How Psychological Flexibility is Cultivated Through Mindfulness

By Benjamin Schoendorff, Contextual Psychology Institute

I was first introduced to formal meditation practice in a Zen dojo in 1994. At the time, my life was chaotic and it would remain so for another 10 years. On several occasions over these ten years, I tried to build a regular meditation practice. Although I never managed more than meditating intermittently, I have no doubt that what little practice I did manage helped me. It helped me by giving me a direct experience of distancing from my thoughts. I had previously experienced what I thought as being a part of my essence, as what was defining me, and thus of the utmost importance.

Through meditation I experienced that my thoughts came and went. They were more like clouds in the sky of my consciousness than what defined that sky. The second thing I experienced was closely related. It was a sense that I was more than my thoughts and emotions, more than my experiences. That there was a part of me that was not affected by my experiences, that remained an observer no matter how painful the feelings of the moment or hooky the thoughts.

When I started getting my life in order and, after a brief course of psychotherapy, decided to make myself useful by becoming a therapist, I made a commitment to being guided by science and to somehow integrate my meditation experience into my work. I naturally gravitated toward behavioural therapies, due to the strong empirical support they enjoyed and their commitment to a scientific approach to the alleviation of human suffering. I just as naturally became interested in Mindfulness-Based Cognitive Therapy which, was then gathering its first research data supporting its possible effectiveness for depressive relapse. However, try as I might I simply could not build a daily mindfulness practice. I felt uneasy recommending it to my clients. I suspected many would, like me, not be able to engage in daily mindfulness practice.

In February 2007, I came across Acceptance and Commitment Therapy (ACT), an emerging mindfulness and acceptance-based approach that seeks to help people develop their psychological flexibility. Psychological flexibility is the ability, in contact with everything that shows up in the moment, to choose and do actions to move toward one’s values, who and what matters most.

In dozens of studies, psychological flexibility has been linked both to positive life functioning and life satisfaction and to a reduction in suffering associated with depression, anxiety, trauma, relationship difficulties and a host of other disorders. The way ACT seeks to train psychological flexibility is by cultivating mindfulness, distancing from unhelpful thought patterns, acceptance of unwanted feelings, identification of one’s values and moving toward them through deliberate actions. You could say it uses mindfulness skills to get folks to behave like the person they want to be.

And here was the catch for me. The person I want to be builds a regular mindfulness practice, but couldn’t. That fed my interest in ACT which seeks to train mindfulness skills even absent a formal mindfulness practice. ACT sees mindfulness as composed of four main elements: the ability to distance from thoughts (a.k.a cognitive defusion), the willingness to experience whatever is present (a.k.a. acceptance), the ability to be present to whatever arises in the moment (a.k.a. contact with the present moment) and, finally, the ability to contact an experience of self as an observer of all experience and transient thoughts, emotions and behavior (a.k.a. self-as context). In ACT these can be trained as discrete processes that together promote the ability to move toward one’s values. One of the most effective ways to do this is through using the ACT Matrix, a simple diagram with two intersecting lines that create four quadrants. The upper left-hand side represents actions to move away from unwanted inner experience (bottom left) and the right-hand side actions (top right) to move toward whom or what is important (values, bottom left). Sorting our behaviours and experiences in these four quadrants gradually helps build our psychological flexibility.

In my case, it has helped me gradually build a daily mindfulness practice that I have been able to keep up for over four months now. I was greatly helped by joining the Numinus team in the Mindful in May challenges for the past two years. Central to the ACT model and standing as a testament to its flexibility is the fact that ACT processes are based in mindfulness, while ACT can also, as was the case for me, help with engaging in more regular mindfulness practice. This is why I believe that mindfulness-based approaches should continue to dialogue and seek integration.

Episode 41: Jon Hopkins on Music for Psychedelic Therapy

 

“As if in each of us There once was a fire

And for some of us

There seem as if there are only ashes now

But when we dig in the ashes

We find one ember

And very gently we fan that ember

Blow on it

It gets brighter

And from that ember we rebuild the fire

Only thing that’s important is that ember

That’s what you and I are here to celebrate”

– Ram Dass quote, lyrics from “Sit Around the Fire”

Some big news before we get to the episode with Jon Hopkins: This episode of the Numinus podcast will be its last. Joe will be joining the team at the Psychedelic Therapy Frontiers podcast as a co-host. The Psychedelic Therapy Frontiers podcast is hosted by Dr. Steve Thayer and Dr. Reid Robison. It is a “weekly conversation about psychedelics, research and the therapy that makes them so powerful as agents for lasting change in mental health.”

This last episode of the podcast will also be hosted on any of the Psychedelic Therapy Frontiers platforms. You can more information about that here. Joe was also recently interviewed on the Psychedelic Therapy Frontiers podcast. You can find that episode on Apple PodcastsSpotify, and Google Podcasts.

 

In this episode of the Numinus podcast, Dr. Joe speaks with Jon Hopkins, musician and producer. Jon is a prolific musician who specializes in electronic music. He has been playing music for over 20 years. He has written six studio albums and has collaborated and produced albums for Coldplay and Brian Eno. His album, Singularity, received a Grammy nomination for Best Dance/Electronic Album in December 2018.

He also collaborated with Brian Eno to create music for Wavepaths. Wavepaths was founded by Mendel Kaelen and Anna Wakefield. The purpose of Wavepaths is to create therapeutic tools that integrate “psychedelic science, machine learning, music theory, psychotherapies and experience design, in collaboration with artists, therapists and researchers.”

His newest album, Music for Psychedelic Therapy, was specifically written to be used in psychedelic therapy sessions.

In this interview Dr. Joe and Jon explored:

 

Here is more information on subjects mentioned in this episode:

 

More quotes from Jon from the interview:

 

“That core wound, whatever that may be, we all have one, I think, of some kind. And we’re eternally trying to heal. As I got older and more in touch with that, I’m more and more clear that all the music-making is a direct response to that.”

 

“We all share great pain just through the nature of existence, and through the nature of what we witness and experience. We’re also able to share the healing of that and the joy that being alive can also bring. This album, whether consciously or not, has an expression of all those things in it.”

 

“When I hear [Music for Psychedelic Therapy] under the influence, I’m like, ‘Wow, where did that come from? Because it’s not me. It’s everywhere. It’s from everything.”

 

“All I know is that beauty is not an isolated feeling or concept. For me, the most beautiful things have a tinge of sadness or melancholy. Maybe beauty without sadness is meaningless.”

 

“What that ember is–to me–is the divine spark. When you connect to it, whether it’s through meditation or psychedelics, you sink into that place of total oneness or unity. It’s the inherent knowledge that there is a part deep inside of you that is shared by everyone. That is the divine spark.”

 

“The most important thing is daily practice because psychedelics open a door and occasionally you need a reminder that will get you there. It’s what you do everyday that has the biggest chance of fanning that ember.”

 

Here are some highlights from their conversation:

 

I want to actually ask you about the lyrics [of “Sit Around the Fire”]. I was really, really touched again listening to them recently. And if you’ll humor me for a second, I’m just going to read the last section so that the listeners know what we’re talking about.

 

“As if in each of usThere once was a fire

And for some of us

There seem as if there are only ashes now

But when we dig in the ashes

We find one ember

And very gently we fan that ember

Blow on it

It gets brighter

And from that ember we rebuild the fire

Only thing that’s important is that ember

That’s what you and I are here to celebrate”

I’m a little embarrassed hearing my own voice do that because on the track it’s just so beautifully performed by Ram Dass. But I wanted to ask you, from your really, really intimate relationship with those words in the music, what is the fire? What is the ember? What are we celebrating?

Let’s start with the ashes. You know, we often feel isolated, alone. We’ve kind of somehow been persuaded that all of this is meaningless to some degree. Some of us have–

I’m definitely familiar with the ashes, Jon [laughs].

Yes, we know what the ashes are.

Didn’t ask you about those [laughs].

Well, in order to think about the ember, it’s nice to think about the ashes, because I feel like as you said you’re familiar with the ember as well. I would say the stage I’m at is that I found that ember and I’m desperately blowing on it and trying to rebuild the fire. But really what the ember is to me is the divine spark.

When you connect to it, whether it’s through meditation, psychedelics or for me, it’s always the way the two inform each other, you sink into that place of total oneness and unity. And that’s  your inherent knowledge that there is a part deep inside of you that is shared by everyone that is the divine spark. I mean, the words for it don’t really cover it, but that’s there. And I think you touch on that sometimes. People with atheistic views will also touch on that, perhaps just not use the same words.

But, you know, you can feel that infinite oneness through looking at a landscape or gazing at a loved one or being in love or, you know, staring at your newborn child. That magic, that kind of ineffable wonder.

And in psychedelics, you get to spend some time there. You get to spend sometimes a few hours in that state. And when you’re in there, you’re like, ‘how will I ever not be like this again?’  Of course you come out and everything comes back. But in that time, you’re fanning the ember. You’re not forgetting everything. You come out–Okay, you go back to normal, but not quite back to normal. And each time you find it.

For me, the most important thing is daily practice for sure because psychedelics open a door, and on occasion, you need a reminder that they will get you there. But it’s what you do everyday that has the biggest chance of finding that end.

And then as to what the fire is, I like to think of it as the collective, all finding their own embers, and collectively, rebuilding the knowledge of our own innate divinity, that we need in order to make sense of this and also to survive.

And he’s also talking about infinities, talking about the fact that, after all, this is a belief system. It is really after your physical body is no longer with you. Consciousness is just, you know–your spark of consciousness just goes back to join the rest and you’re all one again. That’s what’ll happen in the end anyway. So maybe that’s what the fire is.

 

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Episode 40: Dr. Robert Grant on Internal Family Systems Therapy

“What’s healing is the self to part relationship. And that relationship gets built based on the part being able to tell its story without repercussions.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Robert Grant. Dr. Grant is an Internal Family Systems (IFS) therapist, a ketamine-assisted psychotherapist, a pulmonary physician, a professor of medicine at UCSF, a former researcher in HIV prevention and treatment, and a cofounder of the Healing Realms Center. The Healing Realms Center is a clinic specializing in ketamine-assisted psychotherapy.

Dr. Grant is especially well known for his work as an IFS therapist specializing in ketamine treatments. IFS was developed by Dr. Richard C. Schwartz. It is a therapy based on the notion that the human mind is made up of inner parts. And healing involves the cultivation of harmony among these parts. It is commonly used in the treatment of post-traumatic stress.

