In this episode, I am speaking with Aimie Apigian, MD – who is adouble board-certified medical physician in both preventive and addiction medicine and holds double master’s degrees in biochemistry and public health. Dr. Apigian is a leading medical expert on addressing stored trauma in the body and we will discuss how to address stored trauma and overcome fatigue.
Table of Contents
In this podcast, Dr. Apigian and I discuss:
- How trauma is rooted in your biology and not just your psychology
- The link between trauma and fatigue
- Why cellular resources matter when it comes to stopping acute trauma from becoming chronic trauma. (Yes, mitochondria matter!)
- What are the worst early life experiences that can impair the quality of life as an adult?
- The signs you may have trauma patterns wired into your body
- The best protocols to eliminate stress and trauma
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Ari: Hey, there. This is Ari. Welcome back to the show. I think you are going to love today’s episode. I know that I had a lot of fun recording it and I am very impressed with today’s guest that you’re going to hear from. Her name is Dr. Aimie Apigian. She is a double board-certified medical physician in both preventive and addiction medicine and holds double master’s degrees in biochemistry and in public health.
I think she must’ve spent a billion years in school getting all of those degrees. She’s the leading medical expert on addressing stored trauma in the body through her signature model and methodology, the biology of trauma, a new lens that courageously up levels the old methods of trauma work and medicine by reverse engineering trauma’s effects on the nervous system and body on a cellular level. This is a fairly wide-ranging conversation and I make it very conversational.
I introduce a lot of interesting topics and some personal topics that I asked her to comment on. I found her commentary to be incredibly insightful and I would go so far as to say brilliant. I’m very impressed with her work and her knowledge and her paradigm in this area. I would go so far as to say that of everybody that I know who’s working in this field, I would say I’m most impressed with her paradigm and the way she’s putting all the pieces together and making sense of everything. With that said, I hope that you enjoy the podcast and I hope you get a lot of value from it. I know that I personally did, so enjoy. Welcome to the show, Dr. Apigian.
Dr. Aimie Apigian: Thank you, Ari. It’s really good to be here. Like I said, I’ve been waiting for this conversation for a long time, so super excited to join forces here.
Why trauma is your biology and not just your psychology
Ari: Yes, me too. First question I have for you is why is trauma your biology and not just your psychology? This is a meaty one, this is a juicy one, so I’m excited to hear your answer to this.
Dr. Apigian: I’ll give you my short answer and then you can let me know if you want me to go deeper. What happens is that most people think that a trauma is an event that then changes your thoughts and changes your reactions, and so then you find yourself reacting to the event that happened in your past. That’s actually not true. A trauma is the experience of something, and whether that’s an event or whether that was a whole period of your life, like your whole childhood. I don’t know about your childhood, Ari, so I’m not going to put that on you right now, [laughs] I have to say.
For some people, it’s just like no, it’s just like the whole family dynamics, all of that was traumatic. What is trauma? Trauma is anything that, for any reason, any reason at that time overwhelmed our biology, our physiology to meet that stress and it overwhelmed us, it crushed us, and it left us in a state where we didn’t know if we were going to make it.
The way that we made it through that was to just go into ourselves and just– It’s like the turtle that puts its head inside of its shell and it’s just like, “I’m going to just survive by just tucking in and going into this low energy metabolic state.” We call it the chronic free state or the dorsal vagal response, and that’s how we got through. When we look at, wait, a second, trauma is not then just your belief system coming out of an event, it was actually how your biology responded in the moment, and trauma leaves those lasting effects on your biology.
The thoughts are actually just the downstream effect of your biology. When we look at, “Hey, how are we going to get ourselves out of me still reacting to my past?” Ah, well, it’s actually more work on the biology than the psychology.
Ari: It’s 20 different directions I want to go from here.
Why trauma is an energy problem
Dr. Apigian: There’s my short answer.Now, you can decide which part of that you want to go deeper into, which is where your work becomes really important, because trauma is actually an energy problem.
Ari: Oh, interesting. Tell me more about that.
Dr. Apigian: Yes, because if we’re saying that for any reason, the biology, the physiology got overwhelmed, it’s because it did not have the cellular resources to meet the stress, to meet those demands at that time.
Ari: That’s interesting that you conceptualize resilience in the same way that I do. I don’t know if you’ve heard me talk on that topic, but as far as how mitochondria relate to resilience and something I call the resilience threshold, and now that in turn relates to cellular energy-producing capacity. That’s really interesting that you bring that up, because almost universally when I speak to somebody who’s talking about–
I know you literally just tried to take this out of the psychological realm, but just for ease of speaking about it, when I speak to someone who’s talking about trauma and more psychological stuff, trapped emotions, things of that nature, I find that almost universally, they have a purely psychological or neurological way of conceptualizing that, where it’s really cut off and disconnected from the rest of the body. I love where this is going thus far that you have a more holistic integration with physiology, biology more broadly rather than just the purely psychological or neurological.
Dr. Apigian: There’s so much richness here and so much depth to this because exactly what you say, trauma is actually creating a disconnect between our mind, what we associate as our mind and our thoughts and our body and our physiology. We can even see then how we develop bracing patterns to cut off sensations coming from our body up to our brainstem and thus our mind.
