Autoimmunity: Unraveling the Trauma Connection

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Dr. Keesha I’m so delighted to be here. Thanks for having.

Jen Pfleghaar, DO, FACEP

Me.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I have this story that brought me to what I do today, just like you probably do too, and everyone else that does the kind of work we do. So I started off in an ICU at the age of 19 as a registered nurse and did that for about ten years, like real high intensity, got married, had four children, and I was a skydiver. I was a marathon runner. I drove myself like nobody I’ve ever met.

Jen Pfleghaar, DO, FACEP

Like it was.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Crazy. When I look back at that version of my life, I drove myself and when I was about 30 years old, I was diagnosed with rheumatoid arthritis. And like a lot of my patients, it felt like it was all of a sudden, right. Have you ever had patients that come and say all of a sudden, I’m sick? Well, we know that that’s not accurate, that the body’s been trying to tell you for a really long time. And so, you know, when I would get all that, the joint pain, I thought it was some running and I would just pop ibuprofen like it was candy when I got acne, you know, indicating my liver wasn’t very happy and I was pretty toxic. What did I do? I went on Accutane. Very typical, right? Antibiotics are my acne. All the things that Western medicine signs us up for. And so when I got in to see, you know, this doctor had been because overnight I woke up with ten extra pounds on my joints of just like red inflamed puffiness. And it was like someone had taken the batteries out of the Energizer Bunny. I was just collapsed. And she asked me in the course of the history taking process, do you have a family history of autoimmunity? And I said, Well, yeah, I think my grandfather either had rheumatoid arthritis and he died at 57, which is actually the age I am right now. And he was wheelchair bound with it. So it was really interesting because the stuff we’re about to talk about, my grandfather didn’t know back in the 1960s. So you know, she said, well, here are two prescriptions, ripped them off her pad, one’s for methotrexate, one’s for a nonsteroidal anti-inflammatory drug. Take them. And when you get worse, come back. Not if you get worse, but when you get worse and well, change your meds, you know, I mean, that’s what people are being told today.

Jen Pfleghaar, DO, FACEP

Same exact thing.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And, you know, like my patients, I stopped her and I said, well, hang on, hang on, hang on. I’m very disciplined. I make my own food. I run, you know, like I’ll I’ll do whatever, what else is there? And she said, I’m afraid, you know, it’s genetic. That’s it. And in left left me with that right. And I remember on the way home thinking, okay, so my model of medicine that I’ve been born and raised in this is the answer that it has. And I mean, I always tell my patients, like, if an herb had bitten me on the bottom, I wouldn’t even recognize it. Like, not only did I not know other paradigms I wasn’t interested to. I didn’t know to ask a question that there was another paradigm. I was so steeped in the Western model, and so I got curious about whether or not there’s another way to address this. I went into Pet Med, where we keep our medical research and started looking up ways of treating rheumatoid arthritis other than methotrexate. And I found a compelling article on yoga and R.A. And so I went to my first yoga class the next day. And, you know, as yoga teachers do, as we’re holding postures, you know, the yoga teachers started mentioning this word of Vedic medicine, which is the sister science of yoga, a 10,000 year old medical arm of.

Jen Pfleghaar, DO, FACEP

Yoga.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Coming from the same group of literature. And in he said, just enough that I was so intrigued, it was like, oh, that’s interesting. So I went home and I looked it up on the internet again, which in those days was a dial up modem. And I, I was really astonished, you know, like, oh, these guys 10,000 years ago said that we are not all the same. Therefore, there’s no one diet, there’s no one medication regimen, there’s no one protocol. That’s right. For every single person that was revolutionary for me, you know, because I was raised in the mash, the drugs, the symptom paradigm. And so the other thing that it said was autoimmunity is undigested anger. And I remember thinking that I’m not an angry person, you know, and then thinking shortly after that, maybe that’s a problem. I put on my running shoes and I go for a long miles. So I started really diving into this. And one of my qualifications, I suppose, is I eventually got a master’s degree in Vedic medicine. I went back to school, I became a nurse practitioner. I also am board certified in functional medicine. I went back to school eventually after being in private practice for about 3 minutes, discovering that I can’t separate the mind from the heart now in this person sitting in front of me with gastroesophageal reflux disease needs to have their anxiety treated and not with a pill. I need to have more skills. 

