Is It Possible to Truly Heal From Trauma? with Dr. Jim Gordon

Coming up on this week's episode of the Doctor's Pharmacy.

You have to have compassion for yourself if you're reaching for the chunky monkey after something terrible has happened. But then at a certain point, it becomes necessary, if you're going to heal from the trauma, to begin to reverse some of those dietary choices.

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This is Dr. Mark Hyman. and this is Doctors Pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. And today's conversation, I think, is going to matter to a lot of people because it's about trauma. And it's one of the most extraordinary men I've ever met who's been a friend for over 20 years, who I first met when he was the chairman of the Commission on Complementary and Alternative Medicine under President Clinton, where I actually was a very green doctor testifying about the benefits of functional medicine way back when. Jim has been an inspiration to me ever since because he's one of the guys who, when there's trouble, he doesn't run away. He goes right towards it. He's like the firefighter who goes into the burning building. Whenever he's running out, he's running in. And he's done some extraordinary work, particularly around trauma. And today we're gonna talk about trauma and his new book, Transformation: Discovering Wholeness and Healing After Trauma. Jim's a Harvard-educated psychiatrist. He's a world renowned expert in using mind-body medicine to help heal depression, anxiety, post-traumatic stress disorder, and psychological trauma. He's the founder and executive director of the Center for Mind-Body Medicine, and I'm on the board. And he also runs extraordinary courses called Food is Medicine and Mind-Body Training Programs for Health Professionals. And he's just an extraordinary guy. He's created really groundbreaking programs for for doctors, for medical students and health professionals. He's created programs for helping people with cancer, depression and chronic illness. And he's gone into some of the most troubled areas in the world over the last decades, doing extraordinary work, bringing healing and understanding in areas of severe trauma. And I'm talking about a little trauma. I'm talking about bad trauma. People who were living in the ravages of the aftermath of the war in Bosnia, in Kosovo, Israel. He goes to Gaza where there's Palestinians and Jews bringing them together to heal trauma. He goes to Haiti after the earthquake. He's worked with Syrian refugees in Jordan. He's gone into post 9/11 New York and dealt with the trauma of survivors of that. And he's also gone into Katrina in Louisiana where Katrina was really devastating to that community. He's also gone to the Pine Ridge Reservation and worked with Native Americans where suicide rates were off the chart in youth and has dramatically reduced that. He's worked with veterans in the military. He's published papers on his work in major journals. And he's also the author of a great book called Unstuck: you: Guide to the Seven Stage Journey Out of Depression.

So, Jim, welcome to the Doctors Pharmacy.

Thank you, Mark, and thank you for that introduction. So, it's great to be here and to be with you. Yeah, well, Jim, your work is pretty important. And you've taken on something that very few people really have had luck with. Trauma is extraordinarily common. In your book, you talk about the fact that 60% of adults have experienced trauma in their life, that one in four kids have experienced abuse, and that in this society we're seeing the effects of that, the opioid epidemic, the increasing rates of depression, anxiety, the post-traumatic stress disorder, the violence, the mental illness, the shootings. I mean, it's just devastating to our society. And the conflict we experience as a result of it is one of those things that is just really troubling to me. And also it's troubling to the medical profession because we don't have a real clear pathway to fix it. And yet your work is really groundbreaking. It's something different. It's something really that goes to the heart of what's at the root of the trauma and has been successful in places where nothing else has worked. And that's what's so important about your book, because you've been out there doing the hard work. You've been in Parkland after the shootings. You've been again in Haiti and Gaza and all these places. doing the hard work and you took a little time out of all that global traveling to actually write this book and share what you've learned and share the methodology and share a pathway for people who are suffering, which is probably most of us in some way or another, to actually heal. And this is a great gift. So I encourage everybody to check out the book, Transformation.

It's actually the Transformation.

The Transformation.

My editor said, you have to add The transformation.

Discovering wholeness and healing after trauma. So I want to start off by asking you, how did you get into this? Because most people, they think there's an earthquake or a hurricane, they're going the other direction. You're going right into it.

Well, I think it's part of being a doctor. When I became a physician, even as a young kid, I wanted to be helpful to people. And I wanted to be there when people were going through difficult times. That's really what we do as doctors. we're an ER physician for a long time. So you know that. And there's a certain real satisfaction that I think all of us have in being useful to other people. As a doctor, we have the great privilege of that we even get paid to be useful to other people. And so to be there, I recognize really from the beginning as a medical student that I'd like to be there with people when they were going through crises. and that by listening to them and then helping them to find solutions, I could really make a difference in their lives. So that's how I got into it. I got into it from right in medical school. I think the thing is that we have to understand is that some of the examples you gave of the places we work, the trauma is very dramatic. It affects the whole population and trauma is going to come to all of us. if it doesn't come early in life, it's going to come in midlife with illnesses or divorce or difficulties losing a job or, you know, issues with wondering who we are. And if it doesn't come then, it's going to come if we're lucky enough to get older as we grow older and become frail and deal with losses of people and deal with our own death. That's traumatic.

So you basically have taken the things you've learned from going to places with the worst trauma, I mean, in war zones, in disaster areas, where people have really suffered extraordinary loss. And you've taken that insight, which has worked when nothing else has worked, and you've brought it into a way that everybody who's dealt with some level of trauma can heal.

That's exactly right. And what those people do, and what I show in the transformation, is that these people who've been through these extraordinarily difficult times are able to move through and beyond the trauma. And that's been obviously important to them, but also inspiring to me to see that the simple techniques of self-care that we teach them and have group support can make it possible. And I hope it will be inspiring to other people because I keep, I'm constantly amazed at what human beings are capable of in terms of helping and healing themselves and reaching out to others.

It's so true. And you know, you're a Harvard trained psychiatrist. worked at the National Institutes of Mental Health, the tools you got were medication and talk therapy. And while talk therapy can be helpful and medication can be helpful sometimes, you found that they really weren't enough and you developed a whole different way of thinking about how people can heal. It seems to be far more effective. Can you talk about how you came to that and what that is?

