The Shocking Link Between Trauma and Chronic Disease w/ Dr. Aimie Apigian

Anytime we shock a system, it needs time to process and to integrate that. And yet, looking at our culture, we don't give ourselves time. Everything is rushed. Everything is, I need it done yesterday. So that's why we look at that pattern of pushing through is you're pushing through when your body is trying to tell you, I need time. And we don't give ourselves that time.

Welcome to the Dr. Joy Kong podcast. This is where I have a chance to share with you some of the latest developments in the space of holistic health, longevity and wellness. I have always honored intellectual curiosity and scientific rigor combined with real world practicality. My goal is that what you learn here will help you live longer and live better. Hope you enjoy the journey with me. Hello, welcome Back to the Dr. Joy Kong podcast. You know, I'm here to help you live a healthier and happier life. So today I'm really excited to have Dr. Amy Apigian to come join us. And we're going to talk about something that people, many will gladly accept. That's a factor of life some may reject. That's trauma. So some may not think that they've had trauma in their lives, but nonetheless, this is a very important topic. So I want to welcome Dr. Amy to the show.

Thank you so much. It's really an honor to be here. And the conversations that you and I have had already, I love just the synchronicity that we have. Even though other people might say, like, you two do completely different things. Actually, no, we both do the same thing. We're both looking to repair the biology. So excited for our conversation here.

Yeah. Not to mention that I was a psychiatrist. I call myself an ex psychiatrist because I don't really identify with specializing in that because of the idea that somehow you can separate the brain out from the body and just treat that organ. I think that's very one sided. You know, I'm a doctor, period. I'm a doctor of the body. The mind is all one. So. And you were not a psychiatrist, you were a regular physician.

Right.

And you were doing preventative medicine. Somehow you went into the realm of the mind. So, yeah, we'll talk all about that. So I want to introduce you a little bit. So Dr. Amy Apigian is a double board certified physician in preventive medicine and addiction medicine with a master degree in biochemistry and public health. She has written a book that helps revolutionize trauma healing by revealing how our cells, not just our minds, can store trauma. The book is called the Biology of Trauma. Through her practice training, podcasts, YouTube channels and international speaking. She's bridging functional medicine and attachment and trauma therapy, proving that repairing trauma's impact on the mind, body and biology is possible. So that would be really nice to, to know that we can indeed repair from trauma because a lot of people don't even know that they've been traumatized. So what, what, what is the statistic? What do we know about trauma for human life?

You know, I think of the first time that we got shocked by the statistics of trauma, and that was when the adverse child experiences study came out. The very first one that came out in the 1990s with Dr. Vincent Felitti. And here he pulled back the curtain and showed us that even your good citizen suburban female middle class, that many of them had experienced trauma. And we had all assumed up until then that no, like, if you had experienced trauma, then you were somehow an, an other. You, you were, you were different. And so for him to show that it's, it's the average person, it's the person that's your neighbor, it's the person that's the school teacher, it's, it's everyone, doesn't matter what class you are in society, it really opened up the discussion for the first time. Now, you and I both know that even though that study came out in the 1990s, it really didn't get momentum in the medicine realm until recently, when. Now everyone wants to be trauma informed. And they believe that being trauma informed means, you know, doing an ACE score or getting out that checklist of events that may have happened in your childhood. But for me, I never saw myself as having had trauma. And even when I took my ACE score, it was very low, very low. What's a score? An ACE score is they had eight different domains for adverse events that may have happened in your childhood. And it gives you then a score of however many out of those possibilities. And it was a way to measure how much trauma you had had as a child that would predict your disease outcomes as an adult. And this again was also shocking to the medical field because we'd never seen adversity and trauma as being part of the factors that go into your biology. We'd always seen that as, no, no, no, that's emotional. And, and you go and talk to a therapist about that stuff, but it doesn't affect your physical health. What affects your physical health is your genetics, your diet, your lifestyle, but not the emotional stuff. And so to see that actually you take all of those other compounding factors away. Adversity in early childhood does Predict your rate of autoimmunity, your rate of depression, anxiety. And at this point, Dr. Joy, every single chronic health issue, symptom, diagnosis, has been correlated with adversity in childhood.

This has been shown by research.

Yes, this has been shown by research. So we know that. We know those studies now. But for me, it was still. But what's the real definition of trauma? Because when I looked at my childhood, I would not have seen trauma. I would never have used that word. But in 2014, here I was. I was overweight. I was on two mood medications for anxiety and depression. I then was diagnosed with chronic fatigue syndrome of unknown etiology. And then we discovered autoimmunity. And I'm looking at this list, Dr. Joy, and I'm like, shoot, like, all of these are correlated with adverse childhood experiences. So what is the real definition of trauma then, that I could have had trauma? My body has been holding trauma this whole time, and I didn't even know it. As a physician, I didn't know it.

Well, how did you. How did you know you had trauma?

