#190 - Paul Conti, M.D.: How to heal from trauma and break the cycle of shame

28 snips

Jan 10, 2022

Paul Conti, a practicing psychiatrist and author of "Trauma: The Invisible Epidemic," shares his insights on trauma's significant impact on mental health. He discusses how personal experiences shape understanding and how shame often hinders healing. Conti critiques the current mental health system's focus on symptoms rather than root causes, advocating for a more compassionate approach. He also explores innovative treatments, including the potential of psychedelics like psilocybin and MDMA, to transform recovery from trauma.

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INSIGHT

Residential Trauma Care

Most mental health providers might not consider residential trauma care.
This might be because facilities aren’t seen as PTSD-focused, despite addressing underlying trauma.

INSIGHT

Prioritizing Understanding

Psychiatry’s focus on diagnosis often overshadows the importance of understanding individual experiences.
Residential trauma facilities prioritize understanding trauma, regardless of a PTSD diagnosis.

ADVICE

Checklists for Trauma

Checklists, like the Adverse Childhood Experiences (ACE) score, are helpful for evaluating trauma but not definitive.
Consider individual experiences and underreporting due to shame when interpreting such scores.

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Episode Description:

Paul Conti, a returning guest on The Drive, is a practicing psychiatrist and recent author of Trauma: The Invisible Epidemic: How Trauma Works and How We Can Heal From It, in which he offers valuable insights on healing from trauma. In this episode, Paul explains how his personal experience with trauma and his many years seeing patients have shaped his understanding of trauma's impact on the brain, its common patterns and manifestations, and how often people don't recognize the implications of trauma in their own life. He discusses major challenges in recognizing trauma, including the lack of biomarkers in psychiatry and psychology, as well as the misguidance of the mental health system in targeting symptoms as opposed to root problems. He talks about shame as the biggest impediment to healing from trauma and offers solutions to how, as a society, we can start to change the stigma of mental health and allow more people to receive help. Finally, he concludes with a discussion about the potential role of psychedelics like psilocybin and MDMA in treating trauma.

We discuss:

Paul's background and unique path to psychiatry [2:30];
A personal tragedy that shaped Paul's understanding of trauma and resulting feelings of shame and guilt [5:30];
The current state of psychiatry training and need for improvement [20:15];
The over-reliance on outdated metrics and lack of attention to past trauma as impediments to patient care [28:30];
Defining trauma: various types, heterogeneity, and effects on the brain [34:30];
Importance of finding the roots of trauma and understanding the "why" [47:00];
The major challenge of recognizing trauma in patients [55:15];
How shame and guilt are barriers to treatment and healing [1:06:00];
How treating trauma compares to treating an abscess—a powerful analogy [1:11:30];
How evolutionary survival instincts create problems in modern society [1:15:15];
First step toward healing: overcoming the fear of talking about past trauma [1:19:00];
Shame: the biggest impediment to healing [1:25:15];
The antidote to shame and the need for discourse and understanding [1:34:15];
The emotional health component of healthspan [1:41:15];
How to reframe the conversation about mental health for a better future [1:52:00];
The growing impact of trauma on our society and the need for compassion [1:58:45];
Society's antiquated way of treating manifestations of trauma rather than root issues [2:04:15];
Potential role of psychedelics like psilocybin and MDMA in treating trauma [2:11:15];
Parting thoughts and resources for getting help [2:16:30];
More.

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