoms of it after exposure therapy if they're low on

therapy if they're low on dissociation but what I found with

dissociation but what I found with complex PTSD

complex PTSD especially is that the more

especially is that the more complex your presentation of difficulty

complex your presentation of difficulty is we can call it a diagnosis or we can

is we can call it a diagnosis or we can call it an illness the more that we have

call it an illness the more that we have all of these building blocks

all of these building blocks and the key thing is to build one block

and the key thing is to build one block on top of the other and then you can get

on top of the other and then you can get back to 100% most of y'all I've seen it

back to 100% most of y'all I've seen it time and time and time again the reason

time and time and time again the reason that treatments don't work is because we

that treatments don't work is because we don't we're not comprehensive

don't we're not comprehensive enough real trauma treatment see trauma

enough real trauma treatment see trauma doesn't just affect there's not one part

doesn't just affect there's not one part of the brain that's Mis

of the brain that's Mis active your autonomic nervous system

active your autonomic nervous system your brain different parts of your brain

your brain different parts of your brain some parts are hyperactive some parts

some parts are hyperactive some parts are hypo Pro active your sense of self

are hypo Pro active your sense of self your relationships your motivation your

your relationships your motivation your ability to your impulsivity your ability

ability to your impulsivity your ability to control your impulses everything is

to control your impulses everything is affected by trauma this is why trauma is

affected by trauma this is why trauma is the great

the great chameleon so many people I've worked

chameleon so many people I've worked with have a diagnosis of

with have a diagnosis of ADHD but they really have trauma so many

ADHD but they really have trauma so many people I work with have a diagnosis of

people I work with have a diagnosis of bipolar disorder but they have trauma

bipolar disorder but they have trauma so trauma can look like just about

anything okay all right so what we're going to do

okay all right so what we're going to do now so don't give up first of all like

now so don't give up first of all like things can get better and the only

things can get better and the only reason that we don't think they can get

reason that we don't think they can get better so put yourself in the shoes of

better so put yourself in the shoes of someone who did exposure therapy they go

someone who did exposure therapy they go to a psychiatrist the psychiatrist is

to a psychiatrist the psychiatrist is very well trained and very intelligent

very well trained and very intelligent says oh you have a diagnosis of PTSD go

says oh you have a diagnosis of PTSD go to exposure therapy at the end of

to exposure therapy at the end of exposure therapy they're still have PTSD

exposure therapy they're still have PTSD 69% because this onedimensional

69% because this onedimensional treatment is not

treatment is not effective in a certain class of people

effective in a certain class of people it's very effective and this is the way

it's very effective and this is the way that yall need to approach trauma if

that yall need to approach trauma if you're struggling with

you're struggling with it it's not just one thing it is not

it it's not just one thing it is not fixing a problem it is rebuilding

fixing a problem it is rebuilding yourself from the ground up and you say

yourself from the ground up and you say Dr K that sounds like too much work it's

Dr K that sounds like too much work it's not see what the only reason it feels

not see what the only reason it feels like too much work is if you've done a

like too much work is if you've done a lot of work and it has yielded no

lot of work and it has yielded no results then it feels like effort is

results then it feels like effort is useless anything feels like too much

useless anything feels like too much work if you're doing it wrong is it a

work if you're doing it wrong is it a lot of work absolutely is it hard to do

lot of work absolutely is it hard to do absolutely but my overwhelming

absolutely but my overwhelming experience as a clinician is that people

experience as a clinician is that people are into it once you start making

are into it once you start making progress once you're able to go to your

progress once you're able to go to your child's birthday party and be like wow

child's birthday party and be like wow I'm so glad they had such a good time

I'm so glad they had such a good time and I feel like a good parent it's like

and I feel like a good parent it's like you guys want that vein like

you guys want that vein like that's like heroin in your veins right

that's like heroin in your veins right there you begin to live the life the way

there you begin to live the life the way that your evolution is designed you

for this is the way we are supposed to live and it's like drinking water after

live and it's like drinking water after running five miles it just feels so good

running five miles it just feels so good it's just water people say oh my God I

it's just water people say oh my God I don't like the taste of water or they

don't like the taste of water or they drink soda all day

drink soda all day and then they but this is the key thing

and then they but this is the key thing to understand water is whether water

to understand water is whether water tastes good to you or not depends on

tastes good to you or not depends on what your body is

what your body is doing whether treatment is hard or easy

doing whether treatment is hard or easy depends on what you're doing what you're

depends on what you're doing what you're getting out of

getting out of it this is the biggest mistake that we

it this is the biggest mistake that we make so don't give up hope absolutely go

make so don't give up hope absolutely go see someone if this stuff resonates with

see someone if this stuff resonates with you if you guys want to better

you if you guys want to better understand these principles check out

understand these principles check out the guide we're going to watch a video

the guide we're going to watch a video in a second right this is not a place

in a second right this is not a place where I would recommend coaching this is

where I would recommend coaching this is not where coaching is that helpful I

not where coaching is that helpful I mean it can be for some of these things

mean it can be for some of these things like paralysis of initiation and

like paralysis of initiation and motivation and stuff like that but like

motivation and stuff like that but like this is where you all should see a

this is where you all should see a therapist right a trauma informed

therapist right a trauma informed specialist is ideal because they will

specialist is ideal because they will understand more of these

um okay so we're g to get to questions in a

second I love Leaf flow right so do I hey so do I all right

hey so do I all right um so like y'all don't seriously don't

um so like y'all don't seriously don't give up hope like it is crazy how much

give up hope like it is crazy how much we know about trauma we've gotten so

we know about trauma we've gotten so much better at this the last thing that

much better at this the last thing that I want to say is this Disturbed uh sense

I want to say is this Disturbed uh sense of

self-organization outside of trauma see if you have DSO without the symptoms of

if you have DSO without the symptoms of PTSD you can't get a diagnosis of cptsd

PTSD you can't get a diagnosis of cptsd cptsd is hyperarousal hyper vigilance

cptsd is hyperarousal hyper vigilance all the regular trauma Stuff Plus the

all the regular trauma Stuff Plus the Disturbed sense of of self-organization

Disturbed sense of of self-organization disturbance of self organization so what

disturbance of self organization so what I'm noticing in the world today is that

I'm noticing in the world today is that this Disturbed self-organization appears

this Disturbed self-organization appears to be independent of traumatic

to be independent of traumatic events I'm seeing a a society that is

events I'm seeing a a society that is increasingly emotionally

increasingly emotionally disregulated increasingly unable to tap

disregulated increasingly unable to tap into Joy

into Joy increasingly easy to trigger a seizure

increasingly easy to trigger a seizure of negative

of negative emotion increasingly confused about

emotion increasingly confused about their identity in

their identity in life and increasingly increased

life and increasingly increased difficulty in

difficulty in relationships so now the question that

relationships so now the question that I've really wondered is that if you see

I've really wondered is that if you see this DSO

this DSO picture can you do these trauma based

picture can you do these trauma based interventions you don't need exposure

interventions you don't need exposure therapy but can we do all of this other

stuff calm down your nervous system increase your emotional awareness

system increase your emotional awareness articulate

emotions improve your sense of identity reconnect with your positive self deal

reconnect with your positive self deal with negative emotional

with negative emotional disregulation deal with that amigdalar

disregulation deal with that amigdalar pseudo

seizur if we fix all of these things can we improve those DSO symptoms even if

we improve those DSO symptoms even if you don't have cptsd and that's really

you don't have cptsd and that's really what I

what I believe right that's the running

believe right that's the running hypothesis cuz I got I got it's too it's

hypothesis cuz I got I got it's too it's too similar the clinical picture

too similar the clinical picture are so the overlap is so strong I I

are so the overlap is so strong I I can't believe that the same regions of

can't believe that the same regions of the brain are not active and if the same

the brain are not active and if the same regions of the brain are active we can

regions of the brain are active we can do the same stuff and if it works for

do the same stuff and if it works for someone who has such a severe diagnosis

someone who has such a severe diagnosis of cptsd it should work for you and what

of cptsd it should work for you and what are we talking about here we're talking

are we talking about here we're talking about yoga we're talking about

about yoga we're talking about meditation we're talking about getting

meditation we're talking about getting in touch with your emotions we're

in touch with your emotions we're talking about articulating your emotions

talking about articulating your emotions we're talking about developing a sense

we're talking about developing a sense of self we're talking about forming

of self we're talking about forming narrative about your

life and that's what we see in this community because we've been working on

community because we've been working on this crap for yall this is why I'm so

this crap for yall this is why I'm so this is why I care so much about the

this is why I care so much about the trauma guide because the trauma guide is

trauma guide because the trauma guide is the guide for our

the guide for our community and hopefully it makes sense

community and hopefully it makes sense to youall now like where I'm coming from

to youall now like where I'm coming from you don't need cptsd the right answer

you don't need cptsd the right answer for cptsd is medical

for cptsd is medical treatment but for all of us who have

treatment but for all of us who have features of this

features of this who don't have a diagnosis we can still

who don't have a diagnosis we can still understand the basic neuroscience and

understand the basic neuroscience and address those

things right so the guide is not a substitute for clinical treatment it is

substitute for clinical treatment it is everything

else and that's what we're going to show you all today so if you

you all today so if you struggle

struggle with

initiation we're going to help y'all okay one

y'all okay one second all right so I can't watch this

second all right so I can't watch this I'm going to like literally step out of

I'm going to like literally step out of the room because I

the room because I cannot I cannot handle myself chat this

cannot I cannot handle myself chat this is just too much so I'm going to turn

is just too much so I'm going to turn this

this on um I'm going to turn this

on so we're going to watch an early cut and then we're going to do Q&A when I

and then we're going to do Q&A when I get back

okay next up we're going to talk about the paralysis of initiation and a lot of

the paralysis of initiation and a lot of people that I've worked with have

people that I've worked with have struggled with this this almost seems to

struggled with this this almost seems to be a societal phenomenon where people

be a societal phenomenon where people have trouble getting started we know

have trouble getting started we know theoretically that there are other

theoretically that there are other people out there who have goals and they

people out there who have goals and they can wake up and they can sort of just do

can wake up and they can sort of just do it and then they also tell us right like

it and then they also tell us right like if you want to go to the gym what you

if you want to go to the gym what you need to do is just do it you just got to

need to do is just do it you just got to put yourself out there and just get

put yourself out there and just get started CU getting started is the hard

started CU getting started is the hard part but there's a large subset of

part but there's a large subset of people who struggle with just getting

people who struggle with just getting started and as I explored this concept

started and as I explored this concept to try to help the patients that I was

to try to help the patients that I was working with I stumbled into the trauma

working with I stumbled into the trauma literature the original paper on complex

literature the original paper on complex PTSD uses this term paralysis of

PTSD uses this term paralysis of initiation now complex PTSD is a little

initiation now complex PTSD is a little bit different from traditional PTSD and

bit different from traditional PTSD and we're going to dive into that for just a

we're going to dive into that for just a second so in post-traumatic stress

second so in post-traumatic stress disorder you usually have one or a short

disorder you usually have one or a short term series of traumatic events that

term series of traumatic events that then traumatizes us and then we develop

then traumatizes us and then we develop a disorder a psychiatric problem as a

a disorder a psychiatric problem as a result of the intensity of that singular

result of the intensity of that singular trauma on the other hand there's a group