For me, I saw that list of the diseases that I now had and seen that every single one of them correlated with these adverse childhood experiences that I did not relate to. My parents never went to jail. My parents had not divorced when I was a child. I didn't have violence in the home. So I never saw my childhood as being traumatic, especially. Especially compared to, like, my son's childhood. Right. So I adopted Miguel. He came to me as a foster child at 4. By the time he was 5, I was adopting him. I had him for six years in total. And when I compared my childhood to his childhood, there was obvious gap between the trauma and neglect and abuse that he had experienced that had even landed him in the foster care system. And. And my rather now privileged childhood that I saw compared to his.

But still you felt that you had trauma. What. What would your trauma be? Because I. I have a similar story, because at first, I didn't really want to accept. I. I felt that I. I had a pretty good childhood. But. But certain people in my life wanted to convince me that, you know, how I react to things, but maybe a result of past trauma. So that had been a journey and a conversation. So I'm curious to see what you discovered as far as trauma.

Yes. What I started with was not looking at the events in my life, but I started looking at the trauma patterns that are showing up in my life, in my relationships, and my health today. And that is honestly what helped me start to see things that I had never seen before, both in myself and in my patients. So I look for these patterns. Patterns like you may relate to some of these, Dr. Joy. Perfectionism. I take it from the lab that you resonate with that one. People pleasing.

Oh, people pleasing. Okay.

I had a strong pattern to fix people, so. So I call it people fixing. Like, if you have a problem, let me jump in and save you. I assumed the responsibility of fixing you, of saving you. And then there's the pattern of pushing through where there's just this background exhaustion or sense of depletion. But I will figure out a way to override those messages from my body and push through until collapse or burnout. And these are all patterns that I could see of trauma having become chronic in my body. And so looking at patterns, that's how I now identify. Does someone have stored trauma in their body? I'm not at first looking at, well, let's go find that big bad event or the little T trauma in your past. I'm looking at what. What is the evidence today that your body is holding on to these patterns that trauma will leave in our body?

Are you saying that some people can't just be born a perfectionist or, you know, liking pushing through things and is courageous? I mean, does it have to have trauma involved?

That is a great question, and very few people have asked me that question. So this is amazing to be able to bring in this concept already of the biology of trauma, because the biology of trauma goes both ways, meaning it goes from trauma creating an impact on our biology. But our biology can be such that it promotes more trauma responses in our physiology. And that was one of my examples. I looked at my physiology and I could see that from birth. I was born as an under methylator. I had pyroluria. Just taking those two, nothing else for right now. Even though there would have been other factors in my biology, just taking those two, those would have decreased my activity of serotonin, decreased dopamine, decreased gaba, increased glutamate. And now you have this biochemical bath in my brain even as a young child that was less available for feeling safe, less available for bonding. And even if, even if the relationship and the emotional attachment with my mother had been amazing and wonderful, that bonding takes both nervous systems being available to each other, each other. And so if mine does not have as much serotonin activity, I'm not going to feel as much of that safety in that relationship, in that bonding. If I don't have as much dopamine activity, I'm not Going to get the same motivation to connect, to feel good. And these are the roots of the bonding and what we form as our attachment style. And so the very first trauma pattern that can develop in people is this secure attachment or insecure attachment. And those of us who come out of our early childhood with an insecure attachment, that is a trauma pattern already formed in our nervous system. That just means that it's become our default to respond to stress with overwhelm. That's all it means. Stored trauma in the body just changes our default way of responding to change to stress, to loss, to grief, because it's programmed what it feels like we are capable of and what we feel we are able to be present to and to complete, rather than just go into overwhelm.

So this quick link to overwhelm, that's a demonstration that your biology has formed a pattern that responded to a previous, probably some kind of a difficult situation. And then that's how you formed your kind of your neurobiology, and that's how you're responding.

Right. And so they're going to feed off of each other.

I see.

Right. Just like you were mentioning earlier on, like, the mind, the brain, and the body, like, they're inseparable. They're not actually two different organs. They're part of the same system. And that's exactly what we see here, where our biology is going to be impacted by our experiences. But our biology will impact our ability to go through those experiences and will affect what is just a stress versus what will become a trauma for us.

I see. So what do you think of the prevalence of trauma is in the population?

So it's my belief now, Dr. Joy, that everyone has had some degree of trauma. I think in the way that I look at it, is your body had a trauma response, because I see it as these five steps that happens in our physiology. And when we look at those five steps, we are designed to survive anything. And so even from the moment that we're born, our body will go through these five changes in our physiology. Whenever we reach that level of stress that it feels unbearable, feels like we are powerless in the face of what's going on. And that's what then generates a trauma response. So a trauma response is not bad, it's not shameful. It doesn't mean anything other than your body got overwhelmed. You have a certain capacity and the demands placed against you were more than what your body felt capable of. And it goes through these changes in the physiology in order to protect you. So when we see it as Just a physiological shift that happens inside of us. Everyone has experienced those physiological changes at some point in their life. So trauma is just a human experience as they go through life on earth.

Wow, I love how you put it. I've never heard trauma put that way. That, that is your, your ability to cope is the insult to your system has exceeded your ability to cope. And then you have this, this physiological, like a breakdown kind of sequence and, and that. Right, yeah, that's really interesting. And that I think really helped people to put into perspective of what they're experiencing. That the physiologically that they're going through, like avalanche in a sense.

