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

**Andrew Huberman** (0:00)
Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health and performance. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. And now for my discussion with Dr. Paul Conti. Paul, thank you so much for being here today.

**Paul Conti** (0:23)
Thank you so much for having me.

**Andrew Huberman** (0:24)
We could just start off very basic and just get everyone oriented. How should we define trauma?

**Paul Conti** (0:30)
I think we have to look at trauma as not anything negative that happens to us, right? But something that overwhelms our coping skills and then leaves us different as we move forward. So it changes the way that our brains function, right? And then that change is evident in us as we move forward through life. We can see it in mood, anxiety, behavior, sleep, physical health, so we can identify it. And we can also see it in brain changes. If trauma rises to the level of changing the functioning of our brains, then there is almost always a reflex of guilt and shame around the trauma that can lead us and often leads us to bury it, right? To avoid it, which is exactly the opposite of what needs to be done. We need to communicate and put words to what's gone on inside of us. And very often a person knows, but they're not admitting it to themselves because they're afraid of it, right? They don't know what to do.
But if they start talking, then they'll talk about the event or the situation. It could be something acute or it could be something chronic that really has been harmful to them, right? And then they feel different afterwards. But that doesn't always happen. Sometimes it's a process of exploration through dialogue, right? Whether it's written or whether it's spoken of the person sort of exploring the changes inside of themselves, maybe changes to their self-talk inside, changes to their thoughts about the world and whether they can navigate safely and readily in it. And it anchors, as I talk about this, the example I'll use at times is the example of my own life where when I was much younger, in my early 20s, my younger brother took his life by suicide. And the response of guilt and shame and hiding all of it inside of me was, it's just very dramatic, but I wasn't acknowledging it, right? Because I didn't know what to do about it. And I felt guilty and I felt responsible and I felt ashamed. So there was an avoidance inside of me. So I didn't see that the change was in me, but I was taking care of myself poorly. Like there was enough going on that was unhealthy that I couldn't avoid the realization that like, hey, I'm different now. And in these ways that are automatic, you know, my reflex to can I make my way in the world? Can I have a good life? Can I be happy? Well, my reflexes to that were all different. And they were coming through the lens of heightened anxiety, heightened vigilance, a sense of guilt, a sense of shame, and a sense of non belonging in the world. And was ultimately good and helpful people around me and my own realization. And hey, things are not going well, right? That led me to then get some help and to be able to talk about it and realize like, oh my gosh, like I need to face these things that are going on inside of me.

**Andrew Huberman** (3:20)
Why do you think that when we experience trauma, these things that we call guilt and shame surface, those emotions must exist in us for some reason. But in this case, it seems like they don't serve us well. So why is it that we seem to be reflexively wired to feel guilty and feel ashamed when that's the exact opposite of what we need to do in the case of trauma?

**Paul Conti** (3:44)
There's something adaptive that has happened in us through evolution that now becomes maladaptive in the way we live in the modern world. So if you think of through most of human development, people weren't living that long. The idea was to survive and reproduce. So traumatic things that happened to us, it would make sense for them to stay with us. So if you ate a new food and got really, really sick, you better remember that.
If you see someone from the group of people a couple miles away and one of those people attacks you, you better remember that. So the traumatic things that are sort of emblazoned in our brain are built to last. Things that are positive will generate some emotion inside of us, but things that are profoundly negative are much more likely to stay with us. And I think that that was adaptive, when all of that was about survival.