trauma on the other hand there's a group of researchers who discovered something

of researchers who discovered something called complex PTSD which is when the

called complex PTSD which is when the traumatic influence is persistent over

traumatic influence is persistent over time so it's not a one-time thing it's

time so it's not a one-time thing it's an environment that you grow up in or

an environment that you grow up in or once again going back to the prisoners

once again going back to the prisoners of War these are prisoners who are in

of War these are prisoners who are in these camps for years and years and

these camps for years and years and years and what these researchers

years and what these researchers discovered is that when a trauma is

discovered is that when a trauma is repeated that it messes up our ability

repeated that it messes up our ability to start our own actions it seems to

to start our own actions it seems to tamper with our very autonomy and what

tamper with our very autonomy and what they discovered in the prisoners was

they discovered in the prisoners was that these people became incredibly

that these people became incredibly listless because if you kind of think

listless because if you kind of think about it there's nothing there's no

about it there's nothing there's no point in getting anything started in a

point in getting anything started in a prison camp there's nowhere to go

prison camp there's nowhere to go there's there are no goals to accomplish

there's there are no goals to accomplish it's all about survival and what these

it's all about survival and what these researchers discovered is when these

researchers discovered is when these people got released from the prison camp

people got released from the prison camp they still struggled to initiate things

they still struggled to initiate things in their own lives so we're going to

in their own lives so we're going to dive into that Concept in more detail

dive into that Concept in more detail because we've learned a lot about it

because we've learned a lot about it since then the first cause of paralysis

since then the first cause of paralysis of initiation is a loss of autonomy and

of initiation is a loss of autonomy and a lack of reinforcement so let's start

a lack of reinforcement so let's start with kind of a traditional household

with kind of a traditional household let's say a healthy household so in this

let's say a healthy household so in this household you have children that kind of

household you have children that kind of grow up and they want to do things they

grow up and they want to do things they have desires so they go to their parents

have desires so they go to their parents and they say hey I want to go to the zoo

and they say hey I want to go to the zoo today and so the parents says okay fine

today and so the parents says okay fine like I'll take you to the zoo If the

like I'll take you to the zoo If the child has an Impulse to start something

child has an Impulse to start something or do something that impulse gets

or do something that impulse gets reinforced another good example of this

reinforced another good example of this is let's say I'm like painting a picture

is let's say I'm like painting a picture I made something at school and I come

I made something at school and I come home and I show my parents I say hey

home and I show my parents I say hey look at this picture I painted of the

look at this picture I painted of the family and my parents are very very

family and my parents are very very impressed and surprised with it and what

impressed and surprised with it and what they do is they put it up on my fridge

they do is they put it up on my fridge or they put up put it up on my wall at

or they put up put it up on my wall at some point though if you look at a

some point though if you look at a healthy normal household as a child

healthy normal household as a child starts to initiate things that

starts to initiate things that initiation is supported and

initiation is supported and reinforced if we look at something like

reinforced if we look at something like a controlling household or an abusive

a controlling household or an abusive household the picture is very different

household the picture is very different because in a controlling household what

because in a controlling household what I want to do is completely irrelevant it

I want to do is completely irrelevant it is what my parents want me to do that

is what my parents want me to do that becomes important so when I enter the

becomes important so when I enter the fifth grade and I have a choice between

fifth grade and I have a choice between learning this instrument or that

learning this instrument or that instrument which instrument I want to

instrument which instrument I want to learn is not as important as which

learn is not as important as which instrument my parents want me to learn

instrument my parents want me to learn and so what we tend to see is that the

and so what we tend to see is that the the behavioral impulses anytime I try to

the behavioral impulses anytime I try to start and do something those aren't

start and do something those aren't necessarily reinforced and instead of

necessarily reinforced and instead of autonomy I'm sort of taught compliance

autonomy I'm sort of taught compliance the same is true but in a slightly

the same is true but in a slightly different way when it comes to

different way when it comes to neglectful households so in the same

neglectful households so in the same situation if I come home with a a

situation if I come home with a a picture that I painted of my family and

picture that I painted of my family and my parents are absent or there's a

my parents are absent or there's a babysitter there or for whatever 100

babysitter there or for whatever 100 reasons that could possibly be going on

reasons that could possibly be going on something about my desires don't get

something about my desires don't get reinforced in a neglectful household

reinforced in a neglectful household because as a child growing up who is it

because as a child growing up who is it that refor reinforces and supports your

that refor reinforces and supports your desires it's your parents and so even in

desires it's your parents and so even in the case of absent parents we see a

the case of absent parents we see a Common Thread of when I want to do

Common Thread of when I want to do something the world around me doesn't

something the world around me doesn't necessarily help me do it and in the

necessarily help me do it and in the worst case scenarios what we actually

worst case scenarios what we actually see is that if I develop some sense of

see is that if I develop some sense of autonomy I actually get punished for it

autonomy I actually get punished for it if I start to demonstrate initiative

if I start to demonstrate initiative which is one of the other things that we

which is one of the other things that we sort of see in in the trauma literature

sort of see in in the trauma literature is that when we take initiative some

is that when we take initiative some people will get punished for it so I

people will get punished for it so I decided that I wanted to plan a birthday

decided that I wanted to plan a birthday party this weekend with my friends and I

party this weekend with my friends and I tell my parents about it on Thursday but

tell my parents about it on Thursday but then they get really angry with me for

then they get really angry with me for not discussing it with them not getting

not discussing it with them not getting their permission they're incredibly

their permission they're incredibly controlling so all of my initiative kind

controlling so all of my initiative kind of goes down the drain it's all about

of goes down the drain it's all about what other people want so this is the

what other people want so this is the first cause of the paralysis of

first cause of the paralysis of initiation is if we look at the normal

initiation is if we look at the normal child development or normal human

child development or normal human development at some point our desires

development at some point our desires get reinforced our autonomy gets

get reinforced our autonomy gets rewarded but if you grew up in an

rewarded but if you grew up in an environment where your autonomy was not

environment where your autonomy was not rewarded where your desires were not

rewarded where your desires were not reinforced that is a lesson that your

reinforced that is a lesson that your brain will carry forward the second

brain will carry forward the second aspect of paralysis of initiation has to

aspect of paralysis of initiation has to do with the loss of the future

do with the loss of the future Dimension I know it sounds kind of weird

Dimension I know it sounds kind of weird and abstract but it's actually pretty

and abstract but it's actually pretty simple so once again as a child let's

simple so once again as a child let's look at the normal situation so at some

look at the normal situation so at some point I start thinking about the future

point I start thinking about the future right if I have present and loving

right if I have present and loving parents they'll ask me oh what do you

parents they'll ask me oh what do you want for Christmas this year let's write

want for Christmas this year let's write Santa letter we are going to do

Santa letter we are going to do something today that be will be rewarded

something today that be will be rewarded not just tomorrow but a week from now

not just tomorrow but a week from now two weeks from now three weeks from now

two weeks from now three weeks from now similarly supportive parents will take a

similarly supportive parents will take a look at your schedule for the week and

look at your schedule for the week and sort of even if you're in the second

sort of even if you're in the second grade or third GR they will sort of

grade or third GR they will sort of remind you or help you understand that

remind you or help you understand that okay this week you have these two

okay this week you have these two assignments to complete so we need to

assignments to complete so we need to start thinking about tomorrow or even

start thinking about tomorrow or even the end of the week today so with

the end of the week today so with healthy parenting it's kind of bizarre

healthy parenting it's kind of bizarre but we have this part of our brain that

but we have this part of our brain that looks into the future and plans and

looks into the future and plans and executes tasks this is the frontal lobe

executes tasks this is the frontal lobe of our brain that kind of plans things

of our brain that kind of plans things out and makes sure they get done in a

out and makes sure they get done in a normal household this is a part of our

normal household this is a part of our brain that gets supported by our parents

brain that gets supported by our parents but once again once we move to a

but once again once we move to a controlling or a neglectful household

controlling or a neglectful household that all goes out the window so the

that all goes out the window so the first thing is planning for my future

first thing is planning for my future when I have controlling parents is a

when I have controlling parents is a waste of time because my parents have

waste of time because my parents have decided what my future will be in the

decided what my future will be in the worst case scenarios like so for example

worst case scenarios like so for example in my culture there are some traditional

in my culture there are some traditional Indian parents that will plan everything

Indian parents that will plan everything for their kids you're going to be a

for their kids you're going to be a doctor you're going to be a lawyer I had

doctor you're going to be a lawyer I had that conversation with my own dad when I

that conversation with my own dad when I was 9 years old he said we took me and

was 9 years old he said we took me and my brother aside I was nine my brother

my brother aside I was nine my brother was 12 and he said said one of y'all is

was 12 and he said said one of y'all is going to be a doctor and one of y'all is

going to be a doctor and one of y'all is going to be a lawyer and then I ended up

going to be a lawyer and then I ended up applying to med school and people asked

applying to med school and people asked me like why do you want to be a doctor

me like why do you want to be a doctor and I said well this is the conversation

and I said well this is the conversation my dad had with me and my brother was

my dad had with me and my brother was older so he got to choose first and he

older so he got to choose first and he went to law school so here I am and we

went to law school so here I am and we all had a good laugh about it but I

all had a good laugh about it but I never really answered the question the

never really answered the question the point though is that with controlling

point though is that with controlling parents who sort of determine your

parents who sort of determine your future for you they tell you what you

future for you they tell you what you need to accomplish they tell you when

need to accomplish they tell you when you need to accomplish it you're going

you need to accomplish it you're going to learn the cello you're going to learn

to learn the cello you're going to learn the vi you're going to do a sport you're

the vi you're going to do a sport you're going to do this you're going to do that

going to do this you're going to do that or you're going to carry on in your

or you're going to carry on in your Father's Footsteps and you're going to

Father's Footsteps and you're going to play football whatever the situation is

play football whatever the situation is your sense of the future gets negatively

your sense of the future gets negatively impacted you don't get to think about

impacted you don't get to think about the future and plan for the future on

the future and plan for the future on your own and the same is true in

your own and the same is true in neglectful households although once

neglectful households although once again slightly differently because in

again slightly differently because in this case if you're a seven-year-old kid

this case if you're a seven-year-old kid and your parents are absent there's no

and your parents are absent there's no point in planning for a slumber party in

point in planning for a slumber party in the future and remember that as kids we

the future and remember that as kids we don't really know how to plan for the

don't really know how to plan for the future ourselves we actually need adults

future ourselves we actually need adults to teach us how to really use our

to teach us how to really use our frontal loes they sort of train us to do

frontal loes they sort of train us to do all of these things in addition to like

all of these things in addition to like walking and talking and doing laundry

walking and talking and doing laundry and all of these tasks that parents

and all of these tasks that parents teach us are also affected in a

teach us are also affected in a neglectful household so this is the

neglectful household so this is the second thing that happens is that when

second thing that happens is that when we sort of think about the future

we sort of think about the future dimension in a healthy household

dimension in a healthy household thinking about the future Dimension is

thinking about the future Dimension is rewarded if if I make a Christmas list

rewarded if if I make a Christmas list for Santa I actually get those presents

for Santa I actually get those presents if I plan for a slumber party this

if I plan for a slumber party this weekend the slumber party actually

weekend the slumber party actually happens but in the case of controlling

happens but in the case of controlling abusive or neglectful households this

abusive or neglectful households this planning for the future does not get

planning for the future does not get reinforced sometimes it just becomes

reinforced sometimes it just becomes neglected so I don't get rewarded for

neglected so I don't get rewarded for thinking about the future but in the

thinking about the future but in the harshest cases I actually get punished

harshest cases I actually get punished so since I have all these plans of I

so since I have all these plans of I want this for Christmas or I want my

want this for Christmas or I want my friends to come over this weekend but on

friends to come over this weekend but on when Friday rolls around my parent is

when Friday rolls around my parent is has been drinking and they don't feel

has been drinking and they don't feel like having kids in the house so they

like having kids in the house so they tell me to call all my friends and

tell me to call all my friends and cancel at the last minute and then I'm

cancel at the last minute and then I'm left with disappointing all of my

left with disappointing all of my friends and so in the most drastic cases

friends and so in the most drastic cases we actually get punished for thinking

we actually get punished for thinking about the future and this is the problem

about the future and this is the problem in each of these scenarios is that over

in each of these scenarios is that over time in in the simplest case these parts

time in in the simplest case these parts of our brain are not reinforced we don't