 

In this interview Dr. Joe and Dr. Grant explored:

 

Here is more information on subjects mentioned in this episode:

 

More quotes from Dr. Grant from the interview:

 

“It was the human connection that was curative. And the mescaline was helpful maybe because it facilitated that connection.”

 

“Other people may trigger different parts of us that give us an opportunity to learn about our inner processes.”

 

“‘Self’ is the part of us that can see our own trauma without being re-traumatized.”

 

“Healing is a process of hearing out that inner dialogue. So we can really develop a relationship with our parts.”

 

Sometimes spaciousness actually fosters connection because it allows us to see each other more clearly.”

 

“Parts are still there after the healing process. You’re not trying to get rid of them. You’re just trying to allow them to be seen and to play healthy roles that are playful, pleasant, and productive to a certain extent.”

 

Here are some highlights from their conversation:

 

Let’s talk about healing. That’s where I wanted to go next. You said things like, ‘this part needs to tell their story.’ And you gave the example earlier about, maybe someone coming to therapy because they feel confused about whether to stay in or leave a relationship. And that the purpose of the therapy is not to arrive at a conclusion, but to create space for these stories to be heard. Can you tell me what’s healing about having these parts express themselves?  

It’s the beginning of the healing process. So I think that what’s healing is the self to part relationship. And so that relationship gets built based on the part being able to tell its story without causing a reaction or without having repercussions. So creating a connection between the self and the part by listening to their story is an essential step in the process of building those relationships.

We have a number of heuristics which are actually helpful. And if I can digress a bit, the founder, Rick Schwartz, in his most recent iteration of his book with Marta Sweezy, said that IFS could be conceived of as a psychodynamic theory. And so it is in this lineage of psychodynamic process. And because it does embrace the multiplicity of the mind, it allows for conflicting, psychodynamic relationships within the person.

What I like about IFS is that it goes one step in the direction of giving us tools for uncovering exiled or subconscious material. And so a classically trained psychoanalyst might expect to spend hours or days or years listening to the client on the couch, and eventually the subconscious material will bubble up, either in terms of dream interpretation or day time fantasies or behaviors that create ambivalence within them. I mean, they’ll just wait for it. And I love that idea of just waiting, witnessing. And so I have great respect for thoroughly trained psychoanalysts.

And IFS does give us some tools that allow us to move pretty quickly toward uncovering subconscious or exiled material. And so it has a toolbox that allows us to be expeditious. But I don’t think the process is very different from what a psychoanalyst would do. It’s just a little more guided and a little more intentional.

So one of the heuristics that IFS has is called the 6 F’s, and so I can walk us through those. You want to find parts. So whatever part we want to find, we want to see what’s up for the person. It might be that a single part has very strong feelings that need to be heard out. Or there may be a pair of parts that want to stay in or want to get out, a polarized pair of parts. So you want to find the one or two or three that you’re going to work with on that day. And then you want to focus on them, let them know that you’re here to listen to them. And when I say you, it’s actually the client ‘self; is there to listen to them. Now, the therapist’s ‘self’ energy is also very important in this process, so that the therapist ‘self’ and the client ‘self’ are there to listen to the parts. So, you know, it’s intuitive that that’s reassuring. I mean, if you’re wanting to make friends with someone, what do you do? You focus on them. You look them in the eye and you focus and then you flesh out.

So that’s the third F. ‘Tell me more about that. Tell me what that was like for you. Tell me what was the worst part of that or the best part of that? What did you do with that?’ And then there’s this phrase that we use is, ‘how do you feel toward the part?’ And that’s actually a key step because, you know, if you asked me, Bob, ;how do you feel toward that part that’s carrying shame?; And if I say something like, ‘well, I actually dislike that part, it’s annoying. It bothered me my whole life. Why would I be ashamed of it?’ Those are not self qualities. So what that tells you when I answer that way is that it’s not a self to part relationship with being developed. You’re hearing from another part of me that is trying to exile that part carrying the shame. And so you would at that point having asked me how I feel toward the part, but having not heard from self, you would say, ‘okay, can you give attention to the part that wants to get rid of that shame and let’s find out about it. What is it trying to do? What is afraid will happen if we heard  about the shame? What would it rather do if we didn’t have to suppress that part that had all the shame all the time?’

And, you know, and so we change the focus to the part that came up in reaction to the other part, and we continue to do that. And then we’ll ask, ‘how do you feel toward that part that wants to get rid of the shame?’ And, you know, at some point I’ll say, ‘well, I’m curious about what is it trying to do? And I want to know more. And  that’s self energy. And so then that’s our green light to start doing the real work of developing self to part relationships. So the feel toward is one of 6 F’s.

And then and then you want to unblend as much as possible. You want the part to be able to see the self, and the self to see the part and and parts don’t like doing that. They like being connected to self. They like being connected to self so much that they stick to self, like a glove. And so one thing that I like to say is, ‘can we ask the part to give us some distance and spaciousness so that you can see it better and so it can see you better?’ So one of the beautiful things about connection is whether it’s between people or within our parts, within ourselves. Sometimes the spaciousness actually fosters connection because it allows us to see each other more clearly. And then, you know, that can be healthy and relationships as well. Sometimes that relationship I mentioned earlier, ‘do I stay and do I go out?’ Maybe there is a middle ground. It’s, you know, let’s just take some space and, you know, we don’t spend  every day of our lives together. But we think we can walk and have some spaciousness. And that may be all the relationship wants or needs.

And it’s the same way within parts within ourselves, but sometimes asking them to unblend, they’ll say, ‘no, no, I cannot unblend.’ They’re desperate for more attention. But they said, ‘Well, no, it’s if you just give us some space, then I can see you better. You can see me better.’

So there’s unblending and then there’s befriending, just continuing to say, ‘it’s so great that I’ve been trying to protect Bob from feeling shame. You’ve done such a great job. And look how well he’s done in school and that has led to a career. And that’s so great.’ But do you really want to keep doing that all the time? And often they’ll say, ‘No, I’m exhausted.’ I’d rather that Bob, if there were a way for Bob to deal with his shame without me having to work all the time, I would like that, but I don’t think there is a way to do that. That’s why I’ve constructed this job. So the part may say that. You could say, ‘well, you know, I think there is a way to help Bob with the shame without you having to work all the time.’ Sometimes the part would say, ‘I’m not sure that’s possible, but I would want that. So, you know, let’s give that a try.’ And then you can ask, you know, that protective part to rest and it can stay close and watch if it wants, just in case something comes up that makes it afraid. It can step back in if it needs to. But that then gives you an opportunity to go back to that exile, which initially caused the protected part to come up. But that part now is befriended and it’s willing to rest. And so you can work with the exile material.

And then ultimately you would want to get to a point where whatever caused the burden of shame to come to that exile part, then that part can have a chance to leave that situation and unburden that shame. And then the whole system can appreciate that , ‘Yeah, there was a way to deal with the shame that didn’t involve having to compulsively work all the time.’

So the healing process is really one of befriending the parts and airing them out and ultimately giving the exiled parts a chance to be retrieved from the hard situation and then to unburden the beliefs that were important to survive that hard situation. And then to have the rest of the parts come back into the situation, and ask them, ‘did you see what happened there?’ And some of them will come back in and say, ‘oh, yeah, wow, I’m impressed. I didn’t think there was a way to solve that problem. But yeah, there was.’  So great.

And some of them may come back and be a little frightened. Like the example I gave might say, ‘you know, I spent my whole life working obsessively to do well in school. And now what do I do? I don’t know what my job is.’ ‘It’s okay. You know, I’ll work with you. There’s lots of jobs that you could do. Maybe you can work on writing a book or something other than school.’ Maybe oftentimes the job that the protectors want to do has nothing to do with what they were doing. The part of me that wanted to do well in school might want to take up finger painting or, you know, writing poetry like I was doing in college. Maybe they want to go back and do that or, you know, like, hey, who knows? But letting them do what they want, it’s an important part of being a good self for them, a good self leader for them.

I mean the parts are there, they’re still there after the healing process. You’re not trying to get rid of any part. You’re just trying to allow them to be seen and to play their healthy roles, which are roles that are playful and pleasant and productive to a certain extent.

 

Connect with Dr. Robert Grant on the Healing Realms Center website.

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Episode 38: David Treleaven on COVID Trauma

 

"To move through trauma often means going back to what was too much. Often we need to be with someone who is with us saying ‘I’m here. You’re safe. It’s okay to feel it now.’”

In this episode of the Numinus podcast, Dr. Joe speaks with David Treleaven. David is a trauma professional, mindfulness teacher, and educator. He is also the author of Trauma-Sensitive Mindfulness: Practices for Safe Healing. After struggling through symptoms of secondary trauma on a meditation retreat, he developed the Trauma-Sensitive Mindfulness (TSM) approach.TSM helps trauma survivors avoid the risks they face when practicing meditation. TSM has been taught to veterans, prisoners, healthcare professionals, first responders, and many others.

Through workshops and online courses, David teaches mindfulness providers the tools of TSM, so that they can meet the needs of people struggling with trauma. More information on his online training can be found here.

David has worked with organizations like Search Inside Yourself Leadership Institute (developed by Google) and the University of Massachusetts Medical School by bringing them the tools and techniques of TSM to their staff and programs. He is also a visiting scholar at Brown University.

He is the host of The Trauma-Sensitive Mindfulness Podcast. He has had guests on like Sharon SalzbergRick Hanson, and recently Dr. Joe Flanders!

 

In this interview Joe and David explore:

  • Challenges with the definition of the word trauma
  • Is there such a thing as COVID trauma?
  • Why some people are more resilient in the face of difficult experiences
  • Neurobiological models of Post Traumatic Stress (PTS)
  • Diagnosing PTS
  • Approaches to treating PTS
  • The implications of collective trauma from COVID-19

 

Here is more information on subjects mentioned in this episode:

 

More quotes from David from the interview:

“Post-traumatic stress can be the impact of two different impulses acting at the same time.”

 

“Sometimes I think of trauma as us living through impossibility, and then the costs of that.”

 

“The further away I get from academia, I find myself less interested if we count a hundred people and we talk about all of their stories, whether or not we’re going to qualify their experience for being traumatic or not. What I’m most interested in is what, in a very practical way, are going to be the interventions that are going to support this person to have less pain and suffering in their life.”

