EZRA KLEIN: The single best piece of advice I ever got on marriage is that there is no use in thinking of your partner as a single stable entity that exists separate from you. So MDMA combined with therapy is now in phase III trials in the F.D.A. And so two years ago we finally did a study where we looked at what these eye movements cause. I think thats going to be really, really, really important to this conversation. And Im really delighted with Rick Doblin, who runs the Multidisciplinary Association for Psychedelic Studies, M.A.P.S., which forms part of his studies. BESSEL VAN DER KOLK: Exactly. His work is predicated on integrating body . And they become very angry or very frozen. Licia Sky on "Coming to your senses" (COLLECTION) Tapping into her years of experience of providing remote care to her patients, Licia Sky leads us through an exercise of noticing sensations and feelings. So The Body Keeps the Score has I mean, as a book, its a phenomenon, as a social meme, its a phenomenon. And people said, mental illness is a chemical illness, and if we just find the right chemical, well cure it. BESSEL VAN DER KOLK: Language, its really great when you have kids as you do or grandchildren as I do, how you can see kids develop language over time and you can see how as they develop language, theyre able to communicate about what they like, what they dont like, and to form common realities with other people. Youre telling what happened as trauma, and then also people begin rewriting the story, saying things that didnt happen, and that theres some healing that seems to happen here and in some of the other modalities that well talk about, from, in an open environment, imagining the way things didnt play out. And you do something and you feel terrible about yourself. And one of the other things that was interesting Ive not done E.M.D.R. BESSEL VAN DER KOLK: Yeah, brilliant. Something like half of all Americans donated money. I think thats going to be really, really, really important to this conversation. Krista Tippett, host: The psychiatrist Bessel van der Kolk is an innovator in treating the effects of overwhelming experiences on people and society. But on some level, that also cant be the whole answer, because a lot of middle and upper class peoples lives are full of trauma, too. EZRA KLEIN: On the point of touch, that there are a couple lines in your book that have really etched themselves in me. And so it really finds its way into relationships. See, and Dick Schwartz extended what you just said in your relationship to yourself. Bessel van der Kolk, MD is the Principal Investigator for a Multidisciplinary Association for Psychedelic Studies (MAPS) sponsored phase 3 program evaluating the efficacy of MDMA-Assisted Psychotherapy for the Treatment of Moderate to Severe Posttraumatic Stress Disorder (PTSD). BESSEL VAN DER KOLK: Yeah, you live the lie. The imagination was telling and retelling the story, right? But your demands may be too much for me. Exactly. That one thing that actually causes people frustration and shame is they are told theyre in control or should be in control of their minds. But something the study found is that in the people who were traumatized by their experience in war, their memories never really changed. Now the very first study we are funding is a study of touch and trauma. But people are able to go there and not get overwhelmed by shame, or overwhelmed by the horror. And so taking a pill is a respectable thing in Western culture to do, and normal people ingest stuff to make themselves feel better. Because if you told the real story, it would rupture your family, it would rupture your community, it would rupture your workplace. Tell me a bit about the conditions under which an event that could be traumatic becomes a trauma. Risking or giving up those bonds, as Harry did, is a very profound step. Its just this reminder that you have no idea what somebody is carrying. We have culturally cut ourselves off from a lot of touch, right? But your attachment system who you belong to, who knows you, who loves, who you play with this is more fundamental than trauma. Dont just drop the treatments youre using or the medications youre taking and run to something new. And that actually allows them to continue to survive to some degree. What are the three books that have influenced you that you would recommend to the audience? Because the moment you start talking to people, you change your story according to what you think that person wants to hear. BESSEL VAN DER KOLK: To my mind, the biggest lesson from New York was, for one thing, everybody knew the reality of what had happened. And thats a different part of the brain. Were looking for yet another drug doing the same old stuff that we have done. And so, much of trauma is about a rupture of the safety of the people who are supposed to protect you and the people who are supposed to come to your help. And so the way the child is wired is to stay as close to the people who are supposed to take care of them as possible. So its really the conflict between the body feeling very unsafe and the mind not wanting to accept the reality of what has happened to you is at the core of this, yeah. So I dont know how it will work itself out, because in the world we live in, everything gets monetized. Peoples identity is formed around questions like What did I do wrong? or What could I have done differently? That becomes the central preoccupation of their lives. As I like to say to people, life sucks a good amount of the time. Bessel van der Kolk, your book is The Body Keeps the Score, its remarkable. And our current research is very much also in psychedelic agents, which turn out to have a very dramatically positive effect on exactly the courses of defectiveness, self-loathing, internal confusion. How you get narrow minded, and what Janet said back then also, he says, when you get traumatized, the mind has a hard time continuing to grow. But the reality may be very different. I mean, a bunch of the modalities you just talked about, like capoeira or qigong, I dont want to suggest they dont have therapeutic roles, but theyre not primarily seen as therapeutic. But I want to ask about another way that we end up hiding what we feel, which is that trauma has a way of numbing people to their feelings, to their emotions, even to very basic physical sensations. 