It’s our nervous system. Some people want to call it the unconscious mind or the subcon– whatever, whatever. It’s the autonomic nervous system and makes these decisions for us for how it can best help us survive in life. These bracing patterns, then there’s a lot that happens even just here in the thoracic inlet, a lot of jaw type of stuff because– When you don’t want to feel something or you just clench your jaw, when you don’t want to say something that might offend people, “Oh, just clench your jaw,” it helps us hold things in.
That’s exactly what happens on so many levels. When we look at yes, what’s happening on the cellular level, I talk a lot about the capacity. I heard you use that word as well, the capacity of the system to hold stress and not let it overwhelm us. Then we talk about anything that it does not have that capacity for, then our nervous system is making decisions about, “Ah, how do I still help you survive given all that you have going on in your life, given that you can’t fall apart, given that you still have kids to take care of and you still got to get food on the table? You got to show up for them and you have all these life responsibilities so I can’t let you fall apart.” Then there’s these mechanisms, coping mechanisms, even internally that develop in order to help us still keep going even though there’s a part of us that is very much disconnected.
Ari: The last thing you said there was actually a perfect segue into the next thing I wanted to ask you. I often conceptualize the body’s responses as– I think it’s important to frame things as from the perspective of the intelligence of the body, what is the body trying to accomplish by doing this? As an example, fatigue is something I talk a lot about as an intelligent, adaptive response in certain contexts.
In contexts where the environment is perceived to be very harsh, in the context of a pathogen and you’ve got an acute infection, you’ve got a physical injury, we have mechanisms where the increased immune activation and inflammation that results in those scenarios literally engages mechanisms at the mitochondrial level, at the neurological level where our body is designed to respond to that with fatigue.
I emphasize to people that this is not a mistake. Our body is designed to do this because it’s intelligent, because it’s adaptive and it actually, it lowers your subjective energy so you’re less inclined to do your normal routines and go for a jog or go work hard at work all day and just keep pushing and go, go, go. Instead, it’s forcing you to rest so that it can shift resources towards repairing and healing that.
Now, in the context of trauma, I’m really curious to see how you position trauma. Let’s say, severe trauma in that frame. What I mean by that is it, should this be seen as when somebody has a severe trauma, is that an intelligent adaptive response to the scenario that they were in or is this sign of dysfunction? Is this the body gone wrong and it’s in a state of dysfunction that we need to heal? How do you conceptualize that?
Dr. Apigian: This is one of my favorite topics, Ari. In terms of, when we see the fatigue through the lens of trauma, fatigue is the dorsal vagal response. Fatigue is the trauma response. It’s not just an adaptation. It is the trauma response, and so what I teach in my courses is you’ve got the three states of the nervous system. That’s also a misconception, because people often just think of parasympathetic and then you’re fight, flight or freeze and just lump them into two, and no, there’s three categories. The freeze response is that fatigue. That’s going to be a part of that.
There’s some other conditions that are very much part of that freeze response or the trauma response, autoimmunity, fibromyalgia, chronic pain, but chronic fatigue is right there. The reason for that is that when there’s this very sequential neurobiological response to trauma, and it’s the design of the system. Anytime that a person experiences any form of trauma, even what they might consider small traumas, it doesn’t matter. Trauma is trauma. It’s all the same response because there’s only one response to trauma that the body has. That response always includes this freeze response, which is the dorsal vagal response and it goes into a energy conservation state in order to survive.
The first response to a stress or a threat or a sense of danger is always the sympathetic response. Some people, Ari, from childhood were already experiencing so much internal stress that they don’t hardly spend any time in sympathetic, they just go to that fatigue and that freeze response immediately with any stress, like any stress is just overwhelming to them, throws them off. There they go. They feel that energy drain, that collapse in their system.
Going back to the intelligence of the system, that sympathetic response always happens first and the sympathetic response is a very high energy state. Your mitochondria are working at their maximum, right? Like they’re trying to give you as much energy as possible because you got to outrun that tiger or you got to, I don’t know how you outrun an email that’s stressing you out or even [laughs] I don’t know how that escalates, but those are–
Ari: That’s part of the problem, right? When the proverbial–
Dr. Apigian: That’s part of the problem, yes.
Ari: That system of the sympathetic response to stress is by definition an acute system. It doesn’t work very well when-
Dr. Apigian: Long term.
Ari: -the stressor is drawn out over time.
Dr. Apigian: Exactly, and so this is where trauma is an energy problem, because the trigger for this freeze response, the trauma response is a word that’s called thwarted movement, where your ability to move to action to solve the problem is blocked. Whether that’s blocked by external forces, you’re actually trapped in a building or trapped in a car in that type of an event, or you don’t have enough internal cellular resources and so your own system makes that intelligent decision of, we can’t maintain this high energy state. In order to survive, it’s best for us to shut down. Then part of that is this low energy fatigue state.