Well, I think right from the beginning of my work, even as a medical student, I was always interested in what people could do for themselves to help and heal themselves. how their way of looking at the world and the things that they discovered for themselves could help and heal them. And then once I began to work at the National Institute of Mental Health, I got very interested in what we then called holistic or alternative or integrative medicine. And I began to explore all these different approaches. First for myself, meditation and guided imagery. I learned guided imagery from Ruth Carter Stapleton, Jimmy Carter's sister in the '70s.

Wow.

I was learning meditation from different teachers. I started looking at Chinese medicine, which I practice, I was learning how if I used my body with Tai Chi or yoga, I would feel much better and how if I ate differently. So I experimented with all these things on myself first, and then I began to share them and to develop a comprehensive program that I could share first with my patients in my practice and then with whole populations that have been traumatized. And it's an approach that is really educational and respectful. It's saying, We have this extraordinary capacity inside ourselves, which you know so well, that we have the capacity to change our brain chemistry, to change the way our GI tract works, to change the way we look at the world. So why not mobilize that capacity first and be there for people to help them move along this path, either in person or through a book like the Transformation?

Now, one of the things that's so striking about your work is that You can use these tools one-on-one with people and they can be effective. And we're going to talk about some of those tools. But what you found is that when you put people in groups, when you get people to reveal themselves, to have a safe and sacred space to tell their stories, to confront the feelings that they have, to actually have tools like drawing and dancing and shaking and talking and all the music, I mean, just stuff that's not, I mean, what psychiatrist gets up with their patients and starts shaking and dancing? I mean, it's a kind of a.

Weird thing, but it seems to work really well. Well, you know, if the psychiatrists were doing it more themselves, they might want.

To share it with their patients. It's true. But what's so amazing is that when you put people in these groups, it's the group is the medicine, the community is the medicine, and that creates a lot of the healing. So can you talk about how you went from the one-on-one psychiatric model to this group model, which you use to train healthcare professionals, you use to train trainers who can then lead groups in their countries, you use it to work with people in areas of great suffering. Yeah, and now we're actually doing groups.

We're training many peer counselors. We're training veterans to use this model that we're talking about with other veterans. We're training teenage kids at Marjory Stoneman Douglas High School in Parkland, where the shootings were. we're training the peer counselors there to use our model with other kids. So the group is really important. We have forgotten that in medicine. All of our colleagues from aboriginal societies, all the indigenous people around the world-.

All our medicine men colleagues. Yeah.

They know that the group is vital. When you have a really serious physical or emotional problem, they bring people together. When you're going through a difficult time, that connection with other people is so important. So all the techniques are crucial to the healing. And it's also the other part of it that makes it so much richer is being able to share what you're learning with other people. And I advise in the transformation, although I teach all the techniques, I'm also saying, and connect with other people, reach out. when you're doing meditation and guided imagery and it comes into your mind, oh, I should call up my brother or my sister or my aunt or my friend, pay attention to that and reach out to that person and share what you're going through with that person. It's true.

You know, it's in your book, you talk about, you know, the Medicine Man and the shamans, you said, you know, the timeless wisdom of the shamans, who are planet's oldest indigenous healers, and great spiritual and religious traditions tell us that suffering is the soil in which wisdom and compassion grow. These are your words. It's the school from which we graduate committed to healing others' hurt. And you also say that recent scientific evidence bears this out. And so we tend to shy away from suffering. We tend to be afraid of suffering. We tend to kind of try to push the pain down or look away. But in a way, it's the pathway to Compassion, awakening, fulfillment.

It is. Yes. And that comes both out of traditional wisdom, also comes out of my own experience. It's not that I'm choosing to suffer.

Yeah.

And when I have- Oh, we're Jewish.

It'S part of the thing.

But even if you're not Jewish, it's going to come whether you- no matter what your religious persuasion, it's gonna come. And the question is- oh, we like to suffer. Are you gonna fight against it? Or are you gonna accept what you can learn from that suffering? And often what the suffering does is it breaks down some of the structures that were working. And it almost always, if you're willing to pay attention, opens your heart, because your own suffering makes you much more tender toward other people who are also suffering.

Yeah, it's true. You know, 25 years ago when I got very sick from mercury poisoning, I had chronic fatigue, I could barely function. I was so ill. And in that process, I began to understand what other people suffer from. And it allowed me to be a much better doctor because when people came in complaining of all this weird stuff, I didn't think, oh, they were crazy. I thought, wow, they're really suffering. And it's my job to figure it out and to make it safe for them to tell their story and to give them a path to heal. And for me, as a physician, I really wanted to heal myself, but also it drove me to learn as much as I could about how to heal my patients.

Yes. That's beautiful. And that should be in some way part of every physician's education. I think one of the problems for physicians is they try to keep themselves, hold themselves back from the suffering. We need to experience our own suffering so we can be present with other people when they're going through really difficult times.

Historically shamans and medicine men usually came out of some trauma.

Exactly.

They went through some horrible experience that then led them to have this awakening and be able to be healers.

And if they didn't have it on their own, the shaman who picked out a young person who might be appropriate to be the next shaman would create some kind of ordeal so they could really discover who they are, what's possible for them.

So let's go into what is trauma and what are people experiencing and how is it the same or different than post-traumatic stress? or PTSD?

Well, trauma is a Greek word, first of all, and it means injury, injury to the body, mind or spirit. Post-traumatic stress disorder is a diagnosis in the psychiatric diagnostic and statistical manual, and it consists of a whole constellation of symptoms. As I said, everybody is going to experience trauma sooner or later, and the transformation is written for everybody. Included in that group are the percentage of people who experience what can be diagnosed as post-traumatic stress disorder. So after something has happened that is devastating to them in some way, and what that something is is different for different people, they manifest a whole bunch of symptoms, including anxiety, agitation, difficulty focusing, irritability, that's one set of symptoms. They become preoccupied with what happened to them before. They have nightmares and flashbacks of what happened.

Panic attacks.

Panic attacks are part of the first set.

Yeah.