'The Body Keeps the Score' offers uncertain science in the name of self In this, it joins a genre that psychiatrist Bessel van der Kolk popularized . 3 /5. So how can we increase peoples sense of synchronicity with other human beings? EZRA KLEIN: Were going to go through a bunch of these therapies. And I think his formulation approximates what we see here. The Body Keeps the Score, it is a searing read about the way trauma disconnects our minds and our bodies. BESSEL VAN DER KOLK: So I was a very young person. And of course, traditionally, psychotherapy is very much about developing that language for yourself, which is very important. And theres maybe some evolutionary circuits involved with moving your eyes in the direction of threat. What is trauma? The author of "The Body Keeps the Score" explains And Im thinking here less about MDMA, which as you say has a profound self compassion effect, and more about things like mushrooms and LSD. And it sounds to me like you think the same is actually true for adults, that you need space to play, to move, to be in synchronicity with others, to sing, to dance, to have what gets called collective effervescence. which we can talk about, or dance therapy or yoga. Its true! I dont think we are throwing everything against the wall. Just click the "Edit page" button at the bottom of the page or learn more in the Cast & Crew submission guide . [LAUGHTER]. people had like, a 78 percent cure rate. Bessel van der Kolk is the author of The Body Keeps the Score. He was a leading researcher and psychiatrist active in many of the early battles to understand post-traumatic stress syndrome. Bessel van der Kolk MD spends his career studying how children and adults adapt to traumatic experiences, and has translated emerging findings from neuroscience and attachment research to develop and study a range of treatments for traumatic stress in children and adults. Nobody feels bad about it. And then I want to return to a question I said wed tackle here at the end, which is you talked about the ways in which the post- 9/11 period in New York City was actually well handled from the perspective of trauma. Van Der Kolk is author of " The Body Keeps Score; Brain, Mind, and Body in the Healing of Trauma .". So one of the things that is driving this whole trauma issue is that you feel cut off from your community, you do things that embarrass you, you blow up at people. Im a scientist, its an empirical question. But at some point, theres going to be the potential maybe for recovery. Our adult onset P.T.S.D. And that for me was just so cool, because this really opens up the frontier of where our treatments need to go, is how do we repair these networks where the different parts of the brain are disconnected from each other. And it feels soft. EZRA KLEIN: Where do you think psychiatry and mental health as a profession is in its evolution? And that actually allows them to continue to survive to some degree. Whereas the people who werent traumatized by it, their memories kept changing. But reading your book made me think of it on another level, too. And so your identity becomes like, I cannot be with other people, Im no good. But so the question always, if things are going right or wrong, is, like, which parts of the two of you are being brought out in relationship? I have had another very frightening or traumatic experience where I felt intense fear, Part of our nature is to be altruistic and to be generous when people are in distress. So if youre somewhat privileged in our culture, people oftentimes find ways of reestablishing their sense of connection, their communality. The other thing is that money poured into New York. But we both have needs. We know exercise is good. Im very fascinated by the space, both for personal and professional reasons. Because you would think maybe that would be just one system all the way through. Do you worry that it has risks were not paying attention to? It is produced by Jeff Geld, Roge Karma and Annie Gelvin. Theres only your partner in a dynamic with you. And whats fascinating to me is that it gives people a sense of perspective, of who they are, and their sense of self gets very much enhanced. Best-selling Trauma Research Author | Bessel van der Kolk, MD. An intervention you discuss glancingly in the book, but it sounds from something you said earlier like youve been doing more work on, is psychedelic therapy. This is too horrendous for people to do it, I cannot believe that its happened to me, I must feel this way because Im crazy. It is about traumatic experiences: sexual assault, incest, emotional physical abuse, war and much, much more. And our latest data really show that MDMA particularly can really help people to get a much deeper sense of who they are and a deep sense of compassion for themselves. Of course, you get more frozen as we grow older. On one level, its clear I think that providing child care, and pre-K, and well funded schools, and universal health care, and better access to mental health services would help make a society that is better at helping people. So its very accepted at this