That’s always the reason for the trauma response is what’s called the thwarted movement, that blocked ability to move to action, and so then a person has this symptoms of the freeze response and at that time, Ari, like that was the best decision of the body. We even look at how this is happening in early childhood and very early development where a newborn and for the first several, several months of life, they actually have no ability to regulate their own system, and so when they go into sympathetic, they have no ability to bring that back down like we do as adults. Whether we’re doing it in a healthy way or whether we’re doing it in a coping adaptive mechanism, like food, alcohol, substances, whatever it is to calm our system back down, they have no ability to do that for themselves.
If they don’t get that through that relationship and co-regulation with their parent, then they are having to use their own break system and shut the system down, which shuts the mitochondria down, which shuts all of these systems down in order to maintain homeostasis, because otherwise, they would literally die from running out of energy.
They don’t have that ability to regulate themselves, so again, coming back to the fatigue then. Fatigue is part of every trauma response, because every trauma response is the decision, the intelligent decision at that time that we’re running out of cellular resources and we’ve got to shut down and conserve energy in order to get through this. Then you see people struggling with low energy, and that’s what they’re frustrated at. They think that that’s the problem, and that’s actually just the downstream effect of the decision that their body has made for how they can best survive this time in their life.
Ari: That’s such an important reframe to teach people that they’re not just trying to fight against their low energy state. The goal is to understand why their body made that intelligent decision, figure out what triggered the body to make that decision and then undo whatever’s triggering the body into that.
Dr. Apigian: Well, and you just use the word fight, right? They don’t have the energy to fight, right? When they do feel they have energy, if they’re using that energy to fight their own body, they’re running themselves back into that low-energy state. It is such an important reframe, and that’s why I start everybody. I start everybody with that work. We do bodywork and we do that work to get into a place of working with the body rather than fighting against the body.
Where is trauma coming from?
Ari: Where is all of this trauma coming from? It’s become very in vogue to, I don’t want to say just to talk about trauma because I don’t think it’s just an issue of there’s more people talking about it. I think people are talking about it because it is a real thing. I guess the question is, a better way of phrasing it is, why are so many people dealing with trauma now as compared to in the past? This didn’t use to be such a big thing. I would even argue, I would maybe place that in a certain context, which is I know like Steven Pinker, for example, argues that the world has never been better. This is the best time in history to live. Things are better than ever.
We have fewer wars, fewer violence than ever before, fewer less poverty than ever before. We haven’t had World War II. If you’re over, whatever it is, 70 years old or something, then you were a kid during World War II. You didn’t go through the Great Depression. There was arguably a lot of really hard times that people like our parents and grandparents lived through much harder than in our generations, and yet it feels like more people than ever are dealing with their own traumas. How do you conceptualize that? Where are all these traumas coming from?
Dr. Apigian: There’s a lot of different sources, Ari, so one source would be the generational trauma, and that actually gets passed down through epigenetics. It actually changes our DNA expression based on what our grandparents lived through, and so in that sense, their hardships, we’re still carrying those, especially if we haven’t looked at our methylation, we haven’t looked at our epigenetics. That is still affecting our physiology and our biology. There is that piece of we’re not just standalone, we don’t come into this world with a clean slate. We come in already imprinted based on the collective experience of our ancestors, right? Which is a whole fascinating topic. [laughs]
Ari: Well, I’m of Jewish ancestry and my whole father’s side of the family basically doesn’t exist anymore because they were all in at that, what was then Austria, Hungary, and so all of them were wiped out by the Nazis in World War II. Then I have other people who are like family friends or my sister’s husband, his father was in a concentration camp and survived, and so there’s a lot of– that’s a very big thing in their family, like how that trauma was passed down through the generations.
They’re very conscious of it, I think for better or worse, but it’s interesting, something like that, an event like that sort of unprecedented event of millions of people being systematically rounded up and murdered and kind of dealing with the fact that your entire people were attempted, it was attempted to exterminate your, like your entire ethnic race from the face of the earth. There can be pretty heavy traumas involved and things like that, and certainly, there are many, there are other examples of that in lots of different places in the world and lots of different peoples, but anyway.
Dr. Apigian: When you look at that–
Ari: Definitely a good thing in my world.
Dr. Apigian: It is in everybody’s world, right? Like you said, it adapts. That’s its job. Its job is to adapt to our experiences. Those adaptations are what get passed on, and this is where we see even just the epigenetics having changed in the last several decades, and so, no, even though we may not have experienced a world war in our lifetime, the adaptations to previous world war experiences have been passed on and we can see a societal shift in epigenetics as a result of experiences.
Those things affect us on a cellular level, for sure, and then we even just want to look at in utero experience, right? Because again, when we are born, we’ve already had experiences, and what was your in utero experience. Even down to, some of the things like what level of stress was your mother under, because that would’ve been passed on, that would’ve affected her cortisol levels, which at a certain time in pregnancy, she needs to have higher cortisol levels to prime the baby’s nervous system and the brain for being born.
Those changes for preparing their lungs to breathe on their own, so high cortisol is not bad, but it’s just the timing of it. Did that happen in the third trimester when it’s supposed to, or was she stressed from the very beginning, because at that time, high cortisol would’ve been a neurotoxin to the fetus’s developing nervous system? We look at this whole idea around the nervous system and its job is to help us survive. When we’re talking about trauma, we’re really talking about what’s happening in the nervous system and how was that developed.