of our brain are not reinforced we don't have behavioral reinforcement of Desire

have behavioral reinforcement of Desire we don't have positive reinforcement for

we don't have positive reinforcement for planning of the future and in the worst

planning of the future and in the worst cases we actually get punished for doing

cases we actually get punished for doing these things because if you kind of

these things because if you kind of think about it let's say I have a desire

think about it let's say I have a desire and then since my parents are neglectful

and then since my parents are neglectful I make this Christmas list but then no

I make this Christmas list but then no presents show up on Christmas Day what

presents show up on Christmas Day what is the lesson I learn as a child over

is the lesson I learn as a child over time the lesson I'll learn is it's

time the lesson I'll learn is it's better not to have desires in the first

better not to have desires in the first place because then I won't be

place because then I won't be disappointed so it's it's better to just

disappointed so it's it's better to just not want anything at all it's better to

not want anything at all it's better to not try to do anything it's better to

not try to do anything it's better to put forth no effort whatsoever because

put forth no effort whatsoever because at the end of the day I'm living my life

at the end of the day I'm living my life reactively I have no sense of autonomy

reactively I have no sense of autonomy or control and if I try to exert control

or control and if I try to exert control if I am stupid enough to want things

if I am stupid enough to want things then that will actually hurt and lead to

then that will actually hurt and lead to disappointment and then you learn a very

disappointment and then you learn a very dangerous lesson which is wanting things

dangerous lesson which is wanting things and thinking about the future is painful

and thinking about the future is painful and harmful and once you learn this

and harmful and once you learn this lesson this leads to the paralysis of

lesson this leads to the paralysis of initi ation later in life now there's

initi ation later in life now there's another challenge that we kind of run

another challenge that we kind of run into that keeps people who grow up in

into that keeps people who grow up in these kinds of environments from really

these kinds of environments from really initiating things and that is a Reliance

initiating things and that is a Reliance on perfectionism so there's a group of

on perfectionism so there's a group of people that I've worked with and this

people that I've worked with and this group by the way is becoming

group by the way is becoming increasingly common because once again a

increasingly common because once again a lot of people grow up in scenarios like

lot of people grow up in scenarios like this where they can't get started until

this where they can't get started until it's perfect so I'm not going to apply

it's perfect so I'm not going to apply to college unless I know I can get into

to college unless I know I can get into Harvard I'm not going to take this

Harvard I'm not going to take this course unless I know I can get an A I'm

course unless I know I can get an A I'm not going to even learn any skill until

not going to even learn any skill until I practice ahead of time even before I

I practice ahead of time even before I join the course so if I'm learning how

join the course so if I'm learning how to dance I'm going to spend three months

to dance I'm going to spend three months practicing at home so I don't embarrass

practicing at home so I don't embarrass myself when I join the class that is

myself when I join the class that is even for novices so there are a lot of

even for novices so there are a lot of people out there that are very hesitant

people out there that are very hesitant to get started until things are perfect

to get started until things are perfect and let's explore a little bit about why

and let's explore a little bit about why this happens so this too can be tracked

this happens so this too can be tracked back to trauma so if we sort of think

back to trauma so if we sort of think about controlling abusive or neglectful

about controlling abusive or neglectful households these households create

households these households create situations that are very stressful and

situations that are very stressful and dangerous for the child so in order to

dangerous for the child so in order to understand why some people become very

understand why some people become very perfectionistic and why some people can

perfectionistic and why some people can afford to take risks we have to

afford to take risks we have to understand a very important Divergence

understand a very important Divergence that happens very early in life so let's

that happens very early in life so let's start with the case of a healthy

start with the case of a healthy household so if you sort of think about

household so if you sort of think about it the world is objectively a dangerous

it the world is objectively a dangerous place for kids so if I'm like let's say

place for kids so if I'm like let's say an 18-month-old kid one-year-old kid

an 18-month-old kid one-year-old kid 2-year-old kid the world is a dangerous

2-year-old kid the world is a dangerous place I I can barely walk I tend to

place I I can barely walk I tend to stumble a lot things like stairs can be

stumble a lot things like stairs can be incredibly dangerous but it's not just

incredibly dangerous but it's not just that it's also things like when I get

that it's also things like when I get served food does the food burn me or not

served food does the food burn me or not and this is where parents come in

and this is where parents come in because parents who are very attentive

because parents who are very attentive will protect the child from the

will protect the child from the dangerous world and this is like kind of

dangerous world and this is like kind of what we know if you're a parent you'll

what we know if you're a parent you'll understand this that your children will

understand this that your children will try all kinds of things to hurt

try all kinds of things to hurt themselves because they don't really

themselves because they don't really know that the world is a dangerous place

know that the world is a dangerous place and the better you take care of them the

and the better you take care of them the more Reckless they become because there

more Reckless they become because there are never negative consequences for

are never negative consequences for things a parent who's always caught when

things a parent who's always caught when they jump off the bed will not learn the

they jump off the bed will not learn the danger of gravity so these children

danger of gravity so these children become very secure in the world around

become very secure in the world around them because it's a safe place because

them because it's a safe place because mom or dad is there to protect me from

mom or dad is there to protect me from danger so these children become more

danger so these children become more confident they're able to embrace more

confident they're able to embrace more risks they can try new things and they

risks they can try new things and they also enjoy exploring the world they're

also enjoy exploring the world they're very very confident that someone is out

very very confident that someone is out there protecting them they're not really

there protecting them they're not really aware that there's a person out there

aware that there's a person out there protecting them they just know that as

protecting them they just know that as they stumble around someone's always

they stumble around someone's always catching them and they don't get hurt on

catching them and they don't get hurt on the flip side let's look at something

the flip side let's look at something like a neglectful household so in this

like a neglectful household so in this case now the world becomes a dangerous

case now the world becomes a dangerous place because there isn't a parent

place because there isn't a parent paying attention if I slip and fall no

paying attention if I slip and fall no is even watching as I start climbing up

is even watching as I start climbing up the stairs and on my seventh stair since

the stairs and on my seventh stair since I'm like a 13-month-old kid I Stumble

I'm like a 13-month-old kid I Stumble and fall and then I roll down the stairs

and fall and then I roll down the stairs and start crying in the worst case

and start crying in the worst case scenarios even when I start crying

scenarios even when I start crying either the parent doesn't pay attention

either the parent doesn't pay attention doesn't care or even will get mad at me

doesn't care or even will get mad at me for crying and will tell me to be quiet

for crying and will tell me to be quiet so if we see households that are

so if we see households that are incredibly controlling which also can be

incredibly controlling which also can be sort of scary for a child because in a

sort of scary for a child because in a controlling household with very

controlling household with very demanding parents we want our children

demanding parents we want our children to be perfect right don't spill don't

to be perfect right don't spill don't play with this you made a mess this

play with this you made a mess this happened this happened this happened so

happened this happened this happened so very controlling parents will be very

very controlling parents will be very angry with their children for not being

angry with their children for not being perfect abusive households also lead to

perfect abusive households also lead to a Reliance on perfectionism because

a Reliance on perfectionism because usually what the child learns when it

usually what the child learns when it comes to abuse is there is a magical

comes to abuse is there is a magical formula to avoid the abuse If the child

formula to avoid the abuse If the child can be kind enough if the child can be

can be kind enough if the child can be sweet enough if the child can be cute

sweet enough if the child can be cute enough or pretty enough Demir enough

enough or pretty enough Demir enough invisible enough sometimes these

invisible enough sometimes these children can sort of figure out almost

children can sort of figure out almost from a survival mechanism that if I have

from a survival mechanism that if I have an abusive parent there are some days

an abusive parent there are some days that the parent is not abusive and so

that the parent is not abusive and so then the child naturally tries to figure

then the child naturally tries to figure out what is the difference between the

out what is the difference between the abusive day and the non-abusive day and

abusive day and the non-abusive day and this is when they start to develop this

this is when they start to develop this idea that if I'm a perfect child then I

idea that if I'm a perfect child then I will be safe and so perfectionism and

will be safe and so perfectionism and safety go hand in hand so if you try to

safety go hand in hand so if you try to do something in the outside world and

do something in the outside world and you not perfect remember that this stuff

you not perfect remember that this stuff gets baked in to your upbringing in the

gets baked in to your upbringing in the same way that you were understanding how

same way that you were understanding how strong gravity is or what the sun feels

strong gravity is or what the sun feels like or how many fingers you have this

like or how many fingers you have this stuff gets really baked in and

stuff gets really baked in and perfectionism and safety become one and

perfectionism and safety become one and the same so this is another reason why

the same so this is another reason why people struggle with initiating tasks

people struggle with initiating tasks they can be very very afraid of doing

they can be very very afraid of doing something wrong they can't afford to

something wrong they can't afford to make mistakes and they need to be

make mistakes and they need to be perfect before they get started and why

perfect before they get started and why is this it's because the world that they

is this it's because the world that they see does not allow them to make mistakes