And that's exactly what it feels like, feels like the avalanche. It feels like drowning in this wave of fear and panic that that happens at that moment. But this is where your work starts to become so important. Because if our nervous system is sensing what is my current capacity to know whether we're going to have a stress response or whether we're going to go all the way into a trauma response, the repair, the resilience at the cellular level becomes critical to that decision of what is my current capacity. And without tools like stem cells, we're limited in our ability to build our capacity. And so we would be stuck with whatever our capacity is. And as we get older, well, it's going to be less and less and less every year. But we've got better tools now. We have different tools, which is where I see that repair of our biology being our leverage point, which gives me so much hope for trauma healing and recovery.

Okay, so I mean, going back to maybe your story that you realize that you had a lot of trauma and, and that could have had a lot to do with your illness or the, the health struggles. So how did you figure out what to do about this distort trauma in a sense, do you think it's stores in the body?

First of all, I know that it gets stored in the body. So trauma gets stored on three levels. It gets stored in our mind. And by our mind, I mean our thoughts, our beliefs about ourselves, our beliefs about the world, our beliefs about others. So that it informs our default perception of whether you are safe. And that's going to affect my ability to show up with you like this and be open with you and share with you versus be guarded and doubting and distrusting of you. So it changes our mind in the form of our beliefs about ourself and our beliefs about others and the general goodness of the world. But then it gets it stored at the somatic level. Now this is often what those in functional medicine or those who are biohacking are not as much aware of the somatic level. Somatic refers to just the body. It's the Latin word for body, soma. But it really is talking about the tissues and the muscle memory that the body forms. Now, I'm going to assume that you played a musical instrument growing up.

Sort of.

All right. So you will know that you can play a piece of music enough times that you can play it by memory. You're not looking at the sheet of music anymore. Your body knows how to move in order to play those notes. And it's not something that you're even having to think about. It's coming from your body. The other example of a body we call this implicit memory is if someone is in a car accident and now they drive down that same stretch of road, but it's a different day. They can look around and they can see that they're perfectly safe. But their body starts to have a reaction. Their heart starts to race, their hands start to sweat. They grip the steering wheel harder. They feel their whole pelvis muscles and abdominal muscles brace. And their mind says, this is ridiculous. I know that I am safe. But that's this disconnect between the body and the mind. Dr. Joy. It's. It's. Our mind can know something, but our body is still having a reaction. And that is where we look at. It's not just our mind that's controlling our body. Our body has this implicit memory, and it's learned muscle memory. When I see this tree. Oh, I remember that when I saw that tree, I heard the skidding tires. And then this happened, and then this happened, and then I was in total danger. And so now when I'm driving down the same stretch of road and I see the tree, I see these things that my. My nervous system has said this meant danger before. My body is still going to have the same reaction. Even though my mind says, no, it's. It's. It's not the same drive. It's not the same day. So that's the body level. Right.

I guess it's similar to a panic attack.

It's similar to.

Panic attack is like an explosion. Even though your mind said, I know there's nothing going on.

Right.

That's really bad, but I can't stop this. Yeah, yeah.

So in that sense, that's why I can say the body holds on to trauma, but then we also look at the biology level. So I said that there were three levels in which the body holds on to trauma. The mind, our thoughts and beliefs, this body, implicit memory that it seems to take over and have reactions even when I know that it's not necessary. And then our biology. And of course, this is the layer that we don't see. And so those who are going into therapy are not often aware of this level, which is that the more trauma that our body is holding, then we're becoming more nutrient deficient. We're becoming more deficient in magnesium, we're becoming more deficient in zinc and B6. And then we're also having epigenetic changes to our DNA.

Exactly.

Leading to disease.

Now it's going to prevent you from absorbing nutrients, right?

Exactly. So. So when we come to repair them, Right. Like, we're going to need all three layers.

How does it go from trauma to nutrients?

Yeah. So in my book, section one is on how does the body experience trauma? So I walk a person through these five steps that happens in their physiology. And then I say, but if this happened in the past, why, why does the body hold onto it? And how does it hold onto it? So I break down the mechanism of that. And what happens is that the nervous system gets stuck in a loop, and it starts to loop between these steps of the trauma response, because it never fully reset back to safety. So there's always still this background sense of danger of. But it could happen again. And because of that, it loops between being stressed out about it and being overwhelmed by it. And so in this cycle and loop of being stressed and then overwhelmed, stressed and then overwhelmed, that uses up a lot of nutrients because our body is going to generate more energy in our mitochondria every time we're stressed out about it. So it's going to be revving up our mitochondria because of the adrenaline response. And to make energy to make ATP, it uses all of these nutrients. Magnesium is one of the most critical nutrients for so many enzyme reactions in the body. So anytime that we're revving up our engines, every time that we've got our foot on the gas pedal, like, what we have in a stress response, our body's like, okay, we got to pull all these nutrients, we got to have more magnesium, we need more sugar, we need more this, we need more that, because we need. We're being asked to make more energy right now. But then what happens is that once we reach that critical line again, and our body's like, okay, this is too much stress. I'm going to go into overwhelm. When our body switches into that overwhelm state, it's a completely different state. This is no longer driven by adrenaline and the sympathetic nervous system. This is now driven by the vagus nerve. Again, not the ventral vagal parasympathetic that we want. This is a different train leaving the station, but going down the vagus nerve. And this message says to just dim down everything. So it goes to our thyroid, it goes to our mitochondria, and it says we need to make less energy. We're going to just shut things down. We're not going to die, but we're just going to shut things down because it's no longer safe to operate at this high stress level level. And so now we're literally dimming down our metabolism, Our digestive system goes into just doing the bare minimum, which is why we get the leaky gut and the inflammation and the poor absorption of the nutrients. And since we're always either in stress or in overwhelm, our body never has the time in safety to either be able to replenish itself or to clean up the oxidative stress that's happening or to absorb these nutrients that it needs. And so pretty soon a person is going to go into deficiency where they just don't have the nutrients because they haven't given themselves the time and safety since their body's stuck in this loop between stress and overwhelm.