We don’t come in having it already developed, like it develops through experiences that it is adapting to, and it’s either adapting to an environment of nurture, safety, security, support, or it’s adapting to an environment of hardship, deprivation, not enough, scarcity, and yes, a person will survive, but it’s then how is their nervous system even developed? Because that will be their system for their life unless we of course do some work and rewired and reorganize that.
How early childhood can cause trauma
Otherwise, that’s their system that was developed in early childhood.
When I talk with Dr. Vincent Felitti, founded the ACE study, the original Adverse Childhood Experience Study, talk with Robin Karr-Morse, who has written amazing books on the relationship of early childhood to adult diseases. They are very clear, like everything from their work so strongly suggest that those first three years of life is a person’s best health insurance policy.
Many times, many people are coming out of the first three years of childhood already feeling, having had the felt experience of not enough, not enough safety, not enough security. I wasn’t able to really relax into that relationship knowing that all my needs were going to be taken care of. I already started to have to kind of figure out, oh, what’s the emotional energy in this room? How do I get what I need? Do I cry? Do I not cry? Right? You can already see those patterns developing before a baby has the words to express anything. We want to look at that then because that becomes our template for being able to manage stress, becomes our capacity for managing stress, and thus our threshold for what will be a trauma rather than just a stress for the rest of our life.
Then we want to look at exposures, right? Were you exposed to lead? Were you exposed to infections? Were you exposed to ear infections? Were you then given antibiotics? Because all of those things are going to affect your developing nervous systems. In the work that I do, I teach that there are three elements that go into your, basically how predisposed you are to experiencing trauma in your life, Ari. That’s your genetics and epigenetics, so I lump all of those together, your genetics, but then also your epigenetics from the generational stuff.
I look at your attachment, your relationship, the amount of co-regulation that you had with your parent. Then I look at neurodevelopment, and did you actually get through those milestones? Were you an early walker? That’s actually one of the worst things, early walkers are more predisposed to trauma in their lifetime because they didn’t have that time and that sequence of movements that were necessary to really organize the system well. I look at those three things coming from early childhood to be able to predict how much at risk are you of experiencing trauma in your life.
It’s so much more about your system going into an event or an experience, not the actual event or experience itself. Because the more that we can build your, I think we’re kind of coming back to your idea of resilience and the mitochondria, it’s like the more resilient on a cellular level you have going into an experience, the more that your bodies going to be able to get through that experience and not go into that, I have to shut down in order to survive this.
Ari: Yes. Absolutely. Okay. With regards to child development, I have an interesting question for you, at least. I think it’s interesting.
Dr. Apigian: Don’t ask me to analyze your childhood, Ari.
Ari: All right. Next questions.
Dr. Apigian: [laughs]
Ari: I spent some time when I was in my 20s on a kibbutz in Israel, which is a communal farm, and living and working on the kibbutz for about six months. One of the interesting things I learned when I was there was that there was a time, I think it was during the 1970s where on these communal farms in Israel, many of them, I don’t know if all of them, but certainly many of them engaged in an experiment, basically like a child-rearing experiment where they put all of the kids for this certain generation, they put all the kids away from the parents in their own like kids’ house, basically, like kids dormitory. It was like a giant room, I think with– it wasn’t only kids, there was adults there that were supervising, but not the parents of the kids.
I guess I don’t know all the details of it, but they thought at that time that that was what was going to be best for kids, that kids needed to be with other kids. They were raised from the time that they were kind of not maybe tiny babies, maybe from one year old or something like that or two years old to the time that they were through their teen years with just other kids away from their parents. I know if you talk to any of those kids that were raised like that, almost all of them universally would say that they feel very traumatized by it. It’s interesting also to consider some things that I’ve learned recently as I’ve been exploring child-rearing, I read Gabor Maté’s book Hold Onto Your Kids, which kind of blew my mind.
Dr. Apigian: Can I just say right there, like on my upcoming summit, I have both Gabor Maté and Gordon Neufeld, the two authors of that book on my summit.
Dr. Apigian: I know. It’s a topic that we need to bring more into the light for people.
Ari: I’m glad you’re familiar with that material because it relates to what I want to ask you. I mean that book for me, more than any book I’ve ever read in my life, made me go, almost every other page I was going, “Oh my God, I can’t believe how wrong I was in my assumptions. I can’t believe how wrong I was.” The gist of that book for people who are not familiar with it is basically that kids are wired for one primary attachment, and to the extent that your kids are spending time away from you as the parents, with their peers, that primary attachment gets shifted. It gets more and more disconnected from you as the parents and shifted towards their primary attachment, being directed towards their peers. There are many, many, many developmental consequences of that. It’s interesting because my son who’s now five and a half, when he was two, I was of the opinion, like most parents coming from the United States, I had all these ideas in my head that we’re culturally programmed with. My kid needs to learn independence from me and mom, he needs to learn how to be on his own. He needs to be with other kids so he can be properly socialized. We put my kid in the school. It was a very cute school. Nonetheless, we put him in a school away from us from the time he was two years old.
Every day we’d take him there, and he’d be screaming his head off, “No, I want mom. I want dad.” To be honest, it was mostly mom, sad as that makes me feel.
Dr. Apigian: There’s a reason for that, so don’t feel bad.
Ari: [laughs] Yes. It’s mostly dad, now, so I’m okay, but he was literally screaming to us. Screaming, crying to us, “I want to be with you,” and we were sitting there. I now look at it in horror, how I couldn’t see it clearly. We were sitting there going, “No, no, you don’t know. Really, you need to be away from us. You need to be away from us with other kids. That’s what’s best for you so you can be socialized, so you can learn independence.” I look back at it, especially after reading Gabor Mate and Gordon Neufeld’s book, and I’m in horror about it.
I feel really guilty about it. I’ve also explored this topic in greater depth, and sorry for being wordy, I’m just sharing a lot of things I’ve learned over the last few years as I’ve explored this topic. One of which is the other ways that we in the West, and in the North America, and in Europe, make assumptions about child-rearing that are all within the norm for us, but are actually historically abnormal. School, the entirety of school, like if you go to hunter-gatherer societies, and there’s a great new book called The Hunter-Gatherer Guide to the 21st Century by evolutionary biologists, Heather and Bret Weinstein, and they have a chapter in there on parenting, and child-rearing, and education.
Three or four good chapters related to this. One of the things they talk about is, in hunter-gatherer societies, they don’t even have the concept of school. That you would go away from your parents and the elders of your tribe, the adult males and females of your tribe. Instead of just being with them, you’d go off to a separate place to engage in school where you learn this predefined curriculum. That entirety of that concept is actually a modern phenomenon that it’s only in whatever, the last 100 or couple 100 years, that humans are engaging in stuff like that.
Prior to that, children were raised in the presence of their parents, and the other uncles and aunts, and other members of the tribe, where a child was with the adult. A male child was with predominantly the adult males, once they got beyond that their very young ages, following along and learning what those adult males do. The same for the girls with the adult females of the tribe, learning what they do in that role. They weren’t sent off to this place to go learn math and study literature, and science classes, and stuff like that. Anyway, I say all of this, just in the sense of stepping out of our cultural norms, our societal norms, and realizing what if there’s a possibility that that entire thing that we’ve all accepted as totally normal for our children to be away from us all day at school, we all accept that as normal, we all accept that, “Oh, that’s what kids are supposed to do, that’s what’s best for them, but if we step outside of it, like I just said, what if that in itself is a kind of trauma?
Dr. Apigian: It’s not what if, it is.
Dr. Apigian: It is, and this is where many people, Ari, look back on their childhood and say, “I didn’t have any trauma, right? My parents are good people, so why do I feel this way? Why is this my experience in life, that I feel alone, I never do feel truly safe in my body?” Those are the types of ways in which people know that they have trauma patterns wired into their nervous system, stored in their body, is because they just have a general sense that “I can never really fully let myself relax. It’s not safe.” Like you say there are so many social practices that have been normalized, that are actually traumatic.
When we go back to the definition of trauma, we see how it is because it’s anything. Anything that, for any reason, at that time, overwhelmed our system. It doesn’t have to be even something that we remember. Many people, many, many, many people, Ari, are coming out of their childhood with this form of trauma, and don’t recognize it as trauma. They don’t think that maybe they need even to do some work around what would be attachment trauma. It’s not just the push towards independence, but that’s been a huge one, and that has been completely wrong.
I’ll come back to that. I want to just mention a couple of other practices that are very standardized, and yet very traumatic. That would be some of the sleep, how to teach your baby how to sleep, right?
Ari: Yes, the separating stuff.
Dr. Apigian: No, no, no, no. That’s so traumatic for a young newborn who does not have the capacity to regulate their own system. They need someone else bigger and stronger than they are to regulate their system. If they’re crying themselves to sleep, for example, they are actually falling asleep by going into this trauma response and shutting their system down. That then becomes their regular pattern. Then, of course, you go on with life, and that’s just your default now, is with any stress, you just know how to shut down. Then there’s the baby bouncers, and baby carriers that are faced outward.
These things that are actually overwhelming to a baby’s system that we think we’ve been told is good for them. They get bored looking at you, Ari. They get bored looking at you. They need to be out facing the world. No, they don’t. Their system is not ready for that. It doesn’t have the capacity to take in all of that sensory overwhelm, and literally be like, “Hey, where’s mom, where’s dad? I literally cannot see them because they’re behind me.” That’s a terrible, terrible feeling that causes overwhelm. Then when you look at how a baby should be held, the babies should be held by supporting their head.
You’ve got contact on their neck, and then their whole back is leaning up against your arms. When they are in a baby carrier facing forward, they’re not getting that back contact, and our back is where we feel support. Even as adults, we have this phrase, it’s called, “Hey, does someone have my back?” It’s that sense of support. I can go through a lot of hard things if I have someone who’s got my back. This is actually a felt body sensation that comes from early childhood, or the lack thereof came from not having enough of that felt sense of, “Someone has got my back, and I can completely rest into their hold because they’re bigger, they’re stronger than me.”
Those are just a couple of two other common practices that I want to just throw out there to help inspire people to be thinking of everything that they do through the lens of, “What impact would this have on my baby’s nervous system?” This may be something that’s good for them at age five, but not at age two, or not at age six months.
Ari: Yes. A lot of these things, I think we have to be careful of what frame we are examining these questions from.
Dr. Apigian: Exactly, yes.
Ari: Like the sleep training thing is largely a result of parental convenience.
Dr. Apigian: Exactly.
Ari: It’s not asking the question, “What is best for the development of my child’s brain and nervous system? It’s asking the question, “What is best for me to be able to sleep through the night, and what’s less horribly inconvenient for me?
Dr. Apigian: For me, yes. I’ve heard some parents truly think that if they respond to their baby’s cry, they’re teaching their baby to cry more. Again, coming back to that independence, like, “I don’t want my kid to cry so I’m going to teach them from very early that’s not how you get my attention.” How else are they supposed to get– That’s their intelligence system saying, “This is the only way I know to communicate my needs, and if my needs are not being met–” They are going into that dorsal vagal response and shutting down, leading to the pathway that will lead them to chronic fatigue autoimmunity, chronic pain as an adult because this is where it starts.
When we look at the attachment, so many times we have had this misconception that we can jump to the independence without the foundation to promote healthy independence.
Ari: Right, yes.
Dr. Apigian: We even do this to ourselves as an adult. Like, we expect ourselves to perform at a certain level without having the support and safety to actually enable that level of performance and productivity because otherwise, you’re having to, again, going back to that word disconnect, disconnect from those parts of you that don’t feel safe, feel scared. You’re like, “I don’t care what you feel like, you still need to perform at this level. You need to get this done.” That’s what drives us into unhealthy adaptations, and certainly, diseases and symptoms.
When we come back to attachment and that book that you mentioned– I have a new book for you, Ari. It’s The Evolved Nest, work by Dr. Darcia Narvaez. She’s with the University of Notre Dame.
Ari: Evolved Nest, N-E-S-T?
Dr. Apigian: Yes. Evolved Nest. She will walk you through the whole wellness model around childhood.
Ari: Oh, perfect. Great.
Dr. Apigian: Yes, you’re going to love that. So much of what all of them, like Gabor Mate, Gordon Neufeld, Darcia, Allan Schore, everything that we know from attachment is that you need one primary caregiver, which is why it’s the mother first. Always in first. The biological mother is your secure base. Usually, that’s for the first two years of life that you are developing that security with her. From that relationship, then you grow into other relationships. That’s where dad comes into play, so then dads play more of a role in terms of the relationship itself after two years. That’s why you’re son calling out for mom was perfectly normal. [laughs]
Ari: Thank you for that.
Dr. Apigian: Don’t take it personal.
Ari: I didn’t know that my own traumas were going to be healed during this podcast.
Dr. Apigian: Happy to share that insight. That was the biological thing for him. Then what we look at is, unless we have that secure base, Ari, we will never totally feel safe to go out and explore the world because there’s always going to be that element of, “I need my secure base.” From there, we feel safe to explore. When we go out to explore, we always want to come back and just touch base with our secure base and share with them what I just found. “Mom, I just found this electrical outlet. Do you know what these are?” or they’re like, “I just found this. I just explored–“
Their creativity, their exploration completely opens up when they have that secure base. Without that secure base, they keep themselves small. We keep ourselves small. Even as adults, we keep ourselves small because we don’t have that felt sense of safety already built into our system that would be natural if we had the ideal childhood where that would have been established during that time. From my perspective, looking at it through the lens of trauma, that was a trauma because those are lasting effects on our biology that resulted in this trauma response, this dorsal vagal response, at that time, in order to survive because that’s the only way we could have survived at that time.
How childhood experience can affect parenting and why
Ari: Yes, absolutely. Okay. I actually do want to share a little about my personal upbringing. I’m curious what your thoughts on this are. I’ve mostly healed it at this point. When I was young, I remember watching different movies where there would be scenes of a young boy playing with his dad, playing catch with his dad or something to that effect, going for bike rides. I remember asking my dad to go for a bike ride with me, go play catch, whatever it was, and he said to me, “I’m not your friend. I’m your father.” That was exactly what his dad had said to him growing up.
“I’m not your friend. I’m your father.” It was this conceptualizing of the father role as, “I’m a financial provider. I give you a place to live. I pay for you to go to school and stuff like that, but I’m not here to spend time with you, and be your buddy, and go for bike rides, and play sports with you.” It’s interesting, at the time I was a kid, I didn’t really understand. I didn’t feel like necessarily there was something terribly wrong with that, though I had some inner sense just based on watching movies. That was my only reference for comparison of anything different.
It was like, “Other kids’ dads are spending time with them, so why do you have such an objection to it?” As I’ve grown up, I do definitely really feel that’s not the right way to do things. I’ve made my son really into my little buddy. He’s my little adventure partner. I’m always asking him if he wants to go for walks with me and bike rides, and, “Can I take you somewhere? Can we go explore something together? Let’s go rock climbing. Let’s go do this. Let’s go play soccer.” I wonder if I’m going to traumatize him in the reverse way, in some way, you know?
Dr. Apigian: Yes, let’s talk about that. Let’s talk about that because this is a very normal reaction to parents who are trying to create a different experience for their own kids. Sometimes, we can go too much the other direction. I don’t know if that’s the case, so I will speak in general terms.
Ari: Yes. I’m not overly sensitive or offended by anything you say. You don’t have to walk on eggshells. I’m bringing it up because I want your opinion.
Dr. Apigian: Okay. Here it is. As the parent, one of the primary things that we have to do for our children is what Dr. Gordon Neufeld talks about is be the answer for our kids. In that sense, we need to be stronger, kinder, wiser. We need to be that in their life so that when they have problems, they know that they can come to us because we have answers. If we don’t have answers, then we know where to go get answers. They need to see us as a solution, as a resource. We need to also demonstrate and model for them how to handle big emotions that, for them, feel bigger than themselves in the moment.
When they can see us being able to keep that in perspective, then it’s like when they are having a big emotion, they know that they can come to us because they know that we will help them with that. That is one of the main roles that a parent needs to play for their children in their life. Has to in order to be coming out with a healthy secure attachment because, otherwise, if they don’t feel that we have answers for them, if we are not a resource for them, they’re not going to come to us. Their problems, whatever their problems are at three years of age, “I can’t get this toy to work,” that’s their biggest problem, they’re going to feel that those problems start to overwhelm them.
They’re not even going to try to open up that toy. Right there, that’s already the trauma response. They’re just, “That’s too big for me.” We help them grow their capacity for stress, and for troubleshooting, and for planning, and for resolving things. We are the ones that actually build that capacity as they come to us, and we work through it with them, “This is how you do it. Let me show you.” I don’t want to say “but”, and one of the things that we get to do is then teach how to be in relationships with people. How to play, how to laugh, how to have authentic communication that doesn’t feel it compromises your identity or your protection.
There’s this element of being authentic that feels too vulnerable. There’s that balance. How do they learn that balance? That’s in relationship with us. It is true that we do need to be that bigger superhuman resource for them. Superhuman in the sense that it’s bigger than what they are. We need to teach them how to do the relationship piece, and the play, and the laughter, and the connection, and the communication. It’s all of that because where else do they learn that? Even if they were to go out and have friends, how do they learn how to have relationships with friends?
That actually all comes out of their relationship with us. The shift that I see many parents make though when they’ve come out of a childhood that felt rigid to them is they just want to be the friend. They don’t know how to be the parent as well as the friend.
Ari: Oh yes. Yes, I definitely don’t make that mistake. If anything, yes, I definitely also play the disciplinarian role.
Dr. Apigian: Yes, exactly. Yes, the discipline.
Ari: I’m definitely not a jellyfish parent that lets my kids do whatever they want. If anything, I wish I was a little more that way. I wish I didn’t have to be the disciplinarian as much as I am.
Dr. Apigian: Sure, yes, and it’s both right?
Dr. Apigian: It’s both. You do have to play that. Like, “I am bigger, and I am the boss. I am the parent, and this is my home, and I decide what we’re doing as a family. I’m going out biking, would you like to come along?” When they see us as their superheroes, yes, they want to go biking with us. Yes, they want to go play soccer with us. Like, “Yes, I want to spend time with my superhero.”
Dr. Apigian: That’s when we have taken ourselves out of that role of being bigger than they are, and we’re almost like, “Oh, please, will you like me? Will you accept me?” Then we’ve lost the most important role that we need to play in their life for them coming out of childhood feeling safe, and secure, and resourced, and knowing where to go for resources later on in life. Even how to be able to do that and not just get overwhelmed and shut down.
How trauma can affect your physiology
Ari: Yes. Beautifully explained. Let’s loop back into trauma more broadly. Can you summarize what it’s doing to us physiologically? What happens after we’re traumatized? We’ve established, based on all these tangential discussions that we’ve gone down, that a large percentage of people are dealing with trauma to one degree or another, almost pretty much everybody.
Dr. Apigian: Everyone. It’s just the degree to which it’s affecting their life.
Ari: Right. What happens physiologically as a result of that? Then the last thing I want to ask you is what do we do about it, and what do you do about it?
Dr. Apigian: The effects that trauma has on our physiology really relates to the effects that this dorsal vagal response has, and it communicates that to the vagus nerve. You’ve got the ventral vagus nerve that communicates parasympathetic, which is when we are connected, and calm, and curious. We’ve got that, all of that. Then the dorsal vagal response is the trauma response, and so, it is what shuts the body down physiologically. Now, rather than having a healthy digestive system, for example, it’s going to shut that down. It’s not going to make as much stomach acid.
It’s not going to produce as much enzymes in the pancreas to help break down fats and proteins. The liver, the gallbladder, everything just moves into a more static place rather than having flow. Even your lymphatic system, it literally just shuts everything down, and the body itself is just looking for the lowest energy solution to everything. Digestion is really impacted. The other effect that it has on the physiology and the gut is that it really increases one’s intestinal permeability or leaky gut, ad so then the amount of gut inflammation that you have.
Now you’re finding yourselves reacting to more foods that you didn’t have sensitivities to before. Of course, that gut inflammation travels up the vagus nerve to the brain, causing brain inflammation. If you didn’t have what’s called primed microglia before, you certainly have them now. That’s leading to the nervous system now being in this bath of inflammation. Talk about a message, a signal of danger and threat, and so your nervous system now is stuck. It gets stuck in this trauma response because of the effects on the biology that then have the downstream effects on the nervous system.
It becomes this vicious cycle that it’s hard to get out of, which is why I’ve coined that like, this is the biology of trauma. It is both the downstream effect of trauma, but it’s the biology that will keep you stuck in these trauma patterns. That’s just the gut. Then we can look at hormones. Many people say, “Oh, you’ve got high cortisol when you’re really stressed.” Yes, and that’s not necessarily true with trauma. It depends on the spectrum of trauma that you have in your body.
Depends on that spectrum of, are you still mostly in sympathetic or, with time, have you gone more and more into this shutdown, overwhelm state that it’s actually shutting down your adrenal glands, and you may be going more and more towards low cortisol? It’s really impossible to just look at cortisol in terms of knowing where you are in that spectrum because many people, Ari, go back and forth between the sympathetic, and the anxiety, and overwhelm, multiple times in a day. What’s your cortisol levels doing?
They could be all over the place because your body is literally going into what would be generating high cortisol levels, and going into what would be producing low cortisol levels, all in a day. The further along the spectrum, and the more time that you are spending in that freeze response, in that trauma response, then you’re going to be moving more towards that low cortisol. Then we want to look at neurotransmitters. It’s a long list of things that trauma does to the body because it literally affects every single system. The immune system absorbs all of this trauma burden that the body has gone through.
When we look at then, how do we help people, so, what’s our path out of this, Ari, we have to bring in this biology piece that’s keeping people stuck because if they just try to go and reframe your childhood, “Reframe your childhood, Ari. Like, write a different story about it,” or, “It’s just mindset over feelings. It’s just a matter of changing your thoughts, or doing your daily affirmations, or meditation, or yoga,” okay, and what about your inflammation? What about the digestive system? What about your mitochondria?
We need to find what are those pieces for you that are keeping your nervous system stuck in trauma because if you did not have those pieces, and if your body really had all of the cellular resources that it needed, it would have already worked through this and healed already. Something is blocking it in your biology, and that’s what we got to go find out. Where I start with people, is I start with bodywork, and I start with building this connection from what has become a place of disconnect. Many people don’t realize how disconnected they live their everyday life.
This is just always how they’ve done it perhaps, or it’s just developed over time, and they don’t realize how disconnected they are. I start with 21 days of somatic work or bodywork, and then we reach our capacity with that. This is what every person will experience, no matter what modality they’re using. They may see a temporary relief or a temporary change and effect, and it either won’t stick, or their [inaudible 00:57:30], and that’s where we need to talk about the capacity. The biology is what is going to be inhibiting their capacity and be able to increase their capacity for that trauma.
Ari: Beautifully said. I’m curious if you have any thoughts on psychedelic-assisted psychotherapy.
Dr. Apigian: I have lots of thoughts, Ari. I see psychedelics as a tool. Like many things, there are many tools for the trauma healing journey. What I like to do, and what I feel is my responsibility in my role in helping people heal is to know when to use that tool. When is the best time to use that tool? Certainly, like many other tools, it’s not wise to start with that tool. The body may not be ready. If you go on a psychedelic trip, and you really go deep into your body, if it wasn’t actually ready for that level of connection, you’re almost going to be setting yourself to move into self-sabotaging biology later on because it wasn’t ready for that piece.
So much of what I do and I bring to people is helping them understand when to use these different tools in a way that is truly informed by the biology of trauma and how to pull ourselves out from where it’s gone.
Ari: Beautiful. Dr. Apigian, I would love to talk to you for another hour, or two, or three. I know you have to go. Thank you for cutting into your meeting that you were supposed to be in seven minutes ago. I really appreciate your time. This has been a lot of fun, and thank you so much for sharing your wisdom with my audience. I hope that we can do another podcast or two in the coming months. I’ve really, really enjoyed talking to you, and I’m very impressed with not only the knowledge you’ve accumulated but the way you’ve put everything together in this paradigm, and the way you explain it.
It’s really beautiful, and I’ve really enjoyed this. Let people know where they can connect with you, where they can follow your work, and get in touch with you if they want to work with you, or how they should go about doing that.
Dr. Apigian: Right back at you, I look forward to continuing this conversation, and picking it up at another time. They can find me at traumahealingaccelerated.com. That’s what I do. I help accelerate the trauma healing journey, and so that’s where they can find us. Then we’ve got the Biology of Trauma Summit coming up in August, and that’s going to be a huge resource for people if they’re curious about this. That would be a great place to start in looking at all of these different pieces around the biology and where to start with addressing that piece.
Ari: Beautiful. Thank you.
Why trauma is your biology and not just your psychology (02:07)
Why trauma is an energy problem (04:22)
Where is trauma coming from? (17:11)
How early childhood can cause trauma (23:34)
How childhood experience can affect parenting and why (43:43)
How trauma can affect your physiology (51:32)
Psychedelic-assisted psychotherapy (57:52)