point, very rational, to take a pill for depression or anxiety. Ill say that, for me, was the hardest part of reading your book was just being faced with something I already know, but being faced with how much pain people are simply carrying around with them every day. And of course, that is much easier when you have money than if you dont have money. So do you think that there are just limits to what we can access in the kind of deep psyche? I want to put a pin in New York in 9/11 because I want to come back to that and the question of whether or not there are things we can learn as a society, whenever it will be the case that we can begin to recover as a society from Covid and whether or not there are things we can learn in that experience for how to do it well. And something I was thinking about, in the context of some of the other treatments you bring up, is the why. It was almost unrecognizable. Yost's rehearsal of the history of this newfangled idea is both intellectually and anecdotally satisfying. BESSEL VAN DER KOLK: Thank you. So you can actually see, oh my mom gets very upset, as opposed to, oh, thats the world I live in. You hear from my accent, Im northern European, and North America is still very northern European. But the point of your book, I think, in part is that it does make sense. Media. You automatically recoil from being involved with others; you may feel a deep sense of threat when you get close to other people. But Im an essential part of that part of the universe. . And actually, when you get into treating these issues, the hardest thing to actually treat in people is this deep sense of being defective, something being wrong with you. You have psilocybin at other levels of the regulatory process. is? Its very hard to give up that hyper-alertness. Thats really what we are fundamentally all about. And in particular, I was very struck by how much of your research suggests that trauma is an event plus a kind of instigated social crisis. We dont know, because research funding would not really allow people to go into asking these questions at this point. And that sense of what all these mind altering substances do, of opening yourself up, being a part of a larger whole, is very significant also. And of course, we do need to wear our blinders, and we cannot face up to all the bad stuff thats happening in the world. Since the 1970s his research has been in the area of post-traumatic stress. Another book that I think is great, an Australian guy by the name of [Richard] Flanagan, who wrote a book called The Narrow Road to the [Deep] North, about war experiences and how war experiences impact on people and get split off. Which is, of course, the opposite of being traumatized. So we have these layers of the brain that have different functions. You can maybe ask your partner, and thats it. They were always moving and creating things. And you dont really know whats right because you keep sort of getting into trouble again, you try something and you freeze, and you try something and you explode. The mind it hides and warps these traumatic events and our narratives about them in an effort to protect us. So you still need to rewire the physiological system. And Im thinking here less about MDMA, which as you say has a profound self compassion effect, and more about things like mushrooms and LSD. The next thing is that people actually did things. BESSEL VAN DER KOLK: So the issue there is that we need our parents or caregivers to take care of us. Its a very complex mental phenomenon, and our memories are extremely flexible. We have brains in order to get along with each other, to be with other people, to connect with other people. Tweets. for treating post-traumatic stress disorder. particularly showed us is that when terrible things happen to you, you create ways of being in the world, personalities, that help you to cope. So there was no dearth of resources. She described him then as "an innovator in treating the effects of overwhelming experiences on people and society." She catches up with him in 2021 as we are living through . So one of the things I do for the show is I try to keep an eye on the best seller lists. He is the author of The New York Times best seller, The Body Keeps the Score. Can you just talk a bit about what trauma is like for those who love someone who is traumatized? But you treat patients who, the stories their minds have told or the memories their minds have hidden are really shocking. You have psilocybin at other levels of the regulatory process. But the anger and the freeze may still happen. However, after repeated trauma, some people develop a sense that being used is all they are good for, causing them to become compliant with their abusers. Bessel van der Kolk @BesselvdKolk. Listen wherever you get your . And basically, our systems are made to move in synchrony with the people around us. And so early experiences very much shape your perceptions of the world. When Krista interviewed the psychiatrist and trauma specialist Bessel van der Kolk for the first time, his book The Body Keeps the Score was about to be published. And its really quite startling when you get to see how much people actually are coping with. EZRA KLEIN: You have this very powerful line in the book from the writer Jessica Stern where she says, quote, Some peoples lives seem to flow in a narrative. Bessel van der Kolk on Understanding . We are synchronous human beings. Theyd also do a lot of singing together, and a lot of moving together, and a lot of tossing balls together. BESSEL VAN DER KOLK: Yeah. And one in particular here where you say that the things that calm adults are the same things that calm children.
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