If you think about trauma and post-traumatic stress disorder, what you have in post-traumatic stress disorder is a prolongation of responses that are potentially life-saving but that are meant to be turned on quickly and turned off quickly. So the fight or flight response. We all need the fight or flight response to deal with threatening situations. But if it goes on, if after the traumatic event, your heartbeat is still going fast, your blood pressure's up, your muscles are tense, what's going to happen is you're going to get irritable, you're not going to focus well, you're not going to sleep well, you're going to be sort of aggressive and fearful all the time. that's because fight or flight's continuing. Another set of symptoms that happens when we're traumatized seriously is what's called the freeze response. When we shut down, and that's shaped by another part of the autonomic nervous system, fight or flight is what's called, as you well know, the sympathetic nervous system. The freeze response comes out of the oldest part of the parasympathetic nervous system. So when we're completely overwhelmed, for example, if there's an assault or we're in the middle of a war or there's a hurricane and we can't leave our homes and we can't get away, we tend to shut down and withdraw and close ourselves off and resist the situation that's going on. That can be helpful in the immediate situation because we put out endorphins, it numbs our pain, we don't have to deal with the full psychological impact. But if that continues for weeks and months, we become somebody who's kind of- A shut-in.

Shut-in, yeah, exactly.

Shut-in, our bodies shut down, we don't trust other people, we can't connect, and that's because parts of our brain that make it possible to connect with other people have shut down.

So literally it's not only a psychological problem, it's a physiologic, biological problem.

Absolutely. There are major biological changes that come with trauma, and with post-traumatic stress disorder, those changes continue and they make us the part of the diagnosis that we're no longer functional the way that we were. So when I see the kids, you mentioned Gaza, the kids in Gaza after a war, they can't concentrate in school. They're just, you know, kids who are A students start to fail in school. Same thing is happening. This is not just the Palestinian kids in the south of Israel where rockets are coming from Gaza. many of those kids are in the same kind of situation after the war is over. So it's an ongoing biological problem. And what we have is hyperstimulation of the parts of our brain that are responsible, amygdala is one of the parts of the brain and the emotional brain responsible for fear and anger. And a subduing of the parts of our brain, for example, in the frontal part of our cerebral cortex, parts that are responsible for good judgment and self-awareness and self-function. Yeah, and they shut down. So you're irritable, you're angry, you're fearful, and you can't think straight. It's a very difficult situation to be in. And it's not that you're a bad person. It's not that you, even though it's diagnosed as a disorder, it's not like you've got a disease that's gonna go on and on and on.

It's like a broken record, you know?

Exactly.

So you get into a, you get initially a scratch and then you just stay in that loop and your methodology helps people break that loop. And the transformation, the book is really a pathway for people to start to break that loop.

Exactly. And one of the central parts of that, you're right, you're stuck in the past. It's as if the war is long over, the assault is over, the, you know, somebody who died, died a couple of years ago, but it's still as if you're there in that moment. you're stuck in that previous moment. And you're worried also that it's going to happen again. So you're stuck between the past that you can't do anything about and the future that you can't do anything about. And a major part and a beginning part of the work we do is bringing people into the present. Meditation is the time honored way to bring us into relaxed moment to moment awareness of what's happening to us right now.

And you have people use the breath, the soft belly breathing, which is- Soft belly breathing.

We can do a minute or see what we can teach. This is the techniques. I was doing a workshop with a number of traumatized people this weekend and somebody said to me, and as I was teaching many techniques, she said, this is not always easy. I said, no, it's not always easy, but it is simple.

Right.

And soft belly breathing is just As you know, because we've done it together, it's just simply sitting quietly and closing your eyes and breathing in through your nose and out through your mouth.

Don't close your eyes if you're driving.

Don't do this while you're driving. And just breathing deeply in through the nose, out through the mouth with the belly soft and relaxed. And focusing, this is technically a concentrative meditation. and we're focusing on the breath, on the word soft as we breathe in and belly as we breathe out, and on the feeling of our belly being relaxed. And as we do this, more air is going to the bottom of the lungs, more oxygen is going to all the cells in our bodies and helping them to feed them and helping them to be healthier. and we're activating the vagus nerve. V-A-G-U-S means wandering in Latin.

Not Las Vegas. But what's that? Not the Las Vegas nerve.

Not the Las Vegas nerve, the V-A-G-U-S. And that nerve is the antidote to the fight or flight response. And it quiets activity in the amygdala, the center of fear and anger in the brain.

So we have pathways to actually access different parts of your brain. And these are the techniques you teach and they really work.

Exactly. It's all grounded in our biology.

And there's a lot of great science behind this.

Yeah, the science now is showing that meditation, simple techniques like soft belly, can not only help the brain to function better and more effectively and help us to integrate parts of the brain like the left and right hemisphere, that have been disrupted with trauma, but also we can build new brain tissue. We can decrease the amount of not only activity, but tissue in the amygdala, the fear and anger center. We can increase the amount of brain tissue in the hippocampus, which is responsible for memory and modulating the stress response, and we can increase brain tissue in the frontal cortex in those areas responsible for self-awareness and judgment and compassion.

You literally can grow new brain in the right spots and you can calm down brain that's overactive in the wrong spots. Exactly.

It's unbelievable. Exactly. And there's lots of science, research done at Harvard, Sarah Lazar, Breda Holzel, research done at University of California, San Francisco, more and more. Look, if meditation were patentable and profitable, every physician on the planet would be prescribing it for every patient who walked in their door.

It works so well. I mean, for me, it's been transformational. We've had many podcasts about this, but it's like, you know, right up there.

Is food is medicine, meditation is medicine. Exactly. And it is, and it should be basic. We all, and don't wait for your physician to prescribe it. Hopefully more physicians are learning, but it's.

There, it's free, it's available to everybody.

So true.

Now, you talked about the biological effects of trauma, but what's really frightening to me is some of the new data about the epigenetic changes that happen, which is generational effects of trauma. So, if your grandmother had trauma, that trauma can get transmitted as marks in your genes that can affect your biology, which is pretty mind-blowing, but also frightening.

It is scary. That's the bad news, if you will. The first thing about those epigenetic changes. And the changes are not, it's not like the biological mutations caused by x-rays. These are changes.