see does not allow them to make mistakes that if they make some kind of slip up

that if they make some kind of slip up and if they screw up in some kind of way

and if they screw up in some kind of way the world is a fundamentally dangerous

the world is a fundamentally dangerous scary and punishing place and if we are

scary and punishing place and if we are wired in any one of these three ways if

wired in any one of these three ways if our desires and our autonomy has not

our desires and our autonomy has not been reinforced if our capacity to plan

been reinforced if our capacity to plan for the future has actually been

for the future has actually been squashed or neglected or we grew up in

squashed or neglected or we grew up in an environment Enon where we had to be

an environment Enon where we had to be perfect before we get started all three

perfect before we get started all three of these can result in the paralysis of

initiation all righty

righty so all right hold on a

second um yeah so that's that's a

um yeah so that's that's a uh that's one of the videos from the

uh that's one of the videos from the trauma guide and like I said like we

trauma guide and like I said like we we've been working on this for a while

we've been working on this for a while and and when I was making the trauma

and and when I was making the trauma guide

guide y'all can hear me right am I muted okay

y'all can hear me right am I muted okay no y'all can hear me

no y'all can hear me um you know I I was thinking about like

um you know I I was thinking about like us and like what are the things that we

us and like what are the things that we struggle with and it's not and there's

struggle with and it's not and there's Absolut like clinically significant

Absolut like clinically significant stuff and I was also thinking about like

stuff and I was also thinking about like you know if I could take all of my

you know if I could take all of my patients who have diagnoses of some kind

patients who have diagnoses of some kind of trauma or a history of

of trauma or a history of trauma and I could like give them a

trauma and I could like give them a workshop

workshop for not stuff that we do in the office

for not stuff that we do in the office like nothing about I mean there's stuff

like nothing about I mean there's stuff about medication and treatment and stuff

about medication and treatment and stuff like that too but like not that stuff

like that too but like not that stuff but like all the other dimensions of

but like all the other dimensions of their life like how do you find a

their life like how do you find a relationship when you have a history of

relationship when you have a history of trauma um how do you reconnect with

trauma um how do you reconnect with yourself and these are the kinds of

yourself and these are the kinds of things that like you know are not

things that like you know are not specific to a person this is the common

specific to a person this is the common stuff that I would teach to my

stuff that I would teach to my patients um which isn't technically like

patients um which isn't technically like a part of their diagn I mean it's part

a part of their diagn I mean it's part of their diagnosis I guess but it's it's

of their diagnosis I guess but it's it's like I don't know how to describe it

like I don't know how to describe it it's

it's not you know it's not about this

not you know it's not about this relationship that this person has it's

relationship that this person has it's about the

about the principle of why is it hard for this

principle of why is it hard for this group of people to form

group of people to form relationships um

okay yeah so let's do some Q&A so we've got time for we wanted to save some time

got time for we wanted to save some time for Q&A so we've got I know we've like

for Q&A so we've got I know we've like run long and we're at like 2:30 and we

run long and we're at like 2:30 and we started late but let's do Q&A for about

started late but let's do Q&A for about 15 minutes uh can you answer super chat

15 minutes uh can you answer super chat questions I I I don't know I don't know

questions I I I don't know I don't know how to do that

um okay so there's one question here uh since trauma is the great

here uh since trauma is the great chameleon what is your opinion on when

chameleon what is your opinion on when you disagree with your therapist about

you disagree with your therapist about your presentation belief in oneself is

your presentation belief in oneself is important for Recovery yet they are a

important for Recovery yet they are a professional um

professional um okay I'm going to ask if we have mods if

okay I'm going to ask if we have mods if y'all saw good questions if anyone was

y'all saw good questions if anyone was keeping trap can y'all let me know

keeping trap can y'all let me know via uh you know some method of

via uh you know some method of communication just let me

communication just let me know

um okay so what if you disagree with your therapist this is a great

your therapist this is a great question so how do you go

question so how do you go about how do you if your therapist

about how do you if your therapist disagrees or if you disagree with your

disagrees or if you disagree with your therapist about your diagnosis or the

therapist about your diagnosis or the formulation like what do you do about

formulation like what do you do about that right they're the one with the

that right they're the one with the degree but you're the one who's living

degree but you're the one who's living the

the life so this is where I'd

life so this is where I'd say disagreement in therapy is like not

say disagreement in therapy is like not something to be avoided the whole point

something to be avoided the whole point of therapy is that we don't know what

of therapy is that we don't know what the right answer is when we get started

the right answer is when we get started and finding the right answer is a series

and finding the right answer is a series of like re-calibrating after

of like re-calibrating after overshooting or moving in the wrong

overshooting or moving in the wrong direction like that's what therapy is so

direction like that's what therapy is so your therapist doesn't magically know

your therapist doesn't magically know what's going on with you we have the

what's going on with you we have the first layer of information and then we

first layer of information and then we make some conclusions and then we have

make some conclusions and then we have the second layer of information we we

the second layer of information we we Whittle away some of the conclusions and

Whittle away some of the conclusions and then over time we want to kind of like

then over time we want to kind of like pingpong our way like to what the right

pingpong our way like to what the right answer is that's been my experience as a

answer is that's been my experience as a psychiatrist

psychiatrist so if you disagree with your therapist I

so if you disagree with your therapist I think first of all that's totally fine

think first of all that's totally fine secondly I would ask I would ask the

secondly I would ask I would ask the therapists to explain why they believe

therapists to explain why they believe what they believe so walk me through

what they believe so walk me through your

your reasoning and then what you want to

reasoning and then what you want to offer

offer is your own reasoning so let me

is your own reasoning so let me understand why you have your opinion let

understand why you have your opinion let me now explain to you why I think that's

me now explain to you why I think that's good or not good or what my perspective

good or not good or what my perspective is and chances are neither of you is

is and chances are neither of you is going to be 100% right and then the

going to be 100% right and then the question is what can your therapist take

question is what can your therapist take away from your explanation that moves

away from your explanation that moves you closer to the right answer and what

you closer to the right answer and what can you take away from your therapist's

can you take away from your therapist's answer that moves you closer to the

answer that moves you closer to the right

right answer now a lot of therapists myself

answer now a lot of therapists myself included find

included find that having a patient understand what's

that having a patient understand what's truly going on is not going to happen

truly going on is not going to happen fast so I often times find that when I

fast so I often times find that when I explain things to patients or when I

explain things to patients or when I offer a formulation at the very

offer a formulation at the very beginning they will sometimes very

beginning they will sometimes very strongly disagree with something that

strongly disagree with something that I'm very confident in and usually over

I'm very confident in and usually over time we get there right because you have

time we get there right because you have to remember that as a

to remember that as a patient you have more information about

patient you have more information about your life but you're not as

your life but you're not as objective so that's where it's like and

objective so that's where it's like and you know medical doctors therapists

you know medical doctors therapists psychiatrists we get diagnoses like

psychiatrists we get diagnoses like wrong all the

wrong all the time so I you know I there's all kinds

time so I you know I there's all kinds of stuff that we get wrong so I I I

of stuff that we get wrong so I I I think it's more about the process than

think it's more about the process than it is about like being right or wrong so

it is about like being right or wrong so there's try to really understand where

there's try to really understand where they're coming from and I I try to take

they're coming from and I I try to take that to heart right really try to be

that to heart right really try to be open-minded and try to see if you can

open-minded and try to see if you can understand okay how even though I

understand okay how even though I instinctively react to this being

instinctively react to this being incorrect

there's a possibility that if I change my thinking in some ways this could be

my thinking in some ways this could be correct so let me try to do that right

correct so let me try to do that right so the last thing I'd kind of say is

so the last thing I'd kind of say is Steelman instead of straw man their

Steelman instead of straw man their argument I mean it shouldn't be an

argument I mean it shouldn't be an argument but do your best to alter your

argument but do your best to alter your assumptions to see if you can understand

assumptions to see if you can understand where they're coming

where they're coming from good question

from good question okay um now let's go to

there we go okay questions

go okay questions um trauma guide I think comes out at the

um trauma guide I think comes out at the end of the

uh okay a cptsd and ADHD there seems to be a lot of overlap how do you tell the

be a lot of overlap how do you tell the difference between the two if you have

difference between the two if you have both I think you mentioned in another

both I think you mentioned in another video something about how all kids with

video something about how all kids with ADHD end up with some trauma if that's

ADHD end up with some trauma if that's true how do we know comes from ADHD

true how do we know comes from ADHD versus what comes from cptsd it's a

versus what comes from cptsd it's a great

great question so if you've got ADHD and

question so if you've got ADHD and Trauma how do you know what's

Trauma how do you know what's what so there are a couple of different

what so there are a couple of different things to keep in mind the first thing

things to keep in mind the first thing that we have to remember is that

that we have to remember is that psychiatric diagnoses are not real

psychiatric diagnoses are not real things they are abstractions or human

things they are abstractions or human Concepts to try to understand reality

Concepts to try to understand reality so like when I say someone has major

so like when I say someone has major depressive disorder there's absolutely

depressive disorder there's absolutely some kind of biological mechanism but

some kind of biological mechanism but human beings made up the idea of major

human beings made up the idea of major depressive disorder what psychiatric

depressive disorder what psychiatric diagnosis really is is a bunch of human

diagnosis really is is a bunch of human beings observe real things in other

beings observe real things in other human beings and then we try to come up

human beings and then we try to come up with a language that

with a language that unifies what we see in individuals and

unifies what we see in individuals and that's really what a psychiatric

that's really what a psychiatric diagnosis is

diagnosis is so how can you tell the difference

so how can you tell the difference between what's ADHD and what's PTSD or

between what's ADHD and what's PTSD or cptsd so both of these can result in

cptsd so both of these can result in impairment in concentration or attention

impairment in concentration or attention both of them can result in impulsivity

both of them can result in impulsivity both of them can result in emotional

both of them can result in emotional disregulation how can we tell the

disregulation how can we tell the difference so a lot of what we know

difference so a lot of what we know about ADHD is from a neurodiverse

about ADHD is from a neurodiverse perspective we know that their brains

perspective we know that their brains develop in a slightly different way so

develop in a slightly different way so we know that people with ADHD have

we know that people with ADHD have less their frontal loes have less

less their frontal loes have less control over their impulses in their

control over their impulses in their emotions so people with ADHD are more

emotions so people with ADHD are more likely to get emotionally disregulated

likely to get emotionally disregulated and we can track that back to the

and we can track that back to the connections in their brain so our

connections in their brain so our frontal loes are the brakes and they can

frontal loes are the brakes and they can control and re in other parts of our

control and re in other parts of our brain but people with ADHD have breakes

brain but people with ADHD have breakes that seem to be weaker and there's some

that seem to be weaker and there's some kind of genetic component to this some

kind of genetic component to this some kind of the way that your brain is

kind of the way that your brain is wired now things get complicated because

wired now things get complicated because growing up in a neurotypical society as

growing up in a neurotypical society as someone who is neurodiverse results in

someone who is neurodiverse results in usually some level of trauma so if you

usually some level of trauma so if you look at comorbid ADHD and major

look at comorbid ADHD and major depressive disorder what you find is 3%

depressive disorder what you find is 3% of people who have major depressive

of people who have major depressive disorder will grow up to have

disorder will grow up to have ADHD but 70 % of people who have ADHD

ADHD but 70 % of people who have ADHD will grow up to have major depressive

will grow up to have major depressive disorder this is in within a comorbid

disorder this is in within a comorbid population so there is absolutely a

population so there is absolutely a positive impact of ADHD on depression

positive impact of ADHD on depression and the reason for that is because when

and the reason for that is because when you're

you're neurodiverse and people just tell you to

neurodiverse and people just tell you to try harder but your brain can't do that

try harder but your brain can't do that you start to believe something is wrong

you start to believe something is wrong with you you don't have as much

with you you don't have as much self-esteem people don't since you cut

self-esteem people don't since you cut in line you don't get invited to

in line you don't get invited to birthday Pary you have fewer friends

birthday Pary you have fewer friends because you can't wait your turn and all

because you can't wait your turn and all of these there's consequences of

of these there's consequences of untreated ADHD that will end up

untreated ADHD that will end up traumatizing so at that point we've kind

traumatizing so at that point we've kind of got both now this also gets confusing

of got both now this also gets confusing because there are a lot of features of

because there are a lot of features of PTSD like emotional disregulation

PTSD like emotional disregulation difficulty cont

difficulty cont concentrating so how can you tell the

concentrating so how can you tell the difference so there are a couple of

difference so there are a couple of different things to keep in mind the

different things to keep in mind the first is that it's not so important to

first is that it's not so important to really tease it out

really tease it out because many of the things that we will

because many of the things that we will do to fix one we would do to fix the

do to fix one we would do to fix the other anyway so simple example is

other anyway so simple example is meditation right so meditation is a

meditation right so meditation is a useful treatment for PTSD cptsd

useful treatment for PTSD cptsd borderline personality disorder and ADHD

borderline personality disorder and ADHD there are some specifics about the kind

there are some specifics about the kind of meditation which you kind of need to

of meditation which you kind of need to understand but generally speaking the

understand but generally speaking the treatment is going to be the same

treatment is going to be the same dealing with shame whether it comes from

dealing with shame whether it comes from ADHD or PTSD is going to be the not the

ADHD or PTSD is going to be the not the same but there's it's in the same

same but there's it's in the same ballpark let's put it that way so the

ballpark let's put it that way so the treatments for the two will overlap

treatments for the two will overlap quite a bit the third thing is emotional

quite a bit the third thing is emotional disregulation that needs to be improved

disregulation that needs to be improved in both right so this is where the first

in both right so this is where the first thing to keep in mind is it is not

thing to keep in mind is it is not necessary to perfectly tease these two

necessary to perfectly tease these two apart before we

apart before we intervene and this is something that we

intervene and this is something that we learn in clinical medicine right so when

learn in clinical medicine right so when you become a psychiatrist you learn this

you become a psychiatrist you learn this if you're not sure what the diagnosis is

if you're not sure what the diagnosis is lean into a treatment that treats both

lean into a treatment that treats both options so ssris does this person have a

options so ssris does this person have a anxious depression or do they have an

anxious depression or do they have an anxiety disorder with an adjustment

anxiety disorder with an adjustment disorder laid on top who knows in either

disorder laid on top who knows in either case ssris will treat both so if we're

case ssris will treat both so if we're going to start with something let's

going to start with something let's start with an SSRI so the treatments can

start with an SSRI so the treatments can overlap now there are a couple of places

