Transcription
I don't think anybody's ever come to see me for the first time because of their trauma. They come to see me because my relationships aren't working out, or I cannot sleep, or I get so angry and I don't know why. Basically, trauma is being lived out in the present. It's heartbreaking and gut-wrenching sensations. (fast-paced breathing) (heart beating) The event that happens is, in fact, over, but your mind and your sensations keep reliving it, acting like it, feeling like it. Those are automatic reactions of that core part of the brain having to do with survival. So you cannot talk yourself out of feeling this way. You need to have visceral experiences that are different. Create a state in the mind where the mind is able to absorb new ways of looking at things. By expanding our Perception Box, we can really get to see that the reality that you live in is much bigger than the constructs we have created for ourselves to make sense out of the world. (orchestral music)
My name is Bessel van der Kolk. I'm a psychiatrist, author of the book, "The Body Keeps the Score," and I've been working on trauma all my life. We all are living by our sensations, and our sensations are translated by our minds into certain emotions. Traumatized people, they're living by their emotions and their sensations, but the rational brain does not modify it. What you see is big bursts of energy in the right emotional center of the brain. So you feel intense feelings. You feel intense sensations. Sometimes you don't feel any sensations at all, and basically your frontal lobe goes offline and your capacity to tell time goes offline. Your brain is unable to really tell you this belongs to back then, it doesn't belong to right now.
The core imprint of trauma is in that core part of the brain having to do with survival. And when that part of the brain is not laid to rest, it will keep firing. And this constrains our Perception Box. If your perceptions are that the world's a dangerous place and people are going to hurt me, then that becomes your reality and you cannot imagine an alternative reality. And so you'll behave in a way with other people that's either very submissive or very controlling or very vengeful, and people generally are not all that aware that that's the adaptation. That's why you go into therapy, yeah.
This whole notion that you can really talk people out of feeling a particular way, I think it's really mistaken. I think we cannot do that. I'm not at all saying that talking is not helpful. Having a story for what happened to you is terribly important, but being able to tell the story doesn't make the sensations go away. So it's very important to provide people a visceral experience of how it can be different.
I had a patient who was so chronic, not doing well with supportive therapy, but nothing was moving. And then one September we see each other after the summer break and she walks to my office and there's a new person. And I say, "What happened to you?" She said, "Oh, nothing." "Did you do anything unusual?" "Oh yeah, I took boxing lessons." And it turned out that the boxing lessons had completely changed the way that her body moves through the world because the boxing lessons had given her a feeling of, "If somebody assaults me, I can hit him and punch him." And it had the experience of, "Wow, that feels really good. I can stand up for myself." And so it's very important for traumatized people to have experiences that directly contradict the helplessness and the despair of a trauma.
Psychodrama is one of the things that I really discovered can make a profound difference because you get a whole different reality. Let's say we are in a room together and I'm your psychodrama coach, and you say, "Well, my father was a real nasty guy." And then I say, "Okay, would you like to choose somebody to play the role of your ideal dad who would've been there for you when you were three years old, five years old, whatever?" And then we experiment physically and say, "Yeah, why don't you put your hand over here, and the other hand over here." Then they have the ideal father say, "If I'd been your ideal father back then, I would've held you like this." Because somebody holds you, touches you, or reassures you, your physiology calms itself down and the different part of the brain that you need to orient yourself, comes back online. You have the visceral experience of that is what you needed back then. And for a moment you get that reality implanted in yourself.
But possibly the most significant thing that's happened in my 50-year psychiatric career is that psychedelics can really change people's minds. The psychedelics put you in a different frame of mind where the ordinary organization between different parts gets dissolved. What we oftentimes see is that the insular, which sends you messages for your body, still gets activated, but now it gets connected with the frontal lobe that allows your brain to become aware of, "I am really remembering something related to the past, and it's not happening right now." It's changing the brain circuitry that helps you to move into the present, basically. And what you see is people being able to have compassion for themselves, to be able to articulate what they went through, not be judgmental about themselves, and to really say, "This is what happened to me and it's the best I could do, and I feel very sad, but I can now see it and I will no longer lead my life as if it's still happening right now."
After you process the trauma, your Perception Box expands, absolutely. You don't superimpose that particular horrible experience that you had on most interactions that you have. So you really see the world differently. You see yourself differently, and you get a new perspective on who you are and where you come from. (orchestral music fades)