 

“To move through trauma often means going back to what was too much. Often we need to be with someone who is with us saying ‘I’m here. You’re safe. It’s okay to feel it now.’”

 

“In my experience with people when they’ve really moved through or integrated that trauma is that they’re on the other side of a pretty big emotion or discharge through the body, they say, ‘Oh, it’s finally over. It’s been trapped inside of me for a long time. And now I’m integrating it in a different way.'”

 

Here are some highlights from their conversation:

 

COVID might refer to a specific viral entity, but it means so many other things. And I guess there’s a diversity of experiences that people have had. And I don’t know, you tell me, do we want to talk about–what was your distinction there, like traumatic experiences people have had in the pandemic era or or just like some kind of collective trauma that we’ve all experienced living through this? 

Well, there’s so much to say here. I’ll talk about how I’ll define trauma here which would be a response to actual or threatened death, serious injury or threat to physical integrity. And I think it’s important to at least start here and see if we’re on the same page because trauma as it’s become more of a popular mainstream term has become slightly diffuse.

And I’d say the definition has been watered down and there’s been some concept creep in the humanities more generally around trauma, which yes, again, there’s a double edged sword here. Where it’s great that people are talking about trauma and unhelpful in some ways to just generalize.

So I’d like to talk about trauma as an input or a situation that is a threat to life and limb where our survival and our fundamental safety is on the line. And COVID cuts both ways here, where definitely it has been a significant threat and it has been an actual material threat to family. I mean, people, families, communities or people are literally dying or their well-being has been threatened. And then there’s been a whole range of more generalized threat that people could say has been traumatic.

But I’d actually challenge that where I think it’s actually just been more a challenge in adversity and where it got murky and it was confusing about, ‘Is my life in danger here, even though I’ve been triple vaxxed,’ for example. So there’s a whole other place where trauma has happened. And then I think there’s been a massive period of adversity collectively that we’re trying to sort out and maybe we’ll be talking about it here in the conversation.

 

Let’s come back to that very evocative story about the child that gets pulled out of the way of an oncoming car. That seems like a pretty good example of a threat to the child’s life, their safety and that child’s nervous system probably goes into some kind of fight or flight reactivity. And then if I’m extrapolating a little bit, the mother is basically communicating through her reaction, ‘shut that emotion down.’ And the child is basically saying to themselves, if I want to stay connected to mom here, which feels really important right now because I’m kind of freaked out, I have to put that emotion away, inhibit it in some way.’ That sounds to me like an example or a mechanism around how things get stuck. 

I wonder if you can say more about why would that be in evolution that certain really intense experiences get trapped? And even what the hell does that mean for something to get trapped in our nervous system? Can I know exactly what that means experientially and sort of working with clients?

The metaphor that’s worked for me I learned from Babette Rothschild, who’s a trauma writer. She wrote a book called The Body Remembers. Yeah, all the best trauma books are like, ‘The Body Keeps Score of the Body.’ But she’s great. She’s awesome. When she’s training people around trauma and is trying to capture what you’re saying, what’s the essence of it? Why does that stuckness happen? Like, what’s the stuckness?

She’ll bring a bottle of soda up on stage and she’ll start shaking it up, and she’ll basically be talking about how the stuckness is the cap. And her metaphor is saying, ‘now what would happen if we just open this soda right now?’ And of course, it would fly. It’s too much for someone. So in Babette’s work, it’s been a lot about–and in a lot of trauma work, it’s about kind of cracking that soda top and allowing some of the pressurized gas.

But let’s back that up even further, because I think it answers your question. The reason I think that metaphor works is that when it comes to trauma, like with that child, there is some kind of activation. I said factory loaded some kind of deep survival response, often referred to as fight flight. So the sympathetic nervous system and the autonomic nervous system just hit the accelerator. We have the survival response. We don’t have to think about it. It just happens automatically. Flood of adrenaline pupils dilate to try to protect us. And then that’s the moment that I think you’re pointing to. That gets very interesting.

Why the cap? There’s lots of stories about different mammals who are able to shake and discharge that activation. You know, a classic example is the deer who shakes it off. It gets really frozen and then shakes it off, moves on like nothing happened. But what’s happening for humans?

You gave the example around attachment. I’d say, ‘yes, I’m faced with the choice of either being disconnected from my caregiver, which is fundamentally threatening. So let me basically cap that energy through locking my jaw so I can stay connected.; And then in other situations, there’s a legitimate freeze, the intense parasympathetic arousal sometimes known as tonic immobility. Which will come and cap or trap that activation of fight flight in the nervous system that can’t discharge over time.

So it has deep evolutionary roots about why we had that freeze, for example, playing dead like the possum. If you’re a gazelle, you’re dragged to a cave, you might freeze. The predator thinks that you’re dead and won’t actually attack you. There are many different inherited reasons that we have that–but it can create tremendous amounts of suffering in an ongoing way for people because we can’t uncap that freeze and it gets really frustrating.

PTSD or post-traumatic stress can be the impact of two different impulses happening at the same time. So for example, the impulse to run and the impulse to freeze, they’re both happening. They’re both legitimate survival strategies. And that combination of the two creates that charge. And you could say that stuckness.

And I wanted to link it here to what’s happened to a lot of health care workers or even family members. Where I heard stories of people saying I was on one impulse was to hold the line around safety in hospitals around who could come in and out of a ward, for example. And then there’s an equal impulse to, of course, let a family member come and be with someone, that loved one or a family member. And so it creates these impossible situations.

And so sometimes I think about trauma as us living through impossibility. And then the costs of that.

 

I think that I probably learned this vocabulary from you, but maybe I can just ask you, describe it, this notion of like pendulum motion. And there’s another term that I find really useful, like titration. 

Titration?

Exactly. I think these are great tools for people to know. Can you describe those? 

Yes, it doesn’t come from me, but Peter Levine. It comes from Somatic Experiencing, which is a really popular psychotherapeutic approach to trauma or healing. And I don’t receive any money for that. I just trained in it a long time ago and the core principle–this actually gets right back to the soda bottle or the pop bottle.

So imagine that bottle of carbonated water being shaken up, and you could think of that as a traumatized system that there’s a tremendous amount of sympathetic activation fight flight in the container. So the accelerator slammed the ground. But there’s also tonic immobility. So it’s capped and that if you imagine the feeling of the accelerator and the brakes slammed down, that’s often what trauma can feel like or post-traumatic stress. It’s really painful, uncomfortable, and dysregulating.

So the idea behind pendulation and titration in this work around trauma–the idea is you’re going to pendulate your attention, so basically go back and forth between areas of where you feel more trauma and areas where you feel more resourced. And in doing so, you’re doing what’s known as titrating. Which is actually an old concept in chemistry where you’re opening the soda bottle, but only to the degree that a little bit of the carbonation is released and then you’re turning it back.

If you opened it all at once, that’s not titration. It’ll cause an explosion. Someone gets flooded. It’s too much. And we all know this. I think intuitively that we can take only so much until we need to take a break because our systems can’t tolerate it all at once. So the essence of a lot of trauma work is to go back and forth in order to titrate and not have it over, not have trauma overwhelm.

 

I wonder if you’d agree with this statement that at least this might be just one among many qualities. But this is the quality or the expertise of a trauma therapist that might be sensitive to the pace and to not go at it full speed right away because one has to work very carefully with that limit. And if you went to a therapist that doesn’t have that training, they might not know how to work with that. Is that a fair statement? 

That is the essence to me of trauma training. That is why one would train to know how to work with a combustible process. It’s because more is not going to be better when it comes to working with trauma.

Let me give an example of that. So I was trained as a somatic therapist where the main question I had was, ‘Where do you feel that in your body? It’s all I had. I was like, ‘Well, where do you feel that?’ And if you just keep driving someone towards intensity to your point, that actually can be too much for them. Now that can be confusing because when you’re working in any kind of mental health work, I think when you see emotion, you think you’re doing a good job. Someone’s crying. I’m like, ‘I must be doing something right.’ And then I’m trying to amplify it because I think we’ll go deeper. ‘That’ll be great.’ And sometimes that’s true.

But when it comes to trauma, right to your point, it’s not. It’s that you need to have a more nuanced approach and you’re learning to track someone’s mind and body in a really nuanced moment to moment way.

 

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Episode 34: Dr. Devon Christie on Psychedelics as a New Paradigm for Medicine

“As therapists and guides, we’re holding that space for the location of healing to be intrinsic to that person.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Devon Christie. Dr. Christie is a family physician with a focused practice in Multidisciplinary Pain Management and the Senior Lead of Psychedelic Programs at Numinus. She is also a clinical instructor with the UBC Department of Medicine, Kundalini Yoga instructor, Mindfulness-Based Stress Reduction (MBSR) teacher, Relational Somatic Therapist and MDMA-assisted and ketamine-assisted psychotherapist.

She also has first hand experience recovering from chronic pain, traumatic brain injury, PTSD, bulimia, anorexia, and depression. These experiences have served as the foundation for her work.

Dr. Christie and Dr. Joe spoke about:

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Connect with Dr. Devon Christie on Facebook and Instagram.

Follow Numinus on FacebookTwitterInstagramLinkedIn, and YouTube.

 

Here are some highlights from their conversation:

 

I think you and I both believe that psychedelics have the potential to bring about very, very meaningful change in our health care systems, maybe even more broadly than that.

Why do you think there’s so much promise here in mental health or maybe even health more broadly?

There are a lot of ways I could go in answering that question. I mean, the first thing that comes up is just this notion of a paradigm shift where, in my view, what psychedelic assisted psychotherapy proposes, is that we can have the intention of helping individuals to heal, to deeply heal from mental health conditions, from chronic illness in that the location of that healing is inside them.

We talk about this concept of an inner healing, inner healer, or innate healing intelligence as part of preparation for people going into these experiences to trust that that’s there and to allow that to guide the process. And that is as therapists and guides, we’re holding space for that, the location of healing to be intrinsic to that person. Like you cut yourself and then you keep the conditions clean and dry and your cells know how to knit themselves back together. There is an intelligence there.

But I think what our broader system has sort of conditioned us into perceiving is that we need to be fixed somehow by external people or modalities or surgeries or drugs, people that know more than us. And there’s this almost like a victim–there’s just less empowerment. It’s much more passive. And I think the way our system is set up almost kind of encourages that.