And went back to school and got a Ph.D., interestingly enough, in sexology and trauma informed therapy. And so I did my doctoral work in healing, unresolved trauma. And throughout the course like that first six months of my diagnosis, I had started learning how to meditate. I was practicing yoga. I became a yoga teacher and I started asking myself this question like auto immune. That means I’m attacking myself. And I, the way I thought about it was committing suicide in a societally acceptable manner. So I started asking myself the question, Is there a time in my life that I wanted to die because I didn’t then, nor do I now. I had four small children and had a life. I really loved, and so I went backwards looking for that. The answer to that question like, Is there a time I found this little girl version of myself who was ten years old and being sexually abused by the vice principal of the elementary school that I was attending. And I remember looking at her and thinking, Oh yeah, she did. She wanted off the planet. She didn’t understand what was going on. I don’t think I have the language to say anything to the you know, like I told people what was happening, I don’t think in a way they could really hear or understand. I always say, you know, I was raised with no television. 

I was a Navy brat. We lived a lot of years in my childhood in Japan, no television. So I didn’t know the word sex. I didn’t know the word molestation. I know where to be is. I don’t know how my mom could possibly understand what I was trying to say. And my dad was out to sea. And so, you know, in the Navy. And so it was a really interesting time of I can’t understand what’s going on. I went out and I was talking to angels. I was talking to God. I was like, Really in this, if I can’t figure this out, I’m going to hang out with beings that I feel loving, right? And so this is one of the things with highly sensitive people and people that are highly intuitive and psychic is I always say, show me that person and I’ll show you trauma in their childhood because you learn how to dial into different frequencies that you’re not forced to dial into if you don’t have those experiences. Right. This is like the silver lining.

Jen Pfleghaar, DO, FACEP

Right? That’s below certain. Interesting. And a lot of my patients I have on my intake for for trauma, you know, any emotional trauma and, you know, sometimes they’ll they’ll write no on there and I’ll take it a little bit deeper. And they do have trauma, but they shoved it back.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Right.

Jen Pfleghaar, DO, FACEP

Away. And that’s even more of a red flag to me. And then, you know, I’m starting to see this, too. There’s lots of crying and tissues and it’s very emotional and it’s not. And they go to conventional medicine and that’s pushed aside. That’s depression, that’s anxiety.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And I see a therapist.

Jen Pfleghaar, DO, FACEP

Right now just another says and it’s not it’s deep and it’s it’s not their fault the are.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Exactly yeah this is way out of the paradigm of blame and shame and fault this is not this has nothing to do with that. Right. So I in that meditation that day, looking at autoimmunity, I thought, oh, this has to be connected. And sure enough, science tells us today that it is. And in those days I got it. Like this has to be connected. I bet my ten year old self programed my cells, right? And sure enough, we know it takes anywhere from 10 to 30 years to develop a full blown auto immune disease. And it was like 20 years later a turkey timer went, Ping, you’re done, here’s your auto immunity. You can go now, you know, and yet things had changed. I still want to go. And so I thought, well, that must need to be healed. And in just like what you were just saying, I would have never identified as having had trauma because I had shoved it so far back and it wasn’t even a thing. Right. And so when I pulled it out and dusted off and said, I bet these are connected, my R.A. after I went into this, like really.