overlap now there are a couple of places where the treatments don't overlap so

where the treatments don't overlap so for example things like stimulant

for example things like stimulant medication and that's where it is

medication and that's where it is important so we can do things like

important so we can do things like neuropsychological testing right we can

neuropsychological testing right we can offer formal testing to detect the

offer formal testing to detect the deficits of

deficits of ADHD um we can also offer like you know

ADHD um we can also offer like you know diagnostic scales of trauma and things

diagnostic scales of trauma and things like that and so like we can we can

like that and so like we can we can tease things apart in some way but I I'd

tease things apart in some way but I I'd say that practically you know I've

say that practically you know I've treated a lot of people where we're not

treated a lot of people where we're not sure like what is causing what and

sure like what is causing what and that's where like as a clinician what we

that's where like as a clinician what we do is okay like so if I think your

do is okay like so if I think your diagnoses are ADHD and PTSD we can start

diagnoses are ADHD and PTSD we can start somewh on stimulant

somewh on stimulant medication and then we see right what

medication and then we see right what part of this does this fix so if more of

part of this does this fix so if more of it is trauma oriented we would not

it is trauma oriented we would not expect ADHD medication to be that

expect ADHD medication to be that effective at improving things so over

effective at improving things so over time it's like it's like a process right

time it's like it's like a process right and that's why we we really emphasize

and that's why we we really emphasize that you should work with a clinician

that you should work with a clinician the advantage of working with a

the advantage of working with a clinician is that they will collect more

clinician is that they will collect more information over time and you will

information over time and you will refine your diagnosis and you absolutely

refine your diagnosis and you absolutely could both great

question okay next

um okay I'm going to see a therapist for the first time soon do you have any

the first time soon do you have any advice it's hard for me to open up and

advice it's hard for me to open up and talk about myself or how I feel

talk about myself or how I feel emotionally so here's my advice if

emotionally so here's my advice if you're going to a therapist for the

you're going to a therapist for the first

first time so remember that the therapist has

time so remember that the therapist has a job

a job and their job is to do their job so you

and their job is to do their job so you don't need to be great at opening up you

don't need to be great at opening up you don't have to talk about yourself

don't have to talk about yourself emotionally it is their job to make you

emotionally it is their job to make you feel comfortable enough to where you

feel comfortable enough to where you open up whether you kind of want to or

open up whether you kind of want to or not second thing to keep in mind is that

not second thing to keep in mind is that success in therapy is a skill so the

success in therapy is a skill so the first time that you go ice skating I

first time that you go ice skating I wouldn't expect you to know how to ice

wouldn't expect you to know how to ice skate in the same way going to therapy

skate in the same way going to therapy is something that you will get better at

is something that you will get better at overtime so there are some patients that

overtime so there are some patients that I've worked with where like I like one

I've worked with where like I like one of the things that I'll put in their

of the things that I'll put in their formulation and something that I'll let

formulation and something that I'll let them know is that I think you utilize

them know is that I think you utilize therapy very well right so people will

therapy very well right so people will get better at it so my advice would be

get better at it so my advice would be the most important part is showing

the most important part is showing up and then follow their lead and let

up and then follow their lead and let them know what you're looking for let

them know what you're looking for let them know what works for you and what

them know what works for you and what doesn't work for you it's totally fine

doesn't work for you it's totally fine to even tell them hey I I have

to even tell them hey I I have difficulty opening up and talking about

difficulty opening up and talking about my emotions that's totally fair game

my emotions that's totally fair game right so that's their job to help you

right so that's their job to help you get better at

that okay

um what tactic would you take to heal cptsd mixed with moral injury from a

cptsd mixed with moral injury from a specific event I'm confused about what

specific event I'm confused about what moral injury from a specific event

moral injury from a specific event is um what's the relationship between

is um what's the relationship between cptsd addiction and sense of

cptsd addiction and sense of worthlessness so let's talk about

worthlessness so let's talk about that so the first thing to understand

that so the first thing to understand about trauma and addiction is that tra

about trauma and addiction is that tra addiction is not a problem it is a

addiction is not a problem it is a solution so human beings get addicted to

solution so human beings get addicted to things for a couple of reasons so you

things for a couple of reasons so you can absolutely make a genetic argument

can absolutely make a genetic argument where there's a very strong you know

where there's a very strong you know vulnerability and once you get a taste

vulnerability and once you get a taste like the first drop of alcohol and

like the first drop of alcohol and you're hooked I've absolutely seen that

you're hooked I've absolutely seen that but for a lot of people addictions are

but for a lot of people addictions are solutions before they become problems so

solutions before they become problems so addictions give pleasure and take away

addictions give pleasure and take away pain and the problem with cptsd is that

pain and the problem with cptsd is that remember we have emotional

remember we have emotional disregulation we have difficulty so

disregulation we have difficulty so there's two parts there's two ways that

there's two parts there's two ways that people with with trauma have difficulty

people with with trauma have difficulty with their emotions the first is that

with their emotions the first is that their negative emotions in the more

their negative emotions in the more primitive parts of their brain this is

primitive parts of their brain this is places like the the

places like the the these are the part parts of our brain

these are the part parts of our brain that experience fear anxiety things like

that experience fear anxiety things like that those are very itchy they've got

that those are very itchy they've got itchy trigger fingers so they can

itchy trigger fingers so they can trigger very easily and very

trigger very easily and very intensely F that's the first emotional

intensely F that's the first emotional deficit second emotional problem that

deficit second emotional problem that people with trauma have is that their

people with trauma have is that their sense of self often times carries with

sense of self often times carries with it a lot of Shame and guilt and stuff

it a lot of Shame and guilt and stuff like that so this isn't like fear of the

like that so this isn't like fear of the outside world this is a persistent

outside world this is a persistent emotional negative state that I carry

emotional negative state that I carry with me that's actually a different part

with me that's actually a different part of the brain it relates more to the

of the brain it relates more to the default mode

default mode Network these are emotions that are

Network these are emotions that are called social cognitive emotions so we

called social cognitive emotions so we have two types of emotions we have our

have two types of emotions we have our primitive emotions like anger and fear

primitive emotions like anger and fear that even reptiles experience and then

that even reptiles experience and then we have a different part of our brain

we have a different part of our brain that has our social cognitive emotions

that has our social cognitive emotions Pride guilt shame you can't have those

Pride guilt shame you can't have those emotions without a social component I

emotions without a social component I feel proud when people look at me I feel

feel proud when people look at me I feel ashamed when people look at me it

ashamed when people look at me it requires

requires socialization so the people with PTSD

socialization so the people with PTSD have difficulty with that as well the

have difficulty with that as well the third thing that people with PTSD

third thing that people with PTSD struggle with is feeling positive

struggle with is feeling positive emotions these come from a completely

emotions these come from a completely different region of the brain the dorsal

different region of the brain the dorsal medial prefrontal cortex so this is

medial prefrontal cortex so this is stuff like excitement love curiosity

stuff like excitement love curiosity people with trauma feel kind of like

people with trauma feel kind of like numbed out right so it's kind of like

numbed out right so it's kind of like the real tragedy is you feel numbed out

the real tragedy is you feel numbed out in terms of

in terms of positivity but you're you've got a very

positivity but you're you've got a very itchy brain and it's easy to activate

itchy brain and it's easy to activate some of these negative emotions so where

some of these negative emotions so where does Addiction come in addiction fixes

does Addiction come in addiction fixes all three right so if we look at things

all three right so if we look at things like benzo aines these are treatments

like benzo aines these are treatments for anxiety and we developed benzo

for anxiety and we developed benzo diazines by recognizing that

diazines by recognizing that alcohol alleviates people's anxiety so

alcohol alleviates people's anxiety so we developed a pill that basically

we developed a pill that basically activates the same receptor as alcohol

activates the same receptor as alcohol kind of chills you out right so we know

kind of chills you out right so we know we can treat anxiety with certain

we can treat anxiety with certain psychoactive

psychoactive substances next thing that uh

substances next thing that uh psychoactive substances do is they will

psychoactive substances do is they will numb us right so this is also through

numb us right so this is also through the Gaba receptor like alcohol but there

the Gaba receptor like alcohol but there are other ways that they will sort of

are other ways that they will sort of make us forget ourselves that critical

make us forget ourselves that critical self dialogue that is always running in

self dialogue that is always running in our head goes away when we get high for

our head goes away when we get high for example so they alleviate our negative

example so they alleviate our negative emotions the Third thing that they help

emotions the Third thing that they help us do is feel positive emotions so it's

us do is feel positive emotions so it's easier to feel like we're having a good

easier to feel like we're having a good time we're vibing we're relaxing we're

time we're vibing we're relaxing we're chilling we're partying things like MDMA

chilling we're partying things like MDMA or ecstasy can help us feel connected to

or ecstasy can help us feel connected to other people right so if we really look

other people right so if we really look at it the reason that trauma and drugs

at it the reason that trauma and drugs overlap so heavily is because drugs and

overlap so heavily is because drugs and addictions fix the problems of trauma

addictions fix the problems of trauma but only temporarily so we also see this

but only temporarily so we also see this with with things like people who have a

with with things like people who have a history of trauma and have diagnoses of

history of trauma and have diagnoses of borderline personality disorder will

borderline personality disorder will engage with things like Pro promiscuous

engage with things like Pro promiscuous Behavior intense unstable relationships

Behavior intense unstable relationships to help feel loved right because when

to help feel loved right because when I'm head over heels in love with someone

I'm head over heels in love with someone I can feel better about myself so we see

I can feel better about myself so we see that if we look at the Neuroscience of

that if we look at the Neuroscience of emotional challenges with PTSD we see

emotional challenges with PTSD we see that addictions actually like fix all

that addictions actually like fix all three of those so there's a very high

three of those so there's a very high overlap the problem is that the fix from

overlap the problem is that the fix from an addiction is temporary and over time

an addiction is temporary and over time will get objectively

will get objectively worse great

okay how would you heal Trauma from having been in an incubator for a long

having been in an incubator for a long time as a b baby I have no clue I mean

time as a b baby I have no clue I mean that's really interesting there's a lot

that's really interesting there's a lot of like interesting data about you know

of like interesting data about you know per

per natal and and post birth like stuff and

natal and and post birth like stuff and correlations with things like learning

correlations with things like learning disabilities and stuff like that I've

disabilities and stuff like that I've never I don't think I've ever seen a

never I don't think I've ever seen a clinical case where like we thought that

clinical case where like we thought that the trauma originated at the level of an