So it’s this active–you’re the source of healing. We’re going to create the optimal conditions. Do our best to do that. And so that to me is really powerful, empowering, and I think will lead to a lot of support for motivation and health behavior change. And so that’s just one aspect of the paradigm shift.

Another is, as I mentioned, with respect to how much I respect Gabor and his work is just this breaking–quitting this view that comes from biological reductionism that the mind and the body are separate. And that it’s all like–Western medicine is very materialistic and there’s a lot of benefit from that. We’ve learned so much. It’s amazing how much we understand our cellular biology and yet it sort of parses things apart and creates silos of specialties.

For example, where this doctor treats this system and this doctor treats this system and it’s all very focused on the physical. So there’s all these kinds of discrete categorizations, and people get many different diagnoses and go to see many different specialists for each of those separate things.

Yet when you really zoom out and take this more systems approach–which I actually didn’t mention as well, I’m a certified functional medicine practitioner, which is a systems biology view. It’s like, actually, no, it’s all interconnected. We’re alive ecosystems, and mind and body are absolutely intricately simultaneously co-arising. They can’t be separated. I have a thought that is producing chemicals that are influencing my state.

So I really see that psychedelic assisted psychotherapy is going to really support this awareness–approaches that are targeting our emotional well-being and our nervous system regulation and our what we term mental wellbeing will translate into physical, like positive physical outcomes.

Because we know and this is again in Gabor’s work. The stress response is just this common underlying factor between a multiplicity of different expressions of illness, whether we call them mental or physical.

So I’m really excited for that and for the ways that as we continue to research different applications of psychedelic assisted psychotherapy that we’re going to see and learn how much more broadly, this type of intervention may be applicable.

And the final tag on that is to actually support more systemic funding for psychotherapy in general. You know, psychedelics aside, right? We already have evidence for that. We already know that if people have access to psychotherapy, they visit their family physician less.

Psychotherapy as opposed to pharmacotherapy for mental illnesses. The research shows that it likely has much longer term benefits, more impact on quality of life for people rather than just symptom management, and that people prefer it and there are less side effects. So even if psychedelic assisted psychotherapy can also just usher this change in our system to bring parity to approaches that support individuals mental well-being, that would be a win, in my perspective.

Episode 33: Jamie Wheal on Finding Meaning at the End of the World

“Life is tragic, and occasionally it’s magic.”

In this episode of the Numinus podcast, Dr. Joe speaks with Jamie Wheal, author of Recapture the Rapture: Rethinking God, Sex and Death In a World That’s Lost Its Mind and the Pulitzer-nominated bestseller Stealing Fire: How Silicon Valley, Navy SEALs, and Maverick Scientists Are Revolutionizing the Way We Live and Work. He is also the founder and executive director of the Flow Genome Project whose purpose is to build “world-class training programs on peak performance, optimal psychology and leadership.” His work has been covered in the New York Times, Financial Times, Wired, Entrepreneur, Forbes, and many other publications.

Jamie synthesizes history, psychology, neuroscience, and anthropology in order to create techniques and cultural practices centred around transforming human beings through non-ordinary states. Those practices include breathing techniques and psychedelics.

Jamie and Dr. Joe spoke about:

Connect with Jamie Wheal on Facebook and Instagram.

Connect with the Flow Genome Project on FacebookInstagramYouTube, and their website.

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Follow Numinus on FacebookTwitter,LinkedIn and Instagram

 

Here are some highlights of their conversation:

Let’s start with sort of the premise for Recapture the Rapture and what I understand what you’re calling this sort of crisis of meaning that a lot of us are feeling a little kind of disoriented or suffering because the processes or the infrastructures that we use to sort of make meaning out of our complex lives have really been kind of shaken. And many of us are feeling a bit lost around that. So can you just tee that up for us? 

Yeah, for sure. I think what we’re continuing to see even more and more and more of it, like even in this latest round we’re supposed to have vaccines and everybody can be safe and back to summer and then like, ‘oh no we have breakthrough cases, but no, there are no breakthrough cases.’ Actually, there’s whole a lot of hell of a lot more than we thought there were not. What we do with kids? Do we send them back? I was even having this conversation with our kids over the weekend. Because our daughter goes to school in Palo Alto, super on the ball, like maximum lockdown health provisions, and our son is going to school in Colorado. We’re here in Austin, which is in Texas, which is like a wheels off situation. And he was talking about like at this point, you cannot even tell whose side someone is on as to whether they’re wearing a mask or not wearing a mask. Like at one point it was a relatively clear division. It was a tribal identification. Now you have no idea what even the signs and the signifiers of our public actions  or what ideological camps everyone is in. It is a complete epistemological train wreck, but also a socio-cultural, psychological one.

We didn’t end up in this particular mess solely or exclusively because of a particular coronavirus. We’ve been on this slide for the last couple of decades and radically intensified over the last five, which has been and maybe even more. I think you can for sure say two thousand eight was also like a massive disillusioning, but then throw it into the 2016 election onwards.

And what we have is that basically people are orienting their assumptions on life, the universe and everything from organized religion. That was one point that has been dwindling rapidly. And then for the last four hundred years plus we had this experience of modern liberalism, civil rights, nation states, private property, markets, democracy, that kind of bundled gig, including academic institutions, research, science, empiricism, all of that. And that, too, has been kind of crumbling.

And those are the two pillars of meaning. One point to point out is that the roof has been caving in as far as any shared reality we might have been experiencing. Rather than us all becoming grown up, rational, evidence based meritocrats or something that maybe like the Sam Harris and the Christopher Hitchens might have once forecast, we’re actually getting sucked to the extremes into fundamentalism, like doubling down on belief systems and not just traditional religious fundamentalism, anti-vax fundamentalism, populist fundamentalism, take your pick.

There’s all sorts of different narratives, sacred and secular, old and new, that are showing up where people are just doubling down on a rigid belief system versus some form, some form of more provisional sensemaking. So fundamentalism on one side or nihilism on the other. Just burn it all down, blow it up, what the fuck, who cares, let’s party or let’s riot. I mean, very fight club, right, in that sort of sense and diseases of despair, which is obviously a lot of the world. You look into the rise in addiction, anxiety, depression, suicides, all of the things that you would expect when people are unmoored from their surroundings. And of course, this isn’t happening in a vacuum.

This is happening at a time of accelerating exponential change, both better and worse, which is also really hard. And most people put all their belief systems onto one or the other. It’s either like Steven Pinker and Ted talks exponentially better, Matt Ridley. Or the doom and gloom naysayers, Extinction Rebellion and and any others pointing out the decline of civilization and or survivability. And you’re like, wait, which is it? It’s both. And they’re both exponential.

So which way this goes is going to be a crapshoot to the very last minute. And who do I look to to tell me where I should go? Oh, they’re all dead or gone or have abandoned their posts. So it’s every man for himself and do your own research. So that’s kind of the setup, which is we’re in a tight spot and someone broke our dashboard. So how do we find our own cosmic positioning system to reorient to what must be done? Because I think the most the worst thing we can be doing right now is fucking nothing, because we’re in that agitated, irritated, bored state. Like, we need to get off that dime and be moving in whatever direction we’ve chosen.

 

So you are orienting us or trying to inspire us into a new kind of operating system for making meaning. From meaning 1.0, you have identified three key processes or three key mind states: inspiration, healing, and connection. And I’ll let you talk about that and then continue down towards the Alchemist Cookbook. 

There’s an awful lot of utopian thinking in general. If you look at anybody from whether it’s true old school, Alpha and Omega, Judeo-Christian stuff, like there’s going to be the Armageddon and the Rapture or any of those kind of things, that old school stuff, all the way to techno utopianism like Ray Kurzweil. I’m going to upload our consciousness to computers. To blockchain and seasteads. ‘We’re going to disrupt the nation state and we’re going to create our own little communities or civilizations.’ And maybe they float. Maybe they don’t. Maybe they’re in–it is not Croatia. It’s Estonia. One of those Eastern European bloc countries. They have some unclaimed land that is potentially going to be a libertarian crypto paradise. Or the psychedelic renaissance or trance tech like neuro link and implants or immersive VR.

There’s always the, ‘Yes, this is ugly. Yes, this is hard, but there’s some hockey stick redemption at the other end of this.’ And this also shows up in info marketing and self-help and new age and pop psychology. ‘Let’s poke your pain points and you get irritated and agitated. And then we offer you something whether it’s a workshop or a pill or a meditation practice in just seven minutes and then you’ll be delivered.’ And that is such a deep trope, both of Western thought, the Alpha and the Omega, the beginning and the end. But it shows up in communism. It shows up across two thousand years plus of Western thought. But then it was metastasized and weaponized by marketing in the 20th century.

And Tim Wu, the guy who wrote The Master Switch and tons of other stuff. He is a professor and thought leader. He also wrote a book called The Attention Merchants. And it’s basically outlining the genesis of 20th century marketing, like how do we get to Mad Men? How do we get to Don Draper? And the short answer is a bunch of down on their luck literal snake oil salesmen and washed up former preachers. ‘You have bad breath? You’ve got to try Listerine. You’ve got dandruff? Try head and shoulders.’

And then here’s your shot at redemption, in a product, a package, a pill. And that is so entrenched in everything, including the full hijack of the spiritual marketplace. We are almost hard wired to believe that there is an up and out play if only we can find it or buy it. Many of those end up being pathological because if the ends or heaven on earth or off it and the means are always, always justified, and there’s all kinds of spiritual bypassing, there’s all sorts of disassociation from the here and now and often our social and ethical responsibilities to others and ourselves and the whole thing.

That was a long windup to point out that the model of, hey, there’s this three legged stool or flywheel that is the human experience: inspiration, healing and connection. And we never get out of that. We never get out of the endless cycle of getting up to the high ground, remembering what we’ve forgotten, being informed and inspired, if we’re lucky–only to go down into the depths of our brokenness and either get crushed by life events and tragedies. Then we’re forever doing that.

And that sense that redemption lies not in getting to the mountaintop and camping out there because nothing lives up there, you can visit. You can put some prayer flags up there, but you need to get back down in the valleys, right. So there is no end to this. It’s forever. We’re forever being propelled forward from our life of highs and lows. And together, life is kind of  tragic. That’s inescapable. That’s Buddha’s first noble truth.