Jen Pfleghaar, DO, FACEP

Deep.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Healing with this, went away within six months and it has never been back. And I’m 57. So, you know, this is so powerful what we’re talking about here. It’s so powerful. So, you know, the the fact of the matter is, I don’t even ask if there’s trauma on my intake form because I go off of the foundational premise that I have discovered over the years, and that is that everybody has had trauma. So to ask if you have trauma is like saying, do you drink water?

Jen Pfleghaar, DO, FACEP

Yeah.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

So everybody has trauma.

Jen Pfleghaar, DO, FACEP

So and everyone has a whether it’s little big trauma about the trauma that else someone else can use.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, we.

Jen Pfleghaar, DO, FACEP

We.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Call it like you can classify it. I think about it as like capital T trauma or lowercase D trauma. Everybody has lowercase drama. If we talk about like the science that I was talking about between 1995 and 1997, the Centers for Disease Control and Kaiser Permanente conducted the now famous adverse Childhood Experiences study, and it was the biggest study that ever been done on people that self-identified as experienced capital T trauma. They were enrollees in Kaiser’s weight loss program and, you know, successfully losing weight. And then the director of the clinic noticed that or the program noticed that like a large percentage of people were dropping out, even though they were succeeding at their goal. And so when he started bringing people in and asking questions, most of them had had sexual abuse in childhood. So that got him curious. And so they started, you know, they enrolled all these people in this study over 3030 500 and asked this question. 

And this was a questionnaire called the ACS questionnaire before the age of 18. Did you experience and it was ten different kinds of capital T trauma, you know, domestic violence or watch your mother be a victim of domestic violence, sexual abuse, psychological, emotional, physical. Were you abandoned, neglected? Do you have a parent or caregiver that was addicted to a substance or incarcerated, divorced dad? Right. These are the kind of capital t traumas that they classified. We know this is by no means a complete list, but it was very compelling what the findings were and indicated that the more little checkmarks you said is yes on that quiz, the higher your risk for autoimmunity in adulthood, for cancer or all of the chronic issues we see in adulthood in our culture. But, you know, I think the least you’ve written about in the most compelling finding for me that I really like to land on is sure. Of course it makes sense that autoimmunity would arise, but for me it was. You’re less likely to engage in consistent self care the higher your aces score. If you have an aces score of six or more or you live 20 years.

Jen Pfleghaar, DO, FACEP

Or.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Less than someone that doesn’t, you know. So those are the findings that kind of went into the media. But for me it was like, Wow, I have so many patients that come in and say, I’m good for a while, then I’m bad, or I still sabotaged, right? And I thought, This is it right here. If you made up the belief when you were a kid in response to your lowercase t trauma or your capital t trauma that you weren’t worth being cared for or protected, you didn’t deserve to be loved. Child brains make this stuff up because they’re not fully developed yet until they’re 26 years old and kids are self centered. So everything that happens around them, they clock as about them, right? Because we’re self-centered beings, because that’s our developmental stage. So we make up these stories, these belief systems and meanings to match our experiences that oftentimes don’t make sense to an adult, but they make complete sense to the wise mind of the child. And sometimes those include I have to do X to be worthy of attention, like maybe it’s you probably have those two like people that are that over care for others in order to get their worth right. So they go down on the list of what’s important to take care of while everybody else is here and then they get resentful about it. That to me was a very compelling finding of this. The higher the number of Chinese that you experience, the more likely you are to do that.

Jen Pfleghaar, DO, FACEP

Yes. And it’s hard to get patients to buy into this sometimes. Sometimes I remember that to the book, The body keeps the store explained to them that our bodies can’t heal if we’re stuck in this fight or flight mode, this sympathetic mode of trauma. And they try to get it. But it is really hard to get patients to buy into this and know that. So I love that ACS study. I’m going to actually use that and reference back to my patients talking about it so in sync and I’ll get more.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

My book Solving the Autoimmune Puzzle. I put the ACS quiz at the front and then I have them take the quiz and then they have a number. And then I say, So now you have a number. And all the findings that are attenuated with that and those findings don’t need to be your reality now that, you know, you can actually change the trajectory of your compass setting if you’re willing to engage in healing this. So that’s the other thing. Sometimes it comes across as well. I have an ACS score of eight, nine, ten. I did a course for the Shift Network over the summer and we they love solving the auto immune puzzle and the framework that I use that brings trauma in. And so we took we did seven weeks of like four highly sensitive people and, you know, intuitive and psychics. Like what what role did this play in your autoimmune disease that you have today? 