It's not a mutation, it's just a tag that regulates whether your genes are turned on or off.

Exactly, and the ones that we're particularly concerned about are the ones that help us deal with stress that get turned off by trauma. And yes, that does get transmitted from generation to generation. We've seen that in animal experiments, and in studies also, Rachel Yehuda's studies of Holocaust survivors. And those grandchildren, even when they're separated, this is not a social interpersonal transmission, it's a deep biological transmission. So that's the bad news. But the first thing is to become aware of the trauma that you're having and of some of the distress you're having. And particularly if you're having distress that you can't explain easily. For example, if you're always suspicious of other people, or if you're too easily rattled in situations, then it is possible that trauma may come either from historical trauma, that is the trauma that people have experienced socially that's transmitted, or it may be coming from these epigenetic changes. So it's important to become aware of that possibility. The techniques that we're talking about, the techniques that I describe in the transformation, can reverse those epigenetic changes. And research is coming out now, for example, on the effects of meditation in reversing those epigenetic changes.

The bad news, if your ancestors were traumatized or slaves, it's going to get transmitted. The good news is you can fix that.

Exactly.

Exactly. That's amazing. That's amazing. Now, there are two common and dangerous misconceptions that you talk about in your book about trauma. What are they?

Well, the first is the trauma just comes to those other people, that it comes to people who've been in a war or people who've had the most brutal and callous childhoods. Well, it does come to those people. And as I said a little bit ago, it comes to all of us. comes to all of us sooner or later. So it's not-- so if you're not.

Traumatized, yeah, just wait and you will be.

That's true. It's gonna come. And it's a pretty good idea to laugh about it too. And that's one of the ways that people historically have learned how to deal with trauma. And we need to bring that back. That we need to be able to look with a little humor. This is part of being human that it's gonna come to us.

How do you become more resilient is really what you're-- teaching everybody.

So that's the first thing, the myth that it only comes to people in the most extreme situations. The other is that if it comes and it happens to you, it's going to be there for your whole life. You're going to need constant treatment for it. And that's what it's not treatable, really.

That you can manage it.

That's right. It's just utterly untrue that what we've seen again and again using the methods that I describe in the transformation, is people with frank post-traumatic stress disorder, diagnosable by the Harvard trauma scale, by other trauma scales, that those people in the course of working with us and learning the techniques in the transformation are able to shed that diagnosis. They no longer have PTSD. Now, sometimes that can happen quickly. Some of the kids, for example, that we work with who've lost their families in a war, within 10 or 12 weeks, the trauma is gone and seven, 10 months later, it's still gone. And they're really extraordinary. They're quite resilient. They've had good childhoods. So even though they've suffered terrible losses, the death of family members, destruction of homes, they're really not only back to normal, they're in better shape in many ways than they were before the trauma happened. Other people, those of us who've been seriously traumatized early in childhood, who've had ongoing really difficult issues, it's going to take longer. And I think it's a question of being patient, but the same methods can work whether the trauma came early and was overwhelming or whether it came more recently in our lives.

You know, what's sort of interesting about your work is that you've had to go out there and get it funded through philanthropy and support. You've maybe got a few grants, but if it were a prescription pill and it worked as well as this, it would be a multi-billion dollar blockbuster.

Yes, it would.

And it's not well reimbursed by insurance. It's not well recognized by the field. And yet, the traditional treatments we have are not effective. They're just not. You can give people drugs to manage anxiety and antidepressants and any anxiety drugs. You can do therapy. unless you understand that this is a different kind of thing that needs a different approach, it's hard to solve.

It is, but especially in the beginning, but now that we have so much research on the approach, and now that people are beginning to realize the limitations of the other approaches, which certainly can be helpful, but they're recognizing that there's something more is needed. And then beyond that, Our approach can work with people who don't have the capacity to pay for somebody that they can see psychotherapy on a regular basis.

Sure, and also you just mentioned that you can train peers. It doesn't have to be a psychiatrist with a degree from Harvard. It can be just your friend who's learned a few skills about how to lead a group that's right. And guide people through these methods which are accessible, free and simple.

And we can work on a large scale. And this is really important that the method that I'm teaching in the transformation can work pretty much for anybody. Doesn't require any major level of education at all, doesn't require that you be a particular age. You can teach these techniques to little children and they can use them extremely effectively.

So break it down for us in the transformation in your book that's coming out September 10th. What is the method? What are you teaching?

Well, we're teaching a way, we begin by teaching a way of looking at the world, which is what we've been talking about up till now, which is essentially that it is possible for each person, each person who's reading the book, for each of us to learn what we need to learn to help and heal ourselves. That's the beginning. And so I tell some stories in the beginning of people who have done precisely that. So that's the first thing that you have to believe it's possible. and that you don't have to have years of psychotherapy and you don't have to have lots of pills to do it. That for most people, perhaps not everybody, but for most people, this is the fundamental method. And that's what I'm presenting. So that's the first thing. The second thing is that the method teaches you by your own experience. So we did soft belly breathing, and I don't know about you, but even doing that for a few minutes, yeah, I'm relaxed. Yeah, that's so good.

I'm not stressed anymore doing the podcast. I can just chill.

So if you do that for five or 10 minutes, you don't need me to convince you that it makes a difference. So right from the beginning, I'm using techniques that people can, yes, there's scientific evidence and people should look at the scientific evidence, but they experience it. So the first one we use is a soft belly breathing. And then we work with and people understand, oh, okay, I can quiet myself. And that generalizes, because not only do you feel quieter, but your mind understands that you can make, I can make a difference in how I feel, and if I can make a difference in one way, then maybe I can make a difference in other ways. So that's the beginning. Second technique that I teach is working with drawings. And you don't have to be an artist, and there are no grades, and nobody's looking over your shoulder.

I have my main trauma in life, Jokingly, is my art teacher in eighth grade failed me in art, even though I did all the assignments. I tried really hard. I showed up. It was the most traumatic thing in my life at that point. And I still suffer from that trauma because when someone asked me to draw.

Something, we'll be taking care of that one.

Because you're not- Mr. North, I still remember him like it was yesterday.