Life is tragic, and occasionally it’s magic. Which blows our minds and redeems our souls, our souls and gives us a reason for being. And then we’re back to toggling back and forth between those two things. There is nothing to do but laugh but shrug, but be on the inside of the cosmic joke and then it’s comic. And that’s that kind of sharing and buffering with each other. If we couldn’t look at this all and just go Zorba the Greek, like, fucking hell, the full catastrophe, you know. Like yesterday, at last night’s show, we were dancing and raising the roof and it was nothing but quicksilver magic. And today the kids just shit their diapers and the repairman is not coming and the dog just ran away.

So the tragic, the magic, and the comic. And it feels to me that if we center ourselves in the middle of those things without obsessing or fetishizing about one or the other one at the expense of the other, and we just say. ‘this is it, the full catastrophe, the human experience, my job isn’t to bypass it or transcend. It is to bear witness to the whole thing that feels to me more grounded. That feels to me more reality tested than some saccharin, sweet promise of up, up and away.

 

I think in your argument that Flywheel ultimately comes from meaning 1.0 and a more sort of religious framework. One of the reasons why it sort of crumbled, so to speak, is that access to these things was mediated by an elite group in a position of power. And most people had to find access to that through some watered down way and had no direct relationship to this kind of spiritual connection. 

And so you’re introducing some design criteria for how we ought to make meaning 3.0 work. This is pulled out of the classical liberalism model. Can you talk about open source, scalable, and antifragile?

I think particularly in indigenous religions, but also mystery schools. For thousands and thousands of years, for hundreds of thousands and millions of humans, there have been absolutely effective religious and psycho-spiritual practices of initiation and transcendence. They haven’t always been widely distributed. It’s not like every single person in a given society or civilization had access. Sometimes they were quite selective. But there have been massively effective, both indigenous and and sort of quote unquote, civilized techniques of ecstasy and initiatory mystery cults, mystery schools.

But I would say that somewhere post, at least in the West right somewhere, posts Konstantin Augustine like some sort of Orthodox Christianity coming online. Anything kind of more mainstream got pretty watered down, became pretty weak sauce initiations. So that’s the sense of like, ‘hey, no matter how much we might resent or resist the Spanish Inquisition, the priests, all the sort of the man keeping us from our own birthright as far as an initiation into the mysteries. There’s vital glue there, vital nutrients in what organized religion used to offer. And that’s healing, inspiration and connection.

So meaning 1.0 which is all men and women are created equal and entitled to life, liberty, and the pursuit of happiness. You could also say pursuit of happiness, subset, you know, initiation into the mysteries of what it means to be a human on this earth. And so for that to work, the notion of open source means, ‘hey, let’s try and get this out of the cloisters. How can we offer the tools that anybody, anywhere has access to because we subscribe to that sense that every human on this earth is a child of God and entitled to a fair shot at the good life. So if it’s expensive or rare or esoteric or exclusive, then what are we doing right? We’re just perpetuating more of those inequalities that people are becoming increasingly aware of and sick of. So that’s the open source piece.

The scaleable piece is kind of the other side of that, which is just we’re in a tight fix and there’s eight billion of us. So it’s not enough to have, you know, hundreds or a few thousands or even tens of thousands or even millions. We kind of need billions of people on something resembling the same page that this planet matters and that clean air, clean water, and clean soil are probably human birthright and really shouldn’t go along party lines. And that we’re in this to win this. We’re actually in this to perpetuate living on our home planet.

So those are the first two and then the antifragile is–Oh, we are in this goofy, paradoxical state, which I think is creating a lot of mental disease. We are sort of on the one hand in the early twenty first century, let’s say we are sort of blessed with the perspective of gods. You know, we’ve got the Large Hadron Collider and we can sort of look back to the moment of the Big Bang and we can map and model it using the Hubble telescope. We have live feeds from rovers on Mars and at the same time go, ‘oh, oh, shit. You know, more ice melted yesterday in Greenland.’

So we’re sort of coming alive at the very, very same time that we realized we might be in an existential crisis. And I don’t know whether to be happy and elated about this infinite possibility of consciousness and humanity or abjectly terrified as to the stakes. And wouldn’t you know it to make it even weirder, the very same super sophisticated techno economic civilization, including carbon economy and all the things that has provided this platform for us to be watching Alan Watts remix videos on my smartphone on YouTube filled with cobalt, lithium and random rare earth metals and beamed up to satellite. So I get this in real time with no lag.

Episode 31: Dr. Gabor Maté on Trauma, Addiction, and Healing

 

“Addiction is not a disease. It’s an attempt to solve the problem of emotional pain.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Gabor Maté, retired physician, author, and world renowned educator. Dr. Maté has more than 20 years experience in family practice and palliative care. He has worked for more than a decade at the Portland Hotel in downtown East Side Vancouver with patients who suffer from mental illness and addiction.

He is a world renowned expert in trauma, addiction, child development, psychedelics, and the relationship between stress and illness. He is the best selling author of four books like When the Body Says No and The Realm of Hungry Ghosts, for which he won the Hubert Evans Non-Fiction Prize. And he is currently finishing his fifth book, The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture due out in April 2022. His works have been translated into more than 25 languages. And he also offers online video courses including Wholehearted’s Healing Trauma and Addictions.

His work now centres around educating the public on the impact of trauma and human development and training therapists in Compassionate Inquiry. Compassionate Inquiry is a therapeutic method developed by Dr. Maté whose focus is on helping the patient to “recognize the unconscious dynamics that run their lives and how to liberate themselves from them.” He also just released The Wisdom of Trauma on June 8th, 2021, a movie about his life’s work.

Dr. Maté and Dr. Joe spoke about:

Connect with Dr. Maté on his siteFacebookTwitter, and YouTube.

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Follow Numinus on FacebookTwitter,LinkedIn and Instagram

 

Here is a transcription of their conversation:

Dr. Gabor Maté, welcome to The Numinus podcast.

My pleasure. Thank you.

Thanks for making the time to do this. Really appreciate it.

I’ll start by just asking you, how do you describe your professional identity and your activities?

I’m a retired physician. 32 years in family practice, palliative care, and addiction medicine. I’ve written four books, traveled internationally. My books have been published in close to 30 languages.

Now, these days, I’m a teacher, a speaker, and a writer. I’m writing a new book, a couple of new books. All on the subjects that enthused me or excited me as a physician from trauma, addiction, child development, human potential, stress, health and the relationship of the individual to the communal, familial, and social environment.

So really what I’m looking for is the unity of things and how the unity of everything shows up in health and illness.

I’ve listened to you talk on a number of podcasts, and I think what struck me probably the first time I heard you was just how open and honest you are about your own personal history with trauma. And I’m a little self-conscious that you’ve told your story many times. But if you don’t mind, could you tell us about your background? From what happened to you when you were a child.

Yeah, well, I do get a bit, what can I say, jaded, repeating it.

And also, I have to say that my particular history is a bit misleading only because it’s so dramatic that people, when they think of trauma, they think such things have to happen for us to cause something trauma. Where I think trauma is much more subtle than that.

And Clyde Hertzman, who’s a seminal researcher, who died way too young here in Canada, internationally known researcher into child development, said that it’s not the big things, but the daily misfortunes that affect children that have overall impact.

So with that introduction, my trauma is particularly dramatic because it happened in the last two years of the Second World War. Being born a Jewish infant two months before the German occupation of Hungary. My family then goes through the genocide. My grandparents, aunt taken to Auschwitz. My father taken to forced labor.

My mother and I survived the conditions of the allied bombing of Budapest, the ghettoization of Jews, the deportation of Jews. And I experienced hunger and dysentery and separation from my mother. And all of that within the first 12 months of my life.

All of which is a huge impact on the formulation of my personality and my emotional states and determining many aspects of my behaviour and emotional life later on.

So that’s what I can say in a nutshell. But again, I have to emphasize that you don’t need that drama or that degree of historical tragedy for people to be hurt

I definitely want to get into that. I have a question about that in a bit. You started to talk about how those experiences shaped your development. And my understanding is that those experiences and your research has taught you a lot about how trauma affects children, their development.

I wonder if you can just speak to that. How do children adapt and get through these experiences? How does it affect them as they grow up into adults?

Well, let’s just begin by saying that life affects human development. So whatever happens in life will have an effect on human development and whether those things are good, whether those things are harmful. All that will have an effect because we’re creatures of the environment and we’re born with certain biological needs and psychological needs.

In fact, you can’t separate the two because the emotional needs not being met has direct and definable and defined physiological effect on the brain and on the body, and this begins in utero.

So already stresses on a pregnant woman will have an impact on the physiological stress reactivity of the infant. In fact, a study recently within the last two weeks showed that stress on the mother in pregnancy shows documentable effects on the infant’s stress responsivity up to age forty five. And there are some gender differences in how prenatal stress affects the females and males. So it begins in uterus.

So the more stressed women are, the more inflammation that might be in the child’s body, the more the stress regulation mechanisms of the brain might be disturbed. Metabolism is affected and so on. And then this thing goes on to childhood infancy. And so you have a combination of physical effects.

But also if you look at how the human brain develops, the most important determining influence on the actual development of the brain is the quality of emotional relationships between the child and the parenting environment.

I’ll quote you from an article from Harvard Center on the Developing Child published in the Journal of Pediatrics in 2012 that says, “the architecture of the brain is constructed to an ongoing process that begins before birth, continues into adulthood, and establishes either a sturdy or a fragile foundation for all the health, learning, and behaviour that follow.” Not some of the health, learning, and behaviour, all of the health, learning and behaviour that follow.

And a second sentence, “the interactions of genes and experiences literally shapes the circuitry of the developing brain and is critically influenced by the mutual responsiveness of adult-child relationships, particularly in the early childhood years.”

So under the circumstances of my own first year when my mother was concerned with sheer survival, grieving the death of a parent, agonized over the absence and unknown fate of her husband. She could not provide me with those playful, relaxed, stress free interactions that I required for my healthy development.

But you don’t need that degree of stress in modern society. A lot of parents are stressed in such a way that they can’t be responsive to their child’s needs. Not because they don’t love the child, but just because they’re too stressed, too depressed. Having looked at their own traumas, too distracted. So that, again, I’m just emphasizing that you don’t need the drama to create the trauma.

Right. I’ve heard you talk about how children adapt to these highly stressful environments. And that adaptability can sometimes be quite remarkable and actually produce some quite incredible skills or sensitivities later in life, obviously comes at a cost.

Can you articulate how that adaptation happens and how some people end up with these sort of exceptional skills in some ways?