And, you know, there was a lot of despair for them because they had discovered trauma and covered it, done a lot of work. I hear that a lot, too. Like I’ve done so much work around this and yet they still have an autoimmune disease and it’s because they haven’t taken it to the next level. There are different layers that have to be healed. And, you know, it’s one thing to know it and to cognitively do the healing, but there’s another place of really being able to move into the next steps, the next layers of that healing, and a hyper vigilant mind that is still looking to see and myself, are people going to hurt me? Is that energy over there in that person going to harm me? Do I have to shield myself? You know, there’s a lot of that. Can I express my needs, you know, or is that not safe? That hyper vigilant mind creates a hyper vigilant immune system.

Jen Pfleghaar, DO, FACEP

Your.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Adrenals, your hormones, your immune system, your microbiome are all regulated by one thing. And it’s the thing that people don’t talk about in the summit. The one thing that all of that is regulated by is your perceptual field, your perceptions, you believing you’re not safe, worthy, deserving, right. Sure. You’re microbiome governed 60 to 80% of your immune system. Absolutely. And your neurotransmitters and your way for sure. But at the end of the day, like what is creating the environment that they’re living in? What activates the cortisol that your adrenals are constantly putting into your system that break down your gut wall, your your perceptions? That’s it. And so, you know, people are there’s a lot of like, oh, it’s really sexy to talk about vagal nerve stimulation and electronic devices and things like that.

Jen Pfleghaar, DO, FACEP

This is great.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And it’s the same with like emotional freedom technique. It’s great to get you out of an already swampy tidal wave of emotion. But what we really want to do, we want you to be able to do that for sure, but we want to make it so that can we create a reality that you’re not going into this tsunami of emotions anymore, that you don’t trigger any longer? That means healing something much deeper so that you’re not even perceiving yourself as in danger.

Jen Pfleghaar, DO, FACEP

Yeah, absolutely. And that’s fixing the root cause deep down. Yeah. What’s the first step that we can take to heal this past childhood trauma? Because we all have a little or big tease. Mm.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I will usually give the assignment like in solving the autoimmune puzzle, have a bunch of worksheets and things like that. There are several ways of doing this because there’s not the same simple formula for every person, right? I do a lot of trauma healing retreats. I actually work with medicine for people that want to 1 to 1 and in group settings. But the very first thing that I’ll usually assign, like in a summit like this is to just take 24 hours and start observing your own thoughts. And there’s a little practice that you can do where you get a little pile of black pebbles and a little pile of white pebbles. And if you’ve spent your waking hours of one day very, very carefully watching your own thoughts, so instead of being hyper vigilant about what’s going on out there, you’re turning that vigilance into alertness. I call it awake alertness toward your own mind and how it’s patterns are unfolding for you to watch. And at the end of the day, whether you’re on your bed or at the dining room table or on the floor in your bedroom, you go back through and you go, okay, so how many life destructive thoughts did I have? Right, which are I’m not good enough. That person’s not good enough. Everyone’s stupid. I can’t believe they do it that way. What’s wrong with everything? I hate stupid people. Why don’t you know, like all of those kinds of things, right? 