Well, that kind of reminds me of the only thing we learned in medical school about how to help people be healthier. Because we were not taught to tell people to be healthier, right? We help them to be less sick. So that, that was our entire, you know, education. So to be healthier, we have what, diet, exercise and reduce stress. So that's, that, that's our mantra. So that's only we know what to say to patients if it's true healthy, you're gonna exercise and you have to.

Reduce stress, which is, I mean, it's so sad for me to look back and be like, I was one of those physicians that told people that, because it's not true. It's not true at all. And it's still being taught in medical school that there's just the two states of the nervous system, parasympathetic and sympathetic. And they're not even yet teaching that there is this third physiological state that is, I just call it for simplicity's sake, overwhelm. And that is a very different state than either the parasympathetic or the sympathetic. And when you're in that overwhelmed state, no, it's not the right advice to exercise more. It's not the right advice to reduce your stress. You're in a different state now. And being able to know what the body needs at that point is critical for helping people to get out of this loop that they get stuck in between stress and overwhelm.

Okay, yeah. What. What do you teach? How do people get out of that? This, you know, the. The stress. Overwhelm. That's, of course, if you have chronic high stress, then you go into overwhelm right away. Right. So if you're not that stressed, then the overwhelm doesn't happen that often.

Exactly, exactly. There are two reasons why we cross that line from stress into overwhelm. One is it's just been too much too fast, and so something happens and it just happens so fast, or there's so many things that happen that it creates that overwhelm simply because I can't deal with all of this and it feels so big. So too much, too fast is one reason for why our body will cross that. That line into overwhelm. But there's another reason. And for adults, especially adults with any chronic health issues, this is one of the more common reasons. It's just been too little for too long. Too little of nutrients, too little support, too little love, too little touch. We can even look at it at the. From the perspective of early life and our childhood. Did we get enough love? Did we get enough understanding? Did we. Did we get to be heard enough? And when we don't get those things that we need, our body goes into a stress response. Of course it does. Right. Because if it's something that we actually need, we. Our body's going to be stressed. If we don't have what we need and stress is fine for a period of time, our body can generate a great stress response. This is how people become Olympian athletes. They use their stress response to accomplish great, amazing things. So the stress response is not bad. It's just not sustainable. I talk about stress response being like a sprint. If you are sprinting, there's a definite end to which you're like, okay, I can't sprint anymore. And so if we are sprinting and we have not eaten, we have not fed ourselves, we have not let ourselves sleep, we're running on deficiency and depletion. That is a case of it's just been too little for too long, and I'm not going to be able to sprint as long as. As if I were well nourished, if I had slept well, if I'd been taking care of myself, if I had recovered since the last time that I sprinted. And so these are the two reasons. Too much, too fast, and too little for just too long, and our body will be going into overwhelm. So once we go into overwhelm, we need to do something very different than if we're still able to it or if we're still in the sprint. If we're still in the sprint. Well, yeah, let's find ways to be able to slow down and, and not have to sprint. But once you're in overwhelm, it's the equivalent of being on that hamster wheel during stress. You know, the hamster wheel is, is the hamster running, running, running, spinning his wheel. But once the hamster goes into overwhelm, the hamster gives up. He's still on this wheel that's turning around, though. So he's getting banged up on the wall every single time because he just can't keep up anymore. He's not, he's not running anymore. That's what it's like to be in overwhelm. You're kind of in collapse. You're like, I'm done. But the knocks are still coming, but you're not even having the energy to do anything to fight back, to try to keep up. So at that point, the response should not be, well, let's reduce your stress. The hamster's like, I'm not even trying anymore. So self care or better stress management is not going to help me at this point. What is going to help? Well, we've got to provide three things. And now this is the terminology for those who've been in therapy. They might have heard it. The chronic functional freeze. So the freeze is that first step in the trauma response. And our body just kind of goes into this immobilization paralyzed by the panic of I can't do anything. And what it needs when it goes into that step is it needs energy. So it needs the body to catch back up with the energy. So it, it needs that mitochondria to turn back on, to start making energy again. If there's no energy in the system, the body's not going to come back alive again. It also needs a sense of safety. I think of this trauma response as our body's going into like the, the turtle shell. So the turtle goes into its shell when it's surrounded by danger. And he's like, I'm gonna pull into my shell, gonna pull my head in, pull my feet in. And the turtle in is, is stuck right there because you can't move when your feet are pulled into your shell. So that's the paralysis. What does a turtle need to feel like it can poke its head out again? Well, it needs to know that it's not going to get its head bitten off, otherwise it's not going to poke its head out. So that's the same thing that our body needs. I'm not going to open myself back up to life if I'm going to immediately get hurt again. So I need a sense of safety to even feel like I can open back up to life and look around and be like, whoa, what just happened? And that's where a lot of people are, not knowing how to provide themselves that sense of safety. And that's why their body then just gets stuck in that loop. Cause they never reset back to safety. So we have the energy, we have safety. And the third thing that our body needs is time. So when our body goes into the freeze response, it is like a shock to our nervous system. And anytime we shock a system, it needs time to process and to integrate that. And so it needs time. And yet, looking at our culture, Dr. Joy, we don't give ourselves time. Everything is rushed. Everything is. I need it done yesterday. And so that's why we look at that pattern of pushing through, and is. You're pushing through when your body is trying to tell you, I need time. And we don't give ourselves that time. I remember going through the biggest grief in my life. This was in 2014. And because of residency, I was in surgery residency at the time. I jumped right back into work. And I think that that was partly why. Then one month later, I woke up and I could not get out of bed. And. And that's when we. You know, I got diagnosed with the chronic fatigue syndrome that I just hadn't given my body the time to process and to grieve. I was like, nope, come on, we gotta get back to work. We got things to do. We've got residency. We can't get behind. We're gonna. All the stories, all the stories. But that is what we as humans can tend to do, is rush and not give our bodies the time that it needs to process.