Well, so let me quote you again from the same article that I just cited. This is again from Harvard Center on the Developing Child, 2012. “Growing scientific evidence demonstrates that social and physical environments that threaten human development because of scarcity, stress, or instability can lead to short term physiological and psychological adjustments that are necessary for immediate survival and adaptation. But which may come at a significant cost to long term outcomes in learning, behaviour, health, and longevity.”

So they’re saying that the adaptations are necessary in the first place and they help the child endure the immediate stress, but they become a source of problems later on. And that’s largely how I see it.

So it’s not the adaptations that result in these skills, but in working through them later on that result in certain skills. Let’s take an adaptation: tuning out absent-mindedness is an observation, dissociation is an adaptation. When the stress is too much and one can’t change the situation or escape from it, then one dissociates.

Well, that’s not a good thing, but it’s a good thing in the short term because otherwise a child’s brain just couldn’t endure the stress. That same dissociation then results later on in any set of mental health conditions from ADHD where tuning out is the hallmark of it. That’s what I’ve been diagnosed with. Or at the extreme end of the scale, psychosis or dissociative disorders. Now, working them through results in a lot of insight.

Or take an adaptation like–Given my first year of life, I get the message that I’m not wanted, which is certainly the message that the world gave me. Well, then I might work very hard later on to make myself wanted. So that makes me a really good physician. I work hard. I’m available to my clients, more than available day or night. I work hard to ensure that. They do well, all those are good things.

But driving it, to a certain degree, to a significant degree, is this desperation to be wanted and to be validated and to justify my existence. Which the world denied my right to when I was first in this universe.

So that may seem like a good thing. Now being a dedicated physician or whatever professional or pursuit that you have, that’s a good thing. But if it’s driven by an unconscious need, it’s not a good thing.

Now we can learn to work through those things. And I’ve gained a lot of insight and empathy and I daresay compassion through working through my own material. But it wasn’t that the adaptation itself made me compassionate.

It’s true from a very early age on, I was aware of pain in the world, and I was very aware that people have felt pain and were hurt. Who in no way deserved it. And the question, why are people hurting people has always agitated me like this. How could this have happened? What made human beings behave the way they did? And what makes them behave today the way they do? So those experiences certainly can excite those questions in someone’s mind.

As far as sensitivity is concerned, which you mentioned. By and large, I think that’s the one thing that’s genetic here. This is a big mistake that a lot of researchers make. They think people inherit mental diseases. No, they don’t. There’s no gene that codes for any mental illness. There’s no set of genes that code for any mental illness. There’s no set of genes without which you can’t have a mental illness. There are a set of genes which if you have them, you’re more likely to have any number of mental health illnesses, non-specifically.

But with the same genes given good circumstances lead to increased creativity, leadership, spontaneity, aliveness. So what are the genes for? The genes are for sensitivity. And the more sensitive people are, sincere, meaning the Latin word sincere to feel, the more they feel. That means when bad stuff happens, they feel that more and their adaptations become more rigid. At the same time when good things happen, it has a more positive effect on the sensitive person. So sensitivity itself is a neutral quality given the right environment, it’s highly beneficial. Given the negative environment, it leads to more pain and more suffering. But it always makes for a more possibility of insight and empathy.

So you’ve got this film coming out, I believe, at the time we’re recording this, next week. The title of it, The Wisdom of Trauma, speaks to what you just said. This thing about working through, getting insight.

Can you just explain the title? So what is the idea behind the wisdom here?

The wisdom is on two levels. One is the adaptation itself has a certain wisdom in it. So trauma is not what happens to you. Like we often think of trauma as a tsunami or as genocide or as child abuse. Those are traumatic, but they’re not trauma. The trauma comes from the Greek word for wound. So trauma is the wound. But it’s just saying that it’s not what happened to you, it’s what happened inside you.

There’s a wisdom in it. For example, let’s say you have a two year old child and they throw a temper tantrum. And you follow Jordan Peterson’s advice, which is to say that an angry child should be made to sit by themselves. So you give the message that your anger is not acceptable. Now, what will a two year old do if they continually get the message that their anger is not acceptable? What will they do with that anger?

They’ll stuff it down as far as it can go.

Exactly. They will depress it. That’s a wise adaptation. Because to express the anger is to threaten their relationship with the people that they rely on. So there’s a wisdom in that adaptation. So that’s the first wisdom or my tuning out. Believe me, there was a lot of wisdom in my tuning out in my first year of life. I could not have enjoyed life if I hadn’t tuned out a lot, I’m sure. So there’s a wisdom in that. There’s a wisdom in all these manifestations. So that’s the first wisdom of trauma

The second wisdom of trauma is the one we’ve touched upon, which is that when you work it through, you learn so much. I don’t recommend it as a way of learning.

It just so happens that I’m writing about it in a book I’m writing. I’m writing about disease as a teacher. A lot of people even with terminal disease have told me that they wouldn’t switch their disease for non disease because of what they’ve learned. And I don’t recommend that way of learning. I’m just telling you what people have told me. So there’s a lot of wisdom and learning from our traumas. There’s a lot of wisdom in multiple ways.

The wisdom in the adaptations is something that I’ve come to appreciate in some of the more recent trainings I’m getting as a psychotherapist. And it’s this sort of understanding of like sort of de-pathologizing of what clients or patients go through.

And I’ve heard you talk about how we should consider the intelligence or the wisdom in the addiction. That there’s something right about the addiction, even though we tend to focus on everything that’s wrong with it.

Can you talk about the link to addiction here and why this de-pathologizing framing is valuable and important?

Well, it’s a question of whether we want to hold on to a certain model or whether we want to really understand what’s going on. The medical model has addiction as a disease largely inherited, which is genetic nonsense. As I said earlier, there are no genes that code for addiction. Nor are there genes that if you don’t have them, you can’t get addicted.

So while there might be certain sensitivities, which had to do with certain genetic predispositions to do with sensitivities. As I mentioned before, a predisposition is not the same as a predetermination. So to really understand what’s going on in addiction, let’s look at let’s look at what an addiction is.

So I define addiction as–well obviously it’s a complex, psychophysiological process–but it’s manifested in any behaviour that a person finds temporary pleasure or relief in and therefore craves. But suffers negative consequences as a result of and has trouble giving up despite the negative consequences. So short term. Relief, pleasure, craving. Long term. Harm, inability to give it up.

So by that definition then we clearly get that addictions could be to substances and they often are from alcohol to cigarettes, to the illicit substances like opiates and stimulants and so on. But they could also be to shopping, to eating, to work, to gambling, to sex, to pornography, to internet gaming, to the internet itself, to extreme sports, and so on, to any number of activities.

And the issue is not the activities so much as the internal relationship to it. If it’s characterized by craving, pleasure, short term relief of some kind. Negative consequences and difficulty giving up, you got an addiction. I don’t care what the activity is. So now, depending on how we’re going to play this game or not, I could ask you according to our definition and without asking you to be specific in any way, have you, yes or no, at any kind of an addictive pattern in your life?

Of course.

If the answer is yes, then without asking you what it was and what to do. Let me just ask you this. What did it do for you in the short term that you liked about?

It’s funny that you’re using the past tense, you’re assuming I’m well-adjusted and addiction free, which is not necessarily the case.

I’m very kind of sensitive to these things, like I watch my behaviour very closely for whatever reason. And I just see tons of things that I wish I wasn’t doing. Probably the easiest one is just like Twitter and how much I reach for my phone. And to answer your question, it’s because it provides a temporary vacation from the noise in my head.

Okay, so you’re looking for some rest, some mental rest.

Yeah, exactly.

So is that in itself a good thing or a bad thing?

It’s a good thing. The need for the rest is a very real and valid thing, as far as I could tell.

Absolutely. In other words, the addiction is not your primary problem. It’s not a disease. It’s an attempt to solve a problem. And in broad terms, addiction is always an attempt to solve the problem of emotional pain, however, that emotional pain shows up, for example, mental noise.

So my mantra on addiction is not why the addiction, why the pain? Now, if I look at why the pain, I’d have to really look at your life and my life and everybody’s life. Something happened to create that mental noise. And we live in a culture, of course, that delivers and instigates a lot of mental noise. But again, it still has to do with child development. And that mental noise is not an automatic attribute of a human being.

Rather than seeing the addiction as the primary problem, we can look at the issue of the mental noise as a primary problem and and what maybe can be done to quiet it in ways that don’t have negative consequences.

So addiction all of a sudden goes from the disease model to a response to a human experience model. Which means that treating it needs to take into account human experience and the trauma, the traumatic imprint that human experience carries.

So you’ve got this book that you’ve been working on coming out next year, I believe, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture. I have a feeling where we’re getting some little previews from the content of that book.

I just wanted to talk about, you know, that you’ve been quite critical, on record and even in our conversation about mainstream medicine’s approach to trauma and addiction. And then, the title of the book just going so far as to just name the craziness of our own–like the way we live, at least here in the West.

Maybe you can speak to what your main concerns are about the way we think and talk about trauma and addiction and what you’re advocating for and where we should be going with all of this.

So, first of all. Trauma goes way beyond addiction. Actually, what I’m actually saying based on voluminous scientific evidence, let alone human insight, is that most chronic illness, whether physical, so-called or mental so-called, is rooted in trauma.

The British psychologist, Richard Bentall, writes that the evidence relating psychosis, for example, to childhood adversity is stronger or is about as strong, at least as the evidence linking cigarettes and lung cancer or lung disease. So it’s not like we lack the evidence.

That only comes to say mental illness, but all mental illness is a response, in my view, an adaptive response is in some sense–at least to begin that way–to childhood adversity and trauma, as are most chronic illnesses as I show in my book When the Body Says No.

So a Canadian study, men who are sexually abused–I’m trying to remember the study– does they have a 50 percent more chance or double the risk of cancer as adults? Something like that, but certainly elevated risk of cancer. This is regardless of lifestyle factors, by the way, smoking or drinking.

A study out of Harvard, two years ago, women with post-traumatic stress disorder, severe post-traumatic stress disorder doubled the risk of ovarian cancer.

Now, if that was the only study ever done, and it isn’t, and it’s already been shown in animal models, that stress and trauma increased the risk of ovarian cancer. But if that was the only ever study ever done, that should send every physician running to figure out what’s the connection between emotions and malignancies.