the trauma originated at the level of an incubator but it's a very interesting

incubator but it's a very interesting question I'm not saying it can't have an

question I'm not saying it can't have an impact um really interesting question I

impact um really interesting question I don't have an answer to that one

okay is there a significant difference between someone who developed cptsd

between someone who developed cptsd because of one of those three household

because of one of those three household Styles versus someone who developed

Styles versus someone who developed cptsd from a

cptsd from a combination um especially if all three

combination um especially if all three situations are yeah so I think the

situations are yeah so I think the answer is basically yes

answer is basically yes so here's the here's the thing to

so here's the here's the thing to understand about trauma so we know about

understand about trauma so we know about trauma is that trauma shapes you and we

trauma is that trauma shapes you and we know that the way that it shapes you

know that the way that it shapes you causes problems later in life that's how

causes problems later in life that's how we Define trauma so negative events

we Define trauma so negative events shape us all the time but if it doesn't

shape us all the time but if it doesn't cause a negative impact we don't

cause a negative impact we don't diagnose someone with like PTSD so

diagnose someone with like PTSD so there's research on things like

there's research on things like post-traumatic growth where you can go

post-traumatic growth where you can go through something traumatic and you can

through something traumatic and you can end up

end up positive now this is where like this is

positive now this is where like this is why I think the treatment of trauma is

why I think the treatment of trauma is fun right so like I find it clinically

fun right so like I find it clinically enjoyable I know it's kind of weird to

enjoyable I know it's kind of weird to say but like I find it intellectually

say but like I find it intellectually engaging I find I have a lot of

engaging I find I have a lot of compassion I find a lot of like growth

compassion I find a lot of like growth and it gives me like positivity to see

and it gives me like positivity to see people overcome their trauma so I find

people overcome their trauma so I find the experience to be very like enjoyable

the experience to be very like enjoyable gratifying um and what we know is that

gratifying um and what we know is that the way in which you're busted will

the way in which you're busted will shape the way you're busted right so

shape the way you're busted right so like if you have a combination of

like if you have a combination of different traumatic things that can

different traumatic things that can result in like something new or

result in like something new or something different or a combination of

something different or a combination of the above now I don't know that one is

the above now I don't know that one is necessarily worse than the other but we

necessarily worse than the other but we absolutely see like nuances of each of

absolutely see like nuances of each of these manifestations and that's very

these manifestations and that's very common um and so then it's just an issue

common um and so then it's just an issue of like seeing which manifestation is

of like seeing which manifestation is common when

common when so like learning to think about the

so like learning to think about the future again like we want to do that and

future again like we want to do that and we want to learn how to like reward our

we want to learn how to like reward our autonomy like we can do all of the above

autonomy like we can do all of the above it's not either

or so what if I don't have the safety to want to calm down I wouldn't be as safe

want to calm down I wouldn't be as safe anymore if I were calm so that's a very

anymore if I were calm so that's a very common experience of people who have

common experience of people who have been traumatized so if you look at uh

been traumatized so if you look at uh research on

research on trauma what we find is that the most

trauma what we find is that the most important thing for healing trauma is

important thing for healing trauma is safety so we don't talk about this much

safety so we don't talk about this much as clinicians when we lecture about

as clinicians when we lecture about trauma but basically we know that like

trauma but basically we know that like physical safety and even to a certain

physical safety and even to a certain degree emotional safety is very very

degree emotional safety is very very important so the first step to treating

important so the first step to treating any trauma is not emotions or anything

any trauma is not emotions or anything like that is actually physical safety

like that is actually physical safety that's number one and the reason for

that's number one and the reason for that is very simple if you're not

that is very simple if you're not physically safe your hypothalamus will

physically safe your hypothalamus will be pumping out something called CR CR is

be pumping out something called CR CR is corticotropin releasing

corticotropin releasing hormone the CR will go to your your

hormone the CR will go to your your pituitary glands and will release act so

pituitary glands and will release act so your pituitary will pump out act which

your pituitary will pump out act which will cause your adrenal cortices to pump

will cause your adrenal cortices to pump out cortisol as long as your you have

out cortisol as long as your you have cortisol and other kinds of sympathetic

cortisol and other kinds of sympathetic nervous system or stress hormones

nervous system or stress hormones floating through your system you cannot

floating through your system you cannot rewire and you cannot heal like

rewire and you cannot heal like physiologically it is very difficult to

physiologically it is very difficult to do so if we look at the role of these

do so if we look at the role of these stress hormones stress hormones aren't

stress hormones stress hormones aren't about picking up the pieces they're

about picking up the pieces they're about surviving and getting through the

about surviving and getting through the day so what you find in people who have

day so what you find in people who have an experience of trauma who don't feel

an experience of trauma who don't feel safe and aren't safe is that is very

safe and aren't safe is that is very hard to work on the trauma because their

hard to work on the trauma because their brain is is not in a neuroplastic state

brain is is not in a neuroplastic state so let's understand this

so let's understand this okay so our brain develops or becomes

okay so our brain develops or becomes increasingly neuroplastic when we sleep

increasingly neuroplastic when we sleep so if we look at like memory

so if we look at like memory consolidation we have short-term memory

consolidation we have short-term memory and we have long-term memory our

and we have long-term memory our short-term memory which is kind of like

short-term memory which is kind of like our Ram gets Rewritten into our

our Ram gets Rewritten into our long-term memory which is kind of like

long-term memory which is kind of like our hard drive when we sleep so we do

our hard drive when we sleep so we do this process of memory consolidation

this process of memory consolidation this involves a lot of neuroplasticity

this involves a lot of neuroplasticity because we're forming new

because we're forming new memories now if we look at

memories now if we look at sleep stress hormones impede sleep so

sleep stress hormones impede sleep so sleep is when we build a lot of tissues

sleep is when we build a lot of tissues and grow a lot of neuron I mean we don't

and grow a lot of neuron I mean we don't grow too many neurons but bdnf increases

grow too many neurons but bdnf increases brain derived neurotrophic factor I

brain derived neurotrophic factor I think increases in sleep as well so our

think increases in sleep as well so our brain rewires when we

brain rewires when we sleep when we're stressed out we it runs

sleep when we're stressed out we it runs against the sleeping signals so we have

against the sleeping signals so we have these Pro sleep states where we our

these Pro sleep states where we our brain does things like rewire heal and

brain does things like rewire heal and learn and then we have these anti-sleep

learn and then we have these anti-sleep states which is like survive stay awake

states which is like survive stay awake and

and survive and so we absolutely need safety

survive and so we absolutely need safety as part of the healing process so I

as part of the healing process so I think the first step to Healing trauma

think the first step to Healing trauma is creating

is creating safety now that becomes a little bit

safety now that becomes a little bit tricky because sometimes because of our

tricky because sometimes because of our the nature of our hyperarousal and the

the nature of our hyperarousal and the way our nervous system is wired the lack

way our nervous system is wired the lack of safety is not quite as external as we

of safety is not quite as external as we think it is I'm not saying it isn't I

think it is I'm not saying it isn't I mean there people who are in abusive

mean there people who are in abusive households where it's unsafe objectively

households where it's unsafe objectively but the the tricky thing about trauma is

but the the tricky thing about trauma is that we carry that lack of safety within

that we carry that lack of safety within us so there's a balance between creating

us so there's a balance between creating external safety and even when you create

external safety and even when you create external safety it's not like internally

external safety it's not like internally you'll feel safe right away so there's a

you'll feel safe right away so there's a process of of letting yourself rewire to

process of of letting yourself rewire to feeling safe as well great question

feeling safe as well great question we're going to take one

we're going to take one more

um when I was born I was left crying for two hours in an incubator before someone

two hours in an incubator before someone held me and took me to my mother I blame

held me and took me to my mother I blame my constant anxiety for

my constant anxiety for this so that level of specificity I

this so that level of specificity I don't really like have much comment on I

don't really like have much comment on I would feel feel very very surprised to

would feel feel very very surprised to learn

learn that that singular event is responsible

that that singular event is responsible for a persistent adult

for a persistent adult condition would be very

condition would be very surprised so the the other thing that we

surprised so the the other thing that we know is that isolated events in

know is that isolated events in childhood kids are quite

childhood kids are quite resilient so like the the cool thing

resilient so like the the cool thing about kids is that even if they go

about kids is that even if they go through a traumatic experience it is

through a traumatic experience it is very common for them to bounce back and

very common for them to bounce back and that's because like kids are their brain

that's because like kids are their brain is very neuroplastic even their body is

is very neuroplastic even their body is quite changeable right so like kids have

quite changeable right so like kids have their neurons can still grow in ways

their neurons can still grow in ways that adults can't they can create new

that adults can't they can create new neurons most of what happens is pruning

neurons most of what happens is pruning but you know so like the their healing

but you know so like the their healing capacity is way bigger because they're

capacity is way bigger because they're like not in read only mode they're still

like not in read only mode they're still in right mode so that like a lot of them

in right mode so that like a lot of them can children can heal very easily um so

can children can heal very easily um so I'd be surprised I'm not saying it's not

I'd be surprised I'm not saying it's not possible that's something to work

possible that's something to work through with a

through with a clinician um interesting thank you for

sharing um do we know if EMDR is effective for

um do we know if EMDR is effective for cptsd I personally think it is but

cptsd I personally think it is but there's a lot of controversy around

there's a lot of controversy around EMDR and we don't have many studies on

EMDR and we don't have many studies on what's effective for cptsd

uh so my problem has been so good at masking my cptsd that they don't find

masking my cptsd that they don't find the issue any tips as to opening up yeah

the issue any tips as to opening up yeah I'd start with the body right that's why

I'd start with the body right that's why we kind of talked about that like so I

we kind of talked about that like so I don't know if this kind of makes sense

don't know if this kind of makes sense but the way that we've outlined our

but the way that we've outlined our approach to trauma and especially in the

approach to trauma and especially in the guide the reason it's built that

guide the reason it's built that way is because we have gotten these

way is because we have gotten these questions over and over and over and I

questions over and over and over and I have this problem I have this problem I

have this problem I have this problem I have this problem I have this problem

have this problem I have this problem what about this what about this what

what about this what about this what about this what about this what about

about this what about this what about this what about this what about this so

this what about this what about this so what we did is took all those questions

what we did is took all those questions and say okay if we take all of these

and say okay if we take all of these questions how can we understand trauma

questions how can we understand trauma that accounts for all of these so why do

that accounts for all of these so why do we have a video about paralysis of

we have a video about paralysis of initiation and impulsivity because we

initiation and impulsivity because we recognize that there's an overlap

recognize that there's an overlap between the symptomatology of ADHD and

between the symptomatology of ADHD and Trauma we recognize that people with

Trauma we recognize that people with trauma have difficulties that feel like

trauma have difficulties that feel like ADHD so that's in there we recognize

ADHD so that's in there we recognize that people have difficulty opening up

that people have difficulty opening up we recognize that people have difficulty

we recognize that people have difficulty feeling their emotions that's why we

feeling their emotions that's why we start with the

start with the body right and that's why relationships

body right and that's why relationships is at the very

is at the very end so start with the

body okay um

how do I bring up cptsd up to my therapist I resonated with this topic a

therapist I resonated with this topic a lot but I feel like it's not my place to

lot but I feel like it's not my place to initiate the conversation there it is

initiate the conversation there it is right so

right so like I can

like I can say it's absolutely your place to

say it's absolutely your place to initiate the conversation that's your

initiate the conversation that's your job that's why you're going right you're

job that's why you're going right you're going for your benefit not the therapist

going for your benefit not the therapist benefit if it helps you by all means

benefit if it helps you by all means bring it up that doesn't work though

bring it up that doesn't work though right so one of the manifestations of

right so one of the manifestations of cptsd is you feel like it's not your

cptsd is you feel like it's not your place you feel like deferring to the

place you feel like deferring to the other person you feel like following

other person you feel like following someone else's

someone else's lead see when we don't have a

lead see when we don't have a well-formed sense of identity we don't

well-formed sense of identity we don't feel like we deserve very much it's not

feel like we deserve very much it's not my

my place when it's absolutely your place

place when it's absolutely your place like that's the definition of your place

like that's the definition of your place the the reason the therapy is the one

the the reason the therapy is the one place where you get to go for you and

place where you get to go for you and for no one else so whatever you want is

for no one else so whatever you want is fair game

fair game right I within reason it's like the the

right I within reason it's like the the therapist can say

therapist can say no but it's very common so notice that

no but it's very common so notice that notice that your desire to not even

notice that your desire to not even bring it up or your feeling that that's

bring it up or your feeling that that's not my place to bring it up could be a

not my place to bring it up could be a manifestation of the very problem itself

manifestation of the very problem itself and just notice that and then try your

and just notice that and then try your best to bring it

best to bring it up right you can even share so one last

up right you can even share so one last technique that I'll give you all is if

technique that I'll give you all is if you're having so this is like Pro

you're having so this is like Pro technique and therapy okay

technique and therapy okay so sometimes we feel embarrassed

so sometimes we feel embarrassed bringing something up because there's a

bringing something up because there's a lot of emotional energy here there's

lot of emotional energy here there's shame there's guilt there's like oh my

shame there's guilt there's like oh my God this kind of kinky thing kind of

God this kind of kinky thing kind of turns me on and like oh my God I have

turns me on and like oh my God I have these kind of

these kind of thoughts and so we have difficulty like

thoughts and so we have difficulty like tackling that emotion and being

tackling that emotion and being vulnerable so instead what I want youall

vulnerable so instead what I want youall to do is go one layer above

to do is go one layer above it so what you can say to your therapist

it so what you can say to your therapist is there's something that I feel ashamed