Wow.

What just happened? And am I really okay?

Yeah. Of course, everybody, depending on what their physiology was and their past trauma experiences, have different threshold of how much they can take on before they have to just take that time off.

Yeah. I'm reminded, as you say, that of the difference in the veterans coming back from the different wars and the change in the rates of PTSD before we had planes to fly, to fly the soldiers back, they had to come over on boats from Europe. And So World War I, right. Like, they're getting on boats, and now they have to cross the whole Atlantic Ocean on a boat, and they're all together. And so this was their time to process what they had just been through in a community that they all got each other, they all understood what they had been through, and they were able to integrate and process and give themselves that time. But you look at the more recent wars, the ones where they're flying them back, they're not given that time that they had that they were forced to have when it was a boat ride back and the rape therapy had skyrocketed. Yeah. And so just this importance of time, giving our bodies time. It's a gift that very few people give themselves. But I hope that once they know that they need to give themselves the gift of time, more people will do that.

In your opinion, a lot of people who are dealing with chronic illnesses is. And, of course, is an intersection between maybe stored traumas and their. Their biology.

Exactly. And at this point, Dr. Joy, we have all the information that our body or our nervous system is looking at to make a decision about, do I respond with a stress response? Do I respond with a trauma response? What's the best response for me right now in this moment, what with this trigger that just happened, and it's called neuroception, or the perception of our nervous system, and it has this dashboard, and on this dashboard is everything from, yes, my community, do I have resources? Do people support me? Do I have the emotional support that I need to respond to this and know that someone's got my back? But it's also looking at our biology. And this was the big aha moment for me when I then started my trauma work after having developed autoimmunity and chronic fatigue and anxiety and depression and being on mood medications that were affecting my mitochondria as well and causing other nutrient deficiencies. My nervous system's looking at my biology and being like, honey, we'd love to be able to help you out with this trauma work, but you literally don't have the cellular capacity to even process your childhood, to even look at these stories, because that is also stress. And realizing that my biology becomes a cue of danger. And so our nervous system is constantly receiving cues of safety and cues of danger, and depending on how many of each are coming in at this moment in time will determine whether it says, yeah, we can be in parasympathetic, we can Be calm and connected. Creative or no, we're getting more cues of danger. We need to be in stress mode. Or the cues of danger are so many that we just need to shut down. Like the hamster on the wheel that just says, okay, I'm done. And so my own biology can be a source of so many cues of danger that it's now promoting a trauma response. So when I look at, well, what's my degree of inflammation, what's my degree of nutrient deficiency, Those are cues of danger to my system. And so that's where our biology becomes so critical to the conversation of trauma recovery. And how can I promote a biology of safety so that the cues coming from my biology are ones that tell my nervous system, we're good, we've got what you need. We can make more energy if you need to. We can detoxify these toxins that we accumulate in our daily life. We're doing good down here. So you do you. Because we're good down here versus what most people biology is telling them is we're not good down here. We're dealing with so much inflammation. You wouldn't believe all the toxins that we're holding right now. We've got our microglia and all of this neuro inflammation. We, we are having all kinds of fires down here. And when that's the message coming from our own biology, our nervous system is going to say, yeah, I don't have the capacity to deal with this person in my life. That's stressing me out. Right. And we find ourselves responding to people, places and things in our life simply because our biology is at a low capacity and we just don't have the energy to deal with it.

Okay, so how do you make that shift? How do you reset your system in, you know, knowing that there are all these traumas that are affecting it?