And you do a dark pebble. And then for every thought that you have, that’s life. Affirmative. Then you put a white pebble and the front end of this practice, you’ll have, as you can imagine, a little imbalance between the two. And then when you know you’re doing this, like in research in science, we call this injury and later reliability, right? Like once there’s a study researcher that is relating with the participant of a study, we know that affects the outcome of the study. And so we actually have like a variable way to identify that this is exactly this. And now that, you know, you’re awake, awareness is on board with you. The next day when you do this, when you have one of those thoughts that’s going downhill, I call it the lazy mind’s slide, right? So your train of thoughts going downhill, you actually can change your tracks and make your train go on a different train of thought. And, you know, people don’t understand that their mind is not meant to be treated as a passive entity where you like you just sit in front of the TV on the couch and watch whatever goes by. If you’re watching something on your computer or on your phone or on a screen and you don’t like it, usually change it. You know, you don’t sit there and go, I’ll just keep bringing this in. But we don’t do it with our own thoughts. Somehow, some for some reason, humans often will believe that their thoughts are just little pearls.

Jen Pfleghaar, DO, FACEP

Of wisdom.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And they’re not right. And so you just say, Well, that one’s not very glittery. And shiny and life affirmative, that there’s no gold nugget of wisdom here. I’m going to change it and you’ll know, like at the end of the day, I’m going to put a white pebble there instead of a black one. So how can I make this a life affirming thought? So what you’re doing is you’re interacting with your long held patterns of you could even call intrusive, automatic negative thoughts. And you can help them. Yeah. And you can bring in something else. I don’t know if you’ve ever had the experience of like sitting there with a cup of tea watching a hummingbird at the hummingbird feeder, and you’re just enjoying or sitting looking at a sunset or a sunrise, and then all of a sudden some things someone said in the past or some experience that you had that was negative just pops into your mind and.

Jen Pfleghaar, DO, FACEP

Lately.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Interrupts this pastoral scene you’ve been enjoying. Now you’re off to the races with a whole different thing. And so what you’re learning to do is to stop that process and come back to the hummingbird, come back to the sunset or the sunrise and your piece that you were just in. And so you’re learning to be the master of your own mind rather than mind as master.

Jen Pfleghaar, DO, FACEP

Absolutely. I think that happens to all of us. And people start to do meditation. They get very inseminated because they keep having all these thoughts coming in. So it really it takes work. It takes practice. I know. I thought doing a gratitude journal was very life changing for me. Just three things you are grateful for are so simple. In memoriam sets you in this, like you said, this cascade of positivity as opposed to the railroad track to those dark panels. And I do recommend that it’s very easy exercise. I love the pebble exercise. I think that’s great too. As we become more aware and there’s so many things that are mindless, whether it’s scrolling on your phone. Yeah, watching Netflix and we’ve really lost that. You know, being with nature and coming back to where it was, it’s almost like we’re scared of it too. It is scary to sit with your own mind.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Well, that’s what’s important is if you have a sad thought that comes up, it doesn’t mean getting rid of it.

Jen Pfleghaar, DO, FACEP

Like you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Get to feel your feelings. And so sometimes in the law of attraction and manifestation, I call that the tyranny of positive thinking. It’s like what can be called the near enemy of truth. You know, where if you have that, then you’re going to manifested in the world, it’s going to become concrete. Well, now what that does is it becomes a new form of a tyrant where you’re not allowed to feel your feels. You know, it’s important that if you feel sad.

Jen Pfleghaar, DO, FACEP

That.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

You get to witness sad and say, Oh, I feel sad. It’s when you start running into the story I have in my first book, this graphic that’s a dog chasing its tail and it’s right next to it, brain chasing a spinal cord. And I say, you know, a dog chases its tail, but a mind will chase its tail.

Jen Pfleghaar, DO, FACEP

You know.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It’s this little story, its tail around and around and around and around. And you can’t ask the same mind that’s doing that to interrupt and come up with a higher ordered way of doing it. It needs some guidance. And so that’s where the role of like trauma, healing and things like that becomes so important, you know, that you’re not expecting the same mind that creates the problem to solve the problem. That’s usually impossible. So going to somebody that can guide you, that has a lot of wisdom and training in this becomes really important.