This information has been coming in for decades and decades and decades. So whether you’re talking about autoimmune disease or you’re talking about malignancy, that is a huge traumatic imprint every time.

Now Western medicine separates the mind from the body–oh, by the way, the ovarian cancer study, the milder the symptoms of PTSD, the less the likelihood of cancer. Which means that if we help people deal with their traumas, we could potentially prevent malignancy. Now, there are all kinds of physiological reasons for that. The physiological pathways have actually been worked out and none of this is a mystery.

But for all that science, the average medical student never hears this stuff. At least until recently, it’s changing a little bit. The average student does not get a single lecture on trauma. You should get a whole year long course on trauma. They don’t get a single lecture. Except physical trauma, like, you know, broken bones and so on.

So Western medicine separates the mind from the body, the emotions from the physiology, which scientifically is non tenable. In real life, it doesn’t exist. Let me induce any emotion in you and see if he doesn’t have a physiological correlate in your body right away. Whether you’re happy, relaxed or terrified or angry. They all have physiological imprints. They all involve your nervous system, your cardiovascular system, your gut, your immune system, your hormonal apparatus, it’s all one system. Western medicine does not take that unity into account. Either in its understanding of the etiology of illness, the causation of illness and certainly when it comes to the treatment of it.

Number one, Western medicine separates the individual from the environment. So, for example, addiction is seen as an individual problem. It’s not. It’s a multigenerational family problem. It’s also a social problem if you look at today with the hollowing out of the industrial economy in the United States under neoliberalism. The fraying of the social net. You’ve got massive dislocation, massive despair, and you’ve got massive increases in addiction. You can’t separate the individual from the environment.

That ovarian cancer PTSD study. Nobody develops PTSD on their own. That happens in an environment. So that the cancer showing up in the individual female body is a manifestation of a social process. And so that’s not understood.

What’s also not understood by Western medicine is the body’s and the psyche’s own healing capacity. So we’re all about cure, if it’s possible, or symptom suppression in, for example, chronic mental health conditions and chronic autoimmune conditions. All we do is we suppress symptoms. But that the psyche or the Soma, the soul or the body is an innate healing capacity that can be encouraged and invited and supported, that’s not considered in Western medical training or the Western medical ideology.

So those are significant gaps which really limit the–I mean, as amazing as Western medicine can be. And I mean, one is gasps at the miracles that they can perform, but at the same time, it’s so much more limited than it could be. And the miracles are largely in the realm of acute conditions, which are really quite illiterate when it comes to the long term chronic conditions of mind in the body.

Let’s talk for a second about a new development in Western medicine that is getting a lot of attention and has a lot of potential, particularly in the area of trauma and addiction. Something that you’ve been involved with over the last few years. And that’s the psychedelic renaissance.

I understand that you are involved in holding space and doing integration work around ayahuasca ceremonies. Where do you think psychedelics fit into this whole story? And what are your thoughts on how to most skillfully reintegrate these compounds back into our society, given their checkered history?

So, yes, I’ve been involved with ayahuasca work for about 12 years now. Even to the point where at some point I got a warning from Health Canada to cease and desist. Thank you Health Canada. Which is interesting because by the time they sent me that notice, they had already acknowledged that ayahuasca was neither addictive nor harmful. And in fact, they had allowed it for religious purposes, just not for healing purposes. So we could talk about the illogicality of that.

The way you framed the question, Joe, is that this has happened in Western medicine. It hasn’t happened in Western medicine. It has happened largely outside Western medicine. So the renaissance of psychedelic research and interest has not been mainstream by any means.

Precisely because of the failures of Western medicine that I’ve been mentioning, and especially in the mental health field, there’s been real interest in what else is out there. Yeah, we have the resurgence of research, particularly the very detailed and extensive research now on the use of MDMA in the treatment of post-traumatic stress disorder. I mean, if somebody told you five years ago, ‘you know, MDMA could prevent ovarian cancer’, you think they’d be nuts, right? But in fact, this makes perfect sense because if it can help heal PTSD, it can help you heal all kinds of diseases or prevent all kinds of diseases.

So the studies have been with MDMA. Studies with mushrooms now and end of life anxiety. But there’s nothing specific about end of life anxiety. They just allowed studies because those people were dying anyway. But mushrooms, I know, can help anxiety. They can potentially help stimulant addictions. They’ve been studying for that. I’ve seen ayahuasca people go through ayahuasca ceremonies and heal from addictions, from depressions, from anxiety, from compulsions even from severe autoimmune disease.

And none of that is miraculous if you actually get that, you can’t separate the mind from the body, the psyche from the soma, the unconscious emotional dynamics from our physiology. When you get the unity of it all, then you can understand that anything that can powerfully work with the mind, can have powerful impacts on people’s mental states and people’s physiological states. So that’s what’s happening now. Now it’s being documented more and more and again because of the desperation with the failures of the mainstream model.

Having said that, I’m not a psychedelic evangelist. I don’t think they are the answer for a whole lot of reasons. One of them being is that most people will never have access to it. I mean, under the best conditions, I can’t imagine how large numbers of people will be able to be trained enough to pursue these practices or many people who can afford them.

And at the same time, I also think that the sources of these problems are social and economic and political. So that any treatment process only deals with the outcomes, not with sources in a certain sense.

Having said that, given the limitations that we’ve been talking about, psychedelics are a potentially beautiful modality. Sigmund Freud said that dreams are the royal road to the unconscious. Which is true because the dreams really reveal the unconscious, if one knows how to interpret them and integrate one’s interpretation. The problem is dreams are really hard to interpret. Freud I think was terrible interpreting dreams. And some of his interpretations are hair-raisingly arbitrary, I think. But he was certainly looking in the right direction of the how do we get at the unconscious.

Well the psychedelics are a very immediate way of consciously getting at the unconscious, because in the psychedelic experience, people are both conscious and they’re having their unconscious run riot and reveal all its contents. What an amazing modality in the right hands.

You know, I’ve been meaning to ask you this for a long time, it just comes up whenever I hear you speak or I read your stuff and it came up actually right away in our conversation. Your comment that you don’t need drama to have experienced trauma. Is everyone traumatized? Is being born traumatic?

Well birth can be traumatic. And in this society, we actually make sure that a lot of birth is traumatic because of the heavy, unnecessary medical interference with birth. Which would be lifesaving in some cases. But it’s way beyond that right now, and that actually interferes with the natural physiological hormonal processes of birth. So birth need not be traumatic. I mean, unless one says that life is traumatic because, you know, there’s no way to live without being born.

So in writing this new book I looked at, what are basic human needs? And there’s two ways you can hurt people. Now, I can hurt you by never touching you, by never hitting you, by never assaulting you in any way at all. I could hurt you by depriving you from your needs. Not giving enough oxygen to breathe. Not giving enough food or water. I could hurt you like that. I could wound you like that. I could make you sick like that.

Now, we were born with certain needs. And given that our biggest need is that mutually responsive relationship with a nurturing environment, deprived of that, who doesn’t get wounded? And in our society, very few people really get that optimal, nurturing, interactive, responsive environment because their parents are too stressed. Because the community is no longer there to support the parents, as it was throughout our evolution. Because parents are themselves traumatized. Because society creates a lot of strain and puts a lot of burden on people.

So there are very few who are not wounded in this culture. Very few. So if you understand the meaning of the word trauma as coming from wound, then yes, there are very few who are not traumatized to some degree or another. Now, there are, of course, ranges and a whole spectrum of trauma, but hardly anybody escapes it completely.

One thing I learned about you when we met the first time a few weeks ago. I’ll just actually tell the story briefly to kind of give some context. We met at a meeting for the Numinus clinical advisory board that you’re a member on and I work with Numinus.

And I was excited to meet the board. I hadn’t met before. I hadn’t met you. And I was sort of enthusiastic and excited to kind of present to the group that I had that I’m now joining the team. And the facilitator says, ‘so does anyone have any questions for Joe?’ And you sort of looked up and you said, ‘I have a question for Joe.’ I was like, ‘oh, cool. What’s Gabor Maté going to ask me?

You said. ‘Mindfulness, like, what the hell, there’s nothing about trauma in mindfulness. Do you know anything about trauma?’ You just head straight, straight into that. Which I understand very well, why you did. I’d be curious to unpack that a little bit.

But my question here is like you’re tough and you’re critical of, you know, a lot of the sort of systemic and structural things in our society and how medicine operates and all of this kind of stuff. What are you optimistic about? What are you excited about?

Critical is already a formulation. What is a critique? Used properly. What does that word mean?

Like when I say you’re critical, I don’t mean that in a judgmental way. Just that you’re calling out certain flaws or gaps in our understanding of human experience and health and wellness.

I know what you meant, and I need neither find it offensive, nor am I finding anything to defend. But I’m just going to put the word critical into a larger context. A critique is an evaluation.

Yes.

So when I talk about Western medicine, I acknowledge its brilliant achievements. And I say here are its limitations. So I’m not critical. I’m just making a critique. I’m saying, here’s how it is. Here’s what it can do and here’s what can I do and here’s why it cannot do it.

So what am I optimistic about? Life. The possibility of people seeing the truth. I mean, I would not be doing a lot of speaking and writing and advocating if I didn’t think that there was a huge need for people to know the truth, but also a huge capacity which is driving people to know the truth. Not that I have some kind of a special line on the truth, but I do seek and speak the truth to the degree that I’m capable of.

I’m completely optimistic about the human capacity to receive and to grow with reality. And this despite all kinds of social forces against it. In a society that largely denies human reality and not only denies it, it assaults it.

So my optimism has to do with what I believe about human beings. In the diary of Anne Frank, a few months before she was taken Bergen-Belsen to die. She wrote basically that no matter what she says, I believe that people are good at heart. She was one of these really sensitive souls. So in the middle of the greatest crime, arguably, that human beings have ever committed against one another. She said, ‘I believe that people are basically good at heart.

And you believe that?

Oh yeah, I totally believe that. I believe that when the goodness doesn’t show up is because it’s being squelched. Whether you’re talking about Donald Trump or a Hitler of Stalin or to a lesser degree, any number of political leaders from George Bush to Stephen Harper to Justin Trudeau. I don’t care. You’re dealing with degrees of suppression of pain, which results in lack of empathy, in the extreme cases, tremendous cruelty, like monstrous creatures like Stalin or Göring or Hitler.