This is a great question and question that I had to ask myself because by the time I realized I needed to do my own trauma work, there was so much to do. Dr. Joy, I was like, I don't even know where to start. Oh boy. And it feels overwhelming. Look at all the things that I need to do. That was when I learned about functional medicine. Okay, so we're going to say I need to, I need to go get trained in functional medicine, but I also need to go get trained in somatic therapy and I need to get, you know, like I need to learn all this stuff and then I need to do all of this stuff over here and then, and then I need to figure out my Work and my surgery residency and like, it just felt so overwhelming, all of the things that I needed to do. And then of course, you go to the functional medicine training and there's this huge long list of now things that you need to take and things that you need to do. And I'm like, oh, my goodness, like, where do I even start? Yeah, so this is where I sat down and I started working through what I now you as a use as a framework for others is I'm saying, what are the trauma patterns that we see showing up in your life? There are five of them. And I lay these out in chapter nine of my book. We have a sense of disconnection, immobilization, or that paralysis, stuckness. We have a sense of depletion from the energy conservation. We have dysregulation, which is your pattern of responding when stress happens. Do you over respond or do you under respond? Do you overreact? Do you underreact? And then the actual disease. So has it now become so prominent in your biology that, like me, you have a diagnosis and you've got physical health issues to deal with? We take one of those and we say, this is what is the loudest in your life right now. We're just going to look at this one and then we'll come back to the others, but we're just going to take the next best step. And the next best step is looking at what is the biggest disruptor in my life right now. Which pattern is blocking me the most from having the life that I want. Okay, it's my sense of disconnection, for example. Okay, let's work on that. What is happening that it's blocking your body's ability to connect? Because if our body had what it needed, it would actually be able to do all of this healing by itself. Our body is naturally programmed to know how to heal. You and I both believe that. And so I'm looking for what is the block that is preventing your body from already having healed? This sense of disconnection, let's go look at that. Is it biochemical imbalances? Is it toxins? Is it your thoughts and beliefs about yourself? Is it these implicit memories that you're walking around your environment and getting triggered all the time? Or what is it? But let's go find that. And then from there, we create the list of all the things that seem to be blocking our healing, and we prioritize them based on what would be the easiest for you to implement and what would have the greatest impact. And that's what we focus on first. And once we do that, then we come back to the list and say, okay, then what's the next thing that we want to work on? But it's not helpful to try to do it all, because we're going to go right back into that overwhelm. And there's no growth in overwhelm. There is no growth in overwhelm.

Take your time peeling the onion.

Exactly. And I love that. You know, part of the healing process, I think, is coming to receive, acknowledge, but accept the fact that this happens in layers and that that's actually how the body is designed, is to go in layers one step at a time. I don't need to worry about the next layer. I just get to focus on this right now. And that's what keeps me out of overwhelm. When I'm done with this, I don't even need to worry about, okay, what's the next thing that I need to do? My body will show me the next thing that it has.

I can visualize my patients coming to me in total overwhelm. Right. I. I have all these problems. I feel terrible. I can't enjoy my life. Help me, save me, make me a new person. And then I'm feeling that overwhelm. Oh, my God. Now it's all on me. I got to change this person within, you know, 20 days. Yeah. So. So I'm receiving that overwhelm, you know, that triggers my trauma response.

Totally. Yeah. Us practitioners, we are at the biggest risk of vicarious trauma because it's easy to absorb their overwhelm. Yeah. Yeah. It's a lot.

So. But knowing, you know, just hearing what you said about how our biology, about our body happens in layers, and just accepting that and meditate with it, you know, be okay with it. So not needing, like, you are my savior now. I found you, so fix everything now. You know, get that out of your mind. Let's take a journey together.

Exactly.

Yeah. Let's do this together. Yeah. Because we're all on a journey.

We're all on a journey. We are all working on our next level. I'm definitely working on my next level. It's a lot deeper than what it used to be. Right. And so I can look back and I can see the progress that I've made while still recognizing. And this is my next layer that I'm working on, but it allows for this relaxation into the healing process that I had never been able to do before. I had always been stressed about my healing process, and what if we could relax into the healing process, knowing that I've looked through and prioritized what are the most important things for me to do right now. And then I can trust that the next layer will reveal itself when the time is right. I don't need to stress about it.

Yeah. And where does therapy fit into all this?

Well, the body again has the ability to heal by itself when it has what it needs. So therapy is the process of using someone, someone's skills, someone's knowledge to help remove the blocks that we often have put into place in order for the body to heal. So this is why you're going to need a, some, some version of functional medicine practitioner to work on the biology level, because your biology does become a block. But we also have talked about how the implicit memories become a block, that muscle memory to automatically have your body respond to something and your beliefs about yourself, your beliefs about others. And so I love to create this holistic, integrative approach where when I'm working with someone, we're going to work on all three layers at the same time and on the same thing. So if we're working on a person with a person with autoimmunity, well, they also have perfectionism. They also likely have people pleasing tendencies. So while I work on their biology with the autoimmunity to create that biology of safety instead of a biology of trauma, I'm also going to be working on their body's implicit memory to perfectionism and people, please. And I'm also going to be working with their beliefs that they have to be perfect in order to be okay. And when we work on all three layers at the same time, Dr. Joy, people can accept, accelerate their healing journey much faster than if they're trying to only do one piece at a time or go over to this practitioner for this piece, but this practitioner for this piece. And it feels disconnected and they're speaking off in different languages and it's harder to integrate and move forward when it's just pulled in many different directions. So that's why I bring all three pieces together and we focus on one thing at a time. I do generally six week deep dive. So for the next six weeks, for example, we're just going to look at your attachment and attachment insecure attachment is huge for those with autoimmunity, huge for those with autoimmunity. And so we're going to be working on the autoimmunity and these attachment threads while we are kind of creating this container for the body and the nervous system that allows for much further progress. But it's done safely rather than just trying to jump into the deep end of the pool without knowing how to swim. And you're going to drown in your own emotions and the fears that come up.