is there's something that I feel ashamed of that I don't feel comfortable

of that I don't feel comfortable bringing up with you so you go meta

bringing up with you so you go meta right so you're not bringing up the

right so you're not bringing up the thing you're saying this thing is hard

thing you're saying this thing is hard for

for me and then even if that's too hard you

me and then even if that's too hard you can go one level above I want to bring

can go one level above I want to bring something up with you I want to bring up

something up with you I want to bring up that I'm scared to talk about something

that I'm scared to talk about something but even that's hard to talk about so

but even that's hard to talk about so what we want to do is move away from the

what we want to do is move away from the emotion and put that out there right say

emotion and put that out there right say like even one step removed you don't

like even one step removed you don't have to talk about the shameful thing

have to talk about the shameful thing there's something that I'm ashamed of

there's something that I'm ashamed of that I don't want to talk about you can

that I don't want to talk about you can just say

just say that and then it's the therapist job to

that and then it's the therapist job to take over like that's what we're good at

take over like that's what we're good at right that's what we're trained for

right that's what we're trained for we're trained to help you do

we're trained to help you do that and even when we're like so is a

that and even when we're like so is a there's a good technique in therapy

there's a good technique in therapy called going mattera right so and and

called going mattera right so and and that's when when there's something like

that's when when there's something like so if someone says like hey I'm like I'm

so if someone says like hey I'm like I'm here for therapy I want to focus on this

here for therapy I want to focus on this but I don't want to talk about this and

but I don't want to talk about this and so what do we do in therapy we don't say

so what do we do in therapy we don't say okay okay screw you we're going to talk

okay okay screw you we're going to talk about that anyway because you don't want

about that anyway because you don't want to talk about it no what we do is help

to talk about it no what we do is help me understand why you don't want to talk

me understand why you don't want to talk about it totally fine we don't have to

about it totally fine we don't have to talk about it just can you give me a

talk about it just can you give me a little bit of

little bit of context

context cool and then you can bring it up later

cool and then you can bring it up later so then it's your therapist job to get

so then it's your therapist job to get there if you want to talk about it you

there if you want to talk about it you can say hey I want to talk about this

can say hey I want to talk about this thing but I'm too embarrassed and I'm

thing but I'm too embarrassed and I'm going to shut

um how do I explain my cptsd to a family member that has expressed that she wants

member that has expressed that she wants to help but doesn't really understand

to help but doesn't really understand the gravity of my

the gravity of my issues honestly like I'd send them this

issues honestly like I'd send them this video right so one thing that's starting

video right so one thing that's starting to

to happen is that people are starting to

happen is that people are starting to share some of our content like not for

share some of our content like not for themselves but like they're like you

themselves but like they're like you know we we had video about autism and

know we we had video about autism and gender identity we had a video about

gender identity we had a video about relationships with BPD with people with

relationships with BPD with people with borderline personality disorder we've

borderline personality disorder we've had and so we're seeing a lot of like

had and so we're seeing a lot of like sharing going on so you know a lot of

sharing going on so you know a lot of people struggle to convey what we convey

people struggle to convey what we convey don't convey it just share and like I I

don't convey it just share and like I I don't know if yall get this I cannot

don't know if yall get this I cannot remember the last time I know that like

remember the last time I know that like all content creators are like hey if you

all content creators are like hey if you like the video like subscribe and share

like the video like subscribe and share share I can't remember the last time I

share I can't remember the last time I can't remember I mean I've done it

can't remember I mean I've done it before right so maybe on like like why

before right so maybe on like like why men the male suicide or why therapy

men the male suicide or why therapy sucks for men there are a couple of

sucks for men there are a couple of videos that we've done lectures we've

videos that we've done lectures we've done streams that we've done where I've

done streams that we've done where I've asked yall to share things I don't ask

asked yall to share things I don't ask yall to share things

yall to share things like you know sure it helps us but like

like you know sure it helps us but like that's not we're not here for us we're

that's not we're not here for us we're here for you and that's why I don't ask

here for you and that's why I don't ask yall to like subscribe or share

yall to like subscribe or share the only time I ask youall to do it is

the only time I ask youall to do it is when I think it benefits you or someone

when I think it benefits you or someone else who may need help so this is one of

else who may need help so this is one of the rare times where I would say the

the rare times where I would say the whole reason we do this and we store

whole reason we do this and we store these is so that y'all can share it with

these is so that y'all can share it with other people so like if you don't know

other people so like if you don't know like if like let's say you watch a video

like if like let's say you watch a video about BPD and you realize holy crap I

about BPD and you realize holy crap I could have BPD this is what it's like to

could have BPD this is what it's like to be in my shoes I think you should

be in my shoes I think you should absolutely share that with someone who

absolutely share that with someone who you're in a relationship with and be

you're in a relationship with and be like H this person kind of explains what

like H this person kind of explains what my experience is like in a way that I

my experience is like in a way that I can't quite explain

can't quite explain it right or something about addiction or

it right or something about addiction or whatever like if you're if you're a

whatever like if you're if you're a gifted kid and your parents tell you

gifted kid and your parents tell you that you have all the potential in the

that you have all the potential in the world and if you just tried harder send

world and if you just tried harder send them more gifted kids a special needs

them more gifted kids a special needs video right so we're here as a resource

video right so we're here as a resource for your benefit that does not just mean

for your benefit that does not just mean you you're you're the only one that can

you you're you're the only one that can has to watch us so if we explain a

has to watch us so if we explain a concept in a way that it would be useful

concept in a way that it would be useful for someone in your life to understand

for someone in your life to understand then you should share our videos but

then you should share our videos but once again that's not so that we can

once again that's not so that we can increase our views by 0.001% that is

increase our views by 0.001% that is because it benefits you that's why you

because it benefits you that's why you should share or if it benefits someone

would you consider Spanish subtitles I think we're working on

um oh what a beautiful question so we're at time for the day but I'm going to

at time for the day but I'm going to leave yall with one last question that I

leave yall with one last question that I love uh there's two questions man these

love uh there's two questions man these are so so best meditation for trauma

are so so best meditation for trauma we're past time so I don't have time or

we're past time so I don't have time or energy to do meditation today for which

energy to do meditation today for which I apologize but in the trauma guide

I apologize but in the trauma guide we've got hold on a second let me tell

we've got hold on a second let me tell y'all we have a whole new stock of

meditations oh here oh damn it I just realized that people are telling

realized that people are telling me

um these are so good okay we're going to answer one

good okay we're going to answer one quick one one question then we're going

quick one one question then we're going to try to speed run a couple more so

to try to speed run a couple more so first thing is um what was I talking

first thing is um what was I talking about I don't even remember brain death

about I don't even remember brain death is setting in um oh meditations so we

is setting in um oh meditations so we have we have a bunch of meditations let

have we have a bunch of meditations let me

me count uh so we have at I think about 10

count uh so we have at I think about 10 meditations okay no one is an overview

meditations okay no one is an overview one two one two 3 4 5 6 7 8 9 10 there's

one two one two 3 4 5 6 7 8 9 10 there's 11 meditations in the trauma guide

11 meditations in the trauma guide um so definitely check those out I think

um so definitely check those out I think they're great they'll build on the

they're great they'll build on the existing meditations that we've taught

existing meditations that we've taught you all and I just ran into Will trauma

you all and I just ran into Will trauma ever go away quick answer to that

ever go away quick answer to that one possibly actually so we know that we

one possibly actually so we know that we know that like a lot of people will heal

know that like a lot of people will heal from trauma without any overt

from trauma without any overt intervention so the cool thing is like

intervention so the cool thing is like if you look at the body like the body

if you look at the body like the body and brain like heal that's what we're

and brain like heal that's what we're designed to do so the short answer is

designed to do so the short answer is it's very possible that you don't need

it's very possible that you don't need to do a damn thing and you'll just just

to do a damn thing and you'll just just it'll fix itself or your relationships

it'll fix itself or your relationships will organically fix

will organically fix it I wouldn't adopt that strategy

it I wouldn't adopt that strategy though

though um there's another question of how do we

um there's another question of how do we address the sources of trauma out in the

address the sources of trauma out in the world and who is responsible for doing

world and who is responsible for doing so that's a lovely question I love it

so that's a lovely question I love it love it love it love it love it it's Way

love it love it love it love it it's Way Beyond the scope of what we have time

Beyond the scope of what we have time for today so I think this is a oh

for today so I think this is a oh actually that's in the guide what am I

actually that's in the guide what am I saying so I was going to say so we can

saying so I was going to say so we can absolutely talk about it but I think

absolutely talk about it but I think Karma talking about karma is a very good

Karma talking about karma is a very good exploration of this topic so over on the

exploration of this topic so over on the membership side we had a couple of great

membership side we had a couple of great Karma lectures we talk about Karma and

Karma lectures we talk about Karma and the trauma guide because there is this

the trauma guide because there is this whole idea of like you know everything

whole idea of like you know everything we're talking about is fixing you but

we're talking about is fixing you but what about the outside world so I think

what about the outside world so I think that's a very important discussion but I

that's a very important discussion but I I don't think it's a short answer I

I don't think it's a short answer I think it's like a if we're going to talk

think it's like a if we're going to talk about it let's talk about

about it let's talk about it um

it um okay so can you recommend specific

okay so can you recommend specific meditation techniques there's 10 about

meditation techniques there's 10 about 10 of them in the guide um which by the

10 of them in the guide um which by the way is why we built a guide right

way is why we built a guide right because like I don't know if this makes

because like I don't know if this makes sense but there's no way we can get to

sense but there's no way we can get to even 1% of the questions that y'all ask

even 1% of the questions that y'all ask or even share with y'all 1% of like the

or even share with y'all 1% of like the meditations that y'all can try and

meditations that y'all can try and things like that that's why we build

things like that that's why we build these stock resources that are way more

these stock resources that are way more in depth I I don't know if this kind of

in depth I I don't know if this kind of makes sense but

makes sense but you know filming of the trauma guide is

you know filming of the trauma guide is like the

like the filming is a week of me showing up at a

filming is a week of me showing up at a studio at like 8:00 and leaving at 5:

studio at like 8:00 and leaving at 5: and cameras are rolling for like 9 hours

and cameras are rolling for like 9 hours a day for like 5 to seven

a day for like 5 to seven days and so it's it's like you know like

days and so it's it's like you know like in order to duplicate that I would have

in order to duplicate that I would have to stream for like 50 hours in a week so

to stream for like 50 hours in a week so I just can't do that like my voice

I just can't do that like my voice cannot handle it so that's why we build

cannot handle it so that's why we build these resources because there's just no

these resources because there's just no way we can get to everything but it's

way we can get to everything but it's very like and the reason we edit and

very like and the reason we edit and everything is so that like it's very

everything is so that like it's very high

high yield

um so how do you start to build your own sense of self I think it's first of all

sense of self I think it's first of all cleaning out negative emotions and then

cleaning out negative emotions and then starting to bring together emotional

starting to bring together emotional experiences into a new narrative there's

experiences into a new narrative there's a whole video about narrative and

a whole video about narrative and identity and constructing a positive

identity and constructing a positive narrative is something that can be

narrative is something that can be taught it is a skill and it is something

taught it is a skill and it is something that has been shown to improve uh

that has been shown to improve uh outcomes and Trauma so like narrative is

outcomes and Trauma so like narrative is an important part absolutely so there's

an important part absolutely so there's just a way to do it um how to not be one

just a way to do it um how to not be one of the 69% to resist trauma treatment

of the 69% to resist trauma treatment great question so remember that those

great question so remember that those people are not resistant to trauma

people are not resistant to trauma treatment they are resistant to a

treatment they are resistant to a particular intervention for a particular

particular intervention for a particular diagnosis and we know the cause for that