But you're not the only one. I had a similar- and so many people have. I mean, which is, I mean, that's a whole other topic about what's going on in education.

Oh, boy.

We should be encouraging kids to be creative. So what I do is I have people do three drawings. First drawing is draw yourself. And it doesn't have to be representational. Don't get nervous. Stick.

I do a stick man.

Yes, of course. Stick figures. Abstract. I mostly do abstractions. So you start getting out of that, dealing with that old drama of the art teacher, and you start mobilizing your imagination. The second drawing is draw yourself with your biggest problem. And what that helps people to do is to begin to identify something that's going on that's troubling them. And by getting it out on paper, it takes away a little bit of its power because you have a little bit of control over it. You're putting it out there. And then the third drawing is to draw yourself with your problem solved. And sometimes people will say, I don't know. I can't. There's no way to solve it. I wouldn't be here. I wouldn't be reading your book if I could solve the problem. I said, Just do it. See what happens. And most often something appears on the page. And people will say, well, I'm not sure it can really happen, but at least the idea is there. For example, we work a lot with refugees from wars. And one of the things that they draw, the biggest problem is their home has been bombed, they're living in a refugee camp, that's what they draw. Problem solved. They're often drawing themselves back home in a new house. They say, I'm not sure this can happen, I sure hope it can. And I say, put it on the wall of your tent. And they do, because that's the goal toward which they're going. And the same with those of us who are here, whether our biggest problem is, you know, we've lost somebody who's dear to us. Maybe in that drawing, let's say we've lost a spouse or we've lost a parent. In that drawing of the problem solved, people will spontaneously come up with, oh, I can be with friends. I don't have to be so lonely. The problem, biggest problem, is my loneliness, my sadness. And then they draw on the third drawing, and all of a sudden other people are appearing in the drawing, or maybe they're drawing themselves in nature and being in nature is going to help them deal with their sadness. So they're, and it's coming from them. It's not coming from me telling them how to solve their problems. They're making those discoveries. And so each time, each chapter in the transformation teaches another technique, another way to help people understand and move through their trauma.

It was really fascinating to me that you talked about the trauma healing diet. And I don't think most people would think that food and trauma have anything to do with each other, but you say they do. Can you explain it?

Well, part of the problem is that it's exactly what you're saying, is that people don't understand it. And I've never seen a book on trauma that talks about the importance of diet. So I wanted to make sure that I did that.

I thought it was brilliant, but I mean, I all about food is medicine, but even for me, it's a stretch. How does that help?

Well, but you have to think about what happens when you're traumatized. When you're traumatized, it's not just the brain. I mean, most of the research and most of the discussion focuses on damage to the brain, which is real, but it also damages our gut. So, for example, from the top to the bottom. So we become more anxious and we eat foods to deal with our anxiety. That's what happens when we're traumatized. Just as all many of the people who come to see you are in that place. Second of all, we're eating fast. So we don't have time, the stomach doesn't have time to do its job. Third of all, the stress and comes with trauma causes problems in the small intestine. So we start the villi.

You had leaky gut.

Yeah, and leaky gut. Exactly. So the The endothelial cells, the cells that line the small intestine, start opening up and all kinds of proteins that don't belong in our bloodstream start leaking through.

You get food sensitivities.

Yes, so you get sensitive to things you were never sensitive to before.

That creates inflammation, which further inflames your.

Brain and inflames your emotions. Exactly, which in turn affects the gut, which disables the gut more and it's a vicious cycle. So that's, the damage the trauma does.

And there's really great data now how your microbiome plays a role in anxiety.

And depression and many mental disorders. Exactly. And trauma disrupts the microbiome and promotes the growth of the pathogenic, the bad bacteria, and depresses the growth of the good bacteria. And we were talking about the vagus nerve earlier. The vagus nerve is responsive to the microbiome. So if the microbiome the bacteria in the gut is disturbed, then it's going to affect the vagus nerve, which is not going to be sending the same positive, creative, brain stimulating signals back to the hippocampus and the frontal cortex that it should be sending. So the gut is having a major effect on the brain. True.

I've noticed this. I wrote this book years ago called the UltraMind Solution, which was I was noticing in my patients when I would treat their physical issues in their gut, their emotions would get better, their depression would get better, their anxiety would get better, their in fact panic attacks would go away. And I was like, what's going on here? Because I wasn't treating those things, I was treating other problems they had that were, quote, unrelated, but it's all connected.

There's a whole body connected.

Yeah, what do you know? Maybe we should start something called functional medicine where it connects the dots.

But this is, yes, of course, and this is the ancient understanding that we were reviving in the light of modern science.

Yeah, it's true. It's so true. So, you know, one of the things that sort of strikes me is that, you know, you're so courageous and brave to go into these places where, you know, there's still so much trauma going on, like in Gaza. That always struck me. You're bringing Israelis and Palestinians together, people who often hate each other or who've literally had their family members killed, the other family members, or vice versa. And even in that level of trauma, you've created healing. And you talked about a story in the transformation in your book about a young girl, Azar, who you met in a Gaza neighborhood, was bombed in the rubble in the 2014 war with Israel, and her father was killed in the war six months earlier. And you led this group that helped this young girl heal? Can you talk about that?

Sure. And then at some point we ought to come back to some of the elements of the trauma healing diet too.

Okay. All right, all right. Yeah, I want to, well, yeah, we'll actually talk about this girl and then we'll come back to the food part.