Well, how do you address attachment in the biology? I mean, how, where is it?

This is really, really fascinating because attachment is where it all started for me, right? Like I became a foster parent, then adopted. And so I am working with attachment trauma at its, at its core. So I'm looking at how does attachment actually affect our biology and attachment becomes our biology. There are so many studies now that show that flare ups of back pain and neck pain and your circulation issues and your digestive issues, they all go back to attachment. Given that, yes, then whatever we're working on with your health has an A thread all the way back to your early life. And we can see some core beliefs that you hold that contributed to creating the biology that manifested in that particular health issue. And knowing that when you have attachment insecurity, those trauma responses of not being enough or not, or being too much or whatever it was for you that created that overwhelm as an early, early child, then that has now become chronic, chronic stress because it started so early in your life. And so rather than seeing it as like a stress or a trauma that happens in your 20s or later in life, knowing that your body has been under this inner tension since age 4 months or for many since they were born, then we can look at the impact on your biology is so much greater because there's been more time to accumulate that damage. And so that repair of oxidative damage, the repair of the epigenetics, the repair of the nutrient deficiencies is, needs to be more aggressive because the damage has been more.

So you do testing, right? That's one way to address those testing.

Allows us to be much more precise in exactly what you need and in what amount. But given someone coming in, and maybe they're starting off with me with this, you know, the somatic self practices that help them learn how to create inner safety. Even though I haven't done testing with them yet, I kind of know that they would benefit from magnesium, for example. And so just by starting them on a magnesium supplement, I've shown that they experience greater shifts in their trauma somatic work than if they're not taking magnesium. And yet we, we haven't done the testing yet. So there are some things that, just because of how long this has been going on, how long your body has held the trauma, I know that it's running deficient on certain nutrients that just by giving it that, it will already start to have that relief of like, okay, we have some magnesium to work with, we have some zinc to work with. We've got some B6 to work with. Because all of these are ones that get used up more during what we would call chronic stress that has been going on for decades.

Hmm. Okay, do you have an example of a patient where you were taking from overwhelm and not doing well physically to a place of flourishing? What do you do exactly? How do you untangle all the pieces?

Ah, there have been so many, and especially the ones with autoimmunity or who are going through menopause and their trauma is surfacing. And those with that background fatigue and exhaustion experience the fastest shifts. I've also had those with skin issues and psoriasis and ibs. And so they come in and what I'm starting them with is learning how to create their inner safety within a few seconds. What I do is I teach them how to use their body through touch, through movement, in a way that when they notice that themselves, that they've gone into overwhelm or in stress, and they don't want to be in stress, they know how to shift their inner state, their inner physiology to a parasympathetic I'm safe enough right now, state within seconds. And the reason why that is important as the very first step is that the more time that our body spends in stress or overwhelm, the more time it's just accumulating more damage. But the more time that we actually are able to spend in parasympathetic ventral vagal, the more that the body can start to do its his own healing strategies. So that is the first thing to do. The first thing is not to say, all right, let's process your childhood. Let's dig into these stories. We don't even do any stories. I say no stories. No stories for about the first, at least the three months. No stories, meaning we're not talking about anything that's happened to you.

That's interesting.

Yeah, it is interesting. And people are. Because that's what they expect. They expect, okay, I'm going to do trauma work, which means I need to be talking about it. And then they come to me and I'm like, no, we do. We don't have to talk about it. No, what we do first is we create the safety. And here's why that's important. Because then when we are ready to go work on a story in our past, if we start to become Overwhelmed with that story, we can use our new tools and come back to a felt sense of safety immediately. If we haven't learned those skills yet, you are likely going to go into overwhelm just by talking about those stories. And there's no growth in overwhelm. And so I need to be able to give you the skills that allows you to navigate every minute of the day differently and you to be able to tell, hey, I'm starting to get stressed now. And I'm going to ask you what? Well, stress isn't bad. Is this manageable or does this feel unmanageable? And they're going to be able to tell me it's stressful, but it's manageable. Okay, then this is actually our sweet spot. Stress, but manageable. That's where we grow our capacity. Just like we go to the gym and we stress our muscles out, but we keep it within our manageable zone of what we can lift. If we're talking about weights, that's how we grow our muscles. But if we try to lift weights that are way too heavy for us, we break our muscles, we tear our muscles. There is no growth and overwhelm. And so once a person knows how to tell within themselves, is this manageable that I should stay with this even though it's uncomfortable, or is this unmanageable that I need to use what I call my personal anchor system and get back to safety, because that's where I am going to be able to do something different and have more of these moments of feeling safe enough, which is where we need to get people who are recovering from past experiences, whether we want to call it trauma or some other worry. So that is why we don't start with story. We start with our own physiology. We start with learning to shift our own physiology to create that state of safe enough, no matter what is going on outside of us.