diagnosis and we know the cause for that resistance is a high level of

resistance is a high level of dissociation we have other things that

dissociation we have other things that improve

improve dissociation so there's a certain model

dissociation so there's a certain model of of trauma treatment called stare and

of of trauma treatment called stare and the whole model is based on first you do

the whole model is based on first you do this then you do this then you do this

this then you do this then you do this then you do this and when you do it that

then you do this and when you do it that way that's like a comprehensive approach

way that's like a comprehensive approach that checks most of the boxes and deals

that checks most of the boxes and deals with this concept of resistant to trauma

with this concept of resistant to trauma treatment is cptsd curable or do you

treatment is cptsd curable or do you have to deal with it for the rest of

have to deal with it for the rest of your life I personally believe that for

your life I personally believe that for I would say most people it is basically

I would say most people it is basically curable I know it's a bold statement I

curable I know it's a bold statement I may be

may be dumb I may be wrong but I personally

dumb I may be wrong but I personally believe that trauma for most people can

believe that trauma for most people can be cured I do not believe that for

be cured I do not believe that for schizophrenia so I think we know that

schizophrenia so I think we know that some of our psychiatric

some of our psychiatric diagnoses are

diagnoses are like Progressive and more biologically

like Progressive and more biologically driven so schizophrenia is a really good

driven so schizophrenia is a really good example of that

example of that one where but like trauma is different

one where but like trauma is different I've seen people basically be in

I've seen people basically be in complete remission or cure from cptsd

complete remission or cure from cptsd before

before um I'm 50 and never felt happy how long

um I'm 50 and never felt happy how long into treatment for PTSD will I be before

into treatment for PTSD will I be before I can start to feel the short answer is

I can start to feel the short answer is I don't know

so the other thing about trauma treatment is that your mileage may vary

treatment is that your mileage may vary so if we look at most

so if we look at most treatments they tend to be effective

treatments they tend to be effective somewhere around the 8we mark and you'll

somewhere around the 8we mark and you'll have some gains up until about the 16 we

have some gains up until about the 16 we Mark and then beyond that you can

Mark and then beyond that you can absolutely have gains but generally

absolutely have gains but generally speaking it takes two to four months for

speaking it takes two to four months for treatments to start to be

treatments to start to be effective that being said feeling

paper feeling happy is not necessarily one of the things

is not necessarily one of the things that we look

at in in trauma treatment right so we'll like measure some things but we don't

like measure some things but we don't necessarily look at happiness so like

necessarily look at happiness so like this is the kind of thing where

this is the kind of thing where you know the short answer is your

you know the short answer is your mileage may vary the slightly longer

mileage may vary the slightly longer answer which is super

answer which is super cool is complex post-traumatic stress

cool is complex post-traumatic stress disorder is an independent diagnosis

disorder is an independent diagnosis differences in hedonic and UD dionic

differences in hedonic and UD dionic well-being between p cptsd and PTSD I

well-being between p cptsd and PTSD I imagine that the answer to your question

imagine that the answer to your question is somewhere in this paper so what this

is somewhere in this paper so what this paper talks about is that there are two

paper talks about is that there are two kinds of Happiness there is dopaminergic

kinds of Happiness there is dopaminergic happiness and there is serotonergic

happiness and there is serotonergic happiness

happiness dopam energic happiness is what we call

dopam energic happiness is what we call hedonic hon Hedonism hedonic well-being

hedonic hon Hedonism hedonic well-being so this is like my ability to experience

so this is like my ability to experience pleasure UD dionic happiness is a sense

pleasure UD dionic happiness is a sense of contentment peace or internal

of contentment peace or internal happiness that is not tied to a

happiness that is not tied to a particular thing so if I

particular thing so if I like go on a roller coaster that will

like go on a roller coaster that will increase my hedonic happiness playing a

increase my hedonic happiness playing a video game will will increase my hedonic

video game will will increase my hedonic happiness watching pornography will

happiness watching pornography will increase my hedonic happiness because it

increase my hedonic happiness because it gives me

gives me pleasure but especially with things like

pleasure but especially with things like video games and pornography it can

video games and pornography it can decrease my UD dionic

decrease my UD dionic happiness so this is my sense of like

happiness so this is my sense of like peace and joy in

peace and joy in life unfortunately cptsd is associated

life unfortunately cptsd is associated with impairments in both and less of

with impairments in both and less of both so what we do know is that if you

both so what we do know is that if you get treated for this stuff those both of

get treated for this stuff those both of those indices will improve and what we

those indices will improve and what we also know is that in

also know is that in cptsd UD dionic unhappiness is more

cptsd UD dionic unhappiness is more profound than hedonic unhappiness so if

profound than hedonic unhappiness so if you have a history of trauma your

you have a history of trauma your ability to engage in pleasure is

ability to engage in pleasure is modulated or impaired but your ability

modulated or impaired but your ability to feel at peace and feel Joy in life is

to feel at peace and feel Joy in life is even more

even more impaired so the pleasure circuitry is

impaired so the pleasure circuitry is somewhat intact the sense of Peace

somewhat intact the sense of Peace circuitry is more screwed

circuitry is more screwed up so let's just kind of take a quick

up so let's just kind of take a quick look at I think I remember that

um see these findings indicate that core symptoms of

symptoms of cptsd Might hinder individuals from

cptsd Might hinder individuals from living fulfilling lives that's what UD

living fulfilling lives that's what UD dionic happiness is

dionic happiness is okay it's

okay it's bizarre so if you guys are

bizarre so if you guys are wondering so like putting together this

wondering so like putting together this deep dive first thing is for every hour

deep dive first thing is for every hour that I spend telling y'all about

that I spend telling y'all about something there's four hours of stuff

something there's four hours of stuff that I leave

that I leave out and this is like this is why I like

out and this is like this is why I like doing such a deep dive because it's like

doing such a deep dive because it's like cool because if youall ask a question it

cool because if youall ask a question it turns out there's literally at least one

turns out there's literally at least one paper that talks about happiness and

paper that talks about happiness and Trauma

Trauma right so the there's good news and bad

right so the there's good news and bad news here the short answer is how long

news here the short answer is how long will it take you to feel happy I would

will it take you to feel happy I would say give it at least 6

say give it at least 6 months but there are also other caveats

months but there are also other caveats there right because whether you feel

there right because whether you feel happy or not can be somewhat independent

happy or not can be somewhat independent of your treatment so I had a patient who

of your treatment so I had a patient who once came in and I treated them for

once came in and I treated them for major depressive

major depressive disorder and after about two years they

disorder and after about two years they said I don't feel like I've gotten any

said I don't feel like I've gotten any better and I was like well what do you

better and I was like well what do you mean by that because your life is

mean by that because your life is improved we've talked about all the

improved we've talked about all the things that have improved and he's like

things that have improved and he's like I still don't I still feel depressed

I still don't I still feel depressed every day and after tunneling down into

every day and after tunneling down into it that's when we realized this isn't

it that's when we realized this isn't depression this is

depression this is unhappiness and the presence of

unhappiness and the presence of depression is different from the

depression is different from the presence the absence of unhappiness the

presence the absence of unhappiness the these are two separate things the

these are two separate things the treatment of depression moves us towards

treatment of depression moves us towards neutral learning to be happy is its own

neutral learning to be happy is its own separate path this is often times more

separate path this is often times more along the spiritual line as opposed to

along the spiritual line as opposed to the clinical

the clinical line and in trauma that can be true as

line and in trauma that can be true as well and so if someone hasn't felt happy

well and so if someone hasn't felt happy we absolutely know that things like the

we absolutely know that things like the dorsal medial prefrontal cortex are

dorsal medial prefrontal cortex are impaired in cptsd which prevents people

impaired in cptsd which prevents people or makes it difficult for them to feel

or makes it difficult for them to feel positive emotions instead they feel

positive emotions instead they feel numbness when they go to a birthday

numbness when they go to a birthday party for them when they go to their

party for them when they go to their birthday party everyone is happy and

birthday party everyone is happy and celebrating and you're just like I don't

celebrating and you're just like I don't feel anything like it's not bad but I

feel anything like it's not bad but I don't feel

don't feel Joy and that's where there is the so

Joy and that's where there is the so treating cptsd will help with you dionic

treating cptsd will help with you dionic wellbeing

wellbeing absolutely but part of that treatment is

absolutely but part of that treatment is a little bit more spiritual and you can

a little bit more spiritual and you can do that on your own right so you can do

do that on your own right so you can do you can learn to appreciate you can

you can learn to appreciate you can start practicing gratitude there are

start practicing gratitude there are other ways to engage to increase your

other ways to engage to increase your happiness that don't have to do so much

happiness that don't have to do so much with cptsd now I suspect some of these

with cptsd now I suspect some of these techniques will be difficult for people

techniques will be difficult for people with

with cptsd because the parts of their brain

cptsd because the parts of their brain that normally these techniques would

that normally these techniques would activate May somehow be

activate May somehow be impaired so I I recently did a lecture

impaired so I I recently did a lecture on the Neuroscience of

on the Neuroscience of Enlightenment and that may be showing up

Enlightenment and that may be showing up on on one of our channels soon maybe

on on one of our channels soon maybe maybe not I'm not

maybe not I'm not sure but the short answer is your

sure but the short answer is your mileage may vary it is a very good

mileage may vary it is a very good question there's a lot at play between

question there's a lot at play between trauma and happiness and fulfillment

trauma and happiness and fulfillment treatment will

treatment will help but even if it doesn't help don't

help but even if it doesn't help don't give up I guess that's what I mean to

give up I guess that's what I mean to say that the treatment of an illness is

say that the treatment of an illness is not the same as creating happiness in

not the same as creating happiness in your life and sometimes that is an

your life and sometimes that is an independent

independent process and on that note we're at time

process and on that note we're at time for the day way past time so it's been

for the day way past time so it's been an absolute pleasure to be here today

an absolute pleasure to be here today with y'all um let me think

with y'all um let me think about I just want to show y'all a couple

about I just want to show y'all a couple of things before we close out so for

of things before we close out so for those of y'all that are joining us late

those of y'all that are joining us late we do have a trauma guide that is going

we do have a trauma guide that is going to be coming out soon that is available

to be coming out soon that is available for

for pre-order um I know we discussed a lot

pre-order um I know we discussed a lot of dense Neuroscience today so we're

of dense Neuroscience today so we're also improving things in that

also improving things in that Dimension so here we have

some of the trauma guide Graphics right so some of these

Graphics right so some of these complicated Neuroscience things that we

complicated Neuroscience things that we teach y'all we absolutely want to teach

teach y'all we absolutely want to teach y'all like we try to make it accessible

y'all like we try to make it accessible but we're not dumbing it down and I

but we're not dumbing it down and I think that the more that yall understand

think that the more that yall understand the difference between dorsal medial

the difference between dorsal medial prefrontal cortex emotions and amygdalar

prefrontal cortex emotions and amygdalar emotions the more in control of your

emotions the more in control of your life you'll be and in order to

life you'll be and in order to facilitate that understanding we have a

facilitate that understanding we have a lot of cool stuff coming down the

lot of cool stuff coming down the pipeline the trauma guide is made with a

pipeline the trauma guide is made with a lot of love so definitely check it

lot of love so definitely check it out thank youall very much for coming

out thank youall very much for coming here today um and then you know take

here today um and then you know take care of yourselves like don't give up

care of yourselves like don't give up it's not

it's not over like the reason it's it's

over like the reason it's it's reasonable to want to give up because

reasonable to want to give up because you can try really hard and things don't

you can try really hard and things don't improve makes a lot of sense I hear that

improve makes a lot of sense I hear that but it doesn't mean just because things

but it doesn't mean just because things have not improved does not mean that

have not improved does not mean that things are impossible so take car all

things are impossible so take car all happy weekend

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This is your brain on trauma.