Want to talk about Azar first? Yeah. Okay, so Azar is a nine year old Palestinian girl living in Gaza. And during the 2014 war, it was her father was killed, her two uncles were killed, an aunt was killed, and her home was destroyed. And she came into one of our groups, and I wasn't leading the group. The group was being led by a Palestinian teacher who was leading the group for eight kids, all of whom had lost their fathers in that war. And Azar came into the group, and when she did her first pictures in the first group, what she drew as the solution to her problem was that she was in the grave with her father. And when I asked her, she said, the answer to my problem then was for me to die and be with my father. And because there's no reason for me to be alive. That was the most important thing she was saying I could do. This is very striking because it was five, six months, as you said, after the war was over. So nothing had changed. He came through a group with these eight kids. led by a Gaza school teacher. She learned soft belly breathing, she learned work with the drawings, she did shaking and dancing, she used guided mental imagery, she used some written exercises because she could write. And after nine groups, when she drew her drawings again, first of all, instead of drawing herself as this tiny little stick figure with the mouth turned down, She drew herself as a big girl with her brown curls and a skirt, and there was an arrow coming from her heart through a heart that she'd drawn on the page saying, I love nature. And the arrow was headed to this beautiful tree with leaves. So that was who she was now instead of this little tiny stick figure. And then when we asked, okay, and who would you like to be, which is sort of equivalent to having your problem, the solution to your problem, she drew herself with a stethoscope in her ears and the resonator of the stethoscope on the chest of someone who was lying on an examining table. And I said, Azar, what's going on? She said, I am a heart doctor. And I am, this is what I want to be. I want to help people and I want to heal their hearts. And I said, well, who are these five people? She had five other figures standing there. Who are those five people? She said, There were a lot of people in Gaza who had their hearts hurt. I want to help them all, and they're waiting for me to see them.

All right.

So this is what can happen. And nobody was saying to her, oh, Azar, you shouldn't be thinking about death, or Azar, you should be a good girl, or you should focus on school. She was making these discoveries herself using the techniques that are there in the transformation.

It's not like you're hitting people over the head with a hammer. They're discovering this on their own.

Exactly. The job, my job, whether I'm leading a group or writing the transformation, is to create the opportunity for people to make those discoveries and just to be there for them, whether in person or in print, to encourage them to do that. We all have that capacity that she has.

Yeah, interesting. You know, I just reminded me of this book, read probably you read it 30, 40 years ago, Gris for the Mill, which is written by Ram Dass about all the stuff that's tough in life actually is good stuff when it's used to wake you up, to bring that transformation. The transformation.

-Exactly.

-And it's such a great gift that you're giving people and it's done in a way that's not hitting them over the head with a hammer. It allows them to do this through this process of self-discovery. It's done in community, which in a way being witnessed and witnessing is a powerful, powerful way of creating healing.

Yes, exactly.

Okay, so let's go back to the trauma healing diet because, you know, we talked about it in general, but what can you eat to help your trauma?

Well, most of what you can eat are exactly the things that you and other people who are doing functional medicine. That's good. teaching.

I mean, it's really- It's not ding.

Dongs and cupcakes and- well, that's what we go- that's important because that's what we go to when we're traumatized. Comfort to, we go to the ding dongs, the cupcakes, the mac and cheese, the pint of ice cream.

And- Chunky monkey, that's my go to.

And there's a reason for it, because it lowers the level of our stress hormones immediately. It increases the levels of dopamine and serotonin increases endorphin.

So we feel- Momentary pleasure. We feel, I'm sorry, momentary pleasure.

Exactly. And if we feel better for a while, the problem is that after a while, all those effects get reversed. So you have to have compassion for yourself if you're reaching for the chunky monkey after something terrible has happened. But then at a certain point, it becomes necessary if you're going to heal from the trauma to begin to reverse some of those dietary choices. And essentially, the rules are very simple. The first rule, I would say, or the kind of secret sauce in this new diet is mindful eating, eating slowly, paying attention to how things taste, paying attention to the food choices you really want to make once you've cleaned up your diet a little bit. that's working on what, you know, what the researchers call the cephalic phase of digestion, the brain, our mind. So we need to approach food a bit differently, slow down instead of just putting it in.

Eating unconsciously.

Exactly. Eating unconsciously, which is what we do. And especially when we're traumatized, we reach for that comfort food. So eating whole foods, eating organic food, eating much more fiber. we want to nourish the microbiome that I suggest in addition to fermented foods, all the things that you would suggest to patients who are dealing with chronic conditions, I would say are even more important when people have been seriously traumatized because as we were saying earlier, the gut is leaking.

You heal the gut, you heal the brain.

Exactly. So for example, I really recommend the importance of fermented foods. I also suggest that people take probiotics for several months after while they're dealing with trauma, shifting the kind of protein that they eat, obviously eating much more fish and much less red meat, which is pro-inflammatory.

Yeah.

Also suggests supplementary omega-3 supplementary fish oil, because that's important for brain healing and gut healing as well. Fiber is perhaps even more important than it is with more chronic conditions. because it's feeding the microbiome, which in turn is stimulating the vagus nerve in appropriate ways so that the brain functions properly.

We used to call it fiber, now we call it prebiotics.

Those too. Which could be called food too.

Yes, absolutely.

Food, vegetables. So that's the kind of diet. Paying attention to other things that you may want to add to that diet, for example, turmeric, which I know is something that you use as part of your work with chronic illness. It's perhaps even more important after trauma because inflammation is an extremely important part of what trauma does. It promotes inflammation, promotes inflammation everywhere in the body.

In the brain too.

In the brain too, which causes symptoms are depression, anxiety, difficulty focusing, irritability, all of those things are compounded by the damage that's been done to the gut. So if we begin to come back into balance through eating this appropriate healthy diet, we're going to be in better shape. The other thing is that it would also be important to use a high dose multivitamin multimineral. In recent years, there have been some studies done initially in New Zealand after the earthquake there, randomized controlled trial, population trial, using a multivitamin multimineral versus a placebo for people who'd been through the earthquake. And those people who took the multivitamin multimineral, and these people didn't even change their diet particularly, but just taking the multivitamin, magnesium and the healthy mineral helped to reduce the symptoms of post-traumatic stress. They were less anxious, their mood was better, they were able to focus better.

So that's an important- yeah, it's fascinating. I remember reading in a paper years ago about Kosovo where you worked, and they found that people who were in the war zone had much higher excretion of magnesium. And magnesium is what we call the relaxation mineral. It helps you calm down to sleep, to relax your muscles, your nervous systems, helps with anxiety. And all the stress we have causes all this chronic magnesium loss. It increases vitamin loss. And so we can actually help to fix that by replacing some of these nutrients.