In the chapter, I just finished writing, I report the conversation I had with the grand niece of Hermann Göring, Betina, who herself is a healer. And she’s one of these empaths. Göring was an opiate addict, you know? The Reichsmarschall was an opiate addict and a food addict.

And Bettina talks about a healing experience where being an empath, she entered into the psyche of her great uncle. She said it was monstrous and black. Well, of course it was, he was a highly traumatized man. And I think if he hadn’t been traumatized, he could have been a good man. That’s what I believe about any of them.

So, Gábor, it’s very important to me that you continue doing this work and that you sustain your energies, and I know that this afternoon that involves you getting into the pool for a swim.

So we’re at a time here, and I want to make sure that you have that space for self care. And just, again, super grateful that you’ve taken the time to do this. I really enjoyed our conversation. And please keep doing all the good work and we’ll make sure to promote all this cool stuff coming up, your book and the film and all these online courses that you’re doing.

So thanks again.

Episode 30: Emotion and Transformation with Dr. Les Greenberg

 

“The best way to change an emotion is with another emotion.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Les Greenberg, a world renowned psychotherapist and researcher. He is one of the creators of Emotion-Focused Therapy (EFT) and professor at York University in Toronto. EFT centres around utilizing emotion to transform emotion. It is a different approach from the current major schools of psychotherapy like Cognitive Behavioural Therapy. He is also the founder and director of the Emotion-Focused Therapy clinic where he provides therapy for individuals and couples and trains therapists in EFT.

Dr. Greenberg is the author of 17 books like Changing Emotion With Emotion and Emotion-Focused Counselling in Action. And he has published over 100 scientific papers and has written over 80 book chapters.

Dr. Les Greenberg and Dr. Joe spoke about:

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Follow Numinus on FacebookTwitter,LinkedIn and Instagram

 

Here are some highlights from their conversation:

You’ve spoken about the idea of the importance of using emotion to transform another emotion. Can you speak to why that is important and how that works?

My contention is that amygdala-based painful emotions like core fear and core shame are impenetrable to reason. You can’t reason somebody out of these core painful feelings because emotion is a whole embodied experience. And you’re organized to run away. You have a sinking feeling in the stomach. It’s not produced by cognition. It’s produced automatically by the activation of emotion schemes.

We have to find a way to work with these painful emotions and the best way to change an emotion is with another emotion. Spinoza was the first person to state a principle like this. He said, ‘the only way to change an emotion is with an opposing and stronger emotion.’

I think this can be thought of in primitive behavioural terms that some of the emotions are organized as withdrawal emotions. With fear, you run away. And shame, you shrink into the ground. Approach emotions like assertive anger or the sadness of grief, you really are moving forward and towards.

So if I have a client and I can take them to their core feeling of fear or shame and they’re organized to run away, then I can help activate assertive anger or the sadness in which you cry out for comfort or reach out for the lost object.

You can’t run away and thrust forward at the same time. So we’ve now got two opposing action tendencies. The new action tendency is going to transform the old one.

Hebb stated the first law of neuropsychology as “neurons that fire together, wire together.” So if you think of emotion as an emotion scheme, a network that fires. So when you fire shame and at the same time, simultaneously, you fire off anger.

Let’s say you have a drunken, physically abusive father. When you first imagine him in front of you in an empty chair, it fires off these feelings of fear and shame and you shrink and you want to run away. But then if I can help you to feel assertively angry–’I should have had a father who treated me right. I deserved to not be abused’–it generates assertive anger. ‘I’m angry at you for having treated me so unfairly.’

Now this new emotion undoes the old emotion. It doesn’t replace it. It actually transforms it and synthesizes with it to develop a truly novel experience. So your self-organizing system is re-organizing. And maybe the shame, the anger synthesizes with the shame to produce confidence or security or calm or something new. And this is a developmental process.

And rather than thinking about it in learning theory terms like exposure leads to reduction. This actually comes from a Piagetian notion that the development occurs by the synthesis of co-activating schemes.

At a more practical level, the best way to change an emotion is with another emotion.

Episode 29: Ketamine-Assisted Psychotherapy with Dr. Kyle Greenway

 

“We have to design treatments that are fully biological, psychological, and sociological at their core. Psychedelics represent that, and psychiatry has started to take notice.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Kyle Greenway. Dr. Greenway is a senior resident in psychiatry at McGill University. He runs a clinic in Montreal where he and his team treats patients using ketamine-assisted psychotherapy.

His work centres around the intersection of biology, psychology, and sociology for the treatment of his patients. And he has a deep understanding of why psychedelics are so effective in the treatment of many mental illnesses.

Dr. Greenway and Dr. Joe spoke about:

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Follow Numinus on FacebookTwitter,LinkedInInstagram.

Here are some highlights from their conversation:

What do we know right now about the neurobiological and psychological mechanisms of psychedelics? Why are these drugs so effective? What are you betting on in terms of the best theories here?

My favourite theory and this is something I’ll call state-dependent learning.

Even in rats or mice, if you set them loose in a maze, you get their performance. You do it again with them being administered anything ranging from a barbiturate to cannabis to cocaine, you’re going to see differences in performances. When you do it again with them in a sober state, you’ll see that they have learned a lot less from their non-sober learning experience.

For example, if they did it on a barbiturate, then you do it again without a barbiturate in the system, you find out–a reasonable explanation of what’s going on is, ‘okay. They really just didn’t learn as much.’

The fascinating thing is if you re-administer that barbiturate, in fact, they actually regain a lot of the performance you thought they lost. So those memories were not just faultily encoded. They were encoded in the context of what was going on in the brain. In that case, a drug, but the same thing is true of your environment.

So if you study in a very particular environment, for example, with a particular smell, then you go to do a test, and you don’t have access to that smell, you’re going to have less access to those memories that were formed with that particular environment. This is called state-dependent learning. And this is a phenomenon we see all over neuroscience and psychology.

I would say one reason that antidepressants work, again, is because they change that state. So they kind of lessen all of the learnings that you have about who you are, who the world is, how you should react, how you should feel. All of that stuff is kind of lessened.

With a psychedelic, we’re talking about a radically different state. So you have a completely disorganized access to your current environment and your past memories. Things are not so orderly as, ‘Okay. This state is associated with that feeling, that memory, whatever.’

So what we see in the brain–there are many ways of describing it, and you mentioned a couple. The Entropic Brain Hypothesis is essentially describing that the brain has a lot less order to it. Entropy being kind of the lack of order. So when there’s less order, information is not being channelled along its old circuits. Your brain is not clearly saying, ‘Okay. This belongs in the auditory cortex. This belongs in the visual cortex.’ Information kind of bleeds through the different pathways. And this is one way you get hallucinations. If auditory information is kind of channeled into the visual cortex, suddenly you get a little bit of synesthesia, as if you’re seeing sound.

If you do neuroimaging, you find that indeed there are connections being made between networks to a much greater extent than normally would be the case. That definitely involves more entropy in the brain. You can measure that in a variety of ways.

Either the cause of that or a co-artifact of that is that this default mode network is disrupted. The default mode network is the way your brain organizes itself habitually. Maybe the closest thing we have in the brain as a correlate to the ego, your sense of self, who you are, etcetera. So whether it’s a disruption of the default mode network, the orchestrator of the brain–whether it’s a disruption of that that produces this greater entropy or it’s the reverse or they’re kind of parallel processes is not so clear.

But the psychedelic state is absolutely characterized by novel pathways being formed in your brain where information is travelling in different ways. And that kind of ties into the idea that this creates space for growth. You’re not just stuck in the same sort of rut, new things can happen to a much greater extent.

A Framework for Mental Wellness

Start building your own mental wellness plan with the ACT MATRIX.

From an evolutionary perspective, the primary role of the human brain is to keep us safe. Our brain evolved in times where physical or social threats often had life-or-death consequences. When scanning the past or anticipating the future, we developed an 80% negative bias to best avoid harm and support survival, but not necessarily to thrive and become the best version of ourselves. Despite thousands of years of evolution, our brain still reacts to threats in the same way, even if perceived threats are much less destructive than they were in the past. From tigers and hunger, our modern-day threats now include colleagues ignoring our comments in a meeting, being late to daycare, losing benefits at work, not being able to see family and the like.

Our primitive or mammalian brain, called the limbic system, is highly efficient to protect us from perceived threats. It has learnt to either fight, flight or freeze depending on the context and your conditioned responses.

When we feel threatened, the mammalian brain kicks in, often with inappropriate, self-preservation reactions that we later regret as they alleviate the short term discomfort or generate an immediate reward, but do not necessarily take into consideration what is most important to us in time or align to our deepest values. Rather, the brain is wired with these learnt behaviours from the past and will often repeat them again and again, just because they feel most natural to us, even if they no longer serve us.

We may often react automatically in a way that we later regret, if we were not able to manage our emotions to better utilize our more mature, wiser brain called the prefrontal cortex (PFC).

To access our more mature, wiser brain (the PFC), we need to take note of our limiting beliefs, fears and related mental models that are keeping us stuck in a place that no longer serves us, and redirect our responses towards what is most important to us. This is what ACT (Acceptance and Commitment Training) allows us to do: by noticing the unconscious patterns, we can make a conscious choice about our preferred responses, which will move us towards more expansive and constructive habits and behaviours. ACT uses evidence-based interventions grounded in mindfulness to increase mental and emotional skills for handling the difficulties that inevitably arise from life. Mindfulness is at the very root of this foundation as it is one of the catalysts for well-being. We explain more about our approach to the development of a healthier mind and the role of mindfulness in our article “Supporting healthy performance: Four pillars of well-being.”

With that in mind, we use a matrix adapted from ACT:

 

 

All day long, we’re either doing what we call “towards moves” or “away moves.”

TOWARDS MOVES refer to responding according to our values and behaviours, which will lead us towards what really matters to us, expanding our potential for having a rich and meaningful life.

AWAY MOVES refer to reacting with often unconscious and conditioned beliefs, thoughts, emotions that lead to behavioural choices that keep us at bay from whom we really want to be.

The less aware we are of what is driving our choices, the easier it is to lose sight of what really matters — and the more we get stuck and move away from what we really want and need for a thriving life.

A more meaningful and fulfilling life begins with clarifying what is important to us, learning how to mindfully disengage from habitual thoughts and behaviours that take us away from what’s important and choosing moves that lead us in a healthy direction.

Now, you can draw a blank ACT Matrix on a piece of paper and fill it up to start building your own mental wellness plan.