Jen Pfleghaar, DO, FACEP

Absolutely. Can you tell us a little bit about the freedom framework, what that is exactly?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, the freedom framework is what I named the thing that I used when I reversed my own autoimmune illness. And later, ten years later, breast cancer without having to do again any medications.

Jen Pfleghaar, DO, FACEP

And it’s it’s.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Coming from the idea that you are a unique puzzle. Every one of us is. And so I always say, you know, given that there’s no one protocol, like you can’t take the diagnosis of Hashimoto’s and say that there’s a protocol for Hashimoto’s, that’s, that’s Western medicine thinking. Right, it’s the person that’s got the imbalance of the immune system attacking the thyroid. But we really want to address the immune system while we’re watching the thyroid at the same time, you know. And so with that being said, then, the Freedom Framework is addressing this as a puzzle. And if you have a puzzle, you take all the pieces and you dump them out and you turn them all over. You’re always looking for those corner pieces to anchor everything together and the four corner pieces that I always really start with, with all my patients is I do genetic testing on 100% of my patients. I do. The second point or piece of the puzzle is leaky gut. Everybody has leaky gut that has autoimmunity. So you’re looking at food sensitivities and gut health and what’s going on in the terrain as well as the biome. And then the third is going to be toxic burden. So what’s your burden of not only toxicity from the planet that we’ve put in there, but also our own toxic thoughts? And then the fourth corner piece is trauma and they’re all interrelated, like past trauma, science tells us, will impact how genetics express in cells up to 12 generations.

Jen Pfleghaar, DO, FACEP

Right.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

It’s just like and really amazing trauma also impacts the health of the gut and whether or not we can detox those toxins and etc., etc.. So those four are what I look at right away. And then those connect the edge pieces of the freedom framework, which the first one is uncover root causes which are going to be found in the body, mind, heart story, and then the the upper part of the puzzle is to really confront lab data. And this is functional medicine lab data.

Jen Pfleghaar, DO, FACEP

That.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Is looking at you know, prevention, not just do you have a disease, right? Looking beyond TPO and also the data your body is always giving you like your quality is leaves you awake rested due to the night your libido levels you know, your your energy levels so your relationships looking at that data back and then the third edge piece is the third C which is to connect the dots between that lab data that we got back and your lifestyle choices. So are you staying in toxic codependent relationships? If you are in one of those and you do a whole bunch of protocols for diet and supplements, nothing good will happen. You know, you’re not going to reverse your Hashimoto’s because this is a huge piece of why you’re sick. And so that’s why, you know, I look at boundary setting, I always say leaky boundaries leads to leaky gut, and that’s a leaky immune system automatically. So we have to look at that component too. And as well as what’s on the end of your fork, what’s in your cup, how you spend your time, etc.. 

And then the fourth, the bottom edge piece, the fourth C is to create the life with intention that you want rather from the factory default settings of your childhood, which involves killing your trauma, forgiveness, you know, like things like that that are always tell people like you can’t do pulpit forgiveness, like, oh, I forgave them. There’s a whole process us with that where you don’t hurry to it. You have to you have to get through a bunch of different steps before you get to that place, which means forgiveness is that was part of my doctor. Work is so important because you’re getting rid of the frustration, the resentment that you’re bathing your cells in. It’s essential for you, but it’s not reconciliation. You can forgive and still maintain good boundaries. That’s really important. You know, I have to reconcile with anybody that’s hurt you if they haven’t expressed contrition and shown themselves to be safe.

Jen Pfleghaar, DO, FACEP

There’s a lot of things I love that the freedom framework, it’s so beautiful. And I think it’s important for patients to realize that are suffering from an ongoing disease that they need to look at this emotional trauma side. So, Dr. Keesha, where can we find you out? Get a hold of you, sign your book. You can share that with us is a great interview. Thank you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Thank you so much for this work. This you’re doing.