Exactly. And it's vitamin loss at a time when we need them more because when we're under stress, we need higher levels of many nutrients. So that's why it's important to supplement even in the healthy diet with those, with the supplement with supplements. Yeah.

So, you know, one of the things, you know, we often feel in these situations is that our emotions are our enemy, that we don't like to feel the emotions that we're feeling, whether it's anxiety or fear or irritability. And we actually have a negative relationship, but you talk about this concept of befriending your emotions and how important that is in making them your partners in healing trauma. So can you explain that?

Sure. You know, fighting against our emotions is a fool's errand and trying to suppress them, which of course our culture too often tells our parents, the society, no, suck it up, go ahead, forget about it. The show must go on. Don't cry. I'll give you something you really cry for. All the things that are told to children and adults make us shut down our emotions. And when we shut down our emotion, when we shut down one emotion, we shut down the others as well. So if we shut down fear, we also tend to shut down joy. We're not fully ourselves. Whereas if we can accept the emotions, and also if we shut them down, if we try to avoid them, they stay around forever. and they're always there, they're inside us, they're disturbing our digestion, they're disturbing our brain on an ongoing basis. If we accept the emotions that are there, the natural process with emotions is that they come and they go. The problem is when we don't let that happen. So they're essentially, as I see it, there are three stages in the cycle of accepting and moving through the emotions. The first is just to recognize that they're there.

It reminds me of my mother. She said, Whenever I get the urge to exercise, I lay down till it goes away. So if you have a negative emotion, give it a little time and it can pass.

But that's, she's right.

I don't know about that.

It will pass. It will pass if you allow yourself to feel it. I think, you know, even the research that was done long ago on, supposedly correlating the anger of the type A personality with heart disease. Well, it really wasn't the anger so much. It was the resentment. It was the anger that was held inside and you couldn't let go and you were feeling it all the time. If you just get angry and you hit a punching bag for a while, it's going to go. So acceptance, relaxation, so techniques like soft belly, you're feeling something, relax, be aware of it, or you're doing shaking and dancing, you're loosening up your body and you're noticing the emotions come up, let them come and let them go. And then expressing the emotion, whether you're expressing it physically, and if you're a really angry person, it's great to hit a punching bag, it's great to hit pillows to get the anger out, and then you come back to relaxing again. If you try somebody, you try, I try, anybody who's watching, spend 10 minutes going like this and pounding some pillows when you're feeling frustrated and angry. After that, you're going to be relaxed.

It's true. So it's, it's a, just don't hit somebody else.

Yeah, don't, don't hit somebody else. But, but, but that's the temptation when people have been traumatized. I work with vets so much. They're coming back from combat. They're still so often in that state, that fight or flight state. So somebody brushes up against them in a store or bar, they're ready to kill. They've got to bring that out in a way that's safe and all of us do. Same with sadness. If sadness comes, let it come. Accept it, relax with it, express it as you need to.

That's so powerful. Is there anything else from your work that you want to share? Any stories, any techniques, any anything that really matters that you want everybody to know about.

Well, one of the techniques that we should share with people who are watching that I use all the time is shaking and dancing. And this is really important. We talked about when we're traumatized, we're either in fight or flight and we're really tense, or we're shut down, we're numbed out, we're holding the tension in our bodies, our minds are kind of frozen. What I do is I get people up shaking their bodies. You close your eyes, you put your feet shoulder width and you shake up and down for five or 10 minutes and you relax for a couple minutes and have some music that you can move your body to. What happens is you begin to break up the fixed patterns, physical as well as mental patterns that trauma creates. If you have experienced trauma, you need to You not only need to befriend your emotions, you need to re-friend your body. Because when we're traumatized, often our body becomes an enemy. I'm sure you've seen this with people with serious illnesses. You feel like, no, it's alien. I don't want to deal with it. If we've been assaulted, if we've been raped, if we've been sexually harassed, our bodies are uncomfortable for us. So the shaking and dancing brings us back into our body. and it also brings up emotions that we've shucked out. I'll just want to tell you one story. This is working in Haiti after about a year where you were. I was early on in the earthquake. And working there a year afterwards, we did a workshop with nursing students. And there were 90 nursing students who were killed in the earthquake.

I remember I was at the hospital literally the memory is still in my mind where the nursing building was collapsed and as you walked by you could smell the decomposing bodies. It was one of the most horrific things I'd ever experienced and you just, it's still in my nervous system. I mean, I actually just as an aside, I mean, after I went to Haiti and I came back, I was there literally a few days right after the earthquake and the worst of the worst of it and when I came back, I had full-blown PTSD. I had trouble sleeping. I had nightmares. sort of a sense of, like, lack of connection to reality. I mean, I just couldn't understand why what people were doing, living their normal lives when that trauma was going on. I was angry. It was very, very tough.

Well, the work we work, a lot of our work is with people who are doing the kind of work that you're doing. We're working with the caregivers, with the healers, with the physicians, the nurses, the aid workers to Help them deal with that because it's understandable. That does happen. And it doesn't just happen in a place like Haiti. If you're dealing with somebody in your family who's got a life-threatening illness, that's traumatic. And often just dealing with the hospital system can be traumatizing as well. We need to recognize that by being in that world of illness, caring about people that we're also going to be traumatized. The nursing students, there were so 90 of them died in the earthquake. I was doing a workshop for 100 nursing students and these are 17, 18, 19 year old girls. And I was with them teaching them soft belly breathing. We did some guided imagery to help them imagine some change. And then I got them up shaking and dancing. And within three minutes of shaking, half the girls were weeping, crying. Really, you could hear them. And then when we were doing the dancing, girls were crying, girls were laughing, girls were dancing. Afterwards, always afterwards, I say to people, what happened? Tell me what went on. What was it like for you? Any concerns, any difficulties? And For people reading the Transformation, I suggest every time you do one of these techniques or use one of these tools that you take some time to write down what happened, to put it down in a journal so you have it there and take some time to just sit with what happened. So the girls were raising their hands and they're saying, Jim, this is the first time we've been able to cry. It's a year after the earthquake. We've had to be strong. We're nurses. We have to be strong. for the little children, for our parents, for our grandparents. We haven't let ourselves cry. It was so good to cry. And then others said, and it was so good to laugh. This is literally the first time we've laughed in a year. And it's definitely the first time that we've danced. And we're girls. We'd like to dance, but we haven't danced. And this was so freeing for us. And then one of them stood up, she said, and Jim, we love Bob because I was using Bob Marley's three little birds, everything's gonna be all right as the song. She said, we love Bob, but we are Haitian girls and we have wonderful Haitian music. So I said, okay, from now on we'll use the Haitian music. So if people are watching us and want to do shaking and dancing, say five minutes of shaking, and then a minute or two of just standing and relaxing, and then moving to some music, move to some music that's inspiring for you, move to some music that's uplifting and upbeat for you, and see what happens.