Okay. And I'm very interested in that tool you have. You said to shift people within. Yeah, within a few days they learn this tool.

Yes. Yeah. And they learn many different ways, again, using their body. Because we're working at the somatic level, many different ways in order to create that shift in their physiology of safe enough. Because many different experiences can happen to us and we need a variety of tools. We can't just have a hammer. We need a whole bag of tools so that no matter what we go through, no matter what's happening, we have a tool for that that will help my body get back into a safe enough state, because that's where we can grow. That's where we can build our capacity even to be present and to not go into overwhelm anymore.

And that tool is individualized. Everybody has a different way of shifting out of that overwhelm.

It's very similar because the nervous system is so predictable and the principles that it operates on that there are principles that guide us to know what does it need for a sense of safety. Saying that I teach these exercises, for example, one of them is just like pretending that there's a huge rock in front of you and you're going to slowly, slowly, slowly push it away. Now, for some people, when they push this rock away, they get a better relief and return to safety if they push straight forward. Other people get more of a relief if they push out to the side. It doesn't matter. Like, they figure out which way works best for their body. But the principle is still the same. We can feel this weight imploding on us. We're starting to feel suffocated, like we can't breathe. We need to push it away, and we need to actually do a movement. So many people just try to sit on the couch and worry rather than realizing that, no, you gotta move your body. So we're going to pretend that there is a rock right there in front of you, and you're going to push it away. Because when we engage our muscles, when we move our body, it engages our nervous system. And so we're going to be involving our body much more than our mind and our thoughts and just trying to change our thoughts. We're going to be moving our body for these somatic practices that create inner safety within a few seconds.

That's interesting. Did you come up with that method yourself?

It's a combination of everything that I have learned. So given all the trainings that I've done, I then took that and I said, what do I need for myself? And I now teach people what are all the things that I found worked for me and then the patients that I started to apply this with. So now I've worked with thousands of people around the world, and I'm very confident that these exercises I teach, teach 21 of them. That these exercises are ones that shift a person's physiology, no matter who they are, no matter where they are in the world, no matter what culture or background or political party or religion they come from, it doesn't matter. The body is the body, and we. We know the principles and works. Yeah.

So a person gets overwhelmed at work, needs a private space to start pushing some big rocks.

They don't need a private space. They don't need a private space. There are, there are other exercises that they can do that don't draw as much attention but that help to shift our physiology and that, and that's why, like, that's why we need a whole bag of tools and not just one exercise. Because what if you are in public? What if you can't, you know, like lift your arms and push away a rock? Or we do this, you know, vibration with our vocal cord that makes a sound. What if you can't do that because you're in public? Well, it's fine because those are two of the 21 tools. You've still got 19 others that you can use. So this is, this is also what starts to shift people, Dr. Joy. Because for the first time they can feel like there's something I can do. I'm not still just powerless and stuck with this panic. I have something to do. And it's not like call my therapist or call my doctor. I can shift my own physiology. And there's a sense of agency that comes with that, that even that sense of agency starts to shift them out of their chronic trauma patterns that inform us, ah, there's nothing I can do. I'm trapped, I'm powerless and I'm all alone because that's what is the residual of those trauma responses. So even with this, we're, we're breaking through those beliefs and that somatic implicit memory.

Wow, amazing. Well, so needed in the world. So how do people get in touch with you and actually get some relief? With your help?

Yes. I have taken five of these exercises that I have refined with my addiction medicine patients over the years and put them into a five day nervous system reset. I'm happy to share that with your audience. And they can find that on biologyoftrauma.com book. So that is where they will find my book, the Biology of Trauma and then also be able to get my five day nervous system reset that they can see what these somatic exercises are and be able to try out five of them.

Wow, that's great. Okay, that's simple enough. Biologyoftrauma.com and forward/ book. Amazing. And where can they follow you? So you have your YouTube channel. You put out a lot of helpful videos to get people through different humps.

Yeah, they can find me on the different platforms. YouTube is a major one. LinkedIn, Instagram, and always, always putting out content to help educate people on the body and trauma.

Wonderful, wonderful.

What's your Instagram handle, Amy and Dr. Would be Dr. Soctoramy, which I spell A, I, M, I, E. Wonderful.

Thank you so much. Dr. Amy. This has been fantastic. The hour went so fast. Yeah. Thank you for bringing, you know, much needed way forward because a lot of people are stuck and they don't know how to shift out of it and that's no way, not a good way to live. So thank you for doing your work and, and, and spreading your knowledge and wisdom.

Oh, thank you for the work that you do. It's very needed.

Thank you. Okay, Dr. Amy and thank you everyone for listening. Thank you for listening to this episode. Hope you enjoy the content content and if so, please rate and follow this podcast. To reach me you can contact Uplift Longevity center, that is Uplift with a Y. You can also subscribe to my YouTube channel. Joy Kong, MD. See you next time.