Trauma makes your world feel small — here’s how to open it up again

I don't think anybody's ever come to see me for the first time because of their trauma

They come to see 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. There's heartbreaking

and gut-wrenching sensations. 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

My name is Bessel van der Kolk. I'm a psychiatrist, author of the book The Body Keeps a 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 are living by their emotions and their sensations but the rational brain does not modify it What you see is big burst of energy in the bright 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 the world is 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 of that that's the adaptation

That's where you go into therapy. 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 into my office and there 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 to the world

because the boxing lessons had given her a feeling of if somebody assaults me, I can hit them and punch them

And they had had the experience of, wow, that feels really good. I can stand up for myself

And so it's very important for some of these people to have experiences that directly contradict the helplessness and despair of a trauma

Psychodrama is one of the things that we discovered can make a profound difference

because you get a whole different reality. Let's say we're in a room together

and I'm your psychodrama coach and you say, well, my father was a real nasty guy

And I say, okay, would you like to choose somebody who played a role of your ideal dad

who would have been there for you when you were three years old, five years old, whatever

And then we experiment physically. he said, 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 there, I would

have 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 you need to orient yourself come 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 insula

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'm 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

be able to articulate what they went through, not be judgmental about themselves

and to really say, this is what happened to me, and this is the best I could, 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 new perspective on who you are and where you come from