So great, such a powerful thing. And you brought this to places, not just like Haiti, but Parkland with these young kids who suffered the trauma of shooting. I mean, that's just almost an unimaginable trauma for a young kid to be in that situation.

It has been very, very difficult for the, not just for the kids who are there, for their teachers, for their parents, and for the whole community. I think this is an important point. When trauma comes the way it has to Parkland and to many communities in the United States, it doesn't just affect a small group of people. Everybody is affected. And so our work at the Center for Mind Body Medicine, our work is with the whole community. not only with Marjorie Stoneman Douglas and the nearby middle school and the kids, teachers and parents there, but we're doing our best working with the superintendent of schools to work with the whole county. It's 270,000 kids, 30,000 employees just in the school system. So this is really important to do. And I think for people who are watching this, aside from thinking about the work that we do, is to understand that what you're going through that what all of us are going through is not so strange that other people are also experiencing other, either similar or other kinds of trauma, and that they're likely, if we share things with them, they're likely to understand what's going on with us. The other thing about Parkland that's important here for people to know, and especially people who are interested in their helping their children deal with stressful and traumatic situations. At Parkland, we're training peer counselors in the school, and Marjorie Stoneman Douglas. Last year, we trained 130 peer counselors to use the method in the transformation for themselves first and then with the other kids. We're going to train more, and we're hoping to spread this whole peer counseling program as widely as we can.

And I think that's beautiful, Jim. And I think one of the things that's underappreciated about your work is that It's not about you going and doing it to them. You enable them to do it with themselves.

Exactly.

And it is a model that I believe is a big part of the answer to some of the biggest problems we're facing in America today around chronic illness. And yes, you go into places where there's real trauma, but it also is the way people can heal from chronic disease by working together in groups and communities and helping. And that's what we're doing at Cleveland Clinic. we see dramatic results. And I think, honestly, I think this should be a mandatory part of all healthcare and medicine.

I agree. It should be mandatory part of care for others and it needs to be mandatory for all of us. For the people. And that's what we're doing. We're doing that with the health system in Indianapolis, with Eskenazi Health. We're doing with the VA now and Florida. But we've got to take care of ourselves. And then we can teach other people.

How to do it.

If we're not doing it for ourselves, How are we going to teach them?

It's so true, heal the healer. Well, Jim, thank you. This has been an extraordinary conversation. Your work is really inspiring. I'm committed to it. I believe in it. I've seen the benefits of it. Tell us if people want to find out about your work in the Center for Mind Body Medicine, where can they find you?

It's cmbm.org, Center for Mind Body Medicine. I'm not even sure what my website is.

It's cmbm.org.

But that's the center's website.

Yeah, James Gordon, MD. You'll find him.

Yeah, and then I'm on Twitter and I'm starting to get the word out, but the center is really doing getting the word out about the transformation as well as getting the word out about the work.

And you run workshops. You just did one in Carpalo. You had one coming up in December, Healing Life's Inevitable Traumas. You work in populations around the country. You've got programs in Puerto Rico and dealing with the wildfire fallout in Sonoma County, the wellness programs in Broward County that you were just mentioning. So you've got so much work you're doing. It's such good work in the world and you're trying to leave a mark by not just doing the work, but by teaching others how to do the work and scaling it up.

Exactly, and we're very open to working with other communities. That's how we started working in Sonoma. got invited. Same thing with Houston after the hurricane, where we go where people want us to go, where we can really be of significant help. And, you know, we're open to receiving invitations. This is, this is, we want this to be spread. And I really appreciate being here with you and having this opportunity to share this work as widely as possible.

So great. And also, if you're interested, you can watch Jim's TED Med talk called fulfilling traumas hidden promised, you can just Google that and you'll find it. It's incredible talk. And I think that's the beauty of this within the rough edges of what happens to us, there's often something beautiful that comes out of it in terms of healing and growing and building ourselves into beings that are more compassionate and kind and understanding and healing ourselves while we're bringing healing to the world. So thank you for that, Jim.

It's really great. Thank you, Mark.

It's great to be with you. You've been listening to the Doctor's Pharmacy. I'm Dr. Mark Hyman. been here with James Gordon, extraordinary psychiatrist, physician, healer. And if you love the conversation, please share with your friends and family on social media. Leave a comment. We'd love to hear from you. Sign up wherever you get your podcast, and we'll see you next time on the doctor's Pharmacy.

Great. Thanks, Mark.

Hi, everyone. It's Dr. Mark Hyman. So, two quick things. Number one, Thanks so much for listening to this week's podcast. It really means a lot to me. If you love the podcast, I'd really appreciate you sharing with your friends and family. Second, I want to tell you about a brand new newsletter I started called Mark's Picks. Every week, I'm going to send out a list of a few things that I've been using to take my own health to the next level. This could be books, podcasts, research that I found, supplement recommendations, recipes, or even gadgets. I use a few of those. and if you'd like to get access to this free weekly list all you have to do is visit drhyman.com/picks that's drhyman.com/picks I'll only email you once a week I promise and I'll never send you anything else besides my own recommendations so just go to drhyman.com/picks that's P-I-C-K-S to sign up free today hi everyone I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Don't forget, there's a way to listen completely ad free with Hyman plus on Apple podcasts. You can enjoy every episode without any breaks. Just open Apple podcasts and tap try free